Hortensia Mircescu | Université de Montreal (original) (raw)

Papers by Hortensia Mircescu

Les Presses de l'Université de Montréal eBooks, Nov 1, 2015

The Journal of Clinical Endocrinology and Metabolism, Oct 1, 2000

Twenty consecutive patients with adrenal Cushing's syndrome were studied with an in vivo protocol... more Twenty consecutive patients with adrenal Cushing's syndrome were studied with an in vivo protocol to determine the prevalence and diversity of the presence of ectopic or abnormal hormone receptors in their adrenal tissues. All six patients with bilateral ACTH-independent macronodular adrenal hyperplasia were found to have one or two abnormal adrenal receptors, including those for gastric inhibitory polypeptide, vasopressin (V1-vasopressin), ␤-adrenergic agonists, LH/human CG, or serotonin 5-HT 4. The presence of abnormal hormone receptors was found to be less frequently present in unilateral adenomas or carcinomas (3 of 14). The identification of abnormal adrenal hormone receptors can allow new pharmacological therapies of hypercortisolism. We suggest that the clinical screening for the presence of abnormal hormone receptors should be conducted in patients with adrenal Cushing's syndrome and, more particularly, in those with ACTH-independent macronodular adrenal hyperplasia, in the hope of offering medical therapy as an alternative to bilateral adrenalectomy.

Journal of Cystic Fibrosis, 2013

In CF, nutritional status influences pulmonary prognosis and survival. After neonatal screening, ... more In CF, nutritional status influences pulmonary prognosis and survival. After neonatal screening, great attention is given to the attainment of optimal growth. The high prevalence of food intake disorders in CF has led our team to investigate the concept of senso-dysorality. This discipline covers all types of oral feeding difficulties. The senso-motor disorders of orality (dysorality) are related to the exaggeration of the physiological oral gag reflex. Methods: We conducted a prospective mono-centric study on the prevalence of dysorality in paediatric CF patients. Moreover, we evaluated the impact of its management on the quality of life (QOL), food intake and somatic growth. Initial assessment and subsequent monitoring were performed by a dietician and a psychologist in collaboration with a gastroenterologist. The rehabilitation program of the whole oral cavity was performed by speech and language therapists (SLT). Results: 40% (61/153) of children presented with food intake difficulties, 24% (36/153) of children with true senso-dysorality. The latter was noted in 90% (9/10) of patients undergoing enteral feeding (gastrostomy). Multidisciplinary organic, sensory, psychological and nutritional management has been performed in 52.8% (19/36) patients with dysorality. Better appetite was observed in 68.4% (13/19) of cases, improved tolerance to diverse meal textures/consistence in 68.4% (13/19), more serene family meals in 63.2% (12/19) and significant weight gain in 68.2% (13/19). Conclusion: This innovative multidisciplinary approach improves QOL and nutritional status in 2/3 of CFpatients presenting with dysorality.

Encyclopedia of Hormones, 2003

European journal of biochemistry / FEBS, 2002

In a search for genes regulated in response to cAMP we have identified a new protein, p76RBE, who... more In a search for genes regulated in response to cAMP we have identified a new protein, p76RBE, whose mRNA and protein expression is enhanced in thyrocytes following thyrotropin stimulation of the cAMP transduction cascade. This protein presents important similarities with Rhophilin and contains different protein-protein interaction motifs. The presence of HR1 and PDZ motifs as well as a potential PDZ binding domain motif suggests that p76RBE could be implicated in targeting or scaffolding processes. By yeast two-hybrid screenings and coimmunoprecipitation, we show here that p76RBE is a specific binding protein of RhoB and binds selectively to the GTP-bound form of this small GTPase. p76RBE also binds in vitro to components of the cytoskeleton, including cytokeratin 18. p76RBE is essentially cytoplasmic in transfected COS-7 mammalian cells and seems to be recruited to an endosomal compartment when coexpressed with the activated form of RhoB. p76RBE was shown to be mainly expressed in ...

Diabetes & Metabolism, 2012

Impact de l'augmentation de la fréquence des prises alimentaires sur le contrôle de l'appétit et ... more Impact de l'augmentation de la fréquence des prises alimentaires sur le contrôle de l'appétit et les paramètres métaboliques

The Endocrinologist, 2001

Struma ovarii is an ovarian teratoma in which thyroid tissue predominates. The reported incidence... more Struma ovarii is an ovarian teratoma in which thyroid tissue predominates. The reported incidence ranges between 2% and 10% of all cases of teratoma. Malignant transformation, in the form of papillary or follicular carcinoma, is an even rarer event. We report a case of papillary cancer within a struma ovarii and review the pertinent literature. A 3-cm focus of malignancy was discovered after excision of a rapidly progressing pelvic mass in a 35-year-old woman with a family history of dermoid cysts. She was treated with unilateral salpingo-oophorectomy, thyroidectomy, and 100 mCi of iodine-131 to ablate residual thyroid tissue and potential microscopic metastasis. After these procedures, the whole body scan revealed no uptake in the abdominal or pelvic region. A review of the literature since 1970 revealed less than 25 cases of malignancy of the papillary type within struma ovarii and a greater rate for follicular carcinoma. The treatments ranged from exclusive local excision to extensive surgery, with additional thyroidectomy, radioiodine, and even chemotherapy in selected cases. Malignant struma ovarii can be managed satisfactorily by combining surgical procedures with treatment options commonly used for primary thyroid carcinoma. The outcome for papillary carcinoma is overall favorable, even if a less aggressive therapeutic approach is chosen. Follicular neoplasia has a higher rate of recurrence and a worse prognosis. ■

Journal of the Endocrine Society, 2022

Background The SELECT trial led to the approval of Lenvatinib for the treatment of advanced radio... more Background The SELECT trial led to the approval of Lenvatinib for the treatment of advanced radioiodine-refractory differentiated thyroid carcinomas (DTCs) but also revealed an important adverse events’ (AEs) profile which may limit its use in clinical practice. We aim to describe the efficacy and toxicity profiles of Lenvatinib in real life. Methods We included all patients who received lenvatinib for an advanced DTC at our institution, enrolling 27 patients. We reviewed retrospectively electronic medical records to assess efficacy and AEs. Results Among the 24 patients with evaluation of tumor response during treatment, overall response rate (ORR) was 37.0% [95% confidence interval (CI), 19.4 to 57.6], and disease control rate was 85.2% [95% CI, 66.3 to 95.8]. The median progression free survival (PFS) was 12 months [95% CI, 7.5 to 16.5]. The most prevalent AEs were hypertension (77.8%), fatigue (55.6%), and weight loss (51.9%). 25/27 patients (92.6%) experienced at least one grad...

expression in thyroid autonomous adenomas provides insight

Nutrition, Metabolism and Cardiovascular Diseases, 2021

BACKGROUND AND AIMS There is debate over the independent and combined effects of caloric restrict... more BACKGROUND AND AIMS There is debate over the independent and combined effects of caloric restriction (CR) and physical activity (PA) on reduction in fat mass and in epicardial fat thickness. We compared the impact of a similar energy deficit prescription by CR or by CR combined with PA on total fat mass, epicardial fat thickness, and cardiometabolic profile in individuals with type 2 diabetes. METHODS AND RESULTS In this 16-week randomized controlled study, 73 individuals were randomly enrolled to receive: 1) a monthly motivational phone call (Control), 2) a caloric deficit of -700 kilocalories/day (CR), or 3) a caloric deficit of -500 kilocalories/day combined with a PA program of -200 kilocalories/day (CR&PA). Total fat mass, epicardial fat, and cardiometabolic profile were measured at baseline and after 16 weeks. While comparable weight loss occurred in both intervention groups (-3.9 ± 3.5 kg [CR], -5.1 ± 4.7 kg [CR&PA], -0.2 ± 2.9 kg [Control]), changes in total fat mass were significantly different between all groups (-2.4 ± 2.9 kg [CR], -4.5 ± 3.4 kg [CR&PA], +0.1 ± 2.1 kg [Control]; p < 0.05) as well as epicardial fat thickness (-0.4 ± 1.6 mm [CR], -1.4 ± 1.4 mm [CR&PA], +1.1 ± 1.3 mm [Control]; p < 0.05). There were no significant differences in trends for cardiometabolic parameters improvement between groups. CONCLUSIONS For a similar energy deficit prescription and comparable weight loss, the combination of CR&PA provides a greater reduction in fat mass and epicardial fat thickness than CR alone in individuals with comparable weight loss and with a similar energy deficit prescription. These results, however, do not translate into significant improvements in cardiometabolic profiles. CLINICALTRIALS. GOV IDENTIFIER NCT01186952.

Clinical Nutrition, 2016

Background & aims: Vitamin D (Vit D) deficiency in cystic fibrosis (CF) is partially secondary to... more Background & aims: Vitamin D (Vit D) deficiency in cystic fibrosis (CF) is partially secondary to exocrine pancreatic insufficiency. Our aim was to establish a Vit D 3 supplementation protocol that will increase 25(OH)D to the recommended level (30 ng/mL). Methods: Retrospective study of 200 patients (18 years) conducted from February 2007 to June 2014 at the CF clinic of the Centre Hospitalier de l'Universit e de Montr eal. Vit D 3 supplementation protocol was 1600 IU/day or 10,000 IU/week during the summer (May 1st to October 31st) and 3200 IU/day or 20,000 IU/week during the winter (November 1st to April 30th), in addition to the 1200 IU/day included in multivitamins. Results: Significant increase in serum 25(OH)D levels from baseline (25.9 ± 10.3 ng/mL) to follow-up (37.0 ± 11.4 ng/mL) (P 0.001). At follow-up, increased doses during the winter improved serum 25(OH)D levels to a degree comparable to the summer. Conclusions: This supplementation protocol is efficient and needs to be tested in other CF adult cohorts and correlated to potential health benefit measurements.

Canadian journal of diabetes, Jan 30, 2016

To characterize the nutritional treatment of hypoglycemia in adult patients with type 1 diabet... more 1) To characterize the nutritional treatment of hypoglycemia in adult patients with type 1 diabetes mellitus and 2) to compare the characteristics of participants who follow the recommendations with the characteristics of those who do not. A total of 121 adults with type 1 diabetes were included in this cross-sectional analysis. Participants completed a food record and a glycemia and insulin doses logbook to collect data on mild to moderate hypoglycemic events (glycemia <4.0 mmol/L or 4.0 to 5.0 mmol/L with symptoms) and their treatments over a 2-day period. Participants were identified as overcorrecting if they consumed, within 15 minutes after the episode, >20g of carbohydrates for correction. Self-administered questionnaires about fear of hypoglycemia were completed, and cardiometabolic profile variables were measured (glycated hemoglobin, blood pressure, lipid profile and body mass indexes). Of the 121 participants, 94 (78%) reported at least 1 hypoglycemic event, for a to...

In a search for genes regulated in response to cAMP we have identified a new protein, p76 RBE , w... more In a search for genes regulated in response to cAMP we have identified a new protein, p76 RBE , whose mRNA and protein expression is enhanced in thyrocytes following thyrotropin stimulation of the cAMP transduction cascade. This protein presents important similarities with Rhophilin and contains different protein-protein interaction motifs. The presence of HR1 and PDZ motifs as well as a potential PDZ binding domain motif suggests that p76 RBE could be implicated in targeting or scaffolding processes. By yeast two-hybrid screenings and coimmunoprecipitation, we show here that p76 RBE is a specific binding protein of RhoB and binds selectively to the GTP-bound form of this small GTPase. p76 RBE also binds in vitro to components of the cytoskeleton, including cytokeratin 18. p76 RBE is essentially cytoplasmic in transfected COS-7 mammalian cells and seems to be recruited to an endosomal compartment when coexpressed with the activated form of RhoB. p76 RBE was shown to be mainly expressed in tissues with high secretion activity. Our data suggest that p76 RBE could play a key role between RhoB and potential downstream elements needed under stimulation of the thyrotropin/cAMP pathway in thyrocytes and responsible for intracellular motile phenomena such as the endocytosis involved in the thyroid secretory process.

The Journal of Pediatrics, 2000

The Journal of Clinical Endocrinology & Metabolism, 2000

Twenty consecutive patients with adrenal Cushing’s syndrome were studied with an in vivo protocol... more Twenty consecutive patients with adrenal Cushing’s syndrome were studied with an in vivo protocol to determine the prevalence and diversity of the presence of ectopic or abnormal hormone receptors in their adrenal tissues. All six patients with bilateral ACTH-independent macronodular adrenal hyperplasia were found to have one or two abnormal adrenal receptors, including those for gastric inhibitory polypeptide, vasopressin (V1-vasopressin),β -adrenergic agonists, LH/human CG, or serotonin 5-HT4. The presence of abnormal hormone receptors was found to be less frequently present in unilateral adenomas or carcinomas (3 of 14). The identification of abnormal adrenal hormone receptors can allow new pharmacological therapies of hypercortisolism. We suggest that the clinical screening for the presence of abnormal hormone receptors should be conducted in patients with adrenal Cushing’s syndrome and, more particularly, in those with ACTH-independent macronodular adrenal hyperplasia, in the h...

Endocrine Research, 1998

The initial description of GIP-dependent Cushing's syndrome suggested that abnormal or ec... more The initial description of GIP-dependent Cushing's syndrome suggested that abnormal or ectopic expression of adrenal receptors for various ligands may underlie other cases of ACTH-independent hypercortisolism. GIP-dependent Cushing's syndrome has been described in patients with unilateral adenomas or bilateral ACTH-independent macronodular adrenal hyperplasia (AIMAH) and results from the adrenal overexpression of non-mutated GIP receptor. In AIMAH, other patients were identified in whom regulation of cortisol production resulted from an abnormal adrenocortical response either to vasopressin, beta-adrenergic receptor agonists, hCG/LH, or serotonin 5-HT-4 receptor agonists. The identification of the presence of an abnormal adrenal receptor offers the possibility of a new pharmacological approach to control hypercortisolism by suppressing the endogenous ligands or by using specific antagonists of the abnormal receptor.

Diabetic Medicine, 2012

Aims Physical activity is part of a healthy lifestyle and contributes to prevent weight gain and ... more Aims Physical activity is part of a healthy lifestyle and contributes to prevent weight gain and cardiometabolic disorders. Adults with Type 1 diabetes are at risk of weight gain attributable to various factors, including a high prevalence of sedentary lifestyle related to fear of exercise-induced hypoglycaemia. This project aims to observe the association between physical activity level and body composition in adults with Type 1 diabetes. Methods Cross-sectional study; 75 adults with and 75 adults without diabetes (52% men; 41.8 AE 11.8 years old) wore a motion sensor for 1 week and performed a cardiorespiratory fitness test on an ergocycle (VO 2 peak). Body composition was assessed by dual energy X-ray absorptiometry and circumferences measures. Results Mean body composition was not different between the two groups. VO 2 peak was lower among the group with diabetes than the control subjects (29.3 AE 9.2 vs. 33.5 AE 9.0 ml kg)1 min)1 ; P = 0.005), but their physical activity level (ratio total ⁄ resting energy expenditure) was similar (1.68 AE 0.37 vs. 1.65 AE 0.26; P = 0.572). In both groups, having an active lifestyle (physical activity level ‡ 1.7) compared with a more sedentary lifestyle (physical activity level < 1.7) was associated with lower BMI and percentage of total and truncal fat mass (P £ 0.030 to P £ 0.001). Among adults with diabetes, physical activity level was not associated with diabetes treatment (insulin doses) and control (HbA 1c and hypoglycaemia) or cardiovascular risk factors (blood pressure and lipid profile). Conclusion As in the population without diabetes, an active lifestyle is associated with a better body composition profile in adults with Type 1 diabetes.

Diabetes Research and Clinical Practice, 2013

Aims: Carbohydrate counting is an established approach used by patients with type 1 diabetes to i... more Aims: Carbohydrate counting is an established approach used by patients with type 1 diabetes to improve their glycemic control. The aims of this study were to evaluate, in real life conditions, the accuracy of meal carbohydrate estimate and its impact on glycemic variability. Methods: In this cross-sectional study, we observed the ability of 50 adults (48% women) with type 1 diabetes (age: 42.7 AE 11.1 years); diabetes duration: 21.4 AE 12.7 years; HbA1c: 7.2 AE 1.2% (60 AE 10 mmol/mol) to accurately estimate carbohydrates by analyzing 72-h food records and their corresponding 72-h blood glucose excursions using a continuous glucose monitor. Results: The mean meal carbohydrate difference, between the patients' estimates and those assessed by a dietitian using a computerized analysis program, was 15.4 AE 7.8 g or 20.9 AE 9.7% of the total CHO content per meal (72.4 AE 34.7 g per meal). Sixty-three percent of the 448 meals analyzed were underestimated. Greater differences in CHO's estimates predicted higher glycemic variability, as measured by the MAGE index and glucose standard deviation, and decreased time with glucose values between 4 and 10 mmol/L (R 2 = 0.110, 0.114 and 0.110, respectively; P < 0.05). Conclusion: Inaccurate carbohydrate counting is frequent and associated with higher daily blood glucose variability in adults with type 1 diabetes.