bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the desire for long‐term growth hormone replacement in adults
Authors: Holmes Sarah J. , Shalet Stephen M. 
Published: March 2008

SummaryOBJECTIVE Growth hormone replacement In adults may be considered beneficial by clinicians, but patients may not perceive any benefits. The purpose of this study was to determine whether there were any factors which Influenced whether an adult wished to continue on long‐term GH replacement after taking part In a study of GH replacement.DESIGN A 12‐month study (double‐blind placebo controlled for the first 6 months and open for the second 6 months) of GH replacement (0.125 IU/kg/week for the first month and 0.25 IU/kg/week thereafter) In adults.PATIENTS Sixty‐three adults (27 men, 36 women, aged 34.9 ±1.4 (mean ± SE, range 20.1‐59.5) years) with GH deficiency (peak serum GH response to provocative testing less than 10mU/I) who entered a 12‐month study of GH replacement. Thirty patients (48%) wished to continue on GH replacement and 33 patients (52%) did not wish to continue on GH replacement after the study.MEASUREMENTS Biochemical, anthropometric and demographic characteristics, and well‐being, were compared In those patients who wished to continue on long‐term GH replacement and in those who did not. In the two groups of patients the age, height, weight, body mass Index, serum insulin‐like growth factor (IGF)‐I, IGF binding protein (IGFBP)‐3 and IGF‐I age matched standard deviation score (SDS) were compared at entry Into the study, and changes In IGF‐I, IGFBP‐3 and IGF‐I SDS were compared after 6 months of GH replacement. The patients were compared according to pretreatment peak serum GH response to provocative testing, sex, estimated duration of GH deficiency, whether GH deficiency was of childhood or adult onset, presence or absence of additional pituitary hormone deficiencies, underlying pathological disorder, previous therapeutic Interventions, employment status, marital status and living arrangement, and according to development of side‐effects of GH replacement and the requirement for reduction In dose of GH because of side‐effects during the study. Scores on two questionnaire measures of well‐being or distress, the Nottingham Health Profile (NHP) and the Psychological General Weil‐Being Schedule (PGWBS), were compared at entry Into the study In the two groups, as were change in scores on these questionnaires after 6 months of GH replacement.RESULTS Those who continued on GH replacement tended to have a greater severity of GH deficiency (median peak serum GH concentration 0.7 vs 2.3mU/I, P = 0.06), tended to have greater distress in terms of energy (NHP, P= 0.06) and vitality (PGWBS, P= 0.06) at entry Into the study and showed an improvement In energy during the study compared with no change In those who did not wish to continue on GH replacement (NHP, P= 0 06).CONCLUSION Those adults who wished to continue on GH replacement tended to have a greater severity of GH deficiency, to experience more distress in terms of energy and vitality at entry into the study and to experience an improvement in energy after 6 months treatment with GH.
Effect of haemoglobin and endogenous erythropoietin on hypothalamic‐pituitary thyroidal and gonadal secretion: an analysis of anaemic (high EPO) and polycythaemic (low EPO) patients
Authors: Ramirez German , Bittle Polly A. , Rabb Hamid A. , Ballester Oscar , Bercu Barry B. 
Published: March 2008

SummaryOBJECTIVE Correction of anaemia with recombinant human erythropoietin (rHu‐EPO) Improves the responsiveness of thyroidal and gonadal axes to exogenous TRH and GnRH In chronic haemodialysis patients, but the mechanisms remain to be fully elucidated. In order to assess the Influences of endogenous erythropoietin on the hypothalamo‐hypophyseal thyroidal and gonadal axes, we studied the response of polycythaemic and anaemic patients, In comparison to normal controls, after the administration of exogenous TRH and GnRH.DESIGN Exogenous hypothalamic factors, 500μg TRH and 100μg GnRH, were administered as a bolus and blood samples were obtained over a 3‐hour period at 30, 60, 90, 120 and 180 minutes.PATIENTS Five male polycythaemic patients (low EPO), three male anaemic patients (high EPO) and six normal age and sex matched controls were studied.MEASUREMENTS Blood samples were centrifuged Immediately and the serum was stored at −20°C until assayed for total T4, free T4, free T3, TSH, prolactin, growth hormone (TRH test), and FSH, LH, testosterone (GnRH test). Haematological parameters and biochemical profiles were also measured.RESULTS After TRH administration, both patient groups showed a normal TSH response; however, their free T4 and free T3 secretion was blunted compared to controls. Normal basal PRL levels Increased in an exaggerated fashion, whereas, when compared to chronic renal failure patients on chronic haemodialysls, we did not see a paradoxical GH response or a basal GH Increase in these 5 patients. GnRH administration In the study groups elicited a normalization In the LH response without an increase in testosterone levels; however, an exaggerated FSH response was found in the polycythaemic patients (low EPO)CONCLUSIONS Thus by Investigating the role of low endogenous EPO levels In non‐anaemic and anaemic patients with high EPO levels, our study suggests that the underlying chronic disease state may be the major contributing factor in the regulation of the hypothalamo‐hypophyseal thyroid and gonadal axes, rather than the EPO levels.
Impaired social status of growth hormone deficient adults as compared to controls with short or normal stature
Authors: Rikken Berthon , van Busschbach Jan , le Cessle Saskla , Mantenf Wendy , Spermon Tamara , Grobbee Rick , Wit Jan‐Maarten ,   the Dutch Growth Hormone Working Group
Published: March 2008

SummaryOBJECTIVES In adults with growth hormone deficiency (GHD) social problems have been reported, but so far the relative contributions of GHD, additional pituitary deficiencies and short stature have not been distinguished.We therefore compared social data from GHD patients with social data from controls with short or normal stature. Furthermore we Investigated whether social problems are caused solely by the deficiency of GH or also by the associated absence of other pituitary hormones.DESIGN A questionnaire was sent to patients and controls with Items on education, profession, Income, partner and living situation.PATIENTS Two hundred and ten GHD patients treated In childhood but not In adulthood with GH (93 Isolated GHD (IGHD), 111 patients with multiple pituitary deficiency (MPD)) were compared with 53 short controls (height In childhood < third percentile for population) and 39 normal stature controls.RESULTS There were no differences between short and normal controls. There were also no differences between IGHD and MPD patients In any of the Investigated Items. GHD patients did not differ from controls on education level, but scored lower on the profession scale, had a lower Income and had a partner less often; If they had a partner they less often had children; also, more of them lived with their parents.CONCLUSION Since patients with multiple pituitary deficiency did not differ from patients with Isolated growth hormone deficiency, this suggests that the lower scores on the social parameters are the result of the growth hormone deficiency Itself. Since short stature controls had higher scores than patients with growth hormone deficiency and did not differ from normal stature controls in any of the aspects Investigated, It seems unlikely that the problems of the patients with growth hormone deficiency can be attributed to short stature.
Glycosylated and non‐glycosylated prolactin forms are increased after opioid administration as part of surgical anaesthesia
Authors: Priou A. , Bruder N. , Bégou D. , Morange I. , Grazianl N. , Grisoll F. , Brue T. 
Published: March 2008

SummaryOBJECTIVE Previous studies have shown that non‐glycosylated prolactin (NG‐PRL) Increased more markedly than glycosylated hormone (G‐PRL) after TRH or metoclopramlde stimulation. The aim of the present study was to determine whether such results could be extended to oplold‐lnduced PRL stimulation.DESIGN Open and prospective study. Using a newly developed IRMA specific for NG‐PRL, we determined G‐PRL and NG‐PRL immunoreactivities after administration of 0.8‐1.2 mg of the opioid drug phenoperidlne as part of an anaesthesia.PATIENTS Ten male patients anaesthetized for surgical treatment of a prolapsed lumbar intervertebral disc.MEASUREMENTS Samples were obtained hourly pre and post‐operatively, and every 15 minutes during operation for determination of plasma PRL, NG‐PRL and G‐PRL. Plasma Cortisol, ACTH and GH levels were measured in an attempt to differentiate the respective roles of stress and opiate agonists In the variations of PRL levels during surgery.RESULTS A dramatic Increase in PRL levels was observed In all patients from an average of 300 ± 90 to 1200 ± 330 μ/l (mean + SEM) 30 minutes after drug administration. The proportion of G‐PRL immunoreactivity was not significantly different when basal (25‐2%) and stimulated (27%) values were compared (P> 0.05), and when mean increments of NG‐PRL and G‐PRL were compared (345 and 348%, respectively). The opioid drug induced a significant decrease In Cortisol levels after injection and during operation (from 585 ± 63 to 99 ±51nmol/l) with a concomitant decrease In ACTH levels. GH levels were not significantly altered during anaesthesia but were significantly greater (P < 0–05) after than before surgery (5–0 ±1.3 vs 0.98 ± 0.54 mU/l, respectively).CONCLUSIONS We conclude from the present and from previous data that opioid induced anaesthesia is accompanied by an increase In both glycosylated and non‐glycosylated PRL and that different PRL secreta‐gogues may Induce distinct responses In terms of PRL molecular forms.
Familial hyperparathyroidism associated with jaw fibroma: case report and literature review
Authors: Inoue Hiroyuki , Miki Hitoshi , Oshimo Kazushi , Tanaka Katuhiro , Monden Yasumasa , Yamamoto Akihiro , Kagawa Susumu , Sano Nobuya , Hayashi Eijl , Nagayama Masaru , Hayashi Yoshio 
Published: March 2008

SummaryA 53‐year‐old female suliering from renal stones and hypercalcaemia was diagnosed as having primary hyperparathyroidism caused by hyperplasia of the parathyroid glands. She underwent total parathyroidectomy and implantation of parathyroid tissue. After one year, she underwent surgery for a jaw tumour. The pathological findings indicated it to be a cementifying fibroma. Jackson et al. (1990) reported the familial association of hyperparathyroidism with Jaw tumours, and they suggested that this condition represents a new clinical syndrome. We believe that our case belongs to this syndrome.
Response to methimazole in Graves' disease
Authors: Benker Georg , Vitti Paolo , Kahaly George , Raue Friedhelm , Tegler Lennart , Hirche Herbert , Reinwein Dankwart ,   European Multicenter Study Group
Published: March 2008

SummaryOBJECTIVE A variety of regimens continue to be used In the treatment of Graves' disease with antithyrold drugs. We have lnvestigated the factors which determine the initial response to methimazole (time until euthyroidism Is achieved) In Graves' disease.PATIENTS Five hundred and nine patients with Graves' disease in different European countries with normal and subnormal iodine supply. Patients were randomized to treatment with either 10 or 40mg of methimazole per day for one year, with levothyroxine supplementation as required to maintain euthyroidism. Investigations were carried out before treatment and at 3 and 6 weeks and 3, 6, 9 and 12 months.MEASUREMENTS Response was assessed by serial measurements of serum thyroid hormones. TSH receptor antibodies, thyroid autoantibodies and urinary Iodide excretion were measured centrally. Twenty‐minute thyroid uptake was measured by standard techniques. Data were collected and analysed centrally. Standard techniques as well as a stepwise logistic regression model were used to examine the relations between methimazole dose, age, goitre size, presence of endocrine eye signs, thyroid hormone levels, urinary iodide excretion, thyroid uptake, Index of disease severity (Crooks), presence of TSH receptor antibodies and duration of the hyperthyroid phase.RESULTS Within 3 weeks, 40.2% of patients responded to 10mg of methimazole and 77.5% responded within 6 weeks. The corresponding figures for 40mg of methimazole were 64.6 and 92.6%. Significant associations were found between duration of hyperthyroldism and the following variables: goitre size, urinary iodide excretion, methimazole dose, presence of TSH receptor antibodies (TBIAb), Index of disease severity (Crooks) and pretreatment thyroid hormone levels. Response to methimazole was delayed In patients with large goitres, iodine excretion of ≧ 100μg/g creatinine, high pretreatment thyroid hormone levels, elevated levels of TBIAb and treatment with only 10 mg of methimazole. In the 10‐mg group, 46% of patients were euthyrold within 3 weeks when urinary Iodide was <50μg/g of creatinine, and only 27% when iodide was above 100μg/g. By stepwise logistic regression, the main factors for the response to methimazole were dally dose, pretreatment T3 levels, and goitre size. CONCLUSION Methimazole dose, pretreatment serum T3 levels, and goitre size are the main determinants of the therapeutic response to methimazole In Graves' disease, at least In areas comprising low, subnormal and normal iodine supply.
Altered endogenous growth hormone secretory kinetics and diurnal GH‐binding protein profiles in adults with chronic liver disease
Authors: Cuneo Ross C. , Hickman Peter E. , Wallace Jennifer D. , Teh Bin Tean , Ward Greg , Veldhuis Johannes D. , Waters Michael J. 
Published: March 2008

SummaryOBJECTIVE Increased serum GH concentrations and GH responses to a variety of stimuli have been reported in patients with chronic liver disease (CLD). We Investigated the pulsatile pattern of endogenous GH release and GH‐binding protein (GHBP) and insulin‐like growth factor‐I (IGF‐I) diurnal profiles in adults with cirrhosis, in comparison with healthy, matched control subjects.DESIGN Case‐control, cross‐sectional.PATIENTS Seven patients with biopsy proven cirrhosis, and sex, age, height, weight and oestrogen status matched controls.MEASUREMENTS Serum immunoreactive GH concentrations in samples collected at 20‐minute Intervals for 24 hours were analysed using a multi‐parameter deconvolution method to simultaneously resolve endogenous GH secretory and disappearance rates. Diurnal patterns of GHBP (specific immunoprecipitation method) and serum IGF‐I (RIA after acid‐ethanol extraction) were assessed.RESULTS The mean dally GH secretion rate in patients with CLD was Increased (210±93 vs 100±55mU/1/day; P= 0.025), and GH disappearance half‐time was prolonged (43±10 vs 24±9 min; P= 0.006) compared to controls. Detectable GH secretory bursts were more frequent In patients with CLD (10±1 vs 6±3/day; P= 0.038), but of similar mean mass (21±10 vs 17±8mU/l) compared to controls. In patients with CLD, mean serum GHBP was slightly lower (63±36 vs 71±14% pooled control; P > 0.1). Fasting serum IGF‐I concentrations (after size‐exclusion HPLC) were lower in the patients with CLD (13±5 vs 21±2 nmol/I; P < 0.0001). Multiple regression analysis showed that GH secretion rate was increased In patients with CLD with higher Child's classifications (R2= 0.86; P= 0.002) and with lower serum IGF‐I concentrations measured after HPLC (R2= 0.11; P= 0.044).CONCLUSIONS Adults with chronic liver disease have (1) Increased total daily GH secretion rates, which appear to be influenced by disease severity and diminished serum IGF‐I‐mediated negative feedback; (2) markedly impaired endogenous GH clearance, possibly reflecting changes In hepatic GH‐receptor status; and (3) GHBP levels which do not correlate with GH kinetics or serum IGF‐I concentrations.
Raised serum 11‐deoxycortisol in men with persistent acne vulgaris
Authors: Ramsay B. , Alaghband‐Zadeh J. , Carter G. , Wheeler M. J. , Cream J. J. 
Published: March 2008

SummaryOBJECTIVE Acne vulgaris is androgen dependent but the hormonal mechanisms are unclear. Although there have been many studies of serum hormones in women with acne there are few studies in men and the results are conflicting. We have therefore carried out a further study in men.DESIGN AND PATIENTS Fifty men with acne vulgaris were age‐matched against 50 normal men.MEASUREMENTS Serum levels Of dehydroepiandrosterone sulphate (DHEAS), 17α‐hydroxyprogesterone, 11‐deoxycortisol, androstenedione and testosterone were measured by radioimmunoassay, sex hormone binding globulin (SHBG) by immunoradiometric assay and LH, FSH and oestradiol by automated ELISA.RESULTS The acne patients had higher levels of androstenedione, median 7.35nmol/l, (Interquartile range 2.7) vs 6.05 (2.3), P=0.004; testosterone, 21.7nmol/l (7.5) vs 17.55 (7.7), P=0.04; and free androgen index (FAI) 78.26 (40) vs 65.06 (20), P=0.007, but also had higher levels of 11‐deoxycortisol, 13.65 nmol/l (4.3) vs 12.0 (4.3), P= 0.022. The LH, FSH, 17α‐hydroxyprogesterone, DHEAS, oestradiol and SHBG levels were not significantly different. Examination of the Spearman rank correlation coefficient matrices for the serum levels of 17α‐hydroxyprogesterone, androstenedione and 11‐deoxycortisol showed that the strongest correiation was between androstenedione and 11‐deoxycortisol.CONCLUSION Although there was overlap between the results of the acne patients and controls the acne patients tended to have higher levels of androstenedione, testosterone, free androgen Index and 11‐deoxycortisol. The higher levels of 11‐deoxycortisol are suggestive of 11β‐hydroxlase dysfunction which could be due to a primary adrenal defect or a consequence of raised androgens. Also, a pathway between androstenedione and 11‐deoxycortisol has been described in sheep and, although unsubstantiated in man, requires consideration.
Hypothalamic‐pituitary‐testicular function in end‐stage non‐alcoholic liver disease before and after liver transplantation
Authors: Handelsman David J. , Strasser Simone , McDonald Jennifer A. , Conway Ann J. , McCaughan Geoffrey W. 
Published: March 2008

SummaryOBJECTIVE Gonadal dysfunction is common in chronic liver disease, but most of the previous studies have been restricted to men with alcohol‐Induced liver disease. We have evaluated hypothalamic‐pituitary‐testicular function In patients with end‐stage non‐alcoholic liver disease before and at 6 and 12 months after hepatic transplantation.DESIGN A prospective study of hypothalamic‐pituitary‐testicular endocrine function before and after cadaveric hepatic transplantation.PATIENTS Fifty four consecutive patients with end‐stage, non‐alcohollic liver disease were evaluated before and after liver transplanatation.MEASUREMENTS Hypothalamic‐pitultary‐testicular(HPT) axis function was evalutated under basal conditions by single morning measurements of plasma total and free testosterone, sex hormone‐binding globulin and by plasma LH and FSH responses to 100 μg i.v. GnRH.RESULTS Men with chronic non‐alcoholic liver disease had reduced levels of total and free teststerone and increased levels of SHBG compared with controls with normal liver function. Total and free testosterone were positively correlated with basal and stimulated LH (but not FSH) concentrations. Gonadotrophin responses to GnRH were preserved but delayed compared with healthy controls consistent with a predominantly hypothalamic defect in regulation of pitultary‐testicular function. Increasing severity of underlying liver disease was associated with declining total and free testosterone as well as peak GnRH‐stimulated LH concentrations. Splronolactone treatment was associated with decreased circulating testosterone levels only in men with liver disease of lntermedlate severity (Child‐Pugh class B). Following hepatic transplantatlon, total and free testosterone and SHBG concentrations returned progressively towards eugonadal control levels over the first 12 months but total and free testosterone levels remained subnormal.CONCLUSIONS Hypothalamic‐pitultary regulation of testicular function Is Impaired in end‐stage non‐alcoholic liver disease In proportion to the severlty of underlying liver disease. Splronolactone reduces circulating testosterone but only among men with Chlld‐Pugh B liver cirrhosis. Gonadal function Improves, but is not normalized, over the first year following successful liver transplantation.
GH responses to intravenous bolus infusions of GH releasing hormone and GH releasing peptide 2 separately and in combination in adult volunteers
Authors: Tiulpakov A. N. , Brook C. G. D. , Pringie P. J. , Peterkova V. A. , Volevodz N. N. , Bowers C. Y. 
Published: March 2008

SummaryOBJECTIVE Synthetic growth hormone releasing peptides (GHRP) have potent GH‐releasing activity in vivo and in vitro. The nature of the Interaction of GHRP and naturally occurring GH releasing hormone (GHRH) is still far from clear. We investigated GH release in response to individual peptide doses or combined doses of GHRH1–29NH2 and GHRP‐2, a novel GH‐releasing peptide, in normal adults.DESIGN Subjects underwent three tests in a randomized order: (1) i.v. bolus of GHRH1‐29NH2 (1 μg/kg BW), (2) i.v. bolus of GHRP‐2 (1 μg/kg BW), (3) i.v. bolus of GHRH1‐29NH 2 combined with GHRP‐2 (same dosages).SUBJECTS Eight healthy non‐obese male volunteers, aged 25–34 years.MEASUREMENTS Serum GH concentrations were measured by IRMA at −15,0, + 10, 20,30,45,60,75,90 and120 minutes after the boluses.RESULTS Peak GH levels in response to GHRH1‐29NH 2, GHRP‐2 and the combined GHRH1‐29NH 2 and GHRP‐2 administrations were observed between 20 and 45 minutes. Peak GH levels at30 minutes were 32.8 ± 27.3 (mean ± SD), 109.7 ± 56.1 and 140.9 ± 80.6mU/l, respectively. The area under the curve for GH levels (GH AUC) calculated for the first 90 minutes after the GHRH1‐29NH 2 test (2061.2 ± 1601.9mU/1 min) was significantly lower than those after GHRP‐2 (6205.1 ± 3216.9mU/l min) and the combined GHRH1‐29NH 2 and GHRP‐2 challenge (9788.3 ± 5530.4mU/l min) (P = 0.0003 and P = 0.00005, respectively; palred Student's t‐test for log transformed data). Although the GH AUC of the GHRP‐2 test and the combined GHRHl‐29NH 2 and GHRP‐2 test differed significantly (P = 0.016, t‐test), the latter was not signlflcantly dlfferent from the sum of the GH AUCs of each subject after the separate tests.CONCLUSION Although the GH releasing potency of GHRP‐2 significantly exceeded that of GHRH1‐29NH 2, we were not able to demonstrate synergy between the two substances. It is possible that GHRP‐2 given in our study in higher molar quantities than GHRH1‐29NH 2 masked the effect of the latter.