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Biomedical subjects

R P Shearman

Publications and source records attributed to R P Shearman.

At least 55 records · Page 3Linked to original sources
PubMed1980

Incidence of the respiratory distress syndrome in infants of diabetic mothers--perinatal influences.

This survey of 73 infants of insulin dependent (ID) diabetic mothers and 70 infants of gestational diabetics (GD) born at King George V Memorial Hospital between January, 1968 and December, 1975, showed that all 12 babies with RDS were from the ID group. RDS was the cause of all 6 neonatal deaths and together with the 5 stillbirths gave this high risk group a 15% mortality rate. Since no deaths occurred in the GD group, the overall mortality was 8%. In the 6 years, 1970-1975, RDS occurred 21 times more often in babies of ID mothers than in control babies born to non-diabetics. Babies born to ID mothers were of significantly lower mean gestational age than those born to the GD mothers. Within the ID group, those babies with RDS were of significantly lower gestation than those without and the mean gestation was similar to control babies with RDS. Provided the diabetes is controlled and fetal welfare ensured, later delivery, following documentation of lung maturity, may lower the incidence of RDS and therefore perinatal mortality and morbidity.

Diabetes Complications↗
PubMed1980

Is diagnostic gonadotrophin stimulation useful?

Urinary excretion of oestrogens in response to stimulation with a standardized dose of gonadotrophin has been used previously in the differential diagnosis of oligomenorrhoea/amenorrhoea. Patients with polycystic ovarian disease were said to have a characteristic excessive response. In the present study, some patients with laparoscopically proven polycystic ovaries did not show such an excessive response, while others with laparoscopically normal ovaries did. A high LH/FSH ratio correlated well with the laparoscopic finding of polycystic ovaries. It is concluded that where there are adequate facilities for diagnostic laparoscopy and determination of plasma gonadotrophins, there is no further place for the routine use of the standardized gonadotropin stimulation test in the evaluation of suspected polycystic ovarian disease.

Adult↗
PubMed1979

Rate of metabolism of norethisterone in women from different populations.

The rate of metabolism of orally administered norethisterone was compared in fourteen centres by measuring plasma levels of the steroid by radioimmunoassay at varying times after oral administration of a 1 mg dose. The inter-centre differences were of the same order as the intra-centre differences. Variations in metabolism appeared not to be due to variations in body size.

Adult↗
PubMed1979

Prostaglandin F2 alpha-induced prolactin release and luteolysis in the goat.

Injection of prostaglandin F2 alpha (PGF2 alpha) initiated a significant increase in plasma prolactin levels in all goats except those in anoestrus. Luteolysis occurred in non-pregnant goats during the mid luteal phase when the goats were given PGF2 alpha either with or without the suppression of prolactin release by bromocryptine (CB154). Luteolysis and subsequent parturition also occurred in pregnant goats in mid and late gestation after PGF2 alpha injection, with an associated release of prolactin and decrease in plasma progesterone. Acute prolactin release in response to injection of thyrotrophin releasing factor may have had a transient effect on plasma progesterone levels, but did not appear to be luteolytic in either pregnant or non-pregnant goats.

Anestrus↗
PubMed1979

Antecedent factors and outcome in amenorrhea-galactorrhea.

One hundred seventeen patients with amenorrhea and galactorrhea or hyperprolactinemia were evaluated with regard to antecedent factors, results of investigations, and management. Full details of the outcome of prolonged follow-up were available for 104 patients. Patients who developed amenorrhea-galactorrhea after withdrawal of oral contraceptives or postpartum had a lower incidence of pituitary adenomas than did those who developed amenorrhea-galactorrhea spontaneously. Six of a total of 40 tumors were detected only during the follow-up period. This study suggests that patients with spontaneous amenorrhea-galactorrhea have a greater risk of developing a detectable pituitary adenoma than do those with postpill or postpartum symptoms. However, patients with a microadenoma are more likely to have had postpill onset of hyperprolactinemia. Plasma prolactin (PRL) in patients with postpill amenorrhea-galactorrhea increased in proportion to the duration of oral contraceptive use.

Adenoma↗
PubMed1978

Comparative studies on two combination oral contraceptives, one containing synthetic estrogen, the other "natural" estrogens.

Two combined oral contraceptives, one containing ethinyl estradiol and the other micronized estradiol and estriol, were compared by measuring a variety of endocrine and renal parameters over nine months. Significant changes were observed in plasma renin activity (P.R.A.) on the synthetic estrogen. Much larger changes were observed in the total urinary estrogens on patients taking the "natural" estrogens reflecting the amount of estrogens required to be excreted in the urine.

Adult↗
PubMed1978

Plasma prolactin levels and ovarian responsiveness to exogenous gonadotropins.

Standard gonadotropin stimulation tests of ovarian function and basal plasma prolactin measurements have been carried out in 151 patients with amenorrhea or severe oligomenorrhea. In 90 of these a standardized multiple pituitary stimulation test, including the prolactin response to thyrotropin releasing hormone, was also performed. There was a tendency for the basal estrogen excretion and the ovarian response to gonadotropin to be lower in patients with hyperprolactinemia. These correlations were weak and did not reach the levels of statistical significance except when compareing the ovariance response in patients with mild hyperprolactinemia to those with moderate or severe hyperprolactinemia. It is concluded that, in women, elevated plasma prolactin levels have little, if any, direct inhibitory influence on the ovariance response to gonadotropins in vivo.

Female↗
PubMed1978

Characteristics of an antiluteinizing hormone isoantibody produced during gonadotropin induction of ovulation.

Production of an antihuman LH antibody was suspected in a woman with isolated LH deficiency who received human pituitary gonadotropin (hPG) to induce ovulation and who developed secondary drug failure associated with very high "serum LH' values. Binding of [125I]LH to various dilutions of the patient's serum was demonstrated by precipitation with polyethylene glycol or sheep antihuman immunoglobulin G (anti-IgG) but not by precipitation with sheep antihuman immunoglobulin M (anti-IgM). Unlabeled LH competitively displaced [125I]LH from a 1:200 final dilution of the patient's serum, and indicated a single class of binding sites with a binding affinity of 1.5 X 1011 M-1 and a binding capacity of 84 ng LH/ml serum. The isoantibody was reactive against antigenic determinants in hPG, LH, and hCG but not against human FSH. Further examination showed binding to the beta, but not the alpha, subunit of two LH preparations and to beta hCG. It is concluded that repeated administration of hPG to this patient with isolated LH deficiency evoked IgG isoantibody formation against the beta subunit of LH.

Adult↗
PubMed1977

Impact of new diagnostic methods on the differential diagnosis and treatment of secondary amenorrhoea.

The development of homologous prolactin assays, multiple pituitary stimulation, tomography, and computerised axial tomography permit more detailed investigation of patients with secondary amenorrhoea than was formerly possible. 39% of 90 patients with secondary amenorrhoea had hyperprolactinaemia. 10 patients (11% of total) had pituitary tumours. 8 of these women had galactorrhoea (27% of those with galactorrhoea). For patients with hyperprolactinaemia but no tumour, bromocriptine is the treatment of first choice rather than clomiphene or human gonadotrophins. The best treatment for patients with detectable tumour is controversial, particularly when the tumour is confined to the sella turcica. Whether or not these tumors are true neoplasms remains to be determined. Clinically, a history of secondary anemorrhoea with or without galactorrhoea following withdrawal of oral contraceptives remains the commonest presenting syndrome.

Amenorrhea↗