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  • 1
    Electronic Resource
    Electronic Resource
    Hypotensive effects of ovine and human corticotrophin-releasing factors in man (1987)
    Springer
    European journal of clinical pharmacology 31 (1987), S. 531-534 
    Details
    ISSN: 1432-1041
    Keywords: corticotrophin-releasing factor ; hypotension ; ovine CRF ; human CRF ; healthy volunteers ; tachycardia ; plasma noradrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The haemodynamic effects of i.v. bolus injections of 100 and 200 µg ovine CRF and human CRF in man have been compared. Neither ovine CRF 100 µg nor human CRF 100 µg caused a significant change in blood pressure, although the pulse rate was increased in all the subjects tested. The mean maximum increase in pulse rate after human CRF was almost twice that after ovine CRF (21 vs 12 beats·min−1;p〈0.05). After 200 µg ovine CRF in all subjects the diastolic blood pressure declined gradually from 77 mm Hg to a nadir of 67 mm Hg at 22 min (p〈0.002). After 200 µg human CRF diastolic blood pressure fell from 78 mm Hg to a nadir of 61 mm Hg at 6 min (p〈0.002); the fall after human CRF was significantly greater than after ovine CRF (p〈0.05). After 200 µg ovine CRF there was a slight increase in pulse rate lasting for 6 min, and after 200 µg human CRF there was a marked (reflex) tachycardia for 30 min. Only after the highest dose of human CRF did a slight increase in systolic blood pressure occur. The haemodynamic effects of both doses of human CRF were accompanied by significant increases in plasma noradrenaline concentrations, which were significantly greater after the higher dose.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00606625
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  • 2
    Electronic Resource
    Electronic Resource
    Enhancement of the ACTH response to human CRH by pretreatment with the antiglucocorticoid RU-486 (1987)
    Springer
    European journal of clinical pharmacology 31 (1987), S. 609-611 
    Details
    ISSN: 1432-1041
    Keywords: ACTH response ; antiglucocorticoid RU-486 ; plasma cortisol level ; corticotrophin releasing hormone CRH ; healthy volunteers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The response of ACTH to an i.v. bolus injection of 100 µg human CRH at 09.00 h was investigated in five healthy men with and without pretreatment with the antiglucocorticoid RU-486 100 mg given orally 7 h before the injection of CRH. In all five subjects the plasma cortisol level immediately before CRH administration at 09.00 h was significantly higher after pretreatment with the antiglucocorticoid (17.1 vs 11.1 µg/100 ml). Despite this higher baseline cortisol level, in all subjects the maximal CRH-induced ACTH increase was more pronounced after RU-486 loading (Δmax ACTH 39 vs 26 pg/ml). This observation proves that in man physiological concentrations of cortisol determine the response of the pituitary to CRH. Furthermore, the findings suggest reduced circulating glucocorticoid activity after administration of 100 mg RU-486, not completely compensated by an increase in plasma cortisol.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00606640
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  • 3
    Electronic Resource
    Electronic Resource
    Adrenocortical function: An indicator of severity of disease and survival in chronic critically ill patients (1992)
    Springer
    Intensive care medicine 18 (1992), S. 93-96 
    Details
    ISSN: 1432-1238
    Keywords: Adrenocortical insufficiency ; Hydrocortisone ; Apache II ; Critical illness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plasma cortisol levels and modified Apache II (Apache IIm-stay) severity of disease scores were determined at weekly intervals in 159 patients who were treated for at least 7 days at the Critical Care Unit of our hospital. The mean (±SD) plasma cortisol level (0.60±0.28 μmol/l) was clearly elevated in these patients. The highest plasma cortisol levels were measured in patients treated with vasoactive drugs (0.76±0.39 μmol/l). Non-survivors (n=36) had a significantly higher mean plasma cortisol level and Apache IIm-stay score than survivors (respectively 0.78±0.40 vs. 0.54±0.21 μmol/l;p〈0.0003 and 12.6±4.8 vs. 7.3±4.1;p〈0.0001). A significant correlation was found between the individual weekly plasma cortisol levels and the Apache IIm-stay scores (r=0.41;p〈0.0001), especially in the subgroup of patients, who never received glucocorticoids during their stay at the ICU (r=0.51;p〈0.0001). During the 14-month study period only two patients showed a clinical picture of adrenocortical insufficiency and a blunted response of cortisol to 0.25 mg synthetic ACTH(1-24). In conclusion, our data suggest that a high plasma cortisol level, like a high Apache IIm-stay score, indicates severity of disease and poor survival in critically ill patients. De novo adrenocortical insufficiency is rare and therefore routine screening of adrenocortical function is superfluous.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01705039
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  • 4
    Electronic Resource
    Electronic Resource
    Long-term results of two schedules of radioiodine treatment for toxic multinodular goitre (1993)
    Springer
    European journal of nuclear medicine 20 (1993), S. 1056-1062 
    Details
    ISSN: 1619-7089
    Keywords: Hyperthyroidism ; Radioiodine therapy ; Multinodular goitre
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The long-term effects of two schedules of radioiodine therapy in patients with toxic multinodular goitre were evaluated. Forty-five patients (group A) were treated with low doses and 58 patients (group B) with calculated doses adjusted for thyroid weight (1.85–3.70 MBq/g) and radioactive iodine uptake. Follow-up (mean ± SEM) was 4.3 ± 0.2 years and 5.2 ± 0.3 years, respectively (P〉0.1). At the end of follow-up, hyperthyroidism was successfully reversed in 73% (group A) and 88% (group B). In each group, hypothyroidism was present in 7%. The total dose per gram of thyroid tissue was not significantly different in groups A and B (2.1 ± 0.2 vs 2.7 ± 0.2 MBq/g). However, for patients treated with calculated doses the number of 131I administrations was significantly lower (1.3 ± 0.1) than for patients treated with low doses (2.2 ± 0.2), and the percentage of patients who were adequately treated with a single dose was more than twice as high (66% in group B versus 27% in group A). Euthyroidism was reached within a significantly shorter time after treatment with calculated doses (median time 0.6 years in group B vs 1.5 years in group A; life table analysis). It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a low risk of post-treatment hypothyroidism and that calculated (higher) doses appear to be preferable to low doses.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00173483
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  • 5
    Electronic Resource
    Electronic Resource
    Skin blood flow and autonomic reactivity in human poikilothermia (1996)
    Springer
    Clinical autonomic research 6 (1996), S. 91-97 
    Details
    ISSN: 1619-1560
    Keywords: skin blood flow ; autonomic reactivity ; hypothermia ; poikilothermia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Autonomic reactivity is pivotal in maintaining a constant body core temperature. Skin vasomotor reflexes and cardiovascular reactivity were investigated in four women (aged 28–37 years) with acquired poikilothermia, during steady-state spontaneous hypothermia (rectal temperature (Tr)=33.7 ± 1.0°C [mean ±SD]) and steady-state normothermia (Tr=36.7 ± 0.3°C), as well as in 12 normothermic control subjects. Baseline finger temperature (Tf) during hypothermia was significantly lower than during normothermia (Tf=32.4 ± 1.2 compared with 36.2 ±0.3°C, respectively), and than in the controls (Tf=34.8 ±0.8°C). No significant differences in baseline skin blood flow and forearm blood flow were found between subjects during hypothermia or normothermia and controls, suggesting a failure of sympathetic drive to counter-regulate hypothermia in the subjects. Skin vasoconstrictor responses to the contralateral cooling test and neck cooling test were markedly attenuated in three subjects, and to the finger cooling test in two subjects, during normothermia compared with hypothermia. Blood presure responses to the Valsalva manoeuvre and head-up tilting were normal in all subjects, whereas the heart rate response to head-up tilting was blunted in three subjects during hypothermia. The responses of blood pressure and forearm blood flow to the cold pressor test in the subjects during both thermal conditions were comparable with the controls. We conclude that in our subjects, without generalized autonomic failure, poikilothermia has to be attributed predominantly to disorders of the central thermoregulatory pathways. Our findings during hypothermia and normothermia indicate that variations in core and skin temperature significantly affect skin vasomotor reactivity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02291229
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  • 6
    Electronic Resource
    Electronic Resource
    Long-term follow up of breast cancer patients treated for hypercalcaemia with aminohydroxypropylidene bisphosphonate (APD) (1993)
    Springer
    Breast cancer research and treatment 25 (1993), S. 277-281 
    Details
    ISSN: 1573-7217
    Keywords: aminohydroxypropylidene bisphosphonate (APD) ; bisphosphonates ; breast cancer ; hypercalcaemia ; skeletal metastases ; survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary No systematic data are available about the long-term follow up of breast cancer patients treated with aminohydroxypropylidene bisphosphonate (APD) for hypercalcaemia and about the results of APD treatment of recurrent hypercalcaemia in these patients. Treatment with intravenous APD (10-15 mg daily until normalization of the serum calcium level) normalized serum calcium in 29 of 31 patients with hypercalcaemia due to advanced breast cancer. Survival in these 29 patients varied between 8 and 693 days (median 140 days) and 7 patients achieved a partial remission or stabilisation of disease during subsequent anti-tumor therapy. In 16 of the 29 patients in whom APD treatment was initially successful, hypercalcaemia recurred after a median period of 65 days. Eleven of these patients received a second course of APD, which was equally successful as the first in terms of percentage of patients with normalization of serum calcium, total dose of APD needed, and duration to normalization of serum calcium. Recurrent hypercalcaemia occurred significantly faster after the second successful APD course (median 17 days) than after the first (median 65 days). When only patients with progressive disease were taken into account, recurrence of hypercalcaemia usually occurred early, both after a first (median 23 days) and after a second successful APD course (median 17 days). Normalization of serum calcium occurred in 4 of 6 patients receiving a third APD course, in all 3 patients receiving a fourth, and in 1 of 2 patients receiving a fifth course. We conclude that with the use of APD, hypercalcaemia as the cause of death in patients with advanced breast cancer can be avoided or delayed, which offers better prospects for the palliative care of these women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00689842
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  • 7
    Electronic Resource
    Electronic Resource
    Calcaneal Ultrasound Imaging in Healthy Children and Adolescents: Relation of the Ultrasound Parameters BUA and SOS to Age, Body Weight, Height, Foot Dimensions and Pubertal Stage (2000)
    Springer
    Osteoporosis international 11 (2000), S. 967-976 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Adolescents – BUA – Children – Puberty – SOS – Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We investigated the quantitative ultrasound (QUS) parameters broadband ultrasound attenuation (BUA) and speed of sound (SOS) measured in the posterior part of the calcaneus at the region of interest (ROI) with the lowest attenuation, using an ultrasound imaging device (UBIS 3000) in 491 healthy Caucasian children and adolescents (262 girls, 229 boys) between 6 and 21 years old. The relation of age, body weight, height, foot dimensions and pubertal stage to BUA and SOS was assessed. BUA increased nonlinearly with age in boys and girls, r 2 being 0.44 (p〈0.001) and 0.57 (p〈0.001), respectively. SOS increased linearly with age in girls (r 2= 0.04, p〈0.001). There was no significant increase in SOS in boys (r 2= 0.01, p〉0.05). Heel width was significantly correlated with BUA (r= 0.20, p〈0.005 in boys; r= 0.27, p〈0.05 in girls) and with SOS (r=−0.19, p〈0.005 in boys; r=−0.08, p〈0.05 in girls). After downward adjustment of the ROI size according to foot length quartiles, significantly lower BUA and SOS values were found compared with those with the standard ROI size of 14 mm. After correction for heel width and adjustment of the ROI size based on foot length, BUA and SOS were significantly associated with age in boys (r 2= 0.36, p〈0.001 and 0.06, p〈0.05) and in girls (r 2= 0.53 and 0.06, both p〈0.001). Tanner stage was significantly correlated with BUA (r= 0.62, p〈0.001 in boys; r= 0.73, p〈0.001 in girls) but not with SOS. BUA but not SOS increased significantly with the number of years since menarche (p〈0.001). In a multiple stepwise regression analysis in boys, age, weight and foot length were independent predictors for BUA, and age and foot length for SOS. In girls, age and weight were independent predictors for BUA and age was the only independent predictor for SOS. After correction for age, pubertal stages and heel width were no longer determinants for QUS parameters in either boys or girls. In conclusion, BUA increased significantly with age in both sexes. SOS increased with age in both boys and girls, but the increase was small and not statistically significant in boys. SOS, as measured with the UBIS 3000 device, may therefore not be appropriate to assess skeletal status in healthy children. Whether SOS and BUA are affected in children with skeletal disorders has yet to be determined. In boys, age, weight and foot length were independent predictors for BUA and age and foot length for SOS. In girls, age and weight were independent predictors for BUA and age was the only independent predictor for SOS. In our opinion, children with small feet should be measured with a smaller ROI diameter than those with larger feet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980070036
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