INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) <div align="center"> <table id="table1" style="border-collapse: collapse;" border="0" width="100%"> <tbody> <tr> <td colspan="2" align="center" valign="top"><span style="color: #6b818e; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10pt; font-style: normal; font-variant: normal; font-weight: bold; letter-spacing: normal; line-height: 18px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 1; word-spacing: 0px; -webkit-text-stroke-width: 0px; display: inline !important; float: none;">The International Journal of Endocrinology (Ukraine) - Mìžnarodnij endokrinologìčnij žurnal is the professional scientific and practical specialized peer-reviewed journal for endocrinologists, immunologists, nephrologists, gynecologists and doctors of other specialties, dedicated to the problems of endocrine disorders.</span></td> </tr> <tr> <td colspan="2" align="center" valign="top"><hr noshade="noshade" size="1" /></td> </tr> <tr> <td valign="top" width="25%"><img src="" /></td> <td valign="top" width="75%"><span style="font-size: 10pt; font-family: Verdana;"><strong>The founder:</strong> Bukovinian State medical University, Zaslavsky O.Yu.<br /><strong>Publisher:</strong> Zaslavsky O.Yu.<br /><strong>Language of edition:</strong> Ukrainian, English.</span> <p align="justify"><span style="font-size: 10pt; font-family: Verdana;"><strong>Registration Certificate:</strong> КВ № 19313-9113ПР. Issued by the Ministry of Justice of Ukraine 06.09.2012.</span></p> <p align="justify"><span style="font-size: 10pt; font-family: Verdana;">The journal is included in the new List of scientific publications of the Higher attestation Commission, which can publish results of dissertations on competition of scientific degrees of doctor and candidate of Sciences. Order of the MES from 11.07.2019 № 975.</span></p> <p><span style="font-size: 10pt; font-family: Verdana;"><strong>Publication frequency:</strong> 8 times per year.<br /></span><span style="font-size: 10pt; font-family: Verdana;"><strong>Founded: </strong>September 2005</span></p> <p><span style="font-size: 10pt; font-family: Verdana;"><strong>ISSN</strong> 2224-0721 (print)<br /><strong>ISSN</strong> 2307-1427 (online)</span></p> <p><strong><span style="font-size: 10pt; font-family: Verdana;">DOI: 10.22141/2224-0721</span></strong></p> <p><span style="font-size: 10pt; font-family: Verdana;"><strong> <a href=""> <span style="text-decoration: none;"></span></a></strong><strong><br /><a href=""> <span style="text-decoration: none;"></span></a></strong></span></p> </td> </tr> <tr> <td colspan="2" align="center" valign="top"><hr /></td> </tr> </tbody> </table> </div> <table id="table2" style="border-collapse: collapse;" border="0" width="100%"> <tbody> <tr> <td align="left" valign="top" width="98%"><strong>The journal in its publication activity is guided by the recommendations of the following editorial associations:</strong><br /><a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a></td> </tr> <tr> <td align="left" valign="top" width="98%"><hr /></td> </tr> <tr> <td align="left" valign="top" width="98%"><strong>We endorse the following declarations:</strong></td> </tr> <tr> <td align="left" valign="top" width="98%"><a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a></td> </tr> <tr> <td align="left" valign="top" width="98%"><hr /></td> </tr> </tbody> </table> en-US <p>Our edition uses the copyright terms of <strong>Creative Commons</strong> for open access journals.</p><p>Authors, who are published in this journal, agree with the following terms:</p><ol><li>The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a <span><a href=""><strong>Creative Commons Attribution 4.0 International License</strong></a></span>, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.</li><li>Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.</li><li>The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.</li><li>The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.</li><li>The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.</li><li>The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.</li></ol> (Pankiv Volodymyr) (Оnchul Larisa) Tue, 13 Apr 2021 12:24:29 +0000 OJS 60 Appeal of Editor-in-Chief <p>No abstract</p> V.I. Pankiv Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Clinical characteristics of covid-19 patients at King Saud Medical City: a retrospective study <p><em><strong>Background.</strong></em> COVID-19, a new viral disease caused by Corona Virus (SARS-CoV-2) was reported first by Chinese. WHO declared it a pandemic in March 2020. We saw a huge number of this illness that caused a stress on health care systems and a high proportion of mortality. World Health Organization declared it as a pandemic in March 2020. We planned this study with the objective of knowing clinical presentation, hospital management and final outcome of COVID-19 in our population and compare it with other institution who studied the disease elsewhere.<em><strong> Materials and methods.</strong></em> A retrospective study on COVID-19 patients with severe to critical illness was conducted in King Saud Medical City Riyadh. Proper permission was issued by ethical committee of King Saud Medical City. Data was collected manually as well from electronic records. Data was analyzed using standard statistical methods. A total of 689 patients that were admitted to KSMC from 1st March 2020 to 30th of June 2020. <em><strong>Results.</strong></em> More than 50 % of our patients were from Indian subcontinent (India, Pakistan and Bangladesh). Our mean age was 50 years. Females comprised 17.3 % of our patients. Common presentation was breathlessness (79 %), cough (70 %) and fever (67 %). Mean oxygen saturation on presentation was 92 %. Around sixty one percent of our patients were critical and were treated in intensive care unit. Mortality was 35 % and multi-organ failure 25 %. Although diabetes mellitus (37.3 %) and hypertension (29.5 %) were common comorbidities but it did not increase the mortality in our patients. Our mortality seems to be related to late reporting to hospital and severe disease itself. <em><strong>Conclusions.</strong></em> A retrospective study conducted at King Saud Medical city on 689 patients of severe and critical COVID-19. A high proportion were admitted to intensive care unit (60.8 %), 41 % needed invasive ventilation and 29 % required vasopressors and 14 % needed hemodialysis. Mortality of 35 % was recorded in our study. People of Indian subcontinent (Pakistani, Bangladeshi and Indians) formed more than 50 % of patients.</p> Marwah Bin Talib, Abdullah A. Baredhwan, Khaled Alenazi, Ali Almagooshi, Abdulrehman M. Alqahtani, Sultan A. Alsobayeg, Sarah Alhazmi, Waad Awad, Ameera S. Alamri, Parameaswari P. Jaganathan, Manasik N. Abdu, Latif Ahmed Khan Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Modern views on the genetic determinism of GH-secreting pituitary adenomas (literature review and own data) <p><em><strong>Background.</strong> </em>This article presents a review of the current literature on the role of the genetic component in the etiology and pathogenesis of hormone-active pituitary adenomas secreting growth hormone (GH) and clinically manifesting by acromegaly and/or gigantism (multiple endocrine neoplasia 1 (MEN-1), McCune-Albright syndrome, Carney complex, X-linked acrogigantism (X-LAG), familial isolated pituitary adenoma — FIPA). <em><strong>Materials and methods.</strong></em> To identify mutations in the AIP gene and to verify FIPA, 26 patients of the Ukrainian population (19 women and 7 men) were examined in whom acromegaly was diagnosed in adolescence or young age, and genetic analysis was performed. To determine the genetic determinism in the development of GH-secreting pituitary adenoma and differential diagnosis of FIPA and MEN-1 syndromes by sequencing method (MLPA — ligation-dependent probe amplification), the genes MLPA, P244-C1 were studied involving exons 1–6 MEN1 gene, (MLPA, P017-D1) AIP gene. <em><strong>Results.</strong></em> Among those examined, only two patients had AIP gene mutations. In one patient, genetic screening for MEN1 gene mutation was negative and no clinical symptoms suggestive of McCune-Albright syndrome were detected. A variant heterozygous missense c.714C&gt;G (p.Cys238Trp) was found in the AIP gene. This AIP gene assay is compatible with a genetic predisposition to develop pituitary adenoma. The offspring of this patient has a 50% chance of inheriting this variant, acromegaly, hypersomatotropinemia, MEN-1 syndrome, familial isolated pituitary adenoma. Another patient was diagnosed with MEN syndrome type 1 (Wermer syndrome): insulinoma, parathyroid gland adenomas (2), primary hyperparathyroidism with a heterozygous c.134A&gt;G variant (p.Glu45Gly) found in the MEN1 gene. The presence of the c.l34A&gt;G (p.Glu45Gly) class variant 4 is likely to be pathogenic. The prevalence of this variant in the general population is unknown, so it is very rare. <em><strong>Conclusions.</strong> </em>The genetic analysis is appropriate in pediatric and young patients or those with GH-secreting macro/giant pituitary adenoma diagnosed at a young age (under 35), regardless of family history. In patients with a history of a disease, genetic analysis is recommended in any case to identify FIPA and to predict the further course of the disease and the effectiveness of treatment with somatostatin analogues.</p> R. Nikolaiev, L. Rostomyan, A. Beckers, O. Khyzhnyak, M. Mykytyuk, Yu. Karatchentsev, V. Khaziev Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Comorbidity in type 1 and type 2 diabetes mellitus. Vitamin D in the monitoring system <p><em><strong>Background.</strong> </em>The urgency of the problem of comorbi­dity in diabetes mellitus (DM) is due to the observed aging of the population and a significant increase in the prevalence of DM, especially in the older age group, as well as the fact that DM itself is a comorbid pathology. The purpose of the study was to establish the frequency and structure of comorbid states in patients with type 1 DM and type 2 DM when using the team monitoring system, to investigate the provision of patients with vitamin D, and also to analyze, according to published meta-analyzes, the potential ability of vitamin D to positively influence the frequent comorbid patho­logy in patients with DM. <em><strong>Materials and methods.</strong></em> In 42 women with DM (15 with type 1 DM and 27 with type 2 DM), the frequency and structure of comorbidity, established in the context of the team strategy of patient management, were analyzed. The blood level of 25(OH)D was determined by the enzyme immunoassay using an immunoassay on Modular Analytics E170 analyzer. <em><strong>Results.</strong></em> In the considered groups, the average age of women was significantly higher in the group of type 2 DM compared with type 1 DM (56.67 ± 3.03 versus 33.8 ± 2.59 years, p &lt; 0.01). At the same time, 12 comorbid pathologies of the 15 pathological conditions consi­dered were detected in type 1 DM, and in type 2 DM — all 15. With type 1 DM, neuropathy (100 % versus 77.8 %, p &lt; 0.05), retinopathy (100 % versus 55.6 %, p &lt; 0.01) were significantly more frequently detected, and type 2 DM was associated with hypertension (77.8 % versus 20.0 %, p &lt; 0.001), obesity (55.62 % versus 0 %), and liver pathology (33.8 % versus 0 %). In both groups, there was a high incidence of cardiopathy (100 % in type 1 DM versus 88.9 % in type 2 DM), encephalopathy (80 % versus 88.9 %), thyroid patho­logy (60 % versus 77.8 %). The average number of comorbid states significantly prevailed in type 2 DM (8.56 ± 2.19 versus 7.0 ± 0.9, p &lt; 0.05). The blood level of vitamin D was reduced in both types of DM, while in women with type 2 DM, it corresponded to deficiency, and in type 1 DM — with its lack (19.55 ± 1.8 ng/ml versus 28.98 ± 1.2 ng/ml, p &lt; 0.001). <em><strong>Conclusions.</strong> </em>The use of a team exa­mination strategy made it possible to establish that in women with type 1 DM and type 2 DM, there is a rejuvenation of age qualifications, a significant increase in the number of comorbid pathologies. In type 2 DM, the rate of increase in the number of comorbid states is higher than in type 1 DM. Even with a significantly shorter duration of DM, the number of comorbid states is significantly higher in them. Type 1 DM in women is accompanied by vitamin D lack, and type 2 DM is accompanied by vitamin D deficiency. At the same time, today there is no final understanding of whether a lack of vitamin D is a risk factor for DM or DM is accompanied by a decrease in the level of vitamin D. Understanding this issue will determine the optimal timing of the prophylactic administration of vitamin D.</p> O.A. Goncharova Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Prevalence of non-alcoholic fatty liver disease in patients with prediabetes <p><em><strong>Background.</strong> </em>Diabetes mellitus (DM) is one of the largest global health emergencies. Prediabetes is an early stage in hyperglycemia continuum where individual is at an increased risk for development of DM. NAFLD represents a range of liver disorders characterized by hepatic steatosis or accumulation of fat in the liver cells in the absence of excessive alcohol consumption, viral or drug related etiologies. However, not many studies have been conducted to study the prevalence of non-alcoholic fatty liver disease (NAFLD) in persons with prediabetes. This study is an endeavor in that direction. <em><strong>Materials and methods.</strong> </em>This was a cross-sectional observational study. 100 prediabetic patients, fulfilling the criteria as under, were included in the study over a period from November 2017 to March 2019, after informed consent. Investigations carried out on the patients included baseline biochemical parameters like complete hemogram, fasting plasma glucose, liver function tests, kidney function tests, serum electrolytes and specialized investigations like HbA1c, 2-hour-OGTT and serum insulin levels. <em><strong>Results.</strong></em> The study included 38 males and 62 females, with the median age for the study population being 46 years. The mean BMI was found to be 24.29 ± 3.98 kg/m2, and the mean waist circumference was found to be 81.26 ± 8.71 cm. A significant association was found between the level of fatty echotexture on ultrasound and BMI (p = 0.003), and gender (0.05). 30 % population was found to be insulin sensitive, 22 % was found to be depicting early insulin resistance and 48 % had significant insulin resistance. There was a statistically significant correlation between ultrasound and fibroscan findings. A significant statistical correlation was found between HOMA IR and level of fatty echotexture on ultrasound, as well as median liver stiffness on fibroscan. <em><strong>Conclusions.</strong></em> We found a significant correlation between insulin resistance and presence of NAFLD. Also, significant associations were observed between various demographic characteristics and grade of steatosis. There is a need to undertake further studies on a larger scale, to substantiate the observations of this study. This understanding is expected to go a long way in generating awareness and optimizing public health strategies.</p> Bhumi Agarwal, B.M. Singh Lamba, Neera Sharma, Monika Tanwar Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Aspects of hormonal testing of thyroid function in patients with type 1 diabetes mellitus and chronic kidney disease <p><em><strong>Background.</strong></em> Chronic kidney disease (CKD) is known to affect the thyroid axis, including thyroid hormone metabolism. It has been established that a decrease in renal function can be combined with changes in thyroid function. Thyroid dysfunction also has implications for renal blood flow, glomerular filtration rate (GFR), tubular transport, electrolyte homeostasis, and glomerular structure. The purpose of the study was to determine the features of thyroid function in patients with type 1 diabetes mellitus (T1DM) and CKD and develop recommendations for hormonal testing of thyroid pathology. <em><strong>Materials and methods.</strong></em> One hundred and twenty-one patients with T1DM with CKD were divided into 3 groups: group 1 — 78 individuals with GFR ≤ 60 ml/min/1.73 m2, group 2 — 20 people receiving renal replacement therapy (RRT), group 3 — 23 patients after renal transplantation (RT) with adequate graft function (the duration of the renal transplant is 3.62 (1.47; 4.28) years). <em><strong>Results.</strong> </em>In T1DM and CKD group, the diagnostic value of thyroid-stimulating hormone is reduced due to the absence of differences in its values with a decrease in T4 and T3. Free T3 is the most sensitive marker of thyroid dysfunction in CKD. Thyroid disorders in T1D and CKD patients have a non-immune genesis. T1DM patients on RRT after hemodialysis (HD) procedure have an increase in total and free T4 and free T3, consequently, monitoring of thyroid disorders should be done immediately after the HD session. The restoration of normal values of peripheral conversion index and free T3 occurs within 1–2 years after TR, depending on the duration of RRT receiving. After more than 3 post-transplantation years, there is an increase in peripheral conversion index, which characterizes the imbalance of peripheral thyroid hormones towards a decrease in free T3 with relatively stable free T4. <em><strong>Conclusions.</strong> </em>Thyroid dysfunctions are typical for all stages of the pathological process in CKD in patients with type 1 diabetes mellitus, including patients at the terminal stage and after successful kidney transplantation. The changes in thyroid hormones are associated with the RRT experience and can potentially affect the survival of patients.</p> A.G. Sazonova, T.V. Mokhort, N.V. Karalovich Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Prediction model for severity of diabetic retinopathy derived from review of endothelial dysfunction and hypoxia markers <p><em><strong>Background.</strong> </em>According to a wide range of authors, eye damage caused by diabetes mellitus accounts for 80–90 % of the total number of disorders. The development of mathematical predictive models allows for a more versatile analysis of experimental and clinical data. The purpose of the study was to develop a model for predicting the severity of diabetic retinopathy based on a review of markers of endothelial dysfunction and hypoxia. <em><strong>Materials and methods.</strong></em> We used a streptozotocin model of type 2 diabetes mellitus. Determined von Willebrand factor, endothelin-1, 2,3-diphosphoglycerate are used as variables. Also, the transition of the non-proliferative phase of diabetic retinopathy into the proliferative on the 180th day of the experiment was confirmed histologically.<em><strong> Results.</strong></em> We have developed a mathematical model for predicting the studied pathological state based on biochemical blood tests at the early stages of the experiment. We have proven the informative value of endothelial dysfunction markers, von Willebrand factor and endothelin-1, for predicting the transition of non-proliferative diabetic retinopathy into the proliferative phase. We determined the significance of a comprehensive analysis of the level of 2,3-diphosphoglycerate in erythrocytes together with the above markers of the functional status of the endothelium on day 30 for predicting the further course of the disease. <em><strong>Conclusions.</strong> </em>We determined the effectiveness of a comprehensive analysis of the level of 2,3-diphosphoglycerate in erythrocytes together with the above markers of the functional status of the endothelium on day 30 for predicting the further course of the pathological process under study.</p> Ya.V. Sirman, I.V. Savytskyi, N.I. Preys Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Clinical and diagnostic aspects of testosterone deficiency in women of fertile age <p><em><strong>Background.</strong> </em>The role of androgens in a woman has not been fully appreciated. Currently, there is no clear and gene­rally accepted definition of the concept of androgen deficiency in women by analogy with that in men. The purpose of the study was to investigate the clinical and diagnostic aspects of testoste­rone deficiency in women of fertile age. <em><strong>Materials and methods.</strong></em> The study included 60 women with testosterone deficiency without other concomitant pathology. The average age of the patients was 28.3 years. The control group consisted of 20 healthy women. The patients were divided into three groups based on their body mass index (BMI). The first group consisted of 20 overweight women (BMI 25–29.9 kg/m2), the second group — 20 women with first-degree obesity, and the third group — 20 women with second-degree obesity. <em><strong>Results.</strong></em> On the 14th day of the ovarian-menstrual cycle, the patients from the first group showed a tendency towards a decrease in the basal levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and progesterone against the background of significant hypoandrogenaemia. Patients with obesity (II degree) showed a significant decrease in basal levels of LH, FSH, estradiol, progesterone against the background of significant hypoandrogenaemia. The correlation analysis revealed a direct relationship between testosterone deficiency and obesity. Thus, the lowest testosterone values were found in patients of the third group (&lt; 0.05 nmol/l). At the same time, the testosterone level in the patients of the first and second groups was also significantly reduced — from 0.02 to 0.05 nmol/l, respectively. The levels of dehydroepiandrosterone and 17-hydroxycorticosteroids were significantly reduced, especially in the third group — 0.3 μg/ml and 0.1 nmol/l, respectively. <em><strong>Conclusions.</strong></em> Most women of reproductive age with testosterone deficiency have hypomenorrhea with low free testosterone. A direct correlation was established between testosterone deficiency and the degree of obesity in women with androgen deficiency.</p> Z.Yu. Khalimova, A.A. Almakhmatova Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Assessment of the prognostic cancer risk in patients with type 2 diabetes mellitus <p><em><strong>Background.</strong> </em>The epidemiological analysis has shown an increased risk of cancer of the mammalian gland (MG), ute­rine body, and pancreas in patients with type 2 diabetes mellitus (T2DM). The different clinical characteristics and features of the course of DM, and schemes of treatment of patients with these types of oncological diseases (OD) were identified. The purpose of the study was to create a model of mathematical calculation and assessment of the predicted risk of cancer of MG, uterine body, pancreatic and colorectal cancer (CRC) in patients with T2DM, given the importance of diabetes-associated factors of oncogenesis. <em><strong>Materials and methods.</strong> </em>The study included an analysis of medical records of patients with T2DM with first diagnosed OD during 2012–2016. The statistical analysis of the results was performed in the program Statistica 12.0 (StatSoft Inc., USA). The differences between indicators were determined by Student’s t-test, considered significant at p &lt; 0.05. The method of multi-factor analysis and the logistic regression equation was used to calculate the coefficient of prognostic risk of the OD. <em><strong>Results.</strong></em> It was found that cancer of MG and the uterine body was most often diagnosed in people at the age of 60–70 years, with obesity, duration of DM more than 5 years, with HbA1c level &gt; 7.5 %, on combination therapy with drugs without influence on the insulin synthesis with stimulators of insulin production. Patients with CRC had the same characteristics, without gender diffe­rences. Pancreatic cancer was most often diagnosed in patients aged 60–70 years, without obesity, with a duration of DM up to 5 years, with HbA1c &gt; 7.5 %, on monotherapy with insulin or sulfonylureas, without gender differences. The created model for calculating the coefficient of the prognostic risk of MG and uterine body cancer is characterized by high prognostic power (accuracy 76.24 %), good prognostic power for cancer of the pancreas (accuracy 75.0 %), and CRC (accuracy 72.2 %). <em><strong>Conclusions.</strong> </em>Correction of dysmetabolic disorders is a method of prevention of OD in patients with T2DM. The calculation of the predicted cancer risk will contribute to the prevention of malignant neoplasms in patients with T2DM.</p> T.S. Vatseba, L.K. Sokolova, N.M. Koshel Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Social and hygienic characteristics of children from the iodine deficiency region <p><em><strong>Background.</strong> </em>Determining the social and hygienic patterns of children’s health is an important scientific and methodological task of pediatrics, the solution of which makes it possible to manage health processes. Natural factors that affect health include iodine deficiency in environmental components. Nowadays in 19 countries, including Ukraine, the issue of iodine deficiency remains relevant. The purpose was to analyze social and hygienic factors in schoolchildren from the iodine deficiency region. <em><strong>Materials and methods.</strong></em> A survey of schoolchildren (n = 1,973) and their parents (n = 655) was conducted, we have examined 397 children aged 10–12 years from 7 districts of the Chernivtsi region. The concentration of inorganic iodine in a single urine portion was determined in 197 children, salt samples were tested using a rapid test. Results. In 2017, 56.1 % of parents-respondents did not know about the problem of iodine deficiency, and in 2019 — 28.2 %. Out of 397 salt samples taken from households, the presence of iodine was found in 133 (33.5 %) and 45 (41.3 %) of 109 samples taken from trade establishments. Of 509 samples labeled as iodized salt, only 35 % contained iodine and 65 % did not meet the requirements. The hygienic assessment of the balance of children’s diet revealed significant violations that may contribute to the development of iodine deficiency. Of 1,973 respondents, 15.7 % eat natural products. A disharmonious style of family upbringing dominated, which changes the emotional and mental state of a child. The median ioduria in the examined population is in general 58.1 ± 3.2 μg/l, the frequency of goiter among prepubertal children of Bukovinian region is 17.2 %. Two or more concomitant diseases, asthenic, neurotic and affective disorders were detected in 75.5 % of schoolchildren. <em><strong>Conclusions.</strong> </em>Low public awareness, sale of iodized salt on the consumer market, which does not meet hygienic standards for iodine content, low motivation to use iodized salt on the background of iodine deficiency, even mild, are additional risk factors for iodine deficiency in schoolchildren of Chernivtsi region.</p> T.V. Sorokman, M.I. Bachu Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Vitamin D: new aspects of application, effective doses. The current state of the problem <p>In addition to the classic role of vitamin D in maintaining the normal state of the musculoskeletal system in the last decade, there is evidence that reduced serum concentrations of 25(OH)D are associated with a number of extraskeletal diseases (diabetes mellitus, hypertension, thyroid diseases, age-related cognitive decline, dysfunction of the immune and reproductive systems, etc.). Prevention of these diseases is achieved with significantly higher concentrations of 25(OH)D in the serum than those necessary to maintain normal bone tissue, regulate absorption and maintain calcium homeostasis. To ensure the concentration of the circulating form of vitamin D — 25(OH)D in the serum at a level that ensures optimal functioning, you need a higher consumption of this vitamin. Decreased blood concentration of vitamin D (&lt; 30 ng/ml) is observed in 92 % of the adult population of Ukraine, regardless of the season. The causes of vitamin D deficiency are the low efficiency of its endogenous synthesis in the skin due to insufficient insolation and inadequate intake of this vitamin with food. Due to the half-life of vitamin D of about two months, periodic weekly or monthly intake of total doses of cholecalciferol provides the same values in the serum as daily intake. The review of the lite­rature considers the importance of vitamin D deficiency and deficiency in disorders of many systems of the human body and the development of various pathological conditions, which justifies the wider use of methods to correct the status of vitamin D. Despite the need for large-scale randomized clinical trials to determine the use of vitamin D, now there is no doubt that the normalization of the level of 25(OH)D in the serum is required at all age stages of ontogenesis.</p> I.V. Pankiv Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Diabetes mellitus and chronic coronary syndrome <p>Chronic coronary syndrome is characterized by the development of episodes of ischemia due to an imbalance between needs and blood supply to the myocardium. Such episodes are usual­ly provoked by physical or emotional stress or other stressful situations, but can also occur spontaneously. Angina attacks are a classic manifestation of myocardial ischemia. In some cases, the disease may be asymptomatic for a while and begin immediately with acute coronary syndrome. Chronic coronary syndrome may have a long preclinical period on the background of confirmed coronary athe­rosclerosis. This review analyses the relevant data about the current state of the problem of diabetes mellitus and chronic coronary syndrome. In particular, the issues related to the peculiarities of risk assessment, the main factors causing a very high risk of atherosclerotic cardiovascular diseases; classification, the main characteristics of chronic coronary syndrome and its features in diabetes mellitus; diagnosis of chronic coronary syndrome (dosed physical acti­vity — bicycle ergometry, treadmill test, or stress tests; single-photon emission computed tomography, stress echocardiography; stress cardiac magnetic resonance imaging, positron emission tomography ­using radioactive tracers) were considered. Features of conservative therapy for chronic coronary syndrome against the background of diabetes mellitus (prescription of antiplatelet agents, β-adrenergic receptor blockers, calcium channel blockers, nitrates, angiotensin-converting enzyme inhibitors, myocardial cytoprotectors, statins) were analyzed. Treatment of a patient with a combination of diabetes mellitus and chronic coronary syndrome will be successful only if adequate antidiabetic therapy that is safe in terms of hypoglycemia and possible cardiovascular risks, on the one hand, and metabolically neutral antianginal therapy, on the other, is prescribed. Undoubtedly, it is necessary to pay attention to the correction of risk factors for cardiovascular diseases, hypertension and chronic heart failure.</p> V.A. Serhiyenko, A.A. Serhiyenko Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Polypharmacy in elderly people: epidemiology, consequences and prevention strategies <p>Aging is a status often associated with multiple comorbidities which require pharmacologic intervention and complex medication regimens. Aging population results to the increase of chronic diseases and subsequent comorbidities that require concomitant multiple medications. It is reported that about 80 % of elderly have at least one chronic condition, and about half of them have at least two (such as heart disease, hypertension, diabetes mellitus, arthritis, and cancer). According the literature the worldwide polypharmacy prevalence has a wide range (between 5 to 78 %) due to different definitions on the number of medications taken (ranging between 2 and 9) and the different samples studied. In most studies polypharmacy was more common between women and in more elderly people. Many multicenter studies have been performed to define the term of polypharmacy and its prevalence in the elderly population. Polypharmacy is of growing concern for the older adults, because it can be very dangerous for this population due to altered absorption, distribution, metabolism and excretion of the drugs within their body reflecting unexpected pharmacokinetics and pharmacodynamics of various medications. This fact can lead to adverse drug reactions (ADR), drug interactions, noncompliance and reduced adherence, reduced functional status, geriatric syndromes, high risk of hospitalization and possible death. Over the last decade, there are several evaluation tools which can help the General Practitioner prevent the polypharmacy in the elderly. As prescribing for this group of individuals is a very challenging procedure, the General Practitioner should balance between under-treatment, over-treatment and risks and benefits. This review concluded that we need more cross-sectional clinical studies on practical preventive interventions to be applied not only on the population which is already exposed to polypharmacy, but also to the general population.</p> Eirini Kotsalou Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 The impact of vitamin D deficiency on maternal outcomes in pregnancy <p>Results show vitamin D supplementation during pregnancy improves maternal and infant 25(OH)D concentrations and may play a role in maternal insulin resistance and fetal growth. Literature search was performed using PubMed Database of the National Library of Medicine, with date limits from January 2015 to November 2020. We used the keywords: Vitamin D, pregnancy, vitamin D supplementation, hypovitaminosis D, preeclampsia, gestational diabetes, preterm birth, and other related terms. The studies of interest included original papers and review articles on the influence of vitamin D deficiency in pregnancy and the impact of vitamin D supplementation on the maternal outcomes. The published Cochrane review on vitamin D supplementation studies reported that women who receive vitamin D supplementation had lower risk of preeclampsia but with only borderline significance (RR 0.52, CI 0.25–1.05), whereas combined vitamin D and calcium supplementation significantly reduces the risk of preeclampsia. The overall level of evidence is high for vitamin D supplementation playing no role in the prevention of gestational diabetes. Although analysis of the recent observational studies suggests that vitamin D deficiency can increase the risk of C section, there is a need for investigators to conduct RCT to study the impact of vitamin D supplementation on C-section rates. Maternal vitamin D status closest to the delivery was most significantly associated with preterm birth, thereby proposing that later intervention could be used as a rescue treatment to decrease the risk of preterm deliveries. Though the level of evidence is moderate, our analysis shows no significant association between vitamin D and preterm deliveries. Many studies have been designed to investigate an association between postpartum depression and vitamin D. To determine the benefits of vitamin D supplementation in pregnancy would require further evaluation through large, multicenter double-blind randomized controlled clinical trials, with a focus on specific adverse pregnancy outcomes.</p> A. Konwisser, O. Korytko Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Gynecomastia: modern ideas and approaches to treatment <p>A literature review is devoted to the benign growth of glandular tissue of the breast in men. The prevalence of gynecomastia reaches 32–65 % depending on age and the criteria used to determine. Gynecomastia in childhood and during puberty is considered a benign condition, which in most cases passes spontaneously. Gynecomastia in adulthood is more common in the elderly, and targeted examination can reveal the underlying pathology in 45–50 % of cases. Today, most causes of gynecomastia remain unclear and are discussed at the hypothesis level. The tissue of the mammary glands is laid equally regardless of the sex of a child. The development of the mammary glands depends on the androgen-estrogen ratio (AER). With the predominance of estrogens during puberty and low androgen activity, the breast tissue develops and differentiates by the female type. At the return AER, breast tissue does not develop. The possibility of endocrine or systemic disease should be considered. It is usually sufficient to determine basal levels of testosterone, estradiol, luteinizing hormone, and follicle-stimulating hormone. With simple adolescent gynecomastia, there are no permanent hormonal changes. It is important to assess the degree of overall androgenization of the patient. Laboratory tests (clinical, biochemical, hormonal) should correspond to the specific clinical condition of each patient. The effectiveness of therapeutic treatment of gynecomastia in patients without obvious endocrine disorders with the use of hormonal drugs (testosterone, dihydrotestosterone) as well as tamoxifen, danazol, clomiphene should be considered unproven. Surgical treatment is recommended only for patients with prolonged gynecomastia, which does not regress spontaneously or after drug therapy. The extent and type of surgery depend on the size of the breast augmentation and the amount of adipose tissue.</p> M.A. Zaitsev Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000 Clinical case of gestational diabetes insipidus <p>Diabetes insipidus is a rare endocrinological disease and occurs in 2–4 per 100,000 pregnancies. Diagnosis of gestational diabetes insipidus is very difficult because it develops against the background of physio­logical mechanisms that accompany pregnancy: thirst threshold decreases leading to polydipsia and plasma osmolarity decreases causing hypotonic polyuria. Understanding of pathophysiology of the disorder is very important for further management of these vulnerable patients. A 32-year-old patient at 36 weeks of gestation, primigravida, was referred to an endocrinologist with complaints of polyuria (6.5 l/day), nocturia — up to 5 times, severe polydipsia. At 12 weeks of gestation, there was a risk of abortion for prevention of which the patient received progesterone 100 mg intravaginally twice a day until 34 weeks. She has a history of subacute thyroiditis, with no family history of endocrine pathology. Physical examination revealed a decrease in skin turgor, blood pressure 110/85 mm Hg. Heart rate 115 bpm, weight 71 kg (body mass index 26.9 kg/m2). The patient was at high risk of developing preeclampsia. Laboratory data: analysis of urine according to Zimnitsky: volume per day — 6.8 l, specific gravity in portions: 1.012; 1.008; 1.010; 1.005; 1.012; 1.014; 1.010. Total blood count, total urine test, serum sodium and potassium, liver function tests, level of thyroid-stimulating hormone, free thyroxine, thyroid peroxidase antibodies and morning free cortisol level were normal. The patient was administered desmopressin 10 μg intranasally twice daily. Six weeks after delivery, desmopressin was stopped and she had no further evidence of polyuria, polydipsia or nocturia.</p> N.O. Abramova, N.V. Pashkovska, N.I. Stankova, M.S. Khangarot Copyright (c) 2021 Tue, 13 Apr 2021 00:00:00 +0000