Clinical endocrinology
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Clinical endocrinology · Jun 2015
Observational StudyDepletion of high-affinity corticosteroid-binding globulin corresponds to illness severity in sepsis and septic shock; clinical implications.
Corticosteroid-binding globulin (CBG) is cleaved by neutrophil elastase converting the high-affinity (haCBG) conformation of CBG to a low-affinity (laCBG) conformation with a ninefold reduced cortisol-binding affinity. These in vitro data suggest that cortisol release by CBG cleavage results in the targeted delivery of cortisol to areas of inflammation. Our objective was to determine whether CBG cleavage alters circulating levels of haCBG and laCBG in vivo in proportion to sepsis severity. ⋯ Increasing illness severity in sepsis and septic shock is associated with markedly reduced circulating haCBG concentrations in vivo. We propose that low levels of haCBG in chronic inflammation may limit the availability of cortisol to inflammatory sites, perpetuating the inflammatory process.
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Clinical endocrinology · May 2015
RAS mutations in indeterminate thyroid nodules are predictive of the follicular variant of papillary thyroid carcinoma.
RAS mutations are the most common mutations in thyroid nodules with indeterminate cytology by fine-needle aspiration cytology (FNAC), and are mutually exclusive with BRAF mutations. However, the diagnostic utility of RAS mutation analysis is uncertain. We evaluated the diagnostic utility of RAS mutation analysis in indeterminate thyroid nodules. ⋯ Our results suggest that RAS mutation analysis holds great promise as a preoperative diagnostic tool for predicting FVPTC in cytologically and sonographically indeterminate nodules negative for BRAF mutations.
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Clinical endocrinology · May 2015
Observational StudySex steroids levels in chronic kidney disease and kidney transplant recipients: associations with disease severity and prediction of mortality.
Our objective was to characterize and evaluate prognostic implications of circulating sex steroids in patients at different stages of chronic kidney disease (CKD). ⋯ Testosterone levels differ across stages of kidney disease and low testosterone levels predict mortality in males, independent of established and novel predictors of mortality.
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Clinical endocrinology · Apr 2015
Gender-specific co-activation of arginine vasopressin and the hypothalamic-pituitary-adrenal axis during stress.
To study the interaction between copeptin and hypothalamic-pituitary-adrenal (HPA) activation in men and women during hypoglycaemic stress. ⋯ The data from this study indicate that stress-induced release of AVP in women, but not in men, is linked to the co-activation of the hypothalamic-pituitary-adrenal system.
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Clinical endocrinology · Mar 2015
Effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with idiopathic hypogonadotropic hypogonadism.
Idiopathic hypogonadotropic hypogonadism is a rare disorder. This study evaluated the effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with this disorder. ⋯ This study indicated that low total testosterone levels can be considered a significant marker of atherosclerosis in patients with idiopathic hypogonadotropic hypogonadism and that androgen replacement therapy significantly reduces atherosclerotic risk markers in these patients after 6 months.