ACTA ENDOCRINOLOGICA (BUC)

Background. Thyroid nodules are a common pathology worldwide. Fine needle aspiration biopsy (FNAB) is an important diagnostic method for the investigation of malignancy in thyroid nodules. However, according to the Bethesda System used to classify the results, patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS / FLUS) may not be classified as benign or malignant. Therefore, it may be necessary to determine some clinical risk factors to apply the best treatment in these patients. Aim. To determine the factors that increase the risk of malignancy in this patient group. Methods. A retrospective study including 138 patients with an FNAB categorized as AUS/FLUS and operated between June 2015–September 2018. Demographical, Laboratory (TSH) and Ultrasound variables (number, size and characteristics of nodules) of the patients were compared among postoperative histopathological results. Results. Hypo-echoic structure, microcalcification and irregular margin of the nodules were detected to be associated with malignancy in patients with FNAB results of AUS/FLUS (p <0.001). Conclusion. We suggest that surgical treatment should be considered if the patients have nodules with the hypo-echoic structure, microcalcification and irregular margin with an FNAB histopathological result of AUS / FLUS.

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Context. Accumulating data supports the key role of disrupted amino acids (AAs) metabolism in diabetes. Conflicting data regarding the relevance of serum AAs in diabetes and hypertension suggest that their relationship needs further investigation. Objective. To investigate serum AAs as biomarkers of increased BP variability evaluated during 24-hour ambulatory BP monitoring in the presence of type 2 diabetes. Design. Cross-sectional. Subjects and Methods. We analyzed serum AAs using targeted metabolomics (ultrahigh-performance liquid chromatography/mass spectrometry) in patients with type 2 diabetes (n=80). BP variability was assessed using 24-hour ambulatory BP monitoring. Participants were divided into two groups based on the 24-hour diastolic BP variability median value. Results. Aspartic acid, isoleucine, leucine, and phenylalanine were significantly lower, while glutamine was significantly higher in the group with higher diastolic BP variability (p-value <0.05 and variable importance in the projection >1). Corresponding pathways identified as disrupted in patients with diabetes and a higher 24-hour diastolic BP variability were phenylalanine, tyrosine, and tryptophan biosynthesis, phenylalanine metabolism, and alanine, aspartate, and glutamate metabolism (pathway impact value >0). Conclusions. We identified specific changes in serum AAs and target AAs pathways in relation to increased 24-hour diastolic BP variability in patients with type 2 diabetes.

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Anorchia is a syndrome characterized by unilateral or bilateral absence of testicular tissue.\r\nAt puberty, growth and development are normal but secondary sexual development fails to\r\noccur if anorchia is bilateral.\r\nWe present the case of a 21 year-old male with a late diagnosis of bilateral anorchia. The\r\ndiagnosis was suggested by a bilateral empty scrotum, in a patient with male phenotype and\r\npoor secondary sexual development and established by karyotype analysis, hormonal profile\r\nand surgical exploration. The lack of testosterone response to hCG stimulation is the hormonal\r\nhallmark of bilateral congenital anorchia. In the absence of any information about germinal cell\r\npresence, bilateral excision of the testicular nubbins, implantation of testicular prostheses and\r\nhormonal replacement therapy were indicated.

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Background. The concept of NE differentiation in prostate carcinoma has two major aspects: prostate tumors with\r\nprimary NE differentiation and NE differentiation occurred during hormonal therapy for prostate adenocarcinoma, with\r\nthe extreme case of tumor dedifferentiation into a NE hormone resistant carcinoma.\r\nMaterial and method. The patient, 62 years old, with a history of poorly differentiated prostate adenocarcinoma,\r\nhormonally treated with the decrease and then constant maintenance of serum PSA level to 0.01 ng/mL was admitted in the hospital, 8 years after prostate tumor diagnosis, and 3 years after ceasing of hormone therapy, with multiple bone and liver metastases of unknown primary source.\r\nResults. The serum levels of CgA, NSE, CEA, CA19.9, serotonin were elevated. The histopathological examination\r\nof the needle biopsy fragment from a liver metastatic lesion revealed small cell neuroendocrine carcinoma. Despite the\r\nprompt chemotherapy, the disease has progressed, with the occurrence of brain metastases and the patient?s death\r\n6 months after detection of the metastatic disease.\r\nConclusions. The present case confirms the diagnostic difficulties in llymetastatic undifferentiated small cells\r\ntumors, and on the other hand, draws attention to the possibility of NE dedifferentiation as a result of hormone\r\ndeprivation in patients with prostate cancer.

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.

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.