Oral glucose lowering drugs in type 2 diabetic patients with chronic kidney disease

Cláudia Nogueira, Selma B. Souto, Eduardo Vinha, Daniel Carvalho-Braga, Davide Carvalho

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Chronic kidney disease (CKD) represents a challenge in the treatment of type 2 diabetic patients. Renal impairment may affect drug clearance and other pharmacokinetic processes which can increase toxicity and drug to drug interactions or cause ineffective therapy …

Serum and glucocorticoid inducible kinase, metabolic syndrome, inflammation, and tumor growth

Florian Lang, Christos Stournaras

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Serum-and-glucocorticoid-inducible-kinase-1 (SGK1) is under regulation of several hormones, mediators and cell stressors. More specifically, SGK1 expression is particularly sensitive to glucocorticoids, mineralocorticoids, and TGFβ. Moreover, SGK1 expression is exquisitely sensitive to hypertonicity, hyperglycemia, and ischemia …

Subclinical hypothyroidism and vascular risk: Αn update

Eirini Lioudaki, Niki G. Mavroeidi, Dimitri P. Mikhailidis, Emmanouel S. Ganotakis

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Subclinical hypothyroidism (SCH), defined as elevated serum thyroid-stimulating hormone (TSH) in the presence of normal circulating free thyroxine (FT4) and triiodothyronine (T3), is a relatively common condition. Replacement treatment with levothyroxine is justified only for individuals with TSH levels >10 mIU/l …

A review of the metabolic effects of controlled-release Phentermine/Topiramate

Dimitrios N. Kiortsis

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BACKGROUND AND OBJECTIVE: Very few drugs are approved for obesity treatment by regulatory agencies. Very recently phentermine/topiramate controlled-release [PHEN/TPM CR; (Qsymia®)] obtained Food and Drug Administration (FDA) approval as an addition to a reduced-calorie diet and exercise …

From Hippocrates of Kos to Hashimoto and thyroid autoimmunity: A long road of discovery

Leonidas Duntas, Stefanos Geroulanos, Peter Laurberg

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The 2012 Educational Course of the European Thyroid Association (ETA) was a truly unique event. Held 24th-26th May on the island of Kos, in the healing environment of ‘the island of Hippocrates and Asclepius’, it combined an educational level of excellence with the commemoration of the centennial of the description of Hashimoto thyroiditis …

The central CLOCK system and the stress axis in health and disease

Eva N. Kassi, George P. Chrousos

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Optimal regulation of the hypothalamic-pituitary-adrenal (HPA) axis is critical for a successful response to any stressor as well as in non-stressful situations. At the hypothalamic-pituitary level, corticotropin-releasing hormone (CRH) is released into the hypophyseal portal system …

PET and PET/CT imaging in thyroid and adrenal diseases: an update

Giorgio Treglia, Luca Giovanella, Vittoria Rufini

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Positron emission tomography (PET) and PET/computed tomography (PET/CT) with different tracers are imaging methods increasingly used in patients with thyroid and adrenal diseases. The aim of this article is to provide an overview based on literature data about the usefulness of PET imaging in this setting …

The validity of current guidelines regarding surgical management of patients with gastric neuroendocrine neoplasms type 1: a report of a series of seven patients

Georgios Boutzios, John Griniatsos, Nikoletta Dimitriou, Athanassios Zilos, Stavroula Antoniou, Evangelos Felekouras, Gregory Kaltsas

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OBJECTIVE: Gastric neuroendocrine neoplasms Type 1 (GEN type 1) are mostly localized indolent tumors, with only a minority developing lymph node or distant metastasis. Although they are usually managed conservatively, large, invasive, recurrent and grade 2 lesions may require surgical treatment …

Hashimoto’s Thyroiditis: History and Future Outlook

Yuji Hiromatsu, Hiroshi Satoh, Nobuyuki Amino

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Hashimoto’s thyroiditis (HT), a common thyroid disease, is now recognized as an autoimmune thyroid disorder (AITD). However, surprisingly little is known about its discoverer, Hakaru Hashimoto, who first described the disease in 1912 …

The guidelines issued by the European Society for Human Reproduction and Embryology and the American Society for Reproductive Medicine regarding the induction of ovulation with metformin in patients with the polycystic ovary syndrome potentially require reconsideration

Dimitrios Panidis, Konstantinos Tziomalos, Efstathios Papadakis, Eleni A. Kandaraki, Ilias Katsikis

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In 2007, the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) issued guidelines in Thessaloniki regarding the use of metformin and clomiphene for the induction of ovulation in patients with anovulatory polycystic ovary syndrome (PCOS) …

Premenopause: The endocrinology of reproductive decline

Menelaos L. Batrinos

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The ovaries follow a different course of aging from the other endocrine glands and organs. Instead of an inevitable progressive deterioration with advancing age, like all other structures and functions of the organism, including the male gonad, the testis, in the late thirties the ovaries undergo an abrupt diminution …

Thyroglossal duct cyst carcinomas: is there a need for thyroidectomy?

Alexandra Chrisoulidou, Paschalia K. Iliadou, Eleni Doumala, Lemonia Mathiopoulou, Maria Boudina, Maria Alevizaki, Frideriki Patakiouta, Ekaterini Xinou, Kalliopi Pazaitou-Panayiotou

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OBJECTIVE: Thyroglossal duct cyst (TGDC) carcinoma is a rare entity and its management is controversial. The aim of this retrospective study was to: (a) identify patients with TGDC carcinoma followed up in our clinic and (b) study specific characteristics of the disease and their association with thyroid carcinoma …

The “depressive” face of osteoporosis and the “osteoporotic” face of depression

Kyriakos Aloumanis, Kostantinos Mavroudis

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Osteoporosis and depression are two chronic diseases that affect large population groups with great impact on morbidity, mortality and quality of life. An association between osteoporosis and depression has been described in the literature …

An overview of the pathogenesis of thyroid autoimmunity

Giulia Cogni, Luca Chiovato

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Autoimmune diseases are a group of heterogeneous disorders characterized by abnormal lymphocytic activation directed against self-tissues. Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are two of the most common clinical expressions of organ-specific autoimmunity …

Metabolic and other effects of pioglitazone as an add-on therapy to metformin in the treatment of polycystic ovary syndrome (PCOS)

Georgios Valsamakis, Kostas Lois, Sudhesh Kumar, George Mastorakos

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Insulin resistance is a key pathogenic defect of the clustered metabolic disturbances seen in polycystic ovary syndrome (PCOS). Metformin is an insulin sensitizer acting in the liver and the peripheral tissues that ameliorates the metabolic and reproductive defects in PCOS …

Bilateral versus unilateral papillary thyroid microcarcinoma: predictive factors and associated histopathological findings following total thyroidectomy

Theodore Karatzas, Ioannis Vasileiadis, George Charitoudis, Efthimios Karakostas, Sofia Tseleni-Balafouta, Gregory Kouraklis

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OBJECTIVE: The extent of thyroidectomy for papillary thyroid microcarcinoma (PTMC) is debatable. This study investigated the rate and predictive factors of bilateral versus unilateral PTMC with the objective of identifying those patients who may benefit from total thyroidectomy …

Prevention of autoimmune hypothyroidism by modifying iodine intake and the use of tobacco and alcohol is manoeuvring between Scylla and Charybdis*

Peter Laurberg, Stig Andersen, Inge Bülow Pedersen, Nils Knudsen, Allan Carlé

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Although autoimmune hypothyroidism has generally been considered to be a disease that mainly develops because of genetic aberrations and for which adjustment of environment would bring about but slight risk modification, this understanding is increasingly appearing to be incorrect …

Insulin action in morbid obesity: a focus on muscle and adipose tissue

Panayota Mitrou, Sotirios A. Raptis, George Dimitriadis

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The aim of this review is to summarize the mechanisms underlying insulin resistance in morbid obesity. Glucose regulation by insulin depends on the suppression of endogenous glucose production and stimulation of glucose disposal. In morbid obesity, glucose production by the liver is increased …

Incretins and bone: Evolving concepts in nutrient-dependent regulation of bone turnover

Maria P. Yavropoulou, John G. Yovos

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Postprandial variation of bone turnover markers and the closed relationship between bone remodeling and nutrient supply has been extensively studied in the past few years, but  the underlying pathophysiologic mechanisms remain largely unknown …

A 50-year follow-up of the Seven Countries Study: Prevalence of cardiovascular risk factors, food and nutrient intakes among Cretans

Christos M. Hatzis, Christopher Papandreou, Evridiki Patelarou, Constantine I. Vardavas, Eleni Kimioni, Dimitra Sifaki-Pistolla, Anna Vergetaki, Anthony G. Kafatos

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OBJECTIVE: To identify the cardiovascular disease (CVD) risk-factor status and dietary habits of the surviving elderly participants of the initial Seven Countries Study (SCS) cohort and newly recruited middle-aged men from the same villages …