High-risk family colorectal cancer screening service in Ireland: Critical review of clinical outcomes.

Background: We present the 15-year experience of a family colorectal cancer screening service in Ireland with emphasis on real life experience and outcomes.

Methods: Questionnaires were used to assess family cancer history and assign patients to risk categories; 'Moderate Risk', HNPCC, (suspected) genetic syndrome (non-HNPCC), 'Low Risk'. Screening was by full colonoscopy.

Effect of HbE heterozygosity on the measurement of HbA1c.

Aim: Measurement of HbA1c provides an excellent measure of glycaemic control for diabetic patients. However, haemoglobin (Hb) variants are known to interfere with HbA1c analysis. In our laboratory HbA1c measurement is performed by Variant II turbo 2.

Lasofoxifene in osteoporosis and its place in therapy.

Selective estrogen-receptor modulators (SERMs), which have estrogen-like effects on bone and "antiestrogen effects" on other tissues, have been in development for osteoporosis prevention and treatment in postmenopausal women as a safer alternative to long-term estrogen. We conducted a literature review of the skeletal and extraskeletal effects of lasofoxifene, a new generation SERM approved by the European Commission for osteoporosis treatment. Published data on the effects of lasofoxifene are based on 23 clinical pharmacology studies with over 10,000 participants from 17 phase 2 and 3 randomized controlled trials (RCTs).

Nasal pillows as an alternative interface in patients with obstructive sleep apnoea syndrome initiating continuous positive airway pressure therapy.

Side-effects directly due to the nasal mask are common in patients with obstructive sleep apnoea syndrome (OSAS) commencing continuous positive airway pressure (CPAP). Recently, nasal pillows have been designed to overcome these issues. Limited evidence exists of the benefits and effectiveness of these devices.

Effects of calcium on cardiovascular events in patients with kidney disease and in a healthy population.

Background And Objectives: Cardiovascular disease (CVD) is the largest contributor to all-cause mortality in patients with end stage renal disease (ESRD). Accelerated vascular calcification is a key risk factor for CVD in these patients. The etiology of vascular calcification and the specific role calcium supplementation may play in accelerating calcification have not been fully elucidated.

Kidney function and rate of bone loss at the hip and spine: the Canadian Multicentre Osteoporosis Study.

Background: The relationship between kidney function and bone loss is unclear.

Study Design: A prospective observational study.

Setting & Participants: 191 men and 444 women aged > or = 50 years participating in a population-based observational study designed to determine risk factors for bone loss and fractures.

The effects of exercise and physical activity participation on bone mass and geometry in postmenopausal women: a systematic review of pQCT studies.

The cumulative risk of fracture for a postmenopausal woman over the age of 50 can reach up to 60%. Exercise has the potential to modify fracture risk in postmenopausal women through its effects on bone mass and geometry; however, these effects are not well characterized. To determine the effects of exercise on bone mass and geometry in postmenopausal women, we conducted a systematic review of the literature.

Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome.

Background: Obstructive sleep apnea syndrome (OSAS) has been associated with increased morbidity and mortality, principally from cardiovascular disease, but the impact of nasal continuous positive airway pressure (CPAP) therapy is unclear.

Methods: We performed a long-term follow-up study of 168 patients with OSAS who had begun receiving CPAP therapy at least 5 years previously, most of whom had been prospectively followed up, having been the subject of an earlier report on cardiovascular risk factors in OSAS patients. The average follow-up period was 7.

Physiological validation of the concept of glycemic load in lean young adults.

Dietary glycemic load, the mathematical product of the glycemic index (GI) of a food and its carbohydrate content, has been proposed as an indicator of the glucose response and insulin demand induced by a serving of food. To validate this concept in vivo, we tested the hypotheses that 1). portions of different foods with the same glycemic load produce similar glycemic responses; and 2).

Acute bleeding and thrombocytopenia after bone marrow transplantation.

The relationship between hemorrhage and low platelet count was first established in patients with acute leukemia, and has been widely applied to thrombocytopenic patients, including BMT patients. Yet, the role of thrombocytopenia in bleeding post BMT has not been systematically studied. We evaluated the risk of bleeding and outcome associated with thrombocytopenia in BMT patients who had prophylactic platelet transfusions at a trigger of 20 x 10(9)/l.

Leptin has acute effects on glucose and lipid metabolism in both lean and gold thioglucose-obese mice.

Leptin is reported to have effects in peripheral tissues that are independent of its central effects on food intake and body weight. In this study, the acute effects of a single dose of recombinant mouse leptin on lipid and glucose metabolism in lean and gold thioglucose-injected obese mice were examined. Changes were measured 2 h after leptin injection.

Acute bleeding after allogeneic bone marrow transplantation: association with graft versus host disease and effect on survival.

Background: Hemorrhagic complications are frequently implicated clinically for the high morbidity and mortality of acute graft versus host disease (GVHD), however, only few reports characterize the incidence and timing of bleeding in relation to GVHD, and essentially no study has quantified the effect of bleeding on survival of allogeneic patients with GVHD. This study examines the association of bleeding with acute GVHD and the effect of both complications on survival.

Methods: A total of 463 allogeneic patients transplanted at the Johns Hopkins Hospital, were included in the study.

Acute bleeding after bone marrow transplantation (BMT)- incidence and effect on survival. A quantitative analysis in 1,402 patients.

Acute bleeding after bone marrow transplantation (BMT) was investigated in 1,402 patients receiving transplants at Johns Hopkins Hospital between January 1, 1986 and June 30, 1995. Bleeding categorization was based on daily scores of intensity used by the blood transfusion service. Moderate and severe episodes were analyzed for bleeding sites.

Nonoperative extraction of retained common duct stones.

Nonoperative extraction of retained common duct stones was successful in 17 patients during the past two years. Eleven required only one manipulation; the largest number of manipulations required was five. The Burhenne catheter and Dormia basket were employed frequently, but were not always effective.