Abstract：
:We describe three critically ill patients who displayed indirect evidence of transient corticotropin deficiency. All these patients were elderly, were poorly nourished, and had unexplained hypotension intraoperatively or immediately postoperatively. During the hypotensive episodes, they had inappropriately low plasma cortisol levels (10, 12, and 6 micrograms/dl) and responded dramatically to the administration of glucocorticoids. A normal response to infusion of synthetic corticotropin excluded primary adrenal insufficiency. Two patients tested had low thyroxine levels without increased thyrotropin concentrations and depressed levels of gonadotropins. In all three patients, the dose of glucocorticoids was successfully tapered and then discontinued. After recovery, serum thyroxine levels increased, gonadotropins reverted to normal concentrations, and the administration of metyrapone to two patients demonstrated normal hypothalamic-pituitary-adrenal function. Cortisol levels of less than 15 micrograms/dl in critically ill patients suggest the presence of adrenal insufficiency. The infusion of synthetic corticotropin may not exclude adrenal insufficiency attributable to corticotropin deficiency. If direct tests of corticotropin reserve are impractical, treatment with glucocorticoids is warranted.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Kidess AI,Caplan RH,Reynertson RH,Wickus GG,Goodnough DEdoi
10.1016/s0025-6196(12)60188-8subject
Has Abstractpub_date
1993-05-01 00:00:00pages
435-41issue
5eissn
0025-6196issn
1942-5546pii
S0025-6196(12)60188-8journal_volume
68pub_type
杂志文章abstract：:In the three major morphologic groups of lupus nephritis--diffuse, focal proliferative, and membranous--glomerular deposition of immunoglobulins is usually a combination of IgG, IgM, and IgA and is not a good indicator of initial renal severity or outcome. In this study of 60 patients with systemic lupus erythematosus...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1978-06-01 00:00:00
abstract：:The updated cervical cancer screening guidelines recommend that women at average risk who have negative screening results undergo cervical cytological testing every 3 to 5 years. These recommendations do not pertain to women at high risk for cervical cancer. This article reviews recommendations for cervical cancer scr...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2017.06.007
更新日期：2017-08-01 00:00:00
abstract：:Transesophageal echocardiography (TEE) is used frequently in patients with cerebrovascular ischemia. On TEE, a typical appearance of a cardiac fibroelastoma is that of a pedunculated, mobile mass attached to a leaflet of a valve. Surgical excision of the lesion may lead to resolution of the symptoms and prevent furthe...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63944-X
更新日期：1995-09-01 00:00:00
abstract：OBJECTIVE:To estimate the incidence of selected systemic autoimmune diseases (SAIDs) in approximately 14,000 male rescue/recovery workers enrolled in the Fire Department of the City of New York (FDNY) World Trade Center (WTC) Health Program and to compare FDNY incidence to rates from demographically similar men in the ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.09.019
更新日期：2016-01-01 00:00:00
abstract：:Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). Rapid eye movement sleep behavior disorder is strongly associated with neurodegenerative disease, especi...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2017.09.007
更新日期：2017-11-01 00:00:00
abstract：:Prompt and appropriate management measures are critical in order to achieve a favorable outcome after a major overdose of intrathecally (IT) administered methotrexate (MTX). Published information available to guide clinicians in the immediate management of this medical emergency is scant. Herein we describe a 6-year-o...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/71.2.161
更新日期：1996-02-01 00:00:00
abstract：:Physical inactivity increases the risk of many chronic disorders. Numerous studies have convincingly demonstrated that undertaking and maintaining moderate levels of physical activity (eg, brisk walking 3 hours a week) greatly reduces the incidence of developing many chronic health conditions, most notably type 2 diab...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/77.2.165
更新日期：2002-02-01 00:00:00
abstract：:Eleven patients with Alport's syndrome had renal transplantation between 1963 and 1980. The mean follow-up is 6 years (6 months to 14 years). All 11 patients are currently alive. Ten have functioning grafts, and in nine the serum creatinine concentration is less than 2 mg/dl. Three patients received a second allograft...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：OBJECTIVE:To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). PATIENTS AND METHODS:We performed a retrospective search of electronic medical records of all ou...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.07.025
更新日期：2015-11-01 00:00:00
abstract：OBJECTIVE:To investigate the incidence of bone disorders after solid organ transplantation (SOT). PARTICIPANTS AND METHODS:We used Taiwan's National Health Insurance Research Database to identify 9428 recipients of SOT and 38,140 sex- and age- matched control subjects between January 1, 1997, and December 31, 2010, to...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2014.02.017
更新日期：2014-07-01 00:00:00
abstract：OBJECTIVE:To determine the frequency of fetal urinary tract anomalies and to characterize the types of such abnormalities detected on ultrasonography and the outcome of affected patients during a 15-year period at our institution. DESIGN:We retrospectively reviewed the findings on maternal prenatal ultrasound examinat...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/70.6.526
更新日期：1995-06-01 00:00:00
abstract：:The most compelling evidence for the cardiovascular benefit provided by omega-3 fatty acids comes from 3 large controlled trials of 32,000 participants randomized to receive omega-3 fatty acid supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or to act as controls. These trials showed r...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/83.3.324
更新日期：2008-03-01 00:00:00
abstract：:Treatment of seniors with Parkinson disease is within the domain of primary care physicians and internists. A good working knowledge of carbidopa/levodopa principles should allow excellent care of most patients, at least during the early years of the disease. Even later, when levodopa responses become more complicated...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/mcp.2011.0443
更新日期：2011-12-01 00:00:00
abstract：:Lipoproteins are known to be able to transport a variety of drugs. This report suggests that low-density lipoprotein not only functions as an important carrier of cyclosporine in plasma but also facilitates transport of cyclosporine across the cell membrane by means of the low-density lipoprotein receptor. Such a mech...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)64916-7
更新日期：1988-10-01 00:00:00
abstract：:In August 2015, an expert colloquium commissioned by the Sexual Medicine Society of North America (SMSNA) convened in Washington, DC, to discuss the common clinical scenario of men who present with low testosterone (T) and associated signs and symptoms accompanied by low or normal gonadotropin levels. This syndrome is...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2016.04.022
更新日期：2016-07-01 00:00:00
abstract：:Duodenal duplication cysts are rare malformations that characteristically manifest with intestinal obstruction. In a 50-year experience, we found a duodenal duplication cyst in only three patients, one of whom had massive gastrointestinal bleeding as the initial symptom. Six other duplication cysts (two esophageal, on...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60419-4
更新日期：1985-11-01 00:00:00
abstract：OBJECTIVE:To investigate the impact of obesity and underweight on adverse in-hospital outcomes in pulmonary embolism (PE). PATIENTS AND METHODS:Patients diagnosed as having PE based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification code I26 in the G...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2019.04.035
更新日期：2019-10-01 00:00:00
abstract：OBJECTIVE:To investigate the association between physical activity (PA) and risk of mortality in a large middle-aged cohort stratified by inflammatory status. PATIENTS AND METHODS:A total of 336,560 individuals (mean age, 39.7 years; 58% male) who underwent comprehensive health screenings were enrolled in this prospec...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2016.08.003
更新日期：2016-12-01 00:00:00
abstract：OBJECTIVE:To compare the indications for hospital admission between current, former, and never smokers and to compare their costs per hospital admission, testing the hypothesis that the cost per hospital admission would be higher for smokers than for former and never smokers. PATIENTS AND METHODS:This study used a ret...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2018.02.022
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVE:To define mortality associated with isolated tricuspid regurgitation (TR) and identify risk factors associated with decreased survival. PATIENTS AND METHODS:We conducted a retrospective cohort study of residents of southeastern Minnesota with moderate-severe or more severe isolated TR diagnosed between Janua...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2019.04.036
更新日期：2019-10-01 00:00:00
abstract：:Epilepsy is a common condition that affects 0.5 to 1% of all children. Although most children with epilepsy have well-controlled seizures with use of one antiepileptic drug (AED), some children have medically refractory seizures. This situation can be the result of inaccurate classification of the paroxysmal event, us...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/71.9.899
更新日期：1996-09-01 00:00:00
abstract：:At the Mayo Clinic from 1962 through 1973, 592 cesarean sections were done among 16,181 deliveries (3.7%); 48% were primary procedures, and 52% were performed because of previous cesarean delivery. Regional anesthesia using epidural block recently has replaced a balanced general anesthesia as the anesthesia of choice...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1975-07-01 00:00:00
abstract：:The ventriculoatrial shunt (VAS) was developed to control hydrocephalic syndromes effectively. Several complications, however, have been described after the procedure. One of the most serious consequences is the development of severe pulmonary hypertension attributed to multiple and recurrent pulmonary embolization ca...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60069-x
更新日期：1993-12-01 00:00:00
abstract：:Chest pain in a young person is often caused by chest wall tenderness, associated with mitral valve prolapse, or attributed to psychologic factors. Ischemic cardiac pain may be overlooked because of its rare occurrence in this age group. A 35-year-old woman complained of substernal chest pressure precipitated by exert...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)64859-9
更新日期：1988-04-01 00:00:00
abstract：:In a prospective study of 10 patients who underwent liver transplantation and 10 patients who underwent cholecystectomy, we analyzed the postoperative analgesic requirements and the resultant plasma morphine concentrations. Analgesia was more intense, with less medication, and the plasma morphine concentration was sig...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65257-4
更新日期：1989-03-01 00:00:00
abstract：OBJECTIVE:To determine relationships among pregnancy (during and postpartum), acute pancreatitis, and gallstones. PATIENTS AND METHODS:In this retrospective population-based case-control study, we identified all 12- to 50-year-old Rochester, Minn, females diagnosed between 1976 and 1991 as having acute pancreatitis (c...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/75.4.361
更新日期：2000-04-01 00:00:00
abstract：:Noninvasive ventilation refers to the delivery of assisted ventilatory support without the use of an endotracheal tube. Noninvasive positive pressure ventilation (NPPV) can be delivered by using a volume-controlled ventilator, a pressure-controlled ventilator, a bilevel positive airway pressure ventilator, or a contin...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/74.8.817
更新日期：1999-08-01 00:00:00
abstract：:The sympathetic nervous system plays a key role in regulating arterial blood pressure in humans. This review provides an overview of sympathetic neural control of the circulation and discusses the changes that occur in various disease states, including hypertension, heart failure, and obstructive sleep apnea. It focus...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/S0025-6196(11)60492-8
更新日期：2009-09-01 00:00:00
abstract：:Cigarette smoking is the most important preventable cause of morbidity, mortality, and excess health care costs in the United States. From 2000 through 2004, cigarette smoking caused an estimated annual average of 443,595 deaths and cost $193 billion per year in smoking-attributable productivity losses and smoking-rel...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/S0025-6196(11)60523-5
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVE:To investigate whether patients with traumatic brain injury (TBI) have an increased risk of stroke or poststroke mortality. PARTICIPANTS AND METHODS:Using Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study of 30,165 patients with new TBI and 120,660 persons withou...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.09.019
更新日期：2014-02-01 00:00:00
