Primary thyroid failure with concomitant thyroxine binding globulin deficiency.
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Biomedical subjects
Publications and source records attributed to C J Hayter.
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The effect of the dopamine agonist, bromocriptine, and the dopamine antagonist, metoclopramide, on glucose tolerance was examined in maturity onset diabetics and normal subjects. After bromocriptine there was a lowered fasting blood glucose and improved glucose tolerance in the diabetics. The controls showed an initial improvement in glucose tolerance. A reduction in insulin levels and a marked fall in plasma prolactin was observed in all subjects. Growth hormone concentrations were low and unaffected in the diabetics, and there was an inconsistent rise in the normals. After metoclopramide there was some impairment in glucose tolerance in the normal subjects, but this was not significant in the diabetics. There was also a marked prolactin release in all subjects, but no significant effect on insulin or growth hormone. It is concluded that bromocriptine lowers the blood glucose and improves glucose tolerance in maturity onset diabetics. This action may be the result of the lowered prolactin which occurred without a concomitant rise in growth hormone.
Plasma gonadotrophin levels were measured at frequent intervals in six postmenopausal thyrotoxic women treated with carbimazole. All patients showed an increasing follicle stimulating hormone/luteinizing hormone (FSH/LH) ratio as the thyroid hormone concentrations fell to normal and then into the hypothyroid range. Although the increased FSH/LH ratio was primarily due to a rise of FSH, two patients had a rise of both gonadotrophins. It is suggested that menstrual irregularities occurring in premenopausal women with disorders of thyroid metabolism may be related to similar changes.
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The radioactive triolein test has been compared with two chemical methods for the assessment of fat absorption in a group of inpatients from general medical wards. The special feature of the investigation is the use of a radioactive faecal marker to measure the completeness of faecal collections during the investigation period. Estimations of unabsorbed (131)I triolein and faecal fat measured by the chemical methods were made on the same specimens. The results showed that only 48% of the patients provided a complete collection of faeces (defined as a recovery of more than 90% of the faecal marker). From these patients good correlations were found between the triolein absorption test and the two chemical methods.It is suggested that previous criticism of the radioactive triolein test may have been due to incomplete faecal collections causing false results.
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A new method for the bioassay of thyroid stimulating hormone using goldfish is described. The technique can detect thyroid stimulating substances in euthyroid unconcentrated plasma. Early results show that the method compares well with other techniques. Some evidence has been obtained which suggests that in primary myxoedema there may be some impairment of the thyropituitary "servo-mechanism" in older patients.
A rapid, sensitive, and precise method for measuring the plasma digoxin concentration has been developed with the radioimmunoassay technique. Seventy patients receiving digoxin were shown to have plasma digoxin concentrations between 0.4 and 5 ng./ml. Preliminary studies show that though there is a positive correlation between total daily dose and the plasma digoxin concentration, the relationship is not close, and a relatively wide range of plasma digoxin concentrations appear to be consistent with effective digitalization.
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