Currently, the problem of cognitive dysfunction is becoming increasingly important due to the raising demand for effective intellectual activity in modern society. One of the most significant causes of cognitive dysfunction is dismetabolic nature of the disorder, such as diabetes mellitus, which has recently been gaining prevalence. Much of the resistance of clinical symptoms of diabetic encephalopathy to conventional therapy requires a search for new approaches for solving this problem. Cognitive rehabilitation as a correctional technique has proved a positive effect in terms of the treatment of neurodegenerative diseases of different nature.This review present the ways for correction of cognitive impairment using the method of cognitive rehabilitation in patients with diabetes, its methodology, mechanisms of action and perspectives.

Currently, the leading place in the structure of morbidity in older people takes the cardiovascular disease. It is also the leading cause of death in developed countries. The significance of osteoporosis is now also due to the high and growing prevalence of this pathology. Osteoporotic fractures are associated with a reduction in the quality of life in patients, lead to disability, require a significant investment. This pathology is ranked fourth in the structure of mortality after cardiovascular disease, oncopathology, and diabetes.

Numerous studies indicate that these two diseases are associated not only with the occurrence of age, but have common pathogenetic mechanisms. The data obtained suggest that osteoporosis, calcification of the aorta and heart valves and atherosclerotic vascular disease – related pathological processes. Vascular and bone have some common morphological properties, vascular calcification and consists of the same components as the bone tissue.

From the standpoint of modern medicine it is extremely important to identify specific relationships between diseases and their common pathogenetic mechanisms for development of a comprehensive and individual approach to the diagnosis, treatment and prevention.

 

 

This lecture focuses on the diagnosis and differential diagnosis of adrenal incidentalomas with special reference to diagnostic steps, major pharmacological tests, and instrumental studies. Strategies of management of patients with this pathology are described.

Rathke’s cleft cyst is one of the causes of hyperprolactinemia. It forms due to pituitary malformation during embryonic period. Nowadays the correct diagnosis still possesses some issues with interpretation of visual data and variable clinical picture. The article presents a clinical case of a patient with Rathke’s cleft cyst that was initially managed as prolactinoma.

Increased body mass index (BMI) in today's world has become one of the most common and extremely dangerous to humanity diseases. The expansion of fast food chains, high-calorie food, sedentary lifestyle, stress, accumulation of population in cities – the main causes of overweight. In the twenty-first century, in scientific literature introduced a new term "globesity", reflecting the global nature of global problems. However, studies in recent years, several break this logic: "overweight – obesity – the risk of chronic diseases – the risk of premature death." Often, those with elevated BMI have a greater life expectancy than patients with normal or decreased BMI. The latter causes the appearance of a new term "obesity paradox". Indeed, increased BMI significantly reduces the quality of life, increases the risk of social problems. Persons suffering from increased BMI, harder to find a job and to arrange his personal life. In the United States of America the presence of increased body mass index (BMI) results in a significant rise in the cost of health insurance. Reducing excess weight is completely dependent on patients who need along with medication to live a healthy lifestyle. An important direction of minimize obesity and its consequences seem to be a diet, refusal of personal transport, leisure, vacation travel. American society of specialists in the field of metabolic and bariatric surgery define obesity as a chronic, relapsing, multifactorial neurobehavioral disorder in which the increase of fat in the body contributes to the dysfunction of adipose tissue with the development of threat for physical and psychological health of the metabolic and psychosocial consequences.

Background. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Recently, the role of melatonin in the pathogenesis of this syndrome became widely discussed among the scientists, because there is an evidence of its impact on the reproductive function and maturation of oocytes.

Aim. To study a informativeness of melatonin determination and its relationship with sleep disorders in PCOS.

Materials and methods. The study involved 120 women aged 17–35 years: 60 patients with PCOS and 60 women without this disorder as controls. The level of melatonin in the blood, saliva and its metabolite in urine – 6 sulfatoximelatonin were analyzed. To identify sleep disorders survey was conducted using a questionnaire scoring subjective sleep characteristics.

Results. Sleep disorders based on subjective scoring profiles sleep characteristics were identified in PCOS group (up to 70% of patients) regardless of BMI. The level of 6-sulfatoximelatonin in urine, nocturnal melatonin levels in saliva (at 3:00 AM) and melatonin in the blood were significantly higher in patients with PCOS compared with the control group regardless of BMI. The level of melatonin in follicular fluid was lower in patients with PCOS. There was a significant correlation of melatonin levels in the blood and the degree of sleep disorders according to the questionnaire scoring subjective sleep characteristics, the level of melatonin in saliva at 3:00 AM and a 6-sulfatoximelatonin in daily urine (p = 0.046).

Conclusions. PCOS is polyetiology disease, and an important role in the formation and progression in which plays melatonin. Correlation of levels of this hormone in different body fluids suggests its systemic action and direct involvement in the regulation of reproductive function.

 

 

Aim. To study the influence of SERT and GNB3 gene polymorphisms on the results of the treatment of obesity by serotonin-norepinephrine reuptake inhibitors.

Methods. Patients who didn’t achieve significant weight loss in 3 month period during PrimaVera Study were selected for the genetic evaluation and compared with the group of “effective treatment”. The study included 66 patients (57 females and 9 males), mean age 39.29 ± 12.64 years, who received Reduxin (sibutramine + MCC) at the dose of 10 mg. Term follow-up was 3 months. Clinical examination and determination of biochemical parameters was performed at baseline and at the end of the observation period. In order to assess the type of eating behavior and identify hidden depressions a validated questionnaire was used (questionnaire "The types of eating disorders» (DEBQ), Beck Depression Scale). Also conducted a genetic study to assess SERT and GBN3 gene polymorphisms.

Results. In the second group presence of S-allele SERT-gene was significantly associated with higher rates of external type of eating behavior. A statistically significant correlation between the genotype or allele of either body weight, rates of blood pressure, heart rate and cholesterol have not been found. In the first group there was a statistically significant association of S-allele carrier with less weight loss -2.8 kg (compared to l-allele) and higher rates at baseline glucose 5.38 ± 0.63 mmol / l (compared to L-allele of -3.28 kg and 5.04 ± 0.91 mmol / l).

In the study of GBN3 polymorphism in the second group among CC genotype carriers there were higher levels of systolic blood pressure (SBP) before treatment (129.27 ± 9.16 mmHg), SBP and diastolic blood pressure after 3 months of treatment (127.36 ± 8.16 and 78.36 ± 4.3 mmHg) compared with CT genotype (117.27 ± 12.5; 115.45 ± 10.6; 72.91 ± 6.0 mm Hg, respectively) (p <0.05). Also among the carriers of C-allele there were more severe manifestations of depressive syndrome in comparison with T-allele carriers.

Conclusion. Among the carriers of S-allele of SERT gene body weight loss during Reduxin treatment was lower than among the carriers of the L-allele; among the carriers of CC genotype of GBN3 gene higher blood pressure was higher at baseline and during Reduxin treatment, as well as more severe symptoms of a depressive syndrome.

 

The usаge of medical and surgical methods of body weight correction, prevention of obesity and its life-threatening complications with the help of original new and safe technologies is an urgent task of modern medicine. The article presents the results of one month treatment by the medical product consists of peroral carbomer of polyacrylic acid gel for systemic usage with brand name «Portsiola» in patients with overweight and obesity and dynamics of their mass and body composition. The reduction of body weight was mainly due to adipose tissue. The degree of body weight reduction was up to 3 kg in a month and depended on the dose. Adverse events due to uptake of the «Portsiola» were not mentioned.

Introduction. Cardiovascular disease (CVD) remain the leading cause of death in industrialized countries. Patients with coronary heart disease (CHD) in combination with diabetes mellitus type 2 (T2DM) are characterized by more severe CHD and poor prognosis. Resent data indicate microRNAs (miRNAs) as important participants in the pathogenesis of various pathological conditions, including obesity, T2DM and CVD.

The aim of this study was to determine expression of miRNAs associated with the development of CHD, and transforming growth factor beta (TGF-β) in a patients with T2DM and obesity Materials and methods. 42 patients with 1-2 degrees obesity and diagnosed T2DM were divided into 2 groups. The first group with CHD, the second group - without CHD. 9 miRNAs were evaluated: miRNA-1, miRNA-21, miRNA-26a, m miRNA-27, miRNA-33a, miRNA-33b, miRNA-133a, miRNA-133b, miRNA-208.

Results and discussion. Significant differences were found in expression of miRNA-21, miRNA-26a, miRNA27a. An increased expression of miRNA-21, miRNA-27a was found in patients CHD while the expression of miRNA-26a was reduced in comparison with the group without CHD.

Conclusion. The results of this study may be an initial step for the detection of molecular basis in CHD pathogenesis in these patients by quantifying miRNA expression.

 

Introduction. Cardiovascular disease (CVD) remain the leading cause of death in industrialized countries. Patients with coronary heart

disease (CHD) in combination with diabetes mellitus type 2 (T2DM) are characterized by more severe CHD and poor prognosis. Resent data indicate microRNAs (miRNAs) as important participants in the pathogenesis of various pathological conditions, including obesity, T2DM and CVD.

The aim of this study was to determine expression of miRNAs associated with the development of CHD, and transforming growth factor beta (TGF-β) in a patients with T2DM and obesity Materials and methods. 42 patients with 1-2 degrees obesity and diagnosed T2DM were divided into 2 groups. The first group with CHD, the second group - without CHD. 9 miRNAs were evaluated: miRNA-1, miRNA-21, miRNA-26a, m miRNA-27, miRNA-33a, miRNA-33b, miRNA-133a, miRNA-133b, miRNA-208.

Results and discussion. Significant differences were found in expression of miRNA-21, miRNA-26a, miRNA27a. An increased expression of miRNA-21, miRNA-27a was found in patients CHD while the expression of miRNA-26a was reduced in comparison with the group without CHD.

Conclusion. The results of this study may be an initial step for the detection of molecular basis in CHD pathogenesis in these patients by quantifying miRNA expression.