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Biomedical subjects

M Závada

Publications and source records attributed to M Závada.

At least 19 recordsLinked to original sources
PubMed1993

[Parenteral, depot and repeatable forms of Parlodel LAR bromocriptine in the treatment of hyperprolactinemia syndrome. Comparison with oral Parlodel].

Parenteral, depot, repeatable bromocriptine Parlodel LARR (PLO LAR) was used in the treatment of 10 women with hyperprolactinaemia. Two of them had previously an operation of a prolactinoma, eight did not have adenomas. Twenty eight days following administration of 50 mg PLO LAR, the PRL levels ere significantly lower than before treatment; in patients without adenomas they were quite normal. The action of the mentioned 50 mg PLO LAR corresponded roughly to a daily dose of 7.5 mg ParlodelR (PLO) by the oral route, i.e. in 28 days a total of 185 mg bromocriptine. After administration of five PLO LAR injections (50 and later 100 mg), the mean PRL levels in patients without adenomas were normal after 6 months. There were no significant nor pathological changes 28 days following i.m. PLO LAR 50 mg as regards T3, T4 levels, the blood sugar, cholesterol, FSH, LH, STH, TSH, testosterone cortisol, progesterone, 17 beta-estradiol, androstendione, 11 beta-OH androstendione, DHEA-S, 17 alpha-OH progesterone, aldosterone, 17-ketosteroids and 17-ketogenic steroids (in urine). LHRH + TRH + insulin tolerance tests were made repeatedly. Significant changes were found only in PRL levels (decline). In three amenorrhoic patients the originally low progesterone level rose significantly to levels of postovulation progesterone. One of these three women became pregnant after 18 years of unsuccessful treatment of sterility, incl. various oral dopaminergic preparations. The patients tolerated the preparation well and various biochemical and haematological tests were normal. The effect on galactorrhoea was favourable, seven amenorrhoic women had normal menstruation.

Administration, Oral↗
PubMed1983

Endorphin releasers: a new possible approach to the treatment of pain after burns--a preliminary report.

Decapeptide ceruletide (CRL), chemically related to cholecystokinin and gastrin, proved to have remarkable analgesic properties when administered to a group of 22 burned patients, 15 patients with acute myocardial infarction, and 8 patients suffering from pain caused by malignant tumours with metastases. Its effect was such, that many of the patients required no other analgesics (opiates) even after a prolonged administration (up to 10 days) of CRL. In some of the patients a marked euphoria developed. There were no substantial changes in EEG records during CRL administration in 15 controls, among them 4 epileptics. It is probable that CRL helps to activate the internal analgesic system. In the burned patients cortisol, testosterone, renin, prolactin and tri-iodothyronine (T3) levels in serum (plasma) were measured (radio-immunoassays). CRL did not block the stress response (no drop of increased cortisol levels, no increase in low T3 levels), but it modified (influenced) it (drop of the high renin levels, and a tendency to increase the very low testosterone levels). CRL appears to act as an endorphin releaser, as evidenced by the plasma levels of beta-endorphins (quotations). CRL and similar drugs may represent a new, more physiological and probably safer approach to the management of pain.

Burns↗
PubMed1983

Very low serum testosterone levels and severe impairment of spermatogenesis in burned male patients. Correlations with basal levels and levels of FSH, LH and PRL after LHRH + TRH.

The level of testosterone, FSH, LH and, in some cases, of PRL in serum was estimated in 39 burned male patients (mean burn index and S. E. was 31.5 +/- 2.5). The level of testosterone was found markedly decreased to a value as low as 0.19 ng ml-1, and such low level persisted for several weeks after the burn injury. At the same time the mean LH level was normal, while that of FSH decreased. However, in few patients high LH and PRL values were found. The dramatic drop of the level of testosterone and FSH began usually after the second postburn day. The administration of chorionic gonadotropin resulted in a marked elevation of testosterone level in less severely burned patients, while it was negligible in those severely burned. After LHRH plus TRH administration, the mean rise of LH level was almost normal, but FSH responded poorly. The lowest LH, FSH and PRL response was found during the 2nd and 3rd postburn week. The testes from 9 of the eleven patients that died were examined histologically, and no major histological alterations were found in those who died during the first 3 days after burn, while later a severe damage of germinal cells occurred. The pituitary-testicular axis does not operate properly after burn injuries. The main features of the endocrine (metabolic) response after burn are: 1. increased catabolism; 2. decreased anabolism; 3. changed endocrine priorities. To enable the survival an exaggerated response occurs very often with a possible resulting damage to some vital structures. Testosterone (anabolics) may be indicated in the treatment of burned patients.

Adolescent↗
PubMed1982

Bromocriptine and glucose tolerance in acromegalics.

Acromegaly is very often accompanied by impaired glucose tolerance or a manifest diabetes mellitus, with increased immunoreactive insulin (IRI) levels whose response during oral glucose tolerance tests (OGTT) is quite often exaggerated. When the dopaminergic drug bromocriptine is administered to acromegalics, their elevated growth hormone (GH) levels very often decrease, their impaired glucose tolerance (as manifested in OGTT) improves and their exaggerated IRI response becomes more normal. Eighteen patients were treated with bromocriptine. They were followed-up repeatedly during their treatment of varying duration for up to 6 years. These results indicate that raised GH levels are not the only factor that impairs glucose tolerance in acromegalics. During bromocriptine administration, impaired glucose tolerance improved and abnormal IRI levels (OGTT) became more normal even without any decrease in the high GH levels. In non-diabetic acromegalics, when bromocriptine was administered, there was not only an average decrease in the elevated GH values during OGTT, but a normalization of increased IRI values as well, without any major change in the corresponding blood glucose levels. During insulin tolerance tests (ITT), after i.v. insulin, the IRI levels after 30 and 60 min were markedly higher in acromegalics on bromocriptine than in the same patients before its administration, without any significant change in the corresponding blood glucose values. In 2 diabetic acromegalics, bromocriptine administration re-established their lost ability to increase IRI levels during OGTT. This was accompanied by a marked improvement in their glucose tolerance. It is probable that bromocriptine decreases glucagon levels in acromegalics, or at least in some of them. It is suggested that bromocriptine could protect the beta-cells of acromegalics from "exhaustion'.

Acromegaly↗
PubMed1979

Endocrine response after burn.

The use of radioimmunoassays has made new advances in post-burn endocrine studies possible. The mean fasting IRI plasma (pl.) levels were elevated for 7 weeks, sometimes reaching very high values. During OGTT, an impaired glucose tolerance and insulin resistance could be found. Pl. HGH levels were normal or slightly increased, and their hypoglycemia-caused rise in the first two postburn weeks was blocked. Renin and Angiotensin II pl. levels were high or very high in almost all burned patients. They were very sensitive indicators of burn stress. ACTH pl. levels were in some respects unpredictable: sometimes very high, sometimes only moderately elevated, or normal. There was mostly no correlation between them and the respective 17-OHCS. Serum FSH was uniformly low or very low, while LH was high (25%), normal (31%) or low (44%). Pl. testosterone levels were uniformly very low, except for the first 1-2 postburn days, even in minor burns, their levels returning to normal during convalescence. The response after chorionic gonadotropin was similar. This severe peripheric endocrine gland involvement (burn toxins? impaired circulation?) could be found to some extent when T4 (thyroxine) levels in serum were measured, especially during TSH tests. There was no correlation between TSH and T4 values. The pituitary response (LH, TSH, less FSH) to TRF and LHRH was normal in all patients tested. All the above can have far reaching endocrine and metabolic consequences (catabolism, fuel supply, endocrine priorities), with many new research and therapeutic possibilities.

Adrenocorticotropic Hormone↗
PubMed1979

[Effects of venous compression for blood sampling on the results of in vitro tests of thyroid function (author's transl)].

In a group of subjects with a normal as well as pathological thyroid function there was a significant increase in RT3U, serum-thyroxine-concentrations and TSH-levels but there were no significant changes in the T4-RT3U-indices and ETR-tests after 5 min of venous compression. The discordant results were obtained in 21 cases (26.9%) with the RT3U-test and in 4 cases (5,1%) with the T4-serum-level-determination, which may cause diagnostic errors. The non-standardized venous compression time causes a widening of the euthyroid zone which reduces the discrimination capabilities of these function tests. With TSH-determinations these deviations may be of diagnostic importance in the evaluation of TRH-TSH-test results. A standardized and minimum compression time when drawing blood samples is recommended in order to eliminate this potential source of diagnostic error.

Arm↗