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Biomedical subjects

A Gerken

Publications and source records attributed to A Gerken.

36 records · Page 2Linked to original sources
PubMed1984

Cortisol, 11-deoxycortisol, and ACTH concentrations after dexamethasone in depressed patients and healthy volunteers.

The 1 mg dexamethasone suppression test was used to assess pituitary-adrenal activity in 23 depressed patients and 8 healthy volunteers. At 1600h, after administration of the test dose of dexamethasone at 2300h, levels of cortisol, 11-deoxycortisol, and corticotropin were determined following a chromatographic extraction step applying highly specific radioimmunoassay techniques. Cortisol nonsuppressors had significantly increased adrenocorticotropic hormone (ACTH) values and cortisol/11-deoxycortisol ratios. The cortisol/11-deoxycortisol ratio was regarded as a measure of biologically active ACTH. The present results, which indicate a concordance of corticotropin and corticosteroid response, suggest that the parent abnormality of dexamethasone-resistant cortisol concentrations is elevation of biologically active corticotropin.

Adrenocorticotropic Hormone↗
PubMed1984

ACTH and multisteroid responses to corticotropin-releasing factor in depressive illness: relationship to multisteroid responses after ACTH stimulation and dexamethasone suppression.

One hundred micrograms of ovine-corticotropin releasing factor (o-CRF) was administered intravenously to eight unmedicated patients with severe endogenous depression. Responses of immunoreactive (ir)-ACTH and the adrenal glucocorticosteroids corticosterone (B), 11-deoxycortisol (S), cortisol (F) and cortisone (E) were measured and compared with those following synthetic corticotropin stimulation and dexamethasone suppression. A comparative evaluation of the three pituitary--adrenal function tests suggests that hypersecretion of ir-ACTH and adrenal corticosteroids (B, S, F, and E) in depression reflects a central dysfunction rather than an altered responsiveness of the pituitary or adrenal glands. The data illustrate that the o-CRF paradigm is a valuable instrument to further support the hypothesis that a limbic--hypothalamic overdrive is the basic mechanism underlying exaggerated adrenocortical output in the endogenous subgroup of depressed patients.

17-Hydroxycorticosteroids↗
PubMed1984

Mean 14.00-17.00 h plasma cortisol concentration and its relationship to the 1 mg-dexamethasone suppression response in depressives and controls.

Three-hour cortisol-profiles and cortisol responses to a 1 mg dose of dexamethasone were recorded in 31 depressed patients and nine controls. The data indicate that the likelihood of detecting non-suppressible cortisol concentrations after dexamethasone is significantly increased in depressed patients with a hypersecretion of cortisol. However, a considerable subsample of normosecretors shows abnormal DST results. Conversely, hypersecretion is often associated with dexamethasone suppression. In this study a 1 mg-DST did not reflect the adrenocortical activity with ultimate accuracy. Therefore any attempts which correlate psychopathological or biological data with pituitary-adrenal activity and use a DST-result as measure are criticizable . Data derived from volunteers illustrate that medical factors such as weight-loss, steroid-containing contraceptives and sleep deprivation can make a pituitary-adrenal activity test ambiguous.

Adult↗
PubMed1984

Carriage of intestinal protozoal cysts in homosexuals.

A total of 83 male homosexuals were studied to ascertain the carriage of intestinal protozoal cysts. The homosexual group had a significantly (p less than 0.0005) higher prevalence than a control group. One or more types of protozoa were found in 33 homosexuals. The carriage of intestinal protozoal cysts was associated with particular sexual practices and promiscuity, but not with symptomatic bowel disorders. The possible implications of the carriage of these cysts are discussed.

Adult↗
PubMed1984

Plasma dexamethasone concentrations and differential suppression response of cortisol and corticosterone in depressives and controls.

After a dexamethasone suppression test (DST), cortisol, corticosterone, and the test substance were determined by a direct radioimmunoassay in 42 samples obtained from 22 depressed patients and 8 controls. The DST results of both glucocorticoids agreed in most of the tests. In all seven cases with elevated but not definitely abnormal post-DST (1600 hr) cortisol levels (transitional range 30-50 ng/ml) the concurrent determination of corticosterone indicated that this corticosteroid may serve as a potent additional discriminator. Dexamethasone plasma concentrations at 1600 hr after a 1-mg test dose of dexamethasone at 2300 hr were significantly (p less than 0.01) lower in cortisol and corticosterone nonsuppressors than in suppressors. Since these data were obtained 17 hr after ingestion of dexamethasone (half-life 3.5-5 hr) any conclusions about an inverse correlation between dexamethasone and corticosteroid plasma concentrations would be speculative. However, the dexamethasone pharmacokinetics might be an important variable and may contribute to some of the recent uncertainty about the DST.

Adult↗
PubMed1982

Aetiology and management of non-specific vaginitis.

In a study of 100 women with non-specific vaginitis, characterised by a vaginal discharge which was malodorous and pruritic in most cases and caused dyspareunia and dysuria in some, Gardnerella vaginalis was isolated in 46% of patients. When present, G vaginalis was significantly associated with Mycoplasma hominis and Bacteroides species. Isolation of G vaginalis was unrelated to the presenting symptoms. Treatment with povidone-iodine pessaries for two weeks produced no pronounced benefit, either clinically or microbiologically, compared with a placebo. Nevertheless, 68% of all patients followed reported improvement four weeks after the start of treatment. The findings suggest that G vaginalis is one cause of non-specific vaginitis, which is more likely to be seen in women using oral contraceptives and is usually cured spontaneously.

Adolescent↗
PubMed1980

Vaginal pH and microflora related to yeast infections and treatment.

The relationship between vaginal pH, microflora, and yeast infection was investigated in 93 women randomly treated with either nystatin or miconazole pessaries and cream for two weeks. The vaginal pH was measured in a control group of 48 women. In the study group, 37 patients defaulted, 39 were cured, and 17 required treatment during the six-month follow-up period. In both study and control groups before and after treatment the mean vaginal pH was in the range of 4.3-4.6. Lactobacilli were plentiful in 78 (91%) out of 86 patients and shows that lactobacilli and yeasts commonly coexist. The influence of other organisms appeared to be negligible. The trial showed that nystatin and micromazole were equallly effective in the treatment of vaginal yeast infection and that the broad-spectrum activity of micronazole offered no advantage in this condition.

Adolescent↗
PubMed1980

Rectal gonorrhoea in male homosexuals. Presentation and therapy.

In a review of rectal gonorrhoea 73 episodes were studied in 65 homosexual men. The presenting signs and symptoms were carefully noted. Treatment with a single injection of spectinomycin hydrochloride 2 g resulted in a cure rate of 94.5%. The relatively high treatment failure rate associated with rectal gonorrhoea may possibly be due to microbial mechanisms.

Adolescent↗
PubMed1978

Intraoperative autotransfusion for elective aortic surgery.

Intraoperative autotransfusion using the Bentley ATS 100 was used in 23 patients requiring Dacron replacement of their abdominal aorta. An average 2000 ml of blood was reinfused and a total heparinization dose was given. The mean haemoglobin fell 2.8 g/dl and on average 2 pints of banked blood were given in the postoperative period. Coagulation studies performed before and after surgery showed minimal alteration. We feel that further evaluation of this system is essential so that an alternative is established for when banked blood is not available. The system is particularly useful at the present time for such emergencies as a leaking abdominal aortic aneurysm and severe trauma to the liver.

Aorta, Abdominal↗
PubMedDate not supplied

Multisteroid analysis after DST in depressed patients--a controlled study.

111 consecutively admitted in-patients with a depressive syndrome received a dexamethasone suppression test (DST) after all known factors which might confound the test results had been carefully excluded. Plasma concentrations of cortisol, corticosterone and dexamethasone were compared with several diagnostic evaluations (RDC, DSM-III, ICD-9) in a controlled study. The positive predictive value of nonsuppressed corticosteroid levels was only moderate for each diagnostic category. Diagnostic specificities were 84.6% for major depression, endogenous subtype (RDC), 71.2% for melancholia (DSM-III) and 86.8% for endogenous depression (IDC-9) when using a post-DST cortisol value above 50 ng/ml (5 micrograms/dl) as the referent value to define DST nonsuppression. Combined determination of cortisol and corticosterone as an index of dexamethasone-induced suppression raised the sensitivity rate considerably at the cost of the predictive value for major diagnostic categories. Dexamethasone plasma levels were reciprocally correlated with cortisol levels and neglect of samples with low plasma dexamethasone contents improved the diagnostic performance for endogenous depression according to RDC and ICD-9, but not for DSM-III melancholia. Although it would be speculative to suppose that the observed low dexamethasone levels are involved in DST nonsuppression, the present findings emphasize that multisteroid analysis which includes dexamethasone is important in future studies designed to explore the clinical utility of the DST.

Adult↗