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Biomedical subjects

R Dolecek

Publications and source records attributed to R Dolecek.

At least 19 recordsLinked to original sources
PubMed1989

Endocrine changes after burn trauma--a review.

After burn trauma, a very marked endocrine response occurs. Almost all the known hormones take part in it. Their response influences very much the postburn metabolic changes and participates in the integration of the body's response with the nervous and immune systems. In this review, mainly the changes in various hormone levels are described, as well as the possible role of the acute phase response after burn trauma, and the communications between the endocrine and immune systems, the cells of the latter are able to respond to various hormonal stimuli and to secrete various hormones themselves. Some of the hormones are very sensitive indicators of the burn stress, e.g., the T3 levels (very low), testosterone in males (very low), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) (very low), ADH, catecholamines, renin and angiotensin II, cortisol (high), 17-beta-estradiol in males (usually elevated). Other hormones are usually elevated, but not always (ACTH, aldosterone, prolactin, glucagon, immunoreactive insulin, beta-endorphin, rT3, 11-beta-hydroxyandrostenedione), but there are hormones that are unually low (T4, FSH, androstenedione, progesterone--the latter especially in females). Calcitonin, parathyroid hormone, growth hormone are sometimes elevated, as well as LH (measured with RIA methods). TSH is usually normal, the biologically measured LH was reported to be low. The levels of the sensitive indicators of burn stress may be used to evaluate the effect of treatment: if the burn patient is properly treated, the indicators may become earlier normal.

Acute-Phase Reaction↗
PubMed1985

Long-term effect of pizotifen treatment on growth hormone levels of underweight children, including those with anorexia nervosa.

Eight underweight children, 3 of them with anorexia nervosa, were treated for 3 months without interruption with 1.0 to 1.5 mg pizotifen per day. Their mean weight gain was 4.6 +/- 1.1 kg (range 2.5 to 11.5 kg) and their height increased by 1.4 +/- 0.5 cm (range 0 to 4 cm), as in normal controls. Before the start of and at the end of treatment with pizotifen, protracted insulin tolerance tests were performed, during which blood glucose and growth hormone (hGH) levels were measured (10 times over 2 hours). In the same patients, hGH levels were measured (6 times over 2 hours) in the late evening, during sleep. Treatment with pizotifen did not decrease the hGH response to insulin-caused hypoglycaemia. After pizotifen, some blood glucose levels were lower than before pizotifen. The mean hGH values during sleep did not change significantly after pizotifen. In 1 patient with anorexia nervosa the increased hGH levels decreased during treatment to very low levels (she gained 11.5 kg); in another patient they increased (she gained 2.5 kg). The possible mechanisms of pizotifen action are discussed briefly. There were no changes in serum prolactin levels during pizotifen administration.

Adolescent↗
PubMed1984

Growth hormone plasma levels in children treated for 6 months with ketotifen.

Twelve children with pollinosis or bronchial asthma were treated continuously, without interruption, for 6 months with ketotifen (2 mg per day). In the first group of 6 children, growth hormone and blood glucose levels were measured during insulin tolerance tests (-15, 0, 30 and 60 min) and growth hormone levels during the late evening when the children were asleep, before and after 3 and 6 months of treatment. In the second group of 6 children, growth hormone and blood glucose levels were measured during protracted insulin tolerance tests (-15, 0, 15, 30, 45, 60, 75, 90, 105 and 120 min) at the same periods. The results showed that the growth hormone increases and blood glucose decreases were generally the same before and during ketotifen treatment. Growth rate and weight gain in the treated groups were similar to those in control groups of untreated children and were not lower than the average values for Czech children of the same age. Measurements of thyroid stimulating hormone and prolactin levels showed that these also wer not altered during long-term ketotifen administration.

Adolescent↗
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↗
PubMed1981

Ketotifen in the treatment of diabetics with various allergic conditions.

A study was carried out in 30 hospitalized diabetics suffering from allergic conditions to assess the effects of ketotifen on various laboratory parameters. Ten of the patients were on diet only, 10 on biguanides plus diet, and 10 on sulphonylureas plus diet. Most were overweight. Patients received 4 mg ketotifen daily for 14 days. Oral glucose tolerance tests and other laboratory investigations were carried out before and 7 and 14 days after the start of ketotifen administration. There were no pathological changes measured in blood levels of sodium, potassium, SGPT, SGOT, alkaline phosphatase, cholesterol, triglycerides, creatinine, uric acid, non-protein nitrogen, haemoglobin, haematocrit, white cell count and differential, and platelet count. Glucose tolerance improved somewhat during the repeated oral glucose tolerance test, and there were no significant changes either in the immunoreactive insulin or growth hormone levels during the test. In the diabetics on biguanides, initial blood pressures were raised both in the lying and standing positions. The levels decreased significantly to normal during ketotifen administration. The results indicate that ketotifen can be used without problems in the treatment of diabetics with allergic disorders and its suggested that a long-term study with ketotifen in diabetic patients could be useful.

Biguanides↗
PubMed1980

Endocrine studies with mazindol in obese patients.

Detailed endocrine studies were carried out in 95 hospitalized obese patients during their treatment with diet and the tricyclic anoretic mazindol. The results obtained after 1 week or more of mazindol (2 mg or occasionally 4 mg/day) administration were compared with the results after placebo and with the initial pre-treatment values. There were no significant changes in the following parameters: FSH, LH, testosterone, renin, angiotensin II, growth hormone (GH) levels during insulin tolerance tests (ITT), 131I uptake, basal metabolic rate, Achilles tendon reflexes, T3 RIA, rT3 RIA, 17-ketosteroids and 17-ketogenic steroids in urine, both basal and after stimulation with ACTH and metyrapone. Blood glucose and plasma immunoreactive insulin (IRI) levels during oral glucose tolerance tests decreased during mazindol administration, IRI levels were significantly lower during ITTs after mazindol. T4 RIA serum levels increased significantly after mazindol. When mazindol was administered, GH levels increased somewhat in some obese patients during ITTs, while T3 RIA and rT3 RIA decreased in some patients. Mazindol has not only hunger (appetite) suppressing properties, but it probably affects the metabolism of energy substrates as well. The drug was well tolerated and there were no pathological findings in routine laboratory examinations during a long-term study with mazindol (non-stop treatment for 6 months).

Adolescent↗
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↗