Posts Tagged ‘endocrinology’

Research on the effects of intensive treatment on hyperglycemia on type 2 diabetes

July 8, 2010

Dr. Faramarz Ismail-Beigi M.D., PhD., the previous Division Chief of Endocrinology, and a team of internationally renowned UHCMC diabetes specialists researched the effects of intensive treatment of hyperglycemia (or high blood sugar, a condition in which an excessive amount of glucose circulates in the blood plasma) on microvascular outcomes in type 2 diabetes in analyzing the ACCORD randomized trial.

Hyperglycemia is associated with increased risk of cardiovascular complications in people with type 2 diabetes.

The team set out to find out if reducing the blood glucose concentration to normal levels in people with established type 2 diabetes decreases the rate of microvascular complications. 10,251 patients were randomly assigned, 5,128 to the intensive glycemia control group and 5,123 to standard group. Intensive therapy was stopped before study end because of higher mortality in the glycemia group, and patients were transitioned to standard therapy. After reviewing the results, it was clear that intensive therapy did not reduce the risk of advanced measures of microvascular outcomes (such as kidney failure requiring dialysis, or advanced disease of the retina requiring surgery), but delayed the onset of albuminuria and some measures of eye complications and neuropathy.

The conclusion was made that microvascular benefits of intensive therapy should be weighed against the increase in total and cardiovascular disease-related mortality, increased weight gain, and high risk for severe hypoglycemia.

Dr. Ismail-Beigi suggests that “In elderly people with established type 2 diabetes of many years’ duration and a history of prior cardiovascular disease (such as a heart attack), or risk factors for cardiovascular disease, the benefits and risks associated with intensive blood sugar control needs to be carefully assessed on an individual basis.  The best approach is for patients to have a discussion with their health-care provider to set an appropriate blood sugar goal.”

Armand Krikorian, MD publishes “Comparisons of Different Insulin Infusion Protocols”

April 7, 2010

“Comparisons of different insulin infusion protocols: a review of recent literature”

Curr Opin Clin Nutr Metab Care. 2010 March
Krikorian A, Ismail-Beigi F, Moghissi ES.

Division of Clinical & Molecular Endocrinology
Case Western Reserve University
University Hospitals, Cleveland

Read the abstract at CWRUmedicine.org

New Research Published on Antibiotic resistance determinants in Acinetobacter spp

March 31, 2010

We explored the association of antibiotic-resistant phenotypes and genotypes in Acinetobacter spp with clinical outcomes and characteristics in 75 patients from a major military treatment facility. Amikacin resistance was associated with nosocomial acquisition of A baumannii, and carbapenem resistance and bla(OXA-23) were associated with the need for mechanical ventilation. The presence of bla(OXA-23) also correlated with longer hospital and ICU stay. Associations between bla(OXA-23) and complexity, duration, and changes made to antibiotic regimens also existed. Copyright 2010.

Learn more at CWRUmedicine.org

Read why Cushing’s syndrome: Why is diagnosis so difficult?

March 31, 2010

Practicing and perfecting the art of medicine demands recognition that uncertainty permeates all clinical decisions. When delivering clinical care, clinicians face a multiplicity of potential diagnoses, limitations in diagnostic capacity, and “sub-clinical” disease identified by tests rather than by clinical manifestations. In addition, clinicians must recognize the rapid changes in scientific knowledge needed to guide decisions. Cushing’s syndrome is one of several disorders in which there may be considerable difficulty and delay in diagnosis. This article describes a current model of clinical reasoning, some of its challenges, and the application of the principles of clinical epidemiology to meet some of those challenges.

Learn more at CWRUmedicine.org

Congratulations to the Department of Medicine doctors who have been awarded the “Best Doctors” title by their peers.

February 24, 2010

The Department of Medicine would like to congratulate our doctors who have been recognised in Cleveland Magazine’s “Best Doctors” list.

We want to thank the entire community of CWRUmedicine physicians, nurses and staff for the work they do every day.

2010-bestdocsCardiovascular Medicine
Dr. Mauricio S. Arruda
Dr. John Blebea
Dr. Barry A. Effron
Dr. James Fang
Dr. Michel George Farah
Dr. Steven A. Fisher
Dr. Robert Goldstein
Dr. Austin A. Halle IIIte
Dr. Brian Hoit
Dr. Richard A. Josephson
Dr. Joseph I. Krall
Dr. Judith Mackall
Dr. Sri Krishna Madan Mohan
Dr. Carl E. Orringer
Dr. Aaron Proweller
Dr. Daniel I. Simon
Dr. Bruce S. Stambler
Dr. Albert L. Waldo

Clinical and Molecular Endocrinology
Dr. Baha Mahmoud Arafah

Gastroenterology and Liver Disease
Dr. Amitabh Chak
Dr. Fabio Cominelli
Dr. Gregory S. Cooper
Dr. Ashley L. Faulx
Dr. Gerard Isenberg
Dr. Jeffry A. Katz

Oncology and Hematology
Dr. Matthew M. Cooney
Dr. Brenda W. Cooper
Dr. Afshin Dowlati
Dr. Stanton L. Gerson
Dr. Joseph Gibbons
Dr. Smitha Subramanyan Krishnamurthi
Dr. Hillard Michael Lazarus
Dr. Nathan Levitan
Dr. Neal J. Meropol
Dr. Paula Silverman

Infectious Disease & HIV
Dr. Keith B. Armitage
Dr. Barbara M. Gripshover
Dr. Michael M. Lederman
Dr. Robert A. Salata

Nephrology & Hypertension
Dr. Donald E. Hricik
Dr. Daniel B. Ornt
Dr. Michael C. Smith

Pulmonary, Critical Care & Sleep
Dr. Rana B. Hejal
Dr. Hugo Montenegro
Dr. Robert John Schilz
Dr. Kingman P. Strohl