Renin,aldosterone and Cortisol during ethanol intoxication and hangover

The effect of ethanol intoxication and hangover on plasma renin activity (PRA), plasma aldosterone (PA) and plasma Cortisol (PC) concentrations was studied in 7 healthy supine men in controlled clinical conditions during 18 h beginning at 6 p.m. Large individual variation was observed in the response of PRA, PA and PC to ethanol. Following ethanol, stimulation of PRA was observed at the 14th and the 16th hour (P<0.05), of PA at the 4th and the 6th hour (P<0.01 and P<0.05, respectively) and of PC at the 4th and the 14th hour (P<0.01 andP<0.05, respectively). Ethanol ingestion suppressed PC during the first hour (P<0.02). Water ingestion at 8 a.m. suppressed PA between the 14th and the 16th hour (8–10 a.m.) in control and ethanol experiment (P<0.01 and P<0.005, respectively). There was a dissociation between PRA and PA, but intra-individually PRA and PA correlated fairly or well. Plasma arginine vasopressin (AVP) and PC were also significantly correlated. The results suggest that changes in PA and PC as well as the dissociation of PRA and PA after ethanol ingestion might be partly related to dehydration and to the increased secretion of hypothalamic and pituitary hormones as well as to sodium and potassium balance. There was a biphasic effect of ethanol, including an initial suppression of PC and a subsequent increase of PC, PRA and PA. Upright posture appears to exaggerate the stimulating effect of ethanol on PRA, PA and PC.     

Sleep bruxism based on self-report in a nationwide twin cohort

The relative roles of genetic and environmental factors in bruxism are not known. In 1990 a questionnaire sent to the Finnish Twin Cohort yielded responses from 1298 monozygotic and 2419 dizygotic twin pairs aged 33–60 years. We used structural equation modelling to estimate genetic and environmental components of variance in the liability to bruxism. There was a significant gender difference both in childhood (P =0.001) and adult (P =0.007) bruxism. Females compared to males reported childhood bruxism ‘often’ 5.2% vs 4.1% and ‘sometimes’ 17.4% vs 17.3%, and as adults ‘weekly’ 3.7% vs 3.8% and ‘monthly’ 3.9% vs 4.6%, respectively. Bruxism in childhood and adulthood is highly correlated (0.86 in males and 0.87 in females). The proportion of total phenotypic variance in liability to bruxism attributed to genetic influences in childhood bruxism was 49% (95% CI 37–60%) in males and 64% (55–71%) in females, and for adults 39% (27–50%) among males and 53% (44–62%) among females. The correlation between the genetic effects on childhood bruxism and the genetic effects on adult bruxism was estimated in a bivariate model to be 0.95 (95% CI 0.94–0.96) in males and 0.89 (0.88–0.90) in females. Bruxism appears to be quite a persistent trait. There are substantial genetic effects on bruxism both in childhood and as adults, which appear to be highly correlated.     

Dental maturity in hypopituitarism, and dental response to substitution treatment

abstract — In 25 patients with hypopituitarism the relation of skeletal and dental maturity and the effects on it of substitution therapy for 2–4 years were analyzed. Dental age was retarded less regularly and to a lesser degree than skeletal age and statural growth. In most patients dental age was within the range of 0–2 s.d. All components of dental development seemed equally retarded. Changes in dental delay during GH treatment were variable, but in most cases parallel to the changes in statural and skeletal delay. When treatment was discontinued the lag in dental age increased, showing a response similar to that of skeletal age.     

Complications Related to Permanent Pacemaker Therapy

This study evaluates complications related to permanent endocardial pacing in the era of modern pacemaker therapy. There is only limited information available about the complications related to modern cardiac pacing. Most of the existing data are based on the 1970s and are no longer valid for current practice. The recent reports on pacemaker complications are focused on some specific complication or are restricted to early complications. Thus, there are no reports available providing a comprehensive view of complications related to modern cardiac pacing. Four hundred forty-six patients, who received permanent endocardial pacemakers between January 1990 and December 1995 at Kuopio University Hospital, were reviewed retrospectively using patient records. Attention was paid to the occurrence of any complication during the implantation or follow-up. An early complication was detected in 6.7%, and 4.9% of patients were treated invasively due to the early complication. Late complication developed in 7.2% and reoperation was required in 6.3% of the patients. Complications related to the implantation procedure occurred in 3.1%. Inadequate capture or sensing was observed in 7.4% of the patients. Pacemaker infection was detected in 1.8% and erosion in 0.9% of the patients. An AV block developed in 3.6% (1.6%/year) patients who received an AAI(R)-pacemaker due to sick sinus syndrome. There was no mortality attributable to pacemaker therapy. A great majority (68%) of the complications occurred within the first 3 months after the implantation. Complications associated to modern permanent endocardial pacemaker therapy are not infrequent. Eleven percent of patients needed an invasive procedure due to an early or late complication.     

ALCOHOL-RELATED DISEASES ASSOCIATED WITH ISCHAEMIC HEART DISEASE: A THREE-YEAR FOLLOW-UP OF MIDDLE-AGED MALE HOSPITAL PATIENTS

Mortality and morbidity from ischaemic heart disease (IHD) wasstudied in 5404 Finnish males aged 35–64 years who hadbeen hospitalised for alcohol-related disease in 1972 withoutany admissions for IHD during that same period. By record-linkage,morbidity and mortality were followed up to the end of 1975.The mortality of patients with alcohol-related diseases wascompared to 1120 patients with acute appendicitis by calculatingindirectly age-standardised mortality ratios (SMR). The mortalityand morbidity of 5963 patients with acute myocardial infarctionor angina pectoris was also studied. The following SMRs forIHD mortality, non-fatal-MD-hospitalisation and for mortalityfrom all causes respectively, were found: acute myocardial infarction11.6, 7.2 and 7.2; alcohol intoxication 6.0, 4.5 and 4.5; anginapectoris 5.2, 10.5 and 3.4; liver cirrhosis 2.2, 2.5 and 11.8;alcoholism 1.9, 1.9 and 3.6; pancreatitis 1.8, 1.2 and 4.4;alcohol psychosis 1.7, 2.5 and 4.2. IHD mortality and morbidityappeared to be more prevalent in patients hospitalised withalcohol intoxication than in patients with other alcohol-relateddiseases. This suggests that rapid drinking predisposes bothto serious intoxication and to fatal disturbances of cardiacrhythm     

Turner Syndrome: Effect of Hormone Therapies on Height Velocity and Adult Height

ABSTRACT. 76 patients with Turner syndrome received estrogen alone, androgen and estrogen started simultaneously or, after preceding androgen therapy, estrogen with or without androgen. Six patients had spontaneous pubertal development and received no estrogen. Two patients received human growth hormone with androgen during >2.0 years. Height velocity increased during all therapies to mean SD scores of 7.6 during androgen-estrogen started simultaneously, 4.6 during androgen alone, 4.2 during androgen-estrogen after preceding androgen, 2.7 during estrogen alone, and 0.6 during estrogen after preceding androgen. Adult height was measured in all cases, it was 145.5±5.7 (mean ± SD) for the whole series without significant differences between the groups. It correlated strongly with midparent height, and was greater for patients with the 45,X karyotype than for the others combined.     

Ketoconazole is Effective against the Chronic Mucocutaneous Candidosis of Autoimmune Polyendocrinopathy-Candidosis-Ectodermal Dystrophy (APECED)

ABSTRACT Ketoconazole was administered as a single daily oral dose of 200 mg to 12 patients with chronic mucocutaneous candidosis (CMC) of autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED). The study was double-blind and placebo-controlled, with 4-month therapy periods and crossover, and transfer to open-label ketoconazole therapy in cases of failure. During the double-blind trial, all six initially ketoconazole-treated patients showed a clear clinical and mycological improvement. In contrast there was no change or worsening in the initially placebo-treated group (p=0.001). Oral candidosis cleared up in all patients, but more rapidly (<2 weeks) in those aged <25 years than in older patients (4–10 weeks; p=0.001). Similarly, nail candidosis improved more rapidly in the younger group. All patients had a recurrence of the candidosis during 36–48 months of post-therapy follow-up. The recurrences likewise responded to ketoconazole. In one patient serum transaminase activities were transiently and marginally elevated during 2–6 weeks of therapy.     

ENZYMES OF CATECHOLAMINE METABOLISM IN THE BRAINS OF RAT STRAINS DIFFERING IN THEIR PREFERENCE FOR OR TOLERANCE OF ETHANOL

The activities of the catecholamine-synthesizing and inactivatingenzymes were determined in whole brains of two pairs of ratstrains differing in their genetically-determined behaviouralresponses to ethanol. The alcohol-tolerant (AT) rats did notshow any significant differences in enzyme activities when comparedwith the non-tolerant (ANT) strain. The activity of tyrosinehydroxylase was found to be significantly higher in brains ofthe alcohol-preferring (AA) rats, than in those of the alcohol-non-preferring(ANA) strain.     

Adenosine 3‘, 5’ cyclic monophosphate,calcium and magnesium excretion in ethanol intoxication and hangover

Effect of ethanol on adenosine 3′, 5′ cyclic monophosphate (cAMP), calcium (Ca) and magnesium (Mg) excretion was studied in controlled clinical conditions in man. Seven male volunteers served as their own controls. In 5 subjects cAMP excretion was primarily suppressed by ethanol. Ethanol appeared to have a biphasic effect on Ca excretion, an initial stimulation followed by a conservation phase. Mg excretion was stimulated by ethanol in 5 subjects. Subjects having nausea and vomitus and the most severe hangover symptoms had the lowest urinary Ca excretion and the lowest initial cAMP excretion. Ca and Mg metabolism and the susceptibility of the body to the toxic effects of ethanol appeared to be interrelated.