So many cool interventional bariatric procedures that can cause weight loss with many of them also showing metabolic effects like decrease in A1c and changes in hormones (ie ghrelin). #obesity#AACE2021#Endotwitter
Wow this is a thing...bariatric arterial embolization which trans-arterially embolizes the gastric fundus through the left gastric artery (LGA) and/or gastroepiploic artery (GEA) --- leading to lower ghrelin levels #obesity#AACE2021#Endotwitter
Duodenal mucosal resurfacing promising for diabetes and improving insulin resistance but not as good for weight loss (just over 2kg weight loss) #AACE2021#obesity#Endotwitter
Gastric vest with very promising results that may be close to what you would see with surgery. Clip would mimic a sleeve but it can be removed. AspireAssist is like a peg tube used to remove food already eaten...with effective weight loss #AACE2021#obesity#Endotwitter
Intragastric balloons although effective for weight loss over time can cause a lot of symptoms and discomfort in that first 1-2 weeks after placement. Early removal rate 3-19% #obesity#AACE2021#Endotwitter
Jejunal bypass liner -- food on inside and pancreatic secretions on outside of liner leading to less absorption = weight loss and DM control --- down side is possible AE of hepatic abscess, GI hemorrhage and perforation #AACE2021#Endotwitter#obesity
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Yes please tell me what to do with the normocalcemic hyperpara's! #aace2021#Endotwitter
In those with primary hyperparathyroidism the majority are asymptomatic. Next highest is kidney stones. It affects the radius more than fem neck more than lumbar spine #AACE2021#Endotwitter#bone
I'm always amazed at the complexity that is obesity and insulin resistance. 2 types: obesity with insulin resistance and obesity w/o insulin resistance both will have mechanical abcd complications but the second will have dysglycemia & the effects from that #aace2021#endotwitter
Obesity exerts multisystemic effects and there is more to it then just weight and BMI -->thus the creation of the ABCD classification using info from EOSS staging system and other data #obesity#aace2021#endotwitter
It's always a pleasure to hear Dr. Biller speak about pituitary topics. Today is on GHD. Bottom line is that there are many barriers to dx & tx esp in those who had dx as kids and are now adults but treatment can come w/ a lot of benefit #AACE2021#Endotwitter
Here are some considerations on who to test for GHD. Highest being those w/ prior pituitary/brain surgery -- if they have 3 or more pituitary deficits then it is more likely they have GHD than not. #AACE2021#Endotwitter#ghd
Characteristics of GH stimulation tests. ITT still gold standard but not very tolerable/safe or speedy. Glucagon cheap, safe but remember the BMI cut off pts. Macimorelin very fast, easy to use and well tolerated but very expensive #AACE2021#Endotwitter#ghd
Intensive behavioral therapy by physicians can be effective helping lose >5% and even up to 10% weight loss #AACE2021#obesity
Using the term "obesity" can have a negative impact on patient care. When speaking with patients, it is better to use the terms "weight" or "BMI" or even "excess weight" #AACE2021#obesity
When to reimage a nonfunctioning pituitary incidentaloma? Risk of growth depends on size. Dr. Molitch recommends <1cm repeat MRI 1, 2, 5yrs. >1cm 0.5, 1, 2, 5yrs #ENDO2021#Endotwitter
What about symptomatic nonfunctioning pituitary adenomas? Depends on surgery outcome #ENDO2021#Endotwitter
What about Acromegaly and Cushings? Depends on treatment and post-operative cure #ENDO2021#Endotwitter