The purpose of our work was to evaluate the volume of hippocampus-amygdala formation (HAF) in patients with anorexia nervosa (AN), being this structure a crucial target for the glucocorticoid action in the adaptative stress-response. AN patients have biochemical hypercortisolism associated to normal ACTH levels, but do not develop the characteristic clinical features of glucocorticoid hypersecretion. Furthermore, in these patients cortisol levels usually do not suppress after dexametasone challenge. Twenty AN females (aged 30.0+/-5.1) with 10.5+/-4.2 yr of disease underwent a brain magnetic resonance (MR) examination during the recovery phase; an age-matched control group (CG) of 20 healthy female volunteers was also studied. Two interleaved T1-weighted spin-echo sequences for 46 contiguous 2-mm coronal slices (pixel 0.98(2) mm) were used. The volumes of both right and left HAFs were calculated with manual contouring from the third ventricle to the Sylvian aqueduct. IGF-I, T3, gonadotropins, 24-h urine free cortisol, and BMI were obtained for both patients (on admission and on present evaluation) and CG. Mann-Whitney, Wilcoxon and Spearman tests were used. AN patients showed a significant (p=0.0001) reduction of total (right plus left) HAF volume (6.6+/-1.3 cm3) when compared with CG (8.9+/-1.1). No significant difference was found between right and left HAF in both patients and CG. In AN patients, no significant correlation was found between the HAF and all the hormonal parameters or BMIs, while a trend towards significance was observed with duration of the disease (r=-0.398; p=0.082). MR imaging demonstrated a significant volume reduction o

The objective of the study was to determine the tolerability and effectiveness of the slow release (SR) somatostatin analog lanreotide in active acromegaly. Fifty-seven patients, unselected in terms of their previous responsiveness to octreotide therapy, were included in a prospective, open label study carried out at 6 Italian endocrinological centers. The effects of 6 months of SR lanreotide, given at first every 14 days at a dosage of 30 mg, im, were recorded. In some patients (33%), drug dosage was adjusted by increasing the dose (to 60 mg, im) and/or shortening the time interval (every 10 days) of SR lanreotide administration. Fifty patients completed the 6-month period of therapy; 2 subjects dropped out because of adverse events, and 5 dropped out because of ineffectiveness after changes in drug administration. The first SR lanreotide injection produced more than 50% suppression of GH levels from the basal value in 93% of patients. Thirteen days later, baseline GH levels were reduced by over 50% in 25% of patients. Mean GH values were normalized in 85% of patients after 6 months, whereas insulin-like growth factor I (IGF-I) levels were normalized in 38% of patients. No correlation was found between pretreatment GH levels and GH response to SR lanreotide or between changes in GH and IGF-I during therapy. During treatment, there was a significant reduction in the percentage of patients complaining of joint pain, hyperhydrosis, and paresthesias. Changes in soft tissue swelling were documented by significant decreases in finger measurements. Diarrhea and abdominal pain were the most frequent side-effects when therapy was started; these progressively decreased. After the first month of therapy, moderate, mild, and no side-effects were reported by 3%, 40%, and 53% of patients. A nonsignificant increase occurred in asymptomatic gallstones and amylase levels. Minimal changes were noted in carbohydrate tolerance, consisting of a slight increase in glycosylated hemoglobin, a rise in glucose and a decrease in pre- and postprandial insulin levels. No effects on PRL, free cortisol, TSH, or free thyroid hormone levels were noted. No significant change in the percentage of visual field abnormalities was noted. Decreases in pituitary tumor size occurred in 3 of 17 patients reevaluated after 6 months of therapy. The 6-month period of SR lanreotide therapy was compared, on an anamnestic basis, with a 6-month or longer period of sc octreotide therapy (median, 300 micrograms/day) in 34 patients. There were no differences in effectiveness or tolerability between the 2 somatostatin analogs. These data indicate that SR lanreotide at a dose of 30 mg, im, every 14 days is an effective treatment in most unselected acromegalic patients. When administered to a group of poorly responsive patients, an increase in drug dose (60 mg im) and/or a shortening of the drug interval (10 days) seem to improve the GH/IGF-I response. Tolerability to SR lanreotide therapy is high. The use of a new sustained release formulation of somatostatin analog ...

The aim of our study was to define the dose-response effect of a short-term treatment with different recombinant human growth hormone (rhGH) doses (1.25, 2.5, 5.0, 10.0, and 20.0 μg ⋅ kg−1 ⋅ day−1for 4 days) on insulin-like growth factor I (IGF-I) and insulin-like growth factor-binding protein (IGFBP)-3 levels in 21 normal young adults of both sexes. The dose of 1.25 μg/kg rhGH did not modify IGF-I levels. The dose of 2.5 μg/kg rhGH significantly increased IGF-I levels in men ( P < 0.05) but not in women, whereas the higher doses increased IGF-I levels in both sexes ( P < 0.002). IGFBP-3 levels were not modified by 1.25 or 2.5 μg/kg rhGH in either sex. On the other hand, 5.0 μg/kg increased IGFBP-3 levels in men ( P < 0.05) but not in women, whereas the higher doses increased IGFBP-3 levels similarly in both sexes ( P < 0.02). In conclusion, our results demonstrate that IGF-I and IGFBP-3 responses to rhGH are dose and sex dependent. However, IGFBP-3 is less sensitive than IGF-I to rhGH stimulation.

The data demonstrate that low rh-GH dosages significantly improve psychological profiles as rated by HDS evaluation in adult-onset patients with GHD. On the other hand, a 6-month period of treatment does not produce any significant differences in quality of life as measured by KSQ between treated patients and placebo controls.

The first minute of Gd-enhancement allows a more prominent differentiation between malignant and benign breast lesions than the following times.