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- Kirwan, John R, et al.
(författare)
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The effect of therapeutic glucocorticoids on the adrenal response in a randomized controlled trial in patients with rheumatoid arthritis
- 2006
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 54:5, s. 1415-1421
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To measure the effect of low-dose systemic glucocorticoid treatment on the adrenal response to adrenocorticotropic hormone (ACTH) in patients with rheumatoid arthritis (RA). METHODS: Patients with RA who took part in a randomized double-blind placebo-controlled trial of budesonide (3 mg/day and 9 mg/day) and prednisolone (7.5 mg/day) underwent a short (60-minute) test with injection of ACTH (tetracosactide hexaacetate) at baseline and the day after completing the 3-month treatment program. Plasma cortisol measurements at baseline and 3 months were compared within and between the treatment groups. Individual patients were classified as normal responders to ACTH or as abnormal responders if changes were >2 SD below the pretreatment value in the entire group of study patients. RESULTS: Short tests with ACTH injection were performed on 139 patients before beginning the study medication and on 134 patients after cessation of the medication. There were no changes in the placebo group. Mean plasma cortisol levels following treatment were reduced in all active treatment groups. In addition, mean values were significantly reduced for the 30-minute and 60-minute responses to ACTH. The maximum reduction (35%) occurred in the prednisolone group at 60 minutes. Following treatment, 34% of patients taking budesonide 9 mg and 46% of those taking prednisolone 7.5 mg failed to reach the normal maximum cortisol response to ACTH. Four patients failed to achieve the normal percentage increase in cortisol levels, but only 1 patient failed to meet both criteria. CONCLUSION: Low doses of a glucocorticoid resulted in depression of baseline and ACTH-stimulated cortisol levels after 12 weeks of therapy. Although the responsiveness of the hypothalamic-pituitary-adrenal axis in individual patients generally remained within the normal range, these changes should be investigated further.
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- Wastegård, Stefan, et al.
(författare)
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Towards a Holocene tephrochronology for the Faroe Islands, North Atlantic
- 2018
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 195, s. 195-214
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Tidskriftsartikel (refereegranskat)abstract
- The Faroe Islands hold a key position in the North Atlantic region for tephra studies due to their relative proximity to Iceland. Several tephras have been described over the last 50 years in peat and lake sediment sequences, including the type sites for the Saksunarvatn and Mjauvotn tephras. Here we present a comprehensive overview of Holocene tephras found on the Faroe Island. In total 23 tephra layers are described including visible macrotephras such as the Saksunarvatn and Hekla 4 tephras and several cryptotephras. The importance of tephras originally described from the Faroe Islands is highlighted and previously unpublished results are included. In addition, full datasets for several sites are published here for the first time. The Saksunarvatn Ash, now considered to be the result of several eruptions rather than one major eruption, can be separated into two phases on the Faroe Islands; one early phase with two precursor eruptions with lower MgO concentrations (4.5-5.0 wt%) than the main eruption and a later phase with higher MgO concentrations (5.5-6.0 wt%), including the visible Saksunarvatn Ash. The Tjornuvik Tephra, previously considered to be a primary deposit, is now interpreted as a reworked tephra with material from at least two middle Holocene eruptions of Hekla. Several of the tephras identified on the Faroe Islands provide useful isochrons for climate events during the Holocene.
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