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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): 415-418 PubMed PMID: 15665802 Citation  Keywords:  Aged, Aged, 80 and over, Aging:metabolism, Analysis of Variance, Cohort Studies, Humans, Melatonin:metabolism, Middle Aged, Radioimmunoassay, Saliva:metabolism,.   

OBJECTIVES: The purpose of this study was to investigate whether melatonin levels in older cohorts within the 'aged' population were significantly lower than in younger 'aged' individuals and hence point to a possible confound in cross-sectional studies which group individuals over 55 in one category.

SETTING AND DESIGN: Melatonin levels of 35 North Queensland residents over 55 years of age living in an aged-care facility, a retirement village or the general community were compared across three age groups.

METHODS: Subjects were ten 56-65 year olds, eighteen 66-75 year olds and seven over-75 year olds. Information was obtained on sleep, awakening, medical conditions and medications, with subsequent exclusion of those with known medical conditions and/or medications. Melatonin was collected by salivary samples at 2200 hours and concentrations were determined by immunoassay.

RESULTS: Mean melatonin levels were significantly lower (p=.03) in the 'oldest' (over 75 yrs) group compared to the 'youngest' (56-65 yrs) group.

MAIN FINDINGS: The results of this preliminary study indicate that within the older population, melatonin levels appear to decline significantly with age.

CONCLUSIONS: Future studies of melatonin and ageing may benefit from a longitudinal approach, with older subjects sampled across time....

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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): 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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Case Reports 2004; 25(4): 307-309 PubMed PMID: 15361823 Citation  Keywords:  Acromegaly:blood, Empty Sella Syndrome:blood, Female, Growth Hormone:blood, Humans, Magnetic Resonance Imaging, Middle Aged, Octreotide:therapeutic use, Treatment Outcome,.   

: The normal functions of the pituitary gland may be suppressed when the gland is compressed onto the sella floor by arachnoid tissue extending through an impaired sella diaphragm. Interestingly, pituitary hormone hypo- and hypersecretion, including acromegaly, have been observed in patients with an 'empty sella'(1-4). This 'empty sella syndrome' has been classified into a primary form, in which no inciting factor (pituitary irradiation or surgery for a pituitary tumor) is present, and a secondary form, in which the empty sella occurs after pituitary procedures. In this report we describe a patient who presented with clinical and biochemical features of acromegaly and who had an empty sella on pituitary magnetic resonance imaging (MRI)....

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Clinical Trial 2004; 25(4): 302-306 PubMed PMID: 15361822 Citation  Keywords:  Adolescent, Adult, Biomarkers, C-Reactive Protein:metabolism, Cystinyl Aminopeptidase:blood, Female, Humans, Isoenzymes:blood, Middle Aged, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Third, Premature Birth:blood, Prenata.   

OBJECTIVES: Preterm deliveries represent still one of the most important problems in contemporary obstetrics. They are associated with prematurity and higher rate of perinatal mortality and morbidity. During the last few years, the role of C-reactive protein (CRP) in prediction of threatening preterm delivery was emphasized. CRP is produced mainly inside the liver as a response to acute and chronic inflammatory processes.

AIM: The aim of this study was to assess relations between C-reactive protein, oxytocinase, izooxytocinase and vaginal culture in prediction of preterm delivery.

METHODS: This study was performed in the years 2000-2004 in the Department of Septic Obstetrics and Gynecology of Collegium Medicum of the Jagiellonian University. Some 389 patients hospitalized because of threatening preterm delivery or preterm delivery in tractu were enrolled into the trial.

CONCLUSION: C-reactive protein is a useful marker of threatening preterm delivery, overtaking the results of vaginal culture. CAP1 and CAP2 are effective biochemical markers in pregnancy monitoring....

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Clinical Trial 2004; 25(4): 292-296 PubMed PMID: 15361820 Citation  Keywords:  Adult, Feedback, Physiological:physiology, Female, Humans, Hyperthyroidism:physiopathology, Hypothalamo-Hypophyseal System:physiology, Hypothyroidism:physiopathology, Male, Middle Aged, Reference Values, Regression Analysis, Severity of Illness Index, Thy.   

OBJECTIVE: To evaluate the hypothalamus-pituitary-thyroid (HPT) axis in patients with subclinical thyroid dysfunction recently reported to have either symptoms or organ involvements with potential morbidity, in order to better differentiate these patients with respect to controls.

PATIENTS: Sixtythree patients with subclinical hyperthyroidism (HyperT), 178 normal subjects (EuT) and 106 patients with subclinical hypothyroidism (HypoT) were enrolled; the groups presented normal thyroid hormone (FT4, FT3) levels and, respectively, reduced (HyperT), normal (EuT) and increased (HypoT) TSH levels. The negative feedback was simultaneously evaluated by multiple linear regression.

RESULTS: The mean TSH, FT4 and FT3 levels were significantly different in the three groups. The negative correlation between thyroid hormones (FT4 and FT3) and TSH secretion was significant (p<0.001 in HyperT; p<0.01 in EuT; p<0.000001 in HypoT group). FT4 mostly contributed to the negative correlation with TSH. The normal ranges of TSH values was accurately defined on the basis of the regression equation in the EuT group, due to the combining influence of both thyroid hormones (FT3 and FT4). No patient of the HyperT or HypoT group fell inside the range of estimated values of the normal group.

CONCLUSIONS: The HPT axis in patients with subclinical hyper- and hypo-thyroidism is significantly modified with respect to normal subjects. The status of the axis, as evaluated by the relationship between the three hormones (FT4, FT3, TSH) together considered, is characteristic of the normal or pathologic condition. A reliable method based on the regression analysis is proposed to correctly evaluate the status of the HPT axis....

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Clinical Trial 2004; 25(4): 262-266 PubMed PMID: 15361814 Citation  Keywords:  Adult, Biomarkers:blood, Blood Pressure, C-Reactive Protein:analysis, Coronary Disease:blood, Female, Homocysteine:blood, Humans, Hyperlipidemias:blood, Hypothyroidism:blood, Middle Aged, Reference Values, Risk Factors, Severity of Illness Index, Statisti.   

OBJECTIVES: Overt hypothyroidism (OH) is associated with premature atherosclerosis and coronary heart disease (CHD). Recently, C-reactive protein (CRP) and total homocysteine (tHct) emerged as additional independent cardiovascular risk factors. Subclinical hypothyroidism (SH), affecting as many as 15% of middle-aged women is not known to be associated with risk for CHD.

DESIGN AND MEASUREMENTS: We measured CRP and tHct levels as well as conventional cardiovascular risk markers in 44 middle-aged women with newly diagnose SH. Results were compared with those obtained in 10 patients with OH and 19 euthyroid controls.

RESULTS: In SH, tHct and CRP levels were not as augmented as compared to controls. Their mean systolic and diastolic blood pressure values were increased vs. controls (p<0.04;p<0.01, respectively). Mean values of total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides, TC/HDL-C and LDL-C/HDL-C were not different in patients with SH compared to controls. Individual analysis revealed that the percentage of patients with SH having hypertension, hypertriglyceridemia, hypercholesterolemia, elevated TC/HDL-C and LDL-C/HDL-C ratios were higher than the percentage in controls. CRP positively correlated with BMI(r=0.29,p<0.02), and tHct positively correlated with age (r=0.24, p<0.05).

CONCLUSIONS: Our findings suggest that subclinical hypothyroidism in middle-aged women is associated with hypertension and dyslipidemia. CRP and tHct do not appear to contribute to the increased risk for CHD in these patients....

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