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Lo JC, Beck GJ, Kaysen GA, Chan CT, Kliger AS, Rocco MV, Li M, Chertow GM. Thyroid function in end stage renal disease and effects of frequent hemodialysis. Hemodial Int 2017; 21:534-541. [PMID: 28301073 DOI: 10.1111/hdi.12527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION End-stage renal disease (ESRD) is associated with perturbations in thyroid hormone concentrations and an increased prevalence of hypothyroidism. Few studies have examined the effects of hemodialysis dose or frequency on endogenous thyroid function. METHODS Within the Frequent Hemodialysis Network (FHN) trials, we examined the prevalence of hypothyroidism in patients with ESRD. Among those with endogenous thyroid function (without overt hyper/hypothyroidism or thyroid hormone supplementation), we examined the association of thyroid hormone concentration with multiple parameters of self-reported health status, and physical and cognitive performance, and the effects of hemodialysis frequency on serum thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) levels. Conventional thrice-weekly hemodialysis was compared to in-center (6 d/wk) hemodialysis (Daily Trial) and Nocturnal (6 nights/wk) home hemodialysis (Nocturnal Trial) over 12 months. FINDINGS Among 226 FHN Trial participants, the prevalence of hypothyroidism was 11% based on thyroid hormone treatment and/or serum TSH ≥8 mIU/mL. Among the remaining 195 participants (147 Daily, 48 Nocturnal) with endogenous thyroid function, TSH concentrations were modestly (directly) correlated with age (r = 0.16, P = 0.03) but not dialysis vintage. Circulating thyroid hormone levels were not associated with parameters of health status or physical and cognitive performance. Furthermore, frequent in-center and nocturnal hemodialysis did not significantly change (baseline to month 12) TSH, FT4, or FT3 concentrations in patients with endogenous thyroid function. DISCUSSION Among patients receiving hemodialysis without overt hyper/hypothyroidism or thyroid hormone treatment, thyroid indices were not associated with multiple measures of health status and were not significantly altered with increased dialysis frequency.
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Affiliation(s)
- Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Gerald J Beck
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - George A Kaysen
- Division of Nephrology, Department of Medicine, University of California Davis, Davis, California, USA
| | - Christopher T Chan
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Alan S Kliger
- Division of Nephrology, Department of Medicine, Yale School of Medicine and Yale New Haven Health System, New Haven, Connecticut, USA
| | - Michael V Rocco
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Minwei Li
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Glenn M Chertow
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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Lo JC, Beck GJ, Kaysen GA, Chan CT, Kliger AS, Rocco MV, Chertow GM. Hyperprolactinemia in end-stage renal disease and effects of frequent hemodialysis. Hemodial Int 2016; 21:190-196. [PMID: 27774730 DOI: 10.1111/hdi.12489] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION End-stage renal disease is associated with elevations in circulating prolactin concentrations, but the association of prolactin concentrations with intermediate health outcomes and the effects of hemodialysis frequency on changes in serum prolactin have not been examined. METHODS The FHN Daily and Nocturnal Dialysis Trials compared the effects of conventional thrice weekly hemodialysis with in-center daily hemodialysis (6 days/week) and nocturnal home hemodialysis (6 nights/week) over 12 months and obtained measures of health-related quality of life, self-reported physical function, mental health and cognition. Serum prolactin concentrations were measured at baseline and 12-month follow-up in 70% of the FHN Trial cohort to examine the associations among serum prolactin concentrations and physical, mental and cognitive function and the effects of hemodialysis frequency on serum prolactin. FINDINGS Among 177 Daily Trial and 60 Nocturnal Trial participants with baseline serum prolactin measurements, the median serum prolactin concentration was 65 ng/mL (25th-75th percentile 48-195 ng/mL) and 81% had serum prolactin concentrations >30 ng/mL. While serum prolactin was associated with sex (higher in women), we observed no association between baseline serum prolactin and age, dialysis vintage, and baseline measures of physical, mental and cognitive function. Furthermore, there was no significant effect of hemodialysis frequency on serum prolactin in either of the two trials. DISCUSSION Serum prolactin concentrations were elevated in the large majority of patients with ESRD, but were not associated with several measures of health status. Circulating prolactin levels also do not appear to decrease in response to more frequent hemodialysis over a one-year period.
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Affiliation(s)
- Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Gerald J Beck
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - George A Kaysen
- Division of Nephrology, Department of Medicine, University of California Davis, Davis, California, USA
| | - Christopher T Chan
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Alan S Kliger
- Division of Nephrology, Department of Medicine, Yale School of Medicine and Yale New Haven Health System, New Haven, Connecticut, USA
| | - Michael V Rocco
- Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Glenn M Chertow
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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Sherman M, Liu MM, Birnbaum S, Wolf SE, Minei JP, Gatson JW. Adult obese mice suffer from chronic secondary brain injury after mild TBI. J Neuroinflammation 2016; 13:171. [PMID: 27357503 PMCID: PMC4928296 DOI: 10.1186/s12974-016-0641-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/22/2016] [Indexed: 01/06/2023] Open
Abstract
Background A traumatic brain injury (TBI) event is a devastating injury to the brain that may result in heightened inflammation, neurodegeneration, and subsequent cognitive and mood deficits. TBI victims with co-morbidities such as heart disease, diabetes, or obesity may be more vulnerable to the secondary brain injury that follows the initial insult. Compared to lean individuals, obese subjects tend to have worse clinical outcomes and higher mortality rates after trauma. Methods To elucidate whether obesity predisposes individuals to worse outcomes after TBI, we subjected adult lean and obese male/female mice to a mild TBI. The injury was administered using a controlled skull impact (CSI) device. Lean or obese 6-month-old C57 BL/6 mice were subjected once to a mild TBI. Additionally, at day 30 after injury, both the lean and obese mice were tested for increased anxiety using the open field test. Results At day 30 after TBI, compared to the lean mice, we found heightened microglial (MG) activation in the cerebral cortex, corpus callosum, and hypothalamus. Another compelling finding was that, compared to the non-injured obese male control mice, the obese TBI mice had a decrease in the rate of weight gain and serum corticosterone levels at day 30 after injury. Additionally, the injured obese mice displayed higher levels of anxiety as determined by a significant decrease in time spent in the non-peripheral zones in the open field test. In contrast to the obese males, the obese female mice did not exhibit increases in the number of active MG in the brain, changes in weight gain/corticosterone levels, or increased anxiety at day 30 after TBI. Conclusions The data presented here suggests that obese mice have worse outcomes compared to lean mice after mild TBI. Also, the obese males have worse outcomes than the injured female mice. This data may explain the sequela of chronic secondary brain injury in obese adults after a single mild TBI. Also, this report may help shape how the overweight/obese populations are monitored over the days and months following a TBI.
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Affiliation(s)
- Matthew Sherman
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ming-Mei Liu
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shari Birnbaum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Steven E Wolf
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joseph P Minei
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joshua W Gatson
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Department of Neurological Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9160, USA.
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Teng LC, Wang CX, Chen L. Improved erectile function and sex hormone profiles in male Chinese recipients of kidney transplantation. Clin Transplant 2011; 25:265-9. [PMID: 20331686 DOI: 10.1111/j.1399-0012.2010.01237.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Few studies have reported the relationship between duration of dialysis and effect of kidney transplantation on sex hormone levels and erectile dysfunction (ED) in Chinese patients. METHODS Our study included 24 patients with uremia who underwent kidney transplantation. Erectile function in these patients was assessed using the 5-item version of the International Index of Erectile Function (IIEF-5), and serum sex hormone levels were measured pre- and post-transplantation. Post-transplantation changes in IIEF-5 scores were analyzed according to duration of dialysis. RESULTS Twenty-one (87.5%) and 11 (45.9%) of the 24 patients suffered from varying degrees of ED during the pre- and post-transplantation periods, respectively. The pre- vs. post-transplantation IIEF-5 scores were significantly different (p < 0.05) among patients who had undergone dialysis for less than six months. Following transplantation, serum levels of prolactin and β-estradiol decreased significantly (24.35 ± 11.62 vs. 13.93 ± 7.16 ng/mL, p = 0.027; 42.20 ± 15.04 vs. 17.7 ± 7.15 pg/mL, p = 0.000, respectively), whereas levels of testosterone increased (3.07 ± 0.94 vs. 6.54 ± 3.14 ng/mL, p = 0.004). CONCLUSIONS Successful kidney transplantation can significantly ameliorate ED in Chinese patients, especially in individuals with a shorter time on dialysis. Changes in sex hormone levels may contribute to this improvement in ED.
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Affiliation(s)
- Li Chen Teng
- Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Yadav R, Mehta SN, Kumar A, Guleria S, Seenu V, Tiwari SC. A prospective analysis of testicular androgenic function in recipients of a renal allograft. Int Urol Nephrol 2008; 40:397-403. [PMID: 18392945 DOI: 10.1007/s11255-007-9277-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2007] [Accepted: 08/16/2007] [Indexed: 01/24/2023]
Abstract
Eighteen adult males with end stage renal disease (ESRD) were studied to determine the serum levels of gonadotropins (LH and FSH), prolactin (PRL) and testosterone. All of the patients were studied longitudinally while undergoing maintenance hemodialysis (HD) and six months after renal transplantation. Prior to transplantation, significantly high levels of gonadotropins and PRL were observed. During HD the serum testosterone levels tended to be subnormal in most of the uremic patients and low normal in some of the subjects. Renal transplantation led to a significant improvement (P < 0.05) in serum testosterone. Elevated gonadotropin and PRL levels observed in patients on HD returned to the normal range in most of the patients after successful renal transplantation.
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Affiliation(s)
- Rajiv Yadav
- Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Chrapusta SJ, Egan MF, Wyatt RJ, Weinberger DR, Lipska BK. Neonatal ventral hippocampal damage modifies serum corticosterone and dopamine release responses to acute footshock in adult Sprague-Dawley rats. Synapse 2003; 47:270-7. [PMID: 12539200 DOI: 10.1002/syn.10179] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rats with excitotoxic neonatal ventral hippocampal lesions (NVHL) manifest in early adulthood a variety of behavioral and neurochemical abnormalities mimicking those seen in patients with schizophrenia. Some of these aberrations implicate malfunction of the midbrain dopamine systems. We studied NVHL effects on dopamine release in the rat frontal cortex, nucleus accumbens, and striatum during acute stress caused by inescapable continuous footshock (0.45 mA). Serum total corticosterone and prolactin levels were used as peripheral indices of stress. As an indirect index of dopamine release, tissue 3-methoxytyramine levels attained in vivo 10 min after monoamine oxidase inhibition was assayed in rats sacrificed by instantaneous microwave fixation of the brain tissue. Nonshocked NVHL rats showed significantly less nucleus accumbens' 3-methoxytyramine accumulation than their sham counterparts. Frontal cortical 3-methoxytyramine levels rose similarly after 20-min footshock in both groups of rats, but while it normalized after 60-min footshock in the sham rats, it did not decrease in the NVHL rats. Nucleus accumbens' 3-methoxytyramine was significantly elevated after either 20-min or 60-min footshock in both groups, whereas striatal 3-methoxytyramine was significantly elevated in the NVHL rats only. Serum corticosterone showed similar elevations in the sham and NVHL rats, but the patterns differed in that there was no attenuation after 60-min footshock in the latter. The lesion did not affect serum prolactin response. These data indicate that neonatal ventral hippocampal damage enhances and prolongs certain neural and neuroendocrine responses to acute physical stressor(s), and thus may affect adaptation and enhance detrimental effects of stress.
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Affiliation(s)
- Stanislaw J Chrapusta
- Laboratory of Experimental Pharmacology, Polish Academy of Sciences Medical Research Center, Warsaw, Poland.
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Chu SH, Tay SK, Chiang YJ, Chuang CK, Chen HW, Chen CS, Chou CC, Huang CC. Male sexual performance and hormonal studies in uremic patients and renal transplant recipients. Transplant Proc 1998; 30:3062-3. [PMID: 9838349 DOI: 10.1016/s0041-1345(98)00930-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- S H Chu
- Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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Arem R, Thornby JI, Deppe SA. Comparison of Thyroid Hormone and Cortisol Measurements with APACHE II and TISS Scoring Systems as Predictors of Mortality in the Medical Intensive Care Unit. J Intensive Care Med 1997. [DOI: 10.1177/088506669701200102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Thyroid and adrenal functions were evaluated in 49 consecutive critically ill, mechanically ventilated patients admitted to the medical intensive care unit (MICU) at Ben Taub General Hospital in Houston, TX. On admission, severity of illness was assessed by Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II) and Therapeutic Intervention Scoring System (TISS) scores. Thyrotropin Stimulating hormone (TSH) measured with a sensitive assay, thyroxine (T4), tri-iodothyronine (T3), T3 resin uptake, and Cortisol levels were measured on the first MICU day at 8 am, and results were assessed based on ability to predict mortality. It was shown that severe hypothyroxinemia (T4 < 3 μg/dL) was associated with a 75% mortality as opposed to a mortality rate of 19% in patients with a T4 level of 3 μg/dL or more ( p < 0.01), and a high 8 am Cortisol level (>30 μg/mL) was associated with a 56% mortality versus 0% in patients with Cortisol values less than 30 μg/dL ( p < 0.005), whereas a high APACHE II (>25) score and a high TISS (>25) score were only associated with a mortality of 47% ( p = 0.06) and 32% (NS), respectively, versus 21 and 20%, respectively, in patients with scores less than 25. Logistical regression analysis revealed that of all the variables, 8 am Cortisol level had the best predictive value of outcome, followed by T4 levels and T3 resin uptake levels. Although high Cortisol and low T4 levels used alone had a sensitivity of 56 and 75% and a specificity of 100 and 80.5%, respectively, combined low T4 and high Cortisol levels had a sensitivity of 100% and a specificity of 81.5% in predicting mortality. Very low T4 levels, due to severe illness, combined with high Cortisol levels (implying high physiological stress), are more sensitive predictors of mortality than APACHE II, TISS, Cortisol levels, or T4 levels alone, or any other combination of predictors.
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Affiliation(s)
- Ridha Arem
- the Department of Medicine, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX
| | - John I. Thornby
- the Department of Medicine, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX
| | - Scott A. Deppe
- the Department of Medicine, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX
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Affiliation(s)
- C Rivier
- Clayton Foundation Laboratories for Peptide Biology, Salk Institute, La Jolla, California 92037, USA
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Benker G, Jaspers C, Häusler G, Reinwein D. Control of prolactin secretion. KLINISCHE WOCHENSCHRIFT 1990; 68:1157-67. [PMID: 2126309 DOI: 10.1007/bf01815271] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
1. Prolactin is a 21,500 Dalton single-chain polypeptide hormone but may occur in 50 kDa and 150 kDa molecular variants. 2. These large PRL variants may be secreted predominantly; this condition is termed "macroprolactinemia". It is characterized by high immunological and normal biological serum levels of prolactin, and lack of clinical symptoms of hyperprolactinemia. 3. The information on PRL is encoded on chromosome 6. Transcription can be enhanced and suppressed by a variety of hormonal factors. 4. PRL is secreted in a pulsatile fashion; it displays a circadian rhythm (with a maximum during sleep) and is stimulated by some amino acids. PRL also responds to mechanical stimulation of the breast. 5. PRL rises during pregnancy, and maintainance of hyperprolactinemia (and, thereby, physiological infertility) is dependent on the frequency and duration of breast feedings. 6. Hypothalamic regulation of prolactin mainly involves tonic inhibition via portal dopamine. The physiological importance of various stimulating factors present in the hypothalamus is still incompletely understood. In particular, there is still no place for TRH in PRL physiology. 7. PRL is released in response to stress; this response may be mediated by opioids. The low-estrogen, low-gonadotropin amenorrhea of endurance-training women is not mediated by prolactin, however. 8. Estrogens stimulate PRL gene transcription via at least two independent mechanisms. There are many clinical examples of this estrogen effect on prolactin serum levels, and also on the growth of prolactinomas. 9. Mild hyperprolactinemia remains an enigma which cannot satisfactorily be resolved by biochemical or radiological testing. The border between "normal" and "elevated" prolactin is ill-defined. The possibility of macroprolactinemia complicates this matter even further. 10. The number of drugs which suppress prolactin by acting on pituitary D2 receptors, and which are useful in the treatment of hyperprolactinemia, continues to increase. In the field of ergot alkaloids, parenteral application appears to be a logical solution to the problem of the high first-pass effect; in addition, this form of treatment is frequently better tolerated than the oral route. 11. Prolactinoma development is presently being studied employing molecular biological techniques; the question of whether tumorigenesis can be attributed to specific defects of gene regulation remains to be answered.
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Affiliation(s)
- G Benker
- Abteilung für Endokrinologie, Medizinische Klinik und Poliklinik, Universität Essen
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Abstract
PURPOSE This study was undertaken to assess whether circadian variation of thyrotropin (TSH) is affected by the severity of a nonthyroidal illness. PATIENTS AND METHODS On the second day of admission to a medical intensive care unit, 20 consecutive patients with the major diagnosis of acute respiratory failure underwent TSH measurements at 8 A.M., 9 P.M., 11 P.M., and 1 A.M., with two sensitive assays. RESULTS Six patients died, five of whom had hypothyroxinemia (thyroxine [T4] less than 5.5 micrograms/dL) (83%) on the day of the study, whereas only three of the 14 survivors had low T4 (21%; p less than 0.05). Baseline 8 A.M. TSH measured with the two assays was similar in both groups and there was a progressive increase in TSH in survivors and a decrease in nonsurvivors at 9 P.M. and 11 P.M. However, the difference at these time points was not statistically significant. At 1 A.M., TSH levels were significantly lower among nonsurvivors (0.75 +/- 0.34 microU/mL with assay 1, and 0.7 +/- 0.4 microU/mL with assay 2) than in survivors (2.3 +/- 0.46 microU/mL with assay 1, and 2 +/- 0.5 microU/mL with assay 2; p less than 0.005; Wilcoxon test). Five of the nonsurvivors and none of the survivors had a suppressed 1 A.M. TSH level (p less than 0.001), suggesting a good correlation between suppressed 1 A.M. TSH and mortality. After exclusion of patients receiving drugs known to affect TSH levels (two nonsurvivors and four survivors), the same dissociation in TSH changes was observed, and significantly lower 1 A.M. TSH levels were observed in nonsurvivors than in survivors (0.13 +/- 0.08 microU/mL versus 2.7 +/- 0.6 microU/mL with assay 1; p less than 0.01). Cortisol levels were significantly higher only at 8 A.M. in nonsurvivors whether patients receiving drugs were included in the analysis (41.6 +/- 3.2 versus 28.4 +/- 2.7 micrograms/dL; p less than 0.01) or not (45.3 +/- 4.6 versus 30.5 +/- 3.6 micrograms/dL; p less than 0.01). At other times, cortisol levels were similar in both groups. The 24-hour TSH areas under the curve were also lower in nonsurvivors than in survivors whether patients receiving drugs known to affect TSH levels were included or not. However, cortisol areas under the curve were similar in both groups. CONCLUSION It is concluded that fatal illness is associated with a suppression of the late night TSH surge.
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Affiliation(s)
- R Arem
- Department of Medicine, Baylor College of Medicine, Houston, Texas 77030
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Foulks CJ, Cushner HM. Sexual dysfunction in the male dialysis patient: pathogenesis, evaluation, and therapy. Am J Kidney Dis 1986; 8:211-22. [PMID: 3532769 DOI: 10.1016/s0272-6386(86)80029-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Impotence is a common problem in male dialysis patients. Although dialysis patients may appear to have more reasons to be depressed than nondialysis patients, depression has not been found to be correlated with erectile dysfunction in this group. Primary testicular failure is common in male dialysis patients as is hyperprolactinemia. These disorders may be the cause of impotence in some of these patients. An algorithm for the evaluation and treatment of impotence in the male dialysis patient is presented. Successful renal transplantation is associated with improvement in the testicular failure, in the hyperprolactinemia, and in the erectile dysfunction of the male patient with end-stage renal disease.
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Bercu BB, Diamond FB. Growth hormone neurosecretory dysfunction. CLINICS IN ENDOCRINOLOGY AND METABOLISM 1986; 15:537-90. [PMID: 2429794 DOI: 10.1016/s0300-595x(86)80010-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The basis for understanding clinical disorders in the neuroregulation of GH secretion is derived from the complexity of the CNS-hypothalamic-pituitary axis. Studies in animals and humans demonstrate an anatomic, physiological and pharmacological evidence for neurosecretory control over GH secretion including neurohormones (GRH, somatostatin), neurotransmitters (dopaminergic, adrenergic, cholinergic, serotonergic, histaminergic, GABAergic), and neuropeptides (gut hormones, opioids, CRH, TRH, etc). The observation of a defect in the neuroregulatory control of GH secretion in CNS-irradiated humans and animals led to the hypothesis of a disorder in neurosecretion, GHND, as a cause for short stature. We speculate that in this heterogeneous group of children a disruption in the neurotransmitter-neurohormonal functional pathway could modify secretion ultimately expressed as poor growth velocity and short stature.
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Blades RA, Bryant KR, Whitehead SA. Feedback effects of steroids and gonadotrophin control in adult rats with streptozotocin-induced diabetes mellitus. Diabetologia 1985; 28:348-54. [PMID: 3899819 DOI: 10.1007/bf00283142] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The effects of long-and short-term streptozotocin-induced diabetes mellitus on the control of gonadotrophin secretion have been investigated in adult intact rats. A high dose of streptozotocin (80 mg/kg), administered intraperitoneally 3 days before experimentation, inhibited ovulation and reduced the pituitary luteinizing hormone response to luteinizing hormone releasing hormone in proestrous rats. A lower dose (40 mg/kg) did not inhibit ovulation but abolished the luteinizing hormone releasing hormone-priming effect on the pituitary which normally occurs on proestrus, prior to ovulation. Oestrous cyclicity was lost when diabetes was induced for 14 or 56 days, but there was no effect on pituitary responsiveness to luteinizing hormone-releasing hormone compared with control animals. Similar observations were made with rats placed on a food-restricted diet. In all experiments there was no difference between diabetic and control animals in the pituitary luteinizing hormone content, the hypothalamic content of luteinizing hormone-releasing hormone or the ovarian weights. Ovariectomized rats treated with streptozotocin (40 mg/kg) were used to investigate the effects of diabetes on steroid feedback mechanisms. There was an attenuated luteinizing hormone response to ovariectomy in diabetic compared with control animals, and an impaired positive feedback effect of progesterone in oestrogen-primed animals. The results show that streptozotocin-induced diabetes mellitus inhibits feedback action of gonadal steroids and this could account for both the loss of oestrous cyclicity and the reduced pituitary sensitivity to luteinizing hormone-releasing hormone.
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