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T D Spector

Publications and source records attributed to T D Spector.

At least 217 records · Page 12Linked to original sources
PubMed1989

A rational approach to the prevention and treatment of postmenopausal osteoporosis.

Postmenopausal osteoporosis is a common disorder. Its importance is measured by the mortality and morbidity associated with increasing numbers of fractures and the enormous social and economic cost to the community. Although the precise aetiology of postmenopausal osteoporosis remains unclear, prevention is now possible and treatment may be effective if commenced early enough in the course of the disease. Combination therapy with oestrogens and progestogens is currently the treatment of choice for prevention, in conjunction with calcium supplementation and changes in lifestyle. Prophylaxis should be offered to women at 'high risk', although the identification of this group is difficult at present. Treatment of existing disease is less effective, although oestrogens should be tried first, with calcitonin as a second choice. There is no place at present for vitamin D, anabolic steroids or parathyroid hormone. The use of fluoride or diphosphonates cannot be recommended outside research centres until further long term studies are completed, which will enable a comparison of the relative risks and benefits. Postmenopausal osteoporosis is now a preventable disease; however, further knowledge of risk factors and the identification of those at risk is essential. Treatment can then be directed at women who need it and healthy women can be spared a lifetime of unnecessary medication.

Estrogens↗
PubMed1988

Low free testosterone levels in rheumatoid arthritis.

The androgen status of 25 male patients with rheumatoid arthritis (RA) was assessed and compared with that of age matched controls with osteoarthritis (OA). Significantly reduced levels of serum free testosterone were found in the RA group. Within that group free testosterone was unrelated to all indices of disease activity measured, though it was strongly related to latex positivity. These results support the hypothesis that male sex hormones may have a protective role in RA, though prospective studies would be necessary to determine whether the relation was one of cause or effect.

Adult↗
PubMed1988

Epidemiological aspects of studying outcome in rheumatoid arthritis.

Knowledge of the outcome of rheumatoid arthritis (RA) is important both to the patient and to the rheumatologist. However, little data exist on the long-term outcome and effects of treatment on the disease. Consideration is given to the problems that arise in the choice of methods and measures to be used in an outcome study. Patient selection is an underestimated factor, which often produces biases and problems of comparability. Useful lessons can be learnt from examining outcome studies in other chronic diseases.

Arthritis, Rheumatoid↗
PubMed1988

Evidence for similarity in testosterone levels in haplotype identical brothers.

An analysis of 89 male sibling pairs from multicase rheumatoid arthritis families demonstrated an association between HLA and serum testosterone levels. In sibling pairs that were haplotype identical, the mean inter-pair difference in testosterone level expressed as a log ratio was significantly less than sibling pairs sharing neither haplotype (p = 0.03). This difference was independent of the RA status of the pairs. These results suggest the presence of a gene(s) controlling testosterone levels linked to the Major Histocompatibility Complex (MHC) on chromosome 6. These findings may aid understanding of the roles of HLA antigens and sex hormones in the susceptibility to RA and other autoimmune disease.

Arthritis, Rheumatoid↗