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Transfer of adolescents from pediatric care to adult endocrinology services represents a major medical issue. Unfortunately, however, many factors prevent effective transition. The authors of this Viewpoint discuss possible strategies—such as the creation of dedicated transition clinics—that might be implemented to ensure smooth transition to adult care.
In 1988, Barbara Sherwin reported that surgical menopause was associated with a marked decline in verbal memory and that treatment with estradiol immediately after surgery prevented this deficit. The author of this Viewpoint describes how our understanding of estrogen and neurocognitive function has evolved in the 20 years since that seminal report.
Alterations in the hypothalamic–pituitary–adrenal axis play an important part in survival of critically ill patients. The usefulness of currently available therapeutic interventions designed to correct these alterations is, however, unclear. This Review explains the response to stress in critically ill patients and discusses issues surrounding terminology and the role of glucocorticoids in therapy.
Thiazolidinediones are antihyperglycemic drugs used to treat diabetes that increase insulin sensitivity in adipose tissue, muscles and the liver to increase glucose use and decrease its production. They are known, however, to also affect bone. This Review examines the available data to assess the effect of these drugs on skeletal health.
Although osteoporosis can be effectively treated with inhibitors of bone turnover or with bone forming agents, few data are available about an optimum approach. Here, Papapoulos and Makras discuss whether choices can be made based on the available evidence, addressing issues such as selection of patients for treatment, efficacy in lowering fracture risk and monotherapy versus combined therapy.
Some patients with Turner syndrome have a karyotype showing mosaicism. This article describes the case of a boy with 45,X0/46,XY mosaicism, often referred to as mixed gonadal dysgenesis, who was evaluated for short stature. Different types of Turner syndrome mosaicism and their associated phenotypes, as well as the management of short stature in these patients, are discussed.
