bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating immunoreactive inhibin and testosterone levels in men with critical illness
Authors: Dong Qlhan , Hawker Felicity , McWilliam David , Bangah Mohan , Burger Henry , Handelsman David J. 
Published: March 2008

SUMMARY objective We aimed to concurrently characterize serial changes in circulating immunoreactive inhibin (IrlNH) and testosterone (T) as reflections of Sertoli and Leydig cell responses to acute critical illness in man design Blood samples were drawn within 24 hours of admission to an intensive Care Unit and at weekly intervals thereafter for up to 4 weeks while the patient remained in intensive Care Unit or after discharge to a general ward patients We studied 13 male subjects with critical illness requiring intensive therapy measurements Plasma levels of IrlNH, T, LH, FSH and sex hormone binding globulin (SHBG) were analysed in relation to (i) the severity of Illness as indicated by a sepsis score, acute physiology and chronic health evaluation score, and reverse triiodothyronine (rT3) levels and (ii) the outcome of illness as determined by discharge from intensive Care Unit and the two‐month mortality results Overall IrlNH levels remained normal and correlated negatively with rT3 (r=–0·63, P= 0·001) but not with sepsis, acute physiology and chronic health evaluation score, or gonadotrophin levels. Neither admission nor serial IrlNH levels significantly distinguished between the different clinical outcomes. In contrast, T levels were depressed and inversely correlated with both sepsis and acute physiology and chronic health evaluation scores (P > 0·02), and positively with gonadotrophips (P > 0·01), but not rT3 levels. Men eventually discharged from the intensive Care Unit showed a rise, while those remaining showed a fall, in T levels (P= 0·02, time–course interaction). Similarly, T levels were lower in patients who died than in survivors, despite the comparable T levels on admission (P= 0·02, time–course interaction). Despite the fall in T levels, gonadotrophin levels remained inappropriately in the eugonadal range but higher in men who were discharged from intensive Care Unit (P= 0·02, time–course interaction). FSH but not LH levels were correlated with sepsis score (P= 0·402) but not acute physiology and chronic health evaluation score or rT3. conclusions Sertoli cell function as judged by circulating IrlNH levels is much less affected by acute critical Illness than is Leydig cell function as judged by circulating T levels. The suppressive effect of acute critical Illness on Leydig cell function is consistent with a hypothalamicpitultary lesion
Abnormalities of intermediary metabolism following a gestational diabetic pregnancy
Authors: Chan S. P. , Gelding S. V. , McManus R. J. , Nlcholls J. S. D. , Anyaoku V. , Nlththyapanthan R. , Johnston D. G. , Dornhorst A. 
Published: March 2008

SUMMARY objective The aim of this study was to compare intermediary metabolism in glucose tolerant women with previous gestational diabetes and control women without a history of gestational diabetes subjects Fifteen women with previous gestational diabetes and 15 controls individually matched for race age and body mass index were included. Only subjects with normal glucose tolerance were included in this study methods Plasma glycerol, 3‐OH butyrate, non‐esterlfled fatty acids (NEFA), glucose and insulin were measured fasting and following a 75 g oral glucose load results The women with previous gestational diabetes and their matched controls were of similar racial origin, age and body mass index. There was no difference between those with previous gestational diabetes and controls in fasting glycerol, 3‐OH butyrate, NEFA, glucose or insulin concentrations. Following the oral glucose load, glycerol, 3‐OH butyrate and NEFA concentrations fell in both groups. However, compared with controls at 120 minutes, those with previous gestational diabetes had significantly higher concentrations of glycerol (median 57, range 24–216 vs 27, range 8–89 μmol/l, P > 0·005) and 3‐OH butyrate (9, range 1–18 vs 5, range 2–11 μmol/l, P > 0·01). NEFA concentrations were similar in the two groups. Despite similar glucose concentrations during the oral glucose tolerance test the insulin response during the first 60 minutes following oral glucose was significantly reduced in the subjects with previous gestational diabetes when compared with controls (Insulin area, 0–60 minutes; 2172, range 788–4767 vs 2830, range 996–4784 pmol mln/l, P > 0·05). conclusions Women with a previous history of gestatlonal diabetes, despite having normal glucose tolerance, have defective insulin release with resultant abnormalities of intermediary metabolism
The importance of adequate serum ferritin levels during oral cyproterone acetate and ethinyl oestradiol treatment of diffuse androgen‐dependent alopecia in women
Authors: Hugh Rushton D. , Ramsay Ian D. 
Published: March 2008

SUMMARY object To evaluate the treatment with cyproterone acetate and ethinyl oestradlol of diffuse androgen‐dependent alopecia in women design Twenty women were treated for a period of 12 months in a reverse sequential regimen employing cyproterone acetate (CPA, 50 mg once dally from Day 5 to Day 15) and ethinyl oestradlol (EE2, 30 μg once dally from Day 5 to Day 24 of the menstrual cycle), and 20 were left untreated and acted as controls. Half of each group had serum ferritin concentrations above or below 40 μg/I patients Forty Caucasian premenopausal women aged between 18 and 47 years, presenting with diffuse and rogen‐dependent alopecia, were enrolled into this study measurements Hair variables were assessed initially by the unit area trlchogram and again in the same sites 12 months later. Biochemical investigations were performed before treatment and after 3, 6, and 12 months results In the treated group, a significant (P > 0·01) mean increase in total hair density (hair/cm2) and meaningful hair density (non‐vellus hair/cm2) was found in patients in whom the serum ferritin was above, but not below 40 μ g/l. However, in the control group a significant (P > 0·05) mean decrease in total hair density and meaningful hair density was observed after 12 months. No correlation between serum ferritin levels and the degree of hair loss within this group could be established.conclusion Patients treated with the anti‐apdrogen cyproterone acetate and ethinyl oestradlol respond best when serum ferritin is above 40 μg/I
Hormonal management of prostate cancer
Authors: Wasan Harpreet S. , Waxman Jonathan 
Published: March 2008

SummaryIn advanced disease, androgen deprivation remains the usual treatment. The completion of current trials is awaited to confirm whether total androgen blockade will prolong survival. To make further advances in treatment the fundamental biology of the prostate cell, benign or malignant, and its relationship to endocrine manipulation, must be understood. This may then lead to an understanding of clonal escape mechanisms in transformed cells and the clinical correlate of escape, relapse.
Circadian changes in pulsatile TSH release in primary hypothyroidism
Authors: Adriaanse Ria , Brabant Georg , Prank Klaus , Endert Erik , Wiersinga Wilmar M. 
Published: March 2008

SummaryOBJECTIVE We evaluated pulsatile and circadian TSH secretion in primary hypothyroidism.DESIGN In a prospective study, blood was sampled every 10 minutes during 24 hours for assay of TSH (IRMA). Thyroid hormones and TSH responsiveness to TRH were then measured.SUBJECTS Nine patients with overt primary hypothyroidism, seven patients with subclinical hypothyroidism and 16 healthy controls.MEASUREMENTS Computer‐assisted analysis by the Desade and Cluster programs.RESULTS Both computer‐assisted programs revealed an increased TSH pulse amplitude in both overt and subclinical hypothyroidism versus controls (Desade: 36 9 ± 31 4 (mean ± SD)(P<0 001)and2 8 ± 1 9(P<0 001) vs0 4 ± 0 2 mU/l; Cluster: 25 6 ± 25 1 (P<0 001) and 24 ± 14 (P< 0 001) vs 0 4 ± 0 2 mU/l). TSH pulse frequency remained unchanged with approximately 10 pulses/24 hours. A highly significant correlation was found between the mean 24‐hour TSH concentration and the TSH pulse amplitude in all controls and patients but not to TSH pulse frequency. The nocturnal TSH surge was absent in six out of nine patients with overt primary hypothyroidism. The deficient nocturnal rise of TSH in primary hypothyroidism vs controls (22 ± 51 vs 82 ± 41%, P< 0 001), was associated with a loss of the usual nocturnal increase In TSH pulse amplitude and frequency.CONCLUSIONS Mean 24‐hour TSH pulse amplitude is increased in primary hypothyroidism, but TSH pulse frequency remains unchanged. The decrease of the nocturnal TSH increase in primary hypothyroidism is associated with a loss of the usual nocturnal increase in TSH pulse amplitude and frequency.
Dose‐dependent suppression of serum prolactin by cabergoline in hyperprolactinaemia: a placebo controlled, double blind, multicentre study
Authors: Webster J. , Piscitelli G. , Polli A. , D'Alberton A. , Falsetti L. , Ferrari C. , Fioretti P. , Giordano G. , L'Hermite M. , Ciccarelli E. , Crosignani P. G. , DeCecco L. , Fadini R. , Faglia G. , Flamigni F. , Tamburrano G. , Scanlon M. F. ,   (European multicentre cabergoline dose‐finding study group)
Published: March 2008

SummaryOBJECTIVE Dopamine agonists have a well established place in the treatment of hyperprolactinaemic disorders but their use is associated with a high incidence of adverse effects. We have investigated the biochemical efficacy and side‐effect profile of a range of doses of the novel, long‐acting dopamine agonist, cabergoline, in suppressing prolactin (PRL) in hyperprolactinaemic women.DESIGN Multicentre, prospective, randomized, placebo controlled and double blind.PATIENTS One hundred and eighty‐eight women with hyperprolactinaemia secondary to microprolactinoma (n= 113), idiopathic disease (n= 67), empty sella syndrome (n= 7) or following failed surgery for a macroprolactinoma (n= 1).MEASUREMENTS Weekly assessment of adverse symptoms, blood pressure and pulse, serum PRL, blood count, liver and renal function.RESULTS Patients received either placebo (n= 20) or cabergoline 0.125 (n= 43), 0.5 (n= 42), 0 75 (n= 42) or 10 mg (n= 41) twice weekly for 4 weeks. The five treatment groups were comparable in age (mean 31.8, range 16– 46 years), diagnosis, previous therapy, and pretreatment serum PRL. PRL was suppressed to below half the pretreatment level in 5,60,90,95 and 98% and normalized in 0, 30, 74, 74 and 95% of patients taking placebo or cabergoline 0.125, 0.5, 0.75 or 1.0 mg twice weekly respectively (Armitage's test, χ2= 39.3, P < 0.01). Cabergoline therapy (all doses) restored menses in 82% of the amenorrhoeic women not previously treated with dopamine agonists. Adverse events were recorded in 45% of patients in the placebo group and in 44, 50, 50 and 58% of those taking 0.125, 0.5, 0.75 and 1.0 mg cabergoline twice weekly (Armitage's test, P < 0.05). Over 95% of reported symptoms were relatively trivial, most frequently transient nausea, headache, dizziness, fatigue and constipation. More severe adverse events, interfering significantly with the patients’ lifestyle, occurred in 13 (7.7%) patients taking cabergoline; treatment withdrawal was necessary in only one case. No adverse effects were detected on blood pressure or haematological or biochemical parameters.CONCLUSIONS We have shown a linear dose‐response relationship for cabergoline in the treatment of hyperprolactinaemia in the range 0.125– 1.0 mg twice weekly, with normalization of PRL in up to 95% of cases and acceptable tolerability throughout the dose range.
Immunoreactive inhibin levels during ovarian stimulation may predict granulosa cell maturity
Authors: Buckler H. M. , Robertson W. R. , Sun J. G. , Morris I. D. 
Published: March 2008

SummaryOBJECTIVE The aim of the study was to assess whether the immunoreactive inhibin response to ovarian stimulation in polycystic ovarian syndrome was of predictive value for the outcome of ovulation induction.DESIGN Daily injections of purified FSH (Metrodin, Serono Laboratories, UK) were administered for the purpose of inducing development and ovulation of a single follicle.PATIENTS All patients had anovulatory infertility secondary to polycystic ovarian syndrome and were resistant to clomiphene citrate.MEASUREMENTS Alternate day serum samples were obtained for measurement of gonadotropins, sex steroids and inhibin by radioimmunoassay. Alternate day ovarian ultrasound scans were carried out to monitor follicular development.RESULTS There was a high incidence of multiple follicular development (MFD) (10.2 ± 7.1 (standard deviation) follicles). There was a close relationship between the number of follicles on the day of the ovulatory trigger and serum oestradiol (E2) levels (R= 0– 97, P < 0.001). This relationship was not seen with serum immunoreactive inhibin levels (R= 0.31). The cycles were divided into two groups depending whether there was or was not MFD (more than five follicles < 7 mm in diameter on day of hCG administration). The MFD group had 15.6 ± 8.5 follicles and the non‐MFD group 3.2 ± 1.6 follicles. There was no difference in the circulating E2 concentration (pmol/l) per follicle between the two groups (non‐MFD cycles, n= 6,345 ± 28.9; MFD cycles, n= 8, 308 ± 40.29). However, the immunoreactive inhibin concentration (U/ml) per follicle was lower, P < 0.001, in the MFD group (4.3 ± 1 6 vs 6.9 ± 0.5).The maximum and mean follicle diameter were lower, P < 0.01, in the MFD group (maximum follicle size 16.5 ± 3.9 vs 21.2 ± 1.5 mm, mean follicle size 11.5 ± 2 vs 14.9 ± 2.3). When individual cycles were examined E2 and immunoreactive inhibin secretion rose in parallel in cycles with less than five follicles with a rapid rise occurring when the follicles reached about 12 mm in diameter. In cycles where there was MFD there was a disparity between E2 and immunoreactive inhibin secretion with E2 levels rising 4.3 ± 1.4 days before immunoreactive inhibin levels.CONCLUSION These data suggest that in cycles where there are multiple small follicles, E2 secretion is maintained whereas immunoreactive inhibin secretion is substantially lower. Thus, in view of the disparity between E2 and immunoreactive inhibin secretion evident in the MFD group, measurement of immunoreactive serum inhibin concentration may be a better indicator of granulosa cell maturity. Immunoreactive inhibin secretion may occur only from healthy mature follicles.
Abnormalities of the hypothalamo‐pituitary‐gonadal axis after head injury
Authors: Clark John D. A. , Raggatt Peter R. , Edwards Owen M. 
Published: March 2008

OBJECTIVE We aimed to investigate the mechanisms of hypogonadism which develops after head Injury.DESIGN Pulsatile secretion of LH was studied in subjects 6–10 days after major head Injury.PATIENTS We studied five male subjects admitted with major head injuries and six healthy age‐matched control subjects.MEASUREMENTS During the pulsatility study, LH was measured at 5‐minute intervals for 4 hours and 15‐minute intervals for a further 2 hours. In addition, testosterone and LH were measured on Days 1–5, 14 and after 3–6 months.RESULTS The analysis of pulsatile secretion of LH demonstrated an LH pulse frequency similar to control subjects, but a significantly reduced LH pulse amplitude (P < 0.001, fixed threshold method; P<0.02, Detect method). Both testosterone and LH levels were reduced after injury with the nadir occurring on Day 4.CONCLUSIONS Hypogonadism after head Injury is due to defective LH secretion, with normal pulse frequency but a reduced pulse amplitude.
Follow‐up of ovarian endocrine function in premenopausal women after hysterectomy by daily measurements of salivary progesterone
Authors: Vuorento Taru , Mäenpää Juhanl , Huhtanleml Ilpo 
Published: March 2008

OBJECTIVE The effect of hysterectomy on ovarian endocrine function of premenopausal women was studied.DESIGN The patients collected dally salivary samples during one preoperative cycle (1), the cycle of operation (2), the subsequent period of 30 days (3) and the cycle 6 months after operation (4).PATIENTS Forty‐one premenopausal women (aged 33–48 years) undergoing hysterectomy were studied; their preoperative cycles served as controls. The patients were also compared with a reference group of 17 younger fertile women.MEASUREMENTS Salivary progesterone levels were measured by radiolmmunoassay.RESULTS Cycle 1 was more frequently short (P<0.01), with short luteal phase (P<0.01) and low progesterone secretion (P<0.05), than the cycles of younger women. Cycle 2 was longer than the other cycles (P<0.01), due to prolonged follicular phase (P < 0.01). Cycle 3 differed from cycle 1 by the lesser frequency of short cycles (P<0.01). Cycle 4 and its follicular phase were longer than those measured in cycle 1 (P<0.05). Of the women with normal cycle 1,39% (P<0.01) presented with luteal insufficiency (LPD, low luteal progesterone secretion) or anovulation (8%) in at least one of cycles 2 to 4. The frequency of LPD or anovulation was significantly higher in cycle 3 (P<0.05) but not in cycle 4, compared to 1.CONCLUSIONS Acute luteal progesterone deficiency after hysterectomy in premenopausal women is common but in most cases reversible.
Postprandial thermogenesis is reduced in polycystic ovary syndrome and is associated with increased insulin resistance
Authors: Robinson Stephen , Chan Slew‐Pheng , Spacey Slan , Anyaoku Victor , Johnston Deamond G. , Franks Stephen 
Published: March 2008

OBJECTIVE In order to investigate the possible causes and effects of obesity in polycystic ovary syndrome resting energy expenditure, postprandial thermogenesis and insulin resistance were measured in 14 polycystic ovary syndrome subjects and in 14 controls.DESIGN A cross‐sectional study of a selected group of patients was performed.PATIENTS Seven of the PCOS subjects were obese and seven lean. Controls were individually matched for age, race, weight, body mass index (BMI) lean body mass and percentage fat. The obese, but not lean, polycystic ovary syndrome subjects had a greater walst:hip ratio than controls (median (range) obese PCOS 0.865 (0.823–0.960) vs obese control 0.804 (0.823–0.940), P <0.025).MEASUREMENTS Metabolic rate was measured by continuous indirect calorimetry and insulin sensitivity was assessed by a short insulin tolerance test.RESULTS The resting energy expenditure (REE) was similar in PCOS subjects and controls (median (range), 6796 (5489–7774) vs 6833 (4893–8492) kJ/day). REE correlated with LBM in the PCOS group (r= 0.83, P <0.00) and the control group (r= 0.82, P <0.001). Postprandial thermogenesis was reduced in polycystic ovary syndrome (obese: median 45.4 (range 33.6–100.0) vs 86.5 (67.2–109.2) kJ (P <0.05); lean: 79.4 (73.5–108.4) vs 89.9 (76.0–109.2) kJ (P <0.05)). Fasting insulin (9.7 . 3.6 vs 4.4 . 0.8 mU/1, P <0.05) and postprandial incremental insulin rise (163 . 31 vs 116 . 15 mU/1, P <0.025) were higher in polycystic ovary syndrome. Insulin sensitivity was reduced in polycystic ovary syndrome (obese: median 136 (range 92–169) vs 173 (109–225) μmol/1/min (P <0.05); lean: 161 (138–225) vs 194 (161–253) μmol/1/min (P <0.05)). The reduction in insulin sensitivity correlated with the reduced postprandial thermogenesis in the polycystic ovary syndrome group (r= 0.75, P <0.01).CONCLUSION These results confirm previous reports of hyperinsulinaemia and insulin resistance in polycystic ovary syndrome. Furthermore, polycystic ovary syndrome subjects have a reduced postprandial thermogenesis which is related statistically to the reduced insulin sensitivity. The decreased postprandial thermogenesis may predispose women with polycystic ovary syndrome to weight gain.
Pulsatile growth hormone release in normal women during the menstrual cycle
Authors: Faria Amllton C. S. , Bekenstein Lori Waranch , Booth Robert A. , Vaccaro Veronica A. , Asplin Christopher M. , Veldhuls Johannes D. , Thorner Michael O. , Evans William S. 
Published: March 2008

OBJECTIVE We sought to characterize pulsatile growth hormone (GH) release in normal women during the menstrual cycle and to document possible relationships between such characteristics and concentrations of 17 β‐oestradiol and progesterone.SUBJECTS Fifteen women with ostensibly normal menstrual function were studied during the early folllcular phase, 15 during the late follicular phase and 15 during the mid‐luteal phase of the menstrual cycle.DESIGN The phase of the menstrual cycle having been documented, blood samples were obtained from each woman every 10 minutes for 24 hours.MEASUREMENTS Serum GH was measured in each sample by immunoradiometric assay. Pulsatile GH release was appraised utilizing the objective, statistically‐based pulse detection algorithm Cluster.RESULTS The mean (±SEM) integrated serum GH concentration (mU/l min) In late follicular phase women (5335 ± 848) was higher than that observed In early follicuolar phase women (3156 ± 322; P = 0.032). The integrated GH concentration calculated for mid‐luteal phase women (3853 ± 788) was intermediate between but not statistically different from that observed in early follicular (P= 048) and late follicular (P=0.14) phase women. No differences in GH pulse frequency (pulses/24 hours) were found among early follicular (8.27 ± 0.55), late follicular (7.93.0.91) or mid‐luteal (8.47 ± 0.66) phase women. Mean maximal GH pulse amplitude (mU/l) was higher in late follicular phase (8.93 ± 1.00) than early follicular phase (5.74 ± 067; P= 0008) and mid‐luteal phase (5.76 ± 0.74; P= 0.008) women. Similarly, Incremental GH pulse amplitude (mU/l) was higher in late follicular phase (7.33 ± 083) than early follicular phase (4.68 ± 0.58; P= 0.005) and mid‐luteal phase (4.36 ± 0.39; P= 0002) women. No differences In mean pulse widths or In the Interpeak valley mean GH concentrations were found among the groups. Multiple regression of each pulse parameter against serum concentrations of testosterone, 17β‐oestradiol and progesterone revealed a significant (P= 0.045) positive correlation between maximum GH pulse amplitude and oestradiol and a significant (P=0.04) negative correlation between maximal GH pulse amplitude and progesterone (r=0.41).CONCLUSION These results suggest that late follicular phase concentrations of oestradiol may enhance circulating GH via an amplitude‐modulated rather than a frequency‐modulated effect on the endogenous GH pulse. Progesterone may blunt this oestrogen‐associated effect, thus resulting in the observed mid‐luteal phase concentrations of GH. Whether these gonadal hormones act primarily at the hypothalamus and/or anterior pituitary gland remains to be clarified, but the present observations indicate that pulsatile GH release throughout the normal menstrual cycle is significantly amplitude regulated.
Cardiac conduction in patients with hypercalcaemia due to primary hyperparathyroidism
Authors: Rosenqvist Mårten , Nordenström Jörgen , Andersson Mats , Edhag Olof K. 
Published: March 2008

OBJECTIVE To assess whether hypercalcaemia due to primary hyperparathyroidism is associated with significant cardiac arrhythmias.DESIGN AND PARTICIPANTS The prevalence of cardiac arrhythmias and conduction disturbances was evaluated by 12‐lead ECG and 24‐hour long‐term ECG during presurgical hypercalcaemia and after post‐surgical normalization of serum calcium values in 20 patients with primary hyperparathyroidism.RESULTS After surgery, mean±SD calcium levels decreased from 2.85±0.1 to 2.40±0.1 mmol/l (P <0.001). There was a significant increase in QT‐intervals (0.36±0.05 vs 0.39 ± 0.05) and QTc‐intervals (0.38 ± 0.04 vs 0.42±0.03) after surgery (P <0.01). Long‐term ECG showed no change in the minimal heart rate 47 ± 8 vs 48 ± 7 beats/min or in the longest RR interval 1.6 ± 0.5 vs 1.6 ± 0.5 s (P NS). There was no difference in the prevalence of supraventricular or ventricular arrhythmias. No episode of high‐grade AV‐block was observed before surgery. Circadian heart rate rhythm did not change between investigations.CONCLUSIONS It is concluded that moderate hypercalcaemia, in spite of causing a shortening of the repolarization phase (QT‐interval), has no clinically significant effect on cardiac conduction.