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Samir Malkani, Sheri A Keitz, David M Harlan
The current diabetes epidemic threatens to overwhelm the healthcare system unless we redesign how diabetes care is delivered. The number of endocrinologists is grossly inadequate to provide care for all individuals with diabetes, but with the appropriate utilization of the primary care workforce and alternative healthcare providers working together in teams, effective diabetes care can be provided to all. We propose a patient-centered, goal-based approach with resources devoted to care coordination, measurement of outcomes, appropriate use of technology, and measurement of patient satisfaction...
December 2016: Current Diabetes Reports
T Apaydin, H M Ozkaya, F E Keskin, O A Haliloglu, K Karababa, S Erdem, P Kadioglu
PURPOSE: To determine the differences in acromegaly diagnosis, treatment, and follow-up among Turkish endocrinologists, and to investigate how the published guidelines are applied in clinical practice. METHODS: The questionnaire was formatted as an electronic survey, conducted between November and December 2015, and sent weekly for 6 weeks via e-mail to 528 endocrinologists in Turkey. RESULTS: The questionnaire was answered by 37.4 % of endocrinologists...
October 20, 2016: Journal of Endocrinological Investigation
Marc Pusztaszeri, Esther Diana Rossi, Manon Auger, Zubair Baloch, Justin Bishop, Massimo Bongiovanni, Ashish Chandra, Beatrix Cochand-Priollet, Guido Fadda, Mitsuyoshi Hirokawa, SoonWon Hong, Kennichi Kakudo, Jeffrey F Krane, Ritu Nayar, Sareh Parangi, Fernando Schmitt, William C Faquin
The Bethesda System for Reporting Thyroid Cytology (TBSRTC) was proposed in 2007 at the National Cancer Institute Thyroid Fine Needle Aspiration State of the Art and Science Conference held in Bethesda, Maryland. The aim was to address the inconsistent and sometimes confusing reporting terminologies used for thyroid FNA throughout the world. The TBSRTC consists of 6 diagnostic categories, each associated with an implied risk of malignancy that translates directly into a clinical management algorithm. Since the publication of the TBSRTC cytology Atlas in January 2010, considerable experience has been gained regarding its application in cytology practice, clinical impact, and limitations...
October 21, 2016: Acta Cytologica
Fabiana Q Silva, Mehreen Adhi, Karen M Wai, Leann Olansky, M Cecilia Lansang, Rishi P Singh
BACKGROUND AND OBJECTIVE: The purpose of this study was to identify whether endocrinologists and primary care physicians (PCP) adequately screen for ophthalmic symptoms/signs within office visits and provide timely ophthalmology referrals in patients with diabetes. PATIENTS AND METHODS: Patients between the ages of 18 years and 80 years with diabetes who underwent an office visit with an endocrinologist or a PCP between January 1, 2014, and December 31, 2014, were identified...
October 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Chang Hee Jung
Type 2 diabetes mellitus (T2DM) is a complex endocrine and metabolic disorder and is a major global public health problem with a rapidly increasing prevalence. Although a wide range of pharmacotherapy for glycemic control in T2DM is now available, management of T2DM remains complex and challenging. The kidneys contribute to glucose homeostasis primarily by the glucose reabsorption from the glomerular filtrate. The sodium-glucose co-transporter 2 (SGLT2) inhibitors, a new class of antidiabetes agents that inhibit glucose absorption from the kidney tubule independent of insulin, offer a unique opportunity to improve outcomes for patient with T2DM...
September 2016: Journal of Hypertension
Simon B Zeichner, Christine Stanislaw, Jane L Meisel
In recent years, we have learned a great deal about pathogenic mutations that increase the risk of breast and ovarian cancer, particularly mutations in the BRCA1 and BRCA2 genes. Here we review current guidelines on breast and ovarian cancer screening, prophylactic surgery, and other risk-reduction strategies in patients with these mutations, and we detail the data that drive these recommendations. We also discuss guidelines on screening and management for other cancers associated with BRCA1 and BRCA2, such as male breast cancer, pancreatic cancer, and prostate cancer...
October 15, 2016: Oncology (Williston Park, NY)
Efraín Rodríguez-Vigil, Migdalia Rodríguez-Chacón, José J Ruiz Valcarcel
OBJECTIVE: The objective of this study was to assess the current relationship between certain demographics and chemical factors, and the risk of cardiovascular complications, within a Puerto Rican population with diabetes mellitus. RESEARCH DESIGN AND METHODS: A total of 2075 patients with diabetes mellitus were retrospectively evaluated to determine the influence of certain demographics and chemical variables on the appearance of cardiovascular complications. A group of demographic and laboratory variables were analyzed...
2016: BMJ Open Diabetes Research & Care
Paulo Henrique de Souza Castro, Luiz Evaristo Ricci Volpato, Julia Tramujas, Alvaro Henrique Borges
Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base and it is uncommonly observed in clinical practice and is rare in children. This paper describes the surgical treatment of ectopic thyroid at the base of the tongue in a child. The chief complaint of the 12-year-old, melanodermic female patient was the difficulty to swallow for 15 days. The intraoral physical examination barely showed a nodular lesion at tongue base. The CT scan showed a round, well defined hyperdense lesion of approximately 25...
2016: Case Reports in Dentistry
Dania Hirsch, Gloria Tsvetov, Yossi Manisterski, Nirit Aviran-Barak, Varda Nadler, Sandra Alboim, Vered Kopel
OBJECTIVE: To investigate the incidence of Cushing's syndrome (CS) in patients with significant hypercortisoluria and the performance of urinary free cortisol (UFC) screening. DESIGN: Retrospective file review. METHODS: The computerized database of a publicly funded health maintenance organization (HMO) in Israel was searched for all patients who underwent 24-hour UFC testing in 2005-2014 with a result of more than twice the upper limit of normal (ULN)...
October 13, 2016: European Journal of Endocrinology
A E Bobrov, E G Starostina, M M Aleksandrova
AIM: To study mental disorders in acromegaly due to somatotropinoma. MATERIAL AND METHODS: The study included 115 consecutively recruited patients with acromegaly (95 female and 20 male, aged from 21 to 78 years). Acromegaly was diagnosed by endocrinologists according to current guidelines based on clinical, laboratory data and brain MRI. All patients underwent a clinical psychiatric interview based on ICD-10 criteria. The Mini-Mental State Examination scale and Hypomania-Checklist (HCL-32) were used...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Ivan Šterzl, Karolína Absolonová, Petr Matucha
Historically endocrinologists and psychiatrists are aware that disturbances in thyroid disease in beginning or even in clinically intensified states of thyrotoxicosis or hypothyroidism exhibit pathological mental manifestations, masking or potentiating the underlying disease. Immune system disorders cause thyroid organ-specific autoimmune process. This autoimmune thyroid disease binds with a number of disorders in both endocrine or non-endocrine organs. This appears in vascular, neurological, skin, connective tissue, gastrointestinal tract and mental pathology...
2016: Vnitr̆ní Lékar̆ství
Nick Verougstraete, Bruno Lapauw, Sara Van Aken, Joris Delanghe, Christophe Stove, Veronique Stove
BACKGROUND: Microsampling techniques have several advantages over traditional blood collection. Dried blood spot (DBS) sampling and blood collection with heparinized capillaries are the standard techniques. Volumetric absorptive microsampling (VAMS) is a novel technique that collects a fixed volume of blood by applying an absorbent tip to a blood drop. In the present study we explored the feasibility of HbA1c monitoring with VAMS sampling at home and analysis in the laboratory. METHODS: Diabetic patients were enrolled in this study during consultation with the endocrinologist...
October 12, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Christopher S Tran, Clare E Liddy, Dora M Liu, Amir Afkham, Erin J Keely
OBJECTIVE: To describe the impact of an eConsult service on access to endocrinologists along with its influence on changing primary care provider (PCP) course of action and referral behaviors. METHODS: Established in 2011, the Champlain BASE (Building Access to Specialist Care via eConsult) service allows PCPs to access specialist care in lieu of traditional face-to-face referrals. We conducted a cross-sectional study of eConsult cases submitted to endocrinologists by PCPs between April 15, 2011 and January 31, 2015...
October 2016: Endocrine Practice
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Thierry Brue, Frederic Castinetti
Secreting pituitary adenomas that cause acromegaly and Cushing's disease, as well as prolactinomas and thyrotroph adenomas, are uncommon, usually benign, slow-growing tumours. The rarity of these conditions means that their diagnosis is not familiar to most non-specialist physicians. Consequently, pituitary adenomas may be overlooked and remain untreated, and affected individuals may develop serious comorbidities that reduce their quality of life and life expectancy. Because many signs and symptoms of pituitary adenomas overlap with those of other, more common disorders, general practitioners and non-endocrinology specialists need to be aware of the "red flags" suggestive of these conditions...
October 6, 2016: Orphanet Journal of Rare Diseases
Andrea Papp, Clemence Vasserot-Merle, Guido Dorner, Dion Paridaens
This article reports on two cases of severe pediatric Graves orbitopathy (GO) in two adolescents of African origin. Two black male adolescents presented with highly active GO and signs of beginning compressive optic neuropathy. Neither of them were smokers nor had a family history of GO. Besides urgent referral to pediatric endocrinologists, intravenous methylprednisolon pulse therapy was initiated. In spite of the fluctuating thyroid hormone levels in the initial phase of antithyroid therapy, intravenous steroid administration stopped the progression of malignant GO rapidly in both of our patients without any considerable side effects...
August 12, 2016: Orbit
Agnaldo J Graciano, Carlos A Fischer, Carlos T Chone, Giuliano S Bublitz, Marina Sonagli, Cezar A Rodrigues Filho
BACKGROUND: There are a growing number of thyroid ultrasound courses to train endocrinologists, pathologists, and surgeons to perform ultrasound-guided fine-needle aspiration (FNA). However, there are limited data to support the efficacy of ultrasound-guided FNA performed by nonradiologists. METHODS: We compared the efficacy of ultrasound-guided FNA performed by surgeons newly trained in thyroid ultrasound with that of the same technique performed by 1 experienced radiologist...
October 5, 2016: Head & Neck
Rasmus Bo Jansen, Ole Lander Svendsen, Klaus Kirketerp-Møller
INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system...
October 2016: Danish Medical Journal
Richard J Santen, Anju Joham, Lauren Fishbein, Kristen R Vella, Peter R Ebeling, Melanie Gibson-Helm, Helena Teede
CONTEXT: Challenges and opportunities face the next generation (Next-Gen) of endocrine researchers and clinicians, the lifeblood of the field of endocrinology for the future. A symposium jointly sponsored by the Endocrine Society and the Endocrine Society of Australia was convened to discuss approaches to addressing present and future Next-Gen needs. EVIDENCE ACQUISITION: Data collection by literature review, assessment of previously completed questionnaires, commissioning of a new questionnaire, and summarization of symposium discussions...
October 3, 2016: Journal of Clinical Endocrinology and Metabolism
C P Hawkes, S M O'Connell
Many countries have established regulations regarding growth hormone (GH) treatment in children, to standardise care and reduce cost. In this study, we describe current practice in Ireland surrounding child measurement and the approach to diagnosis of GH deficiency. A questionnaire was sent to 139 paediatricians in Ireland and 35 (9 paediatric endocrinologists) responded. Only 13 (37.1%) use the recommended 2-person technique for measuring children under 2. Amongst GH prescribers, there were a variety of GH Stimulation Tests used, sex steroid priming was used by 8 (80%) and the general cut off for a passed test was consistent (7ng/ml)...
2016: Irish Medical Journal
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