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Often, the source of a musculoskeletal problem can be traced to an endocrine disorder. For example, carpal tunnel syndrome is not uncommon in patients who are pregnant or have diabetes, hypothyroidism, or acromegaly. Joint problems and arthritis are other common findings in diabetes, pregnancy, and hyperparathyroidism. Muscle weakness or stiffness is seen in both hypothyroidism and hyperthyroidism, and muscle wasting is a characteristic of adrenocorticoid insufficiency. Bone disorders are common with glucocorticoid excess, acromegaly, and hyperparathyroidism. Some presentations are a classic picture of a specific endocrine condition and are readily recognized if the index of suspicion is appropriately high.
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PMID:Musculoskeletal disorders. When are they caused by hormone imbalance? 194 4

The nonviability of fertilized eggs or the death of the embryo is a frequent event (34 to 60%). They are called recurrent or habitual in the case of more than 2 consecutive abortions. Maternal etiologic factors are discussed: Endocrine disorders (sexual hormones, diabetes, thyroid function), uterine congenital anomalies (septale uterus), uterine tumors (fibromyoma) and uterine synechia formation, cervical incompetence, infections (i.e. mycoplasma infections, chlamydia infection, cytomegalovirus, herpes simplex virus) and autoimmune-disease with antinuclear antibodies. According to the etiology the diagnostic procedures in cases of recurrent abortions consist of hormone analysis, basal body temperature, oral glucose tolerance test, thyroid function and endometrial biopsy. Sonographic examination of the uterus, hysterosalpingography, search for local and systemic infections and cytologic examination for genetic disorders of both parents are obligatory. At the end of the diagnostic scheme HLA-analysis of the parents must be included.
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PMID:[Differential diagnostic considerations in the assessment of habitual abortion]. 208 Jun 25

The face of many endocrine diseases is rapidly changing as early detection and intervention is achieved. Nevertheless, certain musculoskeletal symptoms can suggest a possible endocrinopathy. The clinician can expect the appearance of particular rheumatic problems during the course of a chronic endocrine disorder. This is especially germaine for diabetes and acromegaly, in which the disorder is controlled but not cured. Clearly hormones play a critical role in the development and expression of immunologic disease. Sex hormones and calcitriol have a direct effect on basic immunobiology (3). The rheumatoid synovium responds to parathyroid hormone and calcitriol in concert with local signals such as prostaglandins, interleukins, and interferon (2,77). Finally, the immune system plays a central role in the pathogenesis of several endocrine diseases. The thyroid diseases, Graves' disease and Hashimoto's disease are best studied. The mechanisms of Ia expression leading to immune destruction and lymphocytic infiltration of the gland will be applied to other endocrine disorders.
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PMID:The endocrine system and connective tissue disorders. 226 59

Many Authors agree about a relationship between higher estroprogestinic levels and periodontal inflammation. This study tries to define the relationship between oral contraceptives (OC) and specific gingival signs, like bleeding and plaque. 51 women (15 to 19 years) were studied while using OC, and 36 of the same age group were studied as controls. Only women who had no past medical history of hormone imbalance, diabetes mellitus or dentures were selected. The patients were examined at the beginning of the study and were assigned scores related to the amount of plaque, inflammation and pockets (Loe and Silness gingival index). Use of alcoholic beverages, medications, tobacco, and caffeine were also noted. The only significant difference between the control group and the women taking OC was cigarette smoking: 52.9% versus 41.6% respectively. The average time of treatment was 11.5+5 months. No changes were observed in the buccal and lingual mucosa in both populations. The plaque indexes were very close. The bleeding was significantly higher in the group using OC; same for the gingival index. Pockets deeper than 2 mm were present in 33.3% of the treated women, versus 13.8% of the controls. The results point out a significant direct relationship between OC and gingival inflammation after several months of use. It possible that by prolonging the length of the study the gingival lesions would become even more significant.
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PMID:[Drugs with contraceptive actions and periodontal status. Epidemiological survey]. 347 42

Careful evaluation was carried out in 93 men older than 50 with erectile dysfunction. Their mean age was 61 years and the disorder had been present for a mean of 4.5 years. While 14 men (15%) had psychosocial factors that may have been pertinent, only 2 scored poorly on an Affect Balance Scale and 3 were receiving psychoactive medications. Results of nocturnal penile tumescence were abnormal in 91%. In 39% penile-brachial pressure indices were suggestive of pelvic vascular disease and in 9% were consistent with a pelvic "steal syndrome." Pelvic or peripheral nerve conduction disorders were also commonly seen in 54%. Endocrinopathy may have contributed to the dysfunction in 35%. Twenty-one men had diabetes mellitus, two new cases of hypothyroidism were discovered and hypogonadism was diagnosed definitely in four and considered likely in five others. Coexisting medical conditions were found in more than 90% of the men, especially hypertension, use of antihypertensive medications and atherosclerotic disease. Previous prostatectomies (19%) and vasectomies (30%) were common in the surgical histories. Given the wide range of disorders uncovered in older men complaining of impotence, diagnostic study of potential causes may lead to a more rational approach for the evaluation and management of these men.
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PMID:Evaluation of impotence in older men. 401 64

As a result of the examination of 14500 children, living in the Rostov Region, data have been obtained, characterizing the level and nature of endocrine disturbance in rural children, being evaluated from such aspects as the individual physical and sexual development. Endocrine disease in the rural children (116.2 +/- 3.2%) does not exceed these abnormalities observed among the town children. The prevalence of endocrine diseases increases from 90.3 +/- 5.1% in the children, ranging in age from birth to 7 years old, to 143.2 +/- 5.3% in the schoolchildren. Girls are more often developing obesity (t = 4.2) and endocrine abnormalities (t = 4.6), whereas boys are suffering from delay of the growth (t = 3.5) and sexual maturation. The standard glucose tolerance test, performed in the children at a high risk of diabetes mellitus (with aggravated heredity in regard to diabetes mellitus and obesity of the II, III and IV stages) has revealed intolerance in 59% of the children, of whom 2.2% had diabetic type curves. Based on the data on endocrine abnormalities, a mode of the organization structure for the children's endocrinological service was developed.
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PMID:[Detection of endocrine pathology in children in a rural locale and the organization of their care]. 623 95

Endocrine disorders are important, potentially reversible causes of impotence. Impotence may be an early manifestation of hypopituitarism, nonfunctioning pituitary tumors, prolactin-secreting pituitary tumors, or hyperthyroidism. Treatment of these disorders, as well as many of the other endocrinopathies with which impotence may be associated, usually leads to restoration of libido and potency. When impotence is caused by the autonomic neuropathy of diabetes, however, treatment of the endocrinopathy rarely restores sexual function. Sex therapy or implantation of a penile prosthesis may be useful in selected patients with this cause of impotence.
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PMID:Endocrine causes of impotence. Optimistic outlook for restoration of potency. 662 11

Gastrointestinal endocrinology is the study of the hormonal regulation of digestion. A number of characterized polypeptide hormones have been localized in specific gastroenteropancreatic endocrine cells. The fact that some of these hormones are also found in nerve and brain cells has given rise to the concept of a gut-brain axis. The functional capacities of these endocrine cells are determined by their anatomic location; the luminal exposure of gastroenteric endocrine cells represents an additional avenue for stimulation and release that is not open to pancreatic endocrine cells. Gastroenteropancreatic hormones regulate carbohydrate metabolism, gastric acid secretion, pancreatic exocrine and gallbladder function, gastrointestinal motility and blood flow. These important regulatory hormones may in turn be controlled by a series of gastroduodenal releasing hormones.Diabetes mellitus is the most important metabolic disorder related to a gastroenteropancreatic hormone imbalance. Most tumours producing these hormones are of pancreatic origin and produce a number of hormones; insulinomas and gastrinomas are detected readily because of the serious metabolic distrubances they cause. Other instances of altered circulating concentrations of these hormones result from rather than cause the disease.The challenge of future study is to determine if postprandial changes in the plasma concentrations of these hormones are sufficient or necessary, or both, for the control of digestion.
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PMID:The gastrointestinal endocrine system. 698 56

Sixteen men with missing ejaculation were observed as outpatients in our department within the past years. Among these, four patients with retrograde ejaculation are included. Possible reasons for the missing ejaculation are operations in the genital region or the pelvis, and spinal cord injuries. Endocrine disorders, diabetes mellitus, drug dependence, and psychogenic alterations have to be discussed as etiologic factors. Secondary lack of ejaculation, which is acquired in later years of life, seems to have a poorer prognosis than the primary disease, which begins with puberty. This group of patients is well responsive to psychotherapy. Other therapeutic approaches are hormonal substitution, care of drug dependence, and treatment with sympathicomimetica in some cases of retrograde ejaculation.
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PMID:[Ejaculation inadequacy in sexual disorders]. 720 Sep 67

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. Recent prevalence estimates suggest that 5-10% of premenopausal women have the full-blown syndrome of hyperandrogenism, chronic anovulation, and polycystic ovaries. Evidence suggests that women with polycystic ovary syndrome have a unique disorder of insulin action and are at increased risk to develop non-insulin-dependent diabetes mellitus. Further, non-insulin-dependent diabetes mellitus in women with polycystic ovary syndrome has a substantially earlier age of onset (third to fourth decades) than it does in the general population (sixth to seventh decades). Studies assessing whether abnormalities in insulin action are intrinsic or secondary to the hormonal milieu have found that insulin-induced receptor autophosphorylation is markedly diminished in approximately 50% of polycystic ovary syndrome women. This defect is unique to women with polycystic ovary syndrome and is not seen in other common insulin-resistant states of obesity and non-insulin-dependent diabetes mellitus. In polycystic ovary syndrome women who have normal receptor autophosphorylation, it remains likely that signaling mechanisms downstream of the receptor are abnormal, since these women are also insulin resistant. This distinctive post-insulin-binding defect appears to be genetic, since it is present in cells removed from the in vivo environment for generations.
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PMID:Hyperandrogenic anovulation (PCOS): a unique disorder of insulin action associated with an increased risk of non-insulin-dependent diabetes mellitus. 782 39


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