Medical Treatment with Somatostatin Analogues in Acromegaly: Position Statement.

The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.

Persistent organic pollutants, pesticides, and the risk of thyroid cancer: systematic review and meta-analysis.

Previous epidemiological studies have reported persistent organic pollutants (POPs) and some nonpersistent pesticides and the risk of thyroid cancer. The aim of this study was to assess the association between exposure to POPs, pesticides, and thyroid cancer by carrying out a meta-analysis. Literature searches were performed using PubMed, Embase, and reference lists of relevant articles. Summary risk estimates for thyroid cancer were calculated using fixed-effects and random-effects models. In addition, several subgroup and sensitivity analyses were carried out. Fifteen studies were reviewed, and eight studies were included in the meta-analysis. Pesticide exposure showed positive, statistically significant associations with thyroid cancer [odds ratio (OR)=1.48, 95% confidence interval (CI)=1.15-1.91, I=48%, Pheterogenetiy=0.05]. After subgroup analysis, herbicide exposure (OR=3.00, 95% CI=1.38-6.54) and agricultural exposure to pesticides (OR=1.86, 95% CI=1.04-3.32) was associated with an increased risk of thyroid cancer. A sensitivity analysis showed that the results were robust. Exposure to pesticides was associated with an increased risk of thyroid cancer in this meta-analysis. Future studies should investigate exposure to POPs or pesticides with controls for potential confounders using biological samples.