Parathyroid adenoma presenting with spontaneous cervical and anterior mediastinal hemorrhage: A case report.

Rationale: Spontaneous anterior cervical or mediastinal hemorrhage is a rare presentation of parathyroid adenoma.

Patient Concerns: A 69-year-old woman presented with neck hematoma and dysphagia and was found to have a soft tissue mass adjacent to her thyroid gland as seen on MRI and neck ultrasound.

Diagnosis: Laboratory testing demonstrated elevated calcium and parathyroid hormone supporting diagnosis of parathyroid adenoma.

Circulating ApoJ is closely associated with insulin resistance in human subjects.

Objective: Insulin resistance is a major risk factor for type 2 diabetes. ApolipoproteinJ (ApoJ) has been implicated in altered pathophysiologic states including cardiovascular and Alzheimer's disease. However, the function of ApoJ in regulation of glucose homeostasis remains unclear.

Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.

Objective: Uncontrolled hyperglycemia and iatrogenic hypoglycemia represent common and frequently preventable quality and safety issues. We sought to demonstrate the effectiveness of a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management.

Population: all hospitalized adult non-intensive care unit (non-ICU) patients with hyperglycemia and/or a diagnosis of diabetes admitted to our 550-bed academic center across 5 calendar years (CYs).

Using a triggered endocrinology service consultation to improve the evaluation, management, and follow-up of osteoporosis in hip-fracture patients.

Background: Nearly 2 million osteoporosis-related fractures occur yearly in the United States, with more than 400,000 requiring hospital admissions. Fewer than 30% receive proper evaluation and care for osteoporosis, representing a large opportunity to enhance secondary prevention of fractures. Methods to improve identification and triage of hospitalized fragility-fracture patients are desirable.

Increased microvascular flow and foot sensation with mild continuous external compression.

Intermittent pneumatic compression of the calf and foot increases inflow to the popliteal artery and skin. We hypothesize that mild, continuous pneumatic compression of the lower extremities of type 2 diabetic patients increases microvascular blood flow to skin (SBF) and muscle (MBF) and improves sensation in feet. Data were collected on 19 healthy volunteers and 16 type 2 diabetic patients.

Selective regulation of cellular and secreted multimeric adiponectin by antidiabetic therapies in humans.

Adiponectin, an insulin-sensitizing factor secreted from adipose tissue, is decreased in individuals with type 2 diabetes (T2D) and increased in response to thiazolidinedione (TZD) therapy. Changes in its secretion and assembly into higher-order forms affect insulin sensitivity. To determine the relative potency of TZDs on intra-adipocyte multimerization and secretion of adiponectin, we assessed the impact of in vivo low- or high-dose rosiglitazone treatment alone or combined with metformin in subjects with T2D.

The role of self-monitoring of blood glucose during the treatment of type 2 diabetes with medications targeting postprandial hyperglycemia.

Intensive treatment has been shown to improve glycemic control and reduce the risk of diabetic complications in controlled clinical trials; however, glycemic control has substantial room for improvement in the diabetic population. Management strategies have traditionally focused on achieving A1c targets, with fasting glucose levels serving as the primary measure of day-to-day glycemic control. Considerable evidence indicates that postchallenge plasma glucose, a surrogate for postprandial hyperglycemia, is an independent cardiovascular risk factor, highlighting the fact that optimal glycemic control requires management of both fasting and postprandial glucose levels.

New therapeutic options for treating type-2 diabetes: a review of insulin analogs and premixed insulin analogs.

There is a growing consensus that blood glucose control, and postprandial control in particular, must become more aggressive if we are to stem the growing tide of diabetes-related complications and mortality. For most patients, this means that insulin therapy must begin earlier and that insulin must be titrated sufficiently to achieve tighter glycemic targets. The limitations of traditional treatment regimens, delivery devices and conventional insulin formulations, in conjunction with patient factors, have prevented the majority of people with type-2 diabetes from realizing the potential benefits of insulin therapy and achieving recommended glycemic targets.

Adipocyte differentiation-related protein in human skeletal muscle: relationship to insulin sensitivity.

Objective: To determine whether adipocyte differentiation-related protein (ADRP), a lipid droplet-associated protein that binds to and sequesters intracellular fatty acids, is 1) expressed in human skeletal muscle and 2) differentially regulated in human skeletal muscle obtained from obese non-diabetic (OND) and obese diabetic (OD) subjects.

Research Methods And Procedures: Ten OND subjects and 15 OD subjects underwent a weight loss or pharmacological intervention program to improve insulin sensitivity. Anthropometric data, hemoglobin A(1C), fasting glucose, lipids, and glucose disposal rate were determined at baseline and at completion of studies.