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Biomedical subjects

L P Plotnick

Publications and source records attributed to L P Plotnick.

At least 37 records · Page 2Linked to original sources
PubMed1980

Glucocorticoid and partial mineralocorticoid deficiency associated with achalasia.

A number of patients with ACTH unresponsiveness resulting in glucocorticoid deficiency with normal mineralocorticoid activity have been described. This could be due to an inherited defect within the adrenal gland causing primary unresponsiveness to ACTH or to an inherited progressive degenerative process. The association of achalasia, lack of lacrimation, and glucocorticoid deficiency in two pairs of siblings with normal mineralocorticoid activity has been recently reported. Our case describes an 8.8-yr-old female with glucocorticoid insufficiency, partial mineralocorticoid deficiency, achalasia, and evidence of decreased lacrimation. Sodium depletion produced hyponatremia, and she was unable to increase her plasma aldosterone levels sufficiently, although PRA was markedly elevated. Our case may be part of a progressive degenerative process, possibly affecting both the autonomic nerve structures and the adrenal gland, leading not only to glucocorticoid deficiency but also to abnormal mineralocorticoid secretion.

17-Hydroxycorticosteroids↗
PubMed1980

Increased integrated concentration of norepinephrine, epinephrine, aldosterone, and growth hormone in patients with uncontrolled juvenile diabetes mellitus.

The 24-h integrated plasma concentration of glucose (IC-glucose), norepinephrine (IC-NE), epinephrine (IC-E), cortisol (IC-F), growth hormone (IC-GH), aldosterone (IC-ALDO), and plasma renin activity (IC-PRA) were measured in 11 nonobese juvenile-onset nonketotic diabetic patients exhibiting hyperglycemia and glycosuria and 34 matched control subjects using a portable pump, drawing blood at a constant rate through a nonthrombogenic i.v. catheter. The diabetic patients had a noticeable rise of their IC-NE, IC-E, IC-GH, and IC-ALDO. There was no significant difference between the IC-F and IC-PRA of the patients and the control subjects.

Adolescent↗
PubMed1980

Erythrocyte insulin binding in insulin-dependent diabetes mellitus: lack of relationship to duration and control of diabetes in children and adolescents.

Insulin binding was measured in the erythrocytes (RBCs) of four children and 12 adolescents with insulin-dependent diabetes mellitus in the basal (fasting, nonketotic) state. Children and adolescents with insulin-dependent diabetes mellitus showed normal binding of insulin to their RBCs when expressed as the total insulin bound over the physiologic range of insulin concentrations. The insulin receptor concentration and receptor binding affinity for insulin were also normal. These parameters of insulin binding were not correlated with either the duration of diabetes or the degree of diabetic control in the patients. Since insulin binding by erythrocytes has been shown to reflect binding by traditional target tissues (liver, fat), the data suggest that alterations in binding of insulin to cells in children and adolescents with insulin-dependent diabetes mellitus probably play little, if any, role in the response of these patients to exogenous insulin or in the control of their glucose metabolism in the basal state.

Adolescent↗
PubMed1979

Oxandrolone therapy in patients with Turner syndrome.

Long-term, low-dosage androgen treatment of patients with Turner syndrome results in more rapid growth and significantly greater adult height than in control patients who receive only estrogen for pubertal development. Seventeen patients treated with oxandrolone for one year and ten treated for two years had significantly greater growth velocities during than before treatment. Mean adult height of 25 patients treated with oxandrolone, fluoxymesterone, or both was significantly taller than the height of adult patients with Turner syndrome treated with estrogen only. Excessive skeletal maturation was not generally observed.

Body Height↗
PubMed1979

Comparison of estimates of gonadotropin levels by isolated blood samples, integrated blood concentrations, and timed urinary fractions.

Gonadotropin levels in isolated blood samples, integrated plasma concentrations (IC), and timed urinary collections have been compared in 5 males with delayed puberty and 7 normal adult males. There was a significant correlation between urinary levels in 24-h collection and those in each of four shorter timed collections for both LH and FSH. Similarly, 24-h integrated plasma concentration and 4-h (0800--1200 h) integrated plasma concentration obtained on 10 additional subjects showed significant correlation. The 4-h integrated plasma concentrations correlated with single blood samples or the mean of three samples obtained at 0800, 1200, and 1600 h. These 4-h plasma samples also correlated significantly with all urine collections for FSH but only with the 2200--0800 h urine collection for LH. The study suggests that LH and FSH levels in urine samples collected over several hours correlate with 24-h urinary excretion and that levels in single blood samples estimate the 24-h plasma integrated concentration.

Adolescent↗
PubMed1979

Comparison of physiological and pharmacological tests of growth hormone function in children with short stature.

We studied 30 short-statured children to investigate their 24-h integrated serum concentration of GH (ICGH) and its diurnal pattern and to compare this data with their responses to standard stimulation tests for GH release. Eight patients with normal stimulation tests had a mean (+/- SD) ICGH value of 8.0 +/- 3.8 ng/ml (range, 4.5--16.4), and all had several secretory peaks greater than 12 ng/ml. Nineteen patients with abnormal responses (peak, less than 10 ng/ml) had a mean ICGH value of 2.7 +/- 1.9 ng/ml (range, less than 0.8 to 7.0); this was significantly lower than that of control subjects and patients with normal stimulation tests. However, 5 of these patients had normal ICGH values. Three patients with borderline stimulation test responses (10--12 ng/ml) had normal ICGH values (3.2, 3.4, and 11.9 ng/ml). Of the 22 patients with either abnormal or borderline stimulation tests, 14 had an ICGH result below the range of normal. Of these 14, 11 had no secretory peaks greater than 10 ng/ml, whereas 3 had peaks between 10--12 ng/ml. The 8 other patients had ICGH results in the normal range. Despite significant correlation (r = 0.668), integrated GH values did not correlate with stimulation tests in a minority of the patients, the status of whom remains to be determined by long term response to exogenous GH therapy.

Adolescent↗
PubMed1979

Sustained effect of human growth hormone therapy on children with intrauterine growth retardation.

Previous studies have not clarified whether human growth hormone (HGH) therapy can significantly increase the height of patients with intrauterine growth retardation (IUGR). To determine whether the initial increase in growth rate is sustained through subsequent treatment, 19 prepubertal patients who had IUGR were treated with HGH. Ten of them received a second treatment course. Growth rates (in centimeters per year) were 4.8 +/- 1.4 (mean +/- SD) for the pretreatment period, 7.6 +/- 2.3 for the first treatment period, 4.2 +/- 2.5 for the interval between treatments, 5.9 +/- 1.4 for the second treatment period, and 4.3 +/- 2.6 for the posttreatment period. Growth rates for the two treatment periods were significantly greater than for the periods before, interval between, and posttreatment. Height expressed as the number of standard deviations below the mean for age increased significantly between the onset of treatment and the most recent measurement. These data indicate that HGH has a sustained positive effect on increasing growth rates in children with IUGR, although the magnitude of the effect may decrease with further treatment. Furthermore, we suggest that it is worthwhile to treat patients who have IUGR with HGH for prolonged periods of time, if supplies exceed those necessary to treat children with growth hormone deficiency.

Adolescent↗
PubMed1978

The diagnosis of Leydig cell tumors in childhood.

We report the clinical and hormonal findings in two boys with isosexual precocity secondary to Levdig cell tumor of the testis. The hormonal profile at the initial evaluation was quite different in the two cases suggesting differences in steroid biosynthesis by the tumors. These differences indicate that a dexamethasone suppression test may be required to differentiate between Leydig cell tumors and congenital virilizing adrenal hyperplasia with adrenal rest tissue located within the testes.

Adrenocortical Hyperfunction↗
PubMed1978

Integrated concentrations of follicle stimulating hormone and puberty.

Integrated serum concentrations of follicle stimulating hormone are compared from 25 males (aged 6-27 years) and 8 females (aged 5-16 years). Mean levels of FSH among prepubertal and early-to-mid pubertal individuals were significantly greater during sleep than while awake. Levels for late pubertal and postpubertal individuals do not differ between waking and sleeping periods.

Adolescent↗
PubMed1978

Chemical diabetes in childhood. Integrated concentrations of glucose, insulin, and growth hormone.

Children and adolescents with varying degrees of glucose intolerance were studied with constant, blood withdrawal methods, and concentrations of glucose, insulin, and growth hormone were evaluated during a normal twenty-four-hour routine. Integrated concentrations of glucose and insulin in children with chemical diabetes were normal despite abnormal oral glucose-tolerance tests. All but two insulin-dependent diabetics had elevated integrated concentrations of growth hormone, as did some but not all chemical diabetics. Three of four mildly ketoacidotic individuals with newly diagnosed diabetes, who were studied before insulin therapy, had normal growth hormone-integrated concentrations. These data differentiate pharmacologic and physiologic assessments of carbohydrate homeostasis, and they support the concept that elevated growth hormone concentrations may not be a direct result of poor diabetic control.

Adolescent↗
PubMed1976

Integrated concentrations of luteinizing hormone and puberty.

Integrated serum concentrations of luteinizing hormone have been compared among 30-minute collections from 10 boys (6-18 years old) and 5 girls (5-11 years old). This study suggests that perpubertal as well as pubertal boys have greater mean integrated concentrations of LH during sleep than during waking. One of two pubertal girls had greater concentrations of LH during sleep, while three prepubertal girls did not.

Adolescent↗
PubMed1975

Circadian variation of integrated concentration of growth hormone in children and adults.

A portable constant withdrawal pump was used to determine consecutive 30-min integrated concentrations of growth hormone (ICGH) for a 24-h period in 18 normal subjects, ages 5 to 28 yr. Seven prepubertal, 5 pubertal and 6 young adult subjects were studied under conditions of normal activity. Pubertal, prepubertal, and adult subjects had peaks during waking hours as well as during sleep, but peaks in the adults were usually lower than in the children. Using an analysis of variance, a significant (P smaller than 0.01) downward trend of ICGH was observed to occur during sleep. During waking hours a significant variation (P smaller than 0.01 by analysis of variance) was found with low levels in the first few hours after awakening and an upward trend as the evening approached. Food intake had no significant effect on ICGH nor did the introduction of the indwelling catheter. The mean apparent half-life values of growth hormone calculated on the basis of 87 episodes with 3 or more points on the downslope was 40.1 min. This is significantly higher than the known true half-life of the hormone, suggesting that complete secretory inactivity after a secretory episode is an infrequent event.

Adolescent↗
PubMedDate not supplied

Insulin pumps in children with diabetes.

Insulin pump therapy or continuous subcutaneous insulin infusion is becoming more common. Nurses can expect to encounter a growing number of children who have insulin pumps and an increasing number of questions concerning the general application and efficacy of these pumps. Therefore it is important that pediatric nurse practitioners, school nurses, and pediatric nurses understand insulin pump therapy and its role in the overall treatment of children with diabetes. This article describes the advantages, disadvantages, and alternatives to insulin pump therapy. It also discusses staff expertise, patient selection criteria, and patient education as elements of successful insulin pump management.

Child↗