ACTA ENDOCRINOLOGICA (BUC)

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Context. Mealtime insulin bolus is traditionally administered before meals in children with type 1 diabetes (T1D). Controlled studies on the use of pre-and postprandial insulin bolus have shown variable results. There are no realworld studies on postprandial bolusing of insulin in young children with T1D. Methods. Children with T1D aged <7 years were grouped into preprandial (Group 1) or postprandial (Group 2) groups according to the practice of prandial insulin use. Their retrospective data on mean glycosylated hemoglobin (HbA1c), hypoglycemic events, and diabetic ketoacidosis (DKA) episodes were compared. Results. Forty-four children (mean age 4.1±1.3 years, range 2-7 years) with mean diabetes duration of 2.0±0.7 years (range, 1-4 years) were identified; 23 (52.3%) belonged to Group 1 and 21 (47.7%) to Group 2. There were no differences in the mean HbA1c levels, mean hypoglycemic events, and DKA episodes between the two groups during a mean follow-up duration of two years. Conclusion. Young children with T1D administered insulin bolus during or immediately after meals showed similar long-term glycemic control and diabetesrelated adverse event profile compared to the premeal timing of insulin bolus. Larger real-world studies are needed on flexible insulin bolus timing in young children with T1D.

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Apart from endocrine and reproductive disturbances, polycystic ovary syndrome (PCOS) clusters several cardiovascular risk factors, mainly insulin resistance, obesity and dyslipidemia. In addition, androgen excess\r\nsignificantly contributes to enhanced vascular risk. Several mediators of endothelial dysfunction have been characterized lately in patients with PCOS, emerging as independent\r\npredictors of vascular abnormalities and potentially useful biomarkers of endothelial impairment in PCOS.

Cimicifuga racemosa (CR) is widely used in the treatment of menopausal symptoms, including hormone-related affective disorders in women. Mechanistic studies suggest that unlike hormone-replacement therapy, CR does not stimulate cancerous growth.\r\nObjective: to evaluate CR safety and the antidepressant-like effects compared to estrogen treatment.\r\nMaterials and Methods: we used the forced swimming test (FST) to address the hypotheses that CR alters behavior of ovariectomized (OVX) rats in the FST and the FST-induced expression of c-fos in the rat paraventricular nucleus (PVN). After the FST, all animals were perfused, and the brains were processed for c-fos immunocytochemistry; the plasma was processed for radioimmunoassay of plasma estrogen levels.\r\nResults: OVX group animals spent significantly (P<0.05) more time struggling than CR and E2 groups. The CR and E2 groups animals spent little time in struggle time decreased. CR and E2 groups animals spent significantly (P<0.05) more time swimming than OVX group animals.\r\nConclusion: CR was demonstrated to have antidepressant effect, and establishing the safety symptoms in women in whom hormone-replacement therapy is contraindicated.

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Background. Scintigraphy using 99mTcpertechnetate (TS) is the diagnostic test to differentiate thyroiditis following Graves’ disease (GD) from painless thyroiditis (PT). However, TS may be contraindicated or unavailable. Objective. We compared the diagnostic effectiveness of two TSH receptor antibody (TRAb) immunoassays in untreated PT, already confirmed by qualitative and quantitative(99m) Tc-pertechnetate thyroid uptake (TCTU). Method. TRAb assay and TS were performed in suspected PT patients. All 67 subjects (27 males) with confirmed diagnosis of PT based on qualitative (subjective) low uptake and quantitative uptake below 0.4% (Normal TcTU: 0.4-4%) . During the period of study, we used two 2nd generation TRAb assays. Result. Mean age, TSH, free T4 and TcTU were 40.5± 12.7 years, 0.066±0.089 mIU/L, 2.46±2.18 ng/mL and 0.188±0.0503% respectively. Fifteen (22.39%) of our PT patients were TRAb positive. Sensitivity, specificity, accuracy, PPV and NPV of TRAb in predicting thyroiditis were 81%, 75%, 78.2%, 83.6% and 74.4% in Assay 1. The same parameters were 74%, 64%, 71.2%, 76.8% and 62.7% respectively in TRAb Assay 2. However, ROC curve did not reveal any difference between the two assays. Conclusion. Negative TRAb value does not reliably distinguish PT from mild GD, in situations where TS is contraindicated or unavailable.