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Journal Article 2001; 22(3): 163-168 PubMed PMID: 11449190 Citation  Keywords:  Aged, Aged, 80 and over, Aging, Alzheimer Disease:blood, Case-Control Studies, Cross-Sectional Studies, Female, Humans, Linear Models, Male, Memory, Middle Aged, Reference Values, Testosterone:blood,.   

OBJECTIVES: The purpose of this study was to determine whether the level of serum total testosterone (TT) was different in cases of Dementia of the Alzheimer's Type (DAT) than in controls.

SETTING AND DESIGN: We included 83 referred DAT cases and 103 cognitively screened volunteers (aged 75+/-9 years) from the Oxford Project To Investigate Memory and Ageing.

METHODS: Information was obtained about potential confounds in the relation of DAT with testosterone, including age, gender, education, body mass index, smoking, (ab)use of alcohol, diabetes mellitus, endocrine therapy, and having undergone hysterectomy. TT was measured in non-fasting serum obtained between 10 and 12 a.m. using a competitive enzyme immunoassay.

RESULTS: Men with DAT (n=39) had lower levels (p =0.005) of total serum testosterone (TT=14+/-5 nmol/L) than controls (n=41, TT=18+/-6 nmol/L). Lower TT was more likely in men with DAT, independent of potential confounds (Odds Ratio=0.78, 95% C.I.=0.68 to 0.91). In women there was no difference in TT levels between cases (n=44) and controls (n=62).

MAIN FINDINGS: Our results suggested that low TT may be a co-morbid feature of DAT in men. However, low TT levels could also exacerbate the disease.

CONCLUSIONS: Prospective longitudinal studies should investigate whether low TT levels precede or follow the onset of DAT (209 words)....

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Case Reports 2001; 22(1): 49-52 PubMed PMID: 11335880 Citation  Keywords:  Autoantibodies:analysis, Female, HLA-DR5 Antigen:genetics, Hepatitis C, Chronic:complications, Histocompatibility Testing, Humans, Interferon-alpha:adverse effects, Middle Aged, Thyroiditis, Autoimmune:genetics,.   

OBJECTIVES: The authors described a case of Hashimoto's disease during interferon-alpha (IFN-alpha) treatment for chronic viral C hepatitis in a patient with the specific genetic susceptibility associated with the thyroid disease.

RESULTS: A 60-year-old woman with chronic active viral C hepatitis (HCV genotype = 3a) started IFN-alpha therapy in November '96. Before treatment thyroid function tests were normal and anti-thyroid (anti-thyroglobulin and anti-thyroid peroxidase) Abs were negative. During IFN therapy, serum aminotransferases fell within the normal range and viremia (serum HCV-RNA) became negative after one year. After 20 months, the patient presented clinical features of primary hypothyroidism. Anti-thyroid Abs were found positive. Hormonal, ultrasonographic, radioiodine scanning and fine needle aspiration findings were consistent with the diagnosis of Hashimoto's thyroiditis. The tissutal typing of the patient showed the presence of Human Leukocyte Antigen (HLA) DRB1*11 gene (corresponding to DR5 antigen). IFN-alpha therapy was suspended and a treatment with l-T4 started. Chronic viral infection relapsed after the suspension of the IFN-alpha therapy.

CONCLUSIONS: This case report showed that the clinical appearance of Hashimoto's disease after IFN-alpha therapy for chronic C hepatitis in our patient was associated with a specific genetic predisposition (DR5) for this pathology. Further studies are necessary to evaluate whether the study of HLA antigens may be a very useful tool to detect the patients with a predisposition to develop autoimmune thyroiditis, in order to make a early diagnosis of thyroid disorders during the IFN-alpha treatment....

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Journal Article 2018; 39(3): 219-225 PubMed PMID: 30431736 Citation  Keywords:  Adolescent, Adult, Body Mass Index, Estradiol:blood, Female, Humans, Menstruation Disturbances:blood, Obesity:blood, Oligomenorrhea:blood, Overweight:blood, Risk Factors, Sex Hormone-Binding Globulin:metabolism, Testosterone:blood, Vitamin D:analogs & der.   

INTRODUCTION: Vitamin D (VD) plays a crucial role in calcium metabolism as well as immunological and endocrine homeostasis. Previous studies revealed strong inverse correlation between VD levels and insulin resistance, parathyroid dysfunctions and autoimmune thyroid disease. Insufficient evidence concerns its dependency of ovarian hormones. Malfunctioning of the ovaries results in menstrual disorders that are one of the most common endocrine impairments in young women of reproductive age. MATERIAL AND METHODS: The study was aimed to evaluate the correlation between 25(OH)D serum concentration and estradiol, testosterone as well as body mass index (BMI) in women with oligomenorrhea. 134 women of reproductive age with oligomenorrhea were eligible for the study. 25-hydroxyvitamin D [25(OH)D], estradiol, testosterone and sex hormone-binding globulin (SHBG) were measured using chemiluminescence immunoassay. Free androgen index (FAI) and body mass index (BMI) were calculated. RESULTS: Critical 25(OH)D deficiency (<10 ng/ml) was found in 13.4% of women, the risk of deficiency (<30 mg/dl) was diagnosed in 69.4%, while sufficient level of VD (>30 mg/ml) in 17.2% of them. Significant negative correlation was detected between 25(OH)D and estradiol serum concentrations (r=-0.2; p=0.049), as well as BMI levels (r=-0.22; p=0.01). However, no significant correlation was found between 25(OH)D and testosterone (r=-017; p=0.055), SHBG (r=0.08; p=0.4) and FAI (r=-0.1; p=0.24). CONCLUSIONS: Thorough assessment of vitamin D deficiency/insufficiency is required among patients with menstrual disorders, especially those overweighed and obese. Early screening and VD supplementation in women with estrogen-dependent disorders may become a part of routine management in order to optimize endocrine health....

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Journal Article 2018; 39(4): 305-309 PubMed PMID: 30531706 Citation  Keywords:  Humans, Immunohistochemistry, Intestinal Mucosa:pathology, Intestinal Neoplasms:metabolism, Intestine, Small:pathology, Neoplasm Grading, Neoplasm Invasiveness, Neuroendocrine Tumors:metabolism, Receptors, Somatostatin:metabolism,.   

OBJECTIVE: Somatostatin receptor (SSTR) expression constitutes a pivotal cornerstone for accurate radiological detection and medical treatment of small intestinal neuroendocrine tumors (SI-NETs), and the development of somatostatin analogues for these purposes have revolutionized the clinical work-up. Previous assessments of SSTR isoform expression in SI-NETs have found correlations to overall prognosis and treatment response, however these analyses usually report overall tumoral immunoreactivity, and little is reported regarding histo-regional differences in expressional patterns. METHODS: Thirty-seven primary SI-NETs (WHO grade I, n=32 and WHO grade II, n=5) were collected and assessed for SSTR2 immunohistochemistry. Samples were stratified with regards to histological level of bowel infiltration and spread (mucosal region, muscularis propria region, subserosal region) and each of these tumoral regions was separately scored by SSTR2 staining localization (membrane, cytoplasmic), overall staining intensity and local staining differences within each region. RESULTS: SSTR2 immunoreactivity was progressively weaker as the tumor cells advanced through the small intestinal layers. This was exemplified by a reduction in the amount of tumor samples with strong SSTR2 expression in the deeper histological levels of the section; 56% of tumors displayed strong SSTR2 expression in the mucosal region, as compared to 29% and 30% of tumors within muscularis propria and subserosal layers, respectively. CONCLUSIONS: This observation indicates a down-regulation of SSTR2 expression as the tumors progress through the intestinal wall, which might signify underlying biological processes of importance for SI-NET invasion behavior....

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Journal Article 2018; 39(4): 281-287 PubMed PMID: 30531701 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Brain Neoplasms:radiotherapy, Female, Glioblastoma:radiotherapy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local:radiotherapy, Palliative Care, Radiosurgery, Retrospective Studies, Survival Rate, Treatment.   

OBJECTIVE: Local recurrence of glioblastoma is observed in most patients after standard oncologic treatment (surgery, chemotherapy and radiotherapy). Stereotactic radiosurgery with the Leksell Gamma Knife (SRS with LGK) was used to treat recurrent tumors in selected cases, and retrospective analysis of treatment outcome was performed. METHODS: Altogether 126 patients were treated for glioblastoma at our center from 1992-2014. Sixty-nine patients (55%) were male and 57 (45%) female, with a median age of 56 years (range 17-80 years). Prior to LGK radiosurgery, 123 (98%) underwent surgery, 126 (100%) radiotherapy and 116 (92%) chemotherapy. The median Karnofsky score before LGK radiosurgery was 90% (range 50-100), and the median time from GBM diagnosis to LGK radiosurgery was 12 months (range 1-96 months). The median tumor volume was 3.75 cm3 (range 0.04-37.10 cm3). LGK radiosurgery was performed in a single fraction with a median minimal tumor dose of 12 Gy (range 10-25 Gy) on a median 50% (range 40-86%) isodose line. Two and more LGK radiosurgeries were performed in 19 (15%) cases, a median interval of 9.6 months (range 2-45 months) from the initial LGK radiosurgery. The median prescribed dose in these patients was 12.6 Gy (range 10-15 Gy), and the median volume 5.8 cm3 (range 0.1-13.7 cm3). RESULTS: The median survival from GBM diagnosis was 20 months (range 6-237 months). The median survival after LGK radiosurgery was 7 months (range 1-223 months). The one year survival after LGK radiosurgery was 27%, 2 years 8%, and more than 3 years 4%. Tumor regression on MR images was observed in 17% of patients at a median interval of 7 months. The median interval to tumor progression on MR images after LGK treatment was 8.5 months. No treatment-related radionecrosis with expansive behaviour was detected after radiosurgery. CONCLUSION: We show that LGK radiosurgery is a safe palliative treatment modality in patients with recurrent GBM....

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Journal Article 2018; 39(4): 342-348 PubMed PMID: 30531700 Citation  Keywords:  Adult, Cross-Sectional Studies, Human Growth Hormone:blood, Humans, Hydrocortisone:blood, Insulin-Like Growth Factor I:metabolism, Male, Resistance Training, Testosterone:blood, Time Factors, Weight Lifting,.   

OBJECTIVE: Research indicates that among the many elements of resistance exercise protocols, training volume and total training load are the key factors for post-exercise increase in the secretion of testosterone (T), growth hormone (GH), insulin-like growth factor (IGF-1) and cortisol (C). The aim of this study was to determine the effects of resistance exercises with variable volume and constant intensity and movement tempo on post-exercise concentrations of selected anabolic and catabolic hormones. MATERIALS AND METHODS: 28 experienced powerlifters (27.8 ± 2.9 years, with 6.64 ± 1.29 years of training experience, average body mass of 85.3 ± 3.3 kg and body height of 165.8 ± 10.3 cm) who compete at the national and international level performed three repetitions of barbell squats with a constant external load of 90% 1RM and variable volume (3, 6 and 12 sets of squats) in three stages (pre-exercise, immediately post exercise, and 1h after exercise) over three consecutive weeks. Venous blood samples (10ml) were collected from the antecubital vein, to determine pre- and post-exercise values of the following variables T, GH, IGF-1, C, at rest, immediately after the cessation of the last set of squats, and after 60 minutes of recovery. RESULTS: The T test showed that performing 6 and 12 sets resulted in increases of post exercise GH (p<0.01). Performing 6 sets of squats resulted in post exercise decrease (p<0.01) in IGF-1 and C. Performing 3 sets of squats resulted in immediate post exercise decrease of IGF-1 (p<0.01), which was not maintained 1h after exercise. There were no other significant differences in analysed variables, with the training volume of three sets of three repetitions, confirming previous data suggesting that low volume is the limiting factor in increased post-exercise secretion. CONCLUSION: This study demonstrated that in terms of endocrine response, the optimal volume of high intensity strength exercise is six sets. Therefore, intentionally high volume (12 sets) or low volume (3 sets) are not an effective stimuli for endocrine responses of trained individuals. The 6 sets of squats seems to drive hormonal responses of GH, C and IGF-1, which may play a significant role in stimulating muscle growth and tissue regeneration....

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