Congenital malformations of the urinary system as visceral markers of undifferentiated connective tissue dysplasia.

OBJECTIVE: The relevance of this study is conditioned by the need for urgent search and implementation of effective methods of treatment of urinary system diseases in people of different ages, as well as addressing issues of quality treatment of connective tissue diseases in general and its dysplasia in particular. The aim of the article is to identify congenital defects as visceral markers of connective tissue dysplasia. METHODS: The methodology of this study includes a survey of a group of children with considerable problems in the development and functioning of the urinary system at the age of 2 weeks to 3 years, in order to qualitatively select and determine the most effective methods of treatment. Children who took part in this study had a set of phenotypic and clinical properties of undifferentiated connective tissue dysplasia. RESULTS: The considerable prevalence of undifferentiated connective tissue dysplasia in young children with congenital malformations of the urinary system, especially in children with abnormal development and functioning of kidney tissue, which substantially influences the course of the disease was determined. Also, treatment of undifferentiated connective tissue dysplasia was predicted. CONCLUSIONS: It was concluded that the presence of a malformation of the urinary system, which is acquired by a child from birth, can be considered as a visceral manifestation of undifferentiated connective tissue dysplasia.

AGGRESSIVE COURSE OF DIFFERENTIATED THYROID GLAND CANCER IN A PATIENT WITH INSULIN RESISTANCE: CASE ANALYSIS FROM PRACTICE.

Differentiated thyroid cancer (DTC) is usually characterized by a harmless clinical behavior but in some cases it can manifest itself as a metastatic damage to the bone system. The authors reported case from their practice of an aggressive DTC course in a patient with insulin resistance, accompanied by the development of metastases in the bone system. The main goals of the patient's treatment at each stage of radioiodine therapy were to reduce the foci of metastatic bone damage in terms of their number and volume as well as insulin resistance as a risk factor affecting insulin-like growth factors. A clinical case analysis found that radioiodine therapy might be useful for disease control in cases with potentially aggressive variants of DTC. This category of patients requires careful monitoring of insulin resistance, insulin-like growth factors and appropriate antitumor treatment.

INSULIN-LIKE GROWTH FACTORS IN THE SERUM OF PATIENTS WITH PAPILLARY THYROID CANCER.

OBJECTIVE: The aim is to study the level of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-2 (IGF-2) in the blood serum of patients with papillary thyroid cancer, depending on the main clinical and morphological features of the disease. PATIENTS AND METHODS: Materials and methods: The material was the information about 60 patients with papillary thyroid cancer (group 1). In group 2 there were 10 patients without oncopathology. All patients underwent clinical examination after total thyroidectomy before special treatment (radioiodine therapy): ultrasound diagnosis of the neck, confirmed diagnosis of papillary thyroid cancer by morphological examination of operative material. All patients underwent anthropometric studies (height, weight), on the basis of which the body mass index (BMI) was calculated. The study program also included determination of the level of thyroid-stimulating hormone of the pituitary gland (TSH), thyroglobulin (TG), antibodies to thyroglobulin (AB-TG). It was also determined the serum glucose level. In order to assess insulin resistance, the HOMA-IR index was calculated. All patients were tested for serum IGF-1 and IGF-2. RESULTS: Results: In the blood serum of patients with papillary thyroid cancer in 63% of patients the level of IGF-1 and in 85% - IGF-2 was probably higher than in the control group. There is a relationship between the level of IGF-1, IGF-2 and elevated level of proliferating factor - insulin in the serum of patients with papillary thyroid cancer. This may indicate an aggressive potential of the disease (i.e. clinical data on the prevalence of papillary thyroid cancer coincide with laboratory data). There was found a relationship between the expression of IGF-1, IGF-2 and insulin: at elevated levels of insulin> 24.9 µIU/ml, IGF-1 increases 4.2 times, and IGF-2 - 2.5 times. Evaluation of the relationship between the level of IGF-1 and IGF-2 and cervical lymph node involvement shows that in the absence of lesion (N0) there is an increase in these indicators by 2.2 and 1.8 times, respectively. CONCLUSION: Conclusions: The signaling system of insulin-like growth factors (IGF-1 and IGF-2) plays an important role in the occurrence and progression of malignant tumors. It is especially true for papillary thyroid cancer, so its components can be considered as potential diagnostic and prognostic markers of the disease and targets for anticancer therapy.