Biomedical subjects

A J Goldstein

Publications and source records attributed to A J Goldstein.

15 recordsLinked to original sources

PubMed1991

Metabolic balance studies of mineral supplementation in osteoporosis.

1. We studied the effect of mineral supplementation and its duration in osteoporosis by analysing the calcium and phosphorus balances of 49 treated osteoporotic patients whose median length of calcium treatment was 19 weeks with a range of 8 days to over 4 years. Forty-four studies satisfied statistical criteria of reproducibility and included 35 women (10 also receiving oestrogen replacement therapy) and nine men. 2. Mean calcium balance was positive in women taking calcium supplements alone, +1.9 +/- 2.5 mmol daily (P less than 0.002), and was significantly more positive (P less than 0.05) in women also taking oestrogens, +4.2 +/- 2.1 mmol daily. Calcium balance was not significantly positive in men. 3. Calcium balance correlated negatively with duration of supplementation, but significantly, only when duration of supplementation was expressed logarithmically (r = -0.401, P less than 0.01) giving the regression equation y = 4.2-1.6 log x, where y = calcium balance in mol/day and x = duration of supplementation in weeks. Theoretical net calcium retention, without allowance for dermal loss, could be calculated by integration. 4. Mean phosphorus balance was significantly positive in both groups of women and in the whole population. Although its correlation with duration of supplementation did not reach statistical significance (P less than 0.1), the ratio of the regression slopes for calcium and phosphorus, 1.5:1, corresponded to their molar ratio in bone. 5. These statistics are, we believe, the first to describe an exponential decline in calcium balance during mineral treatment of osteoporosis, but they firmly suggest that such treatment, with or without oestrogen therapy, conveys temporary benefit.

Aged↗

PubMed1990

Fluoride therapy and parathyroid hormone activity in osteoporosis.

1. To determine the relationships between parathyroid hormone activity and long-term sodium fluoride therapy in osteoporosis, cytochemical bioassays (for biologically active parathyroid hormone) were performed in 22 osteoporotic control patients and in 18 patients after 15 +/- 10 months of treatment (60 mg of sodium fluoride daily). Ten patients were studied longitudinally by repeated metabolic balances and were therefore common to both groups. All patients were receiving mineral supplements. 2. Cross-sectional data showed a fourfold mean increase in biologically active parathyroid hormone on fluoride treatment (P less than 0.005) together with a 51% increase in serum alkaline phosphatase (P less than 0.005). Longitudinal data showed, in addition, a significant increase in the calcium balance of 2.4 +/- 1.2 (SEM) mmol daily (P less than 0.05) and the development of a positive phosphorus balance (P less than 0.02). 3. Fluoride-treated patients were then analysed in two groups according to the level of biologically active parathyroid hormone. Thirty-two per cent of values were above the upper limit of normal (18 pg/ml). The mean serum alkaline phosphatase level in this group showed no elevation above that of the control patients, the overall rise being accounted for entirely by patients with normal levels of biologically active parathyroid hormone. High levels of biologically active parathyroid hormone were also associated with relative hypophosphataemia (P less than 0.01), relative hypercalciuria (P less than 0.05) and an increased urine/faecal calcium ratio (P less than 0.025). 4. Results show that long-term fluoride and calcium therapy increase biologically active parathyroid hormone in osteoporosis and that excessive parathyroid hormone activity may account for certain features of the refractory state.

Adult↗

PubMed1988

Association between villous atrophy in rheumatoid arthritis and a rheumatoid factor and gliadin-specific IgG.

93 patients with rheumatoid arthritis (RA) were examined for histological or other evidence of gut abnormalities. 44 had raised levels of IgG to gliadin, and of these 38 (86%) were also positive for IgA rheumatoid factor (RF). 24 patients (15 with raised levels of IgA RF and wheat protein IgG [AB+] and 9 with normal levels of both antibodies [AB-]) underwent jejunal biopsy. 6 of the AB+ and 1 of the AB- patients had villous atrophy. The AB+ group had lower villous surface/volume ratio and small intestinal lactase concentrations than did the AB- group or age-matched controls. There was no significant difference between the two groups of RA patients in disease severity or treatment regimen. The findings suggest that the gut may play a more important part in the immunopathogenesis of some cases of RA than in others, and that the former may be identified by raised levels of IgA RF and wheat protein IgG.

Adolescent↗

PubMed1986

Immunocytology of synovial fluid cells may be of diagnostic and prognostic value in arthritis.

Cells of the synovial fluid (SF) have been examined by immunocytochemical methods. Samples were aspirated from four groups of patients with knee effusions: (a) seropositive inflammatory arthritis (n = 9); (b) seronegative inflammatory arthritis (n = 9); (c) osteoarthritic patients (n = 5); and (d) patients with traumatised knees (n = 4). The proportions of lymphocyte and macrophage subsets within the SF were determined with a panel of monoclonal antibodies. Patients with inflammatory arthritis had significantly larger proportions of activated T cells (RFT2+) and macrophages with the phenotype of interdigitating cells (RFD1+). No significant difference between groups could be found on differential count or when T4+/T8+ subset ratios were calculated. No significant difference in proportions of lymphocyte or macrophage subsets was found between the groups with seropositive and seronegative inflammatory arthritis. In two of three patients, where immunocytochemical analysis was performed before and after intra-articular steroids, reductions in the proportions of RFT2+ T cells and RFD1+ macrophage like cells were seen. It is suggested that such analysis may be of diagnostic or prognostic value.

Antibodies, Monoclonal↗

PubMed1982

The pubococcygens and female orgasm: a correlational study with normal subjects.

The relationship of pubococcygeal condition to orgasmic responsiveness in 102 women from a university community was examined in a controlled, prospective investigation. Pubococcygeal strength was measured with a perineometer while responsiveness was assessed by a standardized interview yielding reliable measures of self-reported orgasmic response. Subjects whose responsiveness might have been impaired by such factors as alcohol consumption, inadequate stimulation, and high sexual anxiety were excluded from analyses. Excellent within-session but poor across-session test-retest reliability of the perineometer measures was noted. Initial Strength Contracting proved to be the most reliable measure. Though the majority of the parous women had performed Kegel exercises after delivery, parity was negatively related to pubococcygeal strength on most measures. Contrary to experimental hypotheses, pubococcygeal strength was not found to be positively related to frequency or self-reported intensity of orgasm. Furthermore, women with higher pubococcygeal strength did not report that vaginal stimulation contributed more to attainment of orgasm, nor did they rate vaginal sensations during coitus as more pleasurable. Only in the case of pleasurability of orgasm through clitoral stimulation was a significant, though low, relationship obtained. Possible factors contributing to the discrepancy between these findings and previous uncontrolled investigations are discussed, as are the implications of these findings for the use of Kegel exercises in the treatment of orgasmic dysfunction.

Adult↗

PubMed1982