The direct and indirect economic burden of hypothyroidism in the United States: a retrospective claims database study.

Objective: To examine direct and indirect economic burden associated with hypothyroidism in the United States.

Methods: Medical costs attributable to hypothyroidism were estimated for patients with hypothyroidism. Non-hypothyroid (euthyroid) controls were matched to patients with hypothyroidism based upon patient characteristics and availability of productivity data.

Effect of Levothyroxine on Kidney Function in Chronic Kidney Disease with Subclinical Hypothyroidism in US Veterans: A Retrospective Observational Cohort Study.

Introduction: Chronic kidney disease (CKD) may be associated with overt or subclinical hypothyroidism [SCH; defined as elevated serum thyroid-stimulating hormone (TSH) despite normal free thyroxine levels). Although some studies have demonstrated that thyroid replacement therapy may improve renal function in overt hypothyroidism, there is no consensus on its benefits in SCH. Clinical and limited economic outcomes were evaluated in levothyroxine-treated US veterans with CKD + SCH.

Cushing's syndrome with no clinical stigmata - a variant of glucocorticoid resistance syndrome.

Background: Cortisol resistance syndrome is a very rare condition characterized by high cortisol levels, but without any clinical features of Cushing's syndrome. Our objective is to present such a case.

Case Presentation: A 41 year old female presented with mild hirsutism and elevated urinary cortisol levels.

The association between adherence to levothyroxine and economic and clinical outcomes in patients with hypothyroidism in the US.

Objective: To evaluate outcomes associated with adherence to levothyroxine (LT4) in the US adult hypothyroidism population.

Methods: We used data from Truven's MarketScan databases from 1 July 2011 through 31 December 2015. Patients aged 18 or older were diagnosed with hypothyroidism (confirmed at least twice) and prescribed LT4.

Comparison of the adherence to the american diabetes association guidelines of diabetes care in primary care and subspecialty clinics.

Background: Diabetes mellitus is a major public health problem with significant morbidity and mortality. Evidence based guidelines have been proposed to reduce the micro and macrovascular complications, but studies have shown that these goals are not being met. We sought to compare the adherence to the American Diabetes Association guidelines for measurement and control of glycohemoglobin (A1c), blood pressure (BP), lipids (LDL) and microalbuminuria (MA) by subspecialty and primary care clinics in an academic medical center.

Update on diabetes diagnosis: a historical review of the dilemma of the diagnostic utility of glycohemoglobin A1c and a proposal for a combined glucose-A1c diagnostic method.

The role of glycohemoglobin A1c (A1c) for the diagnosis of diabetes has been debated for over three decades. Recently, the American Diabetes Association (ADA) has recommended adding A1c as an additional criterion for diabetes diagnosis. In view of the continued debate about the diagnostic utility of A1c, and in view of the unabated burden of undiagnosed diabetes, the search for alternative diagnostic methods is discussed.

Peripheral microvascular response to muscle contraction is unaltered by early diabetes but decreases with age.

Long-term or untreated diabetes leads to micro- and macrovascular complications. However, there are few tests to evaluate microvascular function. A postcontraction blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) technique was exploited to measure peripheral microvascular function in diabetics and healthy controls matched with respect to age, body mass index, and physical activity.

Severe hypercalcemia and acute renal failure: an unusual presentation of sarcoidosis.

Although hypercalcemia is a known metabolic complication of sarcoidosis, it is rarely a presenting manifestation. Long-standing hypercalcemia and hypercalciuria can cause nephrocalcinosis and chronic renal failure. Acute renal failure, although described, is also a rare presentation of patients with sarcoidosis.

Evaluation of control of diabetes mellitus in a subspecialty clinic.

Objective: To determine whether patients with diabetes under follow-up surveillance in a subspecialty clinic are receiving care that meets the guidelines recommended by the American Diabetes Association and American Association of Clinical Endocrinologists.

Methods: We abstracted 2 years of medical records of patients sampled from 2 academic diabetes clinics, managed by board-certified endocrinologists. Information regarding the testing for and results of hemoglobin A1c (A1C), lipids, blood pressure, and microalbuminuria was recorded and analyzed.

Hypertension in Asian/Pacific Island Americans.

Asian/Pacific Islander Americans (APIAs) are the fastest growing population in the United States by percentage. Hypertension is common and increases cardiovascular risk to a great extent in this population. The medical problems of this group are being increasingly encountered by US physicians.

Hemoglobin A1c: past, present and future.

Hemoglobin A1c (HbA1c) has been used for decades to monitor the control of glycemia in diabetes. Although HbA1cis currently undergoing a reassessment, and major developments have been underway in recent years, HbA1c is not recommended at present for diabetes screening or diagnosis. The objective of this review is to summarize the recent developments and to review a potential diagnostic role for HbA1c.

Glycohemoglobin A1c: A promising screening tool in gestational diabetes mellitus.

Context: Current screening tests for gestational diabetes mellitus (GDM) are inconvenient. Therefore, alternative screening tests for GDM are desirable. The use of glycohemoglobin A1c (HbA1c) in screening for GDM remains controversial.

Hyperthyroidism.

The clinical spectrum of hyperthyroidism varies from asymptomatic,subclinical hyperthyroidism to the life-threatening "thyroid storm". Hyperthyroidism is a common form of thyroid disease that mimics many of the common complaints in the emergency department. The diagnosis of hyperthyroidism is often challenging due to the multitude of physical and even psychiatric complaints.

Hypothyroidism: mimicker of common complaints.

Hypothyroidism is a common condition presenting a challenge to emergency physicians in diagnosing the underlying etiology of vague complaints. Making the diagnosis of a critically ill patient in myxedema coma allows early treatment with appropriate thyroid hormone replacement and avoids higher patient mortality. To do this, the emergency physician must maintain a high degree of clinical suspicion for thyroid disease.

Spontaneous long-term remission in a patient with premature ovarian failure.

Objective: To describe a patient with premature ovarian failure who after a pregnancy achieved a prolonged remission, which has lasted for more than 10 years.

Methods: Clinical and laboratory data of a patient who had premature ovarian failure with a spontaneous pregnancy and a prolonged remission are described. The pertinent literature is reviewed and summarized.