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Journals Best Practice & Research. Clin...

Best Practice & Research. Clinical Endocrinology & Metabolism

https://read.qxmd.com/read/38575404/predictors-of-biochemical-response-to-somatostatin-receptor-ligands-in-acromegaly
#1
REVIEW
Mónica Marazuela, Rebeca Martínez-Hernandez, Montserrat Marques-Pamies, Betina Biagetti, Marta Araujo-Castro, Manel Puig-Domingo
Although predictors of response to first-generation somatostatin receptor ligands (fg-SRLs), and to a lesser extent to pasireotide, have been studied in acromegaly for many years, their use is still not recommended in clinical guidelines. Is there insufficient evidence to use them? Numerous biomarkers including various clinical, functional, radiological and molecular markers have been identified. The first ones are applicable pre-surgery, while the molecular predictors are utilized for patients not cured after surgery...
March 19, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38521632/genetic-diagnosis-in-acromegaly-and-gigantism-from-research-to-clinical-practice
#2
REVIEW
Claudia Ramírez-Rentería, Laura C Hernández-Ramírez
It is usually considered that only 5% of all pituitary neuroendocrine tumours are due to inheritable causes. Since this estimate was reported, however, multiple genetic defects driving syndromic and nonsyndromic somatotrophinomas have been unveiled. This heterogeneous genetic background results in overlapping phenotypes of GH excess. Genetic tests should be part of the approach to patients with acromegaly and gigantism because they can refine the clinical diagnoses, opening the possibility to tailor the clinical conduct to each patient...
March 13, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38443225/real-world-value-of-cabergoline-in-the-treatment-of-acromegaly
#3
REVIEW
Ilan Shimon
Cabergoline is an ergot derivative long-acting dopamine receptor 2 (DR2) selective agonist administered orally and widely used for the treatment of prolactin-secreting adenomas and Parkinson's disease. DR2 is expressed in most somatotroph adenomas. In acromegaly, cabergoline is used off-label and its role is limited by the relatively modest efficacy for achieving hormonal remission and thus, it is largely indicated in patients with mild elevation of GH/IGF-I postoperatively. It can be given as monotherapy, usually at a higher weekly dose than usually required to treat prolactinomas, but also as an add-on treatment in patients partially responding to the somatostatin receptor ligands octreotide or lanreotide...
February 28, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38443224/treatment-of-acromegaly-with-oral-octreotide
#4
REVIEW
Ilan Remba-Shapiro, Lisa B Nachtigall
Acromegaly is a rare disease caused by a growth hormone excess, usually due to a secreting pituitary adenoma. Somatostatin receptor ligands (SRL) are the mainstay of medical therapy for patients with acromegaly who fail to achieve biochemical control post-operatively or are not eligible for surgical treatment. SRLs are typically administered as monthly injections and have shown to be effective in maintaining biochemical and radiological control of acromegaly. However, these injections may cause local adverse events and are associated with increased psychological burden in some patients...
February 22, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38413286/the-clinical-and-biochemical-spectrum-of-ectopic-acromegaly
#5
REVIEW
Patricia Fainstein-Day, Tamara Estefanía Ullmann, Mercedes Corina Liliana Dalurzo, Gustavo Emilio Sevlever, David Eduardo Smith
Ectopic acromegaly is a rare condition caused by extrapituitary central or peripheral neuroendocrine tumours (NET) that hypersecrete GH or, more commonly, GHRH. It affects less than 1% of acromegaly patients and a misdiagnosis of classic acromegaly can lead to an inappropriate pituitary surgery. Four types of ectopic acromegaly have been described: 1) Central ectopic GH-secretion: Careful cross-sectional imaging is required to exclude ectopic pituitary adenomas. 2) Peripheral GH secretion: Extremely rare. 3) Central ectopic GHRH secretion: Sellar gangliocytomas immunohistochemically positive for GHRH are found after pituitary surgery...
February 14, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38519400/-micromegaly-acromegaly-with-apparently-normal-gh-an-entity-on-its-own
#6
REVIEW
Lucio Vilar, Luciana Ansaneli Naves, Manoel Ricardo Alves Martins, Antônio Ribeiro-Oliveira
A small proportion of the patients with acromegaly present with apparently normal basal GH levels and suppressible GH levels despite increased IGF-1 levels, a pattern called micromegaly by some authors. Whether this pattern represents a distinct entity or is just an expression of acromegaly in its early stages is still a matter of debate. Nevertheless, these patients have some peculiar characteristics such as being more likely older and male, mostly harbour microadenomas or small macroadenomas, and have lower IGF-1 and postglucose GH levels...
February 13, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38403492/surgical-outcomes-in-patients-with-acromegaly-microscopic-vs-endoscopic-transsphenoidal-surgery
#7
REVIEW
Gerardo Guinto, Gerardo Y Guinto-Nishimura, Rodrigo Uribe-Pacheco, Marcos V Sangrador-Deitos, Eliezer Villanueva-Castro, Ricardo García-Iturbide, David Gallardo, Patricia Guinto, Alejandro Vargas, Norma Aréchiga
Transsphenoidal resection of growth hormone-secreting pituitary neuroendocrine tumors remains the first-line treatment for acromegaly. This can be performed through microsurgery or endoscopic surgery. For the past decades, endoscopic surgery has become the preferred technique in an increasing number of centers worldwide. However, whether it offers superior clinical outcomes has yet to be determined. In this paper, we performed a narrative review of the literature comparing both techniques in the treatment of acromegaly...
February 13, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38290866/current-role-of-pasireotide-in-the-treatment-of-acromegaly
#8
REVIEW
Salman Zahoor Bhat, Roberto Salvatori
"First-generation" somatostatin receptor agonists (SSTRAs) octreotide and lanreotide are the most commonly used first-line pharmacological therapy for patients with acromegaly. A subset of patients respond only partially or not at all to the first-generation SSTRA, necessitating the use of additional pharmacological agents or other modes of therapy. Pasireotide is a "second-generation" SSTRA that has multi-receptor activity. Prospective studies have shown promise in the use of pasireotide in patients with poor response to first-generation SSTRA...
January 24, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38365463/vitamin-d-deficiency-or-resistance-and-hypophosphatemia
#9
REVIEW
Vijaya Sarathi, Melkunte Shanthaiah Dhananjaya, Manjiri Karlekar, Anurag Ranjan Lila
Vitamin D is mainly produced in the skin (cholecalciferol) by sun exposure while a fraction of it is obtained from dietary sources (ergocalciferol). Vitamin D is further processed to 25-hydroxyvitamin D and 1,25-dihydroxy vitamin D (calcitriol) in the liver and kidneys, respectively. Calcitriol is the active form which mediates the actions of vitamin D via vitamin D receptor (VDR) which is present ubiquitously. Defect at any level in this pathway leads to vitamin D deficient or resistant rickets. Nutritional vitamin D deficiency is the leading cause of rickets and osteomalacia worldwide and responds well to vitamin D supplementation...
March 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38087658/the-pathophysiology-of-hypophosphatemia
#10
REVIEW
Nobuaki Ito, Naoko Hidaka, Hajime Kato
After identification of fibroblast growth factor (FGF) 23 as the pivotal regulator of chronic serum inorganic phosphate (Pi) levels, the etiology of disorders causing hypophosphatemic rickets/osteomalacia has been clarified, and measurement of intact FGF23 serves as a potent tool for differential diagnosis of chronic hypophosphatemia. Additionally, measurement of bone-specific alkaline phosphatase (BAP) is recommended to differentiate acute and subacute hypophosphatemia from chronic hypophosphatemia. This article divides the etiology of chronic hypophosphatemia into 4 groups: A...
March 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38238129/revisiting-hypophosphatemic-rickets-osteomalacia
#11
EDITORIAL
Tushar Bandgar, Nalini Shah
No abstract text is available yet for this article.
January 6, 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38171939/menopause-physiology-definitions-and-symptoms
#12
REVIEW
Charlotte Gatenby, Paul Simpson
The menopause transition is usually a gradual process occurring over many years, caused by the cessation of ovarian reproductive function, resulting in the end of menstrual bleeding. In the peri-menopause, ovarian function and therefore the production of the hormones oestrogen, progesterone and testosterone can fluctuate greatly, leading to a wide variety of symptoms, affecting multiple organ systems. Menopause and the management of its associated symptoms can be very challenging for patients and clinicians alike and can negatively impact quality of life...
January 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38161075/best-practice-research-clinical-endocrinology-metabolism-focusing-on-the-menopause-diagnostic-and-therapeutic-strategies
#13
EDITORIAL
Katie A Barber
No abstract text is available yet for this article.
January 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/37634998/progestogens-for-endometrial-protection-in-combined-menopausal-hormone-therapy-a-systematic-review
#14
REVIEW
Petra Stute, Linus Josef Walker, Astrid Eicher, Elena Pavicic, Argyrios Kolokythas, Susanne Theis, Marc von Gernler, Michael von Wolff, Sabrina Vollrath
Menopausal women with an intact uterus choosing estrogens for menopausal symptom relief require a progestogen for endometrial protection. The aim of this systematic review was to evaluate the risks of endometrial hyperplasia resp. malignancy with different progestogens used in combined MHT. Overall, 84 RCTs were included. We found that 1) most studies were done with NETA, followed by MPA, MP and DYD and LNG, 2) most progestogens were only available as oral formulations, 3) the most frequently studied progestogens (oral MP, DYD, MPA, oral and transdermal NETA, transdermal LNG) were assessed in continuously as well as in sequentially combined MHT regimens, 4) FDA endometrial safety criteria were only fulfilled for some progestogen formulations, 5) most studies demonstrated endometrial protection for the progestogen dose and time period examined...
January 2024: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38182436/premenstrual-disorders-and-pmdd-a-review
#15
REVIEW
Emily Cary, Paul Simpson
Defining, diagnosing and managing premenstrual disorders (PMDs) remains a challenge both for general practitioners and specialists. Yet these disorders are common and can have an enormous impact on women. PMDD (premenstrual dysphoric disorder), one severe form of PMD, has a functional impact similar to major depression yet remains under-recognised and poorly treated. The aim of this chapter is to give some clarity to this area, provide a framework for non-specialists to work towards, and to stress the importance of MDT care for severe PMDs, including PMDD...
December 28, 2023: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38160182/post-cancer-care-in-women-with-an-increased-risk-of-malignancy-or-previous-malignancy-the-use-of-hormone-replacement-therapy-and-alternative-treatments
#16
REVIEW
Jenifer Sassarini, Mary Ann Lumsden
No abstract text is available yet for this article.
December 15, 2023: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/38000973/traumatic-brain-injury-abnormal-growth-hormone-secretion-and-gut-dysbiosis
#17
REVIEW
Peyton A Armstrong, Navneet Venugopal, Traver J Wright, Kathleen M Randolph, Richard D Batson, Kevin C J Yuen, Brent E Masel, Melinda Sheffield-Moore, Randall J Urban, Richard B Pyles
The gut microbiome has been implicated in a variety of neuropathologies with recent data suggesting direct effects of the microbiome on host metabolism, hormonal regulation, and pathophysiology. Studies have shown that gut bacteria impact host growth, partially mediated through the growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis. However, no study to date has examined the specific role of GH on the fecal microbiome (FMB) or the changes in this relationship following a traumatic brain injury (TBI)...
December 2023: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/37996257/is-there-a-role-for-growth-hormone-replacement-in-adults-to-control-acute-and-post-acute-covid-19
#18
REVIEW
Navneet Venugopal, Peyton A Armstrong, Traver J Wright, Kathleen M Randolph, Richard D Batson, Kevin C J Yuen, Brent Masel, Melinda Sheffield-Moore, Richard B Pyles, Randall J Urban
The SARS-CoV-2 pandemic created a multitude of medical crossroads requiring real time adaptations of best practice covering preventative and interventional aspects of care. Among the many discoveries borne from efforts to address the myriad clinical presentations across multiple organ systems was a common impact on tissues with cells that express the ACE-2 receptor. The vast majority of acute infections began and often ended in the respiratory tract, but more recent evaluations have confirmed significant extrapulmonary manifestations including symptom clusters that extend beyond the acute phase of infection collectively referred to as "post-acute sequelae SARS-CoV-2 infection" (PASC) or more commonly as "long (-haul) COVID"...
December 2023: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/37914564/meta-analysis-of-mortality-in-adults-with-growth-hormone-deficiency-does-growth-hormone-replacement-therapy-really-improve-mortality-rates
#19
REVIEW
Christa C van Bunderen, Daniel S Olsson
Growth hormone (GH) deficiency (GHD) is one of the most prevalent deficiencies in patients with hypopituitarism and several cohort studies have demonstrated an increased mortality risk in hypopituitary patients with a presumed GHD. The cause of the excess mortality is most likely multifactorial, including the etiology of the hypopituitarism, non-physiological replacement therapies (mostly glucocorticoid), tumor treatment and its side effects as well as untreated GHD. Several years later, other cohort studies that investigated life expectancy in patients with hypopituitarism on GH replacement therapy (GHRT) that showed a normalized mortality...
December 2023: Best Practice & Research. Clinical Endocrinology & Metabolism
https://read.qxmd.com/read/37821339/dyslipidaemia-and-growth-hormone-deficiency-a-comprehensive-review
#20
REVIEW
Matthias Hepprich, Fahim Ebrahimi, Emanuel Christ
Growth hormone deficiency (GHD) is a common complication of several pituitary and hypothalamic disorders and dependent on the onset of disease. It may have severe clinical implications ranging from growth retardation in childhood-onset, to impaired lipid metabolism and increased cardiovascular risk and mortality in adults. GH effectively modulates lipid metabolism at multiple levels and GHD has been associated with an atherogenic lipid profile, that can be reversed by GH replacement therapy. Despite increasing knowledge on the effects of GH on several key enzymes regulating lipid metabolism and recent breakthroughs in the development and wider availability of recombinant GH preparations, several questions remain regarding the replacement therapy in adults with GHD...
December 2023: Best Practice & Research. Clinical Endocrinology & Metabolism
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