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Opioid Induced Pituitary Dysfunction

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesSjötíu og sjö ára kona með flöguþekjukrabbamein í endaþarmsopi var lögð inn vegna slappleika, niðurgangs og ógleði, en hún hafði einnig glímt við bakverki vegna samfallsbrots. Vegna verkjanna var hún meðhöndluð með sterkum ópíóíðum en hrakaði klínískt í kjölfarið með lækkandi blóðþrýstingi, versnandi öndunarstarfsemi og brenglun á blóðsöltum. Gildi kortisóls, TSH og LH mældust lækkuð og prólaktíns vægt hækkað, en nýrnahettuörvunarpróf (Synacthen-próf) og segulómskoðun af heila reyndust eðlileg. Vaknaði þá grunur um að ópíóíðameðferð hefði valdið truflun á starfsemi heiladinguls. Var því hafin sykursterauppbót með hýdrókortisóni með góðum klínískum árangri. Hér er tilfellinu lýst og greint frá alvarlegri en minna þekktri aukaverkun ópíóíða.Senda grein,Prenta greinEnglishFacebookTwitter A 77-year-old woman with a history of anal squamous cell carcinoma was admitted because of malaise, diarrhea and nausea, in addition to back pain related to a verte- bral compression fracture. During the course of treatment, opioid therapy was initiated, following which the patient became progressively hypotensive and hyponatraemic and respiratory drive progressively decreased. Serum levels of cortisol, TSH and LH were decreased and prolactin slightly elevated, but a Synacthen test and brain MRI turned out normal, suggesting a diagnosis of opioid-induced pituitary dysfunction. The patient was given glucocorticoid replacement therapy with good results. Here we present a case of this serious but less well recognised side-effect of opioids

Late Holocene and modern glacier changes in the marginal zone of Solheimajokull, South Iceland

The forefield of the Solheimajokull outlet glacier, South Iceland, has a variety of glacial landforms and sediments that are products of late Holocene and modern glacier oscillations. Several sets of moraine ridges reflect past ice front positions and river-cut sedimentary sections provide information about past environments. Here, we describe sediments and landforms deposited during the late Holocene. Chronology is obtained by C-14 dating and cosmogenic exposure dating. The age determinations suggest that Solheimajokull had major advances in the late Holocene prior to the Little Ice Age, and more restricted advances during the Little Ice Age, after AD 1539. Oscillations of the Solheimajokull ice margin between 1938 and 2010 are documented by aerial photographs. Digital elevation models were produced from selected years in order to quantify ice thickness changes at the glacier margin over the last 50 years. The glacier margin thickened 70-100 m front 1960 to 1996 and then thinned 120-150 m between 1996 and 2010. In 2010, the glacier snout was 20-40 in thinner than in 1960. Additionally, the DEM time-series detect areas of erosion and deposition in the forefield