Publisher: Bukovinian State medical University (Total: 2 journals)   [Sort alphabetically]

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Intl. J. of Endocrinology     Open Access   (Followers: 1)
Clinical Anatomy and Operative Surgery     Open Access   (Followers: 1)
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International Journal of Endocrinology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2224-0721 - ISSN (Online) 2307-1427
Published by Bukovinian State medical University Homepage  [2 journals]
  • Appeal of Editor-in-Chief

    • Authors: V.I. Pankiv
      Pages: 85 - 85
      Abstract: No abstract
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1150
      Issue No: Vol. 18, No. 2 (2022)
       
  • Neutrophil to Lymphocyte ratio is significantly reduced after Sodium
           glucose cotransporter-2 inhibitor treatment in patients with type 2
           diabetes mellitus

    • Authors: Ozge Kurtkulagi
      Pages: 86 - 89
      Abstract: Background. Sodium glucose cotransporter-2 inhibitors (SGLT2i) are novel therapeutic agents that became available in the treatment of type 2 diabetes mellitus (T2DM). This group of antidiabetic agents are associated with reduced glycated hemoglobin (HbA1c), fasting glucose, body weight and body mass index (BMI) in diabetic patients. All those beneficial effects may also be associated with a reduction in inflammatory burden. The purpose of the study is to compare neutrophil to lymphocyte ratio (NLR), a novel inflammatory marker derived from hemogram, before and 6 months after SGLT2i treatment in diabetic subjects. We also aimed to compare fasting glucose, HbA1c and other metabolic parameters as well as anthropometric measures (weight, BMI) before and 6 month after initiation of SGLT2i therapy. Materials and methods. The subjects with type T2DM that show up in internal medi­cine outpatient clinics of Abant Izzet Baysal University Hospital between January 2021 and December 2021 were enrolled to the study. Pretreatment and posttreatment NLR and other parameters were compared. We also obtained pretreatment and posttreatment laboratory data including urea, creatinine, fasting glucose, HbA1c, glomerular filtration rate, aspartate and alanine transaminases, plasma sodium and potassium. Results. Fasting glucose was reduced from 195 ± 72 mg/dl in pretreatment period to 146 ± 53 mg/dl in posttreatment period (p < 0.001). HbA1c was reduced from 9.1 ± 1.7 % in pretreatment period to 7.7 ± 1.7 % in posttreatment period (p < 0.001). The NLR before treatment was 2.6 ± 1.2 % before SGLT2i treatment and was reduced to 2.2 ± 0.6 % in 6th month of SGLT2i therapy. NLR was significantly decreased after treatment (p = 0.003). Conclusions. We suggest that NLR levels could be a marker of reduced inflammatory burden in T2DM subjects receiving SGLT2i treatment.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1151
      Issue No: Vol. 18, No. 2 (2022)
       
  • Primary hyperparathyroidism: optimize the detection and monitoring
           (organizational aspects)

    • Authors: O.A. Goncharova, V.M. Dubovik, I.V. Chernyavska
      Pages: 90 - 93
      Abstract: Background. The relevance of the study is due to the fact that undiagnosed primary hyperparathyroidism (PHPT) significantly increases the risk of osteoporosis and fractures, nephrolithiasis and renal failure, reducing the quality of life of patients. All this necessitates the improvement of the organizational system of disease detection and monitoring. The purpose of the study was to assess the incidence of hypercalcemia (HCa) in patients with endocrine disorders and to determine the sex and age composition in the subgroup with HA. Materials and methods. The frequency of HCa (by total calcium and ionized calcium levels) in 107 patients with endocrine pathology examined in endocrine clinic during November and December 2021 was determined, gender and age characte­ristics, the nature of endocrine pathology in the subgroup with HCa were characterized. The level of total calcium was determined by photocolorimetric method using a photometer ”Solar PM 2111“, set ”SpL“ (Ukraine), the level of ionized calcium was determined by a calculated method depending on the concentration of albumin. Results. Among patients with endocrine pathology, HCa occurs in approximately 30 % of cases. The ratio between men and women is similar in the subgroups with normo- and hypercalcemia. The presence of endocrine comorbidity in patients increases the risk of HCa. The obtained results show that the existing organization of work in Ukraine to identify and monitor patients with HCa needs to be optimized. As a sample, we can use the conceptual model of action of a primary care physician developed by American authors, aimed at optimizing the work on the detection and monitoring of PHPT. Conclusions. For Ukraine, the problem of improving the organizational system for detection and monitoring of HCa, which should include deadlines for monitoring blood calcium le­vels, periodicity of research, further monitoring of people with HCa, provide communications to primary and specialized physicians.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1152
      Issue No: Vol. 18, No. 2 (2022)
       
  • Screening of metabolic syndrome in children and adolescents

    • Authors: N.M. Gromnatska, B.B. Lemishko, O.O. Kulya, I.O. Pasichna, V.M. Beliusova
      Pages: 94 - 99
      Abstract: Background. Metabolic syndrome (MS) is perceived as a cluster of risk factors for cardiovascular disease and type 2 diabetes. The prevalence of MS in children and adolescents rea­ches 6–39 % depending on the identification criteria. Despite the considerable attention paid to MS in children and adolescents, there is no unified agreed consensus on its early scree­ning. Consequently, the purpose of the study was along with the gene­rally accepted criteria evaluate additional markers for MS early screening in children and adolescents. Materials and methods. A cross sectional study was conducted with 155 children aged 9–18 years, which formed 2 groups: a group of children with MS — 90 children with MS on the background of abdominal obesity and a group of children without MS — 65 children with normal body weight. Clinical (antrometric data, blood pressure) and laboratory (fasting glucose, fasting insulin, lipids) parameters were assessed. MS verification was performed according to the recommendations of the IDF Сonsensus (2007). Results. For MS screening in addition to the generally accepted criteria accor­ding to IDF Consensus (2007): abdominal obesity (waist circumference > 90th percentile according to age and gender), fasting glucose > 5.6 mmol/l, triglycerides > 1.7 mmol/l, blood pressure > 130/85 mm Hg, the most probable additional markers were established: neck and hip circumference, waist/hip ratio, body surface area > 90th percentile of distribution according to age and sex, fasting insulin > 15.0 mU/l, homeostasis model assessment for insulin ratio (HOMA-IR) > 2.8, total cholesterol > 5.2 mmol/l, LDL-C > 3.25 mmol/l, VLDL-C > 0.78 mmol/l, blood pressure in terms of distribution > 95th percentile, which contributes to its early detection and correction. Conclusions. Expanding the list of MS additional markers for its early screening in the pediatric and adolescent population is relevant and provides a basis for its timely correction and prevention.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1153
      Issue No: Vol. 18, No. 2 (2022)
       
  • Melatonin in the saliva of adolescent girls with polycystic ovary syndrome

    • Authors: T.V. Sorokman, O.V. Makarova, V.G. Ostapchuk
      Pages: 100 - 103
      Abstract: Background. The formation of polycystic ovary syndrome (PCOS) and the manifestation of its clinical manifestations often begin in adolescence. In recent years, one of the new and modern areas in the study of reproductive dysfunction is the problem of melatonin on the gonadotropic function of the pituitary gland (ovariogenesis). The purpose of the study was to determine the level of melatonin in the saliva of adolescent girls with PCOS. Materials and methods. A single-center prospective simple randomi­zed study was conducted with 23 patients aged 14–18 years (inclusive) with PCOS. The control group consisted of 25 girls of the same age without gynecological status violations. Determination of melatonin levels in saliva was performed by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS). Before salivation during the day and throughout the saliva collection period, patients excluded caffeine, alcohol, and exercise, did not smoke for one hour before collection, did not brush their teeth, did not floss, rinsed their mouths, and did not chew gum. Results. There were no significant differences in the age of the girls in the main group and the comparison group (16.70 ± 0.11 years in the main group and 16.90 ± 0.14 years in the comparison group, p > 0.05). The most common symptoms of PCOS in girls were: hypomenstrual syndrome (86.9 %), dermopathy (82.6 %) and hirsutism (60.8 %). Girls with PCOS had significantly higher melatonin levels in saliva (03:00) (28.89 [18.17; 46.53] pg/ml) compared to girls in the comparison group (12.07 [11.56; 16.27] pg/ml, p < 0.01). A pro­bable difference in melatonin levels in saliva depending on age has not been established. Conclusions. The results of the study indicate a violation of hormonal balance in polycystic ovary syndrome, in particular an increase in melatonin levels, which indicates the need to determine it in the process of diagnosis and treatment.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1154
      Issue No: Vol. 18, No. 2 (2022)
       
  • Magnesium deficiency in type 2 diabetes mellitus and its effect on blood
           glucose control and diabetes complications

    • Authors: Savas Karatas, Yalcın Hacıoglu, Şennur Kose
      Pages: 104 - 108
      Abstract: Background. Diabetes has become more often in all over the world, magnesium is an essential element of the body and has lots of vital functions. There has been a trend to investigate magnesium’s effect on type 2 diabetes pathogenesis and its complications. Still, more data is needed to reveal magnesium and T2 diabetes mellitus (DM) association, therefore we aimed to investigate how common magnesium deficiency in Turkish T2DM patients, and its effect on diabetes control and diabetes complications. Materials and methods. 296 patients with type 2 DM and 96 healthy controls aged between 18–65 years were enrolled in the study. After exclusion criteria, T2DM patients were divided into 2 groups according to magnesium deficiency, metabolic and physical properties of the groups were compared. Also, hypertension, metabolic syndrome, coronary artery disease, and microalbuminuria were also compared according to magnesium deficiency. Results. Magnesium deficiency was found 35.5 % (86/242) in patients with type 2 DM, 4.1 % (4/96) in the control group. Magnesium deficiency was more in female patients (64/86, 74.4 %), male patients had more normal magnesium levels 89/166, 53.6 %) (p < 0.01). Hypomagnеsemia patients with T2 DM didn’t show difference in HbA1c (9.0 ± 1.9 % vs 8.8 ± 1.6 %, p = 0.35), and fasting blood glucose levels (197.24 ± 87.25 vs 177.85 ± 57.22 mg/dl, p = 0.14). Hypomagnеsemia patients with T2DM had significantly higher hyperlipidemia levels (48.8 % (42/86) vs 41.0 % (64/156), p = 0.04). Metabolic syndrome (89.0 % (73/82) vs 83.1 % (123/148), p = 0.22) and coronary artery syndrome (39.5 % (34/86) vs 35.9 % (56/156), p = 0.85) didn’t differ between groups. Hypertension (81.4 % (70/86) vs 67.9 (60/156), p = 0.04) and microalbuminuria (66.7 % (38/57) vs 43.7 (58/119), p = 0.03) were significantly higher in the hypomagnеsemia T2DM group. Conclusions. Magnesium deficiency is not rare in T2DM, however, this deficiency didn’t impact blood glucose control at a significant level in current study, on the other hand, hypertension, microalbuminuria, and hyperlipidemia components of diabetes have been shown to increase with magnesium deficiency.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1155
      Issue No: Vol. 18, No. 2 (2022)
       
  • Modern views on the metabolism and biological effects of vitamin D

    • Authors: S.M. Tkach, V.I. Pankiv, I.V. Pankiv
      Pages: 109 - 117
      Abstract: Vitamin D is a steroid hormone that plays a crucial role in maintaining normal bone condition and calcium homeostasis. In recent years, vitamin D has become a hot topic of endocrinological research, largely Due to the COVID-19 pandemic and the likely correlation between hypovitaminosis D and a high risk of chronic lung disease and associated mortality. Recent studies have shown that vitamin D exhibits a complex multistage metabolism and acts as a hormone on many extracellular targets. This review examines some new intriguing and as yet unclear aspects of vitamin D metabolism, such as new concepts of enzyme regulation, new pleiotropic effects of vitamin D receptor activation (VDR), and epigenetic effects. The mechanisms of vitamin D synthesis in the skin, its metabolism in the hepatic cytochrome P450 system, catabolism, metabolites and transport, gene control and epigenetic modulation are considered in Detail. In addition to the well-known role of vitamin D in calcium and bone metabolism, it has many pleiotropic extraskeletal effects, including potent effects on the immune system, cardiovascular system, adipose tissue and glucose/lipid metabolism, muscle and more. Experimental studies have shown that VDRs are expressed by cancer cell lines. Recent studies have shown a link between low levels of vitamin D and almost all aspects of the metabolic syndrome, such as type 2 diabetes, fasting blood glucose, hypertension, dyslipidemia, obesity and insulin resistance. Several studies have focused on the role of vitamin D in adipose tissue biology. In particular, a negative correlation between vitamin D and leptin or resistin is shown, as well as an inverse correlation with adiponectin. Recent studies in vitamin D-deficient mice have shown impaired secretion of glucose-stimulated insulin by pancreatic islets. Vitamin D is thought to play a role in the pathogenesis and progression of cancer, and vitamin D analogues can slow cancer progression and metastasis. It is concluded that vitamin D is a molecule with several endocrine, paracrine and autocrine effects on many tissues and organs, in addition to maintaining skeletal homeostasis. Research in this area, which aims to clarify the pleiotropy of many effects of vitamin D and its metabolites, continues.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1156
      Issue No: Vol. 18, No. 2 (2022)
       
  • Aspirin resistance: causes, clinical significance, correction

    • Authors: G.F. Gendeleka, A.N. Gendeleka
      Pages: 118 - 123
      Abstract: Aspirin is the most frequently prescribed antiplatelet agent today. It exerts its antiplatelet effect by irreversible inactivation of the platelet cyclooxygenase-1, resulting in an irreversible inhibition of thromboxane-A2 formation. The clinical benefit of antiplatelet therapy with acetylsalicylic acid (ASA) in high risk patients has been convincingly demonstrated through the results of multiple placebo-controlled trials. Nevertheless, a large number of patients treated with aspirin suffers an adverse cardiovascular event. This observation led to the concept of ”aspirin resistance“. The mechanisms of aspirin resistance remain to be determined, although different theories are being discussed. Several tests are used to assess resistance to ASA in vitro. Depending on which assay is used and which population is tested, the prevalence of aspirin resistance varies between 5 % and 60 %. So far, it was not possible to define a clear gold standard for detecting aspirin resistance, which considers both, biochemical data and clinical events, and correlates them in a reproducible way. The clinical implications of aspirin resistance are well-documented through a lot of studies, which conclude that resistance to aspirin in vitro is associated with a significant increased risk for adverse cardiovascular events in cardiovascular patients. Insufficient or excessive antiplatelet effect of acetylsalicylacid may be due not only to changes in the synthesized cyclooxygenase-1, but also to changes in its amount. Literature data on the association of various polymorphic markers of candidate genes with the effectiveness of antiplatelet therapy of ASA are few and contradictory. Therefore, it is currently impossible to identify genetic predictors of the effectiveness of ASA as well as any antiplatelet agent. Continuation of research in this area in the future will predict the patient’s response to a drug and, therefore, individualize the approach to the choice and dosage of antiplatelet drugs, which will reduce the incidence of adverse reactions.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1157
      Issue No: Vol. 18, No. 2 (2022)
       
  • Selenium supplements: is it advisable to use them in treatment of
           pathology of the thyroid gland'

    • Authors: V. Katerenchuk, A. Katerenchuk
      Pages: 124 - 132
      Abstract: The article is a review of the literature in Scopus, Web of Science, MedLine and The Cochrane Library and is devoted to the analysis of the evidence base of the use of selenium supplements for the treatment of thyroid pathology. Despite the variety of thyroid pathology: changes in size and structure, hypo- and hyperfunction, autoimmune, oncopathology, there are not so many drugs used in its medical treatment. Drugs that are justified for various thyroid pathologies include iodine, levothyroxine and, to some extent, triiodothyronine, thyrostatics (methimazole, carbimazole, propylthiouracil), radioactive iodine and glucocorticoids, such as beta-blockers. Acute thyroiditis requires the appointment of antibacterial therapy, and oncopathology — specific chemotherapeutic agents, the effectiveness of which, unfortunately, is not high, and the frequency of appointment is significant. Along with these drugs, selenium drugs have become unprecedented in the last decade in thyroid pathology as a component of possible pathogenetic therapy. These drugs are prescribed to patients with diametrically opposed functional state of the thyroid gland, autoimmune patho­logy, nodules. It appears that thyroid carcinogenesis remains the only pathology where the use of selenium drugs is not recommen­ded, although there are studies that indicate a link between thyroid cancer and selenium deficiency. The results of clinical studies and meta-analyzes are provided through the prism of a survey of Italian and European endocrinologists on the appointment of selenium drugs for the treatment of relevant thyroid pathology. The lack of evidence base for the use of selenium in most types of pathology of the thyroid gland: autoimmune thyroiditis, overt and subclini­cal hypothyroidism, Graves’ disease. According to most studies, the supplementation of selenium to therapy increases its plasma level, affects the activity of selenoproteins and level of antithyroid antibodies, but in no way affects the main clinical parameters such as thyroid hormones, levothyroxine dose, clinical symptoms. In ge­neral, the use of selenium in thyroid pathology cannot be considered appropriate, except for a mild form of Graves’ orbitopathy. Signi­ficant differences in the data of clinical trials and recommendations of thyroid societies with a real frequency of selenium administration by practitioner for the treatment and prevention of thyroid pathology are indicated.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1158
      Issue No: Vol. 18, No. 2 (2022)
       
  • Hypercortisolism on the background of recovery of COVID-19 (сase
           report)

    • Authors: V. Kravchenko, O. Rakov, L.V. Slipachuk
      Pages: 133 - 137
      Abstract: Damage to the lung tissue is a predominant complication of the viral disease COVID-19. Recently, there have been complications from other organs, including highly vascularized endocrine glands. Regarding the adrenal glands, there are reports of their damage with a decrease in their function. Сhanging the function of the adrenal glands (AG) in patients with or after COVID-19 is important. A few adrenal autopsy studies in patients have revealed vascular thrombosis, cortical lipid degeneration, ischemic necrosis, parenchymal infarcts, and other lesions leading to a decrease in AG function. The central mechanism of adrenal dysfunction through hemorrhage and necrosis of the pituitary gland is also possible. This paper presents a rare case of the development of hypercortisolism in a young woman after recovering from COVID-19. Based on high ACTH levels (157 and 122 pg/ml), a negative nocturnal dexamethasone test, and high 24-hour urinary free (daily) cortisol excretion rates, we tentatively suspected Cushing’s disease. Chromogranin A was within the normal range of 21.35 (reference value < 100). Other tests showed an elevated dihydrotestosterone level of 780.6 pg/ml (reference values 24–368 pg/ml). The levels of other anterior pituitary hormones tested were within the normal range. According to clinical guidelines, the drug of choice for the short-term treatment of this disease is steroidogenesis inhibitors — ketoconazole. The effectiveness of such a treatment regimen was previously brought to light by others. In our case, ketoconazole was prescribed at a dose of 400 mg 2 times a day and cabergoline (dostinex) at an initial dose of 1 mg per day. Given the low levels of vitamin D in the blood serum, it was recommended to continue taking vitamin D at a dose of 4000 IU per day. It was recommended to control blood laboratory parameters — serum cortisol, ACTH, AST, ALT, electrolytes, 25(OH)D, blood glucose level after 2 months and decide on further tactics for managing the patient.
      PubDate: 2022-04-22
      DOI: 10.22141/2224-0721.18.2.2022.1159
      Issue No: Vol. 18, No. 2 (2022)
       
 
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