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Biomedical subjects

H Rubinoff

Publications and source records attributed to H Rubinoff.

11 recordsLinked to original sources
PubMed1996

Prevalence of hypothalamic-pituitary imaging abnormalities in impotent men with secondary hypogonadism.

PURPOSE: Because prevalence of structural lesions of the pituitary and hypothalamus in impotent men with secondary hypogonadism was undefined, we evaluated 164 men 27 to 79 years old whose chief complaint was erectile dysfunction and who repeatedly had low serum testosterone levels (less than 230 ng./dl.). MATERIALS AND METHODS: With computerized tomography or magnetic resonance imaging of the sella we detected potentially serious lesions (pituitary lesions greater than 5 mm. or any hypothalamic lesion) in 11 men (6.7%, 95% confidence interval 2.9 to 10.5%), including 5 pituitary microadenomas (5 mm. or larger), 4 pituitary macroadenomas and 2 hypothalamic lesions. RESULTS: Mean serum testosterone was lower in patients with (121 +/- 66 ng./dl., standard deviation) than without (177 +/- 39 ng./dl.) hypothalamic or pituitary imaging abnormalities (p < 0.001). For every 10 ng./dl. decrease in testosterone the risk of hypothalamic or pituitary imaging abnormalities increased 1.2-fold (p < 0.005). Macroadenomas and hypothalamic lesions were confined to 6 subjects with testosterone levels of 104 ng./dl. or less. CONCLUSIONS: The risk of hypothalamic or pituitary imaging abnormalities is low among men evaluated for erectile dysfunction and secondary hypogonadism. However, this risk increases markedly when the serum testosterone level is markedly decreased.

Adult↗
PubMed1989

Testing for recovery of thyroid function after withdrawal of long-term suppression therapy.

Many persons are given thyroid hormone for long periods without sufficient justification. We selected 45 patients whose chart reviews did not demonstrate a clear need for thyroid replacement. Thyroid hormone was withdrawn and blood samples taken for free thyroxine index and TSH levels at 2, 4, 6, and 8 weeks after thyroid withdrawal. At 8 weeks, 30 of the 45 were normal. A single TSH test 8 weeks after thyroid withdrawal appears to be the most efficient way to separate euthyroid from hypothyroid patients.

Adult↗
PubMed1987

Pathophysiology of deoxycorticosterone-secreting adrenal tumors.

Two patients with hypermineralocorticoidism due to deoxycorticosterone (DOC) excess are described. The plasma 17-deoxysteroids of the zona fasciculata (ZF), namely DOC, corticosterone, 18-hydroxydeoxycorticosterone, and 18-hydroxycorticosterone, were elevated. Plasma androgen concentrations were normal, and plasma aldosterone and renin levels were low. One patient, who had benign adrenocortical adenoma, had normal plasma cortisol levels. The other patient, who had metastatic adrenocortical carcinoma, had low plasma cortisol, presumably due to elevated plasma corticosterone levels. While tumors producing only 17-deoxysteroids are rare, they have provided new insights into the regulation of 17-deoxysteroid secretion by the ZF. Presumptive suppression of a non-ACTH factor by adenoma-produced DOC transiently impaired the early postoperative responses to ACTH of the ZF 17-deoxysteroids of the contralateral adrenal. The dissociation of 17-deoxysteroids from cortisol in normal subjects given either dexamethasone or DOC acetate provides additional evidence for such a factor.

Adenoma↗
PubMed1983

Hypercalcemia: long-term follow-up with matched controls.

Using laboratory tests and the presence of complaints thought to be associated with hyperparathyroidism, we retrospectively studied 160 patients found to have hypercalcemia on a routine multiphasic examination in two different calendar years. Each case was compared to a matched control, and mean follow-up was 8.5 yr. The diagnosis of presumptive hyperparathyroidism was made by attempting to eliminate any confounding causes of hypercalcemia and by performing parathyroid hormone assays in 41 unoperated patients. Fifteen patients had a parathyroid adenoma removed (12 during and 3 after the duration of the study). Except for an increase in the incidence of hypertension in black male patients, we noted no significant differences in symptomatology or renal function between patients and matched controls. We conclude that most patients with mild persistent (presumptive) hyperparathyroidism may be left untreated under surveillance for long periods of time without the development of significant complications.

Adenoma↗
PubMed1977

Urinary tract infections.

Urinary tract infections can be found in either sex at any age. While the majority occur in adult females as acute cystitis, recurrent symptomatic bacteriuria, or asymptomatic bacteriuria, adult males with prostatitis or acute pyelonephritis and children with symptomatic urinary tract infections comprise a considerable portion of patients seen. Management in pregnant females or in males with indwelling catheters or before prostatic surgery presents special problems. The choice of drug and dosage schedule should vary according to the infecting agent and the clinical state of the patient.

Anti-Infective Agents↗