Background. Significant proportion of patients with obesity and type 2 diabetes mellitus (DM) have significant weight loss and improved metabolic outcomes as a result of bariatric surgery. To predict the effect of surgical treatment of DM, several scales have been proposed, including ABCD and IMS.
Objective. To estimate accuracy of the ABCD and IMS scales in predicting DM remission in patients undergoing bariatric surgery.
Design and methods. 38 patients with type 2 diabetes were identified after bariatric surgery with a follow-up period of at least 1 year. The KNIME Analytics Platform 4.3.6 (KNIME AG, Switzerland) was used for data processing.
Results. 12.8 % of patients achieved partial remission, 52.6 % complete remission, and 31.6 % did not achieve remission. According to the IMS, no significant results were detected in the remission groups. IMS scale have a low predictive value. A significant result was obtained for the ABCD after CAIM binning. For the binary classification (“Remission”/”Haven’t remission”): AUC = 0.98 and Cohen’s kappa k = 0.86 for probability treshold 0.55399, that maximized F-measure (0.96) were obtained. So, ABCD predictive value is high.
Conclusion. The ABCD have a better predictive value. Ease of use, good prognostic effect allows us to recommend ABCD before bariatric treatment.

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide and one of the most common cause of liver transplantation in developed countries. Type 2 diabetes mellitus (T2DM) is an important risk factor for NAFLD. Additionally, T2DM is believed to accelerate the progression of NAFLD. Therefore, the use of different imaging modalities in this patient cohort appears to be more important than in patients with NAFLD without diabetes mellitus. Moreover, NAFLD is often overlooked in clinical practice. It should be noted that the gold standard for diagnosing NAFLD is still a liver biopsy, however, the method has a number of obvious disadvantages in terms of invasiveness, the impossibility of its frequent use in routine practice, its inapplicability for assessing the dynamics of NAFLD during treatment, and relatively high cost. In this regard, work is underway to find new non-invasive methods for diagnosing NAFLD, especially in the early stages. Radiation diagnosis of NAFLD is based on the use of ultrasound (ultrasound), computed tomography (CT) and magnetic resonance imaging (MRI), the sensitivity and specificity of which vary considerably. Thus, this review summarizes and discusses modern methods of non-invasive diagnosis of different types of NAFLD in patients with T2DM that can potentially have an important prognostic value.

Background. Menstrual cycle disorders (MCD) are common among adolescent girls.
Objective. To study the level of plasma kisspeptin in adolescent girls with obesity and MCD.
Design and methods. The study included 80 adolescent girls with obesity. Group 1 — with MCD, group 2 — without MCD. Inclusion in groups 1 year or more after menarche. Laboratory examination included assessment of carbohydrate and lipid metabolism, hormonal examination.
Results. There were no significant differences in SDS BMI between the groups (p = 0.486 and p = 0.459). Significantly higher in group 1: impaired carbohydrate tolerance (NTU), hypertriglyceridemia (p = 0.022), levels of kisspeptin, luteinizing hormone (LH), total testosterone, anti-muller hormone (AMH), free androgen index (ISA) (p = 0.001, p = 0.008, p = 0.026, p = 0.014, p = 0.027, respectively). The estradiol level in group 2 was significantly higher than in group 1 (p = 0.012). According to the results of the ROC analysis, the optimal value of the plasma kisspeptin level was found to be 53.56 pg/ml.
Conclusion. Obese and MCD patients have significantly higher levels of kisspeptin, as well as LH, AMH, and testosterone than adolescent girls with similar severity of obesity without MCD. The plasma kisspeptin level is 53.56 pg/ml. It can be used as a new diagnostic criterion for predicting the risk of MCD in obese girls. Obese and MCD patients are significantly more likely to have NTU and hypertriglyceridemia compared to obese patients without MCD.

In current study, we described the onset of a case of vasospastic angina against the background of thyrotoxicosis.
In a 48-year-old patient with transplanted heart coronary artery disease and achieved revascularization after stenting, anterior ventricular failure is used and episodes of ST elevation are preserved in the nighttime indicators of Prinzmetal’s angina in leads characterizing the potentials of the anterior septal (V1–V3), complete anterior (V4–V5), lateral (V6, I), lower diaphragmatic (III, avF) tissue of the left ventricle regardless of physical activity and despite optimal drug therapy with calcium channel blockers and nitrates. The patient did not have characteristic clinical signs of thyrotoxicosis, probably due to ongoing immunosuppressive therapy, in particular, glucocorticosteroids.
Destructive thyrotoxicosis was diagnosed due to high T4\T3 ratio, absence of TSH receptor antibodies, and a diffuse decrease of 99mTc-pertechnetate uptake. After increasing the dose of glucocorticosteroids and achieving euthyroid state, the episodes of ST elevation resolved.
This case emphasizes the importance of timely detection and proper differential diagnosis of thyrotoxicosis. The clinical course of thyrotoxicosis in patients with severe cardiovascular pathology is often atypical and complicated. Restoration of normal thyroid function may lead to the regression of associated cardiac arrhythmias.

High cardiovascular mortality (CVD) determines the relevance of their effective primary and secondary preventive measures, based on the principles of a clinical-epideomyological approach and the isolation of risk factors (RFs). Until now, CVD have been the leading cause of deterioration in the demographic indicators of the population of all countries. According to WHO, they account for up to 31 % of deaths and up to 59 % of deaths. Adherence to the principles of a healthy lifestyle, a reduction of the main RFs at the population level can prevent up to 80 % of the premature CVD deaths. At the same time, clinical manifestations of atherosclerosis can arise in the absence of “classic” RFs. To improve CVD prediction results the possibility of using additional criteria, the so-called “new” RFs, is being studied. They include the accumulation of final products of glycation, insulin resistance, obesity and hyperhomocysteinemia. Insulin resistance and hyperhomocysteinemia are thougth to be of the most value for their integration in “classic” RFs of atherosclerosis and atherothrombosis in the diagnosis of CVD and assessing individual prognosis.
Thus, the risk of CVD increases under the influence of a huge number of different genetic, anatomical, physiological,
biochemical, psychoemotional factors, and the identification of markers for the development of CVD is an urgent problem of modern health care.

Background. According to WHO controllable hypertension risk factors include an unhealthy diet, physical inactivity, and wrong daily routine. To date, a large number of experimental studies in rats have studied the effect on the development of unilateral renovascular hypertension (URH) of dietary supplements (minerals, vitamins, flavonoids, caffeine, fats, carbohydrates), physical activity and melatonin therapy.
Objective. To conduct a meta- analysis of studies on risk factors for the development of URH.
Design and methods. The search for publications was carried out in the PubMed, Scopus, Google Scholar databases. A total of 52 publications were selected.
Results. The severity of hypertension decreases when the diet is enriched with potassium, as well as with various antioxidants (vitamin C, flavonoids, melatonin), which reduce oxidative stress in the ischemic kidney. In addition, physical activity can help reduce blood pressure in URH, but at the same time, it increases myocardial hypertrophy. There was no hypertensive effect of increased sodium chloride intake in renal artery stenosis, and no effect of calcium or magnesium supplementation on the URH development. At the same time, caffeine intake significantly increases plasma renin activity and blood pressure in URH.
Conclusion. The majority of experimental studies included in our meta-analysis investigated the influence of factors on the development of URH, but not their effect on blood pressure in the chronic stage of URH.

Primary hypothyroidism is one of the most common endocrine pathologies. Subclinical hypothyroidism (SH) is a common disorder diagnosed with elevated levels of thyroid-stimulating hormone (TSH) and normal serum free thyroxine (T4) levels. There are also the difficulties in diagnosing SH due to its low-symptomatic or asymptomatic course and numerous “masks”: cardiological, gastroenterological, rheumatological, hematological, psychiatric. A wide variety of causes also makes timely diagnosis difficult.
There are many studies proving the effect of SH on the state of the cardiovascular system (CVS) and its association with a higher risk of cardiovascular events. Diastolic dysfunction and arterial hypertension (AH) are commonly observed. Of note, the issue of prescribing replacement therapy with Levothyroxine sodium is still controversial. It is necessary to conduct further research in order to develop unified algorithms for the treatment of patients with FH, including those with concomitant cardiovascular diseases (CVD).
CVD is a frequent companion of hypothyroidism. The studies on FH replacement therapy are of low methodological quality and their conclusions on the outcomes of interest are not consistent. Thus, further studies with a large number of patients are required to identify the effect of FH on the state of the CVS.
In this review, the authors summarize and present the available data on the incidence, pathogenetic mechanisms, cardiovascular pathology in HF, as well as its treatment.

There was a constant searing pain in the right side of the head and a face that was not buying analgesics in a 61-year-old woman, after surgery in 2018 to remove a meningioma in the right frontal lobe followed by a cranioplasty titanium implant. Evaluation of immune status revealed that the allergological test for titanium was positive. According to the results of the MR-study of data for continued growth of the tumor, as well as signs of vasonary conflict of the trigeminal nerve.
The possible development of the galvanic syndrome in patient has been suggested. Thus, the decision to remove the titanium implant has been made. During the operation, the presence of galvanic current (from 3–46 μA) on the titanium plate surface was documented and instrumentally confirmed.
Under the titanium implant during the operation, ectopic foci of neoosteogenesis were visualized. The condition improved in the form of a complete regression of pain syndrome after removing the titanium implant.
The present clinical case is the world’s first description of the development of galvanic syndrome on the surface of titanium cranioplastic mesh. The presence of electroplating repair of bone tissue can be a new step in solving the problem of closing skull defects in neurosurgical patients.

Background. Chest MRI allows diagnosing in the acute period of covid-associated pneumonia (CAP) and assessing the dynamics of treatment. The potential of MRI in postcovid pulmonary arterial hypertension (PAH) study remains unclear. Objective. To examine the chest MRI picture in CAP patients and to quantify the signs of post-COVID PAH. Design and methods. The study included 34 patients who underwent COVID-19 within 3.5–7 months with involvement of the parenchyma of mild severity upon admission of CT1–CT3 according to spiral X-ray CT. All patients underwent chest MRI in ECG- and respiratory-synchronized T1- (T1-WI), T2 (T2-WI) and diffusion-weighted MRI protocols and ultrasound of the heart and large vessels of the chest cavity, with the calculation of systolic pressure in the right ventricle (SPRV). Results. Three groups were distinguished: CT1 (group 1), CT2 (group 2) and CT3 (group 3). The frequency of subsegmental/segmental signs of LA branches thromboembolism was significantly higher in groups CT2 and CT3. LA diameter, SPRV and T1-WI intensity ratio index {Lung/LA} progressively increased from group 1 to group 3. The dependence of SPRV on the {Lung/LA} was fitted using Boltzmann curve (r = 0.92, p < 0.01). Conclusion. Chest MRI in T1- WI allows assessing the degree of post-covid changes in the lung parenchyma thickness and predicting early forms of increased pulmonary arterial pressure and the formation of PAH.