PubMed Health⌕ Search

Biomedical subjects

L I Rose

Publications and source records attributed to L I Rose.

At least 19 recordsLinked to original sources
PubMed1992

Serum androstanediol glucuronide in women with facial hirsutism.

BACKGROUND: Measurement of serum 5 alpha-androstane-3 alpha, 17 beta-diol glucuronide (3 alpha-diolG) has been proposed as a useful biochemical marker of peripheral androgen metabolism. Is 3 alpha-diol G a useful biochemical marker of peripheral androgen metabolism and does it correlate with degree of facial hirsutism? OBJECTIVE: Our purpose was to assess possible correlation between serum 3 alpha-diol G and degree of facial hirsutism and to compare serum 3 alpha-diol G levels with levels of other commonly measured serum androgens. METHODS: Twenty-three consecutive women with facial hirsutism were studied, and serum concentrations of 3 alpha-diol G, testosterone (total, free, and biologically active portions), dehydroepiandrosterone sulfate, and androstenedione were measured. RESULTS: There was no correlation between serum 3 alpha-diol G levels and degree of facial hirsutism. There was a correlation between levels of 3 alpha-diol G and dehydroepiandrosterone sulfate (p less than 0.01), biologically active testosterone (p = 0.01), free free testosterone (p less than 0.02), and androstenedione (p less than 0.05). CONCLUSION: Serum 3 alpha-diol G concentrations have no correlation with degree of facial hirsutism and do not provide additional information over the commonly measured androgens.

Adolescent↗
PubMed1992

Serum androgens and depression in women with facial hirsutism.

BACKGROUND: Studies on the psychopathologic aspects of hirsutism are sparse. Attempts to correlate these aspects with either the extent of the facial hirsutism and/or circulating serum androgens are virtually nonexistent. This study evaluates the psychopathologic aspects of hirsutism and correlates these findings with the extent of the facial hirsutism as well as with the circulating serum androgens. OBJECTIVE: Our purpose was to assess the psychopathologic aspects of facial hirsutism and to determine whether any correlation exists between these findings and either the extent of the facial hirsutism or the circulating serum androgens. METHODS: Twenty consecutive women with facial hirsutism were studied by administration of psychologic tests (DeRogatis Symptom Inventory and the Affects Balance Scale). The results of these tests were correlated with the grade of facial hirsutism as well as serum levels of total testosterone (T), biologically active testosterone (BT), free testosterone (FT), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and androstenedione (A-dione). RESULTS: Significant levels of depression were found. No correlation was found between the psychopathologic measurements and the extent of facial hirsutism or serum levels of T, DHEA, DHEA-S, and A-dione. Significant correlations were found between depression and serum levels of FT and BT. CONCLUSION: There is an increased incidence of depression in facially hirsute women and this correlates with their circulating active testosterone levels and not with the extent of their facial hirsutism.

Adolescent↗
PubMed1992

Finasteride for benign prostatic hyperplasia.

The pathogenesis of benign prostatic hyperplasia is related to the action of 5 alpha-dihydrotestosterone (DHT), the physiologically active form of testosterone. The conversion of testosterone to DHT is catalyzed intracellularly in prostatic tissue by the enzyme 5 alpha-reductase. Finasteride blocks the action of 5 alpha-reductase by competitively inhibiting the binding of testosterone to 5 alpha-reductase. The maximum effect of finasteride on reducing prostatic volume occurs after three months of oral therapy. Most patients experience improvement in urine flow rates, and side effects are minimal. However, following discontinuation of treatment, serum DHT levels return to baseline within two weeks.

5-alpha Reductase Inhibitors↗
PubMed1992

Antiandrogens in the treatment of acne and hirsutism.

Antiandrogens have been found to be effective in the treatment of acne and hirsutism. Cyproterone acetate has been used in Europe for many years, but in the United States it has only been approved as an orphan drug to treat severe hirsutism. Spironolactone is approved in the United States for its antialdosterone effect but not for its antiandrogenic effect, although it is widely used for the latter purpose. While cyproterone is a more effective drug than spironolactone, it is more likely to produce undesirable side effects.

Acne Vulgaris↗
PubMed1991

Androgens and oligomenorrhea in hirsute women.

A recent study demonstrated that hirsute women with irregular menses had higher levels of serum androgens that hirsute women with regular menses. To investigate this finding, we measured total testosterone, biologically active testosterone, free testosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate in 51 hirsute women with regular menses and compared the levels found to those found in 28 hirsute women with oligomenorrhea. There was no significant difference in the degree of facial hirsutism between the two groups. Oligomenorrheic women had significantly higher levels of free testosterone (p less than 0.02) and biologically active testosterone (p less than 0.05). The other androgens did not differ significantly between the two groups. The free fractions of testosterone are the metabolically active forms of the hormone and their levels are a function of the rates of production and clearance of testosterone that are elevated in states of hyperandrogenism. This study confirms that hirsute women with oligomenorrhea have higher levels of free and biologically active testosterone than those with regular menses.

Androgens↗
PubMed1991

GnRH agonists: gonadorelin, leuprolide and nafarelin.

Gonadotropin-releasing hormone (GnRH), a decapeptide synthesized and released by the hypothalamus, regulates production and release of the gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the adenohypophysis. Parenterally administered GnRH was initially used diagnostically as a test of adenohypophyseal reserve of LH and FSH. Subsequently, native GnRH was used therapeutically to treat hypothalamic hypogonadal and infertility states in both men and women. Because of the low potency and short half-life of native GnRH, long-acting, potent analogs have been developed that suppress secretion of native pituitary gonadotropins, resulting in medical gonadectomy. When administered parenterally and, more recently, intranasally, these compounds are useful in the management of prostate and breast carcinoma, endometriosis and uterine leiomyomata, precocious puberty and nontumorous ovarian hyperandrogenic syndromes.

Endometriosis↗
PubMed1991

White forelock in Marfan's syndrome: an unusual association, with review of the literature.

The cutaneous expression of Marfan's syndrome is generally limited to striae distensae and a number of uncommon associations with other dermatologic disorders. To date, there have been no reported cases of hair or nail abnormalities accompanying this disorder. We describe a patient with Marfan's syndrome who presented with an acquired white forelock and we review the literature on the association of poliosis with various entities.

Adult↗
PubMed1991

Etidronate for hypercalcemia of malignancy and osteoporosis.

The biphosphonates are becoming well established as effective agents for the treatment of metabolic bone diseases. Etidronate disodium is the only biphosphonate approved by the U.S. Food and Drug Administration. Accepted indications for etidronate therapy are symptomatic Paget's disease, heterotopic ossification and hypercalcemia of malignancy. An unapproved, but apparently successful use is treatment of postmenopausal osteoporosis. Both oral and intravenous preparations are available. Newer biphosphonates, which may be more efficacious and less toxic than etidronate, are being studied.

Etidronic Acid↗
PubMed1990

Cost effectiveness of routine gonadotropin and androgen measurements in hirsute women.

Many physicians routinely measure the gonadotropins PRL, LH, and FSH and the androgens dehydroepiandrosterone (DHEA), androstenedione (ADIONE), and testosterone, as well as testosterone's biologically active fractions in the evaluation of hirsute women. Is this cost effective? To answer this question, 38 consecutive premenopausal hirsute women were evaluated. Two women each had minor elevations in PRL and FSH, and 11 had minor elevations in LH. Three women had minor elevations in the LH/FSH ratio, and only one was above a ratio of 3, believed to be indicative of polycystic ovarian syndrome. Because these gonadotropin elevations did not correlate with the androgens measured and were of no value in the diagnosis or management of these women, they were not believed to be cost effective. Their routine measurements should be abandoned.

Adult↗
PubMed1990

Desmopressin for diabetes insipidus, hemostatic disorders and enuresis.

Arginine vasopressin preparations have been used in the treatment of diabetes insipidus for many years. Compared with older antidiuretic agents, the synthetic analog desmopressin is more potent, longer acting and easier to use. It is available for intravenous, subcutaneous and intranasal administration. Desmopressin may be useful in the treatment of hemostatic disorders such as von Willebrand's disease and hemophilia A. It has also been used for nocturnal enuresis. The vasopressor effects of arginine vasopressin preparations have been exploited for use as a temporizing measure in controlling acute gastrointestinal bleeding. Side effects such as hyponatremia and water intoxication are uncommon when these drugs are used with proper precautions.

Deamino Arginine Vasopressin↗
PubMed1990

Growth hormone therapy.

Growth hormone from human pituitary glands has been available for 30 years. Because of the scarce supply and the danger of transmitting Creutzfeldt-Jakob disease, use of the hormone was discontinued in 1984. Fortunately, synthetic growth hormone produced with recombinant DNA technology became available in 1985 and eliminated the risk of Creutzfeldt-Jakob disease. Growth hormone is approved for use in the treatment of pituitary deficiency syndromes and, when properly administered at an early stage, is capable of inducing normal skeletal and muscular development. It also has been successfully used to augment growth in patients with Turner's syndrome or constitutional growth delay not associated with obvious growth hormone defects. Side effects are generally not serious, but antibodies to growth hormone develop in about 30 percent of patients.

Growth Disorders↗
PubMed1989

Corticosteroids and adrenal suppression. Characterising and avoiding the problem.

Glucocorticoids are used for a variety of illnesses. One of their major complications is suppression of the hypothalamic-pituitary-adrenal axis, rendering a patient unable to respond to stress. The risk of this suppression may be minimised by the use of short-acting glucocorticoid preparations, administration of the entire daily dose in the early morning, use of topical and intra-articular preparations where appropriate, and the use of alternate-day therapy where appropriate. Most importantly, glucocorticoids should be used cautiously when indicated, and the duration of therapy limited as much as possible.

Adrenal Cortex Hormones↗
PubMed1989

Selection of thyroid preparations.

Hypothyroidism is gratifying to treat, since the response to hormone replacement therapy is excellent. Synthetic levothyroxine is now considered the drug of choice because its effects are more predictable and reliable than those of other thyroid preparations. The choice of dose is based on clinical effects of treatment and on achieving normal levels of triiodothyronine, thyroxine and thyroid-stimulating hormone (TSH). The availability of a new, ultrasensitive TSH assay has increased the value of TSH assay for monitoring the response to hormone replacement therapy.

Drug Combinations↗
PubMed1988

Side-effects of spironolactone therapy in the hirsute woman.

Spironolactone, an aldosterone antagonist with antiandrogenic activities, is often used to treat hirsute women. Several investigators have reported beneficial effects of such treatment, but the dosages used and side-effects encountered differ in their reports. To clarify this issue, 26 consecutive premenopausal women with idiopathic hirsutism were prospectively evaluated during spironolactone treatment. Sixteen women initially received 100 mg spironolactone twice daily on days 4-21 of their menstrual cycles. In 11 women (68%), the dosage had to be decreased or the medication discontinued due to side-effects. The major side-effect, metrorrhagia with 14-day cycles, occurred in 9 women (56%). This side-effect, while not dangerous, was intolerable to these women. In one woman, spironolactone was discontinued because of urticaria and in another because of scalp hair loss. Ten women initially received 50 mg spironolactone twice daily on days 4-21 of their menstrual cycles. Two developed metrorrhagia, but no other side-effects were noted. Because of the incidence of metrorrhagia at higher dosages, we recommend that spironolactone be administered cyclically at a starting dosage of 50 mg twice daily on days 4-21 of the menstrual cycle. Alternatively, one may consider adding cyclical estrogen/progesterone therapy to continuous spironolactone therapy.

Adult↗