The antifracture efficacy of vitamin D in adults - are we assessing it reliably? A systematic review.

Introduction: The antifracture efficacy of vitamin D is still controversial. The aim of this systematic review was to examine if the vitamin D trials were designed adequately to reliably assess its antifracture activity.

Material And Methods: The electronic databases PubMed, Medline, Embase, Web of Science, and Cochrane Library were searched to identify clinical trials evaluating the antifracture efficacy of vitamin D in adults.

Therapy With Intravenous Methylprednisolone Pulses Is Associated With Loss of Bone Microarchitecture in Trabecular Bone Score -Assessment Among Patients With Moderate-to-Severe Graves' Orbitopathy: A Pilot Study.

Background: Therapy with intravenous glucocorticoids (GCs) is associated with various side effects, however, the impact on bone remains elusive. Trabecular bone score (TBS) is a diagnostic tool providing information on bone microarchitecture based on images obtained from dual-energy X-ray absorptiometry. We investigated the influence of the intravenous methylprednisolone (IVMP) pulse administration on TBS in patients with moderate-to-severe Graves' orbitopathy (GO).

FRAX prognostic and intervention thresholds in the management of major bone fractures in hemodialysis patients: A two-year prospective multicenter cohort study.

Purpose: The usefulness of FRAX in predicting major bone fractures in patients with end-stage kidney disease on maintenance hemodialysis treatment has been confirmed in previous studies. For meaningful clinical use, the prognostic and intervention FRAX thresholds need to be established.

Methods: The primary aim of our study was to calculate the optimal cut-off point of FRAX for the best prediction of an increased bone fracture risk in dialysis patients and additionally, to propose its intervention threshold, indicating the need for antifracture pharmacological treatment.

Therapy of moderate-to-severe Graves' orbitopathy with intravenous methylprednisolone pulses is not associated with loss of bone mineral density.

Purpose: To evaluate the influence of intravenous methylprednisolone (IVMP) pulse administration on bone mineral density (BMD) of the lumbar spine and the femoral neck in patients with moderate-to-severe Graves' orbitopathy (GO).

Methods: Thirty-five patients with GO in euthyreosis were treated with 12 IVMP pulses (6 × 0.5 g, 6 × 0.

The utility of FRAX® in predicting bone fractures in patients with chronic kidney disease on hemodialysis: a two-year prospective multicenter cohort study.

Unlabelled: We assessed the FRAX® method in 718 hemodialyzed patients in estimating increased risk of bone major and hip fractures. Over two prospective years, statistical analysis showed that FRAX® enables a better assessment of bone major fracture risk in these patients than any of its components and other risk factors considered in the analysis.

Introduction: Despite the generally increased risk of bone fractures among patients with end-stage renal disease, no prediction models for identifying individuals at particular risk have been developed to date.

Bone mineralization and densitometric evaluation of vertebral fractures in women 6-21 years after the onset of anorexia nervosa symptoms.

Objectives: We attempted to assess bone mineralization and the frequency of fractures occurrence in women with a history of treatment of anorexia nervosa (AN) in adolescence.

Methods: 47 women (age 20-36.8 years) were re-examined 6.

[Treatment of metabolic acidosis in patients with chronic kidney disease (CKD)].

Metabolic acidosis becoming clinically apparent when glomerular filtration rate (GFR) decreases <30 ml/min/1,73m2. Although usually mild, it can have substantial adverse effects like: impair albumin biosynthesis and glucose metabolism, increase protein catabolism with a decrease of muscle mass, increase bone resorption and inhibition of its formation with growth retardation in children. At present KDIGO (Kidney Disease: Improving Global Outcomes) recommendations support oral sodium bicarbonate supplementation and maintaining HCO3 - concentration ≥22 mmol/l in all CKD patients.

Bone mineralization disorders as a complication of anorexia nervosa - etiology, prevalence, course and treatment.

Anorexia nervosa (AN) most often has its onset in adolescence, which is a crucial period to achieve peak bone mass. The hormonal abnormalities (hypoestrogenism, hypercortisolism, decreased secretion of dehydroepiandrosterone, testosterone, insulin-like growth factor) and malnutrition are associated with profound bone mineralization disorders. Densitomertic bone mineral density (BMD) values for osteopenia and osteoporosis were found respectively in 35-98% and 13-50% of women with AN.

Bone metabolism and vitamin D status in patients with multiple sclerosis.

Background: Vitamin D (VD), an important factor for bone health immobilization and immune regulation, has been shown to have low serum concentration in multiple sclerosis (MS) patients. Those patients have also multiple fracture risk factors, including progressive immobilization and long-term glucocorticoids treatment. The aim of the study was to analyze bone health (osteopenia or osteoporosis prevalence) and VD serum concentration in MS patients as well as the influence of disease activity and treatment on bone health.

BONE MINERAL DENSITY IN CHILDREN WITH IDIOPATHIC HYPERCALCIURIA.

Unlabelled: The aim of the study was to evaluate bone mineral density (BMD) in the lumbar spine in children with idiopathic hypercalciuria.

Patients And Methods: The study group included 31 children (14 boys, 17 girls) aged 5 to 17 years (mean age 9.8 ± 4.

Long-term cholecalciferol administration in hemodialysis patients: a single-center randomized pilot study.

Background: Data on the potent pleiotropic extraskeletal effects of vitamin D have renewed interest in its use in selected populations, including patients with chronic kidney disease, but the available data are still insufficient to make recommendations. This study assessed the long-term effect of small cholecalciferol doses on serum vitamin D, parathormone (PTH), and bone mineral density (BMD) in hemodialysis patients.

Material/methods: Nineteen patients with serum 25(OH)D <20 ng/mL were randomized into cholecalciferol (2000 IU 3×/week) and no-treatment groups, then observed for 1 year.

Markers of bone metabolism in children with nephrotic syndrome treated with corticosteroids.

The aim of the study was to assess bone mineral density, bone metabolism markers, and vitamin D level in children with idiopathic nephrotic syndrome in the course of 1-year observation. Twenty five children with nephrotic syndrome aged 5-17 years were enrolled into the study. The median number of relapses was 6 (range 1-22).

[Recommendations for mineral and bone disorder in chronic kidney disease].

The current recommendations for the diagnostics and therapy in mineral and bone disorders (MBD) in chronic kidney disease (CKD) developed by an international group of experts KDIGO and the Board of the Polish Nephrology Consultant's Working Group are presented in the paper. MBD--begin already in the early stages of CKD, and are an important cause of increased morbidity and mortality in this population. The main goals of the therapy are to maintain calcium and phosphate homeostasis and to keep serum parathyroid hormone concentrations in the optimal range.

[Strontium ranelate in post-menopausal osteoporosis].

Strontium ranelate is one of the first-line agents with proven anti-fracture activity used in the therapy of post-menopausal osteoporosis. Its mechanism of action makes it, however, different from other drugs, since it simultaneously stimulates two reverse processes: bone formation and bone resorption. The action of the agent depends on various mechanisms, including the activation of calcium receptors, localised on osteoblasts and osteoclasts, and on the influence on the OPG/RANKL system.

Scuba diving does not affect bone mineral density or bone mineral content.

Objectives: Scuba diving is a very specialized, physically demanding activity. The bones of divers are subjected to stress from water pressure, from the forces generated when their muscles resist water pressure, and from weightlessness. Notably, few studies have addressed the effects of diving on bone mineral density (BMD) and bone mineral content (BMC), and the results have been controversial.

Strontium ranelate in post-menopausal osteoporosis.

Strontium ranelate is one of the first-line agents with proven anti-fracture activity used in the therapy of post-menopausal osteoporosis. Its mechanism of action makes it, however, different from other drugs, since it simultaneously stimulates two reverse processes: bone formation and bone resorption. The action of the agent depends on various mechanisms, including the activation of calcium receptors, localised on osteoblasts and osteoclasts, and on the influence on the OPG/RANKL system.

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency - management in adults.

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive hereditary diseases. The impairment of cortisol synthesis leads to excessive stimulation of the adrenal glands by adrenocorticotropic hormone (ACTH), adrenal hyperplasia, and excessive androgen synthesis. The syndrome is characterised by a considerable correlation between the genotype and the phenotype with the type of CYP21A2 gene mutation affecting the severity of 21-hydroxylase deficiency.

[Congenital adrenal hyperplasia due to 21-hydroxylase deficiency--management in adults].

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive hereditary diseases. The impairment of cortisol synthesis leads to excessive stimulation of the adrenal glands by adrenocorticotropic hormone (ACTH), adrenal hyperplasia, and excessive androgen synthesis. The syndrome is characterised by a considerable correlation between the genotype and the phenotype with the type of CYP21A2 gene mutation affecting the severity of 21-hydroxylase deficiency.

[The role of bone metabolic markers in qualification for treatment of osteoporosis. Results of POMOST study].

Introduction: Increased bone turnover markers (BTM) level is consider as independent risk factor of bone fracture. However, it was not used in 10-year probability of bone fracture method (FRAX) proposed by WHO, which helps in qualification of patients for pharmacological treatment of osteoporosis. The aim of the study was to evaluate the usefulness of BTM in qualification for pharmacological treatment of osteoporosis.

[Bone metabolism disturbances in anorexia nervosa].

Osteoporosis is a frequent complications of anorexia nervosa (AN). The etiology of osteoporosis in AN is multifactorial. Multiaxial hormonal disturbances and chronic undernutrition cause decrease or the lack of increase of bone mineral density (BMD), expected in adolescence.

Quantitative ultrasound in monitoring of skeletal status in adults with end-stage renal disease.

The aim of the longitudinal study was to assess skeletal status in 29 subjects (18 males and 11 females) with end-stage renal disease (ESRD) being on regular hemodialysis. Control group consisted of 494 healthy subjects (305 males and 189 females). Skeletal status was evaluated by quantitative ultrasound measurements at the hand phalanges using DBM Sonic 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS, in m/s), performed three times: at the baseline, six and 12 months later.

[Management of hyperthyroidism with radioactive iodine in end-stage renal disease patients undergoing dialysis].

Although, the abnormal thyroid hormone production and metabolism are relatively common, hyperthyroidism is a very unusual condition. The diagnosis may be difficult because of similar signs and symptoms as in uremia. To our knowledge till now only 18 well documented cases have been reported, 8 of them successfully treated with radioactive iodine.

Bone mineral density in patients on home parenteral nutrition: a follow-up study.

Background And Aims: The variations of bone mineral density (BMD) during home parenteral nutrition (HPN) and their relationship with general, life style, primary disease and HPN risk factors were investigated by a follow-up study.

Design: Patients who had BMD assessment in a previous cross-sectional survey underwent a 2nd BMD at femoral neck (FN) and lumbar spine (LS). Data about risk factors were collected by a structured questionnaire.