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Clinical Medicine Insights. Endocrinology and Diabetes

Anas A Alghamdi, Maswood M Ahmad, Mussa H Almalki
The aim of reporting this case is to highlight the association of two disorders, primary hyperparathyroidism (PHPT) and slipped capital femoral epiphysis (SCFE). They are usually seen in two different age groups and rarely together. PHPT is a rare cause of SCFE and only 10 cases have been reported in the literature worldwide. The patient in our report is a 13-year-old girl who presented to our clinic with bilateral knee pain and a waddling gait. Subsequent investigations showed that she had PHPT and SCFE with low bone mass...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Jesús Devesa, Cristina Almengló, Pablo Devesa
In this review, we analyze the effects of growth hormone on a number of tissues and organs and its putative role in the longitudinal growth of an organism. We conclude that the hormone plays a very important role in maintaining the homogeneity of tissues and organs during the normal development of the human body or after an injury. Its effects on growth do not seem to take place during the fetal period or during the early infancy and are mediated by insulin-like growth factor I (IGF-I) during childhood and puberty...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Simin Babaie Kafaki, Kamaledin Alaedini, Ashkan Qorbani, Leila Asadian, Kaveh Haddadi
OBJECTIVES: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU). METHODS: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012-2015...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Fernando Gondim, Ana Caribé, Karine Ferreira Vasconcelos, Alexandre Dantas Segundo, Francisco Bandeira
BACKGROUND: Vitamin D deficiency has been associated with cardiovascular risk factors, including type 2 diabetes mellitus (T2DM). Evidence shows that patients with low serum 25-hydroxyvitamin D (25OHD) concentrations have a higher risk of developing coronary artery disease. OBJECTIVE: The objective of this study was to assess vitamin D as a predictor of the severity in diabetics with acute coronary syndrome (ACS). METHODS: A total of 166 patients were diagnosed with ACS...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Rachel M Saroka, Michael P Kane, Lawrence Robinson, Robert S Busch
BACKGROUND: Glucocorticoid replacement is commonly required to treat secondary adrenal insufficiency after surgical resection of unilateral cortisol-secreting adrenocortical adenomas. Here, we describe a patient with unilateral cortisol-secreting adenomas in which the preoperative use of mifepristone therapy was associated with recovery of the hypothalamic-pituitary-adrenal (HPA) axis, eliminating the need for postoperative glucocorticoid replacement. CASE PRESENTATION: A 66-year-old Caucasian man with type 2 diabetes mellitus, hyperlipidemia, hypertension, and obesity was hospitalized for Fournier's gangrene and methicillin-resistant Staphylococcus aureus sepsis...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Kevin M Pantalone, Todd M Hobbs, Brian J Wells, Sheldon X Kong, Michael W Kattan, Jonathan Bouchard, Kevin M Chagin, Changhong Yu, Brian Sakurada, Alex Milinovich, Wayne Weng, Janine M Bauman, Robert S Zimmerman
To assess changes in the clinical characteristics and treatment patterns of patients with newly diagnosed type 2 diabetes (T2D), the electronic health record system at Cleveland Clinic was used to create cross-sectional summaries of all patients with new-onset T2D in 2008 and 2013. Differences between the 2008 and 2013 data sets were assessed after adjusting for age, gender, race, and income. Approximately one-third of patients with newly diagnosed T2D in 2008 and 2013 had an A1C ≥8%, suggesting the continued presence of a delayed recognition of the disease...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Ayesha Abid, Shahla Ahmad, Abdul Waheed
The number of individuals being diagnosed with type II diabetes in the United States is increasing. The screening tests for diabetes are able to detect the vast majority of diabetics. However, they do not represent the high-risk individuals who may be prone to diabetes at an earlier age. This brief communication looks at the current screening practices and the gaps in the guidelines.
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Wafaa AlSaggaf, Mohammed Asiri, Balgees Ajlan, Alaa Bin Afif, Roaa Khalil, Anas Bin Salman, Ahmed Alghamdi, Osama Bashawieh, Atheer Alamoudi, Abeer Aljahdali, Nouf Aljahdali, Hussam Patwa, Mohammed Bakhaidar, Suhad M Bahijri, Maimoona Ahmed, Khalid Al-Shali, Samia Bokhari, Amani Alhozali, Anwar Borai, Ghada Ajabnoor, Jaakko Tuomilehto
AIM: To compare the effect of different treatment regimens (oral hypoglycemic agents [OHGs], insulin therapy, and combination of both) on glycemic control and other cardiometabolic risk factors in type 2 diabetes mellitus (T2DM) patients in Saudi. SUBJECTS AND METHODS: Patients with T2DM, but no serious diabetic complications, were randomly recruited from the diabetes clinics at two large hospitals in Jeddah, Saudi Arabia, during June 2013 to July 2014. Only those without change in treatment modality for the last 18 months were included...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Mussa H Almalki, Badurudeen Mahmood Buhary, Shawana Abdulhamid Khan, Abdulrahman Almaghamsi, Fahad Alshahrani
Diabetes is the fifth leading cause of death worldwide. Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes. The aim of this study is to investigate the clinical and biochemical characteristics of DKA among 400 patients admitted to hospital, most of whom had type 1 diabetes (n = 372; 93%). Vomiting (n = 319; 79.8%), nausea (n = 282; 70.5%), and abdominal pain (n = 303; 75.8%) were the presenting symptoms most commonly experienced by the patients. Tachycardia was the most common clinical sign noted in the patients on admission (n = 243; 61...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Leila Asadian, Kaveh Haddadi, Mohsen Aarabi, Amirhossein Zare
OBJECTIVES: This study aimed to determine the prevalence of diabetes mellitus in patients with spinal stenosis and lumbar vertebral disk degeneration, and the correlation of diabetes with these diseases. STUDY DESIGN: This is a cross-sectional study. METHODS: This case-control study was performed during 2012-2014 with 110 patients suffering from lumbar spinal stenosis and 110 patients with lumbar disk herniation, who were diagnosed using clinical and radiological evidences...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Christian Mangrum, Eric Rush, Vijay Shivaswamy
Maturity onset diabetes of the young (MODY) is a rare form of diabetes mellitus typically seen in young adults that results from pancreatic beta-cell dysfunction. MODY4 is a rare subtype caused by a PDX1 mutation. In this case, we present a nonobese 26-year-old male with polyuria and polydipsia. Lab work showed a blood glucose of 511 mg/dL, no ketones or antibodies (insulin, islet cell, and glutamic acid decarboxylase [GAD]), C-peptide of 1.6 ng/mL, and A1c 9.3%. Genetic analysis revealed a novel nonsense mutation in the PDX1 gene, consistent with MODY type 4...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Curtis Triplitt, Susan Cornell
Current guidelines for treatment of type 2 diabetes mellitus (T2DM) indicate a patient-centered approach that should go beyond glycemic control. Of the many antihyperglycemic agents available for treatment of T2DM, sodium-glucose cotransporter 2 (SGLT2) inhibitors offer the advantages of reduced glycated hemoglobin (A1C), body weight (BW), and systolic blood pressure (SBP) and are associated with a low risk of hypoglycemia when used either as monotherapy or with other agents not typically associated with increased risk of hypoglycemia...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Nasrullah K Ghuman, Loai M Saadah, Majdi S Al Najjar, Duha Y Shaheen, Shady I Am, Mouza M Al Ali
OBJECTIVE: To measure effectiveness of liraglutide in reducing glycated hemoglobin (HbA1C), weight, and systolic blood pressure (SBP) in Emirati patients. DESIGN: A retrospective cohort study. SETTING: Endocrinology clinic in a 300-bed military hospital. PATIENTS: A total of 152 patients who qualified for liraglutide between September 21, 2012, (first patient visit) and May 5, 2014 (last patient visit). METHODS: Team collected demographic and clinical data using a standard form...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Alok Kumar, Sunita Singh
Effect of parathyroidectomy on glucose control and hypertension is controversial. Here, we report a case of a patient with primary hyperparathyroidism, type 2 diabetes mellitus, and hypertension in whom parathyroidectomy ameliorated both glucose control and blood pressure. Once high serum calcium levels were noticed, ultrasonography of neck confirmed a well-defined oval hypoechoic mass posterior to the right lobe of the thyroid, confirmed by scintiscan. Parathyroidectomy resulted in improvement of blood pressure and blood glucose...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Entesar Oa El Saghier, Salah E Shebl, Olfat A Fawzy, Ihab M Eltayeb, Lamya Ma Bekhet, Abdelnasser Gharib
BACKGROUND: The association between type 2 diabetes mellitus (T2DM) and low total serum testosterone (LST) has been identified in several cross-sectional studies. OBJECTIVES: To assess the prevalence of androgen deficiency and erectile dysfunction (ED) and their relation to glycemic control within a sample of Egyptian men with T2DM. RESEARCH DESIGN AND METHODS: A cross-sectional study including 70 men having T2DM. Their ages ranged from 30 to 50 years...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Butheinah A Al-Sharafi, Abdallah A Gunaid
Khat chewing is common in Yemen. We conducted this study to see if it affected diabetes control in patients with type 2 diabetes mellitus (DM). We studied 1540 patients with type 2 DM attending an endocrinology clinic in Sana'a, Yemen, of which 997 were khat chewers (KC) and 543 were non-khat chewers (NKC). The patients answered a questionnaire regarding khat chewing. Hemoglobin A1c (HbA1c) and body mass index (BMI) were measured. KC had a higher mean HbA1c of 9.8 (95% confidence interval (95% CI) 9.6-10) than the NKC, with a mean of 9...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Anna-Maria Borissova, Alexander Shinkov, Roussanka Kovatcheva, Jordan Vlahov, Lilia Dakovska, Todor Todorov
AIM: The aim of this study was to compare two nationwide cross-sectional studies of diabetes prevalence in Bulgaria (2006 and 2012) and to assess its dynamics. MATERIAL AND METHODS: The two studies included 2396 and 2033 subjects, respectively. The International Diabetes Federation (IDF) diagnostic criteria were applied, and the data were weighed for type of settlement and age. RESULTS: Diabetes prevalence was found to be 7.9% in 2006 and 9...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Taysir S Garadah, Adla B Hassan, Ahmed A Jaradat, Diab E Diab, Hiba O Kalafalla, Adel K Kalifa, Reginald P Sequeira, Abdul Hameed A Alawadi
BACKGROUND: Adult patients with sickle-cell disease (SCD) often have multiple bone compactions causing tissue hypoxia and osteonecrosis. The impact on bone abnormalities lesion detected by bone mass density is not well defined. AIM: The study is a cross sectional, perspective was designed to assess the prevalence of abnormal BMD in adult Bahraini patients with SCD and to assess the predictive risk of different metabolic variables such as serum level of vitamin D3, testosterone, and parathyroid hormone in addition to lactate dehydrogenase (LDH), hemoglobin (Hb), and reticulocyte count for the development of abnormal bone density on dual X-ray absorptiometry (DXA) scan...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Juha Saltevo, Hannu Kautiainen, Pekka Mäntyselkä, Antti Jula, Sirkka Keinänen-Kiukaanniemi, Eeva Korpi-Hyövälti, Heikki Oksa, Timo Saaristo, Mauno Vanhala
The association between thyroid function and depression is controversial. Both conditions express many similar symptoms, but the studies done give conflicting results. This study draws on a random, population-based sample of 4500 subjects aged 45-75 years old from Finland. The basic clinical study was done in 2007 for 1396 men and 1500 women (64% participation rate). Thyroid stimulating hormone (TSH), free thyroxine (F-T4), and free triiodothyronine (F-T3) were measured in 2013 from frozen samples. The 21-item Beck Depression Inventory (BDI-21) was applied to assess depressive symptoms (score ≥10 points)...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
Moeber Mahzari, Dora Liu, Amel Arnaout, Heather Lochnan
Ipilimumab is a monoclonal antibody directed against CTLA4 T-lymphocyte antigen used as cancer therapy. Immune-related adverse events are common side effects and may include hypophysitis-related hypopituitarism. The clinical features of six patients with ipilimumab-induced hypophysitis (IH) are described. The clinical features of IH reported in clinical trials, including the incidence of IH by gender and the likelihood of adrenal axis recovery, are summarized. Following the development of IH, most patients remain on glucocorticoid replacement despite efforts to withdraw therapy...
2015: Clinical Medicine Insights. Endocrinology and Diabetes
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