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Clinical Endocrinology

Asena Gökçay Canpolat, Mustafa Şahin, Elif Ediboğlu, Murat Faik Erdoğan, Sevim Güllü, Özgür Demir, Rıfat Emral, Demet Çorapçioğlu
INTRODUCTION: Minimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anesthesia complications. When combined with intraoperative measurement of parathyroid hormone (PTH), cure rates are exceeding 97%. Preoperative intact PTH determination in washout samples is really very useful when parathyroid lesions can not be easily distinguished from thyroid lesions or sometimes lymph nodes. Herein, we aimed to report our institutional experience about parathyroid fine needle aspiration (FNA) method and suggest a cut-off ratio for this purpose...
July 13, 2018: Clinical Endocrinology
Esther Rosenkranz, Andrea Thissen, Sonja Siegel, Marc Piroth, Hans Clusmann, Judith Gebauer, Georg Brabant, Ilonka Kreitschmann-Andermahr
OBJECTIVE: Cranial irradiation for brain tumours or leukaemias has been related to cognitive, endocrine and psychosocial late effects as well as sleep disturbances and increased daytime sleepiness. Studies suggest that cranial irradiation might impact on pineal melatonin secretion. Melatonin is an important regulator in human circadian rhythms and the sleep-wake cycle. The study's objective was to investigate melatonin secretion, subjective sleep parameters and their interplay in a cohort of cranially irradiated head and brain tumour and leukaemia survivors at least 3 years after radiotherapy...
July 13, 2018: Clinical Endocrinology
Ashwini Mallappa, Aikaterini A Nella, Ninet Sinaii, Hamsini Rao, Verena Gounden, Ashley F Perritt, Parag Kumar, Alexander Ling, Chia-Ying Liu, Steven J Soldin, Deborah P Merke
BACKGROUND: In a phase 2 short-term (6 months) study of patients with congenital adrenal hyperplasia (CAH), continuous subcutaneous hydrocortisone infusion (CSHI) was found to be a safe, effective, and well-tolerated method of replacing cortisol with improved disease and patient related outcomes. OBJECTIVE: Evaluate the safety and efficacy of long-term CSHI. DESIGN: Single centre, open label, phase 2 extension study. PATIENTS: Five adults with classic CAH...
July 13, 2018: Clinical Endocrinology
Ahmed Al-Sharefi, Richard Quinton
Men with untreated hypogonadism are at high risk of developing anaemia, sarcopaenia and osteoporosis 1 . Ageing males are likewise at increased risk of developing these conditions, so given the age-related decline in serum testosterone (T) concentrations observed in several population-based studies, there has long been an interest in a possible role for testosterone in ameliorating male frailty of old age (FoOA).Although interesting data are emerging from "The T trials" in relation to older men with obesity/metabolic syndrome, the overall evidence of benefit versus safety does not currently favour testosterone use for undifferentiated FoOA in routine clinical practice...
July 10, 2018: Clinical Endocrinology
Soulmaz Shorakae, Sanjeeva Ranasinha, Sally Abell, Gavin Lambert, Elisabeth Lambert, Barbora de Courten, Helena Teede
OBJECTIVE: Insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic low-grade inflammation may act together in a vicious cycle in the pathophysiology of PCOS. However the inter-relationships of these components are not fully understood. We aimed to study these mechanism in the pathophysiology of PCOS PARTICIPANTS AND METHODS: Pre-menopausal women with PCOS (Rotterdam diagnostic criteria) and without PCOS were recruited from a community setting into a cross sectional sub study within a randomized control trial...
July 10, 2018: Clinical Endocrinology
Matilde Calanchini, Ahmad Moolla, Jeremy W Tomlinson, Jeremy F Cobbold, Ashley Grossman, Andrea Fabbri, Helen E Turner
OBJECTIVE: Abnormal liver function tests (LFTs) are frequent in Turner syndrome (TS). The causes and clinical significance are unclear. AIMS: to investigate the prevalence of elevated LFTs in adult TS; secondly, to analyse the associations between elevated LFTs, TS-karyotypes, and TS-related conditions; and thirdly, to evaluate liver stiffness and histological assessment. METHODS: 125 TS women were retrospectively studied. Karyotypes, clinical and biochemical details and aortic measurements were recorded...
July 10, 2018: Clinical Endocrinology
Kerstin Gutefeldt, Christina A Hedman, Ingrid S M Thyberg, Margareta Bachrach-Lindström, Anna Spångeus, Hans J Arnqvist
CONTEXT: In type 1 diabetes (T1D) dysregulation of the GH-IGF-1 axis has been reported. Whether this is related to upper extremity impairments (UEI) is unknown. OBJECTIVE: Examine differences in GH-IGF-1 axis between T1D on subcutaneous insulin treatment and matched controls without diabetes and possible associations between GH-IGF-1 axis and UEI. DESIGN: Cross-sectional population-based study. T1D patients, onset <35 years, duration ≥ 20 years, <67 years old and controls were invited to answer questionnaires and take blood samples...
July 10, 2018: Clinical Endocrinology
Xiuzhen Zhang, Fengyi Yuan
Primary hyperparathyroidism (PHPT) in pregnancy presents a threat to the health of both mother and fetus [1]. The prevalence is reported to be between 0.15 and 1.4%[2], which may be underestimated due largely to the atypical symptoms of PHPT during pregnancy. A 39-year-old woman at 17th week of pregnancy was sent to our emergency department with a history of 72 hours of nausea and repeated vomiting. This article is protected by copyright. All rights reserved.
July 10, 2018: Clinical Endocrinology
Hongxiu Luo, Andrew Tobey, Sungyoung Auh, Craig Cochran, Marina Zemskova, James Reynolds, Cristiane Lima, Kenneth Burman, Leonard Wartofsky, Monica Skarulis, Electron Kebebew, Joanna Klubo-Gwiezdzinska
OBJECTIVE: Pretreatment with lithium (Li) is associated with an increased residence time of radioactive iodine (RAI) in differentiated thyroid cancer (DTC) metastases. There are no data translating this observation into long-term outcomes. The study goal was to compare the efficacy of three methods of preparation for RAI therapy in metastatic DTC - thyroid hormone withdrawal (THW), THW with pre-treatment with Li (THW+Li), and recombinant human TSH (rhTSH). DESIGN/PATIENTS/MEASUREMENTS: We performed a cohort study comparing overall survival (OS) and progression-free survival (PFS) between the three groups: THW(n=52), THW+Li (n=41) and rhTSH (n=42)...
July 4, 2018: Clinical Endocrinology
Wei Wang, Ying Guo, Xinxian Zhang, Jiahua Zheng
INTRODUCTION: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive age women. Irisin is considered to play a role in metabolic disorder and PCOS. However, correlation between irisin and metabolic disorder in PCOS is not clear. MATERIAL AND METHODS: This is a prospective study. Forty patients with PCOS and Thirty patients without PCOS were recruited for in vitro fertilization and embryo transfer (IVF-ET). All PCOS women fulfilled all three Rotterdam consensus criteria...
July 4, 2018: Clinical Endocrinology
Maria Daniela Hurtado, Tiffany Cortes, Neena Natt, William F Young, Irina Bancos
OBJECTIVE: To identify predictors of hypothalamic-pituitary-adrenal (HPA) axis recovery interval and severity of glucocorticoid withdrawal symptoms (GWS) in patients undergoing adrenalectomy for corticotropin-independent cortisol excess. DESIGN: Retrospective study of patients with mild autonomous cortisol excess (MACE), moderate and severe Cushing syndrome (CS) who developed adrenal insufficiency after unilateral adrenalectomy between 1998 and 2017. RESULTS: Adrenalectomy was performed in 81 patients (79% women, median age 52 years [IQR, 42-62])...
July 3, 2018: Clinical Endocrinology
Adriana Albani, Luis G Pérez-Rivas, Christina Dimopoulou, Stephanie Zopp, Paula Colón-Bolea, Sigrun Roeber, Jürgen Honegger, Jörg Flitsch, Walter Rachinger, Michael Buchfelder, Günter K Stalla, Jochen Herms, Martin Reincke, Marily Theodoropoulou
OBJECTIVE: Almost half cases of Cushing's disease (CD) tumours carry recurrent activating somatic mutations in the ubiquitin-specific protease 8 gene (USP8) gene. The USP8 mutational status could predict remission in patients with CD, so our objective was to correlate the presence of somatic USP8 mutations with the rate of recurrence after transsphenoidal surgery (TSS) retrospectively. DESIGN: Biochemical, radiological and clinical data were retrospectively assessed in 48 patients...
June 29, 2018: Clinical Endocrinology
Gian Paolo Rossi, Selene Prisco
In this issue of the Journal, a study by Bislev et al evaluated the interaction between the renin-angiotensin-aldosterone system (RAAS) and parathyroid hormone (PTH) system in a double-blinded randomised placebo-controlled trial. The authors found no effects of RAAS blockade with valsartan on PTH levels. However, in spite of the strength of this approach, their study has important limitations in design that could have affected their conclusions as discussed below. This article is protected by copyright. All rights reserved...
June 26, 2018: Clinical Endocrinology
Oscar Moreno-Perez, Rebeca Reyes-Garcia, Manuel Muñoz-Torres, Esperanza Merino, Vicente Boix, Sergio Reus, Livia Giner, Rocío Alfayate, Beatriz Garcia-Fontana, Jose Sanchez-Paya, Antonio Picó, Joaquín Portilla
OBJECTIVE: HIV infection is associated with an increased risk of cardiovascular disease. Irisin is a miokyne secreted by skeletal muscle, which may influence insulin homeostasis, non-alcoholic fatty liver disease (NAFLD) and atherosclerosis. Our objective was to evaluate the relationships between serum irisin, insulin homeostasis, NAFLD and subclinical atherosclerosis in HIV-infected males. DESIGN: Cross-sectional study in a cohort of HIV-infected patients. PATIENTS: Inclusion criteria: men older than 18 years; antiretroviral therapy (ART) -naïve or on effective ART (< 50 HIV-1 RNA copies/mL) without changes in the previous 6 months; no diabetes or hepatitis C...
June 26, 2018: Clinical Endocrinology
Nidan Qiao, Brooke Swearingen, Nicholas A Tritos
BACKGROUND: To define the symptoms, signs and treatment outcomes in a population of older patients with Cushing's disease (CD). METHODS: We analyzed the clinical presentation and treatment outcomes in 45 CD patients older than 60 years, in comparison to 90 CD patients younger than 60, and a control group of 45 older patients with nonfunctioning pituitary adenomas. We reviewed preoperative clinical characteristics, medical comorbidities, imaging findings and endocrine testing as well as surgical and endocrine outcomes...
June 25, 2018: Clinical Endocrinology
Nasser Laouali, Sylvie Brailly-Tabard, Catherine Helmer, Marie-Laure Ancelin, Christophe Tzourio, Alexis Elbaz, Anne Guiochon-Mantel, Marianne Canonico
CONTEXT: Although endogenous estradiol, generally considered as the female hormone, has been little investigated in men, it could play a role in men's health, mortality in particular. The influence of estrogen receptors (ER) genetic polymorphisms on this relationship has never been studied. DESIGN AND PARTICIPANTS: The Three-City cohort study included (1999-2001) 3650 men ≥65 years who were followed for mortality over 12 years. At baseline, total estradiol (tE2) was measured and ER genotyped in a random subsample of 472 men without hormonal treatment...
June 23, 2018: Clinical Endocrinology
Angeliki Makri, Maria Belen Bonella, Margaret F Keil, Laura Hernandez-Ramirez, Gabriella Paluch, Amit Tirosh, Carolina Saldarriaga, Prashant Chitiboina, Stephen J Marx, Constantine A Stratakis, Maya Lodish
OBJECTIVE: Cushing disease (CD) is a rare entity caused by ACTH-secreting pituitary tumors, leading to prolonged hypercortisolism. Most cases are sporadic but can rarely occur in the context of familial predisposition, due to germline mutations in genes such as MEN1, leading to multiple endocrine neoplasia type 1, MEN1. We have reported previously that CD can be the first and only presenting manifestation of MEN1. In this report, we describe a cohort of pediatric patients who presented with CD as the first manifestation of MEN1...
June 21, 2018: Clinical Endocrinology
Sean C Skeldon, Bruce Carleton, James Brophy, Mohit Sodhi, Mahyar Etminan
OBJECTIVE: Case reports have suggested an increased risk of gynecomastia with HMG-CoA reductase inhibitors (i.e. statins). A recent meta-analysis also found that statins decrease circulating testosterone levels in men. We investigated whether statin use was associated with an increased risk of gynecomastia. DESIGN: Case control study. PATIENTS: A cohort of patients from a random sample of 9,053,240 US subjects from the PharMetrics Plus™ health claims database from 2006 to 2016 was created...
June 19, 2018: Clinical Endocrinology
Atsushi Uchiyama, Hirokazu Watanabe, Hidehiko Nakanishi, Satsuki Totsu
OBJECTIVE: Delayed thyrotropin (TSH) elevation (dTSHe) is common in low birthweight infants. We aimed to clarify the risk factors for the development of dTSHe in infants weighing <2000 g at birth. PATIENTS AND METHODS: According to Japanese guidelines, infants with birthweight <2000 g underwent second capillary TSH screening within 30 days, either at one month of age; or when weight reached 2.5 kg; or at discharge. dTSHe was defined as TSH >20 mIU/L by venous sampling following a normal result (<15 mIU/L) at first screening aged 4-6 days...
June 19, 2018: Clinical Endocrinology
Alan Rogol, Bradley D Anawalt
Many neoplastic diseases that are common in childhood, adolescence and early adulthood were previously uniformly and swiftly fatal. These neoplastic diseases and their therapies are associated with an increased incidence of multiple endocrinopathies. For example, intracranial neoplasias invade the hypothalamus and/or pituitary and cause deficiencies of growth hormone, gonadotropins, thyrotropin or adrenocorticotropin. Cranial radiation used to treat intra-cranial neoplasia is often associated with progressive hypopituitarism that may take years to develop into a clinically significant endocrinopathy [1]...
June 19, 2018: Clinical Endocrinology
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