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 a...

journal_title：Endocrinology and metabolism clinics of North America

authors： Skyler JS

更新日期：1997-09-01 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

authors： Hendrix SL

更新日期：1997-06-01 00:00:00

abstract：:This article describes the basic skills for the design, implementation, and interpretation of randomized controlled studies. Strengths and limitations of each study design are discussed. Epidemiologic issues in the analysis and interpretation of studies, such as loss to follow-up and biases, are included. Numerous cli...

journal_title：Endocrinology and metabolism clinics of North America

authors： Salamone LM,Cauley JA

更新日期：1997-03-01 00:00:00

abstract：:Identifying patients with a high risk of fracture and monitoring a patient's therapeutic response are important. Current methods to evaluate the risk of fracture include the measurement of bone mineral density as well as other risk factors, including those associated with the risk of falling. Several considerations ar...

journal_title：Endocrinology and metabolism clinics of North America

authors： Sowers M

更新日期：1997-03-01 00:00:00

abstract：:Underwater weighing has been the gold standard for the measurement of body composition in humans; however, the two formulas widely used, the Siri and Bronze, were developed using young adult white males. The development of newer techniques in the past 20 years has greatly expanded the accuracy and ease of measuring bo...

journal_title：Endocrinology and metabolism clinics of North America

authors： Harsha DW,Bray GA

更新日期：1996-12-01 00:00:00

abstract：:Various clinical syndromes illustrate the essential role of insulin in modulating somatic growth both in utero and after birth. The effect of insulin on growth is a consequence of direct effects transduced via its homologous receptor and post-receptor signaling pathways and indirect effects on other modulators of grow...

journal_title：Endocrinology and metabolism clinics of North America

authors： Menon RK,Sperling MA

更新日期：1996-09-01 00:00:00

abstract：:In this article, the cellular and molecular mechanisms of diabetic complications have been reviewed. Hyperglycemia-induced mechanisms that may induce vascular dysfunction in specific sites of diabetic microvascular damage include increased polyol pathway flux, altered cellular redox state, increased formation of diacy...

journal_title：Endocrinology and metabolism clinics of North America

authors： King GL,Brownlee M

更新日期：1996-06-01 00:00:00

abstract：:Skin manifestations associated with diabetes mellitus are common and, with close scrutiny, can occur in most, if not all, patients. Little information is available on what common pathophysiologic thread is responsible for the skin manifestation and diabetes. Although controlled studies are lacking, a recognition of th...

journal_title：Endocrinology and metabolism clinics of North America

authors： Sibbald RG,Landolt SJ,Toth D

更新日期：1996-06-01 00:00:00

abstract：:This article discusses several unusual forms of primary thyroid neoplasms. The TCV of PTC and insular thyroid carcinoma appears to have a more aggressive clinical behavior than DTC in most patient groups and may respond to thyroid hormone suppression and radioiodine. Anaplastic thyroid carcinoma, which may develop fro...

journal_title：Endocrinology and metabolism clinics of North America

authors： Burman KD,Ringel MD,Wartofsky L

更新日期：1996-03-01 00:00:00

abstract：:A small abut important subset of patients with differentiated thyroid cancer will die of disease. Our approach to therapy treats almost all patients similarly, with aggressive surgery and I-131 therapy. Meticulous follow-up should include multiple I-131 diagnostic scans using at least 5 to 10 mCi of I-131 with attenti...

journal_title：Endocrinology and metabolism clinics of North America

authors： Sweeney DC,Johnston GS

更新日期：1995-12-01 00:00:00

abstract：: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 o...

journal_title：Endocrinology and metabolism clinics of North America

authors： Clark BA,Brown RS

更新日期：1995-09-01 00:00:00

abstract：:Normal aging is accompanied by many changes in the hormonal systems involved in control of sodium and water balance. These alterations, together with age-associated changes in renal function, diminish the capacity of the elderly person to withstand the challenges of illness, drugs, and physiologic stresses. Thus, the ...

journal_title：Endocrinology and metabolism clinics of North America

authors： Miller M

更新日期：1995-06-01 00:00:00

abstract：:A number of morphologic and physiologic changes accompany pregnancy such as an increase in lactotrophs and prolactin production, and a decrease in gonadotropins and GH. The hormonal milieu can affect patients with prolactinomas, especially macroadenomas, to cause an increase in size in a minority of patients. Complica...

journal_title：Endocrinology and metabolism clinics of North America

authors： Prager D,Braunstein GD

更新日期：1995-03-01 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

authors： Baker HW

更新日期：1994-12-01 00:00:00

abstract：:Glucocorticoids mainly act through binding to cytosolic receptors that translocate to the nucleus after ligand binding, and dimerize to affect gene transcription in multiple fashions. The liganded receptors may interact with DNA at specific glucocorticoid responsive-elements, may physically hinder the ability of other...

journal_title：Endocrinology and metabolism clinics of North America

authors： Yanovski JA,Cutler GB Jr

更新日期：1994-09-01 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

authors： Adler RA,Rosen CJ

更新日期：1994-09-01 00:00:00

abstract：:Renal artery stenosis, particularly related to advancing atherosclerotic disease, is a common concern to internists seeing patients with worsening hypertension and deteriorating renal function. Understanding the hormonal and hemodynamic consequences of critical vascular lesions allows better selection of antihypertens...

journal_title：Endocrinology and metabolism clinics of North America

authors： Textor SC

更新日期：1994-06-01 00:00:00

abstract：:Obesity is associated with a spectrum of metabolic and cardiovascular disorders, including hypertension. Both the degree and the distribution of excess adipose tissue impact on the risk of hypertension and associated cardiovascular diseases. The mechanisms that may lead to hypertension in obese individuals include inc...

journal_title：Endocrinology and metabolism clinics of North America

authors： Hsueh WA,Buchanan TA

更新日期：1994-06-01 00:00:00

abstract：:The gene causing MEN 1 has been localized to chromosome 11, band 11q13, by tumor deletion mapping studies and by family linkage studies. Molecular genetic markers flanking the MEN 1 gene have been defined, and they are of use in identifying disease gene carriers in a family. These individuals, who are at a high risk o...

journal_title：Endocrinology and metabolism clinics of North America

authors： Thakker RV

更新日期：1994-03-01 00:00:00

abstract：:The familial and genetic nature of multiple endocrine neoplasia type 1 (MEN 1) syndrome was first pointed out by Wermer in 1954, who suggested that an autosomal dominant gene with high penetrance controls the trait. The clinical picture is variable, depending mainly on which glands are involved and whether the tumors ...

journal_title：Endocrinology and metabolism clinics of North America

authors： Larsson C,Friedman E

更新日期：1994-03-01 00:00:00

abstract：:The biologic actions of the peptides of the gastrointestinal tract indicate that they exert their effects by interacting with, in many instances, more than one receptor type and receptors on several tissues. Gut hormone profiles in pathophysiologic situations have not demonstrated a significant role for them in diseas...

journal_title：Endocrinology and metabolism clinics of North America

authors： Brown JC

更新日期：1993-12-01 00:00:00

abstract：:External irradiation to the thyroid, even at low doses, induces subsequent development of thyroid nodules and carcinomas, with an estimated incidence of five per one million people per year if they have been exposed to 1 rad. Larger doses are associated with hypothyroidism. External irradiation also induces thyroid hy...

journal_title：Endocrinology and metabolism clinics of North America

authors： DeGroot LJ

更新日期：1993-09-01 00:00:00

abstract：:Pheochromocytomas cause the most dramatic life-threatening crises in all of endocrinology. Pheochromocytoma is an explosive clinical syndrome that may be characterized by either severe hypertension associated with cerebral, cardiac, and renal complications or hypotension, or even shock and sudden death. Other emergenc...

journal_title：Endocrinology and metabolism clinics of North America

authors： Bravo EL,Gifford RW Jr

更新日期：1993-06-01 00:00:00

abstract：:Unlike other pituitary hormones, PRL is under tonic inhibition by the hypothalamus by way of the PRL inhibitory factor, dopamine. GAP and GABA may also be inhibitory. PRL-releasing factors include TRH and VIP and possibly others. Circulating PRL is predominantly monomeric, although some patients with hyperprolactinemi...

journal_title：Endocrinology and metabolism clinics of North America

authors： Molitch ME

更新日期：1992-12-01 00:00:00

abstract：:Although biotechnology has provided physicians with essentially unlimited supplies of growth hormone (GH), there are currently only a few clear-cut indications for exogenous GH therapy. Data now support the use of GH in the treatment of children with GH deficiency and short girls with Turner syndrome. Tantalizing prel...

journal_title：Endocrinology and metabolism clinics of North America

authors： Wilson DM

更新日期：1992-09-01 00:00:00

abstract：:Acromegaly is an unusual insidious but potentially serious chronic pituitary disorder. The delay in diagnosis results not only in unique somatic disfigurement but is also associated with significant mental and emotional dysfunction. This article reviews and describes some of these nonclassic and often overlooked featu...

journal_title：Endocrinology and metabolism clinics of North America

authors： Ezzat S

更新日期：1992-09-01 00:00:00

abstract：:With apparent failure of SU drug therapy, the management of NIDDM patients becomes even more challenging. The following sequence of actions is recommended. 1. Situational dietary noncompliance (eg, a prolonged vacation or a recent period of family or occupational stress) should be treated first by renewed regular cont...

journal_title：Endocrinology and metabolism clinics of North America

authors： Genuth S

更新日期：1992-06-01 00:00:00

abstract：:Hypergonadotropic forms of amenorrhea in young women are many and varied, and the disorder is not nearly as uncommon as previously believed. It is likely that all physicians seeing women with amenorrhea will encounter this disorder. Careful evaluation is warranted to eliminate any associated autoimmune disorders. Beca...

journal_title：Endocrinology and metabolism clinics of North America

authors： Rebar RW,Cedars MI

更新日期：1992-03-01 00:00:00

abstract：:Prostate cancer is the most frequent cancer in men. A discovery of major importance in the endocrinology of prostate cancer is that the testes contribute only 60% of total androgens in adult men; the remaining 40% are synthesized in peripheral tissues, including the normal and cancerous prostate, from inactive androge...

journal_title：Endocrinology and metabolism clinics of North America

authors： Labrie F

更新日期：1991-12-01 00:00:00

abstract：:Insulin-dependent diabetes mellitus is associated with a growing number of immune abnormalities. At the time of clinical onset, most patients developing the disease as children or young adults have autoantibodies reactive with islet beta cells. Current autoantibody markers for IDDM are not sufficient to predict the di...

journal_title：Endocrinology and metabolism clinics of North America

authors： Lernmark A,Bärmeier H,Dube S,Hagopian W,Karlsen A,Wassmuth R

更新日期：1991-09-01 00:00:00

abstract：:This article discusses congenital adrenal hyperplasia (CAH) caused by a deficiency of 21-hydroxylase, which represents 90% of all cases of CAH. As in other genetic disorders of metabolism, the symptoms of CAH are related to both the decrease of the final products of metabolism and the accumulation of precursors that a...

journal_title：Endocrinology and metabolism clinics of North America

authors： Migeon CJ,Donohoue PA

更新日期：1991-06-01 00:00:00

abstract：:Approximately 70% of patients who form metabolic stones have the idiopathic calcium oxalate urolithiasis syndrome, which is diagnosed by exclusion of other identifiable metabolic abnormalities. This article reviews the classification, risk factors, and treatment options for those patients with this syndrome. ...

journal_title：Endocrinology and metabolism clinics of North America

authors： Smith LH

更新日期：1990-12-01 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

authors： Gorlin JB,Sallan SE

更新日期：1990-09-01 00:00:00

abstract：:The authors provide an extensive and comprehensive review of dyslipoproteinemia in children. An effective program for CVD reduction in this population will include an accessible screening program to identify high-risk children, high-quality measurements of TC and LP-C, careful follow-up of screening results with multi...

journal_title：Endocrinology and metabolism clinics of North America

authors： Franklin FA Jr,Brown RF,Franklin CC

更新日期：1990-06-01 00:00:00

abstract：:This review has highlighted some of the experimental studies in animals and humans that have shown an important link between dietary change and atherosclerosis. This relationship was further supported by population studies showing a key role for saturated fat intake in the determination of serum cholesterol level and ...

journal_title：Endocrinology and metabolism clinics of North America

authors： Stone NJ

更新日期：1990-06-01 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

authors： Hodgson SF

更新日期：1990-03-01 00:00:00

abstract：:Endocrinologists may be challenged not only by the great diversity of rare heritable metabolic bone diseases, but also by an unusual array of genetically transmitted skeletal dysplasias. The striking impact that many such skeletal dysplasias have on bone leads physicians naturally to question whether there is a metabo...

journal_title：Endocrinology and metabolism clinics of North America

authors： Whyte MP

更新日期：1990-03-01 00:00:00

abstract：:Physiologic regulation of bone cell function is achieved by the combined actions of some circulating hormones and several locally produced cytokines. Interactions among these agents are important, and the regulated generation of proteolytic activities is likely to play a major role in determining net effects on bone c...

journal_title：Endocrinology and metabolism clinics of North America

authors： Martin TJ,Ng KW,Suda T

更新日期：1989-12-01 00:00:00

abstract：:Familial benign hypercalcemia, or hypocalciuric hypercalcemia, may be defined as a dominantly inherited disorder of calcium and magnesium metabolism, characterized by lifelong hypercalcemia and hypermagnesemia (both of variable degree), that usually is not associated with any symptoms, physical signs, reduced vitality...

journal_title：Endocrinology and metabolism clinics of North America

authors： Heath H 3rd

更新日期：1989-09-01 00:00:00

abstract：:This article covers considerations in the etiologies and therapy of hypercalcemia. The differential diagnosis of hypercalcemia is discussed, with particular emphasis on primary hyperparathyroidism and the hypercalcemia of malignancy. Clinical features of hypercalcemia are also discussed. Therapy of hypercalcemia is co...

journal_title：Endocrinology and metabolism clinics of North America

authors： Bilezikian JP

更新日期：1989-06-01 00:00:00