Management Of Endocrine Disorders Research Articles

A Comprehensive Review of the Role of Biomarkers in the Early Detection of Endocrine Disorders in Critical Illnesses.

Endocrine disorders pose significant challenges in the management of critically ill patients, contributing to morbidity and mortality in intensive care settings. Timely detection of these disorders is essential to optimizing patient outcomes. Biomarkers, as measurable indicators of biological processes or disease states, play a crucial role in the early identification and monitoring of endocrine dysfunction. This comprehensive review examines the role of biomarkers in the early detection of endocrine disorders in critical illnesses. We provide an overview of common endocrine disorders encountered in the intensive care unit (ICU) and discuss the impact of endocrine dysregulation on patient outcomes. Additionally, we classify biomarkers and explore their significance in diagnosing and monitoring endocrine disorders, including thyroid dysfunction, adrenal insufficiency, and hypopituitarism. Furthermore, we discuss the clinical applications of biomarkers, including their utility in guiding therapeutic interventions, monitoring disease progression, and predicting outcomes in critical illnesses. Emerging trends and future directions in biomarker research are also highlighted, emphasizing the need for continued investigation into novel biomarkers and technological advancements. Finally, we underscore the potential of biomarkers to revolutionize the early detection and management of endocrine disorders in critical illnesses, ultimately improving patient care and outcomes in the ICU.

Impact of Variation between Assays and Reference Intervals in the Diagnosis of Endocrine Disorders.

Method-related variations in the measurement of hormones and the reference intervals used in the clinical laboratory can have a significant, but often under-appreciated, impact on the diagnosis and management of endocrine disorders. This variation in laboratory practice has the potential to lead to an errant approach to patient care and thus could cause harm. It may also be the source of confusion or result in excessive or inadequate investigation. It is important that laboratory professionals and clinicians know about these impacts, their sources, and how to detect and mitigate them when they do arise. In this review article, we describe the historical and scientific context from which inconsistency in the clinical laboratory arises. Examples from the published literature of the impact of the method, reference interval, and clinical decision threshold-related discordances on the assessment and monitoring of various endocrine disorders are discussed to illustrate the sources, causes, and effects of this variability. Its potential impact on the evaluation of growth hormone deficiency and excess, thyroid and parathyroid disorders, hyperandrogenism, hypogonadism, glucocorticoid excess and deficiency, and diabetes mellitus is elaborated. Strategies for assessment and mitigation of the discordance are discussed. The clinical laboratory has a responsibility to recognise and address these issues, and although a lot has been accomplished in this area already, there remains more to be done.

Endocrinopathies in Hemoglobinopathies: What Is the Role of Iron?

Hemoglobinopathies, including β-thalassemia and sickle cell disease (SCD), are common genetic blood disorders. Endocrine disorders are frequent manifestations of organ damage observed mainly in patients with β-thalassemia and rarely in SCD. Iron overload, oxidative stress-induced cellular damage, chronic anemia, and HCV infection contribute to the development of endocrinopathies in β-thalassemia. The above factors, combined with vaso-occlusive events and microcirculation defects, are crucial for endocrine dysfunction in SCD patients. These endocrinopathies include diabetes mellitus, hypothyroidism, parathyroid dysfunction, gonadal and growth failure, osteoporosis, and adrenal insufficiency, affecting the quality of life of these patients. Thus, we aim to provide current knowledge and data about the epidemiology, pathogenesis, diagnosis, and management of endocrine disorders in β-thalassemia and SCD. We conducted a comprehensive review of the literature and examined the available data, mostly using the PubMed and Medline search engines for original articles. In the era of precision medicine, more studies investigating the potential role of genetic modifiers in the development of endocrinopathies in hemoglobinopathies are essential.

Applying precision medicine to the diagnosis and management of endocrine disorders.

Precision medicine employs digital tools and knowledge of a patient’s genetic makeup, environment and lifestyle to improve diagnostic accuracy and to develop individualised treatment and prevention strategies. Precision medicine has improved management in a number of disease areas, most notably in oncology, and it has the potential to positively impact others, including endocrine disorders. The accuracy of diagnosis in young patients with growth disorders can be improved by using biomarkers. Insulin-like growth factor I (IGF-I) is the most widely accepted biomarker of growth hormone secretion, but its predictive value for recombinant human growth hormone treatment response is modest and various factors can affect the accuracy of IGF-I measurements. These factors need to be taken into account when considering IGF-I as a component of precision medicine in the management of growth hormone deficiency. The use of genetic analyses can assist with diagnosis by confirming the aetiology, facilitate treatment decisions, guide counselling and allow prompt intervention in children with pubertal disorders, such as central precocious puberty and testotoxicosis. Precision medicine has also proven useful during the transition of young people with endocrine disorders from paediatric to adult services when patients are at heightened risk of dropping out from medical care. An understanding of the likelihood of ongoing GH deficiency, using tools such as MRI, detailed patient history and IGF-I levels, can assist in determining the need for continued recombinant human growth hormone treatment during the process of transitional care.

Passing on the exercise baton: What can endocrine patients learn from elite athletes?

As elite athletes demonstrate through the Olympic motto ‘Citius, Altius, Fortius‐ Communiter’, new performance records are driven forward by favourable skeletal muscle bioenergetics, cardiorespiratory, and endocrine system adaptations. At a recreational level, regular physical activity is an effective nonpharmacological therapy in the treatment of many endocrine conditions. However, the impact of physical exercise on endocrine function and how best to incorporate exercise therapy into clinical care are not well understood. Beyond the pursuit of an Olympic medal, elite athletes may therefore serve as role models for showcasing how exercise can help in the management of endocrine disorders and improve metabolic dysfunction. This review summarizes research evidence for clinicians who wish to understand endocrine changes in athletes who already perform high levels of activity as well as to encourage patients to exercise more safely. Herein, we detail the upper limits of athleticism to showcase the adaptability of human endocrine‐metabolic‐physiological systems. Then, we describe the growing research base that advocates the importance of understanding maladaptation to physical training and nutrition in males and females; especially the young. Finally, we explore the impact of physical activity in improving some endocrine disorders with guidance on how lessons can be taken from athletes training and incorporated into strategies to move more people more often.

Endocrinopathies in thalassemia - a review

Improved treatment has increased survival of patients with thalassemia. However, they still suffer from several endocrine complications mainly as a result of iron overload from multiple transfusions. Endocrinopathies manifest as early as the first decade of life, affecting growth, puberty, psychological development and quality of life. The presence of concomitant anemia, chronic liver disease and cardiomyopathy affect the development and treatment of endocrine disorders, making endocrinopathies in thalassemia a complex disorder. This review focuses on the pathogenesis, diagnosis and treatment of endocrinopathies in transfusion and non transfusion dependent thalassemia. The main points that should be considered in the management of endocrine disorders in a patient with thalassemia are highlighted in this review.
 Ibrahim Med. Coll. J. 2021; 15(1): 47-55

Pharmacoepidemiological assessment of endocrine disorders in a tertiary care teaching hospital

Background: The endocrine disorders such as diabetes mellitus, hypothyroidism and hyperthyroidism along with world’s ageing population has increased the burden of health care systems. The present study aimed to assess the prescribing pattern of drugs in endocrine disease like diabetes and thyroid disorder and to evaluate the drug use in given healthcare against programmed criteria and standards.Methods: A prospective observational study was conducted in 220 patients over six months in a tertiary care teaching hospital. Patients who are diagnosed with endocrine disorder in various (general medicine, surgery and Orthopedics) inpatient departments of study hospital.Results: A prospective observational study was carried out by reviewing prescriptions of 220 patients with lifestyle disorders such as, DM (120), hyperthyroidism (50) and hypothyroidism (50). In diabetes, most of the patients were prescribed with biguanides 75 (47.17%) followed by sulfonylureas 56 (35.22%), alpha-glycosidase inhibitors 20 (12.58%), dipeptidyl peptidase 4 inhibitors 5 (3.14%), meglitinides 2 (1.26%) and thiazolidinediones 1 (0.63%). Most of the prescription containing insulin Actrapid and insulin Mixtard 14 (82.35%) followed by insulin Actrapid and insulin NPH 2 (11.76%), insulin Mixtard and insulin Glargine 1 (5.89%). In hypothyroidism most of the patients were prescribed with propylthiouracil 28 (56%) followed by methimazole 26 (44%). Levothyroxine is the best choice of drug for hypothyroid disorder.Conclusions: Our study found that treatment and management of endocrine disorders were not rational. There is a need of clinical pharmacist involvement for a better patient care in these disorders.

Optoacoustic imaging in endocrinology and metabolism.

Imaging is an essential tool in research, diagnostics and the management of endocrine disorders. Ultrasonography, nuclear medicine techniques, MRI, CT and optical methods are already used for applications in endocrinology. Optoacoustic imaging, also termed photoacoustic imaging, is emerging as a method for visualizing endocrine physiology and disease at different scales of detail: microscopic, mesoscopic and macroscopic. Optoacoustic contrast arises from endogenous light absorbers, such as oxygenated and deoxygenated haemoglobin, lipids and water, or exogenous contrast agents, and reveals tissue vasculature, perfusion, oxygenation, metabolic activity and inflammation. The development of high-performance optoacoustic scanners for use in humans has given rise to a variety of clinical investigations, which complement the use of the technology in preclinical research. Here, we review key progress with optoacoustic imaging technology as it relates to applications in endocrinology; for example, to visualize thyroid morphology and function, and the microvasculature in diabetes mellitus or adipose tissue metabolism, with particular focus on multispectral optoacoustic tomography and raster-scan optoacoustic mesoscopy. We explain the merits of optoacoustic microscopy and focus on mid-infrared optoacoustic microscopy, which enables label-free imaging of metabolites in cells and tissues. We showcase current optoacoustic applications within endocrinology and discuss the potential of these technologies to advance research and clinical practice.

Клинические особенности пациенток с гиперпластическими процессами эндометрия

Aim: to describe clinical characteristics of women with endometrial hyperplasia. Patients and Methods: this retrospective single-center study enrolled 86 women who underwent hysteroscopic curettage (with subsequent histology) on the basis of complaints and ultrasound. All women were divided into three groups. Group 1 included 30 women with endometrial hyperplasia (EH). Group 2 included 30 women with endometrial polyps (EP). Group 3 included 26 healthy women without any endometrium conditions (control group). Somatic status, obstetric gynecologic anamnesis, and comorbidities were evaluated. Results: in women with EH, heavy periods were 2.37- and 2.6-times more common than in groups 2 and 3 (p<0.05) while the rate of other abnormal uterine bleedings was 7.06- and 6.06-times higher, respectively (p<0.05). In women with EH, anemia was diagnosed 4- and 5.2-times more common than in groups 2 (p<0.05) and 3 (p<0.05), respectively. In group 2, inflammatory cervical and vaginal conditions were 3.98- and 3.46-times more common than in group 1 (p<0.05) and group 3 (p>0.05). The occurrence of endocrine disorders in group 1 was 4.49- and 3.9-times higher than in group 2 and 3, respectively (p<0.05). Anamnestic thrombosis, strokes, and migraines were reported only in women with EH. Conclusions: prevention of endometrium conditions entails both early detection and control over ovulation and management of endocrine disorders and treatment of genital tract inflammation. When managing women with uterine fibroids and adenomyosis and anamnestic thrombosis, a doctor should be vigilant about EH. KEYWORDS: endometrial hyperplasia, endometrial polyp, inflammation, hyperplastic conditions, uterus, thrombosis. FOR CITATION: Salamova K.K., Saprykina L.V., Ramazanova A.M. et al. Clinical characteristics of women with endometrial hyperplasia. Russian Journal of Woman and Child Health. 2021;4(2):124–129. DOI: 10.32364/2618-8430-2021-4-2-124-129.

Meeting Report: The Equality Project on Endocrine Complications in Thalassemia: Selected Highlights from the First Turkish Congress, Antalya, 10th-11th December 2018.

Major difficulties reported by endocrinologists /pediatricians/ hematologists in the care of thalassemic patients with endocrine complications were: lack of facilities, correct interpretation of tests, unfamiliarity with medical treatment and the cost of diagnostics and therapeutics. Therefore, there is a felt need to educate and train more endocrinologists/pediatricians/hematologists in this field in order to optimise growth and prevent endocrine complications. To achieve this goal, in 2015, a project called Equality was submitted by three countries (Turkey, Spain and Italy) and approved by the European Union (EU) with the aim to train doctors and nurses, taking care of youth and young adults TM patients, in the prevention, diagnosis, and management of endocrine disorders. The selected highlights of the First Turkish Congress held in Antalya (10th-11th December 2018) are reported. Overall the conference provided a wide coverage of conventional treatment of thalassemias and endocrine complications in patients with β-thalassemia major. Regular surveillance, early diagnosis, treatment and follow-up in a multi-disciplinary specialized setting are recommended.

Management of Endocrine Disorders during Pregnancy

Management of Endocrine Disorders during Pregnancy

Abstract #733: Knowledge and Attitude of Endocrine Trainees Towards the Management of Endocrine Disorders in People Living with HIV in Singapore

Abstract #733: Knowledge and Attitude of Endocrine Trainees Towards the Management of Endocrine Disorders in People Living with HIV in Singapore

Dietary interventions for the potential prevention, treatment and management of endocrine disorders

Dietary interventions for the potential prevention, treatment and management of endocrine disorders

Cost-effective strategies to accelerate diagnosis and management of endocrine disorders in the outpatient setting

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Editorial: Molecular Endocrinology Articles in the Spotlight for January 2012

Beginning with this issue of Molecular Endocrinology, we’ll be highlighting three articles that should be of special interest to our readers. Although all manuscripts accepted for publication in Molecular Endocrinology have a high degree of scientific merit, the three selected for an editorial highlight are meant to showcase particularly novel and significant findings reflective of others that can be found throughout the issue. This first issue of 2012 includes the following articles that are excellent examples of the relevance of basic science findings to clinical management of endocrine disorders. The first, “Reduced bone turnover in mice lacking the P2Y13 receptor of ADP” by Alison Gartland and colleagues, addresses the issue of osteoporosis and the need for drugs that provide alternative treatment for osteoporosis. The authors show that deletion of the P2Y13 receptor, a G protein-coupled receptor for extracellular ADP, leads to a reduction in trabecular bone mass, reduction in osteoblast and osteoclast numbers and an overall reduction in the rate of bone remodeling in mice. They also find that P2Y13R( / ) mice are protected from ovariectomyinduced bone loss. Therefore, the P2Y13 receptor may provide a new therapeutic target that confers a protective advantage in conditions of accelerated bone turnover such as estrogen deficiency-induced osteoporosis. This would be a tremendous benefit to the one third of all women and one fifth of all men over fifty who will experience an osteoporotic fracture in their lifetime. “FXR protects lung from LPS-induced acute injury”, by Wendong Huang and colleagues, is another article in the spotlight this month. This research addresses acute lung injury, which is associated with 17,000–43,000 deaths each year. In one of the important findings of this study, Huang et al. demonstrate that expression of a constitutively active FXR repressed the expression of proinflammatory genes and improved lung permeability and lung regeneration in FXR / mice. Therefore, FXR may be an ideal target for drug development as novel and safe FXR ligands may be effective for the treatments of lung injury and other related diseases. Finally, Signe Altmae and colleagues bring us a Research Resource contribution, “Interactome of human embryo implantation: identification of gene expression pathways, regulation, and integrated regulatory networks.” This study helps us to better understand the complex genetic network that leads to successful embryo implantation and will be relevant to the development of future strategies to alleviate human infertility. The authors are the first to perform thorough computational analysis to identify the potential molecular interactions between implantation-stage endometrium and the embryo. I hope you enjoy these articles, as well as the rest of the exceptional articles in this issue. With best wishes for 2012— Donald B. DeFranco, Editor-in-Chief

Exenatide Use in the Management of Metabolic Syndrome: A Retrospective Database Study

To evaluate the effect of exenatide therapy on cardiometabolic risk factors and anthropometric parameters in patients with metabolic syndrome. From June 2005 to June 2007, we performed a retrospective analysis of data extracted from the records of adult patients with metabolic syndrome being treated with exenatide. Diagnosis of any type of diabetes mellitus was exclusionary. Patients were initiated on exenatide therapy, 5 mcg, 1 hour before their morning and evening meals for the first month and were instructed to titrate up to 10 mcg. Cardiometabolic risk factors (total cholesterol, high-density lipoprotein cholesterol, triglycerides, calculated low-density lipoprotein cholesterol, and blood pressure) and anthropometric parameters (absolute body weight, body mass index, and abdominal girth) were measured at baseline and at 16 +/- 4 weeks after initiating exenatide therapy. Data collected also included age, sex, metabolic syndrome diagnosis, and other concomitant medication used in the management of endocrine disorders. The study population consisted of 299 patients (259 women, 40 men) with an age range of 18 to 74 years. Exenatide treatment was associated with significant reductions in mean body weight (P<.001) and body mass index (P<.001). Weight loss in 76.6% of patients was concomitant with a significant reduction in mean abdominal girth (P<.001). Further analysis revealed significant decreases in mean triglycerides (P<.001), total cholesterol (P<.01), and both systolic (P<.01) and diastolic blood pressure (P<.03). Approximately 60.2% of patients used metformin concomitantly, and half either decreased or discontinued metformin therapy. This is the first report examining the effect of exenatide on patients with metabolic syndrome. We observed a significant improvement in cardiometabolic risk factors and anthropometric parameters as a result of exenatide over the treatment interval.

Dietary supplements and nutraceuticals in the management of endocrine disorders

Purpose of review The use of dietary supplements or nutraceuticals in clinical endocrinology has been growing steadily despite controversy regarding the appropriateness of such therapies. This review provides an evidence-based survey of some popular dietary supplements or nutraceuticals targeting a variety of endocrine disorders. Recent findings The use of thyroid extracts or other natural remedies for thyroid disease is not evidence-based and is not superior to synthetic preparations. Insufficient data support the use of dehydroepiandrosterone or ginkgo biloba for hormonal disorders. Black cohosh and isoflavones may alleviate menopausal symptoms. Weak clinical data support the well tolerated use of several dietary supplements or nutraceuticals in diabetology, including a variety of botanicals and chromium. Carnitine and α-lipoic acid may alleviate diabetic neuropathy. Vitamin E is not a cardiovascular protectant. N-3 polyunsaturated fatty acids improve certain dyslipidemias. Data regarding conjugated linoleic acid and obesity are inconclusive. Isoflavones and vitamin K1 are promising but still unproven agents in osteoporosis, whereas the use of calcium and vitamin D alone has recently been challenged. Summary Patients and physicans must evaluate dietary supplements or nutraceuticals in terms of the – qualitatively variable – supporting clinical evidence and relative risk–benefit profiles. Otherwise, the use of unproven therapies can be dangerous.

Opinion and Evidence for Treatments in Endocrine Disorders

New treatments and treatment protocols for endocrine disorders are evolving rapidly, and research and development activity in the endocrinology field is high. Optimal therapy remains contentious in some areas. To help you keep up to date with the latest advances worldwide on all aspects of drug therapy and management of endocrine disorders, this section of the journal brings you information selected from the rapid drug news alerting service Inpharma WeeklyInpharma Weekly provides rapid alerts to news on drugs and drug therapy. Summarizing information selected from over 1600 biomedical journals, this newsletter is produced by Adis International Limited and is available in a variety of formats. Please contact your nearest Adis office for subscription details. The use of trade names, identified by ['~'] or the use of a registered (((R))) or trademark (trade mark) symbol, is for product identification purposes only and does not imply endorsement.. Each issue contains easy-to-read summaries of the most important research and development news, clinical studies, treatment guidelines, pharmacoeconomic and adverse drug reaction news, and expert opinion pieces published in the world's top endocrinology journals.

Opinion and Evidence for Treatments in Endocrine Disorders

New treatments and treatment protocols for endocrine disorders are evolving rapidly, and research and development activity in the endocrinology field is high. Optimal therapy remains contentious in some areas. To help you keep up to date with the latest advances worldwide on all aspects of drug therapy and management of endocrine disorders, this section of the journal brings you information selected from the rapid drug news alerting service Inpharma WeeklyInpharma Weekly provides rapid alerts to news on drugs and drug therapy. Summarizing information selected from over 1600 biomedical journals, this newsletter is produced by Adis International Limited and is available in a variety of formats. Please contact your nearest Adis office for subscription details. The use of trade names, identified by ['~'] or the use of a registered (((R))) or trademark (trade mark) symbol, is for product identification purposes only and does not imply endorsement.. Each issue contains easy-to-read summaries of the most important research and development news, clinical studies, treatment guidelines, pharmacoeconomic and adverse drug reaction news, and expert opinion pieces published in the world's top endocrinology journals.

Opinion and Evidence for Treatments in Endocrine Disorders

New treatments and treatment protocols for endocrine disorders are evolving rapidly, and research and development activity in the endocrinology field is high. Optimal therapy remains contentious in some areas. To help you keep up to date with the latest advances worldwide on all aspects of drug therapy and management of endocrine disorders, this section of the journal brings you information selected from the rapid drug news alerting service Inpharma WeeklyInpharma Weekly provides rapid alerts to news on drugs and drug therapy. Summarizing information selected from over 1600 biomedical journals, this newsletter is produced by Adis International Limited and is available in a variety of formats. Please contact your nearest Adis office for subscription details. The use of trade names, identified by ['~'] or the use of a registered (((R))) or trademark (trade mark) symbol, is for product identification purposes only and does not imply endorsement.. Each issue contains easy-to-read summaries of the most important research and development news, clinical studies, treatment guidelines, pharmacoeconomic and adverse drug reaction news, and expert opinion pieces published in the world's top endocrinology journals.