This study was designed to determine the effect of sterile and nonsterile intermittent catheterization on the incidence of urinary tract infection (UTI) in patients after spinal cord injury. The study included 29 patients with neurogenic bladder dysfunction treated with intermittent catheterization. One group of 14 patients was on sterile catheterization; another group of 15 patients was on nonsterile catheterization. On a weekly basis, urine samples were obtained and analyzed. A total of 122 urine samples were analyzed. The patients on sterile catheterization had a 28.6% UTI incidence; the group using a nonsterile catheterization technique had a UTI incidence of 42.4%. The most common urinary pathogen in both groups was E. coli (65%). The cost of antibiotics for patients on the sterile catheterization program was only 43% of the cost of antibiotics for those on the nonsterile program. However, the sterile kits cost 371% of the cost of the catheterization kits for the patients in the nonsterile program, so the total cost of managing neurogenic bladder on the sterile program was 277% of the cost of the nonsterile program.

Bacterial Infections↗

PubMedDate not supplied

Circadian rhythms of anterior pituitary hormone secretion: effects of dexamethasone.

Circadian rhythms of hormone secretion are by now well recognized but there are limited data available to compare such rhythms of multiple hormones in individual subjects. Therefore concentrations of serum thyrotropin (TSH), cortisol, growth hormone (GH), triiodothyronine (T3) and prolactin (PRL) were determined in blood samples from six healthy males over periods of 24 hours. A circadian periodicity was identified for cortisol, GH, PRL and TSH; maximum concentrations for TSH and PRL occurred at dissimilar times, namely respectively before and after the GH peak. Maximum TSH coincided with nadir values forplasma cortisol. Dexamethasone administration (3 mg over 36 hours) lowered serum T3 concentration and abolished TSH periodicity without affecting the PRL rhythm. These data suggest that a) nocturnal TSH and PRL maximum levels do not have common mediation; b) there may be an inverse relationship between cortisol and TSH, and c) glucocorticoids at low doses preferentially affect secretion of thyrotropin.

Adult↗

PubMedDate not supplied

Reduced active thyroid hormone levels after delivery.

The effect of delivery on the serum concentration of thyroid hormones was studied in 25 euthyroid women. After delivery serum free and total T3 and T4 fell transiently with a simultaneous increase in reverse T3 while serum TSH and thyroxine binding globulin (TBG) concentrations showed no significant variation. These data suggest that i) similar to what happens in other stressful situations, delivery influences peripheral T4 metabolism, and ii) an elevation of TBG in serum in the early puerperium does not prevent these changes.

Adult↗

PubMedDate not supplied

A study of the binding of Graves' immunoglobulins to orbital antigens.

The binding of Graves' immunoglobulins to membranes of human eye muscle (HEM) and guinea pig Harderian gland (HG) were studied. The membrane fraction of 100,000 X g sediment was used for ELISA. Serum samples from 55 patients with Graves' ophthalmopathy were evaluated for binding to the membrane preparation. There was a higher binding to HG with the sera from the patients with Graves' ophthalmopathy than in the control group (p less than 0.01), but there was no difference in binding to HEM. Purification of IgG from sera improved binding to HG in both patients' (p less than 0.001) and control group (p less than 0.005). There was also an increase in percentage of positive responses obtained with IgG 48% vs serum samples 37%. In 23 out of 24 patients we found the thickening of extraocular muscles by A-scan ultrasonography. In these groups of patients and 3 others with malignant ophthalmopathy the binding of IgG preparation to HG was similar to control group. In all assays there was an overlap between patients with Graves' ophthalmopathy and control subjects, and a lack of relationship between the responses in ELISA and clinical or severity of ophthalmopathy.

Adult↗

PubMedDate not supplied

Triiodothyronine (T3) nuclear binding sites in human placenta and decidua.

We studied the binding of triiodothyronine (T3) to human placenta and decidua. Although the placenta effectively blocks transfer of thyroxine (T4) and T3 it may itself be a thyroid hormone-dependent tissue and may specifically bind T3. A single class of high-affinity binding sites was found (Ka 3.8 +/- 0.31 s.e.m., and 3.3 +/- 10(9) M-1) for both placenta and decidua. Limited capacity was also observed, viz., 0.117 +/- 0.01 and 0.102 +/- 0.018 fmoles/microgram deoxyribonucleic acid (DNA), respectively. Endogenous T3 nuclear saturation was 34 per cent. Our results are consistent with the proposal that placenta and decidua have similar T3 specific nuclear binding sites and that T3 may have a direct action in the placenta.

Cell Nucleus↗

PubMedDate not supplied

Determination of replacement and suppressive doses of thyroxine.

Suppression daily doses of thyroxine (T4) were determined and the daily amounts of T4 required to replace T4 were established in 217 hypothyroid patients. Patients with Hashimoto's thyroiditis treated daily with 2-3 micrograms/kg lean body mass or 1-2 micrograms/kg body weight T4 had normal serum thyrotrophin (TSH) concentrations, normal response to TSH-releasing hormone (TRH) and normal systolic time intervals but doses higher than 3 micrograms/kg lean body mass or 2 micrograms/kg body weight decreased serum TSH concentrations, with no response to TRH and systolic time intervals typical of hyperthyroidism. In 13/32 (41%) hypothyroid patients with Graves' disease following 131I and/or surgery, the daily T4 replacement dose was similar to that in Hashimoto's thyroiditis patients but in 12 (38%) patients daily doses of 2-3 micrograms/kg lean body mass or 1-2 micrograms/kg body weight T4 increased serum T4 and suppressed TSH levels, and in six (9%) lower doses were required to control hypothyroidism. The T4 suppression dose for patients with thyroid cancer was more than 3 micrograms/kg lean body mass or 2 micrograms/kg body weight, whereas approximately 30% of non-toxic nodular goitre patients required less than 3 micrograms/kg lean body mass. It is concluded that replacement or suppression doses of T4 should be individually determined and that different criteria should be applied for their calculation depending on the thyroid abnormality.

Dose-Response Relationship, Drug↗

PubMedDate not supplied

[Clinical approach to the treatment and adverse side-effects of antithyroid drugs (author's transl)].

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Adult↗