European journal of internal medicine
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Eur. J. Intern. Med. · Jan 2008
Comparative StudyPostmenopausal Canarian women receiving oral glucocorticoids have an increased prevalence of vertebral fractures and low values of bone mineral density measured by quantitative computer tomography and dual X-ray absorptiometry, without significant changes in parathyroid hormone.
Daily doses higher than 7.5 mg/daily of prednisone or equivalents confer a great risk of vertebral and hip fractures with a clear dose dependence of fracture risk. Information regarding the utility in assessing trabecular bone mineral density by quantitative computer tomography (QCT) in these patients, either in the Canaries or in Spain, is lacking. Moreover, in this setting, the importance of secondary hyperparathyroidism is still controversial. ⋯ In postmenopausal Canarian women, chronic glucocorticoid therapy is associated with low bone mineral density, measured either by DXA or QCT, with evidence of low turnover and high prevalence of fractures without significant changes in PTH. DXA and QCT provide similar information in the assessment of this high risk population.
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A 29-year-old hospital doctor presented with a febrile illness and a rash that began shortly after commencing a course of oral antibiotics. Initially thought to be a drug reaction, changes in the nature of the rash led to a confirmed diagnosis of measles. An immunisation history revealed that the patient had never received the MMR vaccine. A high index of suspicion is required to diagnose measles in an immunocompetent adult, and we suggest that occupational health departments should be more rigorous in screening for vaccinations in health workers.
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Eur. J. Intern. Med. · Jan 2008
Comparative StudyEthnic variation in certain hematological and biochemical reference intervals in a south Indian healthy adult population.
We established the biochemical and hematological reference intervals among a south Indian healthy adult population attending an HIV referral centre in Chennai, southern India. ⋯ Ethnic variation in reference intervals was observed in certain biochemical and hematological analytes in a south Indian adult population.