Publications by authors named "A de Bustros"
Difficult cases in heart failure: Reversible heart failure secondary to thyrotoxicosis.
Congest Heart Fail
January 1999
Perhaps one of the most important steps in caring for a patient with heart failure is seeking a reversible form of heart failure. Often addressing a disease process, like myocardial ischemia or systemic hypertension, rapidly attenuates the progressive natural history of left ventricular dysfunction. Beyond the usual reversible causes, however, are some that may be overlooked.
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- A 42-year-old woman presented with hyperthyroidism and a large goiter, later developing hypothyroidism and severe neck pain. Biopsy indicated chronic thyroiditis and fibrosis, leading to treatments that included glucocorticoids and tamoxifen, resulting in some improvement.
- She later experienced severe paresthesia, a seizure, and compressive symptoms due to a massively enlarged thyroid that required emergency surgery (isthmusectomy), ultimately diagnosed as Riedel's thyroiditis.
- After treatment, her goiter reduced significantly and most symptoms improved; however, she still has persistent hypothyroidism and hypoparathyroidism, managing her condition with medication. This case highlights the complex nature of
Background: Factitious hypoglycemia is a deliberate attempt to induce a low serum glucose level using either insulin or oral hypoglycemic agents. Sulfonylurea-induced hypoglycemia is more common than incidents of insulin abuse, and hypoglycemia caused by these oral agents is biochemically indistinguishable from insulinoma.
Methods: We describe a case of factitious hypoglycemia resulting from insulin abuse in an adult diabetic patient, review the essentials of glucose homeostasis, and describe diagnostic tests that allow a differential diagnosis.
An activated ras oncogene induces a program of differentiation in the human medullary thyroid cancer cell line TT. This differentiation process is accompanied by a marked increase in the transcription of the human calcitonin (CT) gene. We have localized a unique Ras-responsive transcriptional element (RRE) in the CT gene promoter.
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