Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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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
Medical resource use and costs related to central precocious puberty: a retrospective cohort study.
To evaluate the economic burden of central precocious puberty (CPP) by examining direct health care resource utilization and costs. ⋯ In this study, health care resource use and costs among patients with CPP were substantial before and after the initial diagnosis of CPP.
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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 report our preliminary experience with the revised, more conservative Yale insulin infusion protocol (IIP) that targets blood glucose concentrations of 120 to 160 mg/dL. ⋯ The updated Yale IIP provides effective and safe targeted blood glucose control in critically ill patients, in compliance with recent national guidelines. It can be easily implemented by hospitals now using the original Yale IIP.
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To report a case of reversible chorea in a woman with myxedema coma. ⋯ Neurologic manifestations of hypothyroidism include psychomotor slowing, memory deficits, and dementia, with myxedema coma at the extreme of this spectrum. Although chorea is a rare manifestation of hyperthyroidism, this is the first report of a patient with acquired, reversible choreiform movement disorder while still being severely hypothyroid and treated with levothyroxine.