CPP Treatment Research Articles

USE OF ANTIDEPRESSANTS IN THE MANAGEMENT OF WOMEN WITH CHRONIC PELVIC PAIN

Despite a lack of formal evidence for the efficacy of antidepressants in the treatment of CPP, several lines of evidence suggest that they may play an increasingly important role in the treatment of this disorder. Although best combined as part of a multimodal treatment package that includes psychotherapy, behavior change, and physical activation, they appear to have promise for at least a subgroup of women with chronic pain. The relative safety of these medications and the high prevalence of major depression in this population of patients make the routine empirical trial of these medications a desirable, cost- and time-effective strategy in the treatment of this disorder.

SUPPRESSION OF LH SECRETION IN PRECOCIOUS PUBERTY WITH DEPOT FORMULA AND DAILY INJECTIONS OF GNRH ANALOGUE LEUPROLIDE ACETATE (PROCRENE)

There has been some concern about the suppressive effect of daily inj. of GnRH analogues on LH secretion in the treatment of CPP. To evaluate the difference between Procrene 1 mg daily as bedtime inj. and monthly 3,75 mg depot inj., 12 h overnight LH secretion profiles were made in 9 children with CPP, 3 treated with daily inj. and 6 with depot inj. 30 min. samples contin. suction. All patients treated at least 3 months. The tables give the results. Limit for prepubertal LH ≤ 3.0 IU/l. Conclusion: Depot formulas of GnRH analogues seem to be a more secure treatment for central precocious puberty than daily injections.

Effects of N-methyl-d-aspartate antagonism on spatial learning in mice

C57BL/6Ibg mice were treated with the N-methyl-D-aspartate (NMDA) receptor antagonist 3-(2-carboxypiperazin-4-yl) propyl-1-phosphonic acid (CPP) and tested for selective deficits in spatial learning ability in the Morris water task. Two types of training protocols were used during the initial exposure to the training environment. In protocol 1, animals were given four massed trials before being returned to their home cages. In protocol 2, animals were returned to their home cages after each of the first four trials. Following the initial four trials, both sets of animals were given massed trials in blocks of four. CPP had minor effects on nonspatial learning, with greater impairment seen in animals trained according to protocol 1 than in animals trained according to protocol 2. The drug increased latency to find the platform in the spatial learning form of the task, with no effect of training protocol on latency. When spatial learning ability was measured in terms of the search behavior exhibited by the animals after the platform was removed from the pool, animals trained according to protocol 1 showed a severe CPP-induced impairment in search accuracy. Animals trained according to protocol 2 showed no effect of drug treatment. The results suggest that CPP does not have a reliable effect on place learning and that factors other than the type of learning being tested may contribute to performance deficits following CPP treatment.

EFFECTS OF THE SLOW-RELEASE GNRH AGONST DECAPEPTYL-DEPOT (DD) IN CHILDREN WITH CENTRAL PRECOCIOUS PUBERTY (CPP): PITUTARY-GONADAL FUNCTION, CLINICAL COURSE AND PHARMAKOKINE TICS OF DECAPEPTYL

In an international multicentre trial of (DD) for treatment of CPP, a total of 76 patients, 68 girls and 8 boys, are presently enrolled. There are 50 (3 boys) naive patients (group I) and 26 (5 boys) who have been treated with either cyproterone acetate or Buserelin before (group I). Basal plasma LH (mlU/ml) decreased from 3.3 ± 0.3 (mean ± SE) and 2.8 ± 0.5 to 2.4 ± 0.3 and 1.6 ± 0.3 after 1 year of therapy in groups I and II, resp. The LH response to GnRH i.v. was signif. (p < 0.001) reduced in both groups from 45.1 ± 3.8 and 30 ± 6.4 mlU/ml to 4.2 ± 0.9 and 2.9 ± 0.9 mlU/ml. Similar results were obtained for FSH. Spontaneous nocturnal LH secretion was pulsatile before agonist therapy and prepubertally low after 3 or 6 months. At the same time, E2 levels fell signif. from 118 ± 12 to 52 ± 4 pmol/l (p < 0.01) in group and from 93 ± 22 to 36 ± 5 pmol/l in group II. Clinical signs of gonadarche showed either regression or complete arrest. Decapeptyl plasma levels determined by RIA after extraction showed a highly variable course after i.m. injection of DD, reaching maxinum levels between 30 and 120 min. 4 weeks after the last injection, DD plasma levels ranged from below sensitivity (30 pg/ml) to 567 pg/ml. There seemed to be no correlation between 4-week Decapeptyl levels and plasma E2. Except of short injection pain (anaesthetic spray helpful), no side effects were seen, we conclude that treatment of CPP with DD, given only every 4 weeks i.m., leads to an effective suppression of the pituitary-gonadal axis without clinical escapes, despite variable and sometimes very low plasma levels of the drug.

Carcass and meat quality characteristics and backfat fatty acid composition of swine as affected by the consumption of peanuts remaining in the field after harvest.

Carcass composition, meat quality characteristics and changes in backfat fatty acid composition of swine that were allowed to obtain part or all of their weight gain during the growing-finishing period from gleaning peanuts remaining in the field after harvest were evaluated. Thirty-six cross-bred pigs (18 barrows, 18 gilts) were allotted evenly among the following six treatments: 1) fed a corn-soybean meal-based diet (C) from 26 to 104 kg (CCC); 2) gleaned peanuts (P) from 26 to 102 kg (PPP); 3) C from 26 to 78 kg and P from 78 to 103 kg (CCP); 4) P from 26 to 55 kg and C from 55 to 105 kg (PCC); 5) C from 26 to 56 kg and P from 56 to 103 kg (CCP); 6) P from 26 to 79 kg and C from 79 to 106 kg (PPC). Carcasses from all treatment groups were similar in composition. Carcass fat of pigs in CPP, PPC and, in particular, PPP groups was softer than that from pigs in CCC, CCP and PCC groups. Ratio of unsaturated to saturated fatty acids in backfat increased in proportion to the amount of weight gained while pigs gleaned peanuts. Loins from pigs in the PPP and CPP treatment groups received lower marbling scores than those from the CCC group, but the fat content of the loin was not affected by treatment. No differences were detected between treatment groups in shear force values or sensory panel attributes of broiled loin chops, or in thiobarbituric acid values of vacuum packaged loin sections frozen for 4 mo.(ABSTRACT TRUNCATED AT 250 WORDS)

LUPRON TREATMENT OF PRECOCIOUS PUBERTY (CPP) HAS NOT PRODUCED LOSS OF BONE MINERAL

We tested the hypothesis that GnRH agonist treatment of CPP is associated with loss of bone mineral density (BMD) and content (BMC) after young women treated with GnRH agonists were reported to lose up to 6% BMD in the first treatment year similar to that seen during menopause. We determined lumbar spine (L1-L4) BMD (g/cm2) and BMC (g) by dual photon absorptiometry and measured growth parameters and blood Ca (mg/dl), alk. phos. (AP, mU/ml) and integrated growth hormone (GH, ng/ml) on CPP patients before and after (3 of our 6 patients to date) six months treatment with the GnRH agonist LUPRON (TAP Pharm., 4-8 ug/kg SC qD). Our patients (3 girls 5-8 yr, 9-10 yr bone age [BA]; 3 boys 3-8 yr, 7-10 yr BA) were Stage 3-4 upon entering the study with informed consent. All 6 had similar basal BMD (.724±.05, SEM). Despite reduction of V or T toward prepubertal levels, growth rates and BMC did not decline and GH and BMD increased while Ca and AP decreased. We conclude that early, partial suppression of CPP with LUPRON is not associated with loss of BMD or BMC. Followup with further suppression of CPP should help to distinguish between variable time courses of end organ responses or therapeutic selectivity.