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Growth Hormone Deficiency in Children and Adult Patients with Hypopituitarism: Challenges in the Diagnosis and Management 儿童和成人垂体功能减退患者生长激素缺乏:诊断和治疗中的挑战
Pub Date : 2017-12-15 DOI: 10.31579/2640-1045/004
M. Hosseinlou
Hypopituitarism is the decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain.If there is decreased secretion of one specific pituitary hormone, the condition is known as selective hypopituitarism. If there is decreased secretion of most or all pituitary hormones, the term panhypopituitarism is used. Hypopituitarism is a complex medical condition associated with increased morbidity and mortality, requires complicated treatment regimens, and necessitates lifelong follow up by the endocrinologist.
垂体功能减退是指大脑底部垂体正常产生的八种激素中的一种或多种分泌减少。如果一种特定的垂体激素分泌减少,这种情况被称为选择性垂体功能减退。如果大多数或所有垂体激素分泌减少,则使用术语“全垂体功能减退症”。垂体功能减退症是一种复杂的疾病,与发病率和死亡率增加有关,需要复杂的治疗方案,并需要内分泌学家进行终身随访。
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引用次数: 0
Adrenal Gland Tumor: Current Approaches and Future Directions of Pheochromocytoma. 肾上腺肿瘤:嗜铬细胞瘤的当前治疗方法和未来发展方向。
Pub Date : 2017-12-15 DOI: 10.31579/2640-1045/097
Y. Narsimha Reddy
Pheochromocytomas was a neuroendocrine tumor that arise from sympathetic and parasympathetic paraganglia. Because of the excess secretion of hormones, these tumors often cause debilitating symptoms and a poor quality of life. While medical management plays a significant role in the treatment of pheochromocytoma patients, surgical excision remains the only cure. Improved medical management and surgical techniques and an increased understanding of hereditary disease have improved the outcome of pheochromocytoma patients with benign disease; however, the outcome of patients with malignant disease remains poor. In this review, we discuss the presentation, diagnosis, management, and future directions in the management of this disease.
嗜铬细胞瘤是一种由交感神经和副交感神经副神经节引起的神经内分泌肿瘤。由于激素分泌过多,这些肿瘤往往会导致衰弱症状和生活质量低下。虽然医疗管理在治疗嗜铬细胞瘤患者中发挥着重要作用,但手术切除仍是唯一的治疗方法。医疗管理和手术技术的改进以及对遗传性疾病的了解提高了患有良性疾病的嗜铬细胞瘤患者的预后;然而,恶性疾病患者的预后仍然很差。在这篇综述中,我们讨论了这种疾病的表现、诊断、管理和未来的管理方向。
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引用次数: 0
Management Thyroid Disease in Pregnancy: Preconception, and the postpartum complications 妊娠期甲状腺疾病的管理:孕前和产后并发症
Pub Date : 2017-12-05 DOI: 10.31579/2640-1045/012
R. F. Gross man
Pregnancy has a profound impact on the thyroid gland and thyroid function since the thyroid may encounter changes to hormones and size during pregnancy. The diagnosis and treatment of thyroid disease during pregnancy and the postpartum is complex but knowledge regarding the interaction between the thyroids and pregnancy/the postpartum period is advancing at a rapid pace. For women known to have hypothyroidism, an increase in thyroxine dose by 20–40% when pregnancy is confirmed usually ensures they remain euthyroid. Treatment of subclinical hypothyroidism is recommended if the woman has antithyroid antibodies. Treatment of hyperthyroidism, unless it is related to human chorionic gonadotrophin, involves propylthiouracil in the first trimester. Carbimazole may be used in the second trimester. Thyroid function tests are checked every month and every two weeks following a change in dose. Women with a current or a past history of Graves’ disease who have thyrotropin receptor antibodies require early specialist referral as there is a 1–5% risk of fetal hyperthyroidism. Women with thyroid disorders in pregnancy should be followed up by their GP in the postpartum period. Postpartum thyroiditis may present months after delivery.
怀孕对甲状腺和甲状腺功能有着深远的影响,因为甲状腺在怀孕期间可能会发生激素和大小的变化。妊娠期和产后甲状腺疾病的诊断和治疗很复杂,但有关甲状腺与妊娠/产后之间相互作用的知识正在迅速发展。对于已知患有甲状腺功能减退症的女性,当确认怀孕时,甲状腺素剂量增加20-40%通常可以确保她们保持甲状腺功能正常。如果女性有抗甲状腺抗体,建议治疗亚临床甲状腺功能减退症。甲状腺功能亢进症的治疗,除非与人绒毛膜促性腺激素有关,否则需要在妊娠早期使用丙基硫氧嘧啶。氨甲唑可用于妊娠中期。甲状腺功能测试每月检查一次,剂量变化后每两周检查一次。目前或过去有Graves病病史且有促甲状腺激素受体抗体的女性需要早期转诊,因为胎儿甲状腺功能亢进的风险为1-5%。妊娠期患有甲状腺疾病的妇女应在产后接受全科医生的随访。产后甲状腺炎可能在分娩数月后出现。
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引用次数: 0
Clinical Evaluation of Antihyperglycemic Activity of Metformin in Treatment of Insulin Sensitivity in Polycystic Ovary Syndrome: A double Blind Placebo-Controlled Study 二甲双胍治疗多囊卵巢综合征胰岛素敏感性的降糖活性临床评价:一项双盲安慰剂对照研究
Pub Date : 2017-12-05 DOI: 10.31579/2640-1045/011
Eric Casarini
Polycystic ovary syndrome is the most common endocrinological disorder affecting 4–12% of women and also the most controversial. Metformin was logically introduced to establish the extent to which hyperinsulinaemia influences the pathogenesis of the condition. Early studies were very encouraging. Randomized controlled studies and several metaanalyses have changed the picture and put the drug that was once heralded as magic in a much contracted place. Metformin is one of the longest established oral insulin sensitising agents. For decades its use was restricted to management of type 2 diabetes. However, in the past two decades, its properties as an insulin sensitising agent have been explored in relation to its applicability for women with PCOS. Metformin is an effective ovulation induction agent for non-obese women with PCOS and offers some advantages over other first line treatments for anovulatory infertility such as clomiphene. For clomiphene-resistant women, metformin alone or in combination with clomiphene is an effective next step. Women with PCOS undergoing in vitro fertilisation should be offered metformin to reduce their risk of ovarian hyperstimulation syndrome. Limited evidence suggests that metformin may be a suitable alternative to the oral contraceptive pill (OCP) for treating hyperandrogenic symptoms of PCOS including hirsutism and acne. More research is required to define whether metformin has a role in improving long term health outcomes for women with PCOS, including the prevention of diabetes, cardiovascular disease and endometrial cancer.
多囊卵巢综合征是最常见的内分泌紊乱,影响4-12%的女性,也是最具争议的。二甲双胍的逻辑引入是为了确定高胰岛素血症对病情发病机制的影响程度。早期的研究非常令人鼓舞。随机对照研究和几项荟萃分析已经改变了这一局面,并将这种曾经被誉为神奇的药物置于一个非常收缩的地方。二甲双胍是历史最悠久的口服胰岛素增敏剂之一。几十年来,它的使用仅限于2型糖尿病的治疗。然而,在过去的二十年中,人们一直在探索其作为胰岛素增敏剂的特性,以及其对女性多囊卵巢综合征的适用性。二甲双胍是一种有效的促排卵剂,对于患有多囊卵巢综合征的非肥胖女性来说,它比克罗米芬等其他无排卵性不孕症的一线治疗方法有一些优势。对于克罗米芬耐药的妇女,单用二甲双胍或联用克罗米芬是下一步有效的治疗方法。接受体外受精的多囊卵巢综合征妇女应给予二甲双胍以降低其卵巢过度刺激综合征的风险。有限的证据表明,二甲双胍可能是口服避孕药(OCP)的合适替代品,用于治疗多囊卵巢综合征的高雄激素症状,包括多毛症和痤疮。需要更多的研究来确定二甲双胍是否在改善多囊卵巢综合征女性的长期健康结果方面发挥作用,包括预防糖尿病、心血管疾病和子宫内膜癌。
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引用次数: 0
Pediatric Endocrinology: Global Spread of Type 2 Diabetes Mellitus in Neonatal and Permanent Treatment Using Sulfonylurea Drug Regimen Glibenclamide 儿科内分泌学:新生儿2型糖尿病的全球传播和使用磺脲类药物方案格列本脲的永久性治疗
Pub Date : 2017-08-10 DOI: 10.31579/2640-1045/007
F. Elnady
Pediatric endocrinology is a medical subspecialty dealing with disorders of the endocrine glands, such as variations of physical growth and sexual development in childhood, diabetes and many more. Permanent neonatal diabetes mellitus (PNDM) is a rare form of diabetes characterized by insulin-requiring hyperglycemia that is diagnosed within the first months of life.Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Aim of the Study An explosion of work over the last decade has produced insight into the multiple hereditary causes of a non-immunological form of diabetes diagnosed most frequently within the first 6 months of life. These studies are providing increased understanding of genes involved in the entire chain of steps that control glucose homeostasis. Neonatal diabetes is now understood to arise from mutations in genes that play critical roles in the development of the pancreas, of β-cell apoptosis and insulin processing, as well as the regulation of insulin release.
儿科内分泌学是一门治疗内分泌腺疾病的医学亚专业,如儿童期身体生长和性发育的变化、糖尿病等。永久性新生儿糖尿病(PNDM)是一种罕见的糖尿病,其特征是在生命的最初几个月内诊断出需要胰岛素的高血糖。2型糖尿病是儿科实践中一个新的临床问题。这项研究的目的在过去十年中,大量的工作深入了解了在生命的前6个月内最常见的非免疫型糖尿病的多种遗传原因。这些研究增加了对参与控制葡萄糖稳态的整个步骤链的基因的理解。新生儿糖尿病现在被认为是由在胰腺发育、β细胞凋亡和胰岛素处理以及胰岛素释放调节中发挥关键作用的基因突变引起的。
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引用次数: 0
Classification of Neuroendocrine Tumors: Consensus Guidelines for the Management and Treatment 神经内分泌肿瘤的分类:管理和治疗的共识指南
Pub Date : 2017-08-10 DOI: 10.31579/2640-1045/094
Sonallah Ibrahim
Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. Many are benign, while some are malignant. They most commonly occur in the intestine, where they are often called carcinoid tumors, but they are also found in the pancreas, lung and the rest of the body. Although there are many kinds of NETs, they are treated as a group of tissue because the cells of these neoplasms share common features, such as looking similar, having special secretory granules, and often producing biogenic amines and polypeptide hormones.
神经内分泌肿瘤(NETs)是由内分泌(激素)和神经系统细胞产生的肿瘤。许多是良性的,也有一些是恶性的。它们最常发生在肠道,通常被称为类癌肿瘤,但在胰腺、肺和身体的其他部位也有发现。虽然NETs的种类很多,但由于这些肿瘤的细胞具有共同的特征,如外观相似,具有特殊的分泌颗粒,并且经常产生生物胺和多肽激素,因此它们被视为一组组织。
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引用次数: 0
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Endocrinology and disorders : open access
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