Treatment of Subclinical Hyperthyroidism and Incident Atrial Fibrillation.

Context: Treating overt hyperthyroidism prevents atrial fibrillation (AF). Though subclinical hyperthyroidism (SH) has been associated with AF, it is unknown whether treating SH prevents AF.

Objective: We aimed to identify the association between treating SH and incident AF.

Forensic science: A judicial perspective.

This article describes three major developments in forensic evidence and the use of such evidence in the courts. The first development is the advent of DNA profiling, a scientific technique for identifying and distinguishing among individuals to a high degree of probability. While DNA evidence has been used to prove guilt, it has also demonstrated that many individuals have been wrongly convicted on the basis of other forensic evidence that turned out to be unreliable.

School Gardens in the United States: Current Barriers to Integration and Sustainability.

Objectives: To elucidate details about the barriers (time, funding, staffing, and space) to integrating and sustaining school gardens.

Methods: A total of 99 school gardeners from 15 states participated in an online survey in June 2017. The 29-item survey contained qualitative and quantitative items that we analyzed using descriptive statistics and inductive content analysis.

Intrauterine insemination with husband's washed sperm.

Methods used for artificial insemination with the husband's semen (AIH) have undergone continuous revision in the hope of increasing the pregnancy rates obtained. We report our methodology using technology developed for in vitro fertilization to prepare sperm for intrauterine insemination. Our overall pregnancy rate is 30%.

In vitro fertilization. The Scripps Clinic experience.

The in vitro fertilization (IVF) program at Scripps Clinic and Research Foundation, La Jolla, California, was started in 1983. In vitro fertilization is now an accepted type of infertility treatment for many couples with a disorder of tubal origin, endometriosis, male-factor infertility, or idiopathic infertility. Successful outcome has depended on the woman's age, the cause of infertility, and the number of embryos transferred.

Calcification of the pituitary stalk associated with the clinical diagnosis of schizophrenia.

Three male patients who were at some time diagnosed as schizophrenic are described. They all suffered from a degree of strangulation due to calcification of the pituitary stalk and may have been suffering from a variant of mesodermal hyperplastic disease given a diagnosis of schizophrenia.

Tuberous sclerosis in the aetiology of the so-called idiopathic epilepsies and psychoses.

Ten suspected cases of tuberous sclerosis seen over a period of 4 1/2 years are described. Investigations were carried out in a general practice setting. The place of tuberous sclerosis in the so-called idiopathic and functional psychoses is discussed and an additional aetiological mechanism is postulated.

Increased luteinizing hormone sensitivity to dopamine inhibition in polycystic ovary syndrome.

The elevated LH secretion in 8 patients with the polycystic ovarian syndrome (PCO) was promptly suppressed by the infusion of dopamine (DA; 4 microgram/kg.min for 4 h). Compared to normal women studied during the early follicular phase, the maximal LH suppression due to DA infusion was significantly greater in PCO patients when expressed as either the net or percent decrease.

Prevalence of hyperprolactinemia in anovulatory women.

To determine the prevalence of hyperprolactinemia in an ovulatory patients presenting to a general gynecology clinic, a 1-year prospective study (1978) was instituted. A total of 119 patients with at least 3 months of anovulation were screened with serum prolactin determinations. Those patients demonstrating hyperprolactinemia were further evaluated with a serum TSH level and hypocycloidal polytomography of the pituitary sella.

Changes in pituitary hormones during and following transsphenoidal removal of prolactinomas.

Prolactin (PRL) and other pituitary hormones (luteinizing hormone, follicle-stimulating hormone, growth hormone [GH], thyrotropin stimulating hormone) were measured before, during, and after transphenoidal pituitary adenomectomy in 16 patients with hyperprolactinemia. The diagnosis of prolactinoma was made in three of the 16 patients by the absence of PRL response to thyrotropin-releasing factor (TRF) and a dopamine receptor antagonist, metoclopramide, without radiologic evidence of an adenoma. Contrary to findings in subjects with normal PRL values, the PRL rise in response to anesthesia and operation was absent.

Correlations between seminal radioimmunoreactive prolactin, sperm count, and sperm motility in prevasectomy and infertility clinic patients.

Semen samples were collected from 50 prevasectomy patients and 43 infertility clinic patients. Various parameters were measured, including semen radioimmunoreactive prolactin (rPRL) levels. Linear correlations were tested between the measured parameters, and a significant correlation was found between semen rPRL concentration and sperm count for both the prevasectomy (r = 0.

Progesterone induced acute release of prolactin in estrogen primed ovariectomized women.

Progesterone (10 mg) administered intramuscularly induces a concurrent release of prolactin as well as gonadotropin in estrogen-primed women. The time course of pituitary release of all three of these hormones appears to include a latent phase of 4 hrs and is maintained for at least 5 hrs. It is considered that this effect of progesterone may be mediated through a reduction of hypothalamic dopamine.

Inhibition of gonadotropin and prolactin release by dopamine: effect of endogenous estradiol levels.

The influence of endogenous estradiol (E2) levels on gonadotropin and PRL sensitivity to dopamine (DA) infusion (4 micrograms/kg/min) was assessed at different stages of the follicular phase of the menstrual cycle. Basal LH and FSH levels were comparable in day 2 and day 12 subjects, and despite a 4-fold increase in E2 concentration, the inhibition of LH by DA was small and quantitatively similar and there was no discernible effect on FSH in either group. In marked contrast, day 14 subjects with an elevated basal LH level exhibited a dramatic increase in the sensitivity of LH and FSH to DA inhibition.

The impairment of progesterone-induced pituitary release of prolactin and gonadotropin in patients with hypothalamic chronic anovulation.

Sequential administrations of progessively increasing amounts of estradiol benzoate (EB) for five days followed by 10 mg. of progesterone (P) elicited a prompt pituitary release of luteinizing hormone, follicle-stimulating hormone, and prolactin in normal women during the early follicular phase but not in women with normogonadotropic hypothalamic chronic anovulation with or without associated hyperprolactinemia. Since hypothalamic dopamine functions as an inhibitor for the secretion of both prolactin and gonadotropin, we postulate that sequential EB-P stimulation for simultaneous release of gonadotropin and prolactin may be mediated by a reduction of hypothalamic dopamine in response to progesterone.

Correlation of the effects of dexamethasone administration on urinary 17-ketosteroid and serum androgen levels in patients with hirsutism.

Total 24 hour urinary 17-ketosteroid and serum testosterone (T), androstenedione (delta), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DS), and cortisol levels were measured before and during four days of dexamethasone administration in 28 hirsute patients and 10 women with normal ovulatory cycles. Both the base-line urinary 17-ketosteroids and serum androgen levels were significantly higher (p less than 0.05) in hirsute than in normal subjects.

Characterization of the inappropriate gonadotropin secretion in polycystic ovary syndrome.

To evaluate gonadotropin release in polycystic ovary syndrome (PCO), one or more of the following hypothalamic-pituitary function tests were performed on 24 patients with the syndrome. These tests included (a) the pulsatile pattern and day-to-day fluctuation of gonadotropin release; (b) effects of exogenous estrogen and antiestrogen (clomiphene) administration on gonadotropin release; and (c) pituitary responsiveness to maximal (150 mug) and submaximal (10 mug) luteinizing hormone-releasing factor (LRF) injections. In 10 of the 14 patients sampled frequently (15 min) for 6 h, luteinizing hormone (LH) levels were elevated above the concentration seen in normal cycling women (except the LH surge).