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-MEN1 syndrome is composed of hyperparathyroidism, gastrinoma (pancreatic tumor) and pituitary tum or(remember the 3 Ps). Hyperparathyroidism in MEN1 is caused by hyperplasia of the parathyroid glands. Removal of 3 1/2 glands or total parathyroidectomy with autotransplantation is necessary.
NTIS refers to a syndrome found in seriously ill or starving patients with low fT3, usually elevated RT3, normal or low TSH, and if prolonged, low fT4. It is found in a high proportion of patients in the ICU setting, and correlates with a poor prognosis if TT4 is <4ug/dl. The patho-physiology includes suppression of TRH release, reducedT3 and T4 turnover, reduction in liver generation of T3, increased formation of RT3, and tissue specific down-regulation of deiodinases, transporters, and TH receptors. Although long debated, tissue TH levels are definitely reduced, and tissue hypothyroidism is presumably present. This is often not clinically evident because of the brief duration, and reduced but not absent tissue levels of TH. Although recognized for nearly 4 decades, interpretation of the syndrome is contested, because of lack of data. Some observes, totally without data, argue that it is a protective response and should not be treated. Other observers (as in this review) present available data suggesting, but not proving, that thyroid hormone replacement is appropriate, not harmful, and may be beneficial. The best form of treatment (TRH,TSH,or T3+T4) and possible accompanying treatments (GHRH, Cortisol, nutrition, insulin) lack consensus. In this review current data are laid out for reader’s review and judgment.
A glucagonoma is a rare tumor of the alpha cells of the pancreas that results in the overproduction of the hormone glucagon. Alpha cell tumors are commonly associated with glucagonoma syndrome, though similar symptoms are present in cases of pseudoglucagonoma syndrome in the absence of a glucagon-secreting tumor.
Gallstone ileus is an important, though infrequent, cause of mechanical bowel obstruction, affecting older adult patients who often have other significant medical conditions. It is caused by impaction of a gallstone in the ileum after being passed through a biliary-enteric fistula. The diagnosis is often delayed since symptoms may be intermittent and investigations fail to identify the cause of the obstruction. The mainstay of treatment is removal of the obstructing stone after resuscitating the patient. Gallstone ileus continues to be associated with relatively high rates of morbidity and mortality.
The average human digestive tract is home to as many as 1,000 species of microorganisms. Most of them are harmless -- or even helpful -- under normal circumstances. But when something upsets the balance of these organisms in your gut, otherwise harmless bacteria can grow out of control and make you sick. One of the worst offenders is a bacterium called Clostridium difficile(C. difficile, or C. diff). As the bacteria overgrow they release toxins that attack the lining of the intestines, causing a condition called Clostridium difficilecolitis.
Experts do not know the exact cause of Zollinger-Ellison syndrome. About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1). MEN1 causes hormone-releasing tumors in the endocrine glands and the duodenum.
-Korsakoff's syndrome is a common and preventable sequel of Wernicke's encephalopathy. Thiamine, if given during the stage of Wernicke's encephalopathy, can prevent the onset of Korsakoff's psychosis. The administration of glucose prior to thiamine can precipitate Korsakoff's syndrome, as seen in this case. In such patients, brain MRI frequently shows abnormal enhancement of the mammillary bodies & thallamus
An epidural abscess is a collection of pus (infected material) between the outer covering of the brain and spinal cord and the bones of the skull or spine. The abscess causes swelling in the area. Spinal cord abscess (SCA) is a rare condition capable of causing permanent damage to the spinal cord. Abscesses are caused when injured tissue becomes infected. The body's immune system sends white blood cells to help fight off the infection. They begin to fill the damaged tissue, causing pus to build up.
Labyrinthitis is a mild, often self-limited condition characterized by vertigo, tinnitus, nausea, and a loss of balance. The disorder often follows a viral illness (eg, influenza). Labyrinthitis may also be caused by trauma, bacterial infection, allergies, benign tumors, and certain medications .
Migraine headaches are recurrent throbbing or pulsatile headaches often associated with a prodrome, nausea, vomiting, photophobia, and phonophobia. When they occur, the prodromes are characterized by visual scintillations, scotomas, dizziness, or tinnitus
Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine. Sometimes, narcolepsy can be accompanied by a sudden loss of muscle tone (cataplexy) that leads to weakness and loss of muscle control. Cataplexy is often triggered by a strong emotion, most commonly laughter. Narcolepsy is a chronic condition for which there's no cure. However, medications and lifestyle changes can help you manage the symptoms. Support from others — family, friends, employer, teachers — can help you cope with narcolepsy.
If you suspect that you have sleep apnea, the usual first step is to discuss your suspicions with your primary care physician. If you don’t have a primary care physician, you can go directly to a clinician who is a sleep specialist. But check your health care insurance coverage first. Some policies require you to see a primary care physician first, and some policies limit the sleep centers and testing facilities whose services they will pay for. Unfortunately, you may discover that your policy offers limited or no coverage for the diagnosis and treatment of sleep apnea, in which case you may wish to switch insurers if and when you can.
In developing countries, domestic animals (eg, dogs) are common sources of infection. In the United States, bats and wild animals (eg, raccoons) are the most common reservoirs of infection. The acquisition of rabies from bats can occur from an unrecognized bite or a scratch, and possibly by inhalation of aerosolized viral particles. Bats are found in all states except Hawaii, and spelunking (cave exploration) is a risk factor for rabies acquisition from bats.