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Biomedical subjects

G E Abraham

Publications and source records attributed to G E Abraham.

At least 37 records · Page 2Linked to original sources
PubMed1983

Nutritional factors in the etiology of the premenstrual tension syndromes.

The premenstrual symptom complex many women experience in a moderate to severe form can be divided into four subgroups. Because there is more than one syndrome and nervous tension is one of the most common symptoms, the term premenstrual tension syndromes (PMTS) is used. The most common subgroup, PMT-A, consists of premenstrual anxiety, irritability and nervous tension, sometimes expressed in behavior patterns detrimental to self, family and society. Elevated blood estrogen and low progesterone have been observed in this subgroup. Administration of vitamin B6 at doses of 200-800 mg/day reduces blood estrogen, increases progesterone and results in improved symptoms under double-blind conditions. Women in this subgroup consume an excessive amount of dairy products and refined sugar, and progesterone may be of value in them. The second-most-common subgroup, PMT-H, is associated with symptoms of water and salt retention, abdominal bloating, mastalgia and weight gain. The severe form of PMT-H is associated with elevated serum aldosterone. Vitamin B6 at high dosage suppresses aldosterone and results in diuresis and clinical improvement. Vitamin E helps the breast symptoms. Methylxanthines and nicotine should be curtailed and sodium limited to 3 gm/day. PMT-C is characterized by premenstrual craving for sweets, increased appetite and indulgence in eating refined sugar followed by palpitation, fatigue, fainting spells, headache and sometimes the shakes. PMT-C patients have increased carbohydrate tolerance and low red-cell magnesium. Adequate magnesium replacement results in improved glucose tolerance tests and decreased PMT-C symptoms. Deficiency of the prostaglandin PGE1 may also be involved in PMT-C. PMT-D is the least common but most dangerous because suicide is most frequent in this subgroup. The symptoms are depression, withdrawal, insomnia, forgetfulness and confusion. In ten PMT-D patients the mean blood estrogen was lower and the mean blood progesterone higher than normal during the midluteal phase. Elevated adrenal androgens are observed in some hirsute PMT-D patients. Two PMT-D patients with normal blood progesterone and estrogens had high lead levels in hair tissue and chronic lead intoxication. This subgroups needs careful medical attention when the symptoms are severe. Therapy should be individualized according to the results of the evaluation.

Diet↗
PubMed1983

Effect of a nutritional supplement, optivite, on symptoms of premenstrual tension.

Using a menstrual symptom questionnaire (MSQ) to assess the presence and severity of premenstrual tension (PMT), we evaluated the effect of a nutritional supplement, Optivite, on PMT symptoms in 31 patients for the week after the period (F) and the week before it (L). The total MSQ scores decreased significantly in all patients after Optivite administration at a daily dose of 3-12 tablets for one to six menstrual cycles. The mean +/- S.E. total MSQ scores were F = 8.1 +/- 1.8 and L = 31.5 +/- 2.1 for control cycles and F = 2.3 +/- 0.72 and L = 10.3 +/- 1.4 for treated cycles. The best responses were observed in patients taking 6-12 tablets/day for three or more cycles. If these results can be confirmed by well-controlled studies, this simple and safe nutritional approach can be recommended in the initial management of PMT.

Adult↗
PubMed1983

Interrelations of the various mathematical approaches to radioimmunoassay.

Equations used for calculation of radioimmunoassay data are derived and compared. We show that the equation developed by Fernandez and Loeb is the most general of these. Those of Ekins et al., Hales and Randle, and Rodbard et al. are all derived here from this basic equation by neglecting certain of its terms. The logit-log plot of Rodbard et al. is a logarithmic transformation of the linear Hales-Randle equation. The basic equation, derived here solely from the mass-action law, approaches linearity under certain conditions without complex mathematical transformations of analyte concentrations or observable parameters. Applications are also presented.

Humans↗
PubMed1982

The incidence of premenstrual tension in a gynecologic clinic.

A menstrual symptom questionnaire was used to assess the incidence of premenstrual tension (PMT) in 1,395 regularly menstruating women not on hormonal contraceptives or any other hormonal therapy during routine visits to a gynecologic clinic. Nineteen symptoms were divided into four PMT subgroups: PMT-A (anxiety, irritability, mood swings, nervous tension), PMT-H (weight gain, swelling of extremities, breast tenderness, abdominal bloating), PMT-C (headache, craving for sweets, increased appetite, heart pounding, fatigue and dizziness or fainting) and PMT-D (depression, forgetfulness, crying, confusion, insomnia). The ages of the patients ranged from 13 to 54 years, with a mean +/- S.D. of 32 +/- 8.5 years. Using strict criteria for PMT, 702 patients scored positive for at least one subgroup of PMT, giving an incidence of 50%. When the patients were divided into five-year age groups, a peak incidence of 60% was observed in the third decade of life. The most common PMT subgroups were PMT-A and PMT-H, occurring either alone or in combination. The least common subgroup was PMT-D, occurring in only 12 patients and by itself. The mean cycle length in pure PMT-D patients was significantly shorter (p less than 0.05) than in patients without PMT.

Adolescent↗
PubMed1981

Serum and red cell magnesium levels in patients with premenstrual tension.

Magnesium deficiency has been implicated as a possible causative factor in premenstrual tension (PMT). We have assessed serum and red cell magnesium concentration in nine normal premenopausal women and 26 PMT patients, using atomic absorption spectrometry. The following means +/- SEM were obtained from serum and red cell magnesium, respectively, in mg/100 ml: normal subjects: 1.7 +/- 0.04 and 4.5 +/- 0.25 PMT patients: 1.8 +/- 0.05 and 3.1 +/- 0.24. Mean red cell magnesium level was significantly (p less than 0.01) lower in PMT patients. Red cell magnesium determinations should be included in the evaluation of PMT.

Adult↗
PubMed1981

Dexamethasone suppression test in the management of hyperandrogenized patients.

The authors evaluated 86 hyperandrogenized women with measurements of serum cortisol, dehydroepiandrosterone sulfate, testosterone, and dihydrotestosterone in pooled sera before and after a dexamethasone suppression test. According to strict criteria, 70 (81%) of 86 women demonstrated a major glucocorticoid-suppressible component to their hyperandrogenism. Endocrine therapy was dictated by the results of the dexamethasone suppression test. To assess the predictive value of this test, we evaluated the clinical responses of the subgroup of 55 women who received appropriate endocrine suppression therapy for 6 to 15 months. Of this subgroup, 38 were identified as having adrenal hyperandrogenism; 3 had ovarian hyperandrogenism; and 14 had mixed hyperandrogenism. Of the 55 patients, 49 received dexamethasone alone; 3 received dexamethasone plus Ovral (an oral contraceptive containing the synthetic progestogen norgestrel 0.5 mg and ethinyl estradiol 0.05 mg); and 3, all with ovarian hyperandrogenism, received depomedroxyprogesterone acetate (Depo-Provera). Clinical response was assessed in terms of improvement or no improvement in menstrual status, acne, and hirsutism. Of 29 patients with adrenal or mixed hyperandrogenism associated with abnormal menses, the menstrual status of 17 (59%) improved after dexamethasone therapy. Acne improved in 39 (100%) of 39 subjects. Hirsutism showed moderate to marked improvement in 40 (73%) of 55 women after 6 to 15 months of endocrine suppression therapy. These results indicate the endocrine suppression therapy, particularly with repeated low-dose dexamethasone, prescribed on the basis of a dexamethasone suppression test, is an effective means of managing hyperandrogenism.

Adolescent↗
PubMed1981

Endocrine profile of patients with post-tubal-ligation syndrome.

The endocrine profile of the midluteal phase was assessed in 29 patients with the post-tubal-ligation syndrome, consisting of pain, bleeding and premenstrual tension. Compared to normal controls, the patients had a high serum estradiol and a low serum progesterone level. This abnormal luteal function may be responsible for the symptoms observed and may also explain the failure to conceive following successful reversal of tubal ligation. It is recommended that patients seeking sterilization reversal be screened for abnormal luteal function preoperatively. Selection of sterilization procedures that minimize alteration in luteal function should be given high priority.

Adult↗
PubMed1980

Bromocriptine in the treatment of premenstrual tension syndrome.

Twenty-four women with regular cycles who reported moderate to severe premenstrual tension participated in a double-blind study to test the effectiveness of CB154 on the control of their symptoms. Symptoms were scored daily and were further evaluated objectively twice monthly by physical examination. Control cycle follicular/luteal delta weights were not different statistically from a 0 change (P > .10), despite long-standing symptoms of bloating, swelling, and reported weight gain. CB154 treatment resulted in statistically significant improvement in daily ratings of breast tenderness (P < .005), bloating (P < .02), and depression (P < .05). Significant placebo effects observed for several other symptoms emphasize the psychologic component of this condition as well as the need for caution in the interpretation of any uncontrolled trials for therapies thought effective in the treatment of this disorder.

Adolescent↗
PubMed1979

Relationship between steroidogenesis and oocyte maturation in rat graafian follicles cultured in vitro.

Rat Graafian follicles were dissected from ovaries during the morning of proestrus and incubated in various media. After an 8 h incubation period, ovarian follicles were collected and analyzed, by radioimmunoassay, for progesterone, 17 alpha-hydroxyprogesterone, androstenedione, estradiol-17 beta, and dihydrotestosterone. Following incubation in proestrus (a.m.) serum, preovulatory follicles secreted all these steroids and the output of progesterone, 17 alpha-hydroxyprogesterone and androstenedione was markedly stimulated following the addition of LH to the media. Follicle-enclosed oocytes resumed meiosis when incubated in proestrus serum without added LH. However, germinal vesicle break-down (GVBD) under these conditions was considerably slower than that observed following addition of LH to the medium. "Spontaneous" maturation of oocytes in proestrus serum was associated with increased production of steroids. Oocyte maturation and steroidogenesis both occurred following incubation of ovarian follicles in serum obtained from hypophysectomized rats. Addition of LH to the media markedly accelerated these responses. These results suggest that oocyte maturation and steroidogenesis also occur in cultured ovarian follicles in the absence of gonadotrophic hormones. The relationship between steroidogenesis and/or spontaneous oocyte maturation are discussed.

Androstenedione↗
PubMed1979

Validation of a specific radioimmunoassay to measure plasma cortisol in the fetal sheep.

A procedure utilizing co-chromatography and complementary antiserum comparisons was employed to assess the specificity of a cortisol radioimmunoassay for use in the chronically catheterized fetal sheep preparation. Complementary antiserum comparisons is a technique by which two different cortisol antisera, prepared from conjugates attached at opposite ends of the cortisol molecule, were used to determine cortisol concentrations in the same ovine fetal plasma specimens. Results were not significantly different between the two groups, each measured by a different antiserum. This procedure may be used to assess assay specificity in any species in which steroid radioimmunoassays are being adapted.

Animals↗
PubMed1979

Interrelationships of circulating maternal steroid concentrations in third trimester pregnancies. II. C18 and C19 steroids: estradiol, estriol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, delta 5-androstenediol, delta 4-androstenedione, testosterone, and dihydrotestosterone.

This report describes aggregate time trend effects of advancing gestational age on circulating maternal concentrations of 17beta-estradiol (E2), estriol (E3), dehydroepiandrosterone (D), dehydroepiandrosterone sulfate (D-S), delta 5-androstenediol (delta 5 diol), delta 4-androstenedione (delta 4 A), testosterone (T), and dihydrotestosterone (DHT) in a sequential series of 155 blood samples obtained from 19 normal pregnant women ranging from 26-40 weeks gestational age. Only E2, E3, and D-S show aggregate time trend effects. Log (E2) plots as a linear positive sloping curve from 26-40 weeks. Log (E3) plots as a positive sloping curve that is significantly steeper than log (E2) (P less than 0.05). Log (D-S) plots into a negative sloping curve which mirrors the pattern for log (E2) but cannot be statistically associated with log (E2) except for the opposite sign of their slopes, which are both significantly different from a zero slope (P less than 0.05). delta 4 A, T, DHT, delta 5 diol, and D show no aggregate time trends; however wide, comoving undulations for delta 4 A, T, DHT, and delta 5 diol between 26-28 and 38-40 weeks are confirmed in time by comparison of log mean plots and in magnitude by regressing the C19 steroids on one another. D shows virtually no association with the other C19 steroids. All C19 steroids, except for T, circulate at nonpregnant concentrations, implying that there is little placental secretion of these steroids into the maternal circulation.

Androgens↗
PubMed1979

Peripheral and adrenal venous levels of steroids in a patient with virilizing adrenal adenoma.

The peripheral levels of 17-hydroxypregnenolone (17delta5P), progesterone (P), 17-hydroxyprogesterone (17P), testosterone (T), 5alpha-dihydrotestosterone (DHT), androstenedione (A), androst-5-ene-3beta,17beta-diol (delts5diol), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), estradiol-17beta (E2), and cortisol (F) were measured in peripheral and right adrenal venous blood of an amenorrheic patient with a right virilizing adrenal adenoma. Urinary 17-ketosteroids were markedly elevated and were not suppressed on a low dose of dexamethasone (Dex) for 7 days. Peripheral T level was 1.2 ng/ml and DHEA-S was 13,500 ng/ml. Calculations of the ratios of adrenal venous gradients for delta5 and delta4 steroids suggest that the predominant pathway of steroid secretion used by the tumor was as follows: pregnenolone (delta5P) leads to 17delta5P leads to DHEA leads to A leads to T. Following removal of the adenoma, T returned to normal levels but DHEA-S was still above normal at 4100 ng/ml. The patient became eumenorrheic with marked improvement at her hirsutism and virilization.

17-Hydroxycorticosteroids↗
PubMed1979

Peripheral and ovarian venous concentrations of various steroid hormones in virilizing ovarian tumors.

The ovarian-peripheral gradients of various delta4 and delta5 steroids were determined for a patient with virilizing arrhenoblastoma. The high peripheral testosterone level accompanying this tumor results from increased precursor supply from both the delta4 and delta5 pathways, with the delta5 pathway predominating, and from negligible aromatase activity. A review of 45 cases of androgen-producing ovarian tumors with measurement of peripheral venous testosterone, and of 24 cases with measurement of ovarian venous testosterone, and a comparison with findings in 159 patients with hirsutism of functional origin reveal the following 1) An androgen-producing tumor must be ruled out when peripheral testosterone exceeds 2 ng/ml; 2) an ovarian venous testosterone level exceeding 20 ng/ml generally accompanies a tumor, particularly when the tumor is less than 5 cm in diameter; and 3) virtually all (98%) of the tumors reviewed were accompanied by virilization, regardless of the peripheral concentration of testosterone.

17-Hydroxycorticosteroids↗
PubMed1979

Investigation of a patient with Hodgkin's disease and cholestasis.

A patient with the cholestasis of Hodgkin's disease was investigated. Our studies failed to relate the cholestasis to endocrine abnormalities. The patient had severely abnormal aminopyrine metabolism, suggesting more profound hepatocellular dysfunction than had previously been appreciated.

Aminopyrine↗