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Introduction. Nodular goiter is one of the most common endocrine disorder, and thyroid cancer takes a leading place among malignancy of the endocrine system. The aim of our study is to evaluate the prevalence and risk factors of thyroid cancer. Materials and methods: this is a retrospective case-control study that included 140 patients operated with suspected thyroid cancer according to a cytological study of fine needle aspirates in single center in 2018. All patients underwent preoperative cytological examination with interpretation of the results according to the Bethesda system, thyroid ultrasound examination, thyroid status assessment. The results of the cytological examination, as well as clinical and laboratory data were compared with the data of histological analysis. Results: According to the preoperative cytological study, 76 nodules were reported as Bethesda IV, 4 – Bethesda III, 32 – Bethesda VI, 28 – Bethesda V. According to the results of a histological examination, thyroid cancer was confirmed in 70% of patients: in 89,3% of Bethesda V and 100% in the Bethesda VI group, 52,6% of Bethesda IV, 25% of the Bethesda III. The risk of nodule malignancy was associated with such ultrasound signs as hypoechoicity, calcifications and irregular contours. Conclusions: the improvement of the methods of preoperative diagnosis of thyroid cancer should help to choose the optimal surgical strategy, reduce the number of diagnostic and repeated thyroidectomy.

Thyroid cancer is the most common malignant tumor of the endocrine system. An increase in the incidence of thyroid cancer has been noted over the past decade, mainly due to papillary cancer. The influence of environmental factors, increased availability of medical care, including sensitive diagnostic tests, such as ultrasound and fine - needle aspiration (FNA), can affect the fact of the growth of this incidence. Palpation of thyroid gland has very low diagnostic value for detecting thyroid cancer, while thyroid ultrasound and FNA can detect malignant tumors in 20% of cases. Today, the FNA is the fastest, most accurate, economically accessible, and quite safe method for cytological diagnosis of the thyroid nodules. And molecular genetic testing of FNA samples could serve as an additional reliable diagnostic tool in the case of atypia of undetermined significance.Рак щитовидной железы (ЩЖ) является наиболее распространенной злокачественной опухолью эндокринной системы; за последние десятилетия отмечен рост заболеваемости данной патологией, преимущественно за счет папиллярного рака. Влияние факторов внешней среды, повышение доступности медицинской помощи, в том числе чувствительных диагностических тестов, таких как УЗИ и тонкоигольная аспирационная биопсия (ТАБ), могут повлиять на факт роста данной заболеваемости. Диагностическая ценность пальпации ЩЖ для выявления рака очень низкая, в то время как УЗИ ЩЖ и ТАБ позволяют выявить злокачественные образования в 20% случаев. На сегодняшний день ТАБ узла является наиболее быстрым, точным, экономически доступным и достаточно безопасным методом цитологической диагностики природы узловых образований ЩЖ на дооперационном этапе. С целью унифицирования результатов цитологического исследования в 2009 г. представлена система Bethesda для оценки результатов цитологического исследования ЩЖ. Молекулярно - генетическое тестирование образцов ТАБ может служить дополнительным надежным диагностическим критерием в случае образцов с неопределенным цитологическим диагнозом.

Diabetes mellitus (DM) and heart failure (HF) are frequent comorbidities with a bidirectional relationship. Patients with HF have increased risk of developing DM, and those with DM are at greater risk of developing HF. HF does not fit clearly into the microangiopathy and macroangiopathy groups. It is known that coronary artery disease and arterial hypertension are the major causes of HF; however, it has been shown that DM can trigger functional and structural abnormalities in the myocardium via diabetic cardiomyopathy, a condition with either restrictive or dilated phenotype. While HF treatment is equally effective and safe in patients with and without DM, this statement is not applicable for antidiabetic treatment. Several antidiabetic drugs, such as rosiglitazone, pioglitazone and saxagliptin increase the risk of hospitalisation for HF, therefore these antidiabetic drugs are contraindicated in patients with DM and HF or patients at risk of developing HF. Despite a large number of clinical evidence, uncertainty about the safety of antidiabetic drugs in patients with HF always exists. In this review, the issues of DM treatment in patients with HF are addressed in detail.

Aim. To analyze the association between the polymorphic markers in CTLA4, TNF, IL10 and IL16 genes and the risk of manifestation of endocrine ophthalmopathy (EO) in patients with Graves’ disease (GD). Materials and methods. Case-control study included 248 patients with GD. Using polymerase chain reaction we studied the distribution of alleles and genotypes of polymorphic markers such as A60G (rs3087243) in CTLA4 gene, G(-308)A (rs1800629) in TNF gene, G(-1082)A (rs1800896) in IL10 gene, T3249C (rs4778641) in IL16 gene among 141 patients with Graves’ disease and EO and 107 patients with GD without EO. Results and discussion. The frequencies of A alleles and the AA genotypes were significantly increased and the frequencies of G alleles and the GG genotype polymorphic markers rs3087243 of CTLA4 gene and rs1800896 of IL10 gene, as well as the GG genotype polymorphic marker rs1800629 of TNF gene were reduced in patients with GD and EO. The polymorphism in CTLA4 gene was also associated with the activity and the severity of EO. The comparative analysis of the allele and genotype frequency distribution of polymorphic markers of IL16 gene did not show the significant difference. Conclusion. The risk of manifestation and the development of EO in patients with Graves’ disease can be caused by not only environmental, but also genetic risk factors.

For the past several years, a number of studies addressed glucagon and its role in glycemic homeostasis and the development of diabetes mellitus.Current review discusses basic developmental stages of pancreatic islets with special regard for the role of beta-cells and basic mechanisms of glucagonfunction. We also highlight promising approaches to diabetes compensation based on adjustment of glucagon secretion.

The issues pertaining to etiology, pathogenesis, clinical manifestations, and treatment of endocrine ophthalmopathy (EOP) are discussed. EOP is a heterogeneous autoimmune eye disease most frequently associated with Graves’ disease even though it is just as well encountered both in the patients presenting with chronic autoimmune thyroiditis and in the absence of thyroid dysfunction. Although pathogenesis of EOP remains to be elucidated its autoimmune nature with the involvement of sensitized T-lymphocytes and autoantibodies against orbital tissues leaves no doubt. The understanding of mechanisms underlying the development of EOP gave impetus to the creation of new groups of medicines selectively acting on various pathogenic processes associated with this disease. The management of EOP remains a challenging problem requiring a multi-disciplinary approach for its solution.

To analyze the associations of the rs3087243 CTLA4 polymorphism and the rs1800629 TNF polymorphism with endocrine ophthalmopathy (EOP) in ethnic Russian patients with Graves' disease (GD).The case-control study enrolled 205 patients with GD. The distribution of alleles and genotypes of the rs3087243 CTLA4 and rs1800629 TNF polymorphisms was studied in 141 patients with GD and EOP (a GD+EOP group) and 64 patients with GD without EOP (a GD-EOP group). The polymorphic alleles were identified by polymerase chain reaction-restriction fragment length analysis.The patients with GD in their history and EOP had significantly higher frequencies of A allele and AA genotype and a lower proportion of G allele and GG genotype of the rs3087243 CTLA4 polymorphism. Comparative analysis revealed no significant differences in the frequency of the alleles and genotypes of the rs1800629 TNF polymorphism.The rs3087243 CTLA4 polymorphism is associated with the risk of EOP in ethnic Russian patients with GD.Цель исследования. Анализ ассоциаций полиморфного маркера rs3087243 гена CTLA4 и полиморфного маркера rs1800629 гена TNF с эндокринной офтальмопатией (ЭОП) у пациентов русского происхождения с болезнью Грейвса (БГ). Материалы и методы. В исследовании случай-контроль включили 205 пациентов с БГ. Изучали распределение аллелей и генотипов полиморфных маркеров rs3087243 гена CTLA4 и rs1800629 гена TNF у 141 пациента с БГ и ЭОП (группа БГ+ЭОП) и 64 пациентов с БГ без ЭОП (БГ-ЭОП). Аллели полиморфных маркеров идентифицировали методом полимеразной цепной реакции с последующим анализом длин рестриктазных фрагментов. Результаты. У пациентов с БГ в анамнезе и ЭОП достоверно повышены частоты аллеля А и генотипа АА и снижена доля аллеля G и генотипа GG полиморфного маркера rs3087243 гена CTLA4. Сравнительный анализ частот аллелей и генотипов полиморфного маркера rs1800629 гена TNF достоверных различий не выявил. Заключение. Полиморфный маркер rs3087243 гена CTLA4 ассоциирован с риском развития ЭОП у пациентов с БГ русского происхождения.

Objective: to assess hormonal and metabolic parameters and psychological status of young men with obesity. Methods: The study included 60 men with obesity (BMI>30 kg/m2) divided in two groups. Patients in the first group (n=30) received orlistat for 12 weeks (120 mg 3 times daily with meal). Patients in second group (n=30) followed hypocaloric diet and aerobic exercise. All patients were examined before treatment and after 12 weeks. Evaluation included hormonal and biochemical analyses, 48 patients were examined by psychological questionnaires (Beck Depression Inventory, Beck Anxiety Inventory, Liebowitz Social Anxiety Scale, Dutch Eating Behavior Questionnaire). Results: Patients that received orlistat treatment showed significant decrease of body mass: 50% of patients had decrease more than 5%, 30% of patients - more than 10% (p

The review presents a recent data from the literature on the physiologic and pathophysiologic role of adipose tissue hormones (adiponectin, resistin, leptin). The article details the role of adipocytokines in atherogenesis. It also presents the results of studies depicting the relationship between subclinical hypothyroidism, lipid metabolism and insulin resistance as well as the impact of thyroid dysfunction upon the secretion of adipocytokines.

This article describes the case of a young woman with autoimmune polyglandular syndrome type 2, presented by the primary adrenal insufficiency and thyroid dysfunction. In the course of the disease there was a change of the thyroid functional activity from hypothyroidism to hyperthyroidism, which led to adrenal insufficiency decompensation.