One year of the pandemic - how European endocrinologists responded to the crisis: a statement from the European Society of Endocrinology.

Changes that COVID-19 induced in endocrine daily practice as well as the role of endocrine and metabolic comorbidities in COVID-19 outcomes were among the striking features of this last year. The aim of this statement is to illustrate the major characteristics of the response of European endocrinologists to the pandemic including the disclosure of the endocrine phenotype of COVID-19 with diabetes, obesity and hypovitaminosis D playing a key role in this clinical setting with its huge implication for the prevention and management of the disease. The role of the European Society of Endocrinology (ESE) as a reference point of the endocrine community during the pandemic will also be highlighted, including the refocusing of its educational and advocacy activities.

Resting Energy Expenditure: From Cellular to Whole-Body Level, a Mechanistic Historical Perspective.

The basis of heat generated by the human body has been a source of speculation and research for more than 2,000 years. Basal heat production, now usually referred to as resting energy expenditure (REE), is currently recognized as deriving from biochemical reactions at subcellular and cellular levels that are expressed in the energy expended by the body's 78 organs and tissues. These organs and tissues, and the 11 systems to which they belong, influence body size and shape. Connecting these subcellular-/cellular-level reactions to organs and tissues, and then on to body size and shape, provides a comprehensive understanding of individual differences in REE, a contemporary topic of interest in obesity research and clinical practice. This review critically examines these linkages, their association with widely used statistical and physiological REE prediction formulas, and often-unappreciated aspects of measuring basal heat production in humans.

Cost-effectiveness of Interventions to Manage Diabetes: Has the Evidence Changed Since 2008?

OBJECTIVE: To synthesize updated evidence on the cost-effectiveness (CE) of interventions to manage diabetes, its complications, and comorbidities. RESEARCH DESIGN AND METHODS: We conducted a systematic literature review of studies from high-income countries evaluating the CE of diabetes management interventions recommended by the American Diabetes Association (ADA) and published in English between June 2008 and July 2017. We also incorporated studies from a previous CE review from the period 1985-2008. We classified the interventions based on their strength of evidence (strong, supportive, or uncertain) and levels of CE: cost-saving (more health benefit at a lower cost), very cost-effective (≤$25,000 per life year gained [LYG] or quality-adjusted life year [QALY]), cost-effective ($25,001-$50,000 per LYG or QALY), marginally cost-effective ($50,001-$100,000 per LYG or QALY), or not cost-effective (>$100,000 per LYG or QALY). Costs were measured in 2017 U.S. dollars. RESULTS: Seventy-three new studies met our inclusion criteria. These were combined with 49 studies from the previous review to yield 122 studies over the period 1985-2017. A large majority of the ADA-recommended interventions remain cost-effective. Specifically, we found strong evidence that the following ADA-recommended interventions are cost-saving or very cost-effective: In the cost-saving category are 1) ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB) therapy for intensive hypertension management compared with standard hypertension management, 2) ACEI/ARB therapy to prevent chronic kidney disease and/or end-stage renal disease in people with albuminuria compared with no ACEI/ARB therapy, 3) comprehensive foot care and patient education to prevent and treat foot ulcers among those at moderate/high risk of developing foot ulcers, 4) telemedicine for diabetic retinopathy screening compared with office screening, and 5) bariatric surgery compared with no surgery for individuals with type 2 diabetes (T2D) and obesity (BMI ≥30 kg/m2). In the very cost-effective category are 1) intensive glycemic management (targeting A1C <7%) compared with conventional glycemic management (targeting an A1C level of 8-10%) for individuals with newly diagnosed T2D, 2) multicomponent interventions (involving behavior change/education and pharmacological therapy targeting hyperglycemia, hypertension, dyslipidemia, microalbuminuria, nephropathy/retinopathy, secondary prevention of cardiovascular disease with aspirin) compared with usual care, 3) statin therapy compared with no statin therapy for individuals with T2D and history of cardiovascular disease, 4) diabetes self-management education and support compared with usual care, 5) T2D screening every 3 years starting at age 45 years compared with no screening, 6) integrated, patient-centered care compared with usual care, 7) smoking cessation compared with no smoking cessation, 8) daily aspirin use as primary prevention for cardiovascular complications compared with usual care, 9) self-monitoring of blood glucose three times per day compared with once per day among those using insulin, 10) intensive glycemic management compared with conventional insulin therapy for T2D among adults aged ≥50 years, and 11) collaborative care for depression compared with usual care. CONCLUSIONS: Complementing professional treatment recommendations, our systematic review provides an updated understanding of the potential value of interventions to manage diabetes and its complications and can assist clinicians and payers in prioritizing interventions and health care resources.

4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2020.

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Cirugía de tiroides. Revisión histórica y nuevas tecnologías / Thyroid surgery. Historical review, new technologies

El trabajo repasa la evolución histórica en el entendimiento y en el manejo de la cirugía tiroidea. Describe los orígenes de esta cirugía y su ejecución, mucho antes de que se entendiera el funcionamiento de la glándula. Enumera los personajes más trascendentes de esta historia y cómo otras técnicas aplicadas en la cirugía oncológica general se adaptaron a la cirugía de cabeza y cuello. Se mencionan las innovaciones tecnológicas en cirugía tiroidea.

This work reviews the historical evolution of thyroid surgery, its understanding and management. It mentions the origins of this surgical procedure and its execution well before the understanding of the glandular function. The leading persons in this historical field are enumerated; and a review is made of how other techniques applied in surgical oncology were adapted in head and neck surgery. Technological innovations in thyroid surgery are enumerated.

[A peculiar man - about Hans Selye, as reflected in his Hungarian connections]. / Egy "furcsa ember" - Selye Jánosról magyar kapcsolatainak tükrében.

Hans Selye made a great impact on the Hungarian medical, scientific and public life. His first Hungarian publication about the alarm-reaction appeared 1938 in the Orvosi Hetilap. His Hungarian relationship was quite extensive after the war as he published, gave lectures, and accepted Hungarian students for specialized training in his Canadian institute saw. The rich documents in archives about Selye are currently being processed and those will surely shed light on Selye's life in further details.

[Social-sanitary situation in Marañón's work in the context of the fight against infectious diseases]. / La cuestión sociosanitaria en la obra de Marañón en el contexto de la lucha contra las enfermedades infecciosas.

Gregorio Marañón y Posadillo (1887-1960), played a leading role in the birth of endocrinology in Spain as is well known. However, his medical work included other important and significant fields. Thus, it was especially in the 1910s and 1920s, when Marañón dealt with the social-sanitary situation in madrid probably due to his professional attachment to the treatment of several infectious diseases and epidemic outbreaks. Actually, since 1911 onwards, he was in charge of the wards of infectious diseases in the Hospital General de Madrid where he had the opportunity of treating an important number of patients suffering from this type of pathology and, as a consequence, in the following years he published several articles in medical journals and presented in the Royal Academy of Medicine in Spain, some reports on infectious diseases and the Spanish health and social conditions at the time. This paper try to analyze this field of Marañón's social and scientific activity.

Master of the master gland: Choh Hao Li, the University of California, and science, migration, and race.

This essay examines the origins of the relationship between Choh Hao Li and the University of California, Berkeley. Li came to the United States from China in 1935 for graduate study at the University of Michigan, but ended up enrolling at Berkeley. Over the course of the next two decades, Li went from being a foreign graduate student in chemistry on a temporary visa to an internationally recognized leader in the biochemistry of endocrinology at the head of his own laboratory and a naturalized citizen of the United States. At what was otherwise a dark time for Americans of Chinese descent, Li was garnering adulation in the popular press. He was called the "master of the master gland" for his successes both in isolating and in synthesizing pituitary hormones. Specifically, the essay explores the making of the "master of the master gland" from the perspectives of the history of science and the history of race and migration in the United States, tracing the interplay among Li's scientific work, his migrations, his career aspirations, and his legal status in the United States. A Chinese intellectual cast adrift by the shifting geopolitics of World War II and the early Cold War, Li danced delicately along the margins of membership in American society during the 1940s, only arriving at what turned out to be his final destination after careful and protracted negotiations with officials of the U.S. government, with influential members of the international scientific community, and with representatives of the University of California, Berkeley.

Hormones for life? Behind the rise and fall of a hormone remedy (Gonadex) against sterility in the Swedish welfare state.

In 1948 the pharmaceutical company Leo launched a placental hormonal preparation, called Gonadex, in Sweden. During a press conference, and in commercials and newspapers, it was said that Gonadex could cure sterility as well as many other problems related to the endocrine system. The remedy was described as effective and pure, with no side effects whatsoever. For several reasons, Gonadex was looked upon as a 'Swedish triumph'. Inspired by research on 'mediation', conducted within the field of social studies of pharmaceutical drugs, the present essay explores the political and scientific visions and values behind Gonadex; the propaganda for and marketing of Gonadex; the mediated image of Gonadex in the press; the reception by the medical profession, and finally the hopes and fears of the women who tried (or wanted to try) Gonadex. The essay argues that the public image of Gonadex was 'oversell' of hormone therapy, and that it was shaped by the way endocrinologists at Karolinska Hospital, notably Professor Axel Westman, mediated between Leo, the mass media, and the consumers when, and even before, Gonadex was introduced to the market.

[Marius Tausk (1902-1990), influential endocrinologist and producer of medicines; a retrospect to mark the centenary of his birth]. / Marius Tausk (1902-1990), invloedrijk endocrinoloog en producent van geneesmiddelen; terugblik bij zijn honderdste geboortedag.

Marius Tausk, born in Sarajevo, studied medicine at Graz in Austria. In 1926, he attended a socialist youth rally in Amsterdam. Whilst there, he met Prof. Ernst Laqueur, a pharmacologist in Amsterdam, who offered him a position at Organon, a newly-founded pharmaceutical company in Oss, the Netherlands. He remained in the Netherlands and became the driving force behind this innovative company. Tausk made many contributions to new developments across the field of endocrinology, including the discovery of the adrenal steroids (together with T. Reichstein, Nobel Prize Laureate in 1950), and the development of oral contraceptive pills. He was astute enough to quickly patent the first corticosteroids. He could quickly extract the essential elements from an information source and disseminate this in five languages. His sharp judgment brought him friends and admirers, yet also those who feared him. In 1937 he was appointed as a private lecturer at the Medical Faculty of Utrecht University and in 1956 he was made Special Professor of Theoretical Endocrinology. He was awarded a number of scientific distinctions including two honorary doctorates. In 1949 he was honoured with the Knighthood of the Order of The Netherlands Lion.

[Laqueur and Organon. The university laboratory and the pharmaceutical industry in the Netherlands]. / Laqueur en Organon. Het universitaire laboratorium en de farmaceutische industrie in Nederland.

Since the 1970s cooperation between universities and pharmaceutical firms is business as usual. This has not always been the case. The first alliances between academic scientists and the pharmaceutical industry can be traced back to the 1920s. Compared to the U.S. and most other European countries, the creation of networks between the Dutch academy and industry shows a rather peculiar pattern that is illustrative in clarifying how the relationships between scientists and the pharmaceutical companies were built. Dutch scientists could not ally themselves with the pharmaceutical industry, simply because no Dutch pharmaceutical company specialized in organpreparations existed prior to the 1920s. This situation forced scientists to opt for the strongest form of alliance they could create, namely to take part in the founding of a pharmaceutical company. Ernst Laqueur, a professor in pharmacology at the University of Amsterdam, was one of the three founders of Organon, the Dutch pharmaceutical firm that was founded in 1923. Based on an analysis of the early history of sex endocrinology, this paper examines the creation of networks between Laqueur and Organon. The paper concludes that the university laboratory played a crucial role in the development of Organon. Organon was dependent on Laqueurs laboratory for the provision of the required biological essay techniques in order to manufacture standardized hormone products, Moreover, Laqueur mediated all the contacts between Organon and the clinic, required for the clinical testing of hormones and the provision of raw materials for the making of hormones into chemicals and drugs.