Endocrinología del dopaje y los deportes: hormona de crecimiento, IGF-1, insulina y eritropoyetina / Doping and sports endocrinology: Growth hormone, IGF-1, insulin, and erythropoietin

Entre las sustancias prohibidas por la Agencia Mundial Antidopaje, en el apartado S2 se clasifican como prohibidas, tanto en competición como fuera de competición, las «hormonas peptídicas, factores de crecimiento y sustancias relacionadas y miméticos». En este trabajo realizamos una revisión de: la hormona de crecimiento y sus péptidos liberadores; el factor de crecimiento similar a la insulina tipo 1 como principal factor de crecimiento; la insulina, y la eritropoyetina y otros agentes que afectan la eritropoyesis. En esta revisión analizamos la prevalencia de uso en deportistas profesionales y clientes de gimnasios; las formas de uso, dosis, efectos ergogénicos y sobre el rendimiento físico, así como los efectos secundarios y métodos de detección antidopaje (AU)

Among the substances prohibited by the World Anti-Doping Agency, “peptide hormones, growth factors, related substances, and mimetics” are classified as prohibited both in- and out-of-competition in section S2. This work reviews growth hormone and its releasing peptides, insulin-like growth factor 1 as the main growth factor, insulin, and erythropoietin and other agents that affect erythropoiesis. This review analyzes the prevalence of use among professional athletes and gym clients, the forms of use, dosing, ergogenic effects and effects on physical performance, as well as side effects and anti-doping detection methods (AU)

Doping and sports endocrinology: growth hormone, IGF-1, insulin, and erythropoietin.

Among the substances prohibited by the World Anti-Doping Agency, "peptide hormones, growth factors, related substances, and mimetics" are classified as prohibited both in- and out-of-competition in section S2. This work reviews growth hormone and its releasing peptides, insulin-like growth factor 1 as the main growth factor, insulin, and erythropoietin and other agents that affect erythropoiesis. This review analyzes the prevalence of use among professional athletes and gym clients, the forms of use, dosing, ergogenic effects and effects on physical performance, as well as side effects and anti-doping detection methods.

Endocrinología del dopaje y los deportes: andrógenos anabolizantes / Doping and sports endocrinology: anabolic-androgenic steroids

El consumo de anabolizantes hormonales afecta no solamente a atletas profesionales, sino también a la población general (culturistas, clientes de gimnasios y adolescentes entre otros). En el primer caso su uso está prohibido y sancionado por la Agencia Mundial Anti-Dopaje y los comités olímpicos. Para los segundos es difícil establecer la prevalencia ya que muchos obtienen los productos a través de compras por Internet. Los motivos para su uso son diversos y se han descrito distintas formas de uso, así como diferentes tipologías de consumidores. Entre los efectos secundarios, el hipogonadismo es la causa más frecuente de consulta endocrinológica. En esta revisión se describen, tras una introducción general al dopaje, los antecedentes históricos de los andrógenos anabolizantes, su clasificación, las formas de uso, los efectos fisiológicos, los efectos adversos en diferentes órganos y sistemas, el tratamiento del hipogonadismo, así como los métodos de detección (AU)

The use of anabolic steroids affects not only professional athletes but also the general population (bodybuilders, gym clients, and adolescents). In the first case, its use is prohibited and sanctioned by the World Anti-Doping Agency and Olympic committees. For the other users, it is difficult to establish its prevalence since many obtain the products via the Internet. The reasons for its use are varied and different forms of use and other types of users have been described. Among the side effects of steroid use, hypogonadism is the most frequent cause for endocrinological consultation. After a general introduction to doping, this review describes the historical background of anabolic–androgenic steroids, their classification, forms of use, physiological effects, adverse effects on different organs and systems, treatment of hypogonadism, as well as detection methods (AU)

Doping and sports endocrinology: anabolic-androgenic steroids.

The use of anabolic steroids affects not only professional athletes but also the general population (bodybuilders, gym clients, and adolescents). In the first case, its use is prohibited and sanctioned by the World Anti-Doping Agency and Olympic committees. For the other users, it is difficult to establish its prevalence since many obtain the products via the internet. The reasons for its use are varied and different forms of use and other types of users have been described. Among the side effects of steroid use, hypogonadism is the most frequent cause for endocrinological consultation. After a general introduction to doping, this review describes the historical background of anabolic-androgenic steroids, their classification, forms of use, physiological effects, adverse effects on different organs and systems, treatment of hypogonadism, as well as detection methods.

[State of the art in musicogenic epilepsy: a review of the scientific literature]. / Conocimiento actual de la epilepsia musicogena: revision de la literatura cientifica.

INTRODUCTION: Musicogenic epilepsy is a type of reflex complex epilepsy and is evoked by musical stimulus, specially music with high emotional content to the patient. AIM: To review the state of the art of the musicogenic epilepsy in the current literature. DEVELOPMENT: We have made an analysis of all the patients that have been described with musicogenic epilepsy. Among the most studied variables we have included: the nature of the sound that evoke the seizure, the musical education of the patients, the changes between the different neurophysiological and neuroimaging techniques, the most frequent location and the hemispheric side implication in seizures, and comparison between the different neuroimaging techniques. Most of the patients had seizures when they were listening to music with emotional content. The right temporal lobe is the most affected area in this type of epilepsy. In these studies the structural neuroimaging were normal in most of the patients. CONCLUSIONS: Musicogenic epilepsy is reflex and complex and music with emotional content to the patients is the most frequent stimulus that evoke this type of epilepsy. The right temporal lobe is the most affected area. It seems that exists a correlation between emotional and auditory cerebral processing networks.

TITLE: Conocimiento actual de la epilepsia musicogena: revision de la literatura cientifica.Introduccion. La epilepsia musicogena se clasifica dentro del grupo de las epilepsias reflejas complejas y se caracteriza por desencadenarse con estimulos musicales, especialmente con fragmentos musicales con alta emotividad en la melodia. Objetivo. Revisar el conocimiento actual de las epilepsias musicogenas en la literatura cientifica. Desarrollo. Se ha realizado una revision detallada de los articulos que versan sobre epilepsia musicogena. Para ello se ha llevado a cabo un analisis de todos los casos clinicos descritos en la bibliografia hasta febrero de 2019. Entre las variables mas frecuentes se han estudiado: el tipo de estimulo sonoro desencadenante de las crisis, la presencia o no de educacion musical del paciente, los cambios en las diferentes pruebas complementarias neurofisiologicas y de neuroimagen, y la localizacion y lateralidad hemisferica implicada en este fenomeno. La mayoria de los pacientes tiene crisis evocadas por musica con contenido emocional para ellos. El lobulo temporal derecho es el mas frecuentemente implicado en este tipo de crisis, pero en la mayoria de los casos no se han observado alteraciones estructurales en las pruebas de neuroimagen. Conclusiones. La epilepsia musicogena es refleja y compleja y se caracteriza por desencadenarse con estimulos musicales. La zona que mas se afecta en las pruebas funcionales es el lobulo temporal derecho. Se piensa que existe una relacion entre las redes cerebrales que se encargan del procesamiento de las emociones a traves del estimulo auditivo y el desarrollo de este tipo de epilepsia.

[Music therapy as a non-pharmacological treatment in Alzheimer's disease. A systematic review]. / Efecto de la musicoterapia como terapia no farmacologica en la enfermedad de Alzheimer. Revision sistematica.

INTRODUCTION: Alzheimer's disease (AD) is a neurodegenerative disease which involves, among other manifestations, a progressive deterioration of memory and language, as well as behavioral disorders. In addition to non-curative pharmacological therapies, for the last years, music therapy has been developed as an effective non-pharmacological therapy in order to relieve many of these manifestations. AIM: To analyze the recent scientific evidence about the effect of music therapy on cognitive and behavioral symptoms in patients with AD. PATIENTS AND METHODS: A systematic review has been carried out by means of a bibliographical research using the database PubMed and Science Direct. The key words used for this search were 'Alzheimer's disease' and 'music therapy', as well as the boolean operator 'AND'. We selected those publications between January 2006 and December 2016 and after inclusion criteria, 21 publications were selected. RESULTS: This systematic review has demonstrated the beneficial impact of music therapy on cognition (memory, attention, language), emotion and behavior (anxiety, depression and agitation) in AD patients. CONCLUSIONS: Music therapy constitutes a non-pharmacological therapy effective for some cognitive, emotional and behavioral symptoms in patients with AD. However, further investigations and more evidence in this field are needed to claim conclusively the impact of music therapy on this disease.

TITLE: Efecto de la musicoterapia como terapia no farmacologica en la enfermedad de Alzheimer. Revision sistematica.Introduccion. La enfermedad de Alzheimer (EA) es un trastorno neurodegenerativo que conlleva, entre otras manifestaciones, una afectacion progresiva de alteraciones cognitivas, como la memoria y el lenguaje, asi como de alteraciones conductuales. Ademas de las terapias farmacologicas no curativas, la terapia con musica viene asentandose en los ultimos anos como una terapia no farmacologica eficaz para paliar muchas de las manifestaciones clinicas de la enfermedad. Objetivo. Analizar la evidencia cientifica reciente sobre el efecto de la musicoterapia en los sintomas cognitivos y conductuales en pacientes con EA. Pacientes y metodos. Se ha realizado una revision sistematica mediante una busqueda bibliografica en las bases de datos PubMed y Science Direct, empleando como palabras clave 'Alzheimer's disease' y 'music therapy', y el operador booleano 'AND'. Se consideraron los trabajos publicados entre enero de 2006 y diciembre de 2016 y, tras los criterios de inclusion, se seleccionaron 21 estudios. Resultados. Esta revision sistematica demuestra el efecto beneficioso de la musicoterapia sobre el estado cognitivo (memoria, atencion, lenguaje), emocional y conductual (ansiedad, depresion y agitacion) de los pacientes con EA. Conclusiones. La musicoterapia constituye una terapia no farmacologica eficaz para determinados sintomas cognitivos, emocionales y conductuales de pacientes con EA. No obstante, se necesitan mas investigaciones en este campo para poder definir de forma mas concluyente el efecto que produce la musicoterapia en esta patologia.

Safety of long-term treatment with Pegvisomant: analysis of Spanish patients included in global ACROSTUDY.

PURPOSE: To evaluate the long-term safety of Pegvisomant (PEG) in the Spanish cohort of ACROSTUDY. METHODS: As of July 2013, 199 Spanish patients were included in ACROSTUDY, a global non interventional safety PEG surveillance study. Patients were observed for safety, biochemical outcome and magnetic resonance imaging evaluations. RESULTS: PEG was administered during an average period of 6.7 ± 2.1 years and a mean daily dose of 15.5 ± 7.5 mg. 48.2% of patients received PEG monotherapy. 90.9% of patients had received other medical treatment before PEG start. 195 adverse events (AEs) were reported in 88 patients (44.2%), and serious AEs were described in 31 patients (15.6%). There were no cases of liver tests >10 ULN, or permanent liver damage. Tumor size changes were locally reported in 61 cases (33.5%), with increases observed in 11 patients (6%). In acromegalic patients with diabetes mellitus a decrease in fasting serum glucose value was reported, reaching statistical significance after 1 and 4 years of treatment (-24.6 and -25.9 mg/dl, p = 0.04). After 60 months, normal or lower limit of normal (LLN) IGF-I levels were found in 67.9% of patients. 85.5% of patients showed an IGF-I normal or

Familial isolated pituitary adenoma caused by a Aip gene mutation not described before in a family context.

The cause of familial isolated pituitary adenomas (FIPA) remains unknown in a high percentage of cases, but the AIP gene plays an important role in the etiology. The aim of the study is to describe a family with FIPA syndrome and the results of genomic studies. A 16-year-old man had a giant prolactinoma resistant tomedical treatment with delayed growth and pubertal development. His mother had been previously diagnosed with a nonfunctioning pituitary macroadenoma. Transsphenoidal endoscopic resection was performed and a genetic study revealed a heterozygous mutation in exon 6: 974G>A (p.Arg325Gln). Because the AIP gene is a tumor suppressor gene, we searched for loss of heterozygosity within the AIP gene by amplifying exon 6 from tumor tissue of the patient. In the electropherogram, only the A allele was amplified (hemizygous state), indicating loss of the normal allele. We report a Spanish family with FIPA in whom a mutation in the AIP gene previously unreported in a familiar context was identified.

Jejunal wall triglyceride concentration of morbidly obese persons is lower in those with type 2 diabetes mellitus.

The overproduction of intestinal lipoproteins may contribute to the dyslipidemia found in diabetes. We studied the influence of diabetes on the fasting jejunal lipid content and its association with plasma lipids and the expression of genes involved in the synthesis and secretion of these lipoproteins. The study was undertaken in 27 morbidly obese persons, 12 of whom had type 2 diabetes mellitus (T2DM). The morbidly obese persons with diabetes had higher levels of chylomicron (CM) triglycerides (P < 0.001) and apolipoprotein (apo)B48 (P = 0.012). The jejunum samples obtained from the subjects with diabetes had a lower jejunal triglyceride content (P = 0.012) and angiopoietin-like protein 4 (ANGPTL4) mRNA expression (P = 0.043). However, the apoA-IV mRNA expression was significantly greater (P = 0.036). The jejunal triglyceride content correlated negatively with apoA-IV mRNA expression (r = -0.587, P = 0.027). The variables that explained the jejunal triglyceride content in a multiple linear regression model were the insulin resistance state and the apoA-IV mRNA expression. Our results show that the morbidly obese subjects with diabetes had lower jejunal lipid content and that this correlated negatively with apoA-IV mRNA expression. These findings show that the jejunum appears to play an active role in lipid homeostasis in the fasting state.

Different effect of laparoscopic Roux-en-Y gastric bypass and open biliopancreatic diversion of Scopinaro on serum PYY and ghrelin levels.

BACKGROUND: The impact of bariatric surgery on levels of peptide YY (PYY) and ghrelin is still under discussion. We undertook a simultaneous evaluation of the serum changes in PYY and ghrelin depending on the specific type of bariatric surgery. METHODS: Total PYY and ghrelin were analyzed in 29 healthy persons and in morbidly obese persons undergoing open biliopancreatic diversion (BPD) of Scopinaro (n = 38) or laparoscopic Roux-en-Y gastric bypass (RYGB; n = 13). RESULTS: RYGB resulted in a significantly greater loss of weight and body mass index than BPD. Both RYGB and BPD were associated with a significant increase in PYY, significantly greater for BDP (p = 0.001). Ghrelin rose significantly after RYGB (p = 0.022) but not after BPD. After surgery, PYY correlated positively with weight (r = 0.416, p = 0.009). Ghrelin did not correlate significantly with any of the variables studied. Analysis of variance showed that only the type of surgery contributed significantly to explain the variances in the PYY (p = 0.002) and ghrelin (p = 0.018). CONCLUSIONS: BPD results in a greater increase in PYY and a lower weight loss than RYGB. However, only RYGB was associated with a significant increase in ghrelin. The differing weight loss according to the type of bariatric surgery does not seem to be explained by changes arising in PYY and ghrelin.

Intestinal permeability in adult patients with growth hormone deficiency.

Pathological disruption of the intestinal mucosa increases the paracellular pathway, leading to an increase in the penetration of large molecules. Since growth hormone (GH) has a trophic intestinal effect, we used a double marker test to enable examination of intestinal permeability, which reflects the state of integrity of the intestinal mucosa. We recruited 22 adult patients, mean age 54+/-13.3 years, with GH deficiency due to partial or total hypopituitarism. None had received GH treatment at any time, although they were all in optimized replacement therapy. A control group was composed of 19 healthy age-matched relatives. The intestinal permeability test was performed with lactulose (5 g) and mannitol (1 g) after an oral load of 100 ml of aqueous solution. The urinary lactulose/mannitol ratio and the percentages of lactulose and mannitol excreted were determined on a 5-h urine collection. There were no significant differences between the patients and the control group in the lactulose/mannitol ratio (0.087+/-0.059 vs 0.077+/-0.064, respectively) or in the urinary excretion percentages of lactulose (0.067+/-0.048% vs 0.073+/-0.070%, respectively) or mannitol (5.127+/-3.269% vs 5.068+/-2.985%, respectively). In conclusion, no increase in intestinal permeability was detected in patients with GH deficiency, so that in spite of the known trophic effects of GH on the epithelial crypt cells, there was no intestinal hyperpermeability in these patients.

Serum leptin and habitual fatty acid dietary intake in patients with type 1 diabetes mellitus.

OBJECTIVE: To study the contribution of a normal intake of nutrients to the variability of serum leptin concentrations in persons with type 1 diabetes mellitus. DESIGN: We studied the relation between serum leptin and nutrient intake in a cross-sectional study. METHODS: Serum leptin measured by radioimmunoassay, nutritional data determined by a self-administered 7-day nutritional questionnaire, and the fatty acid composition of the serum phospholipids (measured by thin layer chromatography and gas chromatography) were determined in 60 patients with type 1 diabetes mellitus. Correlation and regression analyses were performed between serum leptin and dietary fatty acids and serum phospholipid fatty acids. RESULTS: In the prediction models for the concentrations of serum leptin in men with type 1 diabetes mellitus, the dietary fatty acids displaced the anthropometric variables, and were independent of the serum testosterone concentrations. This fact remained when the prediction was made on the basis of indirect markers of the intake, such as the serum phospholipid fatty acids. In the women, the fatty acids from the diet or from the serum phospholipids also partly explained the variation in serum leptin, although not displacing the anthropometric variables. CONCLUSIONS: Our data suggest that, in non-experimental conditions, the concentrations of serum leptin in men with type 1 diabetes mellitus and, to a lesser extent, those in women with diabetes, may be influenced by the composition of the habitual diet, especially the type of dietary fat.

[Use of reagent materials for self-monitoring in the metropolitan area of Malaga (1994-1996)]. / Consumo de material reactivo de autoanálisis en el área metropolitana de Málaga (1994-1996).

OBJECTIVES: To find the evolution of consumption of self-analysis material used to control Diabetes (reactive strips of glucose) and the costs involved, in the metropolitan area of Málaga from July 1994 to the first quarter of 1996. DESIGN: Descriptive retrospective study. SETTING: Metropolitan area of Málaga (580, 586 inhabitants), which is divided in two HEALTH DISTRICTS: Málaga East and West. PATIENTS: All diabetics using reactive strips in the metropolitan area of Málaga which are charged to the National Health system. MEASUREMENTS AND MAIN RESULTS: The data base of the health districts of the metropolitan area of Málaga was used for the review of public prescriptions of reactive strips. Consumption in relation to the total population was analysed and the average consumption per diabetic was calculated. The total number of patients for whom reactive strips were prescribed increased considerably over the three years studied. CONCLUSIONS: A considerable increase in consumption of glucose reactive strips was observed in recent years in the metropolitan area of Málaga, mainly because of its generalised use among elderly patients. Consumption of urine strips was small and tended to fall.

Unsaturated fatty acids alter the insulin secretion response of the islets of Langerhans in vitro.

The aim of the present study is to examine the influence which different concentrations of free fatty acids (FFAs) have on the insulin secretion response of the islets of Langerhans when the culture is prolonged over a week. Animals were killed by decapitation and pancreatic islets of Langerhans isolated. The islets were incubated in enriched RPMI and oleic or linoleic acid was added at concentrations of 0.04, 0.1, 0.375, and 1 mmol/l. The medium without FFAs was used as a control. The culture time was 7 days. For insulin secretion studies, islets were selected after preincubation in batches of six islets in 1 ml of KRB (Krebs-Ringer buffer) containing one of the following: 5.5, 11.1, 16 or 26.7 mmol/l glucose, 10 mumol/l forskolin or 20 mmol/l arginine. The results showed a significant increase in insulin secretion observed after culture with 1 mmol/l oleic and linoleic acid compared to the other concentrations and the control culture for all the secretagogues used. However, at this same concentrations no increase was observed in insulin secretion as the glucose concentration rose, and this was noticeable with linoleic acid at concentrations of 0.375 mmol/l. In conclusion, culture of islets of Langerhans for a week with high concentrations of unsaturated fatty acids produces a hypersecretion of insulin which is not influenced by secretagogues such as glucose, arginine, or forskolin. The loss of gluco-sensitivity may become greater as the degree of unsaturation of the fatty acid used increases.

Does the intake of nuts and seeds alter the appearance of menarche?

BACKGROUND: The nutritional state reportedly influences the age of menarche. In this work we investigated the potential relationship between the intake of various types of foods and the age of menarche, irrespective of body weight. METHODS: An overall 777 schoolgirls of ages between 8 and 16 years from Benalmádena (Málaga, Spain) were subjected to a cross-sectional study involving: the age of menarche as the dependent variable; and the weight, body mass index, skinfold thickness, food intake (estimated from weekly food frequency questionnaires), and age of menarche in the proband's mother and sisters as independent variables. Several models were developed in order to calculate the strength of association between the dependent variable (the presence or absence of menarche) and the independent variables. RESULTS: The average age of menarche was 12.4 years. The intake of the various types of foods was not consistent between the different age groups. In girls of 12 or younger, the age of menarche was found to be related to weight: Odds ratio (OR) = 7.06; (Confidence intervals (CI) = 2.80-17.6). On inclusion of various foods groups, the OR rose to 49.89 (CI = 40.85-60.84). In girls over 12, the age of menarche was essentially related to the intake of nuts and seeds (OR = 0.71, CI = 0.40-0.98). Inclusion of other foods groups decreased the OR (OR = 0.34, CI = 0.14-0.39). CONCLUSIONS: Significant statistical relationship between intake of nuts and seeds and the age of menarche was found.

[Diet and hypertriglyceridemia: influence of dietary modifications on plasma lipids, lipoproteins and apoproteins in patients with primary hypertriglyceridemia]. / Dieta e hipertrigliceridemia: influencia de las modificaciones dietéticas sobre los lípidos, lipoproteínas y apoproteínas plasmáticas en pacientes con hipertrigliceridemia primaria.

BACKGROUND: To investigate the influence of dietary changes on plasma lipoproteins and apoproteins in 10 patients with hypertriglyceridemia (plasma triglycerides greater than 1000 mg/dl). METHODS: A sequential study with three periods was designed: 1) Inclusion with uncontrolled free diet; 2) Two weeks of a diet with about 1000 calories/day, controlled with a daily survey; and 3) One week of "free" diet of about 2000 calories. At the end of the three periods the following were measured in each patient: weight, glycemia, plasma IRI and C-peptide, plasma, triglycerides, cholesterol, chylomicron, VLDL, LDL and HDL cholesterol. At the end of the second and third periods the caloric and immediate principles intake were individually considered. RESULTS: A reduction in plasma cholesterol and triglycerides was observed in all cases after the caloric reduction, and also a disappearance of chylomicrons. The reduction of triglycerides took place in all lipoproteins. By contrast, after the low-calorie diet only the VLDL-cholesterol was reduced, while LDL- and HDL-cholesterol increased. The apo C-III/apo C-II ratio was significantly reduced after the low-calorie diet. The plasma glycemia, IRI and C-peptide were negatively correlated with LDL-cholesterol and with the apo C-III/apo C-II ratio. The best model to explain the oscillations of plasma triglycerides depending on the diet was that including the three ingested immediate principles together with the total diet calories. CONCLUSIONS: During the caloric restriction there would be an increased catabolism of VLDL to LDL. This reduction would be mediated by C-III and C-II apoproteins, probably through the oscillations of plasma IRI.

[The response of the growth hormone to acute effort is a function of training]. / La respuesta de la hormona de crecimiento al esfuerzo agudo está en función del entrenamiento.

BACKGROUND: The increase of the growth hormone (GH) during exercise is known although the relationship of this response with other hormones, the type and intensity of the exercise, nutritional state and with the degree of training are reasons for discussion. The aim of this investigation was to study the response of the HG on a group of young adults with different degrees of training, according to the maximum consumption of oxygen (VO2 max) achieved over a short period of time. METHODS: Thirty-nine healthy subjects who underwent maximum effort on the treadmill were grouped according to VO2 max reached (less than 3,000 ml/min; 3,000-4,500 ml/min and greater than 4,500 ml/min). Systolic blood pressure (SBP) and diastolic blood pressure (DBP), respiratory quotient (RQ), O2 pulse, cardiac frequency (CF) respiratory equivalence (RE), glycemia, plasma insulin (PI), C peptide, lactic acid, venous pH, plasma renin activity (PRA), plasma aldosterone, thyrotropine (TSH), triodothyronine (T3), thyroxine (T4), adrenocorticotropine (ACTH), cortisol and GH were measured basally and following achievement of VO2 max. RESULTS: The GH was only increased in those subjects with a VO2 max higher than 3,000 ml/min with a significant positive correlation found between the GH and VO2 max and a significant negative correlation was found between the GH and lactic acid at the end of the test. The increase of glycemia at the end of the test correlated with the VO2 max. The PI and C peptide increased at the end of the test in the subjects with greater VO2 max capacity and correlated positively with the VO2 max and with the GH upon completion of the exercise. CONCLUSIONS: These results suggest that the response of the growth hormone to exercise is a function of maximum oxygen consumption although this only explains 24% of the variants of the growth hormone. Despite important hormonal and metabolic mobilization during exercise, no model of multiple regression has been found which substantially improves the association found between the growth hormone and maximum oxygen consumption.

[Computerized tomography of the pituitary gland in the diagnosis of prolactinoma: a concordance study]. / La tomografía computadorizada de hipófisis en el diagnóstico de los prolactinomas: estudio de concordancia.

BACKGROUND: The diagnostic capacity of computed tomography (CT) of the pituitary gland in the diagnosis of prolactinomas is difficult to define in terms of specificity and sensitivity since, up to the present, there is no definite diagnostic test for prolactin producing tumors. The aim of this study is to establish the consistency of CT of the hypophysis in the diagnosis of the prolactinomas based on a concordance design. METHODS: In the follow-up study of 48 patients diagnosed as affected of prolactinoma a concordance study was carried out on the blind lecture of 35 pituitary gland CT by two radiologists. RESULTS: The degree of concordance for all the diagnosis (kappa = 0.58) was greater than what might be expected by chance. The degree of concordance was also different for the different diagnosis given by the two radiologists: empty sella turcica, kappa = 0.84 (p less than 0.01); macroprolactinoma, kappa = 0.68 (p less than 0.01); microprolactinoma, kappa = 0.45 (p less than 0.01) and normal sella turcica, kappa = 0.28 (NS). CONCLUSIONS: CT of the hypophysis must be less sensitive (more false negatives) in cases of high prolactin due to microprolactinomas and less specific (more false positives) in cases of high prolactin due to a cause other than pituitary tumor, thereby making it a complementary diagnostic test to clinical evaluation and to prolactin determinations.

Effects of triflusal and acetylsalicylic acid on platelet aggregation in whole blood of diabetic patients.

A study was made on the inhibitory effect of triflusal (600 mg/d X 15) and acetylsalicylic acid (ASA, 400 mg/d X 15) on platelet aggregation in whole blood (WB) and platelet-rich plasma (PRP) induced by ADP (2.5 mumol/l), adrenaline (50 mumol/l), collagen (1 microgram/ml) and arachidonic acid (0.8 mmol/l), in 30 insulin-dependent diabetic patients without vascular complications. Determination was also made of the serum levels of thromboxane B2 (TxB2) and of the plasma levels of 6-keto-PGF1-alpha and of beta-thromboglobulin (B-TG). Both drugs exhibited higher inhibitory effects in WB than in PRP. In WB, a significant difference between triflusal and ASA was observed against ADP-induced aggregation (67% and 46% inhibition respectively, p less than 0.01). Both drugs strongly inhibit the formation of TxB2 in serum (85% and 99%, respectively). Triflusal does not significantly change the plasma levels of 6-keto-PGF1-alpha; ASA, by contrast, causes reduction of over 95% in those plasma levels. The plasma levels of B-TG were not modified by either of the drugs.