Clinical endocrinology
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Clinical endocrinology · Jul 2012
Controlled Clinical TrialGlucocorticoid replacement therapy and fibrinolysis in patients with hypopituitarism.
Hypopituitarism is associated with increased cardiovascular mortality, and it has been suggested that unphysiological glucocorticoid replacement regimens might contribute to this risk. Traditional glucocorticoid replacement regimens have often led to excessive serum cortisol levels. The hypercortisolaemia of Cushing's syndrome is associated with an increased risk of thromboembolism. ⋯ An increased dose of hydrocortisone for 2 weeks creates excessive glucocorticoid exposure, but does not significantly affect fibrinolytic-coagulation parameters.
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Clinical endocrinology · Jul 2012
Intensity of pituitary adenoma on T2-weighted magnetic resonance imaging predicts the response to octreotide treatment in newly diagnosed acromegaly.
Primary, preoperative medical treatment is an option in selected patients with acromegaly, but a subset of patients respond poorly. Valid prediction of response to somatostatin analogues (SA) might thus alter treatment stratification. The aims of this study were to assess whether T2 signal intensity could determine long-term response to first-line SA treatment and to assess clinical and biochemical baseline characteristics, as well as histological subtype in relation to the magnetic resonance imaging (MRI) appearances. ⋯ In patients with acromegaly, T2 signal intensity at diagnosis correlates with histological features and predicts biochemical outcome of first-line SA treatment.
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Clinical endocrinology · Jul 2012
Spontaneous remission in thyroid cancer patients after biochemical incomplete response to initial therapy.
To validate the American Thyroid Association (ATA) initial risk of recurrence scheme and the Memorial Sloan Kettering Cancer Center (MSKCC) response to therapy re-stratification approach in a large cohort of patients with differentiated thyroid cancer (DTC) treated outside of the United States. ⋯ These data validate the ATA risk classification as an excellent initial predictor of recurrent/persistent disease and confirm the clinical utility of the MSKCC dynamic risk assessment system in a cohort of patients evaluated and treated outside the United States.
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Clinical endocrinology · Jul 2012
Chemerin levels are positively correlated with abdominal visceral fat accumulation.
Chemerin, a recently discovered adipocytokine, may be linked to obesity and obesity-associated metabolic complications. However, the relationship between visceral fat accumulation and chemerin is still unknown. Therefore, we investigated the relationship between serum chemerin levels and body composition as measured by computed tomography (CT). ⋯ Abdominal visceral fat accumulation, blood pressure and lipid profile were significantly associated with serum chemerin levels. Our findings suggest that chemerin may be a mediator that links visceral obesity to cardiovascular risk factors.
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Clinical endocrinology · Jul 2012
Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national, population-based study.
Vitamin D deficiency is recognized as a global public health problem, but the population-based prevalence of deficiency and its determinants in Australian adults is not known. This study evaluated the vitamin D status of Australian adults aged ≥25 years and risk factors associated with vitamin D deficiency in this population. ⋯ Vitamin D deficiency is common in Australia affecting nearly one-third of adults aged ≥25 years. This indicates that strategies are needed at the population level to improve vitamin D status of Australians.