Endocrine Practice

OBJECTIVE: To study the profile, management, and outcomes of follicular cell-derived thyroid cancer (FCDTC) before publication of the 2016 American Thyroid Association guidelines recommending less aggressive thyroid cancer procedures. METHODS: Patients with FCDTC were seen by one thyroidologist at Mayo Clinic during the 2015 calendar year. Patients underwent surgical procedures for FCDTC in 2015 or earlier at the Mayo Clinic or another institution. Follow-up data were collected from January 1, 2016, through July 20, 2022...

PURPOSE: Parathyroidectomy treats uncontrolled renal hyperparathyroidism, requiring identification of all glands. Three types of enhancement are proposed. Type A lesions have higher arterial phase attenuation than the thyroid, Type B lesions lack higher arterial phase attenuation but have lower venous phase attenuation, and Type C lesions neither have higher arterial phase attenuation nor lower venous phase attenuation than the thyroid.We aimed to outline the imaging features of problematic parathyroid glands in renal hyperparathyroidism and propose a 4DCT interpretation algorithm...

OBJECTIVE: We aimed to assess the early efficacy of anlotinib in progressive radioactive iodine refractory differentiated thyroid cancer (RAIR-DTC) patients in terms of structural, biochemical, and metabolic levels. METHODS: Ten eligible patients were prospectively enrolled to receive anlotinib. Six weeks' response were assessed. Apart from the structural response according to RECIST 1.1, biochemical response was assessed by serum thyroglobulin (Tg), metabolic response was assessed by 18 F-FDG PET/CT according to the EORTC criteria...

No abstract text is available yet for this article.

OBJECTIVE: In thyroid eye disease (TED) inflammation and expansion of orbital muscle and peri-orbital fat produce diplopia and proptosis, severely impacting patient quality of life (QOL). Reported heath state utility (HSU) scores, which are QOL measures, allow quantification of TED impact and improvement with therapies; however, no current QOL instrument has been validated with HSU scores for TED. Here we use disease-specific Graves' ophthalmopathy (GO)-QOL questionnaire and HSU scores to validate QOL impact...

OBJECTIVE: To assess the bedside utility of spectral Doppler ultrasound (SDUS) in the initial evaluation of patients presenting with thyrotoxicosis. METHODS: This is a retrospective cross-sectional study of patients diagnosed with thyrotoxicosis at an academic outpatient endocrinology clinic from August 2019 to November 2022. The thyroid arteries' peak systolic velocities (PSV) were measured bilaterally using SDUS. PSV ≥40 cm/sec in at least a single thyroid artery was considered a reasonable cut-off for Graves' disease, and PSV of peri-nodular artery ≥ 25 cm/sec for toxic adenoma...

OBJECTIVE: Major adverse cardiovascular event (MACE) outcomes associated with sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapies remain unclear in patients with type 2 diabetes and newly diagnosed diabetic foot complications (DFCs). This study examined the impact of SGLT2i and GLP-1 RA use on the rates of MACEs and amputations in patients with type 2 diabetes and without cardiovascular disease. METHODS: Data from the Taiwan National Health Insurance Research Database (2004-2017) were analyzed, focusing on patients with type 2 diabetes without previous MACE and newly diagnosed DFCs...

No abstract text is available yet for this article.

BACKGROUND: Osteoporosis is a chronic progressive disease that requires lifelong monitoring and treatment. Sequencing from one treatment to another at different ages and stages of disease is an approach that can maximize benefits and avoid potential risks from long-term treatment with a single agent. OBJECTIVE: This article reviews clinical trial data in postmenopausal women that evaluate the effects of antiresorptive agents followed by other antiresorptives, osteoanabolic agents followed by antiresorptives, and antiresorptives followed by osteoanabolic medications...

OBJECTIVE: Christmas holidays can impact weight and glycemic control in type 2 diabetes, but their effect on type 1 diabetes (T1D) remains understudied. This study assessed how Christmas holidays affect individuals with T1D who use flash continuous glucose monitoring systems. METHODS: This retrospective study involved 812 adults diagnosed with T1D recruited from 3 hospitals. Clinical, anthropometric, and socioeconomic data were collected. Glucose metrics from 14 days before January 1st, and before December 1st and February 1st as control periods, were recorded...

OBJECTIVE: To assess response predictors to radioactive iodine (RAI) therapy without using thyroid uptake for dose estimate in patients pretreated with methimazole. METHODS: Retrospective analysis of patients with Graves' disease treated with RAI doses determined without using uptake studies. RESULTS: From 242 patients (median age 41.9 years, 66.1% female), initial mean free T4 (FT4) level was 4.7 ng/dL with estimated thyroid size of 49.15 g...

BACKGROUND: Patients with type 1 diabetes (T1D) often face glycemic fluctuations during exercise. HD-tDCS, known for enhancing neuromodulation focus, has shown promise in improving endurance. OBJECTIVE: To evaluate the effects of bilateral dorsolateral prefrontal cortex HD-tDCS on glycemic excursions during a time-trial performance in elite cyclists with T1D. METHODS: In a double-blind, randomized crossover order, nine elite cyclists with T1D (no complications) underwent either HD-tDCS (F3, F4) or control (SHAM) and completed a constant-load trial at 75% of the 2nd ventilatory threshold plus a 15-km cycling time-trial...

OBJECTIVE: There is a relative lack of consensus regarding the optimal management of hyperglycemia in patients receiving continuous enteral nutrition (EN), with or without a diagnosis of diabetes. METHODS: This retrospective study examined 475 patients (303 with known diabetes) hospitalized in critical-care setting units in 2019 in a single center who received continuous EN. Rates of hypoglycemia, hyperglycemia, and glucoses within target range (70-180 mg/dL) were compared in those with or without diabetes, and treated with intermediate acting (IA) biphasic neutral protamine Hagedorn (NPH) 70/30 or long-acting (LA) or rapid-acting (RA) only insulin...

OBJECTIVE: Cosecreting thyroid stimulating hormone (TSH) or prolactin (PRL) in patients with pituitary growth hormone (GH) adenomas has been rarely reported. Our study aimed to elucidate their clinical characteristics. METHODS: We retrospectively collected 22 cases of cosecreting GH and TSH pituitary adenomas [(GH+TSH)oma] and 10 cases of cosecreting GH and PRL pituitary adenomas [(GH+PRL)oma] of Beijing Tiantan Hospital, Capital Medical University between January 2009 and January 2023...

OBJECTIVE: Sodium-glucose-cotransporter 2 (SGLT-2) inhibitors are widely used for diabetes management especially because their effects go beyond glucose control. More recently, their indications and usage have expanded to heart failure (HF) and renal dysfunction therapy in patients both with and without diabetes. Beneficial effects, especially for HF readmission, accrue very early in their treatment trajectory, and this has promoted their use in the hospital setting. Data on their safety and efficacy for inpatient use are accumulating but have lagged behind the outpatient data for their use...

OBJECTIVE: Hyperglycemia in patients with type 2 diabetes mellitus is frequently encountered in the hospital setting. The recent guidelines for the management of inpatient hyperglycemia have included the use of dipeptidyl peptidase 4 inhibitors as an alternative to standard insulin therapy in select patients. This raises the question of the inpatient use of sodium-glucose cotransporter 2 inhibitors (SGLT2i), which have gained increasing popularity in the outpatient setting because of beneficial cardiovascular and renal outcomes...

OBJECTIVE: To analyze prognostic factors in children with differentiated thyroid carcinoma (DTC) who have been treated in a single center in the last 27 years. METHODS: We studied 126 children (≤18 years old) who have been treated with near-total thyroidectomy followed by radioiodine therapy and thyroid hormone replacement. Follow-up of the patients was done 2, 6, and 12 months after treatment and then by yearly evaluation. Response to treatment was defined according to the American Thyroid Association guidelines...

OBJECTIVE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially for type 2 diabetes mellitus, show promise in promoting weight loss and improving heart health in obese individuals without diabetes. Our goal was to examine existing research for conclusive evidence on various types of GLP-1 RAs for weight loss and cardiometabolic benefits in obesity without diabetes. METHODS: We conducted an electronic search on PubMed, Scopus, and Cochrane Central using keywords, such as "GLP-1 RA," "obesity," and "weight loss...

OBJECTIVE: We aimed to evaluate the effects of thyroid-stimulating hormone (TSH) suppression therapy on cardiac structure and function in patients with differentiated thyroid cancer (DTC) following thyroidectomy. METHODS: Two investigators independently searched the PubMed, Embase, Cochrane Library, and Web of Science databases for relevant studies published from inception to January 6, 2023, without any restrictions on language. Standard mean differences and 95% confidence intervals were calculated using fixed or random effects models...

OBJECTIVE: Levothyroxine (LT4) is the standard treatment for hypothyroidism. However, certain patients experience persistent symptoms even after achieving euthyroid status with LT4 therapy. We aimed to determine the frequency of persistent or new symptoms in patients with hypothyroidism after initiating LT4. METHODS: This retrospective study included patients with hypothyroidism who started on LT4 between January 2017 and December 2019 at Mayo Clinic in Rochester, Minnesota, USA...