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Biomedical subjects

S Goodwin

Publications and source records attributed to S Goodwin.

At least 91 records · Page 5Linked to original sources

The relationship between fluoride effects on bone histology and on bone mass in patients with postmenopausal osteoporosis.

Twenty-one patients with postmenopausal osteoporosis were studied for 4 years after initiation with sodium fluoride (NaF), 20-25 mg b.i.d., elemental calcium, 1.0 g/day, and vitamin D2, 50,000-100,000 I.U. weekly. Histomorphometry was carried out on bone biopsies taken prior to and while on NaF treatment. The total bone mineral mass of the central third of the skeleton was measured by neutron activation analysis at 0.5-1.0 year intervals, and the result expressed as the Calcium Bone Index (CaBI), which normalizes the mineral mass to values for normal subjects of the same size. Twelve patients (57%) who developed, within the first 2 years of treatment, histological effects of fluoride (F) (increased bone formation surfaces together with thickened osteoid seams or hyperosteoidosis) increased their CaBI significantly (P less than 0.01) over the 4 year period, from 0.64 +/- 0.02 to 0.78 +/- 0.03 (or 21.0 +/- 2.9%). No other agent is known to stimulate bone growth to this degree. The remaining nine patients showed no histological evidence of F stimulation and no increase in CaBI (from 0.67 +/- 0.03 to 0.66 +/- 0.03 over 4 years). The results suggest that the histological findings of hyperosteoidosis are prerequisite for the increases in bone mass of osteoporotic patients. Although serum and bone F levels were higher in patients with F response compared to those without response, there was considerable overlap in values between the two groups so that these parameters of F retention were not reliable for predicting F response. Histological evidence of hyperosteoidosis appears to be a more reliable predictor of subsequent increase in bone mass. The effect on fracture prevention of the hyperosteoidosis associated with the increases in bone mass remains to be shown.

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A maximised-ADL index of functional status for stroke patients. Methodological considerations.

An index of functional status for stroke patients is presented. It is based on the observation that a patient's disposition is decided by the level of involvement of the most severely affected ADL-parameter. This allowed a suitably selected set of ADL-parameters to be scaled so that an index of functional status could be constructed which did not depend on the assumption of simple additivity of the component ADL-parameters. This index, together with two simplified versions, was contrasted with two summed-ADL indices and with an index of mobility, as predictors of outcome. The study was carried out on 57 patients.

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