Type 2 Diabetes in Pregnancy
Hyperglycemia is common during pregnancy, involving multisystem adaptations. Pregnancy-induced metabolic changes increase insulin resistance. Pregnancy-induced insulin resistance adds to preexisting insulin resistance. Preexisting pancreatic β-cell defect compromises the ability to enhance insulin secretion, leading to hyperglycemia. Women with type 2 DM have similar rates of major congenital malformations, stillbirth, and neonatal mortality, but an even higher risk of perinatal mortality. In utero type 2 DM exposure confers greater ri sk and reduces time to development of type 2 DM in offspring. Preconception care to...
Source: Endocrinology and Metabolism Clinics of North America - June 27, 2019 Category: Endocrinology Authors: Anil Kapur, Harold David McIntyre, Moshe Hod Source Type: research

Pregnancy and Endocrine Disorders
It is my great pleasure to introduce the “Pregnancy and Endocrine Disorders” issue of the Endocrinology and Metabolism Clinics of North America. The guest editor is Dr Mark E. Molitch, Professor of Endocrinology, Metabolism, and Molecular Medicine at the Northwestern University Feinberg School of Medicine in Chicago. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - June 21, 2019 Category: Endocrinology Authors: Adriana G. Ioachimescu Tags: Foreword Source Type: research

Gestational Diabetes Mellitus
Although it has been accepted for decades that women with gestational diabetes mellitus (GDM) are at high risk for future development of type 2 diabetes, vigorous debate regarding the value of detecting and treating GDM has persisted into the twenty-first century. Although results from 2 randomized trials provide strong evidence that treating GDM reduces adverse perinatal outcomes, it remains to be determined whether treatment impacts long-term offspring outcomes. Insulin is the first-line pharmacologic treatment and is added when glycemic goals are not met with nutritional modifications. Oral agent use is controversial, a...
Source: Endocrinology and Metabolism Clinics of North America - June 18, 2019 Category: Endocrinology Authors: Emily D. Szmuilowicz, Jami L. Josefson, Boyd E. Metzger Source Type: research

Other Pituitary Conditions and Pregnancy
Diagnosis of lymphocytic hypophysitis occurring in the peripartum period is based on clinical and neuroradiological data and does not require a biopsy. Its course is generally spontaneously favorable in terms of mass effect but may require the administration of corticosteroids or even transsphenoidal resection. The course of pituitary deficiencies is highly variable; some cases recover over time, whereas others persist indefinitely. Sheehan syndrome is very rare in developed countries. Because agalactia and amenorrhea are often neglected, the diagnosis is generally delayed. Diabetes insipidus occurring in late pregnancy is...
Source: Endocrinology and Metabolism Clinics of North America - June 18, 2019 Category: Endocrinology Authors: Philippe Chanson Source Type: research

Hyperthyroidism and Pregnancy
Clinical hyperthyroidism affects 0.1% to 0.4% of pregnancies. Gestational thyrotoxicosis is due to homology of the structure of TSH and HCG, which weakly stimulates the TSH receptor. Graves ’ disease (GD) most commonly causes clinically significant hyperthyroidism. Given concerns for teratogenicity from antithyroid drugs, these may be discontinued in low-risk GD patients. High-risk patients are treated with propylthiouracil in the first trimester then may transition to methimazole. S urgery is reserved for special circumstances; radioactive iodine is contraindicated. In late pregnancy, GD may remit; postpartum relaps...
Source: Endocrinology and Metabolism Clinics of North America - June 17, 2019 Category: Endocrinology Authors: Kristen Kobaly, Susan J. Mandel Source Type: research

Calcium Metabolic Disorders in Pregnancy
Physiologic changes during pregnancy include calcium, phosphate, and calciotropic hormone status. Calcium metabolic disorders are rare in pregnancy and management with close calcium and vitamin D control and supplementation. Primary hyperparathyroidism is mostly asymptomatic and does not affect conception or pregnancy. It requires control of plasma calcium levels. Surgical intervention may be indicated. Data on severe cases are missing. Osteoporosis in or before pregnancy is rare but usually diagnosed from fractures. Medical treatment other than supplementation is contraindicated. Vitamin D deficiency is common and may aff...
Source: Endocrinology and Metabolism Clinics of North America - June 14, 2019 Category: Endocrinology Authors: Julius Simoni Leere, Peter Vestergaard Source Type: research

Pituitary Tumors in Pregnancy
This article discusses the diagnosis and treatment of patients with prolactinomas, acromegaly, Cushing disease, and other pituitary tumors during pregnancy. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - June 12, 2019 Category: Endocrinology Authors: Wenyu Huang, Mark E. Molitch Source Type: research

Pheochromocytoma and Pregnancy
Pheochromocytoma during pregnancy, although rare, is a perilous condition. The wellbeing of mother and fetus are at stake if not diagnosed and treated antenatally and timely. The diagnosis is frequently overlooked because of the aspecific nature of signs and symptoms and confusion with pregnancy-related hypertension. Measurements of plasma or urinary free metanephrines have the highest diagnostic accuracy. MRI is preferred over ultrasonography. The optimal time for surgical removal is before 24  weeks of gestation or at/after delivery. Laparoscopic adrenalectomy should be preceded by medical pretreatment. Cesarean del...
Source: Endocrinology and Metabolism Clinics of North America - June 12, 2019 Category: Endocrinology Authors: Jacques W.M. Lenders, Katharina Langton, Johan F. Langenhuijsen, Graeme Eisenhofer Source Type: research

Thyroid Nodules and Thyroid Cancer in the Pregnant Woman
Thyroid nodules and thyroid cancer are common conditions and may be identified during pregnancy. The comprehensive evaluation of thyroid nodules during pregnancy includes a medical history, physical examination, ultrasound assessment, and (when indicated) an ultrasound-guided fine-needle aspiration biopsy. Most thyroid cancers detected during pregnancy will not grow nor pose significant risk during gestation, and thyroid surgery in pregnant women poses higher risks than in nonpregnant women. Through a balanced and informed approach to the clinical care of this unique population, outcomes can be optimized for both the mothe...
Source: Endocrinology and Metabolism Clinics of North America - June 11, 2019 Category: Endocrinology Authors: Trevor E. Angell, Erik K. Alexander Source Type: research

Size and Distribution of Transgender and Gender Nonconforming Populations
Accurate estimates of the number and proportion of transgender and gender nonconforming people in a population are necessary for developing data-based policy and for planning and funding of health care delivery and research. The wide range of estimates reported in the literature is attributable primarily to differences in definitions. Other sources of variability include diverse cultural and geographic settings and important secular trends. The transgender and gender nonconforming population is undergoing rapid changes in size and demographic characteristics. More accurate and precise estimates will be available when popul...
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Michael Goodman, Noah Adams, Trevor Cornell, Baudewijntje Kreukels, Joz Motmans, Eli Coleman Source Type: research

Transmasculine Hormone Therapy
Prescribing gender-affirming hormonal therapy in transgender men (TM) not only induces desirable physical effects but also benefits mental health. In TM, testosterone therapy is aimed at achieving cisgender male serum testosterone to induce virilization. Testosterone therapy is safe on the short term and middle term if adequate endocrinological follow-up is provided. Transgender medicine is not a strong part of the medical curriculum, although a large number of transgender persons will search for some kind of gender-affirming care. Because hormonal therapy has beneficial effects, all endocrinologists or hormone-prescribing...
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Justine Defreyne, Guy T ’Sjoen Source Type: research

Dermatologic Conditions in Transgender Populations
This article discusses pathophysiology, diagnosis, and treatment of common skin diseases in the transgender populations. For transmasculine patients, conditions include acne vulgaris and male pattern hair loss. For transfeminine patients, conditions include hirsutism, pseudofolliculitis barbae, and melasma. Postprocedural keloids and other cutaneous complications are discussed. Unique aspects of skin health in transgender persons should be considered in the context of multidisciplinary gender-affirming care. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Howa Yeung, Benjamin Kahn, Bao Chau Ly, Vin Tangpricha Source Type: research

Education Needs of Providers of Transgender Population
This article describes the history of transgender health care professional education and outlines the competencies related to this area. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Lin Fraser, Gail Knudson Source Type: research

Transgender Medicine: Best Practices and Clinical Care for the Future
There has been growing interest in the field of transgender medicine over the past 15 years. PubMed keyword text searches for “transgender” or the antiquated term “transsexual” yielded less than 50 entries prior to 2004. However, since 2005, there has been a steady increase in publications, which reached over 1000 publications per year in 2018. This growth and interest in the field have been largely due to increase d awareness of the medical needs of transgender and gender nonconforming (TGGNC) people not only by the lay public but also by the medical community. (Source: Endocrinology and Metabolism...
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Vin Tangpricha Tags: Preface Source Type: research

Transgender Medicine
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Vin Tangpricha Source Type: research

Copyright
Elsevier (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Source Type: research

Contributors
ADRIANA G. IOACHIMESCU, MD, PhD, FACE (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Source Type: research

Contents
Adriana G. Ioachimescu (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Source Type: research

Forthcoming Issues
Pregnancy and Endocrine Disorders (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Source Type: research

Transgender Medicine
The “Transgender Medicine” issue of the Endocrinology and Metabolism Clinics of North America is a collection of review articles that explore several important facets of this topic. The guest editor is Dr Vin Tangpricha, MD, PhD, Professor of Medicine at Emory University in Atlanta, Georgia, USA. Dr Tangpricha is an expert in the field and one of the authors of the Endocrine Society clinical practice guidelines regarding endocrine treatment of gender-dysphoric and gender-incongruent persons from 2017. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 24, 2019 Category: Endocrinology Authors: Adriana G. Ioachimescu Tags: Foreword Source Type: research

Gender Confirmation Surgery for the Endocrinologist
This article provides the endocrinologist with an overview of the surgical options for transgender and nonbinary patients considering gender confirmation surgery, including feminizing and masculinizing facial, chest, and genital reconstruction. Discussions of the impact of hormones on surgery, and vice versa, as well as information on surgical decision making are provided to help inform patient education via the endocrinologist. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - March 26, 2019 Category: Endocrinology Authors: Sasha K. Narayan, Tessalyn Morrison, Daniel D. Dugi, Scott Mosser, Jens U. Berli Source Type: research

Transfeminine Hormone Therapy
This article aims to review the published literature on FHT and provide guidance to clinicians caring for transgender women. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - March 23, 2019 Category: Endocrinology Authors: Oksana Hamidi, Caroline J. Davidge-Pitts Source Type: research

Fertility Considerations in Transgender Persons
Hormonal therapy and gender-affirming surgeries in transgender people have known deleterious impacts on future fertility using one's own gametes. This review focuses on fertility preservation, including the effects of medical hormone treatment on fertility, available and experimental options of fertility preservation in transgender adults, including sperm cryopreservation for transwomen and oocyte cryopreservation for transmen, and options for prepubertal transgender adolescents, including testicular and ovarian tissue cryopreservation. Transgender patients continue to face barriers and receive infrequent counseling regard...
Source: Endocrinology and Metabolism Clinics of North America - March 23, 2019 Category: Endocrinology Authors: Michael F. Neblett, Heather S. Hipp Source Type: research

Primary Care in Transgender Persons
The preventive health care needs of transgender persons are nearly identical to the rest of the population. Special consideration should be given, however, to the impact of gender-affirming hormone regimens and surgical care on preventive screenings. Providers should integrate a more comprehensive view of health when caring for transgender persons and address the impact of social determinants and other barriers to accessing affirming, inclusive health care. In individual interactions, providers must consider the unique impact that a gender identity and expression different from the assigned gender at birth affects patient-...
Source: Endocrinology and Metabolism Clinics of North America - March 23, 2019 Category: Endocrinology Authors: Brittany L. Whitlock, Elizabeth S. Duda, Molly J. Elson, Paul Parker Schwab, Ogul Ersin Uner, Shawn Wen, Jason S. Schneider Source Type: research

Cancer Risk in Transgender People
Gender-affirming hormonal treatment (HT) in transgender people is considered safe in general, but the question regarding (long-term) risk on sex hormone-related cancer remains. Because the risk on certain types of cancer differs between men and women, and some of these differences are attributed to exposure to sex hormones, the cancer risk may be altered in transgender people receiving HT. Although reliable epidemiologic data are sparse, the available data will be discussed in this article. Furthermore, recommendations for cancer screening and prevention will be discussed as well as whether to withdraw HT at time of a canc...
Source: Endocrinology and Metabolism Clinics of North America - March 23, 2019 Category: Endocrinology Authors: Christel J.M. de Blok, Koen M.A. Dreijerink, Martin den Heijer Source Type: research

Osteoporosis and Bone Health in Transgender Persons
This review summarizes current studies, systematic reviews, and clinical practice guidelines regarding the screening, diagnosis, and treatment of osteoporosis in transgender persons. Gender-affirming hormone therapy has been shown to maintain or promote acquisition of bone density as measured by dual-energy x-ray absorptiometry. No differences in fracture rates have been seen in trans women or men in short, prospective trials. Trans children and adolescents on gonadotropin-releasing hormone may be at risk for decreasing bone density while not on sex steroid hormone replacement. Screening for osteoporosis should be based on...
Source: Endocrinology and Metabolism Clinics of North America - March 23, 2019 Category: Endocrinology Authors: Mary O. Stevenson, Vin Tangpricha Source Type: research

Human Immunodeficiency Virus in Transgender Persons
This article reviews the prevalence of HIV infection among transgender populations and presents psychosocial, behavioral, and individual level factors that contribute to HIV acquisition. The authors provide practical recommendations regarding a patient-centered approach to HIV/sexually transmitted infection risk assessment. The role of preexposure prophylaxis utilization in preventing the transmission of HIV is discussed as well as the current data on HIV treatment outcomes for transgender people living with HIV. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - March 23, 2019 Category: Endocrinology Authors: Cassie G. Ackerley, Tonia Poteat, Colleen F. Kelley Source Type: research

Hormone Therapy in Children and Adolescents
For children and adolescents with gender dysphoria, an interdisciplinary care team is essential for proper diagnosis and appropriate treatment. For children who present with gender dysphoria, once puberty begins, they can be treated with gonadotropin-releasing hormone analogs to stop pubertal progression. This allows for further gender exploration, relief of dysphoria, and better cosmetic outcomes by avoiding the physical changes associated with puberty of the gender assigned at birth. After pubertal suppression, the individual may opt to proceed with puberty or start treatment with gender-affirming hormones. (Source: Endo...
Source: Endocrinology and Metabolism Clinics of North America - March 22, 2019 Category: Endocrinology Authors: Jessica Abramowitz Source Type: research

Etiology of Gender Identity
This article reviews the current literature characterizing potential factors associated with the etiologies of gender identity. The PubMed database was searched for all literature that assessed key elements affecting development of gender identity. Current models attribute gender identity etiology to endogenous biology along with prenatal androgen exposure. However, no genetic loci or specific neuroanatomic regions have been consistently identified as the single explanation for transgender identity. Although environment may play a role in gender expression, there are no data to suggest an exogenous explanation for the deve...
Source: Endocrinology and Metabolism Clinics of North America - March 18, 2019 Category: Endocrinology Authors: Sira Korpaisarn, Joshua D. Safer Source Type: research

The Current Histologic Classification of Thyroid Cancer
Thyroid cancers of follicular cell derivation provide excellent phenotype-genotype correlations. Current morphologic classifications are complex and require simplification. Benign adenomas have follicular or papillary architecture and bland cytology. Well-differentiated thyroid carcinomas exhibit follicular architecture, expansile growth, and variable cytologic atypia and invasiveness; low-risk tumors have excellent prognosis after surgical resection whereas widely-invasive and angioinvasive tumors warrant total thyroidectomy and radioablation. Papillary carcinoma is less differentiated; indolent microcarcinomas can be man...
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Sylvia L. Asa Source Type: research

Diagnosis and Management of Anaplastic Thyroid Cancer
Anaplastic thyroid cancer (ATC) is a devastating and usually incurable diagnosis. Clinical and pathologic diagnosis is best assessed at a tertiary center with concentrated ATC expertise. Expeditious multidisciplinary management is recommended for optimal patient outcomes. Based on multiinstitutional and population-based studies, multimodal therapy that includes chemoradiotherapy with surgery (when feasible) is the preferred initial treatment because it is associated with incrementally improved overall survival. In ATC that carries a BRAF V600E somatic mutation, combination therapy with BRAF and MEK inhibitors has shown pro...
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Ashish V. Chintakuntlawar, Robert L. Foote, Jan L. Kasperbauer, Keith C. Bible Source Type: research

Clinical Diagnostic Evaluation of Thyroid Nodules
This article outlines the diagnostic algorithm for the evaluation of thyroid nodules including biochemical testing, imaging, and, when appropriate, fine-needle aspiration. In addition, the authors review the natural history of benign nodules, follow-up strategies, and indications for repeat aspiration. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Carolyn Maxwell, Jennifer A. Sipos Source Type: research

Clinical Assessment and Risk Stratification in Differentiated Thyroid Cancer
This article aims to describe and discuss the risk stratification systems currently recommended for differentiated thyroid cancer. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Fernanda Vaisman, R. Michael Tuttle Source Type: research

Conventional Thyroidectomy in the Treatment of Primary Thyroid Cancer
This article focuses on conventional surgical management of thyroid cancer, reviewing long-standing and well-accepted main principles and practices. It also covers newer controversies and techniques to conventional thyroidectomy, including changes in the indications for thyroidectomy, the intraoperative management of the recurrent and superior laryngeal nerves and parathyroid glands, the extent of thyroidectomy, and the importance of outcomes measurement and quality improvement. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Benjamin R. Roman, Gregory W. Randolph, Dipti Kamani Source Type: research

Conventional Radioiodine Therapy for Differentiated Thyroid Cancer
This article presents an overview of the use of radioactive iodine (131-I) in the treatment of patients with differentiated thyroid cancer. Topics reviewed include definitions; staging; the 2 principal methods for selection of 131-I dosage; the indications for ablation, adjuvant treatment, and treatment; the recommendations for the use of 131-I contained in the guidelines of the American Thyroid Association and the Society of Nuclear Medicine and Molecular Imaging; the dosage recommendations and selection of dosage approach for 131-I by these organizations; the use of recombinant human thyrotropin for radioiodine ablation,...
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Dorina Ylli, Douglas Van Nostrand, Leonard Wartofsky Source Type: research

Genetic-guided Risk Assessment and Management of Thyroid Cancer
Controversies exist on how to optimally manage thyroid cancer because the prognosis is often uncertain based on clinical backgrounds. This can now be helped with prognostic genetic markers in thyroid cancer, exemplified by BRAF V600E and TERT promoter mutations, which have been well characterized and widely appreciated. The genetic duet of BRAF V600E/RAS and TERT promoter mutations is a most robust prognostic genetic pattern for poor prognosis of differentiated thyroid cancer. The high negative predictive values of the prognostic genetic markers are equally valuable. The best prognostic value of genetic markers in thyroid ...
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Mingzhao Xing Source Type: research

Surveillance for Differentiated Thyroid Cancer Recurrence
Serum thyroglobulin monitoring along with anatomic and functional imaging play key roles in the surveillance of patients with differentiated thyroid cancer after initial treatment. Among patients with a disease stage justifying thyroid remnant ablation or with suspected metastatic disease, radioiodine whole-body scans are essential in the months after surgery. For patients with low to moderate-risk cancers, ultrasonography of the neck (with measurement of serum thyroglobulin on thyroid hormone replacement) are the best initial diagnostic modalities, and are often the only tests required. In individuals suspected of having ...
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Prasanna Santhanam, Paul W. Ladenson Source Type: research

Transoral Endoscopic Thyroidectomy for Thyroid Cancer
The prevalence of low-risk differentiated thyroid cancer (DTC) is dramatically increasing because of superior diagnostic imaging technologies. Remote-access endoscopic thyroidectomy is becoming more popular for the lack of a noticeable neck scar. Transoral endoscopic thyroidectomy, vestibular approach (TOETVA) is the only technique that could be called a true scarless surgery; however, there is a scarcity of long-term studies about its safety and feasibility. Because thyroid cancer is a slow-growing lesion, with adequate follow-up and surveillance, TOETVA is a surgical procedure for the management of low-risk DTC without a...
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Isariya Jongekkasit, Pornpeera Jitpratoom, Thanyawat Sasanakietkul, Angkoon Anuwong Source Type: research

Entering an Era of Precision Management of Thyroid Cancer
Thyroid cancer is a common endocrine malignancy, which has seen a rapidly rising incidence and an unprecedentedly large number of accumulated living cases in recent years. The vast majority of patients with thyroid cancer have an excellent clinical prognosis. Yet, there are patients, albeit in a minority, who have poor clinical outcomes. The fate of thyroid cancer is thus not destined the same in all patients, imposing a constant challenge as to how the management of patients would be most appropriate. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Mingzhao Xing Tags: Preface Source Type: research

Thyroid Cancer
The “Thyroid cancer” issue of the Endocrinology and Metabolism Clinics of North America offers a comprehensive update on a topic that underwent significant transformation in recent years. The guest editor is Mingzhao Xing, MD, PhD, Professor of Medicine, Oncology Pathology and Cellular and Molecular Medicine at Johns Hopkins University School of Medicine. Dr Xing is a distinguished researcher in the field of thyroid neoplasia whose work had an important impact on the development of molecular-based management of thyroid tumors. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Adriana G. Ioachimescu Tags: Foreword Source Type: research

Thyroid Cancer
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Authors: Mingzhao Xing Source Type: research

Copyright
Elsevier (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Source Type: research

Contributors
ADRIANA G. IOACHIMESCU, MD, PhD, FACE (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Source Type: research

Contents
Adriana G. Ioachimescu (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Source Type: research

Forthcoming Issues
Transgender Medicine (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 2, 2019 Category: Endocrinology Source Type: research

Neck Dissection in the Surgical Treatment of Thyroid Cancer
This article addresses central and lateral neck dissection, providing a simplified guide to the most up-to-date and evidence-based practices. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - December 26, 2018 Category: Endocrinology Authors: Ahmad M. Eltelety, David J. Terris Source Type: research

Management of Medullary Thyroid Cancer
Medullary thyroid cancer (MTC) is rare but aggressive. It can be cured only if intrathyroid at diagnosis. MTC can be sporadic (75%) or familial (25%) and the 2 forms are distinguished by RET mutations analysis. Calcitonin is the specific serum marker; its doubling time is the most important prognostic factor for survival and progression; 30% of MTC patients have distant metastases at diagnosis and, when progressing, systemic therapy with vandetanib or cabozantinib should be considered. Before starting this treatment, the possibility of using a local treatment should be evaluated to delay systemic therapy. A multidisciplina...
Source: Endocrinology and Metabolism Clinics of North America - December 26, 2018 Category: Endocrinology Authors: David Viola, Rossella Elisei Source Type: research

Evolving Understanding of the Epidemiology of Thyroid Cancer
The incidence of thyroid cancer worldwide has increased significantly over the past 3 decades, due predominantly to an increase in papillary thyroid cancer. Although most of these cancers are small and localized, population-based studies have documented a significant increase in thyroid cancers of all sizes and stages, in addition to incidence-based mortality for papillary thyroid cancer. This suggests that the increasing incidence of thyroid cancer is due in large part to increasing surveillance and overdiagnosis, but that there also appears to be a true increase in new cases of thyroid cancer. (Source: Endocrinology and ...
Source: Endocrinology and Metabolism Clinics of North America - December 23, 2018 Category: Endocrinology Authors: Carolyn Dacey Seib, Julie Ann Sosa Source Type: research

Coding Molecular Determinants of Thyroid Cancer Development and Progression
Thyroid cancer is the most common endocrine malignancy. Its incidence and mortality rates have increased for patients with advanced-stage papillary thyroid cancer. The characterization of the molecular pathways essential in thyroid cancer initiation and progression has made huge progress, underlining the role of intracellular signaling to promote clonal evolution, dedifferentiation, metastasis, and drug resistance. The discovery of genetic alterations that include mutations (BRAF, hTERT), translocations, deletions (eg, 9p), and copy-number gain (eg, 1q) has provided new biological insights with clinical applications. Under...
Source: Endocrinology and Metabolism Clinics of North America - December 23, 2018 Category: Endocrinology Authors: Veronica Valvo, Carmelo Nucera Source Type: research

Management of Papillary Thyroid Microcarcinoma
This article describes management options for PTM patients and shared decision-making as a novel method for individualizing care. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - December 23, 2018 Category: Endocrinology Authors: Juan P. Brito, Ian D. Hay Source Type: research