sunset. To achieve good holistic management, harmony is needed between physicians and religious scholars ( 1 ). Fasting entails protracted periods of fasting, often exceeding 12-h per day. Prolonged abstinence, particularly in hot climates, subjects many
Salem A Beshyah, Khawla F Ali, and Hussein F Saadi
Elena Valassi, Iacopo Chiodini, Richard A Feelders, Cornelie D Andela, Margueritta Abou-Hanna, Sarah Idres, and Antoine Tabarin
involved in the management of Cushing’s syndrome (%) ( n = 320) Endocrinologist 53.8 97.8 General practitioner/family doctor 18.1 56.3 Self-diagnosed 5.6 – Hospital/emergency doctor 3.8 – Internist 2
Xi Wang and Qi Yu
To evaluate the safety and efficacy of letrozole in girls with progressive precocious puberty (PP) associated with McCune–Albright syndrome (MAS).
Monocentric retrospective cross-sectional and longitudinal study of consecutive patients.
Ten MAS patients treated at Peking Union Medical College Hospital between September 1999 and December 2017 were retrospectively reviewed; those with complications due to PP were followed.
The mean age at letrozole initiation was 4.5 ± 2.6 years, while the mean duration of treatment was 3.3 ± 2.4 years. Letrozole was highly effective at decreasing the rate of skeletal maturation, with a significant decrease in the bone age-to-chronological age (BA/CA) ratio from 1.9 ± 1.1 pre-treatment to 1.5 ± 1.2 on letrozole treatment (P = 0.016). Moreover, growth velocity Z-scores declined from 0.41 ± 0.5 to −0.2 ± 0.31 with treatment (P < 0.001). Predicted adult height Z-scores increased significantly from −2.03 ± 2.33 at baseline to 1.13 ± 0.84 following treatment initiation (P = 0.029). Moreover, vaginal bleeding declined significantly on letrozole.
Our findings suggest that letrozole may be an effective therapy in some girls with MAS, as treatment results in improved BA/CA ratio, growth velocity and predicted adult height. Possible adverse effects include nettle rash.
Richard P Steeds, Vandana Sagar, Shishir Shetty, Tessa Oelofse, Harjot Singh, Raheel Ahmad, Elizabeth Bradley, Rachel Moore, Suzanne Vickrage, Stacey Smith, Ivan Yim, Yasir S Elhassan, Hema Venkataraman, John Ayuk, Stephen Rooney, and Tahir Shah
over-whelming ( 1 ). This entity is termed carcinoid heart disease (CHD) ( 2 ). CHD occurs in patients with advanced stages of cancer that is hormonally active. Its management is complex and challenging as patients usually present late, often with
Lijin Ji, Na Yi, Qi Zhang, Shuo Zhang, Xiaoxia Liu, Hongli Shi, and Bin Lu
drug treatment and management of pregnancy and breastfeeding. In recent years, two studies have conducted questionnaire surveys of clinicians’ management of prolactinomas reflecting self-reported clinical diagnoses and treatment ( 4 , 5 ). However, no
Luca Persani, Biagio Cangiano, and Marco Bonomi
stimulation test ( 18 , 19 ). Clinical presentation CeH represents a challenging condition in clinical practice as it is characterized by suboptimal accuracy of clinical and biochemical parameters for diagnosis and management. Clinical presentation of
C E Higham, A Olsson-Brown, P Carroll, T Cooksley, J Larkin, P Lorigan, D Morganstein, P J Trainer, and the Society for Endocrinology Clinical Committee
mellitus ( 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ). These can be life-threatening if not recognised and treated appropriately; deaths have been reported. Diagnosis and management in this group can be complicated by simultaneous multi
Mônica R Gadelha, Feng Gu, Marcello D Bronstein, Thierry C Brue, Maria Fleseriu, Ilan Shimon, Aart J van der Lely, Shoba Ravichandran, Albert Kandra, Alberto M Pedroncelli, and Annamaria A L Colao
reports the baseline characteristics and occurrence and management of hyperglycemia in patients with acromegaly who were either naïve to medical therapy (C2305) or uncontrolled on first-generation SSAs (C2402) at baseline and were treated with pasireotide
Carole Morin, Keo-Morakort Benedetto, Agathe Deville, Laurent Milot, Aurélie Theillaumas, Valérie Hervieu, Mathieu Pioche, Gilles Poncet, Julien Forestier, Laurent François, Francoise Borson-Chazot, Mustapha Adham, Catherine Lombard-Bohas, and Thomas Walter
initial characterizations and their management are varied and complex. Therefore, national ( 3 ) and international ( 4 , 5 , 6 ) guidelines were regularly updated to help physicians to optimize NEN management, both for neuroendocrine tumours (NET) and
E Kohva, P J Miettinen, S Taskinen, M Hero, A Tarkkanen, and T Raivio
long-term management plan in close co-operation with the patient and the family ( 1 ). It is generally agreed that timely diagnosis and management are important as they potentially prevent adverse health outcomes and improve long-term, health