Postgraduate medicine
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Postgraduate medicine · May 2020
Case ReportsPrimary hyperparathyroidism associated with non-Hodgkin lymphoma: a case report and literature review.
Primary hyperparathyroidism is the third most common endocrine disease, while primary hyperparathyroidism associated with non-Hodgkin lymphoma(NHL) is extremely rare. We report a case of primary hyperparathyroidism associated with NHL. The first symptom of this patient was hypercalcemia. ⋯ Clinically, patients with hypercalcemia as the first symptom should be alert to the coexistence of their two diseases. As primary hyperparathyroidism and NHL occur simultaneously, the relationship between the two diseases requires further study. A review of the literature regarding primary hyperparathyroidism associated with NHL was performed, focusing on clinical presentation, diagnosis, treatment, prognosis, and the connection.
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Postgraduate medicine · May 2020
Practical guidance for using the FreeStyle Libre flash continuous glucose monitoring in primary care.
Use of continuous glucose monitoring (CGM) improves clinical outcomes in type 1 diabetes, and significant benefits been demonstrated in patients with type 2 diabetes, including improved glycemic control, better treatment adherence, and an increased understanding of their treatment regimens. Currently, there are two types of CGM systems: real-time CGM (rtCGM) and flash CGM (FCGM). ⋯ With the increasing prevalence of diabetes, primary care physicians will be compelled to take on more responsibility for managing patients with diabetes. This article focuses on practical approaches and decision-making strategies for utilizing FCGM in primary care settings.
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Postgraduate medicine · May 2020
Treatment of painful polyneuropathies of diabetic and other origins with 10 kHz SCS: a case series.
Painful diabetic polyneuropathy (PDPN) and painful polyneuropathies of other origins are associated with significant personal and societal burdens with treatments limited to symptomatic management. Treatment options include antidepressants, gamma-aminobutyric acid (GABA) analogs, opioids, and topical analgesics, which are intended to alleviate pain and symptoms of neuropathy, but limited data are available on their efficacy. Paresthesia-based low-frequency spinal cord stimulation (LF-SCS) is considered a last-resort treatment modality for PDPN patients. ⋯ Out of five patients with information available at last follow-up, two were completely off their pain medications and two reduced their dose by over 40%. Similarly, at last follow-up, three out of five patients reported sensory improvement in their lower limbs. In conclusion, 10 kHz SCS treatment resulted in significant pain relief in all the patients, decreased reliance on pain medication, and improved lower limb sensory function in the majority of patients.