MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Endocrinology and Metabolism Clinics of North America' source. Sun, 29 Jan 2012 15:12:00 +0100 http://www.medworm.com/index.php?rid=5432218&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100106X%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432218 Tue, 22 Nov 2011 08:04:20 +0100 5432218 http://www.medworm.com/index.php?rid=5432216&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000685%2Fabstract%3Frss%3Dyes Polycystic ovary syndrome (PCOS) is a disease of complex and still poorly understood cause and of variable phenotypes. It is characterized by anovulation, hyperandrogenism, and polycystic ovaries. Infertility is commonly present. A variety of methods has been used successfully to achieve pregnancy in women with PCOS. Maintenance of pregnancy is complicated by a higher rate of premature spontaneous abortions and high risk of gestational diabetes, hypertension, and preeclampsia. However, with careful monitoring and treatment, the outcome of pregnancy in most women with PCOS is excellent. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432216 Tue, 22 Nov 2011 08:04:20 +0100 5432216 http://www.medworm.com/index.php?rid=5432215&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000740%2Fabstract%3Frss%3Dyes Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Several risk factors have been recognized to predict risk for preeclampsia. However, at present no biomarkers have sufficient discriminatory ability to be useful in clinical practice, and no effective preventive strategies have yet been identified. Commonly used medications for the treatment of hypertension in pregnancy include methyldopa and labetalol. Blood pressure thresholds for initiating antihypertensive therapy are higher than outside of pregnancy. Women with prior preeclampsia are at increased risk of hypertension, cardiovascular disease, and renal disease. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432215 Tue, 22 Nov 2011 08:04:20 +0100 5432215 http://www.medworm.com/index.php?rid=5432212&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000673%2Fabstract%3Frss%3Dyes Pregnancy and lactation cause a substantial increase in demand for calcium that is met by different maternal adaptations within each period. Intestinal calcium absorption more than doubles during pregnancy, whereas the maternal skeleton resorbs to provide most of the calcium content of breast milk during lactation. These maternal adaptations also affect the presentation, diagnosis, and management of disorders of calcium and bone metabolism. Although some women may experience fragility fractures as a consequence of pregnancy or lactation, for most women, parity and lactation do not affect the long-term risks of low bone density, osteoporosis, or fracture. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432212 Tue, 22 Nov 2011 08:04:20 +0100 5432212 http://www.medworm.com/index.php?rid=5432211&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000958%2Fabstract%3Frss%3Dyes Adrenal disorders may manifest during pregnancy de novo, or before pregnancy undiagnosed or diagnosed and treated. Adrenal disorders may present as hormonal hypofunction or hyperfunction, or with mass effects or other nonendocrine effects. Pregnancy presents special problems in the evaluation of the hypothalamic-pituitary-adrenal axis in addition to the usual considerations. The renin-angiotensin-aldosterone axis undergoes major changes during pregnancy. Nevertheless, the common adrenal disorders are associated with morbidity during pregnancy and their management is more complicated. A high index of suspicion must be maintained for these disorders lest they go unrecognized and untreated. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432211 Tue, 22 Nov 2011 08:04:20 +0100 5432211 http://www.medworm.com/index.php?rid=5432210&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000661%2Fabstract%3Frss%3Dyes Adequate iodine intake is required for the synthesis of thyroid hormones that are important for normal fetal and infant neurodevelopment. In this review, we discuss iodine physiology during pregnancy and lactation, methods to assess iodine sufficiency, the importance of adequate iodine nutrition, studies of iodine supplementation during pregnancy and lactation, the consequences of hypothyroidism during pregnancy, the current status of iodine nutrition in the United States, the global efforts toward achieving universal iodine sufficiency, and substances that may interfere with iodine use. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432210 Tue, 22 Nov 2011 08:04:20 +0100 5432210 http://www.medworm.com/index.php?rid=5432209&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000697%2Fabstract%3Frss%3Dyes Maternal hypothyroidism, thyroid antibody positivity, and hyperthyroidism may pose significant risks in terms of pregnancy complications and fetal adverse effects. Treatment of hyperthyroidism with thionamides remains the standard of care during pregnancy. Radioiodine use is contraindicated in pregnancy, including in the treatment of thyroid carcinoma, because of the risk of fetal hypothyroidism, subsequent cognitive impairment, and even fetal death. Normal thyroid function during pregnancy is essential to ensure delivery, to the best extent possible, of a healthy baby, which may be achieved with frequent monitoring of thyroid function during gestation and cautious adjustment of medications during treatment. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432209 Tue, 22 Nov 2011 08:04:20 +0100 5432209 http://www.medworm.com/index.php?rid=5432207&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100096X%2Fabstract%3Frss%3Dyes Hyperglycemia in pregnancy is an opportunity for women at risk for complications during pregnancy and beyond to change their life course to improve outcomes for themselves and their offspring. Providers of diabetes care during pregnancy complicated by hyperglycemia in pregnancy have the unique opportunity to make a significant difference. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432207 Tue, 22 Nov 2011 08:04:20 +0100 5432207 http://www.medworm.com/index.php?rid=5432206&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000971%2Fabstract%3Frss%3Dyes Although it has been only 5 years since the last publication of the Endocrinology and Metabolism Clinics of North America issue devoted to Endocrine Disorders During Pregnancy, our knowledge and management of endocrine disorders during pregnancy have evolved and changed. We view pregnancy as a continuum, starting with preconception planning, continuing with gestation of the fetus, and culminating in the postpartum period. We have chosen to represent these phases and selected topics that cover a wide range of the subspecialties primarily within adult endocrinology, but also diseases faced by adolescents, and importantly, the effect these diseases can have on the health of the baby. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432206 Tue, 22 Nov 2011 08:04:20 +0100 5432206 http://www.medworm.com/index.php?rid=5432204&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911001058%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432204 Tue, 22 Nov 2011 08:04:20 +0100 5432204 http://www.medworm.com/index.php?rid=5432203&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911001046%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432203 Tue, 22 Nov 2011 08:04:20 +0100 5432203 http://www.medworm.com/index.php?rid=5432202&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911001034%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432202 Tue, 22 Nov 2011 08:04:20 +0100 5432202 http://www.medworm.com/index.php?rid=5432205&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000983%2Fabstract%3Frss%3Dyes Pregnancy is associated with numerous alterations of normal physiological processes and many disorders predate the pregnancy, whereas others are affected by the pregnancy. This issue is devoted to those common endocrine disorders that endocrinologists encounter in their practice and those involved in clinical research on these topics. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432205 Thu, 13 Oct 2011 04:00:00 +0100 5432205 http://www.medworm.com/index.php?rid=5432217&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000715%2Fabstract%3Frss%3Dyes Overweight and obesity are significant and increasing health problems associated with increased risks of morbidity, quality of life, and metabolic and reproductive health consequences. In women, being overweight or obese is associated with impaired fertility and decreased chance of conception both in natural and assisted reproductive technology births. During pregnancy, overweight and obesity are associated with increased risk of adverse maternal and infant health outcomes. Attention to weight loss before conception may improve fertility and maternal and infant health outcomes during pregnancy. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432217 Wed, 28 Sep 2011 04:00:00 +0100 5432217 http://www.medworm.com/index.php?rid=5432213&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000727%2Fabstract%3Frss%3Dyes The pituitary gland undergoes much anatomic and physiologic variation during pregnancy. Pituitary disease may have a significant impact on a patient prior to conception as well as throughout her pregnancy. It is imperative to provide care to patients affected by pituitary disease with a multidisciplinary approach involving endocrinologists, obstetricians and, when appropriate, neurosurgical care, as this group of disorders can represent a substantial level of morbidity and mortality for both mother and fetus. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432213 Mon, 26 Sep 2011 04:00:00 +0100 5432213 http://www.medworm.com/index.php?rid=5432208&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000703%2Fabstract%3Frss%3Dyes Optimal glycemic control is pivotal to the successful outcome of diabetic pregnancy. The goals for glycemic control include levels for preprandial and postprandial glucose and HbA1c as well as avoidance of severe hypoglycemia. These goals are best obtained with diet, exercise, and insulin treatment, often a multiple-dose insulin regimen or insulin pump. A focus on blood pressure, microalbuminuria, diabetic nephropathy, and diabetic retinopathy is needed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432208 Mon, 26 Sep 2011 04:00:00 +0100 5432208 http://www.medworm.com/index.php?rid=5432214&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000739%2Fabstract%3Frss%3Dyes Prolactin-secreting pituitary tumors are a common cause of amenorrhea and infertility in premenopausal women. The goals of therapy are to normalize prolactin, restore gonadal function and fertility, and reduce tumor size, and dopamine agonists are the preferred therapy. Clinically significant tumor enlargement during pregnancy is uncommon and dependent on tumor size and prepregnancy treatment. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5432214 Fri, 23 Sep 2011 04:00:00 +0100 5432214 http://www.medworm.com/index.php?rid=5196759&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000843%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196759 Wed, 31 Aug 2011 23:00:00 +0100 5196759 http://www.medworm.com/index.php?rid=5196758&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000533%2Fabstract%3Frss%3Dyes Androgen deprivation therapy (ADT) is a major component of the contemporary management of prostate cancer. ADT's use is increasing rapidly. The side effects of this therapy include loss of bone mass and fractures, increase in fat mass, and worsening of insulin resistance, the metabolic syndrome, diabetes and cardiovascular risk, and anemia and loss of muscle. Neuropsychological and sexual symptoms are common. The impact of these side effects is often overlooked or underestimated in decisions about prostate cancer therapy. This review surveys the data relating to the side effects of ADT and provides recommendations regarding their minimization and management. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196758 Wed, 31 Aug 2011 23:00:00 +0100 5196758 http://www.medworm.com/index.php?rid=5196757&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000508%2Fabstract%3Frss%3Dyes Androgens are essential for normal prostate development and are necessary, but not sufficient, for the development of prostate cancer (PCa). Androgen deprivation therapy has long been the mainstay of treatment for PCa bone metastases, providing palliation of symptoms in the majority of patients, followed by relapse and progression. The majority of published preclinical studies demonstrate a stimulatory effect of androgens and androgen receptor signaling on the multistep process of PCa bone metastases, including androgenic promotion of local PCa growth, angiogenesis, invasion, bone targeting, stimulation of PCa growth factors that enhance osteoclastogenesis, and enhancement of Wnt signaling in osteoblasts. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196757 Wed, 31 Aug 2011 23:00:00 +0100 5196757 http://www.medworm.com/index.php?rid=5196753&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000521%2Fabstract%3Frss%3Dyes Androgens are involved in every aspect of prostate development, growth, and function from early in male embryogenesis to prostatic hyperplasia in aging men and dogs. Likewise, androgen deprivation at any phase of life causes a decrease in prostate cell number and DNA content. The process by which the circulating androgen testosterone is converted to dihydrotestosterone in the tissue and dihydrotestosterone in turn gains access to the nucleus where it regulates gene expression, largely via interaction with a receptor protein, is understood, but the downstream control mechanisms by which hormonal signals are translated into differentiation, growth, and function are being unraveled. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196753 Wed, 31 Aug 2011 23:00:00 +0100 5196753 http://www.medworm.com/index.php?rid=5196752&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000612%2Fabstract%3Frss%3Dyes The human prostate is heterogeneous with regard to its embryologic origin. The two most prevalent diseases of aging males, benign prostatic hyperplasia and prostate cancer (PCa), arise from different zones within the prostate. The biology of PCa is also heterogeneous and even within a single individual there often exist prostate cancers with varying potential to progress and metastasize. Through careful study of the histology and molecular signatures of both the human and mouse-modeled disease, treatment decisions can be tailored to individual cases so as to optimize efficacy and minimize side effects from therapy. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196752 Wed, 31 Aug 2011 23:00:00 +0100 5196752 http://www.medworm.com/index.php?rid=5196751&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000570%2Fabstract%3Frss%3Dyes This article reviews the effect of endocrine therapies of breast cancer on bone and the management of bone disease with these endocrine therapies. The effect of these therapies on bone mineral density and bone turnover along with possible interventions is discussed. AIs are also associated with skeletal-related events, which are not discussed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196751 Wed, 31 Aug 2011 23:00:00 +0100 5196751 http://www.medworm.com/index.php?rid=5196749&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000600%2Fabstract%3Frss%3Dyes This article explores the history of endocrine therapy for the treatment of breast cancer, the clinical evidence behind the current standards of care, and controversies that may change these standards in the future. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196749 Wed, 31 Aug 2011 23:00:00 +0100 5196749 http://www.medworm.com/index.php?rid=5196745&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100065X%2Fabstract%3Frss%3Dyes Mammary development begins in puberty in response to an estrogen (E2) surge. E2 does not act alone. It relies on pituitary growth hormone (GH) to induce insulin-like growth factor I (IGF-I) production in the mammary stromal compartment. In turn, IGF-I permits E2 (and progesterone) action. During puberty, E2 and IGF-I synergize for ductal morphogenesis. During pregnancy, progesterone joins IGF-I and E2 to stimulate secretory differentiation necessary to produce milk. Prolactin stimulates milk production, while transforming growth factor-β inhibits proliferation. The orchestrated action of hormones, growth factors, and receptors necessary for mammary development and function are also critical in breast cancer. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196745 Wed, 31 Aug 2011 23:00:00 +0100 5196745 http://www.medworm.com/index.php?rid=5196742&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000831%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196742 Wed, 31 Aug 2011 23:00:00 +0100 5196742 http://www.medworm.com/index.php?rid=5196741&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100082X%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196741 Wed, 31 Aug 2011 23:00:00 +0100 5196741 http://www.medworm.com/index.php?rid=5196740&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000818%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196740 Wed, 31 Aug 2011 23:00:00 +0100 5196740 http://www.medworm.com/index.php?rid=5196756&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000624%2Fabstract%3Frss%3Dyes This article reviews AR and ligand-dependent mechanisms underlying CRPC progression and the status of novel hormonal therapies targeting the AR axis that are currently in clinical and preclinical development. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196756 Thu, 14 Jul 2011 23:00:00 +0100 5196756 http://www.medworm.com/index.php?rid=5196748&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000557%2Fabstract%3Frss%3Dyes Many women take hormone therapy (HT) for menopausal symptom relief. Studies have tried to clarify whether various factors can modify the risk of HT, such as the age at initiation, dose, duration, or type of HT, or characteristics of the individual, such as family history or body mass index. The relative risks of breast cancer associated with HT across various subgroups of women should be considered similar, but absolute risks can vary significantly among women and this may inform individual decision making. For breast cancer survivors, systemic HT should be discouraged. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196748 Tue, 12 Jul 2011 23:00:00 +0100 5196748 http://www.medworm.com/index.php?rid=5196747&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000594%2Fabstract%3Frss%3Dyes Given the worldwide epidemic of obesity, it is inevitably an increasingly common comorbidity for women who develop breast cancer; therefore, it is critical to understand its impact on this disease. This review focuses on the influence of obesity on breast cancer development and progression and describes the hormonal factors that may underlie the observations, with particular emphasis on the roles of estrogen, insulin/insulin-like growth factor axis, and adipokines. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196747 Sun, 10 Jul 2011 23:00:00 +0100 5196747 http://www.medworm.com/index.php?rid=5196755&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000545%2Fabstract%3Frss%3Dyes Androgen deprivation therapy (ADT) is an effective means of palliating symptoms of prostate cancer but is associated with significant toxicities that increase with treatment duration. Primary ADT in men with localized disease provides no survival advantage. Neoadjuvant ADT, when combined with external beam radiation, improves survival for men with locally advanced disease. Immediate adjuvant androgen deprivation does not seem to benefit most men undergoing radical prostatectomy. No evidence supports combined androgen blockade or monotherapy with nonsteroidal antiandrogens for locally advanced prostate cancer. ADT with orchiectomy or gonadotropin-releasing hormone agonists or antagonists is standard care for men with metastatic prostate cancer. (Source: Endocrinology and Metabolism Clinics ... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196755 Thu, 07 Jul 2011 23:00:00 +0100 5196755 http://www.medworm.com/index.php?rid=5196754&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100051X%2Fabstract%3Frss%3Dyes This article summarizes how different estrogens/antiestrogens/estrogen mimics contribute to prostate carcinogenesis, the roles of the different mediators of estrogen in the process, and the potentials of new estrogenic/antiestrogenic compounds for prevention and treatment of PCa. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196754 Thu, 07 Jul 2011 23:00:00 +0100 5196754 http://www.medworm.com/index.php?rid=5196750&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000569%2Fabstract%3Frss%3Dyes Abundant clinical evidence suggests that androgens normally inhibit mammary epithelial proliferation and breast growth. Clinical and nonhuman primate studies support the notion that androgens inhibit mammary proliferation and, thus, may protect from breast cancer. On the other hand, administration of conventional estrogen treatment suppresses endogenous androgens and may, thus, enhance estrogenic breast stimulation and possibly breast cancer risk. Addition of testosterone to the usual hormone therapy regimen may diminish the estrogen/progestin increase in breast cancer risk, but the impact of this combined use on mammary gland homeostasis still needs evaluation. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196750 Thu, 07 Jul 2011 23:00:00 +0100 5196750 http://www.medworm.com/index.php?rid=5196746&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000582%2Fabstract%3Frss%3Dyes Many studies have reported a correlation between elevated estrogen blood levels and breast cancer and this observation has raised controversy concerning the long-term use of hormonal replacement therapy. This review will not address further this controversial topic; but rather, this review focuses on the role of estrogen signaling in first, the normal development of the breast and second, how alterations of this signaling pathway contribute to breast cancer. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196746 Wed, 29 Jun 2011 23:00:00 +0100 5196746 http://www.medworm.com/index.php?rid=5196744&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000636%2Fabstract%3Frss%3Dyes In order to understand the pathogenesis of breast and prostate cancer and to design newer, more effective treatments for these common and sometimes deadly disorders, it is essential to dissect the processes involved in the normal growth and differentiation of these organs. This issue of Endocrinology and Metabolism Clinics of North America focuses on the profound role that hormones play in the normal development of the breast and prostate and the influence of these same hormones on the development and progression of breast and prostate cancer. It has become clear that even in the most advanced, so-called castrate-resistant breast and prostate cancers, hormones and their receptors still play a pivotal role in cancer progression. In advanced prostate cancer, for example, de novo synthesis of... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196744 Thu, 16 Jun 2011 23:00:00 +0100 5196744 http://www.medworm.com/index.php?rid=5196743&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000648%2Fabstract%3Frss%3Dyes This current issue of Endocrinology and Metabolism Clinics of North America compiled by Dr Alice Levine covers the important topic of hormones and cancer and focuses on two hormone-dependent cancers, breast and prostate. The first seven articles cover the mammary gland and breast cancer and the second seven articles cover the prostate gland and prostate cancer. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=5196743 Sun, 12 Jun 2011 23:00:00 +0100 5196743 http://www.medworm.com/index.php?rid=4814490&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000442%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814490 Thu, 12 May 2011 17:47:23 +0100 4814490 http://www.medworm.com/index.php?rid=4814489&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000107%2Fabstract%3Frss%3Dyes Hypertension is a significant contributor to the risk for cardiovascular disease. The increased prevalence of hypertension in women with polycystic ovary syndrome (PCOS) may contribute to the increased risk of cardiovascular disease in these women. Whether hypertension is associated with PCOS independent of obesity remains controversial. Nevertheless, detection and subsequent treatment of hypertension in this population should decrease the adverse sequelae from hypertensive cardiovascular disease. Treatment of risk factors inherent to PCOS, such as hyperandrogenism, insulin resistance, and obesity, may minimize the risk not only for the development of hypertension but also for incident cardiovascular disease independent of hypertension. (Source: Endocrinology and Metabolism Clinics of Nort... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814489 Thu, 12 May 2011 17:47:15 +0100 4814489 http://www.medworm.com/index.php?rid=4814488&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000090%2Fabstract%3Frss%3Dyes Oral contraceptives and postmenopausal hormone therapy may induce hypertension through multiple mechanisms, including sodium and volume retention. Numerous studies have shown significant increases in blood pressure (BP) with the chronic administration of oral contraceptives as well as reversibility with discontinuation. The effects of different classes of oral contraceptive agents and hormonal replacement therapy on BP and associated effects on other cardiovascular risk factors are covered in this article. Novel hormonal replacement therapy that lowers BP is also discussed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814488 Thu, 12 May 2011 17:47:13 +0100 4814488 http://www.medworm.com/index.php?rid=4814487&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000120%2Fabstract%3Frss%3Dyes This article explores the potential mechanisms of glucocorticoid-induced hyperglycemia and dyslipidemia. Interactions between glucocorticoids and other potential cardiovascular risk factors are also reviewed. Safe, alternate strategies for minimizing the need for glucocorticoids are urgently needed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814487 Thu, 12 May 2011 17:47:10 +0100 4814487 http://www.medworm.com/index.php?rid=4814486&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000119%2Fabstract%3Frss%3Dyes The exact mechanism by which glucocorticoid induces hypertension is unclear. Several mechanisms have been proposed, although there is evidence against the role of sodium and water retention as well as sympathetic nerve activation. This review highlights the role of nitric oxide–redox imbalance and their interactions with arachidonic acid metabolism in glucocorticoid-induced hypertension in humans and experimental animal models. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814486 Thu, 12 May 2011 17:47:05 +0100 4814486 http://www.medworm.com/index.php?rid=4814485&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000077%2Fabstract%3Frss%3Dyes Diagnosis of Cushing's syndrome involves a step-wise approach and establishing the cause can be challenging. Several pathogenic mechanisms have been proposed for glucocorticoid-induced hypertension, including a functional mineralocorticoid excess state, upregulation of the renin angiotensin system, and deleterious effects of cortisol on the vasculature. Surgical excision of the cause of excess glucocorticoids remains the optimal treatment. Antiglucocorticoid and antihypertensive agents and steroidogenesis inhibitors can be used as adjunctive treatment modalities in preparation for surgery and in cases where surgery is contraindicated or has not led to cure. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814485 Thu, 12 May 2011 17:46:55 +0100 4814485 http://www.medworm.com/index.php?rid=4814484&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000053%2Fabstract%3Frss%3Dyes This article discusses the genetic disorders that cause low-renin hypertension. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814484 Thu, 12 May 2011 17:46:52 +0100 4814484 http://www.medworm.com/index.php?rid=4814483&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000089%2Fabstract%3Frss%3Dyes This article focuses on 2 main forms of salt-sensitive hypertension (familial or genetic primary aldosteronism [PA] and Gordon syndrome) and the current state of knowledge regarding their genetic bases. The glucocorticoid-remediable form of familial PA (familial hyperaldosteronism type I) is dealt with only briefly because it is covered in depth elsewhere. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814483 Thu, 12 May 2011 17:46:46 +0100 4814483 http://www.medworm.com/index.php?rid=4814482&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000132%2Fabstract%3Frss%3Dyes Glucocorticoid-remediable aldosteronism (GRA) is a hereditary form of primary hyperaldosteronism and the most common monogenic cause of hypertension. A chimeric gene duplication leads to ectopic aldosterone synthase activity in the cortisol-producing zona fasciculata of the adrenal cortex, under the regulation of adrenocorticotropin (ACTH). Hypertension typically develops in childhood, and may be refractory to standard therapies. Hypokalemia is uncommon in the absence of treatment with diuretics. The discovery of the genetic basis of the disorder has permitted the development of accurate diagnostic testing. Glucocorticoid suppression of ACTH is the mainstay of treatment; alternative treatments include mineralocorticoid receptor antagonists. (Source: Endocrinology and Metabolism Clinics of ... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814482 Thu, 12 May 2011 17:46:31 +0100 4814482 http://www.medworm.com/index.php?rid=4814481&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000065%2Fabstract%3Frss%3Dyes A few simple rules can allow physicians to successfully identify many patients with arterial hypertension caused by PA among the so-called essential hypertensive patients. The hyperaldosteronism and the hypokalemia can be cured with adrenalectomy in practically all of these patients. Moreover, in a substantial proportion of them, the blood pressure can be normalized or markedly lowered if a unilateral cause of PA is discovered. Hence, the screening for PA can be rewarding both for the patient and for the clinician, particularly in those cases where hypertension is severe and/or resistant to treatment, in which the removal of an APA can allow blood pressure to be brought under control despite withdrawal of, or a prominent reduction in, the number and doses of antihypertensive medications. (... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814481 Thu, 12 May 2011 17:46:27 +0100 4814481 http://www.medworm.com/index.php?rid=4814480&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100034X%2Fabstract%3Frss%3Dyes Pheochromocytoma is a tumor of the chromaffin cells in the adrenal medulla and sympathetic paraganglia, which synthesizes and secretes catecholamines. Norepinephrine, epinephrine, and dopamine all act on their target receptors, which causes a physiologic change in the body. High circulating levels of catecholamines can lead to severe hypertension and can have devastating effects on multiple body systems (eg, cardiovascular, cerebrovascular), and can lead to death if untreated. Although surgical treatment represents the only modality of ultimate cure, pharmacologic preoperative treatment remains the mainstay of successful outcome. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814480 Thu, 12 May 2011 17:46:23 +0100 4814480 http://www.medworm.com/index.php?rid=4814479&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000326%2Fabstract%3Frss%3Dyes Formal studies have not been performed to assess the cost-effectiveness of screening strategies for endocrine causes of hypertension. However, an understanding of the diagnostic accuracy of available screening tests and the clinical settings where disease identification will lead to improved health outcomes form the basis for a cost-effective strategy. Primary aldosteronism screening should be selective and restricted to settings where knowledge of the diagnosis has the greatest chance of improving health outcomes. Pheochromocytoma is rare; however, because it is a potentially fatal disease, screening strategies should err on the side of not missing the diagnosis, especially in high-risk clinical settings. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814479 Thu, 12 May 2011 17:46:22 +0100 4814479 http://www.medworm.com/index.php?rid=4814477&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000363%2Fabstract%3Frss%3Dyes Hypertension has emerged as a dominant cardiovascular risk factor and cause of cardiovascular disease in most of the world. Effective reduction of high blood pressure, “control of hypertension,” for prevention of future cardiovascular disease is now the main component of prevention for adult populations in both developed and developing nations. The worldwide epidemic of hypertension has prompted public health initiatives and simplified approaches, such as the polypill therapy or attempts to reduce salt intake. These are macrotherapies that are directed to large populations. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814477 Thu, 12 May 2011 17:46:18 +0100 4814477 http://www.medworm.com/index.php?rid=4814476&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000351%2Fabstract%3Frss%3Dyes This issue on endocrine hypertension covers the basic mechanisms, clinical presentations, diagnostic criteria, and therapeutic modalities for a group of hypertensive disorders that, while they represent only a proportion of hypertensive conditions, are very important to consider since many are imminently treatable. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814476 Thu, 12 May 2011 17:46:17 +0100 4814476 http://www.medworm.com/index.php?rid=4814475&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000430%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814475 Thu, 12 May 2011 17:46:16 +0100 4814475 http://www.medworm.com/index.php?rid=4814474&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000429%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814474 Thu, 12 May 2011 17:46:16 +0100 4814474 http://www.medworm.com/index.php?rid=4814473&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000417%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814473 Thu, 12 May 2011 17:46:15 +0100 4814473 http://www.medworm.com/index.php?rid=4814478&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000041%2Fabstract%3Frss%3Dyes Multiple hormonal factors play a major role in the functional and structural abnormalities of hypertension (HT). At present, the kidneys and, in particular, renal Na+ retention are thought to constitute a primary and sustaining mechanism in the development of HT. However, the precise renal and hormonal mechanisms leading to increased Na+ reabsorption and HT remain unknown. Because the vast majority of HT is primary, this article focuses on the major endocrine systems, the RAS, aldosterone, and the SNS, that play a prominent role in the pathogenesis of HT. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4814478 Wed, 06 Apr 2011 23:00:00 +0100 4814478 http://www.medworm.com/index.php?rid=4595757&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000211%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595757 Tue, 01 Mar 2011 00:00:00 +0100 4595757 http://www.medworm.com/index.php?rid=4595756&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000642%2Fabstract%3Frss%3Dyes Neuroendocrine tumors (NETs) are rare neoplasms found in diverse locations within the body. These tumors are commonly classified by the primary tumor's location, further subclassified by their differentiation, and finally segregated by their ability to hypersecrete peptides or amines. A number of groups have summarized their recommendations for diagnosis and therapy; however, the rarity of these lesions makes prospective randomized multiinstitutional trials difficult. Thus, these “consensus statements” often remain opinion-based. The authors have collaboratively developed a consensus on the current diagnostic work-up necessary for patients with NETs to help clinicians with this confusing field and followed this with some of the more advanced surgical techniques and considerations that ... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595756 Tue, 01 Mar 2011 00:00:00 +0100 4595756 http://www.medworm.com/index.php?rid=4595755&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910001003%2Fabstract%3Frss%3Dyes This article reviews the effectiveness and safety of the different protocols and discusses several clinical algorithms used in an attempt to optimize targeted radiopeptide therapy. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595755 Tue, 01 Mar 2011 00:00:00 +0100 4595755 http://www.medworm.com/index.php?rid=4595754&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000976%2Fabstract%3Frss%3Dyes Treatment with radiolabeled somatostatin analogs is a promising tool in the management of patients with inoperable or metastasized neuroendocrine tumors. Symptomatic improvement may occur with all 111Indium-, 90Yttrium-, or 177Lutetium-labeled somatostatin analogs used for peptide receptor radionuclide therapy. If kidney protective agents are used, the side-effects are few and mild, and the median duration of the therapy response is 30 and 40 months, respectively. Overall survival is several years from diagnosis. These data compare favorably with the limited number of alternative treatments. If more widespread use of PRRT can be guaranteed, such therapy may become the therapy of first choice. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595754 Tue, 01 Mar 2011 00:00:00 +0100 4595754 http://www.medworm.com/index.php?rid=4595753&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000988%2Fabstract%3Frss%3Dyes This article considers different options based on the type of tumor and site of origin. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595753 Tue, 01 Mar 2011 00:00:00 +0100 4595753 http://www.medworm.com/index.php?rid=4595752&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000964%2Fabstract%3Frss%3Dyes This article reviews the various imaging methods and their respective advantages and limitations for use in different types of NETs, in particular carcinoid tumors. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595752 Tue, 01 Mar 2011 00:00:00 +0100 4595752 http://www.medworm.com/index.php?rid=4595750&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000952%2Fabstract%3Frss%3Dyes Chromogranin A, although it exhibits limitations, is currently the most useful general tumor biomarker available for use in the diagnosis and management of gastroenteropancreatic neuroendocrine tumors (NETs). The value of the chromogranin A lies in its universal cosecretion by the majority of neuroendocrine cells that persists after malignant transformation. Clinicians aware of the physiologic role of chromogranin A and its secretion in a variety of non-NET–related pathologic conditions can use this protein as a moderately effective tumor biomarker in the management of GEP-NETs. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595750 Tue, 01 Mar 2011 00:00:00 +0100 4595750 http://www.medworm.com/index.php?rid=4595749&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910001027%2Fabstract%3Frss%3Dyes This article describes instruments that have been developed to capture the spectrum of symptoms and the impact of the disease on their overall well-being. The authors discuss the importance of adequate sensitivity, specificity, and reproducibility and the value of psychometric factor analysis to explore the domains that embrace the manifestations of these tumors as well as aspects of the instruments that reflect tumor burden, biochemical, and hormonal status. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595749 Tue, 01 Mar 2011 00:00:00 +0100 4595749 http://www.medworm.com/index.php?rid=4595748&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910001039%2Fabstract%3Frss%3Dyes Obesity is a disease state with polygenic inheritance, the phenotypic penetrance of which has been greatly expanded by the attributes of modern civilization. More than two-thirds of obese persons have comorbidities, many of which are characteristic of cardiometabolic risk syndrome (CMRS) in addition to other life-quality–reducing complaints. The CMRS is associated with increased cardiovascular events and mortality. Individuals with a body mass index greater than 35 infrequently achieve or maintain weight loss adequate to resolve these metabolic and anatomic issues by lifestyle or pharmacologic strategies. Data suggest that some of these patients may be better served by bariatric surgery. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595748 Tue, 01 Mar 2011 00:00:00 +0100 4595748 http://www.medworm.com/index.php?rid=4595747&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910001015%2Fabstract%3Frss%3Dyes This article summarizes the epidemiology and reviews the diagnostic and therapeutic challenges of NETs in children and youth, noting especially those NETs that are more prevalent in young people than in older adults. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595747 Tue, 01 Mar 2011 00:00:00 +0100 4595747 http://www.medworm.com/index.php?rid=4595746&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910001040%2Fabstract%3Frss%3Dyes Neuroendocrine tumors (NETs) are rare, slow-growing neoplasms characterized by their ability to store and secrete different peptides and neuroamines. Some of these substances cause specific clinical syndromes whereas others are not associated with specific syndromes or symptom complexes. NETs usually have episodic expression that makes diagnosis difficult, erroneous, and often late. For these reasons a high index of suspicion is needed, and it is important to understand the pathophysiology of each tumor to decide which biochemical markers are more useful and when they should be used. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595746 Tue, 01 Mar 2011 00:00:00 +0100 4595746 http://www.medworm.com/index.php?rid=4595745&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000099X%2Fabstract%3Frss%3Dyes In this article, updated analyses of the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) registry (1973–2007) are presented and compared with epidemiologic GEP-NET data from Europe and Asia. Several studies have demonstrated a steadily increasing incidence of GEP-NETs, and this escalation is still ongoing (SEER data 2004–2007). The common primary GEP-NET sites exhibit unique epidemiologic profiles with distinct patterns of incidence, age at diagnosis, stage, and survival. Overall, GEP-NET survival has improved over the past 3 decades, although the outcome for poorly differentiated tumors remains dismal. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595745 Tue, 01 Mar 2011 00:00:00 +0100 4595745 http://www.medworm.com/index.php?rid=4595744&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000028%2Fabstract%3Frss%3Dyes Once the Cinderella of cancer, neuroendocrine tumors (NETS) have found their place in the world of cancer. Indeed, while small gut cancers have not increased in incidence, there has been a fivefold rise in the incidence of neuroendocrine carcinomas over the last 30 years. Once called “carcinoid,” the preferred term is now “neuroendocrine carcinoma,” and there have emerged European and North American societies focused solely on these tumors. Guidelines have been developed for diagnosis, staging, and the optimum means of localization, using CT, MRI, PET, and radioactive peptide scans. Critical to the evolution of understanding is a pathological grading system based upon cell mitoses and an index (Ki67) of cell division, as well as a staging ranging from G1 localized, G2 local or lymp... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595744 Tue, 01 Mar 2011 00:00:00 +0100 4595744 http://www.medworm.com/index.php?rid=4595743&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100003X%2Fabstract%3Frss%3Dyes This second issue opens with an article on the epidemiology of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) by Drs Lawrence, Gustafsson, Chan, Svejda, Kidd, and Modlin. As discussed by the authors, there is an apparent increased incidence of GEP-NETs. Further, each anatomical site retains its own unique epidemiological profile; for example, rectal neuroendocrine tumors (NETs) are diagnosed at a younger age compared to colonic NETs, which are detected at an older age and have a worse prognosis. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595743 Tue, 01 Mar 2011 00:00:00 +0100 4595743 http://www.medworm.com/index.php?rid=4595742&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291100020X%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595742 Tue, 01 Mar 2011 00:00:00 +0100 4595742 http://www.medworm.com/index.php?rid=4595741&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000193%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595741 Tue, 01 Mar 2011 00:00:00 +0100 4595741 http://www.medworm.com/index.php?rid=4595740&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852911000181%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595740 Tue, 01 Mar 2011 00:00:00 +0100 4595740 http://www.medworm.com/index.php?rid=4595751&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000654%2Fabstract%3Frss%3Dyes Modern medicine, and specifically clinical diagnosis, relies, among other diagnostic procedures, on the measurements of the biogenic analytes for elucidation and correlation of specific neuroendocrine markers. Tremendous advances have been made in imaging and radioactive uptake procedures to elucidate tumor presence and characterization. However, such advances only partially provide the fundamental degree of tumor activity and clinical confirmational validity. The author points out in some detail the problems that may arise when the methodological differences presented by each investigational study and investigators are not standardized. This variation causes a concern with the specific objectives of the investigator and the specific aims of the research project at hand, and ultimately for... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4595751 Fri, 03 Dec 2010 00:00:00 +0100 4595751 http://www.medworm.com/index.php?rid=4192491&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000836%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192491 Wed, 24 Nov 2010 04:39:35 +0100 4192491 http://www.medworm.com/index.php?rid=4192490&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000666%2Fabstract%3Frss%3Dyes This article describes the evolution of methods to assess in vitro angiogenesis in neuroendocrine tumors and describes some of the clinical data. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192490 Wed, 24 Nov 2010 04:39:35 +0100 4192490 http://www.medworm.com/index.php?rid=4192489&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000630%2Fabstract%3Frss%3Dyes Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are relatively rare neoplasms that characteristically synthesize and secrete an excess of a variety of regulatory peptides, hormones, and neuroamines, which regulate gut and pancreatic function. This excess can lead to distinct clinical syndromes. Therapeutic strategies include surgery, radiofrequency ablation, chemotherapy, chemoembolization, and biotherapy using somatostatin analogs. The clinical syndromes and the various management strategies can lead to altered gut and pancreatic function with nutritional consequences. Diet and nutritional management is critical for GEP NET patients and is the focus of this article. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192489 Wed, 24 Nov 2010 04:39:35 +0100 4192489 http://www.medworm.com/index.php?rid=4192488&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000757%2Fabstract%3Frss%3Dyes Neuroendocrine tumors (NETs) are rare malignancies that arise from endocrine cells located in various anatomic locations, with a dramatic increase in incidence during the last 30 years. Limited therapeutic options are currently available for patients with advanced well-differentiated NETs, including carcinoids and pancreatic NETs. Streptozotocin-based chemotherapy and somatostatin analogues are drugs that are currently used for the treatment of progressive metastatic NETs. Recently, sunitinib demonstrating efficacy in pancreatic islet cell carcinomas has opened a new avenue for the treatment of NETs, and further trials shall be considered in NET types such as carcinoids, poorly differentiated neuroendocrine carcinomas, and several other endocrine tumors that depend on vascular endothelial ... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192488 Wed, 24 Nov 2010 04:39:35 +0100 4192488 http://www.medworm.com/index.php?rid=4192487&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000629%2Fabstract%3Frss%3Dyes This article details several of the signaling mechanisms that have been discovered to play a role in the development and progression of neuroendocrine tumors. The therapeutic options developed to address the various pathways, including their specific mechanisms of actions, are also discussed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192487 Wed, 24 Nov 2010 04:39:35 +0100 4192487 http://www.medworm.com/index.php?rid=4192486&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000721%2Fabstract%3Frss%3Dyes Glucagonlike peptide-1 receptors (GLP-1R) play an increasingly important role in endocrine gastrointestinal tumor management. In particular, virtually all benign insulinomas express GLP-1R in high density. Exendin-4 is a GLP-1 analog that has a longer half-life than GLP-1. Targeting GLP-1R by 111In-DOTA-exendin-4 or 111In-DPTA-exendin-4 offers a new approach that permits the successful localization of small benign insulinomas. It is likely that this new noninvasive technique has the potential to replace the invasive localization by selective arterial stimulation and venous sampling. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192486 Wed, 24 Nov 2010 04:39:35 +0100 4192486 http://www.medworm.com/index.php?rid=4192485&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000708%2Fabstract%3Frss%3Dyes Neuroendocrine tumors (NETs) are difficult to diagnose. Their symptoms may be vague or intermittent, and are frequently associated with much more common diseases; many of the tumors may be asymptomatic. Therefore, diagnosis can be delayed for some years. Because most NETs are secretory, the measurement of circulating biomarkers is helpful not only for diagnosis but also for assessing tumor response to treatment, monitoring disease progression, and use as prognostic indicators. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192485 Wed, 24 Nov 2010 04:39:34 +0100 4192485 http://www.medworm.com/index.php?rid=4192483&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000678%2Fabstract%3Frss%3Dyes This article highlights recent advances in knowledge about diabetic gastroparesis, with an emphasis on the inter-relationships between disordered gastric motor function on glycemia and vice versa, as well as therapeutic strategies for optimizing glycemic control using modulation of gastric emptying. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192483 Wed, 24 Nov 2010 04:39:33 +0100 4192483 http://www.medworm.com/index.php?rid=4192482&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000617%2Fabstract%3Frss%3Dyes Precise automatic control of food intake and energy expenditure maintains a steady weight and is fundamental to survival. The brainstem and hypothalamus are key areas within the brain that integrate peripheral signals from the gut and adipose tissue to control feeding behavior according to energy need. Gut hormones are released after a meal and signal to the brain to initiate meal termination and feelings of satiation. However, reward pathways are able to override this mechanism so that when palatable food is presented, food is consumed irrespective of energy requirements. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192482 Wed, 24 Nov 2010 04:39:33 +0100 4192482 http://www.medworm.com/index.php?rid=4192481&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000691%2Fabstract%3Frss%3Dyes Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are silent and composed by ECL cells, the second most frequent neuroendocrine neoplasms being the high-grade neuroendocrine carcinoma (NEC). In the duodenum, preneoplastic lesions are similarly described for gastrin (G) and somatostatin (D) cells. G-cell NETs are the most frequent neuroendocrine tumors of the duodenum, either functioning or nonfunctioning, followed by D-cell NETs and gangliocytic paraganglioma (GCP). No systematic definition of nonneoplastic lesions exists for endo... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192481 Wed, 24 Nov 2010 04:39:33 +0100 4192481 http://www.medworm.com/index.php?rid=4192480&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000071X%2Fabstract%3Frss%3Dyes This article discusses and reviews the rich history that served as the foundation of modern medicine, from the early descriptions of tumors, to the discovery of hormones and assays, and how they resulted in the treatments available today. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192480 Wed, 24 Nov 2010 04:39:33 +0100 4192480 http://www.medworm.com/index.php?rid=4192477&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000824%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192477 Wed, 24 Nov 2010 04:39:32 +0100 4192477 http://www.medworm.com/index.php?rid=4192476&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000812%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192476 Wed, 24 Nov 2010 04:39:32 +0100 4192476 http://www.medworm.com/index.php?rid=4192475&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000800%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192475 Wed, 24 Nov 2010 04:39:32 +0100 4192475 http://www.medworm.com/index.php?rid=4192484&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000068X%2Fabstract%3Frss%3Dyes Building on the elaborate research studies that have helped map out key decision points in the process of pancreas development, reprogramming of pluripotent embryonic stem cells or induced pluripotent stem cells offers the possibility of overcoming restrictions on tissue supply associated with transplantation of donor islets. In a healthy pancreas, the beta-cell mass can exhibit significant plasticity, as reflected in the normal adaptive response in beta-cell mass to offset the metabolic challenge associated with pregnancy and obesity. In this article, alternative strategies and potential sources of pancreatic stem cells are considered. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192484 Thu, 14 Oct 2010 00:00:00 +0100 4192484 http://www.medworm.com/index.php?rid=4192478&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000733%2Fabstract%3Frss%3Dyes This is the first issue of two on the neuroendocrine system compiled by Dr Arthur (Aaron) Vinik, a world-renowned leader in this field. While most physicians only occasionally consider this system and the tumors that develop, I believe readers will be surprised how important the system is, both in understanding the normal physiology and pathology, and in how commonly disorders arise in our patients. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192478 Mon, 04 Oct 2010 00:00:00 +0100 4192478 http://www.medworm.com/index.php?rid=4192479&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000745%2Fabstract%3Frss%3Dyes Who would have thought that the simple act of instilling acid in the duodenum led to flow of juice from the denervated pancreas, which would lead to the discovery of the hormone secretin and the endocrine system, the first gastrointestinal hormone, and a whole new discipline, that of gastrointestinal neuroendocrinology? Who would have thought that the brain would talk to the gut and this would be a reciprocal relationship? As a scientist who has had his head buried in the GI endocrine system for decades (figuratively speaking), it has been a wonderful journey from the Cinderella discipline to front stage or close to it. In this issue of the Endocrinology Clinics, much of what has transpired in the evolution of this discipline is presented by world authorities who deserve special recognitio... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=4192479 Thu, 30 Sep 2010 00:00:00 +0100 4192479 http://www.medworm.com/index.php?rid=3878448&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000599%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878448 Thu, 19 Aug 2010 06:00:07 +0100 3878448 http://www.medworm.com/index.php?rid=3878447&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000423%2Fabstract%3Frss%3Dyes Whole pancreas has been used successfully for transplantation for more than 30 years, and islets have been used reproducibly with success for 10 years; both procedures require drugs for immunosuppression. Success is judged by discontinuation of exogenous insulin-based treatment and maintenance of normal or nearly normal hemoglobin A1c. Successful pancreas transplantation has beneficial effects on retinopathy, nephropathy, neuropathy, macrovascular disease, and quality of life. Such findings are suggested for islet transplantation, but insufficient information is available to draw firm conclusions. Because of the paucity of annual pancreas donations, research for human beta cell surrogates is essential to provide a transplantation approach to therapy for a greater number of recipients. (Sou... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878447 Thu, 19 Aug 2010 06:00:07 +0100 3878447 http://www.medworm.com/index.php?rid=3878446&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000344%2Fabstract%3Frss%3Dyes Iatrogenic hypoglycemia, typically the result of the interplay of therapeutic hyperinsulinemia and compromised defenses resulting in hypoglycemia-associated autonomic failure (HAAF) in diabetes, is a problem for people with type 1 diabetes mellitus (T1DM). It causes recurrent morbidity is sometimes fatal, leads to recurrent hypoglycemia, and precludes euglycemia over a lifetime of T1DM. Risk factors include those that result in relative or absolute insulin excess and those indicative of HAAF in diabetes. Elimination of hypoglycemia from the lives of people with T1DM will likely be accomplished by new treatment methods that provide plasma glucose–regulated insulin replacement or secretion. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878446 Thu, 19 Aug 2010 06:00:07 +0100 3878446 http://www.medworm.com/index.php?rid=3878445&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000411%2Fabstract%3Frss%3Dyes The prevalence of diabetes is increasing worldwide and the concern regarding the number of new cases of diabetes relates to the development of chronic complications. It has been recognized for years that the complications are a cause of considerable morbidity and mortality worldwide and as such, negatively affect the quality of life in individuals with diabetes with an increase in disability and death. Specifically, the complications of diabetes have been classified as either microvascular (ie, retinopathy, nephropathy, and neuropathy) or macrovascular (ie, cardiovascular disease, cerebrovascular accidents, and peripheral vascular disease). For purposes of this article, the authors focus on a brief review of the major complications. (Source: Endocrinology and Metabolism Clinics of North Am... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878445 Thu, 19 Aug 2010 06:00:07 +0100 3878445 http://www.medworm.com/index.php?rid=3878444&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000037X%2Fabstract%3Frss%3Dyes This article reviews current pump and continuous glucose monitoring therapy and what will be required to integrate these systems into closed-loop control. Issues with sensor accuracy, lag time, and calibration are discussed as well as issues with insulin pharmacodynamics, which result in a delayed onset of insulin action in a closed-loop system. A stepwise approach to closed-loop therapy is anticipated, where the first systems will suspend insulin delivery based on actual or predicted hypoglycemia. Subsequent systems may control to range, limiting the time spent in hyperglycemia by mitigating the effects of a missed food bolus or underestimate of consumed carbohydrates, while minimizing the risk of hypoglycemia. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878444 Thu, 19 Aug 2010 06:00:07 +0100 3878444 http://www.medworm.com/index.php?rid=3878443&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000472%2Fabstract%3Frss%3Dyes This article focuses on inpatient and perioperative insulin management of stable, nonketotic, nonpregnant adults and children with type 1 diabetes. These principles can also be applied to patients with steroid-induced hyperglycemia. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878443 Thu, 19 Aug 2010 06:00:07 +0100 3878443 http://www.medworm.com/index.php?rid=3878442&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000332%2Fabstract%3Frss%3Dyes The current standard of care for patients with type 1 diabetes (T1D) employs a system of intensive diabetes management aimed at near-normal glycemia, which reduces the risk of micro- and macrovascular complications. Optimal management is an ongoing process based on a patient-centered collaboration with a primary care clinician and a multidisciplinary diabetes team that provides diabetes management, including education and psychosocial support. Intensive diabetes therapy attempts to mimic physiologic insulin replacement. Over the past 15 years, there has been widespread use of multiple-dose insulin regimens using a variety of insulin analogs, administered either by injection or insulin pump therapy, together with medical nutrition therapy, frequent self-monitoring of blood glucose and, more... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878442 Thu, 19 Aug 2010 06:00:06 +0100 3878442 http://www.medworm.com/index.php?rid=3878441&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000040X%2Fabstract%3Frss%3Dyes This article discusses recent evidence that associates the developing intestinal microbiome to the pathogenesis of autoimmune T1D. It attempts to identify avenues that should be pursued that relate this new evidence to interventions that eventually could result in prevention. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878441 Thu, 19 Aug 2010 06:00:06 +0100 3878441 http://www.medworm.com/index.php?rid=3878439&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000381%2Fabstract%3Frss%3Dyes This article reviews the conceptual basis for prevention versus intervention trials in settings of T1D, past experiences of clinical trials studying these purposes, and controversial issues regarding disease interdiction, and seeks to provide a roadmap for future efforts to cure this disorder. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878439 Thu, 19 Aug 2010 06:00:06 +0100 3878439 http://www.medworm.com/index.php?rid=3878438&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000393%2Fabstract%3Frss%3Dyes This article reviews these biomarkers and T1D prediction strategies, and discusses potential implications of prediction and natural history for the pathogenesis of T1D. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878438 Thu, 19 Aug 2010 06:00:06 +0100 3878438 http://www.medworm.com/index.php?rid=3878437&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000356%2Fabstract%3Frss%3Dyes This article reviews economic methodologies developed for estimating cost of illness, examines the current literature on diabetes costs, and presents the latest estimates of the economic impact of type 1 diabetes in terms of direct medical costs (ie, treatment costs) and indirect costs (eg, lost wages). (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878437 Thu, 19 Aug 2010 06:00:06 +0100 3878437 http://www.medworm.com/index.php?rid=3878436&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000435%2Fabstract%3Frss%3Dyes This article describes the epidemiology of type 1 diabetes mellitus (T1D) around the world and across the lifespan. Epidemiologic patterns of T1D by demographic, geographic, biologic, cultural, and other factors in populations are presented to gain insight about the causes, natural history, risks, and complications of T1D. Data from large epidemiologic studies worldwide indicate that the incidence of T1D has been increasing by 2% to 5% worldwide and that the prevalence of T1D is approximately 1 in 300 in the United States by 18 years of age. Research on risk factors for T1D is an active area of research to identify genetic and environmental triggers that could potentially be targeted for intervention. Although significant advances have been made in the clinical care of T1D with resultant i... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878436 Thu, 19 Aug 2010 06:00:06 +0100 3878436 http://www.medworm.com/index.php?rid=3878433&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000054X%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878433 Thu, 19 Aug 2010 06:00:06 +0100 3878433 http://www.medworm.com/index.php?rid=3878432&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000538%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878432 Thu, 19 Aug 2010 06:00:06 +0100 3878432 http://www.medworm.com/index.php?rid=3878431&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000526%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878431 Thu, 19 Aug 2010 06:00:06 +0100 3878431 http://www.medworm.com/index.php?rid=3878440&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000320%2Fabstract%3Frss%3Dyes In 1922, Leonard Thompson received the first injections of insulin prepared from the pancreas of canine test subjects. From pancreatectomized dogs to the more recent development of animal models that spontaneously develop autoimmune syndromes, animal models have played a meaningful role in furthering diabetes research. Of these animals, the nonobese diabetic (NOD) mouse is the most widely used for research in type 1 diabetes (T1D) because the NOD shares several genetic and immunologic traits with the human form of the disease. In this article, the authors discuss the similarities and differences in NOD and human T1D and the potential role of NOD mice in future preclinical studies, aiming to provide a better understanding of the genetic and immune defects that lead to T1D. (Source: Endocrin... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878440 Thu, 08 Jul 2010 23:00:00 +0100 3878440 http://www.medworm.com/index.php?rid=3878434&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000460%2Fabstract%3Frss%3Dyes In this issue highlighting recent advances in type 1 diabetes, the editorial team has expertly compiled articles covering the entire spectrum of the disease. From pathophysiology to clinical management and ongoing bench and clinical research efforts, this edition represents a major contribution to academic and practicing physicians involved in type 1 diabetes research and management. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878434 Thu, 08 Jul 2010 23:00:00 +0100 3878434 http://www.medworm.com/index.php?rid=3878435&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000459%2Fabstract%3Frss%3Dyes This timely edition of Endocrinology and Metabolism Clinics of North America focuses on type 1 diabetes mellitus (T1D). Featuring articles by the leaders in the field, we review state-of-the-art clinical care and research into the prevention and cure of this onerous disease. The broad spectrum of topics should be of interest to anyone involved in the care of affected patients or efforts aimed at the prevention and cure of T1D. As we reflect on advances in our understanding of the pathogenesis of this disease and the rapidly changing ways in which patients with T1D are managed, the “T1D glass” (depending on the eyes of the beholder) can be perceived as “half empty” or “half full.” (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3878435 Wed, 30 Jun 2010 23:00:00 +0100 3878435 http://www.medworm.com/index.php?rid=3615934&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000265%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615934 Mon, 31 May 2010 23:00:00 +0100 3615934 http://www.medworm.com/index.php?rid=3615933&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000058%2Fabstract%3Frss%3Dyes Vitamin D has gone through a renaissance with the association of vitamin D deficiency with a wide array of common diseases including breast, colorectal and prostate cancers, cardio-vascular disease, autoimmune conditions and infections. Vitamin D analogs constitute a valuable group of compounds which can be used to regulate gene expression in functions as varied as calcium and phosphate homeostasis, as well as cell growth regulation and cell differentiation of a wide spectrum of cell types. This review will discuss the full range of vitamin D compounds currently available, some of their possible uses, and potential mechanisms of action. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615933 Mon, 31 May 2010 23:00:00 +0100 3615933 http://www.medworm.com/index.php?rid=3615932&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000150%2Fabstract%3Frss%3Dyes This article reviews the role of vitamin D in the pathogenesis of T1D and T2D, focusing on the therapeutic potential for vitamin D in the prevention/intervention of T1D and T2D as well as its complications. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615932 Mon, 31 May 2010 23:00:00 +0100 3615932 http://www.medworm.com/index.php?rid=3615931&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000137%2Fabstract%3Frss%3Dyes Calcitriol (1,25-dihydroxyvitamin D3), the hormonally active form of vitamin D, exerts growth inhibitory and prodifferentiating effects on many malignant cells and retards tumor growth in animal models. Calcitriol is being evaluated as an anticancer agent in several human cancers. The mechanisms underlying the anticancer effects of calcitriol include inhibition of cell proliferation, stimulation of apoptosis, suppression of inflammation, and inhibition of tumor angiogenesis, invasion, and metastasis. This review discusses some of the molecular pathways mediating these anticancer actions of calcitriol and the preclinical data in cell culture and animal models. The clinical trials evaluating the use of calcitriol and its analogues in the treatment of patients with cancer are described. The r... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615931 Mon, 31 May 2010 23:00:00 +0100 3615931 http://www.medworm.com/index.php?rid=3615930&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000186%2Fabstract%3Frss%3Dyes Vitamin D deficiency is the most common nutritional deficiency and likely the most common medical condition in the world. The major cause of vitamin D deficiency has been the lack of appreciation that the body requires 5- to 10-fold higher intakes than is currently recommended by health agencies. There is now overwhelming and compelling scientific and epidemiologic data suggesting that the human body requires a blood level of 25(OH)D above 30 ng/mL for maximum health. To increase the blood level to the minimum 30 ng/mL requires the ingestion of at least 1000 IU of vitamin D per day for adults. In general, there is no downside to increasing either a child's or adult's vitamin D intake. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615930 Mon, 31 May 2010 23:00:00 +0100 3615930 http://www.medworm.com/index.php?rid=3615929&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000125%2Fabstract%3Frss%3Dyes This article describes some of the recent developments with respect to vitamin D and the immune system, and possible clinical implications. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615929 Mon, 31 May 2010 23:00:00 +0100 3615929 http://www.medworm.com/index.php?rid=3615928&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000071%2Fabstract%3Frss%3Dyes Vitamin D physiology has gained more importance and publicity than any of its counterparts in the water- and fat-soluble vitamin groups combined. This is partly because vitamin D deficiency is still widely prevalent in the developed world and the beneficial effects are thought to extend beyond the regulation of calcium and phosphorus homeostasis alone. Vitamin D deficiency becomes even more important in the various stages of chronic kidney disease (CKD); CKD itself is also on the increase. How vitamin D physiology is altered in CKD and how the various treatment modalities can alter the morbidity and mortality associated with CKD is the topic of discussion for this article. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615928 Mon, 31 May 2010 23:00:00 +0100 3615928 http://www.medworm.com/index.php?rid=3615927&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000113%2Fabstract%3Frss%3Dyes This article discusses the amount of vitamin D supplementation needed and the desirable 25-hydroxyvitamin D level to be achieved for optimal fracture prevention. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615927 Mon, 31 May 2010 23:00:00 +0100 3615927 http://www.medworm.com/index.php?rid=3615926&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000006X%2Fabstract%3Frss%3Dyes Two rare genetic diseases can cause rickets in children. The critical enzyme to synthesize calcitriol from 25-hydroxyvitamin D, the circulating hormone precursor, is 25-hydroxyvitamin D-1α-hydroxylase (1α-hydroxylase). When this enzyme is defective and calcitriol can no longer be synthesized, the disease 1α-hydroxylase deficiency develops. The disease is also known as vitamin D–dependent rickets type 1 or pseudovitamin D deficiency rickets. When the VDR is defective, the disease hereditary vitamin D–resistant rickets, also known as vitamin D–dependent rickets type 2, develops. Both diseases are rare autosomal recessive disorders characterized by hypocalcemia, secondary hyperparathyroidism, and early onset severe rickets. In this article, these 2 genetic childhood diseases, which p... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615926 Mon, 31 May 2010 23:00:00 +0100 3615926 http://www.medworm.com/index.php?rid=3615925&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000034%2Fabstract%3Frss%3Dyes Osteomalacia is an end-stage bone disease of chronic and severe vitamin D or phosphate depletion of any cause. Its importance has increased because of the rising incidence of vitamin D deficiency. Yet, not all cases of osteomalacia are cured by vitamin D replacement, and furthermore, not all individuals with vitamin D deficiency develop osteomalacia. Although in the past osteomalacia was commonly caused by malabsorption, nutritional deficiency now is more common. In addition, recent literature suggests that nutritional vitamin D deficiency osteomalacia follows various bariatric surgeries for morbid obesity. Bone pain, tenderness, muscle weakness, and difficulty walking are all common clinical manifestations of osteomalacia. Diagnostic work-up involves biochemical assessment of vitamin D st... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615925 Mon, 31 May 2010 23:00:00 +0100 3615925 http://www.medworm.com/index.php?rid=3615924&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000083%2Fabstract%3Frss%3Dyes The mother is the major source of circulating 25-hydroxyvitamin D concentration in the young infant. Maternal vitamin D status is an important factor in determining the vitamin D status of the infant and their risk of developing vitamin D deficiency and infantile nutritional rickets. There is evidence that the current supplementation recommendations, particularly for pregnant and lactating women, are inadequate to ensure vitamin D sufficiency in these groups. A widespread and concerted effort is needed to ensure daily supplementation of breastfed and other infants at high risk with vitamin D 400 IU from birth and of pregnant women in high-risk communities with 2000 IU. Future studies are required to determine the optimal doses of vitamin D supplementation in pregnancy and during lactation,... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615924 Mon, 31 May 2010 23:00:00 +0100 3615924 http://www.medworm.com/index.php?rid=3615923&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000101%2Fabstract%3Frss%3Dyes Vitamin D is obtained from cutaneous production when 7-dehydrocholesterol is converted to vitamin D3 (cholecalciferol) by ultraviolet B radiation or by oral intake of vitamin D2 (ergocalciferol) and D3. An individual's vitamin D status is best evaluated by measuring the circulating 25-hydroxyvitamin D (25(OH)D) concentration. Although controversy surrounds the definition of low vitamin D status, there is increasing agreement that the optimal circulating 25(OH)D level should be approximately 30 to 32 ng/mL or above. Using this definition, it has been estimated that approximately three-quarters of all adults in the United States have low levels. Low vitamin D status classically has skeletal consequences such as osteomalacia/rickets. More recently, associations between low vitamin D status an... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615923 Mon, 31 May 2010 23:00:00 +0100 3615923 http://www.medworm.com/index.php?rid=3615922&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000149%2Fabstract%3Frss%3Dyes The unique cis-triene structure of vitamin D and related metabolites makes it susceptible to oxidation, ultraviolet (UV) light-induced conformational changes, heat-induced conformational changes, and attacks by free radicals. Vitamin D2 is much less bioactive than vitamin D3 in humans. Metabolic activation and inactivation of vitamin D are well characterized and result in a plethora of metabolites, of which only 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) provide any clinically relevant information. 25(OH)D2 and 25(OH)D3 are commonly known as calcifediol and the 1,25(OH)2D metabolites as calcitriol. In this review the current state of the science on the clinical assessment of circulating 25(OH)D and 1,25(OH)2D is described. (Source: Endocrinology and Metabolism C... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615922 Mon, 31 May 2010 23:00:00 +0100 3615922 http://www.medworm.com/index.php?rid=3615921&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000095%2Fabstract%3Frss%3Dyes The actions of the vitamin D hormone 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) are mediated by the vitamin D receptor (VDR), a ligand-activated transcription factor that functions to control gene expression. After ligand activation, the VDR binds directly to specific sequences located near promoters and recruits a variety of coregulatory complexes that perform the additional functions required to modify transcriptional output. Recent advances in transcriptional regulation, which permit the unbiased identification of the regulatory regions of genes, are providing new insight into how genes are regulated. Surprisingly, gene regulation requires the orchestrated efforts of multiple modular enhancers often located many kilobases upstream, downstream, or within the transcription units themselves. T... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615921 Mon, 31 May 2010 23:00:00 +0100 3615921 http://www.medworm.com/index.php?rid=3615920&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000046%2Fabstract%3Frss%3Dyes This article reviews the role of vitamin D hydroxylases in providing a tightly regulated supply of 1,25(OH)2D3. The role of extrarenal 1α(OH)ase in placenta and macrophages is also discussed, as well as regulation of vitamin D hydroxylases in aging and chronic kidney disease. Understanding specific factors involved in regulating the hydroxylases may lead to the design of drugs that can selectively modulate the hydroxylases. The ability to alter levels of these enzymes would have therapeutic potential for the treatment of various diseases, including bone loss disorders and certain immune diseases. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615920 Mon, 31 May 2010 23:00:00 +0100 3615920 http://www.medworm.com/index.php?rid=3615919&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000162%2Fabstract%3Frss%3Dyes It is with great pleasure that I am afforded the opportunity to act as Guest Editor of this issue of Endocrinology and Metabolism Clinics of North America, entitled “Vitamin D.” This issue features internationally renowned experts who have graciously provided their expertise on a variety of topics related to the importance of vitamin D. Vitamin D initially was considered an essential nutrient that prevented rickets and osteomalacia. It was not until feedback loops were identified, between its production and parathyroid hormone, phosphate, and so forth, that it earned its place as a true endocrine hormone. Its importance, however, seemed to be forgotten until current social and economic conditions brought it back into the limelight with outbreaks of rickets and osteomalacia, even in dev... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615919 Mon, 31 May 2010 23:00:00 +0100 3615919 http://www.medworm.com/index.php?rid=3615918&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000174%2Fabstract%3Frss%3Dyes Drs Christakos, Ajibade, Dhawan, Fechner, and Mady review the metabolism of vitamin D. Hydroxylases are involved in converting the parent molecule to 25-OH vitamin D and then to 1,25-OH vitamin D, the active form. The regulation of these hydroxylases is still not well defined, and this area of research may be of value in considering new therapeutic possibilities, especially the possibility that vitamin D may be involved in many nonclassical functions, as described in this issue. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615918 Mon, 31 May 2010 23:00:00 +0100 3615918 http://www.medworm.com/index.php?rid=3615917&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000253%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615917 Mon, 31 May 2010 23:00:00 +0100 3615917 http://www.medworm.com/index.php?rid=3615916&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852910000241%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615916 Mon, 31 May 2010 23:00:00 +0100 3615916 http://www.medworm.com/index.php?rid=3615915&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985291000023X%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3615915 Mon, 31 May 2010 23:00:00 +0100 3615915 http://www.medworm.com/index.php?rid=3183324&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001236%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183324 Tue, 19 Jan 2010 14:14:33 +0100 3183324 http://www.medworm.com/index.php?rid=3183323&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000930%2Fabstract%3Frss%3Dyes Hugh Montgomery's discovery of the first of more than 239 fitness genes together with rapid advances in human gene therapy have created a prospect of using genes, genetic elements, and cells that have the capacity to enhance athletic performance (to paraphrase the World Anti-Doping Agency's definition of gene doping). This brief overview covers the main areas of interface between genetics and sport, attempts to provide a context against which gene doping may be viewed, and predicts a futuristic legitimate use of genomic (and possibly epigenetic) information in sport. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183323 Tue, 19 Jan 2010 14:14:33 +0100 3183323 http://www.medworm.com/index.php?rid=3183322&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000851%2Fabstract%3Frss%3Dyes Endurance athletes demonstrate an exceptional resistance to fatigue when exercising at high intensity. Much research has been devoted to the contribution of aerobic capacity for the economy of endurance performance. Important aspects of the fine-tuning of metabolic processes and power output in the endurance athlete have been overlooked. This review addresses how training paradigms exploit bioenergetic pathways in recruited muscle groups to promote the endurance phenotype. A special focus is laid on the genome-mediated mechanisms that underlie the conditioning of fatigue resistance and aerobic performance by training macrocycles and complements. The available data on work-induced muscle plasticity implies that different biologic strategies are exploited in athletic and untrained population... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183322 Tue, 19 Jan 2010 14:14:33 +0100 3183322 http://www.medworm.com/index.php?rid=3183321&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001078%2Fabstract%3Frss%3Dyes This article discusses the inevitable use of growth factors for enhancing muscle strength and athletic performance. Much effort has been expended on developing a treatment of muscle wasting associated with a range of diseases and aging. Frailty in the aging population is a major socioeconomic and medical problem. Emerging molecular techniques have made it possible to gain a better understanding of the growth factor genes and how they are activated by physical activity. The ways that misuse of growth factors may be detected and verified in athletes and future challenges for detecting manipulation of signaling pathways are discussed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183321 Tue, 19 Jan 2010 14:14:33 +0100 3183321 http://www.medworm.com/index.php?rid=3183320&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985290900108X%2Fabstract%3Frss%3Dyes The female athlete triad is an increasingly prevalent condition involving disordered eating, amenorrhea, and osteoporosis. An athlete can suffer from all 3 components of the triad, or just 1 or 2 of the individual conditions. The main element underlying all the aspects of the triad is an adaptation to a negative caloric balance. Screening for these disorders should be an important component of an athlete's care. Prevention and treatment should involve a team approach, including a physician, a nutritionist, and a mental health provider. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183320 Tue, 19 Jan 2010 14:14:33 +0100 3183320 http://www.medworm.com/index.php?rid=3183319&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000875%2Fabstract%3Frss%3Dyes This article discusses procedures for monitoring recombinant erythropoietin and its analogues in doping for athletic performance. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183319 Tue, 19 Jan 2010 14:14:33 +0100 3183319 http://www.medworm.com/index.php?rid=3183318&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000917%2Fabstract%3Frss%3Dyes Dehydroepiandrosterone (DHEA) is secreted by the zona reticularis of the adrenal cortex and is converted into potent sex steroids in peripheral target cells. As oral DHEA administration can lead to dose-dependent increases in circulating androgens, which may reach high supraphysiologic levels in women, it has been included in the list of prohibited substances by the World Anti-Doping Agency (WADA). However, evidence for an ergogenic activity of DHEA is still largely nonexistent. Randomized trials in elderly subjects with an age-dependent decrease in DHEA have provided little or no evidence for enhanced physical performance after long-term administration of DHEA, 50 mg/d, and smaller short-term studies in healthy male athletes using higher doses were completely negative. Thus the widely per... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183318 Tue, 19 Jan 2010 14:14:33 +0100 3183318 http://www.medworm.com/index.php?rid=3183317&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS088985290900084X%2Fabstract%3Frss%3Dyes This article shows that there is scientific evidence that GCs mediate ergogenic effects in animals and humans. Moreover, the health risks of using GCs are well characterized. GCs are doping agents and should remain on the World Antidoping Agency's list of banned products. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183317 Tue, 19 Jan 2010 14:14:33 +0100 3183317 http://www.medworm.com/index.php?rid=3183316&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000942%2Fabstract%3Frss%3Dyes Stimulants have been frequently detected in doping control samples and represent a structurally diverse class of compounds. Comprehensive sports drug-testing procedures have been developed using gas or liquid chromatography combined with mass spectrometric detection, and they have revealed various adverse analytical findings, as demonstrated with 2 examples, 4-methylhexan-2-amine and methoxyphenamine. Moreover, the necessity of controlling the use or misuse of stimulating agents is outlined by means of pseudoephedrine, a compound that was prohibited in sports until the end of 2003. Since the ban was lifted, monitoring programs proved a significant increase in pseudoephedrine applications as determined from urine samples collected in competition. As a consequence, a reimplementation of this... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183316 Tue, 19 Jan 2010 14:14:32 +0100 3183316 http://www.medworm.com/index.php?rid=3183315&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000887%2Fabstract%3Frss%3Dyes The potential ergogenic effects of asthma medication in athletes have been controversially discussed for decades. The prevalence of asthma is higher in elite athletes than in the general population. The highest risk for developing asthmatic symptoms is found in endurance athletes and swimmers. In addition, asthma seems to be more common in winter-sport athletes. Asthmatic athletes commonly use inhaled β2-agonists to prevent and treat asthmatic symptoms. However, β2-agonists are prohibited according to the “Prohibited List of the World Anti-Doping Agency” (WADA). Until the end of 2009 an exception was only allowed for the substances formoterol, salbutamol, salmeterol, and terbutaline by inhalation, as long as a so-called therapeutic use exemption has been applied for and was granted b... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183315 Tue, 19 Jan 2010 14:14:32 +0100 3183315 http://www.medworm.com/index.php?rid=3183314&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001091%2Fabstract%3Frss%3Dyes The Athlete Biological Passport (ABP) is an individual electronic document that collects data regarding a specific athlete that is useful in differentiating between natural physiologic variations of selected biomarkers and deviations caused by artificial manipulations. A subsidiary of the endocrine module of the ABP, that which here is called Athlete Steroidal Passport (ASP), collects data on markers of an altered metabolism of endogenous steroidal hormones measured in urine samples. The ASP aims to identify not only doping with anabolic–androgenic steroids, but also most indirect steroid doping strategies such as doping with estrogen receptor antagonists and aromatase inhibitors. Development of specific markers of steroid doping, use of the athlete's previous measurements to define indi... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183314 Tue, 19 Jan 2010 14:14:29 +0100 3183314 http://www.medworm.com/index.php?rid=3183313&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001108%2Fabstract%3Frss%3Dyes Testosterone is the principal male sex hormone. As with all natural steroids, it is biosynthesized from cholesterol. Phase I metabolism employs some very specific enzymes and pathways. Phase II metabolism and excretion follow more general patterns. The effects of testosterone are twofold: anabolic and androgenic. Because of its anabolic effects, testosterone is frequently abused in sports. Because of its endogenous nature, testosterone doping is difficult to detect. The standard procedure is based on the evaluation of the urinary steroid profile. Conspicuous samples then are submitted to compound-specific 13C/12C analysis. Synthetic and endogenous steroids differ in this measure. Numerous xenobiotic compounds have been derived from testosterone. The modifications typically aim at a reducti... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183313 Tue, 19 Jan 2010 14:14:29 +0100 3183313 http://www.medworm.com/index.php?rid=3183312&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000863%2Fabstract%3Frss%3Dyes It is believed that insulin and insulin-like growth factor I (IGF-I) are abused by professional athletes, either alone or in combination with growth hormone (GH) and anabolic steroids. The recent introduction of IGF-I to clinical practice is likely to increase its availability and abuse. Insulin and IGF-I work together with GH to control the supply of nutrients to tissues in the fasted and fed state. The actions of insulin and IGF-I that may enhance performance include increased protein anabolism and glucose uptake and storage. The detection of IGF-I and insulin abuse is challenging. There are established mass spectrometry methods for insulin analogs. The feasibility of using GH-dependent markers to detect IGF-I use is being assessed. (Source: Endocrinology and Metabolism Clinics of North ... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183312 Tue, 19 Jan 2010 14:14:29 +0100 3183312 http://www.medworm.com/index.php?rid=3183311&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000899%2Fabstract%3Frss%3Dyes Catching athletes abusing human growth hormone (GH) by official antidoping tests is challenging because of specific properties of the hormone. Furthermore, the chemical structure of recombinant GH (rGH) is identical to that of the main GH isoform secreted by the pituitary, making it difficult to discriminate between endogenous and injected GH molecules by biochemical tests. The approaches developed to solve the problem include the “marker approach,” which measures changes in concentration of GH-dependent proteins that are inappropriately elevated after rGH injection, and the “isoform approach,” which detects changes in the spectrum of circulating GH isoforms after administration of rGH. A more widespread use of these tests in out-of-competition controls will enhance the likelihood ... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183311 Tue, 19 Jan 2010 14:14:29 +0100 3183311 http://www.medworm.com/index.php?rid=3183310&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000905%2Fabstract%3Frss%3Dyes Human growth hormone (GH) is widely abused by athletes; however, there is little evidence that GH improves physical performance. Replacement of GH in GH deficiency improves some aspects of exercise capacity. There is evidence for a protein anabolic effect of GH in healthy adults and for increased lean body mass following GH, although fluid retention likely contributes to this increase. The evidence suggests that muscle strength, power, and aerobic exercise capacity are not enhanced by GH administration, however GH may improve anaerobic exercise capacity. There are risks of adverse effects of long-term abuse of GH. Sustained abuse of GH may lead to a state mimicking acromegaly, a condition with increased morbidity and mortality. (Source: Endocrinology and Metabolism Clinics of North America... Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183310 Tue, 19 Jan 2010 14:14:29 +0100 3183310 http://www.medworm.com/index.php?rid=3183309&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000929%2Fabstract%3Frss%3Dyes This article describes the worldwide endeavor to combat doping in sports. It describes the historical reasons the movement began and outlines the current status of this effort by international sports groups, governments, and the World Anti-Doping Agency. The purposes, strengths, and limitations of the various entities are illustrated; and recommendations for improvements are made. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183309 Tue, 19 Jan 2010 14:14:29 +0100 3183309 http://www.medworm.com/index.php?rid=3183308&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001145%2Fabstract%3Frss%3Dyes The extensive use of drugs in society, and specifically in sport, is by no means a new phenomenon. What has changed, however, are the methods applied, and the drugs used are now more sophisticated. Throughout history there are plenty of indications that athletes have used “magic” potions to give them an extra punch to gain an unfair advantage and hopefully win. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183308 Tue, 19 Jan 2010 14:14:29 +0100 3183308 http://www.medworm.com/index.php?rid=3183307&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001157%2Fabstract%3Frss%3Dyes Doping in sports has a long history, and Drs. Kamber and Mullis describe the history of the abuse and the establishment of world bodies that arose as anti-doping regulators. The World Anti-doping Agency (WADA) was created following years of scandals and controversy. Its job is to test and regulate doping in sport—a very challenging task! This historical perspective is a great introduction to the topic of this issue. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183307 Tue, 19 Jan 2010 14:14:28 +0100 3183307 http://www.medworm.com/index.php?rid=3183306&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001224%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183306 Tue, 19 Jan 2010 14:14:28 +0100 3183306 http://www.medworm.com/index.php?rid=3183305&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001212%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3183305 Tue, 19 Jan 2010 14:14:28 +0100 3183305 http://www.medworm.com/index.php?rid=3035055&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909001029%2Fabstract%3Frss%3Dyes (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3035055 Sat, 28 Nov 2009 14:10:21 +0100 3035055 http://www.medworm.com/index.php?rid=3035054&cid=s_33223_15_f&fid=33223&url=http%3A%2F%2Fwww.endo.theclinics.com%2Farticle%2FPIIS0889852909000723%2Fabstract%3Frss%3Dyes Congenital hypothyroidism and congenital adrenal hyperplasia are included in many newborn screening (NBS) panels worldwide and in all state-sponsored programs in the United States. Both conditions meet the fundamental prerequisites for NBS: high incidence in the population; biomarkers in the dried blood specimen that are easily detected; and, effective therapies to lessen, if not prevent, the sequelae of late or no treatment. In this review, the history of NBS is discussed for these 2 conditions. The technologies and protocols used in their detection, and related subjects such as genetics, and treatment and outcomes, are also discussed. (Source: Endocrinology and Metabolism Clinics of North America) Endocrinology and Metabolism Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3035054 Sat, 28 Nov 2009 14:10:21 +0100 3035054