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“Essential” hypertension is related to multiple mechanisms that affect cardiac output and peripheral resistance and is a consequence of the interaction between external factors and genetic factors. Neuro-hormonal factors are essential in the pathophysiology of hypertension and among them the renin-angiotensin-aldosterone system (RAAS) has a main role in the physiological and pathological response of the cardiovascular system. RAAS functions as an endocrine system, but also has paracrine and autocrine functions in many tissues and organs. RAAS regulates extracellular fluid volume and peripheral resistance via systemic and local actions in various tissues. RAAS also participates in endothelial dysfunction, inflammation and vascular fibrosis, cardiac fibrosis and cardiovascular remodelling, with worsening hypertension and target organ injury. Aldosterone is involved in “essential” hypertension via discrete variations in the regulation of aldosterone synthesis in the absence of confirmed primary hyperaldosteronism. A complete evaluation of these systems is needed for a thorough understanding of hypertension.

Cardiovascular disease is a complex process that includes genetic, inflammatory and endocrine components. During the last decades, much emphasis has been given to cholesterol and lipids as the primary determinants in cardiovascular disease. However, many endocrine and biochemical factors are involved in the atherosclerosis process as well, both systemically and vascular. Multiple obvious data suggest that hormones are responsible for subtle cardiovascular changes long before the development of overt atherosclerotic. Much research remains to be done regarding the interaction between endocrine systems and their role in atherogenesis.

Introduction: Hip fracture is the most severe consequence of osteoporosis and an important cause of excess mortality in the elderly. Objective: We aimed to evaluate the in-hospital mortality rate after osteoporotic hip fracture in patients treated surgically or functionally in specialized centers in Bucharest. Materials and methods: We calculated the in-hospital mortality rate in 745 patients (540 women [72.48%], with a mean age of 79.1 ± 11 years), surgically or functionally treated for fragility hip fracture over a 12 months period. Results: Average length of hospitalization was 18.12 days. In hospital mortality rate was 5.36% (n=40, women 60%). An important risk factor associated with mortality was age, p=0.001. The male sex was also a risk factor with a mortality rate of 7,8% (n=16), compared to 4.44% in women, p Conclusion: In-hospital mortality rate after hip fracture remains high; probably this being related to the high comorbidity associated with male sex and increased age as risk factors.

Cushing’s syndrome (CS) is a clinical condition resulting from chronic exposure to glucocorticoid excess. Hypercortisolism contributes significantly to the early development of systemic disorders by direct and/or indirect effects. Complications such as obesity, hypertension, diabetes, dyslipidemia, and hypercoagulability cause premature atherosclerosis and increase cardiovascular mortality. These associated abnormalities increase cardiovascular risk not only during the active phase of the disease but also long after the remission of hypercortisolism. Clinical management of these patients should be particularly careful and control of cardiovascular risk factors is necessary for a long period.

Summary Subclinical hypothyroidism (HSC) is a relatively common thyroid dysfunction, characterized by the increase of the thyroid stimulating hormone (TSH) in the presence of normal free thyroxine values. Thyroid hormones are known for the cardiovascular effects, and the consequences of HSC on the cardiovascular system have become the focus of many studies lately. There are clear indications of the relationship between HSC and cardiovascular risk factors such as hypertension, dyslipidemia and atherosclerosis; also, HSC is associated with metabolic syndrome, BMI increase and cardiac insufficiency. Therefore, many clinical trials investigate the benefits and risks of HSC treatment with L-thyroxine.

Background and Aims. The interactions between kidney and thyroid functions are well established: thyroid hormones are necessary for the maintenance of electrolyte and water homeostasis and kidney is involved in the regulation of thyroid hormones metabolism. The aim of our study was to estimate the prevalence of thyroid dysfunction in patients with diabetes mellitus and chronic kidney disease (CKD). Material and Method. 23 patients with diabetes mellitus and CKD in pre-dialysis phase were recruited for this study. All subjects were investigated with thyroid ultrasound and laboratory tests to determine thyroid function, including: serum triiodothyronine (T3), free thyroxine (free T4), thyroid-stimulating hormone (TSH) and antithyroid peroxidase antibodies (ATPO). Results were compared with the same measurements in 21 patients with diabetes mellitus but without CKD. Results. The prevalence of goiter (52.17% vs. 19.04%, p

Background and Aims. Previous studies have shown that aging is an important risk factor for insulin resistance and type 2 diabetes. The beneficial effects of exercise on glucose metabolism are well known. Our goal was to examine whether physical activity improves insulin levels in older individuals. Material and Methods. Plasma glucose and insulin were measured in fasting state and 2 h after a 75-g oral glucose tolerance test in young lean, sedentary, non-diabetic subjects (n=34, age 25±2 years, body mass index- BMI 24.4±0.7 kg/m2) and older, lean, sedentary, non-diabetic subjects (n=36, age 75±3 years, BMI 24.8±0.4 kg/m2), before and after 8 weeks of aerobic exercise. Training consisted of exercise (such as cycling or fast walking) 5 days/week for approximately 30 min/day. Results. Fasting plasma insulin and 2-h serum insulin levels at baseline were significantly higher in older than young subjects (11.6 μU/ml vs 10.0 μU/ml, p=0.0001, 46.3 μU/ml vs 34.0 μU/ml, p=0.0001). Fasting and 2h plasma insulin levels were reduced after 8 weeks of aerobic exercise in older subjects, with no change in body weight. Conclusion. In our study the hyperinsulinemia associated with aging can be blunted significantly by aerobic exercise in older individuals independent of any changes in body composition

Background and Aims. Previous studies have shown that impaired glucose tolerance is present in patients with pheochromocytoma with a prevalence of 25- 75%. The aim of this study was to examine glucose tolerance in 12 patients with pheochromocytoma, before and after medical and surgical treatment. Material and Methods. We evaluated 12 patients aged between 44 and 60 years with confirmed pheochromocytoma. Plasma insulin, fasting blood glucose and 2h glucose levels during the oral glucose tolerance test (OGTT) were measured before and three months after surgical removal of the tumor. Results. Surgical removal of the tumor generated significant changes in plasma and urinary metanephrines (plasma normetanephrine 191.15±13.22 pg/ml after treatment vs. 792.54±86.74 pg/ml at baseline, p

Objectives. Prostate-specific antigen (PSA) is the most used and validated marker ofprostate cancer risk. The aim of this study was to assess PSA levels during treatmentwith testosteronum undecanoat in patients with type 2 diabetes (T2DM). Material and Methods. We evaluated 38 T2DM patients aged between 48 and 61 years withconfirmed hypogonadism. 1000 mg testosterone undecanoate was injectedintramuscular every 10 to 14 weeks. Total testosterone and PSA levels were assessedat baseline and after 6, 12, 24 months of treatment. Results. The average age was55.03 ± 2.40 years and 3 patients (7.89%) had a family history of prostate cancer.Treatment with testosterone undecanoate generated significant changes in serumtotal testosterone (482.29±50.78 ng/dl vs. 246.66±51.50 ng/dl, p < 0.001) but not inserum PSA levels (2.11±.0.49 ng/ml vs. 2.09±0.47 ng/ml, p - NS). Conclusion.Testosterone replacement therapy may normalize serum androgen levels but appearsto have little effect on PSA levels.