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Biomedical subjects

G Buirski

Publications and source records attributed to G Buirski.

At least 19 recordsLinked to original sources
PubMed1997

Nandrolone decanoate and intranasal calcitonin as therapy in established osteoporosis.

This study used a randomized, 2 x 2 factorial design to evaluate over 2 years the effect of intranasal salmon calcitonin and intramuscular nandrolone decanoate on bone mass in elderly women with established osteoporosis. The study was double masked in relation to calcitonin and open in relation to nandrolone decanoate. One hundred and twenty-three women aged 60-88 years who had sustained a previous osteoporotic fracture, or had osteopenia, were recruited through an outpatient clinic. Women were assigned to one of four groups: (1) daily placebo nasal spray, (2) 400 IU intranasal calcitonin daily, (3) 20 intramuscular injections of 50 mg nandrolone decanoate (given as two courses of 10 injections) plus placebo nasal spray, or (4) 20 injections of 50 mg nandrolone decanoate plus 400 IU intranasal calcitonin daily. All subjects received 1000 mg calcium supplementation daily. Outcomes measured included changes in bone mineral density (BMD) at the lumbar spine, as measured by dual-energy quantitative computed tomography (DEQCT), in BMD of the proximal femur, and BMD and bone mineral content (BMC) of the lumbar spine and forearm, as measured by dual-energy X-ray absorptiometry (DXA). Significant positive changes from baseline in DXA BMC at the lumbar spine were observed over 2 years in the calcitonin group (5.0 +/- 1.9%, mean +/- SE) and in the nandrolone deconate group (4.7 +/- 1.9%) but not in the placebo group (1.1 +/- 2.2%) or the combined therapy group (0.7 +/- 1.8%). Modelling based on the 2 x 2 factorial design revealed that nandrolone decanoate was associated with a 3.8 +/- 1.8% (p < 0.05) gain in DXA BMD at the proximal femur. Modelling also revealed that calcitonin treatment was associated with a loss of 11.5 +/- 4.7% in DEQCT BMD at the lumbar spine and a loss of 3.7 +/- 1.8% in DXA BMD at the proximal femur (p < 0.05). There was in vivo antagonism between the two medications of 7.9 +/- 3.9% for DXA BMC at the lumbar spine. Both agents caused positive changes from baseline in lumbar spine BMC. Nandrolone decanoate had beneficial effects on BMD at the proximal femur. This dose of intranasal calcitonin was associated with deleterious effects on trabecular BMD at the lumbar spine and total BMD at the proximal femur. There may be significant clinical antagonism between these two medications.

Administration, Intranasal↗
PubMed1995

Do Australian women have greater spinal bone density than North American women?

The interpretation of bone mineral densitometry results for a particular individual relies on valid reference data from a representative population sample. To establish local reference data, 411 Australian female volunteers had bone mineral densitometry performed at a single medical centre at the proximal femur and lumbar spine using a Hologic QDR 1000-W dual-energy X-ray absorptiometer. These data were compared with reference material from North American women compiled by Hologic. The Australian volunteers had, on average, 7% greater bone mineral density at the lumbar spine for the age range 25-55 years. Possible explanations for this include an actual population difference or the presence of a differential selection bias between the two samples.

Adolescent↗
PubMed1993

The symptomatic lumbar disc in patients with low-back pain. Magnetic resonance imaging appearances in both a symptomatic and control population.

Magnetic resonance imaging of abnormal lumbar discs in 115 symptomatic patients (184 discs) and 63 symptom-free controls (78 discs) have been compared. All symptomatic patients were proven to have discogenic pain at discography. Discs were classified into patterns 1-6 reflecting the progressive changes of nuclear degeneration as previously described. In the symptomatic patient, the more degenerate the disc the more likely it was responsible for pain (P < 0.001), but there was no statistically significant difference in the distribution of abnormal signal patterns between the two groups studied. A small number of patients in both populations demonstrated high signal from disc protrusions but this also could not be used as a predictor of pain. No abnormal lumbar disc signal pattern could be identified that specifically indicated whether a disc would be painful. Magnetic resonance imaging is accurate in determining nuclear anatomy, but until more suitable techniques become available, discography is still the only method for symptomatic assessment in low-back pain.

Adult↗
PubMed1993

Increased levels of leukemia inhibitory factor in synovial fluid from patients with rheumatoid arthritis and other inflammatory arthritides.

OBJECTIVE: To examine synovial fluid (SF) from patients with arthritis, for the presence of the cytokine leukemia inhibitory factor (LIF). METHODS: SF from 152 subjects was examined for LIF, using a radioreceptor competition assay. RESULTS: LIF was present at concentrations of 1-43 ng/ml in the SF of 23% of patients with rheumatoid arthritis (RA) or other inflammatory or infectious arthritides but in only 1 of 29 patients with osteoarthritis (P < 0.01). In the RA patients, the SF LIF concentration correlated significantly with the peripheral blood white blood cell count (WBC) (P < 0.05) and the SF WBC count (P < 0.01), but not with other clinical or radiologic parameters of disease activity or progression. CONCLUSION: LIF is implicated as a potential mediator of the local or systemic inflammatory response or the joint destruction seen in inflammatory arthritis.

Arthritis↗
PubMed1993

Magnetic resonance appearances of developmental disc anomalies in the lumbar spine.

Developmental anomalies of the lumbar spine are common. The disc between anomalous segments has a characteristic appearance on sagittal T2 MR images, not previously described. These have been classified into two types: transitional (where there is only partial fusion of bony segments), or rudimentary (where there is complete fusion of the two adjacent vertebral bodies). Both types produce discs that are smaller than adjacent, normal, mobile, lumbar disc segments. Disc signal intensity, from the anomalous segment, is normal, but the disc lacks an intranuclear cleft. Consideration of these appearances allows identification and differentiation from the normal, mobile lumbar disc in the absence of plain radiographs. Knowledge of such discs permits the application of accurate nomenclature to disc abnormalities above anomalous levels.

Adult↗
PubMed1992

Magnetic resonance signal patterns of lumbar discs in patients with low back pain. A prospective study with discographic correlation.

This study presents a large prospective analysis of abnormal magnetic resonance signal patterns in 1,389 lumbar discs in 892 patients with chronic low back pain. Discographic correlations were available at 166 disc levels. Six different signal patterns were identified, and correlations with discograms would suggest that these patterns reflect the differing and progressive changes of lumbar disc degeneration that occur in vivo in patients with low back pain.

Adult↗
PubMed1992

The effect of aging on intact PTH and bone density in women.

OBJECTIVE: To determine whether age-related bone loss is negatively associated with serum intact parathyroid hormone (PTH). DESIGN: Survey. SETTING: University hospital outpatient department. PARTICIPANTS: 100 community-dwelling women, age 18 to 80, recruited as a convenience sample. MEASUREMENTS: Dependent variables--bone density at the spine and femoral neck by dual-energy X-ray absorptiometry. Independent variables--age, menopausal status (binary) and intact serum PTH by Allegro immunometric assay. RESULTS: Post-menopausal women had higher serum PTH and lower bone density of spine and femoral neck than premenopausal women. Bone density at the spine decreased with age, but this effect was accounted for by menopausal state. Bone density at the femoral neck decreased with age even after adjusting for menopause. Log PTH was negatively associated with bone density at the femoral neck but not significantly at the spine. Multiple regression analysis adjusting for age and menopause showed no significant association between intact PTH and bone density at the spine or the femoral neck. CONCLUSION: Although this study confirmed the rise in intact PTH with age, there is no evidence that this is the mediator of age-related bone loss.

Absorptiometry, Photon↗
PubMed1990

Magnetic resonance imaging in acute and chronic rotator cuff tears.

Magnetic resonance imaging has been assessed in patients with acute rotator cuff tears and normal radiographs (9 cases) and those with chronic tears and changes of cuff arthropathy (9 cases). All images were obtained using a low field strength system (FONAR 0.3 T). Particular attention was placed on the appearances of the tendon and the cuff muscles themselves. Six complete acute tears were clearly identified, but MRI failed to demonstrate two partial tears. Muscle bulk was preserved in all patients in this group. In contrast, all patients with cuff arthropathy had complete tears of the supraspinatus tendon with marked tendon retraction and associated muscle atrophy: these changes precluded primary surgical repair. MRI should be used to assess muscle atrophy preoperatively in those patients with acute tears. When plain radiographs demonstrate cuff arthropathy, the MRI appearances are predictable and primary repair is unlikely to be successful. Further imaging is therefore not indicated.

Acute Disease↗
PubMed1990

M.R. imaging of the knee: a prospective trial using a low field strength magnet.

A double blind prospective study involving fifty patients was performed to assess the diagnostic accuracy of knee MR Imaging using a 0.3 Tesla low field strength scanner. The study compared MR Imaging with arthroscopy. The overall accuracy found for the detection of meniscal tears was 92% and cruciate ligament tears 95%. These results compare favourably with other diagnostic modalities including knee arthroscopy. MR Imaging is good at showing meniscal lesions, especially cleavage tears, though some bucket-handle tears produced no MR abnormality. MR Imaging is very accurate at demonstrating complete cruciate ligament tears. Partial cruciate ligament tears often produced no positive MR findings and in no patients could any features be found to indicate ligamentous laxity.

Adolescent↗
PubMed1989

The non-invasive investigation of lumbar disc degeneration in patients with chronic low back pain.

The painful degenerate disc is a recognised cause of low back pain. Magnetic Resonance Imaging (MRI) has now replaced discography in the non-invasive assessment of disc degeneration. However, the prohibitive capital expense of MRI and the small number of MR units in Australia produce limitations in clinical access. In contrast, Computed Tomography (CT) is readily available and is performed in most patients prior to MRI referral. This prospective study was undertaken to determine whether preliminary CT could offer any information about disc degeneration and so reduce the demand on a MRI scanner. 30 consecutive patients were studied all of whom had both CT and MRI examinations. Of a total 107 discs examined by both techniques, MRI was able to identify 37 degenerate discs. Conclusive evidence of degeneration (i.e. the presence of intervertebral gas) was only seen in 3 discs at CT (1 patient). Of the 29 posterior disc bulges found on CT, all were both bulging and degenerate on MRI. Indications for MRI based on the CT findings are recommended. Using these criteria, 13% (4 patients) of this study group could have avoided an expensive and unnecessary MR investigation. A useful algorithm for the investigation and assessment of patients with chronic low back pain is discussed.

Adult↗
PubMed1987

The investigation of sciatica and low back pain syndromes: current trends.

This report is based on a 3 month study visit to the United States undertaken in the summer of 1985 and sponsored by the Kodak Travel Scholarship. The current attitudes and trends in the investigation of patients with sciatica and low back pain syndromes will be discussed, with a particular emphasis on high resolution computed tomography of the lumbar spine.

Back Pain↗
PubMed1986

Superior vena caval abnormalities: their occurrence rate, associated cardiac abnormalities and angiographic classification in a paediatric population with congenital heart disease.

Angiography of the superior systemic veins was performed on 510 patients with congenital heart disease. An analysis of these angiograms was carried out and a simple angiographic classification of superior vena caval anomalies is presented. Eleven per cent of cases had complete bilateral superior vena cavae, a frequency of occurrence higher than that previously reported. An analysis of associated congenital heart lesions revealed a higher than average association of bilateral superior vena cavae with atrioventricular septal defects and double-outlet right ventricle, but this was seen rarely in cases of transposition of the great arteries. Bilateral superior vena cavae also occurred very frequently (72%) in patients with situs abnormalities. Femoral vein catheterisation is likely to facilitate diagnosis and appropriate radiological signs are discussed.

Adolescent↗
PubMed1986

Cartilage-cell-containing tumours of the pelvis: a radiological review of 40 patients.

Cartilage-cell-containing tumours of the pelvis are responsible for a quarter of all primary bone lesions in this site. Benign tumours are uncommon but when present have classical radiological appearances similar to those described elsewhere. Only the rarest, chondromyxoid fibroma, may cause difficulty in diagnosis. Seventy-three per cent of cartilage-cell tumours are malignant and are either chondrosarcoma or chondroblastic osteosarcoma. Chondrosarcoma occurs after the second decade of life, usually with a longer history, and may be categorised as either a secondary peripheral or primary central tumour, each having typical radiological features. Chrondroblastic osteosarcoma tends to occur in younger patients with a shorter clinical history and is almost exclusively situated adjacent to a sacroiliac joint, producing purely lytic, sclerotic or mixed patterns of bone destruction. Experience suggests that computed tomography is the single most valuable further examination, since the pelvis is a complex structure with confusing overlying soft-tissue artefacts. This technique may indicate both the route and choice of optimal biopsy site.

Adolescent↗
PubMed1984

The radiological features of "solid" aneurysmal bone cysts.

The radiological features of nine solid aneurysmal bone cysts (ABC) have been reviewed. The appearances form a spectrum ranging from lesions indistinguishable from the classical ABC, to an osteolytic lesion with a wide zone of transition, cortical destruction and soft tissue extension. Over half the lesions reviewed fell into the latter category and all were situated in the axial skeleton. Discrimination between the more aggressive solid ABC, giant cell tumour and malignancy may be difficult. Demonstration of an expanded partial cortical rim by either conventional or computerised tomography suggests the diagnosis of solid aneurysmal bone cyst.

Adolescent↗