bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome
Authors: Kiddy Deborah S. , Hamilton‐Fairley Diana , Bush Anne , Short Frances , Anyaoku Vtctor , Reed Michael J. , Franks Stephen 
Published: March 2008

Summary objective Obese women with poiycystic ovary syndrome have a greater frequency of menstrual disturbance and of hirsutism than lean women with the syndrome. initial studies have demonstrated a marked improvement in endocrine function following a short‐term, very low calorie diet. The purpose of this study was to examine the effect of long‐term calorie restriction on clinical as well as biochemical abnormalities in obese women with polycystic ovary syndrome. design We performed a wlthin‐groupcomparison of ciinical and biochemical indices before and during dietary treatment. patients Twenty‐four obese women with polycystic ovary syndrome (mean weight 91·5 (SD 14·7) kg) were scheduled for treatment for 6–7 months with a 1000 kcal, low fat diet. Nineteen of the 24 had menstrual disturbances, 12 had infertility and 19 were hirsute. measurements and results Thirteen subjects lost more than 5% of their starting weight (range 5·9–22%). in this group there was no significant change in gonadotrophin or total serum testosterone levels but there was a marked increase in concentrations of sex hormonebinding globulin (pretreatment: 23·6 (9·5); post‐treatment 36·3 (11·8) nmol/l, P= 0·002) and a reciprocal change in free testosterone levels (77 (26) vs 53 (21) pmol/l, P= 0·009). These changes were accompanied by a reduction in fasting serum insulin levels (median (range) 11·2 (5·2–32) vs 2·3 (0·1–13·8) mU/l, P= 0·018) and the insulin response to 75 g oral glucose. There were no significant changes in these indices in the group who lost < 5% of their inltiai body weight.Of the 13 women who lost > 5% of their pretreatment weight, 11 had menstrual dysfunction. Amongst these women, nine of 11 showed an improvement in reproductive function, i.e. they either conceived (five) or experienced a more regular menstrual pattern. There was a reduction in hlrsutism in 40% of the women in this group. By contrast, in the group who lost less than 5% of their initial weight, only one of the eight with menstrual disturbances noted an improvement in reproductive function and none had a signtficant reduction in hirsutism. conclusions These data indicate that moderate weight loss during long‐term calorie restriction is associated with a marked clinical improvement which reflects the reduction in insulin concentrations and reciprocal changes in SHBG. The improvement in menstrual function and fertility may therefore be consequent upon an increase in insulin sensitivity which, directly or indirectly, affects ovarian function.
The desmopressin stimulation test in the differential diagnosis of Cushing's syndrome
Authors: Malerbi Domingos A. , Mendonça Berenice B. , Liberman Bernardo , Toledo Sergio P. A. , Corradini Maria Cristina M. , Cunha‐Neto Malebranche B. , Fragoso Maria Candida B. V. , Leo Wajchenberg Bernardo 
Published: March 2008

Summaryobjective We assessed the ability of desmopressin to stimulate the pituitary‐adrenal axis in patients with Cushing's syndrome.DESIGN AND SUBJECTS The Cortisol response to 5 or 10 fig of intravenous desmopressin was evaluated in 31 patients with Cushing's syndrome of several aetiologies and in 15 normal subjects.RESULTS Cortisol responses were observed in 15 out of 16 patients with pituitary dependence and in two patients with adrenal nodular hyperplasia, the increase above baseline ranging from 61 to 379% in the responders. Eight patients with adrenal tumours and one with the ectopic ACTH syndrome did not respond to desmopressin, having shown changes In their Cortisol levels from ‐5 to 42% above baseline. Responses occurred in two out of the 15 normal Individuals, whose Cortisol increased 58 and 69% above baseline, respectively. Stimulation tests with standard agents as lysine vasopressin or ovine corticotrophin‐releasing hormone were performed in the same patients and there was a high degree of concordance. No serious adverse reactions were observed in the tests with desmopressin.CONCLUSIONS Desmopressin was able to stimulate the pituitary‐adrenal axis in patients with Cushing's disease and, like corticotrophin releasing hormone, it may prove useful in the differential diagnosis of Cushing's syndrome.
Luteinizing hormone regulation by sex steroids in men with germinal and Leydig cell tumours
Authors: Reznlk Yves , Rleu Max , Kuhn Jean Marc , Mandard Jean Claude , Bottet Philippe , Lemonnier Didier , Bekka Said , Mahoudeau Jacques 
Published: March 2008

SummaryOBJECTIVE We examined the gonadotrophin secretion in patients with increased plasma concentrations of testosterone and oestradiol due to hCG‐producing tumours.DESIGN Comparison of plasma gonadotrophin concentrations before and after stimulation by GnRH, in eight men with hCG‐producing tumours resulting in Increased testosterone and oestradiol plasma levels, and In 29 men with Leydig cell tumours resulting in increased oestradiol and normal to low testosterone plasma levels.PATIENTS Eight men with hCG‐producing tumours (six with testicular tumours, two with extratesticular tumours), 29 men with Leydig cell tumours and 15 normal men. The six men with germinal cell tumours of the testis were studied before and after unilateral orchidectomy.MEASUREMENTS Plasma concentrations of hCG, testosterone and oestradiol were measured before and after intramuscular injection of hCG. LH and FSH were measured before and after intravenous Injection of 100 μg GnRH.RESULTS Plasma LH and FSH concentrations were low In patients with germ cell tumours, who exhibited increased plasma testosterone and oestradiol concentrations, and were normal in patients with Leydig cell tumours, in whom oestradiol only was increased. Plasma LH and FSH were normalized in the five patients with successful (e.g. normal hCG, testosterone and oestradiol) unilateral orchldectomy. Basal plasma testosterone concentrations correlated positively (P <001) with plasma oestradiol concentrations in patients with germ cell tumours and negatively (P <0 01) in patients with Leydig cell tumours.CONCLUSIONS In patients with hCG‐secreting germ cell tumours complete suppression of plasma LH and FSH with increased plasma concentrations of both testosterone and oestradiol are often discovered. No such gonadotrophin suppression is found In patients with Leydig cell tumours, but the negative correlation observed between plasma testosterone and oestradiol in these patients suggests a weak negative feedback effect of oestradiol on LH secretion, which cannot be demonstrated by basal LH measurements in plasma.
Localization of neuroendocrine tumours and insulinomas using radiolabeled somatostatin analogues, 123 I‐Try3‐octreotide and 111in‐pentatreitide
Authors: Ur E. , Bomanji J. , Mather S. J. , Britton K. E. , Wass J. A. H. , Grossman A. B. , Besser G. M. 
Published: March 2008

SummaryOBJECTIVE A number of neoplasms are known to express somatostatin receptors; the use of somatostatin receptor imaging in their localization has recently been described, but the resolution and discrimination of the isotopes used remains sub‐optimal. We have looked at the use of a new” In‐labelled analogue of somatostatin, pentatreotide, in the visualization and functional characterization of a number of neoplastic conditions.PATIENTS Thirteen patients with proven neoplasms were scanned using this agent. Planar and single‐photon‐emission computerized tomographic (SPECT) images of the relevant part of the body were obtained using a gamma‐camera at 10 minutes and 4 and 21 hours after injection of the radiopharmaceutical. In six patients (three carcinoid, three insulinomas) scanning was also performed using 123l‐Tyr‐3‐octreotide.RESULTS Primary tumours or metastases were visualized in six of the seven patients with neuroendocrine tumours, and three of six patients with insulinoma. One patient with an insulinoma who had a positive scan showed absent uptake when rescanned after tumour removal. A rise In blood glucose (more than twice basal) in response to octreotide was seen only in those insulinoma patients with positive scans. In cases where both 111ln‐pentatreotide and 123l‐Tyr‐3‐octreotide scans were performed, both radiopharmaceuticals identified the same 4/ 6 tumours; however, tumour definition (reflecting high tumour to background ratio) was better with pentatreotide on the 21‐hour images with minimum biliary and gut activity, allowing better resolution of the tumour image.CONCLUSION It appears that 111ln‐pentatreotide scintigraphy is a rapid and safe procedure for the visualization of neuroendocrine tumours possessing somatostatin binding sites. A positive scan may be predictive of neuroendocrine responsiveness to octreotide therapy. In addition, it also appears that1” In‐pentatreotide has superior kinetics compared to 123I‐Tyr‐3‐octreotide, typically achieving more satisfactory tumour to background ratios, and may thus be more useful in the localization of endocrine tumours.
A prospective randomized trial of levothyroxine suppressive therapy for solitary thyroid nodules
Authors: Papini E. , Bacci V. , Panunzi C. , Pacella C. M. , Fabbrini R. , Bizzarri G. , Petrucci L. , Giammarco V. , La Medica P. , Masala M. , Pitaro M. , Nardi F. 
Published: March 2008

SummaryOBJECTIVE We examined the effects of l‐thyroxine therapy versus placebo over a 12‐month period on volume of solitary thyroid nodules.DESIGN Prospective randomized clinical trial; placebo and control groups followed for one year in three centres.PATIENTS One hundred and one euthyroid patients with single palpable colloid thyroid nodules.MEASUREMENTS Serum thyroid hormones, TSH, thyroglobulin, anti‐thyroglobulin and anti‐thyroid peroxidase antibodies measured at the first visit and after 2, 6 and 12 months; nodule volume and contralateral thyroid lobe thickness measured by ultrasound in double blind fashion; nodule diameter measured by palpation every 6 months.RESULTS In the treatment group the nodule volume measured by ultrasound decreased progressively but not significantly; in the placebo group no changes were demonstrated. The number of nodules which decreased in size was however significantly larger in the treatment group. None of the initial parameters was predictive for the response. In the treatment group the nodule size assessed by palpation showed a significant decrease after 12 months when compared to baseline.CONCLUSIONS In non‐endemic areas TSH suppression induces nodule volume reduction measured by ultrasound which, although not significant, seems to be progressive and occurring only in a subgroup of patients. Sgnificant palpatory nodule reduction is probably related to decreased thickness of the surrounding thyroid tissue still responsive to TSH.
Growth hormone releasing hormone priming increases growth hormone secretion in patients with Cushing's syndrome
Authors: Leal‐Cerro Alfonso , Pumar Alfonso , Villamil Fernando , Astorga Ricardo , Dieguez Carlos , Casanueva Felipe F. 
Published: March 2008

SummaryOBJECTIVE In patients with Cushing's syndrome, decreased growth hormone (GH) secretion is observed though the basic mechanism is unknown. In states of chronic deficiency of hypothalamic growth hormone releasing hormone (GHRH) release, a blunted GH response to exogenous GHRH has been reported; such impairment can be partially normalized by repetitive GHRH administration (priming).In order to clarify whether a deficit in hypothalamic release of GHRH is the basis of the decreased GH secretion in patients with Cushing's syndrome, GHRH plus pyridostigmine tests were undertaken, both before and after GHRH priming.DESIGN GHRH (200 μg/day as a single s.c. injection) was given daily over 7 days. Two pyridostigmine (120 mg p.o.) plus GHRH (100 μg i.v.) tests were performed before and after priming to assess GH response.PATIENTS Eight patients (seven women, one man), with untreated Cushing's syndrome (six Cushing's disease, one autonomous bilateral adrenal hyperplasia, one adrenal adenoma), were studied.MEASUREMENTS Plasma GH levels were measured by immunoradiometric assay.RESULTS GHRH plus pyridostigmine‐induced GH release was impaired in patients with untreated Cushing's syndrome (mean peak 52 ± 14 mU/l, area under the curve (AUC) 472 ± 96). Repetitive administration of GHRH over 7 days partially restored the GH response to the second pyridostigmine‐GHRH test (mean peak 150±21 mU/l. AUC 1016±104), both P < 005.All of the eight Cushing's syndrome patients studied presented a higher GHRH plus pyridostigmine‐induced GH secretion after priming.CONCLUSIONS Repetitive administration of GHRH increases the pyridostigmine‐GHRH‐induced GH secretion in patients with Cushing's syndrome. This suggests that impaired hypothalamic release of GHRH is a contributing factor to the decreased GH secretion observed in chronic hypercortisolism.
Potentiation of the classic ovine corticotrophin releasing hormone stimulation test by the combined administration of small doses of lysine vasopressin
Authors: Favrod‐Coune C. , Raux‐Demay M. C. , Proeschel M. F. , Bertagna X. , Girard F. , Luton J. P. 
Published: March 2008

SummaryOBJECTIVE To assess the corticotrophic response to ovine corticotrophin releasing hormone (CRH) with the lowest dose of lysine vasopressin able to induce both the greatest stimulation and the lowest degree of side‐effects.SUBJECTS Fourteen healthy young adult males.DESIGN Increasing intravenous doses (either 0, 0.03, 0.1, 0.3, or 1 IU) of lysine vasopressin, infused over 20 minutes, combined with a bolus of 100 μg ovine CRH.MEASUREMENT Radioimmunoassay of plasma ACTH, lipotrophin hormones and Cortisol levels.RESULTS (1) Responses to stimulation tests were evaluated as the area under the curves of plasma levels versus sample times, from 0 to 120 minutes after injection or start of perfusion (six subjects). The lowest dose of lysine vasopressin that induced an additional stimulation in the CRH‐stimulated ACTH response was 0 3 IU. The combination of 1 IU lysine vasopressin with CRH doubled values of the area under the curve for the ACTH. Lysine vasopressin alone (0 3 and 1 IU) failed to stimulate ACTH responses. (2) The combined test (100 μg CRH and 1 IU lysine vasopressin) was carried out on eight additional control subjects. From a mean basal level of 23 ± 5.6 (SEM), plasma ACTH peaked to 104.5±8 ng/l (23.0 ± 1.8 pmol/l) as early as 20–30 minutes after the start of injection. When repeated after a two‐week interval, the combined test induced identical stimulation in a given subject. Results of lipotrophin hormone determinations roughly paralleled those of ACTH. However the effects on Cortisol levels were less clear. Subjects injected with CRH experienced slight facial flush. Following the 1 IU lysine vasopressin dosage, side‐effects were reduced to skin pallor. No changes in heart‐rate or blood‐pressure were observed.CONCLUSIONS Under these conditions, the combination of 100 μg CRH with 1 lU lysine vasopressin constitutes a powerful test for direct assessment of the pituitary reserve and therefore can be employed as a routine investigational tool.
Prenatal diagnosis of congenital adrenal hyperplasia by direct detection of mutations in the steroid 21‐hydroxylase gene
Authors: Rumsby G. , Honour J. W. , Rodeck C. 
Published: March 2008

SummaryOBJECTIVE Our aim was to develop a rapid and accurate method for the prenatal diagnosis of congenital adrenal hyperplasia using the polymerase chain reaction to detect mutations in the steroid 21‐hydroxylase gene. These procedures will help to minimize exposure to dexametha‐sone treatment of either affected males or unaffected females.DESIGN AND PATIENTS Chorionic villus biopsy samples were obtained between 10 and 11 weeks gestation from three females carrying fetuses at risk of steroid 21‐hydroxylase deficiency. Blood samples were taken from parents and the index case in each family.MEASUREMENTS Three common mutations in the 21‐hydroxylase B gene were detected following DNA amplification.RESULTS Prenatal diagnosis of congenital adrenal hyperplasia was successful in all three cases. One affected female was treated with dexamethasone to term. In the other two cases, one affected male and one carrier also male, dexamethasone was withdrawn at an early stage.CONCLUSIONS First trimester prenatal diagnosis of steroid 21‐hydroxylase deficiency was achieved in three pregnancies with a strategy based on direct detection of gene mutations.
The effects of growth hormone on protein metabolism in adult growth hormone deficient patients
Authors: Russell‐Jones D. L. , Weissberger A. J. , Bowes S. B. , Kelly J. M. , Thomason M. , Umpleby A. M. , Jones R. H. , Sönksen P. H. 
Published: March 2008

SummaryOBJECTIVE Growth hormone treatment given to adult growth hormone deficient patients leads to an increase in lean body mass by an unknown mechanism. The aim of this study was to investigate the actions of growth hormone treatment on protein metabolism in adult growth hormone deficient patients.DESIGN Double‐blind, placebo controlled trial of recombinant human growth hormone (0 018 U/kg/day for 1 month followed by 0.036 U/kg/day for 1 month) with isotopic whole body protein turnover studies at 0 and 2 months.PATIENTS Eighteen adult growth hormone deficient patients (nine male, nine female of mean age 46.6 (range 30–56).MEASUREMENTS Whole body isotopic leucine turnover using L‐1‐13C‐leucine measuring leucine R a (a measure of protein degradation), non‐oxidative leucine R d (a measure of protein synthesis) and leucine oxidation rate.RESULTS Lean body mass (P<0.02), circulating insulinlike growth factor I (P<0 01) and insulin (P<0.02) were significantly increased at 2 months in the treatment group but there was no change in the placebo group. When expressed in relation to body weight, leucine fia and non‐oxidative leucine fid increased (P<0.01) and leucine oxidation decreased (P<0.02) after 2 months growth hormone treatment. When expressed in relation to lean body mass non‐oxidative leucine R d increased (P<0.02) and leucine oxidation decreased (P<0.02) but there was no significant change in leucine R a after 2 months growth hormone treatment. In the placebo group there were no significant changes in leucine metabolism expressed as lean body mass or body weight after 2 months. changes in leucine metabolism expressed as lean body mass or body weight after 2 months.CONCLUSION These results indicate that the increase in lean body mass resulting from growth hormone treatment in adult growth hormone deficient patients is due to an increase in protein synthesis.
Coincidental occurrence of primary hyperparathyroidism and cancer‐associated hypercalcaemia in a middle‐aged man
Authors: Gallacher S. J. , Fraser W. D. , Farquharson M. A. , Logue F. C. , McArdle C. , Boyle I. T. , Nairn E. R. , McNicol A. M. 
Published: March 2008

SummaryPrimary hyperparathyroidism (PHPT) is found not uncommonly in patients with cancer. In this report, however, we describe a patient where both humoral hypercalcaemia of malignancy and PHPT were present coincidentally.A 47‐year‐old man was found to have PHPT due to parathyroid hyperplasia. Serum parathyroid hormone (PTH) levels, which were elevated before parathyroidectomy, were undetectable post‐operatively; however, hypercalcaemia persisted. Nephrogenous cyclic adenosine monophosphate was elevated along with this undetectable PTH, indicative of the presence of a PTH‐like factor in the serum. This was confirmed by the finding of an elevated level of PTH‐related protein (PTHr P) in plasma (91 pmol/l, normal <2.6 pmoI/I). Secondary carcinoma was identified in a lesion in the region of the manubrium sternii. This stained positively for PTHr P by immunocyto‐chemistry and PTHr P messenger RNA was detected by insitu hybridization.This case illustrates the value of sensitive PTH assays in distinguishing PHPT from other causes of hypercalcaemia and also shows the importance of considering primary hyperparathyroidism in the differential diagnosis of the patient with cancer and hypercalcaemia.
Endemic juvenile hypothyroidism in a severe endemic goitre area of Sudan
Authors: Moreno‐Reyes Rodrigo , Boelaert Marleen , El Badawi Salah , Eltom Mohamed , Vanderpas Jean B. 
Published: March 2008

SummaryOBJECTIVE The aim of the study was to assess thyroid function, Iodine Intake and exposure to dietary goitrogens of children living in an area with a high prevalence of goitre, in the region of Darfur, Sudan.DESIGN In a village where goitre affected approximately 85% of children, a cross‐sectional survey of thyroid function was performed in children 0–7 years old.PATIENTS Twenty neonates and 190 children, aged 1 month to 7 years, were included.measurements Thyroid hormones, urinary iodide and thiocyanate excretion were measured.RESULTS MeanSD serum T4 was below the normal range at birth (82 ± 50 nmol/l) and in the age group less than 2 years (73·46). Children older than 2 years had even lower serum 14: 37·37 (P >0 001) at 3–4 years and 36·38 (P >0 001) at 5–7 years. Mean serum TSH was 25 8(6 2–107 7) mU/I at birth, 8.3(2. 5–27. 8) In the group less than 2 years, 15. 3(2.9–79.1) at 3–4 years and 16. 4(2.7–98.3) at 5–7 years. The overall prevalence of hypothyroidism (TSH>50 mU/I) was 24%. Mean urinary thiocyanate was high at birth(107·69 pmol/l), normal in the group less than 2 years and higher in children older than 2 years (126·69 pmol/l) (P > 0.001). All age groups had a low urinary iodide concentration.CONCLUSION Hypothyroidism was very frequent in each age group. The higher frequency of hypothyroidism observed in weaned children (< 2 years) was attributed to the combined effects of Iodine deficiency and goitrogens (thiocyanate and glycosylflavones) derived from millet.
Adjunctive cholestyramine therapy for thyrotoxicosis*
Authors: Solomon Barbara L. , Wartofsky Leonard , Burman Kenneth D. 
Published: March 2008

SummaryOBJECTIVE Initial therapy of thyrotoxicosis usually includes beta‐blockade for symptom relief and thionamides to block new thyroid hormone synthesis. In view of the increased enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) in thyrotoxicosis, we proposed that cholestyramine, an anion exchange resin which binds iodothyronines, when used adjunctively with thionamides and a beta‐blocker, would lower serum iodothyronine levels faster than would standard therapy alone.DESIGN A double blind placebo‐controlled cross‐over design was used with patients randomly assigned to either the treatment or control groups. They received their initial treatment for two weeks (Phase 1) followed by a one‐week washout period, and then crossed to the opposite treatment for two weeks (Phase 2). Standard therapy included atenolol 50 mg daily, individualized dosages of methimazole and either 4 g of cholestyramine or 4 g of placebo powder four times per day.PATlENTS Fifteen patients with thyrotoxicosis (14 Graves' disease, 1 toxic adenoma) participated in this study.MEASUREMENTS Total and free thyroxine and triiodothyronine, as well as thyroid‐stimulating immunoglobulin and thyrotrophin‐binding inhibitory immunoglobulin, were measured weekly.RESULTS Seven patients received cholestyramine and eight patients received placebo during Phase 1. A more rapid decline in all thyroid hormone levels was seen in the cholestyramine‐treated group (F= 4–7, P >0.01) than in the placebo group (F= 2–3.1, P= 0 05).In Phase 2, the eight patients who received cholestyramine showed an additional decline in free thyroxine from weeks one to two, but the overall rate of decline in hormone levels was not different between the groups. Immunoglobulin levels remained unaffected regardless of group, treatment, or time.CONCLUSIONS We conclude that cholestyramine is a safe and effective adjunctive agent in the treatment of thyrotoxicosis and that its greatest efficacy may be during the first few weeks of treatment.