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21.
Liesbeth Vandenput Fernand Labrie Dan Mellstr?m Charlotte Swanson Thomas Knutsson Ralph Peeker Osten Ljunggren Eric Orwoll Anna L Eriksson Jan-Erik Damber Claes Ohlsson 《Journal of bone and mineral research》2007,22(2):220-227
Androgens are important regulators of bone and prostate health in elderly men. The role of serum levels of glucuronidated androgen metabolites as predictors of BMD and prostate volume in men is unclear. We show that specific glucuronidated androgen metabolites predict BMD and prostate volume in elderly men. INTRODUCTION: Androgens are important regulators of bone and prostate health in elderly men. Local synthesis and degradation of androgens are likely to be important parameters of biological action of androgens in androgen-responsive tissues. The aim of this study was to determine the role of serum levels of glucuronidated androgen metabolites as predictors of BMD and prostate volume in elderly men. MATERIALS AND METHODS: A subsample of the population-based Swedish part of the MrOS study (n = 631, average age = 75.9 years) was investigated. Bone parameters were measured using DXA. Serum levels of total testosterone (T) and dihydrotestosterone (DHT) were measured by gas chromatography/mass spectroscopy (GC-MS); androstane-3alpha,17beta-diol-3glucuronide (3G) and androstane-3alpha,17beta-diol-17glucuronide (17G) were measured by liquid chromatography/mass spectroscopy. Prostate volume (n = 159) was measured by transrectal ultrasound. RESULTS: The general pattern is that two of the glucuronidated androgen metabolites, namely 17G and 3G, are stronger positive predictors of BMD than the bioactive androgens (T and DHT). In addition, 17G is a clear positive predictor of prostate volume, explaining 4.5% of the variance in prostate volume, whereas the bioactive androgens do not display any association with prostate volume. CONCLUSIONS: Serum levels of specific glucuronidated androgen metabolites predict BMD and prostate volume in elderly men. Future studies should determine if the glucuronidated androgen metabolites also reflect other biological correlates of androgenic activity, including prostate cancer, and if low levels might be a marker of general androgen deficiency in men. 相似文献
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23.
Journal of Neurology - Neuropsychological impairment is common in MS but routine evaluation is cumbersome. Many proposed avenues to more cost effective evaluation of cognition in MS have appeared... 相似文献
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25.
Ralph C Gordon 《Journal of investigative surgery》2006,19(5):279-281
John B. Murphy (1857-1916), one of the most outstanding and controversial surgeons of his age, was a product of the strong clinical programs that developed in Chicago in the late 19th century. Heavily influenced by Christian Fenger, surgeon and surgical pathologist, he went to Europe for training under Theodore Billroth and others. He applied results of his dog lab experiments to human problems while maintaining a large private practice. He is best known for his teaching clinics, for his groundbreaking work with a button for intestinal anastomosis, and for encouraging early operation in appendicitis. Though often in trouble with his fellow surgeons who accused him of stealing patients, especially in the Haymarket affair and when Theodore Roosevelt was shot, he nevertheless made many contributions to the care of surgical patients and development of academic surgery. 相似文献
26.
Mathematical Models for Predicting the Epidemiologic and Economic Impact of Vaccination against Human Papillomavirus Infection and Disease 总被引:2,自引:1,他引:1
Infection with human papillomavirus (HPV) is the primary causeof cervical cancer, other anogenital cancers, genital warts,and recurrent respiratory papillomatosis. Clinical studies havedemonstrated that a prophylactic HPV vaccine can prevent infection,genital warts, and the precancerous lesions that lead to cervicalcancer. Given the absence of data on the long-term effectivenessof HPV vaccination, a number of mathematical models have beendeveloped to provide insight to policy makers by projectingthe long-term epidemiologic and economic consequences of vaccinationand evaluate alternative vaccination policies. This paper reviewsthe state of these models. Three types of HPV mathematical modelshave been reported in the literature: cohort, population dynamic,and hybrid. All have demonstrated that vaccination can significantlyreduce the incidence of cervical cancer in the long term. However,only the cohort and hybrid models have evaluated the cost-effectivenessof vaccination strategies for preventing cervical cancer. Thesemodels have generally shown that vaccinating females can becost-effective. None has accounted for the potential benefitsof vaccinating the population to reduce the burden of recurrentrespiratory papillomatosis and cancers of the vagina, vulva,anus, penis, and head/neck. Given that only the population dynamicmodel can account for both the direct and indirect (i.e., herdimmunity effects) benefits of vaccination in the population,future research should focus on further development of dynamicmodels by expanding the range of epidemiologic outcomes trackedand including the ability to assess the cost-effectiveness ofalternative vaccination policies. cost-benefit analysis economics papillomavirus, human vaccines 相似文献
27.
Elizabeth R. Woods M.D. M.P.H. Jonathan D. Klein M.D. M.P.H. Gina M. Wingood Sc.D. M.P.H. Eve S. Rose M.S.P.H. David Wypij Ph.D. Sion Kim Harris Ph.D. Ralph J. Diclemente Ph.D. 《The Journal of adolescent health》2006,38(6):753.e1-753.e7
PurposeAlthough an adult model of patient-provider mutual exchange of information has been proposed, there is no guiding model for adolescents or measurement methodology. Our purpose was to develop a new scale of patient-provider interaction for adolescents accessing reproductive health care and at risk for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV), and assess the reliability and validity of the scale.MethodsThe Adolescent Patient-Provider Interaction Scale (APPIS) was developed from the Roter and Hall theory of doctor-patient relationships, previously validated adolescent satisfaction and communication scales, and focus group and individual elicitation interviews. To assess construct validity, the new nine-item APPIS was compared with the satisfaction scale used by the Young Adult Health Care Survey (YAHCS), and Kahn’s Provider Communication Scale. Pearson correlation coefficients were used to examine convergence across scales, and factor analysis of the APPIS was performed.ResultsThe study recruited 192 African American girls aged 17.9 ± 1.7 years (range 15–21 years) from three sites: a county STD clinic (n = 51), urban adolescent clinic (n = 99), and a family planning clinic (n = 42). Most participants (85%) rated their overall health care highly (≥ 7 on a 10-point scale); 49% felt that both the provider and patient were “in charge” of the visit, and 88% “strongly agreed” or “agreed” that there was an equal “exchange of information” during the visit. The APPIS showed good internal consistency (Cronbach alpha = .75), and moderate convergence with the six-item YAHCS scale (r = .57, p < .001) and seven-item Kahn scale (r = .48, p < .001). Three factors emerged from exploratory factor analyses, supporting our conceptualization of patient-provider interaction as being multi-dimensional.ConclusionsA new theory-based scale of adolescent patient-provider interaction compares favorably with previous scales of health care satisfaction and communication. The new APPIS may be useful for evaluating approaches to improve health care outcomes for adolescents at-risk for STDs and HIV. 相似文献
28.
Helmut Seidel Barbara Harazin Kristina Pavlas Christine Sroka Jörg Richter Ralph Blüthner Udo Erdmann Jan Grzesik Barbara Hinz Reinhard Rothe 《International archives of occupational and environmental health》1988,61(1-2):95-106
Summary This study was carried out in order: (1) to examine the effects of isolated and combined prolonged exposures to noise and whole-body vibration on hearing, vision and subjectively experienced strain, and (2) to check the combined effects with repeated exposures. Six male subjects were exposed twice to noise (N) at 92 dBA, whole-body vibration (V) in the Z-axis at 4 Hz and 1.0 ms–2 rms, and noise and vibration (NV) for 90 min with each condition. Temporary threshold shifts of hearing (TTS) and their integrals (ITTS) were measured at 4, 6, 10, and 12 kHz. Visual acuity was examined by means of a very sensitive test. Cross-modality matching (CMM) of the handgrip force was used to judge the subjectively experienced strain. NV induced a clear tendency of higher TTS and ITTS than N, with several significant differences most pronounced at 10 kHz. With repeated exposures, the effect of NV decreased, while the reactions to N and V remained unchanged. The individual reactions to NV differed. The influence of the duration of exposures on vision depended on the condition; N caused time-dependent changes, whereas V did not. CMM-data increased with the duration of the exposure during V and NV. N was generally judged to be more straining than V; NV caused higher strain than V during the first 30 min of exposure only. Correlations between different effects suggest certain links between them. Additionally, less motivation — daily obtained by a questionnaire — often correlated with higher ITTS during N and NV. The results also illustrate the combined effects on the individual susceptibility, repetition of exposure, the kind of response, and, possibly, the actual psychic state.Abbreviations CMM
cross-modality matching
- MVC
maximum voluntary contraction force
- N
exposure condition: noise level 92dBA, no whole-body vibration
- NV
exposure condition: combined exposure to noise with a level of 92 dBA and wholebody vibration with 4 Hz, 1 ms–2 rms
- V
exposure condition: whole-body vibration with 4 Hz, 1 ms–2 rms
- TTS
temporary threshold shift
- ITTS
integral of temporary threshold shift
- WBV
whole-body vibration in the common sense
This work was done in the Temporary International Research Team on Combined Effects of Noise and Vibration of the Council of Mutual Economic Assistance of the Socialist Countries. The authors gratefully acknowledge the help and assistance of L.-M. Brumm, Y. Bening, M. Godau, G. Weber, and R. Vizcaino. 相似文献
29.
A 73-year-old woman presenting with persistent swelling of the right knee 30 months after total joint arthroplasty was found to have a Candida parapsilosis infection. Treatment with fluconazole resulted in full recovery. 相似文献
30.
Peter Reimer Sanjay Saini Ken K. Kwong Mark S. Cohen Ralph Weissleder Thomas J. Brady 《Journal of magnetic resonance imaging : JMRI》1994,4(3):331-335
To develop guidelines for clinical magnetic resonance imaging of the liver, the authors undertook an animal study to investigate the effect of dose and pulse sequence on liver signal intensity in gadopentetate dimeglumine—enhanced echo-planar imaging. Serial imaging of the liver was performed in anesthetized rats after intravenous administration of five different doses (0.01, 0.05, 0.1, 0.2, and 0.5 mmol/kg) of contrast agent, with six different pulse sequences. The results show that gadopentetate dimeglumine—enhanced echo-planar images obtained during the perfusion phase can yield either positive (due to increased T1 relaxation rates) or negative (due to susceptibility-induced increased T2 relaxation rates) liver enhancement depending on choice of pulse sequence and dose. At the current clinically recommended dose of 0.1 mmol/kg, maximal liver signal enhancement was seen with a T1-weighted inversion-recovery sequence, while maximal liver signal diminution was seen with a T2*-weighted gradient-echo sequence. The authors conclude that gadopentetate dimeglumine—enhanced echo-planar imaging can provide T1, T2, and T2* contrast that may be exploited for both lesion detection and lesion characterization. 相似文献