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Objective: Obesity is an exceedingly current pathology with many clinical, molecular, and psychological implications. The number of obese people has doubled in the past ten years, and we can observe an early onset of obesity. Bariatric surgery is an effective treatment for severe obesity and type 2 diabetes mellitus (T2DM); Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most prevalent types of this procedure . Nevertheless, no single mechanism has emerged that thoroughly explains the metabolic benefit and subsequent long-term effects after surgery. Webster's new collegiate dictionary defines the noun model as: 'a descriptive or analogy used to help visualize something that cannot be directly observed.' Sustained by this definition, the animal models in nutritional research are fundamental to improve human conditions. Due to the recent boost in experimental surgery, our aim in this study is to set the main technical characteristics of the gastric bypass operation and specific animal care in the metabolic surgery field we have been undertaking in our center. Materials and methods: We chose Wistar rats fed with a high caloric diet (HCD) 82g / 100 g fat, 53/100 g saturated fat, 64/100 g carbohydrates. After 7-15 weeks of this diet, depending on the protocol understudy, a consistent three-fold greater weight gain is achieved than the usual range of the free eating chow. After approximately three months on an HCD, the obese rats manifest biochemical features of the metabolic syndrome. Results: The weight loss for group B (By-pass) was 125 ± 16.16 g, and for group BS (By-pass + Sulodexid), it was 133.10 ± 14.38 g. Although the weight loss was higher in group BS, it is not statistically significantly higher than in group B (p = 0.345), despite administering a pharmacologically active substance in group BS. Although small (approximately 40-50 g), the difference between the control group and groups B and BS is statistically significant with p = 0.016 and 0.026 and Pearson index of 0.674 and 0.628, respectively. Statistical significance also kept the difference between group C and group S (p = 0.028, Pearson Coefficient = 0.621). Conclusions: First of all, Metabolic surgery is the most effective weight-loss method and improvement or even remission of some diseases associated with obesity. Like today's high-calorie diet, the diet administered, mostly of adolescents, generates both obesity and its associated diseases: diabetes, hypertriglyceridemia, hypercholesterolism, thus increasing mortality and overall morbidity. Second, metabolic surgery radically improves the parameters targeting obesity (weight,% EBWL) and its associated conditions: diabetes mellitus, hypertriglyceridemia, hypercholesterolemia, strongly associated with decreasing life expectancy of the general population. Parameters targeted by gastric bypass: glycemia, TGL, CHO, hepatic steatosis, testicular atrophy registering significant improvements.

Aim Cryptorchidism is a rare condition of adult male. The diagnosis is based on examination: impalpable testis and CT/MRI. The surgical correction of cryptorchidism is possible in childhood, but in adult orchiectomy is recommended, considering the malignancy risk. The association with hernia is uncommon. Material and Methods We report the case of a 23 years old male with left inguinal hernia and concomitant left cryptorchidism. MRI revealed the intra-abdominal left testicle, with reduced size and short vessels. Lab analysis were normal. We underwent laparoscopic exploration: the left testicle was small and had pelvic localization. A large inguinal hernia was also confirmed. We decided to perform laparoscopic TAPP (transaabdominal preperitoneal repair) and left orchiectomy. The evolution was uneventful and patient discharged 1st day postoperatively. Histology revealed testicular atrophy with no malignancy, also no spermatogenesis was present. No recurrence was found during follow-up. Results Cryptorchidism in adult is rare. The association with hernia is even more rare. The open management is not easy, often in pelvic/abdominal localization, the inguinal approach can be cumbersome. There is no standard of care for these cases, but we found the minimally invasive approach to be a good choice. Laparoscopic surgery has the advantage of enhanced exploration and orhidectomy can be easily performed. Associated with the orchidectomy, hernia cure can be facilitated by laparoscopic TAPP procedure. Conclusions In cases of concomitant hernia and cryptorchidism, we emphasize the idea of simultaneously cure hernia via laparoscopic TAPP procedure associated with orchidectomy as feasible and safe.

Pheochromocytomas are tumors composed of chromaffin cells that can produce, secrete and metabolise catecholamines. The surgical excision procedure of these tumors may present the risk of significant variations in blood pressure, as well as the chance of cardiovascular complications in the perioperative period. During surgery, patients may be at risk for cardiovascular events such as major variations in blood pressure, pulmonary edema, stroke, myocardial infraction and a long period of intubation. The surgical approach to pheochromocytomas must always be preceded by accurate imaging evaluation, endocrine screening and identification of associated genetic mutations. In addition, the surgical technique of choice consists in using minimally invasive surgical methods, with a transabdominal or retroperitoneal approach.

Matrix metalloproteinases (MMPs) are enzymes involved in the modulation of extracellular matrix (ECM) and adipocytes and preadipocyte differentiation. The pathophysiology of obesity has characterized by many cellular and molecular processes such as inflammatory processes, macrophage infiltration of adipose tissue, and remodeling of ECM via MMP. The purpose of the study was to determine if we can consider MMPs as a marker of effectiveness in bariatric surgery and if sulodexide administration pre- and postoperative has a benefit in terms of tissue remodeling of weight loss. An experimental study has performed using 40 obese Wistar rats (10 rats in the control group and 30 obese rats in study groups). Those in the study group were divided into three groups and underwent gastric bypass (B group), sulodexide administration (S group), gastric bypass, and sulodexide administration (BS group). Sulodexide was administered because of its antithrombotic effect in the procoagulant status of obese subjects. The pre- and postoperative weight, glucose level, cholesterol, triglycerides, MMP-2, and MMP-9 were analyzed. We compared the results to see if bariatric surgery modifies the MMPs status and if there is a correlation between the weight loss and the other parameters and also if sulodexide has any contribution to the results. The MMP-2 and MMP-9 activities were detectable, but MMP-2 was significantly higher than MMP-9. MMP-2 correlates with body weight parameters before surgery and after surgery, after significant bodyweight reduction as a result of bariatric surgery (r = 0.478, p = 0.017). There is a strong correlation between the weight loss, glucose level, and cholesterol and the values of MMP-2 (r = 0.92, p = 0.022, respectively, r = 0.759, p = 0.033). MMP-9 is correlated with weight loss and triglycerides level. But it was not as sensitive as MMP-2. Sulodexide administration in group S had a positive influence on the MMP-2 and MMP-9 compared with the values of groups B and C but without statistical significance. MMP-2 and MMP-9 are the two most important ECM enzymes involved in adipose tissue remodeling after bariatric surgery. The correlations between cholesterol, triglycerides, glucose, weight loss, excess weight, and body mass index (BMI) parameters and MMPs level demonstrate the direct relationship of these enzymes in obesity. Although we believe that more in-depth studies are required, MMPs may be considered a marker of the effectiveness of bariatric surgery.

Background: Combined hysteroscopy and laparoscopy is a valuable method for diagnosing and treating infertility and benign uterine pathology. Both procedures are minimally invasive, reliable, and safe, with a low complication rate. Aim: In this review, we expose the efficiency and safety of hysterolaparoscopy in the management of infertility and other benign uterine pathologies. Method: We performed a systematic literature review on several databases: PubMed®/MEDLINE, PMC, Crossref.org, and Web of Science in the last 10 years. Inclusion criteria: Women of reproductive age with primary or secondary infertility and/or benign uterine pathology. Exclusion criteria: pre-puberty, menopause, couple with male infertility. Conclusion: Hysterolaparoscopy is a useful tool to assess infertility and simultaneously diagnose and treat pelvic and uterine lesions.

Background and Objectives: Anabolic androgenic steroids (AAS), used as a therapy in various diseases and abused in sports, are atherogenic in supraphysiological administration, altering the plasma lipid profile. Taurine, a conditionally-essential amino acid often used in dietary supplements, was acknowledged to delay the onset and progression of atherogenesis, and to mitigate hyperlipidemia. The aim of the present study was to verify if taurine could prevent the alterations induced by concomitant chronic administration of high doses of AAS nandrolone decanoate (DECA) in rats. Materials and Methods: Thirty-two male Wistar rats, assigned to 4 equal groups, were treated for 12 weeks either with DECA (A group), taurine (T group), both DECA and taurine (AT group) or vehicle (C group). Plasma triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), hepatic triglycerides (TGh) and liver non-esterified fatty acids (NEFA) were then determined. Results: DECA elevated TG level in A group vs. control (p = 0.01), an increase prevented by taurine association in AT group (p = 0.04). DECA decreased HDL-C in A group vs. control (p = 0.02), while taurine tended to increase it in AT group. DECA decreased TGh (p = 0.02) in A group vs. control. Taurine decreased TGh in T (p = 0.004) and AT (p &lt, 0.001) groups vs. control and tended to lower NEFA (p = 0.08) in AT group vs. A group. Neither DECA, nor taurine influenced TC and LDL-C levels. Conclusions: Taurine partially prevented the occurrence of DECA negative effects on lipid profile, suggesting a therapeutic potential in several conditions associated with chronic high levels of plasma androgens, such as endocrine disorders or AAS-abuse.

Melanoma has a significant mortality and its growing incidence is associated with important social and health care costs. Thus, investigation of the complex mechanisms contributing to emergence and development of melanoma are of real interest both in scientific research and clinical practice. Estrogens play an important role in the emergence and development of certain types of cancer, such as breast cancer, endometrial cancer and ovarian cancer, but their role in development of cutaneous melanoma is still a matter of debate. Various data suggest that increased levels of endogenous estrogens during pregnancy or exposure to exogenous estrogens by use of oral contraceptives (OCs) and hormone replacement therapy (HRT) may have a potential role in melanoma development and progression. Moreover, there were revealed several intracellular pathways which can support the connection between estrogens, estrogen receptors (ER) and melanoma. While ER-β plays an antiproliferative role, ER-α promotes cell growth and cellular atypia. Thus, inhibition of ER-β activity in the skin can increase the risk for development of cutaneous melanoma and spread of metastatic cells. However, despite recent advances in this area, the exact role and clinical implications of estrogens and estrogen receptors in melanoma are still not entirely understood and require further investigations.

Obesity is a current pathology with many clinical, molecular, and psychological implications. The number of obese people has doubled in the past 10years and we can observe an early onset of obesity. We have used a modified BAROS and SF36TM questionnaire to conduct a descriptive study on 34 obese patients undergoing surgery for obesitylaparoscopic sleeve gastrectomy (LSG). The inclusion criteria were the embodiment of surgery for obesity: BMI (body mass index) >40kg/m(2) or BMI>35kg/m(2) and associated comorbidities. The postoperative BMI was 25.7670 +/- 3.74759kg/m(2) (mean +/- SD). The average number of lost kilograms was 38.74 +/- 12.526 (mean +/- SD), and the average percentage of excess body weight loss (% EBWL) was 85.9952 +/- 22.69028% (mean +/- SD). Patients lost an average of 36.88-38.56kg at 6-12months after surgery, and they reach a % EBWL of 94.69 +/- 30.02% and a normal BMI of 23.96kg/m(2) at 18months postoperatively. All patients significantly reduced the amount of food eaten after surgery. More than 2years after the surgery, patients increased their food intake by about 30%, but maintained their weight loss and a normal BMI. Related to quality of life, 77.78% of patients declared a vast improvement, 11% a good quality of life, and only 3.7% said that the quality of life is worse than before the surgery. Also, a relationship between quality of life and the improvement of sexual life, or with the increased frequency of physical exercise has been observed. Improving quality of life is directly related with the weight loss, with %EBWL, and with the postoperative BMI. Bariatric surgery should be understood in all the positive changes that it generates in everyday life.

Multiple endocrine neoplasia type 2 is a group of medical disorders associated with tumours of the endocrine system. The tumours may be benign or malignant. They generally occur in the endocrine organs (e.g. thyroid, parathyroid, and adrenals), but may also occur in the endocrine tissues of organs not classically thought of as endocrine. We present the case of a 28-year-old female, with history of MEN2A syndrome confirmed by genetic screening and manifested by bilateral pheochromocytoma, for which she underwent right adrenalectomy in 2009 and left adrenalectomy in 2011, as well as by medullary carcinoma of the thyroid, for which total thyroidectomy was performed in 2009. At present, the patient is under replacement treatment of the thyroid function with LT4 and glucocorticoid and mineralocorticoid replacement therapy with Prednisone and Astonin. Currently, the patient has been periodically presenting herself for clinical and therapeutic endocrinological re-evaluation, in the context of an ongoing pregnancy. During a presentation, in September 2015, the pregnancy being in its 24th week, at ultrasonography, a possible remnant of thyroid tissue was detected, a superior and mediolateral adenopathy, well defined, with some interior calcifications, discretely vascularized, therefore of a suspicious nature and a left supraclavicular small cluster of microcalcifications was also detected. Calcitonin blood level was measured in order to dynamically correlate its evolution with the new ultrasound findings with a significant increase at the current dosing reaching 587.20 pg / ml.

Medical students have an increased risk of developing psychological and eating disorders due to the academic stress and the degree of physical activity. The stress during the exam session affects eating attitudes, mental health and physical activity. The aim of the study was to analyse the eating behaviors, mental status and grades of physical activity before and during exam session in medical college students. We performed an analytical observational study in a population of 78 undergraduate 1st and 2nd year medical students (66 girls and 12 boys). Eating-related attitudes were studied using the EAT- 26 questionnaire. Anxiety and depression scores were evaluated with GAD7 and PHQ-9 questionnaires. Physical activity was also assessed. All of the questionnaires were given before and during the exam session. The scores of EAT 26 questionnaire reflect a normal reporting of dieting attitudes, regardless of the time of evaluation. Regarding assessment of anxiety (GAD7) and depression (PHQ-9), an increase in the number of cases of severe anxiety and depression during the exams session was shown. In addition, the physical activity index dropped significantly during the exam period. The academic and psychological stress during the exam session affected the mental status of the medical students causing an increase in the anxiety and depressions scores. Also, the physical activity diminished, emphasizing their psychological state. No significant changes in eating behavior were observed.