Biomedical subjects

A Cranney

Publications and source records attributed to A Cranney.

43 records · Page 3Linked to original sources

PubMed1997

Quality of life measurement in osteoporosis.

Quality of life measurement may be helpful in randomized clinical trials in osteoporosis to assess therapeutic tradeoffs and compare effects of different interventions. Quality of life measures include generic measures, disease targeted measures, and performance based measures. Disease targeted measures increase the coverage of domains that are of particular importance to the patient with established osteoporosis. Several disease targeted measures are currently available. These measures show discriminant validity, but data on longitudinal responsiveness and validity in randomized clinical trials are not yet available.

Humans↗

PubMed1997

Osteoporosis clinical trials endpoints: candidate variables and clinimetric properties.

We reviewed evidence on endpoints used in osteoporosis clinical trials to assist in the development of a set of endpoints to be included in all trials. A MEDLINE search was conducted using the Cochrane Collaboration strategy for each endpoint. Additional published literature was obtained from content experts. A proposed list of endpoints was developed after consultation with experts in the field. Each endpoint was evaluated with respect to validity, reproducibility, redundancy, and feasibility. We classified the endpoints into 2 major categories: clinical health status outcomes and intermediate endpoints, and for each endpoint we present current evidence from the literature as pertains to defined methodologic criteria. Multiple endpoints have been used in osteoporosis clinical trials, and an agreement on a core set of measures needs to be evidence based with an emphasis on validity, reproducibility, and feasibility and to satisfy clinical credibility.

Biomarkers↗

PubMed1997

Responsiveness of endpoints in osteoporosis clinical trials.

The usefulness of an endpoint depends in part on its responsiveness to clinically important change. From existing randomized controlled trials, the responsiveness of endpoints currently employed in osteoporosis clinical trials were examined. The responsiveness is presented as the sample size per group needed to show a statistically significant difference. The large variation found means that careful attention needs to be given to the responsiveness of the population studied when estimating the sample size.

Bone Density↗

PubMed1997

Polymyositis in a patient with thymoma and T cell lymphocytosis.

A patient presenting with agranulocytosis and lymphocytosis (4600/mm3) was found subsequently to have polymyositis (PM) and a thymoma. Immunophenotyping of the circulating lymphocytes revealed mature T cells (CD3, CD5, CD7 positive) with normal proportions of both CD4 (55%) and CD8 (38%) positive cells. PM was confirmed by electromyogram and muscle biopsy. Fewer than a dozen cases of thymoma and T cell lymphocytosis have been reported and ours is the first in which autoimmune manifestations have been noted. The presence of lymphocytosis in a patient with PM should prompt the search for a thymoma.

Adult↗

PubMed1996

Intermittent cyclic therapy with etidronate prevents corticosteroid-induced bone loss: two years of follow-up.

The purpose of this study was to evaluate the efficacy of intermittent cyclic therapy (ICT) with etidronate in preventing the loss of lumbar vertebral bone mineral density (BMD) in patients taking corticosteroids. The study population was a cohort of patients taking corticosteroids for at least two years for polymyalgia rheumatica, asthma, rheumatoid arthritis, systemic lupus erythematosus or other conditions. A tertiary care university teaching hospital-affiliated rheumatology office practice. Inclusion and exclusion criteria yielded eighty-eight patients taking corticosteroids for at least two years who had not taken estrogen or fluoride and had no causes of secondary osteoporosis. Changes relative to baseline in individual vertebral (L2-L4) BMD measurements after one and two years were compared between patients who had taken ICT with etidronate (n = 42) and those who had not (n = 46). We found that BMD in the lumbar spine increased significantly over baseline in patients who had taken ICT with etidronate, by 3.9% after one year and by 5.6% after two years, whereas it decreased by 3.7-3.8% in patients who had not. We conclude that ICT with etidronate prevents corticosteroid-induced osteoporosis and progressively ameliorates BMD over two years. Double blind trials are underway to evaluate whether this increased BMD is associated with reductions in vertebral fracture rates.

Adrenal Cortex Hormones↗

PubMed1994

Osteomyelitis subsequent to abdominal-vaginal sacropexy.

Vertebral osteomyelitis is an uncommon complication of abdominal-vaginal sacropexy. Our patient developed polymicrobial osteomyelitis postoperatively, with the suspected route of infection attributed to contiguous spread from an infected mesh.

Aged↗

PubMed1994

Intermittent cyclic therapy with etidronate in the prevention of corticosteroid induced bone loss.

OBJECTIVE: To assess the potential efficacy of intermittent cyclic therapy (ICT) with etidronate in the treatment of patients with corticosteroid induced osteoporosis. METHODS: Cohort study in a tertiary care university affiliated hospital in corticosteroid treated patients, with polymyalgia rheumatica, asthma, systemic lupus erythematosus, rheumatoid arthritis, or temporal arteritis, examining the effects of ICT etidronate. Patients were included if they were taking corticosteroids for a minimum of one year. Comparison patients were those who had been taking corticosteroids for a minimum of one year and who had not been treated with etidronate or other medication which might alter bone metabolism. A total of 68 patients were included from 253 considered. The mean (SD) dose of prednisone in the ICT etidronate treated patients was 9.3 (6.2) mg and in the comparison patients 9.4 (5.9) mg. The duration of prednisone therapy was 7.8 (5.8) years and 3.4 (4.2) years, respectively (p2 < 0.001). An analysis of covariance demonstrated that this difference did not alter our primary outcome measure. The primary outcome measure was the difference in the percentage change from baseline to one year of followup in bone mineral density (BMD) of the lumbar spine between treatment and comparison groups. RESULTS: ICT etidronate resulted in a statistically significant and clinically important increase in BMD. The BMD of the lumbar spine increased by 3.82% (0.65%), [95% confidence interval (CI), 2.51 to 5.14%] in the 35 ICT etidronate treated patients and decreased by 1.78% (0.76%), [95% CI, -3.34 to -0.23%] in the 33 comparison patients after 12 months (p2 < 0.0001). CONCLUSIONS: ICT etidronate prevented loss of vertebral bone density in patients with corticosteroid induced osteoporosis. Controlled, double blind, prospective trials with longer followup are needed to confirm these results and to demonstrate that increases in bone mass translate into decreased fracture rates.

Adrenal Cortex Hormones↗