Hypoparathyroidism: an uncommon adverse effect of treatment with durvalumab.

Summary: Immune checkpoint inhibitors (ICIs) are monoclonal antibodies approved for the treatment of numerous cancer types. Toxicities induced by ICIs may affect any organ system and manifest as endocrinopathy. The main side effects related to treatment are immune-related adverse events (irAEs), especially thyroid dysfunction and hypophysitis.

Prevalence of metabolic syndrome, insulin resistance, and microvascular angina pectoris in 500 consecutive patients referred to coronarography.

Objective: This work was aimed to evaluate the prevalence of insulin resistance (IR) and metabolic syndrome in a large cohort of 40-60 years old patients with cardiovascular symptoms.

Methods: A total of 500 consecutive males and females referred to coronarography and coronary catheterization, because of spontaneous or after load precordial pain plus denivelisation of ST segment by electrocardiography, were included. Besides standard clinical examinations, ergometry, echocardiography, fundamental laboratory tests, and several other laboratory examinations were also performed, including oral glucose toleration test (OGTT), total and high-density lipoprotein (HDL) cholesterol, triglycerides, apoprotein A1 and B, apolipoprotein (a), uric acid, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), cytokines (tumor necrosis factor α, TNFα, interleukin-1, IL-1, interleukin-6, IL-6), endothelin-1, as well as hormones (insulin, C peptide, leptin, growth hormone, cortisol).

Metastasis of dermatofibrosarcoma from the abdominal wall to the thyroid gland: case report.

Metastases in the thyroid gland are very rare. Even the rarer are sarcoma metastases. A 52-year-old woman was referred to our department for evaluation of a nodule in the right lobe of the thyroid gland.

[Exogenous Cushing's syndrome as a serious side-effect of therapy with ritonavir an inhaled fluticasone].

Inhalation of fluticasone is usually devoid of systemic side-effects. The authors describe a case of a young HIV positive woman treated concomitantly with fluticasone and inhibitors of HIV protease ritonavir and lopinavir in which developed a serious endocrine side-effect - an iatrogenic Cushing's syndrome. Plasma concentration of cortisol < 5.

[Genetic background of tumors originating from adrenomedullar and extraadrenal chromaffin tissue--update].

It is anticipated that an inherited/familial forms of pheochromocytomas cause approximately 20% of all pheochromocytomas. Therefore, the classic "rule of 10" axioma used to remember the key features of disorder is invalid. Various mutations in several genes have been identified, which underly syndromes with paragangliomas and/or pheochromocytomas.

[Genetic background of adrenal cortex tumours--news].

This review has summarized the current knowledge of the genetic background of tumors originating from adrenocortical tissue, manifested as a part of inherited or familial syndromes, as well as specific forms of sporadic tumors caused by aberrant expression of G-protein coupled receptors.

[Endocrine complications in HIV/AIDS patients].

A number of endocrine abnormalities develop in patients with HIV infection, although many are likely responses to infection, stress, and malnutrition. Others are due to infiltration of endocrine glands by tumor or infection. This article reviews adrenal, testicular, resp.

[Treatment with sunitinib and hypothyroidism--a case report and overview of literature].

In the article the authors present the case of a patient with clear cell renal carcinoma, where after nephrectomy local metastases appeared. The treatment of choice was sunitinib. After 20 cycles of therapy heavy hypothyroidism was verified which required substitution by thyroxine.

The low-dose (1 microg) cosyntropin test (LDT) for primary adrenocortical insufficiency: Defining the normal cortisol response and report on first patients with Addison disease confirmed with LDT.

Background: The validity of low-dose 1 microg cosyntropin test (LDT) is reported mainly for the assessment of secondary adrenocortical insufficiency (AI). Likewise the hypothalamic-pituitary disorders, early diagnosis of the initial or partial stages of primary AI has an important role.

Objective: The aim of study was to: 1) establish the normal cut-off level at which the stimulated plasma cortisol (FP) in LDT excludes primary AI; 2) compare the results in elderly subjects to those in younger ones; 3) compare the results between normal and obese subjects; and 4) verify the established cut-off values on the sample of patients suspected to have primary AI.

[Adrenocortical disorders in pregnancy].

Adrenocortical disorders in pregnancy are rare, but unrecognized of them are associated with higher maternal and fetal morbidity. The diagnosis is more complicated because of physiologic changes hormones and frequently lacking normative datas during pregnancy. Therefore increased attention could allow early diagnosis and treatment, that improve prognosis for both the mother and fetus.

[Primary aldosteronism in gravidity].

Endocrinology and obstetrics have one thing in common--diagnosis and treatment endocrine diseases in gravidity. These are modified by physiological changes in gravidity, often missing data and tests in normal condition and the influence of diagnosis and treatment on the pregnant female and fetus have also to be taken into consideration. If diagnosis of primary aldosteronism is suspected, suprimed plasmatic renin activity is determinant indicator (disregarding arterial hypertension, hypokaliaemia, hyperkaliuresis and proteinuria) as well as ultrasound diagnostics or adrenal gland diagnostics means magnetic resonance imaging.

[From the history of endocrinology: reminiscence of the discovery of adrenocortical hormones].

In the article authors describe the milestones in history of discoveries of the adrenocortical hormones. Preparation of the adrenal extract cortine was the first experimental contribution. Cortine prolonged life of animals whose adrenals have been removed and had beneficial effects in patients with Addison disease (AD).

Thirteen novel mutations in the NR0B1 (DAX1) gene as cause of adrenal hypoplasia congenita.

X-linked adrenal hypoplasia congenita (AHC) is a rare developmental disorder associated with primary adrenal insufficiency and combined primary and secondary male hypogonadism. It is caused by deletions or mutations of the NR0B1 (DAX1) gene encoding DAX1, an atypical orphan member of the nuclear receptor superfamily. The continuous molecular genetic analysis of male patients with primary adrenal insufficiency revealed 13 novel mutations within the coding region of the NR0B1 gene which are predicted to inactivate the DAX1 function.

[Epidemiological profile of thyroid volume and disorders in Slovakia].

Unlabelled: After 45 years of successful iodine prophylaxis a total of 6324 subject aged 7 to 70 years from East (72.0%), Central (16.2%) and West Slovakia (11.

Insulin lispro improves postprandial glucose control in patients with diabetes mellitus.

Insulin lispro was compared with regular human insulin with respect to glycaemic control in patients with diabetes mellitus on intensive insulin treatment. Sixty-two patients (55 type 1; 7 type 2) from eight study centres in the Czech Republic, Slovenia and the Slovak Republic participated in a 4-month, open-label, randomized, crossover study. Patients administered insulin lispro immediately before meals or regular human insulin 30 min before meals.

[Adrenal gland incidentaloma].

Adrenal incidentaloma is an incidentally detected formation on examination of another cause such as visualization of the adrenal glands. From 1996 till December 1999 in the Endocrinological Institute in Lubochna 60 patients with adrenal incidentaloma were examined. In 75% afunctional tumours were involved.

Risk factors for glucose intolerance in active acromegaly.

In the present retrospective study we determined the frequency of glucose intolerance in active untreated acromegaly, and searched for risk factors possibly supporting the emergence of the diabetic condition. Among 43 patients, 8 (19%; 95% CI: 8-33%) had diabetes mellitus and 2 (5%; 1-16%) impaired glucose tolerance. No impaired fasting glycemia was demonstrable.

[Dehydrdoepiandrosterone, dehydroepiandrosteron-sulfate and insulin in acute myocardial infarct].

The authors discuss the relationship between dehydroepiandsoterone, its sulphate conjugate and insulin and ischaemic heart disease in patients with acute myocardial infarction. In the examined group of patients they found lower values of dehydroepiandosterone and its sulphate in men, lower values of dehydroepiandosterone in women as compared with mean values with regard to age and a close inverse correlation of insulin and dehydroepiandrosterone and insulin and dehydroepiandrosterone sulphate. Whether dehydroepiandosterone is the "missing link" of hyperinsulinaemia and arterosclerosis is so far only a theoretical issue.

Diabetes mellitus in primary aldosteronism.

Background: Information concerning diabetes mellitus associated with primary aldosteronism is scarce.

Objectives: To determine the prevalence of diabetes mellitus in its two main pathogenetic forms of primary aldosteronism and to evaluate its association with several clinical variables.

Patients: Fifty in-patients (31 female and 19 male, aged 16-66), diagnosed during the years 1980-1998 as aldosterone producing adenoma (n = 26) or as idiopathic hyperaldosteronism (n = 24).

Primary aldosteronism caused by aldosterone-producing adenoma in pregnancy--complicated by EPH gestosis.

Pregnancy in conjunction with primary aldosteronism is an unusual occurrence. We report a 28-year-old woman who presented with mild hypertension and hypokalemia as manifestations of primary aldosteronism caused by an aldosterone-producing adenoma in the left adrenal gland during pregnancy. Although the diagnosis was straightforward, the patient refused to undergo the proposed operation during the second trimester of her pregnancy.

Daily blood pressure profile in Cushing's syndrome before and after surgery.

No significant difference has been demonstrated in the altered circadian blood pressure pattern between the pituitary-dependent and adrenal forms of Cushing's syndrome before surgery. The effect of therapy, however, proved to be different. The mesor was normalized in the pituitary-dependent Cushing's syndrome more conspicuously for systolic than for diastolic blood pressure.

[Occurrence of primary aldosteronism in a group of ambulatory hypertensive patients].

Findings pertaining to the diagnosis and treatment of primary aldosteronism are rapidly expanding. In the present work the authors focused attention on the clinical application of some progressive methods. They examined a group of 115 ambulatory patients with arterial hypertension, not suspected of secondary arterial hypertension, in the course of one year.

Increased thyroid volume and prevalence of thyroid disorders in an area heavily polluted by polychlorinated biphenyls.

Objective: To evaluate whether long-term exposure to heavy environmental pollution with polychlorinated biphenyls (PCBs) could result in impairment of thyroid status as evaluated by an epidemiological field survey.

Methods: Thyroid volume (ThV) was measured by ultrasound in 238 employees of a factory (EMP) which previously produced PCBs and 454 adolescents from the surrounding area polluted by PCBs. Controls (C) were 572 adults and 965 adolescents from much less polluted areas.

[The polycystic ovary syndrome and insulin resistance].

The insulin resistance syndrome and the polycystic ovary syndrome (PCOS) appear to have some following coincidences: the existence of subclinical acanthosis nigricans in PCOS hyperinsulinemic women, correlation of insulin levels and free testosterone, insulin-like growth factor I binding protein (IGFIBP), and sex-hormone binding globulin. Insulin and IGFI act synergically with luteinizing hormone increasing the activity of cytochrome P450c17 and its enzymatic activity in the adrenals. The decrease in IGFI level and IGFI receptors in the ovarian granulosa cells reduce the steroids aromatisation.

[Initial experience with laparoscopic adrenalectomy].

We present the first experience with laparoscopic adrenalectomy, which was in Slovakia introduced to the surgical practice on March 3, 1996. We analyse first seven patients who underwent completed laparoscopic adrenalectomy (five leftsided, two right-sided). Four patients had cortex adenoma (clinically 2 incidentalomas and 2 Cishing syndroma), three patients had cortex hyperplasia (clinically Conn syndroma).