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1.
Clin Endocrinol (Oxf) ; 60(6): 734-40, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15163338

ABSTRACT

OBJECTIVE: Somatostatin analogue treatment is first-line medical therapy for acromegaly. This study compared the efficacy and tolerability of titrated doses of the long-acting somatostatin analogue preparation lanreotide Autogel with fixed doses and with lanreotide prolonged release (PR) 30 mg microparticles. PATIENTS: Patients entering the initial study had received a diagnosis of active acromegaly within the previous 5 years. DESIGN: This open, comparative, multicentre study was a 1-year extension of a previous trial during which patients with acromegaly had switched from lanreotide PR 30 mg microparticles injected intramuscularly every 7, 10 or 14 days, for at least 3 months, to one of three fixed doses of lanreotide Autogel (120, 90, or 60 mg every 28 days, respectively). In this extension study, patients continued to receive 60, 90, or 120 mg of lanreotide Autogel by deep subcutaneous injection every 28 days for 1 year. Doses could be titrated at entry or after four or eight injections, according to the GH/IGF-I response (dose increased if GH > 2.5 micro g/l, or decreased if GH < 1 micro g/l with normal IGF-I). MEASUREMENTS: Mean +/- SEM GH and IGF-I concentrations were analysed and gallbladder echography performed at weeks 0, 16, 32, and 48. Acromegaly symptoms were recorded monthly and tolerance and side-effects were monitored throughout the study. RESULTS: In total, 130 patients entered this extension phase. After 1 year of treatment with titrated doses of lanreotide Autogel, mean GH (2.4 +/- 0.2 micro g/l) and IGF-I (287 +/- 12 micro g/l) concentrations were significantly lower than with lanreotide microparticles (GH, 2.8 +/- 0.2 micro g/l, P < 0.001; IGF-I, 332 +/- 15 micro g/l, P < 0.01) or with fixed-dose lanreotide Autogel (GH, 3.0 +/- 0.2 micro g/l, P < 0.001; IGF-I, 310 +/- 14 micro g/l, P = 0.02). GH hypersecretion was reduced to

Subject(s)
Acromegaly/drug therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Peptides, Cyclic/therapeutic use , Somatostatin/therapeutic use , Acromegaly/blood , Acromegaly/diagnostic imaging , Adult , Analysis of Variance , Anti-Inflammatory Agents, Non-Steroidal/blood , Delayed-Action Preparations , Drug Administration Schedule , Female , Follow-Up Studies , Gallbladder/diagnostic imaging , Growth Hormone/blood , Humans , Injections, Subcutaneous , Insulin-Like Growth Factor I/analysis , Male , Middle Aged , Peptides, Cyclic/blood , Somatostatin/analogs & derivatives , Somatostatin/blood , Ultrasonography
2.
Eur J Endocrinol ; 150(1): 57-63, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14713280

ABSTRACT

OBJECTIVE: A phase I single centre, open label study of the pharmacokinetics and tolerability of a buccal testosterone tablet (COL 1621) was carried out. DESIGN: Twelve testosterone-deficient males were treated with the buccal tablet twice daily for 7 consecutive days. Multiple blood samples were drawn for testosterone, dihydrotestosterone (DHT), bioavailable testosterone and sex hormone-binding globulin (SHBG). RESULTS: After COL 1621, means+/-S.D. serum testosterone level increased to a peak concentration of 26.6+/-5.8 nmol/l (7.7+/-1.7 ng/ml) at 4.8+/-5.8 h and stayed in the eugonadal range. Steady state was achieved within the first 24 h and was maintained in the normal range. The bioavailable testosterone, DHT and free testosterone index followed a pattern very similar to that of testosterone. The mean serum testosterone to DHT ratio was within the normal male range throughout treatment. There was only one treatment-related adverse event (headache). Two-thirds of patients indicated that treatment with COL 1621 was acceptable and that the tablet was convenient to use. Six patients (50.0%) preferred COL 1621 to their previous testosterone replacement therapy, two patients gave preference to their previous treatment and three patients found both treatments to be equally acceptable. Data for one patient was not available. CONCLUSION: We conclude that COL 1621 can efficiently elevate serum testosterone and DHT levels in hypogonadal men within the first day of application, achieve a steady state within 24 h and maintain serum testosterone in the normal range with a twice-daily treatment regimen. COL 1621 provides an effective alternative oral testosterone replacement therapy that gives physiological levels of testosterone and is well tolerated by the patients.


Subject(s)
Androgens/administration & dosage , Androgens/pharmacokinetics , Hypogonadism/drug therapy , Testosterone/administration & dosage , Testosterone/pharmacokinetics , Administration, Buccal , Adult , Androgens/adverse effects , Humans , Male , Middle Aged , Patient Satisfaction , Sex Hormone-Binding Globulin/metabolism , Testosterone/adverse effects
3.
J Clin Endocrinol Metab ; 87(1): 99-104, 2002 Jan.
Article in English | MEDLINE | ID: mdl-11788630

ABSTRACT

Lanreotide Autogel is a new long-acting aqueous preparation of lanreotide for the treatment of acromegaly and is administered by deep sc injection from a small volume, prefilled syringe. The aim of this study was to evaluate the efficacy and safety of this new long-acting formulation in a large population of acromegalic patients previously responsive to lanreotide 30 mg, im (sustained release microparticle formulation). Lanreotide Autogel was administered by deep sc injection every 28 d to 107 patients (54 males and 53 females; mean age, 54 +/- 1.2 yr). All patients had been treated with lanreotide (30 mg) for at least 3 months before study entry and had a mean GH level less than 10 ng/ml after at least 4 subsequent im injections every 14 d (48%), 10 d (32%), or 7 d (20%). Treatment was switched from lanreotide 30 mg injected every 14, 10, or 7 d to 60, 90, or 120 mg lanreotide Autogel, respectively, every 28 d. After three fixed dose injections of lanreotide Autogel, mean lanreotide levels were similar to those obtained at steady state with lanreotide 30 mg. During lanreotide Autogel treatment, the control of acromegalic symptoms was comparable with that previously achieved during lanreotide 30 mg treatment. After 3 injections of lanreotide Autogel, mean GH (2.87 +/- 0.22 ng/ml) and IGF-I (317 +/- 15 ng/ml) values were comparable with those recorded at the end of lanreotide 30 mg treatment (GH, 2.82 +/- 0.19 ng/ml; IGF-I, 323 +/- 16 ng/ml). GH levels below 2.5 ng/ml and age-/sex-normalized IGF-I were achieved in 33% and 39% of patients during lanreotide 30 mg and lanreotide Autogel treatment, respectively. Diarrhea, abdominal pain, and nausea were reported by 38%, 22%, and 18% of patients during lanreotide 30 mg treatment and by 29%, 17%, and 9% of patients, respectively, during lanreotide Autogel treatment. In conclusion, this clinical study shows that lanreotide Autogel is at least as efficacious and well tolerated as lanreotide 30 mg. This new long-acting lanreotide formulation, lanreotide Autogel, which is administered from a small volume, prefilled syringe by deep sc injection, is therefore likely to improve the acceptability of medical treatment for patients requiring long-term somatostatin analog therapy.


Subject(s)
Acromegaly/drug therapy , Hormones/therapeutic use , Peptides, Cyclic/therapeutic use , Somatostatin/therapeutic use , Acromegaly/blood , Chemistry, Pharmaceutical , Delayed-Action Preparations , Female , Hormones/administration & dosage , Human Growth Hormone/blood , Humans , Injections, Intramuscular , Injections, Subcutaneous , Insulin-Like Growth Factor I/analysis , Male , Middle Aged , Peptides, Cyclic/administration & dosage , Somatostatin/administration & dosage , Somatostatin/analogs & derivatives
4.
Br J Dermatol ; 141(3): 521-3, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10583059

ABSTRACT

Diffuse hair loss in women is generally regarded as the female equivalent of male balding and is often referred to as female androgenetic alopecia. In this article we report the case of a young woman with hypopituitarism who presented with the clinical and histological features of female androgenetic alopecia in the absence of detectable levels of circulating androgens or other signs of postpubertal androgenization, showing that this pattern of hair loss is not necessarily androgen dependent.


Subject(s)
Alopecia/etiology , Hypopituitarism/complications , Adolescent , Alopecia/pathology , Female , Hair Follicle/pathology , Humans , Hypopituitarism/pathology
5.
J Endocrinol Invest ; 22(6): 409-18, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10435849

ABSTRACT

OBJECTIVE: To assess the efficacy and tolerability of SR-lanreotide in the treatment of active acromegaly. PATIENTS AND DESIGN: 30 patients (17 men and 13 women) were treated in whom active acromegaly was confirmed by clinical features, a mean GH level of >5 mlU/l and failure to suppress GH to <2 mlU/l after a 75 g glucose load. Patients were treated for a median period of 60 weeks (range 12-168) with im injections of SR-lanreotide 30 mg given every 7-14 days. MEASUREMENTS: Mean GH and IGF-I levels were measured at baseline and every 12-weeks together with symptom score assessment. MRI of the pituitary gland was performed at baseline and if an adenoma was identified at yearly intervals. Gall bladder ultrasound scans were performed at baseline and then every 24-weeks. RESULTS: Twenty-three patients were treated for at least 48-weeks and, in these, GH levels fell from 10.5 mlU/l (7.6-17.6) (median and interquartile range) at baseline to 3.2 mlU/l (2.4-3.9) (p<0.0001) and IGF-I levels ftom 88.9 nmol/L (71.4-137.1) to 56.8 nmol/l (39.3-75.4) (p=0.0002). GH response to treatment was better in elderly patients (age> or =65 years) compared to younger patients but neither sex, pre-treatment GH levels, previous surgery nor previous radiotherapy influenced the response. Treatment resulted in a significant improvement in the symptoms of active acromegaly in the majority of patients. A significant reduction in the size of the pituitary adenoma was documented in 6 of 10 patients who had a repeat MRI scan after one year. Treatment was well-tolerated by the majority of patients; side effects were mainly transient gastrointestinal symptoms. These were severe in only 2 patients necessitating discontinuation of the drug. Two patients developed new gall stones and 4 female patients had temporal hair loss necessitating stopping treatment in one of them. There were minor effects on glucose tolerance which were not of clinical importance. CONCLUSION: Long-term treatment of acromegaly with SR-lanreotide is effective in controlling GH and IGF-I levels and symptoms and is well tolerated in the majority of patients.


Subject(s)
Acromegaly/drug therapy , Antineoplastic Agents/therapeutic use , Peptides, Cyclic/therapeutic use , Somatostatin/analogs & derivatives , Acromegaly/etiology , Acromegaly/pathology , Adenoma/complications , Adenoma/pathology , Adult , Aged , Antineoplastic Agents/adverse effects , Female , Follow-Up Studies , Glucose Tolerance Test , Human Growth Hormone/blood , Humans , Insulin-Like Growth Factor I/metabolism , Magnetic Resonance Imaging , Male , Middle Aged , Peptides, Cyclic/adverse effects , Pituitary Neoplasms/complications , Pituitary Neoplasms/pathology , Somatostatin/adverse effects , Somatostatin/therapeutic use , Time Factors
6.
Eur J Endocrinol ; 140(2): 155-8, 1999 Feb.
Article in English | MEDLINE | ID: mdl-10069660

ABSTRACT

Several cytokines have been shown to be expressed in normal and adenomatous pituitary tissue. Recently, interleukin-8 (IL-8) mRNA was identified by reverse transcription (RT)-PCR in each of a series of 17 pituitary tumours examined. We have investigated further the presence of IL-8 mRNA, using in situ hybridisation in two normal human anterior pituitary specimens and 25 human pituitary adenomas. IL-8 mRNA was not identified in either of the two normal pituitary specimens. Only three of the 25 adenomas were positive for IL-8 mRNA. In these three tumours, which included two null cell adenomas and one gonadotrophinoma, the majority of tumour cells (>90%) were positive for IL-8 mRNA. The remaining 22 adenomas were completely negative. There was no difference in tumour size or type between the IL-8 positive and the IL-8 negative tumours, and immunocytochemistry for von Willebrandt factor showed that the two groups were also similar in their degree of vascularisation. In conclusion, IL-8 mRNA was found in 12% of pituitary adenomas studied and was histologically identified within the tumour cells. In situ hybridisation is a more appropriate technique for assessing cytokine mRNA production by human pituitary tumours because RT-PCR may be too sensitive, identifying very small, possibly pathologically insignificant, quantities of mRNA that could be produced by supporting cells such as fibroblasts, endothelial cells or macrophages.


Subject(s)
Adenoma/metabolism , Interleukin-8/genetics , Pituitary Neoplasms/metabolism , RNA, Messenger/metabolism , Adult , Aged , Aged, 80 and over , Female , Humans , Immunohistochemistry , In Situ Hybridization , Male , Middle Aged , Pituitary Gland/metabolism , Reference Values , von Willebrand Factor/metabolism
7.
CDS Rev ; : 42-3, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10850257
8.
J Infect ; 27(1): 63-6, 1993 Jul.
Article in English | MEDLINE | ID: mdl-8370948

ABSTRACT

Granulomatous hepatitis as the sole manifestation of acute Q fever has been reported only rarely, although minimal hepatic dysfunction may be common in the acute disease. In this paper we report two patients with acute Q fever who presented with hepatitis; one of whom had granulomatous hepatitis on liver biopsy. We discuss the serological diagnosis of acute and chronic Q fever particularly in relation to hepatitis.


Subject(s)
Antibodies, Bacterial/analysis , Coxiella burnetii/immunology , Granuloma/etiology , Hepatitis/etiology , Q Fever/complications , Complement Fixation Tests , Hepatitis/pathology , Humans , Male , Middle Aged , Q Fever/immunology
9.
Clin Endocrinol (Oxf) ; 39(1): 113-8, 1993 Jul.
Article in English | MEDLINE | ID: mdl-8394228

ABSTRACT

We report two patients with treated pituitary gigantism and peripheral neuropathy, one of whom has chronic foot ulceration. Detailed neurophysiological assessment was performed on both patients. The patient with foot ulceration had clinical and neurophysiological evidence of severe neuropathy, whereas the patient without ulceration had only neurophysiological abnormalities. The sweating response to acetylcholine was markedly impaired in the feet of both patients, suggesting pedal autonomic denervation. Neither patient had evidence of diabetes mellitus and detailed investigation failed to reveal an alternative cause of peripheral neuropathy. Optical pedobarography revealed abnormally high pressure (> 10 kg/cm2) under the metatarsal heads of both patients, one such area coinciding with the area of ulceration. Thus in pituitary gigantism elevated plantar pressures may contribute to the development of foot ulceration when severe peripheral neuropathy is present. Furthermore, as in diabetes mellitus, impaired sweating may also increase the risk of ulceration as the resultant dry skin may develop fissures.


Subject(s)
Foot Ulcer/etiology , Gigantism/complications , Peripheral Nervous System Diseases/complications , Adult , Chronic Disease , Foot/pathology , Foot Ulcer/pathology , Gigantism/pathology , Humans , Male , Peripheral Nervous System Diseases/pathology , Pressure , Sweating/physiology
10.
J Prosthet Dent ; 69(3): 247-9, 1993 Mar.
Article in English | MEDLINE | ID: mdl-8445552

ABSTRACT

Research concerning bleaching agents on the mechanical properties of composite resin restorative materials has produced conflicting reports. Representative brands of composite resin restorative materials were studied, including microfil, hybrid, and posterior types. The bleaching agents selected were 30% hydrogen peroxide and two commercial brands of 10% carbamide peroxide. Ten specimens of each material, prepared according to American National Standards Institute/American Dental Association specification No. 27 for diametral tensile testing, were stored in bleaching agents for 1 hour and 168 hours at 37 degrees C. An equal number of specimens stored in deionized water with identical conditions were designated controls. Qualitative examination of bleached specimens revealed a marked change in color, especially the microfilled composite resins. There was no significant difference in tensile strength between controls and exposed samples at either time except for the diminished strength of microfilled composite resins in 30% hydrogen peroxide for one week (p < 0.01).


Subject(s)
Composite Resins/chemistry , Hydrogen Peroxide/chemistry , Peroxides/chemistry , Tooth Bleaching , Urea/analogs & derivatives , Carbamide Peroxide , Color , Drug Combinations , Humans , Materials Testing , Tensile Strength , Tooth Bleaching/methods , Urea/chemistry
11.
J Endocrinol ; 134(1): 149-54, 1992 Jul.
Article in English | MEDLINE | ID: mdl-1500840

ABSTRACT

Tissue kallikrein is a serine protease which may be involved in the intracellular processing of prolactin in the anterior pituitary gland. The expression of tissue kallikrein, in the rat, is promoted by oestrogen and inhibited by dopamine. Human and rat prolactinomas contain markedly increased amounts of tissue kallikrein; this is comparatively reduced if patients are pretreated with the dopamine agonist, bromocriptine, before surgery. Some GH-secreting adenomas are mixed and also contain prolactin-secreting cells. We therefore investigated 27 GH-immunostaining human pituitary adenomas for the presence of immunoreactive tissue kallikrein. Sixteen of the adenomas had positive immunostaining for prolactin; eight of these patients had associated clinical hyperprolactinaemia before the tumour was removed. Tissue kallikrein immunoreactivity was found in ten adenomas, all of which also had prolactin immunopositivity. There was a close relationship between the percentage of cells staining for prolactin and tissue kallikrein but not for GH. A further eight adenomas had patchy positivity, i.e. less than 1% of cells immunostained for tissue kallikrein and six of these also had some prolactin-staining cells. Nine out of eleven purely GH-staining adenomas had no tissue kallikrein immunopositivity, the remaining two showing patchy staining. A review of bromocriptine responsiveness, as assessed by mean GH hormone levels during oral glucose tolerance tests before and after therapy was commenced, indicated that patients with adenomas which stained for prolactin and tissue kallikrein were more likely to respond to bromocriptine than those which failed to do so.


Subject(s)
Adenoma/metabolism , Growth Hormone/metabolism , Kallikreins/analysis , Pituitary Neoplasms/metabolism , Prolactin/metabolism , Adenoma/chemistry , Adenoma/drug therapy , Adolescent , Adult , Aged , Bromocriptine/therapeutic use , Female , Growth Hormone/analysis , Humans , Immunohistochemistry , Male , Middle Aged , Pituitary Neoplasms/chemistry , Pituitary Neoplasms/drug therapy , Prolactin/analysis , Prolactinoma/chemistry
12.
BMJ ; 304(6825): 503, 1992 Feb 22.
Article in English | MEDLINE | ID: mdl-1547428
13.
Horm Res ; 37(3): 113-8, 1992.
Article in English | MEDLINE | ID: mdl-1335954

ABSTRACT

The effect of muscimol, a specific potent GABAA receptor agonist, on prolactin release from human prolactin-secreting tissue was investigated using a perifusion system. Perifusion studies on normal rat anterior pituitary tissue, which has identical GABA receptors to those found in normal human pituitary glands, show that muscimol has a specific biphasic effect on prolactin release. This is characterized by an initial transient stimulation (222.3 +/- 21.6% of basal) lasting for 5-10 min followed by a more prolonged inhibitory phase (63.9 +/- 3.1% inhibition of basal). Five human prolactin-secreting adenomas were studied, and in none of the tumours could a biphasic response be demonstrated. One of the prolactin-secreting adenomas had a blunted inhibitory response, but the other 4 showed no inhibitory effect of muscimol on prolactin release. Muscimol had no significant effect on basal or thyrotropin-releasing-hormone (TRH)-stimulated prolactin secretion from GH3 rat pituitary tumour cells. These studies suggest that the GABAergic effect on prolactin secretion is absent or altered in both rat and human prolactin-secreting tumour cells.


Subject(s)
Muscimol/pharmacology , Neoplasms, Hormone-Dependent/drug therapy , Pituitary Neoplasms/drug therapy , Prolactin/metabolism , Prolactinoma/drug therapy , Adult , Animals , Bicuculline/analogs & derivatives , Bicuculline/pharmacology , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Neoplasms, Hormone-Dependent/metabolism , Pituitary Gland/drug effects , Pituitary Gland/metabolism , Pituitary Neoplasms/metabolism , Prolactinoma/metabolism , Rats , Receptors, GABA-A/physiology , Thyrotropin-Releasing Hormone
14.
J Prosthet Dent ; 66(2): 261-5, 1991 Aug.
Article in English | MEDLINE | ID: mdl-1774689

ABSTRACT

Numerous factors are involved in making an accurate void-free dental artificial stone cast or die. The relationship of the wettability of an elastomeric impression material and its interaction with the gypsum slurry is an important factor. This study examined the relative "pourability" of several impression materials by counting the number of resultant voids in artificial stone casts containing 48 point angles. Those elastomers that exhibited the lowest contact angle with water produced artificial stone casts with the fewest voids. Surfactants applied to the impression material significantly reduced the number of voids in artificial stone casts, as did modified elastomers designated by the manufacturer as hydrophilic.


Subject(s)
Dental Impression Materials/chemistry , Models, Dental , Silicone Elastomers/chemistry , Calcium Sulfate , Dental Casting Technique , Humans , Humidity , Methacrylates/chemistry , Sulfides/chemistry , Surface-Active Agents
15.
Diabetes Res Clin Pract ; 13(1-2): 83-4, 1991 Aug.
Article in English | MEDLINE | ID: mdl-1773718

ABSTRACT

Diabetic ketoacidosis is frequently precipitated by infections. We report three cases in which ketoacidosis was induced by genital herpes infection. There is good evidence that early treatment with systemic Acyclovir is effective in patients with a first attack of genital herpes. Therefore genital examination should be considered in patients with diabetic ketoacidosis particularly when there are symptoms of genital herpes. During episodes of recurrence, diabetic patients need to monitor their blood sugars more frequently and adjust insulin requirements accordingly. We believe that this is the first description of ketoacidosis being associated with this increasingly common and recurrent infection.


Subject(s)
Diabetic Ketoacidosis/etiology , Herpes Genitalis/complications , Acyclovir/therapeutic use , Adolescent , Adult , Female , Herpes Genitalis/drug therapy , Humans
17.
J Endocrinol ; 124(2): 327-31, 1990 Feb.
Article in English | MEDLINE | ID: mdl-2313220

ABSTRACT

Immunoreactive tissue kallikrein was co-localized with prolactin in all the eleven prolactin-secreting adenomas of the human anterior pituitary gland examined in this study. The intracellular distribution of immunoreactivity in the prolactin-secreting cells suggests that tissue kallikrein is located within the Golgi complex of these cells. Both the intracellular hormone-processing action and the kininogenase activity of tissue kallikrein may be of functional importance in human prolactinomas.


Subject(s)
Kallikreins/analysis , Pituitary Neoplasms/analysis , Prolactinoma/analysis , Adolescent , Adult , Female , Humans , Immunohistochemistry , Male , Middle Aged , Pituitary Neoplasms/metabolism , Prolactin/analysis , Prolactin/metabolism , Prolactinoma/metabolism
18.
J Prosthet Dent ; 62(2): 142-5, 1989 Aug.
Article in English | MEDLINE | ID: mdl-2668508

ABSTRACT

Numerous factors are known to effect the accuracy of elastomeric impression materials. Factors often overlooked are the quality of the bond between low-viscosity and high-viscosity elastomers and the presumed cohesive bond between materials during an impression reline procedure. This study examined the bond strength of condensation polymerization polysiloxanes, addition polymerization polysiloxanes, polyethers, and a light-cured polyether urethane dimethacrylate. Of the tested materials, light-cured polyether urethane dimethacrylate exhibited the greatest bond strength. The reline technique, light-body cured to previously cured heavy-body putty, yielded results similar to the simultaneous-cure technique. In terms of bond strength there is no advantage of one technique over the other. The corrective reline technique yielded acceptable results in bond strength. In general, the tested materials exhibited greater tensile strength than bond strength.


Subject(s)
Dental Bonding , Dental Impression Materials , Dental Stress Analysis , Tensile Strength , Viscosity
19.
Clin Endocrinol (Oxf) ; 31(1): 51-7, 1989 Jul.
Article in English | MEDLINE | ID: mdl-2574647

ABSTRACT

Two cases are described in which metastatic adrenocortical carcinoma associated with Cushing's syndrome was treated with mitotane (o,p'DDD). The first patient had initially been treated by bilateral adrenalectomy and, whilst responding to mitotane biochemically and by remission of metastases, experienced repeated episodes of adrenal crisis requiring a substantial increase in steroid therapy. The second patient failed to respond to the drug, but evidence of hepatic enzyme induction was noted during its administration. It is suggested that hepatic microsomal enzyme induction can occur in association with treatment with mitotane and that this can lead to an increased destruction of exogenous steroid with clinical consequences.


Subject(s)
Addison Disease/chemically induced , Adrenal Cortex Neoplasms/drug therapy , Carcinoma/drug therapy , Microsomes, Liver/drug effects , Mitotane/adverse effects , Addison Disease/drug therapy , Adrenalectomy , Adult , Alanine Transaminase/biosynthesis , Aspartate Aminotransferases/biosynthesis , Carcinoma/secondary , Combined Modality Therapy , Enzyme Induction/drug effects , Female , Fludrocortisone/therapeutic use , Humans , Hydrocortisone/therapeutic use , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Male , Microsomes, Liver/enzymology , Middle Aged , Mitotane/therapeutic use , gamma-Glutamyltransferase/biosynthesis
20.
Br Med J (Clin Res Ed) ; 296(6630): 1147-9, 1988 Apr 23.
Article in English | MEDLINE | ID: mdl-2837304

ABSTRACT

The effect of supplementing a low energy (roughly 5.0 MJ), high carbohydrate (180 g), low fat (roughly 25 g) diet with 10-15 g of either cereal fibre or guar gum was investigated in 24 newly diagnosed overweight non-insulin-dependent (type II) diabetics. The patients were divided into three treatment groups: one received a low fibre control diet throughout the study period of 20 weeks and the other received two supplements of cereal fibre and guar gum in a crossover manner. The nutrient content of the diets was kept constant throughout. Though patients taking the low fibre diet showed a smaller reduction in fasting plasma glucose concentrations over the first eight weeks than patients taking a high fibre diet, this difference was not evident at the end of 20 weeks; reductions in weight and glycated haemoglobin values were similar for each dietary regimen throughout the trial. There was little evidence that supplementing a low energy, high carbohydrate diet with fibre confers any therapeutic benefit to type II diabetics and no evidence that taking fibre as viscous polysaccharides is any more beneficial to overweight diabetics than taking a similar fibre supplement as cereal. On the contrary, guar gum caused more abdominal discomfort and flatulence than the other diets.


Subject(s)
Diabetes Mellitus, Type 2/diet therapy , Diabetes Mellitus/diet therapy , Dietary Fiber/therapeutic use , Obesity , Blood Glucose/analysis , Body Height , Body Weight , Diabetes Mellitus/blood , Diabetes Mellitus, Type 2/blood , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Female , Glycated Hemoglobin/analysis , Humans , Male , Random Allocation
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