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Biomedical subjects

E Zbranca

Publications and source records attributed to E Zbranca.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[A statistical analysis of the variation in the cephalometric measures of acromegaly patients].

Acromegaly represents the endocrine disease which includes the somatic and metabolic disorders secondly resulting to the augmentation of the Growth Hormone secretion after the growth cartilages closing (in adult). In this study we want to describe the craniofacial cephalometric qualitative and quantitative disorders and to emphasize their implications in the onset and the evolution of the stomatognathic system dysfunctional syndrome. For proving this things, we made a statistical study using a statistics function named "standard deviation" which is a measure of how widely values are dispersed from the average value.

Acromegaly↗
PubMedDate not supplied

Barraquer-Simons syndrome. Report of a case and review of the literature.

Among lipodystrophies, the Barraquer-Simons syndrome or "parital lipodystrophy of the cephalothoracic type" is a rare condition of unknown origin characterized by a progressive atrophy of the subcutaneous fat of the upper part of the body. We report a 34-year-old woman with progressive loss of subcutaneous fat during 20 years, first affecting the face and spreading to the upper part of the body, equally presenting hypertrophy of the lower body fatty tissue. An overview of this rare syndrome is made.

Adipose Tissue↗
PubMedDate not supplied

[Body composition in amenorrheic and eumenorrheic underweight patients].

Relationship between weight and hypothalamic-pituitary-ovarian axis has been long time studied. Underweight female patients can have or not disturbances of gonadal system and the importance of the weight or body composition in the mechanisms of these abnormalities is not clear. In our study, we have investigated body composition in 15 underweight female patients. Five patients have had anorexia nervosa, with amenorrhea (group AN), and other 10 patients were eumenorrheic, but with low body weight (hypoanabolic syndrome--group HA). Bioelectrical impedance method was used to investigate body composition. Total body water (TBW), lean mass (LM), and fat mass (FM) were determined. Nutritional status was also assessed using body mass index (BMI). The mean body weight was significantly decreased (p = 0.05, 36.6 +/- 4.68 Kg versus 44.1 +/- 4.67 Kg) in group AN as compared to group HA. Fat mass was very low in group AN (9.45% of body weight versus 11.3% of body weight in group HA), but there was not significant difference. Lean mass was significantly decreased in group AN (33.24 +/- 2.37 Kg) in comparison with group HA (39.3 +/- 4.06 Kg). Correlations between anthropometric indices were studied. Positive significant correlations were obtained between body weight and lean mass, total body water and basal metabolism in both groups. In conclusion, our study reveals that body weight has a relative importance in ovarian axis dysfunction, and the most important of body compartments seems to be lean mass.

Adult↗
PubMedDate not supplied

[Thyroxine therapy in benign thyroid nodules].

Levothyroxine (LT4) treatment in benign thyroid nodules is a controversial management. The favorable response varies between 10-60%, being, in some studies, comparable between treated and untreated groups. The aim of this study was to evaluate the response of uninodular goiter at the LT4 treatment, in comparison with untreated patients. The study group (S) included 53 patients diagnosed with nodular goiter, treated with LT4 for 1 year. 26 patients with nodular goiter, age and sex-matched, untreated, constituted the control group (C). All patients were from a minor iodine deficient area. The including criteria were euthyroidism, single nodule, solid (ultrasonography), cold (Scintigraphy), and benign (FNAB). After 1 year mean nodular volume had a significant decrement in both groups, higher in group S (35%: from 7.8 to 5.2 mL, p = 0.0098) than in group C (25%: from 8.4 to 5.9 mL, p = 0.026). Linear regression showed a slight correlation between the nodular decrement and the initial volume (r = 0.23): the responders percentage was higher in nodules with a volume < 5 ml than in those with volume > 5 ml (51.5% vs o 19.6%, p < 0.0001). The evolution of treated nodules seamed to be better than of the untreated ones, but the differences were only slightly significant. We believe that the evolution of thyroid nodules under LT4 treatment can be influenced by the iodine supply, since in most of the studies from minor iodine deficiency regions (Europe, South America) the response is better than in regions with sufficient iodine supply (North America). Knowing the potential side effects of LT4 therapy, this kind of management of benign thyroid nodules should be reserved to selected cases.

Adult↗
PubMedDate not supplied

[The influence of body weight upon the function of ovarian axis].

The relationship between the body weight and the function of hypothalamopituitary-ovarian axis was longtime studied. Frisch and Ravell (1971) have proposed the hypothesis that the onset of menarche is strong related to the achievement of a critical body weight. These authors observed that, despite the decrease in the last 120 years of the menarche age from 16.5 to 12.5 year-old, the body weight at which the menarche appears remains unchanged, 47.5 +/- 0.5 Kg. Many studies show the importance of both, body weight and fat mass percentage, in the appearance of menarche at puberty, or in the restoration of menses after the weight loss amenorrhea. Primary or secondary underweight amenorrhea can be associated to an eating disorder (anorexia nervosa, bulimia nervosa, or the alternation of these to clinical conditions), to severe exercise (athletes, gymnasts, dancers) or to malnutrition. The connected signal between metabolic status and reproductive function may be represented by the substances like: insulin, amino acids, IGFPB-I, leptin. The low levels of leptin were found in underweight female with oligo or amenorrhea. By the other hand, obesity is not a primary factor causing chronic anovulation. However, obesity may aggravate an already existing subtle defect in some women and result in amenorrhea.

Amenorrhea↗
PubMedDate not supplied

[Contribution of ultrasonography in the evaluation of subacute thyroiditis].

Ultrasonography is a useful tool in diagnosing and monitoring thyroid pathology. The aim of this study was to evaluate the value of thyroid ultrasonography in the follow-up of subacute thyroiditis (SAT). The study group included 48 subjects with clinical and biological diagnosis of subacute thyroiditis. All patients were evaluated by ultrasonography and followed-up for a mean period of 12 months. The evaluation protocol included biological data (TSH, T4, erythrocyte sedimentation rate--ESR) and ultrasonography, performed at 1, 2, 3, 6, and 12 months. Initially, all patients had an enlarged thyroid volume (median = 30.5 ml, range 23-90) and a low echogenicity, with an inhomogeneous aspect in 54.1% cases. After a mean period of 3 months thyroid volume had a significant reduction (median volume = 20.2 ml, range 7-36, p < 0.0001). Echogenicity was also significantly improved, with a decrement, on a semi-quantitative scale of 4 degrees (1 = normal, 4 = intense hypoechogenicity), from 3.25 to 2.48 (p < 0.0001). Almost half of the patients (45.8%) presented persistent (although slighter) hypoechoic/inhomogeneous pattern. Ultrasonographic abnormalities were not correlated with the intensity of the inflammatory syndrome and/or the thyroid status. Recurrence appeared in 10 (20.8%) patients. All patients presented a new thyroid enlargement (from a median = 16.1 ml to 31.5 ml, p = 0.056) and an extension of hypoechoic regions. The risk of recurrence could not be correlated with thyroid function, inflammatory syndrome or ultrasonographic aspect. There were not significant differences between the subgroups of patients with and without recurrence concerning the initial thyroid volume (p = 0.889), echogenicity (p = 0.735), TSH (p = 0.321) or ESR (p = 0.1332). Thyroid ultrasonography is useful not only for the initial diagnosis but also for the follow-up of patients with subacute thyroiditis. Remission and recurrence can be appreciated and monitored by the ultrasonographic pattern of the thyroid.

Adult↗
PubMedDate not supplied

[Fertility in prolactinomas--considerations concerning some clinical cases].

Prolactinoma is a frequent endocrine cause of infertility in both man and women. The aim of this study was to evaluate female fertility in association with hyperprolactinemia. The study is a retrospective one, based on the cases monitored in the Endocrinology Department of Iaşi. From the 113 cases of prolactinoma in women we have selected 83 women aged between 18-45 years (fertile age). The diagnosis was suspected on clinical bases: endocrine (amenorrhea-galactorrhea, associated or isolated, spaniomenorrhea, infertility), and tumoral (headache, visual disturbances) syndromes and confirmed by biological (PRL dosage) and morphological (pituitary CT) tests. We classified the found associations between prolactinoma and fertility in: no correlation (previous pregnancies with no desire for another child--76 patients = 75.2%); prolactinoma diagnosed immediately after a pregnancy by persistency of galactorrhea, lack of menses reapparition, headache (16 cases = 15.8%); prolactinoma diagnosed before pregnancy, which was obtained thanks to the hyperprolactinemia treatment (9 patients = 8.9%). All 9 patients of the last group were in remission at the moment of pregnancy apparition and had a normal pregnancy, giving birth to normal children. Infertility associated with prolactinoma is reversible with treatment. Lowering of prolactin levels to normal is often necessary to permit ovulation. Bromocriptine used by pregnant women appears to be safe for the developing fetus, at least in our study where the treatment was interrupted in most cases in the first trimester of pregnancy.

Adolescent↗
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[Hyperprolactinemia and pregnancy].

Prolactin is a polipeptidic hormone secreted by the anterior pituitary gland, whose main role consists in the stimulation of lactation in the postpartum period. The increasing of prolactin secretion can be physiological (pregnancy and lactation) or pathological (hypothalamic and pituitary diseases, iatrogenic, etc.). The suppression of the hypothalamic-pituitary-gonadal axis and the resistivity of the ovary and gonadotropin action are induced in hyperprolactinemia, the amenorrhea and lack of ovulation being the result. Infertility associated with hyperprolactinemia is reversible with treatment, irrespectively to the type of treatment (radical or medical). Lowering of prolactin levels to normal or near normal is often necessary to permit ovulation. Dopamine-like drogs, as bromocriptine, appear to be safe for the developing fetus, at lest when the treatment is interrupted in the first trimester of pregnancy.

Bromocriptine↗
PubMedDate not supplied

[Determination of urinary iodine as a marker of iodine deficiency].

PURPOSE: Determination of ioduria in order to establish the actual degree of iodine deficiency in school-age children from 4 counties in Moldavia. MATERIALS AND METHODS: Urinary iodine was determined in 927 school-children aged 7-14 years from 4 counties: Suceava, Iaşi, Neamţ and Botoşani. The determination was made by cerium-arsenate method and by a semi-quantitative method. RESULTS: The median value of ioduria was 3 micrograms/dL in Suceava, 8.8 micrograms/dL in Iaşi, 7.1 micrograms/dL in Botoşani. In Roman-Neamţ 93.75% of all samples had a value of ioduria below 10 micrograms/dL. From this point of view, Suceava and Roman are with moderate iodine deficiency; Iaşi and Botoşani are with mild iodine deficiency. CONCLUSIONS: Despite the existence of a program of iodine prophylaxis, there are still many regions in Moldavia with iodine deficiency, so it is important to have more measures of sanitary education and prophylaxis in these regions.

Adolescent↗
PubMedDate not supplied

[Lipids profile in a group of hypothyroid patients vs. treated hypothyroid patients].

UNLABELLED: Hypothyroidism, like obesity, is one of the pathological conditions most frequently associated to disorders of the lipid metabolism. Hypercholesterolemia is favored, due to the hormone deficit and to the decreased activity of the lipoprotein lipase. MATERIALS AND METHOD: We observed the determination of the serum concentrations of TSH, of the total cholesterol level, of the triglycerides, HDL, LDL, VLDL and BMI as well. RESULTS AND DISCUSSIONS: We observed the predominance of the female hypothyroid patients, ages 40 through 60 and BMI > 30kg/m2. The presence of the heart condition in the studied group was the predominance of the cases of ischemic heart disease. The cholesterol levels varied depending on the TSH levels. There are multiple mechanisms of the dyslipemic syndrome, its intensity depending on the degree of the thyroid insufficiency, however, not influenced being by its cause. It can be considered an indicator of the disease evolution or of the efficiency of the substitution treatment strategy. The absence of the total normalization of the lipid metabolism, under the conditions of a correct treatment strategy, may raise suspicions regarding a possible associated primitive hyperlipidemia, who need typical therapy.

Adult↗
PubMedDate not supplied

Osteoporosis in liver cirrhosis--overview.

Osteoporosis can occur as a result of liver cirrhosis. The pathogenesis of reduced bone mineral density in liver cirrhosis is multifactorial. It can be caused by alterations in calcium and vitamin D homeostasis, as well as nutritional and dietary factors. Dual-energy X-ray absorptiometry (DXA) has become the gold standard in assessing bone mineral density in patients with liver cirrhosis. In such cases, patients can be treated with calcium and vitamin D supplements, bisphosphonates and hormonal replacement therapy (HRT).

Bone Density↗
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[Differentiated thyroid cancer].

In the interval 1979-1988, out of 1070 operated goiters 77 malignant thyroid tumors were recorded, 60 of them being differentiated: papillary--32 (53.4%), vesicular--12 (20%), mixed forms--16 (26.7%). The differentiated thyroid carcinomas had peculiar clinical biological and prognostic features and were framed: stage I--60%, stage II--23.4% and state III-IV--16.6%. Only 15 cases presented lymph node metastases. In 16 cases the thyroid tumor was associated with another thyropathy: Hashimoto's thyroiditis--5 cases, Basedow's disease--1 case. The surgical intervention was performed in two times: first total lobectomy or total lobo-isthmectomy [correction of lobioistectomy] with contralateral subtotal exeresis, then total thyroidectomy. It is insisted upon a careful surveillance of postoperative evolution (clinical, biological, scintigraphy) in order to detect the recurrence and apply a proper treatment.

Adult↗
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[Hyperthyroidism in the elderly. The clinical forms. The incidence of signs and symptoms. The evolutionary features].

The last 15 years, 1939 patients suffering from different clinical forms of hyperthyroidism were hospitalised in the Clinic of Endocrinology of Iaşi. The frequency of the disease increases with age, especially for the toxic nodular goitre. In older patients we have noted a non-typical clinical course of the disease, with prevailing cardiovascular signs and weight loss. The clinical course is also particular especially because of the associated pathology. We have made some theoretical considerations concerning the possible explanations of these phenomena.

Aged↗
PubMedDate not supplied

[The "cold" thyroid nodule].

The main problem posed by an (apparent) solitary thyroid nodule is cancer identification, present in about 10% of the nodules excised surgically. This percent might increase to 25-30% in the cold scintigraphic nodules. Therefore, a combination of all the methods for nodule assessment is necessary: anamnesis, physical examination, functional tests, therapeutic test with tyrosine and thyroid imaging, but mainly the intensive active exploration including puncture-biopsy with a fine needle and exeresis with extemporaneous and paraffin morphological checking. Starting from a two decades' experience of a group of endocrinologists, surgeons, anatomo-pathologists and specialists in nuclear medicine, in 2,289 thyropathies operated--of whom 1691 (poly)nodular goitres and 1,190 non-capturing nodules--the authors suggest an investigation algorithm for achieving a differentiated surgery in terms of the pre- and intraoperative morphological findings. This attitude permitted both the improvement of the surgeries of thyroid cancers and the exeresis of benign nodules under low-risk surgical conditions or avoidance of a "non-necessary" surgery.

Biopsy↗