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Biomedical subjects

C A Mautalen

Publications and source records attributed to C A Mautalen.

At least 19 recordsLinked to original sources
PubMed1992

Risk for developing osteoporosis in untreated premature menopause.

The bone mineral density (BMD) of the lumbar spine and proximal femur was determined by dual photon absorptiometry in 32 women with untreated premature menopause (cessation of menses before 45 years of age). The BMD of the spine and proximal femur in four obese patients was not different from the BMD of the age-matched controls. On the contrary, the BMD of the nonobese females with premature menopause was significantly lower with respect to the average values found in healthy young women, in age-matched and menopause-matched controls. The BMD deficit was greater over the lumbar spine than in the proximal femur. Forty three percent of nonobese patients were already under the vertebral fracture threshold and 25% of nonobese patients were below the hip fracture threshold. The BMD deficit in the lumbar spine was correlated to the loss observed in the femoral neck (r = 0.59, P less than 0.001), in the trochanter (r = 0.65, P less than 0.001) and in the Ward's triangle (r = 0.73, P less than 0.001). A negative correlation was observed between years of menopause and the BMD of the lumbar spine (r = -0.39, P less than 0.05). The results indicate the high individual risk for osteoporotic fractures in nonobese females with untreated premature menopause. The BMD loss was greater over the skeletal areas that are predominantly composed of trabecular bone compared with cortical bone.

Absorptiometry, Photon↗
PubMed1992

Familial idiopathic hyperphosphatasia (FIH): response to long-term treatment with pamidronate (APD).

A 5-year-old child suffering from familial idiopathic hyperphosphatasia (FIH) was treated by: (1) intravenous infusion of pamidronate (APD) (3 h) (0.75 mg/kg/day) for 5 days; and (2) oral administration of APD (8 mg/kg/day) for 1 year, in association with calcium (1 g/day) as calcium gluconate. A decrease of both serum calcium and phosphate, and a slight PTH increase were observed immediately after the IV treatment; serum alkaline phosphatase did not change, but a marked and rapid decline in the hydroxyprolinuria was observed: basal 659 +/- 207 during IV treatment 169 +/- 59 (mean +/- SD mg/24 h, P < 0.005). At the end of one year of oral APD treatment clinical and radiological findings showed a remarkable improvement. Serum calcium, phosphate and PTH returned to the initial values. Plasma alkaline phosphatase levels showed a 70% decrease: basal 1370 IU/l, 1 year 410 IU/l whereas the hydroxyprolinuria values were similar to those determined at the end of the intravenous treatment (212 +/- 13 mg/24 h), but still significantly lower than the basal levels (P < 0.01). No side-effects were observed. APD appears to be a promising treatment for patients with FIH.

Administration, Oral↗
PubMed1991

Differential action of pamidronate on trabecular and cortical bone in women with involutional osteoporosis.

Since osteoporotic fractures are mainly related to the diminution of the bone mineral density (BMD), the effect of pamidronate (3-amino-1-hydroxy-propylidene) 1,1-bisphosphonate on the BMD of the spine, proximal femur and radius shaft was evaluated in an initial cohort of 35 postmenopausal women with at least one vertebral fracture due to involutional osteoporosis. Pamidronate was given continuously during 18 months in a daily oral dose of 4.8 to 6.0 mg/kg supplemented with calcium (1 g/day). BMD--measured by dual photon absorptiometry--increased after one year 5.3 +/- 1.0% (P less than 0.001) in lumbar spine and 5.3 +/- 1.5% (P less than 0.001) over trochanter. However no significant changes were observed in the BMD of the femoral neck, Ward's triangle or in the cortical bone of the radius shaft measured by single photon absorptiometry. Pamidronate also decreased significantly urinary hydroxyproline-creatinine excretion after 6 months and thereafter maintained a plateau. After 18 months of treatment the diminution was 42.6 +/- 4.9% (P less than 0.001). The differing effects of pamidronate on the BMD of lumbar spine and proximal femur might be ascribed to dissimilarities between the proportions of trabecular and cortical bone in these. These results suggest that pamidronate may be prescribed to prevent fractures in cases of involutional osteoporosis with a significant decrease of BMD in lumbar spine and/or trochanter.

Aged↗
PubMed1991

Compensatory parathyroid hypertrophy after hemiparathyroidectomy in rats feeding a low calcium diet.

The functional and anatomic compensatory response of the parathyroid gland was examined in hemiparathyroidectomized (HPTx) rats whose parathyroid hormone (PTH) secretion was stimulated by a low calcium diet. These responses were compared with those observed in the thyroid gland of hemithyroidectomized (HTx) rats. Rats kept on a low calcium diet for 10 days were subjected to HPTx, HTx, or sham operations. Throughout the experiment (up to 28 days after surgery), serum calcium levels of HPTx rats were lower than the basal, with delta values (mg/dl, mean +/- SEM) of -0.66 +/- 0.17 and -0.84 +/- 0.17, (P less than 0.05) 3 and 28 days after surgery, respectively. Serum PTH decreased significantly from 7 to 21 days after HPTx, reaching normality at day 28 after surgery. In HTx rats, serum thyroxine (T4) levels diminished significantly 7 days after surgery, and attained normality thereafter. The mitotic index (number of metaphases/1,000 cells) in parathyroid glands of colchicine-treated HPTx rats increased significantly in comparison to sham-operated controls, when examined 2 or 40 days after surgery. The mitotic index of thyroid follicular cells was significantly higher than that of their respective controls, 2 but not 40 days after HTx. These results indicate that after HPTx, a delayed compensatory response is found when the animals are kept under a low calcium diet. Parathyroid response is both delayed and of a minor degree compared to that found in the thyroid gland after HTx.

Adaptation, Physiological↗
PubMed1991

Bone mineral density of the spine and radius shaft in children with X-linked hypophosphatemic rickets (XLH).

X-linked hypophosphatemic rickets (XLH) is characterized by inadequate skeletal mineralization. The bone mineral density (BMD) of the radius shaft and the lumbar spine was determined in 13 children with XLH. Ten patients were on treatment, whereas three patients had discontinued treatment 20-32 months prior to this study. Two of them had radiological evidence of rickets. The radius shaft BMD was significantly diminished: Z score was -1.33 +/- 0.89 (P less than 0.001), while the BMD of lumbar spine was significantly augmented (Z score +1.95 +/- 1.17, P less than 0.001). A positive correlation was found between the Z scores for the BMD of the radius shaft and spine. The two patients with overt rickets had lower radius shaft BMD values and a lesser increment of BMD of the spine. The BMD deficit of cortical bone may be related to the lack of efficacy of the treatment and/or to an intrinsic defect of the bone on this disease. On the other hand, the augmented BMD of the lumbar spine might reflect the overabundance of partially mineralized osteoid. The determination of the BMD of the radius shaft by SPA was a sensitive method for detecting abnormalities of the bone mass in XLH patients under treatment without radiological signs of rickets.

Absorptiometry, Photon↗
PubMed1991

Bone mass in totally thyroidectomized patients. Role of calcitonin deficiency and exogenous thyroid treatment.

Calcitonin has an uncertain role in the preservation of bone mass. Since surgical thyroidectomy abolishes the calcitonin secretion in response to calcium, the bone mineral density at the radius shaft and lumbar spine was measured in 60 patients (5 men, 16 premenopausal, 34 postmenopausal euparathyroid and 5 postmenopausal hypoparathyroid women) who had undergone near total thyroidectomy for thyroid cancer 8.4 +/- 0.7 years before the study. All patients were maintained on suppressive doses of thyroid hormones. Bone mineral density values of the radius shaft (expressed as Z-score) of 34 postmenopausal euparathyroid women was significantly below the normal average (mean +/- SEM = -0.59 +/- 0.2; p = 0.01). Bone mineral density of the lumbar spine was also below the normal average although the difference only approached statistical significance (-0.36 +/- 0.2; 0.05 less than p less than 0.1). The bone mineral density of neither the radius nor the spine differed from normal levels in the premenopausal women and the postmenopausal hypoparathyroid women. Unexpectedly, the bone mineral density of the spine was significantly increased in the 5 thyroidectomized men. The results indicate that thyroidectomized women have a diminished bone mass after the menopause only if parathyroid function is normal. Since the patients were receiving thyroid hormone at suppressive doses, the present study is not able to separate the relative contributions of calcitonin deficit and exogenous thyroid on bone mass loss.

Adult↗
PubMed1991

Intravenous pamidronic acid in hypercalcemia due to parathyroid carcinoma.

Three patients aged between 31 and 59 were treated with pamidronic acid (APD) due to severe hypercalcemia caused by parathyroid carcinoma. APD was given in 250 cm3 intravenous saline over a 2 h period in a dose of 0.45 to 0.50 mg/kg per day. Two patients received 6 and the other 9 infusions. Mean serum calcium diminished from 15.7 +/- 1.3 mg/dl to 11.7 +/- 0.6 mg/dl (p less than 0.05). Mean serum ionized calcium decreased from 8.1 mg/dl to 5.5 mg/dl, urinary calcium excretion from 478 mg/24 h to 229 mg/24 h and hydroxyproline from 204 mg/24 h to 117 mg/24 h. Serum calcium returned to pretreatment levels after 5 and 15 days post intravenous APD in two patients. In the third patient treated with 900 mg/day of oral APD, after the intravenous therapy the relapse occurred during the fourth month. The three patients received a second course of intravenous (iv) APD. The effect upon serum calcium (14.6 +/- 1.1 mg/dl to 11.8 +/- 0.6 mg/dl, p less than 0.05) was similar to the one obtained with the first course. Intravenous APD administration appears to be an effective and safe treatment of the severe hypercalcemia due to parathyroid carcinoma. To sustain levels of serum calcium attained in patients with non resectable tumors, a suitable program of iv APD pulses should be established.

Adult↗
PubMed1991

[Epidemiology of proximal femoral fractures in La Plata, Argentina].

The epidemiology of proximal femur fractures (FXf) was studied in the city of La Plata, Argentina. At the time of the study the total population was 288,000 inhabitants and 73,900 (30,700 men and 43,200 women) were 50 years of age and over (Table 1). From May 1, 1989 to April 30, 1990 all the patients admitted in local hospitals with FXf were personally interviewed by one of the authors. Patients living outside the city of La Plata or fractures due to metastatic or Paget disease were excluded. During the period of the study 195 patients with FXf (164 women and 31 men) were registered. The median of age was 80 years in females (range 50 to 96) and 77 years of age (range 50 to 93) in males. The incidence of FXf in women 50 years of age and over was 379.4/100,000 inhabitants and in men 101.0/100,000 inhabitants. The female/male ratio was 3.76 (Table 1). The number of FXf was higher in winter than in summer. (Figure 1). Table 3 indicates the incidence of FXf found in several studies performed in different geographical areas. In females the incidence was similar to that observed in other caucasian populations. The female/male ratio found in the present study is the highest recorded in the literature. This is the first epidemiologic study of osteoporosis performed in Argentina. Further studies should ascertain the low incidence found in males as well as the frequency of osteoporosis in other areas of the country that extend from latitude 22 degrees S to 54 degrees S.

Age Factors↗
PubMed1991

Vertebral compression fractures at the onset of acute lymphoblastic leukemia in a child.

A child with acute lymphoblastic leukemia, spinal osteoporosis with vertebral compression fractures, and hypercalcemia appearing early in the course of the hematologic disease was followed for two and a half years. Bone mineral density (BMD), measured by single photon absorptiometry at the radial shaft, was within normal limits for age and sex. However, x-rays of vertebrae and vertebral BMD, measured by dual photon absorptiometry, showed marked demineralization. Despite leukemic remission, the spinal osteoporosis became worse and the patient required aggressive treatment for eight months. Treatment included 50 units of calcitonin subcutaneously every other day, 1,000 mg/day of oral calcium, and 3,000 IU/day of vitamin D. The back pain disappeared quickly, and laboratory controls showed a significant diminution of bone turnover. No new compression fractures occurred. Eighteen months later, the patient continued in remission and menarche had occurred. Dual photon absorptiometry revealed a significant "catch up" of the lumbar spine BMD. X-ray examination showed a marked remodeling of the vertebral bodies. BMD measurements in this child indicate that bone loss affected the trabecular bone compartment or occurred only at active bone marrow sites. The rapid clinical amelioration and objective biochemical, densitometric, and radiologic evidence of bone improvement warrant further clinical trials on similarly affected patients.

Back Pain↗
PubMed1985

Efficacy of the bisphosphonate APD in the control of Paget's bone disease.

Fifty-four patients with Paget's bone disease have been treated with the bisphosphonate APD. Twenty-six patients had not previously received treatment for Paget's disease; and 28 had been treated before with EHDP alone or in combination with calcitonin. APD was given orally in a mean dose of 500 mg daily (congruent to 6.8 mg/kg of body weight) for 4 to 12 months. Bone pain diminished or disappeared in 34 of 39 patients with symptoms. A very significant diminution of the biochemical indices of bone turnover was observed in all patients, but the responses were faster in patients who had not previously received treatment for Paget's disease. After 4 months of treatment the serum levels of alkaline phosphatase of previously untreated patients diminished from 58.8 +/- 8.0 to 20.0 +/- 3.9 KA units (P less than 0.001) and urinary excretion of hydroxyproline diminished from 108.6 +/- 16.9 to 42.4 +/- 8.3 mg/24 h (P less than 0.001). In 23 of 26 previously untreated patients the biochemical indices decreased to the normal range (complete response). A reduction of 50% or more without reaching the normal range was observed in the other 3 patients (partial response). Actuarial analysis of the duration of the effect 12 months after stopping APD disclosed that 63% of patients who had achieved a complete response but only 23% of those with a partial response were in biochemical remission. A second course of APD was administered to 11 patients. The results were as effective during the second as the first course in 9 patients, whereas 2 patients had no response to retreatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗