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Biomedical subjects

K R Shetty

Publications and source records attributed to K R Shetty.

At least 19 recordsLinked to original sources
PubMed1995

Studies of growth hormone/insulin-like growth factor-I in polio survivors.

In the later years of life, many polio survivors develop post-polio syndrome manifested by progressive muscular weakness. Previous work by the authors showed low IGF-I level in polio survivors compared to age-matched controls. IGF-I concentration tended to be lower in polio survivors who were older, male, obese, and also in persons experiencing difficulty in the activities of daily living which were independent of other factors. IGF-I levels did not correlate with the subjective report of recent decline in functional status. Further studies of nocturnal GH secretion indicated that low IGF-I level was secondary to impaired growth hormone secretion. Low IGF-I levels in subjects with post-polio syndrome were corrected by physiologic doses of hGH and the response was dose dependent. Lesser dosage was required to normalize IGF-I level compared to standard dosages previously used in younger persons. Inasmuch as low IGF-I level resulting from GH deficiency is known to be associated with weakness, muscle atrophy, and decrease in aerobic work capacity, it is postulated that low IGF-I levels that occur in aging polio survivors may have an adverse effect on their neuromuscular function, and that hGH replacement may improve their functional status. Moreover, the new dose-response data may decrease the frequency of side effects in future hGH treatment of older adults.

Adult↗
PubMed1995

Thyroid disease and associated illness in the elderly.

Unlike younger populations with thyroid disease, elderly patients often have multiple complex illnesses coincident with their thyroid disease. This article focuses on common geriatric problems that interact with thyroid disease, including osteoporosis, diabetes mellitus, lipid abnormalities, autoimmune diseases, dementia, and malnutrition. Recognition that thyroid disease can cause or aggravate these disorders will lead to their early detection and appropriate therapy.

Aged↗
PubMed1995

Anterior pituitary function and growth hormone use in the elderly.

Age-related changes in GH and IGF-I secretion occur in both men and women and may partially contribute to the body compositional changes of decreased lean body mass, increased adiposity, alterations in bone density, and increased cardiovascular risk, all of which can affect adversely on functional capacity. hGH, GHRH, GHRP and other trophic factors hold promise as therapeutic strategies to improve the functional status of frail elderly subjects. In addition, there is potential for hGH use in elderly patients in various catabolic states because of its anabolic effects with nitrogen retention. However, careful long-term clinical trials are necessary with development of specific targeting criteria before conclusions regarding efficacy and benefits can be decided.

Adrenocorticotropic Hormone↗
PubMed1994

Human growth hormone effect on serum IGF-I and muscle function in poliomyelitis survivors.

Previous work showed low insulin-like growth factor I (IGF-I) in polio survivors compared with age-matched controls and it was hypothesized that the low IGF-I was caused by the lack of growth hormone (GH) secretion. The present study asked: Is the nocturnal release of GH subnormal in polio survivors? Can the low IGF-I level be raised to the range of healthy young men (240 to 460 ng/mL) by human growth hormone (hGH) treatment? If so, what dose of hGH is required? Does the hormone treatment affect muscle function? Eleven polio survivors with evidence of postpoliomyelitis syndrome, aged 50 to 65 years, and low IGF-I levels (average IGF-I value of 170 ng/mL) were studied. The serum level of GH was measured in the first 4 hours of sleep. The serum IGF-I level was determined before and during hGH treatment at 0.0075, 0.015 or 0.03 mg/kg of ideal body weight (IBW), three times a week for successive periods of 1 month. Before and after hGH treatment, strength was determined in knee extensor and flexor muscles and the elbow flexor and elbow extensor muscles. Nocturnal GH was low in the polio survivors compared with healthy young men. Serum IGF-I was raised into the target range by either 0.0075 or 0.015 mg hGH/kg three times a week. After 3 months of hGH treatment, no consistent changes in muscle strength were observed in the study group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Hyposomatomedinemia in quadriplegic men.

Many studies have shown that vigorous exercise acutely stimulates growth hormone (GH) release but the relative contribution of daily physical activity to maintaining the GH/somatomedin C (SmC) axis is not known. It has been reported that basal and post-exercise plasma SmC values are higher in physically conditioned young men than in sedentary men of similar age. To assess the effect of severe inactivity on the plasma SmC level, basal concentrations of this hormone were measured in patients with quadriplegia (QP) resulting from spinal cord injury (SCI). Venous blood samples were obtained after overnight fast in 41 QP men, ages 24-66, and compared with 119 healthy men of similar ages. Nonparametric analysis of variance showed SmC to be significantly lower in QP than in healthy men (p < .007). Plasma SmC below 0.35 U/ml in adults usually indicates little or no GH secretion by the pituitary gland. In QP, 46% of plasma SmC values were < 0.35 U/ml compared to 24% in the healthy group (p < .02). In both groups, an inverse relationship of SmC and increasing age was observed (p < .01). The data suggest that severe inactivity or SCI tend to cause hyposomatomedinemia. The latter endocrine alteration may contribute to the decrease in lean body mass and muscle atrophy of QP patients, and add further functional impairment to the original neurologic deficit. In addition, hyposomatomedinemia could increase the tendency for pressure sore formation and osteoporosis in SCI patients.

Adult↗
PubMed1993

Prevalence of low plasma IGF-I in poliomyelitis survivors.

OBJECTIVE: To compare plasma levels of insulin-like growth factor-I (IGF-I, also termed somatomedin C) in polio survivors and healthy control subjects and to determine their relation to selected clinical characteristics. DESIGN: Cross sectional study. SETTING: Polio survivors living in the community recruited from the Wisconsin Polio Support Group. PARTICIPANTS: A total of 124 polio survivors (49 males and 75 females), ages 35 to 77 years, and 261 healthy control subjects (139 males and 122 females) of similar age. MEASUREMENTS: Plasma IGF-I levels were compared in polio survivors and age-matched control subjects. In the polio survivor group, the relation of IGF-I to selected clinical characteristics was examined before and after adjusting for covariates. RESULTS: Statistical analyses showed that the IGF-I concentrations were significantly lower in the polio survivors than in the controls. This difference was reflected in the means and standard errors of the two groups (0.45 +/- 0.02 vs 0.60 +/- 0.02 units/mL, P < 0.01). Plasma IGF-I below 0.35 units/mL in adults indicates little or no growth hormone secretion. In polio survivors, 38% of the plasma IGF-I values were < 0.35 units/mL compared with 19% in the healthy group. Univariate analysis showed that IGF-I in the polio survivors was significantly correlated with age, gender, and body mass index, and with dependency, pain, and difficulty in the activities of daily living (ADLs). The correlations with ADL dysfunction were independent of the correlations with age, gender, and body mass index. IGF-I level did not correlate with the subjective report of recent decline in functional status. CONCLUSION: Lower levels of IGF-I are seen in polio survivors, and this finding correlates with ADL dysfunction. The hyposomatomedinemic tendency of polio survivors may have an adverse effect on their neuromuscular function and quality of life.

Activities of Daily Living↗
PubMed1992

Lipid and lipoprotein abnormalities in young quadriplegic men.

To assess the effect of severe inactivity on the serum lipid and lipoprotein profile, 21 quadriplegic men between the ages of 24 and 47 were compared with 20 age-matched healthy control men. The group of quadriplegic men had significantly lower levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), HDL2-C and HDL3-C. The current recommendation for desirable TC is less than 200 mg/dl, whereas HDL-C of less than 35 mg/dl is considered a risk factor for coronary heart disease. Of the 50% (10/20) of the men in the normal control group who had a desirable TC, only 10% (1/10) had a low or undesirable HDL-C value. In comparison, although 81% (17/21) of the group of quadriplegic men had a desirable TC, 53% (9/17) of these individuals had a low HDL-C level. It is concluded that although the presence of lower TC could be beneficial in QM, the decreased values of HDL-C and HDL2-C and the increased ratio of TC/HDL-C suggest a higher risk of coronary heart disease. The findings are consistent with recent reports of an increased prevalence of coronary heart disease in spinal cord injury patients, which could be due to an abnormal lipoprotein profile related to diet, inactivity, changes in body composition, and life style. Moreover, the present data suggest that HDL-C should be measured in quadriplegic men with modifiable risk factors, even if they have desirable TC, to avoid missing an increased coronary heart disease risk status.

Adult↗
PubMed1991

Hyposomatomedinemia in men with post-poliomyelitis syndrome.

The age of onset of the post-poliomyelitis syndrome (PPS) coincides with the tendency for declining activity of the growth hormone/somatomedin C (GH/SmC) axis. The normal plasma SmC range in men before the age of 40 is 0.50 to 1.50 units/mL. After age 40 about 30% of men have a plasma SmC level below 0.35 units/mL, signifying no detectable spontaneous GH secretory pulses. Because the GH/SmC axis stimulates DNA, RNA, and protein synthesis in muscle cells and increases their size and number, a deficiency of the GH/SmC axis could theoretically contribute as a secondary factor to the occurrence or severity of the PPS. Accordingly, the authors measured the plasma SmC level in 10 men with PPS, ages 35 to 63, and in 94 healthy men of similar age. In the PPS men, 100% of the values were less than or equal to 0.40 units/mL, and 90% were less than or equal to 0.35 units/mL. The corresponding proportions in the healthy men were 40% and 27%. Analysis of variance including age as a factor showed SmC to be significantly lower in the PPS men than in the healthy men. In an additional comparison, totally immobile nursing home men did not have lowered SmC values. In fact their SmC values were slightly higher than those of healthy men of similar age. The data revealed a new biochemical feature of PPS, hyposomatomedinemia, which might play a contributory role in the pathogenesis of the syndrome.

Adult↗
PubMed1991

Effects of human growth hormone on body composition in elderly men.

Body composition changes progressively in mid and late adulthood. Lean body mass in men over 50 years old contracts at an average rate of -0.6% per year. Body weight tends to remain stable because of a reciprocal expansion of adipose mass. The shrinkage of the lean body mass reflects the atrophy of skeletal muscles, skin and visceral organs. Because growth hormone causes expansion of the lean body mass and contraction of the adipose mass, and because growth hormone secretion tends to diminish in late adulthood, it has been postulated that geriatric hyposomatotropism is a contributory cause to the body composition changes described above. The authors have tested this hypothesis by recruiting 45 independent men over 61 years old with plasma somatomedin C level below 0.35 U/ml, indicating little or no detectable growth hormone secretion. The 21-month protocol was as follows: baseline period 0-6 months, experimental period 6-18 months and post-experimental period 18-21 months. During the experimental period, 26 men (group I) received approximately 0.03 mg/kg of biosynthetic human growth hormone (hGH) subcutaneously 3 times a week, while 19 men (group II) received no treatment. Plasma somatomedin C was measured monthly. The following outcome variables were measured at 0, 6, 12 and 18 months: lean body mass, adipose mass, skin thickness (dermis plus epidermis), sizes of the liver, spleen and kidneys, the cross sectional areas of ten muscle groups, and bone density at 9 skeletal sites. Lean body mass and adipose mass were also measured at 21 months. In group I, hGH treatment raised the plasma somatomedin C level and maintained it in the range 0.5-1.5 U/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Plasma dehydroepiandrosterone sulfate in nursing home men.

Previous studies have shown the normal range of plasma dehydroepiandrosterone sulfate (DHEAS) for independent community men over 60 years old to be 30-200 micrograms/dL. In human adults, low levels of plasma DHEAS have been correlated with a high mortality rate. In rodents, dehydroepiandrosterone, the precursor of DHEAS, has exhibited antidiabetic, anticarcinogenic, neurotropic, and memory-enhancing effects. We have now measured plasma DHEAS in 50 independent community men age 55-94 and in 61 nursing home men age 57-104. Mean DHEAS was significantly lower in the nursing home men than in the community men. Plasma DHEAS was subnormal (less than 30 micrograms/dL) in 40% of the nursing home residents and in only 6% of the community subjects. In both groups, DHEAS was inversely related to age. In the nursing home men, additionally, plasma DHEAS was inversely related to the presence of an organic brain syndrome and to the degree of dependence in activities of daily living. Plasma DHEAS was subnormal in 80% of the nursing home men who required total care. There was no significant correlation between the plasma concentrations of DHEAS and testosterone, or between plasma DHEAS and one-year mortality rate.

Activities of Daily Living↗
PubMed1990

Thyrotoxicosis induced by topical iodine application.

We describe an elderly man who was admitted with congestive cardiac failure and found to have thyrotoxicosis. He did not have goiter, and he had normal radioiodine uptake in his neck. Serum iodine levels were elevated, explaining the lack of increase in radioiodine uptake in the thyroid gland. He had multiple pressure sores, which were treated with povidone-iodine (Betadine) soaks. Biochemical data were consistent with Graves' disease unmasked by topical iodine application. Povidone-iodine soaks are commonly used in decubitus ulcer care and warrant special attention in patients with preexisting thyroid disorders. We have reviewed the literature on this unusual complication.

Administration, Topical↗
PubMed1980

Legionnaires' disease with profound cerebellar involvement.

An acute febrile illness with pulmonary infiltration and severe cerebellar deficit developed in a woman. The diagnosis of Legionnaires' disease was confirmed by indirect fluorescent antibody tests. Legionnaires' disease should be considered as a diagnostic possibility in patients with pneumonia and cerebellar dysfunction.

Cerebellar Diseases↗
PubMed1978

Radiation-related thyroid carcinoma.

Of 1,825 subjects with a history of head or neck irradiation, 358 (19.6%) were found to have thyroid abnormalities. One hundred sixty-five (9%) had either single or multiple nodules 153 (8.4%) had diffuse thyromegaly, and 40 (2.2%) had had thyroid surgery. Surgery was performed on 113 subjects with nodules; carcinoma was found in 34 (30.1%). Clinical examination of the neck was the most valuable method of detecting abnormalities. Detection of nodules was not significantly enhanced by routine use of thyroid imaging studies. Measurements of levels of serum thyroid-stimulating hormone, thyroxine, triidothyronine resin uptake, and thyroid antibodies were not useful in screening for nodules or carcinoma.

Adult↗