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  Français - August 16, 2011
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  Topic  

Endocrinology

The study of hormones and their associated diseases. Medically speaking, endocrinology involves the diagnosis and management of these illnesses. Endocrinology is often associated with the study of diabetes and metabolism, or with reproductive medicine. Other areas include neuroendocrinology, thyroid disease and metabolic bone disease.

Presentations listing

Management Guidelines for Patients With Thyroid Nodules and... - Prof. David S. Cooper
PCOS and Diabetes: Implications for Screening and Management - Dr. Maria Kraw
Pediatric Endocrinology - Dr. Celia Rodd
Thyroid - Dr. Mark Sherman
Reproductive Endocrinology - David Morris
Reproductive Endocrinology - Dr. G.R. Graves
Paediatric Endocrinology - Dr. Tracey Bridger
Thyroid - Dr. Gary Costain
Neuropituitary - Dr. Ali Imran
Calcium and Metabolic Bone Disorders - Dr. Stephanie Kaiser
Calcium & Metabolic Bone Disorders - Dr. Andrew Karaplis
Reproductive Endocrinology - Dr. Bernard Corenblum
Diabetes/Lipids - Dr. Lawrence A. Leiter
Neuroendocrinology - Dr. Ehud Ur
Thyroid - Dr. Jody Ginsberg
Pediatric Endocrinology - Dr. Elizabeth Cummings
Reproductive Endocrinology - Dr. Ivy Fettes
Thyroid - Dr. Jody Ginsberg
Calcium and Metabolic Bone Disorders - Dr. Andrew Karaplis
Diabetes/Lipids - Dr. Lawrence A. Leiter
Pediatric Endocrinology - Dr. Denis Daneman
Neuroendocrinology - Dr. Ehud Ur
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 Presentation 

"Management Guidelines for Patients With Thyroid Nodules and Differentiated Thyroid Cancer"

Prof. David S. Cooper (biography)
English - 2006-05-26 - 74 minutes
(91 slides)

Summary :
In this presentation Prof. Cooper reviews several recommendations of interest from the 2006 American Thyroid Association (ATA) Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer, published in "Thyroid" earlier this year.

These are the latest ATA guidelines published since 1996. Although advances have been made in the last decade in the...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

Selected features of the 2006 ATA Management Guidelines for Patients with
Thyroid Nodules and Differentiated Thyroid Cancer, relating to:
- Thyroid nodules: diagnosis and management
- Differentiated thyroid cancer: initial and long-term management, directions for future research

Bibliographic references :
1. The American Thyroid Association Guidelines Taskforce. Management Guidelines for Patients with
Thyroid Nodules and Differentiated Thyroid Cancer
THYROID Volume 16, Number 2, 2006.

   


 Presentation 

"PCOS and Diabetes: Implications for Screening and Management"

Dr. Maria Kraw (biography)
English - 2006-04-28 - 26 minutes
(36 slides)

Summary :
In this presentation Dr. Kraw talks about insulin resistance as the link between polycystic ovary syndrome (PCOS) and diabetes, implications for screening, and the management of insulin resistance in PCOS.

Women with PCOS exhibit decreased insulin sensitivity (1), and Dr. Kraw talks about the etiology of insulin resistance in these individuals and how insulin resistance is...

Learning objectives :
At the end of this session, participants will be able to:

- Describe the association between PCOS and diabetes
- Discuss treatment options for insulin resistance of PCOS

Bibliographic references :
1. A Dunaif, KR Segal, W Futterweit and A Dobrjansky Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome Diabetes, Vol 38, Issue 9 1165-1174.

   


 Presentation 

"Pediatric Endocrinology"

Dr. Celia Rodd (biography)
English - 2005-08-14 - 66 minutes
(77 slides)

Summary :
In this presentation Dr. Rodd reviews new findings in various areas of pediatric endocrinology.

Radioactive iodine treatment has long been used in adults with Graves' disease but its role and safety for use in pediatric patients has been unclear. Dr. Rodd starts by reviewing a 36-year retrospective analysis of radioactive iodine treatment in young Graves' disease patients. About a...

Learning objectives :
Topics:

- Thyroid
- Adrenal
- Puberty
- Diabetes mellitus
- Bone-calcium disorders
- Di-SIADH

Bibliographic references :
1. Charles H. Read, Jr., Michael J. Tansey and Yusuf Menda A 36-Year Retrospective Analysis of the Efficacy and Safety of Radioactive Iodine in Treating Young Graves’ Patients J Clin Endocrinol Metab. 2004 Sep;89(9):4229-33.

2. Brian J. Feldman, M.D., Ph.D., Stephen M. Rosenthal, M.D., Gabriel A. Vargas, M.D., Ph.D., Raymond G. Fenwick, Ph.D., Eric A. Huang, M.D., Mina Matsuda-Abedini, M.D., Robert H. Lustig, M.D., Robert S. Mathias, M.D., Anthony A. Portale, M.D., Walter L. Miller, M.D., and Stephen E. Gitelman, M.D.Nephrogenic Syndrome of Inappropriate Antidiuresis N Engl J Med. 2005 May 5;352(18):1884-90.

3. Melvin M. GrumbachA Window of Opportunity: The Diagnosis of Gonadotropin Deficiency in the Male Infant J Clin Endocrinol Metab. 2005 May;90(5):3122-7. Epub 2005 Feb 22.

4. Bart Keymeulen, M.D., Ph.D., Evy Vandemeulebroucke, M.D., Anette G. Ziegler, M.D., Ph.D., Chantal Mathieu, M.D., Ph.D., Leonard Kaufman, Ph.D., Geoff Hale, Ph.D., Frans Gorus, M.D., Ph.D., Michel Goldman, M.D., Ph.D., Markus Walter, M.D., Sophie Candon, M.D., Ph.D., Liliane Schandene, Ph.D., Laurent Crenier, M.D., Christophe De Block, M.D., Ph.D., Jean-Marie Seigneurin, Ph.D., Pieter De Pauw, Ph.D., Denis Pierard, M.D., Ph.D., Ilse Weets, M.D., Ph.D., Peppy Rebello, B.Sc., Pru Bird, Ph.D., Eleanor Berrie, Ph.D., Mark Frewin, Herman Waldmann, M.D., Ph.D., Jean-François Bach, M.D., Ph.D., Daniel Pipeleers, M.D., Ph.D., and Lucienne Chatenoud, M.D., Ph.D.Insulin Needs after CD3-Antibody Therapy in New-Onset Type 1 Diabetes N Engl J Med. 2005 Jun 23;352(25):2598-608.

5. Anna L. Gloyn, D.Phil., Ewan R. Pearson, M.R.C.P., Jennifer F. Antcliff, B.Sc., Peter Proks, D.Phil., G. Jan Bruining, M.D., Annabelle S. Slingerland, M.D., Neville Howard, M.D., F.R.A.C.P., Shubha Srinivasan, M.B., B.S., M.R.C.P., José M.C.L. Silva, M.D., Janne Molnes, M.Sc., Emma L. Edghill, M.Sc., Timothy M. Frayling, Ph.D., I. Karen Temple, F.R.C.P., Deborah Mackay, Ph.D., Julian P.H. Shield, M.D., F.R.C.P.C.H., Zdenek Sumnik, M.D., Adrian van Rhijn, M.D., Jerry K.H. Wales, D.M., F.R.C.P.C.H., Penelope Clark, Ph.D., F.R.C.Path., Shaun Gorman, M.R.C.P., Javier Aisenberg, M.D., Sian Ellard, Ph.D., M.R.C.Path., Pål R. Njølstad, M.D., Ph.D., Frances M. Ashcroft, Ph.D., and Andrew T. Hattersley, D.M., F.R.C.P.Activating Mutations in the Gene Encoding the ATP-Sensitive Potassium-Channel Subunit Kir6.2 and Permanent Neonatal Diabetes N Engl J Med. 2004 Apr 29;350(18):1838-49.

6. Josh Kollars, MD, Abdalla E. Zarroug, MD, Jon van Heerden, MD, Aida Lteif, MD, Penny Stavlo, MSN, Luis Suarez, MD, Christopher Moir, MD, Michael Ishitani, MD and David Rodeberg, MDPrimary Hyperparathyroidism in Pediatric Patients Pediatrics. 2005 Apr;115(4):974-80.

   


 Presentation 

"Thyroid"

Dr. Mark Sherman (biography)
English - 2005-08-14 - 30 minutes
(22 slides)

Summary :
In this presentation Dr. Sherman discusses guidelines for subclinical thyroid disease and topics relating to medications and thyroid function.

In 2004, a scientific review and guidelines for diagnosis and management of subclinical thyroid disease was published by Surks et al., recommending against routine treatment of patients with TSH levels in the ranges of 0.1 to 0.45 mIU/L or...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Subclinical thyroid disease guidelines
- Effects of medications on thyroid function
- Combined T4/T3 treatment for hypothyroidism

Bibliographic references :
1. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ.Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004 Jan 14;291(2):228-38.

2. Shehzad Basaria MD and David S. Cooper MD. Amiodarone and the thyroid Am J Med. 2005 Jul;118(7):706-14.

3. McDonnell ME et al. N Engl J Med. 2005 Jun 30;352(26):2757-9.

4. Steven I. Sherman, M.D., Jayashree Gopal, M.D., Bryan R. Haugen, M.D., Alice C. Chiu, M.D., Kevin Whaley, M.D., Prem Nowlakha, M.D., and Madeleine Duvic, M.D. Central Hypothyroidism Associated with Retinoid X Receptor–Selective Ligands N Engl J Med. 1999 Apr 8;340(14):1075-9.

5. Rodriguez T, Lavis VR, Meininger JC, Kapadia AS, Stafford LF. Substitution of liothyronine at a 1:5 ratio for a portion of levothyroxine: effect on fatigue, symptoms of depression, and working memory versus treatment with levothyroxine alone. Endocr Pract. 2005 Jul-Aug;11(4):223-33.

   


 Presentation 

"Reproductive Endocrinology"

David Morris (biography)
English - 2005-08-13 - 58 minutes
(58 slides)

Summary :
In this talk Dr. Morris discusses the associations of underweight and overweight with with various reproductive and metabolic disorders.

In underweight, anovulation is common and this is associated with a GnRH pulse defect. Low weight is also the main risk factor for osteoporotic fracture in Canadian women, and Dr. Morris shows studies demonstrating increased risks of small for...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Underweight, overweight and associated reproductive disorders
- Birth weight and diabetes/vascular risk
- Reproductive effects of leptin and insulin
- Overweight and PCOS

   


 Presentation 

"Reproductive Endocrinology"

Dr. G.R. Graves (biography)
English - 2004-08-06 - 69 minutes
(79 slides)

Summary :
In this presentation Dr. Graves gives an overview of aspects in reproductive endocrinology such as the hypothalamic-pituitary-ovarian axis, Kallmann Syndrome, puberty, primary and secondary amenorrhea, hyperandrogenism, hirsutism and the role of estrogen in bone health.

A well-functioning reproductive axis depends on messaging between the hypothalamus, pituitary and ovaries....

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Hypothalamus/Pituitary-GnRH, Kallmann Syndrome, Puberty
- Follicle, Menstrual Cycle
- Primary Amenorrhea
- Secondary Amenorrhea including Hyperprolactinemia, Premature Ovarian Failure
- Hyperandrogenism and Hirsutism including PCOS
- Role of Estrogen in Bone Health

   


 Presentation 

"Paediatric Endocrinology"

Dr. Tracey Bridger (biography)
English - 2004-08-06 - 59 minutes
(60 slides)

Summary :
A number of genes have been identified that are important in pituitary development, and in which mutations result in hormonal deficiencies. These include Pit1, PROP1 and others. Dr. Bridger discusses guidelines for the use of growth hormone (GH) (1, 2), and causes of mortality in GH recipients (3-6).

Nutritional Vitamin D deficiency is on the rise, and Dr. Bridger presents the...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Pituitary development and genetics
- Growth Hormone: New guidelines, GH and mortality
- Vitamin D deficiency
- Type 1 diabetes: DKA guidelines
- Obesity

Bibliographic references :
1. Wilson TA, Rose SR, Cohen P, Rogol AD, Backeljauw P, Brown R, Hardin DS, Kemp SF, Lawson M, Radovick S, Rosenthal SM, Silverman L, Speiser P; The Lawson Wilkins Pediatric Endocrinology Society Drug and Therapeutics Committee.Update of guidelines for the use of growth hormone in children: the Lawson Wilkins Pediatric Endocrinology Society Drug and Therapeutics Committee.J Pediatr. 2003 Oct;143(4):415-21.

2. GH Research Society.Consensus Guidelines for the Diagnosis and Treatment of Growth Hormone (GH) Deficiency in Childhood and Adolescence: Summary Statement of the GH Research Societyjcem.2000;85(11):3990-3993

3. Mills JL, Schonberger LB, Wysowski DK, Brown P, Durako SJ, Cox C, Kong F, Fradkin JE.Long-term mortality in the United States cohort of pituitary-derived growth hormone recipients.J Pediatr. 2004 Apr;144(4):430-6.

4. Van Vliet G et al.Sudden death in growth hormone–treated children with Prader-Willi syndrome J Peds.2004;144(1):129.

5. Swerdlow AJ, Higgins CD, Adlard P, Preece MA.Risk of cancer in patients treated with human pituitary growth hormone in the UK, 1959–85: a cohort study The Lancet.2002;360(9329):273-277.

6. Charles A. Sklar, Ann C. Mertens, Pauline Mitby, Glenn Occhiogrosso, Jing Qin, Glenn Heller, Yutaka Yasui and Leslie L. Robison.Risk of Disease Recurrence and Second Neoplasms in Survivors of Childhood Cancer Treated with Growth Hormone: A Report from the Childhood Cancer Survivor Study JCEM.2002;87(7):3136-3141.

7. Michael F Holick.Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosisAmerican Journal of Clinical Nutrition, Vol. 79, No. 3, 362-371, March 2004.

8. European Society for Paediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society.ESPE/LWPES consensus statement on diabetic ketoacidosis in children and adolescents Archives of Disease in Childhood 2004;89:188-194

9. Agras WS, Hammer LD, McNicholas F, Kraemer HC.Risk factors for childhood overweight: a prospective study from birth to 9.5 years.J Pediatr. 2004 Jul;145(1):20-5.

   


 Presentation 

"Thyroid"

Dr. Gary Costain (biography)
English - 2004-08-06 - 52 minutes
(42 slides)

Summary :
In this presentation Dr. Costain gives an overview of hypothyroidism and related treatment issues.

Thyroid disease is quite common and often undertreated and overtreated (1), and Dr. Costain talks about the available thyroid replacement therapies, dosages for thyroxine and monitoring of thyroxine replacement.

A once weekly dosing of thyroxine has been shown to be...

Learning objectives :
After viewing this presentation th participant will be able to discuss:

- Thyroid replacement therapy: dosages and monitoring
- Drugs and other factors affecting thyroxine absorption and metabolism

Bibliographic references :
1. Gay J. Canaris, MD, MSPH; Neil R. Manowitz, PhD; Gilbert Mayor, MD; E. Chester Ridgway, MD. The Colorado Thyroid Disease Prevalence Study Arch Intern Med. 2000;160:526-534.

2. Stefan K. G. Grebe, Russell R. Cooke, Henry C. Ford, Jocelyn N. Fagerström, Diane P. Cordwell, Nigel A. Lever, Gordon L. Purdie and Colin M. Feek.Treatment of Hypothyroidism with Once Weekly ThyroxineJCEM.1997;82(3):870-875.

3. Nemeroff CB.
Clinical significance of psychoneuroendocrinology in psychiatry: focus on the thyroid and adrenal.
J Clin Psychiatry. 1989 May;50 Suppl:13-20; discussion 21-2.

   


 Presentation 

"Neuropituitary"

Dr. Ali Imran (biography)
English - 2004-08-06 - 63 minutes
(42 slides)

Summary :
In this presentation Dr. Imran discusses the clinical scenarios related to various neuroendocrine disorders.

Acromegaly occurs in 3-4 cases per million annually and has various causes. Dr. Imran presents the features and natural history of acromegaly, the associated mortality, diagnostic approach and goals of treatment. Also presented is information about the use of Pegvisomant, a...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Apoplexy
- Acromegaly
- Cushing's syndrome approach
- Diabetes Insipidus approach
- Hypogonadism (M&F)
- Non-functioning adenoma approach
- Panhypopit approach
- Prolactinoma & pregnancy
- GH deficiency

Bibliographic references :
1. Peter J. Trainer, M.D., William M. Drake, M.B., Laurence Katznelson, M.D., Pamela U. Freda, M.D., Vivien Herman-Bonert, M.D., A.J. van der Lely, M.D., Eleni V. Dimaraki, M.D., Paul M. Stewart, M.D., Keith E. Friend, M.D., Mary Lee Vance, M.D., G. Michael Besser, M.D., D.Sc., and John A. Scarlett, M.D.Treatment of Acromegaly with the Growth Hormone–Receptor Antagonist PegvisomantNEJM.2000;342:1171-1177.

2. Takako Saito, San-e Ishikawa, Sei Sasaki, Tomoatsu Nakamura, Kumiko Rokkaku, Akio Kawakami, Kazufumi Honda, Fumiaki Marumo and Toshikazu Saito.Urinary Excretion of Aquaporin-2 in the Diagnosis of Central Diabetes InsipidusJCEM.1997;82(6):1823-1827.

   


 Presentation 

"Calcium and Metabolic Bone Disorders"

Dr. Stephanie Kaiser (biography)
English - 2004-08-06 - 62 minutes
(49 slides)

Summary :
Dr. Kaiser begins her presentation with a review of the parathyroid axis, and gene mutations known to cause disease. This is followed by a recap of hypophosphatemic disorders and an overview of osteoporosis and its treatment.

Mutations in the parathyroid hormone/parathyroid hormone related protein (PTH/PTHrP) receptor have been implicated in Jansen's metaphyseal chondrodysplasia...

Learning objectives :
After viewing this presentation the participant will be able to discuss:

- Mutations in PTH/PTHrP and CaSR leading to disease
- Hypophosphatemic disorders
- Key risk factors for bone fracture
- Treatments for osteoporosis

Bibliographic references :
1. E. Schipani, M.D., Ph.D., C.B. Langman, M.D., A.M. Parfitt, M.D., G.S. Jensen, B.A., S. Kikuchi, M.D., S.W. Kooh, M.D., Ph.D., W.G. Cole, M.D., Ph.D., and H. Jüppner, M.D.Constitutively Activated Receptors for Parathyroid Hormone and Parathyroid Hormone–Related Peptide in Jansen's Metaphyseal ChondrodysplasiaNEJM.1996;335:708-714.

2. Andrew C. Karaplis, Bin He, M. T. Audrey Nguyen, Ian D. Young, David Semeraro, Hidehiro Ozawa and Norio Amizuka.Inactivating Mutation in the Human Parathyroid Hormone Receptor Type 1 Gene in Blomstrand Chondrodysplasia Endocrinology.1998;139(12):5255-5258.

3. Andrew F. Stewart, M.D. Translational Implications of the Parathyroid Calcium ReceptorNEJM.2004;351:324-326.

4. Jacques P. Brown, Robert G. Josse and The Scientific Advisory Council of the Osteoporosis Society of Canada.2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada CMAJ • November 12, 2002; 167.

5. Henry G. Bone, M.D., David Hosking, M.D., Jean-Pierre Devogelaer, M.D., Joseph R. Tucci, M.D., Ronald D. Emkey, M.D., Richard P. Tonino, M.D., Jose Adolfo Rodriguez-Portales, M.D., Robert W. Downs, M.D., Jayanti Gupta, Ph.D., Arthur C. Santora, M.D., Ph.D., Uri A. Liberman, M.D., Ph.D., for the Alendronate Phase III Osteoporosis Treatment Study Group.Ten Years' Experience with Alendronate for Osteoporosis in Postmenopausal WomenNEJM.2004;350:1189-1199.

6. Robert M. Neer, Claude D. Arnaud, Jose R. Zanchetta, Richard Prince, Gregory A. Gaich, Jean-Yves Reginster, Anthony B. Hodsman, Erik F. Eriksen, Sophia Ish-Shalom, Harry K. Genant, Ouhong Wang, Bruce H. Mitlak, Dan Mellstrom, Erik S. Oefjord, Ewa Marcinowska-Suchowierska, Jorma Salmi, Henk Mulder, Johan Halse, and Andrzej Z. Sawicki.Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with OsteoporosisNEJM.2001;344:1434-1441.

7. Pierre J. Meunier, M.D., Christian Roux, M.D., Ph.D., Ego Seeman, M.D., Sergio Ortolani, M.D., Janusz E. Badurski, M.D., Tim D. Spector, M.D., Jorge Cannata, M.D., Adam Balogh, M.D., Ernst-Martin Lemmel, M.D., Stig Pors-Nielsen, M.D., René Rizzoli, M.D., Harry K. Genant, M.D., and Jean-Yves Reginster, M.D.The Effects of Strontium Ranelate on the Risk of Vertebral Fracture in Women with Postmenopausal OsteoporosisNEJM.2004;350:459-468.

   


 Presentation 

"Calcium & Metabolic Bone Disorders"

Dr. Andrew Karaplis (biography)
English - 2003-08-10 - 54 minutes
(54 slides)

Summary :
The World Health organization has named this decade the “Bone and Joint Decade”, in anticipation of new methods of prevention and treatment of musculoskeletal disorders.
The past decade has provided us with much new information on calcium homeostasis. Identification of the PTh receptor and its mutations have now been linked to a number of disorders for which there were no previous...

Learning objectives :
The participant will get an overview of the last decade’s important discoveries in the research of calcium and metabolic bone disorders.



Bibliographic references :
Kos CH, Karaplis AC, Peng JB, Hediger MA, Goltzman D, Mohammad KS, Guise TA, Pollak MR. The calcium-sensing receptor is required for normal calcium homeostasis independent of parathyroid hormone. J Clin Invest. 2003 Apr;111(7):1021-8.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Chan GK, Miao D, Deckelbaum R, Bolivar I, Karaplis A, Goltzman D. Parathyroid Hormone Related Peptide Interacts with Bone Morphogenetic Protein 2 to increase Osteoblastogenesis and decrease Adipogenesis in Pluripotent C3H10T1/2 Mesenchymal Cells. Endocrinology. 2003 Aug 28 [Epub ahead of print].
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

   


 Presentation 

"Reproductive Endocrinology"

Dr. Bernard Corenblum (biography)
English - 2003-08-10 - 60 minutes
(39 slides)

Summary :
Secondary amenorrhea is an endocrine problem and will be the focus of this presentation. Some causes of secondary amenorrhea are hypothalamic amenorrhea, hyperprolactinemia, ovarian failure, PCOS and outflow tract. Here we will review the pathophysiology of these disorders and discuss their clinical management.

Learning objectives :
The participant will review the pathophysiology of secondary amenorrhea and its causes:

- hypothalamic amenorrhea
- hyperprolactinemia
- ovarian failure
- PCOS
- Outflow tract

Bibliographic references :
Mather KJ, Verma S, Corenblum B, Anderson TJ. Normal endothelial function despite insulin resistance in healthy women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 2000 May;85(5):1851-6.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

   


 Presentation 

"Diabetes/Lipids"

Dr. Lawrence A. Leiter (biography)
English - 2003-08-10 - 85 minutes
(64 slides)

Summary :
In this era of evidence-based medicine we have been lucky to have several ongoing studies in diabetes that touch on many levels. We are learning more about the risk factors predisposing to CVD and other complications, and diabetes prevention is now also a major research focus. Several lipid-lowering studies have been conducted to date, and this presentation will provide new information gleaned...

Learning objectives :
The participant will review the results of several major lipid-lowering studies and get an update on the new drugs available like some statins and others, and how these drugs work and how they may be used.

Bibliographic references :
Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, McInnes GT, Mehlsen J, Nieminen M, O'Brien E, Ostergren J. Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial. ASCOT investigators. J Hypertens. 2001 Jun;19(6):1139-47.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes GT, Mehlsen J, Nieminen M, O'Brien E, Ostergren J; ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003 Apr 5;361(9364):1149-58.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

   


 Presentation 

"Neuroendocrinology"

Dr. Ehud Ur (biography)
English - 2003-08-09 - 60 minutes
(47 slides)
(9 questions)

Summary :
Recent important discoveries in pituitary development involve transcription factors, but we are also discovering better ways of diagnosing and treating people with pituitary disorders. Here Dr Ur draws on his own clinical experience with patients as well as new information coming out in the literature to give an update on the diagnosis and workup of patients affected with the following: pituitary...

Learning objectives :
The participant will share in Dr Ur’s own clinical practice findings and learn newer and more effective ways of doing workups for patients having:
- pituitary and adrenal incidentalomas
- hypophysitis
- growth hormone deficiency
- craniopharyngioma
- non-functioning tumors
- prolactinomas
- normoprolactinemic galactorrhoea
- macroprolactinemia
- acromegaly
- Cushing’s Disease

   


 Presentation 

"Thyroid"

Dr. Jody Ginsberg (biography)
English - 2003-08-09 - 54 minutes
(32 slides)
(1 question)

Summary :
In this presentation we will review the condition of Graves Disease in pregnancy, and some important new articles impacting endocrinology. According to Mestman, the preconception control of thyroid disease is as important as glucose control in diabetic women. A discussion on the screening methods and treatments appropriate to Graves Disease in pregnant women is followed by a discussion of 3...

Learning objectives :
The participant will review the screening procedures and treatment options for women with Graves Disease in pregnancy. This will be followed by a discussion of the following 3 papers that have emerged in the past year:

Bibliographic references :
- Anderson S et al "Narrow individual variations in serum T4 and T3 in normal subjects: A clue to the understanding of subclinical thyroid disease" (J Clin Endoc Metab 87:1068-72, 2002)

- Alexander EK et al "Natural history of benign solid and cystic thyroid nodules" (Ann Intern Med 138: 315-18, 2003) http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

- Mazzaferri EL et al "A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma" (J Clin Endoc Metab 88: 1422-41, 2003). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

   


 Presentation 

"Pediatric Endocrinology"

Dr. Elizabeth Cummings (biography)
English - 2003-08-09 - 33 minutes
(31 slides)
(3 questions)

Summary :
In this presentation Dr Cummings gives an update in Pediatric Endocrinology, focusing on the following topics: Pituitary development and genetics, Growth hormone therapy, Prevention of type 1 diabetes and Bone disorders. An abundance of recent studies are presented with the discussion of a range of pediatric endocrinology treatment issues.



Learning objectives :
The participant will get an update in pediatric endocrinology, with a focus on the following topics:

- Pituitary development and genetics
- Growth hormone therapy
- Prevention of type 1 diabetes
- Bone disorders




Bibliographic references :
Diabetes Prevention Trial--Type 1 Diabetes Study Group. Effects of insulin in relatives of patients with type 1 diabetes mellitus. N Engl J Med. 2002 May 30;346(22):1685-91.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Huopio H, Otonkoski T, Vauhkonen I, Reimann F, Ashcroft FM, Laakso M. A new subtype of autosomal dominant diabetes attributable to a mutation in the gene for sulfonylurea receptor 1. Lancet. 2003 Jan 25;361(9354):301-7.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Pulichino AM, Vallette-Kasic S, Tsai JP, Couture C, Gauthier Y, Drouin J. Tpit determines alternate fates during pituitary cell differentiation. Genes Dev. 2003 Mar 15;17(6):738-47.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

   


 Presentation 

"Reproductive Endocrinology"

Dr. Ivy Fettes (biography)
English - 2002-07-28 - 55 minutes
(27 slides)

Summary :
A discussion on some aspects of endocrinology in reproductive medicine. Dr Fettes starts with an overview of gonadotropin-releasing hormone (GnRH) signalling and disease states. A section on polycystic ovarian syndrome (PCOS) diagnosis and treatment follows. Other topics include menopause, andropause and hormone replacement therapy.

Learning objectives :
The participant will become familiar with gonadotropin-releasing hormone (GnRH) signalling and the diagnosis and treatment of polycystic ovarian syndrome (PCOS). Brief overview of menopause and andropause features and related hormone replacement therapy as well.

Bibliographic references :
Migraine in the menopause.

Fettes I.

University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Ontario, Canada.

Many women with migraine, especially those with a history of menstrual migraine, experience an exacerbation as they approach menopause. During this time, the orderly pattern of estrogen and progesterone secretion is lost. The fluctuating and falling levels of estrogen during the perimenopausal years may increase the frequency and severity of migraine. In such women, restoration and stabilization of estrogen levels within the physiologic range are likely to diminish the migraine. Although continuous combined hormone replacement therapy with estrogen and progesterone is becoming increasingly popular for postmenopausal women, many women are still prescribed cyclic replacement initially. For the woman who is susceptible to fluctuations in estrogen and progesterone, initiation of cyclic therapy after menopause may exacerbate migraine. This could occur in a woman who noted an improvement in migraine after menopause with complete cessation of menses and stable levels of estrogen. For the woman with migraine, continuous combined estrogen and progesterone (or estrogen alone, if the uterus has been removed) replacement is the preferred therapy. This can be achieved with a 50-microg/day estrogen skin patch such as Estraderm or Vivelle twice weekly or Climara once weekly, or with an oral estrogen such as Premarin, Ogen, or Estrace, with half the daily dose given every 12 hours to maintain optimal stability. In the presence of a uterus, progesterone should be added, either as low-dose medroxyprogesterone acetate (Provera) 2.5 mg every evening or micronized progesterone (Prometrium) 100 mg every evening. The usual contraindications to hormone replacement therapy may be applied to women with migraine.

Neurology 1999;53(4 Suppl 1):S29-33

   


 Presentation 

"Thyroid"

Dr. Jody Ginsberg (biography)
English - 2002-07-28 - 87 minutes
(23 slides)

Summary :
The first topic of this presenatation is subclinical hypothyroidism (SH). Beginning with the clinical features and causes, the talk goes on to explore conflicting research evidence and the indicated treatments; Discussion of L-T4 treatment of SH. Thyroid cancer is the second main topic, with a focus on clinical features associated with malignancy and evaluation of the thyroid nodule.

Learning objectives :
The participant will gain valuable insight into the controversial condition of subclinical hypothyroidism. Its causes and clinical features are reviewed, as well as conflicting research evidence concerning the type of treatment to be followed. L-T4 is discussed as a treatment option. Brief overview on the clinical features of thyroid cancer malignancy, and how to evaluate the thyroid nodule.

Bibliographic references :
Hyperplacentosis: a novel cause of hyperthyroidism.

Ginsberg J, Lewanczuk RZ, Honore LH.

Department of Medicine, University of Alberta, Edmonton, Canada. jody.ginsberg@ualberta.ca

Human chorionic gonadotropin (hCG), which is capable of thyrotropic activity, is believed responsible for the hyperthyroidism of gestational trophoblastic disease and hyperemesis gravidarum. Hyperplacentosis is a condition of heightened trophoblastic activity characterized by increased placental weight and circulating hCG levels higher than those associated with normal pregnancy. We report the first case of hyperthyroidism associated with hyperplacentosis. Correction of the hyperthyroidism occurred after hysterotomy and correlated with declining hCG levels. Hyperplacentosis should be included among the causes of hCG-mediated hyperthyroidism.

Thyroid 2001 Apr;11(4):393-6

   


 Presentation 

"Calcium and Metabolic Bone Disorders"

Dr. Andrew Karaplis (biography)
English - 2002-07-28 - 68 minutes
(36 slides)

Summary :
In this highly interesting talk, Dr Karaplis shares his expertise on various topics in metabolic bone disease. Molecular and cellular background leads into a descriptive analysis of disease states and their diagnosis and treatment. Diseases covered include osteomalacia, hypercalcemia, hyperparathyroidism, vitamin D deficiency, osteoporosis, rickets, parathyroid hormone-related peptide (PTHrP)...

Learning objectives :
The participant will gain background knowledge on the molecular mechanisms involved in the normal and disease states of bone metabolism; as well as the diagnosis and treatment of these diseases. Conditions discussed include osteomalacia, hypercalcemia, hyperparathyroidism, vitamin D deficiency, osteoporosis, rickets, pseudohypoparathyroidism and hypocalciuric hypercalcemia.

Bibliographic references :
Parathyroid hormone is essential for normal fetal bone formation.

Miao D, He B, Karaplis AC, Goltzman D.

Calcium Research Laboratory, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.

Parathyroid hormone (PTH) is a potent pharmacologic inducer of new bone formation, but no physiologic anabolic effect of PTH on adult bone has been described. We investigated the role of PTH in fetal skeletal development by comparing newborn mice lacking either PTH, PTH-related peptide (PTHrP), or both peptides. PTH-deficient mice were dysmorphic but viable, whereas mice lacking PTHrP died at birth with dyschondroplasia. PTH-deficient mice uniquely demonstrated diminished cartilage matrix mineralization, decreased neovascularization with reduced expression of angiopoietin-1, and reduced metaphyseal osteoblasts and trabecular bone. Compound mutants displayed the combined cartilaginous and osseous defects of both single mutants. These results indicate that coordinated action of both PTH and PTHrP are required to achieve normal fetal skeletal morphogenesis, and they demonstrate an essential function for PTH at the cartilage-bone interface. The effect of PTH on fetal osteoblasts may be relevant to its postnatal anabolic effects on trabecular bone.

J Clin Invest 2002 May;109(9):1173-82

   


 Presentation 

"Diabetes/Lipids"

Dr. Lawrence A. Leiter (biography)
English - 2002-07-27 - 55 minutes
(39 slides)

Summary :
Dr Leiter provides a comprehensive overview of the role of lipids, eg LDL cholesterol in the pathology of Type 2 Diabetes. This is done by taking into account the results of several major studies such as the cholesterol clinical trials WOSCOPS, AFCAPS, 4S, CARE and LIPID; the Heart Protection Study and the GREACE Study. Dr Leiter also does a recap of Type 2 Diabetes pathology and CDA treatment...

Learning objectives :
The presentation provides an overview of the information gleaned from several major LDL-lowering trials; the Heart Protection Study and the GREACE Study. A recap of the pathology of Type 2 Diabetes and CDA treatment guidelines.

Bibliographic references :
Am J Clin Nutr 2002 Aug;76(2):365-72

Effects of high- and low-isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women.

Jenkins DJ, Kendall CW, Jackson CJ, Connelly PW, Parker T, Faulkner D, Vidgen E, Cunnane SC, Leiter LA, Josse RG.

Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada. cyril.kendall@utoronto.ca

BACKGROUND: Many of the benefits of soy have been attributed to soy isoflavones.

OBJECTIVE: The objective was to determine the effects of high- and low-isoflavone soy-protein foods on both lipid and nonlipid risk factors for coronary artery disease (CAD).

METHODS: Forty-one hyperlipidemic men and postmenopausal women participated in a study with three 1-mo diets: a low-fat dairy food control diet and high- (50 g soy protein and 73 mg isoflavones daily) and low- (52 g soy protein and 10 mg isoflavones daily) isoflavone soyfood diets. All 3 diets were very low in saturated fat (< 5% of energy) and cholesterol (< 50 mg/d). Fasting blood samples were drawn and blood pressure was measured at the start and end of each diet.

RESULTS: No significant differences were seen between the high- and low-isoflavone soy diets. Compared with the control diet, however, both soy diets resulted in significantly lower total cholesterol, estimated CAD risk, and ratios of total to HDL cholesterol, LDL to HDL cholesterol, and apolipoprotein B to A-I. No significant sex differences were observed, except for systolic blood pressure, which in men was significantly lower after the soy diets than after the control diet. On the basis of blood lipid and blood pressure changes, the calculated CAD risk was significantly lower with the soy diets, by 10.1 +/- 2.7%.

CONCLUSION: Substitution of soyfoods for animal products, regardless of isoflavone concentration, reduces the CAD risk because of both modest reductions in blood lipids and reductions in oxidized LDL, homocysteine, and blood pressure.

   


 Presentation 

"Pediatric Endocrinology"

Dr. Denis Daneman (biography)
English - 2002-07-27 - 74 minutes
(14 slides)

Summary :
Dr Daneman discusses some new issues in Pediatric Endocrinology (infancy to puberty); as well as a broad range of topics such as insulin resistance, ovary functioning, intersex states, the adrenals and thyroid, and diagnosis of GHD.

Learning objectives :
The participant will become familiar with the latest developments in Pediatric Endocrinology (infancy to puberty). Topics include insulin resistance, ovary functioning, intersex states, the adrenals and thyroid, and diagnosis of GHD.

Bibliographic references :
Induction of puberty in the hypogonadal girl--practices and attitudes of pediatric endocrinologists in Europe.

Kiess W, Conway G, Ritzen M, Rosenfield R, Bernasconi S, Juul A, van Pareren Y, de Muinck Keizer-Schrama SM, Bourguignon JP.

Hospital for Children and Adolescents, University of Leipzig, Germany.

The management of children and adolescents with hypogonadism and in particular the induction of puberty in the hypogonadal girl is subjectto controversy. Therefore, under the auspices and through organization of the Drugs and Therapeutics Committee of the European Society of Paediatric Endocrinology (ESPE), an interactive voting session and workshop was held at the 39th ESPE Annual Meeting in Brussels to discuss these topics. Common practice in Europe and attitudes of pediatric endocrinologists in Europe were questioned and recorded in the 1.5-hour program. We now report on some of the results of the questionnaires and discussions of that session to further the discussion on and knowledge of current concepts of induction of puberty in the hypogonadal girl in Europe. It became clear from the data accumulated here that the start of treatment, the aims of therapy and the modalities of how to treat the hypogonadal girl vary amongst pediatric endocrinologists in Europe. For example, a chronological age > or =11 years was considered appropriate for the start of estrogen therapy by 40.4% (out of 188 answers), while 47.8 and 7.5% felt that a chronological age > or =13 and > or =15 years respectively was appropriate. In respect to the form and route of estrogen administration, the audience was asked for their common estrogen replacement practice: 31.9% used oral 17beta-estradiol treatment, while 10% would prescribe 17beta-estradiol transdermal patches. Another 12.2% would recommend conjugated estrogens (e.g. Premarin) orally, 4.8% use oral estradiol valerate and 39.3% ethinylestradiol orally. Only 1.8% out of 229 physicians answering were undecided. In addition, counseling of patients and their families is quite variable and perceptions for example regarding potential pregnancies in affected women are also not uniform. In this report the authors do not want to provide their own personal views but rather reflect current practice in Europe. It is hoped that a more uniform picture will emerge once European and international guidelines on how to treat the girl with hypogonadism will be available and even more discussions amongst doctors from different countries have been led. Copyright 2002 S. Karger AG, Basel

Horm Res 2002;57(1-2):66-71

   


 Presentation 

"Neuroendocrinology"

Dr. Ehud Ur (biography)
English - 2002-07-27 - 73 minutes
(45 slides)

Summary :
In this lecture Dr Ur gives an overview of some controversial and new issues in neuroendocrinology, e.g., pituitary hormone deficiencies, how to use the ITT (insulin tolerance test), GH deficiency, Acromegaly and mortality, Cushing's Syndrome, Addison's Disease, Phaeochromocytomas, hyperprolactinemia, Kallman's Syndrome, the ectopic ACTH syndrome, familial glucocorticoid deficiency,...

Learning objectives :
The viewer will know how to deal with a number of issues in the medical practice of neuroendocrinology, such as diagnosis of pituitary hormone deficiencies, GHD and hyperprolactinemia; treatment of Acromegaly; testing for Phaeochromocytomas; as well as theoretical background on Kallman's Syndrome, ectopic ACTH syndrome, familial glucocorticoid deficiency, Cushing's Disease, carcinoid tumours and more…

Bibliographic references :
Neuroendocrinology of Leptin

The discovery of the adipostatic hormone leptin formed our understanding of the neurobiology of apetite control and has helped to establish the biological basis of obesity. In recent years there has been a wealth of publications relating to the physiology of this peptide.
This volume sets out to draw together key features of the central effects of leptin. Contributions from leading authorities in the field include reviews of leptin's actions on hypothalamic peptides, the role of leptin in fasting, it's effects on reproductive function, and evidence supporting endogenous brain production of the peptide.
Endocrinologists, diabetologists, obesity specialists and neurobiologists will be interested in this succint and timely review of the effects of the adipostatic hormone leptin on neuroendocrine function.
Click on this link to access the full article:

http://www.karger.com/bookseries/fhore/fhore026.pdf


   


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