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A Study of Adrenal Incidentaloma-Related Hormonal Assays After First Integration of the Diagnosis Within Primary Healthcare.

BACKGROUND: Adrenal incidentalomas are detected in various medical and surgical healthcare departments, including primary healthcare. One up … be integrated into the panel of various chronic disorders of one patient. The collaboration between endocrinologists and primary healthcare physicians might improve the overall long-term outcomes.

Важное значение акромагалоидных физических свойств для клинической практики.

Акромагали и гигантизм - это гормональные расстройства, которые возникают в результате гиперсекретирования хронического роста гормона. Псевдоним префикса используется для описания определенного клинического состояния без четко подтвержденной характеристики патофизиологического механизма и основных биохимических характеристик; псевдоакромегалы или акромигалоидизм соответствуют определению, приведенному выше. В данном случае мы попытаемся представить краткий обзор диагностической оценки акромигалоидной физической внешности при обсуждении two - случаи пациентов, которые имеют такие же клинические

Pycnodysostosis at otorhinolaryngology.

AIM: Pycnodysostosis is a rare autosomal, recessive, skeletal dysplasia caused by a mutation in the cathepsin k gene. Pycnodysostosis is characterized by short stature, characteristic facial appearance (delayed closure of fontanelles and cranial sutures, mandibular hypoplasia and angle disorder, blue sclera), and acroosteolysis of the distal phalanges. Our aim was to describe the otorhinolaryngologic findings, differential diagnoses, various treatment options, and followup in eight cases of pycnodysostosis. METHOD: This retrospective clinical study used data from eight patients diagnosed with

Lowering Targeted Atherogenic Lipoprotein Cholesterol Goals for Patients at "Extreme" ASCVD Risk.

PURPOSE OF REVIEW: To review randomized interventional clinical and imaging trials that support lower targeted atherogenic lipoprotein cholesterol goals in "extreme" and "very high" atherosclerotic cardiovascular disease (ASCVD) risk settings. Major atherosclerotic cardiovascular event (MACE) prevention among the highest risk patients with ASCVD requires aggressive management of global risks, including lowering of the fundamental atherogenic apolipoprotein B-associated lipoprotein cholesterol particles [i.e., triglyceride-rich lipoprotein remnant cholesterol, low-density lipoprotein cholestero

The "Biopsychosocial Model": 40 years of application in Psychiatry.

In 1977, the American pathologist and psychiatrist George Engel (1913-1999) published in the Journal Science his paper "TheIn 1977, the American pathologist and psychiatrist George Engel (1913-1999) published in the Journal Science his paper "Theneed for a new medical model: A challenge for biomedicine", introducing the term Biopsychosocial Model. This model basedon the results of Engel's studies in ulcerative colitis, depression and psychogenic pain, constituted a challenge for biomedicineand the biomedical model. The basic principles of the model included the biological, psychological and so

Laparoscopic Gastric Bypass Reversal with Concomitant Sleeve Gastrectomy (SG) for Refractory Hypoglycemia: an Unusual Procedure.

INTRODUCTION: Post-bariatric surgery hypoglycemia is usually seen in patients with a history of gastric bypass surgery [1], and few experien … D CONCLUSION: Post-bariatric surgery hypoglycemia is a challenging condition, for both surgeons and endocrinologists. Our patient has suffered severe symptoms that were refractory to medical treatment and dietary modifications. Few papers have discussed LGBP conversion to a sleeve gastrectomy for hypoglycemia, but results from small series are showing promising re …

Current evidence for the treatment of hypothyroidism with levothyroxine/levotriiodothyronine combination therapy versus levothyroxine monotherapy.

ObjectiveHypothyroidism is relatively common, occurring in approximately 5% of the general US population aged ≥12 years. Levothyroxine (LT4) monotherapy is the standard of care. Approximately, 5%-10% of patients who normalise thyroid-stimulating hormone levels with LT4 monotherapy may have persistent symptoms that patients and clinicians may attribute to hypothyroidism. A long-standing debate in the literature is whether addition of levotriiodothyronine (LT3) to LT4 will ameliorate lingering symptoms. Here, we explore the evidence for and against LT4/LT3 combination therapy as the optimal appr

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… American Association of Clinical Endocrinologists and American College of Endocrinology position statement on thyroid dysfunction case finding . Endocr Pract . 2016 ; 22 : 262 ‐ 270 . 26848631 10.4158/EP151038.PS 36 Jonklaas J , Bianco AC , Bauer AJ , et al. … Italian Association of Clinical Endocrinologists statement‐replacement therapy for primary hypothyroidism: a brief guide for clinical practice . …

ВРЕМЯ АНДОКРИСНОЛОГИИ COVID-19-2021 Борьба с диабетом инсипидом и гипонатрамией.

AbstractCOVID-19 , изменила характер медицинских консультаций, сделав упор на виртуальное консультирование пациентов, что имеет отношение к пациентам с диабетом инсипиду (ДИ) или гипонатрамией. Основным осложнением лечения демопрессией в ДИ является разбавляющая гипонатраемия. Поскольку плазменный мониторинг натрия не всегда возможен во время COVID-19, мы рекомендуем откладывать дозу десмопрессина раз в неделю до тех пор, пока не произойдет акварез, позволяющий экстрактировать избыточную оставляемую воду. Пациенты должны ежедневно измерять вес своего тела. Пациенты с детективом-детективом, пом

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… However, it may be that endocrinologists may have to accept mild hypernatraemia (<155 mmol/L) as the price of preventing pulmonary oedema. … Treatment of dehydration must be tempered with the potential to precipitate pulmonary oedema with i.v. fluid; treatment plans should be carefully agreed upon between endocrinologists and intensivists. …

Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task.

Central diabetes insipidus (CDI) is a rare endocrine disease deriving from an insufficient production or secretion of anti-diuretic hormone. Recently, CDI has been reported as a rare side effect triggered by immune checkpoint inhibitors (ICI) in cancer patients. Despite its current rarity, CDI triggered by ICI is expected to affect an increasing number of patients because of the expanding use of these effective drugs in a growing number of solid and hematologic malignancies. An appropriate assessment of the severity of adverse events induced by anticancer agents is crucial in their management,

Parathyroid Adenoma as a Rare Cause of Persistent Hypercalcemia in a Female with Polycythemia Vera.

Polycythemia vera is one of the myeloproliferative neoplasms that is distinguished by the uncontrolled production of blood cells and an increased red cell mass due to acquired JAK2 mutation. It has many complications and it might increase the risk of other tumors. However, it does not cause hypercalcemia and is rarely associated with parathyroid adenoma. Here, we report on a 64-year-old female with polycythemia vera found to have hypercalcemia due to parathyroid adenoma.

Rare diseases: a challenge in paediatric dentistry.

Rare diseases are an often an overlooked public health problem. Although they are infrequent, occurring on average in 100-500 people per mil … sciplinary management and initiation of medical therapies with the collaboration of paediatricians, endocrinologists and other health specialists. The role of dental professionals is not limited to the diagnosis of these rare diseases, but it also encompasses delivering specific, patient-tailored treatments, encouraging preventive care with regular dental visits a …

Endometriosis classification systems: an international survey to map current knowledge and uptake.

STUDY QUESTION: Which classification system for endometriosis do clinicians use most frequently, and why? SUMMARY ANSWER: Even with a high … l dataset included the replies of 1178 clinicians, including surgeons, gynaecologists, reproductive endocrinologists, fertility specialists and sonographers, all managing women with endometriosis in their clinical practice. Overall, 75.5% of the professionals indicate that they currently use a classification system for endometriosis. The rASRM classification syste …

The rational use of fine needle aspiration biopsy (FNAB) in diagnosing thyroid nodules.

AIM: Fine needle aspiration biopsy (FNAB) plays a crucial role in the diagnosis of thyroid nodules and enables the number of surgical operations to be reduced. Theoretically, FNAB should be carried out on all nodules, though currently only those displaying certain characteristics are biopsied. Indeed, to perform FNAB on all nodules may be regarded as an excess of zeal. Therefore, it seems advisable that the endocrinologist should be able to confirm on the spot the necessity and utility of FNAB. METHODS: We evaluated on a sample of 263 consecutive requests (209 female, 57 male; age 56.7+/-13.7

Multidisciplinary Management of Morbidities Associated with Chronic Graft-Versus-Host Disease.

Chronic graft-versus-host disease (cGVHD) represents a common long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT). It imposes a significant morbidity burden and is the leading cause of non-relapse mortality among long-term HSCT survivors. cGVHD can manifest in nearly any organ, severely affecting the quality of life of a transplant survivor. While the mainstay of treatment has remained systemic immunosuppression with glucocorticoids, progress has been made within the last few years with approvals of three oral agents to treat steroid-refractory cGVHD: ibrutin

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… Moreover, the nuanced discussion of the relative risks and benefits of hormone replacement therapy warrants involvement of an endocrinologist. Sexual Health and Fertility Genital cGVHD has a significant impact on the sexual health and function of women and men. … Promoting sexual health with cGVHD warrants the multidisciplinary involvement of gynecology, urology, reproductive endocrinologists, and other fertility specialists. …

Osteoporosis Diagnosis and Management: A Review from an Orthopedic Perspective.

Osteoporosis is a systemic skeletal disorder characterized by low bone density and microarchitectural deterioration, both of which lead to increased risk of fracture, disability, institutionalization, and mortality. Dual-energy X-ray absorptiometry (DEXA) remains the gold standard for evaluating bone mineral density and establishing diagnostic thresholds. However, accurate interpretation requires more than the application of numerical cut-offs. Interpretation requires careful evaluation of graphical bands, artifact recognition, awareness of site discordance, and application of least significan

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… Eligibility criteria included international guidelines and consensus statements (WHO, International Society for Clinical Densitometry [ISCD], American Association of Clinical Endocrinologists/American College of Endocrinology [AACE/ACE], American Society for Bone and Mineral Research [ASBMR], Endocrine … American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update. Endocr Pract. 2021;27:379-80. https://doi.org/10.1016/j.eprac.2021.02.001 10.1016/j.eprac.2021.02.001 35. …

Case series: Odontohypophosphatasia or missed diagnosis of childhood/adult-onset hypophosphatasia? - Call for a long-term follow-up of premature loss of primary teeth.

IntroductionHypophosphatasia, a metabolic bone disease caused by a tissue-nonspecific alkaline phosphatase deficiency, leads to undermineralization of bone and/or teeth, impaired vitamin B6 metabolism, and a spectrum of disease presentation. At the mild end of the spectrum, it presents as pathologic fractures in later adulthood. Patients with isolated dental manifestations, typically presenting as premature loss of primary teeth, are classified as having odontohypophosphatasia (odontoHPP). A subset of patients diagnosed with odontoHPP in childhood can later develop extra-dental manifestations

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges.

Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices

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… Card-Onc = cardio-oncologist; CC = clinical cardiologist; CFS = clinical frailty scale; CKD = chronic kidney disease; CM = cardiomyopathy; COPD = chronic obstructive pulmonary disease; CRT-D = cardiac resynchronization therapy defibrillator; CTS = cardiothoracic surgery; DM = diabetes mellitus; Endo = endocrinologist … Extended MDHT members may include critical care physicians, cardiac surgeons, physical therapists, palliative care specialists, nephrologists, endocrinologists, pulmonologists, social workers, dieticians, transplant and/or left ventricular assist device nurses, infectious disease specialists, and psychologists …

Changes of bone turnover markers and bone mineral density among postmenopausal Thai women with osteoporosis receiving generic risedronate.

BackgroundOsteoporosis has been recognized as a significant health issue in Thailand. Pharmacological interventions are important way to prevent fracture. However, one of the main challenges in selecting a medication is high cost, particularly for brand-name drugs. Data on generic bisphosphonate use in Thai are still lacking. Therefore, our study aimed to assess the efficacy and safety of generic risedronate in postmenopausal Thai women with osteoporosis.MethodsThis prospective study was conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from December 2022 to January 2024. S

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… American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the diagnosis and treatment of postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26:1–46. 32427503 10.4158/GL-2020-0524SUPPL 20. … American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the diagnosis and treatment of postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2021;27:379–80. 33577971 10.1016/j.eprac.2021.02.001 32. …

Erythrodermic Presentation of Atopic Dermatitis in a Patient with Secondary Adrenal Insufficiency Caused by Oral Glucocorticosteroid Abuse.

Dear Editor, A 41-year-old man presented to the Department of Dermatology for the first time due to an exacerbation of atopic dermatitis (AD) in the form of erythroderma. The patient had a history of atopic diseases, with being AD active from infancy. On clinical examination, generalized erythematous skin lesions causing acute pruritus and accompanied by severe skin exfoliation and dryness were present. On closer examination, the patient had a collection of signs and symptoms characterizing Cushing syndrome that included a round and full face (''moon face''), supraclavicular fat pads, and prox

Effect of pubertal induction with combined gonadotropin therapy on testes development and spermatogenesis in males with gonadotropin deficiency: a cohort study.

STUDY QUESTION: Are recombinant FSH (rFSH) and hCG effective therapies for promoting testicular growth and spermatogenesis in male adolescen … rtal induction. This last finding is aligned with previous data and may help to reassure paediatric endocrinologists with limited access to rFSH or hCG that the use of exogenous testosterone to induce androgen-dependent changes in patients seeking treatment for pubertal delay is unlikely to compromise spermatogenic potential, should gonadotropins become available …