34 research outputs found
Irreversible social change
In this paper we evaluate how irreversible social change should be evaluated from an ethical perspective. First; we analyse the notion of irreversibility in general terms. We define a general notion of what makes a change irreversible; drawing on discussions in ecology and economics. This notion is relational in the sense; that it claims that a change can only be irreversible for a certain party. Second; we examine ways to evaluate irreversible changes; drawing on discussions from both ethics; particularly the Capability Approach; and economics; particularly Cost-Benefit Analysis and the Safe Minimum Standard. Insights from the field of development studies are also woven into the discussion. Third; we investigate why (adverse) social changes tend to be systematically undervalued in decision making by private actors and policy makers; and argue for applying the Safe Minimum Standard as a decision rule for dealing with irreversible social changes. Finally; we show how our framework can be applied by evaluating the land acquisition process of biofuel producers in Tanzania
Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study
BACKGROUND: Overt hypothyroidism has been found to be associated with
cardiovascular disease. Whether subclinical hypothyroidism and thyroid
autoimmunity are also risk factors for cardiovascular disease is
controversial. OBJECTIVE: To investigate whether subclinical
hypothyroidism and thyroid autoimmunity are associated with aortic
atherosclerosis and myocardial infarction in postmenopausal women. DESIGN:
Population-based cross-sectional study. SETTING: A district of Rotterdam,
The Netherlands. PARTICIPANTS: Random sample of 1149 women (mean age +/-
SD, 69.0 +/- 7.5 years) participating in the Rotterdam Study.
MEASUREMENTS: Data on thyroid status, aortic atherosclerosis, and history
of myocardial infarction were obtained at baseline. Subclinical
hypothyroidism was defined as an elevated thyroid-stimulating hormone
level (>4.0 mU/L) and a normal serum free thyroxine level (11 to 25 pmol/L
[0.9 to 1.9 ng/dL]). In tests for antibodies to thyroid peroxidase, a
serum level greater than 10 IU/mL was considered a positive result.
RESULTS: Subclinical hypothyroidism was present in 10.8% of participants
and was associated with a greater age-adjusted prevalence of aortic
atherosclerosis (odds ratio, 1.7 [95% CI, 1.1 to 2.6]) and myocardial
infarction (odds ratio, 2.3 [CI, 1.3 to 4.0]). Additional adjustment for
body mass index, total and high-density lipoprotein cholesterol level,
blood pressure, and smoking status, as well as exclusion of women who took
beta-blockers, did not affect these estimates. Associations were slightly
stronger in women who had subclinical hypothyroidism and antibodies to
thyroid peroxidase (odds ratio for aortic atherosclerosis, 1.9 [CI, 1.1 to
3.6]; odds ratio for myocardial infarction, 3.1 [CI, 1.5 to 6.3]). No
association was found between thyroid autoimmunity itself an
Somatostatin receptor scintigraphy: Its value in tumor localization in patients with Cushing's syndrome caused by ectopic corticotropin or corticotropin-releasing hormone secretion
purpose: To assess the feasibility of somatostatin receptor scintigraphy for patients with Cushing's syndrome caused by tumors secreting ectopic corticotropin or corticotropin-releasing hormone (CRH).
patients and methods: Ten patients with Cushing's syndrome, nine with ectopic corticotropin-secreting tumors and one with a CRH-secreting tumor, were consecutively studied. For comparison purposes, eight patients with corticotropin-secreting pituitary tumors and one patient with an autonomous adrenal adenoma were investigated. In vivo tumor localization was performed for all patients using a radionuclide-coupled somatostatin analog. The results obtained with this technique were compared with those obtained with conventional imaging techniques. For some patients, the clinical effects of octreotide therapy were evaluated.
results: Somatostatin analog scintigraphy successfully identified the primary ectopic corticotropin-secreting and CRH-secreting tumors or their metastases, or both, in 8 of 10 patients; in 2 patients with corticotropin-secreting bronchial carcinoids, the tumors could not be visualized. Normal scans were obtained for the 8 patients with corticotropin-secreting pituitary tumors and the one patient with an adrenal adenoma.
conclusion: Somatostatin analog scintigraphy can be included as a diagnostic step in the workup of Cushing's syndrome patients with a suspected ectopic corticotropin-secreting tumor or a CRH-secreting tumor
Investigation of the association of the CRTM and CRTL1 genes with radiographically evident osteoarthritis in subjects from the Rotterdam study
__Objective:__ To investigate whether radiographically evident osteoarthritis (ROA) in 55-65-year-old men and women is associated with specific alleles or genotypes of the cartilage matrix protein (CRTM) and cartilage link protein (CRTLl) genes.
__Methods:__ Cases were selected from a populationbased study on the presence of ROA of the knee or hip. Further radiographic analysis included scoring for spine and hand ROA. Controls, selected from the same population, were free of ROA in all joints.
__Results:__ The CRTM locus was significantly associated with hip ROA in men (odds ratio 0.50, 95% confidence interval 0.26-0.95). A significant association between ROA and the CRTLl gene was not observed.
__Conclusion:__ These results suggest that the CRTM locus may play a role in the sex- and joint site-specific pattern of ROA development
Tea and coronary heart disease : protection through estrogenlike activity?
Tea drinking appears to be protective against coronary heart disease in a number of epidemiologic studies. It has been suggested that tea flavonols with antioxidative activity, including quercetin, kaempferol, and myricetin,1 could account for the favorable effect on cardiovascular health. In the older cohort of the Rotterdam Study, we observed an inverse association of tea drinking with severe aortic atherosclerosis.2 Interestingly, the relationship was most pronounced in women, which raised the hypothesis that an estrogen-related mechanism could be involved. Tea drinking in another population-based study of older women appeared protective against bone mineral loss, which may also indicate estrogenicity.3 Tea flavonoids such as kaempferol have indeed been shown to exhibit estrogenic activity in vitro.4 Daily kaempferol intake is almost doubled in regular tea drinkers compared with nondrinkers (a 6-mg increase for 3 to 4 cups of tea). In addition, tea contains lignan polyphenols, such as secoisolaracino