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- August 20, 2008 |
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Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"Calcium & Metabolic Bone Disorders"Dr. Andrew Karaplis (biography)
English - 2003-08-10 - 54 minutes
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Summary :
The World Health organization has named this decade the “Bone and Joint Decade”, in anticipation of new methods of prevention and treatment of musculoskeletal disorders.
The past decade has provided us with much new information on calcium homeostasis. Identification of the PTh receptor and its mutations have now been linked to a number of disorders for which there were no previous...
Learning objectives :
The participant will get an overview of the last decade’s important discoveries in the research of calcium and metabolic bone disorders.
Bibliographic references :
Kos CH, Karaplis AC, Peng JB, Hediger MA, Goltzman D, Mohammad KS, Guise TA, Pollak MR. The calcium-sensing receptor is required for normal calcium homeostasis independent of parathyroid hormone. J Clin Invest. 2003 Apr;111(7):1021-8.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Chan GK, Miao D, Deckelbaum R, Bolivar I, Karaplis A, Goltzman D. Parathyroid Hormone Related Peptide Interacts with Bone Morphogenetic Protein 2 to increase Osteoblastogenesis and decrease Adipogenesis in Pluripotent C3H10T1/2 Mesenchymal Cells. Endocrinology. 2003 Aug 28 [Epub ahead of print].
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
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"Reproductive Endocrinology"Dr. Bernard Corenblum (biography)
English - 2003-08-10 - 60 minutes
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Summary :
Secondary amenorrhea is an endocrine problem and will be the focus of this presentation. Some causes of secondary amenorrhea are hypothalamic amenorrhea, hyperprolactinemia, ovarian failure, PCOS and outflow tract. Here we will review the pathophysiology of these disorders and discuss their clinical management.
Learning objectives :
The participant will review the pathophysiology of secondary amenorrhea and its causes:
- hypothalamic amenorrhea
- hyperprolactinemia
- ovarian failure
- PCOS
- Outflow tract
Bibliographic references :
Mather KJ, Verma S, Corenblum B, Anderson TJ. Normal endothelial function despite insulin resistance in healthy women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 2000 May;85(5):1851-6.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
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"Diabetes/Lipids"Dr. Lawrence A. Leiter (biography)
English - 2003-08-10 - 85 minutes
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Summary :
In this era of evidence-based medicine we have been lucky to have several ongoing studies in diabetes that touch on many levels. We are learning more about the risk factors predisposing to CVD and other complications, and diabetes prevention is now also a major research focus. Several lipid-lowering studies have been conducted to date, and this presentation will provide new information gleaned...
Learning objectives :
The participant will review the results of several major lipid-lowering studies and get an update on the new drugs available like some statins and others, and how these drugs work and how they may be used.
Bibliographic references :
Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, McInnes GT, Mehlsen J, Nieminen M, O'Brien E, Ostergren J. Rationale, design, methods and baseline demography of participants of the Anglo-Scandinavian Cardiac Outcomes Trial. ASCOT investigators. J Hypertens. 2001 Jun;19(6):1139-47.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes GT, Mehlsen J, Nieminen M, O'Brien E, Ostergren J; ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003 Apr 5;361(9364):1149-58.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
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"Neuroendocrinology"Dr. Ehud Ur (biography)
English - 2003-08-09 - 60 minutes
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Summary :
Recent important discoveries in pituitary development involve transcription factors, but we are also discovering better ways of diagnosing and treating people with pituitary disorders. Here Dr Ur draws on his own clinical experience with patients as well as new information coming out in the literature to give an update on the diagnosis and workup of patients affected with the following: pituitary...
Learning objectives :
The participant will share in Dr Ur’s own clinical practice findings and learn newer and more effective ways of doing workups for patients having:
- pituitary and adrenal incidentalomas
- hypophysitis
- growth hormone deficiency
- craniopharyngioma
- non-functioning tumors
- prolactinomas
- normoprolactinemic galactorrhoea
- macroprolactinemia
- acromegaly
- Cushing’s Disease
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"Thyroid"Dr. Jody Ginsberg (biography)
English - 2003-08-09 - 54 minutes
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Summary :
In this presentation we will review the condition of Graves Disease in pregnancy, and some important new articles impacting endocrinology. According to Mestman, the preconception control of thyroid disease is as important as glucose control in diabetic women. A discussion on the screening methods and treatments appropriate to Graves Disease in pregnant women is followed by a discussion of 3...
Learning objectives :
The participant will review the screening procedures and treatment options for women with Graves Disease in pregnancy. This will be followed by a discussion of the following 3 papers that have emerged in the past year:
Bibliographic references :
- Anderson S et al "Narrow individual variations in serum T4 and T3 in normal subjects: A clue to the understanding of subclinical thyroid disease" (J Clin Endoc Metab 87:1068-72, 2002)
- Alexander EK et al "Natural history of benign solid and cystic thyroid nodules" (Ann Intern Med 138: 315-18, 2003) http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
- Mazzaferri EL et al "A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma" (J Clin Endoc Metab 88: 1422-41, 2003). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
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"Pediatric Endocrinology"Dr. Elizabeth Cummings (biography)
English - 2003-08-09 - 33 minutes
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Summary :
In this presentation Dr Cummings gives an update in Pediatric Endocrinology, focusing on the following topics: Pituitary development and genetics, Growth hormone therapy, Prevention of type 1 diabetes and Bone disorders. An abundance of recent studies are presented with the discussion of a range of pediatric endocrinology treatment issues.
Learning objectives :
The participant will get an update in pediatric endocrinology, with a focus on the following topics:
- Pituitary development and genetics
- Growth hormone therapy
- Prevention of type 1 diabetes
- Bone disorders
Bibliographic references :
Diabetes Prevention Trial--Type 1 Diabetes Study Group. Effects of insulin in relatives of patients with type 1 diabetes mellitus. N Engl J Med. 2002 May 30;346(22):1685-91.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Huopio H, Otonkoski T, Vauhkonen I, Reimann F, Ashcroft FM, Laakso M. A new subtype of autosomal dominant diabetes attributable to a mutation in the gene for sulfonylurea receptor 1. Lancet. 2003 Jan 25;361(9354):301-7.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Pulichino AM, Vallette-Kasic S, Tsai JP, Couture C, Gauthier Y, Drouin J. Tpit determines alternate fates during pituitary cell differentiation. Genes Dev. 2003 Mar 15;17(6):738-47.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
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"Reproductive Endocrinology"Dr. Ivy Fettes (biography)
English - 2002-07-28 - 55 minutes
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Summary :
A discussion on some aspects of endocrinology in reproductive medicine. Dr Fettes starts with an overview of gonadotropin-releasing hormone (GnRH) signalling and disease states. A section on polycystic ovarian syndrome (PCOS) diagnosis and treatment follows. Other topics include menopause, andropause and hormone replacement therapy.
Learning objectives :
The participant will become familiar with gonadotropin-releasing hormone (GnRH) signalling and the diagnosis and treatment of polycystic ovarian syndrome (PCOS). Brief overview of menopause and andropause features and related hormone replacement therapy as well.
Bibliographic references :
Migraine in the menopause.
Fettes I.
University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Ontario, Canada.
Many women with migraine, especially those with a history of menstrual migraine, experience an exacerbation as they approach menopause. During this time, the orderly pattern of estrogen and progesterone secretion is lost. The fluctuating and falling levels of estrogen during the perimenopausal years may increase the frequency and severity of migraine. In such women, restoration and stabilization of estrogen levels within the physiologic range are likely to diminish the migraine. Although continuous combined hormone replacement therapy with estrogen and progesterone is becoming increasingly popular for postmenopausal women, many women are still prescribed cyclic replacement initially. For the woman who is susceptible to fluctuations in estrogen and progesterone, initiation of cyclic therapy after menopause may exacerbate migraine. This could occur in a woman who noted an improvement in migraine after menopause with complete cessation of menses and stable levels of estrogen. For the woman with migraine, continuous combined estrogen and progesterone (or estrogen alone, if the uterus has been removed) replacement is the preferred therapy. This can be achieved with a 50-microg/day estrogen skin patch such as Estraderm or Vivelle twice weekly or Climara once weekly, or with an oral estrogen such as Premarin, Ogen, or Estrace, with half the daily dose given every 12 hours to maintain optimal stability. In the presence of a uterus, progesterone should be added, either as low-dose medroxyprogesterone acetate (Provera) 2.5 mg every evening or micronized progesterone (Prometrium) 100 mg every evening. The usual contraindications to hormone replacement therapy may be applied to women with migraine.
Neurology 1999;53(4 Suppl 1):S29-33
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"Thyroid"Dr. Jody Ginsberg (biography)
English - 2002-07-28 - 87 minutes
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Summary :
The first topic of this presenatation is subclinical hypothyroidism (SH). Beginning with the clinical features and causes, the talk goes on to explore conflicting research evidence and the indicated treatments; Discussion of L-T4 treatment of SH. Thyroid cancer is the second main topic, with a focus on clinical features associated with malignancy and evaluation of the thyroid nodule.
Learning objectives :
The participant will gain valuable insight into the controversial condition of subclinical hypothyroidism. Its causes and clinical features are reviewed, as well as conflicting research evidence concerning the type of treatment to be followed. L-T4 is discussed as a treatment option. Brief overview on the clinical features of thyroid cancer malignancy, and how to evaluate the thyroid nodule.
Bibliographic references :
Hyperplacentosis: a novel cause of hyperthyroidism.
Ginsberg J, Lewanczuk RZ, Honore LH.
Department of Medicine, University of Alberta, Edmonton, Canada. jody.ginsberg@ualberta.ca
Human chorionic gonadotropin (hCG), which is capable of thyrotropic activity, is believed responsible for the hyperthyroidism of gestational trophoblastic disease and hyperemesis gravidarum. Hyperplacentosis is a condition of heightened trophoblastic activity characterized by increased placental weight and circulating hCG levels higher than those associated with normal pregnancy. We report the first case of hyperthyroidism associated with hyperplacentosis. Correction of the hyperthyroidism occurred after hysterotomy and correlated with declining hCG levels. Hyperplacentosis should be included among the causes of hCG-mediated hyperthyroidism.
Thyroid 2001 Apr;11(4):393-6
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"Calcium and Metabolic Bone Disorders"Dr. Andrew Karaplis (biography)
English - 2002-07-28 - 68 minutes
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Summary :
In this highly interesting talk, Dr Karaplis shares his expertise on various topics in metabolic bone disease. Molecular and cellular background leads into a descriptive analysis of disease states and their diagnosis and treatment. Diseases covered include osteomalacia, hypercalcemia, hyperparathyroidism, vitamin D deficiency, osteoporosis, rickets, parathyroid hormone-related peptide (PTHrP)...
Learning objectives :
The participant will gain background knowledge on the molecular mechanisms involved in the normal and disease states of bone metabolism; as well as the diagnosis and treatment of these diseases. Conditions discussed include osteomalacia, hypercalcemia, hyperparathyroidism, vitamin D deficiency, osteoporosis, rickets, pseudohypoparathyroidism and hypocalciuric hypercalcemia.
Bibliographic references :
Parathyroid hormone is essential for normal fetal bone formation.
Miao D, He B, Karaplis AC, Goltzman D.
Calcium Research Laboratory, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
Parathyroid hormone (PTH) is a potent pharmacologic inducer of new bone formation, but no physiologic anabolic effect of PTH on adult bone has been described. We investigated the role of PTH in fetal skeletal development by comparing newborn mice lacking either PTH, PTH-related peptide (PTHrP), or both peptides. PTH-deficient mice were dysmorphic but viable, whereas mice lacking PTHrP died at birth with dyschondroplasia. PTH-deficient mice uniquely demonstrated diminished cartilage matrix mineralization, decreased neovascularization with reduced expression of angiopoietin-1, and reduced metaphyseal osteoblasts and trabecular bone. Compound mutants displayed the combined cartilaginous and osseous defects of both single mutants. These results indicate that coordinated action of both PTH and PTHrP are required to achieve normal fetal skeletal morphogenesis, and they demonstrate an essential function for PTH at the cartilage-bone interface. The effect of PTH on fetal osteoblasts may be relevant to its postnatal anabolic effects on trabecular bone.
J Clin Invest 2002 May;109(9):1173-82
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"Diabetes/Lipids"Dr. Lawrence A. Leiter (biography)
English - 2002-07-27 - 55 minutes
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Summary :
Dr Leiter provides a comprehensive overview of the role of lipids, eg LDL cholesterol in the pathology of Type 2 Diabetes. This is done by taking into account the results of several major studies such as the cholesterol clinical trials WOSCOPS, AFCAPS, 4S, CARE and LIPID; the Heart Protection Study and the GREACE Study. Dr Leiter also does a recap of Type 2 Diabetes pathology and CDA treatment...
Learning objectives :
The presentation provides an overview of the information gleaned from several major LDL-lowering trials; the Heart Protection Study and the GREACE Study. A recap of the pathology of Type 2 Diabetes and CDA treatment guidelines.
Bibliographic references :
Am J Clin Nutr 2002 Aug;76(2):365-72
Effects of high- and low-isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women.
Jenkins DJ, Kendall CW, Jackson CJ, Connelly PW, Parker T, Faulkner D, Vidgen E, Cunnane SC, Leiter LA, Josse RG.
Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Ontario, Canada. cyril.kendall@utoronto.ca
BACKGROUND: Many of the benefits of soy have been attributed to soy isoflavones.
OBJECTIVE: The objective was to determine the effects of high- and low-isoflavone soy-protein foods on both lipid and nonlipid risk factors for coronary artery disease (CAD).
METHODS: Forty-one hyperlipidemic men and postmenopausal women participated in a study with three 1-mo diets: a low-fat dairy food control diet and high- (50 g soy protein and 73 mg isoflavones daily) and low- (52 g soy protein and 10 mg isoflavones daily) isoflavone soyfood diets. All 3 diets were very low in saturated fat (< 5% of energy) and cholesterol (< 50 mg/d). Fasting blood samples were drawn and blood pressure was measured at the start and end of each diet.
RESULTS: No significant differences were seen between the high- and low-isoflavone soy diets. Compared with the control diet, however, both soy diets resulted in significantly lower total cholesterol, estimated CAD risk, and ratios of total to HDL cholesterol, LDL to HDL cholesterol, and apolipoprotein B to A-I. No significant sex differences were observed, except for systolic blood pressure, which in men was significantly lower after the soy diets than after the control diet. On the basis of blood lipid and blood pressure changes, the calculated CAD risk was significantly lower with the soy diets, by 10.1 +/- 2.7%.
CONCLUSION: Substitution of soyfoods for animal products, regardless of isoflavone concentration, reduces the CAD risk because of both modest reductions in blood lipids and reductions in oxidized LDL, homocysteine, and blood pressure.
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"Pediatric Endocrinology"Dr. Denis Daneman (biography)
English - 2002-07-27 - 74 minutes
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Summary :
Dr Daneman discusses some new issues in Pediatric Endocrinology (infancy to puberty); as well as a broad range of topics such as insulin resistance, ovary functioning, intersex states, the adrenals and thyroid, and diagnosis of GHD.
Learning objectives :
The participant will become familiar with the latest developments in Pediatric Endocrinology (infancy to puberty). Topics include insulin resistance, ovary functioning, intersex states, the adrenals and thyroid, and diagnosis of GHD.
Bibliographic references :
Induction of puberty in the hypogonadal girl--practices and attitudes of pediatric endocrinologists in Europe.
Kiess W, Conway G, Ritzen M, Rosenfield R, Bernasconi S, Juul A, van Pareren Y, de Muinck Keizer-Schrama SM, Bourguignon JP.
Hospital for Children and Adolescents, University of Leipzig, Germany.
The management of children and adolescents with hypogonadism and in particular the induction of puberty in the hypogonadal girl is subjectto controversy. Therefore, under the auspices and through organization of the Drugs and Therapeutics Committee of the European Society of Paediatric Endocrinology (ESPE), an interactive voting session and workshop was held at the 39th ESPE Annual Meeting in Brussels to discuss these topics. Common practice in Europe and attitudes of pediatric endocrinologists in Europe were questioned and recorded in the 1.5-hour program. We now report on some of the results of the questionnaires and discussions of that session to further the discussion on and knowledge of current concepts of induction of puberty in the hypogonadal girl in Europe. It became clear from the data accumulated here that the start of treatment, the aims of therapy and the modalities of how to treat the hypogonadal girl vary amongst pediatric endocrinologists in Europe. For example, a chronological age > or =11 years was considered appropriate for the start of estrogen therapy by 40.4% (out of 188 answers), while 47.8 and 7.5% felt that a chronological age > or =13 and > or =15 years respectively was appropriate. In respect to the form and route of estrogen administration, the audience was asked for their common estrogen replacement practice: 31.9% used oral 17beta-estradiol treatment, while 10% would prescribe 17beta-estradiol transdermal patches. Another 12.2% would recommend conjugated estrogens (e.g. Premarin) orally, 4.8% use oral estradiol valerate and 39.3% ethinylestradiol orally. Only 1.8% out of 229 physicians answering were undecided. In addition, counseling of patients and their families is quite variable and perceptions for example regarding potential pregnancies in affected women are also not uniform. In this report the authors do not want to provide their own personal views but rather reflect current practice in Europe. It is hoped that a more uniform picture will emerge once European and international guidelines on how to treat the girl with hypogonadism will be available and even more discussions amongst doctors from different countries have been led. Copyright 2002 S. Karger AG, Basel
Horm Res 2002;57(1-2):66-71
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"Neuroendocrinology"Dr. Ehud Ur (biography)
English - 2002-07-27 - 73 minutes
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Summary :
In this lecture Dr Ur gives an overview of some controversial and new issues in neuroendocrinology, e.g., pituitary hormone deficiencies, how to use the ITT (insulin tolerance test), GH deficiency, Acromegaly and mortality, Cushing's Syndrome, Addison's Disease, Phaeochromocytomas, hyperprolactinemia, Kallman's Syndrome, the ectopic ACTH syndrome, familial glucocorticoid deficiency,...
Learning objectives :
The viewer will know how to deal with a number of issues in the medical practice of neuroendocrinology, such as diagnosis of pituitary hormone deficiencies, GHD and hyperprolactinemia; treatment of Acromegaly; testing for Phaeochromocytomas; as well as theoretical background on Kallman's Syndrome, ectopic ACTH syndrome, familial glucocorticoid deficiency, Cushing's Disease, carcinoid tumours and more…
Bibliographic references :
Neuroendocrinology of Leptin
The discovery of the adipostatic hormone leptin formed our understanding of the neurobiology of apetite control and has helped to establish the biological basis of obesity. In recent years there has been a wealth of publications relating to the physiology of this peptide.
This volume sets out to draw together key features of the central effects of leptin. Contributions from leading authorities in the field include reviews of leptin's actions on hypothalamic peptides, the role of leptin in fasting, it's effects on reproductive function, and evidence supporting endogenous brain production of the peptide.
Endocrinologists, diabetologists, obesity specialists and neurobiologists will be interested in this succint and timely review of the effects of the adipostatic hormone leptin on neuroendocrine function.
Click on this link to access the full article:
http://www.karger.com/bookseries/fhore/fhore026.pdf
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Would you like to know more about insulin resistance? Are you looking for information pertaining to Type 2 Diabetes? You can find what you are looking for in over 2000 references available on CMEonDiabetes. |
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