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PubMed1995

Proportionate mortality study of Vietnam-era veterans of Michigan.

This study examines the proportion of deaths from major diseases among Michigan Vietnam veterans. The distribution of deaths among Michigan Vietnam veterans was compared to deaths among veterans serving elsewhere for 1974-1989 to generate a proportionate mortality ratio (PMR). PMRs were estimated overall and for Black versus non-Black veterans. Overall, Vietnam veterans had significantly elevated PMRs for infectious and parasitic diseases and endocrine disease and lower PMRs for all malignant neoplasms combined. Vietnam veterans overall and non-Black specifically had elevated PMRs for non-Hodgkin's lymphoma. Black Vietnam veterans had elevated PMRs for cancer of the digestive organs, peritoneum, and pancreas. The elevated PMR for non-Hodgkin's lymphoma is consistent with results of individuals exposed to phenoxy herbicides. Results suggest that future studies should examine risks among racial groups separately.

Adult↗
PubMed2004

Pulmonary hypertension and systemic diseases.

Secondary pulmonary hypertension (sPH) may develop as a result of few systemic diseases as endocrine diseases, HIV infection, collagen diseases, liver and hematological disorders. In this review we discuss the role of systemic diseases in inducing PH starting from a pathological classification.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[An aged case of orthostatic hypotension possibly due to parasympathetic neurodysfunction].

94-year-old male patient, with orthostatic hypotension, possibly due to impairment of vasoconstriction and parasympathetic nervous system dysfunction was reported. This patient experienced faintness and lower muscle weakness on standing. The blood pressure was 180/90 mmHg in a supine position, while it significantly decreased to 100/58 mmHg in an upright position. There was no evidence indicating the presence of organic brain diseases, cardiovascular diseases, and endocrine diseases, plasma catecholamine, renin, aldosterone, and vasopressin levels at rest were within normal range. Thus, the cause of orthostatic hypotension of this patient was unknown. His systolic blood pressure decreased by 70 mmHg, and his diastolic blood pressure also decreased by 25 mmHg in response to a 70 degrees head-up tilting test (170/71-100/46 mmHg). Plasma vasopressin level significantly increased in response to this test (0.62-67.2 pg/ml). Plasma catecholamine levels also increased (Adr 0.01-0.10 ng/ml, Ndr 0.05-0.22 ng/ml). Other autonomic nervous system examinations revealed normal responses to mental arithmetic test, hyperventilation test, cold pressure test, and adrenalin test. However, the results of the carotid occlusion test, acetylcholine test, atropine test, phenylephrine test were considered to be abnormal. From these findings, we concluded that the functions of sympathetic nervous system were almost intact, while the parasympathetic functions were impared in this case. The orthostatic hypotension of the patient as effectively treated with fludrocortisone. This report suggests that impairment of vasoconstriction and parasympathetic neurodysfunction might be involved in the development of orthostatic hypotension in the elderly.

Acetylcholine↗
PubMed1999

[The concept of resistant depression and therapeutic strategies, particularly, with venlafaxine].

About 30% of depressed patients exhibit depression that is resistant to antidepressant treatment. This resistance may be primary or associated with a concomitant psychiatric or somatic disease. Venlafaxine has shown potent efficacy in certain severe depressions in in-patients and in patients presenting with resistant depression in an open-label study. It was considered of interest to compare, under double-blind, the efficacy of venlafaxine (200 to 300 mg/day) and that of paroxetine (30 to 40 mg/day) (for 6 weeks) in 123 patients presenting with major depression resistant to two correctly conducted antidepressant treatments in the course of an episode of depression of duration not exceeding 8 months. The patients were required not to present with organic disease, particularly endocrine disease. After 28 days of treatment, half of the patients receiving venlafaxine and one third of the patients receiving paroxetine showed a 50% reduction in their total score on the Hamilton scale. In addition, the percentage of patients presenting with remission was significantly higher in the group receiving venlafaxine (42%) compared to that receiving paroxetine (20%). These results require confirmation over the long term and in other forms of resistant depression.

Antidepressive Agents, Second-Generation↗
PubMed1999

[Clinical characteristics and psychotropic therapy of depressive and anxious symptoms of patients with somatic diseases].

OBJECTIVE: To explore the characteristics of depressive and anxious symptoms and the drug therapy response of patients with somatic diseases. METHODS: All the subjects were inpatients in a general hospital. The depressive and anxious symptoms met with the following conditions: hospital anxiety and depression scale (HAD) > 7 scores, Hamilton Depression Scale (HAMD) > 12, Hamilton Anxiety Scale (HAMA) > 10, Clinical Global Impression (CGI) > or = 3. RESULTS: In patients 200, 195 received the therapy, and 5 discontinued. The severity of depressive symptom in descending order was tumor group, blood disease group, endocrine disease group, depressive group, cardiovascular disease group, renal disease group. The effects of Seroxat (serotonin selective reuptake inhibitor, SSRI): showed that the overall efficacy against depressive and anxious symptoms, measured with 50% reduction rate in endpoint scales scores, was 61.6% and 61.5% respectively. CONCLUSION: Different characteristics of emotional symptoms existed among different somatic diseases. Seroxat is effective in treating emotional problems of patients with somatic diseases.

Adolescent↗
PubMed2005

The hormonal pathway to frailty in older men.

Frailty, which is a state of high vulnerability that imparts a high risk of developing adverse health outcomes, affects many elderly subjects, especially men and women aged 80 yr and older (1). Although many different definitions of frailty have been proposed (2), a large portion of the recent literature has focused on the definition developed by L. Fried et al. (1) using the data from the Cardiovascular Health Study. Although this definition has not been officially recognized as the "gold standard" for the diagnosis of frailty, nonetheless most of the studies on frailty in the last 5 yr have used this definition. Several mechanisms have been hypothesized to have an important role in the development of frailty, including inflammation, coagulation and oxidative stress (3). Many authors implicate age-related hormonal changes to be directly or indirectly involved in the development of the frailty syndrome (4). Alterations in hypothalamic- pituitary-testicular, hypothalamic-pituitary-adrenal (HPA) and GH-IGF-I axes that accompany aging have been associated with single components of frailty, such as reduced muscle strength, bone strength or poor mobility (5, 6). However, most of these studies have focused on single hormonal changes rather than evaluating the parallel effect of aging on multiple hormonal axes. In addition, no interventional studies have specifically targeted frail older subjects (7). Since frailty by definition is a multi-system disorder, it is unlikely that changes in one axis (leading to a change in a single hormone) will explain the complexity of the dysregulation leading to frailty. Therefore, global measures of endocrine dysregulation that can discriminate between specific endocrine diseases and endocrine senescence should be developed. Observational and interventional studies will be needed to better define the role of "hormonal dysregulation", alone and in combination with other pathways, in the development of frailty in older men.

Aged, 80 and over↗
PubMed1997

Increased prevalence of thyroid autoantibodies and subclinical thyroid failure in relatives of patients with overt endocrine disease-associated diabetes but not type 1 diabetes alone.

The purpose of this study was to determine the prevalence of thyroperoxidase (TPO) and thyroglobulin (Tg) antibodies, using a sensitive and specific radioimmunoassay method in a large cohort of 254 first-degree relatives of Type 1 diabetic patients with or without other autoimmune endocrinopathy, and to evaluate the predictive value of thyroid antibodies for impaired thyroid function in these groups. TPO and Tg antibodies were found at similar frequencies (12%) in the 254 relatives, and both antibodies were present in 23 cases (9%). Seven subjects displayed subclinical thyroid dysfunction without an abnormal free T4 level. Among first-degree relatives of probands with Type 1 diabetes alone, TPO or Tg antibodies were found in 8 subjects (6%), including 6 with both antibodies. The prevalence of TPO antibodies was significantly greater among relatives of TPO-positive than TPO-negative probands (p < 0.01). In relatives of diabetic patients with other endocrinopathy, frequencies of TPO (20%), Tg (19%) and a combination of both antibodies (15%) were significantly higher than in relatives of Type 1 diabetic patients without endocrinopathy (p < 0.001). TSH levels were abnormal in only one relative of the group without endocrinopathy but occurred in 6 relatives of the proband with overt endocrinopathy-associated diabetes (p < 0.02) in marked association with TPO antibodies (p < 10(-4). It is concluded that relatives of probands with overt endocrine autoimmune disease-associated diabetes, unlike those of probands with diabetes alone, showed increased prevalence of thyroid antibodies and thyroid dysfunction. These results argue for a different risk of thyroid autoimmunity and clinical disease in families of diabetic patients without or with overt endocrine disease. A screening of thyroid autoimmunity is highly recommended for the latter group.

Adolescent↗
PubMed1999

[The activity of renin-angiotensin-aldosterone system (RAA) and possibilities of application angiotensin converting enzyme inhibitors (ACE I) in selected diseases of endocrine glands].

The aim of this presentation is evaluation of the renin-angiotensin-aldosterone system (RAA) in selected diseases of endocrine glands. In patients with acromegaly, Conn's syndrome, hyperparathyroidism, hyperthyroidism, hypothyroidism, phaeochromocytoma and Cushing's disease is possible to formulate the temporarily conclusions according to subsidiary meaning of angiotensin converting enzyme inhibitors (ACE I) in these endocrinopathies. Whereas the ACE I play an important role in the treatment of nephropathy and hypertension in diabetes mellitus.

Aldosterone↗
PubMed2000

Management of hyperthyroidism due to Graves' and nodular diseases.

Endocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision-making for management should be based on clear assessment of advantages and limitations of each of the treatment options. Surgery provides rapid resolution of these conditions, and cure rates are high, although it may be associated with perioperative complications and postoperative thyroid dysfunction. The authors' experience in the surgical treatment of hyperthyroidism and a review of the recent literature are outlined in this report.

Graves Disease↗