Showing papers in "Endocrinology and Metabolism Clinics of North America in 2001"

TL;DR: The promise of nonpeptide CRH type-1 receptor antagonists to directly target the stress system in the brain is highlighted and the implications of aberrant stress system activity on physical and mental health are outlined.

TL;DR: In selected patients, combination therapy with insulin and oral antidiabetic medications can be an effective method for normalizing glycemia without the need for rigorous multiple-injection regimens.

TL;DR: It is hoped that, in the near future, the routine use of a combination of these markers will cost-effectively improve the diagnosis of malignant nodules classified as suspicious on traditional cytology.

TL;DR: The genetics and biochemistry of P450c17 are reviewed as a prelude for understanding the pathophysiology of these diseases and approaches to their diagnosis and management.

TL;DR: It is hoped that newborn screening programs will begin to provide answers to some of these question in addition to their primary function of reducing the morbidity and mortality resulting from CAH.

TL;DR: In humans and most other mammals, the antidiuretic hormone (ADH) is a nonapeptide often referred to as arginine vasopressin (AVP), which is produced by large neurons that originate in the supraoptic and paraventricular nucleus of the hypothalamus and terminate on capillary plexuses scattered throughout the posterior pituitary.

TL;DR: Clinicians who have never missed the diagnosis of Cushing's syndrome or have never been fooled by attempting to establish its cause should refer their patients with suspected hypercortisolism to someone who has.

TL;DR: In this paper, the role of free fatty acids (FFAs) as a link between obesity and insulin resistance/type 2 diabetes is discussed in detail, and evidence is provided showing that increased plasma FFA levels produce insulin resistance dosage dependently, acutely, and chronically.

TL;DR: Revascularization studies in diabetics show that coronary bypass surgery is related to better outcomes than angioplasty procedures, and the impact of better glycemic control on CHD risk is less convincing, especially in clinical trials.

TL;DR: Routine chemistries and an assay for TSH, MR imaging, or CT will delineate the size and extent of the tumor, and bromocriptine use has an extensive safety record and is preferred.

TL;DR: Before obtaining thyroid function tests, clinicians need to consider whether the patient might have pituitary or hypothalamic disease or severe nonthyroidal illness, and whether assessment of the pituitsary-thyroid axis reflects steady-state conditions.

TL;DR: Steroid 11β-hydroxylase deficiency is the second most frequent cause of congenital adrenal hyperplasia, the inherited inability to synthesize cortisol.

TL;DR: The status of the empirical evidence for the development of gender and sexuality in 46,XX persons with classic CAH is reviewed and its implications for clinical practice are reviewed.

TL;DR: Before starting an exercise program, all patients with type 2 diabetes should have a complete history and physical examination, with particular attention to evaluation of cardiovascular disease, medications that may affect glycemic control during or after exercise, and diabetic complications including retinopathy, nephropathy, and neuropathy.

TL;DR: The interpretation of any given thyroglobulin value requires the careful synthesis of all pertinent clinical and laboratory data available to the clinician as mentioned in this paper, which is a significant obstacle to the clinical use of thyroid autoantibodies.

TL;DR: An overview of clinical and genetic aspects of the various forms of CAH with 21-hydroxylase deficiency is presented, which is recognized by genital ambiguity in affected females and by signs of androgen excess in later childhood in males.

TL;DR: Key issues should be emphasized in the management of CAH during gestation, including the need for assessing adrenal steroid replacement and adrenal androgen suppression, particularly in light of the interplay between maternal hyperandrogenism and the protective effect of placental aromatase activity, which provides a relatively large margin of safety for the female fetus.

TL;DR: The main purpose of free T4 and free T3 assays is to distinguish reliably between thyrotoxicosis, hypothyroidism, and the euthyroid state as mentioned in this paper.

TL;DR: From the limited information currently available, androgen supplementation may be of benefit in some men aged more than 65 years, particularly in men with low serum testosterone levels, but it is not yet clear whether the benefits outweigh the risks.

TL;DR: Many classes of oral antihyperglycemic agents are available for the treatment of type 2 diabetic patients, and their effects are additive, as must the specific effects of the agents on glucose metabolism.

TL;DR: The authors have encountered situations in late adolescence in which it has been impossible to separate the urogenital sinus from below and have encountered the rare 46,XX patient raised as a male and committed to the male role.

TL;DR: There is need for continuing study of cognition in patients with CAH to provide basic information about hormonal effects on cognition and the neural mechanisms that mediate those effects and to provide important clinical information to guide psychologic and medical treatment of patients.

TL;DR: Treatment with antioxidants and with inhibitors of the renin-angiotensin system may reverse some of the pathologic vascular changes associated with endothelial dysfunction.

TL;DR: The delta-5 steroid abnormality for the nonclassic 3 beta-HSD deficiency CAH, proven by genotype study, is substantially greater than the hormonal criteria for the disorder published before the advent of molecular information on the gene encoding adrenals and gonads in humans.

TL;DR: The challenge for the primary care physician and diabetologist is to attain excellent glycemic control and aggressive control of blood pressure, while assuring that every patient has appropriate dilated fundus examinations at least annually, preferably by an ophthalmologist or retinal specialist, and regular screening for microalbuminuria.

TL;DR: The technical aspects and clinical applications of the radioactive iodine uptake test and thyroid scintiscanning are reviewed and the choice of radionuclide for the tests is discussed.

TL;DR: As the nosology of obesity improves, diagnostic efficiency and therapeutic success should increase, leading to a decrease in associated morbidity, mortality, and socioeconomic ramifications.

TL;DR: In every culture and throughout the centuries, rites of passage have been practiced to symbolize this process and the acceptance of a child into the realm of the adult with reproductive maturity.

TL;DR: Promising new treatment approaches to classic CAH include LHRH agonist-induced pubertal delay with or without growth hormone therapy, alternative glucocorticoid preparations or dose schedules, CRH antagonist treatment, and gene therapy.

TL;DR: Many isotopes are available for imaging patients with suspected thyroid cancer recurrence and metastases and 123I has better imaging characteristics than 131I and has been shown to be equivalent or superior to low-dose 131I in recent studies.