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Vol 45, No 3 (1999)

Clinical endocrinology
Epidemiological examination of the population of patients with non-insulin-dependent diabetes mellitus in the regions of the Moscow region (based on a computer registry)
Dreval A.V., Misnikova I.V., Redkin Y.A., Golubeva L.B., Shakhidova L.A.
Abstract

Diabetes mellitus register in the Moscow region is created within the framework of the National Register of Russia in 1994. Two districts of the Moscow region served as the model for the register: the Mytischi district and the town of Roshal. The register of insulin-dependent diabetes mellitus (IDDM) includes 1542 patients. The prevalence of IDDM in the Mytischi district is 622.8, in Roshal 1828/100,000. IDDM of obesity is responsible for 33.1%) cases in Roshal and 44.6%) in the Mytischi district. A high percentage of IDDM patients have excessive body weight. The prevalence of late complications of diabetes is much higher in Roshal, where the percentage of patients with retinopathy is very high (89%). High incidence of retinopathy among patients with newly detected diabetes may be regarded as an evidence of late diagnosis of the disease. Collection of reliable information requires special training of endocrinologists, therapists, and other specialists involved in work with diabetes mellitus registers; they should be trained to fill in the information charts and use strictly determined classification of diabetes mellitus and its complications.

Problems of Endocrinology. 1999;45(3):3-7
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The frequency of osteopenia and the dynamics of bone resorption in women with type II diabetes mellitus during menopause
Grigoryan O.R., Chernova T.O., Meshkova I.P., Ignatkov V.Y., Sergeeva N.A., Antsiferov M.B., Dedov I.I.
Abstract

The incidence of osteopenia in women with type 2 diabetes is higher than in the general population only in patients with normal body weight index (BWI). Measurement of biochemical marker of osseous tissue resorption, deoxypyridinolol (DPD), in the urine showed an inverse correlation between DPD level and BWI: the lower BWI, the more severe is bone resorption. Hormone replacing therapy (estrogen-gestagen preparations) had a favorable impact on bone resorption processes in women with type 2 diabetes.

Problems of Endocrinology. 1999;45(3):8-10
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Respiratory disorders during sleep in patients with diabetes mellitus
Poluektov M.G., Melnichenko G.A.
Abstract

Forty patients with diabetes mellitus (7 with insulin-dependent and 33 with noninsulin-dependent condition) were examined in order to elucidate the factors contributing to development of sleep-related breathing disturbances (SKBD). Relationship between SRBD and features and complications of diabetes is studied. Special attention was paid to the role of the peripheral autonomic insufficiency in the development of these disorders in diabetics. We failed to detect a reliable correlation between the presence and severity of SRBD and autonomic regulation and other neurologic or vascular complications of diabetes. Age, body weight, and type of fatty tissue distribution affect the development of SRBD in diabetics, similarly as in the general population.

Problems of Endocrinology. 1999;45(3):11-14
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The use of the drug Wessel Duet F in the complex treatment of lesions of the lower extremities in patients with type II diabetes
Tokmakova A.Y., Milenkaya T.M., Chirkova L.D., Arbuzova M.I., Antsiferov M.B.
Abstract

A comprehensive approach to treatment of ischemic involvement of the lower limbs in patients with type 2 diabetes is proposed. Diabetics often develop obliterating atherosclerosis of the lower limb arteries; the risk of amputation of feet and shins, involving invalidism and death, is rather high. The authors assessed the effect of Vessel Due F (Alfa Wasserman, Italy) on lipid metabolism, blood rheology, and peripheral hemodynamics in 30 patients with type 2 diabetes complicated by the ischemic form of diabetic foot. The course of therapy lasted for 12 weeks. Lipid metabolism notably improved (total cholesterol level decreased), normocoagulation and normalization of peripheral arterial blood flow were attained in the majority of patients, as shown by dopplerography. Therefore, the drug is effective in the treatment of ischemic form of the lower limb involvement in patients with type 2 diabetes.

Problems of Endocrinology. 1999;45(3):14-18
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The experience of using biguanides (metformin BMS) in patients with older non-insulin-dependent diabetes mellitus
Dreval A.V., Misnikova I.V., Zaichikova O.S., Fedorova S.I.
Abstract

Efficacy and safety of metformin BMS are studied in patients aged 60-65 years. The drug effectively normalizes glycemia in patients with non-insulin-dependent diabetes mellitus: during 3-month follow-up the level of HbAjc decreased by 1 % and the level of glycemia after overnight fasting by 1.5 mmol/liter. No clinically significant changes in the levels of liver transaminases, blood urea, creatinine, and lactate were noted in any of the patients. The incidence of side effects during therapy with metformin was low, 20%) patients complained of dyspeptic symptoms mainly at the beginning of treatment. Metformin BMS improved the cardiovascular status: it ameliorated the metabolic processes in the myocardium and coronary circulation. Treatment with metformin BMS is recommended for elderly patients thoroughly selected with due considerations for well-known contraindications for biguanides.

Problems of Endocrinology. 1999;45(3):18-21
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Are new diagnostic criteria and classification of diabetes necessary?
Balabolkin M.I., Kreminskaya V.M.
Abstract

The issues of diagnosis and classification of diseases are given priority. This is understandable, since each classification reflects the level of our knowledge and ideas about the pathogenesis of the disease for a certain period of time. The classification of diseases, therefore, is a kind of tool that helps practitioners navigate the diverse clinical picture of the same disease and correctly conduct the diagnostic algorithm. Ultimately, the classification of the disease, based on current pathogenesis data, provides practical assistance to the doctor in matters of both diagnosis and therapeutic tactics of the disease.

Problems of Endocrinology. 1999;45(3):21-25
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L-thyroxine in the treatment of solitary nodular non-toxic goiter in concomitant coronary heart disease
Troshina E.A., Alexandrov A.A., Gerasimov G.A., Dedov I.I., Martynov A.I., Panchenkova L.A., Martyanova I.I.
Abstract

Endocrinological and cardiological parameters were assessed in coronary patients with nodular euthyroid goiter before and during treatment in order to define the optimal protocols of L-thyroxin therapy. Ultrasonic examination of the thyroid, fine needle puncture biopsy and cytological analysis of biopsy specimens, measurements of thyrotropic hormone, electrocardiography, and high resolution electrocardiography were carried out. The results helped distinguish the cardiological criteria for decreasing the dose of L-thyroxin or its discontinuation in coronary patients with nodular goiter and define the indications for such therapy in this patient population. Therapy with L-thyroxin is justified in the above patient population only on condition of monitoring the cardiovascular status. Therefore, the presence of coronary disease or its risk factors in a patient with nodular colloid proliferating goiter is not a contraindication preventing thyroxin therapy in adequate doses.

Problems of Endocrinology. 1999;45(3):25-28
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The ability to diagnose autoimmune thyroiditis with an X-ray fluorescence method to determine the level of stable intrathyroid iodine
Tomashevsky I.O.
Abstract

The concentration of intrathyroid stable iodine (ISI) is measured using a Russian commercial reference specimen for noninvasive x-ray fluorescent analysis in 74 women with autoimmune thyroiditis (verified cytomorphologically) aged 36-55 years, residents of Moscow, and in 36 women without a history of thyroid diseases, with normal thyroid status confirmed by clinical and laboratory data and /SI level of at least 200 pg/g, which is considered as the critical (control). Noninvasive x-ray fluorescent method for detecting ISI deficiency permits the recognition of autoimmune thyroiditis with sensitivity and accuracy of at least 9% but with low specificity, which recommends it for screening diagnosis.

Problems of Endocrinology. 1999;45(3):28-30
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For practitioners
Implanted fertilized egg and maternal organism
Giudice L.
Abstract

The symbiotic relationship between the mother and the fertilized egg is a continuous connection on which the continuation of the species depends. The most important goal of an implanting embryo is to attach to the maternal endometrium and then introduce it. Thus, he provides for himself a safe place for the next 9 months and access to the nutrients necessary for his existence and continued growth.

 

Problems of Endocrinology. 1999;45(3):30-32
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Miracle or myth? (Melatonin research)
Arendt J.
Abstract

Perhaps more is said about melatonin today than about any other hormone. He is considered almost a panacea for all diseases, a source of youth; in terms of US sales, it currently competes with vitamin C and aspirin. Unfortunately, the role of melatonin is excessively exaggerated, and the claims are largely unfounded or supported only by data obtained in animal experiments [1, 2]. To clarify the mechanism of action of this hormone and its relationship with physiological chronobiology, much more research is needed. In particular, it remains to be determined the most optimal time of appointment and dosage of melatonin for people, allowing to achieve the maximum effect of this drug on the circadian rhythm of a person and on many functions dependent on it.

Problems of Endocrinology. 1999;45(3):33-35
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Experimental endocrinology
Effect of DNA methylation on thyroglobulin gene expression in thyroid pathology
Turakulov Y.K., Kadyrov D.A., Atakhanova B.A.
Abstract

Effect of methylation of different DNA domains on gene expression can manifest at all regulatory levels involved in this process: at the level of transcription and posttranscription, translation and posttranslation. Study of the relationship between DNA methylation and thyroglobulin (TH) gene expression in some thyroid diseases is needed for understanding the mechanisms regulating genetic information in general.

The aim of this study was to investigate the effect of DNA methylation on TH gene expression in thyroid disease. We investigated the probability of contribution of DNA methylation to regulation of TH gene expression. TH gene methylation was studied in nodular euthyroid and diffuse toxic goiter and in thyroid cancer. The 5'-flanking domain of the gene, containing sequences recognized by Hpa 11 and MspI restrictases, was analyzed. The 5'-flanking domain of TH gene is hypermethylated in thyroid cancer. These data indicate an inverse correlation between TH gene expression and methylation.

Problems of Endocrinology. 1999;45(3):36-38
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The effect of mercazolil and thyroid parathyroidectomy on the properties of the Ca2 + -ATPase of the sarcoplasmic skeletal muscle reticulum
Bagel I.M.
Abstract

The kinetic and thermodynamic properties of Ca2+-ATPase of the skeletal muscle sarcoplasmic reticulum (SR) are studied in rats subjected to thyroparathyroidectomy and in rats with thyroid hypofunction induced by mercazolyl (10 mg/kg). The studies included measurements of the blood serum calcitonin and thyroxin.

Removal of the thyroid and parathyroid glands led to an early (in 3 days) significant decrease of Vmax and a drop of Ca by the end of experiment (30 days) and altered the thermodynamic characteristics of Ca2^-ATPase, which indicated changes in the SR membrane protein phase. Mercazolyl induced an increase of Vmax in 3 days and a decrease in Ca in 30 days and changed the thermodynamic properties of the enzyme. Thyroid hypofunction was associated with a drop of thyroxin and calcitonin levels in the serum.

Thyroid and parathyroid dysfunctions involved changes in the structure and function of Ca2+-ATPase of SR.

Problems of Endocrinology. 1999;45(3):38-42
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Reviews
Syndrome "empty" Turkish saddle
Babarina M.B.
Abstract

The syndrome of the "empty" Turkish saddle (PTS) is one of the poorly studied problems of neuroendocrinology. The urgency of this problem has increased at the present time with the widespread use in the diagnosis of the non-invasive method of magnetic resonance imaging (MRI), as well as with the increase in the number of patients exposed to radiation, surgical, combined exposure due to pituitary adenoma.

The term "PTS syndrome" should be understood as the prolapse of the suprasellar tank into the cavity of the Turkish saddle with the pituitary gland spreading along the bottom and walls of the Turkish saddle, accompanied by endocrine, neurological and visual impairment. There are primary (idiopathic) and secondary PTS, which occurs after radiation, surgical and combined methods of treatment of diseases of the chiasm-sellar region. This review will focus mainly on primary PTS syndrome.

Problems of Endocrinology. 1999;45(3):42-47
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R. Fletcher, S. Fletcher, E. Wagner. Clinical Epidemiology. The basics of evidence-based medicine. - M .: Media Sphere, 1998.
Surkova E.V., Antsiferov M.B.
Abstract

A book by Harvard University professors Robert Fletcher and Susan Fletcher and Edward Wagner, a professor at the University of Washington, published by Media Sphere, focuses on the fundamentals of a new, rapidly growing field of knowledge in medical science - clinical epidemiology.

Problems of Endocrinology. 1999;45(3):47-48
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Anniversary
Professor Leonid Moiseevich Golber (on the occasion of his 90th birthday)
 
Abstract

In February 1999, the 90th anniversary of the birth of a prominent Russian scientist and pathophysiologist Professor Leonid Moiseevich Golber was celebrated. L. M. Golber devoted almost 70 years to the service of Russian medical science, while still in his student years he published a number of works on the role of the endocrine system in the pathogenesis of gallstone disease. Since then, all his scientific activities have been associated with the problems of endocrinology and metabolism. His fundamental research on the humoral relationship between the spleen and liver made a significant contribution to the doctrine of the hepatolienal system.

Problems of Endocrinology. 1999;45(3):48-48
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