
Review
The childhood cancer morbidity has been steadily increasing over the last few decades. However, the recent more effective complex treatment approaches have led to a dramatic improvements in the survival rate in childhood cancers. Currently many childhood cancer survivors require a life-long follow-up. Therefore, today doctors of various specialties are faced with different long-term consequences after the complex treatment for cancer. Among the various complications metabolic disorders should be eparately identified as risk factors for cardiovascular diseases, which are the most frequent causes of death. This article describes the current understanding of the various metabolic changes in the patients after treatment for medulloblastoma and acute lymphoblastic leukemia in childhood, the mechanisms of their development and treatment issues.
Research investigating the early programming includes studies addressing the role of intrauterine nutrient availability, which is determined by maternal nutrition. This review will explore the epidemiological evidence for programming of metabolic disease and it will also discuss evidence for the proposed molecular mechanisms and the potential for intervention.
The 17th European Congress of endocrinology was held in Dublin in May 2015. Within the section «Obesity» the preliminary results of the observational program "PRIMAVERA" in the form of an oral report were presented. This article presents a brief review of the literature, reflecting the issues of mechanism of action, efficacy and safety of sibutramine and also includes an extended version of the main provisions of the report.
Lecture
Individuals with type 2 diabetes have increased risk of fragility fractures. It’s not completely clear by which mechanism type 2 diabetes increases skeletal fragility. A combination of factors, including an increased risk of falling (contributed by complications of the disease) and impaired bone quality apparently leads to a greater fracture risk. Some cl asses of drug therapy for type 2 diabetes may also increase fracture risk by their own mechanism of action.
Case Report
Ectopic secretion of ACTH from non-pituitary tumors, referred to as ectopic ACTH syndrome (EAS), accounts for about 10–20% of Cushing’s syndrome (CS). Ectopic hormone-secreting pheochromocytomas (Pheo) are rare. The first publication of association between pheochromocytoma and Cushing’s syndrome by Roux is dated 1955. Pheochromocytoma represents a rare cause of hypercortisolism, accounting for less than 5 % of ectopic Cushing’s syndrome while less than 1 % of pheochromocytomas is accompanied by Cushing’s syndrome.
We are reporting 4 cases of ACTH-secreting pheochromocytoma presenting as Cushing’s syndrome. Data from 4 patients were analysed. There were 4 women from 50 to 63 years old. All patients had a clinical presentation of hypercorticoidism. Their levels of adrenocorticotropic hormone in plasma, 24-hour urinary free cortisol and urinary catecholamine were high. Computed tomography scan of the abdomen in all cases revealed a mass in the left adrenal gland. Left sided adrenalectomy was performed under treatment with a-blocker doxazosin and b-blocker atenolol. Histological examination revealed in 3 cases – pheocromocytoma and in 1 case corticomedullary mixed tumor of the adrenal gland. Additional immunostaining (IHC)of these tumors showed positive immunostaining for chromogranin and ACTH. The IHC search for somatostatin receptors of subtype 2 and 5 (SSTR2, SSTR5) was performed in 3 cases and showed predominately expression SSTR2. The case index of Ki-67 ranged, from 0,5 to 4%. Biochemical signs of hypercortisolism rapidly began to disappear after surgery. Follow up of the patients during the next 2 years on average was with disease remission.
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Profile of microRNAs in human adipocytes and macrophages in inflammation
Metformin reduces energy consumption and increases satiety in obese children
Original studies
The results of surgical treatment of morbid obesity usually considers a variety of factors and the main attention is paid to the dynamics of body weight after surgery. It is generally accepted that in the absence of reducing excess body weight or with minimum weight loss (a few kilograms), the result is considered unsatisfactory. The aim of the work was to compare an objective assessment of gastric bypass (GBS) and gastric banding (GB) and the subjective evaluation of treatment effectiveness by patients themselves. The study included 457 (69.7%) patients that underwent GB and 198 (30.3%) patients after GBS. At the late postoperative period 243 patients (53.2%) were available after the GB and 112 (56.6%) patients after GBS. The frequency of matches between objective and subjective assessment of outcomes of surgery usually did not exceed 50%. Given this, there is a need for a comprehensive analysis of the results of bariatric surgery. Developed multicomponent scale allows to evaluate the effectiveness of any bariatric surgery.
Introduction. Obesity is a disorder of energy balance, which leads to excessive accumulation of fat. In recent years, many important discoveries were made in this field, including the discovery of hormones produced by adipose tissue and the identification of many of the central and peripheral pathways of energy balance.
Objective. To study the levels of hormones that affect appetite and metabolism in women with obesity baseline and after weight loss while taking sibutramine.
Materials and methods. The study included 56 women aged 42,9±9,5 years, with a BMI of 34,6±6,1 kg/m2. All patients underwent clinical, laboratory and instrumental examination. Hormonal study included determination of serotonin, leptin, ghrelin, endothelin-1, adiponectin.
Results: In women with obesity we identified hyperleptinemia and increased serotonin levels. The decrease in body weight in patients receiving sibutramine was accompanied by lower levels of serotonin, leptin, ghrelin, endothelin-1, and increase of adiponectin.
Conclusions: Obese patients have significantly elevated levels of leptin, serotonin, ghrelin compared to women of normal weight. Sibutramine treatment leads to a decrease in serotonin, leptin, ghrelin and is more effective in women with a BMI less than 36,5 kg/m2.
Aim. To evaluate the renal concentration capacity in patients with mild and severe primary hyperparathyroidism (pHPT).
Materials and methods. The study included 77 patients (median age 57 years [52;61]) with pHPT, first group was comprised of patients with mild form (n=23), second group contained patients with severe pHPT without nephrolithiasis (n=28) and the third group contained patients with pHPT and nephrolithiasis (n=26). Osmolality index was calculated as urine osmolality to blood osmolality ratio. Renal concentration capacity impairment was diagnosed with osmolality index less than 2.
Results. Osmolality index in patients with pHPT was low with median 1,66 [1,38;2,1]. We found a high prevalence of renal concentration capacity impairment in patients with pHPT, that was 71,4%. Regardless of presence of nephrolithiasis both patients with mild and severe pHPT had similar prevalence (70%, 75% and 69,2% respectively).
Conclusions. Renal concentration impairment is common in mild and severe pHPT. The findings of this study necessitate for measurement of urine osmolality or osmolality index in all patients with pHPT.Комбинированную терапию ожирения (диета, физические нагрузки + прием орлистата) в течение 7 ± 1 месяцев получали 15 пациентов первой группы (СОАС), 5 – во второй (инсомния) и 8 пациентов без нарушений сна. При сравнении групп не выявлено статистически значимых различий по числу пациентов, принимающих медикаментозную терапию ожирения (р < 0,05). Через 7 ± 1 месяцев лечения ожирения среднее снижение МТ у больных с синдромом инсомнии составило –2,5 [–4; 0] кг, у больных с СОАС –7 [–18; –2] кг, у пациентов без нарушений сна –6,5 [–12; –2,25] кг.

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