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Biomedical subjects

B SIMKIN

Publications and source records attributed to B SIMKIN.

At least 19 recordsLinked to original sources
PubMed1957

Long-term management of patients after adrenalectomy.

Experience with the long-term medical management of 17 patients previously subjected to surgical adrenalectomy was reviewed. Maintenance adrenal cortical replacement requirements consisted of oral cortisone, 37.5 to 50 mg. daily in all patients; desoxycorticosterone acetate (DOCA), 2 mg. daily, sublingually in all patients; and supplemental sodium chloride, 1 to 4 grams daily, in seven patients. This provides steroids with glucocorticoid and mineralocorticoid activity and an adequate salt intake. The subjective well-being of the patient was the best indicator of adequate replacement therapy. Under stable conditions, established dosage schedules required surprisingly little adjustment over long periods of time. The primary need of patients without adrenal glands when they are subjected to such stresses as infections, trauma or surgical operation, is for more glucocorticoids. Ordinarily, more DOCA and extra sodium chloride is not required. Mild infections can be dealt with by temporarily increasing the daily oral cortisone requirement, the patient remaining ambulatory. Severe infections with pronounced systemic manifestations require hospitalization and parenteral administration of glucocorticoids. Knowing how long it takes for the various glucocorticoid preparations to take effect and how long they continue to act is important in the management of patients who have had adrenalectomy, particularly in dealing with extraordinary stresses or emergencies.

Adrenalectomy↗
PubMed1956

Adrenalectomy for control of cancer of the breast.

Bilateral oophorectomy and adrenalectomy were used in the treatment of ten patients with advanced metastatic carcinoma of the breast, and particular attention was given to preoperative and postoperative management by a team of specialists including surgeons, endocrinologist, radiologist and pathologist. Objective and gratifying clinical remissions were achieved in three of the ten patients in this series following total oophorectomy and adrenalectomy. The remaining seven patients all subsequently died of metastatic disease. There were no operative deaths. Known cerebral or hepatic metastasis contraindicates adrenalectomy for metastatic cancer of the breast. Five of the seven patients not benefited by the operation had either cerebral or hepatic metastasis. The best candidates for adrenalectomy are premenopausal women who have previously had a clinical remission following oophorectomy and who have subsequently relapsed. The indications for adrenalectomy in the postmenopausal woman are not clear.

Adrenal Glands↗
PubMed1954

Exophthalmos; certain endocrinological aspects.

The substance isolated from the anterior pituitary and responsible for the induction of thyroid hyperplasia in the tadpole (TSH) is not invariably found in increased amounts in the blood of patients with exophthalmos. The blood concentration of this substance is inversely related to the level of thyroid activity. Thyroid extract, pituitary irradiation and adrenocorticotropic hormone have not been shown conclusively to alter the course of exophthalmos.

Adrenocorticotropic Hormone↗