ACTA ENDOCRINOLOGICA (BUC)

Over the last decades aging has become a major concern for both medical professionals and policy makers. European Commission has been launching a series of initiatives aimed at drawing attention to great social, political and economic importance of aging research and at finding as well as disseminating the best practices in order to attain a very important objective: to add two years of healthy live to people in Europe by 2020. Nevertheless, there is still controversy regarding the accepted age limit for older people and also concerning various aspects of aging and aging research, most important being the difficulty of correlating chronological age to biological age. A new perspective is suggested and this might help scientists and clinicians understand better the problems of old age and could facilitate targeting research and medical strategies to the most appropriate goals. Several very important projects in the field of aging, funded by European Commission, are presented and a novel approach to the specific situation of older people is offered.

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. Evaluation of features of puberal maturity on a representative specimen of adolescents from Mures county.\r\nMaterial and method. The collected data came from the Public Health Authority in 2008, from 2013 teenagers, with ages ranging between 11&#8211;18 years, according to the Physical development registration file, Tanner stages and demographic data.\r\nResults. Boys grew at a faster rate in both height and weight than girls. In the urban areas, there is a preponderence for children in Tanner stages I-IV, compared to Tanner stage V. In the rural area, girls from middle school cover stage I then stage V of development and boys prevail in stage III and decrease in stage V. The teenagers of Mures county between 15-18 of age, both boys and girls, have a higher frequency than the rest of the teenage population of the country in stage V development, and for ages between 11&#8211;14 there is a majority for stage I. Correlating the parent&#8217;s education level and the puberal maturation of teenagers, we concluded that elementary and medium education levels prevail for all Tanner stages involved, without significant differences between them. Late puberty is more frequently associated to the parent&#8217;s elementary education level (68.34%) and rural area, in both genders. In the rural area there is a higher preponderence of children with rank over 2, due to the tendency of families in the urban area to reduce the children&#8217; number in the past years. Out of the entire study group, 3.75% were disharmonious with obesity: 3.94% of boys and 3.56% of girls, with a slight predominance in younger girls. There is no significant correlation between obesity and birth weight (p=0.441) or between puberal maturity level and weight.\r\nConclusion. We must stress upon the importance of monitoring the aspects of physical, neuropsychic development and puberal maturity in children, considered influence factors of morbidity.

Context. Urolithiasis and obesity are now public health problems with an increased incidence worldwide. Management of urolithiasis in patients with morbid obesity is usually associated with higher morbidity and mortality compared to non-obese patients. ESWL is a nonsurgical procedure for the treatment of lithiasis. In obese patients the ESWL efficacy is influenced by the skin-to-stone distance or poorer detection of the calculus because of the fatty tissue. Objective. To highlight the overweight or obese lithiasic patient profile that could be best treated by ESWL. Subjects and Methods. We evaluated ESWL results in 1393 patients with kidney or ureteral stones between 5 and 20 mm. They were divided into 4 groups according to the BMI: Group A-overweight (BMI=25-30 kg/ m2); Group B-grade I obesity (BMI=30-35 kg/m2); Group C-grade II obesity (BMI=35-40 kg/m2) and a control group of normal weight (BMI=18-25 kg/m2). Results. Patients with a higher BMI required a greater number of ESWL sessions. A statistically significant greater number of patients with a waist circumference of >102 cm required more than 2 SWL sessions (p=0.007). Location of the stones in the pelvic ureter had the highest rate of success for obese patients (p=0.00001). The ESWL success rate in overweight and obese patients can be negatively influenced by BMI, abdominal circumference over 102 cm, and hardness of calculi reflected in the radiopacity on KUB. Conclusions. In patients with grade II obesity, pyelocaliceal calculus and increased hardness, other urological alternatives to lithiasis should be considered from the beginning.

Objectives. The aim of this study was to evaluate serum levels of interleukin (IL)-8 in pre- and postmenopausal women and in patients with surgically-induced menopause, and the relationship between IL-8 and vasomotor symptoms. Material and Method. 175 women were enrolled and were divided into 5 groups (I – Fertile women; II – Pre- and perimenopausal women; III – Postmenopausal women; IV – Surgically-induced menopause; V – Chronic inflammation). Multiplex cytokine kits were used to evaluate serum levels of interleukin-8. We determined the serum levels of the follicle stimulating hormone, of the luteinizing hormone, 17β-estradiol, progesterone, dehydroepiandrosterone and dehydroepiandrosterone sulfate using sandwich ELISA. The severity of the vasomotor symptoms was evaluated according to FDA guidelines. Results. Serum concentration of IL-8 in women with natural menopause (233.0±226.5 pg/ml; p<0.001) and in women with surgically-induced menopause (148.0±162.0 pg/ml; p=0.045) is significantly higher than in women of reproductive age (84.88±82.32 pg/ml). Serum levels of IL-8 in premenopausal women, postmenopausal women, and in women with surgically-induced menopause, respectively, with severe and moderate hot flashes, on one hand (174.8±90.94 pg/ml, 369.3±194.2 pg/ml, respectively 274.1±146.3 pg/ml), is significantly higher than in women without vasomotor symptoms or with mild hot flashes, on the other hand (19.97±22.15 pg/ml, 28.66±35.72 pg/ml, respectively 28.94±37.68 pg/ml; p<0.001). Serum levels of IL-8 are significantly higher in women of reproductive age with chronic inflammatory pathology (152.3±121.0 pg/ml) than in women without such pathology (84.88±82.32 pg/ml; p=0.02). Conclusions. IL-8 is significantly higher in postmenopausal women with vasomotor symptoms than in women without vasomotor symptoms. In the postmenopausal group, the serum levels of IL-8 are similar to those in women with chronic inflammatory pathology. IL-8 could be a key factor in occurrence of hot flashes in menopause and could be associated with peripheral vasodilatation in these women.

Researches on ageing phenomenon offer significant information regarding the consequences of stressors on immune system that affects longevity in the elderly. Immunosenescence has become the most common immunodeficiency state in humans, occurring in over 30% of community - dwelling elderly, and greater than 90% of elderly who are ill, taking medication, or residing in longterm care facilities. Immunosenescence may reflect tandem changes in neuroendocrine responses. There are several agingrelated changes in cortisol, DHEA and catecholamines, which are considered to set up a “vicious cycle of endocrinosenescence and immuno-senescence”. The low-level, chronic increase in innate, inflammatory response observed in older adults ultimately results in tissue damage and disease; the key inflammatory mediators in this process are CRP, nuclear factor (NF)-kB, IL-1-beta, IL-6, TNF-alpha, cyclooxygenase-2 (COX-2), and inducible nitric oxide (NO) synthase. Further, glucocorticoid inhibition of IL-6 production was observed to be lower in older compared to younger men following psychological stress. There are individual differences that protect aged people from stressors and strains, and it will be important to identify biological mechanisms of protection and those at risk who might benefit from early behavioral interventions.