Download e-book for iPad: Metabolic and Endocrine Problems in the Elderly by W. J. MacLennan MD, FRCP (Glas., Ed., Lond.), N. R. Peden

By W. J. MacLennan MD, FRCP (Glas., Ed., Lond.), N. R. Peden MA, MB, FRCP (Ed.) (auth.)

Illness in previous age is characterized by way of obscure and extraordinary proposing gains that are usually neglected and wrongly attributed to the aging strategy. this is often really precise of endocrine issues the place hypothyroidism may perhaps mas­ querade as dementia, the place electrolyte imbalance can cause lassitude, and the place diabetes mellitus could produce a variety of problems com­ monly linked to getting older. it really is our goal that our publication offer common functional counsel during this tough region by way of delineating the results of ageing on endocrine functionality and the scientific effects of those; and by way of describing intimately the big variety of featuring scientific fea­ tures of endocrine affliction within the aged. Physicians also are usually baffled and misled via the consequences of getting old and disorder on laboratory checks utilized in the research of endocrine ailment. Our publication describes those alterations intimately, and offers advice on which exams are excellent. getting older and sickness additionally produce sophisticated alterations within the reaction of sufferers to medicinal drugs and substitute, and this can be additionally dis­ stubborn intimately. matters integrated individually and intensive comprise thyroid ailment, the scientific positive factors and remedy of diabetes, postmenopausal alterations, bone illness, fluid and electrolyte imbalance, power imbalance, and medicine caus­ ing endocrine and metabolic issues. those were selected simply because we think of that they current difficulties that are fairly suitable to the aged. Many different matters are coated ordinarily textbooks of endocrin­ ology and feature been omitted.

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Antibodies are detected in up to 80% of sera of patients with Graves' disease but it should be noted that the antibodies are heterogeneous and that serum with TBII activity may not necessarily have TSI activity. There is a high prevalance of other thyroid auto-antibodies in hyperthyroid patients but in elderly women their significance is unclear in that old people with toxic nodular goitres also have a high prevalance of microsomal antibodies (Greenwood et al. 1985). The subject of toxic nodular goitre and its pathogenesis has recently been reviewed by Studer and colleagues (Studer et al.

Shuster S, Scarborough LH (1961) Senile purpura. Q J Med 54: 3}-40 Son P, Lauria DB (1983) Infectious complications in the elderly diabetic. -72 Studd JWW, Thorn MH (1981) Ovarian failure and ageing. Clin Endocrinol Metab 10: 89-113 Sutton MG, Sheps SG, Lie JT (1981) Prevalence of clinically unsuspected phaeochromocytoma - a review of a 50 year autopsy series. Mayo Clin Proc 56: 354--360 Tajima K, Mashita K, Yamone T et al. (1984) Thyrotoxic myopathy associated with subacute thyroiditis. Clin Endocrinol20: 307-312 Thomas B, Mazzaferri EL, Skillman TG (1970) Apathetic thyrotoxicosis: a distinctive clinical and laboratory entity.

1985). The subject of toxic nodular goitre and its pathogenesis has recently been reviewed by Studer and colleagues (Studer et al. 1985). Patients with this usually have had long-standing goitres and indeed may have been treated with iodine for goitre in adolescence. Thyroid enlargement is slow and often unnoticed by the patient, but as this happens, follicles within the gland become autonomous in terms of thyroid hormone production so that they escape from TSH control. Excess thyroid hormone production may not initially be sufficient to cause hyperthyroidism but is sufficient to suppress TSH secretion and abolish the TSH response to intravenous TRH.

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