[Endocrinology: what's new in 2023]. / Endocrinologie: ce qui a changé en 2023.

This overview provides a selection of studies published in 2023 with an impact on clinical practice. In reproductive endocrinology, important studies have addressed fertility preservation in men with Klinefelter's syndrome, the cardiovascular safety of testosterone replacement therapy, and a novel therapy, fezolinetant, for vasomotor symptoms of menopause. The updated European recommendations concerning adrenal incidentalomas will considerably modify current clinical practice. Based on a solid epidemiological work, the prevalence of pituitary adenomas has been confirmed to affect about 1 per 1000 individuals. Finally, a large British study allows to refine the benefit-risk profile of the three options available for the treatment of hyperthyroidism.

Cet aperçu présente une sélection d'études publiées en 2023 ayant un impact sur la pratique clinique. En endocrinologie de reproduction, des études importantes ont abordé la préservation de la fertilité chez les hommes avec un syndrome de Klinefelter, la sécurité cardiovasculaire du traitement substitutif par testostérone et une nouvelle thérapie, fezolinetant, pour les symptômes vasomoteurs de la ménopause. La mise à jour des recommandations européennes concernant les incidentalomes surrénaliens va considérablement modifier la pratique clinique. Grâce à un travail épidémiologique solide, la prévalence des adénomes hypophysaires est confirmée à environ 1 cas pour 1000 individus. Enfin, une large étude britannique permet de raffiner le profil bénéfices-risques des trois options disponibles pour le traitement de l'hyperthyroïdie.

Incidence of gestational diabetes and birth complications in Switzerland: screening in 1042 pregnancies.

To evaluate the incidence of gestational diabetes mellitus (GDM), gestational glucose intolerance (GGI), and birth major complications, a population of 1042 pregnant women was screened after the end of the second trimester with a two-step screening method. Patients with a positive 50-g screening test (plasma glucose ≥ 7.8 mmol/l at 1 h) underwent a 3-h standard 100-g oral glucose tolerance test. Clinical records of patients and newborns were analysed and compared to normotolerant patients group. GDM was found in 4.8% and GGI in 2.6% of all screened women of this study population. The patient group with GDM significantly differed from control, with a higher proportion of Asiatic women (32.0% versus 2.9%, p = 0.001) and high prevalence of previous GDM (26.0% versus 0.0%, p < 0.001). Major neonatal complications occurred more frequently in the dysmetabolic groups compared to normotolerant group. Macrosomia was not noted in our population. Asiatic origin and previous GDM were strongly associated with an increased incidence of GDM in multivariate analysis. This study represents the first epidemiological evaluation of GDM/GGI in Switzerland, with a two-step screening method. Incidence of GDM and GGI as well as birth complications resulted significant in our country.

Positive Bias Temperature Instability in SiC-Based Power MOSFETs.

This paper investigates the threshold voltage shift (ΔVTH) induced by positive bias temperature instability (PBTI) in silicon carbide (SiC) power MOSFETs. By analyzing ΔVTH under various gate stress voltages (VGstress) at 150 °C, distinct mechanisms are revealed: (i) trapping in the interface and/or border pre-existing defects and (ii) the creation of oxide defects and/or trapping in spatially deeper oxide states with an activation energy of ~80 meV. Notably, the adoption of different characterization methods highlights the distinct roles of these mechanisms. Moreover, the study demonstrates consistent behavior in permanent ΔVTH degradation across VGstress levels using a power law model. Overall, these findings deepen the understanding of PBTI in SiC MOSFETs, providing insights for reliability optimization.

[Rare Findings in the Workup of Abdominal Pain]. / Seltene Befunde bei der Abklärung von Bauchschmerzen.

Rare Findings in the Workup of Abdominal Pain Abstract. Atypical symptoms such as abdominal discomfort or epigastric pain can be misleading in patients presenting conditions such as obesity, type 2 diabetes, hypertension or ischemic heart disease. In this article we describe two cases of impressively large adrenal masses discovered only several years after the appearance of nonspecific symptoms.

[Metabolic syndrome of the young adult: what should alert the family doctor?]. / Syndrome métabolique du jeune adulte et diabète gestationnel: rôle du praticien dans le dépistage précoce.

The epidemic prevalence of obesity and its related metabolic disorders (e.g.: diabetes, metabolic syndrome) represents a challenge for next upcoming years, for caregivers and for the health care system globally. Early prevention strategies for type 2 diabetes have been studied and their efficacy has been proven. Moreover there is emerging evidence that childhood obesity is associated with previous exposition to fetal hyperglycemia. Prevention of metabolic troubles may thus consist not only in an early intervention for lifestyle modifications, but also in an effort to identify conditions, such as Gestational Diabetes Mellitus, that seems to have a strong impact on the metabolic imprinting in the future generation.

[A new treatment: bariatric surgery; a new complication: Wernicke-Korsakoff encephalopathy]. / Un nouveau traitement: la chirurgie bariatrique; une nouvelle complication: l'encéphalopathie de Wernicke-Korsakoff.

INTRODUCTION: Bariatric surgery has peripheral or central neurological complications in 5-10% of patients. CASE: We report the case of a 39-year-old man with metabolic syndrome who underwent gastric by-pass surgery and then lost 40 kg over a period of 2.5 months. He subsequently developed symptoms suggestive of Wernicke-Korsakoff encephalopathy, secondary to stenosis of the gastrojejunal anastomosis, which led to repeated unreported vomiting. DISCUSSION: This neurological syndrome, linked to thiamine deficiency, can be found with insufficient nutrition after surgery or severe vomiting after bariatric surgery. The complications are essentially peripheral neuropathy and metabolic dysfunctions, including iron and vitamin (B12, D, folate) deficiencies. This case reminds us that bariatric surgery requires close metabolic follow-up with periodic assays of vitamin levels, including thiamine, even when supplementation was prescribed.