ACTA ENDOCRINOLOGICA (BUC)

Introduction. Prostate specific antigen (PSA) progression is considered to be the earliest evidence of persistent or recurrent disease after primary therapy with curative intent in prostate cancer. The purpose of the study was to evaluate the predictive value of PSA progression under anti-androgen treatment in patients with advanced disease treated by bilateral orchidectomy alone or associated with antiandrogens.\r\nPatients and methods. We studied 87 patients diagnosed with prostate cancer between January 1998 and October 2005 with PSA values over 20 ng/ml. Prostate cancer was confirmed by transrectal ultrasound guided prostate biopsy. In all patients, prostatectomy was not performed, but bilateral orchidectomy. Flutamide 750 mg three times daily was associated from the beginning with surgical castration in patients with bone metastases (n=11). In the other patients, Flutamide 750 mg three times daily was started if a progression of the disease was noted, 29 out of 76 cases. The follow-up protocol included physical examination and digital rectal examination, acid and alkaline phosphatases and seric PSA every 3 months in the first two years and then every 6 months.\r\nResults. Patients were divided after orchidectomy and after 6 months of flutamide therapy in four groups: Group 1 (n= 46 cases) with PSA response, i. e. decrease at less than 1 ng/ml, Group 2 (n= 22 cases) with PSA decrease to 1 - 4 ng/ml, Group 3 (n= 11 cases) PSA response between 4 and 10 ng/ml and Group 4 (n= 8 cases), with PSA serum levels over 10 ng/ml PSA serum levels increased progression occurred in 12, 10, 8 and 8 patients of the four groups, respectively, and disease clinical progression was observed in 7, 7, 6 and 7 patients, respectively. Mean intervals of PSA progression in the four groups were 52, 36, 32 and 11 months, respectively. An important complication rate was observed, represented by acute urinary retention, unilateral ureterohydronephrosis, obstructive anuria, pulmonary and bone metastases, chronic renal failure and hematuria by bladder invasion.\r\nConclusions. Our study confirmed the data from the literature that serum PSA level could be used as an surveillance marker in patients with advanced prostate cancer submitted to orchidectomy with or without anti-androgen receptor therapy and also has an important prognostic value.

Objective. To analyze the clinical value of dissection parathyroidectomy (DP) in patients with chronic kidney disease (CKD) complicated by refractory secondary hyperparathyroidism (HPT). Subjects and Methods. Patients with CKD complicated by refractory secondary HPT were included as the research subjects. Among them, 42 patients who received DP were assigned as the study group, while another 42 patients who underwent conventional total parathyroidectomy were assigned as the control group. Results. The average operative time and postoperative average length of hospital stay of the study group were lower than those of the control group (P<0.05). The study group showed lower levels of parathyroid hormone (PTH) compared to the control group 1 day postoperatively, 7 days postoperatively, 6 months postoperatively, and 12 months postoperatively (P<0.05). The study group exhibited lower serum calcium levels than the control group 1 day postoperatively, 7 days postoperatively, 1 month postoperatively, and 6 months postoperatively (P<0.05). Additionally, the study group demonstrated lower serum phosphorus levels compared to the control group 1 day postoperatively, 7 days postoperatively, and 6 months postoperatively (P<0.05). Conclusions. The application of DP in patients with CKD complicated by refractory secondary HPT holds definite clinical value.

Context. Exercise and anabolic steroids are anticipated to promote fat mass reduction and so to decrease the number of comorbidities related to excessive weight. Objective. The aim of this study was to verify the influence of aerobic exercise and the use of steroids on the accumulation of adipose tissue and on the biochemical limitations of Wistar rats nourished by a hypercaloric diet. Methods. Forty, young male Wistar rats were split into four groups: obese control (n=10), obese under treatment (n=10), obese under aerobic exercise (n=10) and obese under aerobic exercise and treatment (n=10). All animals were fed with a hypercaloric diet and animals under treatment received intramuscular testosterone. Body (weight and visceral fat) and blood (lipidogram, glucose, and liver enzymes) parameters were assessed. Results. The group treated with aerobic exercise and testosterone revealed a reduction in body weight and visceral, perirenal, retroperitoneal and epididymal fats, accompanied by the blood levels of glucose, lactate, LDLcholesterol, HDL-cholesterol, and lactate dehydrogenase; following high-intensity physical activity. Conclusion. The results support the theory that the combination of steroids and physical activity reduces the side-effects of androgenic-anabolic hormones and conveys benefits to some constraints

Context. Ghrelin, in both its acylated and desacylated forms, and leptin can modulate fetal energy balance and development. Objective. The aim of our study is to assess desacylated ghrelin (DAG) and leptin values and influence on intrauterine and postnatal growth in infants with intrauterine growth restriction. Design, subjects and methods. We performed a prospective study on 39 infants recruited over five months, 20 appropriate - for - gestational - age (AGA) infants and 19 small-for-gestational-age (SGA) infants, in which we measured DAG and leptin in the umbilical cord blood and we compared their respective values between the two groups, along with auxological parameters at birth and at 10 months of postnatal age. Results. Our results show that both DAG and leptin have lower values in SGA infants and correlate with most of the anthropometrical parameters at birth. Both hormones correlate with weight at 10 months in SGA infants, but this correlation lacks in AGA infants. Whereas DAG in the cord blood can be considered a predictor for weight at 10 months (β=0.207, p=0.001), the same cannot be stated about leptin (β=0.078, p=0.195). Conclusion. DAG and leptin are involved in both intrauterine and postnatal development, but the extent of their role is still to be determined.

Background. The potential measures of preventing environmental pollutants-induced reproductive toxicity in mammals require adequate investigations. \r\nAim. The protective role of vitamin C against gasoline vapors?induced reproductive toxicity was assessed in male rats. \r\nAnimals and Methods. Vitamin C (200mg/kg body weight) was daily administered orally to albino Wistar rats concomitantly exposed to 17.8cm3h-1m-3 of Premium Motor Spirit (PMS) blend unleaded gasoline vapors(UGV) for 6 hr/day, 5days/week for 10 weeks. \r\nResults and Discussion. No significant changes (P &#8805; 0.05) in the serum FSH and LH levels were observed to be associated with exposure to UGV. However, the results showed that UGV caused a significant decrease (P &#8804; 0.05) in serum testosterone level and distortions in the architectural structure of the testicular tissues in male rats, compared to the control. This suggests that the gonads may be the target tissue of interaction for UGV reproductive toxicity in male rats. Also, treatment of the exposed rats with vitamin C was observed to produce a significant increase in the level of serum testosterone to a mean value within the range obtained for the control. Moreover, the distorted architectural structure of the testicular tissues observed to be associated with exposure to UGV was significantly prevented by the administration of vitamin C. \r\nConclusion. These observations indicated that vitamin C can be effective in the protection of UGV-induced reproductive toxicity in male rats.

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.

Context. Diabetes mellitus is a well known risk factor for COVID-19 patients. However, There is limited data to investigate the association between prediabetes and COVID-19. Objective. We aimed to evaluate the effect of prediabetes and mechanical ventilation on the course of COVID-19 and determine whether patients who recover from COVID-19 infection show changes in cardiac function and laboratory findings during follow-up. Patients and Methods. This study included 87 adult patients who were diagnosed with COVID-19 according to the WHO definition and were admitted for inpatient treatment between April 2021 and August 2021. They were classified into 3 groups, normoglycemia (n=40), prediabetes (n=25), and diabetes (n=22), and then divided into groups according to need for mechanical ventilation. Statistical analyses were performed to compare laboratory, echocardiographic findings and COVID-19 outcomes among the groups. Results. The need of mechanical ventilation was significantly higher in both diabetes and prediabetes groups than the normoglycemic group. Patients with diabetes and prediabetes had significantly higher LV E/Em (p=0.003, p=0.045) and RV MPI (p=0.032, p=0.021) and significantly shorter PAT (p=0.001, p=0.036) and significantly longer RV IVRT (p=0.021, p=0.017), respectively, compared to the normoglycemia group. Patients who required mechanical ventilation had significantly higher CRP (p=0.043), troponin (p<0.001), ferritin (p<0.001), HBA1C (P<0.001), glucose (p=0.019), monocytes (p<0.001), and monocytes-HDL ratio (MHR) (p<0.001) and significantly lower levels of HDL-C (p<0.001). Glucose, HDL-C, troponin, MPV, NLR, PLR level and RV and E/Em were found independently associated with the RVMPI Conclusion. Prediabetes was associated with more impaired LV and RV diastolic functions compared to normoglycemic patients, comparable to those seen in diabetes. Our observations suggest that prediabetes should be considered as diabetes in the risk stratification of patients with COVID-19.

Objective. We analyzed the correlation between glycemic variability and psychological problems such as depression, anxiety disorder, and low self-esteem in pregnant and non-pregnant (excluding gestational diabetes) patients with diabetes. Besides its originality, this study might contribute to better / earlier diagnosis of these psychological conditions, with a special interest in pregnant diabetic women. Better management and cost reduction of care could be a consequence. Methods. We compared diabetic pregnant and non-pregnant women from the perspective of the glycemic variability (for a period of 15 days prior inclusion in the study) and their results on the standardized questionnaires: Beck depression inventory, Hamilton anxiety scale – HRSA, Rosenberg self-esteem test. Results and Conclusions. A statistically significant correlation was identified in both groups between the glycemic oscillation and depression, anxiety, and low selfesteem. Diabetic pregnant women had a higher statistical significance for the correlation between the glycemic oscillation and depression, as well as between the glycemic oscillation and anxiety than non-pregnant diabetic patients. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients.

Context. Polycystic ovarian syndrome is the most common endocrine disorder in women of reproductive age. Objective. The purpose of the present study is to investigate the role of progesterone on survival, in vitro growth and in vitro maturation of follicles and the maturation of oocytes derived from mouse polycystic ovary. Subjects and Methods. To induce polycystic ovary (PCO) female NMRI mice 21 days old were injected daily with testosterone enanthate 1 mg/100g body weight dissolved in sesame oil for 4 weeks (PCO group), while non- PCO group were injected only with vehicle. Follicles were derived from both groups and cultured in MEM-α medium either with progesterone or without progesterone. Sizes of follicles were measured in days 1, 3, 6, 9 and 12. After 12 days follicles were transferred to mature medium, follicles from two groups were cultured for 24 and 48 h and the in vitro maturation of oocytes was assessed. Results. In PCO groups with progesterone, survival and in vitro growth of follicles, significantly increased as compared with PCO groups without progesterone (p<0.05). The in vitro maturation rate in PCO group with progesterone was significantly higher than in those not treated by progesterone (p<0.05). Conclusions. This study demonstrated that progesterone can improve survival, in vitro growth and in vitro maturation of follicles derived from mouse polycystic ovary.

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