The endocrinologic complications in children after anticancer treatment

2016 ◽  
Vol 7 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Galina G Radulesku ◽  
Nina V Matchenkova ◽  
Margarita B Belogurova
Keyword(s):  
Children And Adolescents ◽  
Late Effects ◽  
Alkylating Agents ◽  
Endocrine System ◽  
High Dose ◽  
Endocrine Disorders ◽  
Dramatic Improvement ◽  
Metabolic Disturbances ◽  
End Of Treatment ◽  
Anticancer Treatment

During last three decades, there is a dramatic improvement in the survival of children and adolescents with cancer. This progress has been possible because of the recent programs of improved therapy (radiotherapy, chemotherapy). There are different toxic effects in patients who have received chemotherapy and radiotherapy. One of the most common late effects of anticancer treatment in children and adolescents is endocrine disorders. Radiotherapy, alkylating agents, high-dose chemotherapy with stem-cell transplantation are the main risk factors of endocrine impairment. All parts of endocrine system are involved in the pathologic process during and after the end of treatment of children and adolescents. Abnormalities in hypothalamo-pituitary function, thyroid function, adrenal function, gonadal function are variably associated with anticancer therapy. Different metabolic disturbances, abnormal sexual development and infertility are caused by the dysfunction of endocrine system. There are immediate (during therapy) and delayed (after the end of treatment) onset late effects of antineoplastic therapy. Early diagnosis and early treatment of complications - as the main factors to improve the results of treatment and quality of life of patients surviving cancer. The aim of this article to analyze the possible range of endocrine disturbance in children and adolescents after anticancer treatment, the necessary intensive follow-up for survivors after the diagnosis of cancer and the treatment of possible endocrine disorders.

Impaired follicular development and endocrine disorders in female rats by prepubertal exposure to toxic doses of cadmium

2020 ◽  
Vol 36 (2) ◽  
pp. 63-75
Author(s):  
Saman Saedi ◽  
Mohammad Reza Jafarzadeh Shirazi ◽  
Mohammad Javad Zamiri ◽  
Mehdi Totonchi ◽  
Mohammad Dadpasand ◽  
...  
Keyword(s):  
Steroid Hormones ◽  
Endocrine System ◽  
Follicular Development ◽  
Female Rats ◽  
High Dose ◽  
Endocrine Disorders ◽  
Sprague Dawley ◽  
Sprague Dawley Rats ◽  
Puberty Onset ◽  
Different Doses

Cadmium (Cd) has been associated with several physiological problems including reproductive and endocrine system dysfunction resulting in temporary infertility. The principal objective of this project was to investigate the effects of prepubertal exposure to toxic doses of Cd on puberty onset, the endocrine system, and follicular development. For this purpose, 16 female Sprague-Dawley rats weaned on postnatal day (PND) 21 were randomly divided into 4 groups ( n = 4 per group). The treatments were as follows: 0, 25, 50, and 75 mg/kg/day of cadmium chloride (CdCl2) by oral gavage from PND 21 to observation of first vaginal opening (VO). The results demonstrated that prepubertal exposure to different doses of CdCl2 delays the age of VO, first diestrus, and first proestrus via altering the concentrations of estradiol and progesterone. The low level of these steroid hormones contributed to lower differentiation and maturation of follicles and it finally led to reduced ovarian reservoir of follicles and impaired follicular development. The number of atretic follicles and secondary follicles with premature cavity increased in rats that received a high dose of CdCl2, whereas the number of secondary follicles and corpora luteum decreased in the same circumstances. Taken together, these data suggest that prepubertal exposure to toxic doses of Cd delays the onset of puberty via disorderliness in the concentration of steroid hormones and reduces the ovarian reservoir of follicles, as well as folliculogenesis.

scholarly journals Sepsis as a Pan-Endocrine Illness—Endocrine Disorders in Septic Patients

2021 ◽  
Vol 10 (10) ◽  
pp. 2075
Author(s):  
Weronika Wasyluk ◽  
Martyna Wasyluk ◽  
Agnieszka Zwolak
Keyword(s):  
Host Response ◽  
Peripheral Resistance ◽  
Endocrine System ◽  
Endocrine Disorders ◽  
Hormonal Changes ◽  
Adrenergic Stimulation ◽  
Hypothalamic Amenorrhea ◽  
Somatotropic Axis ◽  
Almost All ◽  
Triiodothyronine Concentration

Sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. One of the elements of dysregulated host response is an endocrine system disorder. Changes in its functioning in the course of sepsis affect almost all hormonal axes. In sepsis, a function disturbance of the hypothalamic–pituitary–adrenal axis has been described, in the range of which the most important seems to be hypercortisolemia in the acute phase. Imbalance in the hypothalamic–pituitary–thyroid axis is also described. The most typical manifestation is a triiodothyronine concentration decrease and reverse triiodothyronine concentration increase. In the somatotropic axis, a change in the secretion pattern of growth hormone and peripheral resistance to this hormone has been described. In the hypothalamic–pituitary–gonadal axis, the reduction in testosterone concentration in men and the stress-induced “hypothalamic amenorrhea” in women have been described. Catecholamine and β-adrenergic stimulation disorders have also been reported. Disorders in the endocrine system are part of the “dysregulated host response to infection”. They may also affect other components of this dysregulated response, such as metabolism. Hormonal changes occurring in the course of sepsis require further research, not only in order to explore their potential significance in therapy, but also due to their promising prognostic value.

Hydrogen and potassium regulation of (pro)renin processing and secretion

1994 ◽  
Vol 267 (1) ◽  
pp. F1-F12 ◽  
Author(s):  
J. A. King ◽  
J. C. Fray
Keyword(s):  
Diabetes Mellitus ◽  
Heart Disease ◽  
Surface Membrane ◽  
Endocrine System ◽  
Renin Secretion ◽  
Endocrine Disorders ◽  
K Channels ◽  
Human Renin ◽  
Cl Channels ◽  
H Channels

H and K ions play central roles in prorenin processing and secretion, and prorenin is abnormally expressed in H and K disorders. At the surface membrane of juxtaglomerular (JG) cells, K is sensed and regulated by K channels (coupled to Cl channels and activated by excess Ca), Na-K-adenosinetriphosphatase, and a KCl/H exchange transporter (regulated by Ca). In JG cell granular membrane, K flux is regulated by K channels and a KCl/H exchange transporter (activated by Ca). H channels and a H pump reside in the granular membrane, which maintain H concentration in the granular matrix at least two orders of magnitude greater than in cytosol. The H pump may also be responsible for maintaining the acidic matrix required for maximal prorenin processing to renin by prohormone convertase for human renin (PCren), the prorenin convertase. These molecules form the core of a chemiosmotic system, which appears to regulate both prorenin processing and renin secretion. Renin secretion and prorenin processing appear to be of more than causal significance in clinical disorders characterized by chemiosmotic imbalance. A critical review of the literature supports the following general conclusions. First, hyperrenin state defines the initial phase in the pathogenesis of heart disease, diabetes mellitus, and hypertension. Second, low-renin syndrome defines the transition-to-establish phase in the pathogenesis of heart disease, diabetes mellitus, and hypertension in which the key feature is renin secretory hyporesponsivity. Third, renin disorders are usually associated with other endocrine disorders (polyendocrinopathies types I, II, and III), suggesting that renin may be an important molecule in the processing of chemiosmotic forces. The key chemiosmotic molecules (K and H) are also important in the processing and export of most (if not all) hormones. Thus, by regulating K and H homeostasis, renin may regulate the endocrine system.

scholarly journals Continuous Infusion of Flumazenil in the Management of Benzodiazepines Detoxification

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Benini ◽  
Rossella Gottardo ◽  
Cristiano Chiamulera ◽  
Anna Bertoldi ◽  
Lorenzo Zamboni ◽  
...  
Keyword(s):  
Plasma Level ◽  
Hospital Admission ◽  
Continuous Infusion ◽  
Clinical Setting ◽  
Withdrawal Syndrome ◽  
Withdrawal Symptoms ◽  
High Dose ◽  
End Of Treatment ◽  
Before And After ◽  
Treatment Changes

An effective approach in the treatment of benzodiazepine (BZD) overdosing and detoxification is flumazenil (FLU). Studies in chronic users who discontinued BZD in a clinical setting suggested that multiple slow bolus infusions of FLU reduce BZD withdrawal symptoms. The aim of this study was to confirm FLU efficacy for reducing BZD withdrawal syndrome by means of continuous elastomeric infusion, correlated to drugs plasma level and patients' compliance.Methods: Seven-day FLU 1 mg/day subcutaneously injected through an elastomeric pump and BZDs lormetazepam, clonazepam, and lorazepam were assessed by HPLC-MS/MS in serum of patients before and after 4 and 7 days of FLU continuous infusion treatment. Changes in withdrawal severity were assessed by using the BZD Withdrawal Scale (BWS).Results: Fourteen patients (mean age ± SD 42.5 ± 8.0 years, 5 male and 9 female), admitted to the hospital for high-dose BZD detoxification, were enrolled in the study. Serum FLU concentrations significantly decreased from 0.54 ± 0.33 ng/ml (mean ± SD) after 4 days of treatment to 0.1 ± 0.2 ng/ml at the end of infusion. Lormetazepam concentrations were 502.5 ± 610.0 ng/ml at hospital admission, 26.2 ± 26.8 ng/ml after 4 days, and 0 at the end of treatment. BWS values decreased during FLU treatment temporal period. FLU was well-tolerated by patients.Conclusions: Elastomeric FLU infusion for BZD detoxification is a feasible administration device to maintain adequate, constant, and tolerated FLU concentrations for reducing BZD withdrawal symptoms.

scholarly journals Out-patient high-dose-rate endobronchial brachytherapy for palliation of lung cancer: an observational study

2016 ◽  
Vol 67 (3) ◽  
Author(s):  
A. Scarda ◽  
M. Confalonieri ◽  
C. Baghiris ◽  
S. Binato ◽  
R. Mazzarotto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Observational Study ◽  
Dose Rate ◽  
Malignant Tumour ◽  
High Dose Rate ◽  
Advanced Lung Cancer ◽  
High Dose ◽  
End Of Treatment ◽  
Co Morbidity ◽  
Central Airway

Background and Aim. Out-patient high-dose-rate endobronchial brachytherapy (HDREB) is a possible option in the palliation of symptoms in patients with advanced lung cancer, but literature data is limited and the technique is still under development in Italy. Our aim was to evaluate safety and effectiveness of out-patient HDREB for palliation of malignant endobronchial tumours in the context of a multidisciplinary approach. Methods. Out-patient HDREB sessions were scheduled at weekly intervals (500-1000 cGy per session) with prior Diodi-laser resection in some cases. Response was assessed bronchoscopically, clinically and functionally at the end of treatment and one month after the last HDREB session. Inclusion criteria was: histological evidence of malignant tumour not susceptible to surgical treatment for extension or co-morbidity. Results. 150 outpatient HDREB sessions were carried out on consecutive 35 patients (mean age 69 yrs, M/F 29/6) with symptoms due to central airway obstruction. A shortterm endoscopic response was observed in 15/28 patients. After delivering 2000 cGy dyspnoea decreased significantly. After one month cough decreased and haemoptysis disappeared. Palliation was obtained in all patients except one during. Lung function tests did not significantly improve after HDREB. No fatal complication occurred. A temporary radiation bronchitis was observed in six patients. Conclusions. This non-comparative, prospective observational study showed a palliative response of HDREB in most of patients with advanced endoluminal lung cancer. The safety of the procedure was good and the rate of non-fatal serious complications was very low.

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