[Emergency card, emergency medication, and information leaflet for the prevention and treatment of adrenal crisis (Addison crisis): an Austrian consensus document]. / Notfallausweis, Notfallmedikation und Informationsmaterial zur Prävention und Therapie der Nebennierenkrise (Addison-Krise): Ein österreichisches Konsensusdokument.

A central goal of the adrenal insufficiency management is the prevention of acute adrenal insufficiency (also known as adrenal crisis or Addison crisis). This consensus document was generated in order to achieve better implementation and harmonization of measures for the prevention and treatment of acute adrenal insufficiency in Austria. The following measures are generally recommended for all patients with adrenal insufficiency and are outlined in this manuscript: (1) Provision of a "steroid emergency card" and possibly also a medical alert bracelet or necklace (or similar identification). (2) Provision of a hydrocortisone injection kit (or alternative glucocorticoid preparations) for emergency use plus sufficient oral glucocorticoid doses for stress situations/illness. (3) Education of patients and relatives on glucocorticoid stress dosing and "sick day rules" as well as on self-injection of hydrocortisone. (4) Provision of a treatment guideline (information leaflet) for the prevention and therapy of the adrenal crisis, which should also be shown to healthcare staff if necessary. (5) Provision of an emergency phone number (contact details) of the responsible endocrine specialist team or other trained staff. (6) Reinforcement of patient education on a regular basis (preferably yearly). This consensus document also includes recommendations for glucocorticoid dosing in the perioperative setting as well as in various other stress situations.

Radiofrequency ablation of thyroid nodules: "Good Clinical Practice Recommendations" for Austria : An interdisciplinary statement from the following professional associations: Austrian Thyroid Association (ÖSDG), Austrian Society for Nuclear Medicine and Molecular Imaging (OGNMB), Austrian Society for Endocrinology and Metabolism (ÖGES), Surgical Endocrinology Working Group (ACE) of the Austrian Surgical Society (OEGCH).

The present "Good Clinical Practice Recommendations" relate to radiofrequency ablation (RFA) training, execution, and quality control, as well as to pre- and postinterventional standards of care. They are aimed at all physicians who intend to learn to perform, or who are already conducting RFA interventions as well as at thyroid specialists providing pre- and postoperative care to RFA patients in Austria. Adoption of these recommendations is strongly encouraged by the afore-listed professional associations.All RFA interventionists who adhere to these standards shall be listed on a homepage linked to these professional associations entitled "RFA centers in compliance with the GCP recommendations of the ÖSDG/OGNMB/ÖGES/OEGCH-ACE." This will ensure harmonization of RFA training and quality control in the performance of the treatment in Austria.

[Prophylaxis and therapy of the glucocorticoid-induced osteoporosis - a review of recent guidelines]. / Prophylaxe und Therapie der Glukokortikoid-induzierten Osteoporose - rezente Leitlinien im Überblick.

Several international guidelines for treatment and prophylaxis of glucocorticoid-induced osteoporosis (GIO) have been published. Consistent with the development of new therapeutic agents, a different approach to treatment can be recognized depending on the year of publication. Also, new insights for the postmenopausal osteoporosis leave their marks on recent guidelines. The working committee on Osteology of the Austrian Society for Rheumatology and Rehabilitation (ÖGR) sifted through actual guidelines and recent literature on the topic to develop recommendations for the prophylaxis and treatment of the GIO.

Sex-hormone-binding globulin is negatively correlated with femoral bone-mineral density in male cardiac-transplant recipients.

BACKGROUND: Osteoporosis and the subsequent increase in incidence of fractures are a common problem after cardiac transplantation. DESIGN: We performed a cross-sectional evaluation of male cardiac-transplant recipients in a late post-transplantation period (4.2 +/- 2.6 years after cardiac transplantation, n = 21). Bone-mineral density was measured by dual-energy X-ray absorptiometry and by quantitative heel ultrasound, and the endocrine characteristics of cardiac-transplant recipients with and without vertebral fractures were investigated. RESULTS: A significant negative correlation was observed between sex-hormone-binding globulin and femoral-neck bone-mineral density (rs = -0.699; p value = 0.001). Linear regression analysis controlling for age and body-mass index proved sex-hormone-binding globulin to be an independent negative predictor for femoral-neck bone-mineral density (r = -0.474; p value = 0.035). Patients with vertebral fractures had significantly lower femoral-neck bone-mineral density (pvalue = 0.035). However, sex-hormone-binding globulin, total and free testosterone, and estradiol did not exhibit significant associations with vertebral fractures in our patients. CONCLUSION: This investigation demonstrates for the first time an association between high sex-hormone-binding globulin levels and low femoral-neck bone-mineral density in a cohort of male cardiac-transplant recipients. Our data support the important role of sex-hormone-binding globulin in the pathogenesis of post-transplantation bone disease, although--possibly because of the small number of patients--we could not prove an interrelation of sex-hormone-binding globulin with vertebral fractures.

Lower serum beta-CrossLaps in male cardiac transplant recipients treated without prednisolone.

Post-transplantation bone disease is a frequent problem after successful cardiac transplantation. We performed a cross-sectional analysis of male heart transplant recipients in the late post-transplantation period. Nine patients (group A) had received immunosuppressive therapy with cyclosporin A and mycophenolate mofetil (steroid-free treatment), and 12 patients (group B) remained on triple-drug therapy, which included glucocorticosteroids. Bone mineral density status was analyzed by osteodensitometry and by markers of bone turnover. Osteopenia was common in both groups (44.4% in group A and 50% in group B) as was osteoporosis (30% and 33.3% in groups A and B, respectively). beta-CrossLaps were significantly lower in sera of cardiac transplant recipients on double immunosuppressive (i.e., glucocorticosteroid-free) regimen than in sera of patients on triple-drug therapy (428.3+/-109.4 vs 661.7+/-337.0 pg/ml, P<0.05). Lower serum beta-CrossLaps levels in patients undergoing glucocorticosteroid-free treatment may indicate a lower risk of bone deterioration in the long term.