Pituitary Apoplexy Secondary to Gonadotropin-Releasing Hormone Agonist for Breast Cancer.

Pituitary apoplexy is a potentially fatal clinical condition that results from pituitary infarction due to ischemia or hemorrhage. We present a case of a 53-year-old female patient with a history of recurrent pituitary macroadenoma who presented with headache, blurry vision, nausea, vomiting, and photophobia after receiving a gonadotropin-releasing hormone (GnRH) agonist, leuprolide, as part of adjuvant endocrine therapy for breast cancer. Magnetic resonance imaging (MRI) confirmed the presence of pituitary apoplexy, and endocrine workup showed anterior hypopituitarism.

Insulin-induced vasoconstriction is prevalent in muscle microvasculature of otherwise healthy persons with type 1 diabetes.

Insulin's microvascular actions and their relationship to insulin's metabolic actions have not been well studied in adults with type 1 diabetes mellitus (T1DM). We compared the metabolic and selected micro- and macrovascular responses to insulin by healthy adult control ( = 16) and subjects with T1DM ( = 15) without clinical microvascular disease. We measured insulin's effect on ) skeletal muscle microvascular perfusion using contrast-enhanced ultrasound (CEU), ) arterial stiffness using carotid-femoral pulse-wave velocity (cfPWV) and radial artery pulse wave analysis (PWA), and ) metabolic insulin sensitivity by the glucose infusion rate (GIR) during a 2-h, 1 mU/min/kg euglycemic-insulin clamp.

Pituitary as a Source of HCG: Residual Levels After Bilateral Testicular Tumor Removal.

Context: Challenging clinical scenario in which elevated β-human chorionic gonadotropin (HCG, subsequently termed HCG) levels suggested occult tumor metastases after removal of bilateral testicular cancers and metastases from them and as well as after chemotherapy.

Case Report: A 22-year-old male, post excision of bilateral testicular tumors, who had no imaging or clinical evidence of residual tumor but an elevated HCG raising the question of the presence and location of occult tumor metastases. Clinical Questions.

SGLT2 inhibitors in the treatment of type 2 diabetes.

The kidney plays an important role in glucose homeostasis via its production, utilization, and, most importantly, reabsorption of glucose from glomerular filtrate which is largely mediated via the sodium glucose co-transporter 2 (SGLT2). Pharmacological inhibition of SGLT2 increases urinary glucose excretion and decreases plasma glucose levels in an insulin-independent manner. Agents that inhibit SGLT2 represent a novel class of drugs, which has recently become available for treatment of type 2 diabetes.