Endocrinology and Metabolic Syndrome最新文献

{"title":"Clinical and Biological Characteristics of Patients Aged 65 and Older with Newly Developed Type 1 Diabetes","authors":"Achilov Mt, Njah Mk, E. Yh, Beizig Am, M. Chadli, K. Ach","doi":"10.4172/2161-1017.1000252","DOIUrl":"https://doi.org/10.4172/2161-1017.1000252","url":null,"abstract":"Objective: Diabetes of elder subjects is characterized by onset after the age of 65, absence of Ketoacidosis, insulin independence for at least 6 months, and presence of circulating islet-cell antibodies. Its marked heterogeneity in clinical features and immunological markers suggests the existence of multiple mechanisms underlying its pathogenesis. \u0000Methods: This is a retrospective study related to the observation of 5 patients aged over 65 years old, diagnosed with diabetes. All patients have had a dosage of pancreatic antibodies: anti glutamic acid decarboxylase antibodies (GAD antibodies) and tyrosine phosphatase antibodies IA2 (IA2 antibodies), with positivity to at least one of them. Their clinical and biological data, namely clinical aspects, family and personal history, metabolic and biological profile, autoimmune context, and degenerative complications, have been determined at the moment of the diagnosis. \u0000Results: This study was carried out on 4 female patients and one male, with an age between 65 and 71 years with a mean of 68 years. The clinical diagnosis is dominated by an insulinopenia in 3 cases with cardinal syndrome, an average blood glucose at admission=17.88 mmol/L, and an average HbA1C=13.24%. This insulinopenia has occurred in 2 cases immediately, realizing an inaugural ketosis. As far as the other 3 cases are concerned, the insulinopenia has taken place, right after a monitored oral anti-diabetic treatment for an average period of 21 months, fulfilling slow Mellitus Diabetes. An average BMI of 25.8 (Extremities 19 and 39) and a waist circumference>80 cm among all patients (range: minimum: 80, maximum 117 cm) with an average of 92.4 cm are also noted. Retinopathy has been recorded among one female patient. Pancreatic antibodies are all directed against GAD-65 antigen while IA-2 antibodies are found negative. \u0000Conclusions: These observations suggest that auto immune Diabetes is possible among the elderly subjects. The absence of any autoimmune context associated with insulin resistance stigma indicates a specific pathophysiology of pancreatic autoimmunity among the elderly subjects. It emphasizes the importance of testing for an appropriate classification of persons with Elder Diabetes. Early diagnosis of LADA would help direct appropriate therapy to optimize glycemic control.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"26 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89730916","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":"Hyponatremia-Finding the Cause","authors":"A. Farhan, T. Tanveer, U. Mumtaz, Raza Ma, M. Shoaib","doi":"10.4172/2161-1017.1000253","DOIUrl":"https://doi.org/10.4172/2161-1017.1000253","url":null,"abstract":"Hyponatremia is a very common finding in elderly and hospitalized patients. Finding its cause is where one has to scratch his head. This case emphasizes how a common occurrence (hyponatremia) can be a manifestation of an underlying rare diagnosis- hypopituitarism. This case is about a seventy years old female presenting with altered state of mentation. Her systemic examination was completely normal except for generalized hypertonia and a Glasgow coma scale of seven. Laboratory investigations revealed hyponatremia with normal chemistry and normal blood complete picture. CT brain and cerebrospinal fluid analysis was also unremarkable. When she was found resistant to treatment (free water restriction and hypertonic saline), she was further investigated and finally diagnosed as a case of hypopituitarism.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"52 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87979263","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":"Advanced Granulosa Cell Tumor and Pregnancy: A Case Report, How to Treat and How to Preserve Fertility?","authors":"Aymen Fm, G. Majed, C. Hanène, L. Joumana, B. Amin","doi":"10.4172/2161-1017.1000250","DOIUrl":"https://doi.org/10.4172/2161-1017.1000250","url":null,"abstract":"Granulosa cell tumors of the ovary are rare ovarian malignancy developed on stromal ovarian cells and \u0000 characterized by estrogen secretion. Histologically, there are divided on two types: adult granulosa tumors, which \u0000 are more frequent and occurring in perimenopausal and post-menopausal women and juvenile granulosa tumors, \u0000 which are rarer and occurring in teenager and adolescent girls. \u0000 The association between GCT and pregnancy is a rare condition with therapeutic challenge consisting on the \u0000 pregnancy and the fertility outcome in a hand and the oncological results in the other. \u0000 We present a case report of an adult granulosa cell tumor discovered fortuitously during caesarian section. We \u0000 report the management of this tumor and the way to preserve the fertility.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"27 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90911124","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":"Resistance to Kinase Inhibitors in Poorly Differentiated and Anaplastic Thyroid Cancer: Preclinical In vitro Evidences","authors":"F. Gianì, D. Tumino, F. Frasca","doi":"10.4172/2161-1017.1000251","DOIUrl":"https://doi.org/10.4172/2161-1017.1000251","url":null,"abstract":"Poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC) are rare but highly aggressive malignancies with an extremely short survival. Poor prognosis is due to their unlimited growth, invasion, migration and resistance to common anticancer therapies. Advances in understanding the molecular alterations in thyroid carcinomas led to development of new therapeutic strategies such as kinase inhibitors. Although several of these compounds have been approved by FDA and EMA for the treatment of radioactive-iodine refractory differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC), no significant clinical efficacy with targeted therapies have been observed in those patients. Herein, we review and summarize the preclinical In vitro evidences of mechanisms of resistance to kinase inhibitors currently used in PDTC and ATC patients.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"36 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2016-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84430882","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":"Pheochromocytoma Presents as Takotsubo Cardiomyopathy","authors":"al-Shawa Yr, K. Ho","doi":"10.4172/2161-1017.1000249","DOIUrl":"https://doi.org/10.4172/2161-1017.1000249","url":null,"abstract":"A hypertensive crisis, with an acute heart failure and pulmonary oedema had complicated anesthesia induction, during an elective surgery was done to an elderly aged patient. This patient had hypertension, with a very controlled BP on Irbesartan (angiotensin receptor blocker), and a normal cardiac function before admission. The operation was aborted, and the patient was resuscitated in the theatre and the ICU. Investigations showed cardiomegaly on CXR, with abnormal size and function of the Lt Ventricle on echocardiograph, as well as high levels of serum troponin, and very high values of serum catecholamine's metabolites (metanephrines and normetanephrines). A high suspicion of pheochromacytoma was raised, and this was confirmed later by the presence of a large RT adrenal mass on abdominal CT scan and MIBG scan. After 3 weeks of supportive treatment in the ICU, with continuous monitoring of the very labile BP, the patient underwent a laparoscopic adrenalectomy. Postoperatively, the patient's BP and cardiac function were restored","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"1 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78644616","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":"The Effect of Hypothyroidism on Insulin Sensitivity and Their Influence on the Serum Lipid Profile and Renal Function","authors":"Abdel-Gayoum Aa","doi":"10.4172/2161-1017.1000248","DOIUrl":"https://doi.org/10.4172/2161-1017.1000248","url":null,"abstract":"The overt and subclinical hypothyroidism is more prevalent in patients with diabetes mellitus than in general population. Recently, more studies have been warranted to elucidate the relationship between thyroid hormones disorders and the insulin activity. The present study aims to investigate the correlations between the thyroid hormone levels in subclinical and overt hypothyroid patients with the insulin resistance and their impact on serum lipid profiles and kidney function. Methods: A total of fifty newly diagnosed hypothyroid patients were recruited for the study and classified into: 1) Subclinical hypothyroid (SH) group: n-26; 2) Overt hypothyroid (OH) group: n=24, and control (C) group: n=18. Fasting blood was collected and serum was used for biochemical analysis. Results: The fasting serum insulin, glucose levels and the estimated insulin resistance index (HOMA) of the SH and OH groups were significantly (P<0.001) elevated compared to control. The regression analysis reviled a significant negative correlation between FT4 and insulin (r=-0.32, P=0.04) and significant positive correlations between TSH and insulin (r=0.57, P=0.002), between TSH and HOMA (r=0.51, P=0.001), between HOMA and uric acid (r=0.37, P=0.02), and between TSH and TG (r=0.47, P=0.002). The serum creatinine, urea and uric acid concentrations were significantly (P<0.001) elevated in the OH group but not the SH. The serum total cholesterol, TG and LDL-cholesterol were significantly elevated in both SH and OH. Conclusion: Hypothyroidism is associated with insulin resistance, renal impairment, hyperurecemia and dyslipidemia, which are atherosclerotic risk indicators. The TSH had maximum impact on the changes. Subclinical and overt hypothyroid patients with elevated TSH are at high risk of developing atherosclerosis, thus may need close monitor to contain the rise in plasma TSH.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"108 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79392844","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":"Adrenal-Renal Fusion Giving Rise to an Intrarenal Adreno-Cortical Adenoma: A Novel Case Report with Review of Current Literature","authors":"Patel, Bejarano Pa, A. Parlade, N. Muruve","doi":"10.4172/2161-1017.1000247","DOIUrl":"https://doi.org/10.4172/2161-1017.1000247","url":null,"abstract":"Adrenal-renal fusion is a rare developmental anomaly in which adrenal tissue extends into the renal parenchyma without separate encapsulation of the two organs. Of the few cases described in the literature, clinically significant adrenal-renal fusion has been associated with adrenal cortical adenomas, which appear to be solid masses with enhancing and infiltrative features on radiographic studies. Only three cases of adrenocortical adenoma associated to adrenal-fusion have been published. We describe an additional and unique case in a 70 year old woman who had an incidentally discovered ectopic adrenal tissue that gave rise to an adrenal cortical adenoma in the setting of adrenal-renal fusion.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"16 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84348477","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":"Thyroid Hormones and the Heart; a Paradigm of Exquisite Fine Tuning,Combining Ancient Hellenic and Oriental Wisdom","authors":"Cokkinos Dv, S. Chryssanthopoulos","doi":"10.4172/2161-1017.1000246","DOIUrl":"https://doi.org/10.4172/2161-1017.1000246","url":null,"abstract":"It must be realized that REM, very plainly defined as LV cavity enlargement above a certain value remains an important cardiological problem. After an anterior AMI despite early primary percutaneous intervention (PPCI) and administration of the drugs considered most efficient today, i.e. Converting enzyme inhibitors (CEIs) or angiotensin receptor blockers (ARBs), βblockers and aldosterone inhibitors, 30% of patients (pts) develop REM which seriously undermines their survival [4].","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"196 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76165659","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":"Severe Hyperparathyroidism with Secondary Osteitis Fibrosa Cystica and Brown Tumors Mimicking Bone Metastasis","authors":"C. Issa, Daher La","doi":"10.4172/2161-1017.1000245","DOIUrl":"https://doi.org/10.4172/2161-1017.1000245","url":null,"abstract":"Introduction: The classical presentation of primary hyperparathyroidism, osteitis fibrosa cystica, has become very rare nowadays. This rarity makes it sometimes misdiagnosed leading to disastrous outcomes. \u0000Methods: We present a case of an undiagnosed primary hyperparathyroidism with severe osteitis fibrosa cystica and brown tumors that was first misdiagnosed as having bone metastasis. \u0000Conclusion: Osteitis fibrosa cystica although rare should be considered in the differential diagnosis of patients presenting with multiple brown tumors, especially since the diagnosis can be easily made by a simple calcium level, thereby avoiding severe adverse outcomes.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"37 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76142098","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":"Estrogen Receptor Related Receptor Alpha (ERRñ) in Skeletal Tissues","authors":"E. Bonnelye","doi":"10.4172/2161-1017.1000244","DOIUrl":"https://doi.org/10.4172/2161-1017.1000244","url":null,"abstract":"Estrogen receptor related receptor alpha (ERRα) was the oldest orphan nuclear receptor with sequence identity to the estrogen receptors, ERα/β. The sequence alignment of the ERRα and the ERs reveals a high similarity (68%) in the DNA-binding domain and a moderate similarity (36%) in other parts of the proteins such as the ligand-binding E domain.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86103775","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}