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Healthy worker effect phenomenon  [cached]
Shah Divyang
Indian Journal of Occupational and Environmental Medicine , 2009,
Abstract: The Healthy Worker Effect (HWE) phenomenon has been under debate since some years. Some epidemiologists regard HWE as an ordinary method problem while others consider it a field of science by itself. This article gives definitions of HWE explained with historical background; discusses factors affecting it and suggests methods to minimize problems associated with it.
Growth hormone replacement therapy in adults  [PDF]
Mustafa G Ta?kale,A Baki Kumbasar,ü Nesrin Osman,Nurgül Ya?ar
Medical Journal of Bakirk?y , 2005,
Abstract: Growth hormone (GH) is a classic anabolic hormone that promotes skeletal growth. It is secreted until late in life. Although pronounced metabolic effects of GH were well documented in both healthy and hypopituitary adults, until the second half of 1980’sGH deficiency in adult life were not considered as a clinical problem for most endocrinologists. Lately it has been observed that the cessation of GH treatment in growth retarded children after puberty resulted in various psychosocial and physical problems. In recent years, adult GH deficiency (GHD) has been acknowledged as a well defined clinical syndrome, consisting of altered body composition, impaired lipid profile, reduced muscle strength, reduced bone mineral density, and a reduced sense of psychological well-being. GHD in adult shows striking similarities with syndrome X, thus carries a high risk for cardiovascular disease. GH replacement can improve some abnormalities of body composition and metabolic perturbations as demonstrated by various studies.
Unusual Marcus Gunn phenomenon in adults  [cached]
Betharia S,Kishore Kamal,Kumar Harsh
Indian Journal of Ophthalmology , 1992,
Abstract: Two unusual cases of Marcus Gunn phenomenon in adults are presented. The first case was characterised by a bilateral jaw-winking phenomenon along with an asymmetric bilateral congenital ptosis, whereas the second case had bizarre spontaneous movements of the affected lid, deficient abduction and pseudoptosis in association with jaw-winking. The pathogenesis of Marcus Gunn phenomenon is discussed.
Diagnosing Growth Hormone Deficiency in Adults  [PDF]
Nigel Glynn,Amar Agha
International Journal of Endocrinology , 2012, DOI: 10.1155/2012/972617
Abstract: Adult growth hormone (GH) deficiency is a recognised syndrome associated with adverse phenotypic, metabolic, and quality-of-life features which improve in many patients when GH is substituted. The appropriate selection of patients at risk of growth hormone deficiency (GHD) is the crucial first step in arriving at a correct diagnosis. Although multiple diagnostic modalities are available including a 24-hour serum GH profile, stimulated GH levels, and insulin-like growth factor-1 (IGF-1) levels, the use of dynamic tests for GH reserves is required in most cases. This paper discusses the utility and drawbacks of the various testing modalities with reference to international guidelines. Regardless of the test chosen, clinical pitfalls including age and obesity must be taken into account. In addition, there is considerable analytical variation in the biochemical measurements of GH and IGF-1 which must be considered before making a diagnosis of GHD in adulthood. 1. Introduction Severe growth hormone deficiency (GHD) in adults can give rise to several abnormalities. Body composition is altered due to increased fat mass and reduced muscle mass. Exercise capacity is reduced, and quality of life is impaired. The plasma lipid profile is unfavourable, and cardiovascular morbidity may be increased [1]. A growing recognition of this clinical syndrome in the last 20 years has led to the therapeutic use of growth hormone (GH) replacement in adults with severe GHD. This treatment is now available in approximately 80 countries worldwide and has been shown to improve many abnormal parameters [2–5]. GHD is established on both clinical and biochemical criteria, but despite significant advances in our understanding of adult GHD, accurate diagnosis remains challenging. Selecting the appropriate patient, performing a reliable diagnostic test, and understanding the clinical caveats as well as the analytical limitations are the crucial steps. Consensus guidelines for the diagnosis of adult GHD have been published by professional societies [6–9]. While helpful, recommended diagnostic criteria are not necessarily universally applicable. Problems exist with the performance of some diagnostic tests in terms of accuracy, reproducibility, and resources required. The interpretation of test results may pose further challenges due the variability of current biological assays. This paper will summarise the current evidence for the appropriate selection of adult patients at risk of GHD, the strengths and limitations of available diagnostic tests, and the characteristics of currently
The effects of growth hormone administration on bone density in healthy adult rabbits
Ahrari Khafi MS,Soroori S,Nakhjavani M,Mortazavi P
Tehran University Medical Journal , 2011,
Abstract: "nBackground: The effects of growth hormone (GH) on bone density in healthy adults is controversial. This study was performed to evaluate the effects of GH administration on bone density under controlled conditions in healthy adult rabbits."n "nMethods: Twenty healthy adult New Zealand white rabbits of both sexes were included in the study. The rabbits were divided into two groups. The experiment group received human GH and the controls placebo for three months. The density of femur and humerus were measured at proximal epiphysis, mid shaft and distal epiphysis by radiography, aluminum step-wedge and appropriate software. Measurements were performed in five stages, once before and four times after the administration of GH or placebo, with 3-week intervals."n "nResults: The mean concentration of serum insulin-like growth factor I (IGF-I) increased significantly after GH administration (P<0.05) in the experiment group. Bone density generally increased in all regions except the distal epiphysis of femur in the test group, but significant difference were only seen in the midshaft of femur in comparison to the controls (P<0.05). In the second stage, bone density decreased slightly in all regions except distal epiphysis of femur, but it increased in the next stages."n "nConclusion: GH can increase bone density (mostly cortical bone) in adult rabbits. According to the similarities seen between growth hormone effects in rabbit and humans, this study suggests rabbits as a model for studying GH effects on bone density in acromegaly, growth hormone deficiency and even in healthy adult humans.
Disseminated mucormycosis in healthy adults.  [cached]
Verma G,Lobo D,Walker R,Bose S
Journal of Postgraduate Medicine , 1995,
Abstract: Three patients of disseminated mucormycosis are described. None had predisposing factors. Two of them presented with nonspecific symptoms along with acute renal failure and peritonitis. Third patient had fulminating primary cutaneous mucormycosis which disseminated later. Development of acute renal failure with smooth enlargement of both kidneys in an apparently healthy individual or appearance of mould in a wound should raise the suspicion of mucormycosis. The hallmark of the infection was vascular invasion and thrombosis. Antemortem diagnosis could be made in one patient only. All patients had progressive downhill course despite supportive treatment, antibiotic and amphotericin in-B in one patient.
Growth Hormone Deficiency (GHD) in Adults: To Treat or Not To Treat?
Boguszewski,Cesar Luiz;
Revista argentina de endocrinolog?-a y metabolismo , 2010,
Abstract: over the last decade, different guidelines have been published for the diagnosis, treatment and monitoring of adult growth hormone deficiency (aghd). themes and recommendations common to the guidelines offer a pragmatic approach to the management of aghd. nevertheless, there is a need for more research in some key areas in which recommendations in the guidelines are supported by moderate evidence, at best. recent meta-analysis and long-term follow-up studies have contributed with valuable information on the efficacy and safety of gh therapy in adults. this review brings a historical perspective of the aghd, with an emphasis on the following aspects: (i) who are the appropriate candidates for gh therapy in adult life? (ii) how to make the diagnosis (iii) the impact of gh therapy; (iv) which therapeutic approach should be used? (v) how to follow and monitor the patients; and (vi) special aspects on mortality and longevity related to the gh-igf-1 axis.
Study of interhemispheric coherence on healthy adults
Jorge, Mario Silva;Botelho, Ricardo Vieira;Melo, Antonio Carlos de Paiva;
Arquivos de Neuro-Psiquiatria , 2007, DOI: 10.1590/S0004-282X2007000300002
Abstract: the interhemispheric coherence of electroencephalogram was studied in a group of healthy individuals in the age range of 20-50 years. the results showed higher coherence for all bands in parietal regions (p3-p4). it was observed that individuals with high values of coherence for a certain frequency band in a pair of electrodes also showed high values of coherence for other bands across other pairs of electrodes. no significant influence on interhemispheric coherence was found for age, gender or hand dominance.
Frequency of the allelic variant (Trp8Arg/Ile15Thr) of the luteinizing hormone gene in a Brazilian cohort of healthy subjects and in patients with hypogonadotropic hypogonadism
Berger, Karina;Billerbeck, Ana Elisa Correia;Costa, Elaine Maria Frade;Carvalho, Luciani Silveira;Arnhold, Ivo Jorge Prado;Mendonca, Berenice Bilharinho;
Clinics , 2005, DOI: 10.1590/S1807-59322005000600006
Abstract: purpose: to evaluate the frequency of allelic variant trp8arg/ile15thr in the luteinizing hormone b-subunit gene in a brazilian population of healthy subjects and in patients with hypogonadotropic hypogonadism. subjects and methods: two hundred and two adults (115 women) with normal sexual function and 48 patients (24 women) with hypogonadotropic hypogonadism underwent a molecular study of the the luteinizing hormone b-subunit gene using a polymerase chain reaction technique followed by enzymatic digestion with the restriction enzymes nco i (for detection of the trp8arg point mutation) and fok i (for detection of the ile15thr point mutation). basal luteinizing hormone and fsh, testosterone, or estradiol levels were measured in 37 healthy subjects (21 women) and in 27 hypogonadotropic hypogonadism patients (13 women) by immunofluorometric methods (hlh-spec and hfsh-spec, autodelfia, wallac oy, turku, finland). results: the genetic variant of the luteinizing hormone b-subunit gene was present at a similar frequency in healthy subjects (14.4%) compared to patients with hypogonadotropic hypogonadism (16.6%). there was no effect of the allelic variant of the luteinizing hormone b-subunit gene on luteinizing hormone levels in patients with hypogonadotropic hypogonadism as compared to healthy subjects. conclusion: this study indicates that the allelic variant trp8arg/ile15thr of the luteinizing hormone b-subunit gene is a common polymorphism in the brazilian population (14.4%). the same frequency of this luteinizing hormone variant in the groups with hypogonadotropic hypogonadism and in the healthy subjects excludes a relationship between this variant and hypogonadotropic hypogonadism.
The Microbiome of the Middle Meatus in Healthy Adults  [PDF]
Vijay R. Ramakrishnan, Leah M. Feazel, Sarah A. Gitomer, Diana Ir, Charles E. Robertson, Daniel N. Frank
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0085507
Abstract: Rhinitis and rhinosinusitis are multifactorial disease processes in which bacteria may play a role either in infection or stimulation of the inflammatory process. Rhinosinusitis has been historically studied with culture-based techniques, which have implicated several common pathogens in disease states. More recently, the NIH Human Microbiome Project has examined the microbiome at a number of accessible body sites, and demonstrated differences among healthy and diseased patients. Recent DNA-based sinus studies have suggested that healthy sinuses are not sterile, as was previously believed, but the normal sinonasal microbiome has yet to be thoroughly examined. Middle meatus swab specimens were collected from 28 consecutive patients presenting with no signs or symptoms of rhinosinusitis. Bacterial colonization was assessed in these specimens using quantitative PCR and 16S rRNA pyrosequencing. All subjects were positive for bacterial colonization of the middle meatus. Staphylococcus aureus, Staphylococcus epidermidis and Propionibacterium acnes were the most prevalent and abundant microorganisms detected. Rich and diverse bacterial assemblages are present in the sinonasal cavity in the normal state, including opportunistic pathogens typically found in the nasopharynx. This work helps establish a baseline for understanding how the sinonasal microbiome may impact diseases of the upper airways.
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