Diabetes therapy and cancer risk: where do we stand when treating patients?

The pathophysiology of type 2 diabetes mellitus conveys increased cancer risk, and any antidiabetic drug may alter that risk in a favorable or unfavorable way. This article discusses the links between diabetes and cancer, the different agents available for treating diabetes, and the cancer risk associated with these therapies.

The clinical utility of free thyroxine in oral levothyroxine absorption testing.

Objective: Original absorption studies for levothyroxine (LT4) were validated using total thyroxine (TT4) measurements. Free thyroxine (FT4) has largely supplanted TT4 in clinical practice. The objective of our study was to assess the clinical utility of FT4 in oral LT4 absorption testing.

Heart failure in hypophosphatemic rickets: complications from high-dose phosphate therapy.

Objective: To report a rare case of hypophosphatemic rickets (HR) leading to extensive cardiac complications.

Methods: We present the clinical course and autopsy findings of a patient with HR, treated with chronic phosphate-only therapy as a child, who subsequently developed tertiary hyperparathyroidism leading to extensive cardiac calcifications and complications. We also review the literature on the pathophysiology of calcifications from HR.

Hypothyroidism as a cause of hyponatremia: fact or fiction?

Objective: To illustrate that severe primary hypothyroidism alone may not be enough to cause hyponatremia in the otherwise healthy ambulatory patient.

Methods: A retrospective chart review was conducted using an academic health center enterprise-wide electronic health record to identify 10 patients with primary hypothyroidism and same-day serum thyroid-stimulating hormone (TSH), sodium, creatinine, and calculated glomerular filtration rate (GFR). Same-day free triiodothyronine or free thyroxine was also recorded if tested.

Is chronic nipple piercing associated with hyperprolactinemia?

Literature on hyperprolactinemia in the setting of a nipple piercing is limited to individuals with concomitant breast/chest wall infection. It is unclear if chronic nipple stimulation from a piercing alone can cause sustained elevations of serum prolactin. Nipple piercing is emerging as a more mainstream societal form of body art, and the answer to this clinical question would potentially alter patient management.

Epiphora after radioactive iodine ablation for thyroid cancer.

Background: Epiphora is a condition in which an overflow of tears occurs because of excessive lacrimal secretion or insufficient drainage of tears due to obstruction of the nasolacrimal system. This ophthalmic complication can be an intermediate to late sequela of radioactive iodine ((131)I) therapy in thyroid cancer patients.

Patient Findings: We present a case of a 23-year-old woman with complaints of bilateral excessive tearing 6 months after (131)I therapy for well-differentiated thyroid cancer.