bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prostate volume in testosterone‐treated and untreated hypogonadal men in comparison to age‐matched normal controls
Authors: Behre Hermann M. , Bohmeyer Jörg , Nieschlag Eberhard 
Published: September 2010

SummaryOBJECTIVE The potential use of testosterone preparations for substitution therapy for ageing men and for male contraception, In addition to the well established substitution therapy of male hypogonadism, make increased testosterone use likely. However, little clinical information is available on the effect of testosterone therapy on the prostate in hypogonadal men.DESIGN AND MEASUREMENTS In a controlled cross‐sectional study, prostate volume measured by transrectal ultrasonography, serum levels of prostate‐specific antigen (PSA) and sex hormones, and uroflow parameters were determined.PATIENTS Three groups of age‐matched men were enrolled in the study: 47 newly diagnosed hypogonadal men before testosterone treatment, 78 hypogonadal men with at least 6 months of effective testosterone therapy and 75 normal men.RESULTS Regression analysis revealed a significant positive correlation of prostate volume with age in normal men and testosterone‐treated hypogonadal men, whereas no significant correlation was detected in untreated hypogonadal men. Prostate volume was significantly lower in untreated hypogonadal men (12.2 (11.0–13.5) ml) (mean (95% confidence limits)) compared to both other groups. However, no significant difference in prostate volume was detected between testosterone‐treated hypogonadal men (21.3 (19.9–22.8) ml) and normal men (22.9 (21.4–24.4) ml). Similar results were obtained for PSA with comparable values in the testosterone‐treated hypogonadal men (0.98 (0.88–1.10) μg/l) and normal men (1.02 (0.91–1.14) μg/l), and significantly lower concentrations in the untreated hypogonadal men (0.64 (0.55–0.73) μg/l). No differences in uroflow parameters were detected between the three study groups.CONCLUSIONS Effective testosterone treatment of hypogonadal men results in prostate volume and prostate‐specific antigen levels comparable to age‐matched normal men. Therefore, testosterone‐induced prostate growth should not preclude hypogonadal men from testosterone substitution therapy.
The level of endothelin‐like immunoreactivity in seminal fluid correlates positively with semen volume and negatively with plasma gonadotrophin levels
Authors: Hammami Muhammad M. , Haq Afrozui , AlSedairy Sultan 
Published: September 2010

SummaryOBJECTIVE The newly discovered vasoactive peptides, endothelin 1, 2 and 3, and their receptors are widely distributed in various non‐vascular tissues. Recent studies have suggested the presence, as well as possible regulatory roles, of endothelins at several levels of the pituitary‐gonadal axis. We determined the level of endothelin‐like immunoreactivity in the seminal fluid and examined its possible correlation with routine semen parameters or plasma levels of FSH, LH or testosterone.DESIGN Prospective study in a tertiary care centre.PATIENTS Ninety‐one men attending infertility clinics for male factor, female factor or both.MEASUREMENTS Endothelin‐like immunoreactivity was determined in seminal fluid using two radioimunoassays, ET1–21 that measures endothelin and ET‐1,2 that measures both endothelin and big endothelin. In addition, the levels of FSH, LH and testosterone as well as routine semen parameters were determined.RESULTS Sperm density ranged from 0 to 315 times 108with a mean (±SD) of 28.5 times 108(±48 times 108) sperm/ml and the percentage of motile sperm ranged from 0 to 85% with a mean of 16% (±20.5%). Mean levels of FSH (n= 33), LH (n= 35) and testosterone (n= 35) were 6.4 ± 4.9 IU/I, 3.5 ± 2.8 IU/I and 21 ± 9.4 nmol/l, respectively. Mean ET1‐21 level (n= 91) was 81 ± 16.5 pmol/l, and mean ET‐1,2 level (n= 33) was 630.5 ± 143 pmol/l. There were significant correlations between the levels of ET1–21 and ET‐1,2 (r= 0.37,P= 0.04), ET1–21 and FSH (r= −0.5,P= 0.006), ET1–21 and LH (r= −0.46,P= 0.01), and ET1–21 level and semen volume (r= 0.23,P= 0.03). Mean level of ET1–21 or ET‐1,2 was significantly lower in patients treated empirically with clomiphene citrate or gonadotrophins (n= 34) compared to untreated (n= 52) patients (P= 0.04).CONCLUSIONS We conclude that in human seminal fluid (1) endothelin‐like immunoreactivity that is specific for active endothelin (ET1–21) represents about 13% of the total immunoreactivity; (2) inactive big endothelin or its N‐terminal derivative(s) may account for most of the immunoreactivity; (3) the production/secretion of endothelin may be inhibited by LH and/or FSH; and (4) endothelin level correlates positively with seminal fluid volume.
Metastatic thyroid cancer presenting as thyrotoxicosis: report of three cases
Authors: Kasagi K. , Takeuchi R. , Miyamoto S. , Misaki T. , Inoue D. , Shimazu A. , Mori T. , Konishi J. 
Published: September 2010

SummaryThree patients with metastatic thyroid follicular carcinoma developed thyrotoxicosis. Two had mild T3 toxicosis without detectable TSH binding inhibitor immunoglobulins (TBII) or thyroid stimulating antibodies (TSAb). Considerable concentration of 131***I by tumours occurred, although serum TSH was undetectable. The third patient developed thyrotoxicosis several months after treatment with 131I had commenced and this was associated with concurrent increase in both TBII (90%; normal, less than 11%) and TSAb (2100%). We conclude that thyrotoxicosis in patients with metastatic thyroid carcinoma may result from a large bulk of tumour functioning either autonomously or after stimulation by TSH receptor antibodies.
The clinical response to somatostatin analogues in acromegaly correlates to the somatostatin receptor subtype 2a protein expression of the adenoma
Authors: Fougner Stine L. , Borota Olivera Casar , Berg Jens Petter , Hald John K. , Ramm‐Pettersen Jon , Bollerslev Jens 
Published: September 2010

SummaryObjective  Reduced expression of the somatostatin receptor subtype 2 (SSTR2) has been suggested as an explanation for the poor response to octreotide in acromegaly, but studies correlating levels of SSTR2 mRNA to octreotide efficacy have been contradictory. Some studies have found better responses to somatostatin analogues in G‐protein α subunit (Gsα) mutation (gsp oncogene)‐positive adenomas. The aim of this study was to determine adenoma SSTR2a protein expression and gsp status in a large group of patients with acromegaly, and relate this to the clinical effect of octreotide.Patients  Seventy‐one patients were included. All underwent transsphenoidal surgery, 23 patients after preoperative octreotide treatment.Measurements  The adenoma SSTR2a expression was examined by immunohistochemistry and Western blot analysis, and gsp status determined. An acute octreotide test was performed, and the change in IGF‐1 level after 6 months preoperative octreotide treatment was recorded.Results  The acute octreotide response in non‐pretreated patients and the preoperative long‐term octreotide response were significantly better in patients with adenomas containing a large proportion of cells that stained positively for SSTR2a by immunohistochemistry. However, the SSTR2a protein level assessed by Western blot did not correlate with the octreotide response. The preoperatively treated group had lower SSTR2a protein levels and fewer adenomas with a large percentage of positively stained cells. The gsp oncogene was detected in 43% of the adenomas but did not correlate to the octreotide response.Conclusion  The clinical effect of octreotide correlates with the proportion of cells positive for SSTR2a in immunohistochemical staining, rather than the adenoma SSTR2a protein level. There may be a down‐regulation of SSTR2a during octreotide treatment.
A 12‐month randomized crossover study on the effects of Lanreotide Autogel and Octreotide long‐acting repeatable on GH and IGF‐l in patients with acromegaly
Authors: Andries Magdalene , Glintborg Dorte , Kvistborg Annette , Hagen Claus , Andersen Marianne 
Published: September 2010

SummaryBackground  Somatostatin analogues have been used successfully for the treatment of acromegaly but no randomized studies have compared the effects of lanreotide Autogel (LAN) and octreotide acetate long‐acting repeatable (OCT).Objective  To compare the effect of LAN and OCT for the treatment of acromegaly in a randomized study design.Material and methods  Twelve acromegalic patients were included and 10 patients completed treatment with LAN or OCT for 6 months and were then switched to the opposite treatment modality for 6 months without a washout period in a randomized crossover design. GH and IGF‐I profiles, clinical and biochemical evaluations were performed at 0, 4, 6, 10 and 12 months.Results  After 6 months of treatment, five patients had GH levels < 0·38 µg/l during both therapies. The remaining patients had GH levels > 0·38 µg/l during both LAN and OCT treatment. Four patients had normalized IGF‐I levels during both treatment regimes. Two patients on LAN and one on OCT had normalized IGF‐I levels during one treatment and not during the other. In three patients, IGF‐I levels were elevated during both therapies. Four patients developed palpable nodules, two patients on LAN and two patients on OCT. Gastrointestinal complaints were seen in three patients during both therapies, in three patients only during LAN, and in one patient only during OCT. Two patients were withdrawn from the study because of serious adverse effects during LAN. After the study period, four patients preferred LAN and six patients preferred OCT treatment.Conclusion  The effects of LAN and OCT therapy on GH and IGF‐I levels were comparable, but 3/10 patients had different treatment efficacies and 6/10 had different side‐effect profiles during the LAN and OCT treatment. These results indicate that a change from LAN to OCT or vice versa may be beneficial in some patients with treatment failure or side‐effects.
Pioglitazone (7·5 mg/day) added to flutamide–metformin in women with androgen excess: additional increments of visfatin and high molecular weight adiponectin
Authors: Ibáñez Lourdes , López‐Bermejo Abel , Díaz Marta , Enríquez Goya , Valls Carme , De Zegher Francis 
Published: September 2010

SummaryBackground and aim  Low‐dose pioglitazone (Pio), flutamide (Flu), metformin (Met) plus an oestro‐progestagen is a novel polytherapy lowering total and visceral adiposity, and reducing carotid intima media thickness (IMT) in hyperinsulinaemic women with androgen excess, without changing their body mass index (BMI). In a search for mediators of PioFluMet's actions, we measured serum levels of visfatin and high molecular weight (HMW) adiponectin.Design and patients  In a double‐blind study, we enrolled 38 young women with hyperinsulinaemic androgen excess [mean BMI: 23·7 kg/m2], all of whom started on Flu (62·5 mg/day), Met (850 mg/day) and a transdermal oestro‐progestagen, each for 21/28 days over 1 year. Patients were randomly assigned to receive, in addition, placebo (n = 19) or Pio (7·5 mg/day; n = 19) on the same 21/28 days.Measurements  Serum concentrations of visfatin and HMW adiponectin, visceral fat by magnetic resonance imaging, carotid IMT by ultrasound, all carried out during study start and after 1 year.Results  PioFluMet raised visfatin by a mean 84% and HMW adiponectin by 157% (P < 0·001), and reduced visceral fat and IMT by a mean 22% and 31% (both P < 0·001). Low‐dose Pio accounted for about half of the PioFluMet effects on IMT, visfatin and HMW adiponectin.Conclusion  In hyperinsulinaemic women with androgen excess, low‐dose polytherapy with PioFluMet evoked striking rises in both circulating visfatin and HMW adiponectin, while lowering IMT and reducing visceral adiposity within 1 year.
Kinetic epidemiological model for elucidating sexual difference of hypertension (KCIS no.20)
Authors: Yen Amy M.‐F. , Chen Tony H.‐H. 
Published: September 2010

AbstractBackground  Woman have lower rate of hypertension than man but it is still elusive how such gender difference can be explained by kinetic epidemiological curves.Objective  The aim of this paper was to develop a multi‐state model for delineating the kinetic epidemiology of hypertension according to the Seventh Report of the Joint National Committee (JNC 7) classification criteria by gender, and to derive gender‐specific kinetic curves.Methods  We used data from a population‐based screening programme with 42 027 participants to fit a four‐state Markov model corresponding to the classification of hypertension from the JNC 7.Results  The young man had higher progression rate but lower regression rate for the movement between normal and pre‐hypertension than the young woman. Such gender difference disappeared after 50 years old. The mean sojourn time of pre‐ and stage 1 hypertension for man and stage 1 for woman was approximately 5 years. However, the corresponding figure for pre‐hypertension for woman was 25 years at age 30, 10 years at age 40 and 5 years afterwards.Conclusion  Elucidating the kinetic epidemiological curves of hypertension explains higher prevalence rate in young man than woman. These findings fit with the role of sex hormones regulating blood pressure demonstrated in the animal model.
Out‐of‐hours demand in primary care: frequency, mode of contact and reasons for encounter in Switzerland
Authors: Huber Carola A. , Rosemann Thomas , Zoller Marco , Eichler Klaus , Senn Oliver 
Published: September 2010

AbstractRationale, aims and objectives To investigate the demand for traditional out‐of‐hours general practitioner (GP) emergency care in Switzerland including GPs' satisfaction and reasons for encounter (RFE).Method During a 2‐month period (2009), a questionnaire‐based, cross‐sectional study was performed in GPs participating in the mandatory out‐of‐hours service in the city of Zurich, Switzerland. The number and mode of patient contacts were assessed to investigate the demand for GP care in traditional out‐of‐hours services. GPs and patient characteristics, including RFE according to the International Classification of Primary Care, were noted. Descriptive statistics and non‐parametric tests were conducted.Results Out of the 295 out‐of‐hours episodes during the study period, 148 (50%) duty periods were documented by a total of 93 GPs (75% men) with a mean (SD) age of 48.0 (6.2) years. The median (interquartile range) number of out‐of‐hours contacts was 5 (3–8) and the demand for home visits was significantly more common compared with practice and telephone consultations. A total of 112 different RFEs were responsible for the 382 documented patient contacts with fever accounting for the most common complaint (13.9%). Although 80% of GPs agreed to be satisfied overall with their profession as primary care provider, 57.6% among them were dissatisfied with the current out‐of‐hours service. Inappropriate payment and interference with their daily work in practice were most frequently reported.Conclusions Our findings indicate that there is still strong patient demand for out‐of‐hours care with special need for home visits, suggesting that new organizational models such as integrating GPs into emergency care may not be an appropriate approach for all patients. Therefore, the ongoing reorganization of the out‐of‐hours‐service in many health care systems has to be evaluated carefully in order not to miss important patient needs.
Magnitude of effect of lithium in short‐term efficacy studies of moderate to severe manic episode
Authors: Storosum Jitschak G , Wohlfarth Tamar , Schene Aart , Elferink Andre , Van Zwieten Barbara J , Brink Wim van den 
Published: September 2010

Objectives:  To provide an accurate estimation of the magnitude of effect of lithium in short‐term efficacy studies conducted in patients with moderate to severe manic episode.Methods:  All placebo‐controlled randomized studies submitted to the Medicines Evaluation Board (MEB) in which lithium was used as the third study arm were selected for the meta‐analysis. The studies were part of registration files submitted to the MEB between the years 1997 and 2005. In addition, Medline and EMbase searches were conducted with the key words ‘manic’ (‘mania’ for the EMbase search) and ‘placebo’ in order to identify additional placebo‐controlled studies of lithium. This search was updated until March 1, 2006. Two effect size indicators were used based on the primary outcome measure of each study: Cohen's standardized effect size based on the difference in mean change from baseline, and numbers needed to treat (NNT) based on the difference in treatment response defined as ≥50% improvement from baseline on day 21.Results:  Six studies were identified. They involved a combined total of 470 patients in the lithium groups and 562 in the placebo groups. The overall standardized effect size was 0.40 [95% confidence interval (CI): 0.28, 0.53] and the overall NNT for response was 6 (95% CI: 4, 13). In the placebo groups response rates varied from 21% to 47%.Conclusions:  The results indicate that lithium is an effective drug in the treatment of moderate to severe manic episode. The variability in placebo response indicates that a placebo control arm in efficacy studies among patients with moderate to severe manic episode is necessary.
Cognitive impairment in later life in patients with early‐onset bipolar disorder
Authors: Tsai Shang‐Ying , Lee Hsin‐Chien , Chen Chiao‐Chicy , Huang Yi‐Lin 
Published: September 2010

Objectives:  Cognitive impairment may interfere with psychosocial functioning in bipolar disorder (BD). There is limited information regarding the cognitive function of elderly bipolar patients with onset at a young age. The present study aimed to investigate the frequency and the determinants of cognitive impairment in elderly early‐onset bipolar patients.Methods:  Using the Clock‐drawing Test (CDT), the Mini Mental State Examination (MMSE), and the Cognitive Abilities Screening Instrument (CASI), we examined euthymic patients with bipolar I disorder in Taiwan, aged 60 years and older. Clinical data were obtained by reviewing medical records and personal interviews with patients and their family members. The onset of BD prior to the age of 40 years is defined as ‘early‐onset’.Results:  Of the 52 early‐onset patients, 42.3% were determined to have cognitive impairment by exhibiting either abnormal CDT or education‐adjusted MMSE scores. In a multiple regression model, years of education and the age at the last manic/hypomanic (but not depressive) episode accounted for the greatest variance in both MMSE and CASI scores. While educational level and the age at the last manic/hypomanic episode were not considered in the regression model, onset with depressive syndrome and current age explained 21.5% of the variance in MMSE scores. Age at the first depressive episode, the first manic episode before the age of 40 years, and comorbid diabetes accounted for 16.7% of the variance in CASI scores.Conclusions:  There appeared to be a sizable proportion of elderly early‐onset bipolar patients having cognitive impairment. It is suggested that clinical manifestation of first‐onset affective episode and impact of medical comorbidity affect the cognition of early‐onset BD in later life.
Long‐term outcome of patients with bipolar disorder commenced on lithium prophylaxis during hospitalization: a complete 15‐year register‐based follow‐up
Authors: Licht Rasmus W , Vestergaard Per , Brodersen Arne 
Published: September 2010

Objectives:  From placebo‐controlled studies of up to two years duration, it has been established that lithium has preventive efficacy in bipolar disorder (BD). However, the effectiveness of lithium under routine conditions seems less pronounced. In the present study, the overall 15.3‐year outcome in BD patients commenced on lithium is described.Methods:  Ninety‐one patients with BD consecutively commenced on prophylactic lithium treatment during hospitalization at the Aarhus University Psychiatric Hospital from 1981 to 1983 were followed until death or censoring occurred during up to 15.3 years of observation. Register‐based outcome measures, available for all patients, included accumulated duration of admission and number of admissions. In addition, serious attempts were made to collect detailed information on treatment during follow up. Simple descriptive statistics were applied; potential independent associations between baseline variables and outcome were examined using logistic regression models.Results:  Of the 91 patients, 27 patients died (six from suicide) during the observation period, which was an excess mortality compared to the general population. Fifty percent of the patients were admitted for more than one month per 20 months of observation and admitted more than once for each four years of observation. Only 19 (21%) patients were not admitted to hospital during the observation period. No statistically significant predictors of poor outcome could be identified. In addition to lithium prophylaxis given for variable lengths of time, the majority of the 36 (40%) patients, from whom treatment data were available, received various other drug treatments during follow‐up.Conclusions:  The overall outcome in patients beginning prophylactic treatment is unsatisfactory. However, due to the observational design and the lack of detailed treatment information during the long follow‐up period, inferences about the efficacy of lithium cannot be made from this study.
Retrospective parent report of psychiatric histories: do checklists reveal specific prodromal indicators for postpubertal‐onset pediatric bipolar disorder?
Authors: Rucklidge Julia J 
Published: September 2010

Objectives:  This study retrospectively investigated the relationship between prodromal symptoms described in the literature for pediatric bipolar disorder (BD) and the diagnosis of BD by comparing adolescents with BD to those in control and attention‐deficit hyperactivity disorder (ADHD) groups.Methods:  Semi‐structured interviews [Schedule for Affective Disorders and Schizophrenia for School‐Age Children – Present and Lifetime version (K‐SADS‐PL) and Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH‐U‐KSADS)] and checklists (Conners’ Rating Scales and Child Behavior Checklist) identified participants (13–17 years) as either normal controls (NC; n = 28), ADHD (n = 29) or BD (n = 25). Bipolar disorder included BD I, BD II and BD not otherwise specified (NOS). Parents completed a widely used but unvalidated symptom checklist published by Papolos and Papolos (The Bipolar Child: the Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder) assessing across three developmental periods (preschool, latency, adolescence) for the presence/absence of psychiatric symptoms, many of which have been described in the literature as prodromal to the emergence of manic symptoms.Results:  While both clinical groups had more psychiatric symptoms than the NC group, more problems were reported in the ADHD group, most of which were symptoms seen as cardinal features of ADHD (e.g., being easily distracted, interrupting, having trouble concentrating). Differences were present by the latency period. Depressed mood was higher in the BD group during latency, and elated mood and fire‐setting were higher in the BD group during adolescence. Results were more similar when comparing adolescents with BD only versus those with both ADHD and BD. Frequency of symptoms was comparable regardless of whether or not there was a family history of BD. Frequency of symptoms was also similar across the BD subtypes.Conclusions:  Using retrospective parent report, a cluster of prodromal psychiatric symptoms specific to BD was not identified, which both questions the utility of a widely used yet unvalidated clinical scale and encourages caution when interpreting information collected via retrospective checklists. Although these data suggest that the presence of prodromal non‐specific psychiatric symptoms flags a more global risk for psychopathology, significant limitations exist when using retrospective report and, as such, further prospective research is required to investigate the progression of psychiatric symptoms across childhood disorders.