bluuebunny/crossref_metadata_2025_split huggingface dataset:
The independent effects of polycystic ovary syndrome and obesity on serum concentrations of gonadotrophins and sex steroids in premenopausal women
Authors: Holte Jan , Bergh Torbjörn , Gennarelli Gianluca , Wide Leif 
Published: March 2008

SummaryOBJECTIVE To investigate the basal levels of gonadotrophins and sex steroids, with special reference to the effects of obesity and body fat distribution, In premenopausal women, both those with polycystic ovary syndrome (PCOS) and those with normal ovaries and regular menstrual cycles.DESIGN Cross‐sectional study. The separate effects of obesity (and body fat distribution and fasting Insulin levels) and PCOS on endocrine variables were evaluated by means of analysis of covariance.PATIENTS Sixty‐seven women with anovulatory menstrual cycles and polycystic ovaries according to ultrasonography and 59 women with normal ovaries and regular cycles, both groups covering a wide range of body mass index (BMI, PCOS, 17·6‐37·4, mean 25·7 kg/m2; controls, 18·8‐40·9, mean 25·1 kg/m2).MEASUREMENTS Serum levels of gonadotrophins, sex steroid hormones, prolactin and GH obtained in the early follicular phase in the controls, fasting insulin levels, anthropometric measures (BMI, skinfolds, waist hip ratio).RESULTS Mean serum concentrations of LH, andro‐stenedione, testosterone, the free androgen index (FAI; all P < 0·0001) and DHEAS (P < 0·01) were higher, and serum FSH (P < 0·01) and serum SHBG levels lower (P < 0·0001), in the PCOS group than in the controls. Women with PCOS had a more pronounced upper body fat distribution and higher fasting insulin levels than the controls. Independent of PCOS, BMI was positlvely associated with serum levels of FSH (P < 0·001) and negatively with levels of LH (P < 0·05), LH/FSH ratio (P < 0·0001), SHBG (P < 0·0001) and androstenedione (P < 0·01), whereas for levels of testosterone, FAI and DHEAS the impact of obesity differed significantly between the groups. Thus, in the PCOS group, testosterone levels (P < 0·05) and the FAI (P < 0·001) were positively associated with BMI, whereas they were constant throughout the entire range of BMI in the controls. DHEAS levels were positively associated with BMI in the PCOS group (P < 0·05) and negatively in the controls (P < 0·01). Measures of upper body fat were related to testosterone and FAI levels, independent of BMI.CONCLUSIONS Lower FSH levels were found in women with PCOS than during the early follicular phase of normally ovulating women, suggesting a role in anovulation in PCOS. Obesity itself exerted effects on endocrine variables, with the net result of a reduced LHIFSH ratio and lower serum levels of androstenedione and SHBG in both groups; obesity was associated with increased levels of DHEAS, testosterone and FAI exclusively in the women with PCOS. The results underline the endocrine impact of obesity and body fat distribution and the necessity of applying reference values of BMI matched subjects when establishing the endocrine profile of women with PCOS.
Evaluation of maternal serum immunoreactive inhibin as a first trimester marker of Down's syndrome
Authors: Wallace Euan M. , Harkness Linda M. , Burns Sheila , Liston William A. 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVE Maternal Serum immunoreactive inhibin has been shown to be significantly elevated in Down's affected pregnancies in the second trimester, suggesting that it may be useful in prenatal diagnosis. We have investigated whether it is similarly elevated in the first trimester.DESIGN Stored maternal sera from women with Down's affected pregnancies and chromosomally normal control pregnancies were retrieved for analysis. These sera had been collected prospectively at either 11 or 12 weeks gestation as a routine antenatal booking procedure.SUBJECTS From records, 11 women were identified as having had a Down's pregnancy. For each of these, 4 controls matched for gestation and duration‐of‐storage were also identified.MEASUREMENTS Two different inhibin immunoassays were evaluated, one using an antibody raised against 31 kDa bovine inhibin and the other, a commercial two‐site assay, using two antibodies directed against two distinct α‐subunit epitopes.RESULTS Neither assay detected a significant effect of gestation on serum inhibin levels. After combining the data from both gestations, no significant difference between the Down's samples and controls for either assay was detected. However, analysis of the data for each gestation separately revealed that one assay detected a significant difference in inhibln levels between Down's affected and unaffected pregnancies at 11 weeks gestation (mean ± SEM 3186 ± 195 vs 2020 ± 172ng/l, P < 0·01) but not at 12 weeks. The other, commercial, assay did not detect a significant difference at either gestation. In addition, there was poor association between the results of the two assays.CONCLUSIONS These data suggest that immunoreactive inhibin, as detected by these assays, will not be useful as a late first trimester marker for Down's syndrome and also that these two assays detect different inhibin species in pregnancy serum.
Treatment with GHRH(1‐29)NH2 in children with idiopathic short stature induces a sustained increase in growth velocity
Authors: Kirk J. M. W. , Trainer P. J. , Majrowskl W. H. , Murphy J. , Savage M. O. , Besser G. M. 
Published: March 2008

SummaryOBJECTIVE Therapy with GHRH in patients with mild GH insufficiency appears to be more effective than in those with severe insufficiency. We, therefore, studied the clinical response of children with idiopathic short stature to treatment with GHRH(1‐29)NH2 (GHRHa) for a period of 12 months.DESIGN Eighteen short pre‐pubertal children (aged 4·3‐11·0 years, 17 male) with idiopathic short stature (height < 3rd centile, peak GH to provocative testing > 20 mu/l) were recruited to receive GHRHa 20 μg/kg by twice daily s.c. injection for one year. One patient was non‐compliant and was withdrawn prior to 3 months of therapy. Pretreatment height velocity was calculated for 12 months and subjects were measured 3‐monthly during therapy. Overnight GH profiles and s.c. GHRH tests (20 μg/kg) were performed at 0, 3, 6 and 12 months of therapy. In addition, an i.v. GHRH test (1 μg/kg) was performed at the start and after 1 month of therapy.MEASUREMENTS Overnight GH profiles were analysed using the Pulsar program.RESULTS Mean (SD) height veloclty (HV) increased from 4·8(0·9)cm/year pre‐treatment to 7·2 (1·6)cm/year after 12 months of therapy (P= 0·001). The children growing slowly (HV < 25th centile) before treatment had a greater growth response than those growing normally (HV ≥25th centile) before treatment. Final height prediction increased by a mean (SD) of 3·4(2.6)cm. Overnight GH levels and GH responses to GHRH testing fell during the 12 months of therapy. Fasting blood glucose and insulin levels increased during therapy, as did IGF‐I. Cessation of GHRHa was followed by catch‐down growth during the first 3 months off therapy: mean (SD) HV 3·89(1·82)cm/year (P < 0·44), although the HV after 6 months (4·9(1·0)cm/year) and 12 months (4·4(1·0)cm/year) was not different from pretreatment values.CONCLUSIONS Short‐term therapy with twice‐daily s.c. injection of GHRHa (20 μg/kg) promoted linear growth in short children who were not GH‐insufficient. The improved height velocity was sustained throughout the 12 months of treatment, followed by catch‐down growth, and returned to pretreatment velocity after cessation of therapy.
Inverse correlation between insulin‐like growth factor binding protein‐I and insulin in patients with acromegaly during treatment with the somatostatin analogue octreotide
Authors: Fredstorp L. , Werner S. , Bang P. , Hall K. 
Published: March 2008

SummaryOBJECTIVE Previous reports have shown an inverse relation between IGFBP‐1 and Insulin levels In healthy men, patients with insulin dependent diabetes mellitus, and insulinoma. We have investigated whether this inverse relation also exists in acromegaly, before and during treatment with octreotide, and whether changes in IGFBP‐1 levels relate to OH and IGF‐I levels.DESIGN We studied short‐term treatment with octreotide in a double‐blind placebo‐controlled 14‐day clinical trial.PATIENTS Eighteen patients with acromegaly were studied.MEASUREMENTS Plasma GH and serum IGFBP‐1 levels were measured at hourly intervals from 0700 to 1800h before randomization (day 0) and on days 4, 6, 8,14 and 20. Serum insulin was determined at 0700, 0800 and 0900 h, and serum IGF‐I at 0700 h.RESULTS Octreotide increased the daily mean IGFBP‐1 level by 43% on day 8 and by 35% on day 14. The IGFBP‐1 levels during octreotide were significantly higher (P < 0·05) compared to placebo, 29·9 ± 3·9 vs 19·9 ± 1·7 μg/l (mean ± SEM) on day 8, and 28·3 ± 3·2 vs 19·.9 ± 1·6 μg/l on day 14. Octreotide treatment significantly suppressed the insulin levels on all observation days by 40–48% compared to placebo. There was a significant inverse correlation between IGFBP‐1 levels and insulin levels, both before treatment and on the last day of treatment (r= 0·79, P= 0·04; r=−0·90, P= 0·02, respectively). GH and IGF‐I were significantly decreased in the octreotide group compared to the placebo group during the entire treatment period. The mean of age related standard deviation scores of IGF‐I In the octreotide group decreased from a pretreatment value of 6·47 ± 0·74 to 3·60 ± 1·20 on day 14. There was no significant correlation between IGFBP‐1 levels and levels of GH and IGF‐I, either before or during treatment.CONCLUSIONS Octreotide treatment, in addition to reducing GH, IGF‐I and insulin levels, is associated with an Increase in IGFBP‐1 concentrations in patients with acromegaly, and it is suggested that the rise in serum IGFBP‐1 Is a consequence of the decrease In insulin secretion.
Endocrine profiles during administration of the new non‐steroidal anti‐androgen Casodex in prostate cancer
Authors: Verhelst J. , Denis L. , Van Vliet P. , Van Poppel H. , Braeckman J. , Van Cangh P. , Mattelaer J. , D'Hulster† O. , Mahler Ch. 
Published: March 2008

SummaryOBJECTIVE Casodex (Zeneca) is a new potent, long‐acting non‐steroidal anti‐androgen, which produces androgen deprivation by blocking the androgen receptor. We evaluated the endocrine effects of Casodex 150 mg daily given in monotherapy as primary treatment for patients with prostate cancer.DESIGN As part of a large, multicentre study comparing the therapeutic effects of surgical castration with 150 mg/day Casodex in monotherapy for patients with prostate cancer, a subgroup of 23 patients on Casodex were studied in detail for changes in endocrine parameters. Serum levels of LH, FSH, testosterone, DHT, oestradiol, prolactin, sex hormone binding globulin and free testosterone were measured at the start of therapy and after 1, 4,8,12 and 24 weeks. Effects on libido, sexual activity and the appearance of hot flushes, breast pain and gynaeco‐mastia were recorded.RESULTS Administration of Casodex resulted in a rise in LH levels in all patients with a mean increase after 24 weeks of 102% (P < 0·001). Mean FSH levels showed a limited increase (7%) after 24 weeks, which was significant only after 1 week (P < 0·001). As a result of the high LH levels, total testosterone levels increased after 24 weeks by 66% (P < 0·001), free testosterone by 57% (P < 0·001) and dihydrotestosterone by 24% (P= 0·0112). Parallel to testosterone, oestradiol levels rose by a mean of 66% (P < 0·001). Mean sex hormone binding globulin and prolactin levels rose by respectively 8% (P= NS) and 65% (P< 0·01).Despite an increase in testosterone levels, excellent androgen blockade was obtained, as shown by a decrease in prostate specific antigen levels in 22/23 patients. Libido was maintained in 8/11 patients, and sexual activity in 5/6. No patient complained of hot flushes. However, mild gynaecomastia and/or breast tenderness were seen in 48 and 30% of cases respectively.CONCLUSION Casodex 150 mg/day monotherapy resembles surgical castration in achieving androgen deprivation, despite an increase in LH and testosterone levels. In contrast to castration, libido and sexual activity are usually maintained and hot flushes are rare. However, mild gynaecomastia and/or breast tenderness were noted In 48 and 30% of patients.
Neonatal primary hyperparathyroidism masked by vitamin D deficiency
Authors: Meeran K. , Husain M. , Puccini M. , Scott H. , Dionisi‐Vici C. , Harvey D. R. , Lynn J. , Thakker R. V. 
Published: March 2008

SummaryNeonatal primary hyperparathyroidism is a life threatening disorder that is associated with severe hypercalcaemia, hypotonia, bone demineralization, fractures and respiratory distress. Treatment consists of total parathyroidectomy and without this affected infants will usually die by the age of three months. We report a patient with neonatal primary hyperparathyroidism who survived without fractures or parathyroidectomy to an age of nine months, and in whom the hypercalcaemia became masked by vitamin D deficiency. At surgery, four‐gland hyperplasia was demonstrated and total parathyroidectomy followed by oral calcitriol treatment has restored well‐being and normocalcaemia. An absence of skeletal complications, a survival beyond three months of age without parathyroidectomy and the masking of the hypercalcaemia by vitamin D deficiency represents a unique combination of metabolic abnormalities in a patient with neonatal primary hyperparathyroidism.
Intrapulmonary shunting causing hypoxaemia in a case of carcinoid syndrome
Authors: Hussain A. , Young E. T. , Greaves J. D. , Hammond P. J. , Hughes J. M. B. , Wallis S. C. , Bloom S. R. 
Published: March 2008

SummaryA case of metastatic carcinoid syndrome with hypoxaemia is described. The hypoxaemia appeared to be due to intrapulmonary shunting. There was Improvement in resting and exercise arterial oxygen saturations following chemotherapy with streptozotocin and 5‐fluorouracil. This was followed by a decrease in the tumour bulk which may have led to a reduction in the secretion of the vasodilator products responsible for shunting. Some features of this case suggest that the hypoxaemia might have been due to dilatation of precapillary and capillary vessels of the pulmonary micro‐circulation. These features are part of the so‐called ‘hepatopulmonary syndrome', of which this case appears to represent a less severe form.
Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules
Authors: Verde Giuseppe , Paplni Enrico , Pacella Claudio M. , Gallotti Cesare , Delpiano Sergio , Strada Sonia , Fabbrini Rossella , Bizzarrl Giancario , Rinaidi Roberta , Panunzi Ciaudio , Geili Darlo 
Published: March 2008

SummaryOBJECTIVE The management of cystic lesions in the thyroid remains controversial. We examined the efficacy and safety of ultrasound guided percutaneous ethanol injection for the treatment of benign cystic thyroid nodules in euthyroid patients.STUDY DESIGN (A) Preliminary randomized trial: 20 patients with predominantly cystic thyroid nodules were randomized in two groups and followed up for 1 month. Group 1 underwent fine needle aspiration of the fluid component of the nodules; Group 2 underwent percutaneous ethanol injection at the end of fine needle aspiration of the cyst fluid. (B) Prospective study: 32 patients with the same clinical characteristics (Group 3) were treated by fine needle aspiration and percutaneous ethanol injection, and followed up for 12 months.METHODS Groups 1 and 2: clinical evaluation, thyroid ultrasonography, thyroid scintiscan and serum thyroid hormone profile were performed before treatment and one month later. Group 3: clinical evaluation, thyroid ultrasonography and serum thyroid hormone profile were performed in basal conditions and 1, 3, 6, 9, 12 months after treatment. Thyroid scintiscan was performed before treatment and 3–6 months later.RESULTS (A) Randomized study: one month after treatment, nodule volume decrease in Group 2 was significantly higher than In Group 1 (Group 2 median 14·75 range 6–29·9 ml; Group 1: median 3·65 range 0·2–18·5 ml; P < 0·01). Nodule volume reduction was greater than 50% versus baseline in 8 (80%) patients in Group 2 and in 3 (30%) patients in Group 1 (P < 0·01). (B) Prospective study (Group 3): a significant nodule volume reduction (P < 0·01 vs pretreatment) was observed 1 and 12 months after percutaneous ethanol injection (pretreatment: median 14·5, range 1·5–65·8 ml; 1 month: median 3·5, range 0·4–38·9 ml; 12 months: median 2·5, range 0·4–34·5 ml). Nodule volume reduction greater than 50% was recorded in 24 (80%) patients. Groups 1–3: recurrence of cyst fluid was demonstrated by ultrasonography in 8 patients of Group 1, in 3 patients of Group 2 and in 1 patient of Group 3. No relevant adverse effects or significant biochemical changes were observed.CONCLUSIONS Ultrasound guided percutaneous ethanol injection of cystic thyroid nodules is a safe, low‐cost and effective therapeutic procedure in patients with benign thyroid cystic nodules. Indeed, nodule volume reduction was significantly greater and more frequent in patients treated by percutaneous ethanol Injection than in those patients who underwent fluid aspiration alone. These results were confirmed in a long‐term prospective trial and only one fluid recurrence was observed during 12 months of follow‐up.
Oral progestogen‐only contraception may protect against loss of bone mass in breast‐feeding women
Authors: Caird L. E. , Reid‐Thomas V. , Hannan W. J. , Gow S. , Glasier A. F. 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVES A worldwide trend towards increasing life expectancy has meant that osteoporosis is emerging as an important public health problem. The loss of bone mineral density and its restoration in association with a premenopausal but physiological hypo‐oestrogenic state may serve as an important model for research into the pathogenesis and prevention of osteoporosis. With this in mind we have undertaken a longitudinal study of changes in bone mineral density over one year in women after childbirth.DESIGN Observational study of 31 women in the first year following childbirth; 11 intending to breast‐feed and use barrier methods of contraception, 9 Intending to breastfeed and to use the progestogen‐only pill and 10 intending to artificially feed and to use barrier methods.PATIENTS Recruitment was from the antenatal clinics of the Simpson Memorial Maternity Pavilion. Only non‐smokers who had regular menstrual cycles prior to conception were included.MEASUREMENTS Bone mineral density was measured at the lumbar spine within 3 weeks of childbirth and repeated at 6 and 12 months post partum. Plasma oestradiol, prolactin and osteocalcin concentrations were measured at each visit.RESULTS Breast‐feeding women using barrier methods lost a mean ± SE of 4·9 ± 1·5% of bone mineral density In the first 6 months following delivery. This was however reversible since by one year the bone mineral density was no different from that measured immediately post partum. Breast‐feeding women using the progestogen‐only pill lost a significantly smaller percentage of bone mineral density in 6 months and by one year bone mineral density war 2·95 ± 0·75% higher than post partum. Artificially feeding women had a steady Increase in bone mineral density In the first year and bone mineral density was on average 4·3 ± 1·2% higher.CONCLUSION Breast‐feeding results in a reversible reduction in spinal bone mineral density. The small amounts of gestagen in the progesterone‐only pill would appear to protect against this loss. The mechanism of this loss in bone mineral density and the potentially bone protective effects of gestagens require further study.
Serotoninergic control of gonadotrophin and prolactin secretion in women
Authors: Ulrich Uwe , Nowara Ingrid , Rossmanith Winfried G. 
Published: March 2008

SummaryOBJECTIVE Due to conflicting observations from previous investigations, the role of serotonin (5‐HT) in the regulation of the human menstrual cycle has not been clearly established. We have therefore investigated the possible participation of 5‐HR in the control of gonadotrophin and PRL secretion in women, using the potent 5‐HT3 receptor antagonist ondansetron as a pharmacological probe.DESIGN Serum profiles of LH, FSH and PRL were obtained in 9 normally cycling women during a control and a treatment cycle, during which ondansetron (8 mg orally) was administered daily. On day 10 of both cycles, the serum pulsatility of LH, FSH and PRL was assessed by frequent blood sampling (at 10‐minute intervals for 10 hours). Pituitary responsiveness was tested by administration of a GnRH bolus (25 μg I.v. after 8 hours).MEASUREMENTS LH, FSH and PRL were serially determined in all blood samples by immunofluorescence assays. The resulting hormone data arrays were searched for significant fluctuations by the Cluster pulse algorithm.RESULTS Compared with control cycles, the temporal organization and the endocrine characteristics of the treatment cycles remained virtually unaltered. Serotonin antagonism did not noticeably affect the LH pulse attributes (frequencies, interpulse intervals, amplitudes). Although FSH amplitudes declined markedly (P < 0·05), the remaining pulse attributes were unchanged. A clear increase (P < 0·05) in the PRL pulse frequency was noted, while PRL pulse amplitudes tended to increase (P= 0·1). Gonadotrophin and PRL release in response to GnRH administration was unaltered by ondansetron treatment.CONCLUSIONS Serotoninergic blockade by a selective 5‐HT3 receptor antagonist failed to modify pulsatile LH secretion, but induced distinct changes in episodic FSH and PRL secretion. Since the pituitary gonadotrophin and PRL responsiveness remained unaltered during 5‐HT3 receptor blockade, the observed alterations in the FSH and PRL secretion presumably relate to altered hypo‐thalamic regulation of these pituitary hormones. Thus, the central regulation of pulsatile FSH and PRL release in women appears to involve 5‐HT3 receptor‐mediated processes.
Dissociation of adrenal androgen and cortisol secretion in Cushing's syndrome
Authors: Cunningham Sean K. , McKenna T. J. 
Published: March 2008

SummaryOBJECTIVES While ACTH may modulate adrenal androgen production, there is evidence that other factors are required. Cushing's disease and ectopic ACTH secretion provide a little utilized opportunity to examine adrenal androgen levels in conditions of ACTH excess. We have compared plasma cortisol values with plasma levels of androstenedione, dehydroeplandrosterone (DHEA), DHEA‐sulphate (DHEAS), testosterone and an Index of free testosterone, the testosterone/sex hormone binding globulin ratio, prior to treatment in patients with Cushing's syndrome.PATIENTS AND MEASUREMENTS Plasma from 15 adult patients with Cushing's disease and three adults with the ectopic ACTH syndrome was obtained prior to treatment and submitted to specific immunoassays for the measurement of the above steroids.RESULTS Plasma cortisol values of 15 patients with Cushing's disease (range 326–1140 nmol/l, normal range 190–690 nmol/l) were elevated in 9; In contrast, plasma androstenedione (4·1–11·3 nmol/l, normal range, men 2·1–7·7, women 3·3–9·9 nmol/l) was elevated in only two patients, plasma DHEAS (3·3–17·8 μmol/l, normal range, men 4·5–18·4, women 3·5–11·8 μmol/l) was elevated in only 4 patients and plasma DHEA (4·8–45·2 nmol/l, normal range 11–48 nmol/l) was normal or low in all 15 patients. Plasma androstenedione was markedly elevated (74 nmol/l) in one of three patients with ectopic ACTH syndrome, moderately elevated in another, and normal in the third patient. In contrast, plasma DHEA and DHEAS levels were suppressed in the patient with the highest androstenedione level and low or normal in the other two patients.CONCLUSIONS These data suggest that ACTH alone does not control adrenal androgen Secretion. The data also suggest that variability in the processing of proopiomelanocortin (the precursor of ACTH and related peptides) occurring in Cushing's disease and ectopic ACTH syndrome may account for differences in the relation of cortisol to androgens observed between the disorders and when compared to that in normal subjects.