[Clinical guidelines «Precocious puberty¼].

The precocious puberty is an urgent problem of pediatric endocrinology characterized by clinical and pathogenetic heterogeneity. The appearance of secondary sex characteristics before the age of 8 years in girls and 9 years in boys requires timely diagnosis and the appointment of pathogenetically justified treatment in order to achieve the target indicators of final growth and prevent social deprivation. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of рrecocious puberty, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

[Efficiency of iodine prophylaxis in Russia: ways of optimization].

The paper deals with one of the most topical problems of modern thyroidology - prophylaxis of iodine deficiency and iodine-deficiency states resulting in mental disorders in children living in the natural mild iodine deficiency regions. It also discusses the causes and degree of mental disorders in the children and gives recommendations on the optimization of the currently existing iodine prophylaxis system in Russia.

[The thyroidal status in childbearing-aged women living in a moderate iodine-deficient area].

The thyroidal status of childbearing-aged females who had no manifest thyroid pathology and lived in a moderate iodine-deficient region was studied 6 years after resumption of lodine prevention.

[Standards of blood thyroid-stimulating levels: state-of-the-art].

This article is a continuation of the discussion on the standards of the upper limit of the norm for the level of TSH in the blood, open on the pages of both foreign and domestic journals.

[Ophthalmological equivalents of primary empty sella syndrome].

The pathological process developing in the paracellar area in the presence of primary empty sella syndrome inevitably involves the optic chiasm and optic nerves closely anatomically connected with hypothalamic nuclei and pituitary infundibulum. Polymorphic visual disorders affect virtually all functions of the eye, but an ocular abnormality cannot be detected during an examination.

Gestational hypothyroxinemia and cognitive function in offspring.

The effects of gestational hypothyroxinemia on the neurointellectual prognosis of children in the first year of life living in an industrial city (megalopolis) with mild iodine deficiency were studied in 13 children of mothers with thyroid hormone-corrected gestational hypothyroxinemia in the first trimester and 10 children of mothers with normal levels of free thyroxine by assessing cognitive functions at ages six, nine, and 12 months using the Gnome mental development scale. The results showed that maternal free thyroxine levels at the early stages (5-9 weeks) of pregnancy correlated significantly with the coefficients of mental development among the children at ages 6, 9, and 12 months, i.e., represented one of the factors defining the neuropsychological development of offspring. Early (not later than nine weeks) correction of gestational hypothyroxinemia with levothyroxine at a mean daily dose of at lest 1.2 microg/kg improved the neurointellectual prognosis of the offspring, increasing the coefficient of mental development of children to 92-97 points during the first year of life, i.e., to the level of development of mental functions of children born to mothers with normal thyroxine levels.

[Iodine prophylaxis and the health status of infants of the first year of life, living in a mild iodine-deficiency industrial megapohs].

Adequate iodine prophylaxis in women living in an iodine-deficiency region, startingfrom early pregnancy, positively affects its course and in their babies' neonatal period, somatic and psychoneurological status (increased the mean neuropsychological status by 4-5 scores, by Improving the parameters of cognitive functions). This necessitates the use of potassium iodine agents in a dose of at least 200 fig/day, as recommended by the WHO (2001), in all early pregnancy women living in an iodine-deficient region.

[Gestational hypothyroxinemia and cognitive functions of offsprings].

То study the impact of gestational hypothyroxinemia on the neurointellectual prognosis in infants living in an industrial megapolis who had mild-to-moderate iodine deficiency, the authors used a "Gnome" mental development scale to assess cognitive function in 13 babies bom to mothers who had first-trimester gestational hypothyroxinemia corrected with thyroid hormonal preparations and in 10 babies born to mothers who had normal free thyroxine levels when the babies were 6,9, and 12 months old. The study indicated that the maternal level of free thyroxine in early (at weeks 5-9) pregnancy significantly correlated with the mental development index of babies at the age of 6,9, and 12 months, i.e. it is one of the determinants of offspring's nervous and mental development. Moreover, early (not later than 9 weeks of pregnancy) correction of gestational hypothyroxinemia with levothyroxine in a mean daily dose of at least 1.2 fig/kg improves the prognosis of progeny's neurointellectual prognosis, by increasing the mental development index up to 92-97 scores in babies in the first year of life, which are consistent with that in babies bom to mothers having normal thyroxine levels.

[The effectiveness of ramipril in the treatment of diabetic nephropathy in normotensive children and adolescents]. / Effektivnost' ramiprila v lechenii diabeticheskoi nefropatii u detei i podrostkov s normal'nym urovnem arterial'nogo davleniia.

To study the effectiveness of ACE-inhibitors in diabetic nephropathy (DN) 12 male and 16 female patients aged 13-21 years with DN having normal blood pressure (BP) were given ramipril (tritace) in a dose 2.5-5 mg/day in the course of 12-24 weeks. Efficacy and safety of the treatment were assessed by changes in albuminuria and proteinuria, BP. Reduction of albuminuria occurred in 19(79.1%) out of 24 patients with microalbuminuria, in 13(54.1%) of them urine excretion of albumin returned to normal levels. All the patients with proteinuria and macroalbuminuria benefited from ramipril therapy because their proteinuria diminished or even disappeared (2 cases). The persistence of the antiproteinuria effect on posttreatment week 12 was 66.6%. Ramipril effect on BP was minimal. It is inferred that ramipril is effective in the treatment of DN at the stage of microalbuminuria and proteinuria in patients with normal BP.