Endocrine

You Don’t Look Diabetic:Diabetes in Non-Obese South Asians–Is There a Molecular or Genetic Basis for Increased Insulin Resistance?

August 24, 2011
You Don’t Look Diabetic:Diabetes in Non-Obese South Asians–Is There a Molecular or Genetic Basis for Increased Insulin Resistance?

By Adelaide Hearst, MD

Faculty Peer Reviewed

Diabetes is a nationwide epidemic in the United States, affecting 23.6 million people, over 7% of the population. But all diabetics may not be created equal. In the US, Asians are 1.6 times more likely that non-Hispanic whites to have diabetes, even after adjusting for body-mass index (BMI), age, and sex. Asians have high rates of type 2 diabetes and coronary artery disease, and increased risk for metabolic syndrome compared to non-Hispanic whites.  Spend a day at Bellevue, …

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Subclinical Hypothyroidism: To Screen or Not to Screen?

August 17, 2011
Subclinical Hypothyroidism: To Screen or Not to Screen?

By Addie Peretz, MD

Faculty Peer Reviewed

Despite the ease of screening for hypothyroidism with hormone assays and the availability of thyroxine replacement therapy, no recommendations regarding routine screening for hypothyroidism in adults are universally accepted. The American Academy of Family Physicians and the American Association of Clinical Endocrinologists recommend periodic assessment of thyroid function in older women.  The American Thyroid Association advocates for more frequent earlier screening, recommending measurement of thyroid stimulating hormone (TSH) beginning at age 35 and every 5 years …

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Ramadan, Fasting, and Diabetes

February 25, 2011
Ramadan, Fasting, and Diabetes

By Sana Shah, Class of  2011

Faculty Peer Reviewed

The Islamic faith is characterized by five central pillars: the public declaration of one’s faith, five daily prayers, an annual tax to the poor, a pilgrimage to Mecca, and annual fasting. Muslims fast together during the month of Ramadan, which is the ninth month of the Islamic lunar calendar and will next occur from August 1st-30th, 2011. The month begins 10 to 11 days earlier each year in the solar calendar and may occur during different …

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From The Archives – Deciphering Fact from Fiction in Hypoglycemia

January 6, 2011
From The Archives – Deciphering Fact from Fiction in Hypoglycemia

Please enjoy this post from the Clinical Correlations archives first posted March 26, 2009

By: Melissa Price, MD

Faculty Peer Reviewed

A 42 year-old male phlebotomist with a history of anxiety presented to the emergency room complaining of four hours of dizziness and diaphoresis. He denied taking any medications. His vitals were stable, his physical exam was significant for a lethargic, diaphoretic young man without focal findings, and his fingerstick value was 43mg/dL. His chest X-ray, EKG, and laboratory results, with the exception of plasma …

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The Heart in Acromegaly

September 1, 2010
The Heart in Acromegaly

By Ari Pollack, MD

Faculty Peer Reviewed

The onset of acromegaly is subtle, and its progression is usually very slow. In fact, the usual interval from the onset of symptoms until diagnosis is about twelve years. The manifestations of acromegaly result from excessive secretion of growth hormone (GH), which targets the liver, resulting in stimulation of hepatic secretion of insulin-like growth factor-1 (IGF-1), which causes many of the clinical manifestations of acromegaly.  The most common cause of acromegaly is a functional pituitary adenoma. The effects …

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Oral Contraceptive Pills: Is It Really Safe to Eliminate Your Period?

May 21, 2010
Oral Contraceptive Pills: Is It Really Safe to Eliminate Your Period?

By Rachel Edlin, MD

Faculty peer reviewed

A 29-year-old female patient with a history of iron deficiency anemia and heavy menstrual periods comes into the clinic for a regular visit. She is tired of iron supplementation and its associated constipation. As she is currently on oral contraceptive pills, you recommend using these to reduce her menstrual period to four times a year. She asks, “Is that really safe?”

Is menstruation necessary?

Monthly menstruation is not the historical norm. Compared with modern women, women in prehistoric …

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Which Thyroid Antibody Assays Should be Checked in Patients with Thyroid Disease?

April 14, 2010
Which Thyroid Antibody Assays Should be Checked in Patients with Thyroid Disease?

Michael Chu MD

Faculty peer reviewed

Case:

A 44-year old female presented to the emergency room with complaints of a lower extremity rash and swelling.  The patient had been in her usual state of health when she presented to her primary care physician with complaints of palpitations, weight loss and insomnia.  Lab tests were performed and she was given a diagnosis of hyperthyroidism.  She was started on propranolol and methimazole, which the patient took intermittently due to intolerance of side effects, which she perceived as …

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How Do You Advise the Balding Patient?

January 13, 2010
How Do You Advise the Balding Patient?

Sagar Mungekar

Faculty Peer Reviewed

The incidence of male pattern hair loss can reach almost 100% in some ethnic groups.1, 2 While treatment of the condition is usually deferred to dermatologists, it is often the primary care physician (PCP) who is first approached for advice. Several medical and surgical treatments exist for male pattern hair loss. Herbal supplements and products on infomercials make cursory non-FDA-approved claims of hair growth. Minoxidil, once developed for hypertension, is available over the counter as a scalp treatment. Finasteride and …

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