Objective:We report a male patient with ovotesticular disorder of sex development (OTDSD), resulting from structurally abnormal Y chromosome. Case report: A 3-year-old boy was admitted to the Surgical Pediatric Department for masculinizing reconstruction. He had a clitorophallus, bifi d scrotum, perineal hypospadias and bilateral impalpable gonads. Pelvic ultrasound and laparoscopy showed a uterus and two gonads with primary ovarian follicles. Chromosome analysis detected a mos 47,XX,mar/46,XX karyotype. Complex genetic evaluation revealed that the marker was Yp isochromosome. Surgical care included a feminizing genitoplasty and separation of the gonads with total excision of testicular tissue. Conclusions: The presented case emphasizes the importance of a systematic approach to the investigation and management of the patients with ovotesticular DSD. It also raises the important issue about gender reassignment in intersex individuals in mid-childhood.

The paper deals with the prevalence and specific features of the metabolic syndrome (MS) in children with different forms of obesity and with the capacities of its correction. Ninety-eight children aged 9-17years, including 44 children with exogenous constitutional obesity and 54 with pubertal juvenile dyspituitarism, were examined. For the diagnosis of MS, clinical exami­nations methods were used. These included: estimation of the body mass index, circumferences of the waist and hips, their ra­tio, the levels of total cholesterol, triglycerides, coagulogram, fasting insulin, the routine glucose tolerance test, and fasting glucose/insulin ratio. The incidence of MS in obese children was 42.9%. A combination of 5 components of MS, such as in­sulin resistence, abdominal obesity, hyperlipidemia, hyperco- agulative changes, and aterial hypertension, was noted in 23.8% of the children and that of 4 and 3 (incomplete MS) components in different combinations was in 52.4 and 23.8%, respectively. The combined therapy low-calorie diet and metformin (Siofor, Berlin-Chemie) was used to correct the metabolic disturbances detected in 28 children aged above 13 years. The use of Siofor in children with MS, unlike dietary monotherapy, substantially improved the values of total cholesterol, fibrinogen, and blood pressure and normalized a response to glycemic load in most patients

Abstract:Aspects of reactivation and remediation of impaired functions of the brain and of the inner organs regulatory systems are crucial to medical science. The study presents the technique of transcranial magnetic therapy (TMT) with extremely low frequency alternating magnetic field employed for balanced activation of central nervous system function. This study was aimed to assess the effectiveness of TMT in diseases caused by hypothalamic-pituitary dysfunction. Material and Methods -90 children aged 10-16 years with different diseases but with similar pathogenic patterns were enrolled in the study. Group 1 included 30 adolescent girls with menstrual irregularities. Group 2 included 30 children with nocturnal enuresis. Group 3 included 30 teenage boys with constitutional delay of growth and puberty. Medical histories were studied, clinical and laboratory evaluation was carried out. TMT stimulation was performed using the device "AMO-ATOS" (TRIMA LLC, Saratov, Russia).Results -Children in all the groups had high incidence of antenatal and perinatal pathologies recorded in their medical histories. Analysis of electroencephalograms (EEG) showed the prevalence of disorganized and flat EEG patterns -70% in all the children. Sympathicotonia being the symptom of autonomic nervous system dysfunction, prevailed in 60-80% of the children. The children in the three groups had hormonal imbalance. The treatment with TMT resulted in considerable improvement in hormonal balance and laboratory findings. Conclusion -ТМТ stimulation is effective in remediation of impaired functions of the brain and treatment of the diseases caused by hypothalamic-pituitary dysfunction.Keywords: hypothalamic-pituitary dysfunction, transcranial magnetic therapy, menstrual irregularities, neurogenic urinary bladder dysfunction, constitutional delay of growth and puberty Cite as Bolotova NV, Averianov AP, Timofeeva SV, Raigorodsky YM, Morova OL. Transcranial magnetic therapy is an effective strategy for remediating neuroendocrine pathology.

Представлены результаты исследования риска возникновения сердечно-сосудистой недостаточности юных спортсменов и подростков при стрессовой физической нагрузке. Описан метод скринингдиагностики риска развития коллапсоидных осложнений. Приведены результаты бесконтактного измерения формы пульсовой волны лучевой артерии в области запястья с использованием полупроводникового лазерного автодина. При измерениях использовался лазерный диод типа RLD-650 со следующими характеристиками: мощность излучения-5 мВт, длина волны излучения-654 нм. Была решена задача по восстановлению формы движения отражателя, в качестве которого выступала поверхность кожи над артерией человека, апробирован метод оценки риска возникновения сердечно-сосудистой недостаточности при физической нагрузке и проведен анализ результатов его применения для оценки риска развития коллапсоидной реакции у юных спортсменов. В качестве анализируемых параметров были выбраны следующие показатели: крутизна систолического подъема на участке быстрой и медленной фазы, скорость изменения пульсовой волны на катакроте, вариабельность кардиоинтервалов, определяемая по временным интервалам между максимумами пульсовых волн. Форма пульсовой волны анализировалась по ее первой и второй производной по времени. Нули первой производной пульсовой волны позволяют выделить время систолического подъема. Минимум второй производной соответствует окончанию фазы быстрого и началу фазы медленного нарастания давления в систолу. Использование первой и второй производной пульсовой волны позволило раздельно анализировать форму пульсовой волны в фазе быстрого и в фазе медленного роста давления во время систолического подъема. Показано, что наличие аномалий в форме пульсовой волны в сочетании с ваготоническим типом нервной регуляции сердечно-сосудистой системы является признаком возникновения опасности коллапсоидной реакции при физической нагрузке. Ключевые слова: сердечно-сосудистая система, пульсовая волна, скрининг-диагностика, полупроводниковый лазерный автодин Работа выполнена при финансовой поддержке Министерства образования и науки РФ (государственное задание № 1376 и 1575).

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