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  • 1
    Electronic Resource
    Electronic Resource
    Primary aldosteronism: difference in clinical presentation and long-term follow-up between adenoma and bilateral hyperplasia of the adrenal glands (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 979-984 
    Details
    ISSN: 1432-1440
    Keywords: Adenoma ; Aldosterone ; Adrenalectomy ; Gynecomastia ; Hyperaldosteronism ; Hyperplasia ; Spironolactone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since 1974 primary aldosteronism has been diagnosed in 71 patients in our outpatient clinic. Thirty-four patients had a unilateral aldosterone-producing adenoma, whereas bilateral adrenal hyperplasia was diagnosed in 37 patients. Although at the time of diagnosis the mean potassium values were lower and mean aldosterone levels were higher in patients with an adenoma, as compared to those with bilateral hyperplasia, these laboratory data did not allow us to differentiate between the two leading causes of primary aldosteronism in the individual patient due to pronounced overlap of laboratory values between the two groups. During the first few years, a successful differential diagnosis was made by adrenal phlebography and separate sampling of plasma aldosterone in both adrenal veins; later non-invasive imaging techniques such as computed tomography and radionuclide scanning were used. The best results were obtained in patients with adenoma who underwent adrenalectomy. Fifty-six percent of these patients were clinically and biochemically cured; 28% were improved and had normal blood pressure values during drug treatment. In contrast, patients with bilateral hyperplasia were treated pharmacologically, but only in half of the patients could normal blood pressure values be achieved. Two thirds of the male patients developed gynecomastia during spironolactone treatment. As expected, unilateral adrenalectomy was unsuccessful in the 7 patients with bilateral hyperplasia who underwent surgery. Our results confirm that surgical treatment of adrenal adenomas and drug treatment of bilateral hyperplasias are the appropriate therapy in primary aldosteronism. A differential diagnosis cannot be made on the basis of clinical and non-invasive laboratory data alone; imaging techniques have to be included in the diagnostic process. The long-term clinical outcome was more favorable in patients with an adrenal adenoma that can be removed surgically than in patients with idiopathic hyperplasia of both adrenal glands.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00577740
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  • 2
    Electronic Resource
    Electronic Resource
    Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey (1993)
    Springer
    Cancer causes & control 4 (1993), S. 313-321 
    Details
    ISSN: 1573-7225
    Keywords: Cancer ; case-control ; colon ; larynx ; melanoma ; occupation ; physical activity ; prostate ; rectum ; socioeconomic status ; Turkey
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A multiple-site case-control study of 15 cancers (stomach; colon; rectum; larynx; lung; melanoma; skin; female breast; male breast; cervix; ovary; uterus; prostate; testis; and bladder) was conducted to evaluate their association with occupational physical activity and socioeconomic status (SES). A hospital-based study population (3,486 male cases and 379 female cases, and 2,127 male and 244 female controls) was established in an oncological treatment center in Istanbul, Turkey, from 1979–84. Assessment of physical activity and SES was based on job titles held by the study subjects. Two measures of physical activity were developed based on energy expenditure and ‘sitting time’ during working hours. Observed risks were adjusted for age, smoking, and SES. Elevated risks were observed among workers who held sedentary jobs for cancers of the colon (odds ratio [OR=1.6), rectum (OR=1.3), melanoma (OR=1.9), male breast (OR=1.4), prostate (OR=5.0), and ovary (OR=2.0). Cancers of the cervix and uterus showed significantly decreasing risks with decreased activity. Risks of cancers of the colon, rectum, larynx, ovary, and melanoma were enhanced after risks for physical activity indices were adjusted for SES, while the associations between physical activity and cancers of the prostate, cervix, and uterus were weakened after SES adjustment. Risks of melanoma rose significantly with both activity indices after SES adjustment. The results of this study support previously reported associations between physical activity and cancers of the colon and rectum observed in developed countries, and provide additional evidence for cancers of the larynx, prostate, cervix, uterus, and melanoma, and point out the importance of SES in evaluation of physical activity and cancers of the colon, rectum, larynx, prostate, breast, cervix, and melanoma in developing countries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00051333
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  • 3
    Electronic Resource
    Electronic Resource
    Occupational physical activity and colon cancer risk in Turkey (1992)
    Springer
    European journal of epidemiology 8 (1992), S. 845-850 
    Details
    ISSN: 1573-7284
    Keywords: Colon cancer ; Risk factors ; Occupational activity ; Turkey
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case-control study of 107 colon cancer cases and 486 controls from an oncological clinic in Istanbul was conducted to examine the association between occupational physical activity and colon cancer in Turkey, where incidence of this disease is low. Only two of the four activity measures showed evidence of an increased colon cancer risk for sedentary jobs (time spent sitting OR= 1.5 and occupational energy expenditure OR= 1.6); neither was statistically significant. Subjects below age 55 showed higher risk associated with sedentary jobs than did the older age group, probably due to their adoption of a more western lifestyle, including dietary habits, less activity, and other factors that may interact to increase the risk of colon cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00145330
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    Paper (German National Licenses)
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