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Biomedical subjects

T Wheatley

Publications and source records attributed to T Wheatley.

At least 37 records · Page 2Linked to original sources
PubMed1987

Pituitary apoplexy: an unusual cause of stroke.

A case of pituitary apoplexy complicated by hemiparesis and dysphasia is reported. Investigations revealed complete obstruction of the left internal carotid artery due to haemorrhagic pituitary expansion. This case and the four previously reported suggest that early diagnosis of this rare complication is essential if surgery is to prevent cerebral infarction.

Adult↗
PubMed1987

Pulsatile secretion of TSH in healthy subjects.

The physiological variations in serum TSH concentration have been investigated using an enzyme amplified immunoassay with improved sensitivity and precision. Blood samples were collected at regular intervals from 10 healthy volunteers during the period 1800 h to 0100 h. Spectral analysis followed by periodic regression analysis demonstrated significant serum TSH pulsatility with periodicities of 60 or 85-100 min. In addition, a significant (P less than 0.001) evening rise in serum TSH concentration was demonstrated in all subjects, with levels rising at around 21.30-22.00 h.

Adult↗
PubMed1987

Thyroid stimulating hormone measurement by an ultrasensitive assay during thyroxine replacement: comparison with other tests of thyroid function.

Serum thyroid stimulating hormone (TSH) was measured using a highly sensitive enzyme-amplified immunoassay in 37 clinically euthyroid patients receiving thyroxine replacement therapy and compared with other biochemical tests of thyroid function. A highly significant correlation (P less than 0.001) was found between the basal serum TSH and the increase in serum TSH concentration 20 min after the administration of thyrotropin releasing hormone (TRH). The basal serum TSH was negatively correlated with the serum total thyroxine (P = 0.05). When patients results were classified as abnormal or normal many discrepancies were noted between the various thyroid tests. A suppressed serum TSH was found in 65% of patients with a normal serum total thyroxine. However, in patients on thyroxine replacement therapy a basal TSH measured by enzyme-amplified immunoassay provides the same information as a TRH test.

Female↗
PubMed1986

Craniopharyngioma with hyperprolactinaemia due to a prolactinoma.

A case is presented in which a histologically proven prolactin secreting pituitary macroadenoma was associated with a large suprasellar craniopharyngioma. The pre-operative prolactin concentration was 8180 mU/l. Although hyperprolactinaemia up to 3000 mU/l in patients with a craniopharyngioma is usually due to stalk compression, greater values may indicate an associated prolactinoma.

Adenoma↗
PubMed1986

Urine discoloration after acetaminophen overdose.

Three patients with acetaminophen overdose were observed to have dark-brown urine at an early stage of their illness. Subsequently, acute anuric renal failure and hepatic dysfunction developed in all three. p-Aminophenol was identified by chromatographic and colorimetric methods in the urine of each case and is thought to be responsible for the discoloration.

Acetaminophen↗
PubMed1985

Insulin oedema and its clinical significance: metabolic studies in three cases.

Three patients with insulin-dependent diabetes mellitus are described in whom generalized oedema and weight gain followed the administration of excessive monocomponent insulins, in two cases associated with symptomatic hypoglycaemia. Serial measurements of plasma volume and transcapillary escape rate of albumin (TERA) using 125I-labelled albumin, serum colloid osmotic pressure (COP) using a membrane colloid osmometer, packed cell volume (PCV), and serum proteins, showed that oedema was associated with an increased plasma volume and TERA, while serum albumin and total protein concentration and serum COP were reduced. A reduction in daily insulin dose abolished hypoglycaemia and resulted in weight loss, natriuresis, diuresis, a reduction in plasma volume and TERA, and an increase in serum albumin, total protein, and COP. Strict metabolic control in previously poorly controlled patients may cause insulin-induced increments in plasma volume and albumin escape rate.

Adult↗
PubMed1985

Adrenal insufficiency and bilateral adrenal enlargement: demonstration by computed tomography.

A patient presented with fever, malaise and a staphylococcal wound infection occurring 3 weeks after severe haemorrhage from a lacerated brachial artery. There were no clinical features to suggest Addison's disease but abdominal computed tomography to exclude abdominal sepsis showed bilateral adrenal gland enlargement with preservation of adrenal shape. This was consistent with resolving adrenal haemorrhage or infarction and endocrinological investigations confirmed primary adrenal failure.

Adrenal Glands↗
PubMed1984

Acute renal failure due to glomerulonephritis associated with staphylococcal infection.

Acute renal failure developed in a diabetic with staphylococcal arthritis and septicaemia in the absence of endocarditis. Renal biopsy showed proliferative glomerulonephritis and there was evidence of alternative pathway of complement activation. Renal function recovered following haemodialysis for 2 months. The association of glomerulonephritis with staphylococcal infection is reviewed.

Acute Kidney Injury↗
PubMed1983

Mild hypothyroidism and oedema: evidence for increased capillary permeability to protein.

Nine female patients with normal serum total thyroxine (T4) and triiodothyronine (T3) but elevated thyroid stimulating hormone (TSH) levels were studied. Six patients had generalised oedema associated with maximal diurnal weight gains in excess of 1.4 kg. Under conditions of forced water diuresis, before and during physiological replacement of 1-thyroxine, the supine transcapillary escape rate of albumin (TERA) was measured, while the venous colloid osmotic pressure (COP), packed cell volume (PCV) and urinary excretion of water and electrolytes were studied in both the supine and upright positions. The TERA, diurnal weight gain and orthostatic increase in COP fell significantly with treatment. In the six patients with oedema and excessive diurnal weight gains, the retention of salt and water on tilting was reduced with thyroxine treatment. In female patients we consider generalised oedema associated with excessive diurnal weight gain, to be a common and early symptom of hypothyroidism, meriting thyroxine replacement therapy.

Adult↗