Effects of tamoxifen on serum prolactin levels, pituitary immunoreactive prolactin cells and uterine growth in estradiol-treated ovariectomized rats.

Pituitary effects of the antiestrogen tamoxifen are not well established, although estrogen is known to have a stimulatory role in prolactin secretion. Effects of tamoxifen on serum prolactin levels, pituitary wet weight and number of prolactin cells were studied. Ovariectomized female Wistar rats were injected, subcutaneously, with estradiol valerate, 50 or 300 micrograms/rat per week for 2 or 10 weeks. Tamoxifen was injected during the last days of estrogen treatment. Data were compared with two other groups, treated with estradiol valerate alone or estradiol valerate plus the dopamine agonist bromocriptine. Serum prolactin levels were increased by estrogen treatment with all doses used. Furthermore, rats treated with 300 micrograms of estradiol valerate, for 2 and 10 weeks, showed a clear increase in pituitary weight and number of prolactin cells (p < 0.05). Bromocriptine decreased prolactin levels, pituitary weight and the number of prolactin cells (p < 0.05). Tamoxifen associated to subacute period of estrogen administration resulted in a significant reduction of serum prolactin levels and pituitary weight (p < 0.05). No effects on prolactin levels or number of prolatin cells were observed with tamoxifen associated to chronic estrogen treatment. Tamoxifen also presented a dose-related inhibitory effect upon estrogen-stimulated rises in uterine weight and DNA content. In conclusion, the results of the present paper showed that tamoxifen reduced estrogen-stimulated prolactin levels in some, but not in other hormonal conditions and that these effects were not mediated by an inhibition of lactotroph cell growth. Further studies are needed to define the exact role of antiestrogens at molecular level in hyperprolactinemic states and their eventual connection with dopamine and its agonists.

Effects of norethisterone acetate and tamoxifen on serum prolactin levels, uterine growth and on the presence of uterine immunoreactive prolactin in estradiol-treated ovariectomized rats.

The aim of the present work was to study the effects of the antiestrogen tamoxifen (TAM), of progestin norethisterone acetate (NA) and of their combination on serum prolactin levels, uterine growth and the presence of uterine immunoreactive prolactin in estradiol-treated rats. Ovariectomized female Wistar rats were injected sc with estradiol valerate (VE, 50 micrograms/rat per week) or oil vehicle. During the second week, estradiol-treated rats also received NA (0.12 or 1.0 mg/rat, sc, daily) or TAM (0.06 mg/rat) alone or in combination with NA (0.12 mg). Serum prolactin levels were suppressed to the same extent in the TAM- and 1.0 mg NA-treated groups compared with rats given estrogen alone (2.3 +/- 0.3 and 5.6 +/- 1.5 ng/ml for TAM and NA groups vs 39.7 +/- 3.6 ng/ml for VE groups, P < 0.05). Except for the lowest dose of NA, uterine wet weight and DNA content were significantly reduced in all groups compared to estradiol alone (236.8 +/- 18.0 and 295.6 +/- 27.8 mg vs 309.4 +/- 32.2 mg for uterine weight in TAM and NA groups vs VE, respectively, P < 0.05; and 1.14 +/- 0.05 and 0.93 +/- 0.04 mg/uterus vs 1.33 +/- 0.06 mg/uterus for uterine DNA in TAM and NA groups vs VE groups). The combination of NA and TAM resulted in a higher degree of suppression of uterine growth than when each drug was used alone, indicating an additive antiproliferative effect of NA and TAM. Although no prolactin immunostaining was detected in the uterus of rats treated with estradiol, uterine immunoreactive prolactin was identified in those treated with NA, TAM or both.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of norethisterone acetate and tamoxifen on serum prolactin levels, uterine growth and on the presence of uterine immunoreactive prolactin in estradiol-treated ovariectomized rats

The aim of the present work was to study the effects of the antiestrogen tamoxifen 9TAM) of progestin noresthisterone acetite (NA) and of their combination on serum prolactin levels, uterine growth and the presence of uterine immunoreactive prolactin estradiol- treated rats. Ovariectomized female Wistar rats were injected sc with estradiol valerate (VE, 50 µg/rat per week) or oil vehicle. During the secon week, estradiol-treated rats also received NA (0.12 or 1.0 mg/eat, sc, daily) or TAM (0.06 mg/rat) alone or in combination with NA (0.12mg). Serum prolactin levels were suppressed to the same extent in the TAM- and 1.0 mg NA-treated groups compared with rats given estrogen alone (2.3 ñ 0.3 and 5.6 ñ 1.5 ng/ml for TAM and NA groups vs 39.7 ñ 3.6 ng/ml for VE groups, P < 0.05). Except for the lowes dose of NA, uterine wet weight and DNA content were significant reduced in all groups compared to estradiol alone (236.8 ñ 18.0 and 295.6 ñ 27.8 mg vs 309.4 ñ 32.2 mg for uterine weight in TAM and NA groups vs VE, respectively, P 0.05; and 1.14 ñ 0.05 and 0.93 ñ 0.04 mg/uterus vs 1.33 ñ 0.06 mg/uterus for uterine DNA in TAM and NA groups vs VE groups). The combination of NA and TAM resulted in a higher degree of suppression of uterine growth than when each drug was used alone, indicating an additive antiproliferative effect of NA and TAM. Although no prolactin immunostaining was detected in the uterus of rats treated with estradiol, uterine immunoreactive prolactin was identified in those treated with NA, TAM ot both. These results suggest that an inhibitory effect on the action of estradiol can play a role in the hormonal modulation of uterine secretion

The Multidimensional Scale of Perceived Social Support: a confirmation study.

This study examined the psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988) with a diverse group of 154 students at an urban college. The following areas were investigated: internal reliability, factorial validity, social desirability bias, and the moderating effect of social support between stressful life events and depression (i.e., the buffering hypothesis). The MSPSS had good internal reliability, and the factor analysis confirmed the subscale structure of the measure: family, friends, and significant other. There was no indication that social desirability bias influenced subjects' responses. Finally, social support was related to depression only for those subjects who were experiencing high levels of life stress, which lends support for the buffering hypothesis.

Anxiety reduction in asthma: four catches to general application.

Anxiety reduction procedures as adjuncts to medical treatment have almost invariably been reported to benefit asthmatic patients in individual case studies. However, the results of more systematically controlled studied are clearly inconsistent. This discrepancy is understandable in view of what is now known about anxiety in asthma. Four catches, each based on what has been reported about the roles and forms of anxiety in asthma, are presented. Each catch argues against general, across-the-board application of anxiety reduction procedures in asthma. Careful evaluation leading to more problem-oriented treatment is needed in view of the different roles of anxiety in asthma.

Psychological contributions to chronicity in asthma: patient response styles influencing medical treatment and its outcome.

Research is reviewed relating to two aspects of response styles among asthmatic patients, neither of which is a mere derivative of the patient's medical condition. One aspect, indexed by panic-fear symptomatology, appears to be associated with the level of attention directed at breathing difficulties, ranging from symptom disregard (low panic-fear symptomatology) to symptom vigilance (high panic-fear symptomatology). A second aspect, indexed by a derived personality dimension, appears to be associated with the quality of the patient's reactions to acknowledged breathing difficulties, ranging from extreme independence (low panic-fear personality) to helpless and ineffective dependency (high panic-fear personality). Simply, these aspects of patient response styles refer both to the attention directed toward breathing difficulties and to the quality of the patient's reactions in response to acknowledged breathing difficulties. Their importance derives from 1) their interaction with the severity of asthma to influence medical decisions about the intensity of prescribed medications and length of hospitalization during medical treatment and 2) their effect on long-term medical outcome. Awareness of these two aspects of patient response styles should enable differential approaches to be adopted by physicians seeking to counteract psychological contributions to chronicity in asthma.

Requests for as-needed medications by asthmatic patients. Relationships to prescribed oral corticosteroid regimens and length of hospitalization.

In a previous study, patient-coping styles, indexed by panic-fear symptomatology, were found to be associated with specific patterns of requesting as-needed (PRN) medications and treatments: Patients who tend to emphasize their symptoms (high panic-fear) requested PRNs frequently, even on days when their pulmonary function levels were essentially normal, while those who tend to minimize their symptoms (low panic-fear) requested PRNs infrequently, even on days when their pulmonary function levels were subnormal. In the present study, we found that patients who requested PRNs frequently spent more days in the hospital than those who requested PRNs only rarely. Intensive medication regimens (i.e., daily corticosteroids or alternate-day corticosteroids supplemented with TAO, cromolyn, or aerosolized steroids) were more often prescribed for patients requesting PRNs frequently than for those requesting PRNs rarely. These differences in patient management were attributable neither to differences in pulmonary function nor directly to differences in panic-fear rating. Thus, patient-coping styles can influence the treatment prescribed, and optimal management requires that individual patient-coping styles be considered in planning a regimen.

Panic-fear in asthma: a divergence between subjective report and behavioral patterns.

The reported frequency of occurrence of Panic-Fear symptoms during asthmatic attacks varies widely and is related to treatment response independently of the objective severity of asthma. In a previous study, symptom minimizers (Low Panic-Fear) requested few as-needed (PRN) medications and treatments while hospitalized, even on days when significant airway obstruction was present. In contrast symptom emphasizers (High Panic-Fear) requested PRNs frequently, even on days when no airway obstruction was present. In the present study, these behavioral differences toward PRNs occurred despite the similar ability of patients in various Panic-Fear groups to perceive and report changes in airway obstruction. Together these results suggest that specific behavioral strategies, which do not derive from differences in symptom perception, influence the treatment response of asthmatic patients differing in Panic-Fear symptomatology.

Panic-fear in asthma: requests for as-needed medications in relation to pulmonary function measurements.

Requests for as-needed medications and treatments (PRNs) by asthmatic patients scoring high, moderate, or low on the Asthma Symptom Checklist panic-fear category were studied for days when patients were matched at normal, intermediate, and subnormal levels of pulmonary function. Low panic-fear patients were the least likely to request PRNs regardless of the pulmonary function level. In contrast, high panic-fear patients often requested PRNs each level of pulmonary function. Only moderate panic-fear patients made progressively more PRN requests on days when pulmonary functions were lower. These observations and others concerning the adverse influence of extreme panic-feat coping styles upon the treatment of asthma were discussed.

Obervations on subjective symptomatology, coping behavior, and medical decisions is asthma.

The Asthma Symptom Checklist (ASC), describing the subjective symptoms reported to occur during asthmatic attacks, has been developed previously. In the present study, the ASC key cluster solution was replicated and refined within a sample of 374 asthmatic inpatients. All of the original symptom categories were reporduced, including two mood categories, Panic-Fear and Irritability, a Fatigue category, and two somatic categories. Hyperventilation-Hypocapnia and Airway Obstruction. Two refinements were notable: (1) The Airway Obstruction category was empirically divided into two conceptually clear components, Dyspnea anc Congestion, and (2) three secondary mood categories, Worry, Loneliness, and Anger, were identified, which describe a continuum of mood between the polar extremes of panic and irritability. Of the symptom categories, only Panic-Fear was related to the intensity of the discharge drug regimens recommended 2 to 6 mouths after ASC administration. Panic-Fear scores were independent of pulmonary function measurements. A combined index based on pulmonary functions and panic-fear yielded the best prediction of discharge steroid regiments. Finally, those physicians rated highest in "sensitivity" to their patients by their supervisors prescribed less steroids overall, but most frequently prescribed discharge steriod regimens in relation to their patients' Panic-Fear scores. In contrast, physicians rated lower on sensitivity prescribed higher steroid regimens overall, but based these drug recommendations more cleary on objective pulmonary functioning, and not in relation to their patients' Panic-Fear scores. The results strongly suggest that the ASC Panic-Fear scale is associated with coping behaviors that importantly affect the patient's overall clinical picture by increasing the apparent severity of the asthma, thereby leading to intensified treatment. The findings stress the need to evaluate independently the objective medical condition and subjective symptomatology with its related coping behavior, in order to direct appropriate modes of therapy to each.