Cumulative exposure to estrogen and psychosis: a peak bone mass, case-control study in first-episode psychosis.

The organizational structural effects of estrogen may be cumulative and permanent by impacting on neurodevelopment, giving rise to "neuroprotective" effects and eventually reduction of psychosis risk. Reduction in bone mineral density (BMD, in g/cm2), as a biological marker of reduced cumulative exposure to estrogen, may be a marker of increased psychosis risk. A sample of 19 first-episode female psychosis patients with minimal previous antipsychotic exposure (mean 10 weeks) and 20 female controls underwent advanced fan-beam dual X-ray absorptiometry (DXA) to assess lumbal spine BMD of the region of L1-L4.

Low plasma ghrelin level in gastrectomized patients is accompanied by enhanced sensitivity to the ghrelin-induced growth hormone release.

Ghrelin is a brain-gut peptide with potent GH-releasing activities. It has been suggested that the majority of circulating ghrelin originates from the stomach, with a smaller portion from the small intestine. Gastrectomy (GASTRX) significantly reduces circulating ghrelin concentrations.

Growth hormone (GH) peaks versus areas under the curve in the diagnosis of adult GH deficiency: analysis of the variables provided by the GHRH + GHRP-6 test.

Background: The diagnosis of growth hormone deficiency (GHD) relies on provocative tests of GH reserve. The aim in these tests is to obtain an objective, biochemical-based, measure of gland function, but clinicians and researchers rely on the GH peak, as a surrogate of the 24-hour pituitary secretion. However, on a mathematical basis the area under the secretory curve (AUC) should be more valid for this evaluation.

Hypopituitarism following traumatic brain injury (TBI): a guideline decalogue.

In order to gain further insight into hypopituitarism, that ensues moderate to severe traumatic brain injury (TBI), a group of experts actively working in the field gathered to exchange recent data and concepts. The objective arising from the meeting was to enhance the awareness of both medical specialists and health care administrators on the problem, whose prevalence is higher than previously thought. Guidelines for the diagnosis and management of TBI-mediated hypopituitarism were produced.

Recruitment and baseline epidemiologic profile of participants in the first phase 3 HIV vaccine efficacy trial.

Objective: To describe recruitment and baseline epidemiologic characteristics of volunteers in the first phase 3 placebo-controlled trial of a recombinant gp120 HIV vaccine (AIDSVAX B/B).

Methods: Volunteers were gay/bisexual men or women at risk for sexually transmitted HIV infection. Recruitment strategies, demographics, and risk factors were assessed.

Circulating and cerebrospinal fluid ghrelin and leptin: potential role in altered body weight in Huntington's disease.

Objective: In addition to neurological impairment, weight loss is a prominent characteristic of Huntington's disease (HD). Neuropathologically, the disease affects the caudate nucleus and the cerebral cortex, and also the hypothalamus. The recently discovered orexigenic hormone of gastric origin, ghrelin and the adipocyte hormone leptin, are two peripherally produced hormones exerting opposite effects on specific populations of hypothalamic neurons that play a key role in regulating energy intake and energy output.

Retroperitoneal malignant fibrous histiocytoma mimicking pheochromocytoma.

We report the case of a 52-yr-old man with a mass in the area of the left adrenal. The clinical features, MIBG uptake, and elevated urinary dopamine levels suggested the diagnosis of pheochromocytoma. He presented with unstable hypertension, tachycardia, weight loss, and the "inflammatory syndrome" (fever, leukocytosis, and high sedimentation rate).

Inhibin B: a potential marker of gonadal activity in patients with anorexia nervosa during weight recovery.

Inhibin B is a product of the gonads and a marker for ovarian follicular development. This was a cross-sectional study designed to assess awakening of the reproductive function by studying secretion pattern of inhibin B during the weight restoration in patients with anorexia nervosa (AN). Twenty patients with AN participated at low weight [body mass index (BMI) 14.

Evaluation of the reproducibility of the GHRH plus GHRP-6 test of growth hormone reserve in adults.

Background: The diagnosis of GH deficiency (GHD) is controversial, relying on GH secretion elicited by the provocative tests of GH reserve. However, the performance of most of the tests in use have not been evaluated rigorously. The repeatability of a test is a prerequisite before evaluating its diagnostic capability.

Growth hormone response to GHRH + GHRP-6 in type 2 diabetes during euglycemic and hyperglycemic clamp.

The aim of this study was to investigate the effect of two different glucose levels on GH response to the combined administration of GHRH+GHRP-6 in patients with type 2 diabetes. GH response to i.v.

Case report of hypopituitarism with suspected syndrome of inappropriate VP secretion (SIADH) due to a large aneurysm of the internal carotid in the sellar region.

Hypopituitarism and hyponatremia, especially when severe, are infrequent findings particularly when the cause of hypopituitarism at presentation is unknown and untreated. Interestingly, hyponatremia is usually seen in elderly patients with hypopituitarism due to various causes. We present a case with unrecognized and untreated hypopituitarism due to a large aneurysm of the internal carotid artery in the sellar region causing the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

The effectiveness of arginine + GHRH test compared with GHRH + GHRP-6 test in diagnosing growth hormone deficiency in adults.

Objective: The objective of this study is to investigate the performance of two novel tests in diagnosing growth hormone deficiency in adults.

Patients: Fifty patients presenting with long-standing hypopituitarism and two control groups consisting of 50 healthy subjects in each group [age-, sex- and body mass index (BMI)-matched] participated in a multicentre study. All underwent two provocative tests on different days within 3 months apart: (i) a combined GHRH + GHRP-6 test and (ii) arginine + GHRH test.

Ghrelin main action on the regulation of growth hormone release is exerted at hypothalamic level.

Ghrelin, a recently isolated hormone, seems to participate in the physiological regulation of GH secretion. Exogenously administered ghrelin stimulates GH discharge in all species so far tested including man, but whether this action is exerted at pituitary or alternatively at hypothalamic level is not known at present. To understand the point of ghrelin action a group of patients with organic lesion mainly in the hypothalamic area and matched controls were studied.

Growth-hormone response to combined stimulation with GHRH plus GH-releasing peptide-6 in obese patients with polycystic ovary syndrome before and after short-term fasting.

Controversial data were reported on GH response to different provocative stimuli in obese patients with polycystic ovary syndrome (PCOS). The objective of our study was to assess the effect of short-term fasting on GH response to combined stimulus with GHRH+GH-releasing peptide-6 (GHRP-6) in obese patients with PCOS and possible relation with leptin and insulin changes during fasting. Twelve obese PCOS women and nine obese control women participated in 3-day fasting.

Effect of 12 months of recombinant human growth hormone replacement therapy on insulin sensitivity in GH-deficient adults as determined by different methods.

Background: Controversial results have been obtained in measuring insulin sensitivity (S(I)) during recombinant human growth hormone (rhGH) treatment in adult growth hormone deficient (GH-deficient) patients.

Aims: The aim of our study was to estimate S(I) before and during treatment using three different methods for quantifying insulin sensitivity in GH-deficient adults treated with rhGH.

Settings And Design: Twenty-one GH-deficient adults were treated with rhGH during 12 months.

Ghrelin-induced GH secretion in normal subjects is partially resistant to homologous desensitization by GH-releasing peptide-6.

Objective: GH secretagogues and GH-releasing hormone (GHRH) exert a complex cross-talk at the somatotrope cell, and undertake homologous and heterologous desensitization. On the other hand, the discovery of ghrelin as a new factor implicated in the regulation of GH secretion makes a thorough assessment of its properties and cell biology processes mandatory. In order to implement this, three different testing schedules were devised using the administration, on the same day, of two GH stimuli administered in sequential order 120 min apart.

A single growth hormone (GH) determination is sufficient for the diagnosis of GH-deficiency in adult patients using the growth hormone releasing hormone plus growth hormone releasing peptide-6 test.

Background: The diagnosis of GH deficiency in adults is based on the provocative testing of GH secretion. When testing a patient with suspected GH deficiency, clinicians assess the whole secretory curve and select the GH peak as an index of secretory capability. This procedure is time consuming and the determination of GH in several samples is necessary.

Dopaminergic tone and obesity: an insight from prolactinomas treated with bromocriptine.

Objective: It has recently been shown that increased body weight is associated with prolactinomas and that weight loss occurs with normalization of prolactin levels. On the other hand, decreased dopaminergic tone in humans is well correlated with obesity. The objective of this study was to correlate changes in prolactin levels with leptin and body mass index (BMI) in patients with prolactinomas treated with the long-acting dopamine agonist bromocriptine (BC).

High output heart failure in patients with newly diagnosed acromegaly.

Purpose: We sought to determine the prevalence and characteristics of heart failure in patients with newly diagnosed acromegaly.

Subjects And Methods: We assessed 102 consecutive patients who had acromegaly (44 men; age range, 22 to 71 years) for signs and symptoms of heart failure. We included a control group of 33 nonobese healthy subjects (13 men; age range, 26 to 70 years).

The impact of cranial irradiation on GH responsiveness to GHRH plus GH-releasing peptide-6.

Patients treated with cranial radiation are at risk of GH deficiency (GHD). We evaluated somatotroph responsiveness to maximal provocative tests exploring the GH releasable pool in relation to the impact of radiation damage to the hypothalamic-pituitary unit. The GH-releasing effect of GHRH plus GH secretagogue [GH-releasing peptide (GHRP)-6] (GHRH+GHRP-6) was studied in 22 adult patients (age, 23.

Response of serum macrophage migration inhibitory factor levels to stimulation or suppression of the hypothalamo-pituitary-adrenal axis in normal subjects and patients with Cushing's disease.

Macrophage migration inhibitory factor (MIF) is a proinflammatory pituitary and immune cell cytokine and a critical mediator of septic shock. It has been reported that MIF is secreted in parallel with ACTH from the pituitary in response to stress or inflammatory stimuli. MIF release from immune cells is also induced rather than inhibited by glucocorticoids.

Physical activity or food intake prior to testing did not affect the reproducibility of GH secretion elicited by GH releasing hormone plus GH-releasing hexapeptide in normal adult subjects.

Objective: Growth hormone deficiency (GHD) in adults is a defined syndrome of which the adverse effects on different areas of body function are reversed under replacement therapy with GH. The diagnosis of GHD is controversial in adults, relying on the GH secretion elicited by the so-called provocative tests of GH reserve. Most of the tests in use, including the widely employed insulin tolerance test, have been shown to be blunted after daily activities, such as mild exercise, heat or food intake, which makes stringent testing conditions mandatory in order to assure reproducibility.

Leptin and the pituitary.

Although leptin was originally viewed as an antiobesity hormone, it is now evident that it may have more pleiotropic actions. Experiments in rodents have shown that leptin activates the sympathetic nervous system, is involved in regulation of blood pressure, hematopoiesis, immune function, angiogenesis and brain, bone and pituitary development. Some biological effects expected based on observations in rodents, have so far not been seen in humans.

The exfoliation syndrome in cognitive impairment of cerebrovascular or Alzheimer's type.

The prevalence of exfoliation syndrome was studied in 39 patients suffering from dementia and cognitive impairment; a positive finding of exfoliation was detected in 11/39 of these patients. A comparison with an age-matched population survey showed that the prevalence of ocular exfoliation and the relative risk were significantly elevated. These results suggested that lesions related to the exfoliative process might be located also in the brain of patients suffering from dementia and cognitive impairment.