ABSTRACT
Acromegaly is caused by excessive secretion of growth hormone by a hypophyseal adenoma type of somatotropinoma. IGF-I is formed in the liver and mediates most biological actions of GH. Treatment of adenomas, which secrete GH, involves pharmacotherapy followed by surgery. Modern pharmacotherapy leaning is based on somatostatin analogues (factor restrictive secretion GH): octreotide, octreotide LAR and lanreotide. The aim of our study was estimation of efficiency of octreotide LAR in the patients with somatotropinoma prepared to neurosurgery intervention. We examined 16 patients (10 of women and 6 men) with the features of active acromegaly. In all cases the increased concentration of HGH and IGF-I were observed. The presence of pituitary adenoma in all patients was confirmed by MRI. The patients were treated with octreotide LAR monthly in dose 20 mg and 30 mg respectively. Before and after application of somatostatin analogues the concentration HGH, IGF-I, PRL in serum were marked. The concentration of GH before octreotide LAR therapy in all patients increased remarkable and ranged from 15.6 to 78.6 ng/ml, mean: 31.20 +/- 16.84 (norm: 0-10 ng/ml), also, in all cases the serum IGF-I level was increased and ranged from 451 to 1107.6 ng/ml, mean: 801.75 +/- 207.82 (norm: 100-400 ng/ml). The prolactin concentration ranged from 7.4 to 49.9 ng/ml, mean: 22.8 +/- 13.7 (norm: 2-20 ng/ml) and in 8 (50%) cases the increased of PRL concentration in serum was observed. After the administration of octreotide LAR the level of: GH [mean: 12.99 +/- 17.16 ng/ml (p < 0.001)], of IGF-I [mean 422.8 +/- 229 ng ml (p < 0.01)] statistical important decreased and prolactin in 8 with increased concentration [mean: 12.45 +/- 5.57 (p < 0.01)] were observed. Long acting somatostatin analogues--octreotide LAR is particular efficient in lowering of growth hormone and IGF-I in patients with somatotropinoma and shows efficiency in normalization of increased prolactin concentration. Because of extreme effectiveness of octreotide LAR, it should be used the routine treatment at the patients suffering from active acromegaly and preparing to neurosurgical treatment.
Subject(s)
Acromegaly/drug therapy , Antineoplastic Agents, Hormonal/administration & dosage , Human Growth Hormone/blood , Insulin-Like Growth Factor I/metabolism , Octreotide/administration & dosage , Peptides, Cyclic/administration & dosage , Prolactin/blood , Somatostatin/administration & dosage , Acromegaly/blood , Acromegaly/immunology , Acromegaly/surgery , Adult , Aged , Female , Hormones/administration & dosage , Human Growth Hormone/metabolism , Humans , Male , Middle Aged , Pituitary Neoplasms/diagnostic imaging , Radiography , Somatostatin/analogs & derivatives , Treatment OutcomeSubject(s)
Global Health , Poliomyelitis/immunology , Poliomyelitis/prevention & control , Vaccination , HumansSubject(s)
Communicable Disease Control/statistics & numerical data , Communicable Diseases/epidemiology , Epidemiology/statistics & numerical data , Global Health , Vaccination/statistics & numerical data , Communicable Disease Control/trends , Epidemiology/trends , Europe/epidemiology , Humans , Poland/epidemiology , Vaccination/trendsSubject(s)
Communicable Diseases/epidemiology , Adolescent , Adult , Child , Child, Preschool , Communicable Diseases/mortality , Female , Humans , Infant , Male , PolandSubject(s)
Communicable Diseases/epidemiology , Adolescent , Adult , Age Factors , Child , Child, Preschool , Communicable Diseases/etiology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , PolandSubject(s)
Communicable Diseases/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Communicable Diseases/mortality , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , PolandABSTRACT
The aim of the study was the investigation of symptoms and origin of the disturbances in personality development of adolescents. The group of 50 patients (22 girls and 28 boys aged from 14 to 20 years) of the Young People's Unit and Outpatient Clinic of the Department of Child and Youth Psychiatry of the Institute of Mother and Child in Warsaw were examined. The study consists of the psychiatric, psychological and sociological types of investigation. The following methods were used in the study: the standard methods of the clinical investigation, Wechsler-Bellevue Intelligence Scale, R. B. Cattell, M. Choynowski and M. Nowakowska 's 16 PF; A. Roe and M. Siegelman 's "My Father" and "My Mother" questionnaires; E. S. Schaefer and R. Q. Bell's Parental Attitude Research Instrument and E. Kobia lka's Family Environmental Questionnaire. The control group was formed in the method of pairs and was investigated in the same way as patients. After the detailed analysis of the data, the final conclusions were formed. They are as follows: In the clinical picture of disturbances of the development of patients personality, the conduct disorders prevailed. The suicidal and parasuicidal behaviour occurred in 1/3 of the patients. Also the depressive and other neurotic symptoms took place. The intelligence level was average and dull normal. The following personality features were established: emotional instability, guilt proness , low self- sentiment , high ergic tension (both sexes); protension ( suspection jealous ), shrewdness (girls) and threat sensitive (boys). Patients attitudes toward both parents were disturbed and unfavourable for normal personality development. The declared mothers attitudes toward patients were also unfavourable for development of mature personality. The general family environment (also living standard) was significantly worse in the criterion group. It should be stressed in conclusion, that the results of the study showed among others that the disturbed family hinder the development of adjustment mechanisms, mainly of the adjustment to the small group, which are essential for the normal personality functioning.
