Endocrinology and metabolism clinics of North America
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Endocrinol. Metab. Clin. North Am. · Dec 1999
Review Comparative StudyMonogenic diabetes mellitus in youth. The MODY syndromes.
Maturity onset diabetes of the young is characterized by early onset diabetes inherited in an autosomal dominant pattern. Classic MODY occurs predominantly in Caucasians and presents before age 25, is nonketotic, and is generally not insulin-requiring. Less than 5% of cases of childhood diabetes in Caucasians are caused by MODY. ⋯ The identification of islet autoantibodies is confirmatory evidence of autoimmune (type 1) diabetes. Because testing for MODY mutations is expensive and is performed at a select number of research laboratories only, routine molecular genetic studies to search for the various MODY mutations should be limited to research investigations. In the future, the availability of gene chip technology may allow rapid screening of mitochondrial and MODY mutations.
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Endocrinol. Metab. Clin. North Am. · Sep 1997
ReviewPancreas and islet transplantation. Challenges for the twenty-first century.
This article reviews both pancreas and islet transplantation in detail. The history of each procedure, the effects of these therapies on glucose metabolism, glucose counterregulation, and islet cell secretory function, as well as the challenges that result from each procedure are considered.
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Endocrinol. Metab. Clin. North Am. · Sep 1995
ReviewPotassium homeostasis and hyperkalemic syndromes.
Acute hyperkalemia can be a life-threatening consequence of a variety of pathologic, pharmacologic, and iatrogenic disorders. Recognition and prompt therapy often reverse the electrophysiologic complications within minutes. Therefore, physicians must have a thorough understanding of potassium homeostasis. The causes of hyperkalemia, intracellular-to-extracellular shifts of potassium, excess exogenous potassium loads, and pseudohyperkalemia are discussed.
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Endocrinol. Metab. Clin. North Am. · Dec 1993
ReviewThe use of chemotherapy in the management of neuroendocrine tumors.
This article discusses chemotherapy of neuroendocrine gut and pancreatic tumors and carcinoid tumors. Single-agent and combination chemotherapy in malignant carcinoid tumors are reviewed, as is chemotherapy of endocrine pancreatic tumors and liver-targeted chemotherapy. Future prospects for the use of chemotherapy are included.
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AKA is an acute metabolic disorder that occurs in ethanol abusers who have usually had a recent binge and who, because of gastritis or another intercurrent illness, stop eating and drinking and often vomit repeatedly. This causes dehydration and ketoacidosis which, unlike in diabetics, is usually associated with little or no hyperglycemia or glucosuria. Despite the ketoacidosis, blood pH findings are variable, depending on the severity of coexisting metabolic alkalosis (owing to vomiting) and respiratory alkalosis (owing to pain or delirium tremens). ⋯ Insulin is usually not necessary, except in patients known or suspected to have diabetes. Because some patients have serious coexisting acute illnesses (which may even have precipitated the acute metabolic disorder), assiduous search for those and the appropriate treatment are essential. The prognosis for the acute metabolic disorder per se is excellent, that for coexisting illness depends on the illness, and that for the ethanol abuse is still often problematic.