Obesity and overweight are significant medical and social problems, and current approaches to their treatment, including hypocaloric diets, bariatric interventions, and pharmacotherapy, including incretin drugs (e.g., glucagon-like peptide-1 receptor agonists), can be accompanied by the development of diffuse hair loss. This article, prepared following a discussion at an expert council, systematizes current data on the prevalence and clinical and morphological variants of alopecia associated with weight loss. The main pathogenic mechanisms are discussed, including metabolic stress, protein-energy malnutrition, and micronutrient deficiencies. Special attention is paid to the role of biotin and vitamin D in maintaining hair follicle function, as well as to risk groups for alopecia in patients undergoing treatment for obesity. Approaches to the prevention, monitoring, and comprehensive management of such patients are presented, taking into account the need to maintain adherence to the main therapy. This article systematizes current data on the prevalence and clinical and morphological variants of alopecia associated with weight loss. It examines the main pathogenic mechanisms, including metabolic stress, protein-energy malnutrition, and micronutrient deficiencies. Special attention is paid to the role of biotin and vitamin D in maintaining hair follicle function, as well as to risk groups for alopecia in patients undergoing treatment for obesity. Approaches to prevention, monitoring, and comprehensive management of these patients are presented, taking into account the need to maintain adherence to the primary therapy.
Congenital hyperinsulinism (CHI) is a rare, genetically heterogeneous disorder characterized by inappropriate hypersecre tion of insulin by pancreatic beta cells and is the most common cause of persistent hypoglycemia in young children. The in cidence of CHI in the general population ranges from 1:30,000 to 1:50,000 live births. Timely diagnosis and treatment of CHI are critical, as persistent hypoglycemia can lead to irreversible damage to the central nervous system. This review summa rizes current understanding of the etiology and pathogenesis of CHI and presents an up-to-date classification of CHI based on duration, etiology, histological form, and response to diazoxide therapy. A detailed diagnostic algorithm is provided, including provocative tests, molecular genetic testing, and imaging studies. The stages of conservative treatment and indi cations for surgical treatment are discussed. The review is based on updated clinical guidelines and is intended for practicing physicians — pediatricians, endocrinologists, and neonatologists — who care for children with hypoglycemic conditions.
BACKGROUND : Although pheochromocytomas and paragangliomas (PPGLs) classically present with distinct clinical signs, there is a category of patients with asymptomatic disease course. Despite the absence of clinical manifestations, these patients retain the risk of life-threatening hypertensive crisis and other cardiovascular complications. The clinical, laboratory, and imaging characteristics of asymptomatic PPGLs remain insufficiently studied and are of significant scientific and practical interest. AIM : To analyze the clinical, laboratory, and imaging characteristics of asymptomatic PPGLs compared to symptomatic ones. MATERIALS AND METHODS : The analysis included 347 patients with histologically confirmed PPGL who underwent surgery at the Saint Petersburg State University Hospital. Retrospective analysis encompassed demographic data, medical history (primary and comorbid conditions), laboratory findings, and computed tomography (CT) data. RESULTS: The PPGLs patient cohort included 45 cases without clinical signs of catecholamine hypersecretion. The asymptomatic subgroup, compared to symptomatic patients, exhibited younger age (43 [33; 51] vs. 48 [37; 57] years); smaller maximum tumor size (34 [27; 53] vs. 45 [34; 60] mm); lower metanephrine/normetanephrine ratio (0.29 [0.10; 0.79] vs. 0.51 [0.09; 1.23]). CT imaging revealed slightly higher radiodensity values in asymptomatic PPGLs during arterial, venous, and delayed phases compared to symptomatic tumors. However, absolute and relative washout percentages did not differ significantly. CONCLUSION : The younger age and smaller tumor size in asymptomatic PPGL patients suggest earlier detection of the disease compared to symptomatic cases. The lower metanephrine/normetanephrine ratio may indicate a higher prevalence of the norepinephrine-secreting phenotype in asymptomatic PPGLs. No pronounced differences were found in imaging characteristics between asymptomatic and symptomatic tumors.
On March 25, 2026, a meeting of the Expert Council entitled "Hypoparathyroidism in the Era of Complex Challenges and Breakthrough Technologies" was held in Moscow at the Endocrinology Research Centre. The meeting focused on the epidemiology of chronic hypoparathyroidism (hypoPT) in Russia, the specifics of patient management with this pathology in other countries, and the similarities and differences between international and Russian clinical guidelines. The meeting discussed advances in improving diagnostics and personalized treatment for patients with hypoPT in Russia, as well as the need to implement best practices in practical healthcare as part of the 2027 clinical guidelines revision. The importance of including chronic hypoPT in the official list of rare (orphan) diseases was highlighted, as was the need to continue studying the characteristics of the disease and its complications, diagnosis, monitoring, and prevention of hypoPT, including in the long term. The meeting also highlighted the relevance of an interdisciplinary professional alliance to achieve optimal treatment outcomes and improve the quality of life of patients with chronic hypoPT. The experts highlighted the need to implement innovative, effective treatment methods, including hormone replacement therapy for hypoPT. The Council discussed the efficacy and safety of the new therapeutic technology, TransCon parathyroid hormone. Invited expert Dilek Gogas Yavuz, MD, Professor at the Marmara University School of Medicine, Department of Endocrinology and Metabolism, Department of Internal Medicine (Istanbul, Turkey), shared her experience with the drug and the results of international clinical trials. This resolution is a summary of the issues discussed in the Council members’ presentations and during the professional discussions.
This article provides a conceptual overview of the methodology and design of prognostic research. It presents cohort studies as the most suitable design for prognostic investigations and discusses in detail the distinctions between traditional etio logical cohort studies and those primarily aimed at predicting outcomes. The article reviews examples of prognostic studies that focus on predicting gestational diabetes mellitus, renal failure in type 2 diabetes mellitus, osteoporotic fractures in postmenopausal women, outcomes of infertility treatment in women with elevated follicle-stimulating hormone levels, and survival in patients with adrenocortical carcinoma. The importance of adhering to the methodological standards outlined in the STROBE and TRIPOD guidelines is emphasized. It also highlights the need to avoid common design and analytical pitfalls, such as measuring predictors after the outcome has occurred or using ROC analysis without developing a multivari able prediction model. Particular attention is given to employing appropriate statistical methods, as a lack of understanding of these methods may lead to biased inferences and diminish the scientific value of the published research. Incorporating well-designed prognostic cohort studies and rigorous analytical approaches will enhance clinical practice and strengthen the evidence base in modern endocrinology.
