Showing papers in "Endocrinology and Metabolism Clinics of North America in 2019"

TL;DR: The incidence of thyroid cancer worldwide has increased significantly over the past 3 decades, due predominantly to an increase in papillary thyroid cancer, but there also appears to be a true increase in new cases.

TL;DR: Results from 2 randomized trials provide strong evidence that treating GDM reduces adverse perinatal outcomes, but it remains to be determined whether treatment impacts long-term offspring outcomes.

TL;DR: The transgender and gender nonconforming population is undergoing rapid changes in size and demographic characteristics and more accurate and precise estimates will be available when population censuses collect data on sex assigned at birth and gender identity.

TL;DR: Thyroid cancers of follicular cell derivation provide excellent phenotype-genotype correlations and give rise to poorly differentiated and anaplastic carcinomas that are less common but far more aggressive.

TL;DR: There are a number of negative outcomes related to aggressive thyroid hormone therapy, including osteoporosis, fracture, and cardiovascular disease, so a graded approach to TSH suppression is recommended by the American Thyroid Association.

TL;DR: Transoral endoscopic thyroidectomy, vestibular approach (TOETVA) is the only technique that could be called a true scarless surgery; however, there is a scarcity of long-term studies about its safety and feasibility.

TL;DR: Half of MTC patients have distant metastases at diagnosis and, when progressing, systemic therapy with vandetanib or cabozantinib should be considered.

TL;DR: Based on multiinstitutional and population-based studies, multimodal therapy that includes chemoradiotherapy with surgery (when feasible) is the preferred initial treatment because it is associated with incrementally improved overall survival.

TL;DR: The genetic duet of BRAF V600E/RAS and TERT promoter mutations is a most robust prognostic genetic pattern for poor prognosis of differentiated thyroid cancer.

TL;DR: Management options for papillary thyroid microcarcinoma patients and shared decision-making as a novel method for individualizing care are described.

TL;DR: This review focuses on fertility preservation, including the effects of medical hormone treatment on fertility, available and experimental options of fertility preservation in transgender adults, including sperm cryopreservation for transwomen and oocyte cryoprevention for transmen, and options for prepubertal transgender adolescents.

TL;DR: The diagnosis and treatment of patients with prolactinomas, acromegaly, Cushing disease, and other pituitary tumors during pregnancy are discussed.

TL;DR: Ten years of active surveillance at Kuma Hospital revealed that only 8.0% of patients showed enlargement of 3 mm or greater, whereas only 3.8% showed nodal metastasis, so active surveillance ought to be the primary method of low-risk papillary thyroid microcarcinoma management.

TL;DR: Current clinical approaches in patients with pheochromocytoma/paraganglioma are summarized, and patients frequently come to the attention of endocrinologist when pheospermocytomas is suspected as a secondary cause of hypertension.

TL;DR: The optimal time for surgical removal is before 24 weeks of gestation or at/after delivery, and laparoscopic adrenalectomy should be preceded by medical pretreatment.

TL;DR: Patients with Cushing syndrome have an increased mortality rate, primarily due to increased cardiovascular death, which is driven by hypertension, diabetes, obesity, and dyslipidemia, which should be evaluated before and after active hypercortisolism.

TL;DR: Clinical approaches for diagnosing primary aldosteronism more frequently and earlier in its course, as well as practical treatment objectives to reduce the risk for incident cardiovascular disease are focused on.

TL;DR: Molecular testing is a diagnostic tool that can be used to help guide the clinical management of thyroid nodules with indeterminate cytology results.

TL;DR: This review summarizes current studies, systematic reviews, and clinical practice guidelines regarding the screening, diagnosis, and treatment of osteoporosis in transgender persons.

TL;DR: Measurement of serum thyrotropin receptor antibodies identifies pregnancies at-risk for fetal and neonatal hyperthyroidism.

TL;DR: unique aspects of skin health in transgender persons should be considered in the context of multidisciplinary gender-affirming care and pathophysiology, diagnosis, and treatment of common skin diseases in the transgender populations.

TL;DR: Rare monogenic forms of hypertension, characterized by electrolyte disorders and suppressed renin-aldosterone axis, are described, which represent simple models for the physiology of renal control of sodium levels and plasma volume, thus reaching a high scientific interest.

TL;DR: Recommendations for cancer screening and prevention are discussed as well as whether to withdraw HT at time of a cancer diagnosis, and reliable epidemiologic data are sparse.

TL;DR: This article focuses on conventional surgical management of thyroid cancer, reviewing long-standing and well-accepted main principles and practices, and covers newer controversies and techniques to conventional thyroidectomy.

TL;DR: Because the effect of normalization of growth hormone and insulinlike growth factor 1 excess on blood pressure levels is unclear, an early diagnosis of hypertension and prompt antihypertensive treatment are eagerly recommended, regardless of the specific treatment of the acromegalic disease and the level of biochemical control attained.

TL;DR: Providers should integrate a more comprehensive view of health when caring for transgender persons and address the impact of social determinants and other barriers to accessing affirming, inclusive health care.

TL;DR: The comprehensive evaluation of thyroid nodules during pregnancy includes a medical history, physical examination, ultrasound assessment, and an ultrasound-guided fine-needle aspiration biopsy.

TL;DR: In nonclassic 21-hydroxylase deficiency, preconceptional low-dose hydrocortisone replacement normalizes the otherwise increased miscarriage rate, as well as the prevention of adrenal crises.

TL;DR: Universal thyroid screening in pregnancy is being undertaken in several countries, although it remains a matter of debate, although benefits of screening for and treating borderline thyroid function are unclear.

TL;DR: Novel approaches that may benefit select patients include resensitization therapies that allow further radioiodine utilization and new immunotherapy concepts.