Searchable abstracts of presentations at key conferences in endocrinology
ea0026mte1 | (1) | ECE2011
Pros and cons of bariatric surgery
Bariatric surgery has become the most effective therapeutic option for morbid obesity (BMI > 40 or >35 with major complications). All established surgical techniques are followed by significant body weight reduction as well as clear improvement /remission of main obesity-associated comorbidities such as type 2 diabetes (DM2), dyslipidaemia, hypertension, sleep apnoea and cardiac dysfunction. Mixed restrictive-malabsorptive techniques, such as Roux-en Y-gastric bypass (...
ea0026mte2 | (1) | ECE2011
Primary hyperaldosteronism
It is now widely recognized that primary aldosteronism (PA) is much more common than previously thought, accounting for up to 510% of hypertensives with most patients normokalemic, and that aldosterone excess has adverse cardiovascular consequences that go above and beyond hypertension development. These findings have supported the concept that PA plays an important role in cardiovascular disease states and should be systematically sought and specifically treated. In rec...
ea0026mte3 | (1) | ECE2011
Management difficulties in recurrences and metastases of thyroid cancer
Patients with thyroid carcinoma are usually considered as having a good prognosis although the disease may take an aggressive course. Indeed, 527% of patients develop locoregional recurrences located in cervical lymph nodes (6075%), thyroid bed (20%) and trachea or muscle (5%), thus worsening the prognosis. Distant metastases develop in 10% of patients and are located mainly in the bones and the lungs but also in the liver leading to a risk of cancer-related death....
ea0026mte4 | (1) | ECE2011
Mass spectrometry in the measurement of hormones
Endocrinology came to its third revolution in the field of hormone determination. As radioimmunoassays in the 60s paved the way to the knowledge of modern endocrinology, and as automated immunoassays in the 70s linked analytical measurement to the clinical practice, nowadays liquid chromatography tandem mass spectrometry (LCMS/MS) represents the evolution of the high-throughput approach, typical of automated platforms, toward the high reliability and specificity o...
ea0026mte6 | (1) | ECE2011
Difficult adrenal cases
Objective: To present 2 difficult adrenal cases in an interactive computer-based CPC format.Methods: The history of present illness will be presented for 2 patients: i) A 24-year-old woman who is 13 weeks pregnant presenting with spells and marked hypertension; ii) A 56-year-old man with hypertension, hypokalemia, and renal insufficiency. For the details of these cases, please see the Meet-the-expert handbook.Results: The attendees...
ea0026mte7 | (1) | ECE2011
When to instigate insulin therapy in DM2
The main pathophysiological feature of type 2 diabetes mellitus is based on combination of impaired β-cell insulin secretion and insulin action in peripheral tissues. However, as progressive loss of the β-cells developes as a consequence of apoptosis, the insulin supply is later necessary. This picture is completely different in type 1 diabetes when insulin insufficiency is developed early in the disease and exogenous insulin is exagerated to maintain metabolic homeo...
ea0026mte8 | (1) | ECE2011
Pathogenesis and management of primary ovarian failure
Primary ovarian failure (POF) is defined as a premature ovarian defect characterized by absent menarche (primary amenorrhea) or secondary amenorrhea lasting at least 6 months associated with a premature depletion of ovarian follicles before the age of 40 years. POF is a frequent disease affecting female fertility and well-being and generating several co-morbidities. Since the onset of POF is frequently silent and fertility defects occur in the occult phases of the disease seve...
ea0026mte9 | (1) | ECE2011
Pleiotropic effects of vitamin D
Vitamin D is phylogenetically an old compound present in simple organisms without skeleton for millions of years. Its primary function, acting as a cytokine, has been the defence against microbial invaders. Vitamin D modulates the innate immune response by inducing the synthesis of endogenous antibiotics in monocytes-macrophages. Epithelial barrier tissues in lung, gut, placenta and skin employ the same antimicrobial mechanisms. Vitamin D also interacts with dendri...
ea0026mte10 | (1) | ECE2011
Biomarkers of thyroid malignancy
This topic will be discussed taking into consideration the need to incorporate the continuously increasing molecular data in the old frame (imagiology, cyto and histopathology and biochemistry). Using this strategy three practical issues may be addressed: diagnosis, prognosis/therapy selection and surveillance.Out of the above mentioned issues we will focus the discussion of the usefulness of molecular markers in two steps of the management of patients w...
ea0026mte11 | (1) | ECE2011
Prolactin and breast tumorogesis: a novel concept of prolactin biology
Prolactin was discovered 80 years ago. It is currently viewed by clinical endocrinologists as a hormone of pituitary origin, whose production is negatively controlled by dopamine, whose biological actions relate exclusively to lactation and reproductive functions, for which any genetic disorder is yet to be identified, and whose unique associated pathology is hyperprolactinemia, which is efficiently cured using dopamine agonists. Although there is no debate about the relevance...
ea0026mte12 | (1) | ECE2011
Treatment strategies for obesity
Overweight and obesity have become an increasingly serious clinical and socioeconomic problem worldwide. Recent systematic analysis of health examination surveys demonstrated that in 2008 an estimated 1.46 billion adults worldwide had BMI of 25 kg/m2 or greater, of these 205 million men and 297 million women were obese. Overweight and obese patients are at increased risk for developing various co-morbidities (type 2 diabetes, hypertension, dyslipidemia, cardiovascul...
ea0026mte13 | (1) | ECE2011
Hyponatraemia
Hyponatraemia is the commonest electrolyte abnormality in hospitalised patients, with a prevalence of 2030% and particularly high incidence in neurosurgical, pulmonary, geriatric, intensive care and oncology units. Up to 6% of patients have severe hyponatraemia (plasma sodium <125 mmol/l). A wealth of data is available which indicates that severe hyponatraemia is associated with cerebral irritation, causing confusion, coma and seizures, and significant excess mortali...
ea0026mte14 | (1) | ECE2011
Graves’ ophthalmopathy (GO)
Immunopathogenesis: Orbital fibroblasts are recognized as the prime target cells of the autoimmune attack. There is good circumstantial evidence that autoimmunity against the TSH receptor is primarily involved, but a suitable animal model of GO is lacking. Autoimmunity against the IGF-1 receptor is nonspecific for Graves disease, but might contribute to the immune response in the orbit.Diagnosis: Diagnosis of GO is based on: i) assessment of eye ch...
ea0026mte15 | (1) | ECE2011
Cushing’s
Cushing syndrome (CS) is associated with systemic complications, like central obesity, moon face, limb atrophy, increased fat mass and reduced bone and lean body mass, excessive fatigue, purple striae, easy bruising and skin ulceration, hirsutism, hypogonadism and decreased libido. Morbidity like hypertension, insulin resistance and/or diabetes mellitus, dyslipidemia, prothrombotic state, vascular disease, atherosclerosis and increased cardiovascular risk, acquired...
ea0026mte16 | (1) | ECE2011
Endocrine care in HIV-infected patients
Several co-morbidities are associated with the HIV infection involving also the endocrine-metabolic system. Consistently, the recent development of HAART therapy ruled out a significant improvement both in the prognosis and life expectancy of HIV-infected patients, but disclosed also new serious drug-related toxicity. Of these, the lipodystrophy syndrome is the most frequent, occurring in up to 83% of HIV-infected patients under HAART. HIV-related lipodystrophy is associated w...
ea0026mte17 | (1) | ECE2011
Management of phaeochromocytomas and paragangiolomas
Pheochromocytomas (PH) and functional paragangliomas (PGL) are neoplasms of chromaffin tissue that synthesize catecholamines. The diagnosis of PH or functional PGL is based on the determination of metanephrines. Most catecholamine-secreting tumors arise in the adrenal glands (PH proper) and are easily detected by computed tomography or magnetic resonance imaging. Patients may also harbor extraadrenal primary tumors (PGL) or distant metastases. Adrenal imaging should therefore ...
ea0026mte18 | (1) | ECE2011
Weird thyroid function tests
Gurnell Mark , Chatterjee Krish
Although overt thyroid disease is easily recognised, lesser disturbances of thyroid function can prove difficult to diagnose and be mimicked by other endocrine and non-endocrine disorders. Establishing the correct diagnosis depends on accurate interpretation of thyroid function tests (TFTs), which is usually straightforward; however, in a minority of situations, the results of FT4, FT3 and TSH measurement either do not fit with the clinical picture and/or appear di...
ea0026mte19 | (1) | ECE2011
Management of primary hyperparathyroidism
The clinical presentation of primary hyperparathyroidism (PHPT) has changed dramatically after increased accessibility to biochemical auto-analysers and the diagnosis is today often made by change in patients without specific symptoms. Operative treatment is recommended in patient with markedly increased calcium levels or typical symptoms. However, the vast majority of patients in the modern clinic do not present organ related symptoms and their calcium levels are only slightl...
ea0026mte20 | (1) | ECE2011
Glucocorticoid replacement therapy
The glucocorticoid replacement therapy has been virtually unchanged since the invention of cortisone 60 years ago. Studies in patients with primary adrenal insufficiency have indicated increased mortality and unfavourable metabolic effects such as reduced bone mineral density, and evidence has accumulated that these patients suffer from reduced health-related quality of life (HRQoL). Although these endpoints possibly relate to inappropriate glucocorticoid therapy, the impact o...
ea0026mte21 | (1) | ECE2011
To whom to offer genetic analysis in patients with pituitary adenoma
Genetic predisposition to pituitary adenomas is increasingly recognized and extends beyond diseases such as MEN1 and Carney complex to familial isolated pituitary adenomas (FIPA). A genetic predisposition occurs in >5% of all pituitary adenoma cases, with MEN1 and FIPA comprising the vast majority of these. The identification of the AIP gene as a predisposition gene for pituitary adenomas in 1525% of FIPA kindreds and in a significant number of young patients ...
ea0026mte22 | (1) | ECE2011
Diabetes and the genome: any use for our patients?
The study of the genetics of diabetes, in its different forms, has produced a huge amount of data only very recently and new information is becoming available as this text is being written. The question, at this time, is: are they any good to our patients?As the study of the genetics of a disease progresses, one would expect several clinical applications, the most obvious being improved prediction and diagnosis, as well as tailored treatment of the disea...
ea0026mte23 | (1) | ECE2011
Transgenic animals in endocrinology
Mice have been used as a model system in biomedicine for several decades. As mammals their relevance to human endocrinology is substantially greater than many other model systems such as flies, worms and yeast. Mice are also easily adapted to various experimental conditions with human relevance. Most importantly, the mouse genome is well annotated, it can be precisely engineered by several powerful ways, and international consortia have recently produced variety novel tools fo...
ea0026mte24 | (1) | ECE2011
Stem cell biology
Cell therapy with Embryonic, Adult or iPSs Stem cells? As knowledge and scientific data start to increase the answer to that question seems still far away. Although all of them have in common their pluripotenciality and their infinite growth in vitro, the physiological regulation of stem cells in vivo is not really defined. Embryonic stem cells isolated from different steps from the initial embryonic development present in culture some different properties. New studies ...
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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