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Biomedical subjects

S Madsen

Publications and source records attributed to S Madsen.

At least 19 recordsLinked to original sources
PubMed1979

Replacement estrogens and endometrial cancer.

We examined the incidence of endometrial cancer in a large prepaid group practice in the Seattle area. From July, 1975, to July, 1977, there was a sharp downward trend in the incidence of endometrial cancer that paralleled a substantial reduction in prescriptions for replacement estrogens. Incidence rates were estimated for estrogen users and nonusers among women 50 to 64 years of age with intact uteri; current long-term users had an annual risk for endometrial cancer between 1 and 3 per cent, whereas nonusers had a risk less than 1/10th as great. These incidence rates remained fairly constant over time among users and nonusers; the drop in overall incidence soon after estrogen use declined suggests that the increased risk associated with estrogens falls quickly after discontinuation. The reduction in incidence of endometrial cancer in this group practice was part of a general decline in the United States after 1975.

Estrogens↗
PubMed1979

1 alpha-hydroxyvitamin D3 treatment of therapy-resistant symptomatic hypocalcemia in a hypoparathyroid patient with intestinal malabsorption.

The case history of a hypoparathyroid female with short bowel syndrome and long-standing therapy-resistant symptomatic hypocalcemia is reported. During treatment with massive doses of the potent vitamin D analog, 1 alpha-hydroxyvitamin D3(1 alpha(OH)D3), normocalcemia was re-established and clinical symptoms of hypocalcemia were relieved. Furthermore, significant improvement of t of intestinal calcium absorption and bone mineral content was observed after three months of treatment with 1 alpha(OH)D3. The data suggest that 1 alpha(OH)D3 may be of therapeutical value in patients with hypoparathyroidism and intestinal malabsorption.

Aged↗
PubMed1979

Scintigraphic skeletal changes in non-dialyzed patients with advanced renal failure.

Technetium-99m-polyphosphate (Tc-PP) bone scintigraphy was performed in 51 patients with advanced renal failure in order to evaluate the applicability of this method in detection of metabolic bone changes in these patients. The creatinine clearance varied from 2 to 40 ml/min and none of the patients had previously been on dialysis treatment. The scintigrams were graded according to the focal and the generalized abnormal uptake of the tracer in the skeleton. 34 patients showed generalized scintigraphic changes and among these the changes in 18 patients were classified as severe. An inverse correlation was found between the kidney function and the generalized scintigraphic classification. Focal bone changes were found in 11 patients. In order to evaluate the influence of the lack of kidney function on the scintigraphic results, 3 patients with acute oliguric renal failure were examined. All had normal scintigrams. It is concluded that Tc-PP bone scintigraphy is a sensitive method in revealing renal osteodystrophy in non-dialyzed patients with advanced renal failure in agreement with previous reports on patients on chronic hemodialysis and after kidney transplantation.

Adolescent↗
PubMed1978

Has vitamin D a direct renal effect on the tubular reabsorption of phosphate? A study in parathyroidectomized (PTX) and non-PTX man.

The effect of 1-alpha-hydroxycholecalciferol (1alpha-OH-D3) on the renal handling of phosphate and the immunoreactive parathyroid hormone in serum (i-PTH) has been studied in 10 patients with a wide range of glomerular filtration rate (GFR), maximal tubular reabsorption of phosphate (TmP) and i-PTH. The patients were treated with 2 microgram 1alpha-OH-D3 per day for approximately 80 days. Before and after this period of treatment, the TmP, i-PTH, 51Cr EDTA clearance, extracellular volume, standard bicarbonate, and serum calcium were measured in each patient. The TmP/GFR ratio was used as an index of the renal handling of phosphate. The index increased significantly (mean 26.5%, p less than 0.01) during the treatment, while i-PTH decreased significantly (mean 37.0%, p less than 0.01). A significant inverse correlation was demonstrated between the TmP/GFR index and i-PTH both before (r = -0.87; p less than 0.001) and after (r = -0.79; p less than 0.01) the administration of 1alpha-OH-D3, while none of the other factors investigated were correlated to the index. This may suggest that the stimulating effect of biologically active vitamin D on the tubular reabsorption of phosphate is mediated via the parallel suppression of PTH, but does not exclude that biologically active vitamin D exerts a direct effect on the human renal tubule. Therefore, the effect of 1alpha-OH-D3 was studied in 5 totally parathyroidectomized patients, in whom concomitant suppression of PTH would not occur. Estimation of TmP/GFR was performed 1) when the patients were vitamin D depleted and hypocalcemic, and 2) after 14-27 days of treatment with 1alpha-OH-D3 to obtain stable normocalcemia. In patients with absent parathyroid function, no increasing effect of 1alpha-OH-D3 on TmP/GFR could be demonstrated. It is therefore concluded 1) that 1alpha-OH-D3 exhibits no antiphosphaturic effect in the absence of PTH and 2) that the previously demonstrated antiphosphaturic effect of 1alpha-OH-D3 in man is mediated via a concomitant suppression of PTH.

Absorption↗
PubMed1978

Calcium-dependent aldosterone secretion in anephric and nonnephrectomized patients on regular hemodialysis.

The present study was undertaken to investigate the effect of a continuous calcium infusion on the plasma levels of aldosterone, renin activity, and cortisol in six anephric and four nonnephrectomized patients on regular hemodialysis. In both groups, a significant increase in whole blood ionized calcium (b-Ca2+) was demonstrated. A significant increase in plasma aldosterone (PAC) was noted in the nonnephrectomized patients, in whom the rise in PAC correlated with the increase in b-Ca2+. However, in the anephric patients only a smaller and insignificant increase in PAC was found. No significant changes were demonstrated in plasma cortisol or renin activity, nor in potassium or sodium concentrations in either group. It is concluded that ionized calcium influences the plasma levels of aldosterone in uremic patients on regular hemodialysis.

Adrenocorticotropic Hormone↗
PubMed1978

Cessation of bone loss in chronic renal failure by 1-alpha-hydroxyvitamin D3: a controlled trial.

The study was undertaken in patients with chronic renal failure (CRF patients) in order to evaluate 1) the degree and course of skeletal demineralisation and 2) the effect on the bone mineral content (BMC) of long-term treatment with 1alpha-hydroxyvitamin D3 (1alpha(OH)D3). BMC was measured on the radius by 241 Am-photonabsorptiometry and the results were corrected for age, sex and bone width. In a cross-sectional study BMC was measured in 191 normal subjects and in 88 renal patients. In a controlled longitudinal trial 22 CRF patients were treated for 25.6 months with 1alpha(OH)D3, while 22 CRF patients did not receive vitamin D supplements. In CRF patients an accelerated bone loss (approximately 3%/year) and a significantly reduced BMC (mean 87.2% of normal) was found. In the 1alpha(OH)D3 treated patients BMC increased on an average 0.9%/year. This was significantly different from the continued bone loss recorded in the non-treated control patients. The data indicate that 1) CRF patients develop reduced bone mass because of accelerated bone loss; 2) cessation of this bone loss may be achieved by long-term treatment with 1alpha(OH)D3.

Adult↗
PubMed1977

The maximal tubular reabsorption of phosphate in relation to serum parathyroid hormone.

The relation between the renal handling of phosphate and the serum concentration of immunoreactive parathyroid hormone (i-PTH) was investigated in 15 patients with a very wide range of i-PTH, glomerular filtration rate (GFR), maximal tubular reabsorption of phosphate (TmP) and TmP/GFR-ratio. The latter was used as an index of the renal handling of phosphate. Seven patients had well functioning kidney allografts (GFR 43.1-64.9 ml/min), while 8 had varying degrees of chronic nephropathy (GFR 2.3-26.7 ml/min). The TmP, i-PTH, 51Cr EDTA clearance, the extracellular volume and serum concentrations of calcium and standard bicarbonate were estimated. An inverse significant correlation was demonstrated between TmP/GFR and i-PTH (p less than 0.001), while none of the other investigated factors correlated thyroid hormone has a key role in the regulation of the tubular handling of phosphate in patients with impaired renal function.

Adult↗
PubMed1977

Aldosterone response to ACTH stimulation in anephric and non-nephrectomized patients on regular hemodialysis.

The effect of ACTH on plasma aldosterone concentration (PAC) and plasma cortisol concentration (PCC) has been investigated in 5 anephric and 6 non-nephrectomized patients on regular homodialysis. Basal PAC was significantly lower (p less than 0.01) in the anephric (mean 37.6 pg/ml) than in the nonnephrectomized group (mean 117.5 pg/ml), whereas basal PCC (18.6 and 16.5 mug/100 ml, respectively) did not differ significantly (p less than 0.05). Following administration of synthetic beta1-24 ACTH, the maximal percentage increase in PAC was significantly lower ( less than 0.001) in the anephric (105%) than in the nonnephrectomized group (286%). The rise in PCC, 118%, in both groups showed no significant difference (p less than 0.05). The higher basal level of PAC and the more pronounced response to ACTH in nonnephrectomized patients correlated with higher basal levels of plasma renin activity compared with the anephric group. An influence of the remaining renin-angiotensin system on the ability to react to an ACTH stimulation is therefore suggested.

Adrenocorticotropic Hormone↗
PubMed1977

Regulation of plasma aldosterone in anephric and non-nephrectomized patients during hemodialysis treatment.

The relationships between plasma aldosterone and changes in plasma potassium, plasma cortisol, plasma sodium, blood volume and body weight have been studied in 6 anephric and 11 non-nephrectomized patients on regular hemodialysis. In all patients, the plasma aldosterone concentration decreased during dialysis. In the anephric patients, a significant correlation (p less than 0.001) was demonstrated between the fall in plasma aldosterone and the fall in plasma potassium (total body potassium depletion). Measurements between consecutive hemodialyses, furthermore, showed a significant correlation (p less than 0.001) in anephric patients between total body potassium repletion (increasing plasma potassium) and the rise in plasma aldosterone. In contrast, the potassium and aldosterone changes did not correlate in the non-nephrectomized group. During dialysis, a decrease was found in all parameters, but no correlation was demonstrable in either group between the changes in plasma aldosterone and the fall in plasma cortisol, sodium, blood volume and body weight. The data in the anephric patients emphasize the important role of potassium in the regulation of aldosterone secretion.

Adolescent↗