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  • 1
    Electronic Resource
    Electronic Resource
    Bromocriptine treatment over 12 years in acromegaly: effect on glucose tolerance and insulin secretion (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 372-378 
    Details
    ISSN: 1432-1440
    Keywords: Acromegaly ; Blood glucose ; Bromocriptine ; Glucose tolerance test ; Insulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It is not known whether the beneficial effect of bromocriptine on glucose homeostasis in acromegaly is limited by a certain duration of therapy. To elucidate this problem, oral glucose tolerance tests were performed in 12 acromegaly patients before bromocriptine medication, under therapy (15.0 ± 6.8 mg/day for 12 ± 3 years), and during a 2-week drug withdrawal after long-term treatment. Initially altered glucose tolerance was normalized in 4 of 5 patients under bromocriptine therapy. During drug withdrawal the mean fasting glucose level and the mean glucose concentration at 120 min after oral glucose load increased from 5.05 ± 0.61 to 5.77 ± 0.78 mmol/1 and from 5.61 ±2.05 to 7.55 ± 3.05 mmol/1, respectively. A deterioration in glucose homeostasis was observed in 9 patients, and impaired glucose tolerance was ameliorated (but not to normal range) in 2 when bromocriptine was withdrawn. The proportion of alterations in glucose tolerance during drug withdrawal corresponded to that before the beginning of long-term bromocriptine treatment. Impaired glucose tolerance, observed in 2 patients under bromocriptine treatment, seemed to be compensated because a distinct elevation of glycosylated hemoglobin A1c was not observed. Bromocriptine led to a significant decrease in basal as well as glucose-stimulated insulin levels, and growth hormone secretion during oral glucose load was reduced in all 12 patients. Similarly to the increased growth hormone secretion after drug withdrawal in 11 patients, a rise in glucose-stimulated insulin secretion was found in all patients; hereby, the mean insulin levels at 0 and 120 min during oral glucose load rose significantly from 7.5 ± 2.6 to 12.1 ± 5.1 mU/1 (P〈0.01) and from 71.3±52.1 to 101.4±50.7 mU/1 (P〈0.02), respectively. A direct relationship between disturbance in glucose homeostasis and degree of hypersomatotropism was not observed. Our data confirm that the beneficial effect of bromocriptine therapy on glucose homeostasis in selected patients with acromegaly is still present after dopaminergic treatment over a mean period of 12 years. Compared with the published rates on improved glucose homeostasis under octreotide, the effect of bromocriptine seems to be more favorable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00186626
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  • 2
    Electronic Resource
    Electronic Resource
    Gallstones in acromegalic patients undergoing different treatment regimens (1992)
    Springer
    Journal of molecular medicine 70 (1992), S. 556-559 
    Details
    ISSN: 1432-1440
    Keywords: Somatostatin ; Octreotide ; Gallstones ; Cholelithiasis ; Gallbladder contraction ; Acromegaly
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The frequency of gallstones during longterm treatment with the somatostatin analogue octreotide reported in different studies varies from 0% to 50%, the reason for this variation being unknown. Therefore, we examined 58 acromegalic patients undergoing different treatment regimens for the frequency of gallstones. Thirteen were treated with octreotide, 20 with bromocriptine, and 25 had no medical treatment after successful neurosurgery. Also, 58 patients without known gallbladder disease served as controls. The postprandial gallbladder contraction was also investigated in 27 acromegalic patients (10 with octreotide, 10 with bromocriptine, and 7 with no medical therapy). Ten of the 58 acromegalic patients were found to have gallstones, 4 of 25 receiving no medical treatment, 4 of 20 treated with dopamine agonists, and 2 of 13 treated with octreotide. In 9 of the 58 control patients, gallstones were detected. Although in the octreotide group the gallstones were newly formed under therapy, there was no difference in gallstone prevalence between the different treatment regimens and the control group. However, the postprandial gallbladder contraction was significantly more often inhibited during octreotide therapy, and this effect was most pronounced during the first hours following injection. Differences in the timing of injections therefore may be an explanation of the variable incidence of cholelithiasis in the different studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184790
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Hydrocephalus communicans (1974)
    Springer
    Journal of neurology 207 (1974), S. 279-287 
    Details
    ISSN: 1432-1459
    Keywords: Hydrocephalus communicans ; Circulation of CSF ; Cisternoscintigram ; Atrio-ventricular shunt operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Aus einem Kollektiv von 56 Patienten mit primär-chronischen Krankheitsverläufen und den Merkmalen POS und/oder spastische Para-/Tetraparese wurden 29 Patienten erfaßt, die nach üblichen cisternoszintigraphischen Kriterien schwere (21 Patienten) bis sehr schwere (8 Patienten) Liquorzirkulationsstörungen aufwiesen, die ätiologisch unklar blieben. 12 dieser Patienten mit zusätzlich pathologischem PEG (Hydrocephalus communicans vorwiegend ohne Außenluftfüllung) erhielten eine atrio-ventrikuläre Liquordrainage. Nur einer der Patienten wurde dadurch gebessert. Ein pathologisches Aktivitätsmuster im Cisternoszintigramm hat also unabhängig von seinem Schweregrad noch keinen Krankheitswert. Danach ist die Indikation zur Shunt-Operation vor allem bei alten Patienten mit pathologischer Liquorzirkulation ohne nachweisbare Ursache nicht befriedigend zu stellen. Die mögliche Verbesserung der Indikationsstellung wird diskutiert.
    Notes: Summary A study of 56 patients with primary chronic general impairment of mental functions and/or para- or tetraparesis was made. Cisternoscintigraphic examination in 29 of these patients demonstrated a severe disturbance of the CSF circulation of unknown etiology; 12 of these, all of whom had pathological pneumoencephalograms, were treated surgically by means of atrioventricular shunts and only one improved after operation. Thus, a pathological cisternoscintigraphic activity pattern does not imply that the patient will be benefited by a shunt operation. Accordingly, the treatment of communicating hydrocephalus, even if severe, in old patients with a cisternoscintigraphically demonstrated pathological CSF circulation of unknown etiology, should be considered with caution and with only 8.3% hope of improving the condition of the patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00312582
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    Paper (German National Licenses)
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