2016 Endocrine Society Guidelines: Central DI

Low ADH production by the posterior pituitary can cause excessive urination, severe dehydration and high sodium measures. The natural response is increased thirst leading to additional water intake. Polyuria could be so advanced that drinking alone would not correct dehydration or sodium anomalies. Supplementation with ADH hormone is needed in these cases.

Please find below excerpts from Endocrine Society guidelines on central diabetes insipidus published in November 2016.

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Goldberg Variations

Goldberg variations is one of the very few pieces that JS Bach published (1741) in his lifetime. It was composed for a two-manual harpsichord. It’s beautifully performed here by Helmuth Walcha, a Bach scholar and legend.

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Amiodarone & Thyroid, 2016 ATA Guidelines

Amiodarone induced thyrotoxicosis could be productive or destructive, called AIT1 and AIT2 respectively. AIT1 hyperthyroidism is primarily due to excessive iodine supplied by the amiodarone, whereas AIT2 is secondary to thyroid inflammation leading to uncontrolled release of preformed hormone. Distinguishing between the two types clinically, biochemically or by imaging studies is often difficult. Common treatments are methimazole, prednisone, surgery or a combination of the three. Amiodarone could also be discontinued if approved by the heart specialist.  

In 2016, American Thyroid Association published guidelines on diagnosis and management of hyperthyroidism, including the amiodarone scenario. The publication provides great explanations and rationales on how to approach amiodarone induced thyrotoxicosis. Please read recommendations and excerpts below for more details.

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Lipid Guidelines: Risk Factors, Lifestyle, Statins

National Lipid Association published guidelines part 1 in April 2015. Please find below key recommendations and rationales on risk factors, lifestyle and statin use in preventing coronary heart disease. Text has been slightly modified for easier and succinct reading.

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Atherogenic Cholesterol Reduction

National Lipid Association published part 1 of guidelines in April 2015. Please find below key recommendations and rationales on significance of atherogenic cholesterol reduction in preventing coronary heart disease. Text has been slightly modified for easier and succinct reading.

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Lipid Guidelines: Root Cause

National Lipid Association published part 1 of guidelines in April 2015. Please find below a key recommendation and rationale regarding ApoB, non-HDL and LDL as root cause of cardiovascular disease.  Text has been slightly modified for easier and succinct reading.

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Bariatric Surgery in patients with type 2 diabetes

A major study published in New England Journal of Medicine in February 2017 shows that bariatric surgery, either RY bypass or sleeve gastrectomy, is superior to medications alone in lowering A1c, body weight, triglycerides, HDL, insulin use and improving quality of life in adults with type 2 diabetes.

A group of 150 patients with baseline A1c 9.2% were randomized to receive surgery plus medications or medications alone. Participants were followed for 5 years. No major surgical adverse events were seen.

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2017 ATA Guidelines: Thyroid & Pregnancy (Part 2)

ATA has “developed evidence-based recommendations to inform clinical decision making in the management of thyroid disease in pregnant and postpartum women. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with these disorders”

Part 2 of recommendations are listed with slightly modified wording for easier and succinct reading:

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