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Gamma Knife® radiosurgery is widely used to treat patients with pituitary adenoma. Although this procedure has a high success rate, it is also associated with potential complications, including visual dysfunction. This Viewpoint considers whether the benefits of Gamma Knife®surgery outweigh the risks.
Hypertension and heart failure can be treated with mineralocorticoid-receptor antagonists, although therapy is associated with an increased incidence of hyperkalemia. Data from three influential clinical trials—RALES, EPHESUS and 4E—are described and the findings discussed within the context of mineralocorticoid-receptor biology.
Proglucagon-derived peptides from the pancreas and gut regulate various aspects of energy homeostasis, with many potential therapeutic applications—glucagon is used to treat hypoglycemia, and researchers are testing glucagon antagonists and glucagon-derived peptide 1 receptor (GLP-1R) agonists to treat type 2 diabetes, and a GLP-2 analogue to treat short-bowel syndrome.
Thyroid-cell proliferation depends on TSH; suppression of TSH with levothyroxine decreases progression and recurrence rates for thyroid cancer. Long-term TSH suppression benefits patients at high risk of cancer recurrence but not low-risk patients, so TSH levels should be targeted accordingly.
Turner syndrome is a common genetic disorder that leads to a wide range of endocrine and other abnormalities, but no firm diagnostic guidelines exist. Growth hormone and hormone-replacement therapy can correct the major features, but the long-term consequences of such treatments are unknown.
