Results of observation of a family case of thyrotropic hormone resistance syndrome

The purpose of the study was to evaluate the development of children with congenital subclinical hypothyroidism and not receiving hormone replacement therapy in order to select therapeutic tactics.Цель исследования – оценить развитие детей, имеющих врожденный субклинический гипотиреоз и не получающих заместительную гормональную терапию, для выбора терапевтической тактики

The effect of sexual differences on the clinical course of type 1 diabetes in children with autoimmune thyroiditis as parts of autoimmune polyglandular type 3 syndrome

The article discusses the effect of sexual differences on the clinical course of type 1 diabetes in children of autoimmune thyroiditis in the autoimmune polyglandular type 3 syndrome. A cross-sectional study was conducted, with the formation of a comparison group. A definite difference in the level of HbA1c% and the incidence of late complications of diabetes. According to the results of this study, it became clear that the female sex is the worst course of type 1 diabetes in combination with autoimmune thyroiditis.В статье обсуждается влияние половых различий на клиническое течение сахарного диабета 1 типа у детей аутоиммунного тиреоидита в составе аутоиммунного полигландулярного синдрома 3 типа. Проведено поперечное исследование, с формированием группы сравнения. Определена разница в уровне HbA1c% и частоте проявлений поздних осложнений диабета. По результатам данного исследования стало понятно, что женский пол характеризуется худшим течением сахарного диабета 1 типа в сочетании с аутоиммунным тиреоидитом

Comparative assessment of modern parameters of glycemic control in children with type 1 diabetes after switching to fast-acting insulin aspart using Flash Glucose Monitoring in real clinical practice

BACKGROUND: Postprandial hyperglycaemia contributes significantly to the lack of glycaemic control in patients with type 1 diabetes mellitus (DM1). At least a quarter of patients forget to inject insulin before meals once a week, and more than 40% of them inject bolus insulin immediately before meals, which does not correspond to the pharmacokinetic effects of ultrashort insulins and determines the need to use insulins with better imitations of physiological insulin secretion.AIM: To assess the effect of fast acting insulin aspart (FIAsp) on the current parameters of glycaemic control in children with DM1 after switching from insulin Asp (iAsp) using continuous glucose monitoring.MATERIALS AND METHODS: A multicenter observational 12-week prospective open-label uncontrolled comparative study was initiated. A group of insufficiently controlled patients were identified (n = 48) including a group on multiple insulin injections therapy (MII) (insulin degludec and IAsp) and a group on continuous subcutaneous insulin infusion (CSII) of iAsp. Three 14-day flash glucose monitoring (FMG) were performed: before transferring patients to FiAsp and after 2 and 12 weeks of the transfer. Key endpoints: HbA1c after 2 and 12 weeks on FiAsp relative to baseline, analysis of 5 FMG target glucose ranges, presented as an ambulatory glycemic profile. Additional indicators: dynamics of insulin daily dose, frequency of glucose self- monitoring, the number of severe hypoglycemia, adverse events that occurred during treatment.RESULTS: 2 weeks after the transfer from IAsp to FIAsp, TIR increased in the entire group of patients: from 53% [44.3; 66.5] to 57% [47.4; 71.0] (p-value = 0.010) and TAR decreased from 38% [24.8; 50.2] to 30.5% [22.0; 45, 0] (p-value = 0.0124). Maintaining and increase time spent in the target glucose ranges during a 12-week observation period, in parallel with a significant decrease in hypoglycemic episodes <3.9 mmol / L per week, on FIAsp therapy naturally leads to an improvement in diabetes control: a decrease in HbA1c from 8.15% up to 7.75% (p-value = 0.0224), more pronounced in the group of patients on CSII — from 7.9% to 7.5% (p-value = 0.028).CONCLUSION: Switching from IAsp to BDIAsp in routine clinical practice in the MII and CSII regimen in children and adolescents with type 1 diabetes allows achieving better glycemic control compared to the previous generation prandial insulin analog Iasp. The better diabetes control is associated with an increase or a trend towards an increase in TIR and a decrease or a trend towards a decrease in TAR and TBR, as well as a significant decrease in episodes of hypoglycemia

The study of medico-social aspects of the quality of life and the level of health care provided to children with type 1 diabetes

The article presents the results of a questionnaire-based survey of children with type 1 diabetes mellitus and their parents, analyzes medical and social aspects of the lifestyle and quality of life and the level of health care provided. Our findings indicate that the pediatric patients face significant social limitations and are at risk of developing complications (inability to attend preschool educational institutions, extracurricular and physical education classes; the need for psychological consultations; lack of conditions for controlling the level of glycemia and insulin at school; problems with school meals). The survey results helped develop recommendations for prevention of complications of diabetes mellitusВ статье представлены результаты анкетирования детей с сахарным диабетом 1 типа и их родителей, проанализированы медикосоциальные аспекты образа и качества жизни, уровень оказываемой медицинской помощи. Полученные результаты свидетельствуют о том, что у детей с данным заболеванием есть существенные социальные ограничения и присутствуют факторы риска развития осложнений (невозможность посещения дошкольных образовательных учреждений, дополнительных занятий, занятий по физической культуре, необходимость психологических консультаций, отсутствие условий для осуществления контроля уровня гликемии и постановки инсулина в образовательных учреждениях, проблемы с приемом пищи в школе). По результатам опроса были разработаны рекомендации, направленные на профилактику развития осложнений

Clinical hyperandrogenism – as the first symptom of Li-Fraumeni syndrome

The purpose of the study is to present a comprehensive approach to the definition of therapeutic tactics for hyperandrogenism syndrome in children on the example of a rare clinical case.Цель исследования – представить комплексный подход к определению терапевтической тактики при синдроме гиперандрогении у детей на примере редкого клинического случая

Innovative direction of educational trajectory of pediatrics under continuous medical education successes, problems and prospects

The main problems and perspectives of the development of continuous medical education (NMI) and the work of the Department of Polyclinic Pediatrics and Pediatrics of the FPK and PP FGBOU in the UGMU of the Ministry of Health of Russia on the introduction of the NMA system are presented. An analysis of the results of the questionnaire survey of 45 pediatricians participating in the implementation of the pilot project for the implementation of the additional educational program “Palliative care in pediatrics.” As a result of the study, 80% of the practitioners indicated that the information on the palliative care system for children is known to them for the first time, and the cycle is timely and in demand by the pediatric community.Представлены основные проблемы и перспективы развития непрерывного медицинского образования (НМО) и работа кафедры поликлинической педиатрии и педиатрии ФПК и ПП ФГБОУ ВО УГМУ Минздрава России по внедрению системы НМО. Проведен анализ результатов анкетирования 45 врачей-педиатров, участвующих в реализации пилотного проекта по реализации дополнительной образовательной программы «Паллиативная помощь в педиатрии». В результате проведенного исследования 80% врачей практического звена указали на то, что полученная информация по системе оказания паллиативной помощи детям познается ими впервые, а проведение цикла своевременно и востребовано педиатрическим сообществом