Effects of testosterone treatment on bone mineral density in hypogonadal men receiving intrathecal opioids.

Background: Opioid induced depression of sex hormones is a common finding in chronic pain patients receiving long-term opioids by oral, parenteral and even intrathecal routes of administration. The hypothalamic suppression by opioids leads to a hypogonadal state with low testosterone levels in males and subsequent low bone mineral density (BMD).

Methods: We have studied the effects of intrathecally administered opioids on BMD in a group of male chronic pain patients.

Urine free cortisol analysis by automated immunoassay and high-performance liquid chromatography for the investigation of Cushing's syndrome.

Background: We compared a widely used immunoassay method for urine free corticoids with a high-performance liquid chromatography (HPLC) method for the investigation of Cushing's syndrome.

Methods: Urine free corticoid analysis using an Immulite:2000 automated immunoassay analyser and urine free cortisol analysis by a specific HPLC method on 39 patients with an elevated baseline immunoassay 24 h urine free corticoid result who were referred from 2000 to 2004.

Results: Reference ranges for urine free corticoids by immunoassay and for urine free cortisol by HPLC were <900 and <170 nmol/day, respectively.

Biochemical assessment and long-term monitoring in patients with acromegaly: statement from a joint consensus conference of the Growth Hormone Research Society and the Pituitary Society.

In April 2003, the Growth Hormone (GH) Research Society and The Pituitary Society developed a consensus statement to address the current status of both biochemical assessment and long-term monitoring in patients with acromegaly. They also highlighted the pitfalls of current GH and Insulin-like Growth Factor-1 (IGF-1) assay methodologies and the difficulties in defining target GH and IGF-1 levels in treated acromegaly.

Novel succinate dehydrogenase subunit B (SDHB) mutations in familial phaeochromocytomas and paragangliomas, but an absence of somatic SDHB mutations in sporadic phaeochromocytomas.

Phaeochromocytomas arising in adrenal or extra-adrenal sites and paragangliomas of the head and neck, in particular of the carotid bodies, occur sporadically and also in a familial setting. In addition to mutations in RET and VHL in familial disease, germline mutations in SDHD and SDHB genes that encode subunits of mitochondrial complex II have also been associated with the development of familial phaeochromocytomas. To further investigate the role of SDHD and SDHB in the development of these tumours we determined the occurrence of germline SDHD and SDHB mutations in four patients with a family history of phaeochromocytoma with associated head and neck paraganglioma, one patient with a family history of phaeochromocytoma only and two patients with apparently sporadic extra-adrenal phaeochromocytoma, one of whom had early onset disease.

Sex hormone suppression by intrathecal opioids: a prospective study.

Objective: Sexual dysfunction and low testosterone levels have been observed previously in males with chronic noncancer pain treated with intrathecal opioids. To investigate the hypothesis that intrathecal opioids suppress the hypothalamic-pituitary-gonadal axis, a prospective nonrandomized investigation of the function of this axis was undertaken.

Design: Ten males with chronic noncancer pain were evaluated for clinical and biochemical evidence of hypogonadism at baseline and during the first twelve weeks of intrathecal opioid therapy.