why endocrinology

48 Pages·2016·18.97 MB·English

THE YEAR OF ENDOCRINOLOGY: PEDIATRIC ENDOCRINOLOGY
JULY 2016 THE LEADING MAGAZINE FOR ENDOCRINOLOGISTS
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THE IMPORTANT ROLE OF ENDOCRINE
SCIENCE IN THE HEALTH AND
DEVELOPMENT OF CHILDREN
• Tipping the Scales: Sedentary kids and
their risk of developing diabetes as adults.
• Young & Restless: What’s the real link
between hyperactive kids and broken bones?
• Growing Concerns: The ongoing debate
linking growth hormone to strokes.
• Mind the Gap: Navigating the rocky
road of transitioning pediatric patients
to adult care.
WWHHYY EENNDDOOCCRRIINNOOLLOOGGYY::
Angel Nadal, PhD, on winning a game of chance.
JJOOLLLLYY GGOOOODD FFEELLLLOOWWSS::
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IN THIS ISSUE
JULY 2016
FEATURE
|
18
Growing Concerns
Ever since a French study linked growth hormone
therapy to strokes two years ago, the debate
has raged on in the endocrinology community.
While most agree that more studies are needed,
researchers disagree on how to proceed.
BY DEREK BAGLEY
FEATURE FEATURE FEATURE
| | |
24 28 34
Tipping the Mind the Gap Young &
Scales Restless
As a pediatric patient transitions to adult
care, the challenges can be overwhelming,
It’s not unusual when research proves not just for the patients…but also for the A new study shows that there’s a link
the benefi ts of what parents have been clinician. Maneuvering through this often between kids with ADHD and broken
telling kids for generations: “Go outside arduous transition takes skill, compassion, bones…but it may not be the link you
and play!” Mom was right: sedentary kids and, most importantly, patience. think it is.
have a higher risk for getting diabetes in
adulthood, according to a new study. BY DEREK BAGLEY BY MARK A. NEWMAN
BY KELLY HORVATH
ENDOCRINE NEWS | JULY 2016 | 1
JULY 2016
FROM THE EDITOR
Pediatric Endocrinology:
The Kids Aren’t All Right THE LEADING MAGAZINE FOR ENDOCRINOLOGISTS
Editor: Mark A. Newman
J [email protected]
Associate Editor: Derek Bagley
ULY MARKS THE HALFWAY POINT IN THE YEAR OF ENDOCRINOLOGY [email protected]
as we continue to celebrate the Endocrine Society’s centennial. And it seems Art Director/Design: Catherine Neill Juchheim,
CNJ Creative, LLC
fi tting that we are spotlighting pediatric endocrinology in this issue as the Society
www.cnjcreative.com
prepares to look forward, since the fi rst year of our second 100 years is only a few
Production Manager: Cynthia Richardson
months away. [email protected]
Prepress & Printing: Cenveo Publishing Services
www.cadmus.com
On page 18, associate editor Derek Bagley tackles the debate surrounding the possible
link between administering growth hormone in children and the chance of stroke Endocrine News is a registered trademark owned by the
Endocrine Society.
in these patients later in life aft er attending a session on this topic at ENDO 2016 in
Endocrine News informs and engages the global
Boston in April. In “Growing Concerns” he talks to the authors of the French study endocrine community by delivering timely, accurate,
that sparked this debate as well as other experts in the growth hormone fi eld. One of and trusted content covering the practice, research, and
profession of endocrinology.
the original authors of the study, Jean-Claude Carel, MD, head of the Department of
Pediatric Endocrinology at Robert Debré Hospital in Paris, France, says that despite
the recommendation of the Endocrine Society to perform more rigorous studies, he
feels that his study’s original fi ndings “could be true and [we should] keep working
on it.”
When I fi rst read “Tipping the Scales,” (p. 24), Kelly Horvath’s article about how President: Henry M. Kronenberg, MD
[email protected]
sedentary kids have a higher risk for getting diabetes in adulthood, I had to admit that
President-Elect: Lynnette K. Nieman, MD
I wondered how I was spared, since one of my summer activities as a kid in Jackson, [email protected]
Ala., was watching All in the Family reruns while eating a pillow-sized bag of Golden Past President: Lisa H. Fish, MD
lisafi [email protected]
Flake potato chips! I think it helped that in my early teens I participated in marching
Secretary-Treasurer: Richard S. Legro, MD
band thus shedding many unwanted pounds. In the article, there are several valid [email protected]
points made that seem like common sense, such as a comment from Casey Crump Chief Executive Offi cer: Barbara Byrd Keenan, FASAE, CAE
[email protected]
MD, PhD, Icahn School of Medicine, Mount Sinai Hospital, New York, N.Y., who says
Chief Publications Offi cer: Richard O’Grady, PhD, CAE
that “Exercise requirements are higher for youth because it's a period of rapid growth,
[email protected]
and more exercise is needed in order for muscles, bones, and the cardiovascular
Th e mission of the Endocrine Society is to advance
system to grow and develop properly.” Which is a better way of saying, “Put down the
excellence in endocrinology and promote its essential and
potato chips and go outside!” integrative role in scientifi c discovery, medical practice,
and human health.
Derek has a second feature in this issue on the diffi culty of transitioning young patients
from pediatric to adult care and the challenges faced by not just the patient but by the Endocrine News® is published 12 times a year
by the Endocrine Society, 2055 L Street, NW,
clinicians as well. In “Mind the Gap” (p. 28) Derek spoke to clinician Carol Greenlee, Suite 600, Washington, DC 20036
Phone [phone] • Fax [phone]
MD, of Western Slope Endocrinology in Grand Junction, Colo., who says that she
www.endocrine.org.
has seen too many patients develop complications simply because there was not a
Print ISSN 2157-2089 Online ISSN 2157-2097
smooth continuity of from childhood into adulthood. “What hurts my heart most is Copyright © 2016 by the Endocrine Society.
All rights reserved.
the personal cost. I’ve seen people resurface in their 30s aft er what I call ‘wandering
in the wilderness’ for 10 years [of not getting adequate care as a young adult],” she • Please send letters to the editor, comments, and suggestions for
Endocrine News® to [email protected].
says. “And then they show up again and they’ve got protein in their urine, they’ve got
• Product print and product online display advertising,
by Pharmaceutical Media, Inc., contact Joe Schuldner,
retinopathy, and your heart just sinks and you feel so sad. Th at causes the cost that I
[email protected], or John Alberto, [email protected].
think all of us would like to stop.” • For classifi ed print advertising by Pharmaceutical Media, Inc.,
Dan Simone, [email protected]
• For classifi ed online advertising by [email protected]
— Mark A. Newman, Editor, Endocrine News Th e statements and opinions expressed in Endocrine News® are those
of individual authors and do not necessarily refl ect the views of the
Endocrine Society.
Advertising appearing in this publication does not constitute
endorsement of its content by Endocrine News or the Endocrine Society.
2 | JULY 2016 | ENDOCRINENEWS.ORG
IN THIS ISSUE
JULY 2016
24
15 28
34
38
2 | FROM THE EDITOR 13 | ENDOCRINE ITINERARY 40 | ADVOCACY
Pediatric Endocrinology: The Kids Endocrinology meetings that span NIH gets a $2 billion funding boost;
Aren’t All Right the globe. NIDDK, NICHD advisory councils
www.endocrine.org
discuss global health; AMA
4 | PRESIDENT’S VIEWPOINT 14 | DASHBOARD approves Society-supported policies
Become an Advocate Highlights from the world of at its annual meeting; European Follow us on Twitter:
endocrinology. Commission's overreaching @Endocrine_News
6 | WHY ENDOCRINOLOGY? decision fails to protect public
A Game of Chance 15 | TRENDS & INSIGHTS health.
BY ANGEL NADAL, PHD A look at the latest research
43 | HORMONE HEALTH
8 | INTOUCH 38 | PRACTICE RESOURCES NETWORK
Meet Krista Kirk, the Society's new THE LEARNING CURVE Bariatric surgery and adolescents
HR chief; ICE-CSE 2016 hosts The Endocrine Society introduces
First Joint Global Symposium the Fellows Training Series, a new 45 | CLASSIFIEDS
on Obesity; the evolving Society educational series that benefi ts Career opportunities
Publications; EndoCares launches both clinical trainees and program
in Peru. directors.
BY KELLY HORVATH
ENDOCRINE NEWS | JULY 2016 | 3
PRESIDENT’S VIEWPOINT
Become an Advocate
Endocrine Society President Henry
M. Kronenberg, MD, meets with
Congressman Joe Kennedy (D-MA)
during the Society's Hill Day in April.
T
HE ENDOCRINE SOCIETY REPRESENTS MORE Th is past April, I joined several Endocrine Society
than 18,000 scientists and clinicians through colleagues in Washington, D.C. for a Hill Day in which
advocacy with policy makers around the globe. Our policy we met with congressional offi ces to discuss the need to
priorities include: extend Medicare coverage to continuous glucose monitors
and the value of endocrine research. One of the high
• Urging the U.S. Congress to points of the day for me was meeting
“
provide substantial, sustainable, with Congressman Joe Kennedy (D-
and predictable federal funding for MA), and hearing his appreciation of the
biomedical research; ...It’s not enough Society and what we do. He couldn’t stress
enough what a diff erence it makes to have
• Infl uencing the European for organizations researcher and physician constituents
Commission’s impact assessment like ours to weigh in on important policy issues. I
on endocrine disrupting chemicals also saw fi rsthand the impact we have –
advocate for
(EDCs); and by the end of the day we had successfully
science and convinced several members of Congress
• Working with policy makers to support legislation; these actions
practice — policy
worldwide to improve access to care happened simply because we shared our
for all our patients. makers want perspective with them.
In addition, the Society works on a to hear from Another example of how Society
wide spectrum of policy issues that members are shaping policies relevant
constituents, too.
have enormous impact on our members to researchers is our ongoing work with
”
from physician payment to quality the National Institutes of Health (NIH).
improvement, coverage of new medical In May, for example, we visited with
technologies and treatments, rules on the director of the National Institute
government travel to scientifi c conferences, and the of Child Health and Development (NICHD). NICHD is
inclusion of female animals, tissues, and cell lines in basic the second largest source of funding from NIH for our
research. members. Society members Richard Legro and Carole
4 | JULY 2016 | ENDOCRINENEWS.ORG
PRESIDENT’S VIEWPOINT
Your Advocacy
Toolkit
Mendelson shared our priorities and concerns with the
senior leadership of the Institute, particularly the need to
TAKE ACTION
maintain support for the next generation of researchers.
NICHD acting director, Catherine Spong, assured us that
The Society sends action alerts when policy makers
moving forward the NICHD will have a greater focus on
are making policy decisions. Consider taking action.
individual awards to trainees.
WRITE TO CONGRESS
In June, Society members, Jean-Pierre Bourguignon and
Richard Ivell, participated in meetings of the Organisation
Visit the Society’s online legislative action center to
fi nd current advocacy campaigns you can participate for Economic Cooperation and Development (OECD)
in at endocrine.org/advocacy in Paris, France, providing input on adverse outcome
pathways for EDCs. Adverse outcome pathways may be
SHARE YOUR STORY used by international and national regulatory bodies in
developing chemical management strategies. Our members
Newspaper commentaries and letters to the editor were the only endocrinologists participating and played an
are widely read by elected offi cials, their aides, and important role as scientifi c experts in these deliberations.
the public. Contact the Society’s media relations
staff to learn opportunities to share your story. Th e Endocrine Society has a robust advocacy program
and our staff continuously advocates on our behalf, but
ATTEND A LOCAL MEETING
it’s not enough for organizations like ours to advocate for
science and practice — policy makers want to hear from
Elected offi cials often host town halls to share ideas
constituents, too. For areas in which you have an interest
and concerns. It is a great opportunity to present
or an important stake, I strongly encourage you to lend
your view.
your voice and participate in advocacy. Th e Endocrine
Society’s Advocacy and Public Outreach Core Committee
CONNECT ON SOCIAL MEDIA
and its Government & Public Aff airs Department are
dedicated to helping Society members take an active role in
Social media has changed the way the public
advocacy. Contact the Society’s government aff airs team at
communicates with policy makers. Join the
[email protected] for more information and
conversation on Twitter by following
assistance with getting involved.
@TheEndoSociety
VOLUNTEER ON A COMMITTEE Th ere are many ways to advocate, ranging from meeting
your legislator to attending a campaign event or town hall
OR TASK FORCE
meeting. Th e adjacent chart contains examples of how you
can become an advocate.
Several Society committees and task forces
participate in advocacy eff orts. Contact
[email protected] and let us know — Henry M. Kronenberg, MD, President,
the issues that interest you. Endocrine Society
ENDOCRINE NEWS | JULY 2016 | 5
WHY ENDOCRINOLOGY?
A Game of Chance
BY ANGEL NADAL, PHD, Professor of Physiology, CIBERDEM and Institute of Bioengineering,
Miguel Hernandez University, Elche (Alicante), Spain
I
never planned a career in endocrinology. It has been Th en chance played its role. Just aft er fi nishing my
the result of my interest in basic research and chance. degree, I assisted with a neuroscience course in Valencia,
Since very early I was interested in the components of on the Mediterranean coast of Spain. Th e course was
matter and how they react and transform. Chemistry was, world-class, plenty of excellent neuroscientists from
therefore, the best election to study a degree. In the 1980s, all over the world, including the Nobel laureate, Prof.
Bachelor studies in Spain had a duration of David Hubel. I was impressed by a
“
fi ve years (they were called “Licenciatura”). young professor of physiology at the
Th e fi rst three years were dedicated to University of Alicante, Bernat Soria,
general chemistry and the last two years I am in debt who gave an outstanding (and relatively
were specialized in an optative branch. I did understandable for a graduate student)
to chance for
enjoy the fi rst three years in the University of talk about ion channels and insulin
Alicante, which had and still has one of the introducing me release in β-cells. Despite my shyness,
best chemistry faculties in Spain. However, to endocrinology aft er Prof. Soria´s talk, I approached
it was tough deciding between physical him and asked whether I could work in
years ago. I hope
chemistry or biochemistry and molecular his lab. A week later he accepted me as a
biology for the last two years of my degree; it it continues graduate student and I started my career
took me several months of thinking. Finally, in endocrinology.
bringing me new
I chose the latter, without any special reason
opportunities in
for it and moved to Madrid. Years later, Prof. Soria also helped me
this fi eld in the to start my own research group. My
During these two years at Autonomous PhD thesis was centered in how β-cells
years to come.
University of Madrid, I was introduced worked in terms of stimulus-secretion
to cell signaling and I was immediately ” coupling, mostly in how the oscillatory
fascinated by the manner that cells talk to electrical activity induced intracellular
each other and the molecular mechanisms calcium oscillations that triggered
used to translate stimuli in responses. When I fi nished my insulin release. I was extremely fortunate to coincide with
degree I knew that I wanted to become a basic researcher. Prof. Maiguel Valdeolmillos, a young scientist who was
So, it was time to fi nd a lab for starting a PhD thesis, an expert in calcium signaling aft er being trained by Prof.
preferably in cell signaling. Now, it seems like something Garcia-Sancho at the University of Valladolid and Prof.
easy and straightforward to achieve, yet I remember that Eisner at University College London. He co-supervised
then I struggled trying to fi nd an attractive project in a good my PhD, and I learned a good deal from him during
laboratory and, not less important, a scholarship that allowed many hours of calcium and patch-clamp recordings.
me to live during this period.
To celebrate 100 years of the Endocrine Society, throughout 2016 Endocrine News is running a “Why Endocrinology?” column
in each issue. If you’d like to share your story with our readers, contact Mark A. Newman at [email protected].
6 | JULY 2016 | ENDOCRINENEWS.ORG
I continued working in calcium signaling and its role in cell that low doses of both E2 and Bisphenol-A (BPA) used the
division during four years of postdoctoral training in the same rapidly initiated pathways to trigger important actions
lab of Prof. Peter A. McNaughton in King’s College London, in β-cells. Th is extended my interest beyond islet signaling to
UK. Although I did not work in endocrinology at King’s, my the role of EDCs in the etiology of diabetes mellitus. We used
period in Prof. McNaughton’s lab was exciting and productive. BPA as a model of EDC to demonstrate that BPA exposure
Moreover, I learned from him many important aspects that alters glucose metabolism. Currently, we continue working to
have been key in my scientifi c career up to now. understand how EDCs increase the susceptibility to type 2
diabetes aft er exposure during diff erent periods of life.
By chance, during my last year at King’s, I worked with my
colleague Miguel A. Valverde, now professor of physiology at My work with EDCs has given me the opportunity not only
Pompeu Fabra University in Barcelona. Miguel was working to participate in the Endocrine Society’s meetings but to join
in rapid responses to steroid hormones and endocrine- the Endocrine Society in some initiatives. I am particularly
disrupting chemicals (EDCs). I will be always grateful to proud to be one of the co-authors of “EDC-2: Th e Endocrine
him for familiarizing me with the world of rapid responses to Society’s Second Scientifi c Statement on Endocrine-
steroid hormones. Since then, I have been working at Miguel Disrupting Chemicals,” led by Prof. Andrea Gore, which
Hernandez University of Elche for almost 20 years trying to summarized the state of science of endocrine disruptors.
understand the role of estrogen receptors in the diff erent cell
types of the islet of Langerhans. I am in debt to chance for introducing me to endocrinology
years ago. I hope it continues bringing me new opportunities
Soon aft er starting to work with estrogens, my group described in this fi eld in the years to come.
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(cid:116)(cid:1)(cid:1)(cid:48)(cid:79)(cid:77)(cid:74)(cid:79)(cid:70)(cid:1)(cid:78)(cid:80)(cid:69)(cid:86)(cid:77)(cid:70)(cid:13)(cid:1)(cid:73)(cid:66)(cid:83)(cid:69)(cid:1)(cid:68)(cid:80)(cid:81)(cid:90)(cid:1)(cid:83)(cid:70)(cid:71)(cid:70)(cid:83)(cid:70)(cid:79)(cid:68)(cid:70)(cid:1)(cid:67)(cid:80)(cid:80)(cid:76)(cid:13)(cid:1)
conventional and SI Units
(cid:116)(cid:1)(cid:1)(cid:38)(cid:77)(cid:74)(cid:72)(cid:74)(cid:67)(cid:77)(cid:70)(cid:1)(cid:71)(cid:80)(cid:83)(cid:1)(cid:86)(cid:81)(cid:1)(cid:85)(cid:80)(cid:1)(cid:21)(cid:17)(cid:1)AMA PRA Category
1 Credits(cid:153)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:21)(cid:17)(cid:1)(cid:34)(cid:35)(cid:42)(cid:46)(cid:1)(cid:46)(cid:48)(cid:36)(cid:1)(cid:81)(cid:80)(cid:74)(cid:79)(cid:85)(cid:84)
“I use ESAP to refresh my memory on endocrine topics, keep up-to-date with
changes in endocrinology, and accumulate CME credits in order to maintain
my medical license. ESAP serves this purpose well, and I plan on continuing to
purchase it regularly.”
— Roger Rittmaster, MD
© 2016 ENDOCRINE SOCIETY
INTOUCH
Krista Kirk Named Chief
Human Resources &
Talent Management
Offi cer
K
rista Kirk, SPHR, SHRM-SCP, joined the Endocrine Some of her key focus areas are:
Society in May in the newly created role of chief
human resources and talent management offi cer. • Onboarding: Develop a comprehensive and continuous
Among many other duties, she will be charged with driving learning environment to immerse newly hired talent
the development of the Society’s talent acquisition activities by in the organization and their position quickly and
developing an overall recruitment strategy. eff ectively.
“I am so excited to be a part of an organization with such • Performance Management and Employee
an important and passionate mission,” Kirk says, adding Development: Develop a program to provide employees
“advancing endocrinology and promoting its essential role in with frequent and productive feedback to keep focused
human health.” on consistent continuous learning.
She comes to the Society with over 20 years’ experience in • Compensation and Rewards: Build a reward and
human resources (HR) where she has built the HR function recognition program (R&R) that is meaningful
from the ground up with two diff erent organizations. Most to employees and will highlight their value to the
recently, she was the vice president of human resources for the organization.
Academy of Managed Care Pharmacy where she was charged
with integrating the function within the overall business • Culture: She will be responsible for weaving the
operating strategy. Society’s core values and culture into every aspect of staff
programs and practices.
“We are so pleased Krista has joined our staff ,” says Society
CEO Barbara Byrd Keenan, FASAE, CAE. “Her 20 years of HR “To help the Endocrine Society achieve its mission, it’s
and talent management experience will guide our eff orts to be important that we create an environment for staff to be nimble
a gold standard employer!” and innovative in order to respond to the ever changing
healthcare landscape and produce products and information
Her role at the Society is to develop a HR strategy to include our members need,” Kirk explains. “A few of my objectives are
talent management as the primary focus. Th e Society’s goal to align individual goals with the organization’s strategy, create
is to develop and support its staff so they can excel and a highly skilled talent pool by moving toward a coaching
continually connect their work to the Society’s mission and model and to facilitate the breakdown of information silos,
enhance member value. and develop tools to approach work collaboratively.”
8 | JULY 2016 | ENDOCRINENEWS.ORG