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UBC Endocrinology Professor Rounds

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121 papers 25 to 100 followers Weekly Professor Rounds at the UBC Division of Endocrinology
By Ehud Ur Professor and Head, Endocrinology, UBC, Vancouver
https://www.readbyqxmd.com/read/30475220/management-of-endocrine-disease-the-role-of-confirmatory-tests-in-the-diagnosis-of-primary-aldosteronism
#1
REVIEW
Julia Morera, Yves Reznik
The strategy for diagnosis of primary aldosteronism (PA) in the hypertensive population includes firstly a screening step, based on the measurement of plasma aldosterone-to-renin ratio (ARR), a test which must have high sensitivity, and secondly a confirmatory step based on the demonstration of excessive aldosterone production independent of the renin-angiotensin-aldosterone system (RAAS) activity. The high proportion of false positive ARR results and conversely of actual PA without a persistent elevation in baseline plasma aldosterone concentration necessitates the addition of a confirmatory step in the work-up of PA diagnosis...
November 1, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28957311/ten-simple-rules-for-structuring-papers
#2
EDITORIAL
Brett Mensh, Konrad Kording
No abstract text is available yet for this article.
September 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/29127240/the-association-of-severe-hypoglycemia-with-incident-cardiovascular-events-and-mortality-in-adults-with-type-2-diabetes
#3
Alexandra K Lee, Bethany Warren, Clare J Lee, John W McEvoy, Kunihiro Matsushita, Elbert S Huang, A Richey Sharrett, Josef Coresh, Elizabeth Selvin
OBJECTIVE: There is suggestive evidence linking hypoglycemia with cardiovascular disease, but few data have been collected in a community-based setting. Information is lacking on individual cardiovascular outcomes and cause-specific mortality. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort analysis of 1,209 participants with diagnosed diabetes from the Atherosclerosis Risk in Communities (ARIC) study (analytic baseline, 1996-1998). Severe hypoglycemic episodes were identified using first position ICD-9 codes from hospitalizations, emergency department visits, and ambulance calls through 2013...
January 2018: Diabetes Care
https://www.readbyqxmd.com/read/29126290/effects-of-levothyroxine-on-pregnant-women-with-subclinical-hypothyroidism-negative-for-thyroid-peroxidase-antibodies
#4
RANDOMIZED CONTROLLED TRIAL
Sima Nazarpour, Fahimeh Ramezani Tehrani, Masoumeh Simbar, Maryam Tohidi, Sonia Minooee, Maryam Rahmati, Fereidoun Azizi
Context: Currently, there is no consensus on universal thyroid screening and levothyroxine (LT4) treatment of pregnant women with subclinical hypothyroidism (SCH) who are negative for thyroid peroxidase antibody (TPOAb-). Objective: We aimed to evaluate the benefits of LT4 treatment on pregnancy outcomes in SCH-TPOAb- women. Design: This study was conducted within the framework of the Tehran Thyroid and Pregnancy Study. A single-blind randomized clinical trial was undertaken in pregnant women who were SCH-TPOAb-...
March 1, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28941311/endocrinopathies-with-use-of-cancer-immunotherapies
#5
Natalie M Villa, Abtin Farahmand, Lin Du, Michael W Yeh, Stephanie Smooke-Praw, Antoni Ribas, Bartosz Chmielowski, Grace Cherry, Angela M Leung
BACKGROUND: Immunomodulatory therapies, including CTLA-4 and PD-1 inhibitors, provide a directed attack against cancer cells by preventing T cell deactivation. However, these drugs also prevent the downregulation of auto-reactive T cells, resulting in immune-related adverse events (IRAEs). Reports show a varied incidence of endocrine IRAEs, ranging from 0% to 63%. OBJECTIVE: To describe the frequency and clinical characteristics of endocrine IRAEs in patients taking cancer immunomodulatory therapies...
February 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/28938434/fgf21-is-an-insulin-dependent-postprandial-hormone-in-adult-humans
#6
Ricardo J Samms, Jo E Lewis, Luke Norton, Francis B Stephens, Christopher J Gaffney, Tony Butterfield, Dennis P Smith, Christine C Cheng, James W Perfield, Andrew C Adams, Francis J P Ebling, Kostas Tsintzas
Context: Fibroblast growth factor 21 (FGF21) secretion has been shown to respond directly to carbohydrate consumption, with glucose, fructose, and sucrose all reported to increase plasma levels of FGF21 in rodents and humans. However, carbohydrate consumption also results in secretion of insulin. Objective: The aim of this study was to examine the combined and independent effects of hyperglycemia and hyperinsulinemia on total and bioactive FGF21 in the postprandial period in humans, and determine whether this effect is attenuated in conditions of altered insulin secretion and action...
October 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28982960/management-of-endocrine-disease-flushing-current-concepts
#7
REVIEW
Isabel Huguet, Ashley Grossman
OBJECTIVE: Flushing can be defined as a sensation of warmth accompanied by erythema that most commonly is seen on the face and which occurs in episodic attacks. Such a problem can be clinically problematic, since many conditions and drugs can be related to flushing, and while often there appears to be no underlying organic disease, it is important to exclude disorders since they may be life-threatening conditions. DESIGN AND METHODS: We performed a search in MEDLINE using the terms 'flushing' in combination with 'carcinoid syndrome', 'pheochromocytoma', 'mastocytosis', 'menopausal hot flush' and 'treatment'...
November 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29061576/sodium-glucose-cotransporter-2-inhibition-in-heart-failure-potential-mechanisms-clinical-applications-and-summary-of-clinical-trials
#8
REVIEW
Yuliya Lytvyn, Petter Bjornstad, Jacob A Udell, Julie A Lovshin, David Z I Cherney
Despite current established therapy, heart failure (HF) remains a leading cause of hospitalization and mortality worldwide. Novel therapeutic targets are therefore needed to improve the prognosis of patients with HF. The EMPA-REG OUTCOME trial ([Empagliflozin] Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) demonstrated significant reductions in mortality and HF hospitalization risk in patients with type 2 diabetes mellitus (T2D) and cardiovascular disease with the antihyperglycemic agent, empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor...
October 24, 2017: Circulation
https://www.readbyqxmd.com/read/29040691/differential-growth-rates-of-benign-vs-malignant-thyroid-nodules
#9
Trevor E Angell, Chirag M Vyas, Marco Medici, Zhihong Wang, Justine A Barletta, Carol B Benson, Edmund S Cibas, Nancy L Cho, Gerard M Doherty, Peter M Doubilet, Mary C Frates, Atul A Gawande, Howard T Heller, Matthew I Kim, Jeffrey F Krane, Ellen Marqusee, Francis D Moore, Matt A Nehs, Ann Marie Zavacki, P Reed Larsen, Erik K Alexander
Context: Thyroid nodule growth was once considered concerning for malignancy, but data showing that benign nodules grow questioned the use of this paradigm. To date, however, no studies have adequately evaluated whether growth rates differ in malignant vs. benign nodules. Objective: To sonographically evaluate growth rates in benign and malignant thyroid nodules ≥1 cm. Design: Prospective, cohort study of patients with tissue diagnosis of benign or malignant disease, with repeated ultrasound evaluation six or more months apart...
December 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28885622/adult-onset-autoimmune-diabetes-current-knowledge-and-implications-for-management
#10
REVIEW
Raffaella Buzzetti, Simona Zampetti, Ernesto Maddaloni
Adult-onset autoimmune diabetes is a heterogeneous disease that is characterized by a reduced genetic load, a less intensive autoimmune process and a mild metabolic decompensation at onset compared with young-onset type 1 diabetes mellitus (T1DM). The majority of patients with adult-onset autoimmune diabetes do not require insulin treatment for at least 6 months after diagnosis. Such patients are defined as having latent autoimmune diabetes in adults (LADA), which is distinct from classic adult-onset T1DM. The extensive heterogeneity of adult-onset autoimmune diabetes is apparent beyond the distinction between classic adult-onset T1DM and LADA...
November 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/29032078/efficacy-and-safety-of-once-monthly-pasireotide-in-cushing-s-disease-a-12-month-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
André Lacroix, Feng Gu, Wilson Gallardo, Rosario Pivonello, Yerong Yu, Przemysław Witek, Marco Boscaro, Roberto Salvatori, Masanobu Yamada, Libuse Tauchmanova, Michael Roughton, Shoba Ravichandran, Stephan Petersenn, Beverly M K Biller, John Newell-Price
BACKGROUND: Cushing's disease is a rare debilitating endocrine disorder for which few prospective interventional studies have been done. We report results of the first phase 3 trial assessing long-acting intramuscular pasireotide in patients with Cushing's disease. METHODS: In this phase 3 clinical trial we recruited patients aged 18 years or older with persistent, recurrent, or de-novo (non-surgical candidates) Cushing's disease who had a mean urinary free cortisol (mUFC) concentration (from three 24 h samples) of 1·5-5·0 times the upper limit of normal (ULN), a normal or greater than normal morning plasma adrenocorticotropic hormone concentration, and a pituitary source of Cushing's syndrome, from 57 sites across 19 countries...
January 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27820619/association-of-a-blood-glucose-test-strip-quantity-limit-policy-with-patient-outcomes-a-population-based-study
#12
Tara Gomes, Diana Martins, Mina Tadrous, J Michael Paterson, Baiju R Shah, Jack V Tu, David N Juurlink, Anna Chu, Muhammad M Mamdani
Importance: Given their high costs, payers have considered implementing quantity limits for reimbursement of blood glucose test strips. The effect of these limits on patient outcomes is unknown. Objective: To determine whether the introduction of quantity limits for blood glucose test strips in August 2013 was associated with changes in clinical outcomes. Design, Setting, and Participants: Cross-sectional time series analysis from April 2008 to March 2015 of residents of Ontario, Canada, aged 19 years and older with diabetes who were eligible for public drug coverage...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28852042/the-mc4r-genotype-is-associated-with-postpartum-weight-reduction-and-glycemic-changes-among-women-with-prior-gestational-diabetes-longitudinal-analysis
#13
Aline Martins de Carvalho, Ping Shao, Huikun Liu, Han-Ling Cheng, Yan Zheng, Junhong Leng, Weiqin Li, Tao Huang, Tiange Wang, Leishen Wang, Shuang Zhang, Gang Hu, Lu Qi
The genetic variants near the Melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and glucose metabolism. We aimed to assess whether the MC4R genotype affected longitudinal changes in body weight and glucose metabolism biomarkers among women with prior gestational diabetes mellitus (GDM). The MC4R genotype, postpartum weight reduction, and glycemic changes between after delivery and pregnancy were assessed in a cohort of 1208 Chinese women who had experienced GDM...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28776086/the-mechanisms-of-action-of-metformin
#14
REVIEW
Graham Rena, D Grahame Hardie, Ewan R Pearson
Metformin is a widely-used drug that results in clear benefits in relation to glucose metabolism and diabetes-related complications. The mechanisms underlying these benefits are complex and still not fully understood. Physiologically, metformin has been shown to reduce hepatic glucose production, yet not all of its effects can be explained by this mechanism and there is increasing evidence of a key role for the gut. At the molecular level the findings vary depending on the doses of metformin used and duration of treatment, with clear differences between acute and chronic administration...
September 2017: Diabetologia
https://www.readbyqxmd.com/read/28605603/efficacy-and-safety-of-degludec-versus-glargine-in-type-2-diabetes
#15
RANDOMIZED CONTROLLED TRIAL
Steven P Marso, Darren K McGuire, Bernard Zinman, Neil R Poulter, Scott S Emerson, Thomas R Pieber, Richard E Pratley, Poul-Martin Haahr, Martin Lange, Kirstine Brown-Frandsen, Alan Moses, Simon Skibsted, Kajsa Kvist, John B Buse
BACKGROUND: Degludec is an ultralong-acting, once-daily basal insulin that is approved for use in adults, adolescents, and children with diabetes. Previous open-label studies have shown lower day-to-day variability in the glucose-lowering effect and lower rates of hypoglycemia among patients who received degludec than among those who received basal insulin glargine. However, data are lacking on the cardiovascular safety of degludec. METHODS: We randomly assigned 7637 patients with type 2 diabetes to receive either insulin degludec (3818 patients) or insulin glargine U100 (3819 patients) once daily between dinner and bedtime in a double-blind, treat-to-target, event-driven cardiovascular outcomes trial...
August 24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28864332/associations-of-fats-and-carbohydrate-intake-with-cardiovascular-disease-and-mortality-in-18-countries-from-five-continents-pure-a-prospective-cohort-study
#16
MULTICENTER STUDY
Mahshid Dehghan, Andrew Mente, Xiaohe Zhang, Sumathi Swaminathan, Wei Li, Viswanathan Mohan, Romaina Iqbal, Rajesh Kumar, Edelweiss Wentzel-Viljoen, Annika Rosengren, Leela Itty Amma, Alvaro Avezum, Jephat Chifamba, Rafael Diaz, Rasha Khatib, Scott Lear, Patricio Lopez-Jaramillo, Xiaoyun Liu, Rajeev Gupta, Noushin Mohammadifard, Nan Gao, Aytekin Oguz, Anis Safura Ramli, Pamela Seron, Yi Sun, Andrzej Szuba, Lungiswa Tsolekile, Andreas Wielgosz, Rita Yusuf, Afzal Hussein Yusufali, Koon K Teo, Sumathy Rangarajan, Gilles Dagenais, Shrikant I Bangdiwala, Shofiqul Islam, Sonia S Anand, Salim Yusuf
BACKGROUND: The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear. METHODS: The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35-70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3-9·3)...
November 4, 2017: Lancet
https://www.readbyqxmd.com/read/28365411/effects-of-intensive-glucose-control-on-microvascular-outcomes-in-patients-with-type-2-diabetes-a-meta-analysis-of-individual-participant-data-from-randomised-controlled-trials
#17
Sophia Zoungas, Hisatomi Arima, Hertzel C Gerstein, Rury R Holman, Mark Woodward, Peter Reaven, Rodney A Hayward, Timothy Craven, Ruth L Coleman, John Chalmers
BACKGROUND: Intensive glucose control is understood to prevent complications in adults with type 2 diabetes. We aimed to more precisely estimate the effects of more intensive glucose control, compared with less intensive glucose control, on the risk of microvascular events. METHODS: In this meta-analysis, we obtained de-identified individual participant data from large-scale randomised controlled trials assessing the effects of more intensive glucose control versus less intensive glucose control in adults with type 2 diabetes, with at least 1000 patient-years of follow-up in each treatment group and a minimum of 2 years average follow-up on randomised treatment...
June 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27965211/gotta-catch-em-all-pok%C3%A3-mon-go-and-physical-activity-among-young-adults-difference-in-differences-study
#18
Katherine B Howe, Christian Suharlim, Peter Ueda, Daniel Howe, Ichiro Kawachi, Eric B Rimm
OBJECTIVE:  To estimate the effect of playing Pokémon GO on the number of steps taken daily up to six weeks after installation of the game. DESIGN:  Cohort study using online survey data. PARTICIPANTS:  Survey participants of Amazon Mechanical Turk (n=1182) residing in the United States, aged 18 to 35 years and using iPhone 6 series smartphones. MAIN OUTCOME MEASURES:  Number of daily steps taken each of the four weeks before and six weeks after installation of Pokémon GO, automatically recorded in the "Health" application of the iPhone 6 series smartphones and reported by the participants...
December 13, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28289041/coadministration-of-canagliflozin-and-phentermine-for-weight-management-in-overweight-and-obese-individuals-without-diabetes-a-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Priscilla Hollander, Harold E Bays, Julio Rosenstock, Mary Ellen Frustaci, Albert Fung, Frank Vercruysse, Ngozi Erondu
OBJECTIVE: To assess the efficacy and safety of coadministration of canagliflozin (CANA) and phentermine (PHEN) compared with placebo (PBO) and CANA or PHEN monotherapies in individuals who were overweight and obese without type 2 diabetes. RESEARCH DESIGN AND METHODS: This 26-week, phase 2a, randomized, double-blind, PBO-controlled, multicenter, parallel-group study enrolled individuals who were obese or overweight without type 2 diabetes ( N = 335, aged 18-65 years, BMI ≥30 to <50 kg/m2 or BMI ≥27 to <50 kg/m2 with hypertension and/or dyslipidemia)...
May 2017: Diabetes Care
https://www.readbyqxmd.com/read/28298470/genetically-driven-hyperglycemia-increases-risk-of-coronary-artery-disease-separately-from-type-2-diabetes
#20
Jordi Merino, Aaron Leong, Daniel C Posner, Bianca Porneala, Lluís Masana, Josée Dupuis, Jose C Florez
OBJECTIVE: This study tested the hypothesis that genetically raised hyperglycemia increases coronary artery disease (CAD) risk separately from the risk conferred by type 2 diabetes as a whole. RESEARCH DESIGN AND METHODS: We conducted a Mendelian randomization (MR) analysis using summary-level statistics from the largest published meta-analyses of genome-wide association studies (GWAS) for fasting glucose (FG) ( n = 133,010 participants free of diabetes) and CAD ( n = 63,746 case subjects and 130,681 control subjects) of predominantly European ancestry...
May 2017: Diabetes Care
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