Management of thyroid nodules in children and adolescents

Wilmar M. Wiersinga

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Thyroid nodules in childhood and adolescence are less prevalent but more often malignant than in adulthood. Malignant nodules are predominantly papillary cancers; benign nodules are mostly solid colloid nodules/adenomas, but can be cystic or due lymphocytic thyroiditis…

Sexual dysfunction in diabetic women

Alexandra Bargiota, Konstantinos Dimitropoulos, Vassilios Tzortzis,, Georgios N. Koukoulis

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Diabetes mellitus (DM) is a common disease worldwide and a growing public health burden. The number of people with diabetes is increasing due to population growth, aging, urbanization, and increasing prevalence of obesity and physical inactivity. Diabetes is known to cause multiple medical …

The efficacy and safety of the naltrexone/bupropion combination for the treatment of obesity: an update

Georgios A. Christou, Dimitrios N. Kiortsis

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OBJECTIVE: The combination of 32 mg naltrexone and 360 mg bupropion prolonged release (NB32) was recently approved by both the food and drug administration (FDA) and the European medicines agency (EMA) as an adjunct to a comprehensive lifestyle intervention to achieve weight loss …

Obesity and renal disease: A possible role of leptin

Dafni-Kalliopi Papafragkaki, George Tolis

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Obesity is one of the most frequently encountered medical problems of our time. Among the complications of this pathologic entity, renal disease is an important issue and its pathophysiologic mechanisms are a challenge for the physician, since a variety of etiologic factors are implicated in its genesis. For example, hypertension, hyperlipidemia and insulin resistance …

The role of the Wnt signaling pathway in osteoblast commitment and differentiation

Maria P. Yavropoulou, John G. Yovos

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Wnts are a large family of proteins that participate in an array of cellular biological processes such as embryogenesis, organogenesis and tumor formation. These proteins bind to membrane receptor complexes comprised of a frizzled (Fz) G-protein-coupled receptor and other membrane co-receptors forming molecular groups that initiate, at least …

Ectopic thyroid: etiology, pathology and management

Nasiru Akamnu Ibrahim, Idowu Olusegun Fadeyibi

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Ectopic thyroid refers to the presence of thyroid tissue in locations other than the normal anterior neck region between the second and fourth tracheal cartilages. It is the most frequent form of thyroid dysgenesis, accounting for 48-61% of the cases.1 Prevalence of this condition is reported to be between 1 per 100,000-300,000 persons …

The Sertoli cell: Novel clinical potentiality

Paschalia K. Iliadou, Christos Tsametis, Athina Kaprara, Ioannis Papadimas, Dimitrios G. Goulis

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The Sertoli cell is important for endocrine and paracrine control of spermatogenesis. Functions attributed to Sertoli cells are: (1) supportive and trophic functions for the cells of the seminiferous epithelium, (2) transport of mature spermatids towards the lumen of seminiferous tubules, (3) secretion of androgen binding protein …

Pegvisomant: a new treatment modality for acromegaly

Niki Karavitaki, John AH Wass

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Acromegaly, a multisystemic disease resulting from excessive growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels in adults, is associated with a two-to-threefold increase in mortality. The available treatment options (surgery, radiotherapy and medical treatment with somatostatin analogues or dopamine agonists) fail to achieve the currently accepted goals of therapy in a substantial number of patients …

How diet interacts with longevity genes

Andrzej Bartke, Michael Bonkowski, Michal Masternak

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In laboratory mice, suppression of growth hormone (GH) signaling by spontaneous mutations or targeted disruption of GH- or IGF1-related genes can lead to an impressive increase of longevity…

Pathogenesis of vascular complications in Cushing\’s syndrome

Predrag Miljic, Dragana Miljic, Joshua William Cain, Márta Korbonits, Vera Popovic

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Chronic exposure to high glucocorticoid levels in Cushing’s syndrome (CS) is often associated with alterations in the hemostatic system and the expression of prothrombotic phenotypes. Increased frequency of both atherothrombotic and venous thromboembolic events (VTE) has been reported in patients with CS …

Expert consensus on the rational clinical use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors

Apostolos Achimastos, Theodoros Alexandrides, Dimitrios Alexopoulos, Vasilios Athyros, Alexandra Bargiota, Eleni Bilianou, Christina Chrysochoou, Evridiki Drogari, Moses Elisaf, Emanouel Ganotakis, Ioannis Goudevenos, Ioannis Ioannidis, Genovefa Kolovou, Vasilios Kotsis, Ioannis Lekakis, Evangelos Liberopoulos, Andreas Melidonis, Vasilios Nikolaou, George Ntaios, Nikolaos Papanas, Stavros Pappas, Christos Pitsavos, Loukianos Rallidis, Dimitrios Richter, Ioannis Skoumas, Nicolaos Tentolouris, Dimitrios Tousoulis, Alexandros Tselepis, KonstantinosTsioufis, Dimitrios Tziakas, Konstantinos Tziomalos, Panagiotis Vardas, Charalabos Vlachopoulos, Dimitrios Vlahakos

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Two proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, evolocumab and alirocumab, have recently been approved by both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of hypercholesterolemia. These fully human monoclonal antibodies selectively block PCSK9, thus permitting the low-density lipoprotein (LDL) receptor to effectively recycle to the surface of liver cells. The administration of these antibodies leads to robust LDL …

Prediction and prevention of type 2 diabetes

Konstantinos Makrilakis, Nikolaos Katsilambros

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Type 2 diabetes mellitus is one of the most costly and burdensome chronic diseases of our time and a condition that is increasing in epidemic proportions worldwide. Its complications are a significant cause of morbidity and mortality and a tremendous economic burden to the society. Effective prevention programs are therefore urgently needed…

Oxidative stress and aging: the potential role of iron

Dimitrios Galaris, Michalis Mantzaris, Christos Amorgianiotis

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According to the free radical theory of aging proposed by Denham Harman more than 50 years ago, oxidatively modified cellular components accumulate continuously in the cells during the organism’s lifespan leading to progressive decline of cellular functions. Since then, it has been shown that proteins, lipids, nucleic acids and other cell components undergo reversible and/or irreversible oxidative modifications during aging …

Intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 in children. Do they play a role in the progression of atherosclerosis?

Lampros Fotis, Dionysios Giannakopoulos, Lela Stamogiannou, Maria Xatzipsalti

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In 1995 David Barker formulated the ‘Barker hypothesis’ according to which there is a correlation between undernutrition in utero and several diseases in adult life. More specifically, undernutrition in utero permanently affects the vascular bed, resulting in a predisposition to diseases later on …

Cardiovascular safety of type 2 diabetes medications: Review of existing literature and clinical implications

Sílvia Paredes, Claudia Matta-Coelho, Ana Margarida Monteiro, Alice Brás, Olinda Marques, Marta Alves, Laura Ribeiro

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Type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and the cardiovascular effect of antidiabetic drugs are today critical medical issues, with the prevalence of T2DM in particular showing a steep increase worldwide, mainly due to unhealthy lifestyle habits. T2DM in association with obesity and other cardiovascular risk factors, results in the development of CVD, the leading cause of morbidity and mortality in patients with T2DM …

Management of Diabetic Retinopathy. An Overview

Eustratios V. Gotzaridis, Athina Markou, Zdenek Gregor

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Patients with type 1 diabetes mellitus experience a high incidence of severe ocular complications and are more likely to have significant ocular problems during their lifetimes. Patients with type 2 diabetes mellitus (DM2), however, make up the majority of clinical cases with diabetic eye disease because of the higher incidence of DM2…

Dysfunction of the Hypothalamic-Pituitary-Adrenal axis in HIV infection and disease

Evangelia Zapanti, Konstantinos Terzidis, George Chrousos

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Abnormalities of the Hypothalamic-Pituitary-Adrenal (HPA) axis have been documented in HIV patients in the early as well as late stages of the infection and range from subtle subclinical disturbances to frank adrenal insufficiency. Potential etiologies of these disorders include opportunistic infections, neoplasms …

The “homeostasis hormone” and its CRF1 receptor. From structure to function

Hesham Fahmy, Katerina Spyridaki, Bhimanna Kuppast, George Liapakis

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The maintenance of homeostasis is a basic prerequisite for life, ensuring the stability of our body in response to external or internal stimuli (stressful stimuli). The maintenance of homeostasis requires alterations in the function of the endocrine system …

Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis

Marina Michalaki, Panagiotis Bountouris, Nikolaos D Roupas, Anastasia Theodoropoulou, Niki Agalianou, Theodoros Alexandrides, Kostas Markou

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BACKGROUND: The current trend in the management of low risk differentiated thyroid carcinoma is to follow less aggressive strategies. Objective: To assess the long-term morbidity and mortality outcomes of low-risk papillary thyroid carcinoma (PTC) patients undergoing minimal intervention. DESIGN: We retrospectively analyzed 137 patients with low-risk PTC …

Endocrine manifestations in DiGeorge and other microdeletion syndromes related to 22q11.2

Sofia Kitsiou-Tzeli, Aggeliki Kolialexi, Ariadni Mavrou

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Microdeletions, translocations or other rearrangements of chromosomal region 22q11.2 have been reported in association with >80 different birth defects and malformations occurring in many combinations and with widely differing severity…

Thyroid autoimmunity and miscarriage

Athina Kaprara, Gerasimos E. Krassas

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The relation of thyroid autoimmunity to miscarriage is an important issue that has attracted the interest of many investigators. A number of papers have been published so far, which include healthy women, women with recurrent miscarriage and those undergoing assisted reproductive techniques. Most studies have shown a significant positive association between the presence of thyroid autoantibodies and miscarriage rate…

Diagnostic and therapeutic review of cystic parathyroid lesions

Nikolaos Pontikides, Spyros Karras, Athina Kaprara, Angeliki Cheva, Argyrios Doumas, Dimitrios Botsios, Aris Moschidis, Elias Efthimiou, John Wass, Gerasimos E. Krassas

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BACKGROUND: Parathyroid cysts (PC) are uncommon entities in routine clinical practice. The vast majority are nonfunctioning and are commonly present as asymptomatic nodular cervical lesions. PC should be considered in the differential diagnosis of an asymptomatic neck mass …

Adiponectin and end-stage renal disease

Anastasia Markaki, Emmanuel Psylinakis, Aspasia Spyridaki

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Adiponectin (ADPN) is an adipokine with significant anti-inflammatory, insulin-sensitizing and anti-atherogenic properties, which is generally associated with a beneficial cardiometabolic profile. Paradoxically, end-stage renal disease (ESRD) is characterized by markedly increased plasma ADPN levels and increased cardiovascular risk. In spite of the cardioprotective properties …

The role of estrogens in cardiovascular disease in the aftermath of clinical trials

Lambrini Gouva, Agathocles Tsatsoulis

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The effects of estrogens on reproductive tissues and climacteric symptoms are unambiguous. However, their effects on other tissues and, in particular, the cardiovascular system remain controversial. In general, premenopausal women are protected from coronary heart disease (CHD) compared with aged-matched men but this `female protection’ appears to be lost after menopause, suggesting beneficial effects of female sex hormones on the cardiovascular system…

Genotype-phenotype relationship in multiple endocrine neoplasia type 2. Implications for clinical management

Friedhelm Raue, Karin Frank-Raue

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Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant tumour syndrome caused by germline activating mutations of the RET proto-oncogene. It has a strong penetrance of medullary thyroid carcinoma (MTC) and can be associated with bilateral pheochromocytoma and primary hyperparathyroidism (MEN2A) within a single patient or family…