Abstract:
:The pathogenesis of intrahepatic cholestasis of pregnancy (ICP) can be related to abnormalities in the metabolism and disposition of sex hormones and/or bile acids, determined by a genetic predisposition interacting with environmental factors. The total amount of oestrogens and progesterone circulating in the blood or excreted in the urine of ICP patients is similar to normal pregnancies. Thus, the search for the cause has been focused on abnormal hormone metabolites. The cholestatic potential of some D-ring oestrogen metabolites is supported by experimental and clinical data. Similar observations with regard to bile acids and progesterone metabolites are still scarce. This article reviews current knowledge in this field, including our own data. Bile acid synthesis appears to be reduced in patients with ICP, in whom primary conjugated bile acids are retained in blood. The major bile acid in blood and urine of these patients is cholic acid instead of chenodeoxycholic acid present in normal pregnancies. Hydroxylation and sulfation of bile acids are enhanced, while glucuronidation appears to be of lesser importance. The synthesis of progesterone appears unimpaired, while the profiles of progesterone metabolites in plasma and urine are different from normal pregnancies, with a larger proportion of mono- and disulfated metabolites, mainly 3alpha,5alpha isomers. Glucuronidated metabolites, however, are unchanged. With the administration of ursodeoxycholic acid (UDCA) to patients with ICP, pruritus and serum liver values are improved, the concentration of bile acids in blood is diminished and the proportion of their conjugated metabolites returned to normal. Simultaneously, the concentration of sulfated progesterone metabolites in blood and their urinary excretion are reduced. The serum levels of bile acids and progesterone metabolites before UDCA administration and their decrease during treatment do not correlate with each other. We propose that patients with ICP have a selective defect in the secretion of sulfated progesterone metabolites into bile and speculate that this may be caused by genetic polymorphism of canalicular transporter(s) for steroid sulfates or their regulation. Interaction with oestrogen metabolites and/or some exogenous compounds may further enhance the process triggering ICP in genetically predisposed individuals.
journal_name
Ann Medjournal_title
Annals of medicineauthors
Reyes H,Sjövall Jdoi
10.3109/07853890009011758subject
Has Abstractpub_date
2000-03-01 00:00:00pages
94-106issue
2eissn
0785-3890issn
1365-2060journal_volume
32pub_type
杂志文章,评审abstract:BACKGROUND:Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS:This is a retrospective mu...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.1080/07853890.2020.1836566
更新日期:2021-12-01 00:00:00
abstract::INTRODUCTION. Premature ovarian failure (POF) can occur naturally at an early age or be due to iatrogenic agents. Indeed, ovaries are very sensitive to cytotoxic treatment, especially to radiation and alkylating agents. METHODS. Several options are currently available to preserve fertility in cancer patients and allow...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853890.2010.546807
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AIMS:A mild increase in liver enzyme levels is sometimes observed in patients with diabetic ketosis or ketoacidosis. The aim of the present study was to assess the cause and prevalence of the elevation of liver transaminase levels in fulminant and acute-onset type 1 diabetic patients experiencing diabetic ke...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.1080/07853890802032711
更新日期:2008-01-01 00:00:00
abstract::Transvaginal ultrasonic monitoring of the lower uterine segment was performed in 15 pregnancies in which the mother had previously had three or more caesarean sections. The typical findings were thinning of the myometrium, asymmetric isthmal structures and ventral ballooning of the isthmus. An image of the other of th...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853899009147256
更新日期:1990-04-01 00:00:00
abstract::Concepts of eating disorders have altered so that anorexia nervosa is now recognized as an important but uncommon syndrome within a spectrum of disordered eating. Behaviours used by dieters constitute the mild end of the eating disorder spectrum. Dieting in young women is for the most part a transient and benign activ...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899209149955
更新日期:1992-08-01 00:00:00
abstract::Health professionals provide care with some purpose in mind. It is reasonable to assume that they are therefore interested in observing and measuring health outcomes. In the recent past, it has become fashionable to describe health outcomes in terms of their impact on 'quality of life', a widely used term that is usua...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853890109002085
更新日期:2001-07-01 00:00:00
abstract::The concentration of nitric oxide (NO) in exhaled air is increased in patients with asthma, suggesting that measuring fractional exhaled NO concentration (FE(NO)) may be used to monitor asthmatic airway inflammation. However, increased FE(NO) is not specific for asthma, as other inflammatory lung diseases may also inc...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853890008995949
更新日期:2000-09-01 00:00:00
abstract::The recent identification of mutations in the RET proto-oncogene that are associated with multiple endocrine neoplasia type 2 (MEN 2) syndromes has allowed therapeutic intervention in affected individuals on the basis of direct genetic testing. The principal endocrine neoplasm that occurs in patients with the MEN 2 sy...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899608999099
更新日期:1996-10-01 00:00:00
abstract::Geneticists have been predicting that advances in their discipline will revolutionize the understanding of human disease and behavior. While there has been considerable progress in disorders showing simple, Mendelian patterns of inheritance, expectations have yet to be fulfilled for disorders and traits showing comple...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.1080/07853890310010023
更新日期:2003-01-01 00:00:00
abstract::Troglitazone is a novel once-daily oral antidiabetic agent for the treatment of type 2 diabetes patients. Here, we report the overall dose response characteristics of troglitazone, with respect to effects on metabolic control, using a pharmacodynamic model. Data from week 12 from two previously reported double-blind, ...
journal_title:Annals of medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.3109/07853899808999405
更新日期:1998-04-01 00:00:00
abstract::Autoantibodies directed to intracellular antigens can be detected in many systemic rheumatic diseases. In this review, we discuss the clinical significance of antinuclear antibodies (ANA) associated with systemic lupus erythematosus (SLE), Slögren's syndrome, scleroderma and polymyositis/dermatomyositis, the immunogen...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899608999081
更新日期:1996-08-01 00:00:00
abstract:INTRODUCTION:The association between sleep disturbances and cardiometabolic diseases has been understudied in blacks with metabolic syndrome. METHODS:This study is a cross-sectional analysis of the Metabolic Syndrome Outcome Study (MetSO) trial. We assessed insomnia symptoms, sleep duration, and risk for sleep apnea. ...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853890.2015.1015601
更新日期:2015-05-01 00:00:00
abstract::This study examined the predictive validity of preadolescent Type A determinants for Type A dimensions in young adulthood (n = 375). Predictive variables, i.e. hyperactivity, aggression, social maladjustment and self-esteem were measured when the subjects were aged 12. Type A dimensions, i.e. hard-driving, competitive...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853899109147935
更新日期:1991-02-01 00:00:00
abstract::Dementia of the Alzheimer type (AD) is clinically characterized by a progressive deterioration of intellect, memory, judgment, and abstract thinking. It is incurable, and causal therapy is not yet available. For the development of therapeutic drugs, valid animal models are needed that mimic the pathophysiological chan...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899809002606
更新日期:1998-12-01 00:00:00
abstract::Clinical experience has indicated that the effects of RU 486 can be divided into dose-dependent and dose-independent effects. Examples of the dose-dependent effects include the antiglucocorticoid effects of RU 486, whereas pregnancy termination or dilatation of the cervix can be considered dose-independent with the va...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853899309147861
更新日期:1993-02-01 00:00:00
abstract::Rapid prototyping (RP) is a common name for several techniques, which read in data from computer-aided design (CAD) drawings and manufacture automatically three-dimensional objects layer-by-layer according to the virtual design. The utilization of RP in tissue engineering enables the production of three-dimensional sc...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.1080/07853890701881788
更新日期:2008-01-01 00:00:00
abstract::Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disease caused by mutations in sarcomeric proteins. It is characterized by left ventricular hypertrophy in the absence of an increased external load, and myofibrillar disarray. While hypertrophy is a common cardiac response to injury, disarray is the pathologi...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 00:00:00
abstract::The mucosal surfaces are the first portals of entry for most infectious agents, among which respiratory and intestinal viruses are of greatest epidemiological importance. To combat these infections, the immune system uses unspecific and specific mechanisms. Unspecific responses include the production of virus-induced ...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853890109002074
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:This meta-analysis aimed to compare the treatment of an acute asthma attack in children in the emergency department (ED) with inhaled corticosteroids (ICS) versus placebo or oral systemic corticosteroids (SC) as assessed by the hospital admission rates. METHODS:After searching Medline, Cochrane, EMBASE, and...
journal_title:Annals of medicine
pub_type: 杂志文章,meta分析
doi:10.3109/07853890.2013.859855
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Several clinical studies have suggested possible increase in cardiovascular risk during and in the first weeks after an acute inflammatory disease. Using influenza vaccine as inflammatory stimulus, we investigated whether arterial endothelial dysfunction could persist beyond the inflammatory state, and wheth...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.1080/07853890701390111
更新日期:2007-01-01 00:00:00
abstract::The causes of colorectal cancer are complex and in most cases obscure, making primary prevention impossible at present. Secondary prevention by finding and treating early asymptomatic cancers may possibly reduce mortality from this very common cancer. Results from conventional treatment have changed little during rece...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899109148076
更新日期:1991-10-01 00:00:00
abstract::On average, 15,000 cases of measles occurred annually in Finland before the initiation of a vaccination programme in 1975. Because of insufficient activity, the vaccination coverage failed to reach the required level of over 90%, and cases continued to occur. The policy was revolutionized in 1982 by launching a projec...
journal_title:Annals of medicine
pub_type: 社论
doi:10.3109/07853899808999395
更新日期:1998-04-01 00:00:00
abstract::Inflammatory bowel diseases (IBD) are chronic inflammatory conditions of the gastrointestinal tract encompassing two main clinical entities: Crohn's disease (CD) and ulcerative colitis (UC). These disorders are characterized by various grades of tissue damage and development of local complications and extra-intestinal...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.1080/07853890.2018.1490025
更新日期:2018-08-01 00:00:00
abstract::MicroRNAs are small non-coding RNAs that bind to multiple target mRNAs to control gene expression post-transcriptionally by inhibiting translation. In mammalian cells, microRNAs play important roles in a diverse array of cellular processes (e.g. cell proliferation and differentiation). However, alterations in their le...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853890.2014.958196
更新日期:2014-12-01 00:00:00
abstract::Copper is a trace element necessary for the normal function of several important enzymes but copper homeostasis is still poorly understood. In recent years remarkable progress has been made in this field following the isolation of the gene defective in Menkes disease. Menkes disease and occipital horn syndrome are X-l...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899609092936
更新日期:1996-04-01 00:00:00
abstract::Several lines of evidence suggest that abnormal brain serotonin metabolism may occur in early onset, type 2 alcoholism in men. Low cerebrospinal fluid 5-hydroxy-indoleacetic acid concentration has been found to be associated with a history of paternal alcoholism, and abnormal oral glucose tolerance tests (tendency to ...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899009147915
更新日期:1990-01-01 00:00:00
abstract::Heart failure syndrome results from compensatory mechanisms that operate to restore - back to normal - the systemic perfusion pressure. Sympathetic overactivity plays a pivotal role in heart failure; norepinephrine contributes to maintenance of the systemic blood pressure and increasing preload. Cardiac norepinephrine...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.1080/07853890.2017.1282168
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Obesity has reached epidemic proportions worldwide. Maternal obesity has consequences for the offspring's later health. Only few studies have focused upon the long-term consequences of maternal obesity on the offspring's later health. METHODS:A total of 13,345 men and women born in Helsinki during 1934-44...
journal_title:Annals of medicine
pub_type: 杂志文章
doi:10.3109/07853890.2014.919728
更新日期:2014-09-01 00:00:00
abstract::The understanding and treatment of schizophrenia have been greatly hampered by uncertainty about etiological factors and controversy about diagnostic boundaries. Adoption studies have helped clarify both of these problems. First, the adoptees study method, the index offspring of adopting-away schizophrenic biological ...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:10.3109/07853899409147896
更新日期:1994-08-01 00:00:00
abstract::Thymoma is an unusual tumour, but it is the most common malignancy in the anterior mediastinum. This tumour is unique in its frequent association with paraneoplastic syndrome and its potential for indolent growth. The distinction between thymomas and other tumours which arise in the anterior or superior mediastinum is...
journal_title:Annals of medicine
pub_type: 杂志文章,评审
doi:
更新日期:1999-10-01 00:00:00