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PubMed2006

Endocrinology update 2006.

Endocrinology has recently witnessed several important developments: The Epidemiology of Diabetes Interventions and Complications study, a follow-up to the landmark Diabetes Control and Complications trial, found that strict glucose control early in the course of type 1 diabetes reduces the risk of microvascular and cardiovascular complications and provides prolonged benefits even if intensive control is not so tightly maintained. Inhaled insulin preparations are now available for mealtime coverage. We now have two new injectable medications for diabetes; pramlintide (Symlin) and exenatide (Byetta) are good adjuncts for patients with both type 1 and type 2 diabetes who have trouble reaching their hemoglobin A1c target, and they can help control and even reduce weight. Thyroxine (T4), instead of being merely a "prohormone," has been found to have direct actions on cells, leading to rapid clinical effects and possibly oncogenesis and angiogenesis. The therapeutic range for thyrotropin (TSH) may be much narrower than traditionally believed: some have proposed that the normal range should be redefined as 0.4 to 2.5 mIU/L. New evidence shows that vitamin D is important for more than calcium control and may help prevent type 1 diabetes.

Diabetes Complications↗
PubMed2005

[A personal view of endocrinology in Chile].

In a short historical review of the outstanding changes occurred in the whole of endocrinology and particularly in Chile over the last 60 years -with the background of an infant mortality drop from 200 per thousand in 1940 to 8 per thousand today and a mean life expectancy increase from 42 to 76 years- the author outlines major achievements in this country. He comments on the use in former days of biological tests on urine extract to measure hormones for diagnostic procedures replaced by hormone determinations in blood by radioimmunoassays; today's medication with synthetic hormones instead of opotherapeutic preparations obtained from organ extracts; the identification of new hormones, receptors and new knowledge that enables us to understand the role of neurotransmitters and neuromodulators, the interaction of neurological, endocrine and immunological systems and the involvement of stress in various diseases. Finally the description of DNA and the international cooperative project to establish the human genome map with unpredictable potential applications in medicine. The author underlines the importance of collaborative work in all branches of medicine, often making cooperation more effective than competition. The enormous expansion of biological information demands that direct application of scientific knowledge to clinical medicine is prevented as being insufficient for an optimal clinical judgment, since a bio-psychosociological perspective of the patient and the doctor's clinical experience are essential factors in the doctor-patient relationship.

Chile↗
PubMed1999

Henry Harrower and the turbulent beginnings of endocrinology.

The emergence of new medical science in the mid-19th century was usually greeted with derision by "practical men" who saw their academic colleagues as elitist intellectuals whose work bore little or no relation to the rough-and-tumble aspects of patient care. This schism, which was nowhere greater than in the field of endocrinology, widened in 1891 when a myxedematous patient was dramatically restored to health after the administration of a thyroid extract. On the one hand, academicians-who saw this result as a triumphal example of the transference of laboratory studies to the bedside--were encouraged to pursue further studies in endocrine pathophysiology and pharmacology. On the other hand, medical practitioners began to believe that crude extracts from glands or other organs, when prescribed as orally administered mixtures, were effective for the treatment of most human ailments. The organotherapeutic forces were ably championed by Henry R. Harrower, MD, a manufacturer as well as a dispenser of organotherapeutic products. For some years, the claims of the organotherapists remained unchallenged. Finally, in 1921, Harvey Cushing, pioneer neurosurgeon and endocrinologist, launched a crushing assault on the purveyors of pluriglandular therapy. These attacks continued over ensuing years, and organotherapy fell into disrepute. Nevertheless, the assertions of "practical men" have not subsided; rather, we are now confronted by insistent claims for a bewildering array of herbal remedies, over-the-counter hormonal products, and alternative therapies.

Endocrinology↗
PubMed1999

[The alcohol dependence in the patients of the Department of Orthopedics and the Department of Endocrinology of the clinical hospital in Białystok].

The authors analyse problem of alcohol dependence in the patients of the traumatic department (orthopedics) and the internal department (endocrinology). The evaluation of the dependence was made by the help of MAST. This test is easy to perform by the patients themselves. As authors predicted, the probability of alcohol dependence was higher among the patients of the orthopaedics department. Although the difference was not statistically significant, the authors confirm that the alcohol dependence may be related to physical traumas, especially in men.

Adolescent↗
PubMedDate not supplied

[Gerontology and endocrinology at the beginning of the 20th century: Dr. Voronoff (1866-1951)].

Rejuvenation by monkey testicle transplanting was terribly fashionable in Paris, between years 1925-1930. The manual miracles done by a group of very well-known surgeons, in Paris, (especially Serge Voronoff and Dartigues) rooted in the head of a too credulous public the idea according to it was possible to be made scientifically younger by genital graftings. The "Etude sur la vieillesse et la rajeunissement par la greffe" (1926), written by Voronoff, provided the clinical, histological and iconographical proofs of a such rejuvenation. The paper analyses that was put forward as "proofs", situated in the scientific and cultural context of the time. A possible link between youth, sexual vigour and animality sends back to a mythic history of gerontology and endocrinology, two medical fields which however became scientific specialties in the beginning of the twentieth century.

Animals↗
PubMed2002

[The endocrinology department].

The clinical activities of the department of endocrinology encompass the care and treatment of diabetes, thyroid diseases, hypothalamo-pituitary, adrenal, gonadic and parathyroid diseases, obesity, hypercholesterolemia and paraneoplastic endocrine syndromes. These domains are briefly described. The research activities of the department have investigated the regulation of thyroid metabolism in vitro, the intrathyroid H2O2 generating system, the physiopathology of toxic thyroid nodules and the effects of ageing on the thyreotropic function of the normal ageing male. Studies of "jet lag" conditions have shed a new light on hormonal chronophysiology. Other investigations have considered the regulation of ketone body metabolism, the relationship between nutritional status and glucose metabolism, and some aspects of immunodiabetology.

Belgium↗
PubMed2004

Child-onset growth hormone deficiency in adulthood. Transfer of patients from pediatric to adult endocrinology units.

Treatment with growth hormone (GH) in adult-onset GH deficiency (AO-GHD) reverses its many metabolic alterations, modifying body composition, bone mass, several cardiovascular risk factors, and improving quality of life. In adult patients with a previous diagnosis of child-onset GH deficiency (CO-GHD), the lack of treatment also produces similar alterations, reversed by GH treatment. In patients with multiple pituitary hormone deficiency, the lack of GH is considered definitive, but in isolated GHD, the need for re-evaluation of the deficit is mandatory. The 'gold standard' test is insulin-induced hypoglycemia, after a wash-out period, and the criterion for GH therapy should be a GH (polyclonal-RIA assay) response less than 3 ng/ml. The initial recommended GH dose is lover than in children, and the dosage must be adjusted to maintain IGF-I levels in the normal range. We propose that decisions about patient recruitment, assessment, confirmation or reevaluation, information about new perspectives, disadvantages and benefits of GH therapy, and the beginning of treatment should be made in cooperation by pediatric and adult endocrinologists, so the patient receives all information from both medical teams, before being transferred to the adult endocrinology department.

Adult↗
PubMedDate not supplied

[Edouard Laguesse at Lille in 1893 created the term "endocrine" and opened the endocrinology era].

In 1893 Edouard Laguesse decided to name the peculiar tiny heaps of cells of pancreas after Langerhans who had discovered them in 1869. As he thought the secretion of these cell heaps was regulating glycaemia he provoked doubt in the minds of his contemporaries but in the same time he was on the way to discovery of a new hormone which was to be at the birth of "endocrinology".

Endocrinology↗
PubMed2005

[The pediatric-to-adult transit clinic as a quality-securing measure in endocrinological diseases].

The establishment of structured transit clinics for pediatric patients with endocrinological diseases entering adulthood is a prerequisite for ensuring the quality of care for patients with chronic endocrine diseases. Since such patients have been receiving constant special pediatric care on a large scale only during the last 20 years, and only now is an improvement in life expectancy and quality of life becoming evident for the individual diseases, a comprehensive store of experience, or even of evaluated data, is lacking. In order to preserve the quality achieved in pediatric care, transitional structures must initially utilize the experience and results achieved in the pediatric setting, and adapt them to the requirements of adult patients. This is an ongoing process, and additional resources are required for the transition, e.g. for joint medical counseling and care, as also for the continuing utilization of non-medical pediatric services. The basis for the implementation of such models is, in principle, provided by the Gesundheitsmodernisierungsgesetz, GMG (health care modernization act), and, for reasons of quality control, the necessary structures should be put in place as quickly as possible.

Adolescent↗
PubMed2004

The role of genetics in pediatric endocrinology.

Information on the genetics of endocrine disorders and genetic testing is increasing rapidly. This makes it important for endocrinologists to be able to efficiently search for clinically relevant information and to access specialized laboratory testing and genetics professionals to assist with diagnosis, education, counseling and management of patients and families. Because new findings are reported in many different publications, current comprehensive information on clinical and laboratory findings of and genetic testing for endocrine disorders cannot be found in any single journal or text. Electronic databases provide rapid access to such information. Endocrinologists need to develop a working understanding of these databases. This review examines principles of inheritance, types of genetic variation and the genetic aspects of selected endocrine disorders. It demonstrates how information on genetics and genetic testing can be obtained and discusses how endocrinologists and geneticists can work together to strengthen the clinical applications of genetics to pediatric endocrinology.

Child↗
PubMed1991

[Endocrinology 1989-1990].

In a brief review the author presents selected results of endocrinological research, published in 1989 to 1990. In the sphere of peptide hormones he mentions findings on the reduced level of the endothelial relaxation factor in the blood stream in atherosclerosis, the classification of endothelin with neuropeptides and the existence of a vasopressin antagonist which causes polyuria after operations of the hypothalamus. Hybrid hormones (biotechnologically prepared combined molecules), mammastatins (inhibitors of proliferation of mammary cell cultures lacking in transformed cultures) and adipsin (a peptide factor lacking in some types of experimental obesity) are other recent advances. Findings on endogenous benzodiazepine substances (occupying receptors for diazepines) and of an endogeneous factor for receptors for tetrahydrocanabinols supplement the contemporary picture. Adrenocortex stimulating immunoglobulins may be the cause of hyperplasia of the adrenal cortex, similarly as TSI is the cause of Graves-Basedow's disease. In the latter evidence of a retroviral aetiology was provided.

Cushing Syndrome↗
PubMed1990

[Analysis of endocrinology consultations in Paris public assistance hospitals: cross-sectional survey of 15 days in 10 departments].

A cross-sectional study was carried out in ten endocrinology departments for a two-week period of time. Three categories of data were collected concerning socio-economic status and epidemiological profiles and management of the patients. The results are presented with comparative analysis of performance of the clinics, and epidemiological data are analysed with reference to the inpatient case mix.

Cross-Sectional Studies↗
PubMed1988

[Halle physicians in the pre- and early history of modern endocrinology].

Textbooks of endocrinology separate the modern development (since 1920) from a pre- and an early history of this discipline. Researching facts of the universities of Wittenberg and Halle appear in the lists of the two periods of inauguration. Pioneers as Ernst Joseph lesser, Ernst laqueur and Frigyes Verzár place the university of Halle in the range of early descriptions of endocrine data.

Endocrinology↗
PubMed1988

[Endocrinology from the viewpoint of the zoologist].

The argument is presented that the scientific discipline of endocrinology originated in experimental zoology. The identification of the first ductless glands and the characteristization of their products required the proof that their excision caused recognizable changes which could be reversed by replacement therapy. This could only be obtained from animal experimentation. Zoologists contributed, but an important factor was the tradition of zoology in the medical curriculum, especially in Middle Europe from where sprang the immortal names of Berthold, Langerhans, Knauer, von Halban, Fraenkel, Biedl, and many others.

Endocrinology↗
PubMed1995

[Arthur Biedl and the beginnings of modern endocrinology. On the 125th birthday of the Austrian pathophysiologist].

Modern endocrinology began to develop at the end of the nineteenth century in four stages: the recognition and localization of endocrine glands, the experimental proof of internal secretion by means of destruction and substitution in animals, their isolation and lastly the synthesis of pure hormones. Arthur Biedl (1869-1933), an assistant of Salomon Stricker (1834-1898), was essentially involved in the first two stages of this research process. This paper presents his work from 1895 to 1914.

Austria↗
PubMed1996

[Importance of ultradian rhythms in endocrinology].

Biological rhythms have been reported for a long time in endocrinology. However, their real study started in the late 60's when the possibility of repeatedly measuring the hormonal signal directly in blood over extended periods of time became available. Although episodic secretory fluctuations have been reported for the majority of hormones, and more specifically peptidic hormones, in mammals, organised secretory episodes on a regular or quasi-regular ultradian basis are less common. Their importance, which is directly connected to the number and the processing of the corresponding receptors on the target cells, is illustrated by the paradigm of the pulsatile release of the gonadotropin hormones. Hormonal ultradian rhythms should be considered both from the nosological and therapeutical point of view.

Activity Cycles↗