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Biomedical subjects

P Lim

Publications and source records attributed to P Lim.

107 records · Page 6Linked to original sources
PubMed1969

Handling of induced hypercalcaemia in hyperthyroidism.

The mean serum calcium of 13 hyperthyroid patients was found to be significantly higher than that of controls matched for sex and age, though none of the patients' values were outside the normal range. Nevertheless, these patients responded very promptly to hypercalcaemia (induced by an intravenous calcium load), and their serum calcium returned to normal much more rapidly compared with the matched controls. There was also increased retention of intravenous calcium load, possibly owing to increased calcitonin production. Calcium infusion may be useful in treating bone diseases in which increased bone resorption exceeds bone accretion.

Adolescent↗
PubMed1969

Hypermagnesaemia in presence of magnesium depletion in acute-on-chronic renal failure.

A patient with renal failure developed hypermagnesaemia, with confusion, drowsiness, and dysarthria. Nevertheless, the dietary magnesium content was low, and investigation showed actual intracellular depletion of magnesium. The cause of this state is not known, though it is presumably connected with a failure to maintain the normal concentration gradient of magnesium across the cell wall. The clinical state and the serum magnesium level returned to normal after treatment with calcium gluconate.

Acute Kidney Injury↗
PubMed1969

Values for tissue magnesium as a guide in detecting magnesium deficiency.

A large-scale survey of the normal magnesium content of various human tissues was carried out to facilitate clinical detection of magnesium deficiency, especially occult deficiency.A review of the literature favours the magnesium content of skeletal muscle as the most reliable index of the body's store of magnesium. There is a significant difference (P < 0.001) in both the serum and erythrocyte magnesium levels between normal pregnant women in the third trimester and the average normal population. The reason for this difference is discussed.

Adult↗
PubMedDate not supplied

Does prophylactic endoscopic sphincterotomy prevent recurrent biliary problems in patients with gallstones and a normal cholangiogram?

BACKGROUND: Endoscopic sphincterotomy (ES) is indicated in patients with confirmed bile duct stones at endoscopic retrograde cholangiopancreatography (ERCP). The role of ES in patients with suspected bile duct stones but a normal cholangiogram, in the prevention of recurrent biliary symptoms, when cholecystectomy is not planned, is unclear. AIM: To determine if prophylactic ES prevents further biliary problems in such patients. METHODS: Patients were identified with gallbladder stones presenting with jaundice, abnormal liver function tests (LFTs) or dilated bile ducts on ultrasound, in whom cholecystectomy was not planned and who had a normal cholangiogram at ERCP. Patients were followed-up to determine the frequency of recurrent biliary problems or repeat investigations. RESULTS: Forty-one patients were included, of whom 20 had an ES. The frequency of pre-ERCP features did not differ between the two groups. Median follow-up was 32 months (range 15-66). Post-ERCP recurrent abdominal pain (5 vs 3; p=0.39), jaundice (3 vs 1; p=0.28), pancreatitis (0 vs 1; p=0.32), and repeat ultrasound (2 vs 1; p=0.52), ERCP (1 vs 1; p=0.97) or cholecystectomy (2 vs 3, p=0.82) did not differ between the two groups. CONCLUSIONS: Patients with gallstones, suspected common bile duct (CBD) stones and a normal cholangiogram need not have a prophylactic sphincterotomy since there is no reduction in recurrent biliary problems and this potentially increases the morbidity.

Aged↗
PubMedDate not supplied

Effect of a unique constant-estrogen, pulsed-progestin hormone replacement therapy containing 17beta-estradiol and norgestimate on endometrial histology.

OBJECTIVE: To evaluate the effect of a 17beta-estradiol(E2)/norgestimate (NGM) HRT regimen, which provides constant estrogen in combination with pulsed progestin administration, on endometrial histology in healthy postmenopausal women 40 to 65 years of age who had experienced natural menopause at least 12 months before the start of the study. METHODS: A total of 1,253 postmenopausal women were randomized to receive either continuous 1 mg E2, or constant estrogen, pulsed progestin regimens of 1 mg E2/30 microg NGM, 1 mg E2/90 microg NGM, or 1 mg E2/180 microg NGM (3 days on, 3 days off) in a 12-month, multicenter, double-blind study. Endometrial biopsies were obtained pre- and post-treatment, and were evaluated by at least 2 (if required, by 3) pathologists who were blinded with respect to treatment and to each other's diagnosis. RESULTS: At the end of the study, no cases of endometrial hyperplasia were diagnosed in subjects who received E2 1 mg/NGM 90 microg or E21 mg/NGM 180 microg, whereas 74 (28%) and 16 (6%) cases of endometrial hyperplasia were diagnosed in subjects who received continuous E2 1 mg and E2 1 mg/NGM 30 microg, respectively. A dose-related endometrial response to NGM was apparent (P < .001). The percentage of patients with inactive/atrophic endometrium increased with NGM dose. CONCLUSION: The results of this study support the safety and efficacy of this unique HRT regimen and suggest that the minimal NGM dose required to protect the endometrium from hyperplasia in a pulsed progestin regimen consisting of continuous E2 1 mg is 90 microg.

Adult↗