[The future of hyperinsulinemia after peritoneal dialysis for well-developed chronic renal insufficiency].
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Biomedical subjects
Publications and source records attributed to J Mirouze.
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Three hundred and thirty Graves' disease patients (258 F. 72 M. ; mean age = 50 +/- 07 years) were treated by 131I from 1961 to 1979 ; 57 % had a goiter and 32 % had exophthalmos. One or several doses of radioiodine were given to each patient without dosimetry. The mean total dose (+/- SEM) was = 8,51 +/- 0,44 mCi and the mean for the first dose 4,34 +/- 4 ans 54,8 % of the patients received only one dose but 10,3 % of them had more than 3 doses. Data obtained by actuarial methods showed 66 % of the cases to be in remission in less than 2 years ; the frequency of hypothyroidism increased steadily by 3 % every year to give 15 % at 5 years and 30 % at 10 years. Remission was slower to occur in goitrous subjects and hypothyroidism was less frequent in this group despite doses significantly higher of radioiodine (p less than 0,001). Recovery was also slower among exophthalmos patients. Finally, the mean 3-hour radioiodine uptake and plasma T3 level were significantly lower six months after the first therapeutic dose among those who were cured of thier hyperthyroidism within two years.
The choice of a contraceptive method for diabetic women must take into account metabolic and vascular risks. Combined oestrogen-progestogen contraception is not contra-indicated in insulin-dependent diabetes but requires close supervision. Progestogens alone for nulliparous women and mechanical devices for multiparous women appear to be preferable. Oral contraceptives have a more limited use in insulin-independent overt or chemical diabetes. In such patients combined oestrogen-progestogen contraception is absolutely contra-indicated and progestogens should be given under strict metabolic monitoring. The potential risks incurred by these women already liable to vascular and metabolic complications make male contraception even more desirable.