Addison's Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties.

Objectives: To demonstrate difficulties in diagnosing and treating Addison's disease caused by tuberculosis.

Materials And Methods: We present a clinical case and review of the literature.

Results: A 62-year-old man presented with gastrointestinal symptoms, weight loss and enlarged adrenal glands.

[Domperidone and the risk of sudden cardiac death].

Domperidone is an antiemetic drug with relatively few side-effects. In the Netherlands, domperidone is available over the counter. Recently, discussion on the safety of domperidone has arisen because an association with sudden cardiac death has been suggested.

Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial.

Background: Percutaneous vertebroplasty is increasingly used for treatment of pain in patients with osteoporotic vertebral compression fractures, but the efficacy, cost-effectiveness, and safety of the procedure remain uncertain. We aimed to clarify whether vertebroplasty has additional value compared with optimum pain treatment in patients with acute vertebral fractures.

Methods: Patients were recruited to this open-label prospective randomised trial from the radiology departments of six hospitals in the Netherlands and Belgium.

Surgical treatment of obesity.

More than half of the European population are overweight (body mass index (BMI) > 25 and < 30 kg/m2) and up to 30% are obese (BMI > or = 30 kg/m2). Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity.

Insights from growth hormone receptor blockade.

Pegvisomant is a genetically manipulated growth hormone (GH) that disables signal transduction through the GH receptor and thus functions as a GH receptor antagonist. In a series of studies of the metabolic effects of GH in healthy male individuals, pegvisomant has been used to create a model of acute GH deficiency but without the typical alterations in body composition. This review summarizes studies of the effects of GH receptor blockade and fasting, either alone or in combination, on determinants of GH release.

Pharmacological therapy for acromegaly: a critical review.

The treatment of acromegaly has changed considerably over the last few decades. In the late 1970s, the introduction of the dopamine receptor agonists made it possible to reduce growth hormone (GH) secretion by somatotropinomas for the first time. Thereafter, the introduction of the somatostatin analogues in the early 1980s had major implications.

Ghrelin drives GH secretion during fasting in man.

Objectives: In humans, fasting leads to elevated serum GH concentrations. Traditionally, changes in hypothalamic GH-releasing hormone and somatostatin release are considered as the main mechanisms that induce this elevated GH secretion during fasting. Ghrelin is an endogenous ligand of the GH secretagogue receptor and is synthesized in the stomach.