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Risk Factors for Spontaneous Preterm Premature Rupture of Membranes

5 June, 2025

Spontaneous rupture of membranes (ROM) is a normal component of labor and delivery. Premature ROM (PROM) refers to rupture of the fetal membranes prior to the onset of labor irrespective of gestational age. Once the membranes rupture, delivery is recommended when the risk of ascending infection outweighs the risk of prematurity. When PROM occurs at term, labor typically ensues spontaneously or is induced within 12 to 24 hours. The preterm PROM is defined as PROM occurring prior to 37 weeks of gestation. Continue reading “Risk Factors for Spontaneous Preterm Premature Rupture of Membranes”

New Diagnostic Criteria of Adrenal Subclinical Cushing’s Syndrome

23 April, 2025

New diagnostic criteria and the treatment policy for adrenal subclinical Cushing’s syndrome (SCS) are proposed on behalf of the Japan Endocrine Society. The current diagnostic criteria for SCS have elicited two main problems: (i) the relatively low reliability of a low range of serum cortisol essential for the diagnosis by an overnight 1-mg dexamethasone suppression test (DST); (ii) different cutoff values for serum cortisol after a 1-mg DST compared with those of other countries.

Continue reading “New Diagnostic Criteria of Adrenal Subclinical Cushing’s Syndrome”

Red Flags in Headache

29 November, 2024

Patients presenting with headaches need to be screened for primary vs secondary etiologies.  “Red flags” associated with secondary headaches are crucial to identify. Physical examination should be completed with careful assessment of clues obtained during the history. It should include blood pressure measurements, assessment of mental status, and cranial nerve (CN) examination including but not limited to fundoscopic examination, gait, and facial strength.

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Rosemont Criteria for Chronic Pancreatitis

29 August, 2024

Chronic pancreatitis is an irreversible disease of exocrine pancreas characterized by progressive destruction of pancreatic parenchyma and remodeling processes leading to the replacement of the exocrine parenchyma by extensive fibrosis. These changes result in malabsorption, diabetes mellitus and severe and chronic abdominal pain.
Moreover, it is possible the development of several complications which will determine the clinical course developing in some cases pancreatic pseudocyst (25-30%), bile duct strictures (40-50%), even pancreatic cancer (1-3%). The mainstay is detecting early pancreatic changes and treating its related complications. Continue reading “Rosemont Criteria for Chronic Pancreatitis”

Diagnostic Criteria for Idiopathic Multicentric Castleman Disease (iMCD)

16 July, 2024

Human herpesvirus-8 (HHV-8)–negative, idiopathic multicentric Castleman disease (iMCD) is a rare and life-threatening disorder involving systemic inflammatory symptoms, polyclonal lymphoproliferation, cytopenias, and multiple organ system dysfunction caused by a cytokine storm often including interleukin-6. Accurate diagnosis is challenging, because no standard diagnostic criteria or diagnostic biomarkers currently exist, and there is significant overlap with malignant, autoimmune, and infectious disorders. Continue reading “Diagnostic Criteria for Idiopathic Multicentric Castleman Disease (iMCD)”

Diagnostic Criteria of Acute Adrenal Insufficiency

27 May, 2024

The Endocrine Society guidelines on the diagnosis and treatment of Acute Adrenal Insufficiency (AAI) defines an adrenal crisis as a medical emergency with hypotension, abdominal symptoms and laboratory abnormalities requiring emergency treatment.

Continue reading “Diagnostic Criteria of Acute Adrenal Insufficiency”

Diagnostic Criteria for Peripartum Cardiomyopathy

17 May, 2024

Typically, peripartum cardiomyopathy occurs in the first 4 months postpartum; fewer than 10% of cases occur prepartum. Common symptoms include dyspnea, cough, orthopnea, hemoptysis, and paroxysmal nocturnal dyspnea. Most affected patients have New York Heart Association (NYHA) class III or IV function. Additional symptoms include nonspecific fatigue, malaise, palpitations, chest and abdominal discomfort, and postural hypotension. Diagnosis requires a high degree of suspicion, because symptoms of peripartum cardiomyopathy can be confused with physiologic changes associated with advanced pregnancy. Continue reading “Diagnostic Criteria for Peripartum Cardiomyopathy”

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