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  • 1
    ISSN: 1569-8041
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Keywords Diabetic nephropathy ; risk factors ; ACE polymorphism ; glycaemic control ; hypertension.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diabetic nephropathy represents a major complication in patients with insulin-dependent diabetes mellitus (IDDM). Intervention trials using angiotensin-converting enzyme (ACE) inhibitors have pointed towards the important pathogenetic role of the renin-angiotensin system. Recently an insertion/deletion (I/D) polymorphism for the gene encoding the ACE has been described, the deletion type being associated with higher plasma ACE levels. As the intrarenal renin-angiotensin system might also be activated in this setting, we determined the ACE genotype together with other risk factors for the development of diabetic nephropathy in 122 patients with IDDM from a single centre with (n = 63) and without (n = 59) nephropathy. Long-term glycaemic control was evaluated using mean HbA1c values from the last 10 years. The two patient group were comparable with regard to duration of diabetes and glycaemic control as assessed by current HbA1c values. However, mean long-term HbA1c values were significantly higher in patients with diabetic nephropathy as was systemic blood pressure. The DD genotype was more prevalent in patients with renal disease. In the subgroup of patients who had had diabetes for more than 20 years (n = 90), the DD genotype was even more frequent in patients with nephropathy, and blood pressure and long-term HbA1c values were also higher in patients with renal disease. Logistic regression analysis revealed long-term glycaemic control, blood pressure and the ACE genotype to be independent risk factors for the prevalence of diabetic nephropathy. [Diabetologia (1997) 40: 327–331]
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0827
    Keywords: Key words: Growth hormone deficiency — GH substitution therapy — Bone mineral density — Bone metabolism — Osteoporosis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Reduced bone mineral density (BMD) and the prevalence for osteoporotic vertebral fractures are symptoms of growth hormone deficiency (GHD) syndrome, and GH replacement therapy is now available for GH-deficient adults. We investigated the long-term effects of GH replacement therapy on bone mineral density (BMD) and bone metabolism in 19 adult patients with GHD over a period of 18 months. In response to GH treatment, the initially decreased IGF-I concentrations rose significantly during 18 months of therapy to levels within the normal range (matched for sex and age) (mean change 158.1 ± 50.8 ng/ml, P 〈 0.001). Parameters of bone formation such as osteocalcin (OC) and procollagen I-C-Peptide (PICP) showed a significant increase in the first 6 months of therapy, followed by a slight decrease in the next months. Markers of bone resorption (CrosslapsR and deoxypyridinoline (D-Pyr) also increased significantly with a peak value after 6 months and all parameters except PICP remained above baseline values after 18 months. BMD of the femoral neck (FN) showed an increase after 18 months of therapy (mean change 0.01 ± 0.03 g/cm2 after 18 months, n.s.). However, the increase in BMD was significant only in the lumbar spine (LS) (mean change 0.03 ± 0.04 g/cm2, P 〈 0.05 after 18 months). We conclude that GH replacement therapy in adult patients with GHD over a period of 18 months causes a pronounced increase in bone turnover mainly during the first 12 months of therapy and increases BMD of the lumbar spine and the femoral neck after 18 months.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    International orthopaedics 21 (1997), S. 343-348 
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé.Étude rétrospective des résultats de divers types d’interventions chirurgicales réalisées sur des patients présentant des métastases pelviennes. Nous avons opéré 43 sujets entre 1980 et 1992, 37 ayant subi une curetage des tumeurs, six une résection dans le tissu sain. L’espérance de vie a été calculée selon le procédé Kaplan-Meier, l’état clinique étant évalué au moyen de la méthode de Karnofsky. L’indice Karnofsky est passé de 55% avant l’intervention à 74% trois mois après l’opération (p = 0,0001), et à 77% à six mois (p = 0,0001). L’espérance de vie des sujets ayant subi une curetage de la tumeur s’est avérée être de treize mois en moyenne, avec un taux de complications de 24% et un taux de récidives locales de 19%. Les sujets traités par resection dans le tissu sain ont survécu en moyenne de seize mois. Nous avons vu des complications dans trois cas sur six, sans qu’il y ait eut récidive. Le traitement chirurgical a nettement amélioré la qualité de la vie de nos patients. Compte tenu du taux de complications et de l’espérance de vie de nos malades après intervention, la curetage de la tumeur semblerait être la méthode de choix dans le traitment de ces sujets.
    Notes: Summary. This retrospective study analyses the benefit of surgery to patients with pelvic metastases. Forty-three patients were operated on between 1980 and 1992, 37 having intralesional and 6 extralesional resections. Thirty-nine had perioperative adjuvant therapy. Survival time was calculated by the Kaplan-Meier method. Clinical evaluation used the Karnofsky performance status which showed improvement from 55% before operation to 74% at 3 months (p = 0.0001) and 77% after 6 months (p = 0.0001). Those having an intralesional resection had a median survival time of 13 months, a complication rate of 24% and a local recurrence rate of 19%. The comparable figures for those with extralesional resection were 16 months survival, complications in 3 out of 6, and no local recurrences. The quality of life was improved by operation and intralesional resection is preferable in most of these patients.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical microbiology & infectious diseases 19 (2000), S. 506-513 
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The effect of a single booster injection of an adult formulation of a combined diphtheria–tetanus vaccine (Td) on diphtheria-specific immunity was evaluated. The booster injection, containing 2 IU diphtheria toxoid per dose, was given as part of the surgical wound management for adults with open soft tissue injuries. Diphtheria antitoxin concentrations were determined in serum samples from 534 patients (199 women and 335 men, aged 18–70 years) using an enzyme immunoassay and a tissue culture toxin neutralization assay. Seroimmunity against diphtheria toxin was classified at three levels: susceptibility, basic protection, and full protection against the toxic manifestations of the disease. Before vaccination, 27.1% of the subjects were susceptible to diphtheria, 26.5% had basic protection, and 46.4% were fully protected. Six weeks (minimum 25 days, maximum 98 days) after a single booster injection, 89.7% of the subjects achieved full protection against diphtheria, and only 3.9% had antitoxin levels below the protective level. The median increase from the prevaccination to postvaccination antitoxin concentration was found to be 14-fold (4.4–47; quartiles Q25 to Q75). The change in antitoxin levels after revaccination was higher in older age groups (P〈0.001), whereas neither sex (P=0.86) nor the country of previous immunization with a different national immunization schedule (P=0.61) had a significant influence on the revaccination effect. Systemic adverse reactions were rare, and local reactions of clinical significance were reported in only 1.9% of subjects.
    Type of Medium: Electronic Resource
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