[Evaluation of renal blood flow by Doppler study in children and adolescents with type 1 diabetes]. / Otsenka pochechnogo krovotoka metodom dopplerometrii u detei i podrostkov s sakharnym diabetom 1 tipa.

Renal blood flow was ultrasonographically studied in 220 children, adolescents, and young, postpubertal patients who had fell ill with type 1 diabetes mellitus (DM) in childhood (of them there were 111 (49.8%) males and 112 (50.2%) females with a disease history of 1 to 27 years (73 patients with diabetic nephropathy (DN) and 150 without DN). Thirty apparently healthy children and adolescents made up a comparison group. Doppler duplex scanning and Doppler pulse-wave study (DPWS) were made at the level of the great renal artery, segmental, interlobar, and arcuate arteries. With DPWS, the values of peripheral resistance were lower than the normal values at the level of interlobar and arcuate arteries in all patients with microangiopathies. There were significant differences between the groups of patients with different types of microangiopathies, the group of patients with DM without DMA, and the control group. Echography was used to determine the volumes of the kidneys in 220 patients. In patients with DM, renal volume was significantly greater than that in the control patients (p<0.05).

[A description of electrophysiological parameters in children and teenagers with diabetic peripheral polyneuropathy]. / Kharakteristika elektrofiziologicheskikh parametrov u detei i podrostkov s diabeticheskoi perifericheskoi polinevropatiei.

Two hundred and ninety patients with diabetes mellitus, type 1, aged 5 to 18, disease duration--1 to 15 years, were examined at the chair for endocrinology of children and teenagers of of the Russian Medical Academy for Postgraduate Training of the Ministry for Health of the Russian Federation. The purpose of the case study was to investigate the electromyogram (EMG) parameters in such patients with respect to the disease duration, carbon metabolism compensation, age specificity and a stage of diabetic peripheral polyneuropathy (DPP). The results primarily denote a lesion in the axons; the pronounced demyelinating process in peripheral nerves of children and teenagers with DPP is highly possible. The obtained data is suggestive of the feasibility to recommend the stimulation EMG method for a comprehensive use in the diagnostics of pre-clinical DPP stages in children and teenagers, for evaluating a severity of the damage to peripheral nerves in DPP of symptom-types forms as well as for a dynamic follow-up of patients and for treatment efficiency evaluation.

[The effectiveness of ramipril in the treatment of diabetic nephropathy in normotensive children and adolescents]. / Effektivnost' ramiprila v lechenii diabeticheskoi nefropatii u detei i podrostkov s normal'nym urovnem arterial'nogo davleniia.

To study the effectiveness of ACE-inhibitors in diabetic nephropathy (DN) 12 male and 16 female patients aged 13-21 years with DN having normal blood pressure (BP) were given ramipril (tritace) in a dose 2.5-5 mg/day in the course of 12-24 weeks. Efficacy and safety of the treatment were assessed by changes in albuminuria and proteinuria, BP. Reduction of albuminuria occurred in 19(79.1%) out of 24 patients with microalbuminuria, in 13(54.1%) of them urine excretion of albumin returned to normal levels. All the patients with proteinuria and macroalbuminuria benefited from ramipril therapy because their proteinuria diminished or even disappeared (2 cases). The persistence of the antiproteinuria effect on posttreatment week 12 was 66.6%. Ramipril effect on BP was minimal. It is inferred that ramipril is effective in the treatment of DN at the stage of microalbuminuria and proteinuria in patients with normal BP.