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At least 595 records · Page 33Linked to original sources
PubMed1997

Interleukin-8 secretion in patients with allergic rhinitis after an allergen challenge: interleukin-8 is not the main chemotactic factor present in nasal lavages.

BACKGROUND: Interleukin-8 (IL-8) is a chemotactic cytokine for neutrophils and primed eosinophils. In allergic rhinitis, allergen exposure triggers leucocyte recruitment. OBJECTIVE: We evaluated in this study IL-8 secretion and the neutrophil chemotactic activity in nasal lavages collected after a nasal allergen challenge. Moreover, the participation of IL-8 in the neutrophil chemotactic activity was quantified. METHODS: Four healthy subjects and 19 patients with allergic rhinitis were exposed to a nasal allergen challenge. As a control, saline challenge was performed in four patients with allergic rhinitis. Concentration of IL-8 was measured by ELISA in nasal lavages collected before and after challenge. Neutrophil chemotactic assay was developed using a 48-well chemotaxis microassembly. RESULTS: After allergen challenge, the healthy subjects, the four patients receiving saline and one patient exposed to allergen did not respond; seven patients presented a single early reaction and 11 patients a dual response. For healthy subjects and the four patients exposed to saline, the level of IL-8 did not increase after challenge in comparison with that at baseline. After allergen challenge, two peaks of IL-8 release were observed for patients with allergic rhinitis during the early (30 min to 1 h 30 min) and the late periods (3 h 30 min to 9 h 30 min), however the difference was not significant for the early period. During the late period, a significant increase in IL-8 concentrations was detected for the patients developing a dual response, whereas the difference was not significant for those presenting only an early reaction. The neutrophil chemotactic activity of nasal lavages from patients with allergic rhinitis collected during the early and the late reactions (17 +/- 2.1 and 23.3 +/- 2.8 neutrophils per high power field (hpf), respectively) was significantly higher than the activity of lavage fluid collected at baseline (9.2 +/- 1.8 neutrophils per hpf). Nevertheless, the addition of a neutralizing anti-IL-8 antibody inhibited weakly the chemotactic activity of lavage fluid from rhinitic patients collected during the early or the late periods (18 and 11% of inhibition) (P = NS). CONCLUSION: These data show that allergen challenge increased significantly the secretion of IL-8 for the patients with allergic rhinitis. However, neutralization of IL-8 in nasal lavages by a specific antibody revealed that the role of this chemokine in granulocyte infiltrate was limited, suggesting that IL-8 acts in connection with other chemotactic factors in this recruitment.

Adult↗
PubMed2003

Cytomegalovirus and Epstein-Barr virus active infection in periapical lesions of teeth with intact crowns.

Herpesviruses seem to play an important role in the pathogenesis of aggressive periodontitis and may also contribute to periapical pathosis. This study determined the presence of human cytomegalovirus, Epstein-Barr virus, and herpes simplex virus productive infection in five symptomatic periapical lesions of teeth having intact crowns and calcified necrotic pulps. Periapical samples were collected in conjunction with periapical surgery and kept frozen until virological examination. Reverse transcription-polymerase chain reaction was used in herpesviral identification. RNA was isolated from periapical tissue by a guanidinium isothiocyanate-acid phenol procedure. cDNAs were generated from highly conserved regions of the test viruses using a preamplification kit. Sensitivity and validity of the PCR-primers were determined according to established methods. Amplification products were identified using gel electrophoresis. Human cytomegalovirus and Epstein-Barr virus dual transcription was detected in all five periapical lesions studied. Herpes simplex virus transcript was not identified in any lesion. The present data suggest that human cytomegalovirus or Epstein-Barr virus activation participate in the pathogenesis of symptomatic periapical lesions. We hypothesize that periapical active herpesvirus infection impairs local defenses, thereby inducing overgrowth of endodontopathic bacteria and the clinical flare-up of inflammation.

Cytomegalovirus↗
PubMed1999

Radial and metacarpal bone mineral density and calcaneal quantitative ultrasound bone mass in normal Japanese women.

Nationwide data on bone mass were collected from 33,992 subjects who underwent screenings for osteoporosis at 65 health care centers in 11 prefectures in Japan. Reference values in Japanese women were evaluated by the four convenient methods frequently used for the screening of osteoporosis based on healthy subjects, defined by their medical history. In addition, the prevalence of low bone mass was estimated in subjects 40 years or older by the four methods. Compared with the young normal subjects aged 20-29 years old, bone mass decreased after 30, 40, and 50 year in the calcaneus by quantitative ultrasound densitometry, the radius by dual energy X-ray absorptiometry (DXA), and the metacarpus by computed X-ray densitometer and digital image processing. The prevalence of a T-score <-1 was relatively similar (45.6-65.5% in the fifth decade and 81.3-94.3% in sixth) in each decade among the four methods. However, the use of a T-score </=-2.5 resulted in a marked difference in the prevalence (5.2-23.5% in the fifth decade, and 18. 7-67.9% in the sixth) among the methods. The cutoff value of bone mass at a T-score -2.5 was greater than the lowest quintile value of the fifth decade in radial bone mineral density (BMD), between the lowest quintile values of the fifth and sixth decades in the two metacarpal methods, and less than the value of the sixth decade in the calcaneal Stiffness index.

Absorptiometry, Photon↗
PubMed1989

Evaluation of white lupines and triticale in calf starter diets.

One hundred fifty-two Holstein calves were used to evaluate white lupines (Lupinus albus cv. Ultra) and triticale in starter diets. The basal diet contained corn, oats, minerals, and vitamins. Starter components were 1) 14% soybean meal; 2) 10% soybean meal and 27% triticale; 3) 22% lupines; 4) 16% lupines and 24.5% triticale; 5) 11% lupines and 8% soybean meal; and 6) 7% lupines, 5% soybean meal, and 26.5% triticale. Dietary CP was approximately 16% of DM. Data collection began on d 4 after birth and continued through d 56. Calves were fed 3.6 kg of fermented colostrum from d 4 to 14 and 4.5 kg of fermented whole milk from d 15 to weaning at d 28. Starter diets and water were offered for ad libitum consumption from d 4 to 56. Dietary treatment had no effect on starter intake or weight gains. Average total gains during the experimental period were 25.6, 23.0, 23.3, 23.2, 25.0, and 21.6 kg for treatments 1, 2, 3, 4, 5, and 6, respectively. Calf health was excellent. Starter diets were examined in a dual flow continuous culture system to evaluate fermentation by rumen bacteria. Digestibilities of DM, organic matter, and total nonstructural carbohydrate did not differ among treatments. Ammonia N concentrations ranged from 11.9 to 13.8 mg/100 ml effluent. Chemical composition of bacteria, efficiency of bacterial protein synthesis, total VFA concentration in the effluent, and amino acid flow were similar for all treatments. The results indicate that lupines and triticale are satisfactory for use in calf starters when included in amounts equal to or less than those used in this experiment.

Animal Feed↗
PubMedDate not supplied

[Prevalence of tuberculosis and HIV infections among participants in an intravenous drug user risk-control program].

BACKGROUND: To determine the prevalence of tuberculosis and HIV infection in addition to the related factors among a population of participants in the risk control program in the town of Lleida. METHODS: The sample was comprised of the newly-enrolled participants in the program in April-June 1996, among whom a questionnaire was handed out for collecting the data concerning the variables involved: age, gender, results of the tuberculin test, BCG vaccination, knowledge of the serology regarding HIV, former imprisonment and number of years having used heroin. The prevalence of the tuberculosis and HIV infection was calculated to a 95% confidence interval (CI). The relating of these two variables to all other variables in the study was determined by means of the odds ratio (OR) and its 95% CI. RESULTS: One hundred and fifty (150) patients were seen, 45 of whom were newly enrolled participants. Eighty percent (80%) were males, averaging 31.1 years of age. The prevalence of this dual infection was 8.9% (95% CI 2.8-22.1). The prevalence of the tuberculosis infection was 27.3% (95% CI 12.4-43.0), being higher among former prison inmates (OR = 3.4; 95% CI 0.5-27.4). The prevalence of the HIV infection was 36.1% (95% CI 21.3-53.8), being greater among those who had been using heroin for longer than 11 years (OR = 7.3; 95% CI 1.0-65.9). CONCLUSIONS: Former imprisonment is the main risk factor for tuberculosis infection. The number of years of heroin use are related to the HIV infection, especially when longer than 11 years. The risk control programs in our country should carry out activities aimed at monitoring tuberculosis and HIV infection.

AIDS-Related Opportunistic Infections↗
PubMed2002

An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture.

Patients with an osteoporotic fracture have at least a 2-fold risk for additional fracture and should benefit from targeted diagnostic and treatment procedures for osteoporosis. To address this issue, we set up an osteoporosis clinical pathway (OCP) for the medical management of patients with low-trauma fracture. Following acute management of the fracture by the orthopedic team, patients are enrolled in the pathway, which is based on an interaction between the OCP multidisciplinary team, orthopedic surgeons and/or primary care physicians. After collection of patient data, suggestions for additional diagnostic examinations with their interpretation, and treatment proposals are made. Patients and their families are also invited to attend a multidisciplinary interactive educational program on physical therapy, lifestyle habits and nutrition. During a 36-month period, 385 patients (311 women, 74 men; mean age +/- SD: 73.0 +/- 13.5 years; hip fracture 45%, ankle/tibia 24%, proximal humerus 8.6%, spine 5.5%, pelvis 3.9%, distal forearm 3.6%, other sites 17.4%) were enrolled in the OCP. An osteoporosis awareness questionnaire administered within 10 days of fracture showed that 73% of patients believed that their fracture was not related to the disease. Dual-energy X-ray absorptiometry, performed in 63% of patients, showed that 86% had low bone mass or osteoporosis. Specific antiosteoporotic therapy was proposed for 33% of patients in addition to calcium and vitamin D supplements, the latter suggested for 93%. A survey performed in 216 patients 6 months later, indicated that 63% of the suggested treatments had been prescribed and that 67% of this group were continuing treatment. Such a clinical pathway for the medical management of low-trauma fracture can help to identify patients with osteoporosis in a high-risk population, provide support to the orthopedic surgeon and/or the primary care physician for diagnostic and treatment procedures, and should significantly contribute to increase awareness of the disease in patients and their families.

Accidental Falls↗
PubMed1987

Intellectual functioning and aggression.

In a 22-year study, data were collected on aggressiveness and intellectual functioning in more than 600 subjects, their parents, and their children. Both aggression and intellectual functioning are reasonably stable in a subject's lifetime and perpetuate themselves across generations and within marriage pairs. Aggression in childhood was shown to interfere with the development of intellectual functioning and to be predictive of poorer intellectual achievement as an adult. Early IQ was related to early subject aggression but did not predict changes in aggression after age 8. On the other hand, differences between early IQ and intellectual achievement in middle adulthood were predictable from early aggressive behavior. A dual-process model was offered to explain the relation between intellectual functioning and aggressive behavior. We hypothesized that low intelligence makes the learning of aggressive responses more likely at an early age, and this aggressive behavior makes continued intellectual development more difficult.

Achievement↗
PubMed2005

Application of fractal flocculation and vertical transport model to aquatic sol-sediment systems.

In estuarine and coastal environments, flocculation occurs between particles of different fractal dimensions and of different densities. Questions remain concerning the level of detail required to model particle flocculation and settling in these heterogeneous systems. This paper compares the goodness of fit between two flocculation models, using measured time series particle size distribution data collected from clay, colloidal silica, emulsified crude oil, clay-crude oil, and silica-crude oil systems. The coalesced sphere (CS) flocculation model includes the effects of heterogeneous particle size and density; the modified coalesced fractal sphere (mCFS) model adds effects due to heterogeneous fractal dimension. Goodness of fit was quantified using values of a minimized objective function, the mean of the sum of the square of the relative residuals (MSSRR). For nearly all tested experimental conditions, MSSRR values varied less than 5% between the CS and mCFS flocculation models. Additionally, collision efficiency values for single-particle-type (alpha(HOMOO)) and dual-particle-type (alpha(HETT)) systems were obtained through parameter regression using the CS and mCFS models. Using the mCFS model, estimated fractal dimension (D) values obtained for clay and clay-oil systems were between 2.6 and 3.0, lower than that postulated by the CS model but higher than that estimated experimentally by the particle concentration technique. The Stokes settling velocity of a clay aggregate of a given mass is reduced with decreased fractal dimension. This results in clay-oil flocculation occurring faster than floc sedimentation in the studied hydrodynamic range. Thus, the mCFS model provides insights to the fate of spilled oil in inland and coastal waters.

Aluminum Silicates↗
PubMed1999

Spaceflight effects on structural and some biochemical parameters of Brassica rapa photosynthetic apparatus.

Chloroplasts play a crucial role in sustaining life on Earth by their dual property in performing the primary fixation of carbon and also in releasing oxygen for use in respiration. Collection of light and its transformation into chemical energy occurs in a thylakoid membrane which is one of the most remarkable transducing systems in the biological world. In order for the light-dependent reactions could take place, a high degree of molecular organization of its constituents is needed. Some results obtained in the framework of the Collaborative Ukrainian Experiment mission (STS-87) which was performed on board of the space shuttle "Columbia" are presented in the given paper. A goal of the study was to obtain data on some parameters of photosynthetic apparatus, namely the chloroplast structure, pigment content and lipid composition of Brassica rapa plants grown in microgravity.

Brassica↗
PubMed1993

[Dual-energy data acquisition for simultaneous 81mKr ventilation/99mTc-MAA perfusion SPECT: ventilation/perfusion ratio mapping in cross section].

Methods of simultaneous pulmonary ventilation/perfusion (V/Q) tomogram (SPECT) for V/Q ratio mapping were reported. Crosstalk was corrected by subtraction assuming crosstalk/signal ratio is constant for an individual examination. Crosstalk was reduced by 85% for that of 99mTc-to-81mKr window (R12), and by 83% for that of 81mKr-to-99mTc window (R21) in a phantom experiment. The R12 and R21 were 1.0-1.9% (mean 1.3%) and 34.6-55.3% (mean 41.9%), respectively in 9 patients (mean age, 56.1 years; range, 38-82 years). V/Q SPECT was undertaken in 7 of the 9 patients. 99mTc-macroaggregated albumin (185 MBq) was injected intravenously in supine position, and 81mKr gas was administered continuously during the SPECT data acquisition. Sixty-four 64 x 64-matrix (size = 8 mm/pixel) images, 20-second acquisition time for each, were collected by a rotating gamma camera in a step-and-shoot fashion during a 360-degree rotation with the two photopeaks, one at 140 keV for 99mTc and another at 190 keV for 81mKr. Examination time was about 40 minutes, and the V/Q ratio maps in cross section were obtained in all of the examinations.

Adult↗
PubMed2005

Dual source support and control at work in relation to poor health.

BACKGROUND AND AIM: Social support and decision authority in relation to health has been examined in extensive research. However, research on the role of different constellations of support sources is conspicuously lacking. The aim of the present study is to describe the health of employees in eight contrasting situations that differ with regard to support from superiors and from workmates and with regard to decision authority. Men and women were studied separately. STUDY SAMPLE AND METHODS: A large sample of Swedish employees (n = 53,371, after exclusion of supervisors) who participated in a national work environment survey was utilized. In addition prospective long-term sick leave data (60 days or more during the 12 months after questionnaire completion) were collected from the national insurance register. RESULTS: Employees who reported below median decision authority had higher prevalence of pains after work and general physical symptoms as well as a higher incidence of long-term sick leave than those with higher decision authority in all subgroups. Those with good support from both workmates and superiors had lower symptom prevalence and long-term sick leave incidence than those with poor support. The groups with either poor support from superiors or from workmates were in an intermediate category with regard to symptom prevalence. The group with good support from superiors but weak support from workmates, however, had as high long-term sick leave incidence as the group with poor support from both superiors and workmates. The patterns were similar for men and women. CONCLUSION: Long-term sick leave was related mainly to poor support from workmates. Prevalence of symptoms, on the other hand, was related to both sources of support and absence of both sources was associated with particularly high prevalence of physical symptoms. This illustrates that it is meaningful to separate the social support sources.

Adult↗
PubMedDate not supplied

Prevalence of radioactive signals from surveillance of an emergency department.

INTRODUCTION: Since the 11 September 2001 terrorist attacks in the United States, concerns have been raised regarding the threat of a radiological terrorist weapon. Although the probability of the employment of a nuclear device is remote, the potential of a radiological dispersal device (RDD) or "dirty bomb" is of concern. While it is unlikely that such a device would produce massive numbers of casualties, it is far more likely that it would result in public panic and perhaps even disable the local healthcare system. The utility of surveillance with radiation detectors in the healthcare setting has not been fully evaluated. OBJECTIVE: The objective of this study was to characterize the prevalence of radioactive sources entering an urban emergency department (ED). METHODS: A retrospective review of data obtained from a radiation detector positioned to detect radioactive people entering an ED of an urban academic hospital that serves 45,000 patients/year was performed. Graphical outputs of radioactivity were recorded in Microsoft Excel (Microsoft, Redmond, WA, US) spreadsheets in microREM/hour. Data were collected continuously from 22 December 2003 to 22 January 2004. An event was defined as any elevation in radiation levels >95% confidence interval from the mean level of background radiation over 72 hours (h). RESULTS: A total of 215 events were observed over a 28-day period, with a mean value of 7.7 events/day, and a maximum of 15 events/day. During the 28-day period, the baseline mean level of background radiation was 2-4 microREM/h. Readings ranged from 2,148.28-17,292.25 microREM/h with a maximum sustained detector exposure of 684.37 microREM. Distinct signal patterns were seen at both detectors including tonic, phasic, dual, and short duration spikes. CONCLUSION: The number of radioactive signals detected from persons entering the ED was much higher than expected. While the vast majority of these signals pose no health threat, they may make routine screening for a radiological terrorist event difficult. Further study is needed to determine this correlation.

Air Pollution, Radioactive↗
PubMed2004

Orchestration of cooperative events in DNA synthesis and repair mechanism unraveled by transition path sampling of DNA polymerase beta's closing.

Our application of transition path sampling to a complex biomolecular system in explicit solvent, the closing transition of DNA polymerase beta, unravels atomic and energetic details of the conformational change that precedes the chemical reaction of nucleotide incorporation. The computed reaction profile offers detailed mechanistic insights into, as well as kinetic information on, the complex process essential for DNA synthesis and repair. The five identified transition states extend available experimental and modeling data by revealing highly cooperative dynamics and critical roles of key residues (Arg-258, Phe-272, Asp-192, and Tyr-271) in the enzyme's function. The collective cascade of these sequential conformational changes brings the DNA/DNA polymerase beta system to a state nearly competent for the chemical reaction and suggests how subtle residue motions and conformational rate-limiting steps affect reaction efficiency and fidelity; this complex system of checks and balances directs the system to the chemical reaction and likely helps the enzyme discriminate the correct from the incorrect incoming nucleotide. Together with the chemical reaction, these conformational features may be central to the dual nature of polymerases, requiring specificity (for correct nucleotide selection) as well as versatility (to accommodate different templates at every step) to maintain overall fidelity. Besides leading to these biological findings, our developed protocols open the door to other applications of transition path sampling to long-time, large-scale biomolecular reactions.

DNA Polymerase beta↗
PubMed2005

Dietary fat type influences total milk fat content in lean women.

Trans fatty acids (TFA) are found naturally in some foods (e.g., dairy products) as well as many processed foods made with partially hydrogenated vegetable oils (PHVO). Data from a growing literature suggest that some TFA decrease milk fat in lactating animals. Because the physiologic effects of TFA in lactating women are unknown, this study was designed to investigate the effects of TFA consumption on human milk fat. A randomized, crossover design (n = 12) was used to study the effect of 3 dietary treatments: high PHVO (regular margarine), low PHVO (low TFA margarine), or low PHVO but high in naturally occurring TFA (butter) on milk fat. Treatments were administered for 5 d, with 7-d washout periods. Maternal adiposity was estimated by dual-energy X-ray absorptiometry. Milk and blood were collected on d 5 of each intervention period. In general, milk and serum fatty acid concentrations mirrored those of the dietary treatments. There were significant interactions between treatment and maternal adiposity on milk fat and infant milk consumption, as well as on serum glucose and nonesterified fatty acid (NEFA) concentrations. Consumption of regular margarine, compared with low TFA margarine, resulted in lower milk fat in leaner, but not in more obese women. Consumption of either regular or low TFA margarine, compared with butter, elevated serum NEFA concentrations in the more obese women. In summary, consumption of regular margarine, compared with low TFA margarine, decreased milk fat in lean women. Further studies are required to determine whether infant milk consumption might compensate for this potentially important change in milk composition.

Absorptiometry, Photon↗
PubMed1999

Omeprazole plus antibiotics in the eradication of Helicobacter pylori infection: a meta-regression analysis of randomized, controlled trials.

This article presents a meta-regression analysis of published studies of omeprazole plus antibiotics (amoxicillin, clarithromycin, or an imidazole derivative) in the treatment of Helicobacter pylori. Eligible studies were all randomized, controlled trials published through April 1996 with 10 or more patients receiving omeprazole plus antibiotics for 5 or more days and testing for H. pylori eradication 4 weeks or more after treatment. Probability of eradication was calculated for each treatment arm, and logistic regression was performed using study characteristics as covariates. Seventy-four studies involving 117 treatment arms with 4,769 patients were identified. The eradication rate was 76% for omeprazole plus clarithromycin and 65% for omeprazole plus amoxicillin dual regimens (P <.0001). Eradication rates for triple regimens were 82%, omeprazole plus amoxicillin plus clarithromycin; 83%, omeprazole plus amoxicillin plus imidazole; and 89%, omeprazole plus clarithromycin plus imidazole. In a multiple logistic regression analysis, significant factors were antibiotic, disease, omeprazole dose, and whether treatment was followed by maintenance omeprazole. A systematic overview of the best available evidence suggests that dual therapy with omeprazole plus clarithromycin is superior to omeprazole plus amoxicillin. Triple therapy is better than dual therapy. Treatment works better on ulcers than on nonulcer dyspepsia. Higher doses of omeprazole give better results. Additional trials exploring higher omeprazole doses for varying durations as well as cost, side effects, and compliance trade-offs with efficacy are recommended.

Anti-Bacterial Agents↗
PubMedDate not supplied

A prototype high-purity germanium detector system with fast photon-counting circuitry for medical imaging.

A data-acquisition system designed for x-ray medical imaging utilizes a segmented high-purity germanium (HPGe) detector array with 2-mm wide and 6-mm thick elements. The detectors are contained within a liquid-nitrogen cryostat designed to minimize heat losses. The 50-ns pulse-shaping time of the preamplifier electronics is selected as the shortest time constant compatible with the 50-ns charge collection time of the detector. This provides the detection system with the fastest count-rate capabilities and immunity from microphonics, with moderate energy resolution performance. A theoretical analysis of the preamplifier electronics shows that its noise performance is limited primarily by its input capacitance, and is independent of detector leakage current up to approximately 100 nA. The system experimentally demonstrates count rates exceeding 1 million counts per second per element with an energy resolution of 7 keV for the 60-keV gamma ray photon from 241Am. The results demonstrate the performance of a data acquisition system utilizing HPGe detector systems which would be suitable for dual-energy imaging as well as systems offering simultaneous x-ray transmission and radionuclide emission imaging.

Americium↗
PubMed1980

Correlation of the growth of Chinese hamster V279-17lb multicellular spheroids with cytokinetic parameters.

The volumes of Chinese hamster V279-17lb multicellular spheroids grown in spinner culture were measured and correlated to DNA distribution and cell volume distribution information. Spheroid growth curves were obtained over a 21-day period using both electronic cell volume measurements and microscope micrometer sizing. The spheroids were collected from the aperture tube after electronic sizing, and single cell suspensions were prepared via trypsinization. Saline-washed cells were then stained with mithramycin and analyzed as unfixed or ethanol-fixed cells for both cell volume and DNA fluorescence measurements. Spheroid growth was determined to have an initial 8- to 9-day rapid growth phase, and a slow phase from 10 to 21 days. The single cell volume distributions of cells obtained from spheroids were dependent on spheroid volume and the relative proportions of small volume noncycling cells to large volume cycling cells comprising the spheroids were also dependent on spheroid volume. DNA distribution data and dual parameter DNA distribution cell volume contour patterns obtained for single cells dissociated from spheroids were closely related to the measured spheroid volume and revealed that the fraction of small, hypoxic G0-like cells was greatest in old, large spheroids.

Animals↗
PubMed2005

Improvement in insulin sensitivity without concomitant changes in body composition and cardiovascular risk markers following fixed administration of a very low growth hormone (GH) dose in adults with severe GH deficiency.

OBJECTIVE: Untreated GH-deficient adults are predisposed to insulin resistance and excess cardiovascular mortality. We showed previously that short-term treatment with a very low GH dose (LGH) enhanced insulin sensitivity in young healthy adults. The present study was therefore designed to explore the hypothesis that LGH, in contrast to the standard GH dose titrated to normalize serum IGF-I levels (SGH), may have differing effects on insulin sensitivity, body composition, and cardiovascular risk markers [lipid profile, C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha) and adiponectin] in adults with severe GH deficiency. PATIENTS AND METHODS: In this 12-month open, prospective study, 25 GH-deficient adults were randomized to receive either a fixed LGH (0.10 mg/day, n = 13) or SGH (mean dose 0.48 mg/day, n = 12), and eight age- and body mass index (BMI)-matched GH-deficient adults acted as untreated controls. Fasting blood samples were collected at baseline and at months 1, 3, 6, 9 and 12. Assessments of insulin sensitivity, using the hyperinsulinaemic euglycaemic clamp technique, and body composition, using dual-energy X-ray absorptiometry, were performed at baseline and at month 12. RESULTS: The LGH decreased fasting glucose levels (P < 0.01) and enhanced insulin sensitivity (P < 0.02), but body composition, nonesterified fatty acid (NEFA) levels and cardiovascular risk markers were unchanged. The SGH did not modify insulin sensitivity, decreased truncal fat mass (P < 0.05), CRP (P < 0.05) and IL-6 (P < 0.05) levels, and increased NEFA levels (P < 0.05). No changes were observed with the untreated controls. CONCLUSION: Our data indicate that, in contrast to the SGH, fixed administration of the LGH enhances insulin sensitivity with no apparent effects on body composition, lipolysis and other surrogate cardiovascular risk markers in adults with severe GH deficiency. Thus, the LGH may potentially be a beneficial replacement dose in reducing type 2 diabetes risk in adults with severe GH deficiency.

Adult↗