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Journal Article 2006; 27(1-2): 16-20 PubMed PMID: 16648779 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Anticonvulsants:therapeutic use, Brain:pathology, Electroencephalography, Female, Humans, Male, Middle Aged, Risk Factors, Secondary Prevention, Seizures:drug therapy, Social Environment,.   

: Patients experiencing solitary unprovoked epileptic seizure have different risks of recurrence. The possible risk factors include in particular: structural cerebral lesion and its cause, history of febrile seizures, family history of epilepsy, the type of seizure, epileptiform EEG discharges and the problem of initiation or (or not initiation) of antiepileptic treatment after the first paroxysm. The factors shown above were evaluated in a group of 30 patients with solitary unprovoked epileptic seizure. Regarding recurrence of epileptic seizure, the only significant factor appeared to be initiation of treatment after the first unprovoked paroxysm (p<0.001). We observed a 30% and 33.33% risk of recurrence following the initial epileptic seizure in patients after the first unprovoked seizure in less than 1 and 3 years, respectively....

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Clinical Trial 2005; 26(6): 811-814 PubMed PMID: 16380700 Citation  Keywords:  Acromegaly:blood, Adult, Cardiovascular Diseases:complications, Female, Glucose Tolerance Test, Growth Hormone:blood, Homocysteine:blood, Humans, Hyperhomocysteinemia:blood, Male, Middle Aged, Risk Factors, Statistics, Nonparametric,.   

: Acromegaly is associated with a two to three-fold increase in mortality related predominantly to cardiovascular disease. The excess mortality is associated most closely with higher levels of growth hormone (GH). Survival in acromegaly may be normalized to a control age-matched rate by controlling GH levels; in particular, GH levels less than 2.5 ng/mL are associated with survival rates equal to those of the general population. Hyperhomocysteinemia has also been recognized as a risk factor for cardiovascular disease, yet there are limited data on the prevalence of hyperhomocysteinemia in patients with acromegaly. Eighteen acromegaly patients (7 male, 11 female, mean age 42.8 +/- 11.0 years) in our endocrine clinic consented to having the following tests performed: complete blood count (CBC), thyroid hormones, folic acid, vitamin B12, plasma homocysteine levels, uric acid, fibrinogen, CRP, fasting glucose, insulin, C-peptide, total serum cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, GH, insulin-like growth factor-1 (IGF-1) and GH levels after an oral glucose tolerance test (OGTT). By history, fourteen had macroadenomas and four had microadenomas; eight had hypertension; two had glucose intolerance, and four had diabetes. Fifteen had had transsphenoidal or transfrontal surgery: two had been cured, but 13 others were taking long-acting octreotide. Five patients had undergone radiotherapy and the acromegaly in two was treated primarily with long-acting octreotide. CBC, thyroid hormone, folic acid, and vit B12 levels were normal in all patients. We divided the patients into two groups according to mean GH levels after an OGTT: Group 1 (GH<2.5 ng/mL, n=10), and Group 2 (GH<2.5 ng/mL, n=8). Comparison of the two groups using Mann-Whitney U testing revealed statistically significant lower levels in Group 1 of the following parameters: GH (1.91 +/- 0.90 vs. 8.58 +/- 5.55 ng/mL, p=0.002), IGF-1 (338.30 +/- 217.90 vs. 509.60 +/- 293.58 ng/dL, p=0.06), GH after an OGTT (1.42 +/- 0.81 vs. 9.01 +/- 4.53 ng/mL, p=0.001), plasma homocysteine (12.85 +/- 4.47 vs. 18.20 +/- 4.99 micromol/L, p=0.05), total cholesterol (164.0 +/- 20.81 vs. 188.0 +/- 22.26 mg/dL, p=0.05) and LDL cholesterol (81.0 +/- 9.64 vs. 116.70 +/- 13.03 mg/dl, p=0.01). Differences between the other parameters were not significantly different. Acromegaly patients with high GH levels after an OGTT have much higher levels of homocysteine than patients with lower GH levels. The role of elevated homocysteine levels as an independent cardiovascular risk factor in the mortality of acromegaly patients should be determined in future studies....

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Journal Article 2005; 26(3): 261-263 PubMed PMID: 15990733 Citation  Keywords:  Aged, Alzheimer Disease:blood, Cognition Disorders:blood, Depression:blood, Female, Folic Acid:blood, Humans, Lipoproteins:blood, Male, Risk Factors, Severity of Illness Index, Smoking:blood,.   

: The risk for Alzheimer's disease (AD) is associated with lifestyle factors, especially cigarette smoking. In this study we investigated the influence of smoking on the serum levels of folic acid, LDL and HDL in AD patients, patients with minimal cognitive impairment (MCI) and patients with major depression. We investigated a total of n = 374 patients in the diagnostic categories:, AD: n = 272, MCI: n = 60, Major depression: n = 42. We found significantly lower HDL levels in smokers and previous smokers in comparison to non-smokers, p<0,05. The LDL: HDL ratio in smokers was significant higher (+20%) compared to previous smokers and non-smokers, p < 0.05. The mean levels of folic acid were statistically significant (p<0.05) lower (-24%) in smokers compared to non-smokers. Patients with MCI and Alzheimer;s disease (and also major depression) who are "smokers" show serum levels of HDL and folic acid that are known to be strong risk factors for vascular damage and increased risk for vascular brain damage and impaired cognitive function. Therefore cessation of smoking, substitution with folate or statin therapy of smoking patients with MCI or AD might be beneficial to slow down further cognitive decline....

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Journal Article 2004; 25(Suppl 1): 43-47 PubMed PMID: 15735585 Citation  Keywords:  Female, Humans, Infant, Newborn, Pregnancy, Premature Birth:epidemiology, Risk Factors,.   

: Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. The diagnosis of preterm labour is difficult and most interventions to halt labour are unsuccessful. Despite this, the lack of good data hinders high quality research. The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. Survival rates amongst preterm infants have changed dramatically over the last decade, with 88% survival for 2728 weeks, and 21% for > or =24 weeks (depending on birth weight). Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described....

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Clinical Trial 2004; 25(4): 262-266 PubMed PMID: 15361814 Citation  Keywords:  Adult, Biomarkers:blood, Blood Pressure, C-Reactive Protein:analysis, Coronary Disease:blood, Female, Homocysteine:blood, Humans, Hyperlipidemias:blood, Hypothyroidism:blood, Middle Aged, Reference Values, Risk Factors, Severity of Illness Index, Statisti.   

OBJECTIVES: Overt hypothyroidism (OH) is associated with premature atherosclerosis and coronary heart disease (CHD). Recently, C-reactive protein (CRP) and total homocysteine (tHct) emerged as additional independent cardiovascular risk factors. Subclinical hypothyroidism (SH), affecting as many as 15% of middle-aged women is not known to be associated with risk for CHD.

DESIGN AND MEASUREMENTS: We measured CRP and tHct levels as well as conventional cardiovascular risk markers in 44 middle-aged women with newly diagnose SH. Results were compared with those obtained in 10 patients with OH and 19 euthyroid controls.

RESULTS: In SH, tHct and CRP levels were not as augmented as compared to controls. Their mean systolic and diastolic blood pressure values were increased vs. controls (p<0.04;p<0.01, respectively). Mean values of total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides, TC/HDL-C and LDL-C/HDL-C were not different in patients with SH compared to controls. Individual analysis revealed that the percentage of patients with SH having hypertension, hypertriglyceridemia, hypercholesterolemia, elevated TC/HDL-C and LDL-C/HDL-C ratios were higher than the percentage in controls. CRP positively correlated with BMI(r=0.29,p<0.02), and tHct positively correlated with age (r=0.24, p<0.05).

CONCLUSIONS: Our findings suggest that subclinical hypothyroidism in middle-aged women is associated with hypertension and dyslipidemia. CRP and tHct do not appear to contribute to the increased risk for CHD in these patients....

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Congresses 2002; 23(Suppl 2): 84-87 PubMed PMID: 12163855 Citation  Keywords:  Animals, Humans, Light:adverse effects, Neoplasms:epidemiology, Neurosecretory Systems:physiology, Risk Factors,.   

: The International Symposium "Light, Endocrine Systems and Cancer" was held on May 2-3 at Cologne University, Germany. The symposium was organized by Professor Claus Piekarski and Dr. Thomas C. Erren, Institute and Polyclinic for Occupational and Social Medicine. The main goal of the symposium was to evaluate the epidemiological and experimental data on the effect of the exposure to light-at-night on cancer risk and to indicate the main directions of future research in the field. The symposium covered also the mechanisms and epidemiology of skin cancer which, however, are not included in the present summary....

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Editorial 2002; 23(Suppl 2): 82-83 PubMed PMID: 12163854 Citation  Keywords:  Circadian Rhythm:physiology, Humans, Light:adverse effects, Neoplasms:epidemiology, Neurosecretory Systems:physiology, Risk Factors,.   

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Editorial 2002; 23(Suppl 2): 79-81 PubMed PMID: 12163853 Citation  Keywords:  Animals, Humans, Light:adverse effects, Neoplasms:epidemiology, Neurosecretory Systems:physiology, Risk Factors,.   

: A conference was held at the University of Cologne on May 2-3, 2002, to discuss the strength-of-the-evidence supporting a linkage between light, endocrine systems and cancer. This overview of the conference is intended to summarize some of the key elements of the conference and to indicate both conclusions and research gaps identified by this reviewer....

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