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Biomedical subjects

C R Edwards

Publications and source records attributed to C R Edwards.

At least 217 records · Page 12Linked to original sources
PubMed1978

Sex hormone changes underlying menstrual disturbances on haemodialysis.

Sequential changes in luteinising hormone (LH), follicle stimulating hormone (FSH), oestradiol (E2), progesterone (PROG), prolactin (PRL) and testosterone (T) were studied throughout the menstrual cycle in ten women on regular haemodialysis. At the time of study seven women were menstruating and three had secondary amenorrhoea. Only one patient had regular menses. In none of the 15 cycles studied was there a normal luteal phase with an adequate PROG rise, although 9 cycles (4 patients) had E2 changes suggesting that ovulation may have occurred. Increased PRL and T levels were found in 9 and 6 women respectively. These hormonal abnormalities can be related to the menstrual disturbances and explain the low fertility seen in these patients. Bromocriptine or prednisolone may prove useful in their treatment.

Adolescent↗
PubMed1977

Metyrapone in long-term management of Cushing's disease.

Metyrapone was used in the long-term management of 13 patients with pituitary-dependent bilateral adrenal hyperplasia (Cushing's disease). The total length of treatment ranged from two to 66 months, with a mean of 21 months. The clinical features of the disease rapidly improved on metyrapone and this improvement was maintained. Although plasma ACTH concentrations rose in all patients, the increase was insufficient to overcome the adrenal blockade induced by the drug. Eight of the 13 patients had additional external pituitary irradiation as definitive treatment of their disease and one underwent a transfrontal hypophysectomy. Radiotherapy cured one patient, and after three years metyrapone was withdrawn. Slight hirsuties was noted in four of the seven women who received the drug for six months or more. A fifth woman had more severe hirsuties and this led to bilateral adrenalectomy. Other than hirsuties, side effects were few and the routine use of metyrapone is recommended as an adjunct to more definitive treatment in all patients who present with Cushing's syndrome, irrespective of aetiology.

Adolescent↗
PubMed1977

Reversible insensitivity to androgens in men with untreated gluten enteropathy.

Plasma androgen and gonadotrophin concentrations have been measured before and during treatment of 23 men with gluten enteropathy. Before treatment, there was marked rise in total plasma-testosterone, free testosterone concentration (as assessed by the free testosterone index), and plasma-luteinising-hormone concentration. In contrast, 5 alpha-dihydrotestosterone concentrations were lower than normal. All these abnormalities reverted towards normal with successful treatment of the jejunal mucosal lesion. These data are consistent with a reversible tissue resistance to circulating plasma-testosterone in men with gluten enteropathy and subtotal villous atrophy.

Adult↗
PubMed1977

A case of apparent hypopituitarism complicating chronic inflammatory bowel disease in childhood and adolescence.

There is conflicting evidence regarding the adequacy of hypothalamic-pituitary function in children and adolescents with chronic inflammatory bowel disease complicated by growth retardation and delayed sexual maturation. A child with Crohn's disease, who has never received corticosteroid therapy, had delay of both growth and sexual maturation and has been investigated over the course of his disease. In addition to a skull X-ray (normal) and thyroid function tests (normal), a standard insulin tolerance test (insulin 0.15 u/kg) and a standard gonadotropin-releasing hormone (Gn-RH) test (100 microgram Gn-RH i/v) were performed when the bowel disease was in relapse and again during a remission of the bowel disease, achieved by surgery. When the bowel disease was in relapse (coincident with growth arrest) results showed an inadequate release of gonadotrophins and of growth hormone (even after pre-treatment with stilboestrol) but normal release of cortisol and prolactin. During a remission of the bowel disease coinciding with a period of rapid "catch-up" growth, release of growth hormone was normal and that of gonadotrophins supranormal. The demonstration of a reversible apparent partial hypopituitarism in this boy not only re-questions the adequacy of hypothalamic-pituitary function in inflammatory bowel disease but also indicates a potential diagnostic pitfall in the routine investigation of growth retardation if gastrointestinal symptoms are not prominent at presentation.

Adolescent↗
PubMed1976

Cyproterone acetate.

Explore the source record for details and available documents.

Adrenocorticotropic Hormone↗
PubMed1976

Hypothalamic-pituitary-gonadal function in men with cirrhosis of the liver.

Hypothalamic-pituitary-gonadal function was studied in 37 cirrhotic males, 25 of whom were alcoholic. Irrespective of aetiology, cirrhotic patients had significantly reduced free testosterone concentrations. Despite low free testosterone concentrations and reduced or absent spermatogenesis, basal levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were normal in nearly all patients, suggesting impaired function of the hypothalamic-pituitary-gonadal axis. In 14 cirrhotic men, seven of whom had gynaecomastia, the ability of the pituitary to secrete LH and FSH in response to exogenous gonadotrophin releasing-hormone (LH/FSH-RH) was asssessed. A normal LH response to LH/FSH-RH was obtained in patients without gynaecomastia. An exaggerated LH response was found in four of seven with gynaecomastia, suggesting Leydig cell failure. The Leydig cell response to exogenous gonadotrophin in eight consecutive cirrhotic patients was probably abnormal but difficult to interpret as all but one were within conventionally accepted limits of normality. The patients without gynaecomastia gave a normal or minimally exaggerated FSH response to LH/FSH-RH. Six of seven with gynaecomastia gave a markedly exaggerated response suggesting failure of spermatogenesis, and all tested were either azoospermic of oligospermic. The single patient with a normal FSH response had a normal sperm count. The pituitary cells can therefore respond to LH/RSH-RH and the Leydig cells of the testes show some response to exogenous gonadotrophin. Similar abnormalities in hypothalamic-pituitary-gonadal function have recently been described in patients with normal liver function on chronic oestrogen therapy.

Adult↗
PubMed1976

Recessive inheritance of diabetes: the syndrome of diabetes insipidus, diabetes mellitus, optic atrophy and deafness.

A few rare syndromes have been delineated in which diabetes mellitus is inherited in association with other conditions. This paper describes five patients, including four siblings in one family, who have diabetes insipidus, diabetes mellitus, optic atrophy and deafness (the DIDMOAD syndrome). The parents of both families are normal but are first cousins. All the patients have insulin-dependent diabetes mellitus with a typical juvenile-onset. The onset of diabetes insipidus was insidious and the symptoms could easily have been ascribed to poor control of diabetes mellitus. The importance of diagnosing diabetes insipidus is that all these patients had dilatation of the urinary tract varying from mild hydroureter to severe hydronephrosis and this improved with treatment of the diabetes insipidus. It is suggested that patients with diabetes mellitus and optic atrophy should have regular screening tests for diabetes insipidus since it is likely that they represent cases of the full syndrome with incomplete clinical expression. The occurrence of this rare syndrome in four siblings of unaffected parents indicates that the syndrome is due to a recessive gene, but the pathogenesis is unknown.

Adolescent↗
PubMed1975

Inhibition of the plasma-aldosterone response to frusemide by bromocriptine.

The administration of the long-acting dopaminergic agonist bromocriptine to five healthy volunteers inhibited the rise in plasma-aldosterone that normally follows the administration of frusemide. This inhibition was not due to a lowering of plasma-renin activity. It is suggested that dopamine may modulate the normal secretion of aldosterone either directly, or indirectly, possible by inhibition of prolactin secretion.

Aldosterone↗
PubMed1975

The development and application of a radioimmunoassay for 18-hydroxy-corticosterone.

A sensitive and specific radioimmunoassay has been developed for 18-hydroxy-corticosterone (18-OH-B) and applied to the measurement of this steroid in peripheral plasma. High specific activity label (3H-18-OH-B) was prepared using the incubation of 3H-corticosterone with duck adrenal mitochondria. Antisera were produced by immunisation with 18-OH-B gamma-lactone 3-oxime conjugated to bovine serum albumin. The antibodies examined showed 100% cross-reactivity with 18-hydroxy-deoxycorticosterone gamma-lactone (18-OH-DOC gamma-lactone), but minimal cross-reactivity with other steroids. Paper chromatography was used to separate 18-OH-DOC gamma-lactone from 18-OH-B gamma-lactone. The interassay precision was 7.6% and the intra-assay precision 11.0%. The accuracy of the method was confirmed by showing a linear relationship between amounts of 18-OH-B added and amounts of 18-OH-B gamma-lactone measured (y = 0.854 X +15.1, r = 0.9. p less than 0.001). The mean plasma level in normal subjects on an ad libitum sodium intake was 225 +/- 92.7 (SD) pg/ml (n = 17) when standing, and 99 +/- 38.3 (SD) pg/ml (n = 6) after lying down for 30 minutes.

18-Hydroxycorticosterone↗
PubMed1973

Vasopressin analogue DDAVP in diabetes insipidus: clinical and laboratory studies.

In seven patients with cranial diabetes insipidus an analogue of vasopressin, DDAVP, produced an antidiuresis lasting up to 20 hours after a single intranasal dose. Lysine vasopressin (LVP) in the same dose produced a less potent antidiuresis which lasted for only three to four hours. The plasma half life of DDAVP was 7.8 and 75.5 min for the fast and slow phases, compared with 2.5 and 14.5 min for LVP. Radioiodine-labelled DDAVP was not destroyed by incubation with late pregnancy plasma, which contains an enzyme that inactivates vasopressin. The slow metabolic clearance of DDAVP, its absorption through the nasal mucosa, and its lack of side effects make this the ideal drug for the treatment of vasopressin-sensitive diabetes insipidus. Patients usually require 10 to 20 mug DDAVP given intranasally twice daily for good clinical control of their diabetes insipidus.

Adolescent↗