OBJECTIVETo evaluate the efficacy and safety of actovegin in patients with diabetic polyneuropathy.RESEARCH DESIGN AND METHODSIn this multicenter, randomized, double-blind trial, 567 patients with type 2 diabetes received 20 intravenous infusions of actovegin (2,000 mg/day) (n = 281) or placebo (n = 286) once daily followed by three tablets of actovegin (1,800 mg/day) or placebo three times daily for 140 days. Total symptom score (TSS) of the lower limbs and vibration perception threshold (VPT) were used as coprimary outcome measures, computed as the area under the curve (AUC) from repeated scores and divided by duration of exposure. Secondary end points included individual TSS symptoms, neuropathy impairment score of the lower limbs (NIS-LL), and quality of life (short form [SF]-36).RESULTSTSS was significantly improved during actovegin treatment compared with placebo, as assessed by AUC (−0.56 points [95% CI −0.85 to −0.27]; P = 0.0003), and from baseline to 160 days (−0.86 points [−1.22 to −0.50]; P < 0.0001). VPT (five sites per foot) decreased by 3% (95% CI 0–6; P = 0.084) with actovegin than placebo, as assessed by AUC, and by 5% (1–9; P = 0.017) after 160 days. NIS-LL sensory function, as assessed by AUC, was significantly improved with actovegin versus placebo (−0.25 [95% CI −0.46 to −0.04]; P = 0.021), as was the SF-36 mental health domain. There were no differences in the incidence of adverse events between the groups.CONCLUSIONSSequential intravenous and oral actovegin treatment over 160 days improved neuropathic symptoms, VPT, sensory function, and quality of life in type 2 diabetic patients with symptomatic polyneuropathy.

Казахский национальный медицинский университет им. С. д. асфендиярова, алматы, Казахстан 2 Казахский научно-исследовательский институт онкологии и радиологии, алматы, Казахстан The BRAF V600E mutation is the most frequent somatic oncogenic event in adult patients with papillary thyroid carcinoma (PTC). This work set out to determine the prevalence of mutant BRAF and its correlations with clinical-morphological characteristics of PTC, and to examine feasibility of detection of BRAF V600E in fine-needle aspiration biopsy material in patients from Kazakhstan. A total of 92 consequent patients diagnosed and treated for PTC from January 2016 to July 2017 were enrolled. Serial tissue sections of formalin-fixed paraffin embedded tissues were stained with hematoxylin and eosin, and immunohistochemically with monoclonal antibodies specific to the BRAF V600E protein. Positive immunohistochemical reaction was registered in 67.4 % of cases.