Searchable abstracts of presentations at key conferences in endocrinology
15th International & 14th European Congress of Endocrinology
ea0029mte1 | (1) | ICEECE2012
Adrenal incidentaloma and subclinical Cushing’s syndrome
The widespread use of abdominal CT/ MRI has resulted in a new and common diagnosis for the clinical endocrinologist the management of patients with adrenal incidentalomas. Defined as an adrenal mass discovered incidentally in the work-up or treatment of clinical conditions not related to suspicion of adrenal disease, incidentalomas cover a spectrum of underlying adrenal pathologies with a common pathway of discovery. Because of the risk of malignancy, they raise uncerta...
ea0029mte2 | (1) | ICEECE2012
Approach to the patient with Cushing’s disease after pituitary surgery failure
The treatment of choice for ACTH-producing pituitary adenoma is selective transsphenoidal adenomectomy. The remission rate after transsphenidal surgical intervention for Cushings disease ranges from 69 to 98% (average 83%). If the first pituitary surgical intervention fails, the following questions should be answered: i) Is the localization diagnosis correct without doubt (pituitary or ectopic source of ACTH- overproduction)? ii) Is it reasonable to recommend repeat pitu...
ea0029mte4 | (1) | ICEECE2012
Challenges of transsphenoidal pituitary surgery
The endoscopic endonasal approach, initially reserved only for sellar lesions, is a continuous evolving speciality of modern neurosurgery, which requires precise anatomical knowledge, technical skills and integrated appreciation of the pathology dealt with. Nowadays, it represents a minimally invasive approach to deal with several diseases interesting mostly the entire skull base namely the suprasellar, retrosellar and parasellar spaces obviating brain retraction...
ea0029mte5 | (1) | ICEECE2012
Meet the expert: discussion of common but difficult thyroid cancer cases
Endocrinologists today face an ever increasing variety of presentations of thyroid cancer related to the well documented increasing frequency of thyroid cancer patients worldwide. The overwhelming majority of these tumors are small microcarcinomas with excellent prognosis for which management is quite straightforward. But many patients are seen for whom optimal steps for management are unclear, constituting therapeutic dilemmas that are typically not well addressed in current ...
ea0029mte6 | (1) | ICEECE2012
Clinical management of adrenocortical carcinoma
A thorough pre-operative hormonal workup is advised following the recommendations of the European Network for the Study of Adrenal Tumors. Demonstration of endocrine activity may serve to the following purposes: i) prove adrenocortical origin of the mass; ii) suggest malignancy, in the event of androgen hypersecretion; iii) provide tumor markers whose assessment may be exploited during follow-up to detect tumor residual or recurrence after surgery; iv) avoid life-threatening p...
ea0029mte7 | (1) | ICEECE2012
Pregnancy and pituitary disorders
The pituitary gland is altered by both anatomical and physiological changes during pregnancy. The most striking finding is the physiological enlargement of the pituitary gland as a result of lactotroph hyperplasia. Hormonal evaluation of pregnant women requires special consideration due to the emergence of the placenta as a new source of hormone production, changes in binding globulin levels and resistance to hormones such as glucocorticoids.Pituitary ad...
ea0029mte9 | (1) | ICEECE2012
Diagnosis and management of SIADH
Hyponatraemia is the commonest electrolyte abnormality in clinical practice; epidemiological data would suggest that SIAD is the commonest cause of hyponatraemia, and it is particularly important in patients undergoing neurosurgery, in whom SIAD is common. Recent data has shown that even mild hyponatraemia (plasma sodium 125135 mmol/l) is associated with gait instability, falls, fractures, osteoporosis and increased mortality. This has led to the recognition that correct...
ea0029mte10 | (1) | ICEECE2012
Elastosonography in the evaluation of thyroid and parathyroid lesions
Finding of a firm nodule during palpation of the thyroid gland is one of the clues for malignancy. In addition to palpation, as a new imaging technique, tissue stiffness can be evaluated by ultrasound elastography (USE); thereby helping us further to detect firm thyroid nodules, even the non-palpable ones. Tissue stiffness is detected by USE through measuring the amount of distortion that occurs when the lesions is subjected to external pressure. The power of USE in detecting ...
ea0029mte11 | (1) | ICEECE2012
Diagnosis and treatment considerations in autoimmune polyendocrine syndrome type 1
Autoimmune polyendocrine syndrome type I (APS-1) is a rare autosomal recessive disorder which starts in early childhood, typically associated with chronic mucocutaneous Candidiasis. Patients with APS-1 later develop autoimmunity against endocrine tissues such as the adrenal cortex and the ovaries, and non-endocrine tissues such as the liver and melanocytes. The disease is caused by mutations in the autoimmune regulator (AIRE) gene that encodes a 54 kDa protein expressed in thy...
ea0029mte13 | (1) | ICEECE2012
Graves’ ophthalmopathy
Management of Graves ophthalmopathy (GO) requires knowledge of smoking behaviour, thyroid function and antibodies, and activity and severity of the ophthalmopathy.Smokers should be strongly adviced to stop smoking because outcome of Graves disease is less favourable in smokers compared to nonsmokers.High serum concentrations of TSH receptor antibodies (TBII) are associated with a more severe and protracted course of GO....
ea0029mte14 | (1) | ICEECE2012
Hirsutism
Hirsutism, affects 58% of the whole female population, results either from an increase in circulating androgen concentrations, an increase in the sensitivity of the pilosebaceous unit to normal androgen concentrations or a combination of these factors. Polycystic ovary syndrome (PCOS) is the underlying cause in vast majority of the patients with hirsutism. PCOS can only be diagnosed after exclusion of some other diseases such as non-classical congenital adrenal hyperplas...
ea0029mte15 | (1) | ICEECE2012
Pituitary tumours in adolescents and adults
Pituitary tumours are usually benign, but aggressive local growth may occur. Malignancy with demonstrable extracranial metastases is rarely seen. Tumour formation is probably the result of genetic changes involving tumour suppressor gene inactivation and oncogene activation. Pituitary adenomas that occur in a familial setting account for 45% of the tumours, they can be part of endocrine-related tumour syndromes. In 2006, Vierimaa et al.1 reported the re...
ea0029mte16 | (1) | ICEECE2012
Management of non-functioning pituitary adenomas
Non-functioning pituitary adenomas (NFAs) are benign pituitary neoplasms arising from the adenohypophyseal cells. They are not associated with clinical evidence of hormonal hypersecretion and have a prevalence of 22 cases per 100,000 people. At presentation, the majority is macroadenomas and their clinical manifestations are the result of pressure effects to surrounding structures.Management options include observation, surgical removal combined or not w...
ea0029mte17 | (1) | ICEECE2012
Multiple endocrine neoplasia type 2
Multiple endocrine neoplasia type 2 (MEN 2) is an autosomal dominant hereditary cancer syndrome caused by missense gain-of-function mutations of the RET proto-oncogene, encoding a receptor tyrosine kinase, on chromosome 10. It has a strong penetrance of medullary thyroid carcinoma (MTC) and can be associated with bilateral pheochromocytoma and primary hyperparathyroidism. MEN 2 is divided into three varieties depending on clinical features: MEN 2A, MEN2B and FMTC (familial MTC...
ea0029mte18 | (1) | ICEECE2012
Normocalcemic primary hyperparathyroidism
Normocalcemic primary hyperparathyroidism (NC-PHPT) is a condition characterized by normal albumin-adjusted total serum calcium or ionized calcium and persistently elevated serum PTH. Therefore, to recognize this entity it is necessary to measure PTH in normocalcemic individuals. The question arises why would someone measure PTH in a normocalcemic subject? A pro-active approach to women evaluated in their early postmenopausal years for parameters of skeletal health as well as ...
ea0029mte20 | (1) | ICEECE2012
The diagnosis and treatment of secondary osteoporosis in children
There is increasing awareness that children with chronic illnesses, particularly those with glucocorticoid use and neuromuscular disorders, have the potential to develop significant bone fragility due to osteoporosis. In such cases, osteoporosis manifests as low-trauma extremity fractures, with vertebral fractures an under-recognized consequence of reduced bone strength. We have studied the Genant semi-quantitative classification for characterizing vertebral fractures in child...
ea0029mte21 | (1) | ICEECE2012
Autoimmune hyperthyroidism: initiation and duration of thionamide therapy
Graves disease is a common autoimmune disorder with autoimmunity against the TSH-receptor being a central pathogenetic element. The disease may present with a number of clinical manifestations, among which hyperthyroidism caused by TSH-receptor stimulating antibodies is the most prevalent. The disease is common in all adult ages and affects women 45 times more often than men.In many countries the preferred initial therapy of the hyperthyroidi...
ea0029mte22 | (1) | ICEECE2012
Clinical management in transgender sex hormone treatment
Gender Identity Disorder (GID) is a condition in which a person experiences discongruency between their assigned sex and what they feel their genderidentity is. A person with gender dysphoria experiences persistently uncomfortable feelings about their birth gender (Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) (American Psychiatric Association, 1994).During the real life experience hormonal treatment starts an...
ea0029mte23 | (1) | ICEECE2012
Subclinical hypothyroidism
Subclinical hypothyroidism (SHypo) is characterized by elevated serum TSH and thyroid hormone levels at the lower limit but within their respective reference range.It is necessary to distinguish between patients with mildly increased serum TSH levels (59 mU/L) and patients with more severely increased serum TSH levels (10 mU/l or higher). About 75% of all SHypo patients have mild disease.The high prevalence (between 4 and 20%...
ea0029mte24 | (1) | ICEECE2012
Approach to the management of the infertile couple
Infertility is defined by the World Health Organization (WHO) as the inability of a couple to achieve conception or bring a pregnancy to term after 1 year or more of regular, unprotected sexual intercourse. It remains a major clinical and social problem, affecting 1315% of couples worldwide. Evaluation usually starts after 12 months, although it might be indicated earlier. The most common causes of infertility are divided into: male factor, related to sperm abnormalities...
ea0029mte25 | (1) | ICEECE2012
Pituitary incidentalomas
During the past several years the wide application of sensitive brain imaging techniques (CT, MRI) has led to an increasing recognition of asymptomatic lesions in the pituitary. Although their etiology covers a wide range of pathologies, most incidentally discovered pituitary lesions are benign adenomas, ranging in size from micro- (<10 mm) to macro- (>10 mm) adenomas. Micro-incidentalomas are very common, with a reported incidence in normal individuals of 420%. ...
ea0029mte27 | (1) | ICEECE2012
Differential diagnosis of Cushing’s syndrome
The characteristics of Cushings syndrome (CS) pathophysiology, the heterogeneity of its clinical presentation and the different patterns of ACTH and cortisol secretion independently of the cause make the diagnosis of ACTH-dependent CS a difficult task in some cases. Clinical symptoms are not always specific enough to establish the diagnosis. 1 mg DEX suppression is one of the most used tests for CS screening. Nocturnal salivary cortisol may be used, but its accuracy has ...
ea0029mte29 | (1) | ICEECE2012
Management of bone loss induced by cancer treatment in early breast and prostate cancer
Patients with endocrine-related cancers are notably at increased risk for developing osteoporosis as a complication from their adjuvant anticancer treatment, especially aromatase inhibitors (AIs) in early breast cancer (EBC) and androgen deprivation therapy (ADT) in early prostate cancer (EPC). AI-induced bone loss (AIIBL) occurs at a rate at least 2-fold higher than bone loss seen in healthy, age-matched postmenopausal women and they have a more than 30% higher risk of fractu...
ea0029mte30 | (1) | ICEECE2012
Treatment of vitamin D deficiency
The need for treating vitamin D deficiency arises either when patients present with musculoskeletal symptoms attributable to hypovitaminosis D or when screening of individuals at high risk reveals the presence of vitamin D deficiency, as defined by serum 25(OH)D levels <20 ng/ml. The recommended dietary intakes of vitamin D vary with age and physiological state. The recommended daily intake ranges from 400 IU in infants, 600 IU in children and adults and 800 IU in those ov...
ea0029mte31 | (1) | ICEECE2012
Cryptorchidism
Normal position of the testes at term birth is on the bottom of the scrotum. In 29% of newborn boys, the testes have failed to descend normally (cryptorchidism), and at the age of three months, 13% of all boys remain cryptorchid. Thereafter spontaneous descent occurs rarely, whereas testicular ascent starts to appear and acquired cryptorchidism becomes a problem almost as often as congenital disorder. Cryptorchidism is associated with an increased risk of testicula...
ea0029mte32 | (1) | ICEECE2012
Management of GEP-NET tumors
Neuroendocrine gastro-enteropancreatic tumors constitute a diverse group of malignant neoplasms with a common feature of hormone production and release. The incidence and prevalence have constantly increased over the last decades with an incidence of about 6/100 000 and a prevalence of 35/100 000 inhabitants. The majority of patients present a metastatic disease at diagnosis. The most common subtypes of GEP-NETs are small intestinal NETs (carcinoids) followed by pancreatic and...
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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