Congenital hypothyroidism – thyroid disease, which occurs approximately 1: 3000-4000 newborns. Early onset of substitution levothyroxine therapy prevents the development of mental retardation. Neonatal screening of сongenital hypothyroidism in Russian Federation was started in 1994. This review presents the data of Russian and foreign researchers about the intellectual outcome of children and adolescents with сongenital hypothyroidism.

This review of literature discusses impact of cytokine regulation in pathogenesis of autoimmune thyroiditis and Graves's disease.

The purpose of the study is to evaluate character of lipid profile changes in Novosibirsk populational sample of men and women (45–69 years) with subclinical and high-normal TSH levels. Current study was performed within the HAPIEE project “Determinants of cardiovascular diseases in Eastern Europe” of the Welcome Trust fond. Populational subsample of 280 subjects (125 men (44.6%) and 155 women (55.4%)) was analyzed. Received data showed that high-normal TSH levels within 1.71–4.05 mIU/l have been associated with higher levels of triglycerides, total cholesterol and LDL cholesterol, compared with low-normal TSH levels 0.17–0.47 mIU/l (р<0.05). Women with subclinical hypothyroidism had significantly higher average levels of total cholesterol and LDL cholesterol compared with women without thyroid disorders.

In 2008–2010 pilot project were realized in Tyumen region on combined preventive maintenance iodine deficiency and iron deficiency conditions, within the framework of which children from pilot of the territory got feeding, enriched premixes of the iodine and ferric while checking group has formed the children, getting monoprevention iodized salt. In study were examined 467 children. Frequency of the goiter on ultrasonography in pilot territory fell from 19.8 to 6.4%, in checking from 12.5 to 10.1%. In group teenager on background combined micronutrient preventive maintenance frequency tests ferritin less 15 mcg/l fell for 76 weeks in four times (p = 0.000), herewith average factors in 2010 above, than in 2008 (p = 0.114). In group teenager checking territory on background monoprevention frequency of the lowered tests ferritin more, than in group on background of the combined preventive maintenance in 2 times (p = 0.004), improvements for period of the study is not revealed.Dynamics indices of iodine deficiency conditions on background of the combined preventive maintenance and monoprevention confirms greater efficiency of the simultaneous using the products fortifications iodine and iron. Shown efficiency micronutrient preventive maintenances of the latent deficit ferric fortifications bread.

Graves' ophthalmopathy constitutes a major therapeutic challenge, so specialists of various disci-plines have to combine their forces. According to the last consensus of EUGOGO (European Group On Graves' Orbitopathy) the treatment of choice for Graves' ophthalmopathy is pulses of glucocorticoid (GC). Evidence for the superiority of any of the different intravenous (iv) glucocorticoid schedules is lacking. Objective: to evaluate the efficacy of two different methylprednisolone pulse therapy schedules in Graves' ophthalmopathy. Materials and Methods: 30 Graves' patients with Graves' ophthalmopathy were subcategorized into two groups: Group A subjects (n = 14) were given iv glucocorticoid daily for 5 days (total 5 g) and Group B patients (n = 16) were given iv glucocorticoid weekly for 5 weeks (total 5 g). All patients were examined by the ophthalmologist before and in 1 and 12 weeks after the treatment. Results: We found that in group A visual acuity was significantly higher than in group B at 12 weeks. By 12 week proptosis, diplopia had improved as well as CAS had fallen in two groups but there were no significant differences between the two groups. Conclusion: Both schedules are effective on proptosis, soft tissue swelling. Daily pulse therapy appeared to be more effective on visual acuity. Thereby in case of active Graves' ophthalmopathy associated with impairment of visual acuity, daily pulse therapy is a treatment of choice. But, in spite of improvement, strabismus, diplopia, proptosis have a marked negative effect on quality of life, disturb a lifestyle. In these cases surgery should be considered. After end of our research two patients (3 orbits) had bone decompression with a good result. We consider that eye muscle surgery is next needed to restore their binocular vision.

Objective: to investigate circadian and individual variability of TSH level in patients taking LT4-replacement therapy for primary hypothyroidism. Methods. 22 patients taking LT4-replacement therapy, at the age of 18–60 years have been included. Measurements of serum TSH were performed at 8.00–9.00 h and 14.00–16.00 during the day and at 8.00–9.00 h in 4–6 weeks. Results. The median of TSH concentrations in the morning was 3.3 mU/l, at the day-time – 2.2 mU/l (р <0.05). The amplitude of TSH circadian variability reached 65% (Me-31.2%). According to the current TSH target ranges (0.4–4.0 mU/l) replacement therapy of 45.5% participants in the morning and 9% participants at the daytime has appeared inadequate. According to the proposed TSH target ranges (0.4–2.5 mU/l) 54.5% participants in the morning and 40% participants at the daytime had no hypothyroidism compensation. TSH levels in 4–6 weeks differed from initial on (+95)–95%. In 4–6 weeks replacement therapy has appeared inadequate in 21.4% participants according to the current TSH target ranges and in 35.7% participants according to the proposed TSH target ranges. Conclusion. The leading role in an estimation of adequacy of LT4 replacement therapy is played by morning TSH level. Difficulties of maintenance of TSH concentration exist both within current and proposed target range.

In our study we try to determine whether small changes in thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants. Sixty ambulatory patients with primary hypothyroidism receiving levothyroxine (L-T4) participated in the study. Patients were divided into 2 groups according to their TSH level. The first group was in TSH low-normal range (0.4–2.0 mU/l), the second in upper-normal (2.1–4.0 mU/l) range. We analyzed the results of several tests: “12 classical hypothyroidism symp- toms”, SF36, HARS, HDRS, Zung scale at baseline and in 3 months. With a small-dose changes we cross the groups to compare the results. Results: At baseline analyze there was a small differ-ence between two groups. Women with in the upper-normal TSH range had more expressed symptoms of hypothyroidism. After small changes in thyroxine treatment we could not say that the clinical picture of a hypothyroidism has changed cardinally, however, it is necessary to notice that there was dynamics of separate symptoms. The same picture was noticed with the depression and anxiety levels. The meanings were rather close and small dose changes in L-T4 treatment were more expressed in group with upper-normal range. The positive dynamics of well-being after dose changing were registered in both groups. Conclusion: Small changes in T4 dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life.