Endocrine Pathology Impact Factor

[Ezilda Newnam]

BMCEndocrine Disorders previously launched a call for papers exploring the current state and future perspectives for risk factors and complications in endocrine disorders, guest edited by Dr Michael O'Reilly (Dublin, IE) Dr Nikolaos Papanas (Xanthi, GR), Prof Abdul Basit (Karachi, PK). We have been pleased to receive many high-quality submissions to this article collection. Find the published articles here.

Sakran N et al., examine the physiological mechanisms in diabetes, risks for complications, the effects of bariatric and metabolic surgery and sheds a light on whether diabetes should be reclassified.

A cohort study by Zhang L et al., identified that gestational diabetes mellitus (GDM) reoccurred in nearly half of women with a history of GDM. Also, risk factors for recurrent GDM and newly diagnosed GDM were shown to be different.

The endocrine system is a network of glands that produce and release hormones. These hormones help control many important body functions, including the body's ability to change calories into energy that powers cells and organs. The endocrine system affects how your heart beats, how your bones and tissues grow, and even your ability to make a baby.

Disorders of the endocrine system happen if your hormone levels are too high or too low, or if your body doesn't respond to hormones in the expected way. You may develop diabetes, thyroid disease, growth disorders, sexual dysfunction, and a host of other hormone-related disorders.

The endocrine feedback system helps control the balance of hormones in the bloodstream. If your body has too much or too little of a certain hormone, the feedback system signals the proper gland or glands to correct the problem. A hormone imbalance may occur if this feedback system has trouble keeping the right level of hormones in the bloodstream, or if your body doesn't clear them out of the bloodstream properly.

Most endocrine tumors and nodules (lumps) are noncancerous. They usually don't spread to other parts of the body. However, a tumor or nodule on the gland may interfere with the gland's hormone production.

The symptoms of an endocrine disorder vary widely and depend on the specific gland involved. However, most people with endocrine disease complain of fatigue and weakness. Certain symptoms may make you think you have a different disease or disorder. Some symptoms that are worth talking to your doctor about include:

Adrenal insufficiency. The adrenal gland releases too little of the hormone cortisol and sometimes, aldosterone. Symptoms include fatigue, stomach upset, dehydration, and skin changes. Addison's disease is a type of adrenal insufficiency.

Cushing's disease. The overproduction of a pituitary gland hormone leads to an overactive adrenal gland. A similar condition called Cushing's syndrome may occur in people, particularly children, who take high doses of corticosteroid medications.

Hyperthyroidism. The thyroid gland produces too much thyroid hormone, leading to weight loss, fast heart rate, sweating, and nervousness. The most common cause for an overactive thyroid is an autoimmune disorder called Grave's disease.

Hypothyroidism. The thyroid gland does not produce enough thyroid hormone, leading to fatigue, constipation, dry skin, and depression. The underactive gland can cause slowed development in children. Some types of hypothyroidism are present at birth.

Hypopituitarism. In this condition, the pituitary gland releases little or no hormones. It may be caused by several different diseases. Women with this condition may stop getting their periods.

Multiple endocrine neoplasia type 1 and 2 (MEN1 and MEN2). These rare, genetic conditions are passed down through families. They cause tumors of the parathyroid, adrenal, and thyroid glands, leading to overproduction of hormones.

Polycystic ovary syndrome (PCOS). The overproduction of androgens interferes with the development of eggs and their release from the female ovaries. PCOS is a leading cause of infertility.

Treatment of endocrine disorders can be complicated, as a change in one hormone level can throw off another. Your doctor or specialist may order routine blood work to check for problems or to determine if your medication or treatment plan needs to be adjusted.

Your endocrine system releases hormones that affect how your body develops and functions. An endocrine system malfunction, caused by genetics, infection, or other factors, can result in various disorders such as diabetes, hyperthyroidism, and polycystic ovarian syndrome (PCOS). If you have fatigue or weakness regularly, it could be a sign of an endocrine disorder, so consult your doctor so that they can diagnose and treat your condition.

Endocrine Pathology (official journal of the Endocrine Pathology Society) publishes research on clinical and basic aspects of endocrine disorders, focusing on diagnostic aspects of endocrine pathology. Coverage includes clinical case presentations and descriptions of techniques. Particular attention is paid to developments in new diagnostic applications of molecular biology and immunohistochemistry.

Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder in females of reproductive age. It is characterized by two or more of the following: irregular menstrual periods, hyperandrogenism, and polycystic ovaries. This activity outlines the evaluation and treatment of polycystic ovarian syndrome and reviews the role of the interprofessional team in managing patients with this condition.

Objectives:Describe the epidemiology of polycystic ovarian syndrome.Review the role of functional ovarian hyperandrogenism (FOH) in the pathophysiology of polycystic ovarian syndrome.Summarize the use of the Rotterdam criteria in the evaluation of polycystic ovarian syndrome.Outline the importance of collaboration and communication among the interprofessional team to emphasize lifestyle changes and close follow-up to improve patient outcomes affected by polycystic ovarian syndrome.Access free multiple choice questions on this topic.

Polycystic ovarian syndrome (PCOS) is the most common endocrine pathology in females of reproductive worldwide. Stein and Leventhal initially described it in 1935. The prevalence ranges between 5% and 15% depending on the diagnostic criteria applied. It is widely accepted among specialty society guidelines that the diagnosis of PCOS must be based on the presence of at least two of the following three criteria: chronic anovulation, hyperandrogenism (clinical or biological), and polycystic ovaries. It is a diagnosis of exclusion, and disorders that mimic clinical features of PCOS must be excluded. These include thyroid disease, hyperprolactinemia, and non-classical congenital adrenal hyperplasia. Selected patients may need more extensive workup if clinical features suggest other causes.

Despite its high prevalence, PCOS is underdiagnosed and frequently takes more than one visit or different physicians to get identified, and these usually occur in more than a one-year timeframe. It is a very frustrating process for the patient. Delay in diagnosis can lead to the progression of comorbidities making it more difficult to implement lifestyle intervention, which is critical for the improvement of features of PCOS and quality of life.

Multiple morbidities are associated with PCOS, including infertility, metabolic syndrome, obesity, impaired glucose tolerance, type 2 diabetes mellitus (DM-2), cardiovascular risk, depression, obstructive sleep apnea (OSA), endometrial cancer, and nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis (NAFLD/NASH). There are different screening recommendations for each of these pathologies, but the clinician must have a low threshold for workup if any manifestation is shown in PCOS patients.[1][2][3]

PCOS is a multifactorial disease. Several susceptible genes have been identified as contributors to the pathophysiology of the disease. These genes are involved in various levels of steroidogenesis and androgenic pathways. Twin studies have estimated about 70% heritability. Also, the environment is a fundamental component in the expression of these genes and the development and progression of the disease.[4][5][6]

Two popular hypotheses postulate that individuals with a genetic predisposition exposed to certain environmental factors lead to the expression of PCOS features. The most common environmental factors include obesity and insulin resistance. Some hypotheses also include fetal androgen exposure.[7]

As already mentioned, PCOS is the most common endocrine pathology in reproductive-aged females worldwide, affecting between 5% and 15% of females depending on the diagnostic criteria. Rotterdam criteria include a broader prevalence than the National Institute of Health 1990 Criteria. Based on the NIH 2012 workshop report, it is estimated that PCOS affects about 5 million reproductive-aged females in the United States. The cost to the healthcare system for diagnosing and treating PCOS is approximately $4 billion annually, not including the cost of serious comorbidities associated with PCOS.

Multiple conditions have been associated with PCOS, including infertility, metabolic syndrome, obesity, impaired glucose tolerance, DM-2, cardiovascular risk, depression, OSA, endometrial cancer, NAFLD/NASH. Higher prevalence has been associated in first-degree relatives with PCOS, prepubertal obesity, congenital virilizing disorders, above-average or low birth weight for gestational age, premature adrenarche, use of valproic acid as an antiepileptic drug. Studies have also suggested that there is a higher prevalence in Mexican-Americans than non-Hispanic whites and African Americans.[8][9]

PCOS is a hyperandrogenic state with oligo-anovulation that cannot be explained by any other disorder. It is a diagnosis of exclusion. Nevertheless, it accounts for the majority of hyperandrogenic presentations.

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