Результаты поиска

Lithium therapy and disorders of the parathyroid glands.

OBJECTIVE: To review the effects of lithium (Li+) on the parathyroid glands. METHODS: We describe the incidence and clinical features of Li(+)-associated hyperparathyroidism and summarize the current state of knowledge of the in vitro and in vivo effects of Li+ on the parathyroid cell. RESULTS: Li+ treatment is known to increase the calcium set-point in the parathyroid glands for inhibition of parathyroid hormone secretion. Evidence suggests that this change in calcium set-point occurs as a result of Li+ interference with transmembrane signal transduction in the parathyroid cell. Li+ therapy

Coexisting hyperthyroidism and primary hyperparathyroidism with vitamin D-deficient osteomalacia in a Vietnamese immigrant.

OBJECTIVE: To present the first report of concurrent hyperthyroidism, primary hyperparathyroidism (PHP), and vitamin D-deficient osteomalacia. METHODS: We describe the complicated clinical course in a 65-year-old Vietnamese immigrant, and underlying factors potentially contributing to her condition are discussed. RESULTS: Our patient, who had hyperthyroidism and hypercalcemia, was found to have an inappropriately high level of intact parathyroid hormone (PTH) because of a parathyroid adenoma, detected on a parathyroid scan. With propranolol treatment, however, improvement was noted in both l

Parathyroid reoperation with use of technetium 99m sestamibi radiolocalization and an intraoperative gamma counter.

OBJECTIVE: To describe a new intraoperative technique for localization of abnormal parathyroid tissue. METHODS: We report a case and discuss the difficulties encountered in reexploration of the neck area. RESULTS: Parathyroid reoperation remains a formidable challenge to even the most experienced endocrine surgeon. Despite the advances in radiographic imaging and localization techniques, accurate intraoperative identification of abnormal parathyroid tissue in a scarred field with obliterated anatomic planes is frequently tedious and occasionally unsuccessful. In a 48-year-old woman with hype

Prevention and treatment of diabetic nephropathy: role of angiotensin-converting enzyme inhibitors.

OBJECTIVE: To discuss the role of angiotensin-converting enzyme inhibitors in the management of diabetes-related renal disease. METHODS: We review the published data from animal studies and clinical trials and outline the adverse effects that may limit the use of these drugs. RESULTS: Diabetic nephropathy is the most common cause of end-stage renal disease and dialysis in the United States. With improving measures to optimize blood glucose control and blood pressure, the progression from mild proteinuria to overt renal insufficiency can now be retarded or even arrested. Studies of therapeuti

Noncardiogenic pulmonary edema complicating diabetic ketoacidosis.

OBJECTIVE: To alert physicians to the possibility of pulmonary edema as a complication of diabetic ketoacidosis. METHODS: We report a case of adult respiratory distress syndrome after resuscitative efforts to compensate the first episode of diabetic ketoacidosis in a previously healthy young woman. RESULTS: In a 26-year-old woman with a 3-day history of malaise, polyuria, nausea, and vomiting, severe hypoxia and rales developed, and intubation and mechanical ventilation became necessary. Hemodynamic evaluation and striking electron microscopic findings on open-lung biopsy confirmed the diagn

Androstenedione aromatization as a cause of gynecomastia in 11beta-hydroxylase and 21-hydroxylase deficiencies.

OBJECTIVE: To report two cases of gynecomastia that occurred in boys with 11beta-hydroxylase and 21-hydroxylase deficiency. METHODS: We describe the physical findings and summarize the laboratory evaluation and treatment of two cases encountered in our medical practice. RESULTS: Both of our patients (a 4-year-old boy and a 17-year-old boy) had extreme virilization and gynecomastia; on laboratory assessment, androstenedione and estrogen levels were high. Treatment with hydrocortisone was recommended. CONCLUSION: Peripheral conversion of adrenal androgen to estrogen likely caused the feminizi

Reversible thioridazine-induced magnetic resonance imaging-documented pituitary enlargement associated with hyperprolactinemia.

OBJECTIVE: To document a case of reversible thioridazine-induced pituitary enlargement associated with hyperprolactinemia in a patient with schizophrenia. METHODS: We describe a 19-year-old woman with paranoid schizophrenia who was taking thioridazine (a phenothiazine), in whom hyperprolactinemia, galactorrhea, oligomenorrhea, and a reversible anatomic pituitary abnormality developed. Serial magnetic resonance imaging (MRI) studies were used to assess the status of the pituitary gland during various pharmaceutical therapies. RESULTS: Laboratory evaluation revealed increased serum prolactin (

Stone bone syndrome--diffuse sclerosis of bone: a newly described clinical disorder.

A 52-year-old man with severe bone pain was found to have diffuse sclerosis of bone and chronic hepatitis C infection. A bone biopsy specimen showed a normal lamellar appearance but dramatically increased bone-forming surfaces. A possible mechanism for this disorder is offered.

Kallmann's syndrome with diabetes insipidus.

A case is presented of a male with Kallmann's syndrome who at the age of 27 developed central diabetes insipidus. Previously, Kallmann's syndrome has been found to be associated with an altered osmotic threshold for vasopressin release and impaired thirst sensation, but to our knowledge, this is the first reported association with diabetes insipidus.

Diabetes insipidus and histiocytosis X: a case of isolated pituitary involvement.

Diabetes insipidus is associated with histiocytosis X in approximately 50% of cases with multiple lesions that involve both intracranial and extracranial structures. Although approximately 8% of cases of diabetes insipidus in children are caused by involvement of the hypothalamus or pituitary infundibulum (or both) by histiocytosis X, diabetes insipidus can be the initial manifestation in many disorders most commonly, intracranial neoplasms. Herein we report a case of isolated histiocytosis X of the pituitary gland in a child for whom medical assistance was sought because of symptoms of diabet

Recurrent hyperthyroidism after radioiodine-induced hypothyroidism: report of two cases and literature review.

The practice at the Mayo Clinic in treating Graves' disease with radioiodine (131 I) is to achieve a hypothyroid state. Less than 10% of the patients need more than one dose. Although cases of transient hypothyroidism have been reported after treatment with 131 I, the recurrence of hyperthyroidism is unusual after hypothyroidism has been induced with 131 I. We studied two cases seen at our institution in the past year in which the circumstances behind the recurrence have never been reported previously. The first case illustrates a recurrence of hyperthyroidism after the patient had received 38

Autoimmune Addison's disease after treatment with interleukin-2 and tumor-infiltrating lymphocytes.

Autoimmune thyroiditis with hypothyroidism is a well-known complication of immunotherapy with interleukin-2 (IL-2) with or without lymphokine-activated killer (LAK) cells. To date, however, no cases of IL-2/LAK-induced autoimmune adrenalitis with adrenal insufficiency have been reported. We describe a patient who developed primary adrenal insufficiency following IL-2/tumor-infiltrating lymphocytes (TIL) immunotherapy for renal cell carcinoma. A 64-year-old male with renal cell carcinoma metastatic to bone, skin, lung, and the central nervous system presented for IL-2/TIL treatment. Nine months

Growth hormone, skeletal growth factors and osteoporosis.

Bone remodeling is regulated by systemic hormones and growth factors acting in concert to maintain normal bone mass. Growth hormone has important effects on bone metabolism and acts by stimulating the production of insulin-like growth factor (IGF) I in the liver. Conditions of growth hormone deficiency have decreased bone mass that could be modified by growth hormone administration. Skeletal cells synthesize a variety of growth factors with diverse properties and levels of regulation. IGF I and II seem to play a major role in the local regulation of bone remodeling, and other growth factors ha

Cancer treatment-induced bone loss.

Cancer treatment-induced bone loss (CTBL) is associated with anti-tumor treatments, including endocrine therapies, chemotherapeutic treatments, radiotherapy, glucocorticoids, and tyrosine kinase inhibitors. Osteoporosis, characterized by the loss of bone mass, can increase the risk of fractures, leading to mortality and long-term disability, even after cancer remission. Cancer and osteoporosis have marked clinical and pathogenetic similarities. Both have a multifactorial etiology, affect the geriatric population, and markedly influence quality of life. Lifestyle management, including calcium a

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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(Suppl 1):1–46. doi: 10.4158/GL-2020-0524SUPPL. 91. …

Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP).

This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon i

Совпадение в полном тексте источника
… 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. doi: 10.4158/GL-2020-0524SUPPL. 13. Campisi G, Bedogni A, Fusco V. …

Therapeutic Perspectives on the Modulation of G-Protein Coupled Estrogen Receptor, GPER, Function.

Estrogens exert their physiological and pathophysiological effects via cellular receptors, named ERα, ERβ, and G-protein coupled estrogen receptor (GPER). Estrogen-regulated physiology is tightly controlled by factors that regulate estrogen bioavailability and receptor sensitivity, while disruption of these control mechanisms can result in loss of reproductive function, cancer, cardiovascular and neurodegenerative disease, obesity, insulin resistance, endometriosis, and systemic lupus erythematosus. Restoration of estrogen physiology by modulating estrogen bioavailability or receptor activity

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… A recent guidance statement from the American Association of Clinical Endocrinologists (AACE) suggests that a soy-rich diet may be used as an alternative approach for estrogen replacement therapy ( 88 ) indicating that endogenous estrogens and phytoestrogens are biologically equivalent. …

Systemic mastocytosis: current status and challenges in 2024.

AbstractSystemic mastocytosis (SM) is a rare disease and has had significant discoveries in its biology, prognostication, and management in the past 2 decades. The latest update of the World Health Organization classification and the new International Consensus Classification are current standards in the diagnosis and prognostication of SM. In clinical practice, SM can be divided into 2 main categories: nonadvanced SM (nonAdvSM) and advanced SM (AdvSM). The integration of clinical signs and symptoms as well as bone marrow morphologic, immunophenotypic, and molecular results is required to diag

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… extracutaneous organs), and PB count recovery. 117 Recently, pure pathologic response criteria based on BM MC burden, KIT mutation VAF, and serum tryptase level (excluding consideration of organ damage) have been proposed. 118 , 119 Conclusion Oncologists, hematologists, allergists, gastroenterologists, endocrinologists …

Catgut embedding in acupoints combined with repetitive transcranial magnetic stimulation for the treatment of postmenopausal osteoporosis: study protocol for a randomized clinical trial.

BACKGROUND: To date, the clinical modulation for bone metabolism based on the neuro-bone mass regulation theory is still not popular. The stimulation of nerve systems to explore novel treatments for Postmenopausal osteoporosis (PMOP) is urgent and significant. Preliminary research results suggested that changes brain function and structure may play a crucial role in bone metabolism with PMOP. Thus, we set up a clinical trial to investigate the effect of the combination of repetitive transcranial magnetic stimulation (rTMS) and catgut embedding in acupoints (CEA) for PMOP and to elucidate the c

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… Western medical diagnostic criteria: Referring to the Clinical Practice Manual-Osteoporosis and Bone Mineral Disorders and the Primary Osteoporosis Primary Care Guidelines (2019) from the Chinese Medical Association, as well as the one formulated by American College of Clinical Endocrinologists (AACE …

Hematological Diseases and Osteoporosis.

Secondary osteoporosis is a common clinical problem faced by bone specialists, with a higher frequency in men than in women. One of several causes of secondary osteoporosis is hematological disease. There are numerous hematological diseases that can have a deleterious impact on bone health. In the literature, there is an abundance of evidence of bone involvement in patients affected by multiple myeloma, systemic mastocytosis, thalassemia, and hemophilia; some skeletal disorders are also reported in sickle cell disease. Recently, monoclonal gammopathy of undetermined significance appears to inc

PD-1 Pathway Inhibitors: Immuno-Oncology Agents for Restoring Antitumor Immune Responses.

Immune checkpoint inhibitors are designed to restore a patient's own antitumor immune response that has been suppressed during tumor development. The first monoclonal antibodies against the immune checkpoint programmed death 1 (PD-1) receptor, nivolumab and pembrolizumab, are now approved for clinical use. Both agents are indicated for the treatment of advanced melanoma, as well as for the treatment of metastatic non-small cell lung cancer (NSCLC). Nivolumab is also approved for the treatment of advanced renal cell carcinoma. In patients with melanoma, these agents result in objective response