EMC - Endocrinologie最新文献

{"title":"Insuffisance antéhypophysaire","authors":"J.-M. Kuhn (Professeur des Universités, praticien hospitalier),&nbsp;H. Lefebvre (Professeur des Universités, praticien hospitalier),&nbsp;V. Folope (Chef de clinique-assistant)","doi":"10.1016/j.emcend.2005.04.001","DOIUrl":"https://doi.org/10.1016/j.emcend.2005.04.001","url":null,"abstract":"<div><p>Multiple signals from central nervous system and peripheral endocrine glands reach the hypothalamic-pituitary system which in turn controls hormonal secretions. Organic lesions or functional disorders of the hypothalamus and/or pituitary lead to a more or less rapid, marked, or complete functional failure of their target endocrine tissues, which consequently induces a pattern of clinical and biological signs. The identification of both a pituitary deficiency and its cause is a prerequisite to the choice of the therapeutic approach. This stage of the diagnosis needs hormonal and radiological investigations which finally will allow determining the endocrine dysfunction pathogenesis.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 3","pages":"Pages 148-170"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92107473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nouveautés thérapeutiques dans l'hyperparathyroïdie primitive","authors":"P. Thomopoulos (Professeur des Universités, Praticien hospitalier)","doi":"10.1016/j.emcend.2005.06.001","DOIUrl":"10.1016/j.emcend.2005.06.001","url":null,"abstract":"<div><p>Modern imaging techniques such as ultrasonography and sestamibi scintigraphy (alone or combined with computed-tomography scanning) are useful for the preoperative localisation of a single adenoma in most cases. In such patients, minimally invasive parathyroidectomy may be considered, either by unilateral approach and local anaesthesia or by a video-assisted procedure. The success rate, assessed by perioperative rapid PTH assays, is of 84-90%, reaching 97% after conversion to conventional parathyroidectomy. Thoracoscopic resection may be considered for mediastinal adenomas. Specialized surgical teams have developed hypnotic approaches, locoregional anaesthesia or ultrasound-guided percutaneous ethanol injection. Medical treatment should soon include those calcimimetic drugs that are currently under evaluation. Anti-PTH immunization has shown efficacy in managing the rare cases of parathyroid cancer.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 3","pages":"Pages 129-139"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74727697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabètes mitochondriaux","authors":"P.-J. Guillausseau ,&nbsp;M. Laloi-Michelin ,&nbsp;M. Virally ,&nbsp;P. Massin ,&nbsp;C. Bellanne-Chantelot ,&nbsp;J. Timsit","doi":"10.1016/j.emcend.2005.06.002","DOIUrl":"https://doi.org/10.1016/j.emcend.2005.06.002","url":null,"abstract":"<div><p>Among all cases of mitochondrial diabetes due to mutations or deletion of mitochondrial DNA, Maternally Inherited Diabetes and Deafness (MIDD), which results from a point mutation 3243 A<!--> <!-->&gt;G, is the most frequently observed form. Described on 1992, MIDD is characterized by its matrilineal inheritance, and its particular phenotype: early onset, low BMI, short stature (in male patients), and associated extrapancreatic manifestations (neurosensorial deafness, pattern dystrophy, neurological and muscular manifestations, cardiomyopathy). Clinically, diabetes presents as either type 1 or type 2 diabetes (80% of cases). It is related to a primary defect in insulin secretion, due to mitochondrial respiratory chain dysfunction. Diabetic retinopathy is less frequent than in common forms of diabetes, due to a less severe hyperglycaemia, and to a lower prevalence of hypertension. A specific mitochondrial nephropathy with poor prognosis is observed in MIDD patients. Coenzyme Q10 should be proposed as curative and preventive treatment. Molecular diagnosis is usually performed from circulating leucocytes. Around 20 different mutations or deletions of mitochondrial DNA associated with diabetes have been described.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 3","pages":"Pages 171-178"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92150299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quand et comment ajuster la substitution en hormones thyroïdiennes chez une femme enceinte ?","authors":"M.-L. Raffin-Sanson","doi":"10.1016/j.emcend.2005.01.001","DOIUrl":"10.1016/j.emcend.2005.01.001","url":null,"abstract":"","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 2","pages":"Pages 103-104"},"PeriodicalIF":0.0,"publicationDate":"2005-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75765688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroïde et grossesse","authors":"J.-L. Wémeau ,&nbsp;M. d'Herbomez ,&nbsp;P. Perimenis ,&nbsp;F.-L. Vélayoudom","doi":"10.1016/j.emcend.2005.01.002","DOIUrl":"10.1016/j.emcend.2005.01.002","url":null,"abstract":"<div><p>Pregnancy increases the requirements in thyroid hormones and raises thyroid volume. Thyroid disorders may appear in case of iodine deficiency, if the thyroid parenchyma is weakened by thyroid autoimmunity, as observed in 10 to 20% of women of child-bearing age. The equilibrium of the thyroid function is all the more imperative as precociously the cerebral development of the foetus depends on the maternal transplacentar supply in thyroid hormones. Pregnancy raises the volume of the goiter, supports its nodular reorganization and potentially the growth of possible cancerous nodules. Hyperthyroidism must be recognized and early treated; in particular, recommendation is made to raise hormonal substitution by approximately 30% as soon as the beginning of pregnancy. Hyperthyroidism during pregnancy is present in 2% of pregnant women and this risk increases in case of hyperemesis gravidarum and twin pregnancies. It should be distinguished from pregnancy Graves' disease which requires hormonal and immunizing monitoring, and systematic monitoring of the foetal development in case of significantly increased TSH antireceptor antibodies. Transplacentar thyroid dysfunction and neonatal dysthyroidism require close cooperation between endocrinologist, obstetrician and paediatrician. Treatment using antithyroid drugs is possible with breast feeding. Appropriateness of tracking pre and postconception maternal thyroid disorders and systematic iodine supplementation during pregnancy are discussed.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 2","pages":"Pages 105-120"},"PeriodicalIF":0.0,"publicationDate":"2005-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72643337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumeurs à rénine","authors":"L. Amar ,&nbsp;A.-P. Gimenez-Roqueplo ,&nbsp;P. Rossignol ,&nbsp;P.-F. Plouin","doi":"10.1016/j.emcend.2005.01.003","DOIUrl":"10.1016/j.emcend.2005.01.003","url":null,"abstract":"<div><p>Primary reninism is a rare disease (about 100 published cases) usually caused by a juxtaglomerular cell renal tumour or, in some cases, by an extrarenal malignant tumour. The clinical presentation is an elevated blood pressure with secondary aldosteronism, and a very high level of plasmatic renin concentration. The CT-scan shows a hypo-intense cortical renal image and absence of renal artery stenosis or cortical infarct. The tumour resection suppresses the secondary aldosteronism and generally results in a relief or an improvement of the hypertension.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 2","pages":"Pages 121-127"},"PeriodicalIF":0.0,"publicationDate":"2005-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2005.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91535521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancers de la thyroïde","authors":"L. Leenhardt ,&nbsp;F. Ménégaux ,&nbsp;B. Franc ,&nbsp;C. Hoang ,&nbsp;S. Salem ,&nbsp;M.-O. Bernier ,&nbsp;L. Dupasquier-Fédiaevsky ,&nbsp;E. Le Marois ,&nbsp;A. Rouxel ,&nbsp;J.-P. Chigot ,&nbsp;L. Chérié-Challine ,&nbsp;A. Aurengo","doi":"10.1016/j.emcend.2004.10.003","DOIUrl":"https://doi.org/10.1016/j.emcend.2004.10.003","url":null,"abstract":"<div><p>Thyroid carcinomas are rare and represent 1% of malignant tumours. Women are more likely to have thyroid cancer, at a ratio of three to one. Thyroid cancer may occur in any age group, although it is most common after the age of 30, and its aggressiveness increases significantly in older patients. Most patients present with a thyroid nodule. Thyroid nodules are frequent but only 5% of them are malignant. Over the last two decades, the widespread of diagnostic tools (ultrasonography, cytology) and changes in the surgical and pathological management of thyroid diseases have led to the increase of thyroid cancer, especially papillary microcarcinomas. Thyroid cancer is more frequent in people who have a history of thyroid exposure to radiation during childhood. The diagnosis is based on the histopathological examination that remains difficult in some cases. The most frequent thyroid cancers (papillary and follicular) are cured in 80-90 % of the cases if treated appropriately. Anaplastic cancer is rare and has a very poor prognosis. The primary therapy for thyroid cancer is total or near total thyroidectomy. Lymph node dissection is not systematically undertaken. Radioiodine treatment is advised for high risk patients and needs high levels of TSH to be effective. Then, patients must remain on thyroid hormone therapy for the rest of their lives. Prognosis factors are well defined and prognosis is good in case of differentiated thyroid cancer. Distant metastases are observed in 10% of the patients, and lung and bones are the most common sites. Locoregional recurrences are observed in 7% of the cases. Prolonged follow-up is recommended, based on physical examination, serum thyroglobulin assessment with TSH stimulation (L-thyroxin off or use of human recombinant TSH), ultrasonography and post therapeutic whole body scan.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 1","pages":"Pages 1-38"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2004.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91724322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiologie de la prolactine","authors":"P. Touraine, V. Goffin","doi":"10.1016/J.EMCEND.2004.10.002","DOIUrl":"https://doi.org/10.1016/J.EMCEND.2004.10.002","url":null,"abstract":"","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"34 1","pages":"50-76"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91324166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impuissance : dysfonction érectile","authors":"T. Lebret ,&nbsp;F. Cour","doi":"10.1016/j.emcend.2004.09.001","DOIUrl":"https://doi.org/10.1016/j.emcend.2004.09.001","url":null,"abstract":"<div><p>The main sexual dysfunction in men is the insufficient rigidity of the penis during erection, the so-called impotency. This designation should be cancelled now, and replaced by “erectile dysfunction” or “dyserection”, or “erectile failure”. In fact, “impotency” is a term associated with a very pejorative connotation, which may induce a feeling of guilt. For the man suffering from this dysfunction, the male impotency is, indeed, a social and relational handicap.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 1","pages":"Pages 77-89"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2004.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91724321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actualités sur la ménopause. Données de la médecine factuelle (« evidence based medecine »)","authors":"H. Rozenbaum","doi":"10.1016/j.emcend.2004.09.002","DOIUrl":"https://doi.org/10.1016/j.emcend.2004.09.002","url":null,"abstract":"<div><p>Following several recent epidemiological studies - including in particular the interventional study of the Women’s Health Initiative (WHI) - the risk-benefit balance of hormone replacement therapy (HRT), as well as its instructions for use and prescription procedures, has been reconsidered. Unlike previously published observational studies, the WHI underlines the absence of preventive effects in terms of cardiovascular disorders. Therefore, despite the awareness of the difference between the WHI studied population and molecules and the French population and steroids used in France, and since we lack equivalent European epidemiological work, we should no longer prescribe HRT for cardiovascular disease prevention. On the other hand, some data from the WHI study do agree with the results of previous observational studies: a slight increase in the risk of venous thrombo-embolism, at least with the use of orally-administered estrogens; a decreased risk of colon cancer with the use of estrogen-progestogens; a protective effect against the risk of osteoporotic fractures in all areas studied. However, the main problem presented by the recent studies concerns the risk of breast cancer: outside data sources support the slight increase in the risk of breast cancer observed during the WHI study with the use of estrogen-progestogens. Besides, the same study did not observe any increased risk with the use of estrogen alone, which constitutes a new datum requiring confirmation. As for the widely-publicised results of the MWS study, which led the European Medicines Agency (EMEA) to revise its position on HRT, these appear too erroneous to be accepted without caution. In terms of medical practice, it is henceforward recommended to prescribe HRT in the lowest possible effective dosage, and to continue treatment only as long as symptoms persist, with temporary suspensions to verify signs of estrogen deficiency. Finally, some recent studies seem to indicate a greater risk of breast cancer in patients undergoing combined continuous - as opposed to sequential - hormone treatment, but this essential difference deserves further study.</p></div>","PeriodicalId":100422,"journal":{"name":"EMC - Endocrinologie","volume":"2 1","pages":"Pages 90-101"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcend.2004.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91724320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}