Articles related to Endocrinology, Diabetes, Metabolism

Can you differentiate between bradykinin-mediated angioedema and the more common histamine-mediated angioedema? How significant is a delayed diagnosis? Do you favor on-demand or preventative therapy? What is the recommended therapy? Access to specialist care and effective treatment in the past 10 years has improved the quality of life and reduced the mortality rate in patients with hereditary angioedema. This wide-ranging report from the British Journal of Hospital Medicine covers emerging treatments and outlines where we’ve been, where we are, and where we’re going in hereditary angioedema (HAE) care.

MDCalc.com offers this helpful tool, which calculates creatinine clearance (CrCl) according to the Cockcroft-Gault equation. The tool also allows height input, which analyzes BMI and provides a modified estimate and range.

Often undiagnosed due to its unspecific symptoms, hereditary angioedema (HAE) is a tricky condition that causes many patients unnecessary suffering with unnecessary surgeries and invasive diagnostic/therapeutic interventions. Read on to educate yourself on some of the alarming numbers on the orphan disease.   

After diagnosis during a partial mastectomy, this patient’s estimated blood loss was 58 mL, causing anemia and requiring a red blood cell transfusion along with ventriculoperitoneal drain placement. With a substantive bleeding history before the diagnosis, what would you do next with this patient? Work her up for von Willebrand disease? Do a complete blood count test to look at platelet count, a peripheral smear to look at the morphology of the platelets, and a coagulation profile? Offer genetic testing for fibrinogen disorders? What would your next steps be? Read the full case presentation and expert opinion to see how your peers responded.

Publication: JAMA Oncology Objective: With NSCLC having relatively poor outcomes and the significant data supporting the use of metformin as an antineoplastic agent, the researchers wanted to compare overall or progression-free survival in chemoradiation alone vs. chemoradiation + metformin stage III NSCLC patients. Design: Randomized clinical trial, open-label, phase 2 study; 167 eligible patients

Findings: Primary outcomes included AMI, HF, stroke, and CVEs; 51 secondary and safety outcomes included angioedema, cough, syncope, and electrolyte abnormalities. ACE inhibitors were associated with a significantly increased risk of four secondary and safety outcomes compared with ARBs.Design: Multinational cohort study; Patients: ~2.3M ACE, ~674K ARB