Vol 57, No 4 (2011)

About informative value of very high prolactin levels in patients presenting with prolactin-secreting pituitary macroadenomas (clinical observations)
Astaf'eva L.I., Kadashev B.A., Tenedieva V.D., Moshkin A.V., Shifrin M.A.
Abstract
The mean blood prolactin level in patients with microprolactinomas is usually 3000-4000 mU/l compared with 10 000-20 000 mU/l in cases presenting with macroprolactinomas. It may be as high as 1 mln mU/l and more in patients with a giant tumour. The measurement of prolactin levels requires laboratory studies of strongly diluted plasma samples. Significant dilution is fraught with erroneous prolactin levels: nevertheless, this approach allows a tendency toward decreasing concentration of prolactin to be revealed which may be important for taking rapid decision concerning the choice of the treatment strategy (either surgical or medicamental) especially in critical situations. A few clinical cases of giant prolactinomas with an unusually high blood prolactin level are described with reference to its dynamics during treatment with cabergoline.
Problems of Endocrinology. 2011;57(4):3-6
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Disturbed balance of steroid hormones in men under 40 years of age presenting with obesity and metabolic syndrome
Katsiia G.V., Goncharov N.P., Chagina N.A.
Abstract
We have studied steroid hormone profiles in young men with normal body mass index suffering obesity and metabolic syndrome. They showed a consistent tendency toward a shift in blood aldosterone level to the upper normal level and beyond. It was higher in patients with metabolic syndrome than with obesity. The testosterone levels displayed the downward trend from normal through obesity to metabolic syndrome values. The main predictors of testosterone dynamics in the course of development of obesity and metabolic syndrome were insulin concentration and BMI. Dynamics of dehydroepiandrosterone levels followed that of testosterone. It significantly decreased in men with metabolic syndrome compared with health subjects. Young men presenting with obesity and metabolic syndrome did not experience changes in morning and evening cortisol levels in peripheral blood. The study revealed the relationship between aldosterone levels and the development of metabolic syndrome mediated through the body mass index and the direct relationship between metabolic syndrome and testosterone dynamics.
Problems of Endocrinology. 2011;57(4):7-12
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The role of YY3-36 peptide in the regulation of body weight in patients presenting with the exogenous constitutional form of obesity
Vlasova I.I., Ametov A.S.
Abstract
The objective of the present study was to measure the total YY3-36 peptide levels in blood sera obtained from the patients presenting with the exogenous constitutional form of obesity and excessive body weight. The secondary objective was to elucidate the influence of YY3-36 peptide on the process of body weight elevation. A significant rise in the serum YY3-36 peptide level was documented in those of the 327 patients included in the study who suffered grade I and II obesity (p<0,05). It was especially high in the patients with grade II obesity (p<0,05). It is concluded that the exogenous constitutional form of obesity is associated with a statistically significant elevation of blood YY3-36 peptide level in patients presenting with grade I and II obesity.
Problems of Endocrinology. 2011;57(4):13-16
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Clinical and metabolic aspects of the influence of type 2 diabetes mellitus on the manifestation of articular syndrome in patients with gonarthrosis
Strongin L.G., Klimova K.D., Grunina E.A., Korneva K.G., Trifonova E.S.
Abstract
The present work was designed to study the influence of type 2 diabetes mellitus on the clinical course of articular syndrome in patients with combined pathology. A total of 45 patients with diabetes mellitus and gonarthrosis were examined and 45 ones with gonarthrosis without concomitant type 2 diabetes. The patients of both groups were matched for age, sex, duration and stage of gonarthrosis, and body mass index. It was shown that concomitant diabetes mellitus promotes progression of articular syndrome. Decompensation of diabetic state leads to exacerbation of pain syndrome, marked functional changes and increased severity of the inflammatory processes in the joints.
Problems of Endocrinology. 2011;57(4):17-20
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The antioxidative activity of oral hypoglycemic agents
Spasov A.A., Kosolapov V.A., Chepliaeva N.I.
Abstract
Oral hypoglycemic agents, such as glibenclamide, gliclazide, metformin, rosiglitazone maleate, and diabenol, are known to exert in vitro a mild direct antioxidatove action. Rosiglitazone maleate showed moderate activity only on the hemiluminescence model with generation of active oxygen species while diabenol behaves as a scavenger of superoxide anion and hydroxyl radical in model hemiluminescence systems. Gliclazide exhibited dose-dependent activity only with respect to stable diphenyl-1-picrylhydrazyl (DPPG) radicals. Metformin and glibenclamide were inactive under in vitro conditions. It is hypothesized that the antioxidative action of hypoglycemic agents used for long-term pharmacotherapy should be attributed to their direct effect on the activity of enzymes of the antioxdative system.
Problems of Endocrinology. 2011;57(4):21-24
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The classical case of the treatment of an adult patient with the salt-losing form of congenital adrenal cortical dysfunction
Sazonova A.I., Molashenko N.V., Iarovaia I.S., Kalinchenko N.I., Troshina E.A.
Abstract
This case report illustrates peculiarities of the clinical course of congenital adrenal cortical dysfunction in adult patients presenting with the salt-losing form of the disease. Analysis of this case confirmed the necessity of dynamic observation of adults with this pathology in order to avoid complications that are likely to develop in case of inadequate treatment.
Problems of Endocrinology. 2011;57(4):25-27
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Evaluation of the efficacy of gonadotrophic inductors of ovulation in rats with hyperandrogenemia given flutamide
Reznikov A.G., Nosenko N.D., Boris E.N., Poliakova L.I., Sinitsyn P.V., Tarasenko L.V.
Abstract
The objective of the present work was to study the influence of antiandrogen flutamide (flutapharm) at a dose of 1.0 mg/kg b.w., human chorionic gonadotropin (choragon, 5 IU), and folliculostimulating hormone (menopur, 0.01 IU) on the morphofunctional characteristics of ovaries. These products were administered either alone or sequentially to sexually mature female rats after the implantation of testosterone-containing polymeric capsules. The presence of hyperandogenism was confirmed by the five-fold rise in the blood testosterone levels. Analysis of the oestrus cycle, the weight and histological structure of the ovaries gave evidence of disturbed folliculogensis, degenerative changes in follicular epithelium, the development of ovarian polycystosis and anovulatory state in the hyperandrogenic animals. It is concluded neither flutamide nor gonadotrophic hormones administered at the above doses promoted normalization of the generative function of rat ovaries. At the same time, stimulation with gonadotropins following glutamide administration restored folliculogenesis, ovulation, an formation of luteal bodies. The results of this study indicate that flutamide can be used to enhance the stimulating action of gonadotropic hormones on the ovaries in hyperandrogenic individuals.
Problems of Endocrinology. 2011;57(4):28-31
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Regulation of the adenilate cyclase signal system by peptides of the insulin family, epidermal growth factor, and leptin and its functional disturbances in lymphocytes from patients presenting with type 2 diabetes mellitus
Kuznetsova L.A., Plesneva S.A., Chistiakova O.V., Sharova T.S., Pertseva M.N.
Abstract
This study showed for the first time the stimulating action of peptides of the insulin family, insulin-like growth factor-1, relaxin, and epidermal growth factor (EGF) on the activity of the adenilate cyclase signal system (ACSS) in lymphocytes from the subjects of the control group. These hormonal effects were enhanced in the presence of guanylimidodiphosphate (GIDP). Moreover, leptin was for the first time shown to increase adenilate cyclase activity in lymphocytes from the control subjects and inhibition of this action by antibodies against leptin receptors. The patients presenting with type 2 diabetes mellitus (DM2) showed the enhanced baseline activity of adenilate cyclase in their lymphocytes whereas its stimulation by the above hormones, both in the presence and absence of GIDP, sharply declined. The influence of leptin on adenilate cyclase activity in patients with DM2 was apparent only at its concentrations above 10–8 M; it was inhibited by antibodies to leptin receptors. The results of this study indicate that disturbances of hormonal stimulation of adenilate cyclase activity in lymphocites of diabetic patients may be due to functional defects located at the receptor level in the case of leptin and at the level of Gs protein and its coupling to adenulate cyclase in case of peptides of the insulin family and GF. These findings confirm the concept being developed by the author according to which molecular defects in the hormone-dependent ACSS system constitute one of the main causes underlying the development of DM2.
Problems of Endocrinology. 2011;57(4):32-36
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Growth hormone and the cardiovascular system
Volevodz N.N.
Abstract
This review highlights current concepts of physiological and pathophysiological effects of growth hormone on the heart. The data of international clinical studies concerning the influence of GH deficit and excess on the cardiovascular system are discussed with special reference to such clinical conditions as somatotrophic pituitary insufficiency and acromegaly. Result of analysis of parameters of the cardiovascular system in the patients receiving growth hormone substitution therapy for somatotrophic insufficiency and GH-suppressive therapy of acromegaly are presented
Problems of Endocrinology. 2011;57(4):37-47
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Biphasic insulin analogs: their potential in the management of type 2 diabetes mellitus
Oranskaia A.N.
Problems of Endocrinology. 2011;57(4):48-55
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NPH insulin. Effective mixing - effective dose regimen
Nikonova T.V.
Abstract
Insulin therapy, a corner stone of the treatment of diabetes mellitus, both type 1 and type 2, has undergone substantial modification since the manufacture of the first insulin preparations 90 years ago up to the present time. Human insulins, such as neutral protamin Hagedorn (NPH) insulins, remain a major instrument of therapy of diabetes mellitus despite rapid developments in this field of knowledge and the wide availability of insulin analogs. When prescribing these preparations, the attending physician should be absolutely confident that the patient has a minimum background of knowledge and skills indispensable for efficacious and safe treatment. Such skills include the habit of mixing NPH insulin suspensions by 20-fold turning the vial or the cartridge upside-down or rolling them between the palms in order to ensure the uniform distribution of insulin in the suspension and its accurate dosing. The manufactures place from one to three glass or metal bullets inside the vials and cartridges for more homogeneous mixing of their contents. P. Kaiser et al. undertook the study of several pharmaceutical forms of NPH insulin manufactured by different companies to estimate the accuracy of dosing (variability of the insulin dose depending on the number of turns of the cartridge for homogeneous mixing). The insulin concentration in a single dose was measured by high-performance liquid chromatography. Marked variability of the insulin dose after less than ten (three or six) turns was documented for all cartridges with the exception of Insuman Basal insulin cartridges ("Sanofi"). It may be expected that the accuracy of dosing will not deteriorate using these cartridges owing to the presence in them of three heavy metal bullets even if the patient does not perform the necessary mixing procedure for one or another reason.
Problems of Endocrinology. 2011;57(4):56-60
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