Time-related changes in the plasma concentrations of prolactin, gonadotropins, sex hormone-binding globulin, and certain steroid hormones in female runners after a long-distance race.

Running is associated with an increase in plasma concentrations of certain anterior pituitary hormones and adrenal steroids. This study reports such increases after a marathon race. Six trained female runners, 26 to 42 years old, participated in a marathon race. Fasting (resting) blood samples were collected a few weeks before the race (baseline) and immediately (0 hour), 1 hour, and 4 hours after the run. The data were analyzed with the use of two-way analyses of variance (F-test), paired t-test, and Page's test. At 0 hour, compared with baseline, significant increases were observed in the plasma concentrations of testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), cortisol (F), free T index (T/SHBG), and prolactin (PRL). At 1 hour, levels of these steroid hormones and PRL declined, some significantly. At 4 hours, levels of all hormones except DHEA-S returned to baseline. No significant changes were observed in concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG), as evaluated by F-test. Running-associated changes in plasma hormonal concentrations revert to baseline in four hours, although DHEA-S may take a little longer.

Plasma gonadotropins, prolactin, and steroid hormone concentrations in female runners immediately after a long-distance run.

Six normally menstruating women who regularly run participated in a 10-mile race. Blood samples were collected within 20 minutes after the completion of the race (group 1). Samples were analyzed, and the results were compared with plasma hormonal concentrations in the same runners in samples collected between 12 and 24 hours after a previous practice run (group 2) and with our nonathletic female controls. Plasma concentrations of the following hormones in group 1 were significantly elevated when compared with group 2: dehydroepiandrosterone (DHA), androstenedione (delta 4A), testosterone (T), cortisol (F), luteinizing hormone (LH), and prolactin (PRL). Levels of 17 beta-estradiol (E2), 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHAS), and follicle-stimulating hormone (FSH) were comparable in groups 1 and 2. However, DHAS in group 1 was elevated when compared with controls, as were HDA, delta 4A,T,F,LH, and PRL. In group 1, but not in group 2, a significant correlation (P less than 0.05) was observed between plasma LH and PRL concentrations but not between FSH an PRL. We conclude that the immediate effect of running is reflected in increased levels of the adrenal androgens, F, LH, and PRL. However, concentrations of these hormones revert back to baseline within 12 to 24 hours after the race.

Female runners and secondary amenorrhea: correlation with age, parity, mileage, and plasma hormonal and sex-hormone-binding globulin concentrations.

Twenty-three white women, ages 18 to 42, with normal menses prior to running were studied. Miles per week varied from 10 to 70 for a period of 1 to more than 10 years. Of these, 6 were amenorrheic (AM), 14 had regular cycles (REG), and 3 with regular cycles became amenorrheic during the course of this study. The incidence of amenorrhea was higher in those less than 30 years of age (66.6%) than in the older group (9.0%); in those who ran 40 miles/week or less (37.5%) than in those who ran more (26.6%); and in the nulliparous (46.6%) than in the parous runners (25.0%). The age of menarche was significantly higher in the AM (13.8 +/- 0.5 years) than in the REG (12.2 +/- 0.3 years). Blood samples were collected between 12 and 24 hours after the last run for hormonal and sex-hormone-binding globulin (SHBG) measurements. Plasma estradiol (E2), SHBG, and LH were significantly lower in the AM than in the REG group. Furthermore, E2, LH, and prolactin were significantly lower in the AM group than in the control group. These results suggest that the incidence of secondary amenorrhea is higher in younger, nulliparous female runners and may be related to delayed onset of menarche.

Development of rural health services: problems illustrated by a nonprofit, privately-based approach.

The historic development of a nonprofit organization designed to improve rural health services in Colorado is described and some of the major problems of rural health are discussed. This corporation, originally derived from four different kinds of provider organizations, has developed a comprehensive approach to improving the utilization of existing rural health resources and to the recruitment and deployment of new resources. Emphasis has been placed on community involvement, decreasing the isolation of rural physicians by linking rural practices with urban resources, centralizing supportive services and development of quality control methods. The peculiarities of the target area and the evolution of the goals and methods of the organization are described in order to facilitate the adaptation of these concepts to other areas.

Medication maintenance of mentally ill patients by a pharmacist in a community setting.

The use of a community pharmacy as a facility for medication maintenance services usually provided by a mental health center was evaluated. The project pharmacist was affiliated with the community mental health center, the community pharmacy facility was borrowed for purposes of this study. Records and prepackaged medication were transported by the pharmacy-clinic. Medication histories were taken and maintained by the pharmacist. Problems such as medication noncompliance, drug side effects, drug interactions and minor alterations in the patients mental status were handled by the pharmacist. Telephone consultations with a psychiatrist were also available. Twenty-two patients were involved in the study over an eight-month period. The evaluation consisted of a patient acceptance questionnaire and a retrospective chart review analyzing the clinical response of patients. Data suggest that selected stabilized psychiatric patients can be safely maintained in the community pharmacy. A carefully structured program and a pharmacist with special competencies are felt to be prerequisites for this type of service.

Biliary stasis after mestranol-norethindrone ingestion. Report of a case.

PIP: This case report concerns a 29-year-old caucasian woman who developed cholestatic jaundice while taking Ortho-Novum 2 mg. Biliary stasis was diagnosed from laboratory tests and gradually subsided when the medication was withdrawn. The condition was found to be reproducible when Ortho-Novum 2 mg. was given again. The patient was later given C-Quens with no return of symptoms which indicated norethindrone was the cholestatic agent.^ieng