Jeannette Y. Wick, RPh, MBA, FASCP

The International Working Group on the Diabetic Foot (IWGDF) Guidance 2015 recently published its evidence-based international consensus guidance. This guideline addresses 5 specific areas of concern in diabetes.

Resistance to thyroid hormone (RTH) occurs in rare patients and its clinical presentation is considerably different than that seen in the usual hyperthyroid patient. Patients with this inherited condition produce inordinate levels of thyroid hormone because their negative feedback loop at the pituitary gland is metaphorically snipped. Concurrently, they have normal levels of thyroid-stimulating hormone.

An article published in Clinical Interventions in Aging outlined a large hospital's successful quality improvement interventions over 5 years to reduce medication errors in their large population of diabetic patients.

In an effort to fight obesity and diabetes and promote healthier diet and lifestyle choices through targeted interventions, public health officials determined which regions of the US have the highest levels of soda and other sugar-sweetened beverage consumption.

Study involving parents of children with type 1 diabetes mellitus shows they need support and assistance in helping their children make healthy dietary choices.

Study results show that treating community-dwelling elders too zealously for elevated thyroid-stimulating hormone levels is a leading cause of thyrotoxicosis.

Precision medicine's role in the management of hypogonadism is still in its formative stages. Researchers suggest that identifying biomarkers associated with individual patients' treatment responses is possible.

Researchers from the University of Washington in Seattle reported that the use of avatars (digital representations of a coach, buddy, or teacher) improved user satisfaction in interactive, online weight management programs for obese teens.

Study results show patients who took statins following ischemic stroke were significantly less likely to have post-stroke early-onset seizures.

In 2010, about 3% of Americans had tried e-cigarettes. Today, around 10% of the population has tried them, with sales growing every year.

Bariatric surgery has been shown to reduce the incidence of type 2 diabetes and albuminuria. However, data connecting the magnitude of weight loss and reduction in obesity-related comorbidities is limited.

A study published in Metabolic Syndrome and Related Disorders indicates that sodium glucose cotransporter-2 inhibitors (SGLT2 inhibitors, which affect both supply and demand pathways in the heart) may be the preferred treatment for diabetics with heart failure.

Fetal exposure to severe starvation or stress appears to elevate risk of hyperglycemia or type 2 diabetes (T2D) later in life. Similarly, low birth weight has been associated with glucose intolerance, suppressed insulin secretory capacity, and increased risk of T2D.

It is unclear how many people have pituitary incidentaloma, but imaging and autopsy studies indicate they are quite common and occur in up to one-third of patients. Fortunately, the vast majority of these serendipitously discovered tumors are clinically insignificant. A management guideline in the Annals of Endocrinology brings endocrinologists up to date on current thinking about pituitary incidentaloma management.

Most self-improvement intervention programs rely on self-monitoring, or increased awareness of bad habits, to help people change their behaviors. Traditionally, programs have used diaries, calendar notes, or check-ins at daily or weekly meetings to help individuals recognize and replace unhelpful routines. The October 2015 issue of Telemedicine and e-Health includes a study that describes how simple electronic feedback can help people with weight problems.

Nonalcoholic fatty liver disease (NAFLD) is now the most common chronic liver disease reported in the United States. Some researchers have hypothesized that TNF-α, as a mediator of inflammation, might be a therapeutic target for NAFLD since inflammation seems to be a component of its etiology.

When patients need pancreatic surgery, surgeons worry about postoperative infections with good reason. Even with strict adherence to infection control technique, ideal surgical procedures, perfect perioperative care, and aggressive antibiotic prophylaxis, morbidity and mortality from infection remains high.

Surgeons and podiatrists debate the best management approach for adolescent hallux valgus (bunions), a condition that occurs in up to 30% of adolescents. Conservative management (including footwear modifications, orthotics, and analgesia) rarely prevents progression. But surgery (a general term that includes more than 100 different procedures) has been associated with a high likelihood of post-surgery recurrence or deformity.

Americans undergo approximately 90,0000 ventral hernia repairs annually. Those who contract methicillin-resistant staphylococcus aureus infections face a difficult course, and clinicians often struggle to eradicate this tenacious infection.

Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) project, a 4-year Centers for Medicare and Medicaid Services-sponsored demonstration project, showed that a telemedicine intervention can improve glycemic, lipid, and blood pressure control.

When women present clinically with acne, hirsutism, and androgenetic alopecia, the likelihood is that the causative hormone is androgen. Collectively, these symptoms signal cutaneous hyperandrogenism.

Intestinal and multivisceral transplantation-and any organ transplant actually-increases risk for infection since immunosuppressants are critical post-surgery. Fungal infections ranging from mild skin rashes to deadly fungal pneumonia can be a problem, and may lead to increased morbidity and mortality in these patients.

What factors must be considered to ensure optimal management of perioperative cardiac arrest in the cardiac surgery patient?

The journal Paediatrics & Child Health recently published results from a research study completed by a team of researchers from across Canada that explored factors that influence the decision to engage in pediatric weight management programs.

Endocrine regulation in ejaculation control is still not well understood. Sex steroids (testosterone and estradiol), pituitary (prolactin and oxytocin), and thyroid hormones may regulate the ejaculatory process, but exact mechanisms are unclear.

A recent study assessed patients with diabetes for the effects of perceived racial discrimination encountered during care, focusing on treatment outcomes such as glycemic control, blood pressure, and LDL cholesterol levels.

Mark Twain said, "When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much the old man had learned in 7 years."

What's the story with salt? Dietary guidelines for adults – especially those who are older, black, have elevated blood pressures, diabetes or chronic kidney disease – recommend consuming less than 1500 mg daily.

Postoperative pulmonary complications (PPCs) after major abdominal surgery are common, with risk increasing with patient age. Major abdominal surgeries alter and disrupt diaphragmatic dysfunction, which has been proven causative of PPCs.

Only 1 in 6 heart transplants is done in a child, which means that globally, approximately 600 children undergo this procedure annually. A paper published in the Journal of Thoracic Disease makes the case for performing pediatric heart transplants in specialized centers and addressing factors unique to the pediatric patient.