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J M Cerletty

Publications and source records attributed to J M Cerletty.

24 records · Page 2Linked to original sources
PubMed1971

Plasma insulin disturbances in primary hyperparathyroidism.

Plasma insulin dynamics were evaluated in 10 patients with primary hyperparathyroidism before and after parathyroidectomy and correction of hypercalcemia. Before surgery fasting plasma insulin concentrations and insulin responses to administered glucose, tolbutamide, and glucagon were significantly greater than postoperative values. Hyperinsulinemia was not associated with altered glucose curves during glucose or glucagon tolerance tests, but a relatively greater insulin response to tolbutamide resulted in an increased hypoglycemic effect following its administration. The glucose-lowering action of intravenous insulin was slightly impaired before treatment. Intramuscular injections of parathormone to six normal men for 8 days induced mild hypercalcemia and hypophosphatemia and reproduced augmented plasma insulin responses to oral glucose and intravenous tolbutamide. 4-hr intravenous infusions of calcium to another group of six normal men raised serum calcium concentrations above 11 mg/100 ml. This did not alter glucose or insulin curves during oral glucose tolerance but markedly accentuated insulin responses to tolbutamide and potentiated its hypoglycemic effect. When highly purified parathormone was incubated with isolated pancreatic islets of male rats, glucose-stimulated insulin secretion was unaffected. These findings suggest that chronic hypercalcemia of hyperparathyroidism sustains a form of endogenous insulin resistance that necessitates augmented insulin secretion to maintain plasma glucose homeostasis. This state is insufficient to oppose tolbutamide-induced hypoglycemia because of an additional direct, selective enhancement of hypercalcemia on pancreatic beta cell responsiveness to the sulfonylurea. The possible direct role of parathormone in these events has not been established.

Adenoma↗
PubMedDate not supplied

Elevated calcium level in parathyroid cyst fluid.

Parathyroid cysts are uncommon neck masses. The diagnosis is generally established when the parathormone level is found to be elevated in the typically clear cyst fluid obtained by fine needle aspiration. We present a case where the serum and cyst fluid intact parathormone levels were normal yet the diagnosis was established by demonstrating an elevated fluid calcium level. The cyst recurred after two attempts at aspiration, so the patient underwent a curative operative excision.

Journal Article↗
PubMedDate not supplied

Results of a community thyroid screening program: who will benefit?

OBJECTIVE: To describe the results of a community-based thyroid screening program. METHODS: We review the recruitment process, the screening questionnaire, the laboratory procedure, and the data analysis. RESULTS: News media advertisements and facility-sponsored communications were used to recruit 1,176 participants, each of whom completed a health questionnaire and had blood withdrawn for a thyroid-stimulating hormone (TSH) assay. Most participants were female (78%), Caucasian (92%), and age 50 years or older (61%). Data from 1,139 participants were analyzed. Abnormal TSH values were found in 107 participants: TSH was low in 21 (2%) and elevated in 86 (8%). Elevated TSH values occurred in 8% of females, 7% of males, 8% of Caucasians, and 7% of Hispanics. Although the percentage of elevated TSH values tended to increase with advancing age, primarily in females, 5% of participants younger than 50 years of age had an elevated TSH. No associations were apparent between abnormal TSH values and health maintenance organization membership, self-rating of overall health, or presence of thyroid-related symptoms. Participants who rated their overall health as "excellent" or "very good" accounted for 48% of the TSH values >12 microIU/mL. CONCLUSION: Experience gained from the conduct of this screening program may help shape the expectations of future screening programs that use disease awareness and self-motivation and provide insights into program design that may maximize participation by the desired target audiences.

Journal Article↗