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Advanced imaging techniques can identify pancreatic features that are characteristic of diabetes subtypes and can help guide molecular and genetic investigations. This Review describes pancreatic imaging in monogenic diabetes mellitus, focusing on the characteristic imaging findings in patients with subtypes of this disease, and relates these features to imaging findings in other exocrine and endocrine pancreatic disorders. The potential of advanced imaging techniques to reveal novel aspects of the pathogenesis and pathophysiology of monogenic diabetes mellitus that are relevant for progression to β-cell disease is also discussed.
Diabetes mellitus diagnosed during the first 2 years of life differs from the disease in older children regarding its causes, clinical characteristics, treatment options and needs in terms of education and psychosocial support. This Review summarized the current knowledge on the clinical management of diabetes mellitus in infants, including diagnostic and therapeutic approaches, ongoing diabetes care and quality control.
Adipokines are emerging as key molecules linking obesity to breast cancer and are found in the tumor microenvironment. This Review discusses the role of peritumoral stroma, adipose tissue and secreted adipokines in breast cancer biology, focusing on leptin and the crosstalk between leptin and estrogen signaling. Research fromin vitroand animal studies on how leptin is involved in the pathogenesis and progression of breast cancer is discussed, along with the potential future use of leptin and its receptor as therapeutic targets in patients with breast cancer.
There is an epidemic of type 2 diabetes mellitus in nearly every nation in the world. This Review gives an overview of the current trends of the diabetes epidemic in a world scenario and discusses the associated major risk factors, particularly genetic and epigenetic factors. The potential impact of the use of HbA1cas an alternative diagnostic tool on global diabetes surveillance is also discussed.
After short introductions into the physiology of aromatase and chemical characteristics of aromatase inhibitors, this Review focuses on the efficacy and safety of aromatase inhibitors in the pediatric population, in particular for the treatment of hyperestrogenism, hyperandrogenism, pubertal gynecomastia, and short stature and/or delayed puberty.
Recent studies suggest previously unrecognized complications of hyponatremia, including falls, osteoporosis and fractures, and show that hyponatremia can have direct effects on bone, mainly via activation of osteoclasts. Here, the emerging relationship between hyponatremia and bone is reviewed, with special emphasis on possible mechanisms, unanswered questions and clinical implications.
This Review discusses the emerging concept that resistance to the metabolic adverse effects of lifestyle factors is mediated by an adaptive response to cellular stress, counteracting mechanisms that otherwise lead to impaired insulin signaling and β cell failure. This response exhibits characteristics of hormesis, originally described in toxicology, whereby exposure of cells, tissues or organisms to low levels of toxin induces resistance to higher toxin concentrations.
The contribution of antipsychotic medications to an increased risk of type 2 diabetes mellitus and cardiovascular disease is controversial. Despite existing guidelines and recommendations, many antipsychotic-drug-treated patients are not routinely assessed for metabolic and cardiac risk factors. This Review outlines the metabolic and cardiovascular risks of various antipsychotic medications in adults and children, defines the disparities in health care and makes recommendations for screening and monitoring of patients taking these agents.
Neonate screening for congenital hypothyroidism is the most successful population-based screening test in pediatrics. The purpose of this Review is to summarize the current knowledge on the etiology underlying thyroid dysgenesis and dyshormogenesis and to provide an update on the evidence concerning the diagnosis and treatment of patients with congenital hypothyroidism.
The aim of this Review is to examine the possible additional benefits of neonatal gonadotropin therapy in male patients with congenital hypogonadotropic hypogonadism. Encouraging results of neonatal therapy, together with a few reports of prepubertal treatment, support the use of this novel therapeutic strategy aimed at improving sexual and reproductive functions in adulthood.
The trace element selenium is increasingly recognized for its importance in health and disease. Supplementing selenium may improve the severity of autoimmune thyroid diseases. Positive supplementation effects have been reported for both Graves disease and Hashimoto thyroiditis. This Review discusses potential mechanisms of action, prospects, and risks associated with selenium supplementation, and highlights current research needs.
Chronic fatigue syndrome (CFS) is a disabling and medically unexplained condition with no readily demonstrable organic or psychiatric explanation. The bulk of evidence supports the presence of several factors related to hypothalamic–pituitary–adrenal axis dysfunction in patients with CFS. Here, the authors review the literature on CFS since 2003, put the new findings into context and evaluate progress against previously made recommendations.
Body adipose tissue changes and metabolic abnormalities are common among HIV-infected patients receiving highly active antiretroviral therapy and contribute to the risk of cardiovascular disease. This Review highlights the pathogenesis and clinical management of these disorders, focusing on the efficacy of treatment strategies, newly available medications, and potential interactions between HIV medications and medications used to treat metabolic disorders.
This Review highlights the milestones in the field of kisspeptin research, in particular developments in the putative interplay of kisspeptins and their cotransmitters, such as neurokinin B, in the central control of GnRH neurons; and the possible role of Kiss1 neurons as conduits for the metabolic regulation of puberty and fertility, with emphasis on intermediate regulatory signals and mechanisms involved.
This Review discusses the association between mitochondrial function and insulin sensitivity in various tissues, such as skeletal muscle, liver and heart, with a main focus on studies in humans, and addresses the effects of therapeutic strategies that affect mitochondrial function and insulin sensitivity.
Antiresorptive therapies, such as bisphosphonates, estrogens, selective estrogen receptor modulators, calcitonin and denosumab, are used to increase bone strength in individuals with osteoporosis. However, no single antiresorptive therapy is appropriate for all patients or clearly superior to other therapies. This Review describes the advances in our understanding of antiresorptive therapies and summarizes the benefits and risks associated with various drugs with an antiresorptive effect.
Knowledge of genetic alterations occurring in thyroid cancer has rapidly expanded in the past decade. This Review discusses genetic alterations in follicular cell-derived thyroid cancers and outlines new insights into thyroid cancer etiology; in addition, the article describes how mutational markers can be used to improve cancer diagnosis and prognostication.
Medullary thyroid carcinoma is a rare endocrine malignancy that, when diagnosed during childhood, is almost always associated with multiple endocrine neoplasia type 2 and a germline mutation in theRETproto-oncogene. This Review discusses a contemporary approach to the diagnosis and treatment of medullary thyroid carcinoma and multiple endocrine neoplasia type 2 syndromes in the pediatric population.
Thyroid cancer is the most common malignancy of the endocrine system and well-differentiated thyroid cancers (DTCs) represent >90% of thyroid malignancies. This Review outlines the current surgical management of DTC and provides an overview of the controversies surrounding the optimal surgical scheme. The recent advances in thyroid surgery, the arguments for and against each surgical approach, and the authors’ personal opinions are also presented.
Preclinical models have shown that inhibition of kinases in mitogenic and angiogenic signaling pathways can have antitumoral effects. Starting with a brief synopsis of a malignancy that responds well to kinase inhibition (chronic myeloid leukemia) compared with one with less durable responses as yet (melanoma), this Review highlights challenges that must be overcome in order to successfully translate small-molecule therapies to thyroid cancer in the future.