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Type II diabetes is increasingly becoming a problem in Latin American countries such as Peru. People living with diabetes must incorporate several behavioral changes in their everyday lives, which are done outside the purview of medical professionals. Support from friends and family members is essential to the successful management of any chronic condition. Our study discusses the role of family involvement in supporting the management of diabetes among Peruvian men and examines how masculine norms play a role in the way such support is received and perceived, and their influence in motivation to adhere to treatment recommendations. In-depth interviews with 20 men from a low socioeconomic status, aged 27 to 68 with a diagnosis of Type II diabetes were conducted. Our analysis suggests the importance of the close, complex, and integrated experience that connects family members and patients with a chronic condition. Participant accounts demonstrate they receive multiple forms of support from a diverse range of social relationships. The overwhelming majority of the people giving the support were female and were especially significant in supporting management practices. The participants' accounts were able to demonstrate how living with a chronic condition, such as diabetes, affects the whole family-physically, mentally, and emotionally-and they experience the disease as one unit. Our study demonstrates the need for a family health experience approach that considers masculine gender norms around health and provides relevant insights to inform family-based treatments and therapies to allow for more and better targeted health care for men.

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Innovative techniques such as the "omics" can be a powerful tool for the understanding of intracellular pathways involved in homeostasis maintenance and identification of new potential therapeutic targets against endocrine-metabolic disorders. Over the last decades, proteomics has been extensively applied in the study of a wide variety of human diseases, including those involving the endocrine system. Among the most endocrine-related disorders investigated by proteomics in humans are diabetes mellitus and thyroid, pituitary, and reproductive system disorders. In diabetes, proteins implicated in insulin signaling, glucose metabolism, and ß-cell activity have been investigated. In thyroid diseases, protein expression alterations were described in thyroid malignancies and autoimmune thyroid illnesses. Additionally, proteomics has been used to investigate the variations in protein expression in adrenal cancers and conditions, including Cushing's syndrome and Addison's disease. Pituitary tumors and disorders including acromegaly and hypopituitarism have been studied using proteomics to examine changes in protein expression. Reproductive problems such as polycystic ovarian syndrome and endometriosis are two examples of conditions where alterations in protein expression have been studied using proteomics. Proteomics has, in general, shed light on the molecular underpinnings of many endocrine-related illnesses and revealed promising biomarkers for both their detection and treatment. The capacity of proteomics to thoroughly and objectively examine complex protein mixtures is one of its main benefits. Mass spectrometry (MS) is a widely used method that identifies and measures proteins based on their mass-to-charge ratio and their fragmentation pattern. MS can perform the separation of proteins according to their physicochemical characteristics, such as hydrophobicity, charge, and size, in combination with liquid chromatography. Other proteomics techniques include protein arrays, which enable the simultaneous identification of several proteins in a single assay, and two-dimensional gel electrophoresis (2D-DIGE), which divides proteins depending on their isoelectric point and molecular weight. This chapter aims to summarize the most relevant proteomics data from targeted tissues, as well as the daily rhythmic variation of relevant biomarkers in both physiological and pathophysiological conditions within the involved endocrine system, especially because the actual modern lifestyle constantly imposes a chronic unentrained condition, which virtually affects all the circadian clock systems within human's body, being also correlated with innumerous endocrine-metabolic diseases.

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MicroRNAs (miRNAs) are small endogenous non-coding RNA molecules capable of regulating gene expression at the post-transcriptional level either by translational inhibition or mRNA degradation and have recently been importantly related to the diagnosis and prognosis of the most relevant endocrine disorders. The endocrine system comprises various highly vascularized ductless organs regulating metabolism, growth and development, and sexual function. Endocrine disorders constitute the fifth principal cause of death worldwide, and they are considered a significant public health problem due to their long-term effects and negative impact on the patient's quality of life. Over the last few years, miRNAs have been discovered to regulate various biological processes associated with endocrine disorders, which could be advantageous in developing new diagnostic and therapeutic tools. The present review aims to provide an overview of the most recent and significant information regarding the regulatory mechanism of miRNAs during the development of the most relevant endocrine disorders, including diabetes mellitus, thyroid diseases, osteoporosis, pituitary tumors, Cushing's syndrome, adrenal insufficiency and multiple endocrine neoplasia, and their potential implications as disease biomarkers.

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BACKGROUND: Turner syndrome (TS) is a rare condition associated with a completely or partially missing X chromosome that affects 1 in 2500 girls. TS increases the risk of autoimmune diseases, including Graves' disease (GD). Moyamoya disease is a rare cerebral arteriopathy of unknown etiology characterized by progressive bilateral stenosis of the internal carotid artery and its branches. Both TS and GD have been associated with Moyamoya. Type 2 spinocerebellar ataxia (SCA2) is an autosomal dominant cerebellar ataxia caused by a CAG repeat expansion in ATXN2. We present the first case of Moyamoya syndrome in a patient with a previous diagnosis of TS and GD who tested positive for SCA2 and had imaging findings compatible with an overlap of SCA2 and Moyamoya. CASE PRESENTATION: A 43-year-old woman presented with mild gait imbalance for 2 years. Her family history was positive for type 2 spinocerebellar ataxia (SCA2). She had been diagnosed with Turner Syndrome (45,X) and Graves disease three years before. Brain MRI revealed bilateral frontal and parietal cystic encephalomalacia in watershed zones, atrophy of pons, middle cerebellar peduncles and cerebellum. MR angiography showed progressive stenosis of both internal carotid arteries with lenticulostriate collaterals, suggestive of Moya-Moya disease. Molecular analysis confirmed the diagnosis of SCA2. CONCLUSIONS: With increased availability of tools for genetic diagnosis, physicians need to be aware of the possibility of a single patient presenting two or more rare diseases. This report underscores the modern dilemmas created by increasingly accurate imaging techniques and available and extensive genetic testing.

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OBJECTIVES: To analyze the efficiency of a multigenic targeted massively parallel sequencing panel related to endocrine disorders for molecular diagnosis of patients assisted in a tertiary hospital involved in the training of medical faculty. MATERIAL AND METHODS: Retrospective analysis of the clinical diagnosis and genotype obtained from 272 patients in the Endocrine unit of a tertiary hospital was performed using a custom panel designed with 653 genes, most of them already associated with the phenotype (OMIM) and some candidate genes that englobes developmental, metabolic and adrenal diseases. The enriched DNA libraries were sequenced in NextSeq 500. Variants found were then classified according to ACMG/AMP criteria, with Varsome and InterVar. RESULTS: Three runs were performed; the mean coverage depth of the targeted regions in panel sequencing data was 249×, with at least 96.3% of the sequenced bases being covered more than 20-fold. The authors identified 66 LP/P variants (24%) and 27 VUS (10%). Considering the solved cases, 49 have developmental diseases, 12 have metabolic and 5 have adrenal diseases. CONCLUSION: The application of a multigenic panel aids the training of medical faculty in an academic hospital by showing the picture of the molecular pathways behind each disorder. This may be particularly helpful in developmental disease cases. A precise genetic etiology provides an improvement in understanding the disease, guides decisions about prevention or treatment, and allows genetic counseling.

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Abstract Objectives To analyze the efficiency of a multigenic targeted massively parallel sequencing panel related to endocrine disorders for molecular diagnosis of patients assisted in a tertiary hospital involved in the training of medical faculty. Material and methods Retrospective analysis of the clinical diagnosis and genotype obtained from 272 patients in the Endocrine unit of a tertiary hospital was performed using a custom panel designed with 653 genes, most of them already associated with the phenotype (OMIM) and some candidate genes that englobes developmental, metabolic and adrenal diseases. The enriched DNA libraries were sequenced in NextSeq 500. Variants found were then classified according to ACMG/AMP criteria, with Varsome and InterVar. Results Three runs were performed; the mean coverage depth of the targeted regions in panel sequencing data was 249×, with at least 96.3% of the sequenced bases being covered more than 20-fold. The authors identified 66 LP/P variants (24%) and 27 VUS (10%). Considering the solved cases, 49 have developmental diseases, 12 have metabolic and 5 have adrenal diseases. Conclusion The application of a multigenic panel aids the training of medical faculty in an academic hospital by showing the picture of the molecular pathways behind each disorder. This may be particularly helpful in developmental disease cases. A precise genetic etiology provides an improvement in understanding the disease, guides decisions about prevention or treatment, and allows genetic counseling.

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Background: Polycystic Ovary Syndrome (PCOS) often present metabolic disorders and hyperandrogenism (HA), facts that may influence the telomere length (TL). Aims: To compare the absolute TL (aTL) between women with PCOS and control women, and their association with the presence of obesity and HA parameters. Materials and methods: The PCOS group included 170 unrelated women outpatients and the control group, 64 unrelated donor women. Anthropometric, biochemical-clinical parameters and androgen profile were determined. The PCOS patients were divided accordingly to the presence of obesity and androgenic condition. The aTL was determined from peripheral blood leukocytes by Real Time quantitative PCR. Results: Women with PCOS exhibited a significantly longer aTL than controls after age adjustment (p=0.001). A stepwise multivariate linear regression in PCOS women, showed that WC (waist circumference) contributed negatively (b=-0.17) while testosterone levels contributed positively (b=7.24) to aTL. The non-Obese PCOS (noOB-PCOS) presented the longest aTL when compared to controls (p=0.001). Meanwhile, the aTL was significantly higher in the hyperandrogenic PCOS phenotype (HA-PCOS) than in the controls (p=0.001) and non hyperandrogenic PCOS phenotype (NHA-PCOS) (p=0.04). Interestingly, when considering obesity and HA parameters in PCOS, HA exerts the major effect over the aTL as non-obese HA exhibited the lengthiest aTL (23.9 ± 13.13 Kbp). Conversely, the obese NHA patients showed the shortest aTL (16.5 ± 10.59 Kbp). Conclusions: Whilst a shorter aTL could be related to the presence of obesity, a longer aTL would be associated with HA phenotype. These findings suggest a balance between the effect produced by the different metabolic and hormonal components, in PCOS women.

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BACKGROUND: Some maternal characteristics indicate worse prognosis in pregnant women with coronavirus disease 2019 (COVID-19). OBJECTIVE: To describe the prevalence of endocrine disorders in pregnancies involving COVID-19, and its impact on maternal outcomes. SEARCH STRATEGY: Search terms were "pregnancy" and "COVID-19". SELECTION: PubMed, Embase, medRxiv, and Cochrane worksheet from February to July 2020 were searched. DATA COLLECTION AND ANALYSIS: Articles describing endocrine disorders in pregnancies with and without COVID-19 involvement were considered. We performed meta-analyses of prevalence using random-effect models and estimated relative risk and 95% confidence intervals (CI) of maternal outcomes relative to presence of endocrine disorders. MAIN RESULTS: Articles included (n = 141) were divided into three data sets: individual (119 articles, 356 women), case series (17 articles, 1064 women), and national registries (7 articles, 10 178 women). Prevalence of obesity ranged from 16% to 46% and hyperglycemia in pregnancy (HIP) ranged from 8% to 12%. In data set 1, HIP and obesity were risk factors for severe disease in crude and age-adjusted models, although not for intensive care unit admission. In data from two national registries, risk of dying was 5.62 (95% CI 0.30-105.95) in women with diabetes and 2.26 (95% CI 1.03-4.96) in those with obesity. CONCLUSION: Obesity and HIP were prevalent in pregnant women with severe COVID-19.

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Background: Equine pituitary pars intermedia dysfunction, also known as equine Cushings syndrome, is a neurodegenerative disease. An important risk factor for Cushings is advanced aging and it is the most common endocrine disorder inolder horses. The prevalence in horses aged over 10 and 15 years is reported as 9.3% and 21%, respectively. Due to the slowprogressive nature of the disease, seasonal variation in hormone output and overlapping endocrine response to other events,accurate diagnosis is challenging. The diagnosis requires the combination of anamnesis, clinical signs, in addition to laboratory tests results. This study aimed to report Cushings syndrome in a Crioulo breed horse focusing on diagnostic methods.Case: A 13-year-old male Crioulo breed, orchiectomized, was attended at the Universidade de Passo Fundo (UPF), in PassoFundo, RS, Brazil. The owner reported that the animal had progressive weight loss and coat abnormal growth, with curlyappearance. From visual inspection, body condition score was 4 (1-9) bulging abdomen was noticed, hirsutism, depressionand lethargy. Also, there was a large neoplastic mass on the left side of gluteal region. Later, this mass was classified inhistopathological examination as a fibroblastic sarcoid and was treated. The animal presented physical parameters withinthe physiological limits of the specie. Normochromic normocytic anemia and neutrophilic leukocytosis were reported in thehematologic evaluation. In coproparasitological examination, there were 300 eggs per gram of feaces. Hyperadrenocorticismwas suspected in the clinical examination and dexamethasone suppression test was performed to confirm the fact. Basal serumwas collected at 17 h (M0) and subsequently 40 µg/kg of dexamethasone was administered intramuscular...(AU)

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Background: Equine pituitary pars intermedia dysfunction, also known as equine Cushing’s syndrome, is a neurodegenerative disease. An important risk factor for Cushing’s is advanced aging and it is the most common endocrine disorder inolder horses. The prevalence in horses aged over 10 and 15 years is reported as 9.3% and 21%, respectively. Due to the slowprogressive nature of the disease, seasonal variation in hormone output and overlapping endocrine response to other events,accurate diagnosis is challenging. The diagnosis requires the combination of anamnesis, clinical signs, in addition to laboratory tests results. This study aimed to report Cushing’s syndrome in a Crioulo breed horse focusing on diagnostic methods.Case: A 13-year-old male Crioulo breed, orchiectomized, was attended at the Universidade de Passo Fundo (UPF), in PassoFundo, RS, Brazil. The owner reported that the animal had progressive weight loss and coat abnormal growth, with curlyappearance. From visual inspection, body condition score was 4 (1-9) bulging abdomen was noticed, hirsutism, depressionand lethargy. Also, there was a large neoplastic mass on the left side of gluteal region. Later, this mass was classified inhistopathological examination as a fibroblastic sarcoid and was treated. The animal presented physical parameters withinthe physiological limits of the specie. Normochromic normocytic anemia and neutrophilic leukocytosis were reported in thehematologic evaluation. In coproparasitological examination, there were 300 eggs per gram of feaces. Hyperadrenocorticismwas suspected in the clinical examination and dexamethasone suppression test was performed to confirm the fact. Basal serumwas collected at 17 h (M0) and subsequently 40 µg/kg of dexamethasone was administered intramuscular...

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Resumen Antecedentes las enfermedades del sistema endocrino pueden afectar la sexualidad por sus efectos hormonales, las comorbilidades asociadas y su impacto psicosocial, tema poco estudiado desde las perspectivas de personas con estas enfermedades. Objetivos: se realizó un estudio cualitativo dirigido a comprender las experiencias sexuales de mujeres y varones con enfermedades endocrinas que producen cambios en la apariencia física. Método: se estructuró un diseño de estudio analítico-interpretativo. Participaron 68 personas entre 20 y 45 años de edad, atendidos en el Instituto Nacional de Endocrinología, La Habana, Cuba. Los instrumentos de recolección de la información utilizados fueron una planilla de datos generales, una guía de entrevista en profundidad y dos pruebas psicológicas proyectivas. Los aspectos éticos fueron considerados. Resultados: de las entrevistas en profundidad, emergieron 4 temas: 1) la expresión multidimensional de la enfermedad, 2) enfermedad y áreas de vida, 3) ejercicio de la sexualidad con la enfermedad, y 4) estrategias de afrontamiento en el área sexual; vinculados con los significados expresados sobre la salud, el cuerpo, el género y la sexualidad. Conclusiones: las/los participantes contextualizaron sus experiencias sexuales en el impacto biopsicosocial de la enfermedad. La reproducción o cuestionamiento de los significados expresados influyó en la calidad de sus experiencias sexuales. El estudio mostró que esta constituye un área de vulnerabilidad para la salud integral de las/los participantes.

Abstract Background endocrine disorders may affect sexuality due to hormonal changes, associated comorbidities and psychosocial impact. This topic remains poorly researched from the perspective of people with these conditions. Objectives: a qualitative research was conducted to understand the sexual experiences of women and men living with endocrine disorders that change their physical appearance. Methods: an analytical-interpretive study was carried out with a sample of 68 participants aged between 20 and 45, and treated at the National Institute of Endocrinology, Havana, Cuba. Data collection instruments were a personal information sheet, an in-depth interview guide and two projective psychological tests. Ethical aspects were considered. Results: in-depth interviews gave rise to four topics: 1) multidimensional expression of the disease, 2) the disease and life areas, 3) sexuality with the disease, and 4) coping strategies in the sexual area. These topics were linked to the meanings of health, body, gender and sexuality. Conclusions: the participants contextualized their sexual experiences within the biopsychosocial impact of the endocrine disorder, as well as the reproduction or questioning of the meanings that influenced the quality of their sexual experiences. The study showed that sexuality is a vulnerable area for the participants' comprehensive health.

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BACKGROUND: Fanconi anemia (FA) is a condition characterized by genetic instability and short stature, which is due to growth hormone (GH) deficiency in most cases. However, no apparent relationships have been identified between FA complementation group genes and GH. In this study, we thereby considered an association between FA and Laron syndrome (LS) (insulin-like growth factor 1 [IGF-1] deficiency). METHODS: A 21-year-old female Mexican patient with a genetic diagnosis of FA was referred to our research department for an evaluation of her short stature. Upon admission to our facility, her phenotype led to a suspicion of LS; accordingly, serum levels of IGF-1 and IGF binding protein 3 were analyzed and a GH stimulation test was performed. In addition, we used a next-generation sequencing approach for a molecular evaluation of FA disease-causing mutations and genes involved in the GH-IGF signaling pathway. RESULTS: Tests revealed low levels of IGF-1 and IGF binding protein 3 that remained within normal ranges, as well as a lack of response to GH stimulation. Sequencing confirmed a defect in the GH receptor signaling pathway. CONCLUSIONS: To the best of our knowledge, this study is the first to suggest an association between FA and LS. We propose that IGF-1 administration might improve some FA complications and functions based upon IGF-1 beneficial actions observed in animal, cell and indirect clinical models: erythropoiesis modulation, immune function improvement and metabolic regulation.

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The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador.

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Laminitis in horses is often associated with endocrine disorders, especially the pituitary pars intermedia dysfunction (PPID) in older animals. Morphologic exams of the laminar tissue of the hoof were performed in two horses with suspected PPID, with no clinical signs of laminitis. Changes compatible with laminitis of endocrine origin were observed, such as rounding of the nuclei of the basal cells, thinning and stretching of the secondary epidermal laminae and tissue proliferation. PPID horses with no clinical signs of laminitis may be affected by lesions of the laminar tissue of the hoof that compromise the integrity of the dermal-epidermal junction and may develop clinical symptoms of the disease. It has been suggested that the development stage of endocrine laminitis is longer, but further studies should be conducted to confirm it.

A laminite em cavalos está frequentemente associada a distúrbios endócrinos, como a disfunção da pars intermedia da pituitária (PPID) em animais mais velhos. Exames morfológicos do tecido laminar do casco foram realizados em dois cavalos com suspeita de PPID após o óbito, os quais não apresentaram sinais clínicos de laminite. Alterações compatíveis com a laminite de origem endócrina foram observadas, como arredondamento da núcleo das células basais, alongamento e afilamento das lâminas epidérmicas secundárias e proliferação tecidual. Cavalos com PPID sem sinais clínicos de laminite podem estar acometidos por lesões do tecido laminar do casco que comprometam a integridade das interdigitações dérmico-epidérmicas e podem desenvolver a sintomatologia clínica da doença. Sugere-se que o período de desenvolvimento da laminite endócrina seja mais longo, porém estudos adicionais devem ser realizados para confirmar essa hipótese.

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Introduction: More than 60 years after the introduction of modern psychopharmacology, electroconvulsive therapy (ECT) continues to be an essential therapeutic modality in the treatment of mental disorders, but its mechanism of action remains unclear. Hormones play an essential role in the development and expression of a series of behavioral changes. One aspect of the influence of hormones on behavior is their potential contribution to the pathophysiology of psychiatric disorders and the mechanism of action of psychotropic drugs and ECT. Objective: We measured blood levels of the hormone cortisol in patients with unipolar depression according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) and compared results with levels found in healthy adults. Method: Blood cortisol levels were measured before the beginning of treatment with ECT, at the seventh session, and at the last session, at treatment completion. Depression symptoms were assessed using the Beck Depression Inventory (BDI). Results: Cortisol levels remained stable in both men and women between the seventh and the last sessions of ECT; values ranged from 0.686±9.6330 g/dL for women, and there was a mean decrease of 5.825±6.0780 g/dL (p = 0.024). Mean number of ECT sessions was 12. After the seventh and the last ECT sessions, patients with depression and individuals in the control group had similar cortisol levels, whereas BDI scores remained different. Conclusion: Cortisol levels decreased during ECT treatment. ECT seems to act as a regulator of the hypothalamic-pituitaryadrenal axis. .

Introdução: Mais de 60 anos após a introdução da moderna psicofarmacologia, a eletroconvulsoterapia (ECT) continua essencial para o tratamento de distúrbios mentais, mas seu mecanismo de ação ainda não é totalmente conhecido. Certos hormônios têm um papel fundamental no desenvolvimento e expressão de uma série de alterações comportamentais. Um aspecto da influência dos hormônios nos comportamentos é sua contribuição potencial para a patofisiologia dos distúrbios psiquiátricos e o mecanismo de ação de psicotrópicos e da ECT. Objetivo: Os níveis do hormônio cortisol no sangue foram medidos em pacientes com depressão unipolar classificados de acordo com a 4ª edição do Manual Estatístico e Diagnóstico de Transtornos Mentais (DSM-IV), e os resultados foram comparados com os níveis encontrados em adultos saudáveis. Métodos: Os níveis de cortisol no sangue foram medidos antes do início do tratamento com ECT, na sétima e na última sessão, após a conclusão do tratamento. Os sintomas de depressão foram avaliados usando o Inventário de Depressão de Beck (BDI). Resultados: Os níveis de cortisol permaneceram estáveis tanto nos pacientes masculinos quanto femininos entre a sétima e a última sessão de ECT; os valores variaram 0,686±9,6330 g/ dL entre as pacientes femininas, e houve uma diminuição de 5,825±6,0780 g/dL (p = 0,024). O número médio de sessões de ECT foi 12. Após a sétima e a última sessão de ECT, os níveis de cortisol nos pacientes com depressão e nos indivíduos no grupo controle foram semelhantes, enquanto os resultados da escala BDI permaneceram diferentes. Conclusão: Os níveis de cortisol diminuíram durante o tratamento com ECT. A ECT parece atuar como reguladora do eixo hipotalâmico-hipofisário-adrenal. .

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Laminitis in horses is often associated with endocrine disorders, especially the pituitary pars intermedia dysfunction (PPID) in older animals. Morphologic exams of the laminar tissue of the hoof were performed in two horses with suspected PPID, with no clinical signs of laminitis. Changes compatible with laminitis of endocrine origin were observed, such as rounding of the nuclei of the basal cells, thinning and stretching of the secondary epidermal laminae and tissue proliferation. PPID horses with no clinical signs of laminitis may be affected by lesions of the laminar tissue of the hoof that compromise the integrity of the dermal-epidermal junction and may develop clinical symptoms of the disease. It has been suggested that the development stage of endocrine laminitis is longer, but further studies should be conducted to confirm it.(AU)

A laminite em cavalos está frequentemente associada a distúrbios endócrinos, como a disfunção da pars intermedia da pituitária (PPID) em animais mais velhos. Exames morfológicos do tecido laminar do casco foram realizados em dois cavalos com suspeita de PPID após o óbito, os quais não apresentaram sinais clínicos de laminite. Alterações compatíveis com a laminite de origem endócrina foram observadas, como arredondamento da núcleo das células basais, alongamento e afilamento das lâminas epidérmicas secundárias e proliferação tecidual. Cavalos com PPID sem sinais clínicos de laminite podem estar acometidos por lesões do tecido laminar do casco que comprometam a integridade das interdigitações dérmico-epidérmicas e podem desenvolver a sintomatologia clínica da doença. Sugere-se que o período de desenvolvimento da laminite endócrina seja mais longo, porém estudos adicionais devem ser realizados para confirmar essa hipótese.(AU)

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Human T-cell leukemia virus type 1 (HTLV-1) infection is endemic in Japan and several countries in South America, Caribbean and Africa. Endocrine and metabolic disorders have been variably reported to be associated with human T-cell leukemia virus type 1 (HTLV-1) infection. Therefore, the aim of this article was to critically evaluate the current knowledge of the endocrine and metabolic disorders associated with HTLV-1 infection. The literature search used PubMed, Web of Science, and LILACS databases in the past 10 years, utilizing, in various combinations, the following keywords: HTLV-1, adult T-cell leukemia, diabetes mellitus, GLUT-1, osteoporosis, hypercalcemia, autoimmune thyroid disorders, diabetes insipidus, inappropriate antidiuretic hormone secretion; pseudohypoparathyroidism; pseudopseudohypoparathyroidism. The proven endocrine manifestations of the HTLV-1 infection are calcium disorders which occur in some patients with acute HTLV-1/Adult T-cell leukemia/lymphoma. The few reports about thyroid, parathyroid, antidiuretic hormone and diabetes mellitus are insufficient to prove a causal association with HTLV-1 infection. The evidence for an association between endocrine disorders and HTLV-1 infection in general, and in asymptomatic patients is lacking. Given all these uncertainties, the endocrine expression of the HTLV-1 infection composes a promising research line for understanding the pathophysiology of this infection.

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Los niños y adolescentes sobrevivientes de cáncer pueden presentar a largo plazo alteraciones endocrinas como consecuencia del tratamiento antineoplásico recibido. Con el objeto de identificar en forma temprana estos efectos tardíos, se presenta una guía práctica que permite realizar un seguimiento desde el punto de visto endocrino, evaluando los factores de riesgo y las complicaciones tardías potenciales que puedan desarrollarse de acuerdo al agente terapéutico utilizado y su dosis. Las alteraciones en el crecimiento, especialmente las causadas por la radioterapia y/ o cirugía craneal, los desórdenes de la pubertad e infertilidad como consecuencia de la quimioterapia, y la osteopenia, son algunas de las endocrinopatías más relevantes. La implementación de un tratamiento hormonal temprano ofrece la oportunidad de optimizar el crecimiento, brindar bienestar y mejorar la calidad de vida al paciente con cáncer en remisión.

Childhood cancer survivors can manifest late endocrine effects after completion of cancer therapy. In order to make an early identification of long-term endocrine sequelae, we present a practical guideline for the follow-up and assessment of the risk factors and potential late complications that will develop in relation to the therapeutic agent used and its dose. Growth impairment due to brain irradiation and/or surgery, pubertal disorders and infertility caused by chemotherapy, and osteopenia, are some of the most prevalent endocrinopathies. Early hormonal treatment can lead to enhance growth rate, available stamina and improve quality of life of the patient with cancer in remission.