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Excessive administration of iodine over a long period may cause hypothyroidism in suitably disposed individuals and provoke the formation of a goiter. The underlying reason for this is the pathological lack of adaptation of the thyroid gland to high doses of iodine with persisting inhibition of hormone production through excess of intracellular iodine (Wolff-Chaikoff effect). Asthmatic patients--as in the case described - are usually affected, when they have taken iodine-containing expectorants over a long time. Provocation of an iodine-induced hypothyroidism by the recently required iodine prophylaxis of endemic goiter is not to be expected because the quantities of iodine lie within the physiological range.  相似文献   

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The dumping syndrome is due to a vigorous reflex distension of the jejunum, caused by the stomach violently evacuating its contents. The aim of treatment is to overcome the drastic evacuation by restoring the rhythmic peristalsis of the stomach (eukinetics). This can be achieved by a special diet. Every meal should begin with well chewed solids (pulp) and avoid all fluids. With a well organised medical staff a complete success can be achieved. Surgical measures in Dumping can be avoided.  相似文献   

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The application of antibiotics at the treatment of osteomyelitis resulted in a rise of the permanent successful treatment rate. This is especially true for the acute hematogenous osteomyelitis, to a certain extent also for the chronic exogenous one, at which even today the antibiotical therapy is not as important as a surgical intervention. Under consideration of the generally accepted therapeutical principles the special importance of a much individualized treatment adjusted to the clinical picture and disease stage is pointed out. The advantages and disadvantages of an application of antibiotics at the osteomyelitis are mentioned and we try to explain the reasons for occasional therapy failures. A special chapter is devoted to the methods of filling and sterilization of the osteomyelitis bone hollows. Our own experiences with an operative combination process are reported.  相似文献   

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According to more recent knowledge L-thyroxine alone is recommended for thyroid hormone replacement therapy, no longer the combination of L-thyroxine and triiodothyronin, since L-thyroxine is converted to triiodothyronine in the periphery of the body. Additional application of triiodothyronine causes unphysiological elevations of blood levels of triiodothyronine. When changing from the combined thyroid hormone therapy to treatment with L-thyroxine alone it is enough in most cases to replace the previous amount of L-thyroxine only; previous recommendations for the dosage of thyroid hormone were rather high. Average requirements of adults for L-thyroxine are around 170 mug per day. Children need about 90--100 mug per m2 body surface per day. -- When hypothyroidism is suspected in newborns or infants no protracted diagnostic procedures are justified with respect to brain development and its requirement of thyroid hormone during this period of life. Replacement therapy should be started within 1--2 days. The exact diagnosis can be established later, for instance during the third day of life when a temporary interuption of treatment for diagnostic purposes has no longer such negative effect on normal brain development. As long as physiological doses of L-thyroxine are used no side effects are to be expected for patients who later turn out to be euthyroid. -- Following exclusion of hyperthyroidism goitres in children and adolescents equally need thyroid hormone replacement therapy to reduce the size or prevent further enlargement or even the development of nodules within the gland. The dosage for this is about half to three quarters of the full replacement dose. The nature of thyroid nodules should be investigated, even surgically, since malignancies can develop in children and juveniles as well as in adults.  相似文献   

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Long-term observation by defined criteria of 121 women who had undergone conisation gave 56 pregnancies in 49 patients. The pregnancy rate established, with due consideration of contraception, other causes of sterility, and sexual activity, was about 75 per cent. Twenty-five deliveries were analysed. Forty per cent of them were premature births, with some of the newborns being of extremely low birth weight, which supported the conclusion that pregnancies following conisation should be given high-risk rating and, generally, lead to hospitalisation of the women concerned.  相似文献   

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