Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
A revised version of the American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer provides an important review of current data on therapeutic modalities and offers improved clinical strategies for the optimal management of these thyroid pathologies.
A systematic review and meta-analysis by Dekkers et al. has assessed the effects of dopamine agonist withdrawal in patients with hyperprolactinemia. But not all dopamine agonists are the same, and much depends on the criteria for patient selection and the drug withdrawal strategy.
Treatment of nonfunctioning neuroendocrine tumors with somatostatin analogs has been controversial, given the low antitumor effects of these drugs. The PROMID study group now reports that octreotide LAR (long-acting release) has a substantial antitumor effect, with longer progression-free survival compared with placebo in patients with well-differentiated neuroendocrine tumors and low tumor burden.
Cut-off values for the peak growth hormone level after an arginine plus growth hormone releasing hormone (Arg-GHRH) stimulation test for the diagnosis of growth hormone deficiency might require adjustment for young adults with obesity. Abdominal obesity is a stronger predictor of the growth hormone response to Arg-GHRH stimulation than BMI or age, and should be considered in adult patients who are evaluated for growth hormone deficiency.
Gastrointestinal surgery may ameliorate glycemic control in type 2 diabetes mellitus within days to weeks—an effect that cannot be explained solely by the changes in food intake and body weight following gastric bypass. Should clinicians, therefore, implement bariatric procedures to treat type 2 diabetes mellitus in patients who do not meet current obesity-based criteria for surgery?
Pheochromocytomas and paragangliomas are rare tumors, but their investigation and management are complex and expensive, both in terms of time and resources. A novel prospective study systematically compared different imaging techniques, and the results provide clinicians with valuable help in deciding the appropriate imaging strategy for patients with pheochromocytomas or paragangliomas.
Adipose tissue transplantation is increasingly being explored as a treatment strategy for metabolic disease—to promote the beneficial metabolic effects of subcutaneous white adipose tissue and brown adipose tissue, as well as those of adipose-derived stem cells. This Review summarizes the current available data on the biology of different adipose tissue depots and conceptualizes the future of adipose tissue transplantation and ongoing research.
Stereotactic radiosurgery can be performed to control tumor growth and hypersecretion of pituitary tumors, which are the most frequent type of intercranial tumors and lead to high rates of morbidity and mortality. Results of long-term studies of this treatment are discussed in this Review, with recommendations for therapeutic management.
The secretion of the SPARC protein by adipose tissue has been associated with obesity, insulin resistance and diabetes-related complications. Kos and Wilding discuss the effects of SPARC in the extracellular matrix and its role in subcutaneous adipose tissue fibrosis. They further discuss the effects of leptin, inflammation and hypoxia in the development of SPARC-mediated fibrosis and the possible contributions of this process to the pathology of obesity and obesity-related metabolic complications.
