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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Maintenance of a nutrient database for use in dietary analysis for clinical trials and other medical research studies is described. The database, maintained at the University of Minnesota's Nutrition Coordinating Center (NCC), has been used to calculate dietary intake data for a wide range of diet-disease related investigations including studies on cardiovascular disease, hypertension, cancer, gastroenterology, and osteoporosis. Potential sources of error associated with nutrient databases are identified. Criteria are provided for the selection of a nutrient database to meet study objectives and to minimize the potential for errors and inconsistencies. NCC database maintenance procedures, designed to provide updated and verified nutrient calculations for clinical research, involve adherence to standardized procedures for all aspects of database maintenance including data selection, imputations, quality control, recipe calculations, and documentation. By maintaining multiple versions of the database, the NCC is able to update and expand a working version of the database while providing database stability for individual research studies.
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PMID:Maintenance of a nutrient database for clinical trials. 260 60

We studied long-term morbidity after parathyroid surgery for primary hyperparathyroidism in 100 patients and compared it with the long-term morbidity of medical follow-up from the literature. The surgical treatment of primary hyperparathyroidism was associated with negative results of neck explorations, persistent hypercalcemia, recurrent hypercalcemia, permanent hypoparathyroidism, or recurrent laryngeal nerve damage in 13 (19%) of 68 patients followed up for five years postoperatively. A review of medical follow-up as reported in the literature showed progression of disease in 8% to 22% of patients followed up for five to ten years. There was no convincing evidence that mild primary hyperparathyroidism resulted in progressive osteoporosis or renal failure. Furthermore, no significant improvement in hypertension, peptic ulcer disease, or renal function followed successful parathyroid surgery. Unless future studies demonstrate progressive osteoporosis or renal damage in untreated, mild primary hyperparathyroidism, medical follow-up is a reasonable alternative to surgery in the compliant patient over 50 years of age.
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PMID:Primary hyperparathyroidism. A review of the long-term surgical and nonsurgical morbidities as a basis for a rational approach to treatment. 270 30

During the period from 1985 till 1988, 48 patients with this disease were treated; in 28 patients (58%) conservatively treated with pronisone, immunated with thrombocytes that possessed onkovin, a remission had been achieved. In 20 patients (41%), following an unsuccessful conservative treatment, splenectomy was performed; of whom 14 were female (70%) and 6 were male (30%), with an average age of 36 years (between 20-52 years). Prior to that they were conservatively treated from 1-15 years (on the average 4.7 years). Despite the failure of the conservative treatment, an indication for splenectomy was the high doses of corticosteroids needed, as well as the appearance of serious unwanted effects of this therapy (ulcer, steroid diabetes, hypertension, osteoporosis), also the unsuccessful treatment with thrombocytes which carried onkovin. There was no surgical lethality; 2 female patients developed deep ileofemoral thrombophlebitis of the left leg, one 7 days, and the other 1 1/2 months following the surgery, and after an adnexoparametritis of the left side. Following intensive anticoagulant and fibrinolytic therapy, a complete recanalization of the vein was achieved in both female patients, without any signs of a postphlebitis syndrome. One patient who had previously been treated for 15 years with high doses of pronisone and persistently refused surgery during this period, followed splenectomy developed miliary tuberculosis which ended lethally 2 months following the splenectomy. In 14 patients (73.6%) a complete remission was attained. In 2 patients (10.5%) the number of thrombocytes was not necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Splenectomy in the treatment of idiopathic thrombocytopenic purpura]. 271 7

Recent information has shed a new light on the control of parathyroid hormone (PTH) secretion by calcium and 1,25-(OH)2D. These new data have permitted a better understanding of the pathogenesis and management of secondary hyperparathyroidism in end-stage renal disease. Emerging evidence has suggested a role for secondary hyperparathyroidism in the development of certain forms of hypertension and osteoporosis. Recent insights have been obtained regarding the occurrence of secondary hyperparathyroidism in obese and black subjects, in patients with multiple endocrine neoplasia type I, and in manic-depressive patients receiving lithium therapy. This review examines some of these recent gains in knowledge concerning secondary hyperparathyroidism, as well as their clinical implications.
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PMID:Update on secondary forms of hyperparathyroidism. 288 9

Calcium deficiency is a constant menace to land-abiding animals, including mammals. Humans enjoying exceptional longevity on earth are especially susceptible to calcium deficiency in old age. Low calcium and vitamin D intake, short solar exposure, decreased intestinal absorption, and falling renal function with insufficient 1,25(OH)2 vitamin D biosynthesis all contribute to calcium deficiency, secondary hyperparathyroidism, bone loss and possibly calcium shift from the bone to soft tissue, and from the extracellular to the intracellular compartment, blunting the sharp concentration gap between these compartments. The consequences of calcium deficiency might thus include not only osteoporosis, but also arteriosclerosis and hypertension due to the increase of calcium in the vascular wall, amyotrophic lateral sclerosis and senile dementia due to calcium deposition in the central nervous system, and a decrease in cellular function, because of blunting of the difference in extracellular-intracellular calcium, leading to diabetes mellitus, immune deficiency and others (Fig. 6).
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PMID:Aging and calcium as an environmental factor. 294 80

Recent studies of vegetarian diets and their effects on morbidity and mortality are reviewed. Vegetarian diets are heterogeneous as are their effects on nutritional status, health, and longevity. Mortality rates are similar or lower for vegetarians than for nonvegetarians. Risks of dietary deficiency disease are increased on vegan but not on all vegetarian diets. Evidence for decreased risks for certain chronic degenerative diseases varies. Both vegetarian dietary and lifestyle practices are involved. Data are strong that vegetarians are at lesser risk for obesity, atonic constipation, lung cancer, and alcoholism. Evidence is good that risks for hypertension, coronary artery disease, type II diabetes, and gallstones are lower. Data are only fair to poor that risks of breast cancer, diverticular disease of the colon, colonic cancer, calcium kidney stones, osteoporosis, dental erosion, and dental caries are lower among vegetarians. Reduced risks for chronic degenerative diseases can also be achieved by manipulations of omnivorous diets and lifestyles.
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PMID:Health aspects of vegetarian diets. 304 2

Lengthened life expectancy, along with the increased chance that much time in late life may be spent with disabilities and terminal dependency, suggests the need for increased efforts in health promotion and disease prevention in elderly persons. Both goals can be achieved, partly through programs that stress both screening and early detection of some diseases, such as cancer, and decreasing the risk factors of others, such as hypertension, heart disease, and stroke. Efforts also need to be addressed at other common sources of disability and dysfunction like osteoporosis, falls, and fractures. Exercise is an important factor in such programs in order to extend active life expectancy and enhance vigor in later life. Habitual exercise is, however, one of the least prevalent of all the health promotion activities. A carefully designed exercise program that includes education about the reasons for exercise, as well as the proper methods of exercise, could considerably change the health profile of the individual patient and the increasing population over age 65 in this country.
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PMID:Health promotion and disease prevention in the older adult. 305 84

As a contribution to the formulation of food guidelines and nutritional goals for Latin America, this article examines the singular situation of the elderly, defined as those persons over 60 years of age. The projected data for the year 2025, published by the Population Department of the United Nations, show that this age group represents an important sector--6.4% of the population in 1980--that is growing. Some countries, however, do have a rate that is comparable to the United States, 11.3%, such as Argentina, 12.7%, and Uruguay, 14.8%, which is similar to that of Europe. Along with other comparative demographic information, the analysis covers some of the biological, physiological, pathological, and psychosocial characteristics that become more common in senescence. To a certain extent, these characteristics bear a direct or indirect relationship with the energy, protein, and nutrient content of the diet. This becomes more evident upon examining the causes of mortality and morbidity in the elderly, whose diseases are quite often chronic and degenerative. Those with the highest incidence, such as the cardiovascular ones--including cerebrovascular accidents, atherosclerosis, and hypertension--diabetes, obesity, osteoporosis, anemias from lack of iron and folates, and some forms of cancer, reveal the influence of certain nutrients in their pathogenesis. Very few studies have been done on the over-70 age group to determine their requirements for energy, proteins, and various nutrients that serve as the basis for appropriate food guidelines. Usually, estimates are extrapolated from data on the 40-and-over age group. Some maintain that the variations for the elderly are small, but since this group is growing and is far from homogeneous, such a hypothesis must be tested. Following a review of recent literature, the article proposes a set of Food Guidelines and Nutritional Goals for persons over 60 in Latin America. It also recommends to countries interested in formulating their own guidelines how to proceed for the short, medium, and long terms. In Latin America and the Caribbean, the elderly are the most neglected group with reference to government programs, and most forgotten by society. They depend to a great extent on the labor force of each country. They suffer most frequently from chronic diseases and have the most need for medical care, they use a broad range of drugs that may interfere with the absorption and utilization of nutrients, as well as foods when may impair the bioavailability of drugs. They show the highest mortality rates, and, in a high proportion, require a normal diet.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Food guidelines and nutritional goals for aging]. 315 33

A young male patient demonstrated unusual features of Cushing's syndrome, atrial myxomas and freckled skin pigmentation. At 4.5 years of age he presented with intermittent swelling of his face and abdomen associated with weight gain and mild hypertension. A left atrial myxoma, suspected from routine physical examination, was surgically removed at 6.1 years of age. The initial mild symptoms clinically thought to be due to Cushing's syndrome, persisted intermittently without any consistent biochemical abnormality. At 10 years of age height velocity decreased and at 12 years early osteoporosis was observed radiologically. Repeated dexamethasone tests revealed a paradoxical increase in cortisol and corticotrophin from normal basal levels. Further investigation showed a cyclical pattern of hypercortisolism. The removal of a pituitary microadenoma failed to correct the features of Cushing's syndrome or prevent intermittent hypercortisolism. At 15.3 years a second left atrial myxoma was removed. This was followed by bilateral adrenalectomy. Histologically the features were consistent with primary pigmented nodular adrenocortical disease. This is the first patient described with cyclical Cushing's syndrome as part of this unusual complex of disorders.
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PMID:Cyclical Cushing's syndrome presenting as short stature in a boy with recurrent atrial myxomas and freckled skin pigmentation. 316 6

More and more people are turning to exercise as a means of achieving long-term health. The World Health Organization has endorsed this concept. The best available evidence suggests that an employee fitness programme will result in decreased health-care costs, decreased absenteeism and increased productivity for the employer. Regular physical activity is also associated with lower mortality rates. Appropriate physical activity may be a valuable tool in therapeutic regimens for the control and amelioration (rehabilitation) of cardiovascular disease, coronary artery disease, hypertension, congenital heart disease, peripheral vascular disease, obesity, chronic obstructive pulmonary disease, diabetes mellitus, musculoskeletal disorders, end-stage renal disease, stress, anxiety and depression, etc. Regular physical activity, independent of other factors, reduces the probability of coronary artery disease and early death. Patients with risk factors for coronary artery disease need more intensive preexercise evaluation than those not a risk, and those with known or suspected cardiovascular disease need the most intensive evaluation and follow-up. Participation in vigorous sports activities, such as jogging, swimming, tennis, etc., helps to protect against the development of hypertension, even when other predisposing factors are present. Several studies have been conducted on the use of exercise in the treatment of hypertension. Physical exercise also contributes to the control of body weight. Consideration of the metabolic abnormalities in patients with type II (adult onset) diabetes indicates that they would make excellent candidates for an exercise programme. Osteoporosis is an important health problem for the elderly. The best treatment available at present is prevention, and a high level of physical activity throughout life can result in a larger skeletal mass during old age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of physical activity in the prevention and treatment of noncommunicable diseases. 323 11


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