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  • 1
    In: Gastroenterology, Elsevier BV, Vol. 158, No. 6 ( 2020-05), p. S-45-S-46
    Type of Medium: Online Resource
    ISSN: 0016-5085
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
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  • 2
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 3, No. Supplement_1 ( 2019-04-15)
    Type of Medium: Online Resource
    ISSN: 2472-1972
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2019
    detail.hit.zdb_id: 2881023-5
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  • 3
    Online Resource
    Online Resource
    The Endocrine Society ; 2022
    In:  Journal of the Endocrine Society Vol. 6, No. Supplement_1 ( 2022-11-01), p. A21-A22
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 6, No. Supplement_1 ( 2022-11-01), p. A21-A22
    Abstract: Anti-obesity medications have been shown to be effective in multiple randomized clinical trials, but there is limited data on the efficacy of these medications in the veteran population. This study was aimed to evaluate the effectiveness of anti-obesity medications in a multidisciplinary weight management clinic at our VA medical center. Methods This was a retrospective, descriptive study of 98 patients seen in a multidisciplinary weight management clinic at our VA medical center between January 1, 2019 and October 31, 2021. General requirements to be seen in the clinic were a BMI & gt;30 or BMI & gt;27 with comorbid conditions. Patients seen at least twice in the clinic were included in the study. Patients who received anti-obesity medications (phentermine-topiramate, naltrexone-bupropion, or GLP-1 receptor agonist (liraglutide or semaglutide)) had weights recorded at medication start date and at 2-4 months, 4-8 months, 8-10 months, and 10-14 months intervals. Baseline BMI, HbA1c, LDL-C and triglycerides were recorded at the medication start and followed up at similar intervals. Results There were 98 participants (56% males) within this study, with mean age of 54.9 years, mean baseline weight of 127.3 kg, and BMI of 43.5. Of all 98 patients seen in the clinic (regardless of being on anti-obesity medicine), 85 experienced some weight loss with 39 losing at least 5% of their body weight. The average weight loss from first to last visit was 4.1%. There were 72 patients who received anti-obesity medications for at least 3 consecutive months, including 12 patients who were subsequently trialed on a second class of anti-obesity medication. There were 35 trials of Qsymia, 43 trials of GLP-1 receptor agonists, and 6 trials of naltrexone-bupropion. For those patients receiving medications, average weight loss at 2-4 months was 3.7% (N=73), 4-8 months was 4.9% (N=58), 8-10 months was 6.0% (N=32), and 10-14 months was 5.5% (N=29). The percentage of patients able to lose at least 5.0% of their weight was 30.1% at 2-4 months, 43.1% at 4-8 months, 68.8% at 8-10 months, and 51.7% at 10-14 months. There was a decrease noted in HbA1c and LDL-C at all time periods, while there was no change in triglycerides. Conclusion Our data shows the effectiveness of anti-obesity medications in a veteran population seen in a multidisciplinary weight management clinic, though to a lesser extent as compared to clinical trials. Given the higher prevalence of multiple chronic conditions seen in veterans when compared to the general population, these patients have additional challenges when trying to achieve their weight loss goals. Further study must be performed to determine the long-term effectiveness and tolerability of these medications in this population. The differential effects among the anti-obesity medications should also be investigated further. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
    Type of Medium: Online Resource
    ISSN: 2472-1972
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2022
    detail.hit.zdb_id: 2881023-5
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2020
    In:  Diabetes, Obesity and Metabolism Vol. 22, No. 9 ( 2020-09), p. 1496-1510
    In: Diabetes, Obesity and Metabolism, Wiley, Vol. 22, No. 9 ( 2020-09), p. 1496-1510
    Abstract: Various intermittent fasting (IF) dietary plans have gained popularity among obese individuals in recent years as a means of achieving weight loss. However, studies evaluating the effect of IF regimens in people with metabolic syndrome, prediabetes and type 2 diabetes (T2D) are limited. The aim of the present review was to briefly elucidate the biochemical and physiological mechanisms underlying the positive effects of IF, especially the effect of the proposed ‘metabolic switch’ on metabolism. Next, we examined the efficacy and safety of IF regimens in individuals with metabolic syndrome, prediabetes and T2D. To achieve this, we performed a MEDLINE PubMed search using combinations of various IF terms, including trials in which participants met the additional criteria for metabolic syndrome, prediabetes or T2D. We found four studies in individuals with metabolic syndrome, one study in people with prediabetes, and eight studies in people with T2D evaluating the effects of different IF regimens. The limited available evidence, with small sample sizes and short trial durations, suggests that IF regimens have a similar effectiveness compared with calorie‐restriction diets for weight loss and improvement in glycaemic variables. In general, most IF regimens are effective and safe. However, there is an increased risk of hypoglycaemia in patients with T2D who are treated with insulin or sulphonylureas. Moreover, long‐term adherence to these regimens appears uncertain. There is a need for large controlled randomized trials to evaluate the efficacy of IF regimens, especially in individuals with metabolic syndrome and prediabetes. If proven to be sustainable and efficacious for prolonged periods, IF could offer a promising approach to improving health at the population level, and would result in multiple public health benefits.
    Type of Medium: Online Resource
    ISSN: 1462-8902 , 1463-1326
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2004918-3
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  • 5
    Online Resource
    Online Resource
    Pleiades Publishing Ltd ; 2022
    In:  Physics of Particles and Nuclei Vol. 53, No. 2 ( 2022-04), p. 441-446
    In: Physics of Particles and Nuclei, Pleiades Publishing Ltd, Vol. 53, No. 2 ( 2022-04), p. 441-446
    Type of Medium: Online Resource
    ISSN: 1063-7796 , 1531-8559
    Language: English
    Publisher: Pleiades Publishing Ltd
    Publication Date: 2022
    detail.hit.zdb_id: 1474545-8
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  • 6
    In: Diabetes, American Diabetes Association, Vol. 70, No. Supplement_1 ( 2021-06-01)
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1501252-9
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  • 7
    Online Resource
    Online Resource
    American Diabetes Association ; 2021
    In:  Diabetes Vol. 70, No. Supplement_1 ( 2021-06-01)
    In: Diabetes, American Diabetes Association, Vol. 70, No. Supplement_1 ( 2021-06-01)
    Abstract: Setting individualized goals for glycemic control is widely accepted as standard of care in the management of diabetes mellitus. This requires integration of numerous factors into the goal HbA1c, many of which can be subjective. Few tools are available to assist in goal-setting, including an online calculator based on work by Cahn et al (1). We aimed to evaluate the current practice of setting personalized HbA1c targets at an academic medical center and compare the targets to those derived from the calculator model and the VA/DoD (Department of Defense) DM guidelines (2). A chart review of outpatient diabetes visits in both primary care and diabetes specialty clinics was performed from 11/2019-12/2020. Documentation of HbA1c goals was assessed. All patient factors that contribute to goal-setting were gathered and a proposed HbA1c goal via calculator model and VA/DoD guidelines was set for each patient. A comparison between these HbA1c goals was conducted. Of the 100 patient charts reviewed, only 25% (25/100) included a specified goal HbA1c. Of those, 88% (22/25) of the clinicians’ goals matched the calculated HbA1c goal, whereas only 32% (8/25) matched the estimated HbA1c based on VA/DoD guidelines. Documentation of individualized glycemic targets in the management of DM is not routinely practiced. When HbA1c goals are specified, they tend to correlate well with suggested goals obtained via a comprehensive calculator and less so with guidelines that rely heavily on a clinician’s subjective assessment. These findings suggest an opportunity to provide further education on setting individualized goals of care in the management of DM, as well as the utility of calculator models in assisting clinicians in daily practice. Cahn A, et al. Clinical Assessment of Individualized Glycemic Goals⋯ Diabetes Care. 2015;38(12):2293-2300.VA/DoD Clinical Practice Guideline for the Management of Type 2 DM in Primary Care. https://www.healthquality.va.gov/guidelines/CD/diabetes/VADoDDMCPGFinal508.pdf. Disclosure A. C. Zuzek: None. C. Kelly: None. L. Sayyed kassem: None. A. Rajpal: None.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1501252-9
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  • 8
    In: International Journal of Endocrinology, Hindawi Limited, Vol. 2022 ( 2022-4-18), p. 1-5
    Abstract: Background. Maintenance dialysis is the most common treatment for end-stage renal disease (ESRD) patients. One of the most ignored but important health issue among dialysis patients is sexual dysfunction, which interferes with quality of life (QoL). Studies showed that the side effects of the two conventional methods of dialysis (hemodialysis (HD) and peritoneal dialysis (PD)) are different on a patient’s health. Therefore, we sought to compare the sexual dysfunction score, both male and female, between patients undergoing HD and PD. Methods. One hundred seventy adults (85 HD and 85 PD) subject with end-stage renal disease (ESRD) on dialysis for at least 2 months were included. For male subjects, the erectile function (EF) domain of the International Index of Erectile Function (IIEF) questionnaire was calculated. Moreover, the Female Sexual Function Index (FSFI) questionnaire was calculated for females. Data were analyzed via SPSS software. Two independent sample t-test with two-sided significance level of 5% was used for comparing the sexual dysfunction score between HD and PD patients. Results. Out of 170 patients with mean age of 49.34 ± 11.7 years, 52.9% were female. Better sexual function scores were obtained in the HD group’s females for desire, orgasm, and satisfaction domains, as well as the total score ( P  = 0.03, 0.016, 0.02, and 0.039, respectively). The erectile function was significantly better in the PD group’s males ( P ). Conclusion. We found better sexual life in the HD group’s females and PD group’s males. Considering dialysis as a life-long treatment of CKD patients, this part of a patient’s life must be taken seriously by the healthcare providers to choose the most suitable method for patients based on their personalized conditions.
    Type of Medium: Online Resource
    ISSN: 1687-8345 , 1687-8337
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2502951-4
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  • 9
    In: International Journal of Endocrinology, Hindawi Limited, Vol. 2022 ( 2022-6-28), p. 1-9
    Abstract: Introduction. Papillary thyroid cancer (PTC) is one of the most prevalent endocrine malignancies that has increased in recent decades around the world. Although the indicator for navigating the surgical extent in PTC patients is still in debate, a key issue is how to predict that there are undetected preoperative tumors in the contralateral thyroid lobe. This study aims to find risk factors for contralateral occult papillary thyroid cancer (COPTC) to facilitate more accurate surgical decisions made for patients with PTC. Materials and Methods. In our study, we included 229 patients who underwent total thyroidectomy plus central and ipsilateral lateral lymph nodes dissection from January 1, 2019, to September 1, 2021. Univariate and multivariate logistic regression analyses were conducted to assess the association between COPTC and clinical-pathological characteristics, as well as the relation between the diameter of the occult lesions and predictors. The forest plot was plotted to visualize the prediction factors from the output of the multivariate regression analysis. A ROC curve was used to evaluate the combining potency of all the risk factors. Results. Of the 229 patients included in our study, 46 with COPTC were assigned to the case group, representing 20.1% in this study. Multifocality in one lobe (OR = 2.21, P = 0.03 ), intact capsule (OR = 2.54, P = 0.01 ), central lymph node metastasis (OR = 3.00, P = 0.02 ), and Hashimoto’s thyroiditis (OR = 2.08, P = 0.04) are more prone to present contralateral occult papillary thyroid carcinoma. The ROC curve of the aggregate potency of the risk factors presents AUC = 0.701 ( P 〈 0.001 ), and the best cutoff value was 2.02, with a sensitivity of 78.3% and specificity of 55.2%. Furthermore, there was no statistical correlation between the diameter of the occult tumor and the four obtained variables. Conclusion. Patients with multifocality in one lobe, intact capsule, central lymph node metastasis, and HT may harbor contralateral papillary thyroid carcinoma. It is essential to be prudent to make a surgical or follow-up decision on these patients. In addition, more clinical rather than postoperative pathological indicators need to be revealed in the future.
    Type of Medium: Online Resource
    ISSN: 1687-8345 , 1687-8337
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2502951-4
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  • 10
    Online Resource
    Online Resource
    Wiley ; 2020
    In:  Journal of Diabetes Vol. 12, No. 12 ( 2020-12), p. 895-908
    In: Journal of Diabetes, Wiley, Vol. 12, No. 12 ( 2020-12), p. 895-908
    Abstract: 最近大流行的2019年新冠肺炎是由严重急性呼吸综合征冠状病毒2型引起的。糖尿病(主要是2型糖尿病, T2DM)和高血糖是新冠肺炎患者诸多共患疾病中的一种, 导致预后不良。报告显示, 新冠肺炎中的糖尿病患者患有严重并发症的风险增加, 包括急性呼吸窘迫综合征、多器官衰竭和死亡。本文探讨潜在的机制和联系, 从而解释在这个患者群体中观察到的更高发病率和死亡率的现象。T2DM患者有潜在炎症水平的增加, 这与肥胖和胰岛素抵抗相关, 此外还有高血压、肥胖、心血管疾病、血脂异常和年龄增大等其他情况。回顾相关证据表明, T2DM患者的高血糖是导致肺和其他组织中血管紧张素转换酶2(ACE2)表达升高的因素之一;ACE2是细胞的“受体”和病毒进入的端口。先前存在的慢性炎症, 伴随着对感染的炎症反应增强和病毒载量的增加, 导致极端的全身免疫反应(“细胞因子风暴”), 这与新冠肺炎病情的加重密切相关。根据现有证据, 专家小组建议对T2DM患者进行安全但严格的血糖、血压和血脂控制, 如果这些患者感染病毒, 这些措施可能有助于减轻新冠肺炎的严重程度。一旦感染发生, 那么应该注意适当的血糖控制, 使用胰岛素并经常监测血糖水平。
    Type of Medium: Online Resource
    ISSN: 1753-0393 , 1753-0407
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2485432-3
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