Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in women with significant reproductive, metabolic, and psychological health implications. The lack of a specific diagnostic test poses challenges in making the diagnosis of PCOS, resulting in underdiagnosis and undertreatment. Anti-Mullerian hormone (AMH) synthesized by the pre-antral and small antral ovarian follicles appears to play an important role in the pathophysiology of PCOS, and serum AMH levels are often elevated in women with PCOS. The aim of this review is to inform the possibility of utilizing anti-Mullerian hormone either as a diagnostic test for PCOS or as an alternative diagnostic criterion in place of polycystic ovarian morphology, hyperandrogenism, and oligo-anovulation. Increased levels of serum AMH correlate highly with PCOS, polycystic ovarian morphology, hyperandrogenism, and oligo/amenorrhea. Additionally, serum AMH has high diagnostic accuracy as an isolated marker for PCOS or as a replacement for polycystic ovarian morphology.

The onset of the COVID-19 pandemic and subsequent county shelter-in-place order forced the Cardinal Free Clinics (CFCs), Stanford University’s 2 student-run free clinics, to close in March 2020. As student-run free clinics adhering to university-guided COVID policies, we have not been able to see patients in person since March of 2020. However, the closure of our in-person operations provided our student management team with an opportunity to innovate. In consultation with Stanford’s Telehealth team and educators, we rapidly developed a telehealth clinic model for our patients. We adapted available telehealth guidelines to meet our patient care needs and educational objectives, which manifested in 3 key innovations: reconfigured clinic operations, an evidence-based social needs screen to more effectively assess and address social needs alongside medical needs, and a new telehealth training module for student volunteers. After 6 months of piloting our telehealth services, we believe that these changes have made our services and operations more robust and provided benefit to both our patients and volunteers. Despite an uncertain and evolving public health landscape, we are confident that these developments will strengthen the future operations of the CFCs.

Purpose: This study analyzed the long-term glycemic trends in thyroid eye disease patients treated with teprotumumab. Methods: A retrospective study was performed at a single institution, including thyroid eye disease patients who started treatment with teprotumumab and had pre- and posttreatment hemoglobin A1c (HbA1c) measurements. Patients were categorized as normoglycemic, prediabetic, or diabetic at baseline. Outcomes included changes in HbA1c from baseline to peak and immediately posttreatment, worsening glycemic control (progression to a higher glycemic category or HbA1c increase ≥0.5%), and recovery to baseline glycemic status. Results: Seventy-one patients were included: 41 (57.7%) normoglycemic, 20 (28.2%) prediabetic, and 10 (14.1%) diabetic (median follow-up 28 months, interquartile range: 18.5–36.0). Median HbA1c increased most in those with diabetes (+1.4%, peak at 4.8 months), followed by prediabetes (+0.5%, peak at 7.7 months) and normoglycemia (+0.3%, peak at 13.2 months). Worsening glycemic control occurred in 90.0% of diabetic, 50.0% of prediabetic, and 44.0% of normoglycemic patients. Initiation or escalation of medical treatment was required by 60.0% of diabetic, 30.0% of prediabetic, and 2.4% of normoglycemic patients. Among patients with worsening glycemic control, those with diabetes had the lowest rate of recovery to baseline (33.3%), relative to prediabetes (75.0%) and normoglycemia (35.3%). Conclusions: Teprotumumab may be associated with worsening of glycemic control, with the most pronounced and persistent effects in patients with preexisting glycemic disturbances. The varied timing of peak HbA1c and ongoing need for medical treatment highlight the importance of systematic glycemic risk assessment and routine HbA1c monitoring throughout and after treatment to guide clinical management.

To report a rare case of endocrine mucin-producing sweat gland carcinoma (EMPSGC) of the eyelid, initially misdiagnosed as a chalazion. A 76-year-old South-Asian male presented with a 9-month history of a painless left upper eyelid lesion. Initial ophthalmic assessment suggested presence of a chalazion that did not resolve with medical management. Examination revealed a 5.5 × 5.5 mm mass at the central left eyelid margin. The lesion transilluminated and extended over the eyelid margin, with splayed lashes but no madarosis. Histopathological examination demonstrated cribriforming glandular epithelium with extracellular mucin and synaptophysin expression, confirming EMPSGC with associated mucinous carcinoma. The patient underwent successful Mohs micrographic surgery with oculoplastic reconstruction and with no evidence of recurrence at five-month follow-up. EMPSGC is an uncommon, low-grade adnexal neoplasm, often under-recognized due to its benign appearance. This case highlights the importance of considering EMPSGC in the differential diagnosis of persistent eyelid lesions, particularly those unresponsive to conservative treatment. Histopathologic evaluation is critical for early recognition and appropriate management of lesions.