Article1 November 1961Familial Incidence of Diabetes in HyperthyroidismLAWRENCE V. PERLMAN, M.D.LAWRENCE V. PERLMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-55-5-796 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHyperthyroidism and diabetes mellitus have certain similarities. Not only are the symptoms of the two conditions (fatigue, anxiety, and weight loss) comparable; hyperthyroid patients are more prone than normal individuals to develop diabetes, and diabetics are more apt to become hyperthyroid. Indeed, several observers have postulated that the two disorders, whose etiologies remain obscure, may be peripheral manifestations of a common central metabolic disorder (1, 2). Since diabetes is known to be an inherited disease, albeit a condition that develops late in life, and since there is a strong familial pattern to hyperthyroidism, it seemed reasonable to investigate the inheritance...References1. JOSLINROOTWHITEMARBLE EHPA: The Treatment of Diabetes Mellitus, Lea & Febiger, Philadelphia, 1946, p. 726. Google Scholar2. LABBEPETRESCO MM: Les alterations des glandes endocrenes dans le diabete sucre. Ann. Anat. Path. (Par.) 11: 761, 1934. Google Scholar3. REVENO W: Thiouracil effect in diabetes mellitus complicated by hyperthyroidism. Amer. J. Med. Sci. 211: 174, 1946. CrossrefMedlineGoogle Scholar4. MEANS JH: Thyroid and Its Diseases, 2nd Ed., J. B. Lippincott Co., Philadelphia, 1948, p. 296. Google Scholar5. RUDYBLUMGARTBERLIN AHLDD: A case of diabetes treated by total ablation of the normal thyroid gland. Amer. J. Med. Sci. 190: 51, 1935. CrossrefGoogle Scholar6. LAHEYALLANMURPHY FWR: Hyperthyroidism and diabetes. Trans. Amer. Ass. Goiter p. 248, 1947. Google Scholar7. BOWENLENZNER BAR: The use of propothiouracil in hyperthyroidism and diabetes: a study of forty-one cases. New Engl. J. Med. 245: 629, 1951. CrossrefMedlineGoogle Scholar8. HOUSSAY B: The thyroid and diabetes. Vitamins Hormones 4: 187, 1946. CrossrefGoogle Scholar9. REGANWILDER JFR: Hyperthyroidism and diabetes. Arch. Intern. Med. 65: 1116, 1940. CrossrefGoogle Scholar10. JOHNS HJ: Hyperthyroidism showing carbohydrate metabolism disturbances. J. A. M. A. 99: 620, 1932. CrossrefGoogle Scholar11. RUPPDIGEORGEPASCHKIS JJAMKE: Hypothyroidism and diabetes mellitus. Diabetes 4: 393, 1955. CrossrefMedlineGoogle Scholar12. JOSLINROOTWHITEMARBLE EHPA: The Treatment of Diabetes Mellitus, Lea & Febiger, Philadelphia, 1957, p. 632. Google Scholar13. RALLISTREETPELL EES: The course and complications of diabetes mellitus, data on 331 cases observed regularly in a diabetic clinic. Diabetes 4: 456, 1955. CrossrefMedlineGoogle Scholar14. BARTELS E: Heredity in Graves Disease, Einar Munksgaard, Copenhagen, 1941, p. 140. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington, D. C.Supported in part by a summer fellowship from the James Hudson Brown Fund of Yale University.Requests for reprints should be addressed to Philip K. Bondy, M.D., Professor of Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven 11, Conn. 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FISHER, M.D., ROGER LESTER, M.D.Autoimmunological aspects of diabetes mellitusISLET-CELL ANTIBODIES IN JUVENILE DIABETES MELLITUS OF RECENT ONSETDie Stoffwechselwirkungen der SchilddrüsenhormoneANTIBODIES TO PANCREATIC ISLET CELLS IN INSULIN-DEPENDENT DIABETICS WITH COEXISTENT AUTOIMMUNE DISEASEAutoimmune Diabetes MellitusEndocrine Disorders and DiabetesAn Association of Thyroid Disease, Ulcerative Colitis and Diabetes MellitusInsulin levels in thyrotoxicosis and primary myxoedema: Response to intravenous glucose and glucagonCHROMOSOMAL SATELLITE ASSOCIATIONDIABETES AND CONGENITAL HYPOTHYROIDISMIl problema dell'eredita' del diabeteMedical genetics 1961 1 November 1961Volume 55, Issue 5Page: 796-799KeywordsAnxietyDiabetes mellitusEtiologyFatigueFellowshipsHyperthyroidismMetabolic disordersWeight loss Issue Published: 1 November 1961 PDF DownloadLoading ...
The occurrence of exercise proteinuria as measured by the albustix dip and read technique was analyzed with respect to several physiological measurements in 499 males who took part in a treadmill exercise test of physical work capacity. The decade—specific incidence of proteinuria after exercise increased with age until the fourth decade. Covariant analysis (holding age constant) shows that oxygen consumption (at standard heart rate of 150 b.p.m.), maximum heart rate reached, systolic blood pressure (with heart rate of 150 b.p.m.) and total time of exercise were significantly correlated (P <.01) with the occurrence of post-exercise proteinuria. Weight was also significantly correlated with the phenomenon but at a lower level of significance (P<.05). There was no correlation with systolic blood pressure at rest or with oxygen uptake per kg body weight (at heart rate of 150 b.p.m.).
ABSTRACT: In 14 (8 men and 6 women) of the 8,641 original examinees in the Tecumseh Study, renal failure (RF) was found to have developed during an eight‐year period. The proportion rose significantly with age. At the initial examination (one to eight years before the onset of RF), no subject subsequently uremic had a history of acute glomerulonephritis or chronic renal disease nor was frankly azotemic, although in 4 there was a suggestion of early disease. Six of the 12 subjects (50 per cent) over age 45 who later became uremic gave a history compatible with urinary‐tract infection (UTI), compared with 380 (22 per cent) of the remaining 1,746 examinees in this age range. Conversely, in 6 of 386 persons (1.6 per cent) with a history of UTI, renal failure developed, in contrast to 6 of 1,372 persons (0.4 per cent) without such a history. Common disorders noted at the initial examination one to eight years before RF were congestive heart failure (9 cases), loss of hearing (7 cases), coronary heart disease (5 cases), hyperuricosemia (5 cases), and hyperglycemia (5 cases). This study shows that most persons in whom renal failure develops are elderly and have pre‐existing vascular disease; in about a quarter of them, the findings at the time of the initial examination indicate early renal disease. Although these data point to a relationship between UTI and RF in some cases, in most patients with a history of UTI, renal failure does not develop.
Recently a simple maneuver has been observed to end prolonged hiccupping in a dozen subjects. The individual is instructed to sit upright and to hold his breath. The patient then maximally extends his head for 10 to 15 seconds or as long as he can hold his breath. This maneuver tends to hold the diaphragm in a relatively fixed position particularly if the breath is held in inspiration. The mechanism appears to be the fixation of the anterior wall of the abdominal musculature which occurs when the head is hyperextended. Interference with diaphragmatic motion by this
The cases of 97 patients with lung abscess were reviewed and were found to be separable into two distinct clinical groups, depending on the clinical circumstances in which the lesion developed. Group I (simple lung abscess) was composed of patients with no other disease; in group II, abscesses occurred in patients with systemic malignant or nonmalignant diseases. Several features, including age, mode of onset, site of abscess, and bacteriologic data, were found to depend on the clinical class of the patient. When compared with patients in group II, group I patients tended to be younger, to have a more insidious onset, to have abscesses in classic locations for aspiration, and to have mixed flora cultured from their sputum. The differences in mortality among the two groups of patients are striking. Two per cent of the patients in group I died (one postoperative death) as compared with 75 per cent of those in group II (one postoperative death and 29 medical deaths). The therapeutic approach used in this ser...
In an epidemiologic study of the total population of Tecumseh, Michigan, 98 deaths from coronary heart disease were observed between 1959 and 1965. Forty-five of the fatalities occurred within 1 hour of the onset of symptoms and were classified as sudden. The proportion of sudden deaths among men was nearly twice that among women, and the incidence increased progressively with age in both sexes. Hypertensive heart disease, coronary heart disease, or diabetes mellitus had been detected on prior examination in 62% of those who died suddenly. Physiologic abnormalities associated with a high risk of coronary heart disease were also found more frequently than in the total Tecumseh population. All but seven of the persons who died suddenly had abnormalities including arrhythmias and conduction defects which were detected in the standard 12-lead electrocardiogram. Although sudden deaths often seem to occur without warning, the victims are predisposed by conditions which are detectable long before the catastrophic event. The identification of conditions which are precursors of sudden death from coronary heart disease permits a rational consideration of possible preventive measures.
Outpatient clinics can be used to train physicians for primary care. Our program, based in the outpatient department of a city-county hospital and operational for three years, has been well accepted by medical residents. The program directed toward primary care training has emphasized continuity of care, house staff supervision, and hospital-clinic interaction. All residents have a one-half day a week clinic during which they follow up on their patients. In the ambulatory inpatient service, two residents are assigned who alternate ward and clinic responsibilities. Clinic physicians are attending staff for this service, which gives them an inhospital base. A lecture, seminar, and conference schedule has been developed for issues related to primary care not covered in the usual medical residency. Internal medicine training programs should include continuing general ambulatory medical experience to train residents in primary care.
THE INCREASING popularity of parakeets as domestic pets, the lack of uniform laws regarding the importation and sale of psittacine birds, and the presence of a large reservoir of the disease among domestic fowl have increased the incidence of psittacosis tremendously. Since Ritter first described the disease under the name of pneumotyphus, psittacosis has been reported as endemic or epidemic in many parts of the world. Any attempt to determine the true incidence of the disease is futile. It is certain that psittacosis occurs much more frequently than is generally realized. That it is overlooked because of the unawareness of the medical profession of its existence is most likely. Psittacosis is an acute infectious disease caused by a number of closely related viruses. In addition to the strains of psittacine origin, there are various other strains which naturally infect other species of birds. These latter infections are referred to as
The interrelationships between hypertension and obesity, two common and major health hazards, are reviewed. Comparisons of simultaneous intra-arterial and cuff blood pressure measurements indicate in general that the association between blood pressure and body weight is real and independent of arm circumference. Hypertension is more common among the obese than among the nonobese and, conversely, a significant proportion of hypertensive persons in the population are overweight. Obese hypertensive subjects experience a greater risk of coronary heart disease than the nonobese, and mortality rates for obese hypertensive persons are higher than for those with obesity alone or hypertension alone. Weight reduction has been shown to lower blood pressure, and it may bring about a more favorable prognosis in obese hypertensive persons. Possible mechanisms that may be responsible for the frequent association between obesity and hypertension have been discussed. Irrespective of the underlying pathophysiologic mechanisms, the adverse metabolic and hemodynamic effects of obesity upon hypertension impose an extra burden and strain on the circulatory system and compromise its functional adequacy. Although it is not precisely known to what extent weight reduction alone may be effective in controlling or preventing the lesser degrees of hypertension, the control of obesity should be an intrinsic part of any therapeutic or preventive antihypertensive regimen.
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