Role and significance of asprosin in feeding behaviour and metabolism

This article presents a review of available information on asprosin — a hormone of white adipose tissue discovered in 2016. The history of its discovery, as well as its action mechanisms and main targets are examined. Changes in the plasma level of asprosin under some pathological conditions are analysed. The importance of studying asprosin is determined by its functions: asprosin regulates physiological processes during fasting and plays an important role in the development of metabolic disorders, such as insulin resistance. There are relatively few studies concerned with asprosin; however, this hormone can already be considered as a diagnostic marker and a potential target in the treatment of certain metabolic disorders, e.g. diabetes mellitus and obesity

A simultaneous pancreas-kidney transplantation for type 1 diabetes mellitus after a long-term of receiving hemodialysis renal replacement therapy. Clinical сase

At the present time, a simultaneous pancreas-kidney transplantation (SPKT) is an effective method of treatment for patients on renal replacement therapy by hemodialysis program in the outcome of the terminal stage of diabetic nephropathy. This method of treatment solves several problems: it reduces the severity of intoxication syndrome, contributes to the achievement of euglycemia in most cases, which certainly allows to slow the progression of micro- and macrovascular complications of diabetes. Despite of positive effect of euglycaemia and kidney function normalization, the accumulated metabolic memory legacy of long-term uncompensated diabetes mellitus is realized, which makes a posttransplantational rehabilitation of patients difficult. A duration of hemodialysis therapy is known as a cardiovascular events risk factor, which affects the surgery result and favorable posttransplant period. More often after successful SPKT microvascular diabetic complications are stabilized, but macrovascular diabetic complications, diabetic neuroosteoarthropathy and mineral and bone disease are progressed. That’s why is necessary to perform regular examination after SPKT by a team of specialists, including nephrologist, endocrinologist, cardiologist, ophthalmologist with correction of ongoing therapy. Therefore both the preparation of  the patient for transplantation with the earliest possible placement on the waiting list and the post-transplant rehabilitation afterwards are extremely important

Nasolacrimal Duct Obstruction Secondary to Radioactive Iodine-131 Therapy for Differentiated Thyroid Cancer

Deterministic effects of medical exposure to ionising radiation can be associated with both the effectiveness of treatment and adverse drug reactions to it. The latter may drastically deteriorate the quality of life of a patient after radionuclide therapy. In addition, the regulations of the Russian Federation require indicating the effective dose of radiation as a measure of damage (risk), but the presence of a deterministic effect in individual organs and tissues complicates monitoring and recording patient exposure doses. The aim of the study was to investigate the effect of radiopharmaceuticals containing 131I on the development of secondary nasolacrimal duct obstruction (NLDO). Materials and methods: the study of secondary NLDO predictors analysed medical history data, post-therapy head-and-neck scintigrams, and methods to prepare patients for treatment. It involved sodium iodide, 131I, formulated as a solution (marketing authorisation number: FS-002065) by the FSUE Federal Center of Nuclear Medicine Projects Design and Development of the FMBA of Russia. Results: the authors unambiguously localised the lacrimal ducts in post-therapy 131I scintigrams of the head and neck and quantified 131I uptake ratios for the lacrimal duct area. Also, they identified a set of NLDO predictors: the age of a patient, the administered activity, the administration of recombinant human thyroid-stimulating hormone, the 131I uptake ratio, etc. The article describes a method for identifying the groups at risk of NLDO following radioiodine therapy for differentiated thyroid cancer. Conclusions: secondary NLDO is a deterministic effect of 131I exposure. The authors have developed a new method for predicting secondary NLDO by a combination of the patient’s individual parameters and treatment plan; the identified predictors help to personalise radioiodine therapy. The authors suggest the following: to include information on secondary NLDO as a complication of therapy to the SmPC section on undesirable effects; to develop approaches to secondary NLDO prevention; and to improve the algorithms for reporting adverse events in case of delayed manifestation and those for following patients up in the medical organisations having administered the radiopharmaceutical or in other medical organisations being applied to for medical care afterwards

Cardiovascular and metabolic status in patients with primary hyperparathyroidism: a single-center experience

IntroductionCardiovascular diseases (CVD) and metabolic disorders (MD) have retained leading positions in the structure of morbidity and mortality for many years. Primary hyperparathyroidism (PHPT) is also associated with a greater incidence of CVD and MD. The aim of the present study was to describe the prevalence and structure of CVD and MD in hospitalized patients with PHPT and to search for possible associations between these pathologies.Methods838 patients with a verified PHPT were included in the study. The studied cohort was divided into 2 groups according to their age at the time of admission: patients aged 18 to 49 years (group A, n = 150); patients aged 50 years and older (group B, n = 688).ResultsThere were no significant differences between two groups in parameters of calcium-phosphorus metabolism. Obesity was diagnosed in 24.2% of patients in group A and in 35.9% in group B. Type 2 diabetes mellitus was more common in older patients (14.4% in group B vs. 2.6% in group A). Arterial hypertension, ischemic heart disease, chronic heart failure and brachiocephalic arteries atherosclerosis were more frequent in older patients, occurring in 79.1%, 10.8%, 8.4%, and 84% of cases respectively. The cutoff points that increased the risk of CVD detection turned out to be age above 56 years, eGFR below 92 ml/min/1.73m2, BMI above 28.3 kg/m2.DiscussionThe present study demonstrated a high incidence of some CVD, as well as disorders of lipid, carbohydrate and purine metabolism in patients with PHPT

Вторичная облитерация слезоотводящих путей при проведении радиойодтерапии 131I дифференцированного рака щитовидной железы

Deterministic effects of medical exposure to ionising radiation can be associated with both the effectiveness of treatment and adverse drug reactions to it. The latter may drastically deteriorate the quality of life of a patient after radionuclide therapy. In addition, the regulations of the Russian Federation require indicating the effective dose of radiation as a measure of damage (risk), but the presence of a deterministic effect in individual organs and tissues complicates monitoring and recording patient exposure doses. The aim of the study was to investigate the effect of radiopharmaceuticals containing 131I on the development of secondary nasolacrimal duct obstruction (NLDO). Materials and methods: the study of secondary NLDO predictors analysed medical history data, post-therapy head-and-neck scintigrams, and methods to prepare patients for treatment. It involved sodium iodide, 131I, formulated as a solution (marketing authorisation number: FS-002065) by the FSUE Federal Center of Nuclear Medicine Projects Design and Development of the FMBA of Russia. Results: the authors unambiguously localised the lacrimal ducts in post-therapy 131I scintigrams of the head and neck and quantified 131I uptake ratios for the lacrimal duct area. Also, they identified a set of NLDO predictors: the age of a patient, the administered activity, the administration of recombinant human thyroid-stimulating hormone, the 131I uptake ratio, etc. The article describes a method for identifying the groups at risk of NLDO following radioiodine therapy for differentiated thyroid cancer. Conclusions: secondary NLDO is a deterministic effect of 131I exposure. The authors have developed a new method for predicting secondary NLDO by a combination of the patient’s individual parameters and treatment plan; the identified predictors help to personalise radioiodine therapy. The authors suggest the following: to include information on secondary NLDO as a complication of therapy to the SmPC section on undesirable effects; to develop approaches to secondary NLDO prevention; and to improve the algorithms for reporting adverse events in case of delayed manifestation and those for following patients up in the medical organisations having administered the radiopharmaceutical or in other medical organisations being applied to for medical care afterwards.Детерминированные эффекты воздействия ионизирующего излучения в ядерной медицине могут быть ассоциированы как с эффективностью терапевтического воздействия, так и с нежелательными реакциями, которые могут резко ухудшить качество жизни пациента после проведения радионуклидной терапии. Согласно требованиям нормативно-правовых актов Российской Федерации необходимо указать эффективную дозу облучения в качестве меры ущерба (риска), однако контроль и учет доз облучения пациента затруднен при наличии детерминированного воздействия излучения в отдельных органах и тканях. Цель работы: изучение влияния радиофармацевтических лекарственных препаратов с содержанием 131I на развитие облитерации слезоотводящих путей. Материалы и методы: при исследовании предикторов возникновения вторичной облитерации были рассмотрены данные из анамнеза пациентов, посттерапевтические сцинтиграфические изображения головы и шеи, проанализирован способ подготовки пациентов к лечению. Лекарственное средство — Натрия йодид, 131I, субстанция-раствор, ФС-002065, производства ФГУП «Федеральный центр по проектированию и развитию объектов ядерной медицины» ФМБА России. Результаты: достоверно определена локализация слезоотводящих путей на посттерапевтических сцинтиграфических изображениях головы и шеи с 131I; количественно определены индексы накопления 131I в области слезоотводящих путей. Выявлен комплекс предикторов облитерации слезоотводящих путей: возраст пациента, введенная активность, введение рекомбинантного аналога тиреотропного гормона гипофиза человека, индекс накопления 131I и другие. Описана методика определения группы риска возникновения облитерации слезоотводящих путей после радиойодтерапии по поводу дифференцированного рака щитовидной железы. Выводы: вторичная облитерация слезоотводящих путей — детерминированный эффект воздействия 131I. Выявленные предикторы позволяют персонализировать проведение радиойодтерапии. Разработан новый способ прогноза развития вторичной облитерации слезоотводящих путей на основе комплекса персональных параметров пациентов и индивидуального плана лечения. Предлагается включить информацию об осложнениях в виде вторичной облитерации слезоотводящих путей в раздел «Побочное действие» инструкции по медицинскому применению лекарственного препарата, разработать подходы к профилактике развития вторичной облитерации слезоотводящих путей, усовершенствовать алгоритмы подачи информации о неблагоприятных событиях в случае отсроченного проявления заболеваний и алгоритмы динамического наблюдения за пациентом непосредственно в медицинских учреждениях, где был применен лекарственный препарат, а также в других учреждениях, в которые пациент обращается за оказанием медицинской помощи