The Diabetic Foot: The Never-Ending Challenge.
Abstract
Diabetes, a major public health concern, is increasing in prevalence worldwide. A diabetic patient has an up to 25% lifetime risk of developing a foot ulcer condition that predisposes that patient to lower-extremity amputation. The underlying pathology is diabetic peripheral neuropathy and peripheral arterial disease (PAD) associated with deformities of foot anatomy due to motor neuropathy. Trauma, often secondary to ill-fitting shoes, precipitates skin breakdown, whereas PAD determines the prognosis for healing. Whenever optimal offloading is guaranteed, a neuropathic ulcer will heal, whereas an ...
Source: Endocrine Development - January 30, 2016 Category: Endocrinology Authors: Peter-Riesch B Tags: Endocr Dev Source Type: research
Diabetes and Cancer.
Abstract
Diabetes and cancer are common conditions, affecting 384 million and 33 million people worldwide, respectively. Therefore, there is great potential for overlap, with people with diabetes also developing cancer and vice versa. However, people with diabetes may be at increased risk of developing cancer when compared with the general population. This is due to both shared risk factors associated with the two diseases and the metabolic derangements associated with diabetes, such as hyperglycaemia, insulin resistance, hyperinsulinaemia and oxidative stress. Glucose-lowering therapies may influence the ...
Source: Endocrine Development - January 30, 2016 Category: Endocrinology Authors: Holden SE Tags: Endocr Dev Source Type: research
Treatment Goals in Diabetes.
Abstract
The quality of glycaemic control in diabetes mellitus relies on accurate individualization of available treatment options. Treatment targets depend on the type and duration of diabetes, the patients' abilities and characteristics and the individual risk for acute and/or late-stage complications. These complications include hypoglycaemia, which can be severe and life threatening, hyperglycaemia, which is a main factor for the development of cardiovascular disease, and macrovascular and microvascular disease, both of which are hallmark features of diabetes-associated constraints. Moreover, other tre...
Source: Endocrine Development - January 30, 2016 Category: Endocrinology Authors: Melmer A, Laimer M Tags: Endocr Dev Source Type: research
Beta-Cell Replacement: Pancreas and Islet Cell Transplantation.
Abstract
Pancreas and islet transplantation are 2 types of beta-cell replacement therapies for type 1 diabetes mellitus. Since 1966, when pancreas transplantation was first performed, it has evolved to become a highly efficient procedure with high success rates, thanks to advances in surgical technique and immunosuppression. Pancreas transplantation is mostly performed as simultaneous pancreas-kidney transplantation in patients with end-stage nephropathy secondary to diabetes. In spite of its efficiency, pancreas transplantation is still a major surgical procedure burdened by high morbidity, which called f...
Source: Endocrine Development - January 30, 2016 Category: Endocrinology Authors: Niclauss N, Meier R, Bédat B, Berishvili E, Berney T Tags: Endocr Dev Source Type: research
The Emerging Role of Epigenetics in the Regulation of Female Puberty.
Abstract
In recent years the pace of discovering the molecular and genetic underpinnings of the pubertal process has accelerated considerably. Genes required for human puberty to occur have been identified and evidence has been provided suggesting that the initiation of puberty requires coordinated changes in the output of a multiplicity of genes organized into functional networks. Recent evidence suggests that a dual mechanism of epigenetic regulation affecting the transcriptional activity of neurons involved in stimulating gonadotropin-releasing hormone release plays a fundamental role in the timing of p...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Lomniczi A, Ojeda SR Tags: Endocr Dev Source Type: research
Normal Variation in Pubertal Timing: Genetic Determinants in Relation to Growth and Adiposity.
Abstract
In humans, there is a considerable variation in age of onset of puberty. Twin studies have indicated that pubertal timing is a highly heritable trait. Recently, a few rare genetic causes of precocious puberty have been reported as well as genetic mutations associated with isolated hypogonadotropic hypogonadism. Genome-wide association (GWA) studies have helped to explore the genetic determinants of the normal variation in pubertal timing, but have been able to explain only 2.7% of the variance in age at menarche, highlighting the involvement of multiple genes with small effect sizes. These studies...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Willemsen RH, Dunger DB Tags: Endocr Dev Source Type: research
Genetics of Hypogonadotropic Hypogonadism.
Abstract
Hypogonadotropic hypogonadism (HH) often manifests as pubertal delay. A considerable proportion of cases of HH is due to genetic mutations. Recognizing those mutated genes and associated phenotypes may improve our diagnostic capabilities. GNRHR and TACR3 should be the first two genes to be screened in a clinical setting for equivocal cases such as constitutional delay in puberty versus idiopathic HH. In Kallmann syndrome (KS), according to the presence of certain accompanying clinical features, genetic screening for particular gene(s) may be prioritized: synkinesia (KAL1), dental agenesis (FGF8/FG...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Topaloglu AK, Kotan LD Tags: Endocr Dev Source Type: research
Sexual Precocity - Genetic Bases of Central Precocious Puberty and Autonomous Gonadal Activation.
Abstract
Precocious puberty has been classically defined as the onset of sexual secondary characteristics in girls younger than 8 years and in boys younger than 9 years. The discovery of potential factors which trigger human puberty is one of the central mysteries of reproductive biology. Several approaches, including mutational analysis of candidate genes, large-scale genome-wide association studies, and (more recently) whole-exome sequencing, have been performed in attempt to identify novel genetic factors that modulate the human hypothalamic-pituitary-gonadal axis, resulting in premature sexual developm...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Macedo DB, Silveira LF, Bessa DS, Brito VN, Latronico AC Tags: Endocr Dev Source Type: research
Congenital Hypogonadotropic Hypogonadism: A Trait Shared by Several Complex Neurodevelopmental Disorders.
Abstract
Reproductive function depends on the activity of the gonadotropic axis, which is controlled by a hypothalamic neural network whose main function is to regulate the secretion of gonadotropin-releasing hormone (GnRH). This endocrine network is not mature at birth, and several phases of activation-inactivation of the gonadotropic axis are necessary for its normal development. The postnatal maturation of the GnRH network lies under the control of a neurodevelopmental program that starts in fetal life and ends at puberty. There are many clinical situations in which this program is interrupted, leading ...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: de Roux N, Carel JC, Léger J Tags: Endocr Dev Source Type: research
Animal Modeling of Early Programming and Disruption of Pubertal Maturation.
Abstract
Puberty is a fascinating developmental transition that gates the attainment of reproductive capacity and culminates the somatic and sexual maturation of the organism. Rather than a circumscribed phenomenon, puberty is the endpoint of a long-lasting developmental continuum, which initiates in utero. Besides important genetic determinants, the tempo of puberty is influenced by numerous endogenous and exogenous factors that, acting at different levels of the developing hypothalamic-pituitary-gonadal (HPG) axis along the maturational continuum indicated above, can influence puberty onset. Among the di...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Castellano JM, Tena-Sempere M Tags: Endocr Dev Source Type: research
Contemporary Trends in Onset and Completion of Puberty, Gain in Height and Adiposity.
Abstract
Recent studies have documented earlier pubertal maturation in both girls and boys. Several factors have been proposed to account for earlier maturation. Epidemiologic studies have indicated that genetic factors are the most important influence contributing to the variability in the onset of puberty. Studies have also noted the association of elevated BMI with earlier puberty in girls, although the relationship between BMI and onset of puberty in boys is less consistent. The relationship of BMI and onset of puberty may be mediated by several factors, including leptin and kisspeptin, changes in bioa...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Biro FM, Kiess W Tags: Endocr Dev Source Type: research
Consequences of Early Life Programing by Genetic and Environmental Influences: A Synthesis Regarding Pubertal Timing.
Abstract
Sexual maturation is closely tied to growth and body weight gain, suggesting that regulative metabolic pathways are shared between somatic and pubertal development. The pre- and postnatal environment affects both growth and pubertal development, indicating that common pathways are affected by the environment. Intrauterine and early infantile developmental phases are characterized by high plasticity and thereby susceptibility to factors that affect metabolic function as well as related reproductive function throughout life. In children born small for gestational age, poor nutritional conditions dur...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Roth CL, DiVall S Tags: Endocr Dev Source Type: research
Nutritional and Pubertal Disorders.
Abstract
Caloric-protein malnutrition can slow growth and cause pubertal delay. This chapter focuses on endocrine abnormalities and pubertal alterations in patients with eating disorders, childhood obesity, the female athlete triad and children cancer survivors. Patients with anorexia nervosa (AN) exhibit multiple endocrine abnormalities, including isolated hypogonadotropic hypogonadism. The delay in pubertal development and reduction in growth seen in AN patients may be a direct result of malnutrition. Appropriate psychiatric, nutritional and hormonal therapy is necessary. It is suggested that obesity dur...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Muñoz-Calvo MT, Argente J Tags: Endocr Dev Source Type: research
Current Changes in Pubertal Timing: Revised Vision in Relation with Environmental Factors Including Endocrine Disruptors.
Abstract
The aim of this chapter is to revise some common views on changes in pubertal timing. This revision is based on recent epidemiological findings on the clinical indicators of pubertal timing and data on environmental factor effects and underlying mechanisms. A current advancement in timing of female puberty is usually emphasized. It appears, however, that timing is also changing in males. Moreover, the changes are towards earliness for initial pubertal stages and towards lateness for final stages in both sexes. Such observations indicate the complexity of environmental influences on pubertal timing...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Parent AS, Franssen D, Fudvoye J, Pinson A, Bourguignon JP Tags: Endocr Dev Source Type: research
Sex Steroid and Gonadotropin Treatment in Male Delayed Puberty.
Abstract
Male delayed puberty is common, affecting up to 3% of the population. Management of patients with pubertal delay is dependent on the underlying cause. The main differential diagnoses of delayed puberty in males include constitutional delay of growth and puberty (CDGP), idiopathic hypogonadotropic hypogonadism and hypergonadotropic hypogonadism. Treatment of isolated CDGP involves expectant observation or short courses of low-dose sex steroid supplementation. More complex and involved management is required in males with hypogonadism to achieve both development of secondary sexual characteristics a...
Source: Endocrine Development - December 21, 2015 Category: Endocrinology Authors: Howard S, Dunkel L Tags: Endocr Dev Source Type: research
