This article provides a review of current literature on the effect of various doses of vitamin D on the parameters of calcium and phosphorus metabolism in patients after bariatric surgery. The decrease of bone mineral density is one of the most frequent complications of the bariatric surgery, which increases the risk of fractures. There are many different mechanisms for impaired mineral metabolism after bariatric surgery, but a decrease in the absorption of calcium and vitamin D plays a key role in this process. Vitamin D is the most important endocrine regulator of calcium homeostasis in the body, which provides the absorption of 90% of calcium in the gut. Patients with morbid obesity have a high risk of vitamin D deficiency even before surgery, which may worsen after operation and in the absence of timely treatment lead to severe disturbances of calcium and phosphorus metabolism. It was found that high doses of vitamin D after bariatric surgery can improve parameters of bone metabolism, and, as a result, prevent fractures after surgery, which generally has a beneficial effect on the quality of life and labor prognosis. The results of the studies available to date open up new opportunities for the prevention and treatment of postoperative complications associated with impaired bone metabolism.

Aim. The aim of our study was to analyze thyroid status in adult patients with Hodgkin’s lymphoma in acute period after radiotherapy on neck region. Material and methods. Thyroid function (TSH, free T 4, anti-TPO) and thyroid ultrasound were evaluated in 22 adults (10 women, 12 men, mean age 30.2 yrs) with a history of Hodgkin’s lymphoma (HL) before radiotherapy on neck region, 7-14 days, 6 month, 1 year after treatment. Results. Incidence of subclinical hyperthyroidism was 13.6% in acute period (7-14 days) after radiotherapy on neck region. There was correlation between dose of radiation and incidence of acute thyroiditis ( r = 0.67, p = 0.03). TSH level fall directly after treatment (1.08 vs 1.88 mkMEd/l р = 0.03), but 6 month after this difference disappeared. T 4 free level decreased 1 yr after treatment (1.18 vs 0.99 ng/ml ) in compare with measurement before treatment ( p = 0,01). Thyroid volume decreased (9.8 ml vs 5.7 ml) 6 month after radiotherapy in compare with measurement before treatment ( p = 0.03), and keep on decreasing 1 yr after treatment (5.35 vs 9.7 ml p = 0.003). Conclusions. These data indicate that some patients with HL receiving high dose of radiotherapy on neck region can develop acute thyroiditis, but this abnormalities are transitory and do not reviewed treatment.

Aim The aim of our study was to analyze thyroid status in adults after treatment for malignancies in childhood and its relationship with dose and type of radiotherapy. Material and methods Thyroid function (TSH, free T4, anti-TPO), thyroid ultrasound and FNA (in case of thyroid nodules more than 1 cm) were evaluated in 106 adults with a history of radiotherapy for brain tumors (BT), acute lymphoblastic leukemia (ALL) and Hodgkin's lymphoma (HL) in childhood and compared with that in healthy controls (n = 33). Group 1 (cranial irradiation 18 Gy): 11 men and 17 women (median age 21.7 ± 4.2 yrs (range 15–30)), 14.6 ± 4 years after treatment for ALL. Group 2 (craniospinal irradiation 35 Gy + boost to the tumor 55 Gy): 28 men and 20 women (median age 19.48 ± 2.76 yrs (range 15 – 26), 7.84 ± 4.68 years after treatment for brain tumors (BT). Group 3 (local irradiation of cervix and mediastinum mean dose 30.9 ± 9.17 Gy): 13 men and 16 women (median age 28.2 ± 6.31 yrs (range 17 – 44), 11.37 ± 7.25 years after treatment for HL. Results Maximal incidence of hypothyroidism was in the group 2 – 58.3% (35.4% – primary, 4.2% – central, 18.8% – mixed). Prevalence of hypothyroidism in groups 1 (9.09%) and 3 (17.24%) doesn't significantly differ from controls. Thyroid volume was lower (mean 4.58±2.39 ml) in group 2 (p<0.001) in compare with other groups and control. TSH was higher (mean 3.72±2.51 MEd/l) in the same group in compare with group 1 and control (p=0.001). Incidence of thyroid nodules (10.34% – group 1; 8.3% – group 2; 20.7% – group 3) doesn't significantly differ between groups and controls (p=0.277). Conclusions These data indicate that treatment of cancer in childhood is associated with development of thyroid abnormality later during the life, and there is a possible link between craniospinal irradiation and incidence of hypo-thyroidism.