Journal of endocrinological investigation
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J. Endocrinol. Invest. · Jan 2005
Review Comparative StudyHormonal cut-offs of partial androgen deficiency: a survey of androgen assays.
While the typical symptomatology of severe hypogonadism in young adults permits the clinical diagnosis of hypoandrogenism, the diagnosis of partial androgen deficiency of the aging male (PADAM), as occurs relatively frequently in elderly males, is much more difficult. This is due to its clinical picture being subtle and aspecific, and to the fact that both clinical and biochemical evidence of androgen deficiency are required for the diagnosis. In the absence of a practical, clinical useful parameter of androgen activity, we have to rely upon bio-active plasma testosterone levels. ⋯ As even when using the same kits, values for plasma testosterone and SHBG may differ significantly between laboratories, each laboratory should define its own normal values. As to the methodology, neither direct measurement of free testosterone by analog assay, nor the FT index (T/ SHB) can be recommended, only values obtained by dialysis, ammoniumsulfate precipitation or calculation yielding reliable estimates of androgen bio-activity. Dialysis and ammoniumsulfate precipitation are however work intensive and not widely used.
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J. Endocrinol. Invest. · Jan 2005
ReviewSomatostatin analogs in the treatment of neuroendocrine gastroenteropancreatic and intrathoracic tumors.
Somatostatin is a peptide hormone that posses several biological functions of which inhibition of hormone secretion from endocrine cells is one. Neuroendocrine tumors usually express somatostatin receptors (SSTRs), although the subtypes and number of SSTRs expressed in a certain tumor is very variable. ⋯ By this approach, it is possible to select patients suitable for treatment. Among patients with functioning neuroendocrine tumors expressing SSTR, more than 80% respond with symptomatic relief during somatostatin analog treatment, while treatment of non-functioning tumors still remains somewhat controversial.
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J. Endocrinol. Invest. · Dec 2004
Hypopituitarism as a consequence of traumatic brain injury (TBI) and its possible relation with cognitive disabilities and mental distress.
Recent studies have demonstrated that hypopituitarism, in particular GH deficiency, is common among survivors of traumatic brain injury (TBI) tested several months or yr following head trauma. We present the results of endocrine, neurological, neuropsychological and psychiatric evaluation in a group of 67 patients who suffered TBI at least one yr ago. Our study shows that decreased endocrine function is either restricted to one or more anterior pituitary hormones and is present in 34% of patients with any pituitary hormone deficit, while multiple pituitary hormone deficiencies are found in 10% of patients. ⋯ Paranoid ideation and somatization negatively correlated with the peak GH responses to GHRH+GHRP-6 test (p = 0.04 and p = 0.03, respectively). Depression scale showed that nearly half of patients suffered from mild to moderate depression. The benefits of hormone replacement therapy on cognitive functioning and mental distress in TBI patients are eagerly awaited.
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J. Endocrinol. Invest. · Nov 2004
Case ReportsPregnancy in Cushing's disease shortly after treatment by gamma-knife radiosurgery.
Gamma-knife radiosurgery (GKR) is considered as a possible treatment for patients affected by unsuccessfully surgically treated pituitary adenoma or not suitable for surgery. The disadvantages of this technique seem to be the length of time to the onset of remission, which is known to be at least of 6 months, and the possible adverse effects. We report here a case of a 13-yr-old female patient with Cushing's disease (CD) due to ACTH-secreting pituitary adenoma. ⋯ The baby and the mother did not show any biochemical signs or clinical symptoms of hypo- or hypercortisolism. This case is interesting, since GKR exerted a very rapid effect and turned to be safe even if performed shortly before pregnancy. Moreover, in spite of the still high disease activity, the pregnancy had a normal course and the fetus did not have any cortisol secretion abnormalities.
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J. Endocrinol. Invest. · Jan 2004
ReviewMetabotropic receptors as targets for drugs of potential use in the treatment of neuropathic pain.
Glutamate is the major neurotransmitter in the mammalian central nervous system and plays a pivotal role in both acute and chronic pain. The actions of glutamate are mediated by two receptor families: ionotropic glutamate receptors (iGluRs), and metabotropic glutamate receptors (mGluRs). ⋯ Among these, group I mGluRs (mGlu1 and -5) have been implicated in the processes of central sensitization and persistent nociception, whereas activation of group II mGluRs (mGlu2/3) is effective against neuropathic or inflammatory pain. In this review we focus on the role of mGlu2/3 in the modulation of persistent pain, and on their potential use as drug targets in pain management.