The clinical spectrum of parathyroid disease

Putting Stress in Historical Context: Why It Is Important That Being Stressed Out Was Not a Way to Be a Person 2,000 Years Ago

It was not until the middle of the twentieth century that scientists and Western societies began to label the combination of physiological and psychological responses that people display when things are getting too much and out of balance as “stress.” However, stress is commonly understood as a universal mechanism that exists across times and cultures. In a certain sense, this universality claim is correct: the physiological and endocrinological mechanisms underlying the stress response are not a modern invention of our body. In another sense, the universality claim is potentially problematic: stress has become, but has not always been, a way to be a person. That is, the social practices, in which the physiological and endocrinological stress mechanisms are embedded, are not the same across times and cultures. Crucially, these social practices are not a negligible by-product, but form an essential part of the way stress is commonly understood and experienced. Against this background, one may still decide to use the word “stress” when speaking about other times and cultures. Nevertheless, one should at least be cautious when doing so for three reasons. First, using the word “stress” when referring to societies different from our own may create the impression of a similarity between then and now, which does not actually exist. Second, it may blind us to the nature of the differences between times and cultures. Third, it naturalizes a contemporary scientific concept, which is more adequately viewed as the result of complex social, historical, and societal processes. Putting the stress concept in historical context and acknowledging that its use emerged in a specific historical environment enables us to take a step back and to think about the ways that stress shapes our lives. In other words, viewing stress as a culture-bound concept can give us the possibility to reflect upon our modern societies, in which the concept emerged.

Serum Levels of Parathyroid Hormone and Parathyroid‐related Peptide in Psoriasis

Psoriasis is a common skin disorder that may be triggered by hormonal disturbances, among other factors. Some studies have demonstrated an elevation of serum parathyroid hormone (PTH) levels in psoriasis and several other diseases of keratinization of unknown aetiology. PTH-related peptide (PTH-rp), on the other hand, is a potent inhibitor of epidermal cell growth factor and is not expressed in psoriatic skin. Serum levels of this peptide have not been reported in psoriasis. Immunoassay was used to measure serum PTH and PTH-rp in 22 patients with plaque-type psoriasis before and after treatment with mometasone furoate. Results were compared with a group of 20 healthy, non-psoriatic volunteers. Serum PTH levels were significantly elevated in the psoriatic group compared with the control group (p=0.001) and were significantly reduced after treatment (p=0.01). A correlation was found between pretreatment serum PTH levels and psoriasis area and severity scores (PASI) (r=0.42; p=0.01). In contrast, serum PTH-rp levels were not different between psoriatics and controls and were not affected by treatment. These findings indicate that serum PTH concentrations reflect disease activity in patients with psoriasis.