Management of hyponatraemia and hypernatraemia during the Covid-19 pandemic: a consensus statement of the Spanish Society for Endocrinology (Acqua Neuroendocrinology Group).

SARS-COV2 infection has swiftly become a pandemic disease of historic relevance and widely variable outcomes. This variable prognosis is related both to uneven damage, among others, to lungs, heart and kidneys, and to a multisystemic inflammatory reaction. All these factors are known to disrupt water balance and potentially induce hyponatraemia or hypernatraemia. Water balance disorders are known mortality and morbidity risk factors in several clinical scenarios and their proper management, though often complex and hazardous, can reduce mortality and length of hospitalization. Clinical uncertainty over COVID-19 outcome, the variety of organs involved in both the infection and water balance and difficulties in clinical examination due to risk of contagion might obstruct proper management of dysnatremic disorders. Thus, the Acqua Neuroendocrinology Group of the Spanish Society for Endocrinology (SEEN) has endeavoured to provide evidence and expert based recommendations on the management of hyponatraemia and hypernatraemia in COVID-19 patients.

Canadian guidelines for the management of adult growth hormone deficiency.

PURPOSE: To develop guidelines for the management of growth hormone (GH) deficiency in Canadian adults to facilitate rational use of GH in appropriate indications. METHODS: The guidelines were developed by group of endocrinologists and an endocrine specialist nurse with an interest in neuroendocrine disorders, representing all regions of Canada and practicing in a variety of settings. A steering committee with broad expertise undertook a systematic review of the evidence relating to adult GHD and GH replacement. This evidence was reviewed by the whole group, and guidelines were developed using a consensus approach. RESULTS: The document addresses the causes and clinical characteristics of GHD in adults and reviews the evidence in support of GH replacement in this group. The authors provide recommendations for the identification of adult GHD, and guidelines for GH replacement in appropriate patients. Also, access to GH therapy across Canada is reviewed.

Evaluación neuroendocrinológica e histopatológica de pacientes azoospérmicos normogonadotrópicos: utilidad de la prueba de estimulación con GnRH / Neuroendocrinologic and histopathologic evaluation of azoospermic, normogonadotropic patientes: usefulness of GnRH challenge test

Se valoró el efecto de la administración de hormona liberadora de gonadotropinas (GnRH) sobre las concentraciones séricas de FSH y LH, Se correlacionaron estos resultados con los hallazgos histopatológicos de biopsias testiculares obtenidas de pacientes azoospérmicos normogonadotrópicos. Se trató de un estudio prospectivo, con grupo testigo. Tuvo lugar en Clínica de Biología de la Reproducción, Centro Hospitalario " 20 de Noviembre" ISSSTE. Quince varones azoospérmicos normogonadotrópicos, sin atrofia testicular. Así como un grupo testigo de diez pacientes sanos. Se realizó una prueba de estimulación con GnRH en ambos grupos y dos días después se efectuó biopsia testicular a los pacientes azoospérmicos. Determinación de las concentraciones séricas de FSH y LH. Además, examen anatomopatológico de las biopsias de testículo. No hubo diferencia significativa en los valores de LH de los dos grupos antes ni después de aplicar la GnRH. Se encontró diferencia significativa en los niveles de FSH, siendo ésto más elevados en los pacientes azoospérmicos. Entre mayor fue el daño testicular, hubo tendencia a que los pacientes presentaran hiperrespuesta de la FSH a la GnRH. La prueba de estimulación con GnRH en pacientes azoospérmicos normogonadotrópicos es útil para detectar casos de lesión gonadal. Entre mayor se la respuesta de la FSH, es más probable que haya alteración histológica del testículo