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Saint-André-lez-Lille, France

D'Herbomez M.,Lille 2 University of Health and Law | Do Cao C.,Center Hospitalier Of Lille | Vezzosi D.,Service dendocrinologie | Borzon-Chasot F.,Federation dEndocrinologie | Baudin E.,Institute Gustave Roussy
Annales d'Endocrinologie | Year: 2010

Chromogranins belong to the family of secretory chromogranin and secretogranin proteins. They are found in secretory vesicles throughout the neuroendocrine system. Chromogranin A (CgA) is the main component. CgA acts as a prohormone submitted to processes of degradation through which active peptides are generated. CgA has auto, para and endocrine functions. It is widely used as an immunohistochemical marker. Despite the lack of international standardization, and the lack of an accurate definition of the diagnostic cut-off levels, some CgA assays are reliable. Numerous studies have suggested that CgA determination may be of interest for the diagnosis and the follow-up of various endocrine tumors. Plasma levels of this general marker are proportional to tumor mass. The localization of the primitive tumor, the presence of associated hormonal secretions and possible renal failure and/or hypergastrinemia must be taken into consideration for proper interpretation of CgA levels. New clinical indications are emerging for the evaluation of stress in intensive care units and the assessment of cardiovascular risk. New assays estimating the concentration of active peptides are under development. © 2010 Elsevier Masson SAS. Source

Conway G.,University College London | Dewailly D.,Center Hospitalier Of Lille | Diamanti-Kandarakis E.,National and Kapodistrian University of Athens | Escobar-Morreale H.F.,University of Alcala | And 10 more authors.
European Journal of Endocrinology | Year: 2014

Background: There is evidence for differences between endocrinologists and other specialists in their approach to diagnosis and management of the polycystic ovary syndrome (PCOS). Objective: A mailed survey consisting of a simple questionnaire aiming to understand current practice for diagnosis and management of the PCOS by specialists across Europe.Methods: The questionnaire consisted of 23 questions grouped to achieve information on i) the general characteristics of the respondents, ii) patients with PCOS seen by endocrinologists, iii) the main diagnostic criteria, iv) biochemical parameters used in the differential diagnosis of hyperandrogenism, v) long-term concerns, and, finally vi) treatment choices. A total of 357 questionnaires representing 13.3% of the members of European Society of Endocrinology (ESE) were available for final analysis; 93% of the respondents were endocrinologists.Results: In relation to the diagnostic criteria, respondents were most likely to select menstrual irregularity as the most frequent criteria used for the diagnosis of PCOS although very high rates were achieved for the use of hirsutism and biochemical hyperandrogenism. It therefore appears that the NIH criteria were followed by the majority of respondents. The most frequent biochemical parameters in the differential diagnosis of hyperandrogenism were total testosterone or free androgen index.Obesity and type 2 diabetes were regarded as the principal long-term concerns for PCOS. The most common treatments for patients with PCOS were metformin (33%), lifestyle modification (25%), and oral contraceptives (22%). More direct treatments of infertility include clomiphene citrate alone or in combination with metformin, prescribed by 9 and 23%, respectively, whereas only 6% used other methods for induction of ovulation. © 2014 European Society of Endocrinology. Source

Conway G.,University College London | Dewailly D.,Center Hospitalier Of Lille | Diamanti-Kandarakis E.,National and Kapodistrian University of Athens | Escobar-Morreale H.F.,University of Alcala | And 9 more authors.
European Journal of Endocrinology | Year: 2014

Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. Great efforts have been made in the last 2 decades to define the syndrome. The presence of three different definitions for the diagnosis of PCOS reflects the phenotypic heterogeneity of the syndrome. Major criteria are required for the diagnosis, which in turn identifies different phenotypes according to the combination of different criteria. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype andplanning potential therapeutic strategies in an affected subject. This paper offers a critical endocrine and European perspective on the debate on the definition of PCOS and summarises all major aspects related to aetiological factors, including early life events, potentially involved in the development of the disorder. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. We have also paid specific attention to the role of obesity, sleep disorders and neuropsychological aspects of PCOS and on the relevant pathogenetic aspects of cardiovascular risk factors. In addition, we have discussed how to target treatment choices based according to the phenotype and individual patient's needs. Finally,wehave suggested potential areas of translational and clinical research for the future with specific emphasis on hormonal and metabolic aspects of PCOS. © 2014 European Society of Endocrinology. Source

Sarkozy C.,University of Versailles | Terre C.,Center Hospitalier Of Versailles | Jardin F.,French Institute of Health and Medical Research | Radford I.,Necker Hospital | And 14 more authors.
Genes Chromosomes and Cancer | Year: 2014

Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. © 2013 Wiley Periodicals, Inc. Source

Rolland A.-L.,Center Hospitalier Of Lille | Dewailly D.,Center Hospitalier Of Lille
Medecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie | Year: 2015

A metabolic syndrome with insulin resistance is found in 60-70% of women with polycystic ovary syndrome (PCOS). This insulin resistance is now recognized as an aggravating factor of PCOS through compensatory hyperinsulinemia. The management of insulin resistance is based mainly on lifestyle and dietary rules. The insulin-sensitizing agents such as metformin, are indicated in cases of glucose intolerance and of course diabetes type 2. However, other molecules show promise, including myo-inositol (MYO). This molecule has an insulin-like action in vivo by acting as intracellular mediator of insulin by means of inositolphosphoglycans. In PCOS, there would be a deficit in MYO at the ovarian level, exacerbating the symptoms. A number of studies suggest indeed that supplementation by MYO improves hyperandrogenism and PCOS cycle disorder but not all are comparative and the small number of patients does not confer great power. During ovulation stimulation by recombinant FSH, supplementation by MYO seems to greatly reduce the risk of multifollicular development and cycle cancellation, as well as the duration of stimulation and the total dose of recFSH. During stimulation for IVF, MYO improves oocyte quality and thus the embryo quality for obtaining more pregnancies. However, none of the studies has sufficient patient number to conclude definitively. Further studies on larger cohorts, comparative, randomized, double-blind would therefore be necessary to assess the best the effects of MYO in PCOS. Source

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