Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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To provide information on molecular biomarkers that can help assess cytologically indeterminate thyroid nodules. ⋯ Progress toward the foregoing goals has been made and continues to evolve with the recent appearance of molecular biomarker tests that can be selectively applied for further assessment of cytologically indeterminate thyroid nodules.
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Comparative Study
Comparative efficacy of vertebroplasty, kyphoplasty, and medical therapy for vertebral fractures on survival and prevention of recurrent fractures.
To evaluate the efficacy of surgical and medical therapies on recurrent vertebral fracture and mortality rates. ⋯ We found that surgical treatment with vertebroplasty or kyphoplasty did not decrease recurrent vertebral fractures in patients presenting with an initial vertebral fracture. Medical and surgical therapies together may shorten the time to refracture, but the observed elevated risk may be due to other confounding factors. We found no difference in survival in patients undergoing kyphoplasty or vertebroplasty in comparison with medical or no treatment groups. The relationship between surgical and medical therapy and vertebral refracture rates should be further evaluated with use of a prospective cohort design.
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Comparative Study
Risk of postoperative hypoglycemia in cardiovascular surgical patients receiving computer-based versus paper-based insulin therapy.
To evaluate the safety and efficacy of replacing a paper-based protocol with a computer-guided glucose management system (CGMS) for the treatment of postoperative hyperglycemia in the cardiovascular intensive care unit (CVICU). ⋯ CGMS treatment of postoperative hyperglycemia in CVICU patients can successfully attain goal glucose levels with a significant reduction in hypoglycemia in comparison with a paper protocol. This association persists after controlling for covariates.
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To determine whether patterns of glucose changes before hypoglycemia vary according to the severity of the event. ⋯ Antecedent glucose change and variability were greater for patients who experienced hypoglycemia. If monitored, these patterns could potentially alert clinicians and help them take preventive measures. Further examination of how these parameters interact with other predisposing risk factors for hypoglycemia is warranted.
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To investigate the racial/ethnic disparities in hemoglobin A1c levels among nondiabetic persons with similar parental history of type 2 diabetes mellitus. ⋯ Among healthy offspring of parents with type 2 diabetes mellitus in this study, African American participants had higher hemoglobin A1c levels than white participants after adjusting for age, adiposity, blood glucose, and known variables. Thus, plasma glucose level is more valid than hemoglobin A1c for diagnosing prediabetes or diabetes in black persons.