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Vol 44, No 2 (1998)

Clinical and epidemiological characteristics of diabetic nephropathy in children and adolescents in Moscow with insulin-dependent diabetes mellitus
Sivous G.I., Kasatkina E.P., Sokolovskaya V.N., Samsonova L.N., Gerasimova N.P., Voichik E.A., Alekseeva T.M., Gvindzhiliya T.V.

A total of 166 patients (72 males and 94 females) with insulindependent diabetes mellitus (IDDM) aged 5 to 21 years with disease duration of 1 to 18 years were examined in order to assess the clinical picture and epidemiology of diabetic nephropathy (DN) in children and adolescents in Moscow. Microalbuminuria (MAU)*was the criterion of DN. DN was diagnosed in 75 (45.7%) of patients: in 64 (85.3%) at the MAU stage and in 11 (14.6%)) at the stage of proteinuria. There were no cases with the nephrotic syndrome or chronic renal insufficiency. The minimal duration of IDDM in adolescents with MAU was about 2 years, in those with proteinuria about 5 years. All patients with DN were pubertal or postpubertal. The incidence of DN did not depend on the sex, age, or pubertal status. DN risk factors in these patients were chronic hyperglycemia, total and prepubertal duration of diabetes, hereditary predisposition to arterial hypertension, and lipid disorders. Therefore, prepubertal children with disease duration of 5 years and adolescents with disease duration of 1 year since IDDM manifestation are to be screened for DN.

Problems of Endocrinology. 1998;44(2):3-6
The effect of normobaric hypoxia on the secretion of insulin and growth hormone
Starkova N.T., Davydov A.L., Koroleva A.V.

Effect of normobaric hypoxia on insulin (IRI) and somatotropic hormone (STH) secretion was studied in 24 normal subjects aged 35-55 years. Control group consisted of 18 subjects administered placebo. Adaptation to normobaric hypoxia was attended by changes in IRI and STH but not in the glycemia level. Hypoxic exposure was associated with an increase of the plasma STH concentration and a tendency to normalization of IRI in all examinees. These parameters correlated with body weight index.

Problems of Endocrinology. 1998;44(2):7-9
The use of the HELPER device for determining infrared radiation of the skin in the diagnosis of diabetic angiopathies
Zhuk E.A.

A HELPER device is offered for the early diagnosis and monitoring of patients with diabetic angiopathies. The device picks up the limb skin temperature gradient. The temperature gradient in the diabetics increases with the progress of diabetic angiopathies in comparison with normal subjects.

Problems of Endocrinology. 1998;44(2):10-12
Evaluation of the effectiveness of chronocorrection of hemocoagulation and microcirculation by angioprotectors and antiplatelet agents of diabetic microangiopathy
Tulemisov E.U., Zaslavskaya R.M., Smirnova L.V.

The efficacies of four protocols for treating patients with insulin-dependent diabetes mellitus (IDDM) and microangiopathies of the I and II degree are compared: traditional therapy with pro dectin (250 mg) and trental (100 mg) 3 times daily (17 patients), prodectin (250 mg) and aspirin (125 mg) 3 times a day (16 patients), chronotherapy with prodectin in a dose of 250 mg and trental in a dose of 100 mg once a day (17 patients), and prodectin (250 mg) and aspirin (125 mg) once a day 1.5-2 h before the acrophase of the circadian rhythm of blood coagulation, microcirculation, and peripheral hemodynamics parameters (16 patients). Before and 15-17 days after treatment, blood coagulation values were studied by the autocoagulation and hemolysate aggregation tests, measurements of blood fibrinogen, antithrombin III, soluble fibrin monomer complexes, and fibrinolytic activity of the blood; microcirculation was assessed by biomicroscopy of the eye conjunctiva, and peripheral hemodynamics by the radioactive xenome method and rheova- sography of the shin. The studies demonstrated a higher efficacy of chronotherapy in comparison with traditional prodectin in combination with trental and aspirin.

Problems of Endocrinology. 1998;44(2):12-13
The optimal diagnostic complex in the surgical treatment of nodular euthyroid goiter
Vetshev P.S., Kuznetsov N.S., Chilingaridi K.E., Vanushko V.E., Ozerov S.K., Gabaidze D.I.

Different methods for preoperative diagnosis of nodular euthyroid formations of the thyroid gland are compared. The sensitivity and specificity of ultrasonic examination (based on the study of the semeiotics of nodular formations of the thyroid), fine-needle aspiration biopsy (under palpation and ultrasonic control), and complex diagnosis (simultaneous assessment of ultrasonic semeiotics of the nodular formation and controlled biopsy under ultrasonic control followed by cytological examination of puncture biopsy specimens) are assessed. With this aim in view, 342 patients with nodular euthyroid formations were examine^ in 1994-1996. Benign nodular formations were detected in 316 (92.4%)) and thyroid cancer in 26 (7.6%o) patients. In the group with benign formations, colloid goiter was diagnosed in 204 (59.7%), follicular-cell adenomas in 78 (22.8%)), and hypertrophic autoimmune thyroiditis in 34 (9.9%) cases. The authors consider that ultrasonic examination combined with fine-needle aspiration biopsy is the most available, safe, and highly effective complex for the diagnosis of nodular euthyroid formations at the preoperative stage. Complex preoperative ultrasonic examination with fine-needle biopsy help single out the group with suspected malignant involvement of the thyroid with a high probability. Use of this complex and intraoperative ultrasonic examination correctly identified the type of thyroid involvement and its morphology in 92.4%o of cases, and thus helped choose adequate volume of intervention.

Problems of Endocrinology. 1998;44(2):14-19
Thyroid diseases in the complex treatment of lymphogranulomatosis
Balashov A.T., Myasnikov A.A.

A total of 212 patients with Hodgkin ’s disease were examined in different periods after multiple-modality treatment. Hypothyroid status was established in 19.8%) and thyroid hyperplasia in 5.4%o patients. Polychemotherapy did not affect the incidence of complications. The incidence and severity of hypothyrosis after multiple-modality treatment of Hodgkin ’s disease depend on the patient's age by the moment of radiation exposure, administration of iodine-containing x-ray contrast agents, and dose of the thyroid exposure. Indications for substitution therapy with thyroid hormones are defined.

Problems of Endocrinology. 1998;44(2):19-21
Endocrine ophthalmopathy
Pavlova T.L., Kotova G.A., Gerasimov G.A.

The urgency of the problem of endocrine ophthalmopathy (EOP) is currently in no doubt. This is due to the fact that relatively recently methods of objective assessment of the state of the eyeball and orbital tissues using ultrasound (ultrasound), computed tomography (CT) and magnetic resonance imaging (MRI) have appeared. At the same time, the etiology and pathogenesis of EOP are not well understood, which undoubtedly affects the validity and effectiveness of various treatment methods.

Problems of Endocrinology. 1998;44(2):22-27
Thyroid disease and pregnancy
Burumkulova F.F., Gerasimov G.A.

In their practice, both endocrinologists and obstetrician-gynecologists often encounter various diseases of the thyroid gland (thyroid gland) in pregnant women, which is of significant clinical and scientific interest both to study the pathology of these disorders and to treat them.

Problems of Endocrinology. 1998;44(2):27-32
Serum prolactin binding in various forms of hyperprolactinemia
Bulatov A.A., Makarovskaya E.E., Marova E.I.

Binding of 125I-labeled prolactin in the sera of women with different forms of hyperprolactinemia was studied. Antiprolactin autoantibodies were detected in the blood of 24% of women with idiopathic hyperprolactinemia. In contrast to idiopathic hyperprolactinemia, there were no autoantibodies to prolactin in pregnant women with physiological hyperprolactinemia and in hyperprolactinemia of tumor origin. These data indicate that the presence of these antibodies in circulating blood can be one cause of idiopathic hyperprolactinemia. Moreover, the prevalence of high-molecular form of immunoreactive prolactin in the blood can be due to binding of an appreciable amount of prolactin monomer to antiprolactin autoantibodies.

Problems of Endocrinology. 1998;44(2):32-35
Morphological analysis of changes in the heart and aorta of rats undergoing bilateral ovariectomy; cardio- and vasoprotective effects of estradiol
Karachentsev A.N., Melchenko I.A.

The effect of bilateral oophorectomy on the structure of the heart and aorta and changes in their structure during substitution estradiol therapy were assessed in rats. Estrogen deficit led to development of nonspecific changes in myocardial and aortic microstructure with tissue edema. Substitute estradiol therapy protected the oophorectomized animals from stress-dependent morphological changes of the cardiovascular system.

Problems of Endocrinology. 1998;44(2):35-39
The health status of children born to mothers with persistent galactorrhea syndrome - amenorrhea treated with parlodel
Sudakova O.D., Kurysheva E.V., Kurlandskaya R.M.

A dopamine agonist - bromo-a-ergocriptine (parlodel) is traditionally used in the treatment of persistent galactorrhea-amenorrhea syndrome (SGA) [11, 13, 19]. Parlodel reduces the frequency of mitoses and the number of secretory granules in the lactotrophs of the adenohypophysis [50], and is capable of slowing the growth of prolactin-secreting pituitary adenomas [1, 40].

According to a number of authors [5, 11, 13, 56], the dosage and timing of the use of the drug depend on the form of LNG. According to most researchers [6, 17, 19, 24, 29], the effectiveness of its use correlates with the form of the disease. However, the effectiveness of parlodel therapy is apparently also influenced by the functioning of the dopaminergic system (DAS) of a particular patient [15].

Problems of Endocrinology. 1998;44(2):39-42
Adrenal incidentoma
Vetshev P.S., Ippolitov L.I., Sinatulina V.A.

Accidentally detected adrenal tumors, or the so-called incidentalomas or adrenalomas (from incidentally discovered adrenal mass), are a relatively new and insufficiently studied problem of endocrinology and endocrine surgery [18, 25, 43, 48, 56].

Issues related to the etiology, morphogenesis, diagnosis and tactics of treatment with incidental have been little studied and are not consolidated into a single integrated system. Several years ago in the periodical press there were few works devoted to this problem [18, 48], and the corresponding sections in the special manuals were extremely short or absent. For many years, hormone-inactive adrenal tumors were, as a rule, an accidental sectional finding [24, 32, 38, 53]. Only with the introduction into wide clinical practice of highly effective diagnostic technologies (ultrasound - ultrasound, computed tomography - CT, magnetic resonance imaging - MRI, selective angiography, etc.) did real possibilities for intravital diagnosis of these tumors appear, as evidenced by the steadily increasing number of publications [ 18, 19, 41, 48, 53, 58, 82]. However, at present, in most cases, incidentalomas are detected by chance during a comprehensive study of the abdominal organs, carried out for some other reason, not related to the pathology of the adrenal glands. Thus, most authors use the term “incidentaloma” to refer to an accidentally detected adrenal tumor [20, 22, 30, 41, 48, 53, 58].

Problems of Endocrinology. 1998;44(2):42-46
Epidemiology of insulin-dependent diabetes mellitus
Dedov I.I., Suntsov Y.I., Kudryakova S.V., Ryzhkova S.G.

The epidemiology of diabetes mellitus (DM) is a section of diabetology that includes the study of the basic laws of the formation of the epidemiological situation and the epidemiological conditions in relation to this disease, as well as environmental, social and biological factors that determine the dynamics of its main epidemiological characteristics.

The end points of the epidemic process are the prevalence of cases of the disease, their frequency and mortality of patients with diabetes. Each of these characteristics is determined by many factors that can change their importance, priority and even lose it over time.

The epidemiological approach to solving a number of diabetological problems is based on the same principles as the epidemiology of other noncommunicable diseases: cardiovascular, oncological and some others. The main ones: the object of study is the population (population); the study of the disease is carried out in vivo of its development and course; in the researcher’s field of vision, the whole set of factors that can be associated with the fact of the development of the disease.


Problems of Endocrinology. 1998;44(2):47-51
E. J. Pavlik, ed. Estrogens, progestins and their antagonists. - Vol. 2. Functions and mechanisms of action. - Boston, Basel, Berlin: Bikhauser, 1996 .-- 632 p.
Bershtein L.M.

The book under review is part of a lengthy and interesting series for specialists, published by the Birkhauser Publishing House and having the common title Hormones in Normal and Pathological Conditions. The first volume of the book, a review of which is published in Issue 3 of the journal “Oncology Issues” for 1997, deals mainly with the degree of oncological risk of estrogen replacement therapy in menopause, about the not always unambiguous anticarcinogenic properties of phytoestrogens and food indoles, and about modern approaches to hormone therapy for prostate cancer, etc., i.e., mainly about the problems of oncological endocrinology. The 2nd volume of this publication, as its editor E. Pavlik writes in the introduction to the book, is devoted to the physiological and molecular mechanisms of action of estrogens, progestins and their antagonists, and is primarily focused on the discussion of the effect of various and often even opposite effects these compounds in different cells and tissues. A highly qualified team of authors, assembled by the editor, was able to ensure the implementation of this difficult and responsible task.

Problems of Endocrinology. 1998;44(2):53-54
From the history of treatment of thyrotoxicosis with radioactive iodine in Russia
Fadeev V.V., Petrova N.D.

The quantitative determination of the content of radioactive iodine in the urine for the evaluation of the functional state of the thyroid gland was first introduced into clinical practice by J. Hamilton in 1939, and in 1942 he developed a method for determining the content of radioactive iodine directly in the thyroid gland, and in the same year reported experiment on a dog who was injected with a large dose (300 μCi per 1 g of body weight) of radioactive 1311, which caused complete destruction of the thyroid gland with complete replacement of its structure with connective tissue with complete safety araschitovidnyh glands. By 1950, there were already many works devoted to this topic. In the mid-50s, such works began to appear in Russia. Among them, one can note the research of M. N. Fateeva (1953), V. K. Modestov (1958), A. 3. Tsfasman (1961), P. I. Egorov (1961), N M. Draznina (1961) and others, but this problem is most fully reflected in the domestic literature in the writings of prof. V. G. Spesivtseva [1-3].

Problems of Endocrinology. 1998;44(2):54-54

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