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Biomedical subjects

A Dupont

Publications and source records attributed to A Dupont.

At least 127 records · Page 7Linked to original sources
PubMed1986

Loss of luteinizing hormone bioactivity in patients with prostatic cancer treated with an LHRH agonist and a pure antiandrogen.

Chronic treatment of adult men with LHRH agonists causes a decrease in serum testosterone and 5 alpha-dihydrotestosterone to castrate levels. In the presence of such low levels of circulating testicular androgens, the concentration of serum LH measured by radioimmunoassay (RIA) sometimes remains normal or is only partially inhibited. In order to assess the biological activity of circulating LH, we have used the mouse interstitial cell assay. Blood samples were obtained from patients with prostatic carcinoma treated with the LHRH agonist [D-Trp6] LHRH ethylamide in combination with the pure antiandrogen Flutamide (Euflex). While serum LH levels measured by RIA were only partially reduced from 2.2 +/- 0.3 (SEM) to 1.1 +/- 0.1 ng/ml after 3 months of therapy, bioactive LH was markedly inhibited from 0.43 +/- 0.04 to 0.030 +/- 0.007 ng/ml, thus causing the ratio of biologically active to radioimmunoassayable LH to drop from 0.26 +/- 0.03 to 0.03 +/- 0.01. In the same patients, serum testosterone levels were decreased from 3.91 +/- 0.51 to 0.14 +/- 0.05 ng/ml after 3 months of treatment. In patients treated for 6 months, the bio/immuno ratio was still reduced at 0.032 +/- 0.005. These data show a marked loss of LH biological activity during treatment of adult men with an LHRH agonist and an antiandrogen. The close parallelism observed between serum testosterone and bioactive LH levels suggests that the loss of biological activity of the gonadotrophin is mainly, if not exclusively, responsible for the inhibition of testicular androgen secretion observed during chronic treatment with LHRH agonists.

Adenocarcinoma↗
PubMed1986

Mortality and life expectancy of Down's syndrome in Denmark.

Based on the register of all persons registered in the Danish National Service for the Mentally Retarded (DNSMR) with a diagnosis of Down's syndrome in the period 1 January 1976-31 December 1980, the persons were followed until 31 March 1984 (a total of 2412 Down's syndrome patients). The difference in mortality for patients in institutions and living outside was significant, with a higher mortality for women with residence in institutions than women living outside. Among males the mortality rate was not significantly different between the two types of residents. Of the total group, a survival rate of 82.4 was found at the end of the age group 5-9 years and this result is similar to recent results from Salford and Japan. Although the life expectancy for the Down's syndrome group has increased, the life expectancy for Down's syndrome at any given age compared with life expectancy for the background population during the above mentioned period was still lower.

Adolescent↗
PubMed1986

Suicide in psychiatric patients in Denmark, 1971-81. I. Demographic and diagnostic description.

Data concerning all suicide cases in Denmark with a psychiatric history (1971-81) were compiled through computer record linkage between central registers. Cases of suicide during and up to 1 year after inpatient hospitalization were investigated. 21% of the suicides took place while the patient was still hospitalized. The overall suicide rates increased slightly faster than in the population without recent psychiatric hospitalization. There were few suicides in the groups over 65 and under 25 years of age. A sharp relative increase in suicide mortality in the provincial and particularly rural populations was noted. Approximately half of the patients were psychotic, mainly with major affective disorder. The percentage of patients with neurosis or personality disorder decreased. 37% of the men and 18% of the women were diagnosed as substance abusers. Fairly consistently, approximately 10% of the suicide victims were characterized by affective reactions or no psychiatric illness.

Adolescent↗
PubMed1986

Ocular toxicity of Anandron in patients treated for prostatic cancer.

Approximately 65% of patients with prostatic cancer treated by the combination therapy using a gonadorelin (LHRH) agonist or orchidectomy in association with the antiandrogen Anandron complained of a delay in recovering vision after bright illumination (sun, television, bright light). Detailed ophthalmological examination revealed an increase in the photostress recovery time to an average of 9 min, while the upper limit of normal is 1 min 20 s. When treatment was changed from Anandron to the other pure antiandrogen flutamide, the value of the photostress recovery time markedly decreased and the visual symptoms rapidly disappeared. Since uninterrupted administration of the antiandrogen is of the outmost importance for the successful therapy of prostatic cancer, the availability of a compound such as flutamide that has no side effect other than those due to hypoandrogenicity should greatly facilitate compliance by the patients and the success of the treatment.

Aged↗
PubMed1986

Treatment of prostate cancer with gonadotropin-releasing hormone agonists.

It is now well established that chronic treatment with GnRH agonists offers an advantageous alternative to orchiectomy and estrogens for the treatment of prostate cancer. Castration levels of androgens can thus be easily achieved without side effects other than those related to castration levels of serum androgens. However, man is unique among species in having a high secretion rate of precursor adrenal steroids which are converted into active androgens in the normal prostate and prostatic cancer. All the enzymes required for the transformation of dehydroepiandrosterone sulfate, dehydroepiandrosterone, androstenedione, and androst-5-ene-3 beta, 17 beta-diol are present in prostatic tissue. Moreover, as shown in many systems, castration levels of serum testosterone (T) at 0.2-0.4 ng/ml exert significant androgenic activity in target tissues. In order to inhibit the action of androgens of both testicular and adrenal origin, GnRH agonists have been administered in association with the pure antiandrogen Flutamide in patients having clinical stage D2 (bone metastases) prostate cancer. A positive objective response assessed according to the criteria of the United States National Prostatic Cancer Project (USNPCP) has been observed in 84 of the 88 patients who had received no previous treatment (95.4%). After 2 yr of treatment, the probability of continuing response is 70% compared to 0-10% by previous approaches. In addition, the death rate at 2 yr is at 10.9% as compared to approximately 50% after standard hormonal therapy. When the same treatment was applied to patients who had received previous hormonal therapy (orchiectomy, estrogens or GnRH agonists alone) before showing a relapse, the response rate decreased to 62.9% and the death rate at 2 yr was 52%.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgen Antagonists↗
PubMed1986

Serum luteinizing hormone (LH) biological activity in castrated patients with cancer of the prostate receiving a pure antiandrogen and in estrogen-pretreated patients treated with an LH-releasing hormone agonist and antiandrogen.

We recently reported almost complete disappearance of serum LH biological activity in previously untreated patients with advanced prostatic cancer receiving combined therapy with a LHRH agonist and a pure antiandrogen. This decrease in LH bioactivity was most likely responsible for the fall of circulating testosterone to castration levels during such treatment. Since patients previously treated with high doses of estrogens or orchiectomy before receiving combined therapy had a less favorable response to the new treatment, we measured serum LH levels by RIA and the mouse interstitial cell bioassay in these 2 groups of patients. Serum samples were obtained from 14 men with advanced prostatic cancer treated from 9-41 months (24 +/- 9 months) with diethylstilbestrol before receiving 500 micrograms/day LHRH agonist ([D-Trp6]LH/RH ethylamide) in combination with 3 daily oral doses of 250 mg pure antiandrogen flutamide and from 21 men castrated for at least 9 months (32 +/- 26 months) before receiving the antiandrogen alone. In previously castrated patients, both bio- and immunoactive LH serum levels were elevated and did not change during at least 3 months of antiandrogen treatment. In estrogen-pretreated men, however, bioactive LH concentrations declined from 1.2 +/- 0.5 (+/- SEM) to 0.04 +/- 0.01 ng/ml after 1 month of combined treatment and remained low thereafter, while serum LH levels, measured by RIA, did not significantly decline (1.4 +/- 0.5 vs. 0.9 +/- 0.1 ng/ml on days--2 and 30, respectively). This decrease in LH biopotency caused the biological to immunological activity ratio to fall from 0.5 +/- 0.2 before the onset of the combined therapy to 0.05 +/- 0.01 after 3 months. Thus, estrogen pretreatment did not prevent the ability of the LHRH agonist-antiandrogen combination to decrease serum LH biological activity. Moreover, the absence of an effect in castrated patients receiving antiandrogen alone indicates that the LHRH agonist, and not flutamide, was responsible for the effects of the combined therapy.

Aged↗
PubMed1986

Stimulation of the circulating levels of glycoprotein hormone alpha-subunit after combined administration of a luteinizing hormone-releasing hormone (LHRH) agonist and flutamide in patients with cancer of the prostate.

To ascertain whether the immunoreactive luteinizing hormone (LH) levels measured following the combined treatment may represent cross-reaction of the LH antiserum with LH subunits, we have examined the effects of therapy on the serum levels of free alpha- and free LH-beta-subunits in intact, castrated, and estrogen-treated patients. In previously untreated patients receiving the LHRH agonist [D-Trp6,des-Gly-NH2(10)]LHRH ethylamide in association with the pure antiandrogen Flutamide, serum-free alpha-subunit levels were stimulated from 0.09 +/- 0.02 to 3.10 +/- 0.84 ng/ml after 5 days, and declined slowly afterwards to 1.33 +/- 0.20 ng/ml after 3 months of combined treatment. In patients pretreated from 12 to 24 months (17.5 +/- 1.0 months) with diethylstilbestrol (DES) prior to receiving the combined therapy, free serum alpha-subunit concentration followed a similar pattern, rising from 0.22 +/- 0.03 to 1.78 +/- 0.28 ng/ml after 15 days of combined treatment, and declining thereafter to 0.81 +/- 0.10 ng/ml after 3 months. Free LH-beta-subunits were below the detection limit in most previously untreated patients and in all DES-treated patients. After correcting for the cross-reactivity of the alpha-subunit in the LH RIA, immunoassayable LH serum levels in previously untreated patients were only slightly reduced from 0.81 +/- 0.06 ng/ml before the onset of the combined treatment to 0.52 +/- 0.05 ng/ml after 3 months. On the contrary, bioactive serum LH levels were drastically inhibited from 0.43 +/- 0.04 to 0.03 +/- 0.01 ng/ml after the same duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgen Antagonists↗
PubMed1986

[Combined anti-androgen treatment in adenocarcinoma of the prostate: first use of a new therapeutically efficacious principle in hormone-dependent cancer].

Since the first observation reported by Huggins et al. in 1941, hormonal treatment of advanced prostatic cancer has been directed primarily at neutralizing testicular androgens by orchiectomy or estrogen therapy. These two approaches yielded a 60 to 80% positive response rate in the many studies carried out over the last forty years. However, responses were short-lived and the disease recurred rapidly in nearly every case. A possible reason for these limited results may well be related to the fact that a unique characteristic of man as compared to other species is a high level of secretion of adrenal steroids that act as precursors and are converted into androgens within the prostatic tissue itself. Complete neutralization of both testicular and adrenal androgens is therefore mandatory to achieve total suppression of the influence of androgens on the carcinoma. To accomplish this goal, we have used a combination of an LHRH agonist (or orchiectomy) and a pure antiandrogen in fifty-two previously untreated patients with prostatic carcinoma and bone metastases (stage D2). Average duration of treatment was eighteen months (six to thirty-two months). An objective positive response assessed according to the criteria set forward by the National Prostatic Cancer Project (NPCP) was recorded during the first treatment months in every case, a significant improvement over the 60 to 80% positive response rate following previous treatments confined to neutralization of testicular androgens by orchiectomy or estrogens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Critical study of an interdisciplinary survey of urinary schistosomiasis in Burkina Faso].

We consider an approach to built on a score summarizing some demographic, social, geographic and parasitologic data for purpose of measuring the health impact of schistosomiasis. Operational definitions are given for the social, ecological and medical variables and for the survey design. Twenty villages from the Bam-Kongoussi district were kept for the survey, giving a sample of 11,396 peoples. The process of the survey is described. The overall response rate is 63%. The sensitivity of the survey's results in regard to the non-responses is considered along with the possibility to implement a call back survey.

Adolescent↗
PubMed1986

Transient tricuspid valve insufficiency following acute inferior myocardial infarction.

Tricuspid valve insufficiency following acute myocardial infarction is uncommon. It may be explained by right ventricular papillary muscle dysfunction. We report the case of a patient with acute tricuspid valve incompetence during the acute phase of a left ventricular inferior infarction with right ventricular myocardial involvement. The treatment during the acute phase consisted of volume loading and positive inotropic agents. Seven days later the clinical signs of tricuspid valve insufficiency and concomitant right heart failure had disappeared. To our knowledge transient tricuspid valve insufficiency following acute inferior myocardial infarction has not been reported previously.

Aged↗
PubMed1986

[Approach to effects on health of hydro-agricultural development in tropical regions. Calculation of absenteeism].

A method is proposed for comparing the number of lost work days for a rural population in a tropical area. It takes into account the pathology of the whole population and not only of the working people. It uses demographic, epidemiologic and clinical data which are generally available. This method allows to assess the usefulness of health programs with regard to the increase of productivity. The example of Mali is presented.

Absenteeism↗
PubMed1985

Long term treatment with luteinising hormone releasing hormone agonists and maintenance of serum testosterone to castration concentrations.

Serum concentrations of luteinising hormone and testosterone were measured by radioimmunoassay one, two, four, seven, and 24 hours after the subcutaneous administration of 500 micrograms of the luteinising hormone releasing hormone agonist [D-Trp6, des-Gly-NH2(10)] LHRH ethylamide or [D-Ser(TBU)6, des-Gly-NH2(10)]LHRH ethylamide in patients who had previously received daily treatment with these peptides for 0, 1, 6, 12, 18, and 24 months. No increase in the serum concentrations of luteinising hormone or testosterone were detected at any time between one and 24 months' treatment. The data show that daily subcutaneous administration of the two luteinising hormone releasing hormone agonists used at the appropriate dose can maintain concentrations of serum androgens equivalent to those after castration during long term treatment.

Bone Neoplasms↗