ACTA ENDOCRINOLOGICA (BUC)

Context. Endometriosis is a common gynecological disease, characterized by ectopic deposits of endometrial tissue outside of the uterine cavity, and it is associated with pelvic pain and infertility, with an important impact on the quality of life. At this point there is a controversy regarding the etiology and pathophysiology of endometriosis and it seems that pro-angiogenic growth factors might be involved, but their role is not completely understood. Objective. To evaluate the serum concentration of the main growth factors in patients with diagnosed endometriosis compared to healthy controls. S ubjects and Methods. A total of 157 women were divided into two study groups (Group I – endometriosis; Group 2 – healthy women). Serum levels of VEGF, G-CSF, GM-CSF, b-FGF, EGF, and HGF were measured with Human Multiplex Cytokine Panels. Results. VEGF serum levels were significantly lower in women with endometriosis compared to controls (1.924±0.145 compared to 1.806±0.078 pg/mL, p<0.001). Serum levels of GM-CSF, b-FGF, EGF, and HGF respectively did not differ significantly between patients with endometriosis and healthy controls. G-CSF had a very low detection rate. Conclusions. The present study showed that VEGF serum levels are significantly lower in endometriosis patients compared to healthy controls, indicating a possible role in endometriosis pathogenesis.

Background. Early detection of coronary plaques in patients with diabetes mellitus (DM) could play a major role in improving the evolution of these patients, targeting a therapeutic intervention in early stages when the chances to reduce the progression of the disease are higher. Aim of the study was to evaluate the presence of coronary lesions and analyze the plaque morphology in patients with type 2 DM using multislice 64 computed tomography coronary angiography (MSCT), and to assess the cardiovascular risk expressed by calcium scoring (CS) in these patients. Methods. The study included 37 patients with type 2 DM. Mean age was 67.38 years (±19.62). In all cases MSCT was performed, CS was calculated and morphology of coronary plaques was analysed. Results. Coronary artery disease was present in 86.48% cases. CS was <100 in 6 patients (16.2%), between 100 and 400 in 7 patients (18.9%) and >400 in 24 cases (64.8%). Coronary plaques were classified as non-calcified in 142 segments, mixed in 78 segments and calcified in 114 segments. In 40.12% of lesions the plaques were nonobstructive, in 44.91% obstructive, and in 14.91% severely obstructive. Conclusions. In patients with type II DM there is a high incidence of coronary lesions and vascular calcification, which could represent an indicator of the severity of coronary artery disease even in asymptomatic diabetic patients. CS calculated with MSCT is increased in these patients, representing a marker of high cardiovascular risk.

Context. Ghrelin, in both its acylated and desacylated forms, and leptin can modulate fetal energy balance and development. Objective. The aim of our study is to assess desacylated ghrelin (DAG) and leptin values and influence on intrauterine and postnatal growth in infants with intrauterine growth restriction. Design, subjects and methods. We performed a prospective study on 39 infants recruited over five months, 20 appropriate - for - gestational - age (AGA) infants and 19 small-for-gestational-age (SGA) infants, in which we measured DAG and leptin in the umbilical cord blood and we compared their respective values between the two groups, along with auxological parameters at birth and at 10 months of postnatal age. Results. Our results show that both DAG and leptin have lower values in SGA infants and correlate with most of the anthropometrical parameters at birth. Both hormones correlate with weight at 10 months in SGA infants, but this correlation lacks in AGA infants. Whereas DAG in the cord blood can be considered a predictor for weight at 10 months (β=0.207, p=0.001), the same cannot be stated about leptin (β=0.078, p=0.195). Conclusion. DAG and leptin are involved in both intrauterine and postnatal development, but the extent of their role is still to be determined.

Background. We describe a case of denosumab-related osteonecrosis of the jaw in a 58-year-old patient with a diagnosis of osteoporosis, treated with Denosumab and a short-time course of bisphosphonates. This case illustrates that use of anti-RANKL agents can lead to a type of osteonecrosis resembling bisphosphonate-related osteonecrosis of the jaws, so this medical condition can be categorized as of antiresorptive - induced osteonecrosis of the jaw. The consensus of present day medical opinion is that the benefits of antiresorptive therapy outweigh the disadvantages. However, to provide optimal management for individual patients, the risk-benefit ratio of osteoporosis therapy must be repeatedly assessed at all stages of a patient’s treatment, and therapeutic decisions taken in the light of the ratio as it applies to the individual.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been a rarely recognized condition. As the prescription of\r\noral bisphosphonates is universalized and the number of people treated with bisphosphonates is increasing, an accurate understanding and proper management of BRONJ are required.\r\nAim. Our aim was to describe the clinical features, treatments and prognosis of patients with oral bisphosphonate-related osteonecrosis of the jaws.\r\nMaterials and Methods. In our study BRONJ is reported in 20 consecutive patients who received BP therapy for osteoporosis with different drug schedules. The length of therapy was 7-73 months before osteonecrosis was observed; in 16 patients BRONJ involved the mandible and in 4 the maxilla. Systemic co-morbidities were present in seven patients, namely, rheumatoid arthritis (20), diabetes mellitus type 2 (10%) and chronic anemia (5%).\r\nResults. Nine of the 14 patients who did not suspend BP therapy demonstrated decreased pain and a clinically significant improvement in function. By using the authors? case series of 20 patients, which are reported in the article and the authors? clinical orientation to evaluation and treatment of oral bisphosphonate-related\r\nosteonecrosis of the jaws are presented.