Search PubMed⌕ Search

Biomedical subjects

S A Westphal

Publications and source records attributed to S A Westphal.

23 records · Page 2Linked to original sources
PubMedDate not supplied

A pilot study of urine iodine excretion in a selected cohort in phoenix.

A pilot study of twenty-four hour urine iodine excretion was carried out in 34 adults who were employees (or their spouses) of Maricopa Medical Center and residents of the Phoenix area. Based on previous estimations, our expectation was that urine iodine excretion values should be high. The mean value was 219 +/- 25 microg/day in the first collection and 229 +/- 23 microg/day when the collection was repeated 4 months later. The results support an adequate amount of iodine in the diet for the group. However, they indicate an iodine intake lower than what previously published studies had estimated for this area. It is not clear whether these results reflect a regional or national trend of decreased dietary iodine intake or changes in dietary iodine intake limited to the cohort studied. These data indicate a need for further study to clarify this finding in view of possible clinical implications resulting from changes in iodine intake.

Journal Article↗
PubMedDate not supplied

Recombinant human granulocyte colony-stimulating factor in treatment of methimazole-induced agranulocytosis.

OBJECTIVE: To describe a patient with methimazole-induced agranulocytosis who was treated with recombinant human granulocyte colony-stimulating factor (G-CSF). METHODS: A case report is presented, in which the clinical and laboratory findings are detailed and the response to treatment is discussed. Pertinent reports from the literature are reviewed. RESULTS: In a 24-year-old woman with Graves' disease who was treated with methimazole, a fever and sore throat developed; bone marrow examination revealed absence of granulocytes. After discontinuation of methimazole therapy, treatment with G-CSF was implemented in an attempt to hasten the reappearance of the granulocytes. The patient's granulocyte count reached 0.5 10(9)/L on the 9th hospital day and was more than 1.5 10(9)/L on the 10th day. Because the recovery time for thionamide-induced agranulocytosis typically ranges from 1 to 2 weeks and sometimes is even longer, G-CSF may have been beneficial in accelerating the return of the granulocytes. CONCLUSION: Only a small number of patients with thionamide-induced agranulocytosis have had G-CSF treatment, and most outcomes have generally supported a beneficial effect. More experience is needed with the use of G-CSF in such circumstances. Nevertheless, its use seems to be a reasonable therapeutic option for consideration in patients with thionamide-induced agranulocytosis.

Journal Article↗
PubMedDate not supplied

Concurrent diagnosis of acromegaly and diabetic ketoacidosis.

OBJECTIVE: To report the occurrence of diabetic ketoacidosis (DKA) in a patient with acromegaly. METHODS: A case report with clinical and laboratory details is presented, and the few other cases of DKA and acromegaly from the literature are discussed. RESULTS: A 37-year-old man requested a consultation because of nausea, vomiting, polydipsia, polyuria, and weight loss. Physical examination revealed findings suggestive of acromegaly, including coarse facial features and enlargement of his hands and feet. Laboratory studies confirmed the diagnoses of DKA and acromegaly. Magnetic resonance imaging disclosed the presence of a pituitary adenoma, which was subsequently removed surgically. Although the DKA had been managed with insulin therapy, 2 weeks postoperatively the insulin dose was tapered and then discontinued because of hypoglycemia. Follow-up showed normalization of growth hormone levels and plasma glucose levels. Only three other cases of DKA associated with acromegaly were found in the medical literature. CONCLUSION: Although DKA is rarely diagnosed in conjunction with acromegaly, this unusual association was confirmed in the current patient.

Acromegaly↗
PubMedDate not supplied

Diabetic ketoacidosis in association with acanthosis nigricans.

OBJECTIVE: To report the occurrence of diabetic ketoacidosis in three patients with acanthosis nigricans. METHODS: Case reports with clinical and laboratory data are presented, and the syndrome of acanthosis nigricans is discussed. RESULTS: Three obese male patients--two American Indians and one Polynesian man--sought medical attention because of symptoms of diabetic ketoacidosis and were noted to have acanthosis nigricans. No factor was identified that could have precipitated the diabetic ketoacidosis, which was resolved by treatment with insulin. CONCLUSIONS: The unexpected association of diabetic ketoacidosis and acanthosis nigricans is documented in these three cases. The hyperinsulinemia associated with acanthosis nigricans results from insulin resistance, and when insulin resistance occurs in combination with impaired insulin secretion, diabetic ketoacidosis can result.

Acanthosis Nigricans↗