OBJECTIVE: To quantify and compare the effect of two different hormone replacement therapy regimens on bone mineral density (BMD) and serum alkaline phosphate levels against a group of no treatment control volunteers. METHODS: An open 104-week comparative study of 113 early postmenopausal women. Fifty volunteered for the no treatment arm; the remainder were randomized to tibolone (T) (n = 32) or conjugated estrogens plus sequential norgestrel (CEEP) (n = 31). BMD was measured at baseline and after 48 and 96 weeks by dual photon absorptiometry. RESULTS: Baseline BMD was lower in nontherapy controls and with women assigned to CEEP compared with the T group. Statistical significance was not reached. By 96 weeks, increased BMD was observed with both therapies at all sites, whereas controls had lost bone compared with baseline. Changes from baseline with both preparations were significantly different (p < 0.05) from changes in controls for all sites, except femoral neck where the change was significant only with CEEP (p < 0.05). Alkaline phosphatase was significantly reduced in both treatment groups compared with controls (p < 0.05) at 48 and 96 weeks. CONCLUSIONS: The significant increases in BMD with T and CEEP confirm both regimens are effective in preventing osteoporosis. Without treatment, BMD declines postmenopausally.

Alkaline Phosphatase↗

PubMedDate not supplied

Changes in leucocyte sodium transport in normotensive relatives of hypertensive subjects. Dissociation from blood pressure.

It has been postulated that depressed membrane sodium transport is a necessary step in blood pressure elevation in essential hypertension. Accordingly, leucocyte sodium efflux-rate constants were estimated in 14 normotensive subjects who had one or more first-degree relatives with essential hypertension, and also in 14 matched control subjects with no such family history, before and after taking bendrofluazide for 7 days. Efflux rates in the controls did not change after the diuretic. However, in the relatives, mean total sodium efflux-rate constant was at first significantly depressed but later rose to normal with the diuretic. This was due almost entirely to an increase in glycoside-sensitive sodium pump activity. Blood pressure remained unchanged in both groups. Thus, assuming that perturbations in leucocytes reflect similar abnormalities in other cell lines, major changes in sodium transport in the normotensive individual without accompanying changes in blood pressure suggest that, while these changes may be a marker for later hypertension, they do not participate directly in blood pressure control.

Adult↗

PubMedDate not supplied

Neonatal abstinence syndrome.

A 12 month review of infants admitted with neonatal abstinence syndrome to a neonatal intensive care unit was undertaken. The relationship of maternal drug abuse to symptoms, the effectiveness of pharmacologic agents in controlling symptoms and the length of inpatient stay were investigated. A retrospective review of maternal and infant records was performed. Those infants with a serial Finnegan score greater than 8 were treated. Pharmacologic treatment was oral morphine sulphate (0.2 mg 4-6 hourly), phenobarbitone (3-7 mgs/kg/day), or combination of the above. 43 infants were admitted to the hospital during the year. The average maternal age was 24.6 years, (18-34 years). Drug use volunteered by the mothers was methadone alone in 6 cases, methadone and benzodiazepines in 14, methadone and heroin and benzodiazepines in 7, methadone and heroin in 10, heroin alone in 2, and other multiple drug use including oral morphine sulphate, dothiepin and cannabis in 4. Average gestational age was 40.3 (35-42 weeks). The average birthweight was 2.81 kgs (1.89-3.91 kgs). Time to onset of withdrawal symptoms was 2.8 (1-13) days. The duration of pharmacologic treatment (oral morphine sulphate and/or phenobarbitone) was 21.8 (1-62) days. The total hospital stay for the 43 infants was 1,011 days. This study confirms that polydrug abuse is the commonest type of drug abuse in Dublin. The duration of withdrawal symptoms is loosely related to drug type, but increasing duration of symptoms is noted for infants exposed to benzodiazepines. Our experience would favour the use of morphine sulphate to treat pure opiate withdrawal symptoms. Over the 12-month period, there was an average occupancy of 3 beds per day in the paediatric department.

Adolescent↗

PubMedDate not supplied

HRT and cardiovascular disease.

Explore the source record for details and available documents.

Cardiovascular Diseases↗