RESUMEN
Nine patients with recurrent purely cystic thyroid nodules after one or two previous cyst aspirations were treated with repeat cyst aspiration and instillation of intracystic tetracycline hydrochloride. All but two of the patients' cysts resolved completely and have not recurred after a follow-up period of 12 to 50 months (mean = 40). The remaining patients had a partial response that left them with clinically insignificant lesions. The procedure was well tolerated and obviated the need for further therapy in all patients. Cyst aspiration and tetracycline instillation is a safe and effective treatment of recurrent purely cystic thyroid nodules that eliminates the need for surgical excision.
Asunto(s)
Quistes/terapia , Soluciones Esclerosantes/administración & dosificación , Tetraciclina/administración & dosificación , Enfermedades de la Tiroides/terapia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Succión , UltrasonografíaRESUMEN
Basal (8:00 AM) serum cortisol levels in peri- or postmenopausal women treated with 0.625 mg daily of conjugated equine estrogens were only slightly higher than pretreatment levels. A 1.25 mg/day dosage resulted in a significant increase in basal serum cortisol levels. In women treated with either dosage, 8:00 AM serum cortisol levels 8 to 10 hours after 1 mg of oral dexamethasone were suppressed to below 5 microgram/100 ml, although there was a significant rise in post-dexamethasone serum cortisol levels in those treated with the higher dosage. It is concluded that while replacement dosages of estrogens increase circulating total serum cortisol levels, they do not interfere with the interpretation of the overnight dexamethasone suppression test.
Asunto(s)
Síndrome de Cushing/diagnóstico , Dexametasona , Estrógenos Conjugados (USP)/farmacología , Hidrocortisona/sangre , Adulto , Anciano , Estrógenos Conjugados (USP)/administración & dosificación , Femenino , Humanos , Persona de Mediana Edad , Transcortina/sangreRESUMEN
The prolactin response to 100 micrograms of intravenous gonadotrophin releasing hormone was studied in seven hypergonadotrophic hypogonadal and four eugonadal women. Prolactin rose from a mean basal level of 7.3 +/- 1.6 ng/ml to a mean peak level of 20.8 +/- 5.2 ng/ml in the hypogonadal women, and did not change significantly from a mean basal level of 7.7 +/- 1.2 ng/ml in the eugonadal women. Dexamethasone suppression did not alter the gonadotrophin or prolactin response to GnRH. Hypergonadotrophic hypogonadal women, like some patients with acromegaly, anorexia nervosa, and anovulatory disorders, show an augmented release of prolactin after GnRH administration.
Asunto(s)
Dexametasona/uso terapéutico , Gonadotropinas Hipofisarias/sangre , Hipogonadismo/fisiopatología , Hormonas Liberadoras de Hormona Hipofisaria , Prolactina/metabolismo , Adulto , Anciano , Femenino , Humanos , Hipogonadismo/sangre , Hipogonadismo/tratamiento farmacológico , Persona de Mediana Edad , Prolactina/sangre , Factores de TiempoRESUMEN
Several attacks of acute intermittent porphyria complicated the treatment of a patient with pulmonary tuberculosis. To determine whether the attacks were drug-induced, the ability of a variety of antituberculous drugs to induce (delta)-amino-levulinic acid synthetase activity in a rat liver model was assessed. Pyrazinamide was found to be capable of significantly inducing amino-levulinic acid synthetase activity; the other antituberculous drugs caused either slight or no induction of amino-levulinic acid synthetase. The data suggest that pyrazinamide was capable of causing an exacerbation of the patient's porphyria. Tuberculosis, by causing debility, may also have aggravated this patient's previously latent porphyria.