ACTA ENDOCRINOLOGICA (BUC)

Background. Adverse effects of gasoline vapour (GV) on reproductive functions have been reported in experimental animals, including the female rats. Aim. Assessment of the ameliorative potencies of vitamins A, C and E against GV-induced toxicity on serum sex hormonal level in female rats. Animals and Methods. Five groups of adult female rats (n = 6) were daily treated respectively with distilled water (control), GV by inhalation (6 hr/day, 5 days /week) for 60 days, vitamins A (400 IU /kg) + GV, C (600 mg/kg) + GV and E (400 IU/ kg) + GV. The animals were sacrificed at the end of experiment, and serum sex hormonal (FSH, LH, estradiol and progesterone) levels were determined. Results. Exposure to GV significantly decreased (P ≤ 0.05) serum FSH, LH, estradiol and progesterone levels (2.26 ± 1.02 mIU/mL, 6.80 ± 1.62mIU/mL, 27.58± 4.27 ng/ mL and 18.82 ± 2.56 ng/mL, respectively), compared to control values (5.15 ± 2.54 mIU/ mL, 13.25 ± 3.30 mIU/mL, 54.02± 5.18 ng/ mL and 38.00 ± 3.56 ng/mL, respectively). The serum hormonal levels obtained for GVexposed rats treated with the vitamins (4.30 ± 2.62 mIU/mL, 12.38 ± 2.40mIU/mL, 52.06 ± 6.28 ng/mL and 36.26 ± 3.66 ng/mL, respectively for Vit. A; 4.66 ± 2.48 mIU/mL, 12.75 ± 2.92 mIU/mL, 53.80 ± 7.29 ng/mL and 36.78 ± 3.68 ng/mL, respectively for Vit. C; 5.62 ± 2.84 mIU/mL, 17.22 ± 2.92 mIU/ mL, 69.98 ± 5.66 ng/mL and 46.88 ± 4.0 ng/mL, respectively for Vit. E) were significantly higher (P ≤ 0.05) compared to the GV-exposed untreated rats. However, the hormonal levels obtained for vitamin E treated GV-exposed rats were significantly higher (P ≤ 0.05) than the levels for vitamins A and C treated GV-exposed rats, respectively. Conclusion. Vitamin E is more effective than A and C in ameliorating the adverse effect associated with exposure to GV on the female serum sex hormonal levels in rats.

The RET proto-oncogene is the most well-known gene involved in medullary thyroid cancer (MTC). The associations between specific RET mutations and the age of onset and aggressiveness of MTC and the presence or absence of other endocrine neoplasms such as pheochromocytoma or hyperparathyroidism have been well documented. When a new mutation is identified in the RET gene, defining that mutation’s codon-specific risk level is important in the management of patients with MTC. Case Report. Here, we present the first report of a patient with a germline variant of Ala641Thr, in the transmembrane domain of the RET gene. A 37-year-old female presented with an anterior neck mass, which was confirmed to be MTC by biochemical tests and pathologic findings. The patient had no identifiable family history of MTC or multiple endocrine neoplasia syndromes. Histology revealed a single unilateral MTC lesion (21 mm × 16 mm) in the right thyroid lobe without cervical lymph node metastasis. Genetic testing revealed a germline Ala641Thr missense mutation in the RET gene. The RET gene variant was inherited by one of her children. Conclusion. Although this novel variant has unknown clinical significance at present, the causative role of this genetic variant in MTC pathogenesis could be clarified by further molecular structure-function studies and additional clinical cases showing a genotype-phenotype relationship.

Objective. The mechanisms underlying the development of diabetic neuropathic pain (NeP) are still unknown. The aim of the study was to evaluate painful diabetic neuropathy in Type II diabetic patients with Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS), thermal and vibratory Quantitative Sensory Testing (QST) and, EMG supported Diabetic Neuropathy Score (DNS) and to evaluate the differences in patients with and without neuropathic pain. Methods. Eighty three Type II diabetic patients (26 males, 57 females) were investigated. Patients with pain were assessed by the LANSS pain scale and a score of ≥12 was classified as NeP. All patients underwent nerve conduction studies (NCS) to obtain EMG supported diabetic neuropathy score (DNS). Cold and warm sensation thresholds and cold pain and heat pain thresholds were obtained for evaluation of A-delta and C type fibers. Vibratory perception thresholds were recorded for evaluation of thickly myelinated fibers. Results. The percentage of NeP (LANSS score ≥12) was 15.7 %. QST revealed significantly lower cold detection, higher warm detection and higher heat pain thresholds at the feet in patients with NeP compared with patients without NeP. Although small fiber dysfunction has been revealed in all patients with NeP, the percentages of the presence of small fiber neuropathy and EMG supported diabetic neuropathy were not significantly different among patients with NeP and without NeP. Conclusions. We concluded that QST is a useful and a noninvasive tool to detect small fiber dysfunction in Type II diabetic patients. QST revealed increased severity of small fiber dysfunction in patients with NeP. Although small fiber neuropathy has been revealed in all Type II diabetic patients with neuropathic pain the absence of pain does not predict preserved small fiber function.

Introduction. Under physiological conditions, maintenance of skeletal mass is the result of a tightly coupled process of bone formation and bone resorption. Disease states,\r\nosteoporosis included, arise when this delicate balance is disrupted such as in menopause.\r\nThe aim of the present work was to study the effect of leptin supplementation on bone metabolism in ovariectomized adult female rats, by measuring indices of bone biomarkers.\r\nMaterial and methods. Forty adult female albino rats were chosen as an animal model for this study and divided into the four equal groups (n=10/group): Group I (control SHAM-operated group), Group II (ovariectomy group). Group III (alendronate group): Ovariectomized rats that received\r\nalendronate 0.1 mg/kg body weight i.p. daily for eight weeks. Group IV (leptin group): Ovariectomized rats that received leptin (10μg/kg body weight) i.p. daily for eight\r\nweeks. The obtained serum is required for determination of: Serum osteocalcin, alkaline phosphatase, calcium and phosphorus levels.\r\nResults. The obtained data revealed that: Treatment with alendronate or leptin caused significant decrease of serum\r\nosteocalcin, specific bone alkaline phosphatase and urinary deoxypyridinoline levels compared to ovariectomy group.\r\nConclusions. The results obtained in the present study provide evidence that daily administration of leptin contributes significantly to improve the bone biomarkers\r\nof ovariectomy in rats. Leptin prevents ovariectomy induced increases in bone turnover in rats.

Background. Dual-energy X-ray absorptiometry (DXA) allows measurement of whole body (WB) and regional bone mineral content (BMC) and density (BMD). Objective. To measure WB and regional bone area, BMC and BMD (arms, legs, ribs and pelvis) in women of different ages. Subjects and Methods. 140 women participated (age range 20-75 yrs). Three subgroups were built: 20-44 yr (30 premenopausal women), 45-59 (80 women), and 60-75 (30 women). WB DXA was performed on a Hologic QDR 4500 A bone densitometer (Hologic Inc., Bedford MA). WB BMD T-scores were calculated by using the manufacturerprovided and the NHANES 1999-2004 reference databases, while the WB BMC Z-scores - based on the latter. Statistical analysis was performed on an IBM SPSS Statistics 19.0 for Windows platform (Chicago, IL). Results. WB BMC and BMD Z-scores were consistently lower than the reference databases showing a difference of about 0.4 – 0.5 SD. The arms, legs and ribs lost more BMC after the age of 50-55, while the pelvis – much earlier. The total decreases in BMC were highest in the pelvis (26.36 %), followed by the arms (16.81 %) and whole body (15.91 %), while the bone area decreased mostly in the pelvis (13.23 %). Conclusion. The age-related declines in regional BMC, bone areas and BMD follow different patterns in appendicular and axial bones.

Objective. Thyroid diseases coexisting with primary hyperparathyroidism (PHPT) may individually change the diagnosis, treatment and follow-up of the patients. In our study, we aimed to investigate the thyroid diseases coexisting with PHPT and the relation between\r\nthese two clinical situations.\r\nMethods. We retrospectively investigated 255 patients who were diagnosed as PHPT between 2004-2009 in our clinic. The general characteristics of the patients, laboratory tests,\r\nwhich were performed preoperatively, neck ultrasonography, thyroid and parathyroid scintigraphy and fine needle aspiration biopsy (FNAB) results were assessed. Cytological\r\nresults of the nodules with preoperative FNAB were compared with the postoperative histological results.\r\nResults. Of the patients, 49 were male (19.2%) and 206 were female (80.8%). Mean age was 54.5?12.8. Bilateral neck exploration (BNE) was performed on 69 cases (27%),\r\nminimal invasive parathyroidectomy (MIP) on 78 cases (30.5%) and BNE plus thyroidectomy on 108 cases (42.5%). When all thyroid diseases were taken into account,\r\nprevalence of the coexisting thyroid disease was 65%, prevalence of nodular thyroid disease 52.1%, thyroid cancer 16.7% and thyroid dysfunction 11.8%. The mean age of the patients with a nodular goitre was significantly higher than of the patients who did not have nodules\r\n(p<0.001). General demographic data, calcium and PTH levels did not show any difference. Number of nodules was correlated with age (p<0.001, r=0.227).\r\nConclusion. The relation between PHPT and nodular thyroid diseases is coincidental and this can be explained by the fact that both diseases occur in advanced age.

Graves&#8217; orbitopathy usually occurs in thyrotoxic patients at the presentation of the\r\nhyperthyroidism.\r\nAim: we conducted a cross sectional study over 8 and a half years of the relation\r\nbetween Graves&#8217; orbitopathy and thyroid status in patients presenting to our joint thyroidophthalmology\r\nclinic at University Hospital of Wales.\r\nMethods: Patients with active orbitopathy were diagnosed clinically and with\r\nappropriate imaging where necessary. This series excluded patients previously treated with\r\nradioiodine or surgery for Graves&#8217; disease. Of 259 patients 140 (54%) had not had 131I or\r\nsurgical therapy. Thirty four percent of the 140 had never been hyperthyroid of whom 19\r\n(13.5%) were euthyroid. Twenty nine of the 140 (20.7%) were hypothyroid receiving\r\nlevothyroxine at referral. There were no significant differences between the hyperthyroid\r\nand non hyperthyroid groups in the incidence of cigarette smoking, family history of thyroid\r\ndisease or maximum proptosis at presentation.\r\nResults: We found a higher prevalence of smokers than reported in the literature in\r\nmoderate and severe TAO across all thyroid status groups including hypothyroid only\r\npatients. This study has emphasized the occurrence of Graves&#8217; orbitopathy in hypothyroid\r\npatients as well as euthyroid individuals.

Background. ThyPRO is a recently developed thyroid-specific quality of life (QoL) questionnaire applicable to patients with benign thyroid disorders(BTD). The aim of the present study was to translate ThyPRO and ThyPRO-39 into Romanian, and to evaluate reliability and cross-cultural validity. Methods. Standard methodology for translation and linguistic validation of patient-reported outcomes (PRO) was applied. The questionnaire was completed by 130 patients with benign thyroid diseases seen at Department of Endocrinology in the Emergency County Hospital, Tîrgu Mureș, Romania, between October 2015 and March 2016. Internal reliability of the Romanian version of the ThyPRO (ThyPROro) scales was assessed for multi-item scales using Cronbach’s alpha coefficient. An efficient method for testing cross-cultural validity is analysis of differential item functioning (DIF). Uniform DIF between the Romanian and the original Danish sample was investigated using ordinal logistic regression. The translation process proceeded without difficulties, and any disagreements were revised by one of the developers and the language coordinator. Results. Internal reliability for ThyPRO was satisfactory. Cronbach`s alpha coefficients for the 13 scales ranged from 0.78 to 0.93 for the ThyPROro and 0.78 to 0.87 for the ThyPROro-39. In the 85-item ThyPRO, nine instances of DIF were found. Most were minor, explaining <3% of the variation in scale score, but DIF in positively worded items were larger, with explained variance (R2’s) around 10-15%. Conclusion. The ThyPROro questionnaire is ready for assessment of health-related quality of life in Romanian patients with benign thyroid diseases.

Background/Aims. Growth hormone deficiency (GHD) in children and adolescents is managed with growth hormone (GH) therapy and aims to achieve optimal height development. However, treatment adherence can be poor, reducing the likelihood of a successful outcome. Adherence varies between geographic regions. This observational study assessed satisfaction and adherence to NutropinAq (somatropin, recombinant human GH) treatment in Romanian children with GHD. Methods. Patients ≥3 years of age with GHD for which GH replacement therapy with NutropinAq had been initiated were recruited from 13 centres in Romania (protocol number: A-38-58035-016). The primary variable was patient/caregiver-reported treatment adherence (assessed at 3, 6 and 12 months on a 5-item Likert scale), secondary variables included treatment satisfaction assessed by the treating physician and patient/caregiver on a 5-point scale. Results. Most patients did not miss any treatment injections in any 3-month period between assessments (≥79.8% of patients were 100% compliant). The incidence of missed injections was higher among patients <7 years of age than older children, but no differences between genders was observed. At study end, 94.3% of patients/caregivers and 94.3% of physicians reported complete satisfaction with treatment. Conclusions. Overall treatment adherence to NutropinAq was high in the Romanian GHD paediatric population, and a high level of treatment satisfaction was reported by patients/caregivers. This suggests reliable treatment outcomes can be anticipated in this population.