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Shimon I.,Institute of Endocrinology and Metabolism | Shimon I.,Tel Aviv University
Pituitary | Year: 2015

Introduction: Cushing’s syndrome (CS) is a rare disease characterized by a collection of signs and symptoms, also common in the general population without elevated cortisol secretion. During the last years more patients with CS are identified earlier and with milder disease. Many of these patients are diagnosed during screening efforts performed for certain or isolated complaints like weight gain, diabetes mellitus (DM), hypertension, osteoporosis, elevated white blood cell counts and more.Methods: In this review article the most popular screening test performed in the studies cited was the 1-mg dexamethasone suppression test.Conclusions: Cushing is not frequent enough to support the use of routine screening in patients with morbid obesity and type 2 DM. Also only 1 % of hypertensive patients have secondary hypertension due to CS. However, screening should be considered in young patients with resistant DM and/or hypertension. Among patients with osteoporosis and vertebral fractures up to 5 % were diagnosed with subclinical hypercortisolism; most of these had adrenal adenoma. Screening for CS is important in subjects with adrenal incidentaloma, and many studies show a high prevalence (~10 %) of Cushing or subclinical CS in these patients. © 2015, Springer Science+Business Media New York. Source


Nikonenko A.G.,Bogomoletz Institute of Physiology | Bozhok Y.M.,Institute of Endocrinology and Metabolism
Cytometry Part A | Year: 2015

The nucleus of an eukaryotic cell is a membrane-bound organelle containing a major part of the cellular genome. Nuclear shape is controlled by forces generated in the cytoskeleton, nuclear envelope and matrix of the nucleus and may change when the balance of these forces is disturbed. In certain cases, such changes may be indicative of cell pathology. Nuclear shape feature is being commonly addressed in both experimental research and diagnostics; nevertheless its symmetry-related aspects receive little attention. This article introduces a technique allowing to estimate nuclear shape asymmetry in digital images captured from cyto- or histological preparations. Implemented in a software package, this technique quantifies the asymmetry using two scenarios. The first one presumes the identification of nuclear pixels laying outside the largest inscribed circle. According to the second scenario, the algorithm searches for nuclear pixels lacking pixel-partners symmetric with respect to the nuclear area's centroid. In both cases, the proportion of "asymmetric" pixels is used to estimate the feature of interest. The technique was validated on images of cell nuclei having distinctive shape phenotypes. A conclusion was made that shape asymmetry feature may be useful accessory to the toolbox of nuclear morphometry. © 2014 International Society for Advancement of Cytometry. Source


Levit S.,Institute of Endocrinology and Metabolism | Philippov Y.I.,Endocrinology Research Center | Gorelyshev A.S.,Endocrinology Research Center
Diabetes Mellitus | Year: 2013

Diabetes mellitus is a heterogeneous group of diseases that, although unified by a number of characteristics, require a differential therapeutic approach. Current review discusses key pathogenic features of type 2 diabetes mellitus that determine therapy goals and options in management. We further enunciate and pathogenetically substantiate a new «gravicentric» concept for treatment of type 2 diabetes mellitus that differs in many ways from the common contemporary approach. Source


Nikonenko A.G.,Bogomoletz Institute of Physiology | Bozhok Y.M.,Institute of Endocrinology and Metabolism
Diagnostic Cytopathology | Year: 2012

Fine-needle aspiration (FNA) cytology is widely used to examine thyroid lesions. However, its diagnostic accuracy is limited by the narrow choice of cytopathologic markers indicative of invasive/metastatic powers of a tumor. The aim of this study was to identify features that may serve as such indicators. We have examined FNA smears of 50 histologically proven papillary thyroid carcinoma (PTC) cases applying computer-assisted morphometry to assess patterns formed by PTC cells. Cytokeratine (CK) 8 immunocytochemistry was used to verify the epithelial origin of cells under study. All analyzed smears contained blood, histiocyte-like cells and CK8-positive follicular cells occurring both as single cells and in monolayer cell sheets. In 60% of cases we revealed cell sheets displaying two distinct cell patterns. The first one (pattern R) consisted of moderately pleomorphic, rather regularly arranged cells having an amphophilic cytoplasm. The second one (pattern I) was formed by highly pleomorphic cells with a basophilic cytoplasm. Patterns R and I were clearly different in cell size and shape as well as in nuclear size and shape. These patterns were never observed within the same cell sheet indicating that they may be formed by different subclones of tumor cells. Thus, it can be concluded that PTC frequently displays two definitely different cell patterns. We think that these patterns have a potential to serve as indicators for early events of an invasive/metastatic process. It remains to be seen whether the simultaneous occurrence of these patterns is a PTC-specific feature. Diagn. Cytopathol. 2012;40:E55-E61. © 2011 Wiley Periodicals, Inc. Copyright © 2011 Wiley Periodicals, Inc. Source


Landau Z.,Diabetes Unit | Klonoff D.,Diabetes Research Institute | Nayberg I.,Diabetes Research Institute | Feldman D.,Diabetes Unit | And 5 more authors.
Diabetes/Metabolism Research and Reviews | Year: 2014

Background: Previous studies have shown that heating the insulin injection site may accelerate insulin absorption. We investigated the pharmacological profile of insulin administered with InsuPatch, a local skin-heating device. Methods: In this randomized, crossover study carried out in 56 subjects with type 1 diabetes treated with insulin pump [mean age 32±13.5 years; 23 women; HbA1c:7.8±0.9% (62±10 mmol/mol) (mean+/-standard deviation)]. Euglycemic glucose clamps were performed after administration of 0.15 units/kg of short-acting insulin analogues. Each subject underwent three clamp procedures: two with the InsuPatch device (day 1 and day 3) and one without the device (day 1 control). The primary endpoints were the following: (1) the change in the area under the curve (AUC) of insulin during the first 60 min post-insulin bolus on day 1 with the InsuPatch device versus day 1 control and (2) parameters to assess the safety of using the device. Results: The area under the curve of insulin during the initial 60 min (insulin AUC0-60) after insulin bolus was increased by 29.7±7% on day 1 InsuPatch versus day 1 control (p<0.01). Maximal post-insulin bolus concentration was 57 mU/L on day 1 InsuPatch versus 47.6 mU/L on day 1 control (p<0.01). On day 3 InsuPatch, insulin AUC0-60 was increased by 27.9±72% versus day 1 InsuPatch (p<0.01). Maximal insulin concentration was 70.4 mU/L versus 57 mU/L, respectively (p=0.05). Conclusions: The use of the heating device upon administration of short-acting insulin analogues in pump-treated type 1 diabetic patients was found to enhance insulin absorption. This heating device may therefore serve to achieve better meal insulin coverage. © 2014 John Wiley & Sons, Ltd. Source

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