Bone turnover in postmenopausal women after withdrawal of estrogen/gestagen replacement therapy

Bone turnover before and after withdrawal of estrogen/gestagen treatment was studied in a randomized trial with 110 healthy female volunteers, who had passed a natural menopause 6 months to 3 years before the start of the study. Urinary excretion of intravenously injected 99m-technetium diphosphonate was measured as an index of bone turnover; plasma bone Gla protein and serum alkaline phosphatase were measured as indices of bone formation; and fasting urinary excretion of hydroxyproline and calcium were measured as estimates of bone resorption. During 2 years of hormone treatment, all variables decreased highly significantly (p less than 0.001) to a constant low level. Three months after withdrawal all variables increased highly significantly (p less than 0.001) towards, but not above, pretreatment and placebo levels. We conclude that withdrawal of estrogen/gestagen replacement therapy in postmenopausal women increases bone turnover, but not in excess of pretreatment values. This indicates that bone loss (after withdrawal) is similar to that seen in the placebo group and that a rebound phenomenon is unlikely.     

The prevalence of chromium allergy in Denmark is currently increasing as a result of leather exposure

Background Chromium allergy has traditionally been caused by occupational skin contact with cement. In 1983, Danish legislation made the addition of ferrous sulphate compulsory in cement to reduce the water‐soluble chromium content to not more than 2 ppm. An effect from this intervention has previously been demonstrated among Danish construction workers. Objectives To investigate the development of chromium allergy among patients with dermatitis tested between 1985 and 2007 in Denmark. Furthermore, to determine causative exposures in patients with chromium allergy. Patients and methods A retrospective analysis of patch test data was performed (n = 16 228) and charts from patients with chromium allergy were reviewed. Comparisons were made using a χ² test. Logistic regression analyses were used to test for associations. Results The prevalence of chromium allergy decreased significantly from 3·6% in 1985 to 1% in 1995 (P_trend < 0·001) but increased to 3·3% in 2007 (P_trend < 0·001). The frequency of clinically relevant cement exposure decreased significantly among patients with chromium allergy from 12·7% in 1989–1994 to 3·0% (P < 0·01) in 1995–2007, whereas the frequency of relevant leather exposure increased significantly from 24·1% during 1989–1994 to 45·5% during 1995–2007 (P < 0·02). Conclusions Chromium allergy is currently increasing in Denmark due to leather exposure.     

Pigmented paravenous chorioretinal atrophy

Two patients with pigmented paravenous chorioretinal atrophy are presented. Both patients had chorioretinal atrophy with pigment clusters located in the paravenous areas, and one of the patients had macular affection. This patient had exotropia and juvenile cataract, the other patient had senile cataract. Electroretinography showed decreased, but not totally extinguished potentials. Automatic and manual perimetry revealed relative and absolute scotomas corresponding to the atrophic paravenous areas. To our knowledge this is only the sixth report of pigmented paravenous chorioretinal atrophy with macular affection.     

Temporal trends of aeroallergen sensitization over twenty-five years

BACKGROUND: Little is known about time trends of allergic respiratory disease in adults, in particular in older adults. Furthermore, few trend studies have used objective measurements of IgE sensitization against inhalant allergens. OBJECTIVES: To investigate time trends of aeroallergen sensitization in adults over a 25-year period. METHODS: The study includes a total of 7820 persons, aged 30, 40, 50, and 60 years, who participated in three repeated cross-sectional studies of the general population of Copenhagen, Denmark, in 1976-1977, 1982-1984, and 1999-2001, respectively. Respiratory allergy was assessed by determination of specific IgE aeroallergen sensitization in stored serum samples. RESULTS: Over this 25-year period, a marked and statistically significant increase in the prevalence of aeroallergen sensitization had occurred. This increase was seen in all age-groups challenging the notion that the allergy epidemic only affects generations born 1960 onwards. For example, in 40-year-olds the prevalence (with 95% confidence intervals) of aeroallergen sensitization was 14.9% (12.7-17.1), 19.7% (17.1-22.3), and 27.6% (25.1-30.1) in 1976-1977, 1982-1984, and 1999-2001, respectively. CONCLUSIONS: Our results support that the allergy epidemic has spread to older adults resulting in a continuing increase in the overall prevalence of aeroallergen sensitization and an increase in the mean age of allergic patients.     

Association between alcohol consumption and aeroallergen sensitization in Danish adults

BACKGROUND: It has been proposed that alcohol consumption may be one of the lifestyle factors associated with a westernized, urban, and affluent lifestyle contributing to the rise in atopic disease. OBJECTIVE: The aim was to investigate the association between alcohol consumption and atopy (aeroallergen sensitization). METHODS: In 1982, a population-based cross-sectional study of 3608 Danes (79% of the invited), aged 30, 40, 50, and 60 years, was carried out. Information on alcohol consumption was obtained by a questionnaire. Aeroallergen sensitization was defined as a positive test for the detection of specific IgE against a panel of 19 common inhalant allergens in stored serum samples. A total of 3317 subjects with complete information on all variables were included in the analyses. RESULTS: We found a statistically significant association between alcohol consumption and aeroallergen sensitization (independent of the type of alcoholic drink consumed). This association appeared to relate only to those who consumed more than 8 drinks/week. After adjustment for confounders this association was only statistically significant for those who consumed 15-21 drinks/week (adjusted odds ratio 1.8, 95% confidence interval 1.2-2.8). CONCLUSION: In this adult general population, self-reported alcohol consumption was positively associated with aeroallergen sensitization.     

Duplex ultrasonography of the portal vein

Although the ability of ultrasonography to provide anatomic detail and physiologic information about the arterial system is well established, its applicability for the venous system and the splanchnic circulation has only recently been recognized. We have found duplex scanning, which is non-invasive, rapid, inexpensive, and reproducible, to be highly accurate in (1) establishing or confirming the diagnosis of portal hypertension, (2) demonstrating portal and splenic vein patency and direction of flow, (3) assessing portosystemic shunt patency, and (4) providing novel anatomic and physiologic information regarding the normal and diseased splanchnic venous system. These ultrasonographic techniques also have a significant role to play in the surveillance of patients who have undergone liver transplantation or massive liver resection. To a great extent, ultrasonography may supplant the invasiveness, discomfort, and expense of contrast angiography in the evaluation of many patients with advanced liver disease.     

Loss of somatal neuropeptide y immunoreactivity in the rat hippocampus following transient cerebral ischemia

Adult male Wistar rats were subjected to 20 min of global cerebral ischemia and allowed to survive for 1, 2, 4, or 21 days. The brains were processed for immunocytochemistry and the hippocampal neuropeptide Y (NPY)-immunoreactive (-i) neurons were counted and compared to control values. In order to map out the subregional distribution of ischemic cell loss in the hippocampus, cells were also counted in hematoxylin-eosin (HE)-stained brain sections processed from additional ischemic rats after 21 days survival. Cell counts demonstrated a significant loss of hippocampal NPY-i somata 1-21 days after ischemia. The ischemic loss of somatal NPY-i was in the CAI stratum oriens, the CA1 stratum radiatum, and the CA3(ab) subfield not correlated to hippocampal cell loss. NPY-i fibers were found in all subfields of the hippocampus 1-21 days after ischemia. It is known that the majority (>50%) of hippocampal somatostatin-i (SS) neurons also costore NPY-i and the SS-i neurons in the CA1 and CA3(ab) regions of the hippocampus are preserved following an ischemic insult. The present results showed a 90% ischemic loss of CA1 and CA3 NPY-i somata. Based on these findings, it is concluded that ischemia selectively damaged NPY-i and not SS-i within some surviving hippocampal neurons that co-localized both peptides prior to the ischemia.