Biomedical subjects

J Wendlová

Publications and source records attributed to J Wendlová.

7 recordsLinked to original sources

PubMed2001

Determination of NTx in second-morning urine: a proposal for the standardization of morning urine collection.

UNLABELLED: According to the instruction manual from the producer of kits for determining the levels of aminoterminal telopeptide of type I collagen of organic bone matrix (NTx), the time of the collection of second-morning urine is arbitrary, i.e., a patient can urinate anytime within the period from about 6 to 8:30 a.m. This time interval is within the period of change in the circadian rhythm of the NTx excretion (maximum excretion with transition into fast decrease of excretion). Therefore, we considered it appropriate to standardize the conditions for the collection of second-morning urine and proposed applying the so-called 2-hour morning urine NTx2 (from 6 to 8.00 a.m. after an overnight fast). We examined 48 female patients aged 33-65 years with primary or secondary osteopenia or osteoporosis (all patients had normal renal functions). In these patients we determined NTx (Osteomark, OSTEX, USA) in standardly used 24-hour urine (NTx24) and in the proposed 2-hour morning urine (NTx2). AIM OF THE STUDY: 1) To find a mathematical character for the dependence of values of dependent variable NTx2 on independent variable NTx24 and to evaluate the statistical significance of this dependence; 2) to compare the ratio of the widths of 95% confidence intervals (C. I.) for NTx2 and NTx24 in patients (index: IO) with the ratio of the widths of reference limits for NTx in arbitrary second-morning urine (NTx2ostex) and in 24-hour urine (NTx24ostex) in healthy women (index: IR); 3) to evaluate the proposed 2-hour urine for the determination of NTx. STATISTICAL ANALYSIS: Stochastic and deterministic linear regressive analysis. Index of 95% C. I., index of reference limits. RESULTS: A statistically significant (P < 0.01) regressive dependence (r2 = 0.781) was found between the values of NTx24 and NTx2. The index for the widths of reference limits (IR) was 1.5 times greater than the index for osteopenic and osteoporotic patients (IO), meaning that the scatter of the NTx2ostex values was greater than NTx2 in the proposed 2-hour urine. CONCLUSION: Based on the statistically significant linear regressive dependence between NTx24 and NTx2 values, it is possible to use the proposed 2-hour morning urine to determine NTx levels in women. The introduction of 2-hour morning urine NTx2 could decrease the fluctuation range of NTx values in repeated examinations and in comparison with the determination of NTx2ostex in a random second-morning urine sample could make its values more accurate.

Adult↗

PubMed2001

[Suggestions for standardized collection of morning urine for assessment of NTx levels in patients with osteoporosis].

UNLABELLED: The authors examined 79 patients (n = 79) with primary and secondary osteoporosis, incl.31 men (nM = 31) aged 31-61 years and 48 women (nF = 48, aged 33 to 65 years. In these patients they assessed NTx (amino-terminal telopeptide of type I collagen of the Ist organic bone matrix) in 24 (NTx24) and 2-hour morning (NTx2) diuresis (from 6 to 8 a.m.). OBJECTIVE: 1. To assess the relationship between values of NTx in th suggested 2-hour diuresis and NTx values in the standard 24- hour diuresis differentiated by sex. 2. To compare the ratio (index) of widths of 95% confidence intervals (CI) for NTx2 and NTx24 with the ratio (index) of reference widths (manual OSTEX, USA) for NTx in the first morning urine (NTx1) and for NTX24 differentiated by sex. 3. Evaluate the suggested 2-hour diuresis for assessment of NTx. STATISTICAL ANALYSIS: Stochastic-determinist linear regression analysis. RESULTS: 1. Between values NTx24 and NTx2 a statistically significant regression correlation was found (p < 0.001) (men: r = 0.352, women r2 = 0.781). The indices of widths of reference limits (IR) of OSTEX Co. USA reach values 2.1 times higher (0.7 times) than indices of widths of CI for osteoporosis (IO) in men as well as women. CONCLUSION: 1. Between values of NTx24 and NTx2 is a significant regression relation. Both urine samples can be used for assessment of the NTx level. 2. Higher values of IR and IO indices for women as well as men confirm a greater dispersal of NTx1 values as compared with NTx2 values. 3. Introduction of two-hour morning diuresis will reduce the extent of variation of NTx values during repeated examinations and provide more accurate information as compared with assessment of NTx in any of the first morning samples of urine according to instructions of the manufacturers of the kits.

Adult↗

PubMed2000

[Changes in bone mineral density in Th12 to L5 vertebrae in female patients with osteoporosis].

UNLABELLED: The authors examined 47 female patients, age 50-60 years, with primary and secondary osteopenia and osteoporosis. In each patients they assessed the bone mineral density (BMD) of the cortical and trabecular bone of vertebrae Th12 to L5 by quantitative computer tonmography (QTC). They did not include in the group patients with deformities of the vertebrae grade one, two and three. These deformities were assessed from a lateral X-ray of the thoracic and lumbar spine. OBJECTIVE: To evaluate the importance of assessed BMD values of vertebrae from the biomechanical aspect. STATISTICAL ANALYSIS: Individual groups of assessment of BMD in cortical and trabecular bone for each vertebra were characterized by means of 95% confidence intervals and their means or median values. RESULTS: The BMD of cortical bone increases from Th12 to L5 almost in a linear fashion. BMD of the trabecular bone declines from Th12 to L3, in L4 abd L5 it rises again. The lowest values were recorded in L3. The greatest decline of BMD of the trabecular bone by 24.05% in L3 as compared with reference values of the given age groups were not conditioned by deformities of the vertebrae. The BMD of cortical bone in osteopenic and osteoporotic patients practically did not differ from reference values for the given age group. CONCLUSION: From the presented work ensues that deformities of the vertebrae do not occur as long as the BMD of cortical bone is within the range of reference values despite a decline of BMD in trabecular bone. It is thus more important to investigate the material qualities of cortical bone because the risk of fractures of the vertebrae depends on the elasticity and firmness. Critical BMD values of cortical bone assessed by QCT for the development of fractures are not known so far. QTC of vertebrae due to its higher radiation load and financial costs is not a routine densitometric method. It will be necessary to develop new densitometric methods which will make it possible to assess BMD or another property of cortical bone and assess critical values for the development of vertebral fractures.

Absorptiometry, Photon↗

PubMed1999

[Paget's disease of bone--treatment with alendronate, calcium and calcitriol].

In the submitted case-history the authors describe the clinical picture, diagnosis and treatment of the non-complicated form of Paget's disease in a 68-year-old patient with typical X-ray findings on the vertebrae, pelvis and left tibia. The laboratory findings revealed liminal alkaline phosphatase (ALP) values, 2.5 times raised values of the aminoterminal telopeptide of collagen I in the organic bone matrix (NTx) in the 24-hour diuresis and slightly elevated osteocalcin (OSCA) levels. The finding of whole-body skeletal scintigraphy was atypical and thus was no diagnostic asset. Aimed transiliacal bone biopsy according to Bordier taken from the pathological focus confirmed the diagnosis of morbus Paget. The patient was treated for six months with the following preparations: Fosamax (monosodium alendronate tablets a 10 mg, Merck Sharp and Dohme, USA) 1 tablet per day, Vitacalcin (calcium carbonate, tablets a 250 mg elemental calcium, Slovakofarma, Slovak Republic) 2 x 1 tablet per day, Rocaltrol (calcitriol tablets a 0.25 ug, Hoffman La Roche, Switzerland) 1 tablet on alternate days). Because of gastrointestinal complaints the authors did not administer 40 mg alendronate per day, as recommended in the American literature. Based on the laboratory finding of normalization of the bone turnover, reduction of the number of osteoplastic foci on the X-ray image of vertebrae and pelvis, regression of the vertebrogenic algic syndrome and improved mobility of the patient, the authors consider the 6-month administration of alendronate, 10 mg per day, calcium carbonate and calcitriol therapeutically effective and successful.

Aged↗

PubMed1999

[Linear regression analysis of values of the calciuria index, N-telopetide and bone mineral density in patients with osteoporosis].

UNLABELLED: The authors examined 49 patients (n=49) with primary and secndary osteoporosis incl. 37 women aged 41-58 years and 12 men aged 38-56 years. In all they assessed the 24-hour calciuria index (Ca/creatinine), the aminoterminal N-telopetide of collagen I of the organic matrix (NTx24) and the bone mineral density (BMD) in the first three lumbar vertebrae using quantitative computed tomography (QC). OBJECTIVE: To find an answer to the questions:1. Is the calciuria index in the 24-hour diuresis a parameter which provides information on osteresorption? 2. Is there a significant negative correlation between values NTx24 and BMD? 3. Is NTx a sensitive parameter of osteoresorption in men and women with primary or secondary osteoporosis? STATISTICAL ANALYSIS: Linear regression analysis. RESULTS: Correlation coefficients for the correlated groups NTx24 - Ca/creatinine (r = 0.023, p>0.05) and NTx24 - BMD (r = -0.238, p>0.05) were not statistically significant. Statistical significance was recorded in the correlation coefficient for pathologically elevated values of NTx24(zNTx24), correlated with BMD (r = -0.3115, p<0.048). CONCLUSION: 1. The calciuria index in the 24-hour diuresis does not provide information on osteoresorption. 2. Between pathologically elevated values of NTx24 and BMD in L1-L3 is a statistically significant negative correlation. 3. NTx is a sensitive parameter of osteresorptioon in men and women with primary and secondary osteoporosis, it reflects the influence of the bone turnover on the density of the bone mineral.

Adult↗

PubMed1998

[Effect of Kliogest on bone metabolism, bone mineral density and quality of life in postmenopausal patients].

UNLABELLED: The author investigated postmenopausal patients (with a natural menopause) (n = 32) where ammenorrhoea persisted for 1-2.2 years. They found a reduced bone mineral density (BMD) (ostoeopenia or osteoporosis) and laboratory tests revealed signs of increased bone turnover (so-called "fast losers"). Before administration of Kliogest R tablets, Novo Nordisk, Denmark, (1 tablet per day) and after 12 months the following parameters were evaluated: 1. Laboratory parameters of bone turnover: serum osteocalcin (OC) amino-terminal N-telopeptide of collagen I in 24-hour diuresis (NTx). 2. Bone mineral desnity (BMD) in lumbal vertebrae L1-L4 assessed by DXA (dual energy X-ray absorptiometry 3. By means of questionnaires climacteric symptoms were evaluated (score of climacteric symptoms). For statistical analysis of the assessed values the non-paired Wilcoxon-Wilcoxon test was used. RESULTS: After treatment the OC levels were significantly lower (alpha = 0.05, p < 0.01), the values of NTx were highly significantly lower (alpha = 0.05, p < 0.001) and the BMD values in the second lumbar vertebra (it is usually most affected by osteoporosis), expressed by the T-score, was significantly higher (alpha = 0.05, p < 0.001). When evaluating the questionnaire "Score of climacteric symptoms" after treatment the number of points characterizing the intensity of symptoms was reduced. Most frequently improvement of the following symptoms was achieved: hot flushes and noctural perspiration, weakness, fatigue, impaired sleep, nervousness, irritability, dry vagina making intercourse unpleasant. CONCLUSION: One-year use of Kliogest increased significantly the density of the bone mineral in the axial skeleton, reduced the bone turnover and improved the quality of life of postmenopausal patients.

Bone Density↗

PubMed1998

[NTx--a sensitive laboratory parameter of bone resorption].

A review of biochemical characteristics, the laboratory principle, as well as the clinical significance and indications of the assessment of the new laboratory parameter of osteoresorption--amino-terminal N-telopeptide of type I collagen of organic bone matrix. NTx is so far the most sensitive biochemical marker of the pathologic bone turn-over. Its assessment is successfully used in: 1. detection of the character of the bone turn-over (osteoresorption) during peri and post-menopause, 2. identification of patients at risk of osteoporosis, 3. monitoring of the effectivity of osteoporosis therapy (biphosphonates, hormonal substitution therapy, calcitonin), 4. diagnosis and control of therapeutic effectivity in M. Paget, 5. early detection of bone metastases in malign diseases. NTx is beneficial in the treatment of out-patients and in clinical practice in the assessment of diagnosis and the therapy of bone metabolic diseases. The advantage of examination resides in easy sample withdrawal and the fast technique of laboratory processing. NTx should become a parameter of routine examination within clinical laboratories.

Biomarkers↗