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Bone Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
It is certainly frustrating to do all the right things, adjusting your lifestyle to optimize your health, and yet still have progressive bone loss. Osteoporosis has a strong genetic component, so do not blame yourself for factors you cannot control. Given that the consequences of osteoporotic fractures can be serious, medication may be worth considering. As an example, hip fractures cause up to a 25% increase in mortality within 1 year of the incident, and up to 25% of women require long-term care after a hip fracture.3 A woman who has osteoporosis (especially is she has had a previous fracture) needs to consult with a pharmacist or an endocrinologist about medication options. Making a reasonable choice involves a careful review of the risks and benefits of medication and shared decision-making.4
Granulomatous Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Albert Alhatem, Robert A. Schwartz, Muriel W. Lambert, W. Clark Lambert
Management: Patients should be referred to an endocrinologist for diagnosis and treatment. Overall, the main recommended management is symptomatic with avoidance of any triggers of mast cell degranulation. H1 antihistamines or antileukotriene agent products can help with pruritis (itching) or flushing. H2 antihistamines can help with gastrointestinal symptoms, such as abdominal pain, heartburn, cramping, and/or diarrhea. As long as tumor masses are present, the possibility exists that one or more may become activated, inducing a potentially disastrous vascular response.
Obstetrics: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
Need endocrinologist.Anti-thyroid drugs, PTU preferred.TFTs and review monthly.Beta-blocker initially.
Transsexualism and hormones
Published in Gynecological Endocrinology, 2022
Harry Benjamin and Magnus Hirschfeld were the pioneers of the transsexualism phenomenon [1]. Gender dysphoria is characterized by suffering from strong, persistent discomfort between biological sex and experienced expressed gender, with significant impairment in interpersonal, familial, social, professional and other important area of functioning [2]. Transgender individuals desire to have secondary sexual characteristics of the opposite sex. Transsexual identification is permanently present and the disorder is not a part of some other disease [3]. Diagnostic procedure of sex reassignment is a multidisciplinary task that requires diagnostic assessment, psychotherapy or consulting by a mental health professional (MHP), endocrine investigations and finally surgeon involvement. The diagnosis of gender identity disorder (GID) is made by a MHP. The endocrinologist has to exclude other endocrine diseases, to confirm diagnosis, initiate hormone affirming therapy and perform subsequent individual follow-ups. After at least one year of hormone affirming therapy highly qualified surgeons can perform operations. Sex reassignment surgery is recommended only after both endocrinologist and MHPs find surgery advisable.
The continuum of care of anticancer treatment-induced hypothyroidism in patients with solid non-thyroid tumors: time for an intimate collaboration between oncologists and endocrinologists
Published in Expert Review of Clinical Pharmacology, 2022
Maria V. Deligiorgi, Dimitrios T. Trafalis
The intricacy of the management of hypothyroidism [37,38] reflects the complex integration of the physiology of TH [21,22], the metabolomics profile of hypothyroid patients [39], and the clinical implications of TH metabolites [40–43] under the control of HPT axis [44]. Besides sharing similarities with hypothyroidism in general population [20–22,37,38], hypothyroidism related to anticancer treatment modalities in patients with solid non-thyroid tumors shows a distinct profile of paramount clinical importance for many reasons. First, clinicians should be aware of the dual effect of hypothyroidism on cancer initiation and progression: promoting or inhibitory. This effect is ascribed to the dual role of TH signaling in cancer accomplished by integration of four types of TH actions, implicated in all hallmarks of cancer [45–57]. Figure 1 illustrates Type 1 (A) and Type 2 (B) TH actions, historically classified as genomic. Figure 2 illustrates Type 3 and Type 4 TH actions, historically classified as non-genomic. Second, hypothyroidism can remain undiagnosed or be misattributed to other conditions with detrimental consequences. Third, the interpretation of the diagnostic tests may not be straightforward, requiring prompt referral to endocrinologists. Fourth, guidelines for the management of anticancer treatment-induced hypothyroidism in patients with solid non-thyroid tumors, based on strong evidence are still lacking, highlighting the importance of a personalized approach guided by clinical judgment [25–29].
Device Development for Biosimilars: Human Factor Engineering for a Teriparatide Pen
Published in Expert Opinion on Biological Therapy, 2022
Ronak Patel, Pravin Nair, Meenal Bhatnagar, Sridevi Khambhampaty, Suresh Gupta
The intended user population for Teriparatide Pen is not just the patients but also their caregivers and HCPs. Osteoporosis patients: Men and postmenopausal women with osteoporosis; men with primary or hypogonadal osteoporosis; and men and women with osteoporosis associated with sustained systemic glucocorticoid therapy.Caregivers: Some patients may receive help from a lay caregiver, such as a friend or a family member, who may administer the injection to the patients.Healthcare professionals (HCPs): As with most medical products, HCPs are also considered as intended users because they may prepare the pen for their patients, inject them and/or demonstrate to them how to use it while they are at a clinic or hospital. A variety of medical specialists treat people with osteoporosis, including internists, gynecologists, family doctors, endocrinologists, rheumatologists, physiatrists, orthopedists, and geriatricians.