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Clinical Endocrinology

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https://www.readbyqxmd.com/read/29791966/outcomes-of-bethesda-categories-iii-and-iv-thyroid-nodules-over-5-years-and-performance-of-the-afirma-gene-expression-classifier-a-single-institution-study
#1
Kelsi E Deaver, Bryan R Haugen, Nikita Pozdeyev, Carrie B Marshall
OBJECTIVE: The second edition Bethesda System for Reporting Thyroid Cytology estimates 6-18% malignancy rate of category III (B3) and 10-40% for category IV (B4) nodules; however, reported malignancy rates have considerable variability among institutions. Use of molecular classifiers (including Afirma Gene Expression Classifier, GEC) can be utilized in management of thyroid nodules. Our objective was to analyze malignancy rates of B3 and B4 nodules and determine clinical outcomes of GEC Benign nodules...
May 23, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29791007/should-all-patients-with-adrenal-insufficiency-or-a-subgroup-of-patients-with-pre-diabetes-be-treated-with-dual-release-hydrocortisone
#2
Roberta Giordano
Guarnotta et al. compare the effects of dual-release (DR) hydrocortisone 36 months' treatment in 13 patients with primary adrenal insufficiency and 36 with secondary adrenal insufficiency, compared to conventional glucocorticoid treatment. A retrospective evaluation was conducted on the effects of 36 months of DR hydrocortisone therapy on visceral adiposity, insulin secretion and insulin sensitivity. Forty-nine patients with adrenal insufficiency were recruited. This article is protected by copyright. All rights reserved...
May 23, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29788534/prospective-evaluation-of-68-ga-dotatate-pet-ct-in-limited-disease-neuroendocrine-tumors-and-or-elevated-serum-neuroendocrine-biomarkers
#3
Sophie Gabriel, Philippe Garrigue, Laetitia Dahan, Frédéric Castinetti, Frédéric Sebag, Karine Baumstark, Cendrine Archange, Jha Abhishek, Karel Pacak, Benjamin Guillet, David Taïeb
CONTEXT: The 68 Ga-labelled somatostatin analogues (68 Ga-DOTA-SSAs) is becoming popular as an important diagnostic tool in neuroendocrine tumors as evidenced by a growing number of reports detailing institutional experience with various DOTA peptides. However, only few prospective studies have compared 68 Ga-DOTA-SSAs and somatostatin receptor scintigraphy (SRS) in gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and pulmonary neuroendocrine tumors. OBJECTIVE: The aim of our prospective study was to perform head-to-head comparison between 68 Ga-DOTATATE PET/CT and standard imaging work-up (SI) that included multiphasic CT, liver MRI, and SRS using single photon emission computed tomography...
May 22, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29781519/assessment-of-vertebral-microarchitecture-in-overt-and-mild-cushing-s-syndrome-using-trabecular-bone-score
#4
Helene Vinolas, Virginie Grouthier, Nadia Mehsen-Cetre, Amandine Boisson, Renaud Winzenrieth, Thierry Schaeverbeke, Charles Mesguich, Laurence Bordenave, Antoine Tabarin
OBJECTIVE: Osteoporotic fractures associated with Cushing's syndrome (CS) may occur despite normal bone mineral density (BMD). Few studies have described alterations in vertebral microarchitecture in glucocorticoid-treated patients and during CS. Trabecular bone score (TBS) estimates trabecular microarchitecture from dual-energy X-ray absorptiometry acquisitions. Our aim was to compare vertebral BMD and TBS in patients with overt CS and mild autonomous cortisol secretion (MACE), and following cure of overt CS...
May 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29781512/natural-history-of-rathke-s-cleft-cysts-a-retrospective-analysis-of-a-two-centers-experience
#5
Elisa Sala, Justin M Moore, Alvaro Amorin, Giulia Carosi, Hector Martinez, Griffith R Harsh, Maura Arosio, Giovanna Mantovani, Laurence Katznelson
OBJECTIVE: Rathke's Cleft Cyst (RCC) is a common sellar lesion which may cause visual impairment, hypopituitarism, and headaches from mass effect. The natural history of these lesions is currently unclear. We investigated the natural history of RCCs and compared surgically treated patients with those treated conservatively. METHODS: We performed a retrospective cohort study of patients diagnosed with a RCC between 1996 and 2016 at Stanford University and Ospedale Maggiore Policlinico di Milano...
May 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29772605/response-to-letter-by-aaron-hanukoglu-et-al
#6
Ihsan Turan, Ali Kemal Topaloglu, Bilgin Yuksel
We appreciate the valuable comments on our article by Hanukoglu and Hanukoglu. With regard to cutaneous involvement in systemic pseudohypoaldosteronism (sysPHA), we agree with Hanukoglu and Hanukoglu in that these co-occurrences are not rare. Indeed, in our study, three of four patients with sysPHA1 showed skin manifestations. This article is protected by copyright. All rights reserved.
May 17, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29758100/diagnostic-approach-to-low-renin-hypertension
#7
Silvia Monticone, Isabel Losano, Martina Tetti, Fabrizio Buffolo, Franco Veglio, Paolo Mulatero
Renin-angiotensin-aldosterone system (RAAS) plays a crucial role in maintaining water and electrolytes homeostasis and its deregulation contributes to the development of arterial hypertension. Since the historical description of the "classical" RAAS, a dramatic increase in our understanding of the molecular mechanisms underlying the development of both essential and secondary hypertension has occurred. Approximatively 25% of the patients affected by arterial hypertension display low renin levels, a definition that is largely arbitrary and depends on the investigated population and the specific characteristics of the assay...
May 14, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29754425/effects-of-oestradiol-for-luteal-phase-support-in-fresh-embryo-transfer-cycles-a-retrospective-cohort-study
#8
Wei Zhao, Yifeng Liu, Peng Xu, Yiqing Wu, Kai Chen, Xiaoyan Guo, Fan Zhang, Yun Huang, Linlin Zhu, Runjv Zhang, Dan Zhang
OBJECTIVE: Any benefit of oestradiol supplementation with progesterone for luteal support after fresh embryo transfer in in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycles remains controversial. In this study, we further addressed this question in cycles using gonadotropin-releasing hormone (GnRH) agonist for ovarian stimulation. DESIGN: A retrospective cohort study in a tertiary teaching and research hospital. PATIENT(S): A total of 1602 patients were given oestradiol valerate (E) in addition to progesterone(P) as luteal support...
May 12, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29751363/sex-specific-associations-of-insulin-like-peptides-in-cord-blood-with-size-at-birth
#9
Mireille Nm van Poppel, Martina Eder, Uwe Lang, Gernot Desoye
OBJECTIVE: Insulin-like peptides (insulin, IGF-1, IGF-2) are essential regulators of fetal growth. We assessed the role of these peptides for birth size in a sex-specific manner. DESIGN: Cross-sectional cohort analysis. PATIENTS AND MEASUREMENTS: In 369 neonates, cord blood insulin, C-peptide, IGF-1 and IGF-2 levels were measured. Outcomes were placenta weight, birth weight, length, and ponderal index. In linear regression models the association of insulin-like peptides with growth outcomes was assessed, adjusted for gestational age and delivery mode...
May 11, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29741297/a-pedunculated-aldosterone-producing-adenoma-drained-by-an-extra-vein-causing-puzzling-results-of-adrenal-vein-sampling
#10
Marieke S Velema, Tanja Dekkers, Ad R M M Hermus, Henri J L M Timmers, Johan Langenhuijsen, Mark Arntz, Benno Kusters, Graeme Eisenhofer, Jacques W M Lenders, Jaap Deinum
Primary aldosteronism (PA) is a common cause of endocrine hypertension in which two main subtypes are distinguished: bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA).1 Computed tomography (CT) and adrenal vein sampling (AVS) are used to differentiate between these subtypes. There are two basic conditions for AVS. First, aldosterone concentrations should be corrected for peripheral blood admixture by normalizing for cortisol concentration. Second, it is assumed that either adrenal is drained by one vein...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29741296/assessment-and-management-of-bone-health-in-women-with-oestrogen-receptor-positive-breast-cancer-receiving-endocrine-therapy-position-statement-of-the-endocrine-society-of-australia-the-australian-and-new-zealand-bone-mineral-society-the-australasian-menopause
#11
Mathis Grossmann, Sabashini Ramchand, Frances Milat, Amanda Vincent, Elgene Lim, Mark A Kotowicz, Jill Hicks, Helena Teede
OBJECTIVE: To formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy. METHODS: Representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing five key questions. RESULTS: Women receiving adjuvant aromatase inhibitors and the subset of premenopausal woman on tamoxifen have accelerated bone loss and increased fracture risk...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29741290/comparison-of-high-intensity-focused-ultrasound-and-radioiodine-for-treating-toxic-thyroid-nodules
#12
Luca Giovanella, Arnoldo Piccardo, Cinzia Pezzoli, Fabiano Bini, Riccardo Ricci, Teresa Ruberto, Pierpaolo Trimboli
PURPOSE: We compared the effectiveness of high intensity focused ultrasound (HIFU) and radioiodine (RAI) to treat patients carrying toxic thyroid nodule (TTN). Normalization of serum thyrotropin (TSH) 1 year after treatment was the primary endpoint; concurrent changes in nodules' volume and scintigraphic pattern were also evaluated as secondary endpoints. MATERIALS AND METHODS: Among patients ≥18 years old with TTN observed at our centre between January 1st , 2016 and December 31th , 2016 we prospectively enrolled 17 and 15 age and sex-matched patients treated with RAI and HIFU, respectively...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29741215/role-of-dotatate-pet-ct-in-preoperative-assessment-of-phaeochromocytoma-and-paragangliomas
#13
Matti L Gild, Nikita Naik, Jeremy Hoang, Edward Hsiao, Rachel T McGrath, Mark Sywak, Stan Sidhu, Leigh Walter Delbridge, Bruce Gregory Robinson, Geoff Schembri, Roderick John Clifton-Bligh
CONTEXT: Diagnosis of paragangliomas (PGL) and phaeochromocytomas (PC) can be challenging particularly if the tumour is small. Detection of metastatic disease is important for comprehensive management of malignant PC/PGL. Somatostatin receptor imaging (SRI) agents have high sensitivity for these tumours, particularly the DOTA family of radiopharmaceuticals labelled with 68 Gallium. OBJECTIVE: To describe the utility of SRI in primary assessment (i.e. before surgery) for PC/PGL and whether measures of maximum standardized uptake (SUVmax) could be used to distinguish between adrenal adenomas and PCs...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29733445/effects-of-treatment-with-an-angiotensin-2-receptor-blocker-and-or-vitamin-d3-on-parathyroid-hormone-and-aldosterone-a-randomized-placebo-controlled-trial
#14
Lise Sofie Bislev, Lene Langagergaard Rødbro, Jesper Nørgaard Bech, Erling Bjerregaard Pedersen, Lars Rolighed, Tanja Sikjaer, Lars Rejnmark
OBJECTIVE: Emerging evidence support a positive, bidirectional and clinical relevant interaction between parathyroid hormone (PTH) and the renin-angiotensin-aldosterone-system (RAAS). A beneficial effect of the widely used RAAS inhibitors might include a PTH lowering effect, as high PTH levels may be harmful to cardiovascular health. We aimed to investigate whether PTH levels are lowered by short-term treatment with an angiotensin 2 receptor blocker (valsartan) independently of co-administration of vitamin D3...
May 7, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29727484/leptin-and-igf-1-in-relation-to-body-composition-and-bone-mineralization-of-preterm-born-children-from-infancy-to-8-years
#15
Charlotte A Ruys, Monique van de Lagemaat, Harrie N Lafeber, Joost Rotteveel, Martijn J J Finken
OBJECTIVE: Preterm birth has been associated with altered body composition, especially increased fat mass (FM) and decreased bone mineralization, and leptin and IGF-1 have been suggested to be involved in the regulation of both. We aimed to study the interplay between leptin, IGF-1, FM, and bone mineralization measured in infancy and childhood of children born preterm. DESIGN: Observational study. PATIENTS/SUBJECTS: Seventy-nine (40 boys) preterm-born children (gestational age ≤32 weeks and/or birth weight ≤1500g) aged 8 years...
May 4, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29722904/renal-complications-of-lipodystrophy-a-closer-look-at-the-natural-history-of-kidney-disease
#16
Baris Akinci, Sadiye Mehtat Unlu, Ali Celik, Ilgin Yildirim Simsir, Sait Sen, Banu Nur, Fatma Ela Keskin, Basak Ozgen Saydam, Nilufer Ozdemir Kutbay, Banu Sarer Yurekli, Bekir Ugur Ergur, Melda Sonmez, Tahir Atik, Atakan Arslan, Tevfik Demir, Canan Altay, Ulku Aybuke Tunc, Tugba Arkan, Ramazan Gen, Erdal Eren, Gulcin Akinci, Aslihan Arasli Yilmaz, Habip Bilen, Samim Ozen, Aygul Celtik, Senay Savas Erdeve, Semra Cetinkaya, Huseyin Onay, Sulen Sarioglu, Elif Arioglu Oral
OBJECTIVES: Lipodystrophy syndromes are a group of heterogeneous disorders characterized by adipose tissue loss. Proteinuria is a remarkable finding in previous reports. STUDY DESIGN: In this multi-center study, prospective follow-up data were collected from 103 subjects with non-HIV associated lipodystrophy registered in the Turkish Lipodystrophy Study Group database to study renal complications in treatment naïve patients with lipodystrophy. METHODS: Main outcome measures included ascertainment of chronic kidney disease (CKD) by studying the level of proteinuria and the estimated glomerular filtration rate (eGFR)...
May 3, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29706030/preconception-management-of-thyroid-dysfunction
#17
Onyebuchi E Okosieme, Ishrat Khan, Peter N Taylor
Uncorrected thyroid dysfunction in pregnancy has well recognised deleterious effects on fetal and maternal health. The early gestation period is one of critical fetal vulnerability during which maternal thyroid dysfunction may have lasting repercussions. Accordingly, a pragmatic preconception strategy is key for ensuring optimal thyroid disease outcomes in pregnancy. Preconception planning in women with hypothyroidism should pre-empt and mirror the adaptive changes of the thyroid gland by careful levothyroxine dose adjustments to ensure adequate fetal thyroid hormone delivery in pregnancy...
April 29, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29702750/in-systemic-pseudohypoaldosteronism-type-1-skin-manifestations-are-not-rare-and-the-disease-is-not-transient
#18
Aaron Hanukoglu, Israel Hanukoglu
We read with interest the recent paper by Turan et al. (published online April 18, 2018) on eight patients with hypoaldosteronism resulting from biosynthetic defects of aldosterone secretion (3 cases) or aldosterone insensitivity syndromes named as pseudohypoaldosteronism type 1 (PHA) (5 cases).1 In 1991, we described for the first time that PHA type I may appear in two forms with distinct clinical, genetic, and endocrine characteristics.2 These two forms were named as the renal form, and the systemic (multi-system) form of PHA...
April 27, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29693263/clinical-associations-of-maternal-thyroid-function-with-fetal-brain-development-epidemiological-interpretation-and-overview-of-available-evidence
#19
Tim I M Korevaar, Henning Tiemeier, Robin P Peeters
TH is an important regulator of metabolism, growth and development in practically all tissues of the human body. During pregnancy, major changes occur in thyroid physiology including an increase in TH binding globulins, an increase in TH degradation by thyroid degrading enzymes (due to placental expression of type 3 deiodinase) and an increase in thyroid stimulation through high concentrations of human chorionic gonadotropin (hCG). Both overt hypothyroidism and Graves' hyperthyroidism, which occur in approximately 0...
April 24, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29683196/hypogonadism-and-male-obesity-focus-on-unresolved-questions
#20
Mathis Grossmann
Obesity, increasing in prevalence globally, is the clinical condition most strongly associated with lowered testosterone concentrations in men, and presents as one of the strongest predictors of receiving testosterone treatment. While low circulating total testosterone concentrations in modest obesity primarily reflect reduced concentrations of sex hormone binding globulin, more marked obesity can lead to genuine hypothalamic-pituitary-testicular axis (HPT) suppression. HPT axis suppression is likely mediated via pro-inflammatory cytokine and dysregulated leptin signalling and aggravated by associated comorbidities...
April 23, 2018: Clinical Endocrinology
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