Terapevt Arkh
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Cardiovascular complications including arrhythmias and cardiac conduction disorders are one of the main reasons of high mortality rate in acromegaly, while they have not been well explored.
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Primary aldosteronism (PA) is the most common reason of secondary hypertension, that can be cured surgically or treated with targeting medical treatment. In many cases PA is not diagnosed on time, leading to aldosterone-specific cardiovascular and nephritic lesions. Effective methods of treatment make it reasonable to perform case detection testing for PA at least once in all patients with hypertension. ⋯ The last one is performed only after discussing with patient the advantages and disadvantages of all therapy methods and positive intention to surgery. Laparoscopic unilateral adrenalectomy is the procedure of choice in patients with unilateral adrenal disease. In patients with bilateral aldosterone hypersecretion, the optimal is a low-sodium diet and lifelong treatment with a mineralocorticoid receptor antagonist administered at a dosage to reach a high-normal serum potassium concentration.
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To investigate the link between the hypoglycemia (registrated accurately by the professional Continuous Glucose Monitoring CGM; severe hypoglycemia at home) and the hetero-/homozygote carriage of single nucleotide polymorphisms (SNP) of cytochrome systems geneCYP2C9(rs1799853CYP2C9*2 иrs1057910CYP2C9*3) at the patients with Type 2 Diabetes Mellitus (T2DM) used sulphonylurea (SU). ⋯ At the real clinical practice the assessment of carriage of SNPs of geneCYP2C9before inclusion of SU to glucose-lowering scheme of T2DM-therapy it necessary to carry out for the detecting patients with a higher risk of hypoglycemia and rising of Glycemic Variability.
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The purpose of the study is to increase the effectiveness of treatment of metabolic syndrome (MS) in young patients with vitamin D deficiency. ⋯ To increase the effectiveness of MS treatment in young patients with vitamin D deficiency, it is necessary to determine the level of melatonin (urinary 6-sulfatoxymelatonin) and, if it decreases, carry out correction of melatonin and 25 (OH) vitamin D in addition to the standard therapy of this syndrome.
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Gut microbiota (GM) is a set of bacteria which colonize the gastrointestinal tract. GM and its active metabolites take part in intestinal and hepatic gluconeogenesis, in the synthesis of incretin hormones, and affect the regulation of appetite. ⋯ There are conflicting data in the literature on the role of specific microorganisms in the development of metabolic disorders. Research is needed to identify specific types of bacteria and their active metabolites which affect the development of obesity and type 2 diabetes.