ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Predicting the risk of fracture in osteopenic patients depends chiefly on BMD, age, and the history of previous fractures. Age may be a surrogate for bone quality and extraskeletal factors such as the propensity to fall and cushioning by soft tissue. Various investigators have itemized other risk factors for fracture. We include a table showing fracture risk by age group for patients in the next 10 years based on the three major risk factors.

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The liver plays a central role in the metabolic processing of hormones through its oxidation, reduction, and conjugation of hormones leading to their excretion in bile or urine. Thus, progressive impairment of liver function as a result of a loss of functional hepatocellular mass is associated with many biochemical abnormalities that are used to assess the function of various endocrine glands. Disturbances in glucose homeostasis and insulin metabolism are the best studied and can produce both impaired glucose tolerance and hypoglycemia. As a result of dysfunction in the hypothalamic-pituitary-gonadal axis, hypogonadism occurs. Alterations in thyroid hormone levels and thyroid hormone-binding protein levels can mimic either biochemical hyper- or hypothyroidism. Other less well recognized endocrine consequences of liver disease exist as well and occur depending upon the severity of the underlying liver disease. Each will be discussed in this review.

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Advances in our understanding of the physiological mechanisms subserving reproduction and those mediating responses to stress now permit us to understand in detail at least one mechanism by which stress compromises fertility. In women, stress, as evidenced by an increase in cortisol secretion, suppresses hypothalamic gonadotropin-releasing hormone (GnRH) input to the pituitary-ovarian axis. If the decrement in GnRH drive is chronic, anovulation results. Episodic decrements in the GnRH pulse generator likely result in luteal inadequacy or oligo-ovulation. The more complete the suppression of GnRH, the more likely is the reproductive compromise to be clinically recognizable. Profound and persistent loss of GnRH input manifests as amenorrhea, whereas episodic or less profound interruptions in GnRH secretion can be clinically occult and present only as decrements in luteal phase progesterone secretion by the corpus luteum in the face of preserved menstrual cycle intervals, i.e., so-called luteal phase defects. Recognition of stress-induced compromise of ovarian function expands therapeutic options because, at least in theory, stress management and reduction will lead to return of GnRH drive, resumption of ovulation and menses, and restoration of fertility.

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We present two cases which illustrate the diversity of presentation characterizing childhood Graves' disease. We also review current concepts of diagnosis and treatment with emphasis on aspects of care which are unique to the pediatric age group.

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

False-positive diagnoses of thyroid metastases are exceedingly rare. We describe a patient who had a fine needle biopsy of a lymph node that suggested the diagnosis of a thyroid metastasis where the source of the thyroid tissue was from another patient: tissue that had been left on the side of the tissue bath and had floated into the slide of our patient.

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A 51-year-old white female patient presented initially with a history of unexplained leukocytosis and central diabetes insipidus (DI). One year later, she was diagnosed with myelofibrosis which subsequently progressed to acute leukemia. She underwent three cycles of chemotherapy with daunorubicin and cytarabine, prior to receiving an allogenic bone marrow transplant. The patient received desmopressin acetate which was eventually discontinued 5 months later, as the DI resolved. The patient relapsed 8 months post-transplant, with recurrence of symptoms of DI. This case illustrates that DI can be the initial manifestation of myelofibrosis and that bone marrow transplantation can effectively treat the condition.

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1051-2144    

出版商:OVID    

年代:1995

数据来源: OVID