Differential AT III-response to oral and parenteral administration of 17 beta-estradiol.
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Biomedical subjects
Publications and source records attributed to A Basdevant.
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Other workers have reported increased adipose tissue lipoprotein lipase after a weight loss in obese subjects and have suspected that this enzyme is a primary factor of pathophysiological significance. In order to determine whether this effect was the consequence of refeeding rather than weight loss, six obese females were included in a controlled study. Adipose tissue lipoprotein lipase was measured before weight loss, at the end of 30 days on a diet of 800 kcal/day (mean weight loss 8.7%), and four times during the 8 days after the initiation of refeeding a 1500 kcal/day mixed diet to insure weight stability. Adipose tissue lipoprotein lipase decreased by 77% by the end of the weight loss, and an average 2-fold increase (24.2 +/- 2.7 mean +/- sem versus/11.1 +/- 2.3 mU/10(6) cells, p less than 0.01) was shown as early as 2 days after refeeding. Peak values after refeeding did not surpass predieting values. Changes during restriction and peak postrefeeding values were both positively correlated to baseline values. It can be concluded that the previously shown increase in lipoprotein lipase during weight stability after a weight loss is likely to be a secondary effect of partial refeeding; the individual sensitivity of adipose tissue lipoprotein lipase to nutritional induction could be of critical importance.
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Two groups of insulin-treated outpatients (one followed up at the Hotel-Dieu Hospital and the second mainly supervised by general practitioners) were chosen at random in 1978. The two populations were comparable in age, age at diagnosis, sex, level of education, overall activity and socio-professional and economic status. Outpatients followed up in the diabetic unit had better blood glucose control, with about the same number of hypoglycaemic reactions as patients followed up in general practice. This better control was associated with more social activity and less visits to the physician, despite the fact that patients attending the hospital spent more money on their diet and had more daily insulin injections. All these differences remain significant after adjustment for the duration of diabetes. It may be inferred that attempts to improve control in insulin-treated patients are associated with a more active life and with no increase in the frequency of hypoglycaemic reactions.
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Epidemiological data tend to relate some of the sex differences in plasma lipid levels to the physiological secretion of estrogens and progesterone. The influence of sex hormones on plasma lipoprotein metabolism has not been extensively investigated. Precise correlation between plasma lipids and circulating hormones levels are still lacking. The short term effect on plasma lipids of large variations in estradiol and progesterone plasma levels occurring during the menstrual cycle has been studied in eight fertile women over a total of 18 cycles. Concentrations of plasma lipids, particularly triglycerides and HDL cholesterol levels were remarkably stable in the three hormonal situations studied, namely during menstruation (low estradiol and progesterone levels), in the follicular phase of the cycle (high estradiol and low progesterone levels) and in the luteal phase (high estradiol and progesterone levels). Considerable variation of plasma estradiol levels (400%) did not modify, the plasma lipid values on a short term basis (8-21 days). The physiological role of 17-beta estradiol and progesterone in the sex differences of blood lipid levels remains to be clarified. If this metabolic effect exists, it does not seen to be influenced by short term variation in hormone levels.
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The vascular complications of oral contraceptive treatment affect both arteries and veins, and vessels of all calibres in the systemic, pulmonary and portal circulations may be involved. In most cases thrombophlebitis develops under the combined influence of drug-induced blood changes and alterations in the vascular wall. Thickening of the connective and muscular fibers of the intima is commonly found, either isolated or associated with proliferation of the endothelium and/or thickening of the tunica media. These lesions are unrelated to those of atherosclerosis. Systematic investigations being impossible, the true incidence and extent of vascular wall alterations are necessarily under-estimated. The physiopathology of these non-specific lesions is unknown, but synthetic oestrogens seem to be mainly responsible for their occurence. Oestrogens might act on the vascular wall either directly or through changes in blood composition. Such lesions unquestionably have clinical repercussions.
Seven postmenopausal women have been treated daily with 3 mg oestradiol percutaneously applied upon the skin. Blood samples were drawn at 8-h intervals during a 4-day period and on days 5, 7 and 9 from the beginning of the treatment. Plasma Plasma oestradiol (E2), oestrone (E1), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined by radioimmunoassay on these samples. The plasma E2 level was significantly increased in the 12th hour (73 +/- 17 pg/ml) but the maximal plasma concentration was obtained only at the third day of treatment (110 +/- 24 pg/ml). Thereafter the mean plasma concentration was more stable. Increments in E1 was smaller and the plasma E2/E1 ratio was 1.51. Plasma FSH and LH di not change significantly during the course of the treatment. Thus the percutaneous administration of E2 appears to be an effective and safe method of delivering E2 into the circulation, and mimicking the physiologic condition. The advantages of this method are discussed.
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