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Biomedical subjects

S A Eriksson

Publications and source records attributed to S A Eriksson.

13 recordsLinked to original sources

Bone density in medieval skeletons.

We studied the most complete skeletons found in an excavation from the 14th and 15th century in central Stockholm. One hundred eighty-seven were from men and 156 from women: 241 individuals were estimated to be between 20 and 39 and 102 between 40 and 59 years old at death. We examined the bones radiographically and by dual photon absorptiometry. The bone mineral density (BMD) was similar to the finding in North America and Northern Europe today as was the relationship between men and women. However, there appeared to be a higher diaphyseal bone density in the lower extremities, especially in men. The femur score was higher and the BMD of the femoral and tibial shafts was higher than today. In the upper extremities the diaphyseal bone density was lower. Meema's index, as well as the metacarpal score, was smaller than in individuals in this century and the BMD of the humeral shaft was also lower than seen today. Overall, the metaphyseal bone density was similar to what we now consider normal; i.e., the mean BMD of the femoral neck was 0.96 g/cm2 in men and 0.90 g/cm2 in women and of the distal radius 0.43 and 0.32 g/cm2, respectively. The low diaphyseal density and in the upper extremities may be related to the nutritional status, whereas the greater need for walking and standing in the 14th and 15th century might have led to the high diaphyseal density in the lower extremities. There was no evidence of bone loss after 40 years of age in either sex in our study. The average expected lifespan for an adult individual was less than 50 years and we suggest that the relatively high bone density in the older age group may be due to selection of the most physically fit. The activity pattern, therefore, may be considered the most important determinant for the differences.

Adult↗

Are ulcer healing and prophylaxis studies appropriately analysed?

AIM: To discuss statistical problems related to common study objectives and designs in ulcer healing and prophylaxis studies. FINDINGS: The nature of the study objective determines when to use a statistical analysis according to the All Patients Treated (APT) approach and when to use the Per Protocol (PP) approach. How patients discontinuing the study are handled in the statistical analysis depends on whether the discontinuation is judged to be treatment-related. CONCLUSION: Survival analysis, in the form of life-tables, should be used more in the analysis of time to relapse. Studies with a drug-free or a reduced-dose follow-up are very often analysed incorrectly - the analysis should be based on the original randomization and not on patients healed in the acute phase.

Clinical Trials as Topic↗

Bone mineral status in end-stage liver disease and the effect of liver transplantation.

BACKGROUND: The aim of this study was to determine bone mass at different skeletal sites in patients with end-stage liver disease and the effect of liver transplantation on bone mineralization. METHODS: Bone mineral density in different skeletal regions was measured by photon absorptiometry in 25 patients with chronic liver disease, and the measurements were repeated in nine patients after orthotopic liver transplantation. RESULTS: In patients with liver failure bone mass values were not significantly different from those of controls. After liver transplantation bone mass decreased significantly during the first 6 posttransplant months at the distal radius, lumbar spine, and femur (p < 0.01) and was still below pretransplant values at the 12th posttransplant month. Serum osteocalcin increased significantly from the 3rd month after transplantation (from 6.9 +/- 4.4 to 12.0 +/- 6.5 micrograms/l; p < 0.0001) and remained increased throughout the first posttransplant year. CONCLUSION: Early and accelerated bone loss occurred after liver transplantation. This bone reduction seems to be mainly the result of increased bone resorption, possibly related to corticosteroid therapy.

Absorptiometry, Photon↗

Combined treatment with calcitonin and 1,25-dihydroxyvitamin D3 for osteoporosis in women.

Twenty-two middle-aged women with severe osteoporosis were treated for 2 years with either 0.5 mg of synthetic human calcitonin subcutaneously three times per week combined with 0.5 micrograms of calcitriol and 0.5 g of calcium per day orally or calcium only. The treatment with calcitonin plus calcitriol (12 patients) resulted in a significantly increased calcium absorption rate. The mean values for serum phosphate did not change during the treatment period and the mean values did not differ between the treatment groups, but the serum calcium and urinary Ca/Cr ratio increased somewhat in the group given the combined treatment. There was no evidence that the combined treatment improved the bone density in this study. It is possible that calcitriol, instead of increasing the effect of calcitonin by suppression of the parathyroid, might have counteracted its effect by increasing the bone resorption.

Absorptiometry, Photon↗

Screw positions in femoral neck fractures. Comparison of two different screw positions in cadavers.

To evaluate the influence of different screw positions on the stability of fixation in femoral neck fractures, 30 cadaveric proximal femora were osteotomized and fixed with 2 cannulated screws. The proximal screw was placed either with a posterior cortical support in the femoral neck or centrally, supported only by cancellous bone. The distal screw rested on the femoral calcar. The specimens were tested in bending, using the force at 2 and 5 mm deflection at the osteotomy site and at fracture, as an expression of the stability of fixation. The test sequences were recorded on a x-y plotter and on videotape. Bone density measurements were made at the femoral neck, Ward's triangle, and the trochanter region. Our findings indicate that a posterior position with cortical support for the proximal screw, compared to a central screw position with only cancellous bone support, increases the stability of femoral neck fractures.

Aged↗

Verapamil increases serum ionized calcium and serum phosphate in patients with post-surgical hypoparathyroidism.

The calcium homeostasis in eight patients with postoperative hypoparathyroidism was examined before and after 2 weeks of administration of verapamil in an oral dose of 80 mg three times daily. Serum ionized calcium increased during verapamil treatment (from mean +/- SD of 1.10 +/- 0.06 to 1.24 +/- 0.38 mmol l-1; P less than 0.05), as well as total serum calcium corrected for protein (from 2.11 +/- 0.13 to 2.18 +/- 0.13 mmol l-1; P less than 0.05). During treatment with verapamil there was an increase in serum phosphate (from 1.08 +/- 0.15 to 1.19 +/- 0.20 mmol l-1 P less than or equal to 0.05) and in the urinary excretion of phosphate (P/creatinine ratio from 1.22 +/- 0.69 to 1.83 +/- 0.97; P less than or equal to 0.05). The serum 1,25-dihydroxyvitamin-D3 and serum parathyroid hormone were below the detection limits both before and after verapamil treatment. There were no significant changes either of the intestinal absorption of calcium or of the urinary calcium excretion. Serum osteocalcin was insignificantly reduced after treatment (1.60 +/- 0.70 before treatment and 1.25 +/- 0.71 micrograms l-1 after treatment). Thus in patients with post-surgical hypoparathyroidism verapamil has effects on calcium and phosphorous homeostasis. Since calcium absorption was not influenced by verapamil, it is suggested that verapamil affects bone mineral metabolism.

Adult↗

Prediction of vertebral strength by dual photon absorptiometry and quantitative computed tomography.

We measured the lumbar bone mineral of 19 cadavers (10 women, 9 men) by dual photon absorptiometry (DPA) and quantitative computed tomography (QCT). In addition, we determined the ultimate load and stress of each vertebra, and finally ash content and volumetric ash density of the vertebral body. We found that single energy QCT was inferior to DPA and dual energy QCT in the prediction of the ultimate load or stress of vertebrae (P less than 0.001). The ultimate stress was best predicted by using the dual energy QCT results (r = 0.71; SEE = 36.3 N/cm2) whereas the ultimate vertebral load was best predicted by using the DPA (BMC) results (r = 0.80; SEE = 740 N). If the QCT finding was multiplied with the surface area of the vertebral body it could be used to predict the ultimate load with good accuracy (r = 0.74; SEE = 841 N). All the above correlations were higher in women than in men. The frequency of vertebral compression fractures in the material was well correlated with the bone mineral findings. A nonlinear (third degree) relationship between mineral content and mechanical characteristics is proposed but within the area of measurement used in clinical practice a linear (first degree) equation is preferred.

Aged↗

Outcome of falls in women: endogenous factors associated with fracture.

Thirty-six women who had sustained soft-tissue injury after a simple fall were compared with age-matched controls who had suffered a fracture in a similar fall. Subjects aged 45-70 years who had suffered a fracture had significantly lower bone density in the proximal femur and lower grip strength than their controls. No differences in femoral bone density or grip strength were found between the two groups at ages over 70, but the women with fractures were on average of greater body weight than the no-fracture group. Bone mineral density declined more rapidly with age and was less closely correlated with body weight and time since menopause in the no-fracture group than among the women with a fracture. We conclude that the determinants of fracture vary with age; low bone density and low muscle strength are associated with fracture below the age of 70 but not at higher ages.

Accidental Falls↗

Bone mass in women with hip fracture.

The bone mineral density was determined by dual-photon absorptiometry on the proximal femur in 32 women with femoral neck fractures, 30 with trochanteric fractures, 39 with a fracture elsewhere than the hip, and 16 premenopausal healthy women. Single-photon absorptiometry was performed at two sites on the radius. The bone mineral density in the neck and intertrochanteric area was greater in the women with femoral neck fractures than in those with trochanteric fractures. The bone mineral distribution in the proximal femur was essentially the same for the femoral neck fracture group as for the reference group of healthy women. Neither the Singh index, determined in radiographs, nor the measurements on the radius by single photon absorptiometry provided a reliable estimate of the bone mineral density in the proximal femur.

Adult↗

Changes in bone histomorphometry and bone mineral during treatment of osteoporosis with 1 alpha-hydroxyvitamin D3 and calcium.

Treatment with 1 alpha-OHD3 supplemented with calcium will possibly unveil symptoms of spinal pain (8/10) and increase physical activity (7/10) in patients suffering from osteoporosis. An increase in trabecular bone (8/10) as well as a decrease in bone resorption (9/10) accompanied by measured increased bone mineral (6/10) has been observed. Some patients did not show any response to this kind of treatment.

Aged↗