Endocrine Practice最新文献_第8页

Use of the 36-Point Thyroid Symptom Questionnaire to Potentially Guide Optimal Thyroid Hormone Replacement Therapy 使用36点甲状腺症状问卷可能指导最佳甲状腺激素替代治疗。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.09.007

Thanh D. Hoang DO, FACP, FACE , Arjun A. Patel MD , Andrew J. Spiro MD , Nora L. Watson PhD , Mohamed K.M. Shakir MD

Objective

To determine the association between a transition from levothyroxine (LT4) to combination therapy and change in the Thyroid Symptom Questionnaire (TSQ-36).

Methods

We performed a post hoc subgroup analysis of 2 previous randomized, double-blind, crossover studies (total n = 143) to evaluate patient symptoms on treatment with LT4, desiccated thyroid extract (DTE), and levothyroxine + liothyronine (LT4+LT3). The TSQ-36 was completed at the end of each treatment period in the context of normal thyroid stimulating hormone levels. Patients were stratified based on their TSQ-36 score on LT4: Low Symptoms (TSQ-36: 0-12), Moderate Symptoms (TSQ-36: 13-24), and High Symptoms (TSQ-36: 25-36). Mean TSQ-36 scores were compared on LT4, LT4+LT3, and DTE. Treatment-blinded preference of therapy was also stratified by TSQ-36 score on LT4.

Results

In cohort 1, the Moderate-High Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (P = .01). In cohort 2, the High Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (P < .01) and on LT4+LT3 vs LT4 (P < .001). The Moderate Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (P = .02). The Low Symptoms group had significantly lower TSQ-36 scores on LT4 vs DTE (P = .03) and LT4+LT3 (P = .02). Patients who preferred combination therapy had significantly higher TSQ-36 scores than patients who preferred LT4. Persistent symptoms may be due to a relative deficiency in triiodothyronine, which could be remedied by combination therapy.

Conclusion

The TSQ-36 can potentially be used to quantify patient symptoms and guide thyroid hormone therapy. Patients on LT4, with moderate-to-severe symptoms despite normalization of thyroid stimulating hormone, could consider a trial of combination therapy. Patients with low symptoms on LT4 should generally avoid combination therapy.

目的：确定从LT4过渡到联合治疗与甲状腺症状问卷（TSQ-36）变化之间的关系。方法：我们对之前的两项随机、双盲、交叉研究（总n=143）进行了事后亚组分析，以评估患者接受LT4、甲状腺提取物（DTE）和左旋甲状腺素+碘甲状腺原氨酸（LT4+LT3）治疗后的症状。在TSH水平正常的情况下，TSQ-36在每个治疗期结束时完成。根据LT4的TSQ-36评分对患者进行分层：低症状（TSQ-36: 0-12）、中度症状（TSQ-36: 13-24）、高症状（TSQ-36: 25-36）。比较LT4、LT4+LT3和DTE的TSQ-36平均评分。采用TSQ-36 LT4评分对治疗盲性偏好进行分层。结果：在队列1中，中高症状组在DTE上的TSQ-36评分明显低于LT4 （p=0.01）。在队列2中，高症状组在DTE上的TSQ-36评分明显低于LT4 (p结论：TSQ-36有可能用于量化患者症状和指导甲状腺激素治疗。服用LT4的患者，尽管TSH恢复正常，但仍有中重度症状，可考虑联合治疗的试验。LT4症状较轻的患者一般应避免联合治疗。

{"title":"Use of the 36-Point Thyroid Symptom Questionnaire to Potentially Guide Optimal Thyroid Hormone Replacement Therapy","authors":"Thanh D. Hoang DO, FACP, FACE , Arjun A. Patel MD , Andrew J. Spiro MD , Nora L. Watson PhD , Mohamed K.M. Shakir MD","doi":"10.1016/j.eprac.2025.09.007","DOIUrl":"10.1016/j.eprac.2025.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between a transition from levothyroxine (LT4) to combination therapy and change in the Thyroid Symptom Questionnaire (TSQ-36).</div></div><div><h3>Methods</h3><div>We performed a post hoc subgroup analysis of 2 previous randomized, double-blind, crossover studies (total <em>n</em> = 143) to evaluate patient symptoms on treatment with LT4, desiccated thyroid extract (DTE), and levothyroxine + liothyronine (LT4+LT3). The TSQ-36 was completed at the end of each treatment period in the context of normal thyroid stimulating hormone levels. Patients were stratified based on their TSQ-36 score on LT4: Low Symptoms (TSQ-36: 0-12), Moderate Symptoms (TSQ-36: 13-24), and High Symptoms (TSQ-36: 25-36). Mean TSQ-36 scores were compared on LT4, LT4+LT3, and DTE. Treatment-blinded preference of therapy was also stratified by TSQ-36 score on LT4.</div></div><div><h3>Results</h3><div>In cohort 1, the Moderate-High Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (<em>P</em> = .01). In cohort 2, the High Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (<em>P</em> < .01) and on LT4+LT3 vs LT4 (<em>P</em> < .001). The Moderate Symptoms group had significantly lower TSQ-36 scores on DTE vs LT4 (<em>P</em> = .02). The Low Symptoms group had significantly lower TSQ-36 scores on LT4 vs DTE (<em>P</em> = .03) and LT4+LT3 (<em>P</em> = .02). Patients who preferred combination therapy had significantly higher TSQ-36 scores than patients who preferred LT4. Persistent symptoms may be due to a relative deficiency in triiodothyronine, which could be remedied by combination therapy.</div></div><div><h3>Conclusion</h3><div>The TSQ-36 can potentially be used to quantify patient symptoms and guide thyroid hormone therapy. Patients on LT4, with moderate-to-severe symptoms despite normalization of thyroid stimulating hormone, could consider a trial of combination therapy. Patients with low symptoms on LT4 should generally avoid combination therapy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 53-59"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Training Programs for Thyroid Biopsy and Ablation: A Systematic Review 甲状腺活检和消融培训计划：系统回顾。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.09.010

Sharon Bridgemohan , Andrea Ortiz MD , Gilberto Perez Rodriguez Garcia MD , Sannidhi Kolukula , Gonzalo J. Acosta MD , Christopher Samouce PhD , Samsun Lampotang PhD, FSSH, FAIMBE , Juan P. Brito MD, MS , Naykky Singh Ospina MD, MS

Objective

To evaluate the structure, components, and outcomes of educational programs designed to train clinicians in thyroid fine needle aspiration (FNA) and ablative procedures.

Methods

A systematic review of 5 databases was conducted for studies published from 2000 through April 2025 evaluating training interventions for thyroid FNA or ablative techniques. Two independent reviewers screened, extracted data, and assessed risk of bias for all eligible studies.

Results

Ten studies met inclusion criteria: nine addressed FNA training, and one addressed radiofrequency ablation (RFA). All studies were rated at moderate to high risk of bias. Common instructional components included didactic sessions (n = 5), hands-on simulation (n = 9), supervised clinical experience (n = 4), and multimodal approaches (n = 7). Simulation models varied in complexity, including food-based models, cadavers, and 3D-printed phantoms. Reported educational outcomes included improved learner confidence and perceived realism (reaction outcomes); enhanced accuracy, procedural speed, and knowledge (learning outcomes); and improvements in biopsy adequacy, malignant diagnostic yield, and procedural wait times (clinical outcomes). The single RFA study demonstrated a median nodule volume reduction of 82% at 12 months following simulation-based and supervised training.

Conclusion

Structured, multimodal training programs in thyroid FNA and RFA improve both learner performance and clinical outcomes. These findings support the integration of simulation-based learning and supervised procedural experience into thyroid intervention training.

目的：评估临床医生在甲状腺细针穿刺（FNA）和消融手术方面的培训计划的结构、组成和结果。方法：对2000年至2025年4月发表的5个数据库进行系统回顾，评估甲状腺FNA或消融技术的培训干预。两名独立审稿人对所有符合条件的研究进行筛选、提取数据并评估偏倚风险。结果：10项研究符合纳入标准：9项涉及FNA培训，1项涉及射频消融（RFA）。所有研究的偏倚风险均为中至高。常见的教学内容包括教学环节（n=5）、动手模拟（n=9）、有监督的临床经验（n=4）和多模式方法（n=7）。模拟模型的复杂性各不相同，包括基于食物的模型、尸体和3d打印的幽灵。报告的教育成果包括提高学习者信心和感知现实主义（反应结果）；提高准确性、程序速度和知识（学习成果）；以及活检充分性、恶性诊断率和手术等待时间（临床结果）的改善。单一RFA研究表明，在基于模拟和监督训练的12个月后，中位结节体积减少82%。结论：结构化的、多模式的甲状腺FNA和RFA培训方案提高了学习者的表现和临床效果。这些发现支持将基于模拟的学习和监督的程序经验整合到甲状腺干预训练中。

{"title":"Training Programs for Thyroid Biopsy and Ablation: A Systematic Review","authors":"Sharon Bridgemohan , Andrea Ortiz MD , Gilberto Perez Rodriguez Garcia MD , Sannidhi Kolukula , Gonzalo J. Acosta MD , Christopher Samouce PhD , Samsun Lampotang PhD, FSSH, FAIMBE , Juan P. Brito MD, MS , Naykky Singh Ospina MD, MS","doi":"10.1016/j.eprac.2025.09.010","DOIUrl":"10.1016/j.eprac.2025.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the structure, components, and outcomes of educational programs designed to train clinicians in thyroid fine needle aspiration (FNA) and ablative procedures.</div></div><div><h3>Methods</h3><div>A systematic review of 5 databases was conducted for studies published from 2000 through April 2025 evaluating training interventions for thyroid FNA or ablative techniques. Two independent reviewers screened, extracted data, and assessed risk of bias for all eligible studies.</div></div><div><h3>Results</h3><div>Ten studies met inclusion criteria: nine addressed FNA training, and one addressed radiofrequency ablation (RFA). All studies were rated at moderate to high risk of bias. Common instructional components included didactic sessions (<em>n</em> = 5), hands-on simulation (<em>n</em> = 9), supervised clinical experience (<em>n</em> = 4), and multimodal approaches (<em>n</em> = 7). Simulation models varied in complexity, including food-based models, cadavers, and 3D-printed phantoms. Reported educational outcomes included improved learner confidence and perceived realism (reaction outcomes); enhanced accuracy, procedural speed, and knowledge (learning outcomes); and improvements in biopsy adequacy, malignant diagnostic yield, and procedural wait times (clinical outcomes). The single RFA study demonstrated a median nodule volume reduction of 82% at 12 months following simulation-based and supervised training.</div></div><div><h3>Conclusion</h3><div>Structured, multimodal training programs in thyroid FNA and RFA improve both learner performance and clinical outcomes. These findings support the integration of simulation-based learning and supervised procedural experience into thyroid intervention training.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 87-97"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endocrine Practice: Another Year of High-Impact Endocrinology Research and Reviews 内分泌实践：又一年的高影响内分泌学研究和评论

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.11.009

Vin Tangpricha MD, PhD, FACE (Editor-in-Chief)

引用次数: 0

Inpatient Diet Orders and Continuous Glucose Monitoring in Noncritically Ill, Hospitalized Adult Patients 非危重症、住院成人患者的住院饮食命令和持续血糖监测。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.09.002

Anushka Sharma BS , Evangelos Vassilakis , Kristen L. Flint MD , Hui Zheng PhD , Melissa S. Putman MD, MMSc , Hassan S. Dashti PhD, RD

Objectives

Inpatient diet orders are commonly prescribed in clinical practice and may influence the glycemic management in hospitalized patients, yet empirical data remain limited. This study aimed to evaluate the relationship between diet orders and continuous glucose monitoring (CGM) derived glycemic measures in noncritically ill hospitalized adults.

Methods

This secondary analysis used data from a prospective, observational study. Inpatient diet orders were extracted from clinical documentation and standardized into 11 general diet order categories. The primary outcome was percent time in range (70-180 mg/dL). Secondary outcomes included time above range, time below range, and glycemic variability. Associations were examined using multivariate linear mixed-effects models, accounting for demographics, insulin therapy, and other relevant medications.

Results

The analytical sample included 283 hospitalized adults (mean age 60.7 years, body mass index 38.5 kg/m², 36.4% female), primarily admitted to medical units, with most having type 2 diabetes (77.4%). CGM-derived glycemic measures and insulin therapy use varied significantly across inpatient diet orders. Compared to a regular diet, a regular diet with restrictions was associated with lower time in range and higher time above range, whereas diabetic and liquid diets were associated with higher time below range. Measures of glucose variability did not differ across diet orders.

Conclusions

Inpatient diet orders are modestly associated with 24-hour CGM-derived glycemic measures adjusted by insulin therapy and other related medications. Future research is needed to standardize diet order classifications and assess their impact on inpatient glycemic management.

目的：住院患者饮食单在临床实践中常用，可能影响住院患者的血糖管理，但经验数据仍然有限。本研究旨在评估非危重住院成人饮食顺序与连续血糖监测（CGM）衍生血糖测量之间的关系。方法：该二次分析采用前瞻性观察性研究的数据。从临床文献中提取住院患者的饮食顺序，并将其标准化为11种一般饮食顺序。主要终点是在范围内的时间百分比（TIR; 70-180 mg/dL）。次要结局包括高于范围的时间（TAR）、低于范围的时间（TBR）和血糖变异性。使用多变量线性混合效应模型，考虑人口统计学、胰岛素治疗和其他相关药物，检查相关性。结果：分析样本包括283名住院成人（平均年龄60.7岁，BMI 38.5 kg/m2，女性36.4%），主要入院医疗单位，多数为2型糖尿病（77.4%）。cgm衍生的血糖测量和胰岛素治疗的使用在住院患者的饮食顺序中有显著差异。与常规饮食相比，有限制的常规饮食与较低的TIR和较高的TAR相关，而糖尿病饮食和流质饮食与较高的TBR相关。血糖变异性的测量结果在不同的饮食顺序中没有差异。结论：住院患者的饮食顺序与胰岛素治疗和其他相关药物调节的24小时cgm衍生血糖测量有一定的相关性。未来的研究需要标准化饮食顺序分类，并评估其对住院患者血糖管理的影响。

{"title":"Inpatient Diet Orders and Continuous Glucose Monitoring in Noncritically Ill, Hospitalized Adult Patients","authors":"Anushka Sharma BS , Evangelos Vassilakis , Kristen L. Flint MD , Hui Zheng PhD , Melissa S. Putman MD, MMSc , Hassan S. Dashti PhD, RD","doi":"10.1016/j.eprac.2025.09.002","DOIUrl":"10.1016/j.eprac.2025.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Inpatient diet orders are commonly prescribed in clinical practice and may influence the glycemic management in hospitalized patients, yet empirical data remain limited. This study aimed to evaluate the relationship between diet orders and continuous glucose monitoring (CGM) derived glycemic measures in noncritically ill hospitalized adults.</div></div><div><h3>Methods</h3><div>This secondary analysis used data from a prospective, observational study. Inpatient diet orders were extracted from clinical documentation and standardized into 11 general diet order categories. The primary outcome was percent time in range (70-180 mg/dL). Secondary outcomes included time above range, time below range, and glycemic variability. Associations were examined using multivariate linear mixed-effects models, accounting for demographics, insulin therapy, and other relevant medications.</div></div><div><h3>Results</h3><div>The analytical sample included 283 hospitalized adults (mean age 60.7 years, body mass index 38.5 kg/m<sup>2</sup>, 36.4% female), primarily admitted to medical units, with most having type 2 diabetes (77.4%). CGM-derived glycemic measures and insulin therapy use varied significantly across inpatient diet orders. Compared to a regular diet, a regular diet with restrictions was associated with lower time in range and higher time above range, whereas diabetic and liquid diets were associated with higher time below range. Measures of glucose variability did not differ across diet orders.</div></div><div><h3>Conclusions</h3><div>Inpatient diet orders are modestly associated with 24-hour CGM-derived glycemic measures adjusted by insulin therapy and other related medications. Future research is needed to standardize diet order classifications and assess their impact on inpatient glycemic management.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 16-22"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osilodrostat Treatment for Cushing Syndrome: 5 Years on Since Regulatory Approval 奥西洛司他治疗库欣综合征：自监管部门批准以来的五年。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.09.005

Kevin C.J. Yuen MD, FRCP (UK), FACE, FEAA

引用次数: 0

Automated Insulin Delivery for Minoritized and Nonminoritized Populations With Type 1 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 1型糖尿病少数和非少数人群的自动胰岛素输送：随机对照试验的系统回顾和荟萃分析

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.09.198

Puguh Oktavian MD , Citrawati Dyah Kencono Wungu PhD , Sony Wibisono Mudjanarko PhD , Indah Mohd Amin PhD

Objective

Despite the efficacy of diabetes technologies, significant ethnic and racial disparities persist in the care and outcomes of individuals with type 1 diabetes. Therefore, this study evaluates the efficacy and safety of automated insulin delivery (AID) systems in nonminoritized (non-Hispanic White) and minoritized (Hispanic, non-Hispanic Black, Asian, and others) populations with type 1 diabetes.

Methods

We conducted a systematic review and meta-analysis of studies identified on PubMed, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov up to August 18, 2025. The primary outcome was the percentage of time-in-range (3.9-10.0 mmol/L). Secondary outcomes included time-below-range and glycated hemoglobin. Data were pooled as mean differences (MDs) with 95% CIs.

Results

Twelve studies involving 327 participants from minoritized groups and 1377 participants from nonminoritized groups were included. AID systems significantly improved time-in-range in both minoritized (MD 13.90% [95% CI 9.64 to 18.16], I² = 20%, P < .0001; high certainty) and nonminoritized groups (MD 10.66% [95% CI 9.12 to 12.21], I² = 15%, P < .0001; high certainty). Favorable effects were observed on glycated hemoglobin for both minoritized (MD −0.49% [95% CI −0.69 to −0.29]) and nonminoritized groups (MD −0.34% [95% CI −0.46 to −0.23]). No significant increase in severe hypoglycemia or diabetic ketoacidosis was observed.

Conclusion

The AID systems improve glycemic outcomes in minoritized and nonminoritized populations with type 1 diabetes and have good safety profiles. AID systems hold promise for reducing racial and ethnic disparities in diabetes care and outcomes.

目的：尽管糖尿病技术有效，但1型糖尿病患者的护理和预后仍然存在显著的民族和种族差异。因此，本研究评估了自动胰岛素输送（AID）系统在非少数族裔（非西班牙裔白人）和少数族裔（西班牙裔、非西班牙裔黑人、亚洲人和其他）1型糖尿病患者中的有效性和安全性。方法：我们对PubMed、Scopus、Web of Science、Cochrane Library和ClinicalTrials.gov上截至2025年8月18日的研究进行了系统回顾和荟萃分析。主要终点为范围内时间百分比（TIR; 3.9-10.0 mmol/L）。次要结局包括时间低于范围（TBR）和糖化血红蛋白（HbA1c）。数据以95%置信区间（ci）的平均差异（md）合并。结果：纳入了12项研究，涉及327名来自少数族裔和1377名非少数族裔的参与者。AID系统显著提高了少数群体（MD 13.90% [95% CI 9.64 ~ 18.16], I2 = 20%, p < 0.0001，高确定性）和非少数群体（MD 10.66% [95% CI 9.12 ~ 12.21], I2 = 15%, p < 0.0001，高确定性）的TIR。在少数组（MD -0.49% [95% CI -0.69至-0.29]）和非少数组（MD -0.34% [95% CI -0.46至-0.23]）中均观察到良好的HbA1c效果。严重低血糖或糖尿病酮症酸中毒未见明显增加。结论：AID系统改善了少数和非少数1型糖尿病患者的血糖结局，并且具有良好的安全性。艾滋病系统有望减少糖尿病治疗和结果方面的种族和民族差异。

{"title":"Automated Insulin Delivery for Minoritized and Nonminoritized Populations With Type 1 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Puguh Oktavian MD , Citrawati Dyah Kencono Wungu PhD , Sony Wibisono Mudjanarko PhD , Indah Mohd Amin PhD","doi":"10.1016/j.eprac.2025.09.198","DOIUrl":"10.1016/j.eprac.2025.09.198","url":null,"abstract":"<div><h3>Objective</h3><div>Despite the efficacy of diabetes technologies, significant ethnic and racial disparities persist in the care and outcomes of individuals with type 1 diabetes. Therefore, this study evaluates the efficacy and safety of automated insulin delivery (AID) systems in nonminoritized (non-Hispanic White) and minoritized (Hispanic, non-Hispanic Black, Asian, and others) populations with type 1 diabetes.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of studies identified on PubMed, Scopus, Web of Science, Cochrane Library, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> up to August 18, 2025. The primary outcome was the percentage of time-in-range (3.9-10.0 mmol/L). Secondary outcomes included time-below-range and glycated hemoglobin. Data were pooled as mean differences (MDs) with 95% CIs.</div></div><div><h3>Results</h3><div>Twelve studies involving 327 participants from minoritized groups and 1377 participants from nonminoritized groups were included. AID systems significantly improved time-in-range in both minoritized (MD 13.90% [95% CI 9.64 to 18.16], I<sup>2</sup> = 20%, <em>P</em> < .0001; high certainty) and nonminoritized groups (MD 10.66% [95% CI 9.12 to 12.21], I<sup>2</sup> = 15%, <em>P</em> < .0001; high certainty). Favorable effects were observed on glycated hemoglobin for both minoritized (MD −0.49% [95% CI −0.69 to −0.29]) and nonminoritized groups (MD −0.34% [95% CI −0.46 to −0.23]). No significant increase in severe hypoglycemia or diabetic ketoacidosis was observed.</div></div><div><h3>Conclusion</h3><div>The AID systems improve glycemic outcomes in minoritized and nonminoritized populations with type 1 diabetes and have good safety profiles. AID systems hold promise for reducing racial and ethnic disparities in diabetes care and outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 98-107"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thyroid Arterial Embolization for the Management of Benign and Malignant Thyroid Disease: A Systematic Review 甲状腺动脉栓塞治疗良性和恶性甲状腺疾病：系统综述。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.07.024

Hannelore Iris Coerts BSc , Brooke D’Mello BSc , Frederik Anton Verburg MD , Edward Visser MD , Jesse Pasternak MD , Menno Vriens MD , Bart de Keizer MD , Pieter Jan van Doormaal MD , Tessa Malaika van Ginhoven MD

Objective

Thyroid arterial embolization (TAE) is a minimally invasive procedure that reduces blood flow to the thyroid gland by injecting particles into the superior and/or inferior thyroid artery. It has been sporadically used for goiter, Graves’ disease, thyrotoxicosis, and thyroid cancers, but no reviews have assessed its safety and efficacy.

Methods

Databases were searched until January 2024. English-language studies on TAE were included. Studies using TAE for arterial aneurysms or lacking full text were excluded. No meta-analyses were performed.

Results

Among 1203 retrieved articles, 24 studies met inclusion criteria: TAE was used for goiter (8 studies), Graves’ disease (8), thyroid malignancy (5), and thyrotoxicosis (4). The primary outcome was safety and efficacy. Limited evidence suggested benefits, including goiter size reduction and symptom relief with minimal complications like neck pain and hematoma. In Graves’ disease, TAE induced hormonal and immunologic changes, normalizing thyroid function in some patients. In thyroid cancer, it alleviated symptoms and facilitated safer surgery. However, serious risks, including nontarget embolization and mortality, require caution.

Conclusion

This review presents an overview of the literature regarding safety and efficacy of TAE. The lack of robust data, significant risk of serious complications (including nontarget embolization and mortality), and absence of a standardized, safe protocol preclude recommending TAE as a routine treatment option. Given the high efficacy and lower complication rates of current established therapies, TAE should only be considered in exceptional circumstances, when standard treatments have failed or are contraindicated, and then only at specialized centers with extensive embolization expertise.

简介：甲状腺动脉栓塞（TAE）是一种微创手术，通过向甲状腺上动脉和/或甲状腺下动脉注射颗粒来减少甲状腺的血流量。它偶尔被用于甲状腺肿、格雷夫斯病、甲状腺毒症和甲状腺癌，但没有评论评估其安全性和有效性。方法：检索数据库至2024年1月。TAE的英语研究也包括在内。使用TAE治疗动脉瘤或缺乏全文的研究被排除在外。未进行meta分析。结果：在1203篇检索文章中，24篇研究符合纳入标准：TAE用于甲状腺肿（8篇）、Graves病（8篇）、甲状腺恶性肿瘤（5篇）和甲状腺毒症（4篇）。主要结局是安全性和有效性。有限的证据表明，益处包括甲状腺肿大缩小和症状缓解，并发症如颈部疼痛和血肿最小。在Graves病中，TAE引起激素和免疫变化，使一些患者的甲状腺功能正常化。在甲状腺癌中，它缓解了症状，促进了更安全的手术。然而，严重的风险，包括非靶栓塞和死亡，需要谨慎。结论：本文综述了有关TAE安全性和有效性的文献。由于缺乏可靠的数据，严重并发症（包括非靶栓塞和死亡）的显著风险，以及缺乏标准化、安全的方案，因此不推荐TAE作为常规治疗选择。鉴于目前已建立的治疗方法的高效率和较低的并发症发生率，只有在特殊情况下，当标准治疗失败或禁忌时，才应该考虑TAE，然后只有在具有广泛栓塞专业知识的专业中心。

{"title":"Thyroid Arterial Embolization for the Management of Benign and Malignant Thyroid Disease: A Systematic Review","authors":"Hannelore Iris Coerts BSc , Brooke D’Mello BSc , Frederik Anton Verburg MD , Edward Visser MD , Jesse Pasternak MD , Menno Vriens MD , Bart de Keizer MD , Pieter Jan van Doormaal MD , Tessa Malaika van Ginhoven MD","doi":"10.1016/j.eprac.2025.07.024","DOIUrl":"10.1016/j.eprac.2025.07.024","url":null,"abstract":"<div><h3>Objective</h3><div>Thyroid arterial embolization (TAE) is a minimally invasive procedure that reduces blood flow to the thyroid gland by injecting particles into the superior and/or inferior thyroid artery. It has been sporadically used for goiter, Graves’ disease, thyrotoxicosis, and thyroid cancers, but no reviews have assessed its safety and efficacy.</div></div><div><h3>Methods</h3><div>Databases were searched until January 2024. English-language studies on TAE were included. Studies using TAE for arterial aneurysms or lacking full text were excluded. No meta-analyses were performed.</div></div><div><h3>Results</h3><div>Among 1203 retrieved articles, 24 studies met inclusion criteria: TAE was used for goiter (8 studies), Graves’ disease (8), thyroid malignancy (5), and thyrotoxicosis (4). The primary outcome was safety and efficacy. Limited evidence suggested benefits, including goiter size reduction and symptom relief with minimal complications like neck pain and hematoma. In Graves’ disease, TAE induced hormonal and immunologic changes, normalizing thyroid function in some patients. In thyroid cancer, it alleviated symptoms and facilitated safer surgery. However, serious risks, including nontarget embolization and mortality, require caution.</div></div><div><h3>Conclusion</h3><div>This review presents an overview of the literature regarding safety and efficacy of TAE. The lack of robust data, significant risk of serious complications (including nontarget embolization and mortality), and absence of a standardized, safe protocol preclude recommending TAE as a routine treatment option. Given the high efficacy and lower complication rates of current established therapies, TAE should only be considered in exceptional circumstances, when standard treatments have failed or are contraindicated, and then only at specialized centers with extensive embolization expertise.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 67-76"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anaplastic Thyroid Carcinoma: A Contemporary Review of Challenges and Advances 间变性甲状腺癌：挑战和进展的当代回顾。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.08.009

Amanda Silver Karcioglu MD , Cristian Slough MD , Symone V. Jordan MPH , Taylor D. Brown MD, MHS , Mac Kenzie J Reece DO, MS , Desiree T. Campbell BS , Daniella Dennis MD , Amisheila Gloria Kinua MD , Sarah L. Spaulding MD , Ariana Goli , Keith Bible MD , Jeremy L. Freeman MD , Kate Newbold MD , Ashok R. Shaha MD , Mark Urken MD , Mark Zafereo MD , Amr H. Abdelhamid Ahmed MD, MMSc , Gregory W. Randolph MD

Objective

To review the epidemiology, molecular landscape, diagnostic strategies, and treatment options for anaplastic thyroid carcinoma (ATC), with emphasis on the role of targeted therapy and multimodal care.

Methods

A comprehensive review of current literature and clinical guidelines was performed, focusing on diagnostic approaches, molecular profiling, and treatment strategies including surgery, radiation, systemic therapy, and emerging targeted and immunotherapies.

Results

ATC represents <2% of thyroid cancers but accounts for over 50% of thyroid-cancer related mortality, with median survival of <1 year. Timely biopsy and molecular testing, particularly for BRAFV600E, allow initiation of targeted therapy. For resectable disease, surgery with adjuvant chemoradiation improves survival. In unresectable or metastatic disease, dabrafenib plus trametinib has significantly improved outcomes in BRAFV600E-mutant ATC, while immunotherapy and other targeted agents show emerging promise.

Conclusions

Despite advances, ATC remains highly lethal. Early multidisciplinary care centered around individual patient care goals expedited molecular testing, and enrollment in clinical trials are critical to improving survival and guiding future therapeutic strategies.

间变性甲状腺癌（ATC）占所有甲状腺癌的2%，是一种罕见的侵袭性疾病，中位生存期不到一年。在诊断时，所有ATC患者均为晚期IV期疾病，反映出整体预后不良。多学科方法可实现最佳护理。在制定治疗计划时，细胞学、免疫组织化学和分子分析的快速诊断以及早期护理目标的讨论是至关重要的。及时评估和组织取样以评估BRAF状态和其他可靶向突变，允许在适用时启动个性化治疗。对于局限于颈部的疾病，可以进行前期手术，然后进行辅助化疗和放疗。对于局部晚期或转移性疾病，如果无法进行靶向分子治疗，可以考虑化疗-放疗。分子诊断的进展继续扩大对间变性甲状腺癌驱动因素的理解，靶向生物治疗为诊断患有这种致命疾病的患者提供了希望。目前正在进行必要的研究，以更好地预测患者预后并推动改进的治疗策略。

{"title":"Anaplastic Thyroid Carcinoma: A Contemporary Review of Challenges and Advances","authors":"Amanda Silver Karcioglu MD , Cristian Slough MD , Symone V. Jordan MPH , Taylor D. Brown MD, MHS , Mac Kenzie J Reece DO, MS , Desiree T. Campbell BS , Daniella Dennis MD , Amisheila Gloria Kinua MD , Sarah L. Spaulding MD , Ariana Goli , Keith Bible MD , Jeremy L. Freeman MD , Kate Newbold MD , Ashok R. Shaha MD , Mark Urken MD , Mark Zafereo MD , Amr H. Abdelhamid Ahmed MD, MMSc , Gregory W. Randolph MD","doi":"10.1016/j.eprac.2025.08.009","DOIUrl":"10.1016/j.eprac.2025.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>To review the epidemiology, molecular landscape, diagnostic strategies, and treatment options for anaplastic thyroid carcinoma (ATC), with emphasis on the role of targeted therapy and multimodal care.</div></div><div><h3>Methods</h3><div>A comprehensive review of current literature and clinical guidelines was performed, focusing on diagnostic approaches, molecular profiling, and treatment strategies including surgery, radiation, systemic therapy, and emerging targeted and immunotherapies.</div></div><div><h3>Results</h3><div>ATC represents <2% of thyroid cancers but accounts for over 50% of thyroid-cancer related mortality, with median survival of <1 year. Timely biopsy and molecular testing, particularly for <em>BRAFV600E</em>, allow initiation of targeted therapy. For resectable disease, surgery with adjuvant chemoradiation improves survival. In unresectable or metastatic disease, dabrafenib plus trametinib has significantly improved outcomes in <em>BRAFV600E</em>-mutant ATC, while immunotherapy and other targeted agents show emerging promise.</div></div><div><h3>Conclusions</h3><div>Despite advances, ATC remains highly lethal. Early multidisciplinary care centered around individual patient care goals expedited molecular testing, and enrollment in clinical trials are critical to improving survival and guiding future therapeutic strategies.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 118-126"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moving Beyond Body Mass Index: New AACE Obesity Algorithm 超越身体质量指数：新的AACE肥胖算法

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.10.010

Juliana Santos Simonetti MD, DABOM , Monica Agarwal MD, MEHP, FACE, DABOM

引用次数: 0

Advances in Islet Function Replacing Strategies After Total Pancreatectomy 全胰切除术后胰岛功能替代策略的研究进展。

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.eprac.2025.07.012

Siyuan Peng MD, Bo Zhao MD, Xiaolei Yi MD, Xuhui Li MD, Jun Zhang MD, Jie Wang MD, Ruineng Li MD

Total pancreatectomy is one of the radical treatments for various severe pancreatic conditions, including pancreatic cancer, chronic pancreatitis, and pancreatic trauma. However, the postoperative complication rate is higher compared to other surgical methods, and all patients inevitably develop insulin-dependent diabetes due to the loss of islet function. Previously, studies focused on pancreas/islet transplantation or stem cell therapy conducted in diabetic patients have achieved significant success, suggesting that adopting similar strategies to preserve or restore islet function after total pancreatectomy is feasible. To date, numerous preclinical and clinical studies have been conducted in this field, providing some basis for selecting islet function replacing strategies after total pancreatectomy. This article will provide a review of the existing islet function replacing strategies after total pancreatectomy, as well as those in various stages of research. It will analyze the clinical evidence, advantages, and disadvantages of different strategies, thereby offering a reference for physicians in the relevant field.

全胰腺切除术是各种严重胰腺疾病的根治性治疗方法之一，包括胰腺癌、慢性胰腺炎和胰腺创伤。然而，与其他手术方式相比，术后并发症发生率较高，并且由于胰岛功能的丧失，所有患者不可避免地发生胰岛素依赖型糖尿病。此前，针对糖尿病患者进行的胰腺/胰岛移植或干细胞治疗的研究已经取得了显著的成功，这表明在全胰腺切除术后采用类似的策略来保持或恢复胰岛功能是可行的。迄今为止，该领域已经开展了大量临床前和临床研究，为全胰切除术后胰岛功能替代策略（ifrs）的选择提供了一些依据。本文将回顾现有的全胰腺切除术后的国际财务报告准则，以及处于不同研究阶段的国际财务报告准则。分析不同策略的临床依据及优缺点，为相关领域的医生提供参考。

{"title":"Advances in Islet Function Replacing Strategies After Total Pancreatectomy","authors":"Siyuan Peng MD, Bo Zhao MD, Xiaolei Yi MD, Xuhui Li MD, Jun Zhang MD, Jie Wang MD, Ruineng Li MD","doi":"10.1016/j.eprac.2025.07.012","DOIUrl":"10.1016/j.eprac.2025.07.012","url":null,"abstract":"<div><div>Total pancreatectomy is one of the radical treatments for various severe pancreatic conditions, including pancreatic cancer, chronic pancreatitis, and pancreatic trauma. However, the postoperative complication rate is higher compared to other surgical methods, and all patients inevitably develop insulin-dependent diabetes due to the loss of islet function. Previously, studies focused on pancreas/islet transplantation or stem cell therapy conducted in diabetic patients have achieved significant success, suggesting that adopting similar strategies to preserve or restore islet function after total pancreatectomy is feasible. To date, numerous preclinical and clinical studies have been conducted in this field, providing some basis for selecting islet function replacing strategies after total pancreatectomy. This article will provide a review of the existing islet function replacing strategies after total pancreatectomy, as well as those in various stages of research. It will analyze the clinical evidence, advantages, and disadvantages of different strategies, thereby offering a reference for physicians in the relevant field.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 1","pages":"Pages 108-117"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0