Trauma and the endocrine system.

The endocrine system may be the target of different types of trauma with varied consequences. The present article discusses trauma of the hypothalamic-pituitary axes, adrenal glands, gonads, and pancreas. In addition to changes in circulating hormone levels due to direct injury to these structures, there may be an endocrine response in the context of the stress caused by the trauma.

Neoplasia endocrina múltiple atípica presentación de un caso / Atypical multiple endocrine neoplasia: a case presentation

Las neoplasias endocrinas múltiples constituyen síndromes con herencia autosómica dominante en los cuales hay afectación tumoral de 2 o más glándulas endocrinas, agrupadas según la afectación glandular en grupos: 1, 2A, 2B y las mixtas. Presentamos una paciente atendida en el INEN, del sexo femenino, de 44 años de edad, que a los 24 años fue operada de adenoma bronquial tipo carcinoide, 11 años más tarde fue intervenida quirúrgicamente por carcinoma medular del tiroides, y 7 años después comienza con aumento de volumen de las manos y los pies, por lo que ingresa en nuestro servicio donde se le diagnostica un adenoma hipofisario productor de GH, un tumor de la pineal, así como un tumor cromafín del riñón derecho. Dada la atipicidad del cuadro, y por no haber encontrado en la literatura revisada casos similares, consideramos oportuna su presentación(AU)

Multiple endocrine neoplasm are syndromes with autosomal dominant inheritance, where there is tumoral involvement of two or more endoce glands, grouped by glandular afection as: 1, 2A, 2B, and mixed. Case of a female patient, aged 44 seen in National Institute of Endocrinology (NIEN) and that when she aged 24 was operted on by a carcinoid bronchial adenoma, eleven year after she showed a increase in hands and feets volumen and is admissed in our service and is diagnosed as HG-producer hypophyseal adenoma, a tumor of pineal gland as well as a chromaffin tumor in right kidney. Due to atypical picture, and the lack of similar cases in reviewed literature, we considered appropriate its presentation(AU)

The neurohumoral response to trauma.

The bodily response to injury is an integrated and protective mechanism involving all systems, and hence it should be considered as a whole. The nervous system, especially the psychic center of the cerebral cortex, seems to initiate these responses. In the present study the neurohumoral response to trauma was assessed in experimental animals and clinical subjects. Immediately after trauma acetylcholine levels increased, suggesting enhanced activity of the central nervous system. This was followed by predominant activity of the sympathetic nervous system, as evidenced by increased catecholamine levels. During the later postoperative period, histamine levels also increased. There appears to be a good correlation between increased histamine content and fibroblastic proliferation in the traumatized area. These observations suggest that levels of the neurohumors increase in a definite sequence after trauma, facilitating the process of repair, regeneration, and normal convalescence. Therefore, trauma should be minimized during repair and the patient should receive proper sedation and rest during the pre- and postoperative periods, since each quantum of response depends upon the amount of sensory input that occurs at the time of trauma and in the post-traumatic period.