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https://www.readbyqxmd.com/read/28332936/ethical-concerns-about-emerging-treatment-paradigms-for-gender-dysphoria
#1
Stephen B Levin
The increasing incidence of request for medical services to support gender transition for children, adolescents and adults has consequences for society, governmental institutions, schools, families, health care professionals, and, of course, patients. The sociological momentum to recognize and accommodate to trans phenomena has posed ethical dilemmas for endocrinologists, mental health professionals and sexual specialists as they experience within themselves the clash between Respect for Patient Autonomy, Beneficence, Nonmalficience, and Informed Consent...
March 23, 2017: Journal of Sex & Marital Therapy
https://www.readbyqxmd.com/read/28332881/an-individualized-approach-to-the-evaluation-and-management-of-primary-aldosteronism
#2
Anand Vaidya, Carl D Malchoff, Richard J Auchus
OBJECTIVE: With the increased emphasis on personalized and individualized medicine, the American Association of Clinical Endocrinologists Adrenal Scientific Committee has developed a series of articles to update members on personalized medicine as it applies to adrenal diseases. METHODS: Synthesis of literature review, guidelines from professional societies, and personal experience. RESULTS: Since Conn described primary aldosteronism (PA) over 60 years ago, debate has raged about the prevalence of PA in the hypertensive population, the wisdom of broadly screening for PA, and prudent approach to the evaluation and management of these patients...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28331462/a-case-of-malignant-pheochromocytoma-presenting-7-years-after-the-initial-surgery
#3
Larsa Al-Omaishi, Jonathan Babin, Ralph L Corsetti
BACKGROUND: Pheochromocytoma (PHEO) is a rare tumor of the adrenal medulla and sympathetic ganglion that produces the catecholamines norepinephrine and epinephrine. Traditionally, approximately 10% of PHEOs were thought to be malignant, but recent developments in PHEO research have noted that specific genetic mutations are associated with higher risk of metastatic spread. CASE REPORT: We report the case of a 71-year-old female who presented with abdominal pain in September 2009 when she was 64 years old...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331372/a-glucokinase-gene-mutation-in-a-young-boy-with-diabetes-mellitus-hyperinsulinemia-and-insulin-resistance
#4
Andrey O Emelyanov, Elena Sechko, Ekaterina Koksharova, Igor Sklyanik, Tamara Kuraeva, Alexander Mayorov, Valentina Peterkova, Ivan Dedov
We report the case of a 12-year-old boy with a glucokinase (GCK) mutation, and diabetes with hyperinsulinemia and insulin resistance. For 4 years, the patient intermittently received insulin medications Actrapid HM and Protaphane HM (total dose 5 U/day), with glycated hemoglobin (HbA1c) levels of 6.6%-7.0%. After extensive screening the patient was found to carry a heterozygous mutation (p.E256K) in GCK (MIM #138079, reference sequence NM_000162.3). Insulin therapy was replaced by metformin at 1,700 mg/day...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28331102/clinical-features-of-women-with-turner-syndrome-experiencing-transition-period-in-japan
#5
Satsuki Nishigaki, Takashi Hamazaki, Akitoshi Tsuruhara, Toshiko Yoshida, Takuji Imamura, Hiroshi Inada, Keinosuke Fujita, Haruo Shintaku
Turner syndrome results from the entire or partial loss of the second X chromosome, and is associated with a number of medical problems. Affected women require long-term medical follow-up. This study investigated the status of medical follow-up focusing on the transition for young adult women with Turner syndrome (TS). The clinical profiles of 63 women with TS over the age of 16 were retrospectively examined. Thirty-three women are continuously followed by pediatric endocrinologists at our pediatric division...
March 22, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28329583/dermatologic-care-of-the-transgender-patient
#6
Timothy Hermosura Almazan, Filamer D Kabigting
Literature is limited regarding the medical and cosmetic dermatologic issues pertinent to transgender patients and the reasons why 19 transgender individuals seek care from dermatologists. Clinical management of this population has historically been limited to 20 mental health providers, endocrinologists, and select surgeons with expertise in sex reassignment surgery. The impact of hormonal 21 therapy on transgender skin has been well documented in endocrinology journals, but is underrepresented in dermatology 22 literature...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328015/pcsk9-inhibitor-access-barriers-issues-and-recommendations-improving-the-access-process-for-patients-clinicians-and-payers
#7
REVIEW
Seth J Baum, Peter P Toth, James A Underberg, Paul Jellinger, Joyce Ross, Katherine Wilemon
The proprotein convertase subtilisin/kexin type 9 inhibitors or monoclonal antibodies likely represent the greatest advance in lipid management in 30 years. In 2015 the US Food and Drug Administration approved both alirocumab and evolocumab for high-risk patients with familial hypercholesterolemia (FH) and clinical atherosclerotic cardiovascular disease requiring additional lowering of low-density lipoprotein cholesterol. Though many lipid specialists, cardiovascular disease prevention experts, endocrinologists, and others prescribed the drugs on label, they found their directives denied 80% to 90% of the time...
March 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28326101/spectrum-of-endocrine-disorders-in-central-ghana
#8
Osei Sarfo-Kantanka, Fred Stephen Sarfo, Eunice Oparebea Ansah, Ishmael Kyei
Background. Although an increasing burden of endocrine disorders is recorded worldwide, the greatest increase is occurring in developing countries. However, the spectrum of these disorders is not well described in most developing countries. Objective. The objective of this study was to profile the frequency of endocrine disorders and their basic demographic characteristics in an endocrine outpatient clinic in Kumasi, central Ghana. Methods. A retrospective review was conducted on endocrine disorders seen over a five-year period between January 2011 and December 2015 at the outpatient endocrine clinic of Komfo Anokye Teaching Hospital...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28324050/transgender-health-in-endocrinology-current-status-of-endocrinology-fellowship-programs-and-practicing-clinicians
#9
Caroline Davidge-Pitts, Todd B Nippoldt, Ann Danoff, Lauren Radziejewski, Neena Natt
Context: The transgender population continues to face challenges in accessing appropriate health care. Adequate training of endocrinologists in this area is a priority. Objectives: 1) Assess the status of transgender healthcare education in United States (US) endocrinology fellowship training programs, and 2) assess knowledge and practice of transgender health amongst practicing US endocrinologists. Design: Mayo Clinic and Endocrine Society developed and administered a web-based anonymous survey to 104 endocrinology fellowship program directors (PDs) and 6,992 US MD members of Endocrine Society...
January 10, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28322617/clinicians-views-on-management-and-terminology-for-papillary-thyroid-microcarcinoma-a-qualitative-study
#10
Brooke Nickel, Juan P Brito, Alexandra Barratt, Susan Jordan, Ray Moynihan, Kirsten McCaffery
BACKGROUND: There is growing acceptance that the increase in thyroid cancer incidence is in part a result of overdiagnosis of small low-risk papillary microcarcinomas (PMCs) with indolent clinical course. Although surgery is the cornerstone treatment for patients with PMCs, recent management guidelines are shifting toward inclusion of more conservative treatments such as active surveillance. There is little evidence on clinicians' experience in managing PMC patients and their attitudes toward treatment options, including their willingness to accept a nonsurgical option...
March 21, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28318938/diabetes-nurse-case-management-in-a-canadian-tertiary-care-setting-results-of-a-randomized-controlled-trial
#11
Danni Li, Tom Elliott, Gerri Klein, Ehud Ur, Tricia S Tang
OBJECTIVES: To examine the effects of a 6-month nurse case manager (NCM) intervention compared to standard care (SC) on glycemic control and diabetes distress in a Canadian tertiary-care setting. METHODS: We recruited 140 adults with type 2 diabetes and glycated hemoglobin (A1C) levels >8% (64 mmol/mol) from 2 tertiary care facilities and randomized them to: 1) a 6-month NCM intervention in addition to SC or 2) SC by the primary endocrinologists. Assessments were conducted at baseline and at 6 months...
March 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28306523/evaluation-of-thyroid-test-utilization-through-analysis-of-population-level-data
#12
Jasmine Gill, Vilte E Barakauskas, Dylan Thomas, Karina Rodriguez-Capote, Trefor Higgins, Don Zhang, Amanda VanSpronsen, Oksana Babenko, Roberta Martindale, Mathew P Estey
BACKGROUND: Inappropriate laboratory test utilization can result in unnecessary patient testing and increased healthcare costs. While several thyroid function tests are available, thyroid-stimulating hormone (TSH) is recommended as the first-line test for investigating and monitoring thyroid dysfunction. We evaluate thyroid test utilization in Northern Alberta in terms of testing patterns, frequencies, and reflex cutpoints. METHODS: This retrospective study analyzed thyroid test requests from January to December 2014...
March 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28303702/studies-on-the-quality-nutrition-in-women-with-polycystic-ovary-syndrome-pcos
#13
Małgorzata Szczuko, Patrycja Sankowska, Marta Zapałowska-Chwyć, Paweł Wysokiński
Background: Polycystic ovary syndrome (PCOS) manifests itself with various symptoms, therefore it interests representatives of many medical specializations: general practitioners, gynecologists, endocrinologists, dermatologists, cardiologists and those who deal with metabolic disorders, such as dieticians. Objective: The aim of this study was perform the qualitative assessment of components of diets of women with PCOS as one of the major factor contributing to the disease...
2017: Roczniki Państwowego Zakładu Higieny
https://www.readbyqxmd.com/read/28299309/two-siblings-with-the-same-severe-form-of-21-hydroxylase-deficiency-but-different-growth-and-menstrual-cycle-patterns
#14
Mariarosaria Lang-Muritano, Karine Gerster, Susanna Sluka, Daniel Konrad
Congenital adrenal hyperplasia (CAH) is one of the most frequent autosomal recessive diseases in Europe. Treatment is a challenge for pediatric endocrinologists. Important parameters to judge the outcome are adult height and menstrual cycle. We report the follow-up from birth to adulthood of two Caucasian sisters with salt-wasting CAH due to the same mutation, homozygosity c.290-13A>G (I2 splice), in the 21-hydroxylase gene. Their adherence to treatment was excellent. Our objective was to distinguish the effects of treatment with hydrocortisone (HC) and fludrocortisone (FC) on final height (FH) from constitutional factors...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28289431/management-issues-of-congenital-adrenal-hyperplasia-during-the-transition-from-pediatric-to-adult-care
#15
REVIEW
Jin-Ho Choi, Han-Wook Yoo
Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers...
February 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28286936/analysis-of-diabetes-quality-assessment-findings-and-future-directions-for-the-appropriate-management-of-diabetes-in-korea
#16
Yu Jin Kim, Suk Chon, Seungjoon Oh, Jeong-Taek Woo, Sung Woon Kim, Sang Youl Rhee
Background/Aims: Due to recent increases in the disease burden of diabetes mellitus, the Health Insurance Review and Assessment Service (HIRA) of Korea implemented a quality assessment of the treatment of diabetes to improve patient care. The present study was conducted to identify any changes after the implementation of the diabetes quality assessment (DQA). Methods: The present study evaluated eight quality assessment indicators that were proposed by the HIRA in all patients with diabetes who visited a university hospital in Korea between 2009 and 2014...
March 15, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28279296/diagnosing-and-managing-carcinoid%C3%A2-heart%C3%A2-disease-in-patients%C3%A2-with%C3%A2-neuroendocrine-tumors-an-expert-statement
#17
REVIEW
Joseph Davar, Heidi M Connolly, Martyn E Caplin, Marianne Pavel, Jerome Zacks, Sanjeev Bhattacharyya, Daniel J Cuthbertson, Rebecca Dobson, Simona Grozinsky-Glasberg, Richard P Steeds, Giles Dreyfus, Patricia A Pellikka, Christos Toumpanakis
Carcinoid heart disease is a frequent occurrence in patients with carcinoid syndrome and is responsible for substantial morbidity and mortality. The pathophysiology of carcinoid heart disease is poorly understood; however, chronic exposure to excessive circulating serotonin is considered one of the most important contributing factors. Despite recognition, international consensus guidelines specifically addressing the diagnosis and management of carcinoid heart disease are lacking. Furthermore, there is considerable variation in multiple aspects of screening and management of the disease...
March 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28277114/interdisciplinary-consensus-on-management-of-premenstrual-disorders-in-switzerland
#18
Petra Stute, Christine Bodmer, Ulrike Ehlert, Roger Eltbogen, Ankica Ging, Isabelle Streuli, Michael von Wolff
Premenstrual disorders (PMD) can affect women throughout their entire reproductive years. In 2016, an interdisciplinary expert meeting of general gynecologists, gynecological endocrinologists, psychiatrists and psychologists from Switzerland was held to provide an interdisciplinary algorithm on PMD management taking reproductive stages into account. The Swiss PMD algorithm differentiates between primary and secondary PMD care providers incorporating different levels of diagnostic and treatment. Treatment options include cognitive behavioral therapy, alternative therapy, antidepressants, ovulation suppression and diuretics...
March 2, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28275532/surgical-correction-of-the-webbed-neck-an-alternative-lateral-approach
#19
Imen Mehri Turki
Objective: The webbed neck deformity or pterygium colli is the number one symptom of the Turner syndrome that leads the patient to consult a doctor. Various but rare surgical approaches have been described to correct this deformity. We reviewed our experience with the surgical correction of the pterygium colli. Methods: Through five clinical cases, we describe the surgical technique with a lateral approach which provides a better control of the operative site, allows for the excision of the underlying trapezial fascial web, thus preventing recurrence seen in the posterior approach, and restores a normal hairline...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28274950/management-of-endocrine-disease-diagnostic-and-therapeutic-approach-of-tall-stature
#20
Edoarda Vasco de Albuquerque Albuquerque, Renata C Scalco, Alexander Augusto de Lima Jorge
Tall stature is defined as a height of more than 2 standard deviations (SD) above average for same sex and age. Tall individuals are usually referred to endocrinologists so that hormonal disorders leading to abnormal growth are excluded. However, the majority of these patients have familial tall stature or constitutional advance of growth (generally associated with obesity), both of which are diagnoses of exclusion. It is necessary to have familiarity with a large number of rarer overgrowth syndromes, especially because some of them may have severe complications such as aortic aneurysm, thromboembolism and tumor predisposition and demand specific follow-up approaches...
March 8, 2017: European Journal of Endocrinology
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