Misleading normal TSH and persistently elevated creatine kinase: clues to the diagnosis of chronic Sheehan's syndrome.

A 53-year-old woman was referred for medical evaluation of therapy-resistant dyslipidaemia accompanied by elevated creatine kinase levels. Because cessation or alteration of her medication did not improve laboratory abnormalities, hypothyroidism was considered, despite the fact that thyroid stimulating hormone levels were within the reference interval. On further evaluation, she was found to have panhypopituitarism and empty sella turcica as shown by MRI.

Measurement of the enriched stable isotope Fe in iron related disorders- comparison of INAA and MC-ICP-MS.

As a safer alternative for the use of radioactive tracers, the enriched stable Fe isotope has been introduced in studies of iron metabolism. In this study this isotope is measured with instrumental neutron activation analysis (INAA) in blood samples of patients with iron related disorders and controls after oral ingestion of a Fe containing pharmaceutical. Results were compared with those derived from MC-ICP-MS, applied on the same samples, and analytical and practical aspects of the two techniques were compared.

[The fragile yellow jersey: bone health in cyclists].

Although cycling has positive health effects, including improvement of cardiovascular fitness, it does not have a favourable effect on bone health. In professional cyclists, the bone mineral density (BMD) will actually have decreased at the end of an intensive season. As a professional cyclist's career progresses, there will be a further decrease in BMD particularly in the hip and lumbar spine.

Large-sample neutron activation analysis in mass balance and nutritional studies.

Low concentrations of elements in food can be measured with various techniques, mostly in small samples (mg). These techniques provide only reliable data when the element is distributed homogeneously in the material to be analysed either naturally or after a homogenisation procedure. When this is not the case or homogenisation fails, a technique should be applied that is able to measure in samples up to grams and even kilograms and regardless of the distribution of the element.

Severe Infections are Common in Thiamine Deficiency and May be Related to Cognitive Outcomes: A Cohort Study of 68 Patients With Wernicke-Korsakoff Syndrome.

Background: Wernicke encephalopathy can have different clinical outcomes. Although infections may precipitate the encephalopathy itself, it is unknown whether infections also modify the long-term outcome in patients developing Korsakoff syndrome.

Objective: To determine whether markers of infection, such as white blood cell (WBC) counts and absolute neutrophil counts in the Wernicke phase, are associated with cognitive outcomes in the end-stage Korsakoff syndrome.

Is vitamin D deficiency a confounder in alcoholic skeletal muscle myopathy?

Background: Excessive intake of alcohol is often associated with low or subnormal levels of vitamin D even in the absence of active liver disease. As vitamin D deficiency is a well-recognized cause of myopathy, alcoholic myopathy might be related to vitamin D deficiency. Chronic alcoholic myopathy affects approximately half of chronic alcoholics and is characterized by the insidious development of muscular weakness and wasting.

[Dance, art and top performance sport with specific injuries].

Professional theatre dance has high and specific physical demands, comparable to top sport. Dance injuries are often caused by faulty technique due to compensation for physical limitations. Knowledge of these limitations and professional teaching can prevent many problems.

The effect of alcohol on postprandial and fasting triglycerides.

Alcohol has a significant additive effect on the postprandial triglyceride peak when it accompanies a meal containing fat, especially saturated fat. This results from a decrease in the breakdown of chylomicrons and VLDL remnants due to an acute inhibitory effect of alcohol on lipoprotein lipase activity. Furthermore, alcohol increases the synthesis of large VLDL particles in the liver, which is the main source of triglycerides in the hypertriglyceridemia associated with chronic excessive alcohol intake.

Severe hypertriglyceridemia influenced by alcohol (SHIBA).

Aims: This study was conducted to examine the relationship between triglyceride (TG) levels and a history of excessive drinking in patients with severe hypertriglyceridemia (HT).

Methods: Alcohol intake as well as other risk factors associated with HT were searched for in case records of 300 patients known to the laboratory to have had a TG level over 11.3 mmol/l.

[Shedding new light on vitamin D--reassessment of an essential prohormone].

Vitamin-D deficiency is no longer to be seen only as a cause of osteomalacia, rickets and osteoporosis. There is a causal relationship with muscle function and also with the functioning of our immune system. Furthermore, vitamin-D deficiency is associated with a higher risk of autoimmune diseases and several forms of malignancy, such as prostate, colon and breast cancer.

[Medical problems of musicians].

Most individuals enjoy making music, but pleasure may be diminished by physical complaints. The most common complaints in musicians include injuries of the upper part of the body including the shoulder and spine, skin disorders and hearing problems. Injuries are not so much related to the extent of rehearsing and playing but are mostly the result of a wrong position and misuse of the instrument.

Polyphenolic grape extract inhibits platelet activation through PECAM-1: an explanation for the French paradox.

Background: Moderate and prolonged consumption of red wine is associated with decreased cardiovascular morbidity and mortality. Inhibition of platelet functions by ingredients in red wine is thought to be one of the causes. However, the molecular mechanism of this inhibition has remained unexplained.

Alcohol and illicit drug use among emergency room patients in the Netherlands.

Aims: To clarify alcohol and illicit drug use within the emergency room population in three different regions in The Netherlands, focusing on whether interventions for these substances should be region specific.

Methods: Alcohol and illicit drug use were assessed using a self-report questionnaire filled in by the patients, and by combining self-report with staff judgement on alcohol and illicit drug use.

Results: Data on alcohol use (self-reported and staff judgement combined) resulted in prevalence rates of 4.

Self-reported alcohol use among Dutch emergency room patients: variations in prevalence rates owing to methodological differences.

Aims: This study compared different methods of assessing self-reported alcohol use among emergency room patients in order to explain the variations in reported prevalence rates.

Methods: Alcohol use prior to patient's injury or illness was assessed in one hospital by a self-report questionnaire in three different ways: (i) administered by emergency room staff, (ii) administered by research staff, or (iii) sent to the patient's home by post.

Results: Results show variations in self-reported alcohol use 6 h prior to the injury or illness ranging from 4.

Anemia in critically ill patients.

Anemia is common in acute critically ill patients. Although blood loss, either by trauma, surgery, phlebotomies or gastrointestinal bleeding, may play a role, the anemia in these patients bears many similarities to the anemia characteristic of chronic disease. Serum iron is low with a high concentration of ferritin and low-to-normal transferrin and serum transferrin receptor levels.

Rapid intake of alcohol (binge drinking) inhibits platelet adhesion to fibrinogen under flow.

Background: Moderate alcohol consumption is associated with decreased mortality from cardiovascular disease. Drinking large amounts in a short period (binge drinking) is associated with increased cardiovascular morbidity. We tested whether rapid consumption of a large dose of alcohol affects platelet aggregation and adhesion.

Drink to prevent: review on the cardioprotective mechanisms of alcohol and red wine polyphenols.

Moderate alcohol consumption has convincingly been associated with decreased cardiovascular mortality in epidemiological studies and metaanalyses. This decreased mortality has been attributed to changes in lipid profiles, decreased coagulation, increased fibrinolysis, inhibition of platelets, increased nitric oxide, and antioxidant capacities of alcoholic beverages. Most of these laboratory and animal studies, as well as small intervention trials in human volunteers, have revealed many interesting mechanisms that contribute to the cardioprotective effects of alcohol, red wine, or red wine polyphenolic compounds.

Diabetes mellitus and alcohol.

Alcohol influences glucose metabolism in several ways in diabetic patients as well as in non-diabetic patients. Since alcohol inhibits both gluconeogenesis and glycogenolysis, its acute intake without food may provoke hypoglycaemia, especially in cases of depleted glycogen stores and in combination with sulphonylurea. Consumed with a meal including carbohydrates, it is the preferred fuel, which may initially lead to somewhat higher blood glucose levels and hence an insulin response in type 2 diabetic patients.

Wine polyphenols and ethanol do not significantly scavenge superoxide nor affect endothelial nitric oxide production.

Epidemiological studies have shown that moderate intake of red wine reduces the risk of coronary heart disease. It has been proposed that the antiatherogenic effect be due to the scavenging of reactive oxygen species by polyphenols and ethanol or an effect on endothelial nitric oxide (NO) production. We have determined the reaction rates of superoxide with four different polyphenols and ethanol.

Acute pancreatitis complicating intrabiliary rupture of liver hydatid cyst.

Acute pancreatitis is a rare complication of hydatidosis, and the successful use of endoscopic sphincterotomy in the treatment of pancreatitis complicating ruptured hydatid cyst has been very rarely reported.We report here a case of a 50-year-old man, known to have hydatid cyst of the liver, who presented with upper abdominal pain. Amylase and lipase were elevated and echinococcus serology was positive.

Characteristics of piraltin, a polyphenol concentrate, produced by freeze-drying of red wine.

Moderate consumption of red wine is associated with a decreased risk for coronary heart disease. Apart from alcohol, an additive role for wine polyphenols has been suggested. However, the real contribution of these compounds can only be studied when available without the alcohol component.

No acute effect of red wine on the coagulation pathway in healthy men.

Binge drinking is associated with an increased risk of cardiovascular events. Those events often happen within hours after alcohol is consumed. Apart from arrhythmias and changes in blood pressure, these events may be caused by an acute (i.