Two Cases of Simmonds's Disease

Hausmann, Walther; Kalinowski, Steven T.; Marquand, H. S. Le

doi:10.1136/bmj.1.4712.924

Cited by 5 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This test was also negative in a male case verified at necropsy (Paschkis and Cantarow, 1951). Dangerous hypoglycaemia may result from intravenous insulin in these patients (Hausmann et al, 1951), but there seems to be little doubt that mild cases of hypopituitarism will not show the expected hypoglycaemia unresponsiveness. It has been repeatedly emphasized that the excretion of 17-ketosteroids in hypopituitarism is extremely low.…”

Section: Variation In Severity Of Clinical Picturementioning

confidence: 99%

Endocrine Dysfunction in Post-partum Hypopituitarism

Oelbaum¹

1952

BMJ

View full text Add to dashboard Cite

A GASTRIC GOSSIP BIISH MEDICAL JOURNAL the ulcer seen for the first time with a long recurrent history -particularly if its position in the stomach is then on the more distal lesser curvature.The Duodenal Ulcer But what of the duodenal ulcer ?-variously estimated as three times more common than gastric ulcer in London, five times mnore common in the country as a whole, seven times more common in the Army, and ten times more common in America. There is here, if anything, a slight swing of the therapy pendulum to the medical side, and this from a logical point of view I find hard to understand. Admitted that it is not such a fatal disease, that the bogy of carcinoma is absent, and that probably, at all events in the earlier stages, the periods of natural remission of symptoms are longer-even so, most duodenal ulcers eventually follow a similar pathological course to that of gastric ulcers, including one feature not common to gastric ulcer-obstruction. A young patient with duodenal ulcer, with a relatively short history and mild symptoms, particularly if his ulcer is uncomplicated and he himself a neurotic, is going to call for medical measures. But I can see no reason for varying the course previously mentioned for gastric ulcer should the response not be both definite and rapid. To let a duodenal ulcer, simply because it is unlikely to be fatal, become intractable and complicated is to let it be intolerable to the patient and a reflection on his medical attendants. When surgery becomes a necessity in such a case the technical and mechanical difficulties are often far greater than those of the largest gastric ulcer. It is a question, as so often is the case in medicine, of being forewarned and forearmed.Having mentioned obstruction as an ultimate outcome of duodenal ulceration, I might briefly consider, and perhaps slightly lament the passing of, the operation of gastrojejunostomy. Twenty years ago it was the accepted surgical treatment of peptic ulceration. Many thousands of patients have obtained permanent relief from it. But many series of figures in other countries have shown that on this scale it will have a 25% failure rate-obviously too high to balance its slightly (now only very slightly) lower mortality rate than procedures which have succeeded it. It looked as though vagotomy might give it renewed popularity. But there is still a small group of patients with duodenal ulcer who, if carefully selected, will benefit as much from gastro-jejunostomy as they would from gastrectomy. Assessment of SurgeryAnd now, what of the results of surgery? The mortality from gastrectomy should now be less than 2%. For this we have to thank the advances in anaesthesia in the last 10 years, the greater appreciation of the need for adequate pre-and post-operative treatment (particularly in respect of hydration.and blood chemistry), and the wider application of the antibiotics and sulphonamides. It may be asked whether 2% is still not too big a risk. As the overall morbidity rate of peptic ulceration is very little less, and wo...

show abstract

Section: Variation In Severity Of Clinical Picturementioning

confidence: 99%

Endocrine Dysfunction in Post-partum Hypopituitarism

Oelbaum¹

1952

BMJ

View full text Add to dashboard Cite

show abstract

“…body weight when severe hypopituitarism is suspected. Rolland and Matthews (1952) reported severe hypoglycaemic symptoms in a man with hypopituitarism after 1.5 units of insulin, and Haussmann et al (1951) induced hypoglycaemic shock with 1.75 units of insulin in a woman with Simmnonds's disease who then remained semicomatose for two weeks despite energetic treatment.…”

Section: Hypoglycaemiamentioning

confidence: 99%