Features of the natural course of subclinical hypothyroidism in young athletes

Objective: to assess the natural course of subclinical hypothyroidism in young athletes.Methods: In the prospective single-center uncontrolled study, data from 3,062 outpatient records of young athletes (members of the Russian national team) of both sexes (middle age — 15 [14; 16] years) and underwent medical examination in the period from January 2021 to September 2022 were studied. All athletes were divided into 2 groups according to the presence of subclinical hypothyroidism (an increase in the level of thyroid-stimulating hormone from 5 to 10 mUn/l with a normal level of T4 free). During a dynamic follow-up (1 year), athletes with subclinical hypothyroidism underwent a repeated study of the concentration of thyroid-stimulating hormone, free thyroxine and antibodies to thyroperoxidase.Results: Signs of subclinical hyperthyroidism were found in 58 young athletes (30 boys (51.7 %) and 28 (48.3 %) girls). During dynamic observation with continued habitual physical activity, spontaneous normalization of the level of thyroid-stimulating hormone was observed in 74 % of young athletes. At the same time, normalization of thyroid-stimulating hormone in girls was observed less often compared to boys (p = 0,272). In no case did clinically pronounced hypothyroidism develop.Conclusion: The majority of young male and female athletes with subclinical hypothyroidism have spontaneous normalization of hormonal profile against the background of persistent physical and psycho-emotional stress. The data obtained make it possible, subject to the possibility of dynamic observation, to recommend doctors working with young elite athletes not to prescribe hormonal replacement therapy and not to modify the usual lifestyle

Effect of testosterone in young ice-hockey players on hematological, biochemical parameters and the level of physical performance

Ice-hockey combines intense physical activity at high speed with elements of power struggle. Testosterone is the main anabolic hormone, an increase in which during adolescence is associated with faster growth, increased muscle mass, physical strength, and increased overall and aerobic performance. Thus, it is interesting to study the effect of different testosterone levels on metabolic parameters and physical performance of young ice-hockey players.Objective: to compare hematological and biochemical parameters, as well as exercise performance in young ice-hockey players, depending on the testosterone level.Materials and methods: the study included 100 young ice-hockey players aged 15–17 years (average age 15.3 ± 1.1 years). The study group included 25 young ice-hockey players with an increased level of total blood testosterone (> 27.5 nmol/l). The control group included 75 young athletes with normal testosterone levels. All athletes included in the study underwent the PWC 170 test to assess physical performance. Assessment of hematological parameters included hemoglobin (HGB), hematocrit, red blood cell, mean corpuscular volume (MCV), mean concentration hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). β-crosslaps, myoglobin and creatine phosphokinase (CPK) activity were measured to assess the functional state of muscle and bone tissue.Results: A comparative assessment of the CBC in young ice-hockey players did not reveal significant differences depending on the level of serum testosterone level. Tolerance to physical activity in the study groups also did not differ. Young ice-hockey players with increased testosterone levels showed lower β-crosslaps values compared to the control group. The values of other biomarkers of the functional activity of muscle tissue did not depend on the level of testosterone levels.Conclusion: Increased serum testosterone level in the range from 27.5 to 40 nmol/l, detected in young ice-hockey players aged 15–17 years, is not associated with a change in hematological and biochemical parameters. High total testosterone levels do not improve physical performance. It is necessary to continue studies to assess the dynamics of the serum testosterone in young ice-hockey players to clarify the long-term effects of androgens on the metabolic and functional indicators of young athletes. Increasing serum testosterone levels in athletes is subject to wide discussion in the community of sports physicians and endocrinologists

Frequency and structure of endocrine diseases in young elite athletes

There is no data on the prevalence of endocrine disorders in young elite athletes in Russia.Objective: to assess the prevalence of endocrine pathologies and their structure in children and adolescents involved in elite sport.Materials and methods: the study included data from outpatient records of members of national sports teams, who underwent special medical examination. The data of a random sample of 1081 outpatient cards of young athletes, for 26 sports, were analyzed.Results: we found a high prevalence of endocrine pathology (18.6 %) in children and adolescents involved in high-performance sports. Thyroid diseases are most the most frequent in young athletes (in 57.3 % of cases). On second place is obesity (12.3 %). The frequency of weight deficiency and short stature is 8.4 % each. Autoimmune thyroiditis occupies a leading place in the structure of thyroid pathology in young elite athletes. Subclinical hypothyroidism takes the second place, and nodular goiter — the third place.Conclusion: young elite athletes are characterized by a high frequency of endocrine pathology, the leading place in which is occupied by thyroid diseases. It is necessary to further studies aimed at assessing the mechanisms of hormonal adaptation in elite young athletes to assess their impact on the development of the child and the correct interpretation of the hormonal profile obtained during a special medical examination

Experimental and theoretical study of electronic and hyperfine properties of hydrogenated anatase (TiO2_2): defects interplay and thermal stability

In this study we report on the results from emission $^{57}$Fe M${\"o}$ssbauer Spectroscopy experiments, using dilute $^{57}$Mn implantation into pristine (TiO$_2$) and hydrogenated anatase held at temperatures between 300-700 K. Results of the electronic structure and local environment are complemented with ab-initio calculations. Upon implantation both Fe$^{2+}$ and Fe$^{3+}$ are observed in pristine anatase, where the latter demonstrates the spin-lattice relaxation. The spectra obtained for hydrogenated anatase show no Fe$^{3+}$ contribution, suggesting that hydrogen acts as a donor. Due to the low threshold, hydrogen diffuses out of the lattice. Thus showing a dynamic behavior on the time scale of the $^{57}$Fe 14.4 keV state. The surrounding oxygen vacancies favor the high-spin Fe$^{2+}$ state. The sample treated at room temperature shows two distinct processes of hydrogen motion. The motion commences with the interstitial hydrogen, followed by switching to the covalently bound state. Hydrogen out-diffusion is hindered by bulk defects, which could cause both processes to overlap. Supplementary UV-Vis and electrical conductivity measurements show an improved electrical conductivity and higher optical absorption after the hydrogenation. X-ray photoelectron spectroscopy at room temperature reveals that the sample hydrogenated at 573 K shows presence of both Ti$^{3+}$ and Ti$^{2+}$ states. This could imply that a significant amount of oxygen vacancies and -OH bonds are present in the samples. Theory suggests that in the anatase sample implanted with Mn(Fe), probes were located near equatorial vacancies as next-nearest-neighbours, whilst a metastable hydrogen configuration is responsible for the annealing behavior

Topical antibiotics for acute rhinosinusitis in children

In this article, the authors provide an overview of existing data on the use of topical antibacterial drugs in acute rhinosinusitis in children. General information on the etiology of acute rhinosinusitis is given. Indications for systemic and topical antibiotic therapy in acute rhinosinusitis are noted, indicated in Russian and international consensus documents. The advantages of using the combined preparation of thiamphenicol and N-acetylcysteine in acute rhinosinusitis in children and adults are considered separately. It is concluded that the topical antibacterial therapy of acute rhinosinusitis, despite all its advantages, is not an equivalent substitute for systemic antibacterial therapy in the treatment of severe and, especially, complicated forms of acute rhinosinusitis. The practitioner should be guided by the indications for systemic and topical antibacterial therapy adopted in Russian consensus documents. If there are indications for systemic antibiotic therapy, local remedies are only ancillary treatment, the action of which is aimed at enhancing the effect of systemic antibiotics. In the case of monotherapy with local drugs containing antibacterial components, it is mandatory to re-evaluate the patient’s condition and the dynamics of the symptoms of the disease for 2–3 days of treatment, and in the absence of positive changes, reconsider the need for systemic antibacterial therapy. More promising is the use of combined drugs that, in addition to affecting the causative agent of the disease, achieve anti-inflammatory, decongestion or mucolytic effects. It is convenient and rational to use nasal sprays, however, in order to improve the delivery of the active substance to the site of inflammation in acute rhinosinusitis, the use of nebulizer is justified

Pharmacoeconomic research of surgical treatment of juvenile nasopharyngeal angiofibroma: preoperative endovascularly occlusion classes

Introduction. Intraoperative control of bleeding during surgical treatment of juvenile nasopharyngeal angiofibroma (JAN) remains controversial. There is no consensus as to the routine use of preoperative embolization, given its high cost and inconsistent availability of the procedure in care centers. There were no publications devoted to the comprehensive pharmacoeconomic analysis of preoperative vascular embolization (PVE) occlusion classes on the surgical treatment of JAN by the time of publicationAim. To evaluate pharmacoeconomic value of preoperative vascular embolization (PVE) occlusion classes (non-embolized, incomplete and complete) on the surgical treatment of JAN.Materials and methods. A total of 139 patients who underwent JNA surgical resection in 2013–2021 time period were identified. All of these patients were treated in National Medical Research Center for Children’s Hematology, Oncology and Immunology named after Dmitry Rogachev. We evaluated JNA surgical resection outcomes, length of stay (LOS) with prognostic factors using a multiple linear regression (MLR), cost-per-day (CPD), cost-minimization analysis (CMA), cost-utility ratio (CUR), willingness to pay (WTP) with purchasing power parity (PWP).Results and discusion. Surgical transnasal endoscopic treatment of JAN in the quaternary healthcare center, regardless of the degree of embolization and the presence/absence of intraoperative blood transfusion, is at the willingness-to-pay threshold for the healthcare system of the Russian Federation. The most cost-utility method of treatment remains the absence of embolization (within clips placed in the larger diameter vessels). and the absence of blood transfusion, the least cost-utility method is the incomplete embolization, regardless of the presence/absence of blood transfusion.Conclusion. The results of the pharmacoeconomic study emphasize the high significance of the rejection of routine preoperative vascular embolization of JAN and implementation of standard risk-adapted treatment algorithm for indications of preoperative vascular embolization. Which is particularly important for resource allocations and health policy decision making to increase the efficacy and safety of the JNA treatment

Temperature dependence of the local electromagnetic field at the Fe site in multiferroic bismuth ferrite

In this paper, we present a study of the temperature-dependent characteristics of electromagnetic fields at the atomic scale in multiferroic bismuth ferrite (BiFeO$_3$ or BFO). The study was performed using time differential perturbed angular correlation (TDPAC) spectroscopy on implanted 111In (111Cd) probes over a wide temperature range. The TDPAC spectra show that substitutional $^{111}$In on the Fe$^{3+}$ site experiences local electric polarization, which is otherwise expected to essentially stem from the Bi$^{3+}$ lone pair electrons. Moreover, the TDPAC spectra show combined electric and magnetic interactions below the Néel temperature $T_N$. This is consistent with simulated spectra. X-ray diffraction (XRD) was employed to investigate how high-temperature TDPAC measurements influence the macroscopic structure and secondary phases. With the support of ab initio DFT simulations, we can discuss the probe nucleus site assignment and can conclude that the $^{111}$In ($^{111}$Cd) probe substitutes the Fe atom at the B site of the perovskite structure

Metal-insulator transition in crystalline V2O3 thin films probed at atomic-scale using emission Mössbauer spectroscopy

Microscopic understanding the metal-to-insulator transition (MIT) in strongly correlated materials is critical to the design and control of modern “beyond silicon” Mott nanodevices. In this work, the local MIT behaviors in single crystalline V$_2$O$_3$ thin films were probed on an atomic scale by online $^{57}$Fe emission Mössbauer spectroscopy (eMS) following dilute ($<10^{-3}$ at.%) implantation of $^{57}$Mn$^+$ (T$_{1/2}$ = 90 s). Both the epitaxial and the textured V$_2$O$_3$ thin films grown by direct current magnetron sputtering were studied. Three structural components were resolved and identified in the eMS spectra with parameters characteristic of Fe in the 2+ valence state, which are attributable to Fe in either lattice damage or structural defects and Fe in the intrinsic crystal structure of V$_2$O$_3$, respectively. The results prove that the oxygen vacancies are common in the V$_2$O$_3$ thin films. With co-existence of both the non-stoichiometry and epitaxial strain in the thin films, the epitaxial strain plays a dominant role in controlling the global MIT properties of the film. The atomic scale structural transition captured by the eMS affirms the early-stage dynamics of the MIT of V$_2$O$_3$ thin film reported previously. These results approve the feasibility to tune the electronic transport of the V$_2$O$_3$ thin films for the next-generation Mott nanodevices by the epitaxial strain via the sample growth parameters