Endurance run increases circulating IL-6 and IL-1ra but downregulates ex vivo TNF-a and IL-1ß production

Contains fulltext : 4818.pdf (publisher's version ) (Open Access

Welke schadelijke effecten van drop zijn mogelijk?

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Dehydroepiandrosterone administration in humans: evidence based?

Contains fulltext : 48414.pdf (publisher's version ) (Open Access)Dehydroepiandrosterone (DHEA) and its ester dehydroepiandrosterone sulphate (DHEAS) are produced by the adrenal glands. These hormones are inactive precursors that are transformed into active sex steroids in peripheral target tissues. After a peak in early adulthood, there is a marked decrease in plasma concentrations throughout adult life. These hormones are thought to affect mood and well-being, have neurosteroid effects and may influence the immune system. Animal experiments suggest that DHEA has many other effects, including anticancer, immune-enhancing, neurotropic and general antiageing effects, but information based on studies in humans is limited. In female patients with adrenal insufficiency, treatment with DHEA replacement doses of 20 to 50 mg results in improvements in mood, quality of life and libido. These studies usually lasted only a few months, so the effect of chronic DHEA treatment or its effectiveness in male patients is not known. Some studies suggest a favourable effect of pharmacological doses of DHEA in the treatment of depression. DHEA may have a very limited effect on cognitive function in elderly people, and some studies suggest a beneficial immunomodulatory effect of DHEA in patients with autoimmune diseases, but further studies are warranted before introducing DHEA for these indications in clinical practice

Welke schadelijke effecten van drop zijn mogelijk?

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Gegeneraliseerde histoplasmose door endogene reactivering van een latente infectie bij een HIV-seronegatieve man

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Cortisol, 11beta-hydroxysteroid dehydrogenases, and hypertension.

Item does not contain fulltextHypersecretion of cortisol is associated with hypertension. In addition, an abnormal cortisol metabolism may play a role in the pathogenesis of hypertension. The 11beta-hydroxysteroid dehydrogenase (11beta-HSD) isozymes catalyze interconversion of cortisol and cortisone and play an important role in the regulation of the effects of cortisol. Activity of 11beta-HSD type 2, converting active cortisol in inactive cortisone, is crucial in preventing access of cortisol to the renal mineralocorticoid receptors (MRs). Decreased activity of this isozyme in the kidney, either congenitally in Apparent Mineralocorticoid Excess syndrome or acquired following licorice consumption, allows cortisol access to the MRs, resulting in hypokalemic hypertension. In normotensive subjects, an association has been demonstrated between blood pressure increase on a high-salt diet and a mild decrease of renal 11beta-HSD2 activity. In ectopic adrenocorticotropic hormone (ACTH), plasma cortisol levels are very high, resulting in mineralocorticoid hypertension caused by saturation of the available renal 11beta-HSD2 capacity. Activity of the 11beta-HSDs has also been demonstrated in many extrarenal sites. Several studies have demonstrated extrarenal effects of cortisol on blood pressure, as well as a possible role for altered extrarenal 11beta-HSD activities in the pathogenesis of hypertension. More studies are needed to clarify the role of 11beta-HSDs in the pathogenesis of hypertension

[No response to antihypertensive therapy: consider non-adherence],Geen reactie op antihypertensieve therapie: denk aan therapieontrouw.

Contains fulltext : 53403.pdf (publisher's version ) (Closed access)In 3 patients, 2 men aged 62 and 43 years, respectively, and 1 woman aged 53 years, the medication prescribed to reduce blood pressure was insufficiently effective. Drug adherence was questioned. The first patient was afraid of the side effects mentioned in the medication information leaflet. The second patient had insufficient plasma levels of the medication but would not discuss the subject. The blood pressure of the third patient was uncontrolled despite treatment with three antihypertensive drugs. During a short hospital stay, her blood pressure responded favourably to treatment with only one of the three drugs. Subsequent repeated instruction did not improve her situation. Drug adherence is an important issue in daily clinical practice. In patients with asymptomatic conditions like hypertension, adherence is expected to be poor and worsen over time. Adherence is very difficult to measure. Risk factors for poor adherence include complex medication schedules, multiple dosing times, depression and real or suspected side effects. Measures to improve drug adherence include simplifying the medication schedule, discussing the schedule during check-ups, using automated blood pressure measuring devices at home, maintaining e-mail contact with the patient and involving a specialised nurse. Increased awareness of poor adherence is an important step toward improving hypertension treatment

NI: New legislation to crack down on teenage drinkers using bogus ID.

Underage drinkers in Northern Ireland will find it increasingly difficult to get their hands on cheap drink. New legislation due to take effect today will require young people to show a passport, photocard driving licence or an electoral identity card before they can buy alcohol in an off licence. The move represents a tightening up of existing laws and it will put the onus on sellers to make sure people are old enough to buy alcohol. It means that teenagers and young people will no longer be able to hide behind fake ID printed off the internet, while off licences will be required to display notices setting out the offences relating to its sale or purchase for under-18s

Gegeneraliseerde histoplasmose: endogene reactivatie van een latente infectie bij een HIV-seronegatieve man.

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