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Consider metabolic syndrome a combination of different conditions
No wonder metabolic syndrome is called syndrome X. Instead of being recognized as a separate disease, it is considered a constellation of many conditions. "The biggest problem is a failure to address the underlying problem—insulin resistance," says Robert Epstein, MD, chief medical officer for Medco Health Solutions in Franklin Lakes, N.J. He calls metabolic syndrome one of the country's top five health problems.
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Global guidelines launched for Type 2 diabetes
The International Diabetes Federation (IDF) launched the first global evidence-based guidelines for Type 2 diabetes at the September meeting of the European Association for the Study of Diabetes, in Athens. Diabetes afflicts more than 194 million people worldwide. "Estimates and projections agree that the number of diabetes cases that may be reached in the next 25 years would qualify as the largest epidemic humanity has ever experienced," said Philip Home, joint chair of the IDF Task Force on Clinical Guidelines.
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Hypopituitarism in older adults
Patients with hypopituitarism may present with many different signs and symptoms which result from reduced secretion of one or more of pituitary hormones. Severe hyponatremia and hypoglycemia are rare but potentially life threatening presenting clinical features of hypopituitarism. As these abnormalities are completely restored with replacement therapy and patients are often undiagnosed until admission, a high clinical suspicion is necessary to diagnose a patient with hypopituitarism. We present five cases exhibiting rare symptoms of hypopituitarism?severe hyponatremia, hypoglycemia and osteoporosis?as the only presenting feature; these cases illustrate that hypopituitarism must be considered in the differential diagnosis of these abnormalities, especially in older patients.
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Headache, palpitations, sweating, and high anxiety
A 43-year-old white man presents for reevaluation of recurrent episodes of palpitations, diaphoresis, headache, and acute anxiety. At the initial visit 2 years ago, the patient complained of episodic palpitations with vague chest pain, which would last for several minutes and then subside. At that time his BP was 120/72 mm Hg. A follow-up stress test had negative results. The patient continued to have paroxysmal spells lasting about 15 minutes of palpitations, diaphoresis, headache, nausea, and apprehensiveness several times a month. Following the gradual resolution of these symptoms, he reported feeling weak and washed-out. At one point he was hospitalized for rapid atrial fibrillation, which converted back to normal sinus rhythm after medical treatment.
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