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Biomedical subjects

I Blum

Publications and source records attributed to I Blum.

At least 73 records · Page 4Linked to original sources

Primary hyperparathyroidism: possible cause of primary hyperaldosteronism in a 60-year-old woman.

Hypertension and hypokalemia were found in a 60-yr-old woman suffering from primary hyperparathyroidism. Laboratory investigations in this patient disclosed 1) elevated levels of plasma aldosterone (PA) which could not be suppressed by a high sodium diet alone or in combination with fludrocortisone (Florinef); 2) a decline of the elevated PA levels after 4 h of ambulation; and 3) low PRA which was unresponsive to stimulation by a low sodium diet coupled with diuretic-induced volume depletion and 4 h of ambulation. These findings were consistent with the diagnosis of primary hyperaldosteronism. Extirpation of a parathyroid adenoma reduced the patient's serum calcium level to normal, and subsequently, a normalization of her blood pressure, serum electrolytes, PA, and PRA were observed. On the basis of these data is is suggested that in this case hyperaldosteronism may have been caused directly or indirectly by primary hyperparathyroidism.

Adenoma↗

Superiority of bromocriptine over pyridoxine in the treatment of patients with acromegaly or galactorrhea.

Sixteen patients, eight with acromegaly and eight with galactorrhea, were treated with pyridoxine (600 mg/day) for a three-month period. The clinical and biochemical changes induced by the drug were compared with those induced by bromocriptine (2.5 to 50 mg/day) administered for the same length of time to the same patients. Pyridoxine induced lowering of growth hormone and prolactin levels in two acromegalic patients. In only one patient with galactorrhea after irradiation of the hypophysis for active acromegaly did pyridoxine treatment stop and galactorrhea and induce renewal of menstrual bleeding without significantly changing the basal prolactin levels. In another patient with a chromophobe adenoma of the hypophysis, it reduced the excessively elevated prolactin levels. On bromocriptine therapy, all the patients reported signifcant clinical improvement paralleled by significant drops in plasma growth hormone and prolactin. It appears that at the dosages administered bromocriptine is preferable to pyridoxine in the treatment of patients with acromegaly or galactorrhea.

Acromegaly↗

Effect of triiodothyronine administration on the plasma TSH and prolactin responses to TRH in patients with hypothalamic-pituitary insufficiency.

A study was carried out in 10 patients with multiple pituitary hormone deficiencies to determine the response of thyroid-stimulating hormone (TSH) and prolactin (PRL) to thyrotropin-releasing hormone (TRH) and their suppressibility by treatment with triiodothyronine (T3) given at a dose of 60 microgram/day for 1 week. In 3 patients the basal tsh values were normal and in 7 patients, 2 of whom had not received regular thyroid replacement therapy, they were elevated. The response of TSH to TRH was normal in 6 patients and exaggerated in 4 (of these, 1 patient had not received previous substitution therapy and 2 had received only irregular treatment). The basal and stimulated levels of TSH were markedly suppressed by the treatment with T3. The basal PRL levels were normal in 7 and slightly elevated in 3 patients. The response of PRL to TRH stimulation was exaggerated in 2, normal in 6 and absent in 2 patients. The basal PRL levels were not suppressible by T3 treatment but in 4 patients this treatment reduced the PRL response to TRH stimulation. From these findings the following conclusions are drawn: (1) T3 suppresses TSH at the pituitary level, and (2) the hyperreactivity of TSH to TRH and the low set point of suppressibility are probably due to a lack of TRH in the type of patients studied.

Adolescent↗

Acute delirious state after epsilon-amino caproic acid administration.

Prior to intravenous pyelography, a patient known to have iodine hypersensitivity was injected intravenously with a bolus of 2 gm epsilon-amino caproic acid (EACA). Immediately following the injection the patient developed an acute episode manifested by a delirious state, with auditory, visual, and kinesthetic hallucinations. The entire episode lasted 8 min, and no residual psychiatric or neurologic symptoms were observed. To the best of our knowledge no such side effect of EACA has been reported so far.

Aged↗

Urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) excretion in depression.

Twelve acute depressed patients were studied in the course of antidepressant treatment. Three-day-24-hour urine samples for 3-methoxy-4-hydroxy-phenylglycol (MHPG) were collected both before and after a five week treatment schedule. MHPG were estimated by spectrophotometry. Initial MHPG excretion did not reflect the severity of pretreatment depression and final MHPG showed no specific correlation with post-treatment improvement. No specific or uniform influence of different anti-depressant treatments or changes in MHPG was evident. Depressed patients with bipolar affective disorder tend to have initially lower MHPG levels than patients with unipolar depression. Urinary MHPG excretion measurements may prove not to be a useful index in the diagnosis and choice of treatment in patients suffering from primary depression.

Adult↗

beta-adrenergic blocking drugs in psychiatry: present status, future approaches and research.

Clinical trials with propranolol were performed in 44 carefully selected psychiatric patients. Propranolol was administered in 8 equal doses over 24 hours and increased at a daily rate of 400 mg. Treatment was monitored by patient's reactions and by periodic examination of pulse rate and blood pressure. Results showed marked to moderate improvement, often within 24 to 48 hours, in two-thirds of the patients treated. Concurrent with stabilization of heart rate and blood pressure at about 60/min and 90/60 mm Hg respectively, improvement was noted in anxiety, psychomotor hyperactivity, thought process disturbance, hallucinations, and disturbances in affect. Our studies and those of other investigators indicate that propranolol and oxprenolol, and possibly other beta-adrenoceptor blocking drugs, may have a beneficial influence on psychotic syndromes. Further well-controlled clinical trials seem warranted. Indications for use, dosages, and combinations with other drugs, mainly phenothiazines, must be delineated. Laboratory investigations may add considerably in these respects ans may lead to safe treatment regimes with minimal side effects.

Adrenergic beta-Antagonists↗

The combined effect of growth hormone and methandrostenolone on the linear growth of patients with multiple pituitary hormone deficiencies.

Six patients with multiple pituitary hormone deficiencies (MPHD) were initially treated with separate courses of methandrostenolone and growth hormone and later with the two drugs combined. During the basal period the mean growth velocity was 2.8 cm/year. Methandrostenolone alone, 0.02-0.05 mg/kg/day given to four of the patients led to an acceleration of the growth velocity to a mean of 5.0 cm/year, while growth hormone 6 mg/week alone accelerated the growth rate to a mean of 6.0 cm/year. Combined therapy led to a striking increase in the mean growth rate to 9.3 cm/year. The shortcoming of the combined growth hormone-androgen therapy was the fast acceleration in skeletal maturation even after short-term administration.

Adolescent↗

Beclomethasone dipropionate and chronic asthma. The effect of long-term aerosol administration on the hypothalamic-pituitary-adrenal axis after substitution for oral therapy with corticosteroids.

Beclomethasone dipropionate aerosol at a dose of 100 mug four times a day was administered to 32 patients suffering from chronic perennial asthma. Twenty-three of these patients had previously received prolonged treatment with corticosteroids, causing various degrees of adrenal suppression in some patients. Almost complete recovery of adrenal function was observed within a period of six months in most patients. Treatment with beclomethasone dipropionate did not affect the hypothalamic-pituitary-adrenal axis in the other nine asthmatic patients who had not received prolonged corticosteroid therapy previously and who served as a control group.

Administration, Oral↗