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Biomedical subjects

J M McMillin

Publications and source records attributed to J M McMillin.

At least 19 recordsLinked to original sources
PubMed1998

Postpartum psychosis and postpartum thyroiditis.

The term postpartum psychosis refers to a group of severe and heterogeneous disorders with psychotic symptoms that occur most frequently in the context of a mood disorder during the postpartum period. We report a case of 'postpartum psychosis' possibly associated with postpartum thyroiditis in a 29 year-old woman. The appearance of psychotic symptoms was chronologically related to the onset of postpartum thyroiditis and resolution of psychosis synchronized with the achievement of biochemical euthyroidism. The patient had typical symptoms of 'classic postpartum psychosis' (a historical term not included in DSM-IV, but used frequently by many physicians to describe diagnostic and therapeutic challenges posed by puerperal psychoses). Three months postpartum, the patient began to believe that she was pregnant with the Christ child, although she was not pregnant. Her delusions resolved around the 'pregnancy' and harm to her 'unborn' child. She also believed that her child (Jesus) was going to be killed. Other key symptoms included hallucinations, mixed mood symptoms, agitation and transient disorientation. Her DSM-IV diagnosis on admission was major depression with psychotic features and her discharge diagnosis (most likely diagnosis) was psychotic disorder due to thyrotoxicosis caused by postpartum thyroiditis. The differential diagnosis of co-occurring psychosis and postpartum thyroiditis can be examined relative to four possibilities: (1) psychosis due to thyrotoxicosis caused by postpartum thyroiditis; (2) a coincidence (no association between psychosis and postpartum thyroiditis); (3) precipitation of psychotic symptoms and disorientation related to a postpartum thyroiditis in a woman with a pre-existing mood disorder; or (4) both psychosis and thyroiditis caused by a pre-existing defect in autoimmunity. The authors stress the importance of early diagnosis and prompt treatment of postpartum psychosis. They discuss the indications for thyroid screening in postpartum psychoses. Further research is needed to clarify the nosology and mechanisms of severe postpartum disorders and to elucidate treatment-relevant and etiologically-distinct subsets of postpartum psychosis.

Adult↗
PubMed1994

ADHD and the thyroid.

Explore the source record for details and available documents.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Syndrome of plasma cell dyscrasia, polyneuropathy, and diabetes mellitus.

Multiple myeloma associated with sclerotic bone lesions and polyneuropathy represents a distinct subset of the plasma cell dyscrasias. We describe a case of biclonal gammopathy (the second case reported), insulin-resistant diabetes mellitus, and no evidence for anti-insulin receptor antibodies. After treatment with chemotherapy and irradiation, the diabetes resolved, the polyneuropathy lessened greatly, and the patient is alive without evidence of progression five years later. The reports of 95 other cases are reviewed. This syndrome occurs in younger patients (mean age, 48 years) and is frequently associated with organomegaly, endocrinopathies, and skin changes. Irradiation to the sclerotic bone lesions frequently lessens the neuropathy and endocrinopathies and may result in long-term remission. The mechanism of action leading to the systemic effects seen in this syndrome is unknown but is likely related to proteins secreted by the abnormal plasma cells.

Adult↗
PubMed1988

Hypocalcemia associated with estrogen therapy for metastatic adenocarcinoma of the prostate.

We report 2 cases of true hypocalcemia (not caused by decreased binding proteins) associated with metastatic prostate cancer and review previously reported cases. Hypocalcemia is a common but frequently unrecognized complication of prostatic cancer. Estrogen therapy often is associated with the hypocalcemia, which may be asymptomatic. The hypocalcemia is always associated with osteoblastic metastases and usually it is associated with increased serum alkaline phosphatase activity, acid phosphatase activity and serum parathyroid hormone concentration. Serum concentrations of magnesium, phosphorus and vitamin D frequently are decreased. Patients are in a positive calcium balance. The osteoblastic metastases seem to act as a calcium sink, creating a "hungry tumor phenomenon". The role of estrogens may be to stop the resorption of normal bone resulting in lower serum calcium concentrations.

Adenocarcinoma↗
PubMed1983

A newly recognized neuroectodermal syndrome of familial alopecia, anosmia, deafness, and hypogonadism.

We describe a large, three generation kindred in which 16 individuals were affected with alopecia, hyposmia or anosmia, conductive deafness associated with protruding ears, microtia, and/or atresia of the external auditory canal, hypogonadotropic hypogonadism due to LH/FSH deficiency, and a greater than normal tendency to dental caries. Variable manifestations include mild facial asymmetry, mental retardation, congenital heart defect, and cleft palate. This seems to be a previously undescribed pleiotropic autosomal dominant trait with variable expressivity. The manifestations can be explained on the basis of involvement of the ectoderm and neuroectoderm of the first and second branchial arches, of Rathke's pouch, and of the diencephalon.

Abnormalities, Multiple↗
PubMed1980

Hormonal correlates of hypophagia in white-tailed deer.

Deer exhibit a number of adaptive annual changes in common with hibernators. Each winter deer have a period of voluntary hypophagia and losses of body weight. This is accompanied by a shift to fat metabolism and increased recycling of urea nitrogen to maintain positive nitrogen balance. Deer also show alterations in activity patterns and decreased metabolic rates, heart rates, and body temperatures during winter. Male deer exhibit an additional period of hypophagia associated with rut. Rut-associated hypophagia is either directly controlled by serum testosterone or internally coupled to the annual testosterone cycle. The adaptive value of rut-associated hypophagia is unknown but may be associated with insuring reproductive success. Both winter and rut-associated hypophagia are most likely synchronized to the environment by photoperiod. The winter adaptive changes may be caused by a primary alteration in appetite control with secondary changes in thyroid hormone economy, or the hypophagia may be independent but internally coupled to other neuroendocrine changes.

Animals↗
PubMed1977

Prolactin dynamics following transphenoidal hypophysectomy for metastatic carcinoma of the breast.

In nine patients who had undergone trans-sphenoidal hypophysectomy, prolactin dynamics were studied with intravenous thyrotropin releasing hormone (TRH). Residual prolactin secretory reserve was demonstrated in seven. Five patients were TRH tested both before and after trans-sphenoidal hypophysectomy. Hypophysectomy did not alter base line prolactin concentration but did decrease prolactin response to TRH from 55 ng/ml to 21 ng/ml (p less than 0.001). Post-hypophysectomy L-Dopa suppressed baseline prolactin concentrations to undetectable levels. There was no correlation between alterations in prolactin dynamics and tumor response to hypophysectomy. Trans-sphenoidal hypophysectomy is not effective in ablating prolactin secretion and serious doubts are raised about the role of altered prolactin dynamics in inducing breast cancer remission.

Breast Neoplasms↗
PubMed1977

Effect of oral estramustine phosphate on pituitary, gonadal, and adrenal function in the green monkey (Cercopithecus aethiops sabaeus).

We studied the effects of estramustine phosphate on pituitary, gonadal, and adrenal function in the green monkey. A 2-week course of estramustine phosphate (75 mg per day) reversibly suppressed the luteinizing hormone and testosterone response to luteinizing hormone-releasing hormone but did not affect pituitary-adrenal function assessed by the 11-deoxycorticosterone response to metyrapone. Treatment with oral estramustine phosphate also resulted in a significant increase in corticosteroid-binding globulin but did not affect a series of liver enzymes nor hematology. The results are consistent with a pure estrogen effect produced by hydrolysis of the carbamate-ester bona at a site distant from estrogen target tissues and could explain most of the reported in vivo effects of this compound.

Administration, Oral↗