Calcitonin (CT) is a sensitive marker for medullary thyroid carcinoma. Normalization of early postoperative CT level is a favorable prognostic factor. The aim of this study was to establish the prognostic value of CT-level kinetics by preoperative tumor stage and postoperative elimination rate. Blood serum from 22 medullary thyroid carcinoma (MTC) patients without remote metastases was assayed. A commercial RIA DSL-1200 test was used to assay CT levels. Basal CT 42 pg/ml and stimulated CT 120 pg/ml were considered normal. The patients were divided into three groups according to the intensity of the postoperative CT level reduction in blood serum. Group 1 comprised patients who showed basal CT normalization within the first 2-3 days after surgery. Group 2 included those patients with slow (from 2 to 4 weeks) CT-level normalization. Group 3 included patients with CT levels that reduced within 14 days, but subsequently increased. Preoperative basal CT varies from 216 to 1654 pg/ml and depends on tumor-node-metastasis (TNM) stage. In seven patients, no basal CT decrease to normal values was observed; in five of these patients, disease recurrence was detected 2-6 months after surgery. In the group with slowly decreasing CT levels, no strong correlation between preoperative CT level and the postoperative time to normalization of basal and peak CT could be established; this may be due to the small number of patients. Our study showed that preoperative CT level depended on the disease stage. Postoperative CT elimination rate is independent of preoperative CT level. Postoperative increase in the basal or stimulated CT level is an unfavorable prognostic factor, implying disease recurrence.

BackgroundVitamin D supplements are recommended in individuals with vitamin D insufficiency and established osteoporosis to reduce risk of fracture and falling. Active vitamin D metabolites have been found to be more effective for fall prevention than native vitamin D.ObjectivesThe aim of this study was to compare the efficacy of strontium ranelate in combination with alfacalcidol and strontium ranelate alone on bone mineral density (BMD) and fall risk in postmenopausal women with osteoporosis.MethodsA total of 48 women (mean age 62.4 years) with postmenopausal osteoporosis were randomized to strontium ranelate monotherapy 2 g/day (n = 16), strontium ranelate 2 g/day plus alfacalcidol 1 μg (n = 16) or control (n = 16) and followed for 6 months. All women received calcium and vitamin D3 supplements. BMD was measured at the lumbar spine and proximal femora at the beginning and end of therapy. Patients performed functional tests such as the “up and go” and chair rising tests to estimate risk of fall status. Biochemical markers of bone turnover were also assessed.ResultsStatistically significant increases in BMD compared with baseline values and the control group were observed in both strontium ranelate treatment groups. Increases were also statistically significant in the strontium ranelate combination group compared with strontium ranelate alone. Strontium ranelate combination therapy for 6 months improved patients’ ability to perform functional tests as well as increasing the number of women capable of performing the tests. No significant changes were observed in women receiving strontium ranelate monotherapy or in the control group. Serum levels of β-CrossLaps, a marker of bone resorption, were significantly reduced compared with control in both strontium ranelate groups. A significantly greater reduction was observed in the strontium ranelate combination group compared with strontium ranelate alone (24.0 %; P = 0.008). Increases in type 1 procollagen total N-terminal propeptide (TP1NP), a marker of bone formation, reached statistical significance in both strontium ranelate groups compared with baseline.ConclusionStrontium ranelate and alfacalcidol combination therapy improves bone quality, fall risk and markers of bone turnover to a greater extent than strontium ranelate alone in patients with established osteoporosis.

Актуальність. Незважаючи на проведені заходи, що спрямовані на ліквідацію йодної недостатності, Республіка Узбекистан (РУз) залишається зоною значної поширеності йододефіцитних захворювань. Мета дослідження — вивчення динаміки поширеності йододефіцитних захворювань серед населення в РУз. Матеріали та методи. Поширеність йододефіцитних захворювань серед школярів РУз вивчалася з урахуванням рекомендацій Всесвітньої організації охорони здоров’я. Були проаналізовані такі показники, як поширеність дифузного зоба, йодурія, споживання йодованої кухонної солі. Дані порівнювалися з результатами досліджень попередніх років. Результати. Згідно з показниками йодурії, частка тяжкого дефіциту йоду (менше 20 мкг/л) знизилася з 94,4 % у 1998 році до 21,4 % у 2004 році, до 1,9 % — у 2010 і 2016 роках. Оптимальний рівень споживання йоду (понад 100 мкг/л) збільшився від 0 % в 1998 році до 46,3 % у 2004 році, до 63,7 % — у 2010 і до 76,3 % — у 2016. Порівняльний аналіз поширеності дифузного зоба I і II ступенів показав, що частка даного захворювання становила загалом 72,8 % в 1998 році, 58,8 % — у 2004, 40,2 % — у 2010 і 28,6 % — у 2016. Висновки. Значну роль у прогресі в галузі профілактики йододефіцитних захворювань у РУз відіграв ухвалений у 2007 році закон «Про профілактику йододефіцитних захворювань». Незважаючи на проведені широкомасштабні заходи, дані щодо вмісту йоду в кухонній солі і сечі, отримані у 2016 році, свідчать про те, що 25 % населення РУз все ще залишаються в стані йодного дефіциту.

Background: Diabetes mellitus (DM) is a major cause of blindness, and cardiovascular risk is the highest in diabetics. More than 40% of all trauma-unrelated lower extremity amputations are performed because of diabetic foot syndrome and lower extremity gangrene; 35–40% of all deaths due to uremia occur in diabetics. Objective: To study the prevalence of late complications of DM in the Republic of Uzbekistan and risk factors contributing to their progression. Methods: 1,000 and 1,141 patients with type 2 DM, resident in urban and rural areas of Uzbekistan, respectively, underwent general clinical examination in which arterial pressure, carbohydrate and lipid metabolism parameters were measured. A special questionnaire was filled out for each patient. Results: The study established a higher prevalence of late complications of DM in urban diabetics as compared with those in rural regions (p < 0.001). The incidence of macroangiopathies of lower extremity vessels, diabetic foot syndrome and myocardial infarction was found to be higher in males than that in females, while the prevalence of ischemic heart disease was registered as higher in females regardless of region. An increase in the incidence of late complications of DM with disease duration was found in residents of both regions (p < 0.001). The prevalence of macroangiopathies, diabetic polyneuropathy and diabetic foot syndrome in the decompensated stage of disease was high among both urban and rural residents. The smokers had a higher prevalence of diabetic retinopathy, macroangiopathies of lower extremity vessels, myocardial infarction and ischemic heart disease regardless of region. Age also contributes to the progression of late complications of DM. Conclusions: The incidence of late complications of DM was higher in urban diabetics than in their rural counterparts in the present study. Sex, age, disease duration, compensation stage and bad habits were found to be risk factors for the progression of late complications of DM.