Endocrine Abstracts

A central tenet in medicine is that disruption of homeostatic mechanisms leads to disease and effective therapy must re-establish normal physiology. The sun imposes a 24-hour periodicity to life and circadian rhythms have evolved to maintain homeostasis through the 24-hour day/night cycle. In humans, there is a central clock that controls the sleep/wake cycle which metabolically is a fast/feed cycle. The clock maintains homeostasis by synchronising metabolism to the time of fe...

The Women’s Health Initiative studies reported that the menopausal hormone therapy (MHT) regimen containing conjugated equine estrogen (CEE) and medroxyprogesterone acetate increased, whereas CEE alone reduced breast cancer incidence. These observations suggest the possibility that CEE might exert unique actions on breast and also suggest the need to eliminate the progestogen from MHT regimens. A MHT regimen called a tissue selective estrogen complex (TSEC), containing CE...

Bone turnover markers reflect the work of the osteoblast and the osteoclast. They can be measured in blood or urine and allow for an inexpensive and non-invasive way to study bone metabolism. They have been evaluated for their use in predicting risk of fracture, accelerated bone loss or the presence of secondary osteoporosis, but for all these uses they are not yet established. They are useful in monitoring the response to treatment of osteoporosis, especially with drugs such ...

Abstract unavailable at the time of publishing...

Two anti-CD-20 radioantibody therapies: Y-90 ibritumomab tiuxetan (Zevalin) and I-131 tositutumomab (Bexxar) were approved in the USA in the early 2000s. The safety and efficacy of both Bexxar and Zevalin were proven relative to rituximab. While Zevalin remains on the market, sales are reportedly low. Bexxar exited the market in 2014 after low sales. Bexxar cost $26K USD, ‘very expensive’ by early 21st century standards, but low compared to cancer therapies in 2016. ...

Hypogonadotrophic hypogonadism (HH) in males is defined both biochemically – low serum testosterone (T) level with LH+FSH levels in or below the lower half of the reference range – and clinically. ie. the person is actually hypogonadal. This clinical criterion is crucial for an accurate diagnosis adult-onset HH in men, because biochemical features are common to other scenarios for which T treatment is presently not indicated. These include afternoon-, or non...

Cushing’s disease (CD), caused by a corticotroph pituitary adenoma, is associated with multi-system morbidity and when untreated or suboptimally treated with an increased mortality. Transsphenoidal adenomectomy is the first choice of treatment for CD. Medical treatment is an option in patients in whom surgery is not successful or not feasible. Medical therapy for CD can be classified into pituitary-directed drugs, adrenal-blocking drugs and glucocorticoid receptor antagon...

Recent years have seen a dramatic rise in interest in preserving fertility in women facing treatment for cancer and other serious diseases, and fertility preservation is rapidly becoming a mainstream part of reproductive medicine. This approach, however, serves to remove oocytes or ovarian tissue before cancer treatment, rather than directly protecting the ovary itself. Some chemotherapies and radiotherapy have well known adverse effects on follicle number, although the detail...

Hypogonadotrophic hypogonadism (HH) is the only form of infertility that is directly treatable with hormone replacement, either in the form of gonadotrophin injections, or pulsatile GnRH if the underlying defect is hypothalamic and pituitary function is intact. However, men with HH face a complex and confusing journey to access treatment: misinformed that they are irredeemably infertile, struggling to find a clinician with relevant experience and authorisation to prescribe gon...

Recent advances in the treatment of teenage cancers have led to an increasing focus on the late effects of treatment, amongst which fertility is prominent with surveys ranking potential loss of fertility as amongst the most important concerns of teenage and young adult patients. The various treatments for teenage cancer including chemotherapy, radiotherapy and surgery can all potentially compromise fertility with the most toxic therapies being alkylating agent based chemothera...