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Biomedical subjects

Zbigniew Stanisław Herman

Publications and source records attributed to Zbigniew Stanisław Herman.

At least 19 recordsLinked to original sources
PubMed2006

[Thyroid hormone resistance syndrome].

Resistance to thyroid hormones (RTH) is an inherited syndrome characterised by reduced target tissue responsiveness to these hormones. In the recent years, it has become clear that RTH is probably much more common than is generally recognised, and is often misdiagnosed and inaccurately treated. Subjects suffering from RTH have raised serum thyroid hormone levels and raised or inappropriately normal thyrotropin levels. Two major forms of a clinical presentation of this disorder are asymptomatic or slightly symptomatic subjects with generalised resistance and patients with thyrotoxic features suggesting predominant pituitary resistance. Surprisingly, these various clinical situations are determined by the same genetic defect. In this paper, aetiology, symptoms, clinical classification, diagnosis and treatment of RTH are reviewed with putting special emphasis on the results of recently published studies.

Diagnosis, Differential↗
PubMed2006

[Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency].

Congenital adrenal hyperplasia is a general term applied to a group of several inherited enzymatic defects of cortisol biosynthesis. The most frequent cause of this disease is by far 21-hydroxylase deficiency which is considered one of the commonest metabolic disorders. The degree to which the activity of this enzyme is diminished correlates with the severity of congenital adrenal hyperplasia and therefore the clinical presentation of 21-hydroxylase deficiency has a wide spectrum of clinical and laboratory abnomalities. The recent developments have improved prenatal diagnosis and treatment of affected females to minimise genital virilisation. Despite progress made in its recognition and treatment, diagnosis and management of 21-hydroxylase deficiency is still the subject of many debates and controversies. In this paper, aetiology, symptoms, diagnosis and treatment of 21-hydroxylase deficiency in various groups are reviewed with putting special emphasis on the results of recently published studies.

Adrenal Hyperplasia, Congenital↗
PubMed2006

[Normoaldosterone spironolactone sensitive hypertension].

We report the case of normoaldosterone spironolactone sensitive hypertension. Patients suffering from this recently identified form of arterial hypertension exhibit clinical symptoms resembling the symptoms of primary aldosteronism. The described disturbances may be misdiagnosed as essential hypertension because plasma aldosterone levels and aldosterone/renin ratio in patients are within the normal ranges. In the described state of the examined female, detection of the disease and implementation of spironolactone treatment not only normalised arterial blood pressure but also allowed to avoid unnecessary administration of many antihypertensive agents.

Aged↗
PubMed2006

[Precocious puberty].

Precocious puberty is usually defined as the appearance of secondary sexual development before the age of 8 years in girls and 9 years in boys. Precocious puberty is a heterogenous condition generally divided into central and peripheral forms driven respectively by hypothalamic-pituitary axis or by excessive production of sex steroids. Taking into account the risk associated with the underlying disorder as well as the impact of precocious puberty on stature growth and development of reproductive and mental functions, this condition has important consequences for affected children and their families. In this paper, the pathophysiology, clinical presentation, laboratory and radiological features, and treatment of the disorders leading to precocious puberty are reviewed. Particular attention is devoted to the results of the recently published studies.

Child↗
PubMed2006

[Postparum thyroiditis].

Postpartum thyroiditis is one of the most common endocrinological disorders annually affecting millions of women world-wide. It is is defined as a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery. A thyrotoxic phase of postpartum thyroiditis may be brief and unnoticed before a more long-lasting (permanent in up to 30%) hypothyroid phase occurs. The disease, found in approximately 5-10% of mothers in the general population, is an autoimmune disorder, and thyroid antibody-positive women in the first trimester have a 33% to 50% chance of developing thyroiditis in the postpartum period. Women suffering from other autoimmune conditions, or having a previous or family history of thyroid disease are at increased risk of its development. In this paper we present an overview of the pathogenesis, clinical aspects, diagnosis, and treatment options for postpartum thyroiditis with putting special emphasis on the results of recently published studies.

Diagnosis, Differential↗
PubMed2006

[Markers of inflammatory process in stable and unstable coronary artery disease].

Clinical studies performed in last few years proved great role of inflammatory processes in development of atherosclerosis. Inflammatory markers indicating unstable atherosclerotic plaque were isolated. These biomarkers are used in diagnostics and identification of patients with unstable angina pectoris and miocardial infarct. Moreover usefulness of proinflammatory markers in indicating patients with high cardiovascular risk was confirmed. In result different markers of inflammation found their use in diagnostics of patients with stable and unstable coronary artery disease.

Angina Pectoris↗
PubMed2006

[Incidentaloma--one of the greatest challenges of modern endocrinology].

Technological advance of the recent years has contributed to the development of the situation during which clinically inapparent masses are discovered in endocrine organs by high-resolution radiological imaging procedures that have been performed for other reasons. Most of these lesions, frequently referred to as incidentalomas, are clinically insignificant benign and hormonally inactive adenomas that neither pose a risk to a patient's health nor warrant the risks of further diagnosis and treatment. One of the greatest challenges of modern endocrinology is to distinguish the vast majority of clinically insignificant changes from other masses requiring further management such as hormone-secreting tumours and malignant lesions. Over the years a myriad of the diagnostic and therapeutic approaches has been recommended and presently there are still no uniform guidelines. The purpose of his article is to give an overview on the recent advances in diagnosis and management of pituitary and adrenal incidentalomas. We provide the reader with practical recommendations and underline areas in which further studies are required.

Adrenal Gland Neoplasms↗
PubMed2005

[Anabolic therapy in osteoporosis--part 1].

Osteoporosis is one of the most important problems in developed societies. Unfortunately, all drugs available nowadays on the market exhibit antiresorptive action bringing only moderate benefits to patients suffering from this disease. For the last few years, the number of studies on the suggested use of anabolic therapy in the treatment of osteoporosis has been growing up. In the present study we describe in details sodium fluoride, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins), growth hormone, insulin-like growth factor I, and parathormone and its analogues, describing their mechanism of action and adverse effects. We also show the results of experimental studies and clinical trials in which the mentioned drugs were used. On the basis of available results we are trying to establish the exact position of anabolic agents in pharmacotherapy of osteoporosis.

Human Growth Hormone↗
PubMed2005

[Recent insights into the role of aldosterone in physiology, pathology and therapy].

Recently, it has become clear that the action of aldosterone is far more complicated than it was previously thought. Beyond regulating sodium and volume homeostasis by its epithelial action, the hormone exhibits its effects in other organs, such as the heart, blood vessels and central nervous system. Some of these actions, so called non-genomic effects, are not related to the aldosterone-induced stimulation of classical mineralocorticoid receptors. In this paper we discuss the progress made in understanding the physiological function of aldosterone and the role of its excess in the etiology of cardiovascular disorders. In the second part of this article, we provide an overview of the clinically-proven benefits of a new selective aldosterone-receptor antagonist, eplerenone.

Aldosterone↗
PubMed2005

[A rare association of postpartum thyroiditis and ulcerative colitis].

It is well known that chronic thyroiditis is frequently associated with other autoimmune disorders, but its association with inflammatory bowel diseases has rarely been described. We report a case of a 26-year-old woman, seven months after delivery, who developed a moderate attack of ulcerative colitis. Laboratory analysis, ultrasonography, anti-thyroid antibodies and cytological examination of fine needle aspiration biopsy led us to diagnose postpartum thyroiditis. The patient also presented erythema nodosum, anti-parietal cell and anti-intrinsic factor antibodies and a family history of autoimmune disorders. This case illustrates the need for clinical awareness of concomitant postpartum thyroiditis and ulcerative colitis and suggests that in patients with inflammatory bowel diseases thyroid function test should be carried

Adult↗
PubMed2005

[Gonadotropin-releasing hormone analogs].

Pituitary-gonadal axis activity depends on pulsative hypothalamic gonadotropin-releasing hormone (GnRH) secretion. Two groups of GnRH analogs, agonists and antagonists, are presently used for the treatment of clinical conditions in which modulation or interference with sex hormone production is beneficial. They are administered in assisted reproductive technologies to prevent premature luteinizing hormone surges during controlled ovarian stimulation. Due to an inhibitory effect on the growth of hormone-dependent tumors, GnRH analogs are used in the treatment of some cancers. In the present study we discuss in details both these applications. Moreover, we review the potential role of these agents in pharmacotherapy of endometriosis, uterine myomas and central precocious puberty. Based on the available literature we try to show their exact place in the medical therapy of gynecological disorders.

Endometriosis↗
PubMed2005

[Anabolic therapy of osteoporosis].

Osteoporosis is one of the most important problems in developed societies. Unfortunately, all drugs available nowadays on the market exhibit antiresorptive action bringing only moderate benefits to patients suffering from this disease. For the last few years, the number of studies on the suggested use of anabolic therapy in the treatment of osteoporosis has been growing up. In the present study we describe in details sodium fluoride, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins), growth hormone, insulin-like growth factor I, and parathormone and its analogues, describing their mechanism of action and adverse effects. We also show the results of experimental studies and clinical trials in which the mentioned drugs were used. On the basis of available results we are trying to establish the exact position of anabolic agents in pharmacotherapy of osteoporosis.

Anabolic Agents↗
PubMed2005

[Verapamil-induced hyperprolactinemia--a case report].

In many cases hyperprolactinemia can be caused by taking medications. Occasionally, verapamil-treated patients experience a slight asymptomatic increase in serum prolactin level. In this article we report the case of 42-year woman with manifest verapamil-induced hyperprolactinemia whose clinical symptoms suggested the occurrence of prolactinoma. A marked increase in prolactin levels and the preserved reactivity of this hormone in dynamic tests suggested that the patient exhibited "hypersensitivity" to verapamil. In the described state of the examined female detection of the disease, verapamil withdrawal and temporary bromocriptine administration have led to a full normalization of patient's clinical status.

Adult↗
PubMed2005

[Growth hormone deficiency in children and adults].

Recently, it has become clear that growth hormone (GH) deficiency is by far more frequent disease than it was previously thought. This disorder, associated with remarkable morbidity and mortality, is characterised by a variety of auxological, clinical, genetic, radiological and laboratory abnomalities, which may be pronounced to a different extent in patients. Despite progress made in its recognition and treatment, diagnosis of GH deficiency is still the subject of many debates and controversies. Numerous studies have helped to determine the optimum management of GH replacement in both children and adults. In this paper, aetiology, symptoms, diagnosis and treatment of GH deficiency in various age groups are reviewed with putting special emphasis on the results of recently published studies.

Aged↗
PubMed2005

[Modern pharmacotherapy of benign prostatic hyperplasia].

Benign prostatic hyperplasia is the most common medical problem affecting elderly men throughout the world. With increasing awareness of health issues amongst males, the morbidity caused by this disease is not longer being accepted as just part of growing old. Until about 10 years ago, surgery was the only effective treatment for symptomatic benign prostatic hyperplasia. Now, many men suffering from this disorder may be effectively treated with a medical therapy. This article provides an overview of the efficacy and safety of 5alpha-reductase inhibitors, alpha1-adrenoceptor antagonists and herbal remedies, putting special emphasis on the current place of these agents in the modem therapy of benign prostatic hyperplasia. Wherever possible, our opinion is based on the detailed analysis of the results of available clinical trials.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed2005

[Advance in treatment of polycystic ovary syndrome].

Polycystic ovary syndrome (PCOS) is a common endocrine disorder of uncertain origin, which has been defined as the association of androgen excess with chronic anovulation in women without specific ovarian, adrenal and pituitary gland syndromes. Recent studies have shown that PCOS is associated with hyperinsulinemia and insulin resistance and may lead to some cardiovascular diseases. Early diagnosis and therapy of this disease reduces or even reverses the reproductive and metabolic morbidities and reduces risk factors for cardiovascular disorders. The new data concerning the pathogenesis and management of PCOS have changed its treatment strategy. The management of polycystic ovary syndrome is now complex and includes life style modifications, dietary-induced weight loss, oral contraceptives, clomiphene citrate, gonadotropins, antiandrogens and insulin-sensitising agents. In this article, we review all these treatment options. Although both standard and novel therapies are discussed, special attention is paid to the progress made in the recent years.

Androgen Antagonists↗
PubMed2005

[Adipose tissue: a new endocrine organ].

In the recent years we have begun to appreciate that adipose tissue is more than just a passive repository for excess energy. It is a highly active endocrine organ secreting a range of bioactive peptides with both local and distant action collectively called 'adipokines' or 'adipose tissue hormones'. They include leptin, adiponectin, resistin, acylation-stimulating protein (ASP), plasminogen activator inhibitor-1 (PAI-1), tumor necrosis factor alpha (TNFalpha), interleukin 6, and angiotensinogen. Some of these are specific fat-related hormones that are involved in regulating energy homeostasis, carbohydrate and lipid metabolism, vascular homeostasis and immune response. Moreover, the tissue is implicated in the metabolism of some steroid hormones. Disturbances in adipokine production may have potential repercussions in the pathophysiology of obesity, insulin resistance, and dyslipidemia. Reversal or alleviation of these changes seem to be a promising target for management of the mentioned disorders. The objective of this review is to summarise the most important aspects of biology, actions and regulation of these hormones with a special emphasis on the most recent literature.

Acylation↗