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Biomedical subjects

G D Borowski

Publications and source records attributed to G D Borowski.

7 recordsLinked to original sources

Effect of long-term amiodarone therapy on thyroid hormone levels and thyroid function.

Both hyperthyroidism and hypothyroidism have been noted to occur in some patients treated with amiodarone for cardiac arrhythmias. To determine the frequency of the development of thyroidal abnormalities in patients receiving amiodarone, 45 euthyroid patients were prospectively evaluated. Serum samples were obtained for measurement of thyroxine, thyrotropin, triiodothyronine, and triiodothyronine resin uptake prior to initiation of amiodarone treatment and serially over a 12- to 27-month period during which amiodarone was administered. The patients were divided into four subgroups as follows: Group I (n = 22) had elevated thyroxine levels, Group IIA (n = 13) had normal thyroxine levels and normal thyrotropin levels, Group IIB (n = 7) had normal thyroxine levels and elevated thyrotropin levels, and Group III (n = 3) had subnormal thyroxine levels. Demographic factors (such as route of administration, cardiac diagnosis, sex of the patient, or indication for amiodarone therapy) and amiodarone levels had no significant effect on the thyroid hormone parameters. However, Group I patients were statistically older than the patients in the other groups. Linear regression analysis revealed a negative correlation for thyroxine levels and a positive correlation with thyrotropin levels with age for the whole group. The various groups were not statistically affected by duration of therapy, but a positive trend existed for increasing thyroxine levels. Although virtually all patients showed changes in their thyroid hormone levels, chemical hyperthyroidism (elevated thyroxine and triiodothyronine levels without symptoms) developed in only two patients (4 percent), and clinical hyperthyroidism (elevated thyroxine and triiodothyronine levels with symptoms) developed in no patients. Four patients (9 percent) became biochemically and clinically hypothyroid. Thus, amiodarone frequently influences thyroid hormonal parameters, but less commonly causes a change in actual thyroid function. However, hyperthyroidism and hypothyroidism do occur in a significant number of patients.

Age Factors

Recurrent thyrotoxicosis after I-131 induced hypothyroidism.

The first clinically and biochemically documented case of recurrent thyrotoxicosis after I-131 induced hypothyroidism in a patient with Graves' disease is reported. Two months after the administration of 9.2 mCi of I-131, the subject developed hypothyroidism. One month later, the patient became euthyroid. Then, nine months following ablation, the patient again developed thyrotoxicosis. A second dose of I-131 of 12.5 mCi was required to finally produce permanent hypothyroidism. This case illustrates the recurrence of hypothyroidism after what had seemed to have been adequate I-131 radiation.

Adult

Blood pressure response to thyrotropin-releasing hormone in euthyroid subjects.

The iv administration of TRH has been associated with side effects, such as nausea, flushing, and urinary urgency. However, few reports mention changes in blood pressure. This study defines the mean and range of the blood pressure responses in 70 euthyroid patients subjected to iv administered TRH. The mean increase was 21.0 +/- 1.4 mm Hg for systolic and 13.9 +/- 1.0 mm Hg for diastolic blood pressure; however, individual peak values increased as much as 56 and 42 mm Hg, respectively. Thus, the hemodynamic response to iv administered TRH can be quite severe in some subjects, and caution is suggested in selecting patients for testing.

Blood Pressure

Recurrent pneumoperitoneum after hysterectomy.

In most instances, patients with an acute abdomen and pneumoperitoneum have a perforated hollow viscus as the underlying cause. Clinicians must not forget, however, some of the less common causes of free air in the abdomen. We describe pneumoperitoneum from a vaginoperitoneal fistula, developing after hysterectomy, well known to gynecologists, but rarely noted in the medical literature.

Abdomen, Acute