Iodine deficiency in Azerbaijan after the discontinuation of an iodine prophylaxis program: reassessment of iodine intake and goiter prevalence in schoolchildren.

The goal of this study was to assess the prevalence of iodine deficiency (ID) in Azerbaijan after the discontinuation of an iodine prophylaxis program by assessing the prevalence of goiter, iodine intake, and thyroid function. The study included 942 schoolchildren (475 boys and 467 girls) ages 8-14 years, from 13 distinct regions. The survey included the following: (1) clinical evaluation; (2) assessment of thyroid volume both by ultrasound and by palpation; (3) determination of iodide in a morning urine specimen using the classic Sandel-Kolthoff reaction in 347 schoolchildren; (4) determinations of thyrotropin (TSH), triiodothyronine (T3), thyroxine (T4), thyroglobulin (Tg), and anti-thyroid peroxidase (TPO) in serum (n = 165) and TSH in whole blood spotted on filter paper (n = 942). The prevalence of goiter for the whole country was determined by ultrasound (US) to be 86% and by palpation 66%, reaching 100% in the mountainous regions of Caucasus. The median urinary iodine excretion (UIE) was 54 microg/L, reaching level of 26 and 39 microg/L in the Caucasus region. In conclusion, according to the World Health Organization (WHO) classification, Azerbaijan now has mild to moderate ID (median UIE, 54 microg/L) and in the mountainous regions with severe ID. The high prevalence of goiter and the low UIE emphasizes the need for urgent medical reintervention. An iodination program is now implemented by our team in the mountainous regions under the auspice of the government of Azerbaijan.

[Pathogenesis of lower limb diabetic angiopathies in patients with non-insulin-dependent diabetes mellitus]. / K patogenezu diabeticheskikh angiopatii nizhnikh konechnostei u bol'nykh insulinnezavisimym sakharnym diabetom.

Some indices of the system of homeostasis, lipid metabolism, lipid peroxidation (LPO), the levels of IRI, C-peptide, glycosylated Hb and glycemia (on an empty stomach) were investigated in 131 patients with noninsulin dependent diabetes mellitus (the patients ranged in age from 40 to 60). Correlation analysis has shown that derangements in the system of homeostasis, lipid metabolism and LPO are correlated and interrelated, resulting in disorder of the arterial blood flow in the lower limbs and hence to the development and progression of diabetic angiopathies. The authors have proposed a scheme of LPO involvement in the development of lower limb diabetic angiopathies.

[Disorders of blood coagulation and microcirculation in diabetics]. / Narusheniia gemokoaguliatsii i mikrotsirkuliatsii u bol'nykh sakharnym diabetom.

Determination of platelet aggregation and disaggregation and the use of coagulogram indices reflecting the main stages of blood coagulation (the levels of fibrinogen and soluble complexes of fibrin-monomer, fibrinolytic activity) are recommended for the diagnosis of chronic DIC-syndrome in patients with diabetes mellitus. This syndrome is noted in diabetic patients before the development of clinical symptoms of microangiopathy but in parallel with microcirculatory disorders according to the results of conjunctival biomicroscopy. Platelet aggregation indices show correlation with the conjunctival index in diabetic patients even before the development of a clinical picture of diabetic retinopathy.

[Hemostasis and lipid metabolism in patients with non-insulin- dependent diabetes mellitus and angiopathy of the lower extremities]. / Gemostaz i lipidnyi obmen u bo'lnykh insulinnezavisimym sakharnym diabetom s angiopatiei nizhnikh konechnostei.

A study of hemostasis and lipid metabolism, a basal level of immunoreactive insulin, hemoglobin A1C was performed in 81 patients with non-insulin-dependent diabetes mellitus and associated angiopathy of the legs. Decompensated stage of the diabetes was characterized by hypercoagulation and hyperlipidemia. Treatment of diabetic angiopathy of the legs should be aimed both at compensation of diabetes and correction of abnormalities in hemostasis and lipid metabolism.

[Dynamics of lipid peroxidation in patients with noninsulin-dependent diabetes mellitus]. / Dinamika perekisnogo okisleniia lipidov u bol'nykh insulinnezavisimym tipom sakharnogo diabeta.

The time course of erythrocytic lipid peroxidation (LP) was studied in 55 patients with insulin independent diabetes mellitus aged 40 to 60 years LP was assessed by the content of malonic dialdehyde (MDA) and peroxidative hemolysis of erythrocytes (PHE). During diabetic decompensation LP activity was increased, especially in the presence of lower limb angiopathies. The authors assumed an idea of the involvement of LP products in the pathogenesis of vascular lesions. Diabetic compensation did not cause normalization of LP activity however the use of antioxidant (alpha-tocopherol acetate) led to a significant decrease in LP activity which can be of importance for the treatment of the early stages of diabetic angiopathies.

[Characteristics of disturbances in the hemostasis system in patients with insulin-dependent diabetes mellitus with angiopathies of the vessels of the lower extremities]. / Osobennosti narushenii v sisteme gemostaza u bol'nykh insulinnezavisimym tipom sakharnogo diabeta s angiopatiiami sosudov nizhnikh konechnostei.

Indices of the system of hemostasis, the levels of glycolysated hemoglobin were studied in 67 patients suffering from non-insulin-dependent diabetes mellitus with lower limb angiopathies (aged 40 to 60). Rheovasography of the lower limbs was performed. The patients were treated with antidiabetic drugs per os (with the exception of hydroxydione sodium succinate), platelet aggregation inhibitors (pentoxifylline, acetylsalicylic acid) and vasodilators (xanthinol nicotinate, solcoseryl and cinnarizine). The use of pentoxifylline after therapy increased the rate of platelet aggregation inhibition and decreased the prothrombin index, not influencing the other indices of the system of hemostasis. Pentoxifylline combined with acetylsalicylic acid at small doses normalized not only platelet indices but also the other indices of the system of hemostasis. Positive changes in the system of hemostasis were accompanied by a rise of the rheographic index in patients with vascular functional changes. In obliterating atherosclerosis the rheographic index was not on an increase indicating the necessity of corrective therapy of vascular lesions, first of all in the system of hemostasis, in the early period of diabetes mellitus.