Abstract:
:This article discusses the evolution of therapy for type I diabetes and considers how physicians should be thinking about the disease in the late 1990s. The biases herein are that management strategy has evolved such that contemporary practice should routinely entail a system of "flexible intensive therapy" directed at meticulous glycemic control. To accomplish this requires a skilled management team including an educated, motivated patient and family working in a negotiated therapeutic alliance; a further goal should be the development of effective approaches to interdict the pathogenetic process such that disease prevention is possible.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Skyler JSdoi
10.1016/s0889-8529(05)70272-3subject
Has Abstractpub_date
1997-09-01 00:00:00pages
647-57issue
3eissn
0889-8529issn
1558-4410pii
S0889-8529(05)70272-3journal_volume
26pub_type
杂志文章,评审abstract::Since its discovery, ANF has provided multitudinous opportunities to explore its relationship to various biologic functions. Hundreds of publications investigating various aspects of this newly discovered hormone system have appeared. ANF exhibits a plethora of direct and indirect biologic activities that oppose the h...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-03-01 00:00:00
abstract::Osmoreceptor sensitivity is enhanced in healthy elderly subjects and AVP secretion is increased, relative to that of younger subjects, when plasma osmolality rises. Increased AVP secretion/unit increase in plasma tonicity reflects a decrease in collecting tubule sensitivity to AVP by an as yet unknown mechanism in the...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::The regulation of energy balance is enormously complex, with numerous genetic, hormonal, neural/behavioral, and societal influences. Although the current epidemic of obesity has its underpinnings in the changes in culture during the last half century, the role of the neuroendocrine system in the genesis of obesity is ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70211-5
更新日期:2001-09-01 00:00:00
abstract::Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are s...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2010.08.009
更新日期:2010-12-01 00:00:00
abstract::Nelson's syndrome (NS) is a condition which may develop in patients with Cushing's disease after bilateral adrenalectomy. Although there is no formal consensus on what defines NS, corticotroph tumor growth and/or gradually increasing ACTH levels are important diagnostic elements. Pathogenesis is unclear and well-estab...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2020.05.004
更新日期:2020-09-01 00:00:00
abstract::The notion that Graves' ophthalmopathy is an autoimmune disease has been based primarily on the clinical associations between it and Graves' hyperthyroidism, and on the frequently beneficial response of the disease to immunosuppressive therapy. Recent advances in molecular biology have led to new insights into the pat...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70132-8
更新日期:2000-06-01 00:00:00
abstract::The incidence, clinical presentation, and types of thyroid cancers presenting in childhood are reviewed. The role of antecedent radiation in papillary and follicular thyroid cancers and genetics of medullary thyroid carcinoma are discussed. Unique aspects of therapy and prognosis for the pediatric patient with thyroid...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::Male infertility is a common problem but only about one quarter of patients have specific or defined conditions that make them either sterile or severely infertile. About half of these patients have untreatable primary seminiferous tubule failure, and donor insemination or adoption are the only possibilities of having...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::In summary, patients who will remain on glucocorticoids for more than a few weeks are clearly at risk for osteoporosis. A list of therapeutic strategies is provided in Table 2. While our therapy remains inadequate at this time, newer agents are on the horizon. In the near future, it may be possible to recommend specif...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Based on the 2010 version, the 2017 World Health Organization (WHO 2017) classification is for pancreatic neuroendocrine neoplasms (PanNEN). The WHO 2017 classification introduces the novel well-differentiated neuroendocrine tumor of high grade (NET G3). A sharp distinction between NET and poorly differentiated neuroe...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2018.04.008
更新日期:2018-09-01 00:00:00
abstract::Women who cannot or choose not to take estrogens do have alternatives; however, the options are few and unproven in longterm clinical trials with respect to safety and efficacy. Many available alternative treatments may alleviate the symptoms of the menopause, but do not convey long-term protection against osteoporosi...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70253-x
更新日期:1997-06-01 00:00:00
abstract::Adrenocortical carcinoma (ACC) is rare but one of the most malignant endocrine tumors. This article reviews and summarizes the current knowledge about the treatment of ACC. The epidemiology and molecular events involved in the pathogenesis of ACC are briefly outlined. The different diagnostic tools to distinguish beni...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2015.02.008
更新日期:2015-06-01 00:00:00
abstract::Thyroid nodules are extremely common, affecting from 4% to 7% of the population. Fine-needle aspiration biopsy is the most accurate and cost-effective technique for nodule diagnosis. It is simple, safe, and should be the first test used in patient work-up. Routine thyroxine (T4) suppressive therapy is no longer recomm...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70282-6
更新日期:1997-12-01 00:00:00
abstract::Ambiguity of the external genitalia may be based on disordered steroid biosynthesis or may arise from fundamental genetic and chromosomal abnormalities that produce failure of gonadogenesis. This article first discusses congenital adrenal hyperplasia and then considers the diverse abnormalities that cause disordered g...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-06-01 00:00:00
abstract::Conventional therapy of hypoparathyroidism consists of oral calcium and either activated vitamin D or vitamin D supplements at varying doses. Although adjusting dosing of calcium and/or activated vitamin D or vitamin D itself, the serum calcium should be obtained weekly or monthly depending on the clinical situation. ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2018.07.012
更新日期:2018-12-01 00:00:00
abstract::Glucocorticoid-induced bone loss has been recognized for almost 50 years, yet it remains an important medical problem and a common cause of fracturing. Loss of skeletal mass may occur early in the course of glucocorticoid therapy and appears to be related to the cumulative dose of steroid, as well as to the usual risk...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::Medullary thyroid carcinoma (MTC) is a rare type of thyroid cancer, demonstrating variable behavior from indolent disease to highly aggressive, progressive disease. There are distinguishing phenotypic features of sporadic and hereditary MTC. Activation or overexpression of cell surface receptors and up-regulation of i...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2014.02.004
更新日期:2014-06-01 00:00:00
abstract::Ethnicity is a complex yet important construct and an independent risk factor for diabetic heart disease (DHD) with paramount clinical significance. Clinicians should try to better understand the role of ethnicity through more questions. The risk of DHD is modified by ethnicity through more questions. The risk of DHD ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2006.06.004
更新日期:2006-09-01 00:00:00
abstract::Insulin resistance in skeletal muscle is a major hallmark of type 2 diabetes mellitus (T2D) and obesity that is characterized by impaired insulin-mediated glucose transport and glycogen synthesis and by increased intramyocellular content of lipid metabolites. Several studies have provided evidence for mitochondrial dy...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2008.06.006
更新日期:2008-09-01 00:00:00
abstract::Transgender persons receiving gender-affirming hormone therapy and procedures may face specific skin conditions. Skin diseases in transgender patients often are underdiagnosed and underrecognized despite their important impact on quality of life and mental health. This article discusses pathophysiology, diagnosis, and...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2019.01.005
更新日期:2019-06-01 00:00:00
abstract::The liver is key to glucose homeostasis. Any disruption of its metabolism, structural integrity, or intracellular dynamics may alter the liver's ability to maintain normal glucose homeostasis. When such disruption affects hepatic glucose output, hypoglycemia may eventuate. Multiple drugs including alcohol may alter th...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::Morbid obesity has reached epidemic proportions in the United States. Unfortunately, medical interventions have been largely ineffective in this growing population. Currently bariatric surgery is the most effective intervention in managing morbid obesity and its comorbidities. As more patients become eligible for and ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(03)00002-1
更新日期:2003-06-01 00:00:00
abstract::The goal of this article is to differentiate the insulin resistance syndrome from the metabolic syndrome. In the case of the insulin resistance syndrome, the abnormalities and clinical syndromes that are increased in prevalence in insulin-resistant individuals have been summarized, with a brief discussion of the causa...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2004.03.002
更新日期:2004-06-01 00:00:00
abstract::An approach to the diagnosis and follow-up of patients with osteoporosis is described. A system of classification of vertebral fractures is outlined, and the relative merits of different techniques for bone mineral density are discussed. The importance of identifying factors that accelerate bone loss is stressed. The ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Estrogen deficiency at menopause is associated with increased risk of bone loss and osteoporosis. Aromatase inhibitors (AIs) are increasingly being used for the treatment of postmenopausal hormone-sensitive breast cancer because of better disease-free survival compared with tamoxifen seen in clinical trials with AIs. ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2011.05.008
更新日期:2011-09-01 00:00:00
abstract::The pathogenesis of atherosclerosis in human immunodeficiency virus (HIV)-infected individuals is incompletely understood and appears to be multifactorial. Proatherogenic changes in blood and tissue lipids are associated with an increased risk of cardiovascular disease among HIV-infected subjects, and these changes ma...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2014.06.003
更新日期:2014-09-01 00:00:00
abstract::Statins are widely used in secondary and primary prevention of atherosclerotic cardiovascular disease. They reduce cardiovascular events and mortality, and have an excellent safety record. Recent case reports suggest a possible association between statins and adverse effects on cognition. This article reviews recent l...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2015.09.007
更新日期:2016-03-01 00:00:00
abstract::Mediators of neuroendocrine and autonomic function seem to play important roles in the core symptoms of major depression. Although centrally directed corticotropin-releasing hormones and norepinephrine contribute to core symptoms such as alterations in anxiety, arousal, and mood, they also exert significant potentiall...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(01)00022-6
更新日期:2002-03-01 00:00:00
abstract::Serum thyroglobulin measurement has greatly facilitated the clinical management of patients with differentiated thyroid cancer and a variety of other thyroid disorders. Thyroglobulin autoantibodies remain a significant obstacle to the clinical use of thyroglobulin measurement. The interpretation of any given thyroglob...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70194-8
更新日期:2001-06-01 00:00:00
abstract::The degree of hyperglycemia may be an important predictor of morbidity and mortality among patients with MI or stroke, and in those undergoing surgical procedures including coronary artery bypass. Hyperglycemia should be aggressively controlled from the time of hospital admission regardless of the patient's primary me...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70162-6
更新日期:2000-12-01 00:00:00