Biomedical subjects

V Theisen

Publications and source records attributed to V Theisen.

3 recordsLinked to original sources

PubMed1993

Amiodarone-induced thyroid dysfunction.

Cases of hypothyroidism and hyperthyroidism associated with amiodarone therapy are described, and the mechanisms, clinical appearance, and management of amiodarone-induced thyroid dysfunction are discussed. A 72-year-old man with a history of recurrent ventricular tachycardia unresponsive to conventional antiarrhythmic drugs was started on amiodarone therapy. Initially he responded well, but after three months he began to have fatigue, dry skin, and intolerance of cold. His serum thyroid-stimulating hormone (TSH) concentration had risen from 4.4 microU/mL before amiodarone therapy began to 20 microU/mL, consistent with hypothyroidism. He was started on sodium levothyroxine for thyroid hormone replacement; the dosage was adjusted in accordance with subsequent TSH measurements. His hospital course was complicated by congestive heart failure. The second patient was a 43-year-old man with a history of atrial fibrillation who developed hyperthyroidism when placed on amiodarone therapy. He had persistent sweating, intolerance of heat, restlessness, and tachycardia. Thyroid function tests confirmed the presence of hyperthyroidism. The patient was treated with propylthiouracil and propranolol, and amiodarone was discontinued. He remained unresponsive to the propylthiouracil, which was discontinued, and was scheduled for radioactive iodine treatment. The mechanism of amiodarone-induced thyroid dysfunction may involve the large iodine content of the drug. Amiodarone-induced hypothyroidism may range in severity from mild symptoms to severe myxedema; the skin, hair, and nails are particularly affected. Persons with clinical hyperthyroidism secondary to amiodarone treatment show the signs and symptoms of a hypermetabolic state resulting from thyroid hormone excess. Amiodarone-induced hypothyroidism is treated with levothyroxine and hyperthyroidism with antithyroid drugs. Amiodarone can cause thyroid dysfunction, which can have serious consequences.

Adult↗

PubMed1983

Psychosocial factors influence control of moderate and severe hypertension.

Factors affecting the degree of blood pressure control achieved by antihypertensive drug treatment in 150 patients with moderate and severe essential hypertension were analyzed. Patients were under continuing treatment for 1-23 years. Most patients were referred for hypertension which was difficult to control. All were managed by the senior author. They received multiple drug regimens and extensive efforts were made to encourage their adherence to the regimens. In spite of these efforts, 16 (11%) had poor blood pressure control. Satisfactory control was achieved in 52 (35%) patients and excellent control in 82 (55%) patients. As a group, their ideal body weight (IBW) was 125 +/- 22% (mean +/- SD) of normal. The mean number of antihypertensive tablets per day was significantly greater (P = 0.0009) in those with poor control as compared to those with satisfactory and excellent control. As % IBW increased, the number of antihypertensive tablets increased (P = 0.0021). We examined the relationship of blood pressure control with an index of compliance, with psychosocial factors (life events score, martial status) and with socioeconomic factors (work status, income). Poor blood pressure control was associated with a lower compliance index (P less than 0.0001) and a higher life events score (P less than 0.006). Poorly controlled patients were more likely to have poor health in general (P = 0.0002), to have kept fewer medical appointments during the preceding year (P less than 0.0001), to be unmarried (P less than 0.0001), to be unemployed (P less than 0.0028) and have a lower income (P less than 0.009). As % IBW increased, compliance index decreased, (P = 0.0045). Therefore, psychosocial and socioeconomic factors, as well as physical factors, influence blood pressure control in moderate and severe essential hypertension.

Age Factors↗

PubMed1979

A hospital-based screening, referral, and follow-up program for high blood pressure.

A hypertension program staffed largely by volunteer nurses in a hospital outpatient department is described. A three-year evaluation shows 19% of 4,282 clients screened as having high readings, 86% of those referred saw a physician for high blood pressure, 92% of those who saw a physician began treatment for high blood pressure and 50% of those under treatment were showing successful control or progress toward successful control.

Evaluation Studies as Topic↗