Thyrotrophin augmentation after commencing thyroxine replacement in primary hypothyroidism.

Abstract:

:Prospective measurements of serum thyrotrophin and thyroxine concentrations were made in six patients with primary hypothyroidism treated consecutively with an incremental regimen of oral thyroxine. A fall in thyrotrophin occurred over several months, accompanied by a concurrent slow rise in serum thyroxine. Those patients with the highest initial values for thyrotrophin showed the typical curvilinear decline in thyrotrophin, whereas the remaining patients disclosed a transient rise in thyrotrophin for the first 3 months. This paradoxical rise was not associated with depression of cardiac output or glomerular filtration rate. The significance of thyrotrophin augmentation is uncertain, but it may be more common than generally appreciated. It did not occur in those patients with the most severe degrees of thyroid deficiency. Thyroxine exerts a dual action, and augmentation of thyrotrophin may reflect a dominant effect of increased protein synthesis, in contrast to negative feedback inhibition which suppresses thyrotrophin. These opposing actions are in competition at different dose levels of thyroxine, and may contribute not only to augmentation or suppression of thyrotrophin, but also to the curvi-linear pattern of fall. Such variations impair the utility of thyrotrophin as an index of euthyroidism.

journal_name

Postgrad Med J

authors

Ghose RR,Upadhyay HP

doi

10.1136/pgmj.62.723.11

subject

Has Abstract

pub_date

1986-01-01 00:00:00

pages

11-4

issue

723

eissn

0032-5473

issn

1469-0756

journal_volume

62

pub_type

杂志文章
  • Pseudotumour cerebri in a patient with Castleman's disease.

    abstract::A patient with systemic Castleman's disease (angiofollicular lymph node hyperplasia) including bone changes and peripheral neuropathy, is described. She also had pseudotumour cerebri, and, as this association has been reported previously, it is unlikely to be due to chance. ...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.64.749.217

    authors: Black DA,Forgacs I,Davies DR,Thompson RP

    更新日期:1988-03-01 00:00:00

  • Vaginal vein thrombosis in pregnancy.

    abstract::Vaginal vein thrombosis in a pregnant woman is reported. This entity should be differentiated from vaginal arteriovenous fistula which may cause severe antepartum, intrapartum and post-partum haemorrhage. The humoral and mechanical factors which favour the occurrence of varicosities and thrombosis are briefly describe...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.59.692.394

    authors: Gitstein S,Ballas S,Peyser MR

    更新日期:1983-06-01 00:00:00

  • Typhoid fever with severe pancytopenia.

    abstract::A patient suffering from typhoid fever with severe pancytopenia is presented. Bone marrow examination revealed extensive haemophagocytosis which possibly contributed to the pancytopenia. ...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.73.855.41

    authors: Sood R,Roy S,Kaushik P

    更新日期:1997-01-01 00:00:00

  • The pathogenesis of dilated cardiomyopathy.

    abstract::Using the WHO/ISFC definition and recommendations of nomenclature for cardiomyopathies, the aetiology is unknown. Over many years research has concentrated on defining pathogenetic mechanisms and owing to the widespread use of the bioptome-permitting recovery of fresh endomyocardial tissue-myocarditis has emerged as b...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:

    authors: Olsen EG

    更新日期:1992-01-01 00:00:00

  • Mentoring perception and academic performance: an Academic Health Science Centre survey.

    abstract:PURPOSE:To determine the association between professors' self-perception of mentoring skills and their academic performance. DESIGN:Two hundred and fifteen professors from Imperial College London, the first Academic Health Science Centre (AHSC) in the UK, were surveyed. The instrument adopted was the Mentorship Skills...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/postgradmedj-2015-133542

    authors: Athanasiou T,Patel V,Garas G,Ashrafian H,Shetty K,Sevdalis N,Panzarasa P,Darzi A,Paroutis S

    更新日期:2016-10-01 00:00:00

  • Propranolol, renin and hypertension: a review.

    abstract::When plasma renin activity is related to sodium balance as evaluated from urinary sodium excretion, a physiological index of normality is obtained along with the ability to detect subtle variations in renin secretion. This has made it possible to correlate more closely the antihypertensive action of propranolol with t...

    journal_title:Postgraduate medical journal

    pub_type: 临床试验,杂志文章,评审

    doi:

    authors: Laragh JH,Bühler FR

    更新日期:1976-01-01 00:00:00

  • Active immunization against varicella of children with acute leukaemia or other malignancies on maintenance chemotherapy.

    abstract::Twenty-six patients with acute leukaemia and other malignancies susceptible to varicella were vaccinated with the Oka-strain live attenuated varicella vaccine during maintenance chemotherapy. All recipients showed no adverse clinical reactions. There was no spread of vaccine virus. Seroconversion was 94% in seronegati...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:

    authors: Haas RJ,Belohradsky B,Dickerhoff R,Eichinger K,Eife R,Holtmann H,Goetz O,Graubner U,Peller P

    更新日期:1985-01-01 00:00:00

  • Microscopic polyarteritis: clinical features and treatment.

    abstract::The clinical features, treatment and survival of 36 patients with microscopic polyarteritis diagnosed between 1957-1988 have been reviewed. All had a focal segmental necrotizing glomerulonephritis on renal biopsy with evidence of a small vessel vasculitis. Most had a prodromal illness of less than 1 month. Severity of...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.65.766.515

    authors: Rodgers H,Guthrie JA,Brownjohn AM,Turney JH

    更新日期:1989-08-01 00:00:00

  • Lessons from falling coronary heart disease mortality in the United States.

    abstract::The marked decline in coronary heart disease mortality in the United States since the late 1960s is most likely due in large part to successful efforts at primary prevention, attributable in turn to improved eating habits, better control of blood pressure and a reduction in smoking. Another part of the decline can pro...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.60.699.15

    authors: Epstein FH

    更新日期:1984-01-01 00:00:00

  • Acyclovir treatment of herpes simplex encephalitis: experience in a district hospital.

    abstract::Herpes simplex encephalitis may be underdiagnosed in Britain. We report eight patients treated at one hospital over three years. Fever, impaired consciousness or focal neurological signs were seen in all patients at presentation but herpes simplex encephalitis was rarely considered as the initial diagnosis. The electr...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.63.746.1037

    authors: Gulliford MC,Chandrasekera CP,Cooper RA,Murphy RP

    更新日期:1987-12-01 00:00:00

  • Patterns of acute oncology admissions: an exploratory analysis of over 7000 patient episodes.

    abstract:BACKGROUND:Following the National Chemotherapy Advisory Group report, calling for better management of patients with cancer admitted acutely to hospital, Clatterbridge Cancer Centre, with Merseyside and Cheshire Cancer Network, implemented an acute oncology service (AOS) for the region's seven acute trusts. STUDY DESI...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/postgradmedj-2015-133805

    authors: Neville-Webbe HL,Wong H,Marshall E

    更新日期:2016-11-01 00:00:00

  • The US residency programme--lessons for pre-registration house officer education in the UK?

    abstract::The 1994 NACT Wyeth-Ayerst Travelling Fellowship provided the opportunity to compare the education and welfare of pre-registration house officers in the UK with their nearest counterpart in the US residency system. Investment in all aspects of learning was impressive, as was the retention of the central role of the pa...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.71.835.273

    authors: Salter R

    更新日期:1995-05-01 00:00:00

  • Effect of nivazol in Nelson's syndrome.

    abstract::We report the use of nivazol in a patient with Nelson's syndrome. Nivazol was highly effective in reducing ACTH secretion but, contrary to reports of its use in other primates, in our patient nivazol did have systemic glucocorticoid effects. ...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.64.749.220

    authors: Ball JA,Williams G,Yeo TH,Joplin GF

    更新日期:1988-03-01 00:00:00

  • Camel bites: report of severe osteolysis as late bone complications.

    abstract::Four cases of severe osteolysis of bones subsequent to camel bite are described. The first had osteolysis of the ribs with traumatic diaphragmatic hernia. Two cases had similar appearances of gross osteolysis of the shafts of the radius and ulna, whilst one had osteolysis of the humeral shaft. The similarities in the ...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.65.770.900

    authors: al-Boukai AA,Hawass NE,Patel PJ,Kolawole TM

    更新日期:1989-12-01 00:00:00

  • Cerebral scintigraphy--the phoenix rises again.

    abstract::This paper reviews the development of cerebral scintigraphy from its early days of planar imaging with simple technetium-99m labelled compounds to the recent revival of the technique in the form of positron-emission and single-photon emission tomography. A short explanation of instrumentation and radiopharmaceuticals ...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章,评审

    doi:10.1136/pgmj.64.747.4

    authors: Shepstone BJ

    更新日期:1988-01-01 00:00:00

  • Colonoscopy in patients aged 80 years or older and its contribution to the evaluation of rectal bleeding.

    abstract::Colonoscopies performed in patients aged 80 years or older at the Sheba Medical Center were analysed according to the primary indication for the procedure: 101 colonoscopies were performed because of rectal bleeding of at least 2 months duration, and 335 for all other indications. Carcinoma of the large bowel was foun...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.68.799.355

    authors: Bat L,Pines A,Shemesh E,Levo Y,Zeeli D,Scapa E,Rosenblum Y

    更新日期:1992-05-01 00:00:00

  • Who makes prescribing decisions in hospital inpatients? An observational study.

    abstract:PURPOSE OF THE STUDY:Errors involving drug prescriptions are a key target for patient safety initiatives. Recent studies have focused on error rates across different grades of doctors in order to target interventions. However, many prescriptions are not instigated by the doctor who writes them. It is important to clari...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/postgradmedj-2011-130602

    authors: Ross S,Hamilton L,Ryan C,Bond C

    更新日期:2012-09-01 00:00:00

  • Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice.

    abstract:OBJECTIVE:The Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) age-based clinical prediction rules identify children at very low risk of a significant head injury who can safely avoid CT. Our goal was to independently validate these prediction rules. DESIGN:Cross-sectional study....

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/postgradmedj-2013-305004rep

    authors: Schonfeld D,Bressan S,Da Dalt L,Henien MN,Winnett JA,Nigrovic LE

    更新日期:2015-11-01 00:00:00

  • Misoprostol does not alter the pharmacokinetics of propranolol.

    abstract::Twelve healthy volunteers took part in a randomised, double-blind, balanced, cross-over study to investigate the effect of misoprostol on the pharmacokinetics of propranolol. The subjects took propranolol 80 mg twice daily by mouth plus either misoprostol 400 micrograms twice daily or placebo by mouth for 14.5 days, f...

    journal_title:Postgraduate medical journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/pgmj.67.787.455

    authors: Bennett PN,Fenn GC,Notarianni LJ,Lee CE

    更新日期:1991-05-01 00:00:00

  • Acute leukaemia during azathioprine therapy.

    abstract::Various tumours, in particular lymphomas, have been reported in association with azathioprine treatment, both after renal transplantation and in other conditions. A case is reported here of acute myeloid leukaemia associated with azathioprine therapy for rheumatoid arthritis, and this is now the third case reported in...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.53.617.173

    authors: Gilmore IT,Holden G,Rodan KS

    更新日期:1977-03-01 00:00:00

  • Cholestyramine in the peritoneal cavity of the rat.

    abstract::The effects of cholestyramine in the peritoneal cavity of the rat are described. Cholestyramine causes mild peritonitis with adhesion formation between the liver and the omentum. In the management of biliary peritonitis, a lavage solution containing a suspension of cholestyramine would appear to be contra-indicated by...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.55.650.881

    authors: Walker EM

    更新日期:1979-12-01 00:00:00

  • Bilateral superselective arterial microcoil embolisation in delayed post-traumatic high flow priapism.

    abstract::High flow arteriogenic priapism is uncommon and usually occurs after trauma to the genitoperineal area. The onset of prolonged erection can be delayed and is often relatively pain free. Arteriography in this case illustrated the causative bilateral arteriocavernosal fistulae and pseudoaneurysms. Treatment consisted of...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pmj.77.905.193

    authors: Gujral S,MacDonagh RP,Cavanagh PM

    更新日期:2001-03-01 00:00:00

  • Changing thyroid status related to pregnancy.

    abstract::A case of post-thyroidectomy hypothyroidism is reported. The patient became euthyroid in three consecutive pregnancies, reverting to hypothyroid within three months of delivery on each occasion. The alteration in thyroid status is attributed to pregnancy related changes in antibody titres, though the laboratory data t...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pmj.77.911.591

    authors: Shankar P,Kilvert A,Fox C

    更新日期:2001-09-01 00:00:00

  • Comparison of nifedipine, prazosin and hydralazine added to treatment of hypertensive patients uncontrolled by thiazide diuretic plus beta-blocker.

    abstract::In 93 patients with hypertension uncontrolled by bendrofluazide 5 mg plus atenolol 100 mg daily, the effects of adding nifedipine (up to 60 mg/day, n = 31), prazosin (up to 20 mg/day, n = 31), or hydralazine (up to 200 mg/day, n = 31) were compared in a 6 month open random parallel group study. The three drugs did not...

    journal_title:Postgraduate medical journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/pgmj.63.736.99

    authors: Ramsay LE,Parnell L,Waller PC

    更新日期:1987-02-01 00:00:00

  • Post-exposure prophylaxis for blood borne viral infections in healthcare workers.

    abstract::Healthcare workers have a high risk of occupational exposure, more so in developing countries, with high incidence of blood borne diseases and prevalence of unsafe practices. Among the various blood borne diseases, the most common and important ones are HIV infection, hepatitis B, and hepatitis C. Most of the occupati...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章,评审

    doi:10.1136/pmj.79.932.324

    authors: Varghese GM,Abraham OC,Mathai D

    更新日期:2003-06-01 00:00:00

  • Muscarinic receptors in lung.

    abstract::Muscarinic receptors are present on several different cells in lung and are predominantly involved in bronchoconstriction and mucus secretion. Muscarinic receptor activation leads to breakdown of phosphoinositides in airway smooth muscle cell membranes, which leads to intracellular calcium release and contraction. Mus...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章,评审

    doi:

    authors: Barnes PJ

    更新日期:1987-01-01 00:00:00

  • Depression in primary care: three key challenges.

    abstract::The recognition and treatment of depression is a challenging area of clinical practice, especially in primary care where there are many patients with various presentations and a multitude of causes for distress. The prevalence of depression is increasing, and it is predicted to become second only to ischaemic heart di...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.2008.068387

    authors: Lester H,Howe A

    更新日期:2008-10-01 00:00:00

  • Missed Addisonian crisis in surgical wards.

    abstract::Three women were admitted to the surgical wards with acute gastro-intestinal symptoms and despite good clinical (pigmentation, hypotension) and biochemical (hyponatraemia, acidosis) evidence of Addisonian crisis had unnecessary investigations with delay in the diagnosis and appropriate management of this medical emerg...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.63.739.367

    authors: Small M,MacCuish AC,Thomson JA

    更新日期:1987-05-01 00:00:00

  • Posterior leukoencephalopathy syndrome.

    abstract::Posterior leukoencephalopathy syndrome is a newly recognised brain disorder that predominantly affects the cerebral white matter. Oedematous lesions particularly involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem, and cerebellum. This rapidly evolving neurological condition...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章,评审

    doi:10.1136/pmj.77.903.24

    authors: Garg RK

    更新日期:2001-01-01 00:00:00

  • Crohn's disease and pericarditis.

    abstract::A patient is described who developed acute pericarditis during a severe first attack of Crohn's disease. The opportunity was taken to measure levels of circulating immune complexes, both during the acute phase of the illness and during convalescence; no significant change in these levels from normal values was found. ...

    journal_title:Postgraduate medical journal

    pub_type: 杂志文章

    doi:10.1136/pgmj.60.708.682

    authors: Manomohan V,Subbuswamy SG,Willoughby CP

    更新日期:1984-10-01 00:00:00