Team- and case-based learning to activate participants and enhance knowledge: an evaluation of seminars in Germany.

Introduction: There is a strong need for high-quality continuing medical education (CME) in Germany. To maintain a medical license, physicians are required to participate in regular training. Although evidence suggests that compared to lectures interactive methods can impart sustainable knowledge and a high degree of satisfaction, few interactive CME courses are offered.

[Reduced incidence of side-effects of growth hormone substitution in 404 patients with hypophyseal insufficiency. Results of a multicenter indications study].

Background: Substitution of pituitary insufficient patients with recombinant human growth hormone (rhGH) in addition to the conventional substitution with glucocorticoids, L-thyroxine and sex hormones has been approved by the regulatory authorities in 1995 with the imposition to conduct surveillance studies to monitor drug safety.

Results: 24% of all patients were within their 2nd treatment year, 15% within their 4th year, maximum treatment period was 6 years. There were 2 peaks within the patients age distribution: 30 to 39 years (24%) and 50 to 59 years (24%).

Comparison of gonadotropin-releasing hormone and gonadotropin therapy in male patients with idiopathic hypothalamic hypogonadism.

Objective: To compare pulsatile gonadotropin-releasing hormone (GnRH) therapy with gonadotropin therapy in male patients with idiopathic hypothalamic hypogonadism.

Design: Prospective study. Patients had free choice between the two forms of therapy.

Psychopathological and neuropsychological symptoms in patients with subclinical and remitted hyperthyroidism.

To investigate relationships between hyperthyroidism and behavior, 45 formerly hyperthyroid patients (now euthyroid) and 51 control subjects were investigated by (a) a semi-structured psychiatric examination, (b) self-rating scales to assess mood states and personality, and (c) neuropsychological tests. Patients with "subclinical" or "remitted" hyperthyroidism showed more abnormalities than the controls in all dimensions investigated. Forty-three percent of patients (10% of controls) complained of "seriously reduced" well-being with feelings of fear, hostility, and inability to concentrate.

[TRH-stimulated growth hormone secretion in acromegaly. Therapeutic results with 188 patients].

TRH-induced stimulation of hGH secretion before and after operation or radiotherapy and during bromocriptine treatment was tested in 188 patients with acromegaly. A normal hGH level (basal level less than 5 ng/ml) was achieved after operation in 106 patients (58%). Postoperatively persisting elevated hGH levels were reduced to normal by bromocriptine in 39%, by radiation in 22% and by combined radiation and bromocriptine in 48%.

[Testosterone and estradiol levels in male gynecomastia. Clinical and endocrine findings during treatment with tamoxifen].

Oestradiol-(E2) levels in serum were significantly higher in a group of 91 males with gynaecomastia than in a control group. The levels were highest in patients with testicular tumour, hyperprolactinaemia and idiopathic gynaecomastia. In gynaecomastia of puberty and primary or secondary hypogonadism, the E2 level was within normal limits, but the testosterone/oestradiol ratio was significantly reduced.

[Hyperprolactinemia in the male: clinical aspects and therapy].

Fifty-seven male patients with hyperprolactinemia have been investigated. Macroadenomas were found in 49 patients of whom 24 had received pituitary surgery before elevated PRL levels were discovered. In 8 patients radiology of the pituitary fossa revealed either evidence of microadenoma or a completely normal sella turcica.

[Effect of caerulein on blood glucose, serum insulin, glucagon, prolactin and growth hormone before and after oral glucose load in healthy volunteers and diabetic patients (author's transl)].

Eleven healthy volunteers, five type I diabetics, and one type II diabetic man were examined. After an overnight fast caerulein (20 ng/kg) was injected intravenously and 60 min later an oral glucose tolerance test was performed with 100 g glucose in the normals and 25 g glucose in the diabetics. Blood pressure, pulse rate, blood glucose, serum insulin, glucagon, prolactin and growth hormone values were measured during the whole period of 240 min and compared with the same parameters in control tests in the same persons without caerulein application.

Persisting suppression of prolactin secretion after long-term treatment with bromocriptine in patients with prolactinomas.

The effect of bromocriptine withdrawal after long-term treatment on prolactin levels has been investigated in thirty-seven patients with prolactinomas. In ten patients with macroprolactinomas and post-operatively excessively high prolactin levels persisting suppression of prolactin secretion after bromocriptine withdrawal has been observed. This effect was not observed in patients with microprolactinomas or macroprolactinomas with only moderately elevated prolactin levels.

[Pituitary hormone secretion induced by optokinetic stimulation (author's transl)].

A slight optokinetic stimulation induces a significant increase of serum levels of antidiuretic hormone 1,1 +/- 0.8 pg/ml (mean +/- SD) to 3,3 +/- 1,9 pg/ml (mean +/- SD). Serum levels of gGH and cortisol remain unchanged, whereas serum prolactin levels decrease slightly.

Increased urinary excretion of triiodothyronine (T3) and thyroxine (T4) and decreased serum thyreotropic hormone (TSH) induced by motion sickness.

We exposed 35 male subjects to a rotary chair and motion sickness was provoked by Coriolis effect. This stress caused an increased excretion of urinary T3 and T4 and a decrease of TSH levels in serum. The increment in urinary excretion of thyroid hormones may serve as a very useful measure for the quantitation of physical stress.

Increased secretion of growth hormone, prolactin, antidiuretic hormone, and cortisol induced by the stress of motion sickness.

The stress of motion sickness was experimentally provoked by Coriolis effect. Significant and reproducible increases from the basal serum level (delta mean +/- S.E.

[Drug therapy of hyperprolactinemia and acromegaly].

Hyperprolactinemia can be treated medically. Thus all patients with a normal sella turcica and those patients with only slight enlargement of the sella turcica can be treated medically with the dopaminagonist bromocriptine. This treatment is also indicated in paitents with postoperative persisting hyperprolactinemia.

Hemodynamic response to digitalization in patients with hypertensive cardiovascular disease.

Twenty-eight patients with hypertensive cardiovascular disease (HCD) and incipient myocardial dysfunction underwent hemodynamic studies at rest and during exercise before and 30 minutes after administration of 0.6 mg beta-methyl-digoxin intravenously. Measurements were made during right heart catheterization with a balloon-tipped catheter.