Endocrine

Should I Add Sugar or Splenda to My Coffee?

June 6, 2013
Should I Add Sugar or Splenda to My Coffee?

By Reda Issa

Faculty Peer Reviewed

As a medical student, I adjusted to waking up at 6 AM every day – with the help of coffee, of course. Living in New York City and its fast-paced routine requires that extra kick those beans provide. So, should I add sugar or Splenda to my coffee? Half a century ago this question did not exist, but obesity was not a word in the Merriam-Webster then. Today, we have to think more carefully.

Non-sucrose based sweeteners can be …

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Too Much of a Good Thing: The Evidence Behind the Need for a Bisphosphonate Holiday

May 9, 2013
Too Much of a Good Thing: The Evidence Behind the Need for a Bisphosphonate Holiday

By Jenna Piccininni

Faculty Peer Reviewed

Bisphosphonates are a relatively new medication having only been approved to treat osteoporosis in the US since 1995 . In addition, large placebo controlled trials have, at most, 10 years of follow-up data. Thus, there are still questions regarding the long-term use of these agents. There are a few well-established side effects of bisphosphonates including rare osteonecrosis of the jaw and more common esophageal irritation. However, several more recent case reports suggest a correlation between prolonged bisphosphonate use and …

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In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

April 17, 2013
In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

By David G. Rosenthal and Robert Gianotti, MD

Faculty Peer Reviewed

Case: A 33-year-old man comes to your clinic complaining of worsening acne over the last 6 months. You note a significant increase in both BMI and bicep circumference. After several minutes of denial, he reveals that he has been using both injectable and oral anabolic steroids. He receives these drugs from a local supplier and via the Internet. He confides that his libido has dramatically increased and he feels increasingly pressured at work, describing …

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The Effect of Bariatric Surgery on Incretin Hormones and Glucose Homeostasis

April 4, 2013
The Effect of Bariatric Surgery on Incretin Hormones and Glucose Homeostasis

By Michael Crist

Faculty Peer Reviewed

Until recently, little thought was given to the important role played by the duodenum, jejunum, and ileum in glucose homeostasis. The involvement of the gut in glucose regulation is mediated by the enteroinsular axis, which refers to the neural and hormonal signaling pathways that connect the gastrointestinal (GI) tract with pancreatic beta cells. These pathways are largely responsible for the increase in insulin that occurs during the postprandial period. In 1964 McIntyre and colleagues first reported the phenomenon of …

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White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

March 20, 2013
White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

By Lauren Foster

Faculty Peer Reviewed

Hypertension is a pervasive chronic disease affecting approximately 65 million adults in the United States, and a significant cause of morbidity and mortality . Antihypertensives are widely prescribed due to their effectiveness in lowering blood pressure, thereby reducing the risk of cardiovascular events. However, the phenomenon of the “white coat effect” may be a complicating factor in the diagnosis and management of hypertensive patients. It is well established that a considerable number of people experience an elevation of their …

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What Is Andropause? Is Testosterone Supplementation the Answer in Older Men?

September 20, 2012
What Is Andropause?  Is Testosterone Supplementation the Answer in Older Men?

By Kylie Birnbaum

Faculty Peer Reviewed

Women have long bemoaned menopause and its physiological, psychological, and sexual effects. Fortunately, hormone replacement therapy has provided relief for symptomatic women. Less attention is paid to men, who also experience declines in their sex hormones. Decreased testosterone may explain many symptoms experienced by elderly men, such as poor sexual function and libido, decreased bone mineral density, fatigue, and decreased muscle mass and strength. Should physicians treat elderly men with testosterone replacement therapy?

Late-onset hypogonadism, or “andropause,” is the …

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A Study of Cultural Complications in the Management of Diabetes

April 18, 2012
A Study of Cultural Complications in the Management of Diabetes

By Kimberly Jean Atiyeh

Faculty Peer Reviewed

Ms. KS is a 49- year-old Bangladeshi woman with a history of diabetes mellitus and non-adherence to medical treatment or follow up, who was reluctantly brought to the Bellevue ER by her family for nausea, vomiting, and fevers for one day. Her most recent hospitalization was 9 months prior for epigastric discomfort in the setting of uncontrolled diabetes with a hemoglobin A1C of 12.4%. On arrival, her physical exam was significant for tachypnea, tachycardia, and dry mucus membranes. …

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Obesity 2.0: More Than Just the Extra Weight

February 9, 2012
Obesity 2.0: More Than Just the Extra Weight

By Aviva Regev

Faculty Peer Reviewed

Introduction

Few people these days are unaware of the “obesity epidemic,” with its inception here in the United States and its steady, insidious spread around the globe. The numbers are truly staggering: in 2008, the World Health Organization estimated that 1.5 billion adults–over 20% of the earth’s population–were overweight, and 500 million of those were classified as obese, with a body mass index greater than 30. In the United States, over a third of the population is overweight, and …

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When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

February 1, 2012
When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

By Joseph Larese

Faculty Peer Reviewed

Hemoglobin A1C (HbA1c) is an invaluable tool for monitoring long-term glycemic control in diabetic patients. However, many clinicians managing diabetics have encountered the problem of HbA1c values that do not agree with fingerstick glucose logs. Before suspecting an improperly calibrated glucometer or poor patient record keeping, it is useful to consider the situations in which HbA1c may be spuriously elevated or depressed. These issues are best understood after reviewing how HbA1c is defined and measured–topics fraught with considerable confusion.…

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Male Hormonal Contraception

January 20, 2012
Male Hormonal Contraception

By Kaley Myer, Class of 2012

Faculty Peer Reviewed

As a female, I like the idea of males taking hormonal contraceptives. In a semi-sadistic way, I relish the idea of a man taking a pill every day to prevent impregnation of my gender. Traditionally, contraception has been a female responsibility, from diaphragms to oral contraceptive pills to intrauterine devices. Male condoms, coitus interruptus, and the more permanent vasectomy require male participation, but these methods do not dominate the contraceptive market. Indeed, couples are encouraged to …

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Bariatric Surgery: A Cure for Diabetes?

October 20, 2011
Bariatric Surgery: A Cure for Diabetes?

By Amy Dinitz

Faculty Peer Reviewed

The lifetime risk of developing diabetes for persons born in 2000 is around 35% and the NHANES database has suggested a greater than fourfold increase in prevalence over the last three generations.  While bariatric surgery has become the most effective treatment for obesity, it has also been found to be an extremely effective treatment for type 2 diabetes.  It was initially thought that the weight loss experienced by patients after bariatric surgery was responsible for improved glycemic control.  However, …

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Metabolic Syndrome: Fact or Myth?

September 30, 2011
Metabolic Syndrome: Fact or Myth?

By Vicky Jones, MD

A 40-year-old female presented to her primary care provider with a chief complaint of weight gain over the past year.  She wants to be fully evaluated for any kind of medical disorder that could have caused it.  She has been seen by multiple specialists but no one can give her a “straight diagnosis”.  Their advice is for her to lose weight.  She insists she never had problems with her weight in the past and has no known medical disorders. Her physical …

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