[Sexual and reproductive function in males with somatotropinoma].

The examination of 72 males with somatotropinoma has found that 65% of such patients have hypogonadism which is essential in pathogenesis of sexual dysfunction and spermatogenetic disorders. However, hypogonadism in males with somatotropinoma does not provoke sexual dysfunction in most the cases. High production of somatotropic hormone and insulin-like growth factor 1 in somatotropinoma leads to prostatic hyperplasia which is not accompanied with a rise of a PSA level and symptoms of infravesical obstruction.

[Efficacy and safety of bivalos therapy for postmenopausal osteoporosis. Results of Russian multicenter trial].

AIM: To study effects of one-year therapy with bivalos on mineral bone density (MBD) of the spine in patients with postmenopausal osteoporosis (PMO), effects of bivalos (strontium ranelate) on MBD of the neck of the femur and femur, the levels of bone metabolism markers, quality of life, tolerance of long-term therapy. MATERIAL AND METHODS: The study was made of 60 females aged 54-75 years with PMO. MBD was measured with x-ray absorptiometry in the vertebra and proximal femur. Bone markers in blood serum were detected by enzyme immunoassay. RESULTS: After a year of taking bivalos MBD in lumbar vertebra increased by 4.68 +/- 4.94%, in the neck of the femur--by 2.0 +/- 4.29%, in the proximal femur--by 3.10 +/- 3.34%. A significant 19.5% rise in bone alkaline phosphatase and a 16.5% fall in the level of CT were noted showing a stimulating effect of bivalos on bone formation and an inhibiting effect--on bone tissue resorption. Bivalos treatment raised quality of life of the patients: better motility, regress of depression, improved self-appraisal, decreased number of patients with pain in the spine, attenuated pain. The drug was well tolerated, unwanted effects arose in 15% patients, discontinuation of the drug because of toxicity occurred in 5%. Serious side effects were not observed. CONCLUSION: Strontium ranelate is effective in PMO and is well tolerated.

[Russian consensus on the diagnosis, treatment, and monitoring of acromegalia (draft)].

Acromegaly is a serious disease of the hypothalamic-pituitary system, caused by chronic overproduction of growth hormone (GH) in individuals with completed physiological growth, affecting mainly people of working age. The disease is characterized by significant disability of patients and a reduction in life expectancy, the main reasons for which are complications caused by prolonged hypersecretion of GH. These include primarily damage to the cardiovascular system, respiratory system, metabolic disorders, malignant neoplasms of the gastrointestinal tract. At the same time, timely diagnosis and adequate treatment can reduce mortality several times, significantly improve the quality of life of patients.Until now, the problem of optimizing the diagnosis of acromegaly, especially the so-called "soft" form, as well as the choice of the most effective and safe treatment method, is relevant all over the world and in our country in particular.At the V Russian Congress of Endocrinology, a draft consensus on the management of patients with acromegaly was discussed. Subject to the provisions of the international agreement and Russian experience, recommendations are offered for the diagnosis, treatment and monitoring of this disease for further discussion, followed by the adoption of a final consensus.

[The clinical features of acromegaly and its treatment policy according to age at the onset of disease].

The hormonal activity and the duration of an active phase of the disease are important factors that are involved in the pathogenesis of organ and system complications decreasing lifespan in patients with acromegaly. A hundred and forty patients with active acromegaly were examined to determine the age-related features of the course of the disease. According to the age by the moment of the examination, all the patients were divided into 3 groups: 1) 14 patients aged 20-39 years; 2) 72 patients aged 40-59 years; and 3) 54 patients aged 60 years or more. The mean age at the onset of disease was 27.5±1.9, 37.5±1.0, and 51.2±1.2 years in Groups 1, 2, and3, respectively (p - 0.000); the duration of a latent period being 3.8±0.7, 6.2±0 6, and 9.3±0 8years (p.

[The specific features of the course of acromegaly in old age and possibilities of somatulin treatment].

Acromegaly is a severe neuroendocrine disease caused by chronic excessive production of growth hormone. There are 50-70 cases of this disease per 1 million people. In the vast majority of cases, the cause of the disease is a pituitary adenoma from somatotrophic cells. With the advent in clinical practice of prolonged analogues of somatostatin, endocrinologists have new therapeutic options. In the article we present a clinical case of the patient with the diagnosis: acromegaly, active form; Endosuprasellar pituitary adenoma (somatotropinoma); Hypopituitarism (secondary adrenal insufficiency, secondary hypothyroidism); Chronic pyelonephritis in the acute phase; Hypertension of the II stage, ischemic heart disease, angina pectoris II functional class; Common atherosclerosis with a primary lesion of the aorta, coronary vessels and cerebral vessels.

[Vitrum osteomag in prevention of osteoporosis in postmenopausal women: results of the comparative open multicenter trial]. / Vitrum osteomag v profilaktike osteoporoza u zhenshchin v postmenopauze: rezul'taty sravnitel'nogo otkrytogo mnogotsentrovogo issledovaniia.

AIM: To investigate efficacy, tolerance and safety of the drug vitrum osteomag one tablet of which contains 600 mg calcium (1500 mg calcium carbonate), 200 IU of cholecalcepherol, 40 mg of magnesium, zinc (7.5 mg), copper (1 mg), manganese (1.8 mg) and boron (250 mcg) in women with osteopenia for prevention of osteoporosis. MATERIAL AND METHODS: A multicenter comparative open trial of vitrum osteomag influence on mineral bone density (MBD), change of pain syndrome in bones, index of calcium-phosphorous metabolism covered 334 postmenopausal women with osteopenia. MBD was measured in low-back spine and proximal part of the hip with DEXA method. All the patients were divided into 3 groups: 125 women taking 2 tablets of vitrum osteomag daily for 12 months (group 1); 111 women taking 1500 mg calcium carbonate (group 2); 96 women--control group (only observation). RESULTS: Vitrum osteomag relieved pain in the back and joints, had a positive effect on bone density (+1.5%) and proximal parts of the hip (0.6-0.93%) exceeding the effect of calcium carbonate only which preserves the initial MBD in low back spine but does not prevent bone loss in the hip. MBD dynamics in patients given vitrum osteomag differs essentially from one in the control group (from -1.9 to -2.91%) which demonstrates a reliable preventive anti-osteoporotic effect of this medication. The drug increases the level of general and ionized calcium in blood but does not cause hypercalcemia lowering the level of parathormone in blood. The rate of side effects in group 1 was 14.4% and did not differ much from that in group 2 (16.2%). CONCLUSION: The results of the study allow to recommend vitrum osteomag for prophylaxis of a rapid loss of bone tissue mineral density.

[Determination of the value of Na+/H+-metabolism in erythrocytes of patients with arterial hypertension of endocrine origin]. / Opredelenie velichiny Na+/H+-obmena v éritrotsitakh u bol'nykh s arterial'noi gipertenziei éndokrinnogo geneza.

The paper is concerned with the results of determination of a value of Na+/H(+)-metabolism in 66 patients with arterial hypertension of different genesis, including 21 patients with stage 11 essential hypertension, 8 patients with renal hypertension, 25 patients with Itsenko-Cushing syndrome or disease, 7 patients with pheochromocytoma, and 5 patients with primary hyperaldosteronism. The control group consisted of 11 healthy persons without predisposition to essential hypertension. It was shown that a value of Na+/H(+)-metabolism in patients with essential hypertension exceeded a 3.8-fold the control values. In patients with hyperglucocorticism, pheochromocytoma, arterial hypertension of renal genesis, the rate of Na+/H(+)-metabolism was significantly decreased as compared to that of a group of patients with essential hypertension. It could be used in differential diagnosis of the hypertensive syndrome. The problem of the diagnostic value of this indicator in primary hyperaldosteronism needs further investigation.

[An analysis of the interrelationship of the HLA genotype and carbohydrate metabolism in the families of probands with insulin-dependent diabetes mellitus]. / Analiz vzaimosviazi HLA-genotipa i sostoianiia uglevodnogo obmena v sem'iakh probandov s insulinzavisimym sakharnym diabetom.

A total of 15 families were investigated: probands with insulin-dependent diabetes mellitus and their relatives of the 1st degree of progeny (43 persons) in order to study the distribution of HLA antigens and their interrelationship with the gravity of a course of diabetes mellitus and the type of GTT. Antigens DR3 and/or DR4 were revealed in 93% of probands, especially in heterozygous patients (57.1%). A low level of C-peptide (0.21 +/- 0.03 ng/ml) was noted in most of the probands excluding 3 patients with nephropathy. Distinct relationship of antigens DR3 and DR4 with a clinical course of disease and its severity was undetectable. Antigens DR3 or/and DR4 were detected in 96% of the relatives with the prevalence of antigen DR4 (in 54.2%). During GTT normal tolerance was observed in 82.1% (23 persons), disorders were noted in 4, insulin-dependent diabetes mellitus--in one. Most of the relatives (82.6%) with normal glucose tolerance had antigens DR3 and/or DR4. Irrespective of the type of DR antigens the probands' relatives were characterized by moderate hyperinsulinism (by the results of IRI and C-peptide of blood serum).

[Insulin, glucagon and C-peptide content in the blood of acromegaly patients]. / Soderzhanie v krovi insulina, gliukagona i C-peptida u bol'nykh akromegaliei.

The content of pancreatic hormones and their relationship with the degree of carbohydrate metabolism disorder as well as the somatotropin level were studied in 26 patients with acromegaly. It was found that the degree of carbohydrate metabolism disorder is not dependent on the increase extent in the growth hormone concentration. Hyperinsulinemia was practically revealed in all the patients regardless of the glycemic curve type. There was no correlation between glycemia and insulin indices as well. It was determined that hyperglucagonemia provokes no carbohydrate metabolism injury.