Effect of illness on serum growth hormone response to intravenous glucose

Intravenous glucose was given to nine control patients, 16 ill patients without malignancy, and 20 patients with localized or metastatic malignancy to study hGH responses. All of the controls showed normal hGH suppression 1 hr after glucose. A paradoxical rise in hGH levels 1 hr after glucose was observed in the group of ill patients without tumors ( p < 0.05) and the group with malignancy ( p < 0.05) when each group was compared with the control group. Elevated plasma cortisol levels and a severe degree of illness correlated positively with the paradoxical hGH response, while plasma free fatty acids and insulin showed no correlation. These studies suggest that hGH levels may paradoxically rise soon after intravenous glucose in ill patients with or without malignant disease, and the paradoxical response is not specifically related to etiology but rather is a result of the stress of significant illness acting on the hypothalamus-anterior pituitary

Ernest L. Mazzaferri, MD, MACP (1936-2013)

Professor and physician Dr. Ernest L. Mazzaferri Sr. passed away on May 14, 2013, at 76 years of age ( 1 , 2 ). Ernie is remembered as a caring and talented physician, an accomplished scholar and educator, as well as a loving husband, father, and grandfather. He was a luminary figure, and few people have had a greater impact in thyroidology in recent decades. Here we include reflections from a few of us that knew him, as well as commentaries from people who did not. Ernie's passion was caring for patients and how to improve their care. Our goal is to pay tribute and memorialize the person we knew and the impact that he had on patients around the world through his dedication to research, lecturing, and writing that achieved remarkable global influence