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Endokrynologia Polska 2018;69(2):120-127.
WięcejEndokrynologia Polska 2018;69(2):128-134.
WięcejEndokrynologia Polska 2018;69(2):135-141.
WięcejEndokrynologia Polska 2018;69(2):142-149.
WięcejEndokrynologia Polska 2018;69(2):150-155.
WięcejEndokrynologia Polska 2018;69(2):156-162.
WięcejTHE AIM OF THE STUDY: Evaluation of the results of surgical treatment in patients with hyperparathyroidism related to MEN syndrome MATERIALS AND METHODS: The group of three women and two men aged between 17 and 72 years ( av. 38.6) with MEN- related hyperparathyroidism within 419 patients were operated between 2010-2016. MEN1 syndrome was diagnosed in four patients and MEN2 only once. Pre- and postoperative results of PTH levels and serum calcium values were compared. RESULTS: The mean preoperative serum PTH level was 215,56 pg/ml, whereas calcium concentration was 1.40 mmol/l. Three Patients with MEN1 syndrome had three and two thirds of parathyroid gland taken, and one had a single parathyroid gland excised with biopsy of the rest glands performed. A patient with MEN2 syndrome had one parathyroid gland excised. Postoperatively, we reported decreased secretion of both PTH (a mean serum PTH concentration 6.72 pg/ml), and serum calcium concentration 1.11 mmol/l. One patient (25%) with MEN 1 developed recurrent hyperparathyroidism after five years from the surgery. The patient was reoperated. The rest of the parathyroid gland was removed with an implantation into separated muscle pockets in the anterior forearm muscles. CONCLUSIONS: 1. MEN syndrome is a rare cause of primary hyperparathyroidism. 2. Subtotal parathyroidectomy helps to bring back a normal calcium metabolism. 3. Recurrence of hyperparathyroidism in patients with MEN syndrome requires total parathyroidectomy with an autotransplantation into the anterior forearm muscles.
WięcejBackground: Hypovitaminosis D is associated with abnormal female sexual functioning. The aim of our study was to assess whether vitamin D supplementation affects sexual functioning and depressive symptoms in young women with low vitamin D status. Methods: The study included 47 women with vitamin D deficiency or insufficiency. All women with vitamin D deficiency were treated with oral vitamin D, while women with vitamin D insufficiency were either treated with vitamin D or left untreated. At the beginning of the study and six months later, all patients completed questionnaires evaluating female sexual function (FSFI) and depressive symptoms (BDI-II). Results: The total FSFI score and scores in three domains (sexual desire, orgasm and satisfaction) were lower while the overall BDI-II score was higher in women with vitamin D deficiency than in women with vitamin D insufficiency. Vitamin D improved sexual desire in women with both vitamin D deficiency and vitamin D insufficiency, increased the total FSFI score and scores for orgasm and sexual satisfaction, as well as decreased the total BDI-II score in women with vitamin D deficiency. Conclusions: The obtained results indicate that vitamin D supplementation improves female sexual functioning and mood in women with low vitamin D status.
WięcejIntroduction: No previous study has investigated sexual functioning in prediabetic women. Aim: This study was aimed at investigating sexual function in young women with various types of prediabetes. Methods: The study included four groups of women: women with isolated impaired fasting glucose (Group A; n=19), isolated impaired glucose tolerance (Group B; n=18), presence of both impaired fasting glucose and impaired glucose tolerance (Group C; n=18), as well as matched healthy controls (Group D; n=19). All participants completed questionnaires evaluating sexual function (Female Sexual Function Index - FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition – BDI-II). Results: The total FSFI and BDI-II scores were lower in Group C than in the remaining groups of women, while the total FSFI score was lower in Groups A and B than in Group D. Patients with both impaired fasting glucose and impaired glucose tolerance had lower scores in all domains (sexual desire, arousal, lubrication, orgasm, sexual satisfaction and dyspareunia). Compared to Group D, Group A was characterized by lower domain scores for sexual desire and sexual satisfaction, while Group B by lower domain scores for desire, arousal and orgasm. In all groups of prediabetic women, the overall FSFI score correlated negatively with the degree of insulin resistance and weakly with the total BDI-II score. Conclusions: Impaired fasting glucose and impaired glucose tolerance may disturb sexual functioning and induce depressive symptoms.
WięcejIntroduction In the search for markers of invasiveness of pituitary adenomas, we studied the expression of Ki-67 antigen, TOPO 2A (topoisomerase 2 alpha), AIP (Aryl Hydrocarbon Receptor-Interacting Protein) and VEGF (Vascular Endothelial Growth Factor) in somatotropinomas. Material and Methods We retrospectively studied a group of 31 patients who underwent pituitary tumour surgery. Expression of Ki-67, TOPO 2A, AIP and VEGF in surgical specimens was determined by immunohistochemistry. Relations between quantitatively determined markers and clinical symptoms, tumour features, and MR imaging, were analysed. Acromegaly was confirmed by hormonal tests in all patients studied. Local invasiveness (cavernous sinus penetration, optic chiasm compression or suprasellar extension) was observed in 18/31 patients (58,1%). Results Ki-67 was expressed in 77.4%, TOPO 2A in 87.1%, AIP in 83.8%, and VEGF in 87.1% of 31 cases of somatropinoma. Median values of Ki-67, TOPO 2A, AIP and cytoplasmic VEGF indices were 1.2% [IQR=2.2], 1.5% [IQR=1.6], 21.26% [IQR=20.1] and 20.4% [IQR=15.4], respectively. Ki-67, TOPO 2A, AIP and VEGF expression was not correlated with age nor with patient gender (p > 0.05). Only Ki-67 and TOPO 2A correlated with tumour size (for Ki-67: r=0.42, p=0.025; for TOPO 2A: r=0.53, p=0.003). Ki-67 and TOPO 2A levels were significantly higher in invasive compared to noninvasive somatropinomas (Ki67 mean values: 1.85±1.33% vs. 0.95±1.07%, p=0.024; TOPO 2A mean values: 2.19±1.63% vs. 1.45±1.23%, , p=0.011). Conclusions Ki-67, TOPO 2A, AIP and VEGF were expressed in over 70% of all somatotropinomas. Only Ki-67 and TOPO 2A expression correlated with tumour size and tumour invasiveness.
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