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Journal Article 2004; 25(6): 429-434 PubMed PMID: 15665805 Citation  Keywords:  Adult, Cholesterol, HDL:blood, Cholesterol, LDL:blood, Female, Humans, Hysterectomy, Leiomyoma:blood, Lipids:blood, Middle Aged, Ovariectomy, Postoperative Period, Triglycerides:blood, Uterine Neoplasms:blood,.   

OBJECTIVE: The aim of this study was to asses the influence of operative treatment of leiomyomas on lipid profile. The study was conducted from April 1, 2000, through April 30, 2002 in The Department of Septic Gynecology and Obstetrics at Collegium Medicum of the Jagiellonian University.

METHODOLOGY: Most hysterectomies are performed because of leiomyomas, which are the most common benign tumors of the female reproductive organ. Pathogenesis and evolution of uterine leiomyomas are not well understood. Treatment of leiomyomas is divided into operative and inoperative. Operative methods include generally laparoscopic myomectomy, conservative myomectomy and hysterectomy. 130 women with diagnosed leiomyomas were analyzed in four groups.

CONCLUSION: Regardless of the type of performed surgery, decrease in cholesterol, HDL and LDL are observed 10 days after operation, with return to preoperative values at 6 months after surgical procedure. The highest level of cholesterol and LDL (6 moths from surgery) is observed in patients who underwent hysterectomy with bilateral oophorectomy....

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Clinical Trial 2004; 25(6): 419-422 PubMed PMID: 15665803 Citation  Keywords:  Adult, Anti-Anxiety Agents:administration & dosage, Antidepressive Agents:administration & dosage, Antipsychotic Agents:administration & dosage, Depression:drug therapy, Drug Therapy, Combination, Female, Humans, Hyperprolactinemia:blood, Male, Middle Age.   

OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this study was to prove whether the same is true for low doses of amisulpride.

METHODOLOGY: Plasma prolactin levels were measured in 5 males and 5 females with depressive symptoms who were treated with 50 mg of amisulpride per day as an augmentation to antidepressants (n=5), benzodiazepine anxiolytics (n=8) or in monotherapy (n=1). Six of these patients were assessed prior to onset of amisulpride treatment and after 10 days of amisulpride use. Four patients had been using amisulpride for more than a month.

RESULTS: There was a significant increase of prolactin levels from mean 16+/-6 ng/ml to 113+/-65 ng/ml (median 14.5 ng/ml to median 92 ng/ml; Wilcoxon matched pair test, p=0.027). All patients had hyperprolactinemia (30-200 ng/ml). The prolactinemia was significantly higher in females (mean 160+/-50 ng/ml; median 198 ng/ml) than in males (mean 48+/-12 ng/ml; median 48 ng/ml; Mann-Whitney U test, p=0.041).

CONCLUSION: Even low doses of amisulpride used as an augmentation to antidepressant treatment, benzodiazepines or in monotherapy seem to be associated with hyperprolactinemia. The co-medication of antidepressants and benzodiazepines can potentially increase intensity of prolactinemia....

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Journal Article 2004; 25(6): 411-414 PubMed PMID: 15665801 Citation  Keywords:  Adolescent, Adult, Circadian Rhythm:physiology, Female, Humans, Hyperprolactinemia:metabolism, Melatonin:blood, Middle Aged, Prolactin:blood,.   

OBJECTIVES: Relationship between melatonin and prolactin has been suggested on the basis of both experimental and clinical studies. However, there are scarce and controversial data concerning melatonin concentrations in hyperprolactinemic patients. Therefore, the aim of the present study was to evaluate the circadian rhythm of melatonin in female patients suffering from hyperprolactinemia.

MATERIAL AND METHODS: The study was performed on 28 women aged 17-58 years (mean+/-SEM: 30.5+/-1.8 years) suffering from idiopathic hyperprolactinemia and 14 healthy volunteers aged 20-50 years (mean+/-SEM: 36.4+/-3.0 years) with normal prolactin levels. Blood samples for measurements of serum melatonin and prolactin concentrations were collected at 08:00, 12:00, 16:00, 20:00, 24:00, 02:00, 04:00, 06:00, and 08:00 h. Melatonin and prolactin concentrations were measured by enzyme immunoassay.

RESULTS: Significant increase in melatonin serum concentrations was also observed in hyperprolactinemic patients in comparison with healthy volunteers during the night. Similar increase was also observed in the area under curve of melatonin concentrations. However, no correlation was found between prolactin and melatonin concentrations in any examined time points.

CONCLUSION: The results of the present study confirm suggestions of the presence of the relationship between melatonin and prolactin secretion....

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Clinical Trial 2004; 25(5): 391-396 PubMed PMID: 15580176 Citation  Keywords:  Adrenocorticotropic Hormone:blood, Adult, Aged, Anxiety:etiology, Caregivers:psychology, Cell Count, Disabled Persons:rehabilitation, Endocrine System:physiology, Female, Humans, Hydrocortisone:blood, Influenza, Human:immunology, Lymphocytes:immunology, M.   

OBJECTIVES: The purpose of this study was to determine whether psychological well being as well as metabolic, neuroendocrine and immune functions were different in non spousal primary caregivers of disabled elderly than in controls.

SETTING AND DESIGN: We randomly recruited 38 primary family carers of over 65 year old recipients of health home care services and 37 controls stratified according to sex and age.

METHOD: Data were collected on psychological wellbeing (including anxiety, depression and self-perceived quality of life), on neuroendocrine and immune conditions (haemanalysis and metabolic signs, plasma ACTH, cortisol, prolactin, intra-lymphocyte content of beta-endorphins, NK cell activity and number), as well as on the incidence and severity of influenza disease during previous winter.

RESULTS: Caregivers showed greater anxiety, although mean scores did not reach pathological levels. Neither depression nor satisfaction on quality of life did differ significantly, nor differences in haemanalisis and metabolic signs were found, apart from leukocyte and lymphocyte number, which was significantly lower in carers. Plasma levels of ACTH, cortisol and prolactin, the intra-lymphocyte content of beta-endorphins as well as the NK cell number and cytotoxicity did not show significant differences. Incidence and severity of influenza episodes was also similar, whereas the duration of influenza disease showed to be significantly longer.

CONCLUSIONS: Non spousal caregivers of disabled elderly suffer from only slight alterations of psychological, endocrine and immune parameters, and do not respond very differently to influenza disease. This does not support therefore any generic privilege for them in the allocation of public support or respite services....

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Clinical Trial 2004; 25(5): 386-390 PubMed PMID: 15580175 Citation  Keywords:  Adult, Carbon Dioxide, Female, Humans, Hydrocortisone:metabolism, Hypothalamo-Hypophyseal System:physiopathology, Male, Panic Disorder:chemically induced, Pituitary-Adrenal System:physiopathology, Reference Values, Saliva:metabolism, Sex Factors,.   

OBJECTIVES: The underlying mechanisms of panic attacks (PA's) are still unclear. Theories focusing on these mechanisms differ in their description of the relationship between panic and fear. The main controversy concerns whether a PA resembles the classical flight response, or whether it is qualitatively different from fear. According to the first theory, a PA would result in hypothalamic-pituitary-adrenal axis (HPA-axis) activation, whereas according to the second, it would not. So far, inconclusive results have been reported in studies measuring HPA-axis activity after laboratory evoked PA's. The present study was designed to assess cortisol levels following a 35% CO2 challenge in Panic Disorder (PD) patients compared to healthy volunteers as a measurement of HPA-axis activity.

DESIGN: Twenty-three PD patients and 20 healthy volunteers participated in the study. Cortisol was determined in saliva at regular intervals before and after the challenge. Furthermore, attention was paid to possible gender effects.

RESULTS: Although the 35% CO2 inhalation induced a significant increase in anxiety, no cortisol increase was found. Moreover, there was no difference between patient and control cortisol values following the 35% CO2 challenge, whereas the delta anxiety scores were far more pronounced in the patient group. Interestingly, male PD patients showed higher cortisol values.

CONCLUSIONS: This study may be in accordance with the view that PA's are not accompanied by an important HPA-axis activation. There are some indications for aberrant cortisol secretion in male PD patients. Further research needs to confirm whether male and female PD patients differ in their underlying mechanisms related to HPA-axis activity....

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Clinical Trial 2004; 25(5): 381-385 PubMed PMID: 15580174 Citation  Keywords:  Adult, Body Composition, Energy Metabolism:physiology, Exercise:physiology, Female, Humans, Leptin:blood, Obesity:blood, Physical Endurance:physiology, Physical Fitness:physiology,.   

OBJECTIVE: Recent studies have concluded that an energy expenditure by an acute exercise session has no immediate effect on leptin levels while some showed a decline in leptin levels. The purpose of this study was to investigate any possible effects of training status of the subjects on acute exercise-leptin relationship in obese patients.

MATERIALS AND METHODS: Fourteen obese sedentary females were enrolled to the study and effects of acute incremental exercise on serum leptin levels were determined at rest and at maximal exercise performance. Then, they participated to a 12-weeks endurance aerobic training programme performed in the laboratory on a computer controlled cycle ergometer and their leptin levels were re-evaluated and the leptin-acute exercise relationships obtained under different training levels in the same group of subjects were compared. The body compositions were determined by bioelectrical impedance. Pre and post training blood samples were taken at rest and at the maximal exercise performance. Serum leptin levels were analysed in duplicate by RIA. Data were evaluated using, paired t and Pearson's tests.

RESULTS: Leptin levels were not acutely affected by the incremental exercise either before (23.62+/-3.5 ng/ml and 22.62+/-3.6 ng/ml) or after (13.13+/-3.4 ng/ml and 13.82+/-3.6 ng/ml) endurance training. The marked decrease in leptin levels following training was closely correlated with fat mass loss R= 0.899 (P= 0.0001).

CONCLUSIONS: This study indicates that an increase in energy expenditure by acute exercise has no significant acute effect on leptin level regardless of the training status of the subjects and decrease in leptin levels after a 12-weeks endurance aerobic training programme are closely associated with the fat mass loss....

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Clinical Trial 2004; 25(5): 373-380 PubMed PMID: 15580173 Citation  Keywords:  Adolescent, Adult, Anti-Bacterial Agents:therapeutic use, Combined Modality Therapy, Female, Gestational Age, Humans, Obstetric Labor, Premature:therapy, Pregnancy, Pregnancy Outcome, Tocolysis, Treatment Outcome,.   

OBJECTIVE: The aim of this study was to determine: a) to what extent application of antibiotics enhances efficiency of tocolysis; b) whether the duration of antibiotic treatment influences its efficacy; c) what criterion is decisive for efficacy of tocolysis assisted by antibiotic therapy.

MATERIALS AND METHODS: 223 successive women with unifetal pregnancies, aged 17 to 42 (average age 27.3), admitted to the Department of Gynecology and Obstetrics of the JU Medical College in the period from January 1, 1999 to September 9, 2001, were enrolled in the study. Using clinical methods such as: assessment of contractile activity of the uterus, of uterine cervix and membranes, presence of bleeding and other clinical symptoms, these women were diagnosed with imminent preterm labour.

CONCLUSIONS: Antibiotic treatment enhances the efficacy of tocolysis, influencing the time of prolonging pregnancy in imminent preterm delivery. This synergistic effect is clinically crucial as in this way significantly larger number of children will be born at term and also a number of premature neonates who survive may be increased....

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Clinical Trial 2004; 25(5): 368-372 PubMed PMID: 15580172 Citation  Keywords:  Adult, Body Temperature Regulation:physiology, Circadian Rhythm:physiology, Humans, Hypothalamo-Hypophyseal System:physiology, Male, Melatonin:physiology, Middle Aged, Reference Values, Thermogenesis:physiology, Thyroid Gland:physiology, Thyrotropin:blood.   

OBJECTIVE: Melatonin plays a role in the regulation of biological rhythms, body temperature presents circadian variations with lower levels during nighttime, when melatonin levels are very high, and thyroid hormones influence shiver independent thermogenesis. We have investigated on possible interactions between the hypothalamic-pituitary-thyroid axis and melatonin in the control of body temperature in humans.

METHODS: Peripheral blood samples for thyrotropin-releasing hormone (TRH), thyroid-stimulating hormone (TSH), free-thyroxine (FT4), melatonin levels determination and body temperature measurements were obtained every four hours for 24-hours starting at 0600 h in a controlled temperature and light-dark environment from ten healthy males, aged 38-65 (mean age +/-s.e. 57.4+/-3.03, mean body mass index +/-s.e. 25.5+/-0.75). We calculated fractional variation and correlation on single time point hormone serum levels and tested whether the time-qualified data series showed consistent pattern of circadian variation.

RESULTS: A statistically significant difference was evidenced for the fractional variation of daytime TSH serum levels (0600 h-1000 h vs. 1000 h-1400 h, p=0.01, 1000 h-1400 h vs. 1400 h-1800 h, p=0.0001, 1400 h-1800 h vs. 1800 h-2200 h, p=0.001) and for the fractional variation of FT4 serum levels at 1800 h-2200 h vs. 2200 h-0200 h (p=0.02). FT4 serum levels correlated positively with TRH serum levels at 1000 h (r=0.67, P=0.03) and at 1400 h (r=0.63, p=0.04), negatively with TSH serum levels at 2200 h (r=-0.67, p=0.03), negatively with melatonin serum levels at 2200 h (r=-0.64, p=0.04) and at 0200 h (r=-0.73, p=0.01). TRH serum levels correlated positively with TSH serum levels at 0200 h (r=0.65, p=0.04) and at 0600 h (r=0.64, p=0.04). Body temperature correlated positively with FT4 serum levels at 1000 h (r=0.63, p=0.04) and negatively with melatonin serum levels at 0200 h (r=-0.64, p=0.04). A clear circadian rhythm was validated for body temperature (with acrophase in the morning) and melatonin, TRH and TSH secretion (with acrophase at night), while FT4 serum level changes presented ultradian periodicity (with acrophase in the morning).

CONCLUSION: Changes of TSH serum levels are smaller and those of FT4 are greater at night, when melatonin levels are higher, so that the response of anterior pituitary to hypothalamic TRH and of thyroid to hypophyseal TSH may be influenced by the pineal hormone that may modulate the hypothalamic-pituitary-thyroid axis function and influence the circadian rhythm of body temperature....

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