ACTA ENDOCRINOLOGICA (BUC)

Objective. To find out the relationship of thyroid hormone profile of females with outcomes after intra cytoplasmic sperm injection (ICSI). Method. It was a cross sectional study conducted in Islamabad Clinic Serving Infertile Couple from June 2013 till August 2015. T3 (triiodo thyronine), T4 (thyroxine) and TSH (thyroid stimulating hormone) of 168 consented females was estimated after they underwent the first step of treatment protocol (ovarian down regulation) for ICSI. Pregnant group had ß hCG result more than 25 IU/mL while the rest were included in the non-pregnant group. Both groups were compared by using independent sample t-test. Pearson correlation coefficient was used to associate T3 and T4 with other pregnancy variables with their significance. Results. Non pregnant women had significantly higher mean values for T3 and T4 as compared to pregnant women (p <0.05, p<0.01). Difference in mean TSH value between non-pregnant and pregnant women was not significant p=0.08. It was found that T4 gave significant negative association with grading of embryo-I, blastocysts formed, thickness of endometrium and number of gestational sacs. Conclusion. Disturbance in thyroid profile with raised T4 levels leads to alteration in endometrial thickness and quality of embryos required for implantation and hence conception.

Context. The androgen/androgen receptor interaction plays a critical role in the development of the male genital system, and investigations around these receptors can expand our knowledge about mechanisms of some male abnormalities such as hypospadias. Objective. In the present study, the expression of androgen receptor (AR), fibroblast growth factor-10 (FGF10), and fibroblast growth factor receptor-2 (FGFR2) genes were investigated in prepuce tissue of healthy and hypospadic children. Design. It was a case-control study with follow-up about up to eight months after operation. Subjects and Methods. Patients’ tissue samples (n=20) and controls tissue samples (n=20) were collected after surgery and circumcision. After RNA extraction and cDNA synthesis, the Real time PCR was performed to evaluate and compare the levels of gene expressions. Both groups were checked until eight months after surgery. Results. The results showed that FGFR2 gene expression had significantly decreased in prepuce tissue of patients compared with healthy children (p-value <0.05). Patients and healthy children follow up showed that 20% of hypospadic patients who needed reoperation had AR gene upregulation along with FGF10 and FGFR2 downregulation. Conclusions. Taken together, interestingly, FGF10/ FGFR2 signaling has an important role in external genital system development and wound healing process.

Aims: Prolonged exposure to a glucocorticoid excess leads to cognitive impairment in experimental animals as well as humans. The present study tries to identify the cognitive deficits in patients with Cushing’s syndrome and to evaluate the possible residual deficits in patients after treatment. Materials and methods: 19 patients (women) with a history of chronic endogenous hypercortisolemia were investigated for etiology using clinical and biochemical criteria. Cognitive functions were evaluated using a battery of psychometric tests: the Rey Auditory Verbal Learning Test (RAVLT), the BCR2 battery for general intellectual potential and the Prague test, for divided attention and resistance to psychic fatigue. The patients were divided into two groups (before surgical treatment– Cushing and after surgical treatment – postCushing) without differences in age or duration of studies between groups (p = ns). The controls were considered to belong to the general population for which the psychometric tests were standardized. Results: Both groups showed an altered pattern of incremental learning - scores below standard in the last two trials of the RAVLT (one sample t test, one tailed, p<0.05), and the total score (p<0.05 for PostCushing, p=0.07 for Cushing); both had very low total scores in the battery for intellectual potential. The PostCushing scores were significantly better than those of the Cushing group for only one nonverbal test (complex perceptual analysis), p<0.02. There appears to be no significant effect of cortisol exposure on distributive attention; there is however an alteration in the resistance to psychic fatigue. Daily average cortisol exposure was positively correlated with the number of errors in learning for both groups (r=0.65, p=0.058 for Cushing; r=0.85, p<0.005 for PostCushing) Duration of illness was negatively correlated with the total learning score in the PostCushing group (r=-0.68, p<0.05). For the Cushing group there was a strong negative correlation between the duration of illness, general performance (r=-0.81, p<0.05) and verbal scores (r=-0.77, p<0.07).

There are no new national growth references for the Romanian population and the current recommendations for short stature evaluation is the use of the Swiss growth charts developed based on a longitudinal study. The aim of the present paper is to present the new synthetic growth references for Romanian children. Material and methods. We used local Romanian data from 9 studies with information on height and weight obtained between 1999 and 2016. Based on their plausibility and methodology six studies were selected for generating the National Synthetic Growth References for Romanian Children based on the specific methodology described previously. The selected studies included 8407 subjects measured in schools/kindergartens. Age is reported in years covering a range from 3-18 years. Height and weight were measured at a precision of 0.1 cm and 0.1 kg. All children were measured at normal temperature, in light clothes, without footwear. Results. We present the charts and tables with the common centiles for height, weight and body mass index for boys and girls. Conclusion. We suggest synthetic growth references based upon recent growth data from 6 different Romanian regions as new National Growth Charts for Romanian children.

Objectives. The objective of this retrospective study was to evaluate weight gain at 3 months following insulin therapy initiation and to determine if it is due to fat or fat free tissue. Methods. Fifty-eight patients with T2DM and initiation of insulin therapy were evaluated. Body composition was assessed with InBody720 device (Biospace, Korea) before and 3 months after the initiation of insulin therapy. Results. The insulin therapy was initiated with basal insulin in 84.48% of the cases. The initial dose of insulin was 22.76±12.89 units/day and increased at 3 months to 30.81±18.49 units/day (p<0.001). The initial HbA1c was 9.86±2.02% and decreased to 7.58±1.19% (p<0.001). The body weight increased from 87.01±17.37 kg to 88.04±16.64 kg (p=0.026). The fat body mass and the percent of fat decreased with no statistical significance; the intracellular and extracellular body water increased significantly (intracellular: 26.30±5.96 vs. 27.26±6.16; extracellular: 16.61±3.63 vs. 17.03±3.84; p<0.001). Conclusion. During the first 3 months after initiation of insulin therapy a modest weight gain due to increase in the body water after restoration of the metabolic balance was observed.

Context. The variety of tumor-seeking radiopharmaceuticals, which are currently in clinical use, may have a potential role as imaging agents for adrenal gland tumors, due to physiological characteristics of this organ. Objective. The purpose of this study was to evaluate the diagnostic potential of 99mTc-HYNIC-TOC, 99mTc(V)- DMSA, and 99mTc-MIBI in the assessment of adrenal tumors, by correlating with imaging findings and histopathologic results. Design. The research is designed as a crosssectional prospective study. Patients and method. The study included 50 patients with adrenal tumors (19 hormone-secreting and 31 nonfunctioning) and 23 controls without adrenal involvement. In all patients, single-photon emission computed tomography (SPECT) was performed, using qualitative and semiquantitative analysis. The tumor to nontumor tracer uptake was conducted by using a region-ofinterest technique. Adrenal to background (A/B) ratio was calculated in all cases. Results. 99mTc-HYNIC-TOC scintigraphy showed a high statistical significance between A/B ratios, while other two tracers resulted in a lower sensitivity, specificity and accuracy. Futhermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumors (the receiveroperating- characteristic curve analysis, A/B ratio cut-off value of 8.40). Conclusion. A semiquantitative SPECT analysis showed that 99mTc-HYNIC-TOC is a highly sensitive tumorseeking agent for the accurate localization of adrenal tumors.

Context. Identification of CV risk factors from T2DM diagnosis allows optimization of treatment to prevent CV complications and death. Objective. The primary objective of the study was to describe the CV risk factors in patients with T2DM at the time of diagnosis and/or therapeutic specific measures taken. Design. This was a non-interventional, multicenter, retrospective chart review of newly diagnosed patients with T2DM in 49 study centers in Romania. Subjects and Methods. Adults with a diagnosis of T2DM between January - December 2014. Statistical analysis used appropriate descriptive methods. Results. 1218 patients were included, mean age (SD) at diagnosis was 59.16 (10.87) years. Half of the patients (54%) presented obesity and 47.7% of patients had arterial hypertension. Overall, 76.2% of subjects had LDLcholesterol ≥ 100 mg/dL, and 59.1% had triglycerides ≥ 150 mg/dL. The mean glycemia was 198.8 mg/dL (78.3) and 50.2% of patients had HbA1c ≥7%. Sedentary lifestyle in 73.8% of the cases, and 91.3% unhealthy eating habits reported. In addition to diet, 82.2% of patients received antidiabetes treatment, 62.6% lipid-lowering, and 66.6% antihypertensive medication. Conclusion. This retrospective study showed a high prevalence of CV risk factors and/or established CV disease at the time of T2DM diagnosis in Romania.

Background. Malignant melanoma is the most aggressive form of skin cancer with a rapidly increasing incidence rate. In contrast to other tumors, the role of sex steroid hormones\r\nin the initiation and progression of melanoma remains unclear.\r\nObjective. To assess the interaction between the content and composition of gangliosides and sex steroid hormones 17&#946;-\r\nestradiol (E2) and testosterone (T) in malignant melanoma.\r\nPatients and methods. The analysis included 45 melanoma patients (age 28-86; 14 men, 15 non -pregnant women in mid\r\nfollicular phase and 16 postmenopausal women) and 46 healthy controls. Serum levels of gangliosides (GM1-3, GD1a,b,2,3, GT1b, GQ1b), estradiol, testosterone measured in serum by chromatographic and immunochemiluminescence methods were correlated with sex and age.\r\nResults. Steroid hormones levels showed no differences between groups (p>0.05), while total gangliosides in normal\r\nserum were significantly lower than total ganglioside concentrations determined in melanoma samples (18.63 ? 3.17 mg/dL versus 74.82 ? 34.56 mg/dL) (p<0.05). There were no differences related to sex or age within groups regarding total gangliosides levels. Gangliosides pattern in\r\nmelanoma patients compared to control showed lower GM3, higher GD3, lower GM3/GD3 ratio, increased GD2 levels, and\r\nno significant variation of GM1, GM2, GD1a, GT1b gangliosides. There is a positive correlation between estradiol levels and total gangliosides concentration both in non-pregnant premenopausal and postmenopausal melanoma patients. GM3 is negatively correlated with estradiol levels in melanoma group, GT1b and O-Acetyl GD3 concentrations are positively correlated with estradiol levels in women with melanoma. Testosterone levels showed no significant\r\ncorrelation with the content and pattern of gangliosides in melanoma patients.\r\nConclusions. The correlations between content and composition of gangliosides and estradiol in melanoma suggest a possible role of these molecules in melanoma behavior.

Background. The aim of the present study was to measure the effects of raloxifene on bone metabolism and strength in orchiectomized male rats. Materials/Methods. Forty-three 4-month-old Wistar albino male rats were used and divided into 3 groups as orchiectomy (ORCX; n=23), sham (n=15), and control (n=5). Raloxifene (10 mg/kg/day) and methylcellulose (0.5 mL/day, as a vehicle treatment) treatments were initiated 2 months after ORCX for 2 months, then the rats were sacrificed. The left femur and fourth lumbar vertebrae (LV4) were measured to assess the effects of the orchiectomy and the raloxifene treatment and maintenance regimens. Bone strength was assessed using a compression test for the vertebrae and a three-point bending test for the femurs (N/mm). Results. Raloxifene increased femoral and vertebral bone strength in osteoporotic rats, but this increase was not statistically significant. Bone strength was found to be 267.44±18.03 in the femurs of the ORCXraloxifene group and 246.32±49.37 in the femurs of the ORCX-C group (p>0.05). Vertebral bone strength was 147.78±09.51 in the ORCX-raloxifene group and 114.61±05.93 in ORCX-C group (p=0.488). Raloxifene also increased the femoral and vertebral bone density compared with the control group, but the change was not significant. While raloxifene significantly decreased the serum osteocalcin levels (p=0.007), it did not decrease the carboxyterminal cross-linking telopeptide of bone collagen (CTX) levels significantly (p=0.066). Conclusions. Raloxifene caused a statistically significant decrease in serum osteocalcin levels and a non-significant reduction in NTX levels in orchiectomized rats.

Context. Literature shows that patients taking antipsychotic medication risk developing metabolic complications. Objective. The study aims to compare the presence of the metabolic syndrome (MS) and its components in outpatients treated with long acting injectable (LAI) olanzapine and risperidone. Design. A double-center study was performed on outpatients with psychosis, which were divided into two samples: one treated with olanzapine and another with risperidone. Subjects and Methods. The following data were analyzed: age, gender, severity of psychiatric symptoms, blood pressure, waist circumference, fasting blood glucose, lipid profile, tobacco use, medication, and time intervals related to psychosis duration (pre-LAI and LAI treatment). Results. The study included 77 patients with schizophrenia and schizoaffective disorder. MS was present in 45 (58.4%) patients. Subjects with MS and abdominal obesity had higher durations of psychosis and of LAI treatment. Patients with hypertension had a higher pre- LAI treatment interval. Risperidone was associated with higher rates of hypertension and higher values of abdominal circumference than olanzapine. Conclusions. The presence of MS is related to the duration of the psychosis and the time spent on LAI treatment with no differences between olanzapine and risperidone. Hypertension may be a consequence of age, disorder induced stress, or of treatment with risperidone.