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BACKGROUND: The prevalence of dysnatremia varies widely (from 1 to 63%), and depends on comorbidities, the effects of more than 18 hormones and hormone-like substances, which confirms the importance of maintaining blood sodium levels in the tight physiologic range and makes it possible to consider its deviations as an endocrine pathology. Both hypo- and hypernatraemia are associated with a multiple increase in mortality, risk of fractures, and gross balance disturbances. At the same time, the clinical manifestations of dysnatremia are not specific, reflect an osmotically mediated decrease in brain function, which potentially may be missed in clinical practice. AIMS: to study the specifics of diagnosis, differential diagnosis and treatment of dysnatremia states by specialist doctors using a sociological survey method. MATERIALS AND METHODS: A cross-sectional sociological uncontrolled study was conducted by questioning doctors about hypo- and hypernatremia using the online questionnaire Questionnaire on hypo-and hypernatremia in clinical practice created on the Google forms platform. The invitation to fill in the questionnaire was sent to the email addresses included in the database of the Russian Association of Endocrinologists. A total of 353 completed questionnaires were received. RESULTS: The poll demonstrated a low frequency of determining blood sodium levels - less than 38% of specialists prescribe sodium in more than half of the cases, including the cases of diseases associated with dysnatremia, which correlates with less practical experience of doctors. The overwhelming majority of endocrinologists (82%) in their clinical practice encounters deviations of the sodium levels in patients, but only 6% recognize the possession of the competence of managing patients with dysnatremia. The discrepancy between the lower limit of normal range to 135-136 mmol/l was observed in 22% (62/278), the inconsistency of the upper normal limit to 145-146 mmol/l - in 47% (131/278) of laboratories, and in 33% (41/278) laboratories, which are used by doctors, there was a discrepancy along both limits of the reference interval. The presence of a hypertonic solution (3%) of sodium chloride in a hospital was noted only by 38% of respondents. Conclusions: There is an unphysiological variation in reference intervals for blood sodium concentration in 55% of laboratories, a low frequency of sodium levels evaluation in the blood (in more than half of clinical situations only 38.2% of doctors prescribe the estimation of blood sodium level) and the lack of educational competence in managing patients with syndromes of hypo- and hypernatremia in 94% of endocrinologists.

Objective To assess the current management of prolactinoma among endocrinologists in China. Methods An online survey of a large sample of endocrinologists was conducted in China. The questionnaire included 21 questions related to controversial issues about the management of prolactinomas. Doctors in the endocrinology department of a university-affiliated hospital or a comprehensive secondary hospital in 12 cities from East, West, South, North and Middle China were surveyed. Results A total of 290 valid questionnaires were collected, and the response rate was 40%. When hyperprolactinemia occurred, 97% of the respondents would test thyroid-stimulating hormone routinely. 22% of the respondents considered that prolactin levels 250 ng/mL could occur in all the following situations as macroprolactinoma, mircoprolactinoma, macroprolactinemia and drug-induced hyperprolactinemia. Surgery was not recommended by 272 (94%) endocrinologists as the first choice for treating microprolactinomas. 58% and 92% of endocrinologists would start drug treatment for microprolactinomas and macroprolactinomas at diagnosis. 70% and 40% chose to withdraw treatment after 2–3 years of prolactin normalization in microprolactinomas and macroprolactinomas. In case of pregnancy, 57% of the respondents considered bromocriptine as choice for women patients. Drug discontinuation after pregnancy was advocated in 63% and 27% for microprolactinoma and macroprolactinoma. Moreover, 44% of endocrinologists believed that breastfeeding was allowable in both micro- and macroprolactinoma. Conclusion This is the first study to investigate the management of prolactinomas among endocrinologists in China. We found that the current clinical treatment was not uniform. Therefore, it is necessary to strengthen the training of endocrinologists to improve clinical diagnosis and treatment practices.

Introduction: Diabetes is taking the form of a pandemic. All ages and all sections of society are affected by it and physicians are no exception to it. Aim: To know the glycaemic status and level of glycaemic control among the physicians who were attending a National Diabetes Conference. Materials and Methods: A cross-sectional study was conducted at a national conference “Diabetes India” held in Delhi in February 2017. Physicians and Endocrinologists were the delegates. All physicians willing for assessment of their Glycaemic status were included and HbA1C was done. Data was analysed and mean, percentage and p-value were calculated. Results: Out of 108 physicians, 3 (2.78%) had impaired glucose tolerance, 54 (50%) had diabetes mellitus and 51 (47.22%) were euglycaemic. Out of 51 physicians, only 3 physicians (5.88%) had HbA1C less than or equal to 5.6, 9 (17.65%) had HbA1C more than 6.5, 39 (76.47%) had impaired glucose tolerance. Conclusion: Very high incidence of diabetes mellitus and impaired glucose tolerance was found among physicians and endocrinologist in this study and the alarming result warrants further research with more participants.

The adherence by endocrinologists to guideline regarding levothyroxine (LT4) therapy and the compliance of patients may impact the management of hypothyroidism. The aim of this study was to compare the adherence of Italian endocrinologists to the ATA/AACE and ETA guidelines on the management of newly diagnosed primary hypothyroidism and to validate the Italian version of the Morisky-Green Medical Adherence Scale-8 (MMAS-8) questionnaire as applied to the evaluation of the adherence of patients with hypothyroidism to LT4 treatment.This was an observational, longitudinal, multicenter, cohort study, involving 12 Italian Units of Endocrinology.The study enrolled 1,039 consecutive outpatients (mean age 48 years; 855 women, 184 men). The concordance of Italian endocrinologists with American Association of Clinical Endocrinologists/American Thyroid Association (AACE/ATA) and European Thyroid Association (ETA) recommendations was comparable (77.1% and 71.7%) and increased (86.7 and 88.6%) after the recommendations on LT4 dose were excluded, considering only the remaining recommendations on diagnosis, therapy, and follow-up. The MMAS-8 was filled out by 293 patients. The mean score was 6.71 with 23.9% low (score6), 38.6% medium (6 to8), 37.5% highly (= 8) adherers; the internal validation coefficient was 0.613. Highly adherent patients were not more likely to have good control of hypothyroidism compared with either medium (69% versus 72%, P = .878) or low (69% versus 43%, P = .861) adherers.Clinical management of hypothyroidism in Italy demonstrated an observance of international guidelines by Italian endocrinologists. Validation of the Italian version of the MMAS-8 questionnaire provides clinicians with a reliable and simple tool for assessing the adherence of patients to LT4 treatment.AACE = American Association of Clinical Endocrinologists; ATA = American Thyroid Association; EDIPO = Endotrial SIE: DIagnosis and clinical management of Primitive hypothyrOidism in Italy; eCRF = electronic case report form; ETA = European Thyroid Association; fT3 = free triiodothyronine; fT4 = free thyroxine; LT4 = levothyroxine; MMAS-8 = Morisky-Green Medical Adherence Scale-8; PH = primary hypothyroidism; T3 = triiodothyronine; T4 = thyroxine; TSH = thyroid-stimulating hormone; US = ultrasonography.

Primary hyperparathyroidism is a common condition that affects 0.3% of the general population in which excessive production of PTH is there. With changing trends it is diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, we reported series of three cases of 30-40-year-old women with osteolytic lesions and bone resorption in maxilla or mandible. Two of presented cases demonstrated evidence of lesions in both mandible and maxilla which is a very rare event. A thorough diagnostic work-up emphasizing on biochemical and radiographic investigations were discussed. We highlighted the role of endocrinologist, oral and maxillofacial surgeons, general practitioner dentists, and radiologists in diagnosing and managing such patients.

On June 5 2017 we have lost one of the most famous Russian endocrinologists member of Diabetes Mellitus journal Editorial board Professor Sagdulla A. Abusuev.

Background: Despite a shift in diabetes care internationally from secondary to primary care, diabetes care in the Republic of Ireland remains very hospital-based. Significant variation in the facilities and resources available to hospitals providing outpatient diabetes care have been reported in the UK. The aim of this study was to ascertain the structure of outpatient diabetes care in public hospitals in the Republic of Ireland and whether differences existed in services provided across hospitals. Methods: We conducted a cross sectional observational study of the 36 public general hospitals providing adult outpatient diabetes care in the Republic of Ireland. Data relating to numbers of specialist medical, nursing and allied health professionals, waiting times for new and return patients, patterns of discharge back to primary care and engagement in quality improvement initiatives were recorded. Results: Thirty-five of the 36 eligible hospitals participated in the study. Sixty percent of these had at least one consultant endocrinologist in post, otherwise care delivery was led by a general physician. Waiting times for newly diagnosed patients exceeded six months in 30% of hospitals and this was higher where an endocrinologist was in place (47% V 7%, p = 0.013). Endocrinologists were more likely to have developed subspecialty clinics, access to allied health professionals and engage more in quality improvement initiatives but less likely to discharge patients back to primary care than general physicians (76 v 29%, p = 0.005). Conclusions: Variations exist in the structure and provision of diabetes care in Irish hospitals. Endocrinology-led services have more developed subspecialty structures and access to specialist allied health professionals and engage more in quality improvement initiatives. Nonetheless, waiting times are longer and discharge rates to primary care are lower than for non-specialty led services. Further studies to determine the extent to which case-mix variation accounts for these observations are warranted. Aspects of hospital-based outpatient care could be developed further to ensure equitable services are provided nationally. At a time when the delivery of diabetes services in primary care is being promoted, further research is warranted on the factors influencing the successful transition to primary care.

Aims: Raising awareness of diabetic retinopathy (DR) was shown to be a key element for early diagnosis and treatment of this blinding disease. There is very limited data about the knowledge level, attitude, and behavior of diabetic patients regarding DR in Turkey. This study was planned to assess the awareness of DR and the utilization of eye care services among Turkish diabetic patients. Methods: Diabetic patients who were under the care of ophthalmologists, endocrinologists, and/or primary care physicians were administered a questionnaire in order to assess their awareness of diabetes and its ocular complications. Results: A total of 437 patients (51.8% female and 48.2% male) with a mean age of 55.2 ± 11.9 were included in the study. Of the 437 patients, 31.8% had not been educated about diabetes, 88.1% were aware that diabetes can affect the eyes, and 39.8% thought that diabetics with good glycaemic control might suffer from DR. While 86.7% thought that early diagnosis was possible in DR, 77.3% previously had eye examinations, and 41.9% stated that annual eye examinations were necessary for diabetics. An educational level of middle school or higher, duration of DM longer than 5 years, previous DM education, and recruitment from the university (ophthalmology department and endocrinology department) were associated with better awareness of DR. The independent factors associated with visiting an ophthalmologist on a regular basis were DM education, DM duration, and site of recruitment. Conclusion: Although most of the patients know that DM affects the eye, there is a lack of appropriate knowledge and behavior about the management of DR. The importance of better control of DM and regular eye examination in the prevention of DR should be emphasized. © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.