Russell R. Cooke

Acidic isoforms of chorionic gonadotrophin in European and Samoan women are associated with hyperemesis gravidarum and may be thyrotrophic.

There is conflicting evidence concerning the role of human chorionic gonadotrophin (hCG) in the aetiology of hyperemesis gravidarum (HG); particular isoforms of hCG may be the critical factor. Ethnic differences in HG prevalence and putative thyrotrophic effects of hCG may also relate to differences in hCG isoform profiles. To address these issues we examined the relationship of hCG isoforms to HG and thyroid function tests in two groups of women from ethnic backgrounds with significantly different HG prevalence rates.

Inhaled beclomethasone dipropionate suppresses the hypothalamo–pituitary–adrenal axis in a dose dependent manner

Little is known about the dose–response relationship of potential, unwanted, effects of inhaled beclomethasone (BDP) on the hypothalamo–pituitary–adrenal (HPA) axis, particularly in non‐specialist clinic settings. The purpose of our study was to investigate the dose–response relationship of inhaled BDP on the HPA axis in a general practice patient population. We also explored the optimal testing strategy in this population and correlated effects of inhaled BDP on the HPA axis with other systemic corticosteroid side effects.

Serum free thyroxine levels in cats maintained on diets relatively high or low in iodine.

Excessive or deficient intake of iodine may play a role in the development of goitre and hyperthyroidism in cats. Previous investigations have shown that the serum free thyroxine level of cats is affected by brief administration of food high or low in iodine content. We have now measured serum free thyroxine levels in groups of cats fed relatively high or low iodine diets for much longer periods (5 months). In contrast to our earlier findings, the chronic ingestion of relatively high or low iodine diets did not lead to statistically significant differences in serum free thyroxine levels. The results of the present investigations show that the cat is able to maintain normal levels of thyroid hormone despite prolonged high or low iodine diets. It may be that the adaptive mechanisms that are called into play during chronic high or low iodine intake lead to thyroid disease, particularly in certain predisposed individuals.

Platelet tritiated imipramine binding in patients suffering from mania

Platelet imipramine binding was measured in 16 patients suffering from DSM-IIIR mania and compared with binding values reported in depressed and healthy control subjects recruited in a parallel study (Ellis et al., 1990). Binding levels in the manic group did not differ from control values, but were higher than in the depressed group. Within the manic group, binding did not differ with severity of illness or the presence of depressive symptoms but there was a trend to lower values (comparable to those in the depressed group) with increasing duration of illness. This raises the possibility that changes in imipramine binding in depression and mania may be similar, consistent with the permissive hypothesis of serotonin function.

Platelet tritiated imipramine binding in psychiatric patients: relationship to symptoms and severity of depression

The clinical and research significance of reduced imipramine binding has remained unclear despite considerable investigation. This study used an assay of demonstrated reliability to investigate the clinical correlates of imipramine binding to platelets in 63 depressed and 33 nondepressed psychiatric patients and 40 healthy control subjects. Both patient groups had Bmax values significantly lower than those of the healthy controls. Unequivocal associations between binding parameters and individual symptoms or groups of symptoms were not established, but a negative correlation between Kd and the number of adverse life events experienced in the preceding 6 months was apparent. These findings provide no support for the view that reduced binding is a trait marker for susceptibility to depression and cast doubt on its specificity as a state marker for the syndrome of depression.

Platelet 3H‐imipramine binding during recovery from depression

Decreased binding of tritiated imipramine to platelets has been considered to be a potential biological marker of depression. However, it has been unclear how binding values alter during treatment and recovery. This study investigated imipramine binding parameters and depressive symptoms in 25 patients suffering from major depression at entry to the study and 1, 3 and 6 months later. Although the initial Bmax values were significantly lower in the depressed patients than in healthy subjects, it was not possible to establish a clear relationship between recovery from depression and Bmax. The power of this study to detect an effect of at least 10% of the variance in Bmax due to factors related to recovery from depression was 0.78.

Thyroid function tests in acutely ill patients. comparison of analogue based free thyroid hormone assays with free thyroxine index

&NA; A prospective study of 100 acutely ill patients was carried out to assess the value of the free thyroxine (FT4) assay as a replacement screening procedure for the free thyroxine index (FT1). We found that the FT4 assay was significantly influenced by the albumin concentration, so that the number of follow‐up tests required increased markedly. This was especially true at the low end of the FT4 range where the need for thyrotropin assays increased by 162%. The free triiodothyronine (FT3) assay was also shown to be albumin dependent. It is not useful to replace one set of difficulties due to protein binding with another, and overall it was concluded that it is not cost‐effective to screen hospital patients for thyroid dysfunction using free hormone assays based on labelled analogue techniques.