Acta Endocrinologica-Bucharest最新文献

Parathyroid cancer is an uncommon endocrine malignancy. It has slow clinical course and low malignancy potential. It represents 1% of primary hyperparathyroidism. It results with more agrressive biological behaviour and severe clinical condition than benign reasons. Extended resection in the first operation is essential for PC treatment and decreases local recurrence that is observed in high frequency. Palliative surgery should be considered in patients with unresectable tumor. Immunotherapy and recent interventional radiological procedures are considered for patients that are unfit to surgery. Effect of adjuvant chemotherapy and radiotherapy is limited however recent immunization studies are promising. Parathyroid cancer epidemiology, staging system, diagnosis and advancements in treatment are considered according to recent literature in this review.

Background: Diabetes mellitus has been associated with many different musculoskeletal system problems.

Objective: This study aims to show the prevalence of musculoskeletal disorders in patients with diabetes and to reveal their relationship to the metabolic parameters and microvascular complications.

Methods: Seven hundred two diabetic patients who consecutively applied to our clinic between March 2017 and February 2018 were included in this prospective cross-sectional study. The relationship of the musculoskeletal disorders including carpal tunnel syndrome, Dupuytren's contracture, adhesive capsulitis, flexor tenosynovitis, limited joint mobility syndrome, Charcot arthropathy, diabetic foot and gout to the patients' age, gender, type of diabetes, duration of diabetes, metabolic parameters, and microvascular complications were evaluated.

Results: Musculoskeletal system disorders were detected in 45.9% (n = 322) of the 702 diabetic patients evaluated in our study. The most common disorders were carpal tunnel syndrome 17.7% (n = 124), Dupuytren's contracture 14.4% (n = 101), and adhesive capsulitis 13.8% (n = 97). A statistically significant relationship of the HbA1c level with Dupuytren's contracture, carpal tunnel syndrome, and adhesive capsulitis was detected (p<0.05).

Conclusions: Patients' age, duration of diabetes, HbA1c level, and presence of microvascular complications are associated with musculoskeletal disorders in this population.

Context: Osteonecrosis (ON) is bone death caused by inadequate blood supply and its optimal management remains uncertain.

Objective: We describe the outcomes of BP (pamidronate) treatment in our patients.

Design: Data regarding clinical, laboratory, magnetic resonance imaging (MRI) studies, and bone mineral density measurements (BMD) were recorded before and one year after treatment (reevaluation). The severity of the clinical picture was assessed using the criteria of the common terminology criteria for adverse events (CTCAE).

Subjects and methods: There were four female patients (patient 1, acute lymphoblastic leukemia; patient 2, immune thrombocytopenic purpura; patients 3 and 4, systemic lupus erythematosus) .All of them had been treated with high-dose prednisolone. Clinical picture of all patients were consistent with grade 3 according to CTCAE(: severe symptoms, limiting self-care ).

Results: ON lesions were multifocal in the lower limbs in all of them and none of them had any fractures. All of them had been treated with high-dose glucocorticoid. Patients were treated with pamidronate (1 mg/kg/day, with maximum dose of 60 mg/day, for two days, quarterly). At the time of re-evaluation(one year after treatment), the lesions were stable on MRI, and their clinical condition was consistent with grade 1 according to CTCAE(asymptomatic). No side effects related to the use of bisphosphonates were observed except for increased BMD (SD score of 2.9) in one of the patients.

Conclusions: Pamidronate may be an effective treatment for the improvement of functional impairment and pain among patients with severe osteonecrosis (ON) lesions.

Background: Chronic inflammation is associated with different cancers, and is identified as a key pathogenic mechanism in ovarian cancer. The purpose of our study was to evaluate systemic inflammation markers, as predictive and prognostic factors, in ovarian cancer patients with initial surgical treatment.

Subjects and methods: We performed a retrospective study on 60 ovarian cancer patients with primary cytoreduction surgery, between 2010-2018, with a follow-up period of at least one year. We analyzed systemic inflammation markers and their correlations with the clinical, paraclinical, tumor characteristics, or treatment particularities, and evaluated them as prognostic factors for overall survival.

Results: In the univariate analysis, no statistically significantly differences were observed, by correlating the systemic inflammation markers with age, reproductive status, FIGO stage, or type of cytoreduction. Higher neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were statistically significant associated with deceased patients, and lower lymphocyte-monocyte ratio (LMR) had statistical significance for living patients. For the patients in the group, the increase of NLR, as well as of PLR leads to the increased risk of death, and the increase of LMR leads to the decrease of this risk. In the multivariate regression analysis, the increase of NLR determined an increased risk of death by 9.7%, and for LMR a reduced risk of death by 46.9%.

Conclusions: Systemic inflammation markers had no statistical significance correlated with age, reproductive status, FIGO stage, serous cancer type, or type of cytoreduction but only with overall survival. NLR is an independent risk factor, while LMR is an independent protection factor as well as optimal cytoreduction.

Urinary Bladder paraganglioma accounts for 0.06% of all bladder tumors and 1% of all pheochromocytoma. Most tumors are localized at the dome or trigone and are unifocal. The presenting complaints are painless hematuria, micturition syncope. It may be sporadic or associated with hereditary predisposition syndromes such as Hereditary Paraganglioma-Pheochromocytoma Syndrome.

Case report: A 70-year-old male presented with complaints of hematuria. The physical examination was unremarkable. The CT scan revealed an enhancing mass in the lateral wall of bladder. The mass was resected, and histopathological examination showed features of tumor cells arranged in Zell ballen pattern. Tumor cells show mild nuclear pleomorphism, round to oval vesicular nuclei, prominent nucleoli and moderate to abundant granular basophilic cytoplasm. Rare mitosis and no necrosis were noted. On immunohistochemistry, tumor cells were immunoreactive to Synaptophysin, S-100P and negative for CK7 suggesting Paraganglioma. The patient is doing fine after two years of follow up. Due to its rarity, there are no recommendations for treatment and monitoring but, their risk of malignancy forces a long-term follow up. Initial management included early reassessment by cystoscopy, transurethral bladder resection (TURB) and imaging.

Context: Congenital hypothyroidism (CH) is one of the most common preventable causes of intellectual disability, and can be diagnosed in the early period through neonatal screening programs.

Objective: The purpose of this study was to determine the prevalence of CH and recall rates in the province of Adıyaman.

Design: This retrospective study evaluated the data of newborn screening program in Adıyaman province between January 2015 and December 2020.

Subjects and methods: The thyroid-stimulating hormone (TSH) cut-off value in the screening program is 5.5 mIU/L and TSH values lower than 5.5 mIU/L are regarded as normal. Babies with TSH levels exceeding 5.5 mIU/L were defined as 'recalled'. TSH measurements and clinical diagnoses of the recalled babies were evaluated.

Results: TSH was <5.5 mIU/L in 62270 (90.08%) of the newborns, 5.5-20 mIU/L in 6114 (8.84%), and >20 mIU/L in 742 (1.07%). Venous T4-TSH values were normal in 673 of the 742 babies with TSH levels exceeding 20 mIU/L, while 63 babies were diagnosed with CH. Heel blood results were normal in 5880 of the 6114 babies with TSH levels of 5.5-20 mIU/L and for whom repeat heel blood was requested. TSH levels in repeat heel blood were >5.5 mIU/L in 184 babies and 93 of them were diagnosed with hypothyroidism. The recall rate among babies undergoing heel blood TSH measurement in the province of Adıyaman was 9.9%. 156 babies were started on thyroid replacement therapy with diagnoses of CH. The incidence of babies diagnosed with hypothyroidism was 1/443.

Conclusion: According to the CH screening results, the recall rate and incidence of CH in the province of Adıyaman were higher than the global general figures. Both the low TSH threshold value employed in neonatal hypothyroidism screening and the province falling within the iodine deficiency region may account for this.

Introduction: Infertility is a very discussed problem in many endocrinological and gynecological courses and congresses. In a rapidly revolving environment women tend to postpone pregnancy to have security in their financial life and career.We discuss primary and secondary infertility and the hormonal results in women that presented for a desire to conceive with their partner.Infertility is considered to have many causes and annual follow-up is important, especially in women with no children and a stable partner.Hormonal parameters are often not recommended until late after 30 years of age, in women who adress routine consultations and should be considered much early on in their reproductive life, especially in women with familly history of premature menopause.

Conclusions: There is still a lot to research in the field of ovarian response and poor ovarian reserve, but promising studies are being made in the present and near future.

Turner syndrome is the most common sex chromosomal abnormality in about 1:2000-2500 live female births. While short stature and delayed puberty are the most common presentations of patients, atypical findings can also be seen. In this article, we present the Turner twins, who were diagnosed during inguinal hernia surgery when bilateral uterus and ovaries were found within the hernia sac. To the best of our knowledge, our cases were the first defined heterokaryotic monozygotic twins with isochromosome Xq 46,X,i(X)(q10) and Xq mosacism (46,X,i(X)(q10;q10)[42]/47,X,i(X)(q10;q10)x2[8]).

Objective: Thyroid dysfunction represents common disorder occurring very frequently among women of reproductive age, including pregnancy. The aim of this literature review was to determine in which way thyroid function during pregnancy is associated with GDM.

Design: We conducted review of the literature following the basic principles of literature search.

Methods: Two researcher independently searched PubMed in the period of last five years (2018-2023) to identify eligible studies regarding thyroid function and GDM.

Results: From 51 papers initially found after the inserting key words in PubMed search field 30 were excluded after the title and abstract review. After reading full text of 21 articles, 15 were included in the review.

Conclusions: Our review of literature showed not only that two most common disorders during pregnancy were GDM and thyroid dysfunction, but also indicated that they were in positive correlation.