[Densitometry findings in women using gestagen contraception]. / Denzitometrické nálezy u zen uzívajících gestagenní hormonální antikoncepci.

OBJECTIVE: To prove the influence of gestagen contraception on bone mass with x-ray osteodensitometry (DEXA) with regard to BMI. DESIGN: Cross-sectional observational descriptive study. SETTING: Osteology centre, NZZ Bormed Ostrava. METHODS: In the study premenopausal women who had been using gestagen contraception (Depo-Provera inj.) at least for one year were included. Bone density was measured in regular manner (whole-body densitometer Hologic W). Z-score at lumbar spine, whole femur and femoral neck was assessed. RESULTS AND CONCLUSIONS: 58 of 116 patients had normal bone density. In 58 ill patients the bone density dropped below the age norm. In 11 women the Z-score decreased below -2.5 SD. Inverse relationship between BMI and bone density (BMD) was found, both between BMI and Z-score (p=0.0001), and BMI and T-score (p=0.0001). The relationship between duration of gestagen use and bone density was not statistically significant. Marked decline in BMD and correlation with patients' low BMI was identified. When prescribing gestagen contraception possible negative effect on skeleton, particularly in women with low BMI should be considered.

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.