ACTA ENDOCRINOLOGICA (BUC)

The increase in prevalence of obesity in children is well known worldwide, with important implications for health.\r\nAim. To evaluate the growth patterns of normal weight, overweight, obese and underweight schoolchildren from western Romania, in order to understand how body mass is related to height gain.\r\nMaterial and method. A total of 3626 children aged 7-18 years, were examinated, between February 2010-June 2011. Children were classified as normal weight, underweight, overweight and obese, using IOTF criteria.\r\nResults. We present the growth curves in regard to BMI class and the comparison of the 50th percentile of each BMI class, in boys and girls separately. The period of significant height difference/year at the 50th percentile for each BMI class indicates that overweight and obese boys have important height gain between 11-14 years, while for underweight boys it is constant between 11-18 years. In overweight and obese girls, an important height difference/year is observed between 7-11 years, while in underweight group it is seen between 10-13 years.\r\nConclusions. In boys, increased BMI leads to taller young stature, delayed growth spurt, but similar height at age of 18 years, while in the underweight group we observed a prolonged growth spurt with increased height at 18 years. Increased BMI, in girls, resulted in early growth spurt and similar height at 18 years when compared to normal weight peers. Final height was independent of BMI in both girls and boys.

Mixed gonadal dysgenesis and ovotesticular disorders of sex development, are rare conditions that occur sporadically,\r\nwith unknown prevalence. Clinical manifestation of this diseases is sexual ambiguity. The authors present a pediatric\r\ncase with sexual ambiguity and karyotype 45, X/46, XY, the child of a HIV-positive mother receiving multiple antiretroviral treatments for a period of 16 years.

Background. Heart failure (HF) is a disease with a high prevalence in the elderly population. Problems posed by HF diagnosis and management within this special category validate the interest in studying ways to improve the quality and duration of life in these patients. Aim. To determine the prognostic accuracy of certain clinical and laboratory parameters and to predict mortality rates in elderly patients with HF. Study design. It is a cohort, analytical, prospective, observational, crosssectional study conducted between 2006- 2008. Data regarding patient survival over a period of six months were recorded from the moment of enrollment. Subjects and methods. The study group consisted of 177 patients of over 65 years of age admitted to geriatrics, internal medicine and cardiology units, diagnosed with HF. A series of clinical and laboratory data from these patients has been examined, including NT-proBNP and CRP. Results. CRP levels higher than 3.57 mg/dL determined a hazard ratio (HR) of 3.9 (CI95% 1 - 15.2, p=0.04), urea levels higher than 79 mg/dL determined a HR of 8.8 (CI95% 1.1 - 37.4, p=0.003) and NT-proBNP levels higher than 9370 pg/mL determined a HR of 18.6 (CI95% 5.2 - 66.2, p<0.001). After multiple comparison adjustments (Bonferroni correction), only urea and NT-proBNP remained independent variables predicting 6-month mortality in elderly patients with HF. Conclusion. High NT-proBNP and urea levels were independent predictors for mortality in elderly patients with heart failure.

Obesity involves both genetic and environmentl influences, but the mechanisms of the genetic effects are not well understood.\r\nObjective. The aims of the study were to investigate the frequency of perilipin gene polymorphism in order to identify the relationship between insulin resistance and gene polymorphism in obese women.\r\nSubjects and methods. Study population included 31 obese women and 10 women with normal weight as a control group. All of the entire coding exons of PLIN gene were amplified by polymerase chain reaction (PCR). Insulin resistance (IR) was estimated using the homeostasis model assessment (HOMA-IR).\r\nResults. In the obese group, 29 (93.6%) patients were homozygous and 1 patients (3.2%) was heterozygous for the c.580C>.G (p.Pro194A1a)(rs. 6496589) mutation and 1 patient (3.2%) was Pro194A1a. Homozygous. Val156Leu. Heterozygous mutation at exon 5 at PLIN gene (p=0.072). As for exon 8 at PLIN gene in obese group, 6 patients (19.3%) had heterozygous for the c.1113T>C (Pro371Pro) (rs2304796) mutation, and 12 patients (38.7%) had heterozygous for the c.1113T>C and c.1119C>T (p. Val373Val) (rs2304795) mutation, and 4 patients (12.9%) had homozygous for the c.113T>C and c.1119C>T mutatons (p=0.009). In obese patients with no nucleotide substitution at exon 8, mean levels of systolic and diastolic blood pressures were higher than those of obese subjects with gene polymorphism. However, there were no statistically significant differences for HOMA-IR levels between obese women with and without perilipin gene polymorphism.\r\nConclusions: Perilipin gene polymorphisms such as heterozygous and homozygous for the c.1113T>C and c. 1119C>T (rs2304795) at exon 8 were associated with obesity risk. However, no relationship was found between insulin resistance and polymorphisms of perilipin gene in obese women.

Introduction. Vinegar is known with its positive impact on post-prandial dysmetabolism. The aim of this study was to\r\nelucidate the acute effects of high amount vinegar on blood glucose and lipid parameters.\r\nMaterial and Methods. Sixteen type 2 diabetic patients who had been treated with metformin only, were served a\r\nstandardized meal to which 50 g vinegar was added on the first day but not on the second day. Blood glucose, insulin and lipid levels were measured during fasting and at the second hour after intake of the meal.\r\nResults. Postprandial increase in the levels of venous blood glucose measurements was not different in the vinegar group when compared with the reference group (p=0.163). There was no significant difference on postprandial insulinemia (p=0.796). While investigating the effect of the vinegar on postprandial lipemia, no differences in triglyceride\r\nchanges was found between vinegar and reference group (p=0.816).\r\nConclusion. In this study in which we have tried to find an answer to the question about the effect of high amount grape\r\nvinegar on postprandial metabolism, no favorable or deleterious effect on postprandial changes of glycemia and\r\nlipemia was found.

Objective. The aim of the present study was to evaluate the effect of electromagnetic field (EMF) exposure during developmental period on parameters of oxidative stress and histopathology of testis and testosterone level in adult rat F1 generation. Methods and study design. In treatment group pregnant rats were exposed to 3mT EMF, 50Hz for 21 days. The sham group contained pregnant rats under same condition, but out off the EM field. Pregnant rats in room were used as control group. After delivery, the blood samples of mothers for biochemical analyses of total antioxydant capacity (TAC) and malondialdehide (MDA) were provided. The male pups were kept until maturity, then their TAC, MDA and testosterone levels were analyzed, also their tests were removed for investigation of histopathology changes with light microscopy. Results. Biochemical analysis showed that TAC and MDA was significantly increased in pregnant rats in the treatment group when compared with the control group (p<0.05). In adult male of F1 generation MDA was significantly increased in treatment group, but TAC and the testosterone level was significantly decreased in the treatment group as compared with the control group (p<0.05). Microscopic results revealed that in experimental group seminiferous epithelium contained many small irregular empty spaces as the sign of cellular sloughing, spermatogenic cells appeared to be disrupted. The nuclei of spermatogonia cells were heterochromatic, also dense of germinal epithelium and the number of spermatozoa was decreased. Conclusion. The results of this study suggest that pregnant rats exposure in EMF led to oxidative stress in adult male of F1 generation and showed adverse effect on testosterone and spermatogenesis in adulthood which may produce subfertility.

Background. Paraganglioma develop from embryological neural crest cells from the base of the skull, mediastinum, retroperitoneum, urinary bladder and scrotum. The most common location of the retroperitoneal form is situated between the aorta and vena cava, at the level of left renal vein, or more distally, to the aortic bifurcation. The care of patients with paraganglioma is a challenge for many physicians and surgeons because of its clinical features and therapeutic implications. Case presentation. We report the case of a 22-years old female patient with symptomatic retroperitoneal paraganglioma who was successfully treated with complete surgical excision. The pathological report confirmed the presence of chromaffin tumours. Postoperative care was uneventful, the patient being discharged after 10 days. Follow-up evaluation showed no recurrence after 4 years. Conclusion. Although a very rare condition, retroperitoneal paraganglioma has to be considered in the differential diagnosis of retroperitoneal tumours. Complete surgical resection is crucial for treatment and histological assessment as these tumours are potentially curable if they are diagnosed correctly. In our experience, the best surgical approach is open surgical excision for large masses located in the interaortocaval region, with a clear operatory field and good control over the major blood vessels. Follow-up is strongly recommended.

Background. Iodine deficiency and/or thyroid autoimmunity are the most common causes of hypothyroidism development among pregnant women. In this study, we aimed to investigate the effect of iodine consumption and thyroid autoimmunity on TSH levels and abortus. The study sample consisted of 104 patients, 79 in abortus and 25 in control groups. TSH, free T4, free T3, anti-TPO, anti-Tg, spot urinary iodine concentrations, and thyroid volumes of the cases were measured by ultrasonography. The spot urine concentration was below 100 μg/L in 93% of the cases included in the study. The TSH levels of the abortus group cases were significantly higher than those of the controls (p=0.025). The percentage of subclinical hypothyroid cases were significantly higher among the cases evaluated due to abortus compared to the control group (p<0.001). Abortus and control groups did not differ statistically with respect to the presence of autoimmune thyroid diseases (p=0.424). Spot urine iodine concentrations of abortus cases with subclinical hypothyroid were significantly lower than those with TSH levels below the defined range (p=0.001). Spot urine iodine concentrations of the cases with subclinical abortus with negative thyroid autoantibodies were also significantly lower than those with TSH levels below the defined range (p=0.017). TSH levels above 1 μIU/mL for the first trimester and 2 μIU/mL for the second trimester may be indicators of iodine nutrition in pregnancy losses.

Background. Aortic dissection is a life-threatening disorder and up to 20% of patients die before receiving medical care. Marfan syndrome is noted in 5–9% of individuals who suffer from aortic dissection. Case presentation. We present the case of a 53 years old woman, with undiagnosed Marfan syndrome, addressed to our clinic complaining about thoracolumbar pain appeared 4 days ago, after a trauma. According to the revised Ghent criteria for the diagnostic of Marfan syndrome she had a positive family history and more than 7 points of systemic findings. She was also diagnosed with extensive aortic dissection and right pneumothorax. Because of the cachexia and important scoliosis, the operative and post operative risk was high and we decided a medical management. She remained haemodynamically stable, with a false lumen partially trombosed, and was discharged home after 23 days. Discussion. The particularity of our case represent the diagnostic of Marfan syndrome after the appearance of a vital risk vascular complication – aortic dissection, the emergency surgical intervention being limited by the clinical and prognostical particularities of these two comorbidities. Conclusion. Aortic dissection in Marfan syndrome represents a diagnostic and therapeutic challenge for interdisciplinary practitioner physicians.

Xanthomatosis is a rare disease; predominantly, it is a response to altered lipid levels in the form of a mucocutaneous granulomatous proliferative disorder of unclear origin. When blood lipid levels exceed the normal values, the macrophages around the blood vessels may result in xanthoma. The present case was observed in a 55-year-old woman who suffered from Cushing’s disease and had atypical xanthomas in her oral mucosa that were diagnosed by histopathological analysis and were associated with normal serum cholesterol levels.