Minerva Endocrinologica

The diagnostic work up of adrenal tumours, often incidentally discovered, has emerged as an ever-increasing diagnostic problem for clinical endocrinologists. No imaging modality has sufficiently high sensitivity and specificity at differentiating benign from malignant adrenal lesions. It has long been observed that adrenocortical carcinomas (ACCs) present an immature pattern of steroidogenesis, dominated by steroid hormone precursors. Modern mass spectrometry-based assays can generate multi-steroid metabolite profiles in urine collections, which can detect differences between ACCs and benign adrenocortical adenomas (ACAs)...

Adrenal incidentaloma is a frequent clinical finding. Once an adrenal mass is detected, is mandatory to determine whether the lesion is malignant or benign and whether it is hormonally active or non- functioning, to estabilish an adequate treatement or follow-up. The European Society and ENSAT Guidelines recently provided the best recommendation based on the available literature. However, due to the retrospective design of the majority of the studies, the small number of patients included and the inadequate follow-up, some issues are still unresolved...

Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. It has been undergone to in-depth clinical and laboratory investigations, with the help of the most important research groups of all over the world. Nonetheless the cure for this kind of neoplasia is not right around the corner, given its complexity and multi-faceted feature, that lead researchers to think at "one person one ACC". Currently total resection is the most concrete option for ACC patients, whenever possible. Although years are still necessary for an effective treatment, indubitably the use of mitotane, among the available pharmacological treatments, in the early 60's revolutionized the approach to this rare disease...

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BACKGROUND: We aimed to analyze the relationship between the combination with hypertension and the level of inflammatory cytokines in peripheral serum in patients with type 2 diabetes mellitus (DM), and to explore the value of inflammatory cytokines in predicting type 2 DM combined with hypertension. METHODS: A total of 120 patients diagnosed with type 2 DM in our hospital from March 2014 to September 2016 were selected. The clinical data were retrospectively analyzed...

BACKGROUND: To investigate the related influencing factors of abnormal renal function in elderly in patients with type 2 diabetes mellitus (T2DM) and their clinical significance. METHODS: The clinical data of elderly T2DM patients hospitalized in Beijing Luhe Hospital from January 2013 to June2016 were retrospectively analyzed. According to their glomerular filtration rate (GFR) levels, these patients were divided into GFR ≥90 mL/min/1.73m2 group (Group A), GFR =60-90 mL/min/1...

BACKGROUND: Studies comparing serum 25-hydroxyvitamin D concentrations in women with and without PCOS have produced inconsistent results. Additionally, no previous studies have evaluated associations between vitamin D and specific PCOS phenotypes. METHODS: This case-control study was conducted among women undergoing intrauterine insemination. Cases (n=137) were diagnosed with PCOS and then further classified into 3 diagnostic phenotypes based on combinations of the Rotterdam criteria [ovulatory dysfunction +polycystic ovaries (n=55); ovulatory dysfunction +androgen excess (n=15); and ovulatory dysfunction, +polycystic ovaries, +androgen excess (n=67)]...

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No abstract text is available yet for this article.

Zollinger-Ellison syndrome (ZES) is a clinical syndrome characterized by gastric acid hypersecretion due to the ectopic secretion of gastrin by a gastrinoma, a neuroendocrine tumor (NET) which mostly develops in the duodenum and in the pancreas. This syndrome was first described by Zollinger and Ellison in 1964; if left untreated, ZES can lead to multiple complications mainly due to gastric hypersecretion and some patients can suffer from the complications of an advanced metastatic disease. Although its clinical features are considered typical, the diagnosis of ZES is often challenging for the clinician...

BACKGROUND: The aim of this study was to investigate the levels of thyroid hormone and antithyroid antibodies and their relationship with pregnancy outcome in patients with gestational diabetes mellitus (GDM) and diabetic patients. METHODS: Fifty patients with GDM and 50 pregnant patients with diabetes were selected. Their levels of fasting blood glucose (FBG), glycosylated hemoglobin, FT3, FT4, TGab, TSH, TPOab were measured until parturition. RESULTS: There were no statistically significant differences in the age, gestational age, weight, FBG and glycosylated hemoglobin between the two groups (P>0...

Secondary adrenal insufficiency may pose specific challenges during pregnancy. The interpretation of diagnostic tests is hindered by physiological adaptations of the HPA axis. Due the relevant increases in CBG, measurement of salivary cortisol may be preferable, but lacks sufficiently established cut-offs both for early-morning evaluation and during dynamic testing. Hydrocortisone should be used for replacement to avoid overexposure of the fetus, with dose adjustments according to clinical judgement. To account for increased free cortisol levels during the course of pregnancy, hydrocortisone may be increased by 5-7...

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Growth hormone (GH) is not approved for use during conception and pregnancy. Nevertheless, data from the clinical care practice reveal that most women concieve on GH replacement therapy (GHRT), and more than half continue on GHRT also during pregnancy. GH stimulates the hypothalamic-pituitary-gonadal axis at all levels, and there is evidence that GH deficiency impacts the morphology of reproductive organs, onset of puberty, ovarian function and fertility. Patients with hypopituitarism often conceive using assisted reproductive techniques and several studies support the benefit of GH supplementation for achieving fertility in women with growth hormone deficiency...

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The desire to reproduce is a base human instinct. However, for many individuals, the chances of being able to have a genetic child are compromised by a number of factors. For some, therapies aimed at treating serious medical illness, such as cancer; result in a deleterious impact on the function of eggs and sperm in the future thus compromising future fertility. In women, a predictable decrease in egg quality and quantity occurs with advancing maternal age. Therefore, women who choose to delay childbearing until their late 30s or early 40s may experience fertility difficulties that would not have been present earlier in life...

Human reproduction has always generated more than its share of emotion that exceeds the life and death issues of medicine. For patients that are unable to conceive naturally, medical advances have greatly expanded treatment options. Assisted reproductive technology (ART) is a highly evolving, complex, and controversial field of medicine in which ethical principles play a large role in decision-making. The following highlights ethical considerations regarding ART, specifically in vitro fertilization (IVF), that practicing obstetricians and indeed all physicians may encounter...