Jay Silverberg

Nocturnal Cortisol, Thyroid Stimulating Hormone, and Growth Hormone Secretory Profiles in Depressed Adolescents

Twelve depressed adolescents and 12 controls matched for age, sex, Tanner stage, time of menstrual cycle (females), weight, and time of year assessed were studied over 3 nights. Measurements for cortisol, thyroid stimulating hormone, and growth hormone were made on serum collected at 10 P.M., 12 midnight, 1 A.M., 2 A.M., 3 A.M., 4 A.M., and 6 A.M. in eight pairs and every 20 minutes from 8 P.M. to 7 A.M. in four pairs. Cortisol secretion did not significantly differentiate the groups. Thyroid stimulating hormone secretion was significantly elevated in the depressed group at one time point. Growth hormone secretion significantly differentiated the two groups at most time points, and the depressed adolescents significantly hypersecreted growth hormone (area under the curve). Implications for the diagnosis, etiology, and treatment of adolescent depression are discussed.

Familial Hyperthyroxinemia Due to Abnormal Thyroid Hormone Binding

A patient had an elevated serum total thyroxine (T4) free thyroxine (free T4), free T4 index, and T4/thyroxine-binding globulin ratio. The serum triiodothyronine (T3), as well as the thyrotrophin response to thyrotrophin-releasing hormone was normal and consistent with the clinical euthyroid status. The basis for the elevated serum total T4, free T4 index, and T4/thyroxine binding globulin is the abnormally enhanced binding of thyroid hormone by albumin, or by an anomalous protein migrating with a mobility similar to albumin as determined in paper electrophoretic systems. The abnormal T4 protein binding was also seen in several members of the patients family indicating that the condition was familial. A new type of serum T4 protein binding abnormality that results in hyperthyroxinemia may falsely indicate thyrotoxicosis in clinically euthyroid subjects.

Nocturnal Growth Hormone Secretion in Depressed Older Adolescents

Abstract A study of nocturnal growth hormone secretion in nine depressed adolescents and nine matched controls showed significantly greater secretory amplitudes at 2400 and 0100 hours in the depressed group. These differences were not related to sleep latency, total amount of slow wave sleep before the first REM period, nocturnal cortisol, or nocturnal free T4 levels. These findings suggest disturbed CNS regulation of nocturnal growth hormone in adolescent depressives.

Lectures, interactive learning, and knowledge retention in continuing medical education

&NA; At an annual continuing medical education (CME) event, the subject of the management of asthma in pregnancy was taught to attendees using a lecture format and, in consecutive years, a small group interactive teaching format was used. For both years of the study, knowledge retention was assessed by comparing multiple choice test scores on a pretest, a post‐test, taken shortly after the educational intervention, and a follow‐up test taken 3 months after the educational intervention. Scores showed a significant improvement following the lecture and small group teaching formats for the post‐test and follow‐up tests. Scores at the preteaching and post‐teaching tests were similar for the lecture and small group teaching formats. The scores on the follow‐up test, however, were slightly better for the lecture group compared with the small group teaching format, although the difference was small and not significant. We conclude, therefore, that in a CME setting the lecture format of teaching compared favorably with small group learning in terms of knowledge retention.

Diabetes and driving: 2015 Canadian Diabetes Association updated recommendations for private and commercial drivers.

a Division of Endocrinology and Metabolism, Department of Medicine, Queen’s University, Kingston, Ontario, Canada b Winnipeg Regional Health Authority, Health Sciences Centre Winnipeg, Winnipeg, Manitoba, Canada c Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Mississauga, Ontario, Canada d Medicine and Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada e Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada f Section of Endocrinology and Metabolism, John Buhler Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada g McGill Nutrition and Food Science Centre, McGill University, Montreal, Quebec, Canada