bluuebunny/crossref_metadata_2025 huggingface dataset:
Community Health Screenings Can Complement Public Health Outreach to Minority Immigrant Communities
Authors: Siddaiah Roopa , Roberts Jon E. , Graham Leroy , Little Anne , Feuerman Marty , Cataletto Mary B.
Published: March 2015

Objectives : We sought to provide culturally competent, community-based respiratory health screening and education in minority communities with high concentrations of Latino immigrants on Long Island and to assess the impact of this intervention on their decision to seek medical care. Methods : Seven health care screenings were performed in communities with high concentrations of immigrants from Latin America. A subgroup of participants who identified themselves as Hispanic/Latino were analyzed. After completion of a respiratory health questionnaire and spirometry, screening scores were calculated, education provided, and recommendations were made for medical evaluation in those who screened positive. A positive screen was defined as abnormal respiratory symptoms, abnormal spirometry, or both. Follow-up contacts were made at 1, 6, and 12 months to assess compliance with the recommendation to seek care in those who screened positive. Results : High positive screening rates for both men (64%) and women (61%) were found. Of the participants who screened positive and were advised to seek medical care, 52% did so. Compliance with the recommendation to seek care was associated with the presence of an identified medical provider at baseline. Of those who screened positive and who did not comply with team’s recommendation, 75% were unable to identify a health care provider. Conclusions : A significant number of participants who screened positive could not identify a health care provider and did not follow-up with the recommendation to seek medical evaluation. Community-based screenings provide an opportunity to access at-risk immigrant populations for health screening and education, and to facilitate referral and access to medical services.
Community Engagement in Health Status Instrument Development: Experience With the HIV Disability Questionnaire
Authors: O’Brien Kelly K. , Bayoumi Ahmed M. , King Kenneth , Alexander Rob , Solomon Patricia
Published: March 2015

Background : People with HIV face a variety of health-related challenges from HIV, concurrent health conditions, and side effects of treatment. These health-related challenges may be termed disability . Community involvement in conceptualizing and understanding disability is essential to developing appropriate measurement tools. Objective : To describe a community–academic partnership in the development of a new self-administered health status instrument, the HIV Disability Questionnaire (HDQ), using a community-engaged approach. Methods : With a Community Advisory Committee, we used categories from the Episodic Disability Framework , a conceptual framework developed in an earlier stage of research, as a foundation for item generation. Results : The purpose of the 70-item HDQ is to characterize the presence, severity, and episodic nature of disability experienced by adults with HIV. The Community Advisory Committee suggested items beyond those in the Episodic Disability Framework , refined item phrasing, order, response options, and questionnaire instructions to enhance feasibility and relevance of the HDQ to adults with HIV, advised on how to structure the questionnaire to capture the episodic nature of disability, and suggested next steps for testing and implementation. Conclusions : The HDQ is the first HIV-specific questionnaire to describe disability experienced by adults with HIV. Engaging community research partners in the development of the HDQ enhanced the questionnaire’s relevance, feasibility, and face and content validities. This approach may be considered by others interested in health status instrument development.
Dowries and Debts: Fuzhounese Youth Geographies of Fear, Resentment, and Obligation
Authors: Hung Winnie Tam
Published: March 2015

Chinese family networks are often lauded as the source of Chinese American success in education and used as a bolstering tool to propagate myths of the model minority. This study of Fuzhounese youth, however, reveals that many Chinese American youth view getting married and having children as more important than educational status for establishing place and face in the United States. Against the backdrop of growing privatization of the nation’s economy and its emphasis on personal responsibility and worker flexibility, my analysis of the effects of familial obligations as a national and transnational debt complicates caricatures of Asian American families as the model minority. By calling attention to the negotiations that Fuzhounese youth make in order to forge economic relationships that take into consideration familial expectations, this article underscores the ways in which filial piety and obligations shape the marriage and educational aspirations of Fuzhounese youth.
Unfaithful Returns: Reiterations of Dissent, U.S.–Korean Militarized Debt, and the Architecture of Violent Freedom
Authors: Baik Crystal Mun-hye
Published: March 2015

This essay explores the unsettling material and affective ties associated with militarized debt within the post-1945 Korean diaspora. By mobilizing Jane Jin Kaisen’s video installation Reiterations of Dissent as a device of critical sensing or “sightless vision,” I address three central questions. First, how exactly does Reiterations of Dissent hint at seemingly forgotten or hidden memories of war and occupation eclipsed by state-produced narratives? That is, what formal mechanisms are mobilized by Kaisen to gesture to the spectral dynamics occluded from the field of vision? Second, what are the dimensions of militarization, and what subsequently emerges as “permission costs” or obligatory sacrifices deemed necessary for a flourishing U.S.–South Korean militarized friendship? Last, how might the framework of militarized debt shift Asian/American studies more expansively toward Asia and the Pacific, especially as the field of Korean/American studies labors toward a decolonized future?
The Debts of Memory: Historical Amnesia and Refugee Knowledge in The Reeducation of Cherry Truong
Authors: Bui Long T.
Published: March 2015

This article explores the challenges of memorywork for Vietnamese diasporic subjects in the face of postwar historical amnesia and trauma. It analyzes Aimee Phan’s The Reeducation of Cherry Truong , which tells the story of two families that fled from the Vietnam War still grappling with the messiness of their war-torn past. The main character, Cherry, attempts to “reeducate” herself about her wayward kin, and while the novel may be read simply as a coming-of-age text, this major fictional work illustrates the ways second-generation subjects must recuperate convoluted histories of war to understand the causes of their own precarious life and uncertain future in the world. Offering a powerful analytic for situating gendered practices of remembering and forgetting, the term “reeducation” suggests that refugee memorywork never simply takes the form of nostalgia or denial of the past but a constant negotiation of history as interpreted through past wrongs or obligations. It raises epistemological and moral dilemmas related to refugee subject formation, characterized by more than the condition of exile from the homeland but the active processing of postwar economic bonds and demands. As a hermeneutic for critically reading the refugee as a figure of debt, “reeducation” links the programmatic indoctrination of South Vietnamese political prisoners by communists to the Western pedagogical program to civilize refugees from South Vietnam, recognizing the psychic and material debt survivors of war owe to the sacrifices and suffering of others, and the political agency found in that recognition.
The Work of Feeling in James Hervey’s Meditations among the Tombs (1746)
Authors: Parisot Eric
Published: March 2015

James Hervey’s Meditations among the Tombs (1746) was published at the height of the literary taste for mortuary sentimentalism. A prose counterpart to contemporary ‘graveyard poetry’, feeling was central to its brand of religious didacticism. As a result, Hervey’s tract can be read as a comprehensive exploration of the didactic opportunities afforded by death, one that expertly employs a series of affective vignettes to cultivate a range of emotional responses, at once looking back to the ‘fear and trembling’ of Reformation theology, and looking forward to the pleasurable frisson of Gothic fiction and the emotional pedagogy of sentimental literature.
The Sorrow of Soreness: Infirmity and Suicide in Medieval England
Authors: McNamara Rebecca F.
Published: March 2015

Infirmity played an important role in the history of emotions related to suicide in the Middle Ages. Scholars have previously dismissed or overlooked infirmity in suicide cases, and have rarely focused on emotions related to suicide. An analysis of medieval English court rolls and Crown writs demonstrates that infirmity was an emotionally meaningful way of explaining and responding to suicide. The discourse of suffering and sickness provided a conduit for emotions in a bureaucratic medium for which explicit reference to emotions was inappropriate. This is especially evident in responses to petitions for the return of suicides’ confiscated goods and chattels during the reign of Edward I.
Mourning under Medical Care: A Study of a consilium by Bartolomeo Montagnana
Authors: Cohen-Hanegbi Naama
Published: March 2015

A medical consilium written by the physician Bartolomeo Montagnana (1380–1452) documents the medical advice offered to his patient, Johannes of Milano. Montagnana diagnosed Johannes’s ill health as the result of intense sorrow over his daughter’s death. This case constitutes an exceptional source for the investigation of grief, mourning, health, and normativity in fifteenth-century Italy. This article traces some sources of influence and parallels to this case among contemporary medical, literary, and religious writings that address the notions of unhealthy and sinful grief. Together with Bartolomeo Montagnana’s consilium , they demonstrate the role medicine and physicians assumed within the social and cultural construction of grief during this period.
Dying 101: Emotion, Experience, and Learning How to Die in the Late Medieval artes moriendi
Authors: Ruys Juanita Feros
Published: March 2015

This article explores the complex interaction of imagination, self-formation, emotion, and experience at play in the developing ars moriendi genre of late medieval Europe. The art of learning how to die was designed to instruct readers in how to prepare themselves for death. Early exemplars aimed to arouse fear, asking readers to identify with and learn from the experience of a young man dying unprepared. Yet a problem with a strategy of extreme emotional investment was that the emotion of fear could become overwhelming, leading to terrified stasis rather than positive action. A remedy appears through the application to the genre of the emergent epistemology of experience.
Narratives of Death and Emotional Affect in Late Medieval Chronicles
Authors: Marchant Alicia
Published: March 2015

Despite their ostensibly unemotive tone, medieval chronicle narratives communicate an intricate range of emotions, particularly fear and hope, associated with death and the posthumous fate of human beings, both as individuals and in relation to the broader narrative of Christian salvation. The numerous records of deaths of individuals narrated in chronicles are intrinsically emotive events, and privileged loci both for the depiction of emotion and for the manipulation of readers’ emotional responses to the narrative. The supposedly relentless sequential ordering of chronicles is often varied on these occasions for emotive effect. Following Roland Barthes’s suggestive essay ‘ Tacitus and the Funerary Baroque’, and taking the example of the execution of the Archbishop of York, Richard Scrope, in 1405, I argue that the reiteration of death is itself central to the chronicle texts’ significance.
‘Share with me in my Grief and Affliction’: Royal Sorrow and Public Mourning in Early Eighteenth-Century England
Authors: Oberlin Amy B.
Published: March 2015

At the beginning of the eighteenth century, English royal funerals became private affairs, displacing the centre of public commemoration of royal deaths. Print took the place of the traditional public funeral as the forum for both royal and public mourning. Throughout the period, affective rhetoric became a greater part of the mourning dialogue between court and public that occurred in print. An examination of this language suggests that early political newspapers were proponents of the nascent culture of sensibility.
The Sign Language Situation in Mali
Authors: Nyst Victoria
Published: March 2015

This article gives a first overview of the sign language situation in Mali and its capital, Bamako, located in the West African Sahel. Mali is a highly multilingual country with a significant incidence of deafness, for which meningitis appears to be the main cause, coupled with limited access to adequate health care. In comparison to neighboring countries, the first school for deaf children was established relatively late—in 1995. Various sign languages have been used in Malian deaf education, but, following the regional trend, the schools for deaf children eventually settled for a variety of ASL adapted to French. The vast majority of Malian signers have not received formal education, however, and have no or only limited command of ASL. They use various forms of the local sign language, Malian Sign Language (Langue des Signes Malienne, LSM). The best-documented variety of LSM is the one used in Bamako, for which a dictionary and an annotated corpus exist. Another annotated corpus has been compiled for several varieties found in the Dogon area. Ambivalent attitudes are found in the deaf community with regard to the value and linguistic status of LSM and ASL, which pose a threat to the continued use of LSM, and deaf Malians are found to switch to ASL in areas in contact with deaf education or with formally educated signers.
Sociolinguistic Variation and Change in British Sign Language Number Signs: Evidence of Leveling?
Authors: Stamp Rose , Schembri Adam , Fenlon Jordan , Rentelis Ramas
Published: March 2015

This article presents findings from the first major study to investigate lexical variation and change in British Sign Language (BSL) number signs. As part of the BSL Corpus Project, number sign variants were elicited from 249 deaf signers from eight sites throughout the UK. Age, school location, and language background were found to be significant predictors for the use of regional number sign variants. The results suggest that leveling may be taking place in BSL number signs inasmuch as younger signers are using a decreasing variety of regionally distinct number sign variants. These results need to be understood in light of the sociolinguistic characteristics of the British deaf community, which differ from those of spoken language communities, with which linguists are more familiar.
Lexical Properties of Slovene Sign Language: A Corpus-Based Study
Authors: Vintar Špela
Published: March 2015

Slovene Sign Language (SZJ) has as yet received little attention from linguists. This article presents some basic facts about SZJ, its history, current status, and a description of the Slovene Sign Language Corpus and Pilot Grammar (SIGNOR) project, which compiled and annotated a representative corpus of SZJ. Finally, selected quantitative data extracted from the corpus are presented. The article discusses certain lexical and semantic properties of SZJ, for example, the role of fillers and gestures. Figures are compared to related works, particularly corpus-based studies of British Sign Language (BSL) and Auslan. The article concludes by outlining plans for future research and ways in which the present corpus could improve basic reference works for SZJ and serve as a basis for new technologies.
A Preliminary Study on Interpreting for Emergent Signers
Authors: Smith Caitlin , Dicus Danica
Published: March 2015

Sign language interpreters work with a variety of consumer populations throughout their careers. One such population, referred to as emergent signers , consists of consumers who are in the process of learning American Sign Language, and who rely on interpreters during their language acquisition period. A gap in the research is revealed when considering the interaction between this growing population and the interpreting field. The present study thus attempts to provide a preliminary examination of the topic by reporting on the findings of a survey conducted with interpreters affiliated with Gallaudet Interpreting Service at Gallaudet University. Results show that interpreters are working on a regular basis with this population that the work is different from traditional interpreting work with fluent signers, and that interpreters have differing opinions on how the work should be approached. Implications for future areas of study and the overwhelming need for research on this subject are also discussed.
Supplementing an Educational Video Series with Video-Related Classroom Activities and Materials
Authors: Golos Debbie B. , Moses Annie M.
Published: March 2015

Teachers of deaf children express concern over a lack of curricular materials appropriate for and beneficial to the deaf population, particularly for language and literacy development and in early childhood classrooms. In addition, more and more deaf children are attending classrooms in which their teachers may not be fluent in ASL. This, too, indicates a need for curricular resources that support and extend language and literacy instruction for deaf children. The current study examines the potential of classroom activities designed to supplement an educational video series in ASL. The participants included one teacher, six deaf children, and one child of a Deaf adult (Coda) in an early childhood classroom. Over the course of two weeks, the teacher showed the participants an educational video and implemented six supplemental activities, all of which were designed to promote a set of early literacy skills (e.g., vocabulary, knowledge of story elements, sequencing ability). Each activity was video-recorded and transcribed for children’s displays of literacy-related behaviors. The teacher also filled out a survey in order to provide feedback on the usability and effectiveness of the activities. The findings suggest that the children displayed many of the targeted skills during the classroom activities, and the descriptive statistics show higher mean scores in targeted skills following the classroom activities. Although they are exploratory, these findings suggest the potential benefit of incorporating such activities into early childhood classrooms.
RUSSIAN ASSOCIATION OF ENDOCRINOLOGISTS NATIONAL PRACTICE GUIDELINES (CLINICAL SIGNS, DIAGNOSIS, DIFFERENTIAL DIAGNOSIS, TREATMENT). Acromegaly
Authors: Dedov I I , Molitvoslovova N N , Rozhinskaia L Ia , Mel'nichenko G A
Published: March 2015

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Pregnancy in acromegaly: a new clinical case and brief reviuw of the liturature
Authors: Ilovaĭskaia I A , Dreval' A V , Pokramovich Iu G
Published: March 2015

Women of reproductive age with acromegaly can be interested in pregnancy, even when the pituitary tumor keeps rather big sizes, or control over secretion of GH and IGF-1 has not been reached. In this regard doctors often meet questions of acromegaly influence on the course of pregnancy. Now a little more than 100 cases of pregnancy at acromegalic female patients were described. In article the short review of the cases published in literature is carried out, and a new own clinical case of pregnancy at the patient with acromegaly is represented. The young woman (24 y.o.) received treatment with octreotide prolonged release in a dose 20/40 mg after non-radical adenomectomy for somatoprolactinoma, on this background she became pregnant, and continued medical treatment during all pregnancy. There were no complications during pregnancy and/or pathology of fetal formation. In women with acromegaly treatment with somatostatin analogs is not the indication for pregnancy interruption. It is possible to stop this treatment for the period of pregnancy as such break in treatment is safe for mother and fetus in most cases according to the literature. However if the estimated risk of further growth of a pituitary tumor is high, treatment can be continued during pregnancy.
Clinical benefits of switching type 2 diabetes patients from human insulins to insulin analogs
Authors: Kudinov V I , Nichitenko M S , Ibragimova V A
Published: March 2015

Achievement and long-term maintenance of optimal glucose control is still a big problem in many patients with type 2 diabetes. Diabetes related complications and cardiovascular diseases also can do more difficult the choice of glucose lowering therapy. Insulin therapy is the most effective method of treatment in such patients. However treatment with human insulin is often associated with hypoglycemia and weight gain, which are additional barriers to achieve glycemic control. Presented clinical cases show that switching from human insulin for insulin analogues detemir (Levemir) and aspart (NovoRapid) provide a significant improvement in glycemic control without increasing of risk of hypoglycemia and weight gain.
Modern insulin therapy with insulin analogues detemir and aspart in children and adolescents: The problems and solutions
Authors: Kuraeva T L
Published: March 2015

DCCT (Diabetes Control and Complications Trial) study showed that intensified insulin therapy associates with significant reduction both of development and progression of vascular complications compared to conventional insulin therapy in type 1 diabetic patients. Modern algorithms of diabetes treatment in children and adolescents reflect the need to achieve and maintenance of glycemic control as closely as possible to normal level. Insulin analogues have improved pharmacokinetic and pharmacodynamic properties, and also have less variability than human insulin. So they have more physiologic and predictable profile actions and, therefore, provide the possibility to achieve optimal glycemic control with low risk of hypoglycemia. Current review demonstrates the benefits of basal-bolus therapy with insulin analogues detemir (Levemir) and aspart (NovoRapid) and advantages of insulin NovoRapid in the continuous subcutaneous insulin infusion (CSII) compared with human insulin in children and adolescents with type 1 diabetes mellitus.
The cardiovascular form of autonomous neuropathy in the adolescents with type 2 diabetes mellitus
Authors: Eremina I A , Laptev Dmitry N , Zil’berman Lyubov I , Dubinina I A , Kuraeva Tamara L , Shcheglova O S
Published: March 2015

Objective. To estimate the prevalence of the cardiovascular form of autonomous neuropathy (CAN) and the factors associated with this condition in the adolescents suffering from type 2 diabetes mellitus (DM2) in comparison to the adolescents present- ing with type 1 diabetes mellitus (DM1). Material and methods. The study included 24 adolescents with DM2 and 30 ones with DM1 matched for the age, duration of the disease, and the quality of its compensation. The control group was comprised of 17 adolescents with exogenous constitutional obesity (ECO). All the patients were examined by means of Holter ECG monitoring with the estimation of the daily cardiac rhythm variability based on the mean weighted variation of rhythmogram (MWVR) and the length of the QTc interval. In addition, standard cardiovascular tests were performed including deep-breath test, the Valsalva maneuver, and the 30:15 intermittent fitness test. Cardiovascular autonomous neuropathy was diagnosed in the patients exhibiting deviation from the normal values in 3 of the five parameters of interest, viz. MWVR, QTc length, and three functional tests. Results. CAN at the subclincal stage was more frequently diagnosed in the adolescents with DM2 than in those suffering DM1 (29.2 and 10% of the cases respectively; p<0.05). This condition was not found in any of the patients presenting with endogenous constitutional obesity. MWVR in the adolescents with DM2 was lower than in the patients with DM1 (p=0.02) or ECO (p=0.04). The QTc duration was greater in the DM2 patients than in the adolescents of the same age presenting with ECO (p=0.02) and comparable with that in the patients suffering DM1 (p=0.3). In the adolescents with DM2, positive correlation between CAN, the duration of diabetes, the quality of its compensation, and the patient’s age was documented while the length of the QTc interval negatively correlated with these three variables. Moreover, the occurrence of CAN positively correlated with peripheral neuropathy. No relationship with the severity of insulin resistance was observed.
Enhanced spontaneous and induced secretion of the proinﬂammatory cytokine TNF-alpha by monocytes-macrophages from the blood of the patients presenting with type 2 diabetes mellitus
Authors: Mirzoeva L A , Nikiforov N G , Aladinsky V A , Sobenin I A , Nedosugova L V , Orekhov A N
Published: March 2015

Type 2 diabetes mellitus (DM2) is known to be associated with the accelerated development of atherosclerosis. The current concepts of atherosclerosis take into consideration the possible role of inflammation in its pathogenesis which theoretically implies the modification of macrophages in accordance with the proinflammatory phenotype and the production of the proinflammatory cytokine tumour necrosis factor-alpha (TNF-α) by these cells. In connection with this, we undertook a study of spontaneous and induced secretion of proinflammatory cytokine TNF-α by monocytes-macrophages from the blood of 20 patients presenting with newly diagnosed type 2 diabetes mellitus (HbA1c - 8,9%) and the healthy volunteers showing up no disturbances of carbohydrate metabolism. It was shown that blood monocytes-macrophages of the patients presenting with DM2 are characterized by the enhanced ability (compared with the cells from the healthy subjects) to synthesize TNF-α in both native and interferon-y stimulated states up to 750 versus 270 pg/ml culture medium and to 1653 pg/ml versus 378 pg/ml culture respectively. This difference was statistically significant (p <0.05). It is concluded that the results of the study help to explain the elevated blood TNF-α level in the patients with type 2 diabetes mellitus and provide an insight into the mechanism underlying the development of the systemic inflammatory reaction accelerating the progression of atherosclerosis associated with diabetes mellitus.
Parathyroid cancer: a case report
Authors: Lapshina A M , Voronkova I A , Abrosimov A Yu , Molochkov R V , Bel’tsevich D G , Voskoboinikov V V
Published: March 2015

The authors describe a rare case of parathyroid cancer characterized by the obscure clinical picture of hyperparathyroidism and subtotal ingrowth of the tumour through the right lobe of the thyroid gland.
X-linked immune dysregulation, polyendocrinopathy and enteropathy (IPEX syndrome): the description of a clinical case and a short literature review
Authors: Tikhonovich Yu V , Petryaikina E E , Rybkina I G , Garyaeva I V , Tyul’pakov A N
Published: March 2015

IPEX syndrome (X-linked immune dysregulation, polyendocrinopathy, enteropathy) is one of the rare hereditary X-linked forms of neonatal diabetes mellitus associated with mutations in the FOXP3 gene. The disease is characterized by the combination of polyendocrinopathy (more frequently neonatal diabetes mellitus) with enteropathy and immune dysregulation. In the majority of the cases it has an unfavourable prognosis. The present article presents for the first time in the Russian-speaking literature the description of the genetically verified case of IPEX syndrome.
The inﬂuence of disordered fat metabolism on male fertility at the reproductive age and the eﬀectiveness of the ECF programs
Authors: Vityazeva Irina I , Altashina Mariya V , Troshina Ekaterina A
Published: March 2015

The excessive body weight and obesity in the men of the reproductive age exert the negative influence on their reproductive system and can promote the development of infertility. The high prevalence of obesity and the reduction of the birth rate in the developed countries stimulate the extensive investigations into the mechanisms by which the excess adipose tissue affects male fertility. The authors overview the literature publications concerning the hormonal profile and the adipokine level, as well as disturbance of spermatogenesis in the men with disordered fat metabolism with special reference to the peculiarities of the management of infertility with the application of the assisted reproductive technologies.
Insulin therapy of type 2 diabetes mellitus in the period of acute stroke: the importance of the insulin administration technique
Authors: Strongin Leonid G , Grigoryan I G , Gustov A V , Belyaeva N G
Published: March 2015

Hyperglycemia in the period of acute stroke aggravates prognosis of its outcome in the patients with type 2 diabetes mellitus (DM2). The objective of the present study was to compare the effectiveness and safety of intravenous and subcutaneous ad- ministration of insulin to the patients presenting with DM2 in the period of acute stroke for the achievement of the same target blood glucose level of 7.8-10.0 mmol/l. At admission, the patients were randomized into two groups to be treated either with intravenous (n=36) or subcutaneous (n=37) injections of insulin. Intravenous insulin therapy resulted in a more favourable dynamics of the clinical course of the stroke patients estimated based on the National Institute of Health stroke scale (NIHSS) (p<0.001) and the activity of daily living (ADL) index (p<0.01). Moreover, it was associated with a reduced variability of glyce- mia (p<0.01) and a lower frequency of hypoglycemic episodes (p=0.019) compared with subcutaneous injections.
The new paradigm of obesity
Authors: Samorodskaya I V
Published: March 2015

Despite the well-proved relationship between obesity and a number of chronic diseases, the information about the influence of the body weight on the life expectancy is contradictory. A wealth of literature publications deal with the paradoxical relation of the survival rate to obesity that manifests itself among the patients with the elevated body mass index (BMI) and moderate obesity as opposed to the patients having the normal or lowered BMI. The American Association of Endocrinologists proposed the new paradigm of the evaluation of BMI and obesity. The consensus of the Russian specialists as regards this paradigm needs to be reached in conjunction with the development of the relevant guidelines for practicing healthcare providers.
Diﬀuse euthyroid goiter. The algorithms of treatment and prophylaxis with iodine preparations. A lecture
Authors: Troshina Ekaterina A
Published: March 2015

Iodine deficiency is known to be a major cause leading to the development of diffuse goiter. The available data indicate the existence of natural iodine deficiency over the entire territory of the Russian Federation. Nevertheless, there is up to now no legislative regulation of prophylaxis of iodine-deficiency diseases in the country by means of universal table salt iodization. Iodine-deficiency disorders are believed to currently affect 10-15% and 13-35% of the urban and rural populations of Rus- sia respectively. Calcium iodide preparations are widely applied to treat and prevent diffuse goiter in the patients including children, pregnant and breast-feeding women.
Federal clinical recommendations on diagnostics and treatment of type 2 diabetes mellitus in the children and adolescents
Authors: Zil’berman Lyubov I , Kuraeva Tamara L , Peterkova Valentina A
Published: March 2015

Type 2 diabetes mellitus (DM2) morbidity has increased over the past years. Its rapid growth affects young subjects among those of other age groups including adolescents and pre-pubertal children. The diseases develops in the association with obesity and metabolic syndrome but remains asymptomatic during a long period. Therefore, its detection requires an active diagnostic search. The present clinical recommendations highlight the major problems pertaining to the diagnostic and treatment strategies for the management of the patients presenting with type 2 diabetes mellitus.
The evaluation of the agreement between fasting glycemia at the ﬁrst prenatal visit and the results of the glucose tolerance test in diagnostics of gestational diabetes mellitus
Authors: Popova P V , Dronova A V , Sadikova E R , Parkkinen M P , Bol’shakova M V , Nikolaeva A E , Kutueva F R , Grineva E N
Published: March 2015

Objective. To evaluate the importance of determining fasting glycemia at the first prenatal visit for timely diagnostics of gesta- tional diabetes mellitus (GDM). Material and methods. The study included 577 pregnant women examined with the use of the oral glucose tolerance test (OGTT) during weeks 24-28 of pregnancy. The results of the test were compared with the fasting glucose level at the first prenatal visit. Results. The mean fasting blood glucose level at the first prenatal visit was 4.70±0.61 mmol/l. In 25% of the patients, fasting glycemia at this time was 5.1 mmol/l or higher. Only in 36% of the women (52 of the145 ones) with the fasting blood glucose level ≥5.1 and <7 mmol/l at the first prenatal visit, the results of OGTT were consistent with the criteria for GDM. The mean fasting blood glucose level at the first prenatal visit (up to week 16) was significantly higher than on weeks 24-28 (4.71±0.61 and 4.53±0.69 mmol/l respectively, p<0.001). The ROC analysis failed to reveal the fasting blood glucose level that could be used to predict the development of gestational diabetes with a reliable sensitivity and specific- ity. Conclusion. Further population-based investigations are needed to elucidate the relationship between fasting glycemia in the first trimester of pregnancy and its unfavourable outcome.
The levels of immunoreactive proteins and cytokines in the blood of the patients presenting with autoimmune thyroid diseases
Authors: Maklakova T P , Zorina V N , Shapel’ T T , Boiko O N , Zorina R M , Zorin N A
Published: March 2015

We determined the levels of TSH, free T4 (fT4), immunoregulatory proteins (alpha-2-macroglobulin (α2-MG), lactoferrin (LF), alpha-1-antitripsin (α1-AT) , and cytokines (TNF-alpha, IL-6, IFN-gamma)) in the blood of 50 women presenting with diffuse toxic goiter (DTG) and 35 women with autoimmune thyroiditis (AIT) before and 4-6 months after the treatment. Thirty healthy women served as controls. Hypothyroidism in the outcome of AIT was associated with hypercytokinemia and the enhanced levels of a2-MG and LF, but not a1-AT. The treatment had no effect on these parameters but normalized the TSH and T4 levels. Manifest DTG was associated with the increased IFN-gamma, IL-6, α2-MG, LF, and α1-AT levels . The treatment during 4-6 months resulted in the reduction of the IL-6 and α2-MG levels whereas the hormonal status of the patients became normal. The persistence of certain disturbances suggested that dysfunction of the immune system was not totally corrected despite the normalization of the hormonal status and could be interpreted as the risk factor of a relapse of thyroid pathology.
Expression of estrogen and androgen receptors in tissues of external genitalia of girls with congenital adrenal hyperplasia
Authors: Kopylova I V , Sysoeva V Yu , Glybina T M , Kareva M A
Published: March 2015

The reason of post-operative introital stenosis in girls with CAH is a poor estrogenization of external genitalia before vaginoplasty. It is possible that the local sensitivity to estrogens can be reduced due to prenatal androgen excess in addition to inadequate compensation, which results to decrease of estrogens production by the ovaries. Objective. To determine the distribution of estrogen and androgen receptors in genital tissue, depending on the form of CAH, the degree of external virilization and serum levels of androgens. Material and methods. The waste surgical tissues obtained during routine feminizing genitoplasty (clitoro- and vaginoplasty) was used for immunohistochemical study of estrogen (α and β) and androgen receptors in girls with CAH (n=13 and n=8, respectively). Results. The expression of estrogen (α, β) and androgen receptors was determined in genital tissues of girls with CAH. There was no significant correlation between the number of immunopositive cells in the tissues of labia minora and vagina and the degree of virilization, as well as between the number of cells expressing the receptors and serum levels of androgens (testosterone, 17-hydroxyprogesterone). There was no difference in the expression of estrogen and androgen receptors between girls with salt-wasting and simple virilizing forms of CAH. The expression of estrogen receptor α in vaginal tissues was reduced in girls who underwent repeated vaginoplasty and were under preoperative local estrogen therapy in comparison to patients in whom the vaginoplasty was performed for the first time (p=0.045). Conclusion. The distribution of estrogen and androgen receptors in the labial and vaginal tissues in girls with CAH doesn’t depend on the form of disease, external virilization and serum levels of androgens. Girls undergoing repeated vaginoplasty may have a reduced sensitivity to local estrogen therapy due to decrease of estrogen receptors expression in the vaginal mucosa.
The fifty two week study of the effectiveness and safety of Apidra insulin therapy in combination with Lantus insulin in the children and adolescents with type 1 diabetes mellitus and poor glycemic control
Authors: Peterkova Valentina A , Kuraeva Tamara L , Andrianova Elena A , Titovich Elena V , Svetlova Galina N , Petryaikina Elena E , Bashnina E B , Malievsky O A , Taranushenko Tatyana E , Votyakova O I , Kovalenko T V , Kovarenko M A
Published: March 2015

The present multi-center non-randomized open prospective phase IV study was carried out based at 8 clinical centers of the Russian Federation. It included 89 patients at the age from 6 to 17 years suffering from type 1 diabetes mellitus during a period over 1 year. The children treated with Lantus (insulin glargin) in combination with any short-acting insulin in accordance with the basal-bolus regime and having the HbA1c level from=>8% to =<10% were transferred to Apidra (insulin glulisine) therapy in combination with Lantus insulin. The number of patients in the first age group (6-12 years) having the HbA1c level <8% within 12 months after the onset of therapy was 51.1%. However, only 31.1% of them, did not experience episodes of symptomatic hypoglycemia during this period with the blood glucose level =< 3.1 mmol/l. In the age group 2 (13-17 years), 31.1% of the patients reached the target HbA1c level <7.5% during the 12 month treatment period, but only 13.3% had no episodes of symptomatic hypoglycemia of =<3.1 mmol/l during this period. The HbA1c level in groups 1 and 2 decreased from 8.75±0.6 to 8.05 ±1.06% (p=0.046658) and from 8.77±0.58 to 7.96±1.12% (p=0.017533) respectively. The requirements for insulin in either group did not significantly change throughout the study period. A total of 1866 hypoglycemic episodes were recorded (i.e. 20.73 episodes per patient) including 90.8% of daytime and 9.2% of nocturnal hypoglycemia; symptomatic hypoglycemia accounted for 98.8% of all the cases and asymptomatic one for 1.2%. Fifty three (0.35%) cases were interpreted as severe hypoglycemia (blood glucose level ≤2 mmol/l), five (0.27%) patients had to be hospitalized . Hypoglycemic episodes were not documented in 13 children.
Medicamental treatment of Itsenko-Cushing’s disease. The current state-of-the art
Authors: Melnichenko Galina A , Popovich Vera , Rozhinskaya Lyudmila Y , Belaya Zhanna E
Published: March 2015

Itsenko-Cushing’s disease (ICD) is a severe progressive neuroendocrine pathology characterized by the heterogeneous clinical picture and the high risk of complications. The main goals of ICD therapy include the total removal or the pituitary neoplasm or the reduction of its volume and/or stabilization of its growth, normalization of the cortisol level and secretion rhythm, the achievement of reverse development of clinical manifestations, and the retention of the pituitary hormonal function with a minimal risk of relapses. At present, both the improved methods for diagnostics of ICD and the development of its pharmacotherapy are needed. In the routine clinical practice, ICD is usually treated with the medicines of the following groups: blockers of glucocorticoid receptors and steroidogenesis, dophamine receptor antagonists, and multi-ligand somatostatin analogs. The evidence-based substantiation for the use of the above preparations was provided by the retrospective studies with the description of a series of cases which substantially restricts the reliable interpretation of the data on the effectiveness and safety of various medicines applied to manage the patients presenting with Itsenko-Cushing’s disease. The multi-ligand somatostatin analog pasiretoide is the sole preparation approved for the treatment of adult patients suffering ICD whose surgical treatment is either ineffective or impossible. The evaluation of the effectiveness and safety of pasiretoide therapy is based on the results of the prospective randomized double-blind classical study in which two doses of pasiretoide were used. By month 6 after the onset of the treatment with pasiretoide, the median of the daily decrease of the urinary cortisol level in the patients with ICD was 47.9%. The safety profile of this medication proved to be similar with that of other somatostatin analogs, with the exception of the higher frequency of hyperglycemia. Pasiretoide, like other somatostatin analogs, most frequently caused such adverse reactions as gastrointestinal disorders. At the same time, it ensured the stable reduction of the cortisol level by suppressing the ACTH production, and thereby decreased the main manifestations of hypercortisolism, induced clinical and hormonal remission, and improved the quality of life of the patients suffering Itsenko-Cushing’s disease.
The role of the genetic factors in pathogenesis of hypogonadotropic hypogonadism
Authors: Eneva N G , Nefedova L N , Loktionova A S , Ilovaiskaya I A , Kim A I
Published: March 2015

Modern diagnostics of hypogonadism is based on the results of X-ray and laboratory (biochemical) investigations that reveal the idiopathic form of the disease in the majority of the patients. However, the recent studies have demonstrated a number of genes, whose disturbed function may be responsible for the development of hypogonadism. This creates the prerequisites for the extension of diagnostics of hypogonadism by means of genotyping of the various forms of the pathology in question and thereby may facilitate the choice of the relevant treatment strategy. The present review is focused on the elucidation of the pathogenetic role of candidate genes involved in the development of isolated hypogonadotropic hypogonadism.
Dimorphism -23HphI in the INS gene (rs689): the association with type 1 diabetes mellitus in the populations of the Russian Federation, the inter-population comparison of the frequencies
Authors: Ivanova O N , Stepanova S M , Smirnova N B , Zvereva Ya S , Suntsov Yu I , Bardymova T P , Danilova G I , Kovalenko T V , Titovich E V , Kuraeva T L , Peterkova V A , Dedov I I
Published: March 2015

Objective. The objective of the present study was to elucidate the association between dimorfism -23HphI in the INS gene (rs689) and type 1 diabetes mellitus in several populations of the Russian Federation and to compare the frequency of alleles of this dimorphism in different populations. Material and methods. The case-control association was investigated in five populations of the Russian Federation, viz. Russian, Bashkir, Udmurtian, Yakutian, and Buryat ones. The DNA samples from 528 patients presenting with type 1 diabetes mellitus and 439 control subjects were available for the investigation, Polymorphism typing was performed using the RFLP-PCR technique. The degree of association of the trait of interest with the disease was estimated based on the odd ratio (OR) values. The calculations were made with the use of Statistica software package, version 6, www.statsoff.com and Microsoft Office Excel-2003. Results. The statistically significant association of type 1 diabetes mellitus with T allele and AA rs689 genotype was documented for the Russian, Bashkir, Udmurtian, and Yakutian populations. The protective marker in these populations were T allele and T+ genotype. A similar association was not found for the Buryat population characterized by the lowest diabetes morbidity rate. This population was significantly different from the remaining ones in the high frequency of A allele (87% vs 69-75%; p є [0.0002-0.004]) and AA genotype (77% vs 45-60%; p є [0.00006-0.01]). Conclusion. This study has demonstrated the inter-population differences in the frequency of rs689 alleles and the population-specific differences in the association of rs689 alleles with type 1 diabetes mellitus. It is concluded that the consideration of population-related peculiarities of clinical and genetic associations is an indispensable precondition for the further development of personalized medicine.
RAS-pathies: Noonan syndrome and other related diseases. The literature review
Authors: Faassen Mariya V
Published: March 2015

The present review considers a group of diseases, known as Ras-pathies, formed in 2010. One of its representatives is Noonan syndrome is encountered in the pediatric practice in the first place as a syndrome accompanied by right-hand side cardiological disorders and short stature. The multiple molecular-genetic mechanisms underlying Noonan syndrome are associated with the activity of PTPN11, SOS1, and other genes. The group of RAS-pathies includes, besides Noonan syndrome, type 1 neurofibromatosis, Noonan syndrome with multiple lentigo (LEOPARD), craniofaciocutaneous syndrome, capillary and arteriovenous malformation syndrome, Costello syndrome, and Legius syndrome. All these conditions are associated with the molecular disturbances in the Ras/MAPK cascade that produce the characteristic clinical picture apparent as multiple dysembryogenic stigmata, short stature, cardiac disorders, and predisposition to the neoplastic growth.
The federal clinical recommendations on diagnostics and treatment of congenital hypothyroidism in the children
Authors: Chikulaeva O A
Published: March 2015

Congenital hypothyroidism is a cause of frequent inborn thyroid disorders. The deficiency of thyroid hormones markedly slows down the development of the nervous system and psychomotor functions of the newborn infant. Early diagnostics and well-timed beginning of the treatment of this condition make it possible to significantly improve the mental development of the child. This communication proposes the project of clinical recommendations on diagnostics and treatment of congenital hypothyroidism in the children for the extensive discussion.
The federal clinical recommendations on diagnostics and treatment of toxic goiter
Authors: Troshina Ekaterina A , Sviridenko Natalya Yu , Vanushko Vladimir E , Rumyantsev Pavel O , Fadeev Valentin V , Petunina Nina A
Published: March 2015

The proposed clinical recommendations discuss the modern approaches to diagnostics and treatment of the diseases with the clinical picture of thyrotoxicosis.