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Backgraund: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders found during pregnancy. Currently, it is relevant not only to search optimal target levels of glycemia during pregnancy, but also to study the ­effect of different glycemia levels on fetal development and further changes in glucose and lipid metabolism in children.Aims: To describe perinatal period, physical development and metabolic status of children born to women with GDM and different glucose levels during pregnancy.Materials and methods: The perinatal period features and anthropometric parameters at birth were evaluated in 300 children born to women with GDM and different levels of glycemia during pregnancy. Over the course two years, 141 children have been evaluated for physical development parameters and glucose and lipid metabolism. Fasting and postprandial glycemia was measured with glucometer for 14 days in 33 children aged 1 to 4 years.Results: The anthropometric parameters of children at birth did not differ from the parameters of the control group (p> 0.05) when during pregnancy fasting blood glucose was less than 5.1 mmol / l and 7.0 mmol / l 1 hour after a meal. The glycemia in women above this level was associated with an increase of frequency and risk of a body mass index, body mass / length ratio and head circumference “above average” in children at birth (p 0.05). The change in metabolic parameters was represented by neonatal hypoglycemia in children of GDM group (GDM group — 23%, control group — 3.5%, p = 0.000002), the least risk of which occurred in group with the lowest fasting and postprandial glycemic values during pregnancy. Fasting glucose, and insulin levels, НOMA index, triglycerides and cholesterol, as well as monitoring fasting and postprandial glycemia for 14 days, were obtained no significant differences between the comparison groups of children (p> 0.05).Conclusions: The lowest risks of neonatal hypoglycemia and anthropometric deviations at birth were associated with the lowest glycemia levels during pregnancy, which correspond to the criteria of the Russian clinical guidelines.

Congenital hyperinsulinism causes irreversible damage to the cerebral cortex with subsequent disability in children. The article presents the features of etiopathogenesis, clinical picture of the disease. The histological variants of pancreatic lesions are analyzed in detail. The principles of correct diagnosis are formulated. A new in Russia method for the preoperative determination of the histological form of the disease, which is carried out at the y, Almazov National Medical Research Centre since 2017, – PET/ CT with 18F-DOPA, explained the biochemical basis of its clinical application and the examination technique. The principles of the selection of drug therapy with possible complications, the need for an adequate assessment of its effectiveness are described. If it is impossible to achieve a stable target euglycemia without the need for intravenous glucose infusion, surgical correction of the disease is indicated. In schematic drawings and intraoperative photographs, approaches to surgical treatment are described, the stages of operations and possible complications are clearly disassembled. The results of surgical interventions at the N.N. V.A. Almazov for 01.2017–02.2021, where 39 children with congenital hyperinsulinism were operated on. According to PET/CT with 18F-DOPA, 15 diffuse and 24 focal forms were diagnosed. After surgery, in 12 (31%) patients, a diffuse lesion of the gland was confirmed, in 23 (59%) – a focal nature of the lesion, in 4 (10%) – an atypical form was diagnosed intraoperatively. Of 39 children, 36 (92%) have complete relief of hyperinsulinism, a significant improvement in psychomotor development, of which 9 (23%) need insulin replacement therapy with minimal dosages, these are 8 children with a diffuse form of the disease and 1 child with an atypical one. Intraand postoperative complications were not observed. Thus, partial pancreatectomy for focal forms, subtotal for atypical and near total for diffuse forms, can cope with hypoglycemia due to congenital hyperinsulinism and prevent damage to the central nervous system of newborns and infants.

This study presents literature data over the past few years on markers of acute myocardial damage after radiofrequency ablation. Information on markers such as troponin I and T, creatine phosphokinase and its fractions, CRP and interleukins and myoglobin is presented in detail. For each potential myocardial damage indicator, data related to their expression site, chemical basis of each marker and correlation between the degree of damage caused by radiofrequency exposure and the levels of various biomarkers of myocardial damage are provided.Received 12 November 2019. Revised 26 February 2020. Accepted 27 February 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributionsConception and study design: O.L. Zajfrid, R.B. Tatarsky, E.S. VasichkinaDrafting the article: O.L. Zajfrid, K.A. Chueva, A.V. Mikhailov Critical revision of the article: O.L. Zajfrid, R.B. Tatarsky, E.S. Vasichkina, I.L. Nikitina, D.S. LebedevFinal approval of the version to be published: O.L. Zajfrid, K.A. Chueva, E.S. Vasichkina, A.V. Mikhailov, D.S. Lebedev, I.L. Nikitina, R.B. Tatarsky

Purpose. Evaluate the effect of metabolic control of gestational diabetes mellitus (GDM) on the perinatal period course and anthropometric parameters of newborns.Materials and methods. 300 newborns were divided into 4 groups depending on the metabolic control of the mother. Group 1: fasting glycemia 5.3 mmol/L and> 7.8 mmol/L (n = 46), respectively; Group 4: control (n = 114). The analysis of the perinatal period course was carried out, the anthropometric parameters were estimated according to the tables INTERGROWTH-21st.Results. Differences in the frequency of obstetric injuries, which risk is associated with «above average» body weight of the newborn (p = 0.04), were found between the GDM group and the control group (38.7 and 12.3%, respectively, p = 0.0000005). The risk of having a baby with «above average» body weight (Group 1/Group 4, OR = 1.9, p = 0.1; Gr. 2/Gr. 4, OR = 2.6, and Gr. 3/Gr. 4, OR = 3.7, p Conclusions. Group 1 showed the lowest frequency and risk of adverse effects, which meets the control criteria of the Russian consensus.

Tadalafil is a drug from the phosphodiesterase-5 inhibitors (PDE-5) group, which is used to treat erectile dysfunction (ED), lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) and ED with LUTS in patients with BPH. The efficacy and safety of tadalafil were reviewed. The focus was on cardiovascular safety of tadalafil due to frequent cardiovascular comorbidities in patients with ED. We concluded that tadalafil is well tolerated and safe in patients with cardiovascular comorbidities and, in addition, has a beneficial effect on the cardiovascular system.

The prevalence of the excessive weight and obesity increasing in the human population is a significant concern to the public health. The article provides a literature review devoted to pathophysiologic aspects of the obesity and vitamin D deficiency interconnection. A role of adipokines (leptin, adiponectin), cells of the immune system, proinflammatory cytokines in the pathogenesis of obesity and place of vitamin D as an endocrine and paracrine regulator of inflammatory processes in the fatty tissue. An important role of the vitamin D deficiency in the genesis of the insulin resistance is shown that underlies the fatty tissue accumulation and formation of the metabolic profile characteristic of obesity. Direct and indirect vitamin D effect on the insulin synthesis in the pancreatic gland and sensitivity to it of insulin receptors in the body tissues is demonstrated.

6 449 schoolchildren aged 6 to 18 years living in various parts of Saint-Petersburg were examined with the purpose to study the physical development of children. To assess the level of growth processes international normative Z-score scales for the length of the body (WHO Growth Reference 2007) were used.The majority (65.4%) of the surveyed children and adolescents revealed the average physical development. The number of schoolchildren whose length of body exceeds the average value was higher (26.1 per cent) than the number of schoolchildren with below-average growth (8.5 percent; p < 0.001). High rates of body length in boys were more common (7%) than among girls (4,5%; p = 0.001). Frequency of short stature in girls was higher (1.2%) than in boys (0.7 percent; p = 0.03). Age-specific analysis showed that the average body length at the age of 12 was more common in boys, at an older age in girls. The lowest average level of physical development in boys is at the age of pubertal growth leap (12–15). In girls the highest rate of the number of teenagers with the average level of physical development is among high school girls (16–18) on achievement of the definitive body size. In all groups a shift in the distribution of the variants differing from the average level of physical development in the direction of the higher body length is observed. The obtained results indicate the need for the in-depth analysis of the factors that cause deviations in physical development with subsequent development and implementation of preventive measures.

Myocarditis defined by the World Health Organization (WHO), International Society and Federation of Cardiology as an inflammatory disease of the heart muscle confirmed by histological, immunological and immunohistochemical criteria continues to challenge clinicians due to the significant heterogeneity of clinical presentations, specific problems in relation to diagnostic and therapeutic options [1, 2].

The physical and neurological development of children born to mothers with gestation diabetes mellitus (GDM) is a matter of research interest. We examined 28 children whose mothers were diagnosed with GDM, in the newborn period and at 6 months. By the parameters of physical development at birth the number of children with outstripping development and the average body mass index (BMI) was predominant and by the end of the first semester of life most of the children had the values of the average parameters specified above, that is, normal for that age, range, but the proportion of the deficient BMI remained unchanged. Insulin therapy during pregnancy had no significant impact on the frequency characteristics of children with physical development disorders. The neurological disorders of the six-month-old children born of women with gestation diabetes mellitus and non-targeted metabolic control were more severely represented by sensory sphere disturbances and interaction with subjects; to a lesser extent - by emotional and voice development. The children of this group had the minimum disturbances in the development of the motor sphere.

Introduction Restrictive cardiomyopathy (RCMP) is characterized by restrictive filling and reduced diastolic volume of either or both ventricles with normal or near-normal systolic function and wall thickness. It may occur idiopathically or as a cardiac manifestation of systemic diseases and various neuromuscular disorders. Often RCMP occurs with severe symptoms of heart failure and has an poor prognosis. Given the presence of structural myocardial abnormalities, atrial dilatation, this group of patients has a high risk of heart rhythm and conduction disturbances. Objective To present our clinical experience in RCMP with the heart rhythm and conduction disturbances in children. Material and methods The study was approved by the Institute Ethical Review Board. On behalf of the children enrolled in the study, written informed consent was obtained from the next of kin. The study included 18 children with RCMP presented with heart failure class II-IV. The genotyping was performed to all patients. The identified genetic variants were classified according to ACMG guidelines. We analyzed clinical history, data of physical examination, laboratory findings, ECG, echocardiography, Holter monitoring, genetic test, cardiac MRI and CT performed according to clinical indications and physician's. Results Mean age of RCMP manifestation was 2,1 y.o. [0–11] with HF as a main clinical feature. Rhythm and conduction disorders were reported in 83% (n=15) of children. The structure of the disorders included: atriventricular block 1–2 degrees in 22% (n=4), supraventricular disorders (extrasystole, tachycardia, atrial fibrillation) in 44% (n=8), ventricular disorders (extrasystole, tachycardia) in 16% of patients (n=3). One patient had a combined rhythm and conduction disorder (sinus sick syndrome, atrial fibrillation, supraventricular and ventricular tachycardia), which required implantation of a pacemaker with a defibrillator function. In one patient, the manifestation of the disease was with hemodynamically significant permanent-recurrent atrial tachycardia. Mortality in this group of patients was 27% (= 5), the cause of death was the progression of heart failure in 3 children and sudden arrhythmial death in 2 patients. Conclusions Thus, RCMP is a severe, genetically caused, with early manifestation progressive disease with high risks of rhythm and conduction disturbances, sudden arrhythmial death. According to the testimony, patients should receive antiarrhythmic therapy and, if necessary, pacemaker implantation is indicated.

The patients with obesity are known to suffer 25-hydroxy vitamin D (25(OH)D) deficiency, but the relationship between these two conditions remains unclear. The blood 25(ON)D levels in practically healthy women were compared with the amount and distribution patterns of the fatty tissue and with the content of plasma adipocytokines. The absence or deficit of vitamin D was documented in 61.3% of the women included in the present study. They exhibited negative correlation between 25(ON) D levels and body weight. The patients with obesity were characterized by correlation between the 25(ON)D levels and waist circumference, body weight, BMI, and the amount of fatty tissue. The women of reproductive age with the reduced blood 25(ON)D level ( OR 1.86 [0.88—3.95]; CI 95%) or 25(ON)D deficiency (OR 2.23 [1.03—4.80]; CI 95%) were at a higher risk of development of obesity compared with the women in whom the 25(ON)D levels were in excess of 75 nmol/l. The study confirmed correlations between adypocytokine levels and the amount of fatty tissue even though it failed to demonstrate a significant relationship between the levels of adipocytokines and vitamin D.

Aim. To study the effect of new derivatives of 3 substituted tietan-1,1-dioxide on some mediator systems of the brain in order to determine the possible mechanism of antidepressant effect of these compounds. Methods. In an experiment with male mice studied was the effect of three most active derivatives of tietan-1,1-dioxide, which exhibit antidepressant properties [3 methooxytietan-1,1-dioxide (H14), 3-(2-isopropoxy-5-methylphenoxy)-tietan-1,1-dioxide (H40) and 3-phenylsulphonyltietan-1,1-dioxide (N69)] on the neurotransmitter systems of the brain. In the experiments used were the tests of pharmacological interaction with a sympatholytic reserpine, with a nonselective agonist of dopamine receptors apomorphine, with a dopamine receptor antagonist haloperidol, with a precursor of serotonin 5-oxytryptophan, with a precursor of dopamine levodopa, with an α2-adrenoceptor agonist clonidine, and with an agonist of M-cholinoceptors arecoline. Results. It has been shown that the spectrum of neuropharmacological effects of new derivatives of tietan-1,1-dioxide (H14, H40, N69) is diverse and is associated with the effects on the adrenergic, dopaminergic and serotonergic brain structures. Thus, H14 reduces the severity of hypothermia induced by reserpine, apomorphine, clonidine, and levodopa, as well as the severity of reserpine ptosis, haloperidol catalepsy and 5- oxytryptophan hyperkinesis. H40, in contrast to H14, has no effect on haloperidol catalepsy and hypothermia induced by levodopa, while H69 has no effect on clonidine-induced hypothermia. All the compounds do not alter the latent period and duration of the arecoline tremor. Conclusion. New derivatives of tietan-1,1-dioxide possess properties, which are inherent to antidepressants, and may be recommended for further in-depth study of their antidepressant activity.

In clinical practice, the greatest difficulties for diagnosis are polyendocrinopathies. Of these, polyendocrine syndromes are the least studied, in which the functions of several peripheral endocrine glands are initially impaired. The main cause of this pathology are autoimmune lesions [5, 6].