Jordan E Pinsker

Sansum Diabetes Research Institute · Clinical Research

Background: In our U.S. Department of Defense hospital system, pediatric endocrinology and radiology resources to evaluate bone age radiographs are limited. Our tertiary care center provides expert specialty support to remotely stationed beneficiaries at more than 30 Department of Defense medical facilities using a well-established, asynchronous,...

Pediatricians play an important role in diagnosing OI as a cause of fracture and may be asked to differentiate this uncommon genetic diagnosis from intentional trauma and other causes of fracture. Early referral to a pediatric endocrinologist, physical therapist, and orthopedic surgeon for the evaluation and treatment of low bone mass and recurrent...

Long-distance travel across multiple time zones presents unique challenges for patients taking insulin, requiring adjustments in both timing and dosage of basal insulin when several times zones (>=5) are traversed. Travel across the International Date Line adds to the confusion, as existing resources and dosing calculators often do not account for...

Pyogenic liver abscess is a rare complication of diabetes, usually seen in adults greater than 50 years of age who have had diabetes for many years. We describe an 18-year-old male with type 2 diabetes found to have a pyogenic liver abscess caused by Klebsiella pneumoniae, and show accompanying images from his evaluation for fever of unknown origin...

Introduction Primary hypothyroidism is a well-known cause of poor linear growth in children. A rare finding with profound or long-standing disease is anterior pituitary enlargement (pituitary pseudotumor). This case highlights this uncommon finding, discusses clinical situations in which gradual dose escalation of levothyroxine may be advisable and...

Studies in preterm infants have shown that prolonged treatment with topical iodine (multiple doses, often over multiple days) can transiently suppress thyroid function. However, it is uncertain if topical iodine exposure for very short periods of time can cause significant changes in thyroid function. We report two cases of transient hypothyroidism...

Continuous glucose monitoring (CGM), while a relatively new technology, has the potential to transform care for children with type 1 diabetes. Some, but not all studies, have shown that CGM can significantly improve hemoglobin A1c levels and reduce time spent in the hypoglycemic range in children, particularly when used as part of sensor-augmented...

The majority of telemedicine interventions for diabetes have failed to show objective improvements in outcomes. We describe the real-time diabetes monitoring system (RT-DMS), which augments our successful telemedicine system for pediatric patients with type 1 diabetes by allowing automated uploads of glucometer readings. The addition of automatic t...

Context: The cortisol stress response to sedation and anesthesia in children is not well characterized. It is not clear whether it is necessary to give stress doses of corticosteroids to children with adrenal insufficiency undergoing sedated procedures. Objective: Our objective was to describe the cortisol stress response to sedation and anesthe...

X chromosome aneuploidy has been identified as a potential risk factor for the development of neuroblastic tumors. We report a case of a 4-year-old girl with a 45,X karyotype incidentally discovered to have a large ganglioneuroblastoma on initial screening ultrasound. The incidence of these tumors in girls with Turner syndrome as well as their poss...

CONTEXT: Turner syndrome (TS), in which there is loss of all or part of one sex chromosome, occurs in one in 2500 live-born females and is associated with characteristic findings. Detailed healthcare checklists and screening guidelines are commonly used to detect known complications affecting individuals with TS. Even with the use of these guidelin...

We created a website for patients and families that allowed them to review clinic test results, review educational materials related to these results and post questions to their diabetes educator. Fingerstick haemoglobin A(1c) (HbA(1c)) testing and periodic use of a continuous glucose monitoring system (CGMS) were offered to all patients. The HbA(1...

Ghrelin, an enteric hormone with potent appetite stimulating effects, also stimulates growth hormone release. We hypothesized that altered levels of total ghrelin (TG) or acylated ghrelin (AG) could affect growth by altering growth hormone secretion, subsequently affecting insulin-like growth factor-1 (IGF-1) generation or by altering appetite and...

The aim of this study was to evaluate the impact on pediatric care of the Pacific Asynchronous TeleHealth (PATH) system, a provider-to-provider teleconsultation platform utilized by military medical facilities throughout the Pacific Region. This review focuses on access to care, quality of care, and cost savings for the Department of Defense as a r...

To discuss a case of ovotesticular disorder of sex development (DSD) with ambiguous genitalia, isodicentric Y sex chromosome mosaicism, and unique histopathologic findings. We report the clinical, laboratory, imaging, and operative findings, and we highlight the pertinent features of this case. Results of hormonal and genetic testing are reviewed,...

Pseudohypoparathyroidism type la (PHP-1a) is an uncommon disorder that results from an inactivating mutation in the GNAS gene. It can present with resistance to several hormones, in addition to parathyroid hormone (PTH). Patients may have the classic Albright's hereditary osteodystrophy (AHO) phenotype and can develop resistance to thyroid stimulat...

We report the first child presenting to the emergency department with undiagnosed myxedema in whom incidental detection of pericardial effusion led to diagnosis. Moreover, this patient presented with the highest serum thyrotropin concentration reported to date, a phenomenon that caused the hook effect during laboratory analysis. We discuss key elem...