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In 50 patients with bronchial asthma requiring systemic treatment with glucocorticoid preparations, a CRH test has been performed in addition to the conventional determination of cortisol in the serum and 24-h urine in order to evaluate the function of the hypothalamo-pituitary-cortico-adrenal axis. According to the CRH test, 19 of the 50 patients were suffering from corticoadrenal insufficiency, whereas both the conventional tests had yielded a high percentage of false-positive and false-negative findings. There was no indication for the assumption that development of insufficiency of the corticotropic axis was in any way dependent on the glucocorticoid preparation or on the dosage or duration of treatment.
View Article and Find Full Text PDF[Corticosteroids].
Medicina (Firenze)
August 1991
Divisione di Medicina, Ospedale Civile, Camerino, MC.
Adrenal steroids, particularly glucocorticoids, are used in a variety of conditions ranging from adrenal insufficiency requiring substitution therapy (glucocorticoids and mineral-corticoids), to a wide range of clinical disorders in which undesired inflammatory reactions must be reduced (glucocorticoids). The anti-inflammatory effect, typical of glucocorticoids, is mainly due to the interference with arachidonic acid metabolism, from which both prostaglandins and leukotriens, mediators of inflammation, take origin. ACTH is also employed with the same indications of glucocorticoids, but its use is limited, since its effect depends on the stimulation of cortico-adrenal gland with subsequent release of not only glucocorticoids but also mineral-corticoids and androgens.
View Article and Find Full Text PDFA study was made of CVS function in 48 patients with Addison's disease by submaximum bicycle ergometry to specify and improve the existing criteria of assessment of a degree of gravity of disease and the working capacity of patients before and after hormonal substitution therapy. According to the results of bicycle ergometry, the working capacity of these patients was lowered, the total volume of work done, loading power, and maximum oxygen consumption were also lowered. The data obtained can be used for assessment of therapeutic efficacy and in medical labor examination to determine the working capacity of patients with hypocorticism.
View Article and Find Full Text PDFFor a long time endocrine pathology was unrecognized or even denied to exist in Black Africans, but this is not true. It seems to be recognized more frequently since medicalization has increased. This pathology does not present any particularities.
View Article and Find Full Text PDFIn 8 cases of Addison's disease due to adrenal tuberculosis, the substitutive treatment appeared unnecessary since more than one year. Urinary 17-OHCS were in the normal range but did not rise after ACTH injection except in two cases. In all the cases, plasma ACTH was elevated but lower than in severe adrenal insufficiency, and in the range of those observed in congenital adrenal hyperplasia.
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