Aims/hypothesis. Moderate alcohol intake has been associated with increased life expectancy due to reduced mortality from cardiovascular disease. We prospectively examined the effects of alcohol consumption on mortality in Type 2 diabetic patients in Switzerland. Methods. A total of 287 patients with Type 2 diabetes mellitus (125 women, 162 men), recruited in Switzerland for the WHO Multinational Study of Vascular Disease in Diabetes, were included in this study. After a follow-up period of 12.6±0.6 years (means ± SD), mortality from CHD and from all causes was assessed.Results. During the follow-up, 70 deaths occurred (21 from CHD, 49 from other causes). Compared with non-drinkers, alcohol consumers who drank alcohol 1 to 15 g, 16 to 30 g and 30 g or more per day had the following risk rates of death from CHD: 0.87 (95% CI: 0.25 to 2.51, NS), 0.00 (95% CI: 0.00 to 0.92, p less than 0.05) and 0.37 (95% CI, 0.01 to 2.42, NS), respectively. The corresponding risk rates of death from all causes were 1.27 (95% CI: 0.68 to 2.28, NS), 0.36 (95% CI: 0.09 to 0.99, p less than 0.05) and 1.66 (95% CI: 0.76 to 3.33, NS). Conclusions/interpretation. In Swiss Type 2 diabetic patients moderate alcohol consumption of 16 to 30 g per day was associated with reduced mortality from CHD and from all causes. Alcohol intake above 30 g per day was associated with a tendency towards increased all-cause mortality. [Diabetologia (2003[Diabetologia ( ) 46:1581[Diabetologia ( -1585
The prevalence of incidentally discovered lesions within the pituitary (pituitary incidentalomas) is about 10%. The most common form of sellar mass are clinically nonfunctioning adenomas (less than 10 mm); functioning adenomas, however, are rare. Incidentally discovered pituitary microadenomas causing growth hormone hypersecretion are uncommon. In addition, the association of autosomal dominant polycystic kidney disease with acromegaly is exceptional and has not yet been reported to our knowledge.
Autoimmune thyroid disease (AITD) is quite common and comprises goitrous and nongoitrous eu- and hypothyroid Hashimoto's Disease with or without preceding thyrotoxicosis, classical hyperthyroid Graves' Disease and its rarer eu- and hypothyroid variants. There is no generally accepted international classification of AITD. Important aspects of the pathogenesis of AITD have been elucidated in the past two decades. AITD may be explained by an excess of either stimulating and/or destructive/blocking immune processes or by a balanced coexistence of various of these pathological autoimmune features. The HLA (DQA1*0501) is involved in determining the susceptibility to AITD. The measurement of antibodies against thyroidal peroxidase and TSH receptor has become the cornerstone in the diagnosis of AITD. Antibodies directed against TSH receptors are stimulating (TSAb) or blocking (TSBAb). In routine measurements they are determined by a radioligand assay which does not distinguish between these two different types of antibodies. A valid interpretation of antibody results is therefore only possible in connection with the clinical findings and the results of thyroid hormone measurements. We present here four unusual cases with AITD which illustrate its complexity and summarize the present state of knowledge on this disease.
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