Hyponatremia related to ectopic secretion of cancer cells of arginine vasopressin(AVP)or atrial natriuretic peptide(ANP)is most commonly caused by small cell lung cancer.The ideal treatment would be one that not only ...Hyponatremia related to ectopic secretion of cancer cells of arginine vasopressin(AVP)or atrial natriuretic peptide(ANP)is most commonly caused by small cell lung cancer.The ideal treatment would be one that not only corrects the hyponatremia,especially if it is life threatening,but at the same time causes regression of the cancer,and thus improves both quality and length of life.As one is waiting for chemotherapy,surgery,or radiotherapy to decrease the cancer burden,tolvaptan has been used to correct the hyponatremia to improve symptoms or prevent death.Mifepristone,a progesterone receptor modulator/antagonist has been used to treat various cancers.The oral 200mg tablet was given to an 80-year-old woman who developed sudden extensive lung cancer with a serum sodium of 118 mmol/L.She refused chemotherapy but agreed to take mifepristone.The hyponatremia was completely corrected(145 mmol/L)within one month of treatment.She was in complete remission for 5 years and died not from lung cancer,but an acute myocardial infarction.Mifepristone may serve the purpose to not only quickly correct hyponatremia when it is related to an endocrine paraneoplastic syndrome,but also to provide improved quality and length of life.展开更多
Objective To determine the confounding effect of oocyte reserve and age on pregnancy rates per oocyte retrieval and a comparison of the average number of babies born from a given oocyte harvest. Methods In vitro ferti...Objective To determine the confounding effect of oocyte reserve and age on pregnancy rates per oocyte retrieval and a comparison of the average number of babies born from a given oocyte harvest. Methods In vitro fertilization-embryo transfer （IVF-ET） cycles were retrospectively reviewed over a l O-year period They were stratified according to whether they had normal oocyte reserve （day 3 serum FSH 〈12 mlU/ml and serum estradiol 〈50 pg/ml） or diminished oocyte reserve. Mild stimulation was used if low oocyte reserve. The pregnancy rate per retrieval included all pregnancies （fresh or frozen embryo transfer） resulting from one retrieval. The average number of babies born was also compared according to reserve. Results For the diminished oocyte reserve group, the live delivered pregnancy rates per transfer were 80% as good in women aged 〈35 years, 70% as good in women 3639 years, but only 43% as good as women aged 40-42 years. However, because of more total embryos the pregnancy rate per given oocyte retrieval was only 55% as good for women with diminished oocyte reserve aged 〈39 years. The average number of babies born per retrieval was twice as high as those with normal reserve for this age group. Conclusion The use of mild follicle stimulating hormone （FSH） stimulation allows a live delivered pregnancy rate per transfer that is 75% as good for women aged 〈39 years but because of less embryos a likelihood of pregnancy rate per retrieval only half as good as women with normal reserve.展开更多
文摘Hyponatremia related to ectopic secretion of cancer cells of arginine vasopressin(AVP)or atrial natriuretic peptide(ANP)is most commonly caused by small cell lung cancer.The ideal treatment would be one that not only corrects the hyponatremia,especially if it is life threatening,but at the same time causes regression of the cancer,and thus improves both quality and length of life.As one is waiting for chemotherapy,surgery,or radiotherapy to decrease the cancer burden,tolvaptan has been used to correct the hyponatremia to improve symptoms or prevent death.Mifepristone,a progesterone receptor modulator/antagonist has been used to treat various cancers.The oral 200mg tablet was given to an 80-year-old woman who developed sudden extensive lung cancer with a serum sodium of 118 mmol/L.She refused chemotherapy but agreed to take mifepristone.The hyponatremia was completely corrected(145 mmol/L)within one month of treatment.She was in complete remission for 5 years and died not from lung cancer,but an acute myocardial infarction.Mifepristone may serve the purpose to not only quickly correct hyponatremia when it is related to an endocrine paraneoplastic syndrome,but also to provide improved quality and length of life.
文摘Objective To determine the confounding effect of oocyte reserve and age on pregnancy rates per oocyte retrieval and a comparison of the average number of babies born from a given oocyte harvest. Methods In vitro fertilization-embryo transfer （IVF-ET） cycles were retrospectively reviewed over a l O-year period They were stratified according to whether they had normal oocyte reserve （day 3 serum FSH 〈12 mlU/ml and serum estradiol 〈50 pg/ml） or diminished oocyte reserve. Mild stimulation was used if low oocyte reserve. The pregnancy rate per retrieval included all pregnancies （fresh or frozen embryo transfer） resulting from one retrieval. The average number of babies born was also compared according to reserve. Results For the diminished oocyte reserve group, the live delivered pregnancy rates per transfer were 80% as good in women aged 〈35 years, 70% as good in women 3639 years, but only 43% as good as women aged 40-42 years. However, because of more total embryos the pregnancy rate per given oocyte retrieval was only 55% as good for women with diminished oocyte reserve aged 〈39 years. The average number of babies born per retrieval was twice as high as those with normal reserve for this age group. Conclusion The use of mild follicle stimulating hormone （FSH） stimulation allows a live delivered pregnancy rate per transfer that is 75% as good for women aged 〈39 years but because of less embryos a likelihood of pregnancy rate per retrieval only half as good as women with normal reserve.
