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Biomedical subjects

S Ortolani

Publications and source records attributed to S Ortolani.

At least 19 recordsLinked to original sources

Active-feedback control of the magnetic boundary for magnetohydrodynamic stabilization of a fusion plasma.

Stable operation with control on magnetohydrodynamic modes has been obtained in the modified reversed field experiment employing a set of 192 feedback controlled saddle coils. Improvements of plasma temperature, confinement (twofold), and pulse length (threefold) and, as a consequence of the magnetic fluctuation reduction, strong mitigation of plasma-wall interaction and mode locking are reported.

Journal Article↗

Superiority of alfacalcidol compared to vitamin D plus calcium in lumbar bone mineral density in postmenopausal osteoporosis.

In a randomized multicenter, double-blind, double-dummy, parallel group study a comparison of the efficacy and safety of 1 microg alfacalcidol to 880 IU vitamin D plus calcium carbonate (1 g calcium) once daily per os was performed on 148 postmenopausal osteoporotic Caucasian patients with normal vitamin D serum levels for 18 months. Bone mineral density (BMD) was measured at baseline, 12 and 18 months. Safety parameters were followed during the entire study period. Sixty-nine (90.8%) in the alfacalcidol group and 67 (93.1%) in the vitamin D group were included in the ITT analysis. Lumbar BMD in the alfacalcidol group increased by 0.017 g/cm2 (2.33%) and 0.021 g/cm2 (2.87%) from baseline (P<0.001) at 12 and 18 months, respectively, whereas in the vitamin D plus calcium group the increase was 0.005 g/cm2 (0.70%) from baseline (N.S.) at both 12 and 18 months. The higher changes from baseline in the alfacalcidol group, as compared to the changes in the vitamin D plus calcium group at both 12 and 18 months, were found to be statistically significant (P=0.018, 0.005). A small increase of mean femoral BMD was achieved in both groups (N.S.). Adverse events were similar in both groups. No significant differences were noted between the groups in serum calcium. In conclusion, alfacalcidol was found to be superior in significantly increasing lumbar BMD as compared to vitamin D plus calcium while safety characteristics were found to be similar in both treatments.

Aged↗

Feedback stabilization of multiple resistive wall modes.

Active feedback stabilization of multiple independent resistive wall modes is experimentally demonstrated in a reversed-field pinch plasma. A reproducible simultaneous suppression of several nonresonant resistive wall modes is achieved. Coupling of different modes due to the limited number of the feedback coils is observed in agreement with theory. The feedback stabilization of nonresonant RWMs also has an effect on tearing modes that are resonant in the central plasma, leading to a significant prolongation of the discharge pulse.

Journal Article↗

Rapid suppression of bone resorption and parathyroid hormone secretion by acute oral administration of calcium in healthy adult men.

Acute effects of oral calcium supplementation have been studied mainly in pre- and post-menopausal women, whereas very few data concerning men are available. We investigated the effects of 1.2 g of oral calcium administered for 4 days in 18 healthy young men. The day before the first calcium dosing (day -1) and the day of the last calcium dosing (day 4) total and ionized serum calcium and intact PTH were measured at multiple time-points up to 24 h; calcium, C-terminal telopeptide (CTX), pyridinoline (PYD) and deoxypyridinoline (DPD) were measured in urine collected every six h. On day 4, total and ionized serum calcium increased during the 6 h following oral calcium: the maximum increase over baseline was 5.04 and 7.4% respectively, occurring after 2.9 +/- 1.9 h (mean +/- SD) and 2.6 +/- 0.9 h. The AUC was significantly higher on day 4 than on day -1 for both total serum calcium (+4.6%, p<0.02) and ionized serum calcium (+9.2%, p<0.0001). Twenty-four h urinary excretion of total calcium increased significantly on day 4 (+15.1%, p<0.02), mainly as a consequence of increased excretion during the first 6 h. Serum PTH was suppressed by oral calcium, with a significant reduction of AUC on day 4 (-15.1%, p<0.05). Serum concentrations of intact PTH dropped from 26.4 +/- 9.8 pg/ml at time zero to a minimum mean value of 14.9 +/- 7.6 pg/ml at time +2 h. Bone resorption markers significantly decreased on day 4 (CTX -33.2%, p<0.001; PYD -28.5%, p<0.05; DPD -35.8%, p<0.02). Most of the effect was seen in the first 6 h after oral calcium load. These data support the concept that acute suppression of PTH and bone resorption induced by calcium administration is not gender specific and provide the rationale to further assess also in men the long-term effects of oral calcium in the prevention and treatment of osteoporosis.

Administration, Oral↗

Bone loss and recovery in regional migratory osteoporosis.

Regional migratory osteoporosis (RMO) is a migrating arthralgia of the weight-bearing joints of the lower limb associated with focal osteoporosis. Little information is available on a quantitative assessment of systemic or local osteoporosis. In this study, we report three cases of RMO in which spine, hip and whole body serial assessments of bone mass have been evaluated to outline their extent and time course of changes. Systemic osteoporosis, with a prevalent involvement of the mainly trabecular skeletal sites, was present in all the patients, with T-scores below -2.5 at both the lumbar spine and femoral neck. Bone loss in acute episodes ranged from -75.5% to -14.7% and appeared related to the severity of the episode. In acute episodes the demineralizing process affected the whole limb from the hemipelvis to the foot: the bone loss ranged from -33.6% to -3.5% at sites with prevalent trabecular composition and from -19.1% to -1.1% at sites with prevalent cortical composition. Bone recovery was complete in one episode out of six. In the other five cases, the average residual bone loss was 26% (range 13.9-32.7%). Our observations suggest that RMO occurs in subjects with systemic osteoporosis and densitometric assessment may aid in the clinical management.

Acute Disease↗

Regional migratory osteoporosis: a pathogenetic hypothesis based on three cases and a review of the literature.

Regional migratory osteoporosis (RMO) is a migrating arthralgia of the weight-bearing joints of the lower limb which mainly affects middle-aged males. Its aetiology is unknown. The association of RMO with generalised osteoporosis has recently been reported. A concurrent systemic osteoporosis was also reported in some cases of transient osteoporosis of the hip (TOH), a disorder closely related to RMO. In its turn, TOH is considered a reversible stage of avascular necrosis of the hip (AVN), and the aetiopathogenesis of both of them remains strongly debated. We report three cases of RMO associated with generalised severe idiopathic osteoporosis. Three men, in the fourth and fifth decades of life, complained of at least four episodes of arthralgia in the lower limbs, with a migratory pattern, radiographic focal osteoporosis and final clinical resolution. The most striking common feature of these patients was the presence of a severe systemic osteoporosis with a prevailing trabecular involvement. We suggest that a prolonged or exaggerated activation of regional acceleratory phenomena (RAP) is the cause of transient osteoporosis. Bone tissue microdamage due to osteoporosis may be the most frequent noxious stimulus that turns RAP on, and, bone tissue microfracture is the most prevalent consequence. When this pathogenetic pathway is activated, the progression from focal osteoporosis and bone marrow oedema to avascular necrosis is associated with the amount of structural damage.

Adult↗

Effects of 12-month GH treatment on bone metabolism and bone mineral density in adults with adult-onset GH deficiency.

Serum bone-Gla protein (BGP), bone alkaline phosphatase (B-AP), and C-terminal cross-linked telopeptide of type I collagen (ICTP) levels were evaluated in 18 adults with acquired GH deficiency (GHD, 14 males and 4 females, age range: 25-59 yr) before, at 3, 6, 9 and 12 months of rec-GH treatment (0.125 IU/kg/week for the first month, followed by 0.25 IU/kg/week for 11 months) and 6 months after the withdrawal of therapy. Total body bone mineral density (BMD, g/cm2) was measured with dual energy X-ray absorptiometry (Hologic QDR 1000/W) before, at 12 months of GH treatment and 6 months after its withdrawal. Before treatment, BGP (mean+/-SE: 5.1+/-0.4 ng/ml), B-AP (59.4+/-6.5 IU/l), ICTP (3.1+/-0.3 ng/ml) levels of patients were similar to in healthy controls (BGP: 5.4+/-0.1 ng/ml; B-AP: 58.2+/-2.0 IU/l; ICTP: 4.1+/-0.3 ng/ml). GH treatment caused a significant increase of BGP, B-AP, ICTP levels, the maximal stimulation of bone resorption, occurring after 3 months of GH treatment, while the maximal effect on bone formation being evident later (at 6th month). A slight decline in BGP, B-AP, T-AP and ICTP levels occurred at 9-12 months of therapy, although the values remained significantly higher than in basal conditions and with respect to healthy controls. Before treatment, mean total body BMD of patients (1.110+/-0.027 g/cm2, range: 0.944-1.350 g/cm2) was not significantly different (z-score: +0.47+/-0.31, NS) from that observed in healthy controls (1.065+/-0.008 g/cm2, range: 1.008-1.121 g/cm2). GH therapy was associated with a significant reduction of mean total body BMD values (6th month: -1.8+/-0.5%, p<0.01; 12th month: -2.1+/-1.0%, p<0.05 vs baseline), particularly evident in the first six months of treatment. Six months after the withdrawal of GH therapy, BGP (5.9+/-0.5 ng/ml), B-AP (57.3+/-7.0 IU/l) and ICTP (3.2+/-0.1 ng/ml) levels returned similar to those recorded before treatment, while total BMD increased (+1.5+/-0.7, p<0.05), remaining however slightly lower than in basal conditions (-0.6+/-1.2, NS). In conclusion, our study shows that: a) acquired GHD in adulthood is associated with both normal bone formation/resorption indexes and normal total body BMD; b) GH therapy causes a significant rise of bone formation/resorption markers (earlier and greater for bone resorption); c) one-year GH therapy is associated with a reduction of total body BMD values, particularly evident in the first 6 months of treatment; d) the effects of GH therapy on bone turnover are transient, being completely reverted six months after the withdrawal of GH therapy; e) the increase of total body BMD (up to baseline values) after GH withdrawal might be explained as consequence of persisting effects of previous GH stimulation on bone remodeling.

Absorptiometry, Photon↗

Quasi-single-helicity reversed-field-pinch plasmas

The reversed field pinch (RFP) is a configuration for plasma magnetic confinement. It has been traditionally viewed as dominated by a bath of MHD instabilities producing magnetic chaos and high energy transport. We report experimental results which go beyond this view. They show a decrease of magnetic chaos and the formation of a coherent helical structure in the plasma, whose imaging and temperature profile are provided for the first time. These quasi-single-helicity states are observed both transiently and in stationary conditions. The last case is consistent with a theoretically predicted bifurcation. Our results set a new frame for improving confinement in high current nonchaotic RFP's.

Journal Article↗

Bone densitometry: assessing the effects of growth hormone treatment in adults.

Dual-energy X-ray absorptiometry (DXA) is the reference method for the measurement of bone mineral mass at different skeletal sites. It has been widely used in recent years to assess the effects of growth hormone (GH) treatment on bone metabolism. In normal individuals, bone mineral content (BMC) and density (BMD), as assessed using DXA, correlate with body size. Therefore, using DXA in patients with congenital GH deficiency (GHD), who have a smaller body frame, would be expected to result in lower bone mass. Thus, comparisons with reference data derived from populations of normal body size are invalid. The evaluation of the effects of GH administration should take into account the possible effects of GH on bone size, not only in children, but also in adults. The enlargement of bone, due to stimulation of the periosteal apposition, may partially mask an increase in BMC, resulting in little or no change in BMD. The ability of GH to affect bone area therefore requires analysis of the possible changes in bone area and BMC, as well as BMD. This issue has been poorly handled in the studies published to date. Lastly, the acceleration of bone turnover induced by GH leads to an increase in bone remodelling space, which in turn is associated with a reduction in BMC and BMD, independent of the net balance between breakdown and formation in each metabolic unit. This bone loss is completely reversible when the remodelling space returns to previous levels. This phenomenon must be taken into account when analysing the effects of GH treatment on bone mass, because a net gain in bone mass may be found in long-term GH treatment or after GH discontinuation, even if bone loss was evident during the first 6 months of treatment. In conclusion, the interpretation of bone density data in patients with GHD, and after GH administration, should take into account some of the methodological aspects of bone densitometry, as well as the specific actions of GH on bone metabolism and body composition.

Adult↗

Bone assessment after total knee arthroplasty by dual-energy X-ray absorptiometry: analysis protocol and reproducibility.

Bone quality is important for the success of joint prostheses implantation, and the assessment of bone density after total knee arthroplasty by means of dual-energy X-ray absorptiometry may be useful for monitoring implant stability. The aim of this study is to suggest a validated analysis protocol for the assessment of bone status after total knee arthroplasty. A dedicated densitometric analysis protocol of five regions of interest was designed, and 10 subjects who had received an uncemented knee prosthesis (8 females and 2 males, aged 55-74 years) underwent three consecutive scans in posteroanterior and lateral projections, with repositioning after each scan to test the suitability and reproducibility of the protocol. The reproducibility of the measurement of bone mineral content and density in the femoral and tibial regions ranged, respectively, from 2.1% to 4.1%, from 0.9% to 2.6% for the posteroanterior scans, and from 2.7% to 5.6% and from 2.3% to 4.7% for the lateral scans, depending on the considered region. Our results confirm that the suggested protocol allows precise assessment of bone mineral content and density, and that dual-energy X-ray absorptiometry is reliable for the evaluation of bone mass around prosthetic implants.

Absorptiometry, Photon↗

Metabolic effects of biosynthetic growth hormone treatment in severely energy-restricted obese women.

OBJECTIVE: Severe energy restriction in the treatment of obesity is limited by catabolism of body protein stores and, consequently, loss of lean as well as fat tissue. Growth hormone (GH), whose secretion is markedly impaired in obesity, is endowed with both lipolytic and protein anabolic properties. The aim of this study was to verify the effects of GH administration on body composition, plasma leptin levels and energy metabolism in obese patients undergoing severe dietary restriction. DESIGN: Single-blind placebo-controlled study. Twenty obese women were fed a diet of 41.86 kJ/kg ideal body weight (IBW) daily for 4 weeks: 10 of them were randomly assigned to a 4 week treatment with biosynthetic GH (rhGH, Saizen, Serono, Rome, Italy), 1 U/kg IBW/week in daily subcutaneous injections; the other 10 patients, matched for age and BMI, received vehicle only. SUBJECTS: Twenty women with simple obesity (age: 25.4+/-1.07 y, BMI: 35.9+/-0.35 kg/m2). MEASUREMENTS: Plasma IGF-I and leptin, serum markers of bone turnover (serum bone isoenzyme of alkaline phosphatase, osteocalcin and urinary hydroxyproline), nitrogen balance, body composition (by DEXA), and resting energy expenditure (REE, by indirect calorimetry) were evaluated at baseline and after 4 weeks. RESULTS: Mean IGF-I plasma levels, not influenced by energy restriction in patients receiving placebo, displayed a significant increase in the group treated with rhGH. The mean weight reduction and fat mass loss were not significantly different in the two groups (6.0+/-0.51 vs 7.2+/-0.30 kg, NS, and 5.36+/-0.460 vs 4.28+/-0.572 kg, NS, with rhGH and placebo, respectively). Likewise, plasma leptin levels decreased significantly in weight-reduced subjects receiving either rhGH (from 16.2+/-2.37 to 6.4+/-0.39 ng/ml, P < 0.05) or placebo (from 14.3+/-2.55 to 7.7+/-3.77 ng/ml, P < 0.05). On the contrary, the mean decrease of lean body mass (LBM) was significantly lower in the GH-treated patients than in those receiving vehicle (1.52+/-0.60 vs 3.79+/-0.45 kg, P < 0.05). In keeping with these findings, the mean daily nitrogen balance was significantly less negative in the GH-treated subjects than in the vehicle-injected patients (mean of the 4 week daily urine collections -185.7+/-40.33 vs -363.9+/-55.47 mmol/d, P < 0.05, respectively). Further, a significant reduction of mean REE was recorded in the energy-restricted placebo-treated patients (from 8807+/-498 to 7580+/-321 kJ/24 h, P < 0.05), but not in the patients receiving rhGH (from 8367+/-580 to 8903+/-478 kJ/24 h, NS). Actually, when corrected for LBM, REE was even increased by GH administration (from 197.9+/-11.76 to 219.3+/-9.87 kJ/kg LBM/24 h, P < 0.05), whereas it was unchanged in the placebo group (from 201.7+/-13.85 to 190.0+/-9.87 kJ/kg LBM/24 h, NS). A tendency of serum markers of bone turnover to increase was observed in the patients treated with rhGH, however with no changes in bone mineral content and density. CONCLUSION: rhGH treatment, though unable to enhance diet-induced weight and fat mass reduction, was effective in stimulating IGF-I production and conserving LBM and increasing its energy metabolism even in the presence of severe energy restriction.

Adult↗

Effect of ipriflavone--a synthetic derivative of natural isoflavones--on bone mass loss in the early years after menopause.

OBJECTIVE: We studied whether oral administration of ipriflavone, a synthetic derivative of naturally occurring isoflavones, could prevent bone loss occurring shortly after menopause. DESIGN: Fifty-six women with low vertebral bone density and with postmenopausal age less than five years were randomly allocated to receive either ipriflavone, 200 mg three times daily, or placebo. All subjects also received 1,000 mg elemental calcium daily. RESULTS: Vertebral bone density declined after two years in women taking only calcium (4.9 +/- 1.1%, SEM, p = 0.001), but it did not change in those receiving ipriflavone (-0.4 +/- 1.1%, n.s.). A significant (p = 0.010) between-treatment difference was evidenced at both year 1 and year 2. At the end of the study, urine hydroxyproline/creatinine excretion was higher in the control group than in the ipriflavone group, as compared to no difference at baseline. Five patients taking ipriflavone and five taking placebo experienced gastrointestinal discomfort or other adverse reactions, but only one and four subjects, respectively, had to discontinue the study. CONCLUSIONS: Ipriflavone prevents the rapid bone loss following early menopause. This effect is associated with a reduction of bone turnover rate.

Administration, Oral↗

A double blind, placebo-controlled trial of ipriflavone for prevention of postmenopausal spinal bone loss.

One hundred ninety-eight postmenopausal women (aged 50-65 years) with vertebral bone density (VBD) 1 SD below the mean value for normal, age-matched, postmenopausal subjects were enrolled in six Italian centers and 134 completed 2 years of treatment. All subjects were randomly allocated to a 2-year treatment with oral ipriflavone (200 mg t.i.d.) or a matching placebo, according to a double-blind, parallel group design. All patients also received an oral daily calcium supplement of 1 g as calcium carbonate. VBD and markers of bone turnover were measured at baseline, and every 6 months. A complete routine analysis of liver and kidney functions along with hematological parameters were measured before and at the end of treatment period. The valid completers analysis showed a significant increase of VBD in ipriflavone-treated women with average percent changes of +1.4 after 1 year, and +1% at the end of treatment period (P < 0.05). The placebo group presented a significant decrease of VBD after 2 years of treatment (P < 0.05). The difference between treatments was significant (P < 0.01). The intention to treat analysis confirmed the significant decrease of VBD in the placebo group, with no changes in ipriflavone-treated women. Skeletal ALP significantly decreased in ipriflavone-treated women (P < 0.05). Serum BGP and urine HOP/Cr showed a significant decrease only in ipriflavone-treated women, suggesting an inhibitory effect on bone turnover rate. Adverse reactions, mainly gastrointestinal, occurred to a similar extent in the two treatment groups. The evaluation of patients' compliance, assessed by residual tablets count, revealed a drug intake of more than 80% after 2 years in 92.5% and 92.8% of patients treated with ipriflavone or placebo, respectively. This study demonstrates that ipriflavone can prevent bone loss in postmenopausal women with low bone mass.

Aged↗

Effect of chronic treatment with ipriflavone in postmenopausal women with low bone mass.

We present the results of two multicenter, double-blind, placebo-controlled, 2-year studies to evaluate the efficacy and tolerability of ipriflavone in postmenopausal women (PMW) with low bone mass. 453 PMW (aged 50-65 years) with a vertebral (VMD) or radial (RMD) mineral density value 1 SD lower compared with age-matched controls, were randomly selected to receive oral ipriflavone (200 mg T.I.D. at meals) or matching placebo, plus 1 g oral calcium daily. Vertebral (study A, by dual X-ray absorptiometry-DXA) and radial (study B, by dual photon absorptiometry-DPA) bone density, serum bone Gla-protein (BGP), and urinary hydroxyproline/creatinine (HOP/Cr) were measured every 6 months. In both studies, the Valid Completers (VC) analysis showed a maintenance of bone mass in ipriflavone-treated women, whereas in the placebo group, bone mineral density (BMD) was significantly decreased. The final outcome was a bone-sparing effect of 1.6% in study A, and of 3.5% in study B after 2 years. The Intention to Treat (ITT) analysis confirmed the decrease in the placebo group, with no changes in ipriflavone-treated women. A significant (P < 0.05) between-treatment difference was found in both studies. Biochemical markers of bone turnover decreased in patients treated with ipriflavone, thus suggesting a reduction of bone turnover rate. Twenty-six women treated with ipriflavone and 28 receiving the placebo dropped out because of side effects, mainly gastrointestinal. The compliance to the oral long-term treatment was good. The results of these studies show that ipriflavone is able to prevent both axial and peripheral bone loss in PMW with low bone mass, and is well tolerated.

Absorptiometry, Photon↗

Periprosthetic bone density around fully hydroxyapatite coated femoral stem.

In this study, periprosthetic bone mineral density was measured at scheduled time intervals after surgery by dual energy x-ray absorptiometry in 21 patients to assess the history of bone density redistribution after femoral stem insertion. Measurements of changes in bone density with time were obtained for the regions of the greater trochanter, the lateral cortex, the tip, the medial cortex, and the calcar. In all regions, bone density decreased during the first 3 months after surgery; this was followed by a prolonged period of 18 to 30 months of bone gain, a subsequent period of steady state, and the final resumption of bone aging processes after the third postoperative year. The greatest loss was observed in the calcar region after 6 months (greater than 50%). The characteristic pattern of time related bone density changes obtained in this study may make it possible to compare other pathologic, design, or stiffness related patterns. This could have clinical relevance in the early diagnosis of pathologic processes and as a means of evaluating prosthetic designs.

Absorptiometry, Photon↗

Effects of recombinant growth hormone (GH) treatment on bone mineral density and body composition in adults with childhood onset growth hormone deficiency.

Lumbar spine, whole proximal femur and total body bone mineral density (BMD, g/cm2) and the regional soft tissue composition were measured with dual energy X-ray absorptiometry (Hologic QDR 1000/W) in eight adults with childhood onset GHD, before and after 6 months of recombinant GH treatment (0.5 IU/kg/week). Data obtained from patients were compared with those recorded in an age and sex matched control group. Before treatment, lumbar (L2-L4) spine BMD (mean +/- SD: 0.811 +/- 0.159 g/cm2), whole proximal femur BMD (0.739 +/- 0.094 g/cm2) and total body BMD (0.946 +/- 0.087 g/cm2) of patients were significantly (p < 0.001, 0.01 and 0.001, respectively) lower than those recorded in an age- and sex-matched control group (1.077 +/- 0.155 g/cm2, 0.968 +/- 0.166 g/cm2 and 1.168 +/- 0.058 g/cm2, respectively), although three patients showed BMD values at the lower limit of the normal range. Mean lumbar spine BMD, whole proximal femur BMD and total body BMD did not significantly change alter 6 months' GH treatment (-1.4 +/- 3.7%, +2.7 +/- 3.7% and -1.1 +/- 5.0% vs basal values, respectively). On the other hand, trochanteric subregion showed a significant 4.8 +/- 5.3% increase (vs basal, p < 0.05), while other hip subregions did not show significant changes. GH therapy caused marked effects on body composition; in fact, a significant decrease (p < 0.01) of trunk fat (-25.2 +/- 15.0%) and a marked increase (p < 0.01) of limbs lean mass (+10.0 +/- 5.3%), resulting in a significant (p < 0.02) reduction (-16.5 +/- 13.5%) of the axial to peripheral fat ratio (APFR), were clearly evident after six months of therapy. In conclusion, our study shows that six months of GH treatment do not exert relevant effects on the BMD of adults with childhood onset GHD. On the contrary, the effects of GH therapy on body composition are more marked, being clearly appreciable after six months of treatment.

Adult↗

Effects on bone mineral density of 12-month goserelin treatment in over 40-year-old women with uterine myomas.

We evaluated the effects on bone mineral density (BMD) of a 12-month treatment with goserelin depot, a gonadotropin-releasing hormone agonist, in a group of women with symptomatic uterine myomas requiring hysterectomy. Sixteen women, mean age 45.6 +/- 5.0, reporting menorrhagia associated with uterine myomas, candidates for hysterectomy, were scheduled to be treated with goserelin depot for 12 months. BMD was measured at the vertebral (L2-L4) and proximal femur level (femoral neck and trochanter) at the start of therapy and 6, 12, and 18 months later using dual energy X-ray absorptiometry (Hologic QDR 1000/W). The patients were followed for a minimum of 6 months after the end of treatment. Thirteen of the 16 women enrolled completed the treatment and three suspended it after 5, 6, and 7 months, respectively, because of side effects (hot flashes, insomnia, depression). Of the 13 women who completed the treatment, three underwent hysterectomy because of myoma regrowth and the recurrence of symptoms 3-18 months later; four reached the menopause 5-16 months later, and six were all menstruating normally with a follow-up varying from 6 to 18 months. After 12 months of therapy we observed a bone loss at vertebral, femoral neck, and trochanter of 4.4% (P < 0.05 versus baseline; P = not significant versus 6 months), 7.5% (P < 0.01 versus baseline, P < 0.01 versus 6 months), and 7.6% (P < 0.001 versus baseline, P < 0.05 versus 6 months), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗