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Biomedical subjects

A Tomova

Publications and source records attributed to A Tomova.

14 recordsLinked to original sources

Low testosterone levels and unimpaired melatonin secretion in young males with metabolic syndrome.

The interrelations between testosterone, insulin and melatonin levels in males with metabolic syndrome (MS) are still not clarified, especially in young age groups. The aim of the present study was to compare the testosterone serum levels in young men with MS to those in healthy controls, and to determine the possible changes in their melatonin rhythm, as well as the relation between melatonin, insulin and lipid profile. Fasting insulin and testosterone concentrations were measured in 10 healthy nonobese and 10 MS patients. Blood samples for melatonin, insulin and luteinizing hormone (LH) were collected at 19.00, 03.00 and 11.00 hours. A significant difference was found between the testosterone levels in controls and patients. Luteinizing hormone levels in both groups were similar, however, higher night LH levels in MS patients were observed. No changes in the melatonin concentrations of the two groups were found. In conclusion, total testosterone levels were significantly lower in young men with MS compared with healthy age-matched controls. Mild hypoandrogenia in hyperinsulinaemic patients was not related with changes in their melatonin levels. No alterations in the endogenous melatonin rhythm of the MS patients were found.

Adult↗

Elevated plasma endothelin as an additional cardiovascular risk factor in patients with Cushing's syndrome.

BACKGROUND: Recently the pathophysiological role of endothelin (ET) has been presumed in a number of adrenal disorders such as primary hyperaldosteronism, pheochromocytoma and adrenocortical insufficiency. AIM: The aim of the present study was to evaluate circulating ET-1 levels in patients with endogenous Cushing's syndrome. METHODS AND RESULTS: Plasma ET-1 levels were determined by highly sensitive RIA. Thirteen untreated subjects with Cushing's syndrome were studied: eight women and five men of mean age 44.2+/-9.5 Years (s.d.). In ten of them, Cushing's disease had been diagnosed and three had adrenal adenomas. ET-1 was 3-fold higher in the patient group than in age-matched healthy controls (n=13): 1.59+/-0.78 vs 0.46+/-0.20 pmol/l respectively, P<0.001. In adrenal adenoma patients, ET-1 was not significantly higher than in the Cushing's disease subjects (1.84+/-0.67 vs 1.51+/-0.83 pmol/l respectively, P>0.05). In three patients who died of severe cardiovascular complications, plasma ET-1 was significantly higher than in the remaining patients (2.34+/-0.35 pmol/l, P<0.05). A positive correlation was found between the total cholesterol (6.94+/-1.75 mmol/l) and ET-1 levels in the patients with Cushing's syndrome: r=+0.73, P<0.02. No correlation was observed, however, between the levels of ET-1 and blood pressure (183+/-37/106+/-18 mmHg), plasma cortisol levels (455.2+/-74.5 nmol/l) or urinary cortisol excretion (1463+/-726 nmol/24 h). The successful treatment and correction of hypercortisolism in seven patients led to insignificant reduction in plasma ET from 1.34+/-0.69 to 0.73+/-0.53 pmol/l, P>0.05. CONCLUSION: Our results clearly demonstrate that the ET system is activated in Cushing's syndrome. Elevated plasma ET-1 levels probably play a role in the pathogenesis of accelerated and early atherosclerosis development in this disorder.

Adenoma↗

Increased plasma endothelin levels in patients with male hypogonadism.

Endothelin has various paracrine and endocrine effects on the male reproductive system. Testosterone is probably responsible for the higher endothelin levels in males. In addition, there is much ambiguity about the relationship between gonadotrophic hormones and endothelin. In order to study in more detail the relationship of endothelin with the hypothalamo-pituitary-gonadal axis in the male, we investigated 18 male patients with various forms of hypogonadism (seven with hypergonadotrophic hypogonadism and 11 with hypogonadotrophic hypogonadism). Eight age-matched healthy males served as controls. The basal endothelin levels in patients with hypogonadism (0.95 +/- 0.53 fmol ml(-1)) were significantly higher than those of the controls (0.54 +/- 0.06 fmol ml(-1); P < 0.05). Males with hypergonadotrophic hypogonadism had significantly increased endothelin concentrations (1.05 +/- 0.57 fmol ml(-1); P < 0.05), whereas those with hypogonadotrophic hypogonadism (0.89 +/- 0.53 fmol ml(-1)) had nonsignificantly (P > 0.05) elevated levels. No significant correlation was found between plasma endothelin levels and gonadotrophin, prolactin and testosterone concentrations. The results of this study suggest that plasma endothelin levels are increased in males with hypogonadism.

Adolescent↗

The influence of hyperthyroidism on the hypothalamic-pituitary-gonadal axis.

We have investigated the function of the hypothalamic-pituitary-gonadal (H-P-G)-axis in patients with severe, untreated Graves' disease. We studied 7 male and 6 female healthy volunteers, and 7 male and 7 female patients with Graves' disease. Hormone profiles were developed by blood sampling every 10 min for an 8 hour period. In women this was done in the early follicular phase of menstrual cycle. LH-, FSH-, and PRL levels were measured using immunoradiometric assays and testosterone (T), estradiol (E2), sex-hormone binding globulin (SHBG), and progesterone (P) were measured with standard assays. The pulsatility of LH, FSH and PRL was calculated using the programmes Pulsar, Cluster and Desade. The temporal relationship of plasma LH, FSH, and PRL pulses was also investigated using specific concordance analysis. Data were evaluated by means of non-parametric statistics. LH-secretion was increased in all hyperthyroid patients, while FSH-secretion was increased in hyperthyroid men only. Pulsatile characteristics of LH- and FSH-secretion (frequency, peak shape) in patients were not different from controls. No change in PRL-secretion was shown. Significant copulsatility occurred between LH and FSH, and LH and PRL. This was more pronounced in hyperthyroid than in healthy study subjects. Plasma levels of steroid hormones and sex-hormone-binding globulin were significantly (p<0.005) increased in hyperthyroid men. Free Androgen Index was significantly (p<0.005) decreased in hyperthyroid males. No other auto immune diseases were noticed. Our results indicate that the function of the H-P-G axis is not impaired in hyperthyroid patients, but gonadotropin levels are increased. Hyperthyroid men show relative primary gonadal insufficiency that may be due to exaggerated SHBG levels. The copulsatility of LH and FSH, and of LH and PRL was confirmed both in patients and controls.

Adult↗

Sex differences and similarities of hormonal alterations in patients with anorexia nervosa.

The aim of the present study was to gain better insight into hormonal disturbances in male patients with anorexia nervosa. It included six men with anorexia nervosa aged 13-26 years, with a mean body weight of 42.83 +/- 8.03 kg, a body mass index of 15.08 +/- 1.26 and an average degree of weight loss 29.98 +/- 4.73%. The results were compared with those of 15 healthy age-matched males and 40 women with anorexia nervosa. Prolactin, growth hormone and the gonadal and thyroid axis were studied in detail. The gonadotropin basal levels and their responses to gonadotropin-releasing hormone in male patients were lower, but not significantly, in comparison with healthy men. The basal levels and the responses of luteinizing hormone in anorexic women were significantly lower in comparison with female controls, but the decreased basal level of follicle-stimulating hormone showed an exaggerated response to gonadotropin-releasing hormone. In male anorexics the testosterone levels (7.1 +/- 10.9 nmol l-1) were significantly lower. The changes in the thyroid axis and in prolactin secretion were almost the same in male and female patients. The data of this study suggest that endocrine disturbances in males are similar to those in females with anorexia nervosa, but differences exist mainly in relation to the gonadal axis.

Adolescent↗

Factors related to sex hormone binding globulin concentrations in women with anorexia nervosa.

The published reports concerning serum levels of sex hormone binding globulin (SHBG) in women with anorexia nervosa are few in number and controversial. Indeed, very little is known of the factors influencing SHBG concentrations in these patients. In an attempt to clarify this problem we evaluated serum levels of SHBG, estradiol, testosterone, luteinizing hormone, follicle stimulating hormone, triiodothyronine, thyroxine, their free fractions and insulin in 19 women with anorexia nervosa. Plasma glucose levels, total protein, triglycerides and cholesterol were also studied. Seven healthy women with normal weight and regular menstrual cycles served as controls. The serum concentrations of SHBG in patients with anorexia nervosa (165.27 +/- 63.5 nmol/l) were significantly higher (p < 0.01) than those in the control group (96.21 +/- 38.04 nmol/l), but the levels of estradiol, testosterone, free triiodothyronine and the ratio of testosterone to SHBG were significantly lower. An inverse correlation between SHBG and body weight (r = -0.761) was found in the patients. The alterations in SHBG concentrations were not associated with the changes in testosterone, gonadotropins, thyroid hormones and biochemical parameters. These findings suggest that body weight is one of the more important factors influencing the SHBG concentrations in women with anorexia nervosa.

Adolescent↗

A clinicomorphological study of pituitary tumors associated with the clinical syndrome of acromegaly.

Transsphenoidal adenomectomy was done on 125 acromegalics. A clinicomorphological study was performed on 113 of these patients. The distribution of morphological types of tumors was similar in both sexes. In the total group it was: sparsely granulated GH cell adenomas 52.8%, densely granulated 25.7%, mixed somatotroph and lactotroph adenomas 15.9%, plurihormonal adenomas 1.8%, acidophil stem cell adenomas 2.6%, and oncocytoma 1.8%. The GH plasma level in male patients was significantly higher than in female patients. In both sexes GH secretion was highest in patients with mixed GH and PRL cell adenomas followed by patients with densely granulated GH cell adenomas. Plasma PRL levels were significantly elevated in all males, except for those with densely granulated GH adenomas where prolactinemia was normal. The mean plasma PRL levels were also elevated in females with highest values in mixed somatotroph and lactotroph adenomas. The PRL levels in female patients with densely granulated GH cell adenomas are more elevated than in female patients with sparsely granulated GH cell adenomas.

Acromegaly↗

[Endocrine changes in males with anorexia nervosa: 2 of the authors' own cases].

Two men with nervous anorexia were fully investigated and the results were compared with those of 15 healthy men and 19 women with the same disease. A similarity of the hormonal changes in both sexes concerning the somatotropic hormone, thyroid and cortico-suprarenal axis was established. A difference was found between the women and the two men concerning the gonadotropic hormones which in the men showed a well expressed reaction to gonadoliberin with an early maximum.

Adolescent↗

[Acromegaly and pregnancy].

Pregnancy in women with acromegaly is very rare. The introduction of dopaminergic treatment revealed new possibilities for conception. Four acromegalic women who conceived during a course of bromcryptin treatment and after an unsuccessful transsphenoidal adenectomy are presented. Two of the women have given birth to a normal child, the third woman aborted willfully and the delivery of the fourth woman is forthcoming. Bromcyptin was given during the whole course of pregnancy in progressively increasing doses up to 15 mg daily according to the increased levels of the somatotrophic hormone (STH). The action of bromcryptin on some hormones of the mother and the child is discussed. The mother's serum STH level increased in the course of the pregnancy progressively despite the treatment and fell after the delivery while the child's STH levels were normal.

Abortion, Induced↗

[Diagnosis and treatment of idiopathic hypogonadotropic hypogonadism in men based on a clinical case].

A patient with tertiary hypogonadotropic hypogonadism was followed up for many years. On the basis of this observation the possibilities for a correct diagnosis with the gonadoliberin test are pointed out. A positive effect of the treatment with gonadotropic hormones, especially on the spermatogenesis, is established. Several other new therapeutic means which can be applied in these patients are discussed.

Adult↗

[Immunological activity of the blood sera from cattle with chronic mycotoxicosis].

Attempts were made to disclose and reproduce the immunologic activity of the blood sera of cows, aborted fetuses, and newborn calves in feeding the cows with feeds acted upon by small amounts of toxic moulds. Studied were blood samples of cows in advanced pregnancy or such that had freshly calved, of cows with liver dystrophy, and of newborn calves with toxic dyspepsia. The methods of immunodiffusion and immunoelectrophoresis were employed. It was found that in continuous feeding with mould-affected forages the toxins that gained access into the body attacked chiefly the liver. Along with other changes it induced the release of a complex antigen that was likely to bear the character of both the toxin and the liver proteins. It is believed that the process of building up of specific immune defense against mycotoxins is more complex and continuous. Thus, the immunity obtained is not so effective as in the case of microbial infections.

Abortion, Veterinary↗

[Case of the progressive pulmonary form of mucoviscidosis in an adult patient].

A case with pulmonary form of mucoviscidosis in a female, aged 57, is described, with a high perspiration test--328 mEqv/l Cl with the clinical picture of chronic bronchitis, cylindric bronchiectasis in exacerbation, chronic exacerbated respiratory, insufficiency and pulmonary heart H3, with a lethal end. At necropsy, the characteristic changes for mucoviscidosis were established in the lungs, stomach and pancreas. The possibility of recurrent advancement of the disease is admitted, induced by involutive hormonal disturbances.

Cystic Fibrosis↗