Influence of iodization programmes on the epidemiology of nodular goitre
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Emilio Fiore , Massimo Tonacchera , Paolo Vitti Iodine is essential for the synthesis of thyroid hormones. Iodine deficiency can affect human health in different ways, and is commonly referred to as iodine deficiency disorders (IDD). These range from defective development of the central nervous system during the fetal–neonatal life, to goitre in the adult. Only a few countries were completely iodine sufficient before 1990. Since then, a major effort has been made to introd...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Assessing health-related quality of life in patients with benign non-toxic goitre
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Torquil Watt , Per Cramon , Daniel M. Frendl , John E. Ware Jr. Health-related quality of life (HRQoL) assessments are increasingly used to evaluate treatment effects and to shape the delivery of value based care. Valid generic and disease specific tools are available for quantifying HRQoL in patients with non-toxic goitre. However, few studies have applied these validated instruments to assess HRQoL in patients with benign non-toxic goitre. Limited evidence suggests that patien...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Ruling in or ruling out thyroid malignancy by molecular diagnostics of thyroid nodules
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Markus Eszlinger , László Hegedüs , Ralf Paschke Routine morphologic cytology is the basis for any kind of (integrated) molecular FNA diagnostics. The rule out (gene expression classifier) approach requires confirmation by independent studies, whereas the rule in approach (detection of BRAF, NRAS, HRAS, and KRAS and PAX8/PPARG- and RET/PTC rearrangements) has been investigated by several groups with overall reproducible results. Moreover, molecular screening f...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Current role and value of fine-needle aspiration in nodular goitre
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Zubair W. Baloch , Virginia A. LiVolsi Thyroid nodules are common and, depending on the detection technique used, can affect 50% or greater of the population. The primary diagnostic test to assess the nature of these nodules is fine-needle aspiration cytology. Most thyroid nodules are benign and often are multiple. However, the morphology of these nodules may mimic neoplasms showing features such as papillary growth, micro-follicles and even oncocytic metaplasia. Lesions with th...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Diagnostic role of ultrasound and elastosonography in nodular goiter
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Teresa Rago , Paolo Vitti Among several ultrasound patterns, thyroid nodule hypoechogenicity, spot microcalcifications, and an absent halo sign are used for predicting increased risk of thyroid malignancy. The predictive value of ultrasound, however, increases at the expense of its sensitivity, and malignancy is predicted with high specificity only when multiple ultrasound features are simultaneously present. Ultrasound features are important in determining the strength of the i...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Role of isotope scan, including positron emission tomography/computed tomography, in nodular goitre
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Luca Giovanella , Luca Ceriani , Giorgio Treglia Nuclear medicine techniques were first used in clinical practice for diagnosing and treating thyroid diseases in the 1950s, and are still an integral part of thyroid nodules work-up. Thyroid imaging with iodine or iodine-analogue isotopes is the only examination able to prove the presence of autonomously functioning thyroid tissue, which excludes malignancy with a high probability. In addition, a thyroid scan with technetium-99m-m...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Genetic and non-iodine-related factors in the aetiology of nodular goitre
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Nils Knudsen , Thomas Heiberg Brix Genetic and a large number of environmental non-iodine-related factors play a role in the cause of nodular goitre. Most evidence for the influence of genetic and environmental factors in the cause of goitre is from cross-sectional, population-based studies. Only a few studies have included prospective data on risk factors for nodular goitre, although few prospective data are available on the effect of iodine and tobacco smoking on goitre develo...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The impact of goitre and its treatment on the trachea, airflow, oesophagus and swallowing function. A systematic review
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Jesper Roed Sørensen , Laszlo Hegedüs , Søren Kruse-Andersen , Christian Godballe , Steen Joop Bonnema In this systematic review, we investigated the effects of goitre and its treatment on the trachea and the oesophagus. A total of 6355 papers were screened in scientific databases, which disclosed 40 original studies (nine descriptive and 31 interventional). Although most studies are hampered by a number of methodological shortcomings, it is uncontested that g...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Epidemiology of nodular goitre. Influence of iodine intake
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Allan Carlé , Anne Krejbjerg , Peter Laurberg More than one tenth of the world population is to some degree affected by goitre and most of these harbour nodules. The large differences in thyroid disease prevalence between populations may be caused by genetic and environmental factors. Among the latter, iodine deficiency seems by far to be the most important risk factor. Thus, nodular goitre is a condition predominantly seen in iodine deficient areas of the world. In the p...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Improving diagnostic and therapeutic aspects of nodular goitre
Publication date: August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 4 Author(s): Laszlo Hegedüs (Source: Best Practice and Research Clinical Endocrinology and Metabolism)
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Pharmacogenetics of osteoporosis
Publication date: Available online 12 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Francesca Marini , Maria Luisa Brandi The challenge of personalized medicine is to move away from the traditional ‘one-size-fits-all’ pharmacology to genotype-based individualized therapies. As an individual's response to drugs is under the control of genes, personal genetic profiles could help clinicians to predict individual drug response and prescribe the right drug and dose, thereby optimising efficacy and avoiding risk of adverse effects. Currently, the concrete...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Nutritional aspects of bone health
Publication date: Available online 20 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): René Rizzoli Bone mass, geometry and microstructure, and bony tissue material level properties determine bone strength, hence the resistance to fracture. At a given age, all these variables are the consequence of the amount accumulated and of the structure developed during growth, up to the so-called peak bone mass, and of the bone loss and microstructure degradation occurring later in life. Genetic factors primarily contribute to the variance of the determinants of bone ...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Future directions for new medical entities in osteoporosis
Publication date: Available online 20 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Serge Ferrari Odanacatib, a selective cathepsin K inhibitor, decreases bone resorption, whereas osteoclast number increases and bone formation is maintained, perhaps even increased on some cortical surfaces. In a phase 2 clinical trial, post-menopausal women receiving odanacatib presented a sustained reduction of bone resorption markers, whereas procollagen type 1 N-terminal propeptide returned to normal. In turn areal bone mineral density increased continuously at both spi...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The emergence of Parkinson disease among patients with Gaucher disease
Publication date: Available online 23 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Deborah Elstein , Roy Alcalay , Ari Zimran In the last decade, several lines of evidence have been presented that document the clinical manifestations, genetic associations, and sub-cellular mechanisms of the inter-relatedness of β-glucocerebrosidase mutations and the emergence of Parkinson disease among carriers and patients with Gaucher disease. This review is an attempt to apprise the reader of the recent literature with the caveat that this is an area of intensive explo...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Epidemiology and diagnosis of lysosomal storage disorders; challenges of screening
Publication date: Available online 26 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Sandra D.K. Kingma , Olaf A. Bodamer , Frits A. Wijburg The lysosomal storage disorders (LSDs) are a group of genetic disorders resulting from defective lysosomal metabolism and subsequent accumulation of substrates. Patients present with a large phenotypic spectrum of disease manifestations that are generally not specific for LSDs, leading to considerable diagnostic delay and missed cases. Introduction of new disease modifying therapies for LSDs has made early diagnosis a prior...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Mineralocorticoid substitution and monitoring in primary adrenal insufficiency
Publication date: Available online 27 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Marcus Quinkler , Wolgang Oelkers , Hanna Remde , Bruno Allolio Patients with primary adrenal insufficiency usually show pronounced impairment of aldosterone secretion and, therefore, require also mineralocorticoid replacement for full recovery. Clinical signs of mineralocorticoid deficiency comprise hypotension, weakness, salt craving and electrolyte disturbances (hyperkalemia, hyponatremia). Mineralocorticoid deficiency is confirmed by demonstration of profoundly decreased ald...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The clinical spectrum and pathophysiology of skeletal complications in lysosomal storage disorders
Publication date: Available online 27 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Lorne A. Clarke , Carla E.M. Hollak Lysosomal storage disorders affect multiple organs including the skeleton. Disorders with prominent skeletal symptoms are type 1 and 3 Gaucher disease, the mucopolysaccharidoses, the glycoproteinoses and pycnodysostosis. Clinical manifestations range from asymptomatic radiographical evidence of bone pathology to overt bone crises (Gaucher), short stature with typical imaging features known as dysostosis multiplex (MPS), with spine and joint de...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Non-neuronopathic lysosomal storage disorders: Disease spectrum and treatments
Publication date: Available online 27 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Gregory M. Pastores , Derralynn A. Hughes Distinctive facial features, hepatosplenomegaly or cardiomyopathy with or without associated skeletal dysplasia are clinical manifestations that may be suggestive of an underlying lysosomal storage disorder (LSD), However, these features may not be evident in certain subtypes associated primarily with central nervous system involvement. Age at onset can be broad, ranging from infancy to adulthood. Diagnosis may be delayed, as manifestati...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The attenuated/late onset lysosomal storage disorders: Therapeutic goals and indications for enzyme replacement treatment in Gaucher and Fabry disease
Publication date: Available online 27 August 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Carla E.M. Hollak , Neal J. Weinreb Enzyme replacement therapies have been developed and authorized for commercial use for six different lysosomal storage disorders. For Gaucher disease, Fabry disease and mucopolysaccharidosis type 1, disease-specific treatments have been available for more than a decade. Although long term follow-up data are still sparse, therapeutic goals for patients with Gaucher disease and Fabry disease have been formulated and published for both adults and...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Bridging the age spectrum of neurodegenerative storage diseases
Publication date: Available online 1 September 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Barry Boland , Frances M. Platt For over a century, researchers have observed similar neurodegenerative hallmarks in brains of people affected by rare early-onset lysosomal storage diseases and late-onset neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Increasing evidence suggests these apparently disparate diseases share a common underlying feature, namely, a dysfunctional clearance of cellular cargo through the secretory-endosomal-autophagic-lysosomal...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Parathyroid hormone therapy for hypoparathyroidism
Publication date: Available online 10 September 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Natalie E. Cusano , Mishaela R. Rubin , John P. Bilezikian Hypoparathyroidism is a disease characterized by hypocalcemia and insufficient parathyroid hormone (PTH). It is a rare disorder that has been given an orphan disease designation in the United States and European Union. Hypoparathyroidism is the only endocrine deficiency disease for which the missing hormone, PTH, is not yet an approved therapy. Conventional therapy includes calcium and active vitamin D supplementation...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Current and future treatments of secondary osteoporosis
Publication date: Available online 16 September 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Raquel Soriano , Sabina Herrera , Xavier Nogués , Adolfo Diez-Perez Osteoporosis is commonly associated with menopause and ageing. It can, however, also be caused by diseases, lifestyle, genetic diseases, drug therapies and other therapeutic interventions. In cases of secondary osteoporosis, a common rule is the management of the underlying condition. Healthy habits and calcium and vitamin D supplementation are also generally advised. In cases of high risk of fracture,...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Efficacy and safety of currently marketed anti-osteoporosis medications
The objective of an anti-osteoporosis treatment is to reduce fracture rates, ideally at all skeletal sites (i.e. spine, hip, and other non-spine). The armamentarium against osteoporosis includes anti-resorptive agents (i.e. bisphosphonates, selective estrogen receptor modulators and denosumab), bone-forming agents (i.e. peptides from the parathyroid hormone family) and one agent with a dual mechanism of action (i.e. strontium ranelate). All these medications combine antifracture efficacy with a reasonable benefit/risk profile. However, the choice of a particular chemical entity, in one individual patient is based on the kn...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Current and future treatments of osteoporosis in men
Publication date: Available online 16 September 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Jean-Marc Kaufman , Bruno Lapauw , Stefan Goemaere One in three osteoporotic fractures occur in men and the consequences of a fracture in men tend to be more severe than in women. Still, only a small minority of men with high risk of fracture are detected and treated. Although there are gender differences in the pathophysiology of osteoporosis, such as in the pattern of bone loss, similarities predominate, which is also the case for clinical risk factors. It seems appropriate...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Mitochondrial UCP2 in the central regulation of metabolism
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Chitoku Toda , Sabrina Diano Uncoupling protein 2 (UCP2) is a mitochondrial anion carrier protein, which uncouples the oxidative phosphorylation from ATP production by dissipating the proton gradient generated across the mitochondrial inner membrane. UCP2 regulates not only mitochondrial ATP production, but also the generation of reactive oxygen species (ROS), considered important second-messenger signals within the cell. The importance of UCP2 was firstly reported in macrophag...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Neural control of the endocrine pancreas
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Rayner Rodriguez-Diaz , Alejandro Caicedo The autonomic nervous system affects glucose metabolism partly through its connection to the pancreatic islet. Since its discovery by Paul Langerhans, the precise innervation patterns of the islet has remained elusive, mainly because of technical limitations. Using 3-dimensional reconstructions of axonal terminal fields, recent studies have determined the innervation patterns of mouse and human islets. In contrast to the mouse islet, en...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Crosstalk between gastrointestinal neurons and the brain in the control of food intake
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Gilles Mithieux Recent data have emphasized that the gastrointestinal nervous system is preponderant in the sensing of nutrients and hormones and its translation in terms of control of food intake by the central nervous system. More specifically, the gastrointestinal neural system participates in the control of hunger via the sensing of at least two major macronutrients, e.g. glucose and protein, which may control hunger sensations from the portal vein. Protein are first sensed...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The hypothalamic arcuate nucleus and the control of peripheral substrates
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Aurélie Joly-Amado , Céline Cansell , Raphaël G.P. Denis , Anne-Sophie Delbes , Julien Castel , Sarah Martinez , Serge Luquet The arcuate nucleus (ARC) of the hypothalamus is particularly regarded as a critical platform that integrates circulating signals of hunger and satiety reflecting energy stores and nutrient availability. Among ARC neurons, pro-opiomelanocortin (POMC) and agouti-related protein and neuropeptide Y (NPY/AgRP neurons) are considered as two...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Hypothalamic control of bone metabolism
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Kunal Sharan , Vijay K. Yadav Bones are structures in vertebrates that provide support to organs, protect soft organs, and give them shape and defined features, functions that are essential for their survival. To perform these functions, bones are constantly renewed throughout life. The process through which bones are renewed is known as bone remodeling, an energy demanding process sensitive to changes in energy homeostasis of the organism. A close interplay takes place between...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Hypothalamic effects of thyroid hormones on metabolism
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Noelia Martínez-Sánchez , Clara V. Alvarez , Johan Fernø , Rubén Nogueiras , Carlos Diéguez , Miguel López Over the past few decades, obesity and its related metabolic disorders have increased at an epidemic rate in the developed and developing world. New signals and factors involved in the modulation of energy balance and metabolism are continuously being discovered, providing potential novel drug targets for the treatment of metabolic...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Hypothalamic control of adipose tissue
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): A. Stefanidis , N.M. Wiedmann , E.S. Adler , B.J. Oldfield A detailed appreciation of the control of adipose tissue whether it be white, brown or brite/beige has never been more important to the development of a framework on which to build therapeutic strategies to combat obesity. This is because 1) the rate of fatty acid release into the circulation from lipolysis in white adipose tissue (WAT) is integrally important to the development of obesity, 2) brown adipose tissue (BAT)...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Hypothalamic control of hepatic lipid metabolism via the autonomic nervous system
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Eveline Bruinstroop , Eric Fliers , Andries Kalsbeek Our body is well designed to store energy in times of nutrient excess, and release energy in times of food deprivation. This adaptation to the external environment is achieved by humoral factors and the autonomic nervous system. Claude Bernard, in the 19th century, showed the importance of the autonomic nervous system in the control of glucose metabolism. In the 20th century, the discovery of insulin and the development of te...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The hypothalamic neural–glial network and the metabolic syndrome
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Martin Jastroch , Silke Morin , Matthias H. Tschöp , Chun-Xia Yi Despite numerous educational interventions and biomedical research efforts, modern society continues to suffer from obesity and its associated metabolic diseases, such as type 2 diabetes mellitus, and these diseases show little sign of abating. One reason for this is an incomplete understanding of the pathology of the metabolic syndrome, which obstructs the development of effective therapeutic strategies. Whi...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

The interaction between nutrition and the brain and its consequences for body weight gain and metabolism; studies in rodents and men
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Susanne E. la Fleur , Mireille J. Serlie Aberrant feeding behavior can lead to obesity and obesity-related medical consequences, such as insulin resistance and diabetes. Although alterations in glucose metabolism (i.e. insulin resistance), in the presence of excessive fat tissue are often explained by the consequences of dysfunctional adipose tissue, evidence is emerging that also altered brain functions might be an important determinant of insulin resistance. In this review, w...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Genes and the hypothalamic control of metabolism in humans
Publication date: October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 28, Issue 5 Author(s): Anke Hinney , Anna-Lena Volckmar , Jochen Antel Heritability of obesity and body weight variation is high. Molecular genetic studies have led to the identification of mutations in a few genes, with a major effect on obesity (major genes and monogenic forms). Analyses of these genes have helped to unravel important pathways and have created a more profound understanding of body weight regulation. For most individuals, a polygenic basis is relevant for the genetic predisposition ...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Sex hormone replacement in ovarian failure – new treatment concepts
Publication date: Available online 2 October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Jenifer Sassarini , Mary Ann Lumsden , Hilary OD. Critchley Premature ovarian failure is associated with decreased bone mass and fractures, and an increased risk of premature death from cardiovascular disease. There is also fertility compromise associated not only with the loss of ovarian function but, in those with pre-pubertal POF, inadequate uterine morphology. A wide variety of hormone replacement regimes are reported, but there is no clear evidence of best practice. Hormone...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Current topics in testosterone replacement of hypogonadal men
Publication date: Available online 2 October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Eberhard Nieschlag All forms of hypogonadism – primary, secondary and late-onset – require testosterone substitution. The indication is given when the patient presents with symptoms of androgen deficiency and the serum testosterone levels are below normal. Several testosterone preparations and modes of application are available of which those producing physiologic serum levels should be preferred e.g. preferentially transdermal gels and long-acting intramuscular test...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Growth hormone replacement in adults - Current standards and new perspectives
Publication date: Available online 2 October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Charlotte Höybye , Jens Sandahl Christiansen Growth hormone deficiency (GHD) in adults is an established clinical syndrome characterised by adverse body composition with more body fat than lean body mass, unfavourable blood lipids, decreased physical fitness and poor quality of life. No specific biomarker for GHD exists and the sometimes difficult diagnosis should be made in accordance with, established guidelines. Measurements of insulin-like growth factor I (IGF-I) is oft...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Is DHEA replacement beneficial in chronic adrenal failure?
Publication date: Available online 2 October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Katharina Lang , Stephanie Burger-Stritt , Stefanie Hahner Although dehydroepiandrosterone (DHEA) and its sulfate ester dehydroepiandrosterone sulfate (DHEAS) are the most abundant steroid hormones in the human circulation, its exact physiological role is not yet fully understood. In patients with adrenal insufficiency, secretion of DHEA is impaired, leading to decreased circulating DHEA and DHEAS levels, and to androgen deficiency in women. Replacement of DHEA in patients with ...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research

Optimal glucocorticoid replacement in adrenal insufficiency
Publication date: Available online 7 October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Marianne Øksnes , Richard Ross , Kristian Løvås Adrenal insufficiency (glucocorticoid deficiency) comprises a group of rare diseases, including primary adrenal insufficiency, secondary adrenal insufficiency and congenital adrenal hyperplasia. Lifesaving glucocorticoid therapy was introduced over 60 years ago, but since then a number of advances in treatment have taken place. Specifically, little is known about short- and long-term treatment effects, and morbi...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - October 12, 2014 Category: Endocrinology Source Type: research