Endocrinology and Metabolism Clinics of North America RSS feed: Current Issue. Endocrinology and Metabolism Clinics of North America updates you on the latest trends in patient management; keeps you up to date on the newest advances; and provides a sound basis for choosing treatment options. Each issue focuses on a single topic in endocrinology and metabolism and is presented under the direction of an experienced guest editor.http://www.endo.theclinics.com/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. Endocrinology and Metabolism Clinics of North America0889-8529383September 2009 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.endo.theclinics.com/article/PIIS0889852909000656/abstract?rss=yesContents10.1016/S0889-8529(09)00065-6Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6viiixhttp://www.endo.theclinics.com/article/PIIS0889852909000668/abstract?rss=yesForthcoming Issues10.1016/S0889-8529(09)00066-8Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6xxhttp://www.endo.theclinics.com/article/PIIS0889852909000590/abstract?rss=yes These issues contain a potpourri of endocrinological conditions important to the pediatric endocrinologist.ForewordDerek LeRoith10.1016/j.ecl.2009.07.004Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6xixiiihttp://www.endo.theclinics.com/article/PIIS0889852909000589/abstract?rss=yes The last issue of Endocrinology and Metabolism Clinics of North America dedicated to pediatric endocrinology was published in 2005. The great volume of significant scientific advances since then in endocrinology in general and pediatric endocrinology in particular has made it impossible to cover even the most salient advances in just one volume. Therefore, I am grateful to the editor, Dr. LeRoith, as well as the publisher for agreeing to produce a two-volume series on pediatric endocrinology.PrefaceRobert Rapaport10.1016/j.ecl.2009.07.003Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6xvxvihttp://www.endo.theclinics.com/article/PIIS0889852909000541/abstract?rss=yesIn the last few years, there have been remarkable advances in the development of new and more sophisticated genetic techniques. These have allowed a better understanding of the molecular mechanisms of genetically determined pediatric endocrine disorders and are paving the way for a radical change in diagnosis and treatment. This article introduces some of these concepts and some of the genetic techniques being used.Genomics in Pediatric Endocrinology—Genetic Disorders and New TechniquesAlfred Tenore, Daniela Driul10.1016/j.ecl.2009.06.001Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6471490http://www.endo.theclinics.com/article/PIIS0889852909000565/abstract?rss=yesThis article summarizes the ontogenesis and genetics of the thyroid with regards to its possible congenital dysfunction and briefly refers to the roles of the mother-placenta-fetal unit, iodine effect, and organic and functional changes of the negative feedback mechanism, as well as maturity and illness, in some forms of congenital hypo- and hyperthyroidism. This article also describes the published literature and the authors' data on the clinical aspects of congenital hypothyroidism, on the alternating hypo- and hyperthyroidism in the neonatal period, and on neonatal hyperthyroidism.Congenital Disorders of the Thyroid: Hypo/HyperFerenc Péter, Ágota Muzsnai10.1016/j.ecl.2009.07.002Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6491507http://www.endo.theclinics.com/article/PIIS0889852909000504/abstract?rss=yesEndocrine disorders are common in infants in the neonatal ICU. They often are associated with prematurity, low birth weight or very low birth weight, and small size for gestational age. They also frequently occur in infants who are critically ill or stressed. This article describes the most common conditions and current knowledge regarding management.Perinatal Endocrinology: Common Endocrine Disorders in the Sick and Premature NewbornSharon J. Hyman, Yeray Novoa, Ian Holzman10.1016/j.ecl.2009.06.005Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6509524http://www.endo.theclinics.com/article/PIIS0889852909000553/abstract?rss=yesThis article reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Most of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remains restriction of energy intake with lifestyle modification. There are few long-term studies of pharmacotherapeutic interventions for pediatric obesity. Bariatric surgical approaches are the most efficacious treatment but, because of their potential risks, are reserved for those with the most significant complications of obesity.Pediatric Obesity: Etiology and TreatmentMelissa K. Crocker, Jack A. Yanovski10.1016/j.ecl.2009.06.007Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6525548http://www.endo.theclinics.com/article/PIIS088985290900053X/abstract?rss=yesThe worldwide epidemic of childhood obesity in the last decades is responsible for the occurrence in pediatrics of disorders once mainly found in adults, such as the metabolic syndrome. A key factor in the pathogenesis of metabolic syndrome is insulin resistance, a phenomenon occurring mainly in obese subjects with a general resistance to the insulin effect only on carbohydrates metabolism. Given that the metabolic syndrome is driven by obesity, the prevalence of the latter will strongly influence the prevalence of metabolic syndrome. This article addresses the causes of metabolic syndrome and the relevance of obesity in the pediatric population.Metabolic Syndrome in Pediatrics: Old Concepts Revised, New Concepts DiscussedEbe D'Adamo, Nicola Santoro, Sonia Caprio10.1016/j.ecl.2009.06.002Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6549563http://www.endo.theclinics.com/article/PIIS0889852909000577/abstract?rss=yesChildren's growth is a hallmark of their normal development and the association between nutrition and linear growth in children is well accepted. Growth requires an adequate supply of many different nutritional factors, some form the “building materials,” whereas others play regulatory roles. In this article we describe the growth of the growth plate and discuss the role of nutritional affected hormones on this process. In addition we describe the effect of local regulators and nutritional factors on the growth process and suggest the involvement of new regulatory factors in the translation of nutrition to growth.Nutrition and Bone Growth in PediatricsGalia Gat-Yablonski, Michal Yackobovitch-Gavan, Moshe Phillip10.1016/j.ecl.2009.07.001Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6565586http://www.endo.theclinics.com/article/PIIS0889852909000498/abstract?rss=yesGrowth hormone is a widely used hormone. This article describes its historical use, current indications and studies for possible future uses.Growth Hormone: The Expansion of Available Products and IndicationsSherry L. Franklin, Mitchell E. Geffner10.1016/j.ecl.2009.06.006Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6587611http://www.endo.theclinics.com/article/PIIS0889852909000516/abstract?rss=yesThe approach to the child with growth retardation who is in puberty remains an important clinical challenge. The use of high-dose growth hormone (GH), suppression of puberty with GnRH analogs in combination with GH, and the use of selective inhibitors of the aromatase enzyme with aromatase inhibitors (also in combination with GH) are all therapeutic choices that have been studied. Aromatase blockade effectively blocks estrogen production in males with a reciprocal increase in testosterone, and a new generation of aromatase inhibitors, including anastrozole, letrozole and exemestane, is under investigation in adolescent subjects with severe growth retardation. This class of drugs, if judiciously used for a window of time, offers promise as an adjunct treatment of growth delay in pubertal patients with GH deficiency, idiopathic short stature, testotoxicosis, and other disorders of growth. These evolving uses of aromatase inhibitors, however, represent off-label use of the product, and definitive data on their efficacy are not available for each of the conditions mentioned. Safety issues regarding bone health also require further study.Strategies for Maximizing Growth in Puberty in Children with Short StatureNelly Mauras10.1016/j.ecl.2009.06.004Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6613624http://www.endo.theclinics.com/article/PIIS0889852909000528/abstract?rss=yesThe combination of targeted gene knockout studies in animals and human mutational analysis has demonstrated the key role of the IGF system in mammalian growth, both in utero and postnatally. The concept of IGF deficiency as a diagnostic category for children with growth failure first was proposed in the mid 1990s, and has gained support through the demonstration of patients with mutations in key components of the growth hormone (GH)-IGF axis, as well as the widespread use of IGF-I assays for evaluating short stature. The US Food and Drug Administration has approved IGF-I therapy for treating children who have severe primary IGF deficiency, defined as a height SD score ≤-3 and a serum IGF-1 SD score ≤-3, normal serum GH. Recent studies have demonstrated the efficacy and safety of IGF-I therapy in such patients, and investigations are in progress to determine optimal dosing. The availability of IGF-I therapy thus has expanded the therapeutic tool chest available to endocrinologists caring for children who have growth failure.Recombinant Human Insulin-Like Growth Factor-1 Treatment: Ready for PrimetimeGeorge M. Bright, Jessica R. Mendoza, Ron G. Rosenfeld10.1016/j.ecl.2009.06.003Endocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6625638http://www.endo.theclinics.com/article/PIIS088985290900067X/abstract?rss=yesIndex10.1016/S0889-8529(09)00067-XEndocrinology and Metabolism Clinics of North America 38, 3 (2009)2009-09-01Endocrinology and Metabolism Clinics of North America2009-09-01383S0889-8529(09)X0004-6639661