Background: This case report highlights an overlooked cause of hyperglycemia and risk of polypharmacy in a patient with end-stage renal disease (ESRD).
Case Summary: A 75-year-old non-English speaking male with type 2 diabetes mellitus, hypertension, coronary artery disease status post percutaneous coronary intervention, and ESRD secondary to immunoglobulin G kappa nephropathy on nightly peritoneal dialysis reported a loss of appetite, decrease in weight, and an increase in symptoms of depression. As a result of these symptoms, his nephrologist initiated megestrol acetate (MA), an agent commonly used in ESRD to help stimulate appetite and improve weight.
Background Chronic migraine has a well-documented association with increased insulin resistance and metabolic syndrome. The hypothalamus may play a role in the progression of insulin resistance in chronic migraine through the regulation of orexigenic peptides such as neuropeptide Y. Insulin resistance may lead to increased risk of future type 2 diabetes mellitus in patients with chronic migraine, which is more likely to occur if other pathogenetic defects of type 2 diabetes mellitus, such as impaired pancreatic β-cell functions and defects in intestinal glucagon-like peptide-1 secretion after meals.
View Article and Find Full Text PDFPurpose: Report occurrence of late-onset choroidal metastasis from breast cancer.
Methods: Retrospective chart review.
Results: The authors report 3 patients with choroidal metastasis from breast cancer that presented more than 20 years after diagnosis of the primary tumor.
Purpose: To assess the possibility of determining the insertion distance from the limbus of horizontal and vertical extraocular rectus muscles with anterior segment optical coherence tomography (AS-OCT).
Methods: The right eyes of 46 patients underwent AS-OCT. The horizontal and vertical extraocular rectus muscle insertion distances from the limbus were measured in a masked fashion by two pediatric ophthalmologists.
Purpose: To evaluate the effects of multiple intravitreal injections of ranibizumab on retinal nerve fiber layer (RNFL) thickness in patients with wet age-related macular degeneration (AMD).
Methods: This observational, comparative study included patients with 10 or more total ranibizumab injections and involved the measurement of RNFL thickness at baseline. Twenty-nine eyes of 29 consecutive patients were evaluated via intraocular pressure (IOP) and measurements of the total and nasal RNFL thicknesses at the initial and final follow-up by using optical coherence tomography.
Background: Comorbidity of migraine with anxiety and depression may play a role in the link between migraine and obesity. We examined the moderating and mediating roles of ghrelin in the relationship between depression (and anxiety) and body weight in newly diagnosed migraineurs.
Methods: Participants were 63 newly diagnosed migraine patients (using the ICHD-II criteria) and 42 healthy volunteers.