Endocrinology
Article Abstract:
The treatment status of several endocrinologic disorders is reviewed. Diabetes mellitus, a condition caused by insufficient insulin secretion, affects 12 million Americans, and leads to renal failure in many patients. About one-fourth of the diabetic patients on dialysis (artificial filtration of the blood to remove wastes) have diabetic nephropathy, a severe kidney disorder. Blacks have a higher incidence of diabetic nephropathy than whites, as do insulin-dependent diabetics who also have a sibling with diabetes or a parent with hypertension. A major research study is now underway to test whether intensive insulin therapy can affect the development or progression of diabetic neuropathy. Another endocrinologic disorder, acromegaly, which is characterized by gradual enlargement of the bones of the face and extremities, can now be treated with the drug octreotide; it reduces levels of growth hormone and decreases symptoms. Octreotide is also used for treating some hormone-secreting tumors and, in fact, is only approved by the Food and Drug Administration for the latter condition. The molecular structure of a substance called inhibin has been described. Inhibin inhibits FSH (follicle stimulating hormone, which affects the ovaries and lining of the uterus) with little effect on LH (luteinizing hormone, which helps to cause ovulation). It appears that this substance may serve as a tumor marker for some forms of cancer, such as recurrent ovarian cancer. Activins are a class of molecules that stimulate the gonads (ovaries or testes) and other cells, and lead to increased levels of red blood cells and hemoglobin. Inhibins and activins are an exciting focus of current research. Parathyroid hormone-like protein (PLP) may cause elevated blood calcium levels, which are found in patients with certain forms of cancer. Developing an accurate assay for PLP would help elucidate the cause of abnormal calcium levels in these cancer patients. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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Endocrinology
Article Abstract:
Alendronate sodium and slow-release sodium fluoride appear to be effective in the treatment of osteoporosis. Both drugs increase bone density and reduce the incidence of bone fractures. Patients with asymptomatic primary hyperparathyroidism can be managed conservatively provided they do not have bone loss. Those who do should be treated surgically even if they have no symptoms. Research has shown that even low doses of corticosteroids can cause bone loss in men and women. Consequently, all patients should be given the smallest dose and should be monitored for bone loss. Radioactive iodine treatment for Graves' disease could result in the production of antibodies that could worsen Graves' eye disease. Research has shown that patients treated with radioiodine have a greater chance of worsening eye disease than those treated with surgery or anti-thyroid drugs. Removing the thyroid gland may be the best treatment for such patients. Metformin is effective in controlling blood sugar levels in patients with type II diabetes.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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Endocrinology
Article Abstract:
Hormonal replacement therapy (HRT) not only helps to protect menopausal women from osteoporosis but reduces the death rate from cardiovascular disease by 50%. Although the risk of breast cancer is higher in women receiving HRT, a combination of estrogen and progestin lowers the risk of endometrial cancer. Risk factors for osteoporosis include smoking, excess alcohol use, poor diet and sedentary life-style. If reducing these factors plus HRT fail, bisphosphonates such as etidronate disodium may increase vertebral bone mineral content and reduce the incidence of vertebral compression fractures. A new test for Cushing's syndrome allows physicians to differentiate easily between two causes of the disease and prescribe the correct treatment. New diagnostic imaging techniques allow physicians to see silent or hidden cancers. McCune-Albright syndrome has been found to result from overproduction of adenosine monophosphate (cAMP), which allows the ovaries to function without the influence of other hormones.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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