AccessMyLibrary provides FREE access to over 30 million articles from top publications available through your library.

Do I need to be an endocrinologist to diagnose Cushing's disease?(Letters)

Postgraduate Medical Journal

| July 01, 2003 | Jabbar, A | COPYRIGHT 2003 British Medical Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

Around October 1999, while playing cricket after a long time, I fell down for no apparent reason. The same event happened a month later. Being mainly concerned about unexplained falls, I sought help from neurological colleagues. Two neurologists examined me and both reassured me: "your exam is normal and there is nothing to warrant any further investigations". I checked my vitamin B12, which was 81.0 pg/ml (normal range 200-900). A combination of B12 deficiency and proximal myopathy could explain my falls. Having put on 4 kg over the past year, I sought advice from an internist. More concerning was that the central weight gain was starting to affect my appearance. The internist ascribed it to middle age spread and having checked my glucose and lipids, referred me to our nutritionist. Thee nutritionist having seen the results gave a good diet and exercise plan. Following this diet and exercise plan, I developed pain in my left foot and it got so severe that I presented to our radiologist with an x-ray film. On first look, he dismissed it as normal but on closer look identified a hairline fracture in the fifth metatarsal. I was referred to an orthopaedic surgeon who advised me to avoid brisk walks for two weeks.

I questioned both of them--why did I break my bone? I was told that it may happen with strenuous workouts. Now I started to notice a change in my sleep, mood, and thoughts. I began to wake up about 3-4 am for no good reason and it was difficult to go back to sleep. Though unable to have a good night's sleep of seven hours, which used to be a "must" for me, I was still full of energy during the day but would develop a headache at the end of a busy clinic. I sought advice from my psychiatric colleague. "It appears like mania or hypomania but why should you have it? Forget it, or if you like you may try some sedatives". For headache, no recommendation.

I asked my staff nurse to check my blood pressure in the busy clinic and it was 180/100 mm Hg. Not surprisingly, I got more and more worried and one day while doing an endocrine ...

Related articles from newspapers, magazines, journals, and more
Seek 24-hour urine in suspected preeclampsia.(Women's Health)
Magazine article from: Family Practice News Boschert, Sherry April 1, 2006 700+ words
...and the law. Instead, get a 24-hour urine collection. If there's not time for that, get a 12-hour urine collection, and order a pregnancy...kit, and the gold standard is 24-hour urine collection," he said. To diagnose...
Get 24-hour urine in suspected preeclampsia.(Obstetrics)
Magazine article from: OB GYN News Boschert, Sherry February 1, 2006 700+ words
...and the law. Instead, get a 24-hour urine collection. If there's not time for that, get a 12-hour urine collection, and order a pregnancy...kit, and the gold standard is 24-hour urine collection," he said. To diagnose...
Clinical value of 24-hour urine hormone evaluations.
Magazine article from: Townsend Letter for Doctors and Patients Broughton, Alan January 1, 2004 700+ words
...numerous advantages to using the 24-hour urine hormone evaluations. These evaluations...assay limitations of saliva. The 24-hour urine provides a stable indicator of output...of cortisol are measured in the 24-hour urine hormone evaluation, indicating whether...
24 HOUR URINE COLLECTION.
CareNotes December 1, 2001 700+ words
24 HOUR URINE COLLECTION GENERAL INFORMATION: What is it? A 24-hour urine collection is when you need to save all the urine...amounts during the day and night. With the 24-hour urine the chemical in question can be measured correctly...
24 hour urine collection.(urine testing and volume measurement)
CareNotes May 1, 2006 700+ words
...GENERAL INFORMATION: What is it? A 24-hour urine collection is when you need to save all...during the day and night. With the 24-hour urine the chemical in question can be measured...special container to collect the 24-hour urine. This container has a wide opening and...
24 hour urine collection.
CareNotes May 1, 2007 700+ words
...GENERAL INFORMATION: What is it? A 24-hour urine collection is when you need to save all...during the day and night. With the 24-hour urine the chemical in question can be measured...special container to collect the 24-hour urine. This container has a wide opening and...
More rapid triage possible: six-hour, 12-hour urine collections shown to...
Magazine article from: OB GYN News Zoler, Mitchel L. June 15, 2004 700+ words
PHILADELPHIA -- A 6-or 12-hour urine collection can accurately diagnose proteinuria...having preeclampsia is to use a 24-hour urine collection, but this delays confirmation...compared the results of 6-and 12-hour urine collections with those from a 24-hour...
Cross sectional longitudinal study of spot morning urine protein: creatinine...
Magazine article from: British Medical Journal Ruggenenti, Piero Gaspari, Flavio Perna, Annalisa Remuzzi, Giuseppe February 14, 1998 700+ words
...REPRODUCIBLE IN ASCII] Urine specimens A 24 hour urine collection was undertaken by 177 outpatients...the 24 hour period. Specimens from 24 hour urine collections and from untimed morning...complete blood count was done and 24 hour urine protein, sodium, and urea excretion...
Findings from M. Sahin and co-researchers advance knowledge in obesity and...
Newspaper article from: Obesity & Diabetes Week March 9, 2009 700+ words
...and 2 mg overnight dexamethasone suppression tests in obese subjects...and a low-dose dexamethasone suppression test (LDDST); 24-hour urine cortisol was collected...overnight 1-mg dexamethasone suppression test we also performed...
Secondary Osteoporosis: When and How to Work Up.(Brief Article)
Magazine article from: Family Practice News November 15, 2000 700+ words
...serum calcium or 24-hour urine calcium test is elevated...is elevated or the 24-hour urine calcium level is low...cushingoid appearance, a 24-hour urine cortisol test or low-dose dexamethasone suppression test is useful. Multiple...
For more facts and information, see all results
©2009 Gale, a part of Cengage Learning. All rights reserved.
About us | FAQs | Contact us | Privacy policy | Terms and conditions
Other Gale sites: Encyclopedia.com | HighBeam Research | Acquire Content | Books & Authors | Goliath | MovieRetriever | Smart QandA