Clinics in Endocrinology and Metabolism最新文献_第10页

Index 指数

Clinics in Endocrinology and Metabolism Pub Date : 1985-08-01 DOI: 10.1016/S0300-595X(85)80015-3

引用次数: 0

2 Trace element metabolism in the fetus and neonate 2胎儿和新生儿微量元素代谢

Clinics in Endocrinology and Metabolism Pub Date : 1985-08-01 DOI: 10.1016/S0300-595X(85)80006-2

Patricia A. Pleban, Brenda S. Numerof, Frederick H. Wirth

引用次数: 17

6 Post-partum hyperthyroidism 产后甲状腺功能亢进

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80041-4

Paul G. Walfish, John Y.C. Chan

引用次数: 51

9 Hyperthyroid heart disease 9甲状腺功能亢进性心脏病

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80044-X

J.C. Forfar, G.C. Caldwell

{"title":"9 Hyperthyroid heart disease","authors":"J.C. Forfar, G.C. Caldwell","doi":"10.1016/S0300-595X(85)80044-X","DOIUrl":"10.1016/S0300-595X(85)80044-X","url":null,"abstract":"<div><p>The importance of cardiovascular system involvement in hyperthyroidism has been recognized for many years. In the middle-aged and elderly patient, often with mild but prolonged elevation of plasma thyroid hormones, symptoms and signs of heart failure and complicating atrial fibrillation may dominate the clinical picture and mask the more classical endocrine manifestations of the disease. Pitfalls in diagnosis and the importance of early recognition and treatment are discussed. Despite experimental evidence for a short-term isotropic action of thyroid hormone excess, clinical data support the existence of a reversible cardiomyopathy in hyperthyroidism with impaired contractile reserve. Enhanced myocardial performance at rest primarily reflects the peripheral actions of thyroid hormone excess. Most, if not all, of the cardiac abnormalities return to normal once a euthyroid state has been achieved, although atrial fibrillation may persist in a minority. Optimum treatment requires rapid and definitive antithyroid therapy, usually using a large dose of radio-iodine, and rapid control of heart failure. Systemic anti-coagulation is indicated in the presence of atrial fibrillation and should be continued until sinus rhythm has been present for at least three months, either spontaneously or after cardioversion.</p></div>","PeriodicalId":10454,"journal":{"name":"Clinics in Endocrinology and Metabolism","volume":"14 2","pages":"Pages 491-508"},"PeriodicalIF":0.0,"publicationDate":"1985-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0300-595X(85)80044-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14003510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 42

4 Diagnosis of hyperthyroidism: The newer biochemical tests 4甲状腺机能亢进的诊断:最新的生化检查

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80039-6

J. Seth, G. Beckett

{"title":"4 Diagnosis of hyperthyroidism: The newer biochemical tests","authors":"J. Seth, G. Beckett","doi":"10.1016/S0300-595X(85)80039-6","DOIUrl":"10.1016/S0300-595X(85)80039-6","url":null,"abstract":"<div><p>Investigation of suspected hyperthyroidism is conventionally based on measurement of total or free T<sub>4</sub> as the initial test, followed in equivocal cases by total or free T<sub>3</sub>, and the TRH test. Recent developments in techniques for measuring free hormones and TSH promise to change this approach. Free T<sub>4</sub> and free T<sub>3</sub> can now be rapidly and simply quantitated in whole serum using labelled analogue radioimmunoassays. Specific and highly sensitive assays using labelled monoclonal antibodies are now available for serum TSH that permit the suppressed levels found in most cases of hyperthyroidism to be distinguished from euthyroid levels. These newer assays are available at a cost per test that is often similar to that of the more established tests.</p><p>Available evidence indicates that measurement of basal serum TSH by a sensitive labelled antibody method can serve as a first line test, at least in uncomplicated cases of suspected hyperthyroidism. In patients with a suppressed TSH, a serum free T<sub>4</sub>, and in equivocal cases free T<sub>3</sub>, will distinguish the clinical and subclinical forms of hyperthyroidism. Such an approach would obviate the need for the TRH test. It must be emphasized, however, that experience with this new approach is limited. Caution is advised in the interpretation of low TSH and free hormone levels when there are associated complicating features, such as severe non-thyroidal illness, or pregnancy.</p><p>These developments mark a trend in thyroid function testing away from measurement of circulating total hormone levels. The newer tests provide an assessment of end organ (thyrotroph) response, and an assessment of biologically active (free) hormone to which the tissues are exposed. These complementary approaches have the potential to identify relatively minor degrees of thyroid dysfunction.</p></div>","PeriodicalId":10454,"journal":{"name":"Clinics in Endocrinology and Metabolism","volume":"14 2","pages":"Pages 373-396"},"PeriodicalIF":0.0,"publicationDate":"1985-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0300-595X(85)80039-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15049579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

8 Radio-iodine treatment of hyperthyroidism— a more liberal policy? 放射性碘治疗甲状腺机能亢进——一个更自由的政策?

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80043-8

Keith E. Halnan

引用次数: 19

Recent issues 最近的问题

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80034-7

引用次数: 0

5 Hyperthyroidism with a low iodine uptake 5甲状腺机能亢进伴低碘摄取

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80040-2

R.L. Himsworth

引用次数: 5

1 The pathogenesis of graves' disease 格雷夫斯病的发病机制

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80036-0

A.A.R. Gossage, D.S. Munro

{"title":"1 The pathogenesis of graves' disease","authors":"A.A.R. Gossage, D.S. Munro","doi":"10.1016/S0300-595X(85)80036-0","DOIUrl":"10.1016/S0300-595X(85)80036-0","url":null,"abstract":"<div><p>The abnormally increased thyroid activity that is characteristic of Graves' disease is caused by immunoglobulins which specifically interact with the thyroid cell and stimulate it. Increases and decreases in thyroid activity in Graves' disease can be clearly related to rise and fall of these immunoglobulin-mediated activities. The level of immunoglobulin stimulatory activity can be used for prediction of the likelihood of neonatal Graves' disease and of recurrence of disease after cessation of treatment with antithyroid drugs.</p><p>Investigation of patients with Graves' disease and their families has led to identification of particular human leukocyte antigens and genetically linked markers on immunoglobulins which both appear to incur increased susceptibility to certain autoimmune diseases. Differences in immune function, when compared with control populations, have been found in patients with these genetically linked markers. Protection against autoimmune disease-is maintained by purposeful inhibition of any self-directed activity within each function of the immune system and by the controlling interaction of other immune functions. No single deficiency of immune function can be selected as giving the major risk of autoimmune disease, but rather a sum of relative defects resulting in an increased risk. In some patients with Graves' disease the self-protection mechanisms regain sufficient control of the immune functions to reduce the activity of the autoimmune disease, and the patient may achieve clinical remission. Often, however, there is evidence that abnormal immune activity directed against thyroid tissue has persisted with liability to recurrence of the Graves' disease.</p></div>","PeriodicalId":10454,"journal":{"name":"Clinics in Endocrinology and Metabolism","volume":"14 2","pages":"Pages 299-330"},"PeriodicalIF":0.0,"publicationDate":"1985-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0300-595X(85)80036-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14003508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Index 指数

Clinics in Endocrinology and Metabolism Pub Date : 1985-05-01 DOI: 10.1016/S0300-595X(85)80045-1

引用次数: 0