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Endocrine Disorders
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Lisa Spence, Nana Adwoa Gletsu Miller, Tamara S. Hannon
Endocrine hormones are chemical signals that exert effects on tissue and organs throughout the body. Hormones play a critical role in the regulation of physiological homeostasis and are involved in growth and development, appetite regulation, metabolism, sexual and reproductive function, sleep, and mental health. Endocrine diseases result from abnormal levels of endocrine hormones or abnormalities in the signaling response. Diabetes mellitus, which occurs when insulin is not produced or when insulin signaling is impaired, is a common endocrine disease in children. Diabetes mellitus include type 1 diabetes, type 2 diabetes, and prediabetes. Related diseases include cystic fibrosis-related diabetes and steroid-induced hyperglycemia. Diabetes insipidus results from a disorder in the production or action of vasopressin. Youth with gender dysphoria may have higher rates of overweight and obesity. Growth hormone deficiency in children can lead to short stature, but in most cases the cause of short stature is constitutional, secondary to genetics or to nutrition, as well as to complications of non-endocrine diseases. Nutrition is an important consideration for clinical management of endocrine diseases as diet may play a role in the etiology of the disease or diet may modify the response to therapy. Moreover, nutrition status may be used as a criterion for diagnosis of the disease or to evaluate its progression. The objective of this chapter is to describe the pathophysiology, medical management, and medical nutrition therapy of common pediatric endocrine disorders.
Fenugreek (Trigonella foenum-graecum)
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
The Chereso and Cepham research teams conducted an open-label, one-arm, non-randomized study in 50 premenopausal women (age = 18–45 years, BMI <42) suffering from PCOS. It is important to emphasize that PCOS, the most prevalent hormonal disorder among women of reproductive age, leads to irregular menstrual cycles, excessive body or facial hair, miscarriage, and infertility. All recruited subjects took Furocyst® (2 x 500 mg capsules/day) over a period of 90 consecutive days. This study focused on determining two important aspects: (1) reduction of ovarian volume, and (2) the number of ovarian cysts. Institutional review board (IRB) approvals were obtained [21, 22].
General Aspects of Endocrine Physiology
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
There are three types of hormones: (i) peptides, for example, produced by the hypothalamus, pituitary, pancreas, parathyroid, gut and heart; (ii) amines, for example, produced by the adrenal medulla and thyroid and (iii) steroids, for example, produced by the adrenal cortex, ovary and testis (Table 59.1).
Localized, on-demand, sustained drug delivery from biopolymer-based materials
Published in Expert Opinion on Drug Delivery, 2022
Junqi Wu, Sawnaz Shaidani, Sophia K. Theodossiou, Emily J. Hartzell, David L. Kaplan
Nearly 80% of women from high-income countries have reported using oral hormonal contraceptive pills [32]. These hormones include androgens, estrogens, and/or progesterone. Combination pills that include both estrogen and progestin are associated with breakthrough bleeding, a twofold risk of myocardial infraction and stroke and a 37 times higher risk of venous thrombosis [32,33]. Additionally, contraceptive pills must be taken daily, leading to decreased patient compliance and drug effectiveness if the user forgets to take or misplaces the pills. Subdermal implants that achieve sustained, long-term systemic release of contraceptives were created to address these issues [34]. Nexplanon is an etonogestrel-releasing ethylene vinylacetate copolymer rod-shaped implant inserted subdermally in the arm, and can be left in place for 3 years via surgical incision [35]. If the patient sustains injuries near the implant site, however, the implant could be damaged and may require surgical removal [36]. Additional side effects associated with systemic subdermal contraceptives include menstrual disturbances, acne, headache, abdominal pain, hair loss, weight gain, and follicular cysts [34]. Currently, the most popular local contraceptive delivery systems are intrauterine devices (IUDs), which are used by more than 168 million women worldwide. However, IUDs also have complications such as causing infections, pelvic inflammatory disease, uterine perforation, and menstrual disturbances [37,38].
Effects of different doses of estrogen on ER expression and ovarian function in patients with unexplained recurrent abortion
Published in Gynecological Endocrinology, 2022
Yamin Qiu, Jie Lin, Qing Xu, Linhua Zeng, Chao Liu
In clinical practice, estrogen and pregnancy stimulus are commonly used for sequential treatment. However, due to the lack of uniform treatment guidelines, the dosage of hormone therapy is different, the course of treatment is different, and the ratio of progesterone is different, so the curative effect varies greatly. When the number of endometrial receptors is reduced or the function is abnormal, the endometrial proliferation ability is decreased, and the responsiveness to estrogen stimulation under physiological conditions is reduced. It is speculated that it may be related to the reduction and saturation of estrogen receptors. Therefore, in the hormone therapy of URSA, high-dose estrogen is mostly used, ignoring the side effects of high-dose estrogen. Roy [18] and other studies have shown that for some patients, the treatment of high-dose estrogen has little effect. Some researcher even believe that high-dose estrogen will cause endometrial fibrosis and affect the expression of receptors [19]. High-dose hormone therapy also has risks of breast hyperplasia, gastrointestinal reactions, weight gain, liver and kidney damage, thrombosis, and cardiovascular and cerebrovascular diseases.
Bu-Shen-Ning-Xin decoction alleviates premature ovarian insufficiency (POI) by regulating autophagy of granule cells through activating PI3K/AKT/mTOR pathway
Published in Gynecological Endocrinology, 2022
Xiaoqing Dou, Xin Jin, Xingbei Chen, Qun Zhou, Hanyu Chen, Mingxiao Wen, Wenjun Chen
Premature ovarian insufficiency (POI) is defined as the cessation of menstruation before the expected age of menopause, which is generally more junior than 40. The diagnosis of POI is mainly determined by significantly increased serum FSH level (>40 IU/L) [1]. POI is clinically characterized by menoxenia and symptoms induced by estrogen deficiency, such as hot flashes, night sweats, sexual discomfort, vaginal dryness, and poor sleep [2]. Currently, the main method for treating POI is the supplement or intervention of hormones, such as estrogen, progesterone, androgen, and dehydroepiandrosterone [3]. However, significant side effects will be induced by the therapy of hormones, such as metabolic dysfunction, hyperglycemia, and osteoporosis [4]. Therefore, it is urgent for the development of a novel strategy with minor side effects for the treatment of POI.