ABSTRACT
Objetivo: Apresentar as complicações neurocirúrgicas que ocorrem com grande frequência; apesar dos esforços para prevení-las, algumas são inevitáveis. Método: Analisaram-se as principais complicações decorrentes de procedimentos neurocirúrgicos e os tratamentos específicos, baseados em revisão literária e em experiência própria. Conclusão: O tratamento médico dessas complicações pode ser transitório ou definitivo da causa subjacente, conforme a evolução clínica do paciente...
Subject(s)
Humans , Postoperative Complications/therapy , Intraoperative Complications , NeurosurgeryABSTRACT
OBJECTIVE: GH influences thyroid function and anatomy. Although goiter is frequent in acromegalic patients, the effects of GH deficiency (GHD) are difficult to assess, because hypopituitaric subjects who lack GH often also have a partial or complete deficit of TSH. STUDY DESIGN: We studied thyroid morphology and serum levels of thyroid hormones in adult members of a large Brazilian kindred with untreated isolated GHD due to a homozygous mutation in the GHRH receptor gene (GHRHR; nine men and 15 women; GHD group) and compared them to subjects heterozygous for the same mutation (eight men and 10 women; HET group) and subjects homozygous for the wild-type allele [seven men and 11 women; control (CO) group]. RESULTS: GHD subjects had a smaller thyroid volume (TV) than HET and CO. The TV of the HET group was intermediate between those of the GHD and CO groups. When TV was corrected by body surface area, it remained smaller in the GHD and HET groups than in the CO group, but the difference between GHD and HET groups disappeared. The GHD group had lower serum T3 levels than the CO group and higher free T4 levels than HET and CO groups. CONCLUSIONS: Individuals with severe untreated GHD due to a homozygous GHRHR mutation and heterozygous carriers of the same mutation have smaller TV than normal subjects, suggesting that GH has a permissive role in the growth of the thyroid gland. In addition, GHD subjects have reduced serum total T3 and increased serum free T4, suggesting a reduction in the function of the deiodinase system.
Subject(s)
Human Growth Hormone/deficiency , Thyroid Gland/anatomy & histology , Adult , Body Mass Index , Female , Homozygote , Humans , Male , Middle Aged , Mutation , Organ Size , Receptors, Somatotropin/blood , Thyroid Gland/pathology , Thyroid Gland/physiopathology , Thyrotropin/bloodABSTRACT
Diabetes insípido é uma síndrome caracterizada por poliúria e polidipsia. Existem várias causas para o seu desenvolvimento. O traumatismo craniencefálico corresponde à cerca de 3 por cento das causas de diabetes insípido central. Os autores relatam o caso de um paciente com 27 anos de idade, politraumatizado, que desenvolveu diabetes insípido dois dias após o trauma. Discutem a fisiopatologia, diagnóstico, tratamento e fazem uma revisão de leiteratura médica.
