J. G. Jacobsen

Twenty-five patients with newly diagnosed thyrotoxicosis participated in a double-blind study of the added effect of propranolol during tiamazol treatment. During the trial, the effect of treatment was ascertained by estimation at regular intervals of the clinical score (Crooks-Wayne index), free thyroxine index, serum triiodothyronine, serum reverse triiodothyronine, serum thyroglobulin and serum thyroglobulin antibodies. Both groups became euthyroid within two weeks. No statistically significant difference in the values for the clinical score or for any of the laboratory parameters measured was found between propranolol- and the placebo-treated patients. It is concluded that propranolol has no beneficial effect on tiamazol-treated hyperthyroid patients.

Bartter's syndrome is characterized by chronic hypokalaemia, activation of the renin-angiotensin system and normal blood pressure. To investigate whether a generalized disturbance of sodium-potassium pump function might be of pathogenetic importance, lymphocytic sodium-potassium homeostasis was examined in 5 patients suffering from Bartter's syndrome. Two of the patients were treated with potassium chloride supplementation, the others were without medical treatment when studied. All were severely hypokalemic (serum potassium 2.8 +/- 0.24 mmol/l, mean +/- SEM). Lymphocyte sodium and potassium concentration (14.4 +/- 0.37 and 94.4 +/- 7.7 mmol/l, respectively), ouabain sensitive 22Na-efflux rate constant (2.68 +/- 0.25 h), and absolute ouabain sensitive efflux rate (38.16 +/- 4.2 mmol l-1 h) did not differ from matched controls. Ouabain binding capacity was 126 900 +/- 23 500 sites/cell in patients vs 50 400 +/- 17 900 in controls (p less than 0.05). In conclusion, patients with Bartter's syndrome may have an intrinsic abnormal pump function, characterized by an increased pump density and a low cation turn-over rate per pump unit.

1. Based on three cases of the Bartter syndrome, two adults and one child, the pathogenesis of the syndrome is discussed. 2. It is suggested that protracted salt-volume loss may induce autonomous renin overproduction, leading to the manifestations of the syndrome.

Geriatric care refers to the specialized care and treatment plans curated exclusively for the elderly, usually those aged 65 and above. It is a holistic approach that caters to the physical, mental, and emotional wellbeing of the elderly, and focuses on the challenges and unique needs that arise with aging. Geriatric care is important because it caters to integral aspects of senior-hood like management of chronic conditions, medication management, and maintaining functional independence. Care at home for senior citizens provides personalized support and assistance in-house, offering a myriad of benefits. The aim of this article is to provide insights into the role of GM to non-geriatrician readers and to summarize the main aspects of the value of a geriatric approach across the spectrum of healthcare.