Search NEL Online

Journal Article 2005; 26(6): 733-738 PubMed PMID: 16380672 Citation  Keywords:  Adult, Comorbidity, Diabetes Mellitus, Type 1:epidemiology, Female, Humans, Infertility:epidemiology, Menstruation Disturbances:epidemiology, Pregnancy, Pregnancy Complications:epidemiology, Sexual Dysfunction, Physiological:epidemiology,.   

: Among young type 1 diabetic women disturbances of reproductive system and other related disorders are often present. The present paper, which reviews the literature of the part several years aims to present some of those disorders. Special attention is focused on menstrual irregularities, fertility and sexual problems. Type 1 diabetic women usually have a delayed menarche and an early onset of menopause than nondiabetic women. They are also at higher risk of having menstrual disturbances, such as amenorrhea and oligomenorrhea. It has been suggested that the GnRH pulse-generator in the hypothalamus is responsible for diabetic menstrual dysfunction. The risk of sexual and gestational problems is higher in type 1 diabetes than in the general population, but fertility in diabetic women seems to be similar to nondiabetics....

Read abstract  Full text PDF

Case Reports 2005; 26(6): 757-758 PubMed PMID: 16380671 Citation  Keywords:  Aged, Atrophy, Diagnosis, Differential, Empty Sella Syndrome:complications, Fatigue:diagnosis, Female, Hormones:therapeutic use, Humans, Hydrocortisone:therapeutic use, Hypopituitarism:complications, Inflammation:complications, Magnetic Resonance Imaging,.   

: A 75-year-old woman complained about progressing fatigue. She appeared somnolent, but fully oriented and in no acute distress. Her face was pale and puffy. She did not show any signs of focal neurological disease, and the remainder of the physical examination was unrevealing. Routine laboratory tests were unremarkable except for hyponatremia and mildly decreased levels of free T3 and free T4, with TSH in the normal range. Pituitary function tests demonstrated secondary adrenal insufficiency and hypothyroidism. Magnetic resonance imaging (MRI) unmasked hypophysitis with the characteristic findings of homogeneous gadolinium uptake of the pituitary and a prominent pituitary stalk ('dural tail sign', arrows in Fig. 1 A and B, sagittal and coronal views). Substitution of hydrocortisone and levothyroxine resulted in rapid and sustained improvement of all symptoms and normalisation of laboratory findings. MRI abnormalities normalized within the following six months. At follow-up three years later, MRI signs had further regressed and demonstrated an empty sella (Fig. 2 A and B)....

Read abstract  Full text PDF

Comment 2005; 26(6): 757-758 PubMed PMID: 16380670 Citation  Keywords:  Circadian Rhythm:drug effects, Diabetes Mellitus, Type 2:blood, Double-Blind Method, Humans, Hydrocortisone:blood, Hypoglycemic Agents:pharmacology, Hypothalamo-Hypophyseal System:drug effects, PPAR gamma:agonists, Pituitary-Adrenal System:drug effects, T.   

OBJECTIVES: PPAR-gamma agonists are able to inhibit pituitary tumour development and tumoral hormonal secretion in rodents both in vitro and in vivo. Their use for treatment of Cushing Disease (CD) has been suggested but the clinical experience with the two PPAR-gamma agonists commercially available (rosiglitazone and pioglitazone) was not impressive. Short-time treatment has been proposed to be the cause of unsuccessful results on CD in humans. We report here the effect on early-morning plasma cortisol levels of a long-time treatment with rosiglitazone at the highest approved dose.r />r /> METHODS: Because PPAR-gamma receptors are located in normal corticotroph cells we tested in a placebo-controlled study the influence of rosiglitazone on cortisol secretion. The study enrolled 30 newly diagnosed type 2 patients which were assigned to receive either rosiglitazone (8 mg/day) or placebo. Plasma morning cortisol (8.00 a.m.) was measured at the baseline and at the end of the study.r />r /> RESULTS: Rosiglitazone vs placebo did not modify the early morning plasma levels of cortisol (13 microg/dl [3-21] vs 11 microg/dl [7-23] [median and range]) after 26 weeks of treatment.r />r /> CONCLUSION: The discrepancy between in vitro and animal data on one side and clinical data on the other side warrant further investigations into the mechanisms of action of PPAR-gamma agonists on ACTH secretion before other clinical studies will be conducted....

Read abstract  Full text PDF

Clinical Trial 2005; 26(5): 447-452 PubMed PMID: 16264418 Citation  Keywords:  Adolescent, Aging:physiology, Body Height:drug effects, Child, Female, Growth Hormone:therapeutic use, Hormones:blood, Human Growth Hormone:deficiency, Humans, Magnetic Resonance Imaging, Male, Pituitary Gland:anatomy & histology, Predictive Value of Test.   

INTRODUCTION: Certain relationships between pituitary size and growth hormone (GH) secretion have previously been observed, however they are still a matter of controversy. Organic abnormalities of the hypothalamic-hypophyseal region are important for predicting growth response to GH therapy.r />r /> AIM: Evaluation of relations between GH secretion and the pituitary size in short children and estimation of the efficacy of GH therapy in children with GH deficiency (GHD).r />r /> PATIENTS AND METHODS: The analysis comprised 216 short children (159 boys). Two GH stimulation tests, as well as magnetic resonance image (MRI) examination, were performed in each patient. All the patients with GHD were treated with GH for, at least, one year.r />r /> RESULTS: Significant correlations were found between pituitary height and GH secretion (p < 0.05). Patients were classified into three (3) groups: 1) pituitary hypoplasia (HP) for height age; 2) HP for the chronological age but not for the height age; 3) normal pituitary size. Significant differences in GH secretion were observed among the groups (6.1+/-5.3 vs. 8.1+/-4.4 vs. 12.3+/-9.1 ng/mL, respectively). There was a negative correlation between GH peak and height gain during GH therapy (r = -0.34). The highest growth improvement was noticed in patients with HP for the height age.r />r /> CONCLUSIONS: Pituitary hypoplasia for the height age is related to more severe GH deficiency and the best response to GH therapy....

Read abstract  Full text PDF

Comparative Study 2005; 26(5): 468-472 PubMed PMID: 16264417 Citation  Keywords:  Animals, Cells, Cultured, Female, Galanin:administration & dosage, Injections, Intravenous, Injections, Intraventricular, Ovariectomy, Pituitary Gland:drug effects, Pituitary Hormones:blood, Rats, Rats, Inbred WKY,.   

OBJECTIVES: Galanin and its receptors are widely distributed within the central and peripheral nervous system, especially in hypothalamus including preoptic area, paraventricular nucleus (PVN), supraoptic nucleus (SON) and median eminence. Galanin plays an important role in the control of food intake, energy expenditure, reproduction, water balance and various neuroendocrine functions. Galanin may affect hormones release, but the exact mechanism of the peptide action remains unclear and possible direct effects of galanin on the pituitary are controversial. The aim of this study was to examine the effects of galanin on pituitary hormones release after the central and peripheral administration of the peptide.r />r /> MATERIAL AND METHODS: (i) Experiment I - Intracerebroventricular (icv) administration of galanin: Galanin at a concentration of 0.5 microg in 5microl vehicle (artificial cerebrospinal fluid) or equal volume of the vehicle was slowly (1microl/min) infused into the third ventricle with an automatic pump (CMA/100; Sweden) through an inner cannula inserted into the guide cannula. After the end of the infusion the rats were transferred to their home cages with free access to food and water. At 60 min after the infusion of galanin or vehicle, animals were decapitated and trunk blood was collected in plastic tubes containing 1000 IU aprotinin (inhibitor of protease) per each ml of blood. (ii) Experiment II - Intravenous (iv) injection of galanin: Galanin in a dose of 10 microg in 300 microl of saline or 300 microl of saline alone was injected into the tail vein. After the injection the animals were transferred to individual cages with free access to food and water. At 60 min after the injection of galanin or saline, animals were decapitated, and trunk blood was collected in plastic tubes containing 1000 IU of aprotinin (Trascolan). The blood samples were centrifuged (3000 rpm for 20 min at 4 degrees C). Serum samples were frozen until hormonal analyses were performed. Serum rLH, rFSH, rPRL, rGH, rTSH concentrations were measured with RIA methods.r />r /> RESULTS: Galanin administered icv increased significantly rPRL and rTSH levels (p<0.01, p<0.05, respectively). Plasma rPRL and rTSH concentrations were not changed after iv injection of galanin. Galanin injected centrally inhibited significantly rGH release (p<0.01), however, galanin given iv stimulated rGH (p<0.01). Serum rLH and rFSH concentrations were not changed after icv and iv injections of galanin.r />r /> CONCLUSION: Galanin may be involved in the modulating mechanism of pituitary hormones release....

Read abstract  Full text PDF

Clinical Trial 2005; 26(5): 473-479 PubMed PMID: 16264416 Citation  Keywords:  Acute-Phase Reaction:physiopathology, Adipose Tissue:physiology, Adolescent, Anthropometry, Biomarkers, Blood Glucose:metabolism, Body Composition:physiology, Child, Cytokines:blood, Endothelium, Vascular:physiology, Female, Hemoglobin A, Glycosylated:met.   

OBJECTIVES: There is increasing evidence that an ongoing cytokine-induced acute-phase response is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidemia and atherosclerosis. The aim of this study was to investigate the relationship of inflammation and endothelial activation with insulin resistance in childhood obesity.r />r /> METHODS: Two hundred and eleven (122 boys) obese children and adolescents were examined. Fasting levels of ultra-sensitive C-reactive protein (CRP), fibrinogen (FB), interleukin-6 (IL-6), interleukin-1beta (IL-1beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF), glucose, insulin, and HbA1c were determined. Insulin resistance was assessed by the homeostasis method.r />r /> RESULTS: HOMA IR correlated significantly with all measures of adiposity as well as with majority of inflammation and endothelial dysfunction markers. After adjustment for age, gender, BMI and fat mass, the correlation with insulin resistance remained significant for CRP, ICAM-1 and von Willebrand factor. There was a trend for association between HOMA IR and IL-6 as well as HOMA IR and fibrinogen.r />r /> CONCLUSION: Acute-phase reaction and endothelial activation correlate with insulin resistance in obese youth. It is possible that the cluster of these pro-atherogenic factors may contribute to the accelerated atherosclerosis in obese children....

Read abstract  Full text PDF

Journal Article 2005; 26(5): 480-486 PubMed PMID: 16264415 Citation  Keywords:  Adult, Antibodies, Protozoan:analysis, Blood Donors:psychology, Enzyme-Linked Immunosorbent Assay, Exploratory Behavior:physiology, Female, Humans, Male, Personality Tests, Reward, Toxoplasmosis:immunology,.   

OBJECTIVES: Toxoplasma gondii, a parasitic protozoan, infects about 30 - 60% of people worldwide. Toxoplasma is known to induce behavioral changes and an increase of dopamine in mice. The presence of anti-Toxoplasma antibodies (latent toxoplasmosis) is also a risk factor for schizophrenia. Latent toxoplasmosis in men (male soldiers) is associated with lower novelty seeking. As the novelty seeking is supposed to negatively correlate with level of dopamine, the observed effect was interpreted as indirect evidence of increased dopamine levels in subjects with toxoplasmosis. However, it is also possible that the observed effect was caused by association of both novelty seeking and Toxoplasma infection with a third factor, e.g. size of place of residence.r />r /> METHODS: Personality profile of 290 blood donors (205 men and 85 women) were measured by Cloninger's TCI (Temperament and Character Inventory) and their blood samples were assayed for the presence of anti-Toxoplasma antibodies. Difference between Toxoplasma-infected and Toxoplasma-free subjects was tested with ANCOVA method with gender, size of place of residence, and age as covariates.r />r /> RESULTS: The present analysis revealed that lower novelty seeking was associated with latent toxoplasmosis both in men and women. The effect of infection on novelty seeking remained significant even after adjustment for size of place of residence (p<0.01).r />r /> CONCLUSION: Decreased novelty seeking in Toxoplasma-infected subjects have been already confirmed in three independent populations (male soldiers and male and female blood donors). These findings suggest that the local inflammation-induced increase in dopamine in the brain of infected subjects can represent a missing link between toxoplasmosis and schizophrenia....

Read abstract  Full text PDF

Journal Article 2005; 26(5): 487-492 PubMed PMID: 16264414 Citation  Keywords:  Aging:metabolism, Antigens, CD:metabolism, Antigens, CD3:metabolism, Antigens, Differentiation, T-Lymphocyte:metabolism, Biomarkers, CD8-Positive T-Lymphocytes, Dehydroepiandrosterone Sulfate:blood, Fatigue Syndrome, Chronic:blood, Female, Humans, Inflamm.   

: There are a few reports that chronic fatigue syndrome (CFS) may be accompanied by changes in hormones, such as dehydroepiandrosterone (DHEA) and insulin-like growth factor (IGF1). This study examines the serum concentrations of DHEA-sulfate (DHEAS), IGF1 and IGF1 binding protein-3 (IGFBP3) in 20 patients with CFS and in 12 normal controls. The IGFBP3/IGF1 ratio was computed as an index for IGF1 availability. We found significantly lower serum DHEAS concentrations in CFS, but no significant differences either in IGF1 or the IGFBP3/IGF1 ratio between CFS patients and normal controls. The decrease in serum DHEAS was highly sensitive and specific for CFS. There were significant and positive correlations between serum DHEAS and serum zinc and the mitogen-induced expression of the CD69 molecule on CD3+CD8+ T cells (an indicator of early T cell activation). There was a significant and negative correlation between serum DHEAS and the increase in the serum alpha-2 protein fraction (an inflammatory marker). Serum IGF1, but not DHEAS, was significantly and inversely correlated to age. The results show that CFS is accompanied by lowered levels of DHEAS and that the latter may play a role in the immune (defect in the early activation of T cells) and the inflammatory pathophysiology of CFS....

Read abstract  Full text PDF