CLINICO-HORMONAL VARIANTS OF THE SYNDROME OF HYPERANDROGENIA

Endocrine diseases accompanied by hyperandrogenia and disorder of the reproductive function of the body occur in clinical practice. This article reviews the main genetic and hormonal changes, as well as clinical manifestations of the syndrome of hyperandrogenia, based on the analysis of studies of domestic and foreign authors, with the aim of further improving the diagnosis and treatment of this pathology

HYPERCORTISOLISM: CLASSIFICATION, PATHOGENESIS, CLINICAL MANIFESTATIONS. DIAGNOSIS OF ENDOGENOUS HYPERCORTISOLISM

The relevance of the study of Cushing's syndrome with different etiology as well as the states of hypercorticism, which is not associated with endogenous hypercortisolism, is due to the difficulty of the diagnosis of this disease. Accurate knowledge of the classification criteria for the diagnosis of hypercorticism enables subsequently to establish the correct diagnosis and to administer the appropriate treatment. It was found that the cause of hypercorticism can be endogenous and exogenous factors. There is a particular group of patients requiring screening for hypercorticism using special diagnostic tests. Only a clear understanding of etiopathogenesis of hypercorticism and its clinical manifestations by the specialist, the correct interpretation of diagnostic results make it possible to establish the diagnosis, to administer the appropriate treatment and significantly reduce the morbidity and mortality of patients of this profile and improve their quality of life

THE ROLE OF MAST CELLS DEGRANULATION REACTION IN THE ADJUSTMENT OF INSULIN IN DIABETES MELLITUS PATIENTS

Introduction: Strategy of treatment of patients with diabetes (DM) in Belarus is based on a basis of domestic and international conciliatory documents in the area of diabetes. Patients with DM apply domestic production insulin, and at development of individual intolerance or allergic reaction, there is a possibility to replace applied insulin other less antigenic preparation. Aim: To conduct a reaction clinics-experimental research based on mast cells degranulation corpulent cages (RDMC), arising on various kinds of the insulin applied in republic of Belarus. Material and methods: Estimation RDMC of animals on various kinds of insulin which received 31 patient with DM with presence in the anamnesis of various allergic reactions and necessity for correction insulin therapy or change of a preparation of insulin. Monitoring fasting and postprandial glycemia was carried out, degree of indemnification of a carbohydrate exchange was estimated. The applied technique consists in revealing RDMC of a rat at incubation with whey of the patient and investigated insulin. At presence in whey of the patient specific IgЕ to the given kind of insulin occurs degranulation corpulent cages. Results: More than 80 % of patients had sub- or decompensation of a diabetes. Sharply positive tests (RDMC more than 40 %) are absent. On 5 entered preparations of insulin positive reactions (3-13 %) are fixed. All preparations of insulin had weakly positive RDMC (29-55 %). Сonclusion: Carrying out RDMC on various kinds of insulin will help the clinical physician to pick up less immune medical product in case of presence at the patient of allergic reaction. All preparations of insulin investigated in given work can be applied to complex treatment DM

ENDOTHELIAL NITRIC OXIDE SYNTHASE GENE G894T POLYMORPHISM IN PATIENTS WITH CORONARY HEART DISEASE AND DIABETES MELLITUS TYPE 2

The aim of the study is to estimate the frequency of occurrence of genotypes and alleles of the G894T polymorphic variant of the endothelial nitric oxide synthase (eNOS) gene in patients with chronic coronary heart disease (CHD) and in healthy individuals residing in Grodno region. Material and methods. A total of 135 patients were examined. Among them there were 65 patients with CHD and diabetes mellitus (DМ) type 2 and 70 patients with CHD without DM type 2. The control group included 30 otherwise healthy individuals. Identification of the eNOS gene G894T polymorphism was performed using polymerase chain reaction. Results. Distribution of frequencies of genotypes and alleles of the G894T polymorphic variant of the eNOS gene was revealed in the examined patients as well as in the control group by the results of molecular genetic testing. When determining the frequency of the G894T polymorphic variant of the eNOS gene in the total sample of patients it was established that there were 81 (49.1%) carries of the eNOS 894GG genotype, 63 (38.2%) carries of the heterozygous 894GT genotype, and only 21 (12.7%) patients with the 894TT genotype. Frequency of the 894G allele was 68.2%, while frequency of the 894T allele was 31.8 %. Conclusion. Statistically significant prevalence of the homozygous 894TT genotype of the G894T polymorphic variant of the eNOS gene was established in the 1st group of patients (р=0.01) as well as in the 2nd group (р=0.03) in comparison with the control group. The presence of the 894ТT genotype of the eNOS gene G894T polymorphism increases the risk of CHD by 1.5 times (95% CI 1.29 – 1.74)

DIAGNOSIS AND TREATMENT OF ACTH-DEPENDENT AND ACTH-INDEPENDENT ENDOGENOUS HYPERCORTISOLISM

The study topicality of the differential diagnosis of various forms of endogenous hypercortisolism is due to the difficulty of topical diagnosis of neuroendocrine tumors of various localization, which produce ACTH, glucocorticoids, despite the significant improvement of existing methods of investigation that determines further treatment. Only a thorough search for the primary source of the tumor, which produces glucocorticoids or ACTH, enables to clearly identify the method of treatment and to significantly reduce subsequently the morbidity and mortality of patients with hypercortisolism

MODERN APPROACHES TO THE THERAPY OF ENDOCRINE OPHTHALMOPATHY

Background: The number of patients with thyroid disease is increasing due to people suffering from Graves' disease, which is often accompanied by endocrine autoimmune ophthalmopathy. This complication leads to impaired vision and a decrease in the quality of life of patients. Purpose: The analysis of domestic and foreign literature was conducted with the purpose of studying modern approaches to pathogenetic and symptomatic therapy of patients with endocrine ophthalmopathy. Material and methods: 55 literature sources were analyzed. Results: The comparative evaluation of the efficacy of various schemes and methods of treatment of endocrine ophthalmopathy was carried out. Conclusions: One of the priorities in fighting endocrine ophthalmopathy is the search for new methods of treatment, as well as the improvement of existing schemes and programs

ENDOCRINE OPHTHALMOPATHY: ETIOLOGY, PATHOGENESIS, CLINICAL PICTURE, DIAGNOSIS

The relevance of the study of endocrine ophthalmopathy is due to the high prevalence of this disease and a high risk of developing impaired vision that leads to disability of patients. This lecture presents the main genetic, immunological, clinical manifestations of endocrine ophthalmopathy in order to improve the diagnosis and treatment of this pathology. The clinical picture of endocrine ophthalmopathy is various, unique for every patient and depends on the activity and severity of the process, which requires combined etiopathogenetic therapy. The importance of timely diagnosis for endocrine ophthalmopathy with an assessment of the activity of the process for choosing the right tactics for managing patients is very high