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Biomedical subjects

G Forsbach

Publications and source records attributed to G Forsbach.

At least 19 recordsLinked to original sources
PubMed1991

Noninsulin dependent diabetes mellitus and pregnancy in Mexico.

We analyzed 215 consecutive patients with diabetes mellitus and pregnancy, 118 (54.83%) with noninsulin dependent diabetes mellitus (NIDDM), 90 (41.86%) with gestational diabetes mellitus (GDM) and 7 (3.26%) with insulin dependent diabetes mellitus (IDDM). NIDDM and GDM patients had no significant difference in age and body mass index. There were no maternal deaths, nor episodes of ketoacidosis. Maternal and neonatal complications occurred with a similar frequency in NIDDM and GDM. We concluded that in our population, diabetes associated with insulin-resistance occurred in over 96% of our pregnant diabetic patients and was associated with an increased prevalence of maternal and neonatal complications. Earlier perinatal care has to be established in NIDDM patients, and obese young women should be screened to detect GDM from early gestation and advised to reduce weight before pregnancy ensues.

Adult↗
PubMed1991

The stimulatory effect of estradiol 17-beta on prolactin mRNA is inhibited by anti-calmodulin drugs.

The stimulatory action of estrogens on prolactin (PRL) secretion and synthesis is well known; on the other hand, anti-calmodulin drugs have recently been shown to inhibit prolactin in vitro release induced by estrogens. Based on these data, we decided to evaluate the in vivo effect of anti-calmodulin drugs (trifluoperazine and W7) on basal and estradiol-17 beta stimulated levels of PRL mRNA in anterior pituitary lobes obtained from adult male rats. Total RNA was isolated from pooled pituitaries recovered from animals under the same treatment and, from it, hybridizable PRL mRNA was detected. Estradiol-17 beta consistently stimulated PRL mRNA levels by 3-4 fold. The utilization of either trifluoperazine or W7, invariably inhibited estradiol-17 beta stimulated PRL mRNA. Metoclopramide, a drug with antidopaminergic activity, potentiated the stimulatory effect of estradiol-17 beta on PRL mRNA levels. These results suggest that anti-calmodulin drugs have an in vivo antiestrogenic effect on PRL mRNA levels confirming previous in vitro studies. Although, it is difficult to be conclusive about the mechanism through which these drugs act, one possibility is that the calcium-calmodulin system may be involved.

Animals↗
PubMed1988

Prevalence of gestational diabetes and macrosomic newborns in a Mexican population.

Prevalence of gestational diabetes was investigated in 693 pregnant patients between the 24th and 28th wk of gestation. A glucose screening test (GST) was performed with a 50-g glucose load, followed by a blood sample 1 h later. Patients with glucose levels greater than 140 mg/dl 1 h after the GST were scheduled for a full oral glucose tolerance test (OGTT). One hundred seven patients had an abnormal GST, and 30 patients (4.3%) were diagnosed as having gestational diabetes mellitus (GDM). The percentage of GDM increased significantly when glucose levels were greater than 180 mg/dl to a maximum of 84.61% when glucose levels were greater than 200 mg/dl. Also, patient age was directly related to GDM, which increased in incidence to 20% when patients greater than 26 yr had an abnormal GST. After delivery, newborn weights were compared between those born to mothers with GDM (n = 30) and those born to mothers with an abnormal GST (n = 77). Patients with an abnormal GST and normal OGTT had 12 (15.58%) macrosomic and 2 premature newborns. However, patients with GDM had 5 (16.66%) macrosomic and no premature newborns. Patients with a normal GST had 7.33% of the macrosomic newborns. There was no perinatal mortality in newborns of GDM mothers; only 1 of the 5 macrosomic newborns presented transient hypoglycemia. Evaluation of 26 GDM patients was possible after delivery, disclosing 3 (11.53%) with non-insulin-dependent diabetes mellitus and 5 (19.23%) with impaired glucose tolerance. These results showed 4.3% undetected GDM in our population and no differences in the proportion of macrosomic newborns between those born to mothers with GDM and those born to mothers with an abnormal GST.

Adolescent↗
PubMed1987

Pituitary function in human pseudocyesis.

Two young women with clinically established pseudocyesis were studied by endometrial biopsy, basal hormonal serum levels and dynamic pituitary testing. Basal serum levels of PRL and TSH were in the normal range; estradiol - 17 beta, progesterone and FSH were in the follicular phase range, but LH was in the follicular phase range in one patient and in the climateric range in the other one. The histologic assessment of the endometrial biopsies disclosed a proliferative endometrium in both patients. A group of six patients with hypothalamic amenorrhea were subjected to dynamic pituitary testing to compare results with those obtained in the two patients with pseudocyesis. The dynamic pituitary response to GnRH, TRH and metoclopramide was normal in the two patients with pseudocyesis and in the group with hypothalamic amenorrhea; moreover, challenge with estradiol benzoate (EB) in the two patients with pseudocyesis disclosed a normal positive feedback of LH. These observations and the analysis of data already published suggest that the amenorrhea of pseudocyesis is associated neither with a persistent corpus luteum nor chronic hyperprolactinemia. We suggest that an abnormality in neurotransmitter pathways results in alterations of pituitary hormone secretion. However, additional patients must be studied to prove or disprove this hypothesis.

Adolescent↗
PubMed1987

Neuroendocrine regulation of anterior pituitary function in patients during and after molar pregnancy.

Only partial studies evaluating the endocrine profile in molar pregnancy have been performed. In order to characterize the neuro-endocrine pattern during and after molar pregnancy, we studied the basal hormonal levels of hCG, human placental lactogen (hPL), FSH, GH, TSH, free thyroxine index (FTI), oestradiol-17 beta (E2), and progesterone (PG), as well as the anterior pituitary response to TRH, GnRH, and hypoglycaemia induced by insulin in 7 patients during molar pregnancy and one week after molar abortion. hCG showed significantly higher serum levels during rather than after molar pregnancy and hPL was detectable in only 4 patients during, but in none after molar pregnancy. FSH values were in the follicular phase range before and after molar abortion (12.7 +/- 0.8 and 12.7 +/- 3.5 IU/l). PRL had elevated basal levels before and after molar abortion; 103.0 +/- 16.5 and 43 +/- 10.6 micrograms/l, respectively (P less than 0.05). GH levels were distinctly elevated in 3 patients during molar pregnancy; after molar abortion, the basal GH values were normal in all patients less than 10 micrograms/l. Basal cortisol and TSH levels were in the normal range before and after molar abortion. The FTI was above the normal range in 3 patients during molar pregnancy, whereas after molar abortion the values were normalized. E2 levels were elevated before and after molar abortion, 1881 +/- 477 and 96.5 +/- 39.2 ng/l, respectively (P less than 0.01). PG levels before and after molar abortion were 30.9 +/- 5.4 and 10 +/- 6.7 micrograms/l, respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1979

The effect of pregnancy and lactation on pituitary prolactin-secreting tumours.

Management of the amenorrhoea-galactorrhoea syndrome due to pituitary tumour is still controversial. However, in cases of pituitary prolactin-producing adenomas, ovulation and pregnancy are readily induced medically with bromocriptine. In our series of 14 patients conception occurred in all cases within 6 months of treatment. All of the 14 women had uneventful full term pregnancies and normal infants. Neither neurological nor visual symptoms appeared in these patients during their pregnancies. Lactation had no apparent effect on the growth of the pituitary tumour since radiological and neurological evaluations were unchanged. Prolactin levels for each patient following the termination of pregnancy and breast feeding were apparently diminished or similar to the prolactin levels obtained prior to treatment. This finding could add to the evidence that probably there was no further growth of the pituitary tumour. Three of the 14 women have had a second pregnancy without any complications. It is recommended that patients with microadenomas can be allowed to become pregnant on bromocriptine alone, provided that they are carefully supervised during pregnancy.

Adenoma↗
PubMed1978

Bromocriptine. Clinical experience in the induction of pregnancy in amenorrhea-galactorrhea syndrome.

This study included a group of 50 women with amenorrhea-galactorrhea who were treated with bromocriptine (2-bromo-alpha-ergocryptine). Forty-two of these patients ovulated, and 36 conceived within 8 months of treatment. The pregnancies of 30 women reached a duration of 20 weeks or longer following ovulation induced by bromocriptine. Except in 1 case which ended in 10-week spontaneous abortion, the pregnancies of 26 patients terminated in 24 single, one twin, and one triplet births. All of the 29 newborns were healthy, and no congenital malformations were detected. The main side effects during treatment were transient constipation and nausea. Following delivery, return to pretreatment status was noted in all patients, which supports the fact that bromocriptine is not a curative agent.

Adult↗
PubMed1977

Gonadotropic responsiveness to clomiphene, LRH, estradiol, and bromocriptine in galactorrheic women.

Twenty hyperprolactinemic patients with galactorrhea were studied to determine their gonadotropic responses to various stimuli. Five women lacked response to gonadotropin following the administration of clomiphene citrate. Ten patients who had luteinizing hormone releasing hormone (LRH) tests before and during bromocriptine administration exhibited varied FSH and LH responses that apparently were unaffected by bromocriptine therapy. A loss of the normal positive feedback of estrogens at the level of the hypothalamus was demonstrated in most patients before and during bromocriptine therapy. Long-term treatment with bromocriptine in 11 women resulted in a decrease of serum prolactin, cessation of lactation in all, and pregnancy in 8. These results suggest that the failure of normal secretion of gonadotropins in hyperprolactinemic women may result from 1) inadequate release of endogenous LRH, and 2) loss of the positive feedback of estrogens, as a result of the same hypothalamic disturbance that provokes the hyperprolactinemia. In turn, the elevated prolactin levels may exert a short-loop negative feedback at the hypothalamic level, inhibiting cyclic gonadotropin release.

Bromocriptine↗
PubMed1977

Relationship of maternal, fetal, and amniotic fluid prolactin levels.

Serum prolactin (PRL) was measured by radioimmunoassay in 80 women in serum and amniotic fluid during various stages of normal pregnancy and at delivery. In addition, prolactin levels were measured in cord sera at 60 newborns. PRL levels in maternal serum progressively increased during pregnancy, and they were lower than the corresponding levels in amniotic fluid. A relative decline in the amniotic fluid prolactin between the 39th and the 40th week of gestation was observed. The mean concentration of PRL in umbilical blood was significant lower than that in maternal blood at delivery. The lack of correlation between the PRL in amniotic fluid and the levels found in maternal and newborns serum suggests an independient source of PRL in each of the three compartments.

Amniotic Fluid↗
PubMed1977

Anterior pituitary function during early neonatal period.

Anterior pituitary responsiveness to parturition was studied in 28 normal newborn infants. Cord blood sera samples were obtained for measurement of TSH, HGH, PRL, and FSH at birth and at intervals during four hours. The neonate infant's pituitary response to parturition consists of both PRL and TSH increments, which is probably mediated by an increase in TRH release.

Fetal Blood↗
PubMed1976

Therapeutic use of gonadoliberin (follicle-stimulating hormone/luteinizing hormone-releasing hormone) in women.

Certain conclusions may be drawn from the present review: 1. Synthetic FSH/LH-RH may induce ovulation; therefore, a therapeutic effect has been established in some cases of anovulatory infertility, but it is still difficult to assess the correct dose of FSH/LH-RH because of individual variations in response. 2. Gonadoliberin may also be used to induce ovulation after follicular maturation has been evoked by other agents. FSH/LH-RH can be utilized for supplementing the LH surge after clomiphene therapy in cases of clomiphene failure. When associated with HMG, the synthetic decapeptide may be helpful in avoiding the ovarian hyperstimulation syndrome. 3. The "triggering" of ovulation by a continuous infusion of FSH/LH-RH might be a convenient means of controlling the timing of ovulation. 4. It is expected that FSH/LH-RH blocking analogs may be used to inhibit both LH and FSH release induced by endogenous gonadoliberin in women seeking contraception.

Anovulation↗