Purpose: Bone mineral density (BMD) measured with dual x-ray absorptiometry (DXA) is the clinical standard for the diagnosis of osteoporosis and prediction of bone fracture risk. In the aging skeleton, osteoporosis is often concomitantly present with degenerative joint disease (DJD).
Methods: In this study, we evaluated tissue-level changes in the differentially loaded concave (CC) and convex (CV) sides of the lumbar spine in a sample of postmenopausal women with scoliosis.
Inhalant use disorder is a psychiatric condition characterized by repeated deliberate inhalation from among a broad range of household and industrial chemical products with the intention of producing psychoactive effects. In addition to acute intoxication, prolonged inhalation of fluorinated compounds can cause skeletal fluorosis (SF). We report a young woman referred for hypophosphatasemia and carrying a heterozygous ALPL gene variant (c.
View Article and Find Full Text PDFObjective: Several studies have shown that patients with end-stage liver disease (ESLD) have lower bone mineral density (BMD) and a higher prevalence of osteoporosis compared to an age-matched population. Hyperinsulinemia and insulin resistance are typically associated with increased BMD. We hypothesized that patients with nonalcoholic steatohepatitis (NASH) and underlying insulin resistance may have higher BMD than patients with cirrhosis from other causes.
View Article and Find Full Text PDFPurpose: To determine whether a correlation between ABCC6 mutations and ocular phenotypic expressions exists.
Methods: In this study, 28 relatives of a consultand with known pseudoxanthoma elasticum were recruited for evaluation of the ocular manifestations of the disease, including peau d'orange appearance, angioid streaks, choroidal neovascular membranes, peripapillary atrophy, and retinal drusen. Comprehensive eye examinations were documented for all patients, who were then evaluated for the presence of known mutations in the aforementioned ABCC6 gene.
The purpose of this post hoc analysis was to determine whether baseline concentrations or early changes in serum bone turnover markers were correlated with changes in bone mineral density (BMD) at 18 months in patients with glucocorticoid-induced osteoporosis (GIO) treated with teriparatide (n=80; 20 mug/day) or alendronate (n=77; 10 mg/day). Bone markers included type I collagen N-terminal propeptide (PINP), type I collagen C-terminal propeptide (PICP), bone alkaline phosphatase (bone ALP), and cross-linked C-telopeptide of type I collagen (Sbeta-CTX). The relationship between baseline and early changes in markers and the 18-month changes in lumbar spine (LS) and femoral neck (FN) BMD was evaluated using Spearman correlation analysis.
View Article and Find Full Text PDFReduced osteoblast function is a primary defect in glucocorticoid-induced osteoporosis (GIO), and is reflected by decreased biochemical markers of bone formation, such as serum osteocalcin (OC) and procollagen type I N-terminal propeptide (PINP). This analysis compared the effects of teriparatide and alendronate on OC and PINP in patients with GIO. In a double-blind study, women (N=159) and men (N=38) with GIO were randomized to either teriparatide 20 mug/day by subcutaneous injection or to alendronate 10 mg/day orally.
View Article and Find Full Text PDFThe sub-segmental analysis of dual energy X-ray absorptiometry (DXA) scans from scoliotic vertebrae has established that there are differences in bone mass between the concave and convex sides of the vertebrae. Furthermore, these differences persisted in patients with low bone mass and were related to the geometry and applied loads, suggesting that this is a good model of bone adaptation in response to external stimuli. The goal of this study was to characterize the response of the human scoliotic spine to anti-resorptive treatments and estrogen withdrawal on the concave and convex sides of the spine.
View Article and Find Full Text PDFObjective: To evaluate the relationship between bone mass and risk of breast cancer and to determine the effect of raloxifene therapy on breast cancer incidence in women categorized by bone mass into low bone mass and osteoporosis subgroups.
Design: In this post hoc analysis, data were analyzed from the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, enrolling postmenopausal women with low bone mass (N = 7705), and the Continuing Outcomes Relevant to Evista (CORE) trial, a follow-up to MORE enrolling 4011 MORE participants. Total follow-up was for up to 8 years.
The dual purpose of this process paper is to describe the implementation of an intensive insulin infusion program against multiple barriers, despite the increasing evidence in the literature supporting glycemic control, and to report the glucose outcomes. Traditional hyperglycemic management has been done either by subcutaneous sliding scale or intravenous insulin infusions based on absolute glucose numbers. A review of the literature, with particular evidence within the cardiothoracic surgical (CTS) population, has shown significant deleterious effects of even mild hyperglycemia.
View Article and Find Full Text PDFNearly one-third of all women and one-sixth of all men over age 65 have osteoporosis, and this condition is often accompanied by lumbar scoliosis. Previous work has shown that, in a group of postmenopausal women with scoliosis and osteoporosis, both the bone mineral content (BMC) and bone mineral density (BMD) were greater on the concave side than the convex side. The goal of this study was to examine the structure-function relationships in the spines of patients with low bone mass and scoliosis using a patient-specific biomechanical model.
View Article and Find Full Text PDFStudy Design: In this study, we elucidated the bone quantity and distribution in lumbar spines of a group of 176 postmenopausal women (average age 72 years) with scoliosis.
Summary Of Background Data: Adolescent idiopathic scoliosis is associated with a low bone mineral density, but the bone mineral density in adult lumbar scoliosis has not been well-characterized.
Methods: Dual-energy x-ray absorptiometry analysis of the femoral neck and lumbar spines of 176 postmenopausal women were used to assess the bone mineral density and bone mineral content at both anatomic sites.
J Clin Endocrinol Metab
February 2004
A patient with a large prolactinoma developed a metastatic islet cell tumor secreting pancreatic polypeptide. Dopamine agonist drugs reduced the prolactin levels to normal, caused a 7-fold decrease in the pancreatic polypeptide levels, and inhibited the liver metastases. Elevated chromogranin A levels also normalized on the higher doses of bromocriptine.
View Article and Find Full Text PDFApproximately 16 million people in the United States have diabetes mellitus, and the number of diagnoses is increasing at an alarming rate. A very costly disease in both human and economic terms, diabetes (currently the seventh leading cause of death) is common in both the old and young, crossing all racial, ethnic, and economic barriers. Diabetes significantly increases the risk of cardiovascular, cerebrovascular, and peripheral vascular disease, retinopathy, neuropathy, and nephropathy.
View Article and Find Full Text PDFThe authors present the case of an 81-year-old woman with severe hypocalcemia due to osteoblastic metastases from breast cancer. The clinical and laboratory characteristics of this condition are discussed, some therapeutic dilemmas considered, and the literature briefly reviewed.
View Article and Find Full Text PDFMutations affecting the pro alpha 1(I) or pro alpha 2(I) collagen genes have been identified in each of the major clinical types of osteogenesis imperfecta. This study reports the presence of a heritable connective tissue disorder in a family with an osteopenic syndrome which has features of mild osteogenesis imperfecta but was considered idiopathic osteoporosis in the proband. At age 38, while still premenopausal, she was found to have osteopenia, short stature, hypermobile joints, mild hyperelastic skin, mild scoliosis, and blue sclerae.
View Article and Find Full Text PDFThis paper further characterizes the estrogen-binding protein we have described in the cytosol of the yeast Saccharomyces cerevisiae. [3H]Estradiol was used as the radioprobe, and specific binding of cytosol fractions was measured by chromatography on Sephadex minicolumns. Other 3H-steroids did not exhibit specific binding.
View Article and Find Full Text PDFA protein macromolecule in the cytosol of the unicellular eukaryotic yeast Saccharomyces cerevisiae selectively binds the vertebrate estrogen hormone 17 beta-estradiol with high affinity. Lipid extracts of the yeast cells or the conditioned growth medium yield a substance that can bind competitively to the tritiated estradiol-binding sites in the yeast and to mammalian estrogen receptors. These findings suggest that the binding protein may be a primitive hormone receptor and that the lipid-extractable substance represents the endogenous ligand.
View Article and Find Full Text PDFThe role of spironolactone in the aetiology of gynaecomastia was examined in terms of its ability to bind to the oestrogen receptor in cytosol, to cause specific oestrogenic effects in the absence of endogenous oestrogen and to be antioestrogenic in the presence of oestradiol. Tamoxifen, a non-steroidal antioestrogen, was chosen as an internal standard for comparison. Spironolactone and tamoxifen competitively inhibited the binding of oestradiol-17beta to its receptor in uterine and mammary cytosol, with inhibition constants of 2 x 10(-5) and 1 x 10(-7) mol/l respectively.
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