Graham F. Read

Cardiff Puerperal Mood and Hormone Study

Participants were 120 primaparous women who had vaginal delivery of a non-handicapped child. Saliva was collected twice daily through parturition to day 35 post-partum. In the prepartum, a highly sign

Comparisons of plasma and salivary cortisol determinations for the diagnostic efficacy of the dexamethasone suppression test.

The current status of the saliva dexamethasone suppression test (DST) is discussed and results from the literature reviewed. Evidence is presented that demonstrates that the efficacy of the salivary-based test is equal to that of the plasma DST provided that specifically developed radioimmunoassays are used for determination of salivary cortisol. Such evidence relied on measurement of cortisol in 300 matched samples of plasma and saliva provided by patients admitted to a routine psychiatric ward over a 2-year period. The results according to diagnosis (DSM-III categories) were in line with those generally reported. The influence of anticholinergic medication was examined: this had no significant effects on the performance of the plasma or salivary-based DST.

Prenatal Testosterone Levels in XXY and XYY Males.

It has been postulated that behavioural differences between normal males and those with an additional X or Y chromosome may be related to pre- or postnatal hormonal variations. The prenatal hormone st

Salivary cortisol for monitoring adrenal activity during marathon runs.

In non-elite male runners (n = 8), changes in adrenal activity were monitored by measurement of salivary cortisol in samples collected at 4-mile intervals during marathon runs. These changes were compared with those in similarly timed samples collected on rest days. Immediately prior to the Cardiff marathon, at 09.00 h, mean salivary cortisol concentrations (21.5 nmol/l) were higher than those in similarly timed rest day samples (14.9 nmol/l). Cortisol concentrations increased during the marathon, and although values at 25 miles were high (79.4 nmol/l), maximum values (87.9 nmol/l) were observed in samples collected 30 min after completion of the run. Some Cardiff marathon runners also participated in the Bristol marathon (n = 4) and a non-competitive event (n = 3). The changing pattern in secretory activity was similar in all events. The easy collection of saliva without cessation of exercise is ideal for monitoring the hormonal response to exercise.

The pharmacokinetics of oral and intramuscular administration of dexamethasone in late pregnancy

Background To compare the pharmacokinetics of orally administered dexamethasone with intramuscular administration in antenatal patients at risk of preterm delivery.

A comparison of menstrual cycle profiles of salivary progesterone in British and Thai adolescent girls

Menstrual-cycle profiles of salivary progesterone concentration, obtained by radioimmunoassay of daily samples collected throughout the cycle, were obtained from Thai (n = 232) and British (n = 130) adolescent girls up to 4 years postmenarche. These profiles were graded from 1 to 5 ranging, respectively from concentrations at the detection limit of the assay to profiles generally observed for the mature premenopausal woman. Contingency table analysis of the grade frequencies for Thai-British pairs of girls matched for chronological age and age at menarche (n = 2 x 90) demonstrated that British girls had more mature cycles (22/90) than Thais (11/90) (P less than 0.05) particularly in the first 2 years postmenarche (P less than 0.01). For these matched pairs of girls there was no evidence to support the view that girls with an early age of menarche develop their profiles more quickly following menarche than those with a late age of menarche, as previously reported and which was thought to be important in the development of breast cancer. The findings of this study also suggest that adolescent girls in Britain develop their menstrual cycle profiles of salivary progesterone more quickly than their Thai counterparts and this may be of value in formulating hypotheses regarding any role that ovarian progesterone secretion may have on subsequent breast cancer risk.

A Robust Assay for Dexamethasone in Plasma Using a Heterologous 125I Radioligand and a Magnetizable Solid-Phase Antiserum

An assay using an antiserum raised against a dexamethasone 21-hemisuccinate conjugate and the heterologous radioligand dexamethasone 21-(carboxymethyl) ether was developed, validated, and used to study the pharmacokinetics of this steroid for 12 h following administration to patients with congenital adrenal hyperplasia. Coupling the antiserum to magnetizable cellulose allowed rapid separation of bound/free steroid. A C-21 rather than a C-3 antiserum was used to minimize interference with a main metabolite, 6β-hydroxydexamethasone. Close correspondence of assay (0·35 nmol/L) and curve (0·25 nmol/L) sensitivities suggests that interference by matrix effects is minimal. This was confirmed by good agreement in data from the in-house assay and that of a reference procedure. Good precision was demonstrated by the precision profile and Shewhart chart quality control data. The latter also demonstrated the assay was robust and reliable in routine practice.

Salivary steroid assays: still awaiting a killer application.

In this issue, Peter Wood addresses the issue of the current status of assays for steroids in saliva. I must declare an interest, having been associatedwith twoprevious reviews of this topic in 1984 and 1993. Katz and Shannon heroically demonstrated that corticosteroids could be estimated in saliva in the 1960s, but given the poor sensitivity of the analytical technique – mandating impractically large sample sizes – their pioneering studies passed little noticed. The introduction of radioimmunoassay techniques for steroid estimation made salivary assays more practical, one of the first publications coming from Landman et al. in 1976. The Tenovus Workshop on this topic held in 1982 resulted in dozens of publications, the majority concerned with cortisol. Certain criteria were also emerging:

Direct Assays for Adrenal Steroids in Neonates

are not very quick, and are not amenable to automation; however, they do not require special instruments or systems, like HPLC apparatus or dry-chemistry analysers, and are therefore within the capabilities of a larger number of laboratories. The measurement of I)-bilirubin offers the possibility of a more correct interpretation of persistingly elevated levels of direct-reacting bilirubin, in the follow-up of icteric patients; recently, its usefulness in the monitoring of livertransplant recipients has been reported. Deeper insight into the clinical meaning of this particular bilirubin molecular species is expected to derive from increased number of measurements in different pathological conditions; for this, the analytical procedures herein referred to can be of some help. C FRANZINI, G Cxrrozzo