ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Hypocalcemia, a rather common electrolyte abnormality, can constitute a medical emergency when signs and symptoms are present. Clinical manifestations of hypocalcemia are due both to the actual level of the serum calcium concentration and to the rate of its fall. Symptomatic hypocalcemia has a typical presentation of neuromuscular irritability known as tetany. The most serious manifestations of tetany are laryngospasm, seizures, and cardiac arrhythmias. Evaluation of the hypocalcemic patient requires consideration of both the emergent nature of the presentation as well as the differential diagnosis. The causes of hypocalcemia are generally divided into those etiologies associated with absent production of parathyroid hormone (the hypoparathyroid states) and those due to an abnormality of vitamin D metabolism. The vitamin D-deficient states are usually associated with secondary increases in parathyroid hormone, thus providing for a convenient laboratory distinction between these two main categories. Magnesium deficiency is a special cause of hypocalcemia due both to parathyroid hormone and vitamin D dysfunction. When patients have symptomatic hypocalcemia, treatment is indicated. Parenteral therapy with intravenous calcium gluconate can rapidly relieve symptoms and provide time for the underlying cause to be evaluated and treated definitively.

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The polycystic ovary syndrome (PCOS) is a multifaceted disease. PCOS is the most frequent cause of hyperandrogenism and anovulation. The full-blown syndrome, as defined prior to the 1970s, is only one aspect of the spectrum of ovarian hyperandrogenism. There are both genetic and environmental components in the pathophysiology of this disorder. Hyperinsulinism secondary to insulin resistance is one such factor. The relationship between hyperinsulinism and PCOS may be more important in a temporal than in a quantitative fashion. For example, puberty may be an “insulin-sensitive window” in which subsequent ovarian function is permanently altered. Hyperinsulinemic PCOS can be an early clinical manifestation of a genetic background that conveys suspectibility to cardiovascular and metabolic complications later in life. This concept has major consequences in terms of disease prevention and public health.

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The recent dietary recommendations of the American Diabetes Association for patients with diabetes mellitus include an individualized approach based upon the diabetes management goals of each patient that takes into consideration preference of the patient and control of hyperglycemia and dyslipidemia. Weight loss and reduction of adiposity is an important goal of diet therapy for patients with non-insulin-dependent diabetes mellitus (NIDDM), many of whom are obese and insulin-resistant. A gradual sustained weight loss achieved by moderate reduction in total daily energy intake (∼250–500 kcal) and a simultaneous increase in energy expenditure by augmenting physical activity is recommended. As far as diet composition is concerned, besides a low saturated fat, high carbohydrate diet, a high monounsaturated fat diet may also be recommended. Intake oftransfatty acids and cholesterol should be restricted and alcohol should be completely avoided. Protein intake should be between 10–20% of the total energy intake. Fiber-rich sources of complex carbohydrates are preferred over refined sugars. The diet should be wholesome and provide the recommended dietary allowances of all vitamins and minerals. Beyond this, vitamin supplements are not justified.

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A significant number of studies have demonstrated a rhythmicity in the time of day of birth. For day active mammals, the normal time of delivery is during the hours of darkness, while the converse is true for nocturnal animals. This concept also applies to human pregnancy. Both the start of labor and actual time of delivery appear to occur more frequently at night than other times of the day. Although the mechanism(s) regulating this pattern remains undefined, there seems to be a relationship to rhythms in hormone secretion. The underlying hypothesis suggests that rhythmic changes in circulating hormone concentrations have a profound influence on the contractile characteristics of the myometrium. The changing hormone concentrations result in rhythms in uterine contractions, with the peak of activity occurring at night. This “temporal priming” of the uterus may be responsible for the nocturnal dominance of the initiation of labor and parturition. Data from non-human primates also suggest a strong influence of photoperiod on these rhythms. However, the influence of light:dark cycles on endocrine and uterine activity patterns during human pregnancy has yet to be determined.

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study gives an overview of glucose sensing strategies for potential use in diabetes therapy. The basis for the most commonly used amperometric glucosensors is the Clark electrode which measures oxygen tension. Coupling this sensor with glucose oxidase led to the first specific “biosensor” for glucose measurement. This sensor has been used for more than 20 years in thein vitroartificial pancreas (“Biostator”). The development of implantable glucose sensors has been hampered by the disappointingin vivobehavior of these sensors. Alternative glucose sensing techniques including noninvasive approaches are still experimental. Combining the microdialysis technique for continuous sampling of subcutaneous extra-cellular fluid with anin vitroon-line amperometric glucose oxidase electrode (the “Ulmer Zuckeruhr” or “sugar watch” system), permits continuous glucose sensing for 72 hours. Although there are differences and delays between changes in tissue and blood glucose concentrations, a complete automated feedback-controlled insulin delivery system is possible if fast acting insulin analogs can close the insulin delivery “feedback loop.”

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Bone pain has many possible causes. Malabsorption is a cause which is often overlooked and is more common than previously thought. Malabsorption of vitamin D, calcium, or both probably play a role, and “typical” findings of malabsorption can be absent.We retrospectively studied several patients presenting with bone pain who were eventually found to have malabsorption. Laboratory and clinical data that can serve to heighten the suspicion of malabsorption as a cause of bone pain are presented. Treatment and response are discussed.

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Among the various etiologies of central diabetes insipidus, idiopathic diabetes insipidus comprises the largest group. We present a case of idiopathic diabetes insipidus with an antecedent viral syndrome. A 39-year-old Asian man presented with polyuria and polydipsia after a viral syndrome. A diagnosis of diabetes insipidus was established, and magnetic resonance imaging (MRI) of the brain demonstrated thickening of the pituitary stalk. Six months after his initial presentation, he was found to have hypogonadotropic hypogonadism while his other pituitary functions remained intact. A follow-up MRI scan 2 years after the onset of his symptoms revealed complete normalization of the size of the infundibular stalk. The etiology of the lesion is unknown but most likely represents an inflammatory response to a viral infection or an autoimmune process that resulted in “stalkitis.”

ISSN:1051-2144    

出版商:OVID    

年代:1996

数据来源: OVID