ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01010.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01011.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01012.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01013.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01014.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01015.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01016.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objective.To evaluate primary hyperparathyroidism (HPT) as a risk factor for hip fractures.Design.A population‐based, record‐linked, prospective study with a mean observation time of 17 years (women) and 16.5 years (men).Setting.A cohort obtained from a register of hospital admissions in the Uppsala Health Care Region, Sweden, 1965–1983.Participants.All patients (1373 women and 551 men) who were admitted to hospital with the diagnosis of HPT during the period. Comparisons were made with the entire background population.Measurements.Cohort subjects were followed with regard to a first instance of hip fracture prior to or after the diagnosis of HPT. The observed number of cases was compared with that expected on the basis of person‐years of observation and incidence rates in the background population. Analyses were made for cervical and trochanteric fractures, and for patients operated and not operated for HPT.Main results.(i)Women.During 23 341 person‐years of observation, 67 cases of first hip fractures occurred, yielding a relative risk (RR) of 0.93 (95% confidence interval [CI] 0.72–1.19). The RR for cervical fractures was 0.77 (CI 0.54–1.06), and for trochanteric fractures 1.33 (CI 0.88–1.93). Operation for HPT did not influence the risk of hip fracture. (ii)Men.The total person‐years was 9091. Eleven fractures were observed—compared with the expected 7.90 (RR 1.39; CI 0.69–2.50). Men operated for HPT had an increased risk for cervical hip fractures (RR 2.73; CI 1.18–5.39). Owing to the few fractures in this group (n= 8) the relevance of this is uncertain.Conclusions.This study indicates that HPT is not a risk factor for

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01017.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives.To evaluate the effect of conventional antihypertensive drugs and/or inhibitors of steroid production in the management of hypertension in Cushing's syndrome.Design.A retrospective open clinical study with pre‐and post‐treatment assessment.Setting.A university hospital, where patients were initially admitted and then followed‐up in an ambulatory clinic over a period of 6 years.Subjects.Forty consecutive hypertensive patients with Cushing's syndrome.Interventions.Patients were divided into two groups according to the different management of hypertension. The first group (group 1) of 28 patients included those treated with antihypertensive drugs at full dose (diuretics, calcium antagonists, angiotensin converting enzyme [ACE] inhibitors, as single agents or in combination). The second group (group 2) of 12 patients received ketoconazole alone.Main outcome measures.Blood pressure variations compared to pre‐treatment levels.Results.Blood pressure normalization was obtained in four of the 28 patients of group 1. In 12 of the remaining patients, ketoconazole, an inhibitor of steroid production, was subsequently added and this normalized blood pressure in all but the one in whom Cortisol was not decreased. In the 12 patients of group 2, ketoconazole alone lowered blood pressure within normal limits in all but one who had longstanding hypertension.Conclusions.In hypertensive patients with Cushing's syndrome, conventional antihypertensive therapy is mostly ineffective. Blood pressure response is satisfactory only after the restoration of normal Cortisol levels, indicating the need for a specific treatment for hypertension in this d

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01018.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives.The purpose of this study has been to investigate by ultrasonographic methods the flow velocities of cerebral arteries because increased blood viscosity due to haematocrit elevation can cause neurological symptoms in polycythaemia vera patients, because of the resulting decrease in cerebral flow.Subjects and design.Twenty newly diagnosed patients, with haemoglobin values of>18 g dl−1and/or an haematocrit of>50%, were examined by transcranial Doppler. Recordings were performed in basal conditions and after pharmacological and/or phlebotomic treatment, when haematocrit values were ≤ 50%. Blood velocities were evaluated in middle (MCA), anterior (ACA), posterior (PCA) cerebral arteries and in the basilar (BA) artery.Results.Basal recordings showed decreased velocities (MCA: 39.40 ± 9.34 cm s−1; ACA: 34.05 ± 10.25 cm s−1; PCA: 31.46 ± 5.97 cm s−1; and BA: 27.47 ± 7.42 cm s−1); pre‐ and post‐treatment value differences observed in MCA, ACA and BA were highly significant (P<0.001).Conclusions.A decrease in cerebral flow could be a risk for multifocal micro‐ischaemic cerebral infarctions leading, after several years, to a multi‐infarct dementia; an early reduction in erythrocyte burden should be very useful in polycythaemic patients in pre

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb01019.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY