Controversy about latest edition of thyroid cancer staging. Elliot A. Asare wrote a letter disagreeing with the inclusion of microscopic extrathyroidal extension in the 8th edition of staging, arguing it's very subjective, with high interindividual variability and no prognostic value.
Anticoagulation in hyperthyroidism and atrial fibrilation. A taiwanese paper from Chang et al compared direct oral anticoagulants (apixaban, dabigatran, etc) vs warfarin in hyperthyroid individuals with atrial fibrilation, with in a comparable rates of ischemic stroke / systemic embolism and lower risk of major bleeding HR 0.65.
Ketogenic diets and microbiota. Basciani from Italy treated 3 groups of obese individuals with 3 types of very low caloric ketogenic diets (780 Kcal, 14% Carb, 40% fat, 46% protein), that included vegetable, whey or animal proteins. All groups lose weight equally, but the effect on microbiota was better with vegetables and whey, and the whey group got better muscle performance.
Insulin sensitizers and PCOS. Chuan Xing et al from China compared TZD, metformin and GLP-1 analoges alone or in combination in PCOS. They found that metformin + TZD and metformin + GLP-1 were superior to monotherapy in hyperandrogenemia, being met+TZD particularly good in menstrual cycles and met+GLP-1 in glycemia.
Thyroid nodule management. Grani from Italy reviews contemporary managment of thyroid nodules, focusing in most controversial topics like what to do with indeterminate cytologies, explaining current availability of molecular techniques (thyroseq, AFIRMA mib, mRNA), proposing finally an algorithm for benign nodule follow-up.
Vitamin D does not reduce falls. That is what Le Bof and workmates found in Boston with healthy adults using daily dose of 2000 IU.
Inpatient diabetic covid management. Mary Korytkowsky shares with us her experience and reccomendations from Pittsburgh. Here her advise about diabetes drugs:
- Secretagogues: hypoglycemia risk - more interaction with personnel
- Metformin: contraindicated - probably unstable patient - renal or hepatic failure - hypoxia.
- DPP4-inh: not indicated - concern for abrupt deterioration.
- SGLT2-inh: contraindicated - DKA, genital infections, volume depletion.
- GLP1 analogues: contraindicated - nausea and vomiting.
- TZD: contraindicated, fluid retention.
Dietary sodium and potasium and FGF-23. Humalda from the Netherlands studied the effects of dietary Na and K supplementation in pre-hypertensive individuals. FGF-23 is considered a new CV risk factor. Both Na and K reduced FGF-23 but with differential effect on the rest of bone mineral parameters.
Trans women and prostate cancer. De Nie from Netherlands showed reduced prostate cancer incidence in trans women receiving antiandrogen plus estrogen therapy, Standarized Incidence Ratio (SIR) of 0,20.
There are many more articles, JCEM is always full of interesting stuff. If you want further details about some article you can send uss a message.
