Endocrine Practice最新文献

{"title":"Primary Aldosteronism Classification With 18-Oxocortisol and Gallium-68–Pentixafor Positron Emission Tomography/Computed Tomography","authors":"Yinjie Gao PhD ,&nbsp;Jie Ding MD ,&nbsp;Yu Wang MM ,&nbsp;Yue Zhou PhD ,&nbsp;Yushi Zhang MD ,&nbsp;Ling Qiu PhD ,&nbsp;Li Huo MD ,&nbsp;Anli Tong MD","doi":"10.1016/j.eprac.2025.02.012","DOIUrl":"10.1016/j.eprac.2025.02.012","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the noninvasive and accurate evaluation methods of primary aldosteronism (PA) classification.</div></div><div><h3>Methods</h3><div>There were 99 patients with aldosterone-producing adenoma (APA) and 61 with idiopathic hyperaldosteronism recruited in this study. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gallium-68 (⁶⁸Ga)–pentixafor positron emission tomography (PET)/computed tomography (CT) were performed in this cohort. Statistical analysis was used to calculate the diagnostic efficiency of single or double methods.</div></div><div><h3>Results</h3><div>In steroid profiling detected by LC-MS/MS, the average levels of 6 steroids apart from aldosterone in the APA group were higher than those in the idiopathic hyperaldosteronism group. The differential diagnostic efficiency of 18-oxocortisol (cutoff value at 0.132 ng/mL) was greater than other steroids, with a sensitivity of 75.3% and specificity of 91.2%. As for ⁶⁸Ga-pentixafor PET/CT, visual analysis showed a sensitivity of 93.7% and specificity of 56.3%. At the optimum maximum standardized uptake value of 8.00, the sensitivity was 69.8%, and the specificity was 93.7%. Taking into account the 18-oxocortisol level and ⁶⁸Ga-pentixafor PET/CT maximum standardized uptake value, 100% of patients with double positive results were placed in the right APA subtype. If the 18-oxocortisol level with ⁶⁸Ga-pentixafor PET/CT visual analysis was combined for PA subtyping, the sensitivity of at least 1 positive was 95.2%, and a total of 87.2% of patients could be classified correctly.</div></div><div><h3>Conclusion</h3><div>The LC-MS/MS and ⁶⁸Ga-pentixafor PET/CT have great advantages on the subtyping of PA. There was a high accuracy of the combination of the 2 methods, which will contribute to avoid an unnecessary adrenal venous sampling operation before surgery for most patients with PA.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 614-619"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Effects of Tirzepatide: A Systematic Review and Meta-Analysis","authors":"A.B.M. Kamrul-Hasan MBBS, MD ,&nbsp;Sanja Borozan MD ,&nbsp;Deep Dutta MBBS, MD, DM, DNB, FRCP, FACE ,&nbsp;Lakshmi Nagendra MBBS, MRCP, MD, DM, DrNB, FRCP ,&nbsp;Dina Shrestha MBBS, MD ,&nbsp;Joseph M. Pappachan MD, FRCP","doi":"10.1016/j.eprac.2024.12.017","DOIUrl":"10.1016/j.eprac.2024.12.017","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 703-706"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring in Hospitalized Patients With Type 2 Diabetes: A Step Forward in Inpatient Glycemic Control","authors":"Alejandra Rivas-Montenegro MD,&nbsp;Roberto Añez-Ramos MD,&nbsp;Alba Galdón-Sanz Pastor MD,&nbsp;Olga González-Albarrán PhD","doi":"10.1016/j.eprac.2025.02.007","DOIUrl":"10.1016/j.eprac.2025.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effect and safety of continuous glucose monitoring (CGM) use in glycemic control compared to standard approach in hospitalized patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>This was a pilot randomized controlled clinical trial that enrolled 37 hospitalized patients with type 2 diabetes admitted in medical and surgical wards. All patients used CGM (Abbott FreeStyle2 or FreeStyle3) and concomitantly 6-point point of care glucose. In group A (<em>n</em> = 19), daily CGM profiles, alarms, and trend arrows were considered for glycemic therapeutic decisions and in group B (<em>n</em> = 18) were based on point of care glucose. Primary outcomes included the difference in time in range 70-180 mg/dL, hospital glycemia risk index, time below range measured as the percentage below 70 mg/dL and below 54 mg/dL, and time above range measured as the percentage above 180 mg/dL and above 250 mg/dL.</div></div><div><h3>Results</h3><div>Time in range was higher in group A: 78.26 ± 10.83% vs 67.39 ± 19.13% <em>P</em> = .04. Time above range level 1 in group A: 14.37 ± 8.33% vs group B: 23.28 ± 16.62% <em>P</em> = .04. Asymptomatic hypoglycemic events were more detected by CGM-group (1.65 ± 2.03 vs 0.31 ± 0.60 <em>P</em> = .01). Overall mean absolute relative difference: 14.7%. Diabetes technology society error grid: 69.5% zone A and 29.3% zone B.</div></div><div><h3>Conclusions</h3><div>The implementation of CGM in hospitals could represent a significant advancement in diabetes management, offering a more comprehensive and dynamic approach to monitoring glucose levels. Further research is needed to explore the long-term impacts of CGM on clinical outcomes and to optimize its integration into hospital protocols.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 564-570"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors, Microbiology, and Prognosis of Diabetic Foot Osteomyelitis: A Retrospective Cohort Study","authors":"Jun Ren MD ,&nbsp;Hao Gao MD ,&nbsp;Wen Luo MD, PhD ,&nbsp;Shuaikun Lu MD ,&nbsp;Congxiao Fu MD ,&nbsp;Hu Wang MD ,&nbsp;Guoliang Wang MD, PhD ,&nbsp;Zhenfeng Zhu MD ,&nbsp;Yong Zhang MD, PhD ,&nbsp;Yunfei Zhang MD, PhD","doi":"10.1016/j.eprac.2025.01.007","DOIUrl":"10.1016/j.eprac.2025.01.007","url":null,"abstract":"<div><h3>Objective</h3><div>To determine risk factors, microbiology, and prognosis of diabetic foot osteomyelitis (DFO).</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 456 persons diagnosed with diabetic foot disease admitted to a grade-A tertiary hospital from January 2012 to December 2022. Multifactorial Cox regression was used to analyze independent risk factors for DFO. Medical records were reviewed to determine etiologic agents and antibiotic susceptibility profiles. In addition, 5-year survival rates of all DFO patients and those undergoing amputation were analyzed using Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>Multivariate Cox regression identified higher Wagner grades (hazard ratio 3.17, 95% confidence interval 2.04, 4.94) as independent risk factors for DFO. In the DFO group, a total of 62 patients had positive bone or deep tissue cultures. The most prevalent Gram-positive bacterial isolates were <em>Staphylococcus aureus</em> (11.29%) and <em>Enterococcus faecalis</em> (11.29%), while Gram-negative infections were caused most often by <em>Proteus vulgaris</em> (4.84%). Polymicrobial infections were common (27.41%). Five-year survival rates were lower among DFO patients than in matched DF controls, and lower among major amputation than minor amputation and nonamputation DFO patients.</div></div><div><h3>Conclusions</h3><div>Higher Wagner grades were independent risk factors for DFO. Major amputation does not improve 5-year survival rates in DFO patients.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 578-584"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"People With Adrenal Insufficiency Who Are in Adrenal Crisis Are Frequently Unable to Self-Administer Rescue Injections","authors":"Whitaker J. Hover ,&nbsp;Aiden D. Krein ,&nbsp;Julia Kallet BS ,&nbsp;Gregory L. Kinney PhD ,&nbsp;Phyllis W. Speiser MD ,&nbsp;Selma F. Witchel MD ,&nbsp;Diane Donegan MD ,&nbsp;Alexandra Ahmet MD ,&nbsp;Julia Anthony MS ,&nbsp;Sofia Llahana MSc ,&nbsp;Susan L. Majka RN, JD ,&nbsp;Michal F. Slovick MD ,&nbsp;Joshua D. Stilley MD ,&nbsp;Paul L. Margulies MD ,&nbsp;Michael T. McDermott MD ,&nbsp;Erin A. Foley MPH ,&nbsp;Elizabeth A. Regan MD, PhD","doi":"10.1016/j.eprac.2025.02.017","DOIUrl":"10.1016/j.eprac.2025.02.017","url":null,"abstract":"<div><h3>Objective</h3><div>Individuals with adrenal insufficiency (AI) are at risk of acute adrenal crisis and death, particularly during illness or trauma, and may require rapid treatment with parenteral glucocorticoid such as hydrocortisone to manage a crisis. Current guidelines recommend timely self-injection in an evolving crisis. Little is known about the patient experience with emergency injections. We surveyed people with AI regarding success with emergency injections.</div></div><div><h3>Methods</h3><div>In 2022 a survey was conducted through the National Adrenal Diseases Foundation website of individuals with AI or their caregivers about experience with managing an adrenal crisis. They reported on adrenal crisis events that required an emergency cortisol injection and the success or failure of the injection, context of the event and reasons for failure.</div></div><div><h3>Results</h3><div>Nearly half (41%) of adrenal insufficient patients were unable to self-administer an emergency glucocorticoid injection, citing effects of their crisis-associated illness and confusion as major barriers. Failed injections led to bad outcomes (sicker, need for hospitalization, or death) in 36% of cases.</div></div><div><h3>Conclusions</h3><div>Effective, timely, management of an impending adrenal crisis can prevent progression to hospitalization, multisystem failure requiring intensive care unit care, and death. Reliance solely on patient self-injection may result in worse outcomes. Treating physicians should include patient education about injections and specific practical instruction in the technique, as well as the potential need for assistance in a crisis. US Food and Drug Administration approval of a glucocorticoid autoinjector, greater engagement with Emergency Medical Services clinicians, hospital emergency staff, and other health care professionals, is key for future success in managing adrenal crises.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 625-630"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulse Control Disorders in Patients With Hyperprolactinemia on Dopamine Agonist Therapy-How Concerned Should We Be?","authors":"Ghazal Daftari, Nicholas A Tritos","doi":"10.1016/j.eprac.2025.04.018","DOIUrl":"10.1016/j.eprac.2025.04.018","url":null,"abstract":"<p><strong>Objective: </strong>Dopamine agonists (DAs), including cabergoline and bromocriptine, are the mainstay of treatment for prolactinomas. An underappreciated adverse effect associated with DAs is impulse control disorders (ICDs), characterized by the development of compulsive behaviors, including hypersexuality, pathological gambling, binge eating, and compulsive shopping, among others, which can negatively impact patients' and families' lives. This article reviews the prevalence, risk factors, presumed pathophysiology, and diagnostic and management strategies for ICDs in hyperprolactinemic patients treated with DAs.</p><p><strong>Methods: </strong>Electronic literature searches were conducted to retrieve pertinent articles for inclusion in this article.</p><p><strong>Results: </strong>The reported prevalence of ICDs in patients with prolactinomas or hyperprolactinemia on DAs ranges from 7.5% to 46% across studies, with cabergoline being more commonly implicated than bromocriptine. Younger age, male sex, and specific genetic polymorphisms appear to increase the risk of ICDs. Diagnostic tools, such as the Minnesota Impulse Disorders Interview, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease, the Barratt Impulsivity Scale-11, and computer-based tests, are instrumental in identifying ICDs. Patient education and periodic screening are advisable for early detection. Management strategies for patients who develop ICDs may include a decrease in DA dose or medication discontinuation, and psychiatric evaluation.</p><p><strong>Conclusion: </strong>ICDs may occur in patients with hyperprolactinemia on DAs and negatively influence their lives if undetected. Further studies are needed to fully elucidate the risk factors and underlying mechanisms and to identify effective therapies for managing ICDs in patients with hyperprolactinemia on DAs.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Heart Failure With Type 1 Diabetes and Type 2 Diabetes Among US Adults.","authors":"Ashwin K Chetty, Alissa S Chen","doi":"10.1016/j.eprac.2025.04.019","DOIUrl":"10.1016/j.eprac.2025.04.019","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Neck Ultrasound as Surveillance in Older Adults With Thyroid Cancer.","authors":"Nina Francis-Levin, Edward Shao, Jacob Ortlieb, Brittany Gay, Mousumi Banerjee, Maria Papaleontiou, Megan R Haymart","doi":"10.1016/j.eprac.2025.04.020","DOIUrl":"10.1016/j.eprac.2025.04.020","url":null,"abstract":"<p><strong>Objective: </strong>Close to one-quarter of thyroid cancers occur in older adults (ie, aged ≥ 65). This group also has other comorbidities and higher risk of death from other causes. Data on optimal neck ultrasound use for thyroid cancer surveillance in older adults are limited.</p><p><strong>Methods: </strong>We identified patients aged ≥ 65 years diagnosed with thyroid cancer using data from the Centers for Medicare & Medicaid Services linked to health data from University of Michigan between 2016-2021 (median follow-up 3 years, range 0-6 years). We assessed demographic characteristics, comorbidities, frequency of neck ultrasound, and cause of death.</p><p><strong>Results: </strong>Of the 2007 patients diagnosed with thyroid cancer, median age was 74 years (range 65-100) and 65.1% were female. Overall, 76 (3.8%) died of thyroid cancer, and 259 (12.9%) died of other causes. There were more comorbidities in the cohort who died of other causes during the study period, eg, 179 (69.1%) in the cohort who died of other causes had heart disease compared with 868 (43.3%) of those in the entire cohort. Patients who died of other causes received a mean of 1.36 neck ultrasounds (range 0-12) and the remainder of the cohort received a mean of 2.38 neck ultrasounds (range 0-26) during the study period, P < .001.</p><p><strong>Conclusions: </strong>Older adults with thyroid cancer are more likely to die of causes other than thyroid cancer. To improve high-value care in older adults with thyroid cancer and high-risk of death from other causes, there is need for individualized plans for neck ultrasound use.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"ChatGPT-4's Accuracy in Estimating Thyroid Nodule Features and Cancer Risk From Ultrasound Images\".","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1016/j.eprac.2025.04.013","DOIUrl":"10.1016/j.eprac.2025.04.013","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like Peptide-1 Receptor Agonists Are Associated With Improved Survival and Reduced Liver-Related Events in Patients With Type 2 Diabetes and Metabolic Dysfunction-Associated Liver Disease: A Large Real-World Retrospective Study.","authors":"Benjamin D Liu, Mohammed Aly, Cindy Hsin-Ti Lin, Noordeep Panesar, Hannah Hill, Kamran Qureshi","doi":"10.1016/j.eprac.2025.04.017","DOIUrl":"10.1016/j.eprac.2025.04.017","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1 RAs) or pioglitazone (PGZ) are associated with improved survival, reduced liver-related outcomes (LROs), and better metabolic outcomes in patients with type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated liver disease (MASLD) or steatohepatitis (MASH).</p><p><strong>Methods: </strong>We used the TriNetX platform to identify adults with T2DM and MASLD/MASH from 2006 onward (n = 558 075) using Internation Classification of Diseases codes. Patients with confounding liver diseases, overlapping study medications, or bariatric surgery were excluded. Three exclusive cohorts-GLP-1 RA, PGZ, and other antidiabetic agents (controls)-were formed. After 1:1 propensity score matching, time-to-event analyses were performed using Cox proportional hazards models and Kaplan-Meier methods.</p><p><strong>Results: </strong>Among matched groups, GLP-1 RAs (n = 17 465) were associated with a 40.9% reduction in all-cause mortality versus controls (hazard ratio [HR] 0.59; P < .0001) and significantly lower rates of LRO (HR 0.77) and liver transplantation (HR 0.33). In contrast, PGZ (n = 1803) showed reduced LRO rates (HR 0.68) but not mortality. In cirrhotic patients, GLP-1 RA was linked to fewer transplant events but did not significantly reduce mortality. GLP-1 RA therapy noted greater reductions in body mass index and hemoglobin A1c relative to controls.</p><p><strong>Conclusions: </strong>In this large real-world cohort, GLP-1 RA use was associated with improved survival and hepatic outcomes in T2DM patients with MASLD/MASH, particularly among those without established cirrhosis. PGZ exhibited hepatic benefits. These findings highlight the potential importance of further prospective studies to evaluate early GLP-1 RA therapy in this high-risk diabetic population with MASLD/MASH.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}