Vol 18, No 4 (2016)


Russian Association of Endocrinologists clinical practice guidelinesfor diagnosis, treatment and preventive measures in congenital adrenal hyperplasia due to 21-hydroxylase deficiency patients in adulthood

Melnichenko G.A., Troshina E.A., Molashenko N.V., Sazonova A.I., Uzhegova Z.A.


Russian clinical practice guidelines presents the main approaches to the diagnosis, treatment and follow-up of patients with classical and nonclassical forms 21-hydroxylase deficiency. The techniques of diagnostic tests and parameters of hormonal indicators to assess the adequacy of replacement therapy glucocorticoids and mineralocorticoids are considered.
Consilium Medicum. 2016;18(4):8-19
pages 8-19 views

Dipeptidyl peptidase 4 inhibitors for the treatment of type 2 diabetes mellitus

Morgunova T.B., Fadeev V.V.


Type 2 diabetes mellitus is one of the most common endocrine diseases. This article discusses the new classes of antihyperglycemic agents (dipeptidyl peptidase 4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors), the approaches for prescription these drugs. The article also discusses the cardiovascular safety of new antihyperglycemic agents.
Consilium Medicum. 2016;18(4):20-23
pages 20-23 views

Glycemic control in patients with type 2 diabetes mellitus

Ametov A.S., Chernikova N.A.


The problem of glycemic control in patients with diabetes mellitus (DM) still remains one of the most topical. The goal of modern management of diabetes mellitus is to find individual approach for each patient. Chronic hyperglycemia is the leading cause of late DM complications and requires optimal treatment and achievement of metabolic targets after the debut of the disease. In reality, however, more than half of patients do not achieve their target goals, because of inadequate glycemic control. To minimize errors of glycemic control indicators patients must use portable glucometers, associated with the parameters corresponding modern standards.
Consilium Medicum. 2016;18(4):24-27
pages 24-27 views

Cardiac autonomic neuropathy: role of metabolic therapy

Kotova O.V., Akarachkova E.S.


Neuropathy is one of the most common complications of diabetes mellitus (DM) and affects about 60% of patients. Patients with type 2 DM can have this complication after several years of poor glycemic control, and sometimes these patients already have neuropathy at the time of DM diagnosis. Diabetic autonomic neuropathy (DAN) is a type of diabetic peripheral neuropathy. Whereas, cardiac autonomic neuropathy (CAN) is a type of diabetic autonomic neuropathy and the most commonly form of DAN. It is now known that 50% of patients with DM suffering from diabetic neuropathy have asymptomatic CAN (form of diabetic autonomic neuropathy - DAN), while 100% of patients with symptoms of CAN have classic diabetic neuropathy. Orthostatic hypotension (OH) is a common manifestation of CAN. In general, the prevalence of OH among elderly patients is 54-68% and 6% in the general population. OH is a serious problem primarily because of the impact on the course of chronic somatic diseases. The existence of OH is an independent risk factor for incidence of myocardial infarction (and for mortality as well), stroke, heart failure and arrhythmias. This article deals with Ewing’s five standard tests for diagnosing cardiovascular pathology. This article discusses the possibility of prescribing preparations of a-lipoic acid, vitamin B preparations, preparations containing vitamin B-complex and biologically active substances in the capacity of possible pathogenetic DAN therapy. Cocarnit is a complex preparation, containing vitamins B and metabolically active compounds, which can improve total somatical state of patients with DAN.
Consilium Medicum. 2016;18(4):28-30
pages 28-30 views

The clinical features of proliferative diabetic retinopathy

Lipatov D.V., Kuzmin A.G., Tolkacheva A.A., Chistiakov T.A.


The Pandemic of diabetes worldwide has led to increasing incidence and changing patterns of eye damage in this disease. The emergence of new modern methods of diagnosis and treatment of diabetic retinopathy does not reduce the number of eye complications this type in patients with diabetes mellitus. This is due to the fact that the proliferative process in diabetic retinopathy has become more variable - growth of proliferative tissue can be seen not only in the posterior segment of the eye, but also in other structures of the eyeball. All this makes it extremely difficult to timely diagnosis, delay the starting time of treatment and, ultimately, worsens the prognosis of the disease.Objective. The aim of this work was the generalization of the data variants of the course of the proliferative process in diabetic retinopathy and modern methods of its treatment.Material and methods. The study centered on patients with proliferative diabetic retinopathy from different regions of the Russian Federation, held examination and treatment in the Department of Ophthalmology National Endocrinology Research Center.Conclusion. The Extension of our knowledge about types of the course of the proliferative process in diabetic retinopathy allows us to diagnose pathological changes in the eye and timely treatment. All of this can contribute to a more optimistic prognosis of the disease.
Consilium Medicum. 2016;18(4):31-34
pages 31-34 views

Diabetic Retinopathy Barometer Project: international project results

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«Барометр диабетической ретинопатии» [Diabetic Retinopathy (DR) Barometer] - международный проект для оценки текущей ситуации с лечением диабетической ретинопатии, проведение которого было инициировано Международной федерацией диабета (Internatio- nal Diabetes Federation, IDF), Международным агентством по предотвращению слепоты (International Agency for the Prevention of Blind- ness, IAPB) и Международной федерацией по изучению проблем старения (International Federation on Ageing, IFA).В рамках проекта в 41 стране мира (включая страны Европы, Северной и Южной Америки, Африки, Среднего Востока, Азии и Океании) при финансовой поддержке компании Bayer Pharma AG* среди 3590 пациентов с СД и почти 1,5 тыс. медицинских работников было проведено количественное исследование.
Consilium Medicum. 2016;18(4):36-37
pages 36-37 views

Circadian model of carbohydrate metabolism regulation in normal

Kitcyshin V.P., Salukhov V.V., Demidova T.A., Sardinov R.T.


The variability of plasma glucose, which is identified as normal during the day, is not spontaneous. All of the known regulatory mechanisms of carbohydrate metabolism, without exaggeration, take part in its formation. These mechanisms are hierarchically structured. Their cyclic dynamics of functional activity, the close relationship between them based on the principle of operation of control systems with inverse connection create more or less obvious fluctuations of glucose. These fluctuations of glucose form typical stable patterns at certain time periods. The hypothalamus plays the most important role in this regulation. In particular, the suprachiasmatic nucleus forms the circadian rhythm of glucose dynamics of healthy people. The article is devoted to modern concepts of circadian functioning of the systems that regulate carbohydrate metabolism.
Consilium Medicum. 2016;18(4):38-42
pages 38-42 views

Diagnostics of neuroendocrine tumours: role of the therapist

Volkova N.I., Porksheyan M.I.


In the article there are presented the modern data on neuroendocrine tumors (NET) addressed, first of all, to doctors of a therapeutic profile. There are in detail described main clinical syndromes, which are also widespread in the general population, and their features within NET.
Consilium Medicum. 2016;18(4):44-48
pages 44-48 views

Vitamin D deficiency: the cause or the result of obesity?

Karonova T.L., Shmonina I.A., Andreeva A.T., Bairamov A.A., Beliaeva O.D.


This article discusses the cause-effect of the relationship between obesity and Vitamin D deficiency, both of them being very important medical conditions. The study results showed high comorbidity of these conditions and a negative effect of obesity on vitamin D deficiency development. According to the study results, obese patients need to lose more than 5% weigh and use large doses of cholecalciferol to prevent or treat vitamin D deficiency.
Consilium Medicum. 2016;18(4):49-52
pages 49-52 views

Psychological assessment of the patients before and after bariatric surgery

Neymark A.E., Eganyan S.A., Grineva E.N.


The article describes and analyzes the results of a variety of psychological research in bariatric surgery, the psychological characteristics of patients with morbid obesity and after bariatric surgery. It's necessary to conduct a detailed study psychological emotional-personal sphere of patients before and after bariatric surgery. It choosed psychological techniques for working with patients.
Consilium Medicum. 2016;18(4):53-56
pages 53-56 views

On the role of neuroendocrine abnormalities in the pathogenesis of cognitive dysfunction in major depressive disorder (a literature review with authors’ comments)

Bekker R.A., Bykov Y.V.


Major depression correlates to several known neuroendocrine abnormalities (e.g. HPA axis dysregulation) and is often comorbid with endocrine disorders (e.g. diabetes). On the other hand, major depression is one of the leading causes of cognitive decline, and it is well-known fact that functional and social recovery correlates better to cognitive functioning than to general improvement in depressive symptoms. This article thoroughly reviews different correlations between endocrine functions and cognition, and the existing evidence base for hormonal/endocrine correction of cognitive dysfunctions commonly seen in depressions.
Consilium Medicum. 2016;18(4):57-61
pages 57-61 views

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