Clinical endocrinology
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Clinical endocrinology · Nov 2006
Randomized Controlled TrialInvestigation of the skin characteristics in patients with severe GH deficiency and the effects of 6 months of GH replacement therapy: a randomized placebo controlled study.
The presence of GH receptor in human skin and its appendages suggests a direct effect of GH on skin characteristics. The skin is usually thin and dry in patients with GH deficiency (GHD). Sheehan's syndrome classically refers to postpartum hypopituitarism and GH is one of the earliest pituitary hormones lost. While severe GHD is a well-established feature of Sheehan's Syndrome, skin characteristics and the effects of GH replacement therapy (GHRT) have been investigated neither in Sheehan's syndrome nor in other disorders of GHD. The aim of this study was to investigate the skin characteristics, including the sebum content, hydration (skin capacitance), transepidermal water loss (TEWL), pH and skin temperature, and particularly the effects of 6 months of GHRT on these parameters in GH deficient patients with Sheehan's syndrome. ⋯ The present study clearly shows that the sebum content on the forehead and skin hydration of the forehead and forearm are significantly decreased in GH deficient patients with Sheehan's syndrome. However 6 months of GHRT significantly increased only the sebum content on the forehead. These data suggest that GH and/or IGF-I may have a modulatory role on several skin characteristics.
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Clinical endocrinology · Jan 2005
Randomized Controlled Trial Clinical TrialRosiglitazone improves insulin sensitivity and glucose tolerance in subjects with impaired glucose tolerance.
This study was designed to evaluate the effects of rosiglitazone (ROS) on insulin sensitivity, beta-cell function, and glycaemic response to glucose challenge and meal in subjects with impaired glucose tolerance (IGT). ⋯ Rosiglitazone treatment significantly improved insulin resistance and reduced postchallenge glucose and insulin concentrations in patients with impaired glucose tolerance without remarkable effects on beta-cell secretory function.
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Clinical endocrinology · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialReplacement therapy with levothyroxine plus triiodothyronine (bioavailable molar ratio 14 : 1) is not superior to thyroxine alone to improve well-being and cognitive performance in hypothyroidism.
There is evidence from recent controlled clinical studies that replacement therapy of hypothyroidism with T4 in combination with a small amount of T3 may improve the well-being of the patients. As the issue is still the subject of controversial discussion, our study was assigned to confirm the superiority of a physiological combination of thyroid hormones (absorbed molar ratio 14 : 1) over T4 alone with regard to mood states and cognitive functioning. ⋯ Replacement therapy of hypothyroidism with T4 plus T3 does not improve mood and cognitive performance compared to the standard T4 monotherapy. There is even a higher risk of signs of subclinical hyperthyroidism associated with impaired well-being of the patients, which is clearly caused by significant fluctuations in the steady-state fT3 serum concentrations.
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Clinical endocrinology · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialModulation by progestogens of the effects of oestrogen on hepatic endocrine function in postmenopausal women.
Oral but not transdermal oestrogen administration reduces IGF-I, and increases GH binding protein (GHBP) reflecting effects on hepatic endocrine function in postmenopausal women. As progestogens attenuate the effects of oestrogen on circulating lipid levels according to their androgenic properties, we have investigated the impact of progestogen types on the hepatic endocrine effects of oestrogen. ⋯ Oestrogen effects on IGF-I, GHBP and SHBG are dependent on the route of administration with progestogens having variable effects. Among the progestogen types, norethisterone, the most androgenic, had the greatest effect, particularly on IGF-I. Progestogens modulate the effects of oestrogen on hepatic endocrine function in relation to their intrinsic androgenic properties. The modulatory effects of progestogens on IGF-I during oestrogen therapy may have long-term implications for lean body mass.
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Clinical endocrinology · Dec 2002
Randomized Controlled Trial Comparative Study Clinical TrialGlucocorticoids as prophylaxis against acute mountain sickness.
Acute mountain sickness (AMS) characterized by presence of symptoms including headache, nausea, excessive fatigue, loss of appetite, irritability and insomnia is a major impediment to work performance in human subjects who are rapidly inducted to high altitude (HA) during the initial phase of induction. The present study aims at to evaluate the efficacy of prophylactic administration of low dose glucocorticoids in prevention of AMS in normal healthy men who are inducted to HA by air. ⋯ These observations suggest that administration of low-dose glucocorticoids can curtail acute mountain sickness significantly without influencing the normal adreno cortical response to hypoxia.