Prospective evaluation of a week one overnight metyrapone test with subsequent dynamic assessments of hypothalamic-pituitary-adrenal axis function after pituitary surgery.

Objective: To determine whether an overnight metyrapone test (OMT) within the first week postpituitary surgery can definitively assess the hypothalamic-pituitary-adrenal (HPA) axis, compared with subsequent dynamic tests and glucocorticoid requirement at 6 months.

Design: Prospective study measuring morning cortisol levels on days 3 and 4 post-operatively, OMT day 5-7 and week 6, week 6 250 μg short Synacthen test (SST) and week 7 insulin tolerance test (ITT).

Patients And Measurements: Forty participants who underwent pituitary surgery at a single centre (Cushing's disease excluded) were followed for at least 6 months.

Growth hormone (GH) enhances anaerobic capacity: impact on physical function and quality of life in adults with GH deficiency.

Context: Anaerobic capacity is impaired in adults with GH deficiency (GHD), adversely affecting physical function and quality of life (QoL).

Objective: To investigate whether GH replacement improves anaerobic capacity, physical function and QoL in adults with GHD.

Design: One-month double-blind placebo-controlled crossover study of GH (0·5 mg/day), followed by a 6-month open phase.

Impairment of anaerobic capacity in adults with growth hormone deficiency.

Context: The anaerobic energy system underpins the initiation of all physical activities, including those of daily living. GH supplementation improves sprinting in recreational athletes, a performance measure dependent on the anaerobic energy system. The physiological and functional link between GH and the anaerobic energy system is unknown.

Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: a meta-analysis of published observational studies.

Estrogen and selective estrogen receptor modulator (SERM) treatments for acromegaly have received limited attention since the development of newer pharmacologic therapies. There has been ongoing research evidence suggesting their utility in the biochemical control of acromegaly. Therefore, the aim of this meta-analysis was to synthesise current evidence with a view to determining to what extent and in which acromegalic patient subsets do estrogen and SERMs reduce IGF-1 levels.

Long-term efficacy and safety of subcutaneous pasireotide in acromegaly: results from an open-ended, multicenter, Phase II extension study.

Pasireotide has a broader somatostatin receptor binding profile than other somatostatin analogues. A 16-week, Phase II trial showed that pasireotide may be an effective treatment for acromegaly. An extension to this trial assessed the long-term efficacy and safety of pasireotide.

Cancer risk after medical exposure to radioactive iodine in benign thyroid diseases: a meta-analysis.

Radioiodine-131 ((131)I) is widely used for diagnosis and treatment of benign thyroid diseases. Observational studies have not been conclusive about the carcinogenic potential of (131)I and we therefore conducted a meta-analysis. We performed a literature search till September 2011 which included (131)I as a diagnostic or treatment modality ((131)I for treatment of thyroid cancer was excluded).

The aerobic performance of trained and untrained handcyclists with spinal cord injury.

The purpose of this study was to compare the cardiorespiratory response and mechanical efficiency (ME) of highly trained spinal cord injured (SCI) handcyclists with untrained SCI men. Ten trained handcyclists (≥ 2 years training) and ten untrained but physically active SCI men completed an incremental exercise test to exhaustion and a sub-maximal test (50 and 80 W) on an electromagnetically braked arm ergometer. The trained participants completed a questionnaire on their training and race performance over the past year, including average training volume (in kilometers), number of training sessions per week and best 20-km time trial.

The hormonal response of older men to sub-maximum aerobic exercise: the effect of training and detraining.

The hormonal response of 32 older men (70-80years) to a bout of sub-maximum aerobic exercise was examined before, after 16weeks of resistance or aerobic training and again after 4weeks of detraining. Blood samples were obtained at rest and immediately post sub-maximum exercise (30min @ 70% VO(2) max) to determine the concentrations of growth hormone (GH), insulin-like growth factor-1 (IGF-1), testosterone (Test), sex hormone-binding globulin (SHBG) and the calculation of free testosterone (FT). Both training groups had significant increases in leg strength and VO(2) max after 16weeks training but leg strength and VO(2) max returned to pre-training levels in the aerobic training and resistance training groups, respectively.

Relationships between blood levels of fat soluble vitamins and disease etiology and severity in adults awaiting liver transplantation.

Background And Aims: Although malnutrition is common in liver disease, there are limited data on fat soluble vitamins in various diseases. The aims of this study were to: (i) determine fat soluble vitamin levels in patients assessed for liver transplantation; (ii) compare levels between different disease etiologies (hepatocellular and cholestatic) and between subgroups of hepatocellular disease; and (iii) assess the multivariate contribution to vitamin levels of etiology and various indicators of disease severity.

Methods: This was a cross-sectional study of 107 inpatients awaiting liver transplantation, mean age 47 years.

The blood pressure response of older men to maximum and sub-maximum strength testing.

Strength testing is commonly used to determine the muscular strength of older individuals participating in a resistance training program. The purpose of this study was to non-invasively examine and compare the blood pressure (BP) and heart rate (HR) response of maximum and sub-maximum strength tests in older men. Twenty-four healthy men aged 70-80 yr were recruited for the study.

Dark adaptation in vitamin A-deficient adults awaiting liver transplantation: improvement with intramuscular vitamin A treatment.

Background/aims: Although vitamin A deficiency is common in chronic liver disease, limited data exist on impairment of dark adaptation and response to therapy. The aims were (1) to assess dark adaptation in patients, (2) to assess the relationship between dark adaptation and vitamin A status, zinc and Child-Pugh score, (3) to compare perceived and measured dark adaptation and (4) to assess the dark adaptation response to intramuscular vitamin A.

Methods: This was a prospective study of 20 patients (alcoholic liver disease 10, other parenchymal diseases six, cholestatic diseases four) awaiting liver transplantation.

Can aerobic training improve muscle strength and power in older men?

This study examined the effect of aerobic training on leg strength, power, and muscle mass in previously sedentary, healthy older men (70-80 yr). Training consisted of 30-45 min of cycle ergometry at 50-70% maximal oxygen consumption (VO2max), 3 times weekly for 16 wk, then 4 wk detraining, or assignment to a nontraining control group (n = 12 both groups). Training increased leg strength, leg power, upper leg muscle mass, and VO2max above pretraining values (21%, 12%, 4%, and 15%, respectively; p < .

The effect of strength training and short-term detraining on maximum force and the rate of force development of older men.

This study examined the effect of strength training (ST) and short-term detraining on maximum force and rate of force development (RFD) in previously sedentary, healthy older men. Twenty-four older men (70-80 years) were randomly assigned to a ST group (n = 12) and C group (control, n = 12). Training consisted of three sets of six to ten repetitions on an incline squat at 70-90% of one repetition maximum three times per week for 16 weeks followed by 4 weeks of detraining.

Strength training improves submaximum cardiovascular performance in older men.

Purpose: To determine if 16 weeks of strength training can improve the cardiovascular function of older men during submaximum aerobic exercise.

Methods: Twenty four men aged 70-80 yr were randomly assigned to a strength training (ST; n = 12) and control group (C; n = 12). Training consisted of 3 sets of 6 - 10 repetitions at 70% to 90% of 1RM, 3 times per week, on an incline squat machine for 16 weeks, followed by 4 weeks detraining.

Resistance training reduces the blood pressure response of older men during submaximum aerobic exercise.

Objective: The objective of this study was to determine whether 16 weeks of resistance training (RT) can reduce the blood pressure response and improve the cardiovascular function of men aged 70-80 years during submaximum aerobic exercise.

Methods: Twenty-four men aged between 70 and 80 years were randomly assigned to an RT group (n = 12) and control group (n = 12). Training consisted of three sets of six to 10 repetitions at 70-90% of one repetition maximum, three times per week, on an incline squat machine for 16 weeks.

Octreotide LAR vs. surgery in newly diagnosed patients with acromegaly: a randomized, open-label, multicentre study.

Objective: This prospective randomized study evaluated the efficacy and safety of octreotide LAR vs. surgery in newly diagnosed acromegalic patients.

Methods: Totally 104 male and female patients were enrolled in a 50-week, exploratory, open-label and randomized study.

The role of growth hormone replacement in a growth hormone deficient patient with underlying cardiomyopathy and severe congestive heart failure.

It has been reported that growth hormone (GH) deficiency induced cardiomyopathy responds to growth hormone replacement therapy. We describe the case of a middle-aged male with cardiomyopathic heart failure and growth hormone deficiency of the adult secondary to surgical panhypopituitarism. We demonstrate clinical and hemodynamic improvement of cardiac function with growth hormone replacement therapy despite underlying structural heart disease.

Controversies regarding the effects of growth hormone on the heart.

Growth hormone (GH) profoundly affects the developing and adult myocardium. Adult patients with GH deficiency (GHD) and GH excess (acromegaly) provide important models in which to understand the effects of GH in adult cardiac physiology. An increasing body of clinical and experimental evidence illustrates the specific physiological abnormalities that are likely associated with the excess cardiovascular mortality observed in both acromegaly and GHD.

GH treatment in adults with chronic liver disease: a randomized, double-blind, placebo-controlled, cross-over study.

Patients with chronic liver disease (CLD) are catabolic and GH-resistant. The effects of supraphysiological recombinant human GH (rhGH; 0.2 IU.