Delay in specialist consultation in cancer patients.

A psychiatric evaluation of 75 cases of different types of cancer revealed significant psychological morbidity in 81% of cases. The time lag, if any, between primary diagnosis and presentation to oncologists was noted and the reasons for the delay were ascertained. 62% of patients (N = 47) delayed three months or more and this group also showed significantly greater (p < 0.05) psychological morbidity compared to those who delayed less than three months (N = 28). 89% of patients used denial as a mental defence mechanism and there was no significant difference in the degree of denial displayed by both groups. Psychological reasons such as denial of the illness, fear of cancer, fear of its treatment, and domestic difficulty were commonly cited as causes of delay. It is hoped that addressing these issues will reduce delay and help early detection in cancer programmes.

Growth hormone in mares and stallions: pulsatile secretion, response to growth hormone-releasing hormone, and effects of exercise, sexual stimulation, and pharmacological agents.

Short-term patterns of growth hormone (GH) secretion and factors affecting it were studied in mares and stallions. In Exp. 1, hourly blood samples were collected from three mares and three stallions in summer and winter. Although GH concentrations varied in a pulsatile manner in all horses, there was no effect of sex or season (P greater than .1) on plasma GH concentrations and no indication of a diurnal pattern of GH secretion. In Exp. 2, 10-min blood samples were drawn for 8 h from 12 mares; after 6 h, porcine GH-releasing hormone (GHRH) was administered i.v. at 0, 45, 90, or 180 micrograms/mare (three mares per dose). Pulsatile secretion of GH occurred in all mares and averaged 2.4 +/- .3 peaks/6 h; amplitudes were variable and ranged from 2.6 to 74.4 ng/mL. Eight of nine mares responded within 20 min to GHRH injection, but there was no difference (P greater than .1) among the three doses tested. In Exp. 3, plasma GH concentrations in stallions increased (P less than .05) 8- to 10-fold after 5 min of acute physical exercise or exposure to an estrual mare. Restraint via a twitch (5 min) and epinephrine administration (3 mg i.v.) also increased (P less than .05) plasma GH concentrations by approximately fourfold. In Exp. 4 and 5, administration of either .4, 2, or 10 mg of thyrotropin-releasing hormone (TRH) or 100 or 500 mg of sulpiride (a dopamine receptor antagonist) increased (P less than .01) plasma prolactin concentrations but had no effect (P greater than .1) on GH concentrations during the same period of time.(ABSTRACT TRUNCATED AT 250 WORDS)

Properly timed injections of cortisol and prolactin produce long-term reductions in obesity, hyperinsulinaemia and insulin resistance in the Syrian hamster (Mesocricetus auratus).

Naturally obese female Syrian hamsters were injected daily with prolactin at 0 or 12 h after cortisol injections for 10 days while held in constant light. Controls were similarly injected with saline. Animals were then held on short daylengths (10 h light:14 h darkness) for 10 weeks. They were allowed free access to food and water from birth to time of death. Ten weeks after treatment, retroperitoneal fat stores, plasma concentrations of insulin and glucose, and hypoglycaemic responsiveness to exogenous insulin were determined. The control groups as well as the 12-h hormone treatment group were obese, hyperinsulinaemic and insulin resistant. However, the 0-h treatment dramatically reduced retroperitoneal fat stores (41-55%), plasma insulin concentration (60-70%) and the insulin to glucose ratio (63-68%) compared with controls. Values for these parameters in the 0-h treatment groups were similar to those of their lean litter-mates. Furthermore, the 0-h group but not the 12-h group was more sensitive than control animals to the hypoglycaemic effects of exogenous insulin at doses 0.2 and 2.0 U/kg body weight. These results demonstrate that timed daily injections of cortisol and prolactin in specific temporal relationships can produce marked reductions in obesity, hyperinsulinaemia and insulin resistance in the Syrian hamster that persist long after the termination of treatment. This study also suggests an important role for the interactions of circadian neuroendocrine systems in the regulation of these metabolic states.