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Biomedical subjects

M L'Hermite

Publications and source records attributed to M L'Hermite.

At least 37 records · Page 2Linked to original sources
PubMed1983

Exploration of hirsutism: elements for a strategy.

50 women complaining of hirsutism were investigated in order to establish an optimal strategy for hirsutism exploration. Basal hormonal evaluations were of great value, especially serum testosterone and, to a lesser degree, DHA-S and LH. LH response to LHRH stimulation appeared of little diagnostic value. ACTH stimulation tests may be useful in detecting enzyme deficiencies in patients with normal basal values. The origin of hyperandrogenism can hardly be detected by the inhibition tests. However, these tests allow to determine whether the androgen secretion is still under ACTH and/or LH control.

Adolescent↗
PubMed1983

Dopaminergic regulation of prolactin secretion in the hyperprolactinemic syndrome.

The prolactin responses to an oral challenge of L-dopa (0.5 g) and bromocriptine (2.5 mg) were studied in 31 hyperprolactinemic females without radiological abnormalities of pituitary fossa, in 12 hyperprolactinemic patients with minor radiological evidence suggesting the presence of a pituitary adenoma and in 16 normal volunteers in the early puerperium with physiological hyperprolactinemia. Administration of bromocriptine was followed by a similar suppression of prolactin secretion in the functional as well as the adenomatous hyperprolactinemic patients. By contrast, a significantly blunted response to L-dopa was noted in the patients with pathological hyperprolactinemia (with and without radiological abnormalities of the pituitary fossa). These results suggest that the L-dopa suppression test might serve as a reliable indicator to detect prolactin-secreting microadenomas in patients with persistent hyperprolactinemia and radiologically normal pituitary fossae.

Adenoma↗
PubMed1983

Treatment of hyperprolactinaemic patients with pergolide.

Eighteen hyperprolactinaemic patients were orally treated for up to 16 months with pergolide mesylate, a new potent long-lasting dopaminergic ergot derivative. In all cases, Prl normalization (less than 25 ng/ml) was achieved at a once-a-day dose of 50-300 micrograms. All women recovered and/or exhibited normal menstrual function. Among the 6 women wishing to become pregnant, 4 of them conceived within 4 months; there were other causes for infertility than hyperprolactinaemia in the 2 other couples. A macroprolactinoma man experienced important improvement in well-being as well as objective regression of his visual fields defect. This suggests a shrinkage effect of pergolide on the tumoural process. Another man regained normal potency and normal testosterone within 2 weeks. While 10 patients were completely free of any side effect, 7 experienced transiently mild gastro-intestinal side effects or postural hypotension. Only one patient discontinued her treatment because of dizziness. The present study demonstrates the high potency, the good tolerance and the excellent efficacy of pergolide in the treatment of hyperprolactinaemia.

Adolescent↗
PubMed1982

Potent 48 hours inhibition of prolactin secretion by pergolide in hyperprolactinaemic women.

The duration of the inhibition of Prl secretion by pergolide, a new dopaminergic ergoline, was investigated in 5 hyperprolactinaemic women after a single oral 50 micrograms dose. In each subject, blood samples were collected every 2 h for 18-24 h to establish baseline Prl level and then every 3 h for 48-51 h after pergolide administration. In each subject, levels were potently suppressed by at least 80% of baseline and brought down to the normal range. Prolactin suppression was quite sustained throughout the study period in 4 patients and to a lesser degree in the remaining subject. This potent long-lasting inhibition of Prl secretion should enhance the efficacy and acceptability of the chronic treatment of hyperprolactinaemia with this new dopamine agonist and, for example, allow drug intake only once every other day.

Adolescent↗
PubMed1981

Bromocriptine compared to long-acting estrogens in lactation prevention: clinical efficacy, prolactin secretion and coagulation parameters.

Sixty-eight mothers who did not want to breast-feed their babies were submitted to one of the following regimes: an intramuscular injection of estrogen (25 mg) within 1 h after delivery (n = 24) or the administration of bromocriptine for 15 or 23 days (n = 21 and 23, respectively). A careful clinical evaluation was performed every day by the same examiner during the first 7 days postpartum; blood samples were collected on days 0, 3 and 5 for human prolactin (hPRL) and estradiol, also in some cases on day 17; assays were measured by radioimmunoassay. An evaluation of the coagulation parameters was performed on day 5 in 9 estrogen-treated patients and in 25 bromocriptine-treated patients. Only 5 (11%) out of the 44 patients treated with bromocriptine experienced at least one undesirable effect of breast engorgement, in contrast to 16 (67%) out of the 24 estrogen-treated patients; this difference was statistically highly significant (P less than 0.001). Dizziness was a significant side-effect of bromocriptine treatment, occurring in 20% of the cases. In the patients in whom the administration of bromocriptine was withdrawn after 15 days, a significant mean rebound elevation of hPRL levels above the normal range occurred on the 17th day. The latter observation gives some support to earlier proposals to continue bromocriptine for up to a total 3 wk in order to avoid rebound lactation. There was no significant alteration of fibrinogen, Howell time, activated partial thromblastin time (APTT), prothrombin time (PT), thrombin time and coagulation time; mean plasminogen levels were comparable in both treated groups, while mean antithrombin III levels were increased in the bromocriptine-treated group. The significance of the latter finding requires further evaluation.

Antithrombin III↗
PubMed1980

[Clinical study of veralipride in menopausal sudden flushes (author's transl)].

A double-blind clinical study was conducted to compare the therapeutic activity of veralipride and placebo in menopausal sudden flushes. Comparison of final numerical rate showed a statistical significant superiority for veralipride. Tolerance was excellent and no significant difference was observed between clinical side effects, or biological parameters studied (blood counts and differential, and blood bilirubin, transaminases, glucose, cholesterol, or creatinine levels) in the two groups.

Adult↗
PubMed1979

Prolactin response to TRH in diabetic ketoacidosis.

The prolactin response to 200 microgram thyrotropin-releasing hormone (TRH) IV was studied in seven patients with diabetic ketoacidosis, at the start of the treatment, and again, in the same patients, five days after recovery, when the diabetes was well controlled. Normal basal prolactin concentrations and prolactin responses to TRH were found in both situations. There was no correlation between basal prolactin concentrations, or magnitude of prolactin responses to TRH, and any of the metabolic variables measured. These findings do no suggest a role for prolactin in the development of diabetic ketoacidosis.

Adult↗
PubMed1979

Unaltered basal prolactin secretion during short-term oestriol treatment in post-menopausal women.

Six post-menopausal women were submitted, at 1 month interval, to oral oestriol treatment for 14-day periods at daily doses of 2 and 6 mg. Blood samples were collected for LH, FSH and PRL measurements (by RIA) every other day during treatments as well as during a 14-day control period. Through the effect on LH levels was questionable, oestriol resulted in a clear and significant, although moderate, gradual decrease of mean FSH levels. At the doses used, which are effective in thetreatment of menopausal symptoms, but are devoid of any proliferative effect upon the endometrium, oestriol failed to induce any stimulatory effect on basal PRL secretion in these post-menopausal women.

Estriol↗
PubMed1979

Effect of cyproheptadine on thyrotrophin and prolactin secretion in normal man.

In order to investigate the effect of cyproheptadine, a compound with antiserotoninergic activity, on the secretion of thyrotrophin (TSH) and prolactin (PRL), the nocturnal secretory patterns of these hormones have been studied in 4 normal men in the basal state and after an oral treatment with the drug. In addition, the TSH and PRL responses to TRH of 6 women were compared in the basal conditions and after cyproheptadine treatment. The TSH nocturnal secretion was slightly modified by drug treatment. The response to TRH as well as the basal levels were comparable in the treated and non-treated subjects. In contrast, the PRL secretion measured through the nocturnal investigation was significantly inhibited by cyproheptadine administration as were the PRL basal levels in the TRH test. The PRL response to TRH was comparable in both situations.

Adult↗
PubMed1979

Tiapride-induced chronic hyperprolactinaemia: interference with the human menstrual cycle.

Four regularly menstruating volunteers were submitted to an oral treatment, for 3 consecutive cycles and starting on the first day of a cycle, with tiapride at daily doses ranging from 1 x 100 mg to 2 x 100 mg. The first and the last cycle under treatment, as well as a prior control cycle, were thoroughly studied by means of daily measurements of blood concentrations of LH, FSH, prolactin (PRL), oestradiol and progesterone. Tiapride, a benzamide derivative with dopaminergic blocking activity at the level of the lactotrophes, increased mean PRL secretion in each subject but a permanent hyperprolactinaemia above 700 uU/ml was attained only in one subject. Despite these widely fluctuating PRL levels in most subjects, the resulting overall hyperprolactinaemia induced in all cases a progressive deterioration of the function of the corpus luteum: 5 cycles showed luteal phases reduced by 2--5 days, one cycle was characterized by some slight luteinisation but questionable ovulation and the 2 remaining cycles were anovulatory. The interruption of drug intake one week after the onset of menses led thereafter to a cycle with a likely inadequate luteal phase but of normal length. It is concluded that even a non-permanent hyperprolactinaemia can impair the normal function of the hypothalamo-pituitary-ovarian axis, as well as exhibit some effects in a cycle consecutive to the normalization of PRL. With the exception of the impaired luteal progesterone secretion, the pooled hormonal data from the short luteal phase cycles under tiapride-induced hyperprolactinaemia exhibit very little significant differences, as compared to the corresponding values in the control cycles. Some delay in the onset of follicular maturation, however, should be assumed since the follicular phase had been lengthened by 1 to 31 days in 5 of the 6 cycles with luteinisation during treatment. The present results are compatible with a double impact -- both at the ovarian and the hypothalamo-pituitary levels -- of hyperprolactinaemia in its mechanisms of impaired function of the hypothalamo-pituitary ovarian axis.

Administration, Oral↗
PubMed1978

Acute endocrine profile of sulpiride in the human.

Normal men and normally menstruating women received i.m. injections of 0.1 to 4.0 mg/kg sulpiride. This psychotropic drug induced a very rapid (already significant after 5 minutes) and sustained (still significant after 7 hours) elevation of prolactin (PRL) concentrations in all subjects with no consistent modification of LH and FSH. After injection of 4.0 mg/kg, there was similarly no modification of mean TSH concentrations in the women tested in the luteal phase, as well as of mean GH levels in men. Sulpiride prevented the inhibitory effect on PRL levels of 500 mg levodopa, administered orally simultaneously; levodopa administered 2 hours prior to sulpiride failed to counteract the PRL-stimulatory effect of sulpiride. Under chronic sulpiride-induced hyperprolactinaemia, levodopa exhibited however a very slight inhibitory effect on PRL concentrations. These data are in agreement with the hypothesis that sulpiride acts mainly at the pituitary level by blocking dopamine receptors of the lactotropes and support the concept that the menstrual cycle perturbations observed under chronic sulpiride administration result from hyperprolactinaemia itself or from a mechanism quite similar to that by which sulpiride induces hyperprolactinaemia.

Adolescent↗
PubMed1978

Simultaneous study of cortisol, growth hormone and prolactin nyctohemeral variations in normal and obese subjects. Influence of prolonged fasting in obesity.

Hourly integrated concentrations (IC) of growth hormone (GH), prolactin (PRL) and cortisol were determined by a continuous sampling procedure in six obese women, before and at the end of a 12 day fast, and in eight normal controls under basal conditions. Hormonal 24 h IC and nyctohemeral variations were calculated from these data. Nyctohemeral rhythms were investigated by the periodogram method. A significant increase over basal values of 24 h IC of PRL, GH and cortisol was observed at the end of the fasting period. Nyctohemeral variations--but not nyctohemeral rhythm--of IC-GH were found in normal subjects. They were abolished in obese patients under basal conditions but restored during fasting. The circadian rhythm of cortisol was not altered in obesity. A shift of the normal nyctohemeral rhythm of PRL was observed in obese patients, but the normal pattern was restored during fasting.

Adult↗