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At least 595 records · Page 33Linked to original sources
PubMed1997

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↗
PubMed1997

Psychiatric symptoms, bone density and non-specific symptoms in patients with mild hypercalcemia due to primary hyperparathyroidism: a systematic overview of the literature.

To determine (1) the relationship between primary hyperparathyroidism with mild hypercalcemia and psychiatric disturbances, bone density, or non-specific symptoms, and (2) the effect of parathyroidectomy on these outcomes, a systematic and critical review of the literature was conducted. Relevant citations were identified using MEDLINE (1966 to August, 1995) and PsycINFO (1967 to August, 1995). Studies were included for the overview if they described patients with mild hypercalcemia (< 12 mg/dl), and if they dealt with at least one of the following outcomes: psychiatric disturbances, bone density, joint pain, constipation, polyuria/nocturia or weight loss. Either a calculated effect size or Z score was used to estimate the effect of the disease or parathyroidectomy on these outcomes. Seven studies met the inclusion criteria for this overview. Two out of three case-control studies on psychiatric symptoms found a significant association between primary hyperparathyroidism with mild hypercalcemia and psychiatric disturbances (effect sizes; 0.17, 1.2 and 1.6). One of the three studies also examined the effect of parathyroidectomy on psychiatric symptoms, and found an effect size of 1.5. All four cross-sectional studies that measured bone mass showed significantly reduced bone density in the forearm and the lumbar spine. The bone loss ranged from 0.9 to 1.4 standard deviation below the age- and sex-adjusted mean value in the forearm, and was 0.5 in the spine. There was no relevant study regarding non-specific symptoms. Among the seven studies, five did not explicitly indicate whether the patients had classical symptoms of either osteitis fibrosa cystica or renal stones. Primary hyperparathyroidism with mild hypercalcemia is associated with psychiatric disturbances and reduced bone density. Nevertheless, further research is needed to determine the symptoms, particularly for a group of patients without either classical bone disease or renal stones. The effects of parathyroidectomy on these outcomes also remain to be determined.

Bone Density↗
PubMed1999

Multinational, placebo-controlled, randomized trial of the effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT study. Fosamax International Trial Study Group.

This randomized, double-masked, placebo-controlled trial evaluated the safety, tolerability and effects on bone mineral density (BMD) of alendronate in a large, multinational population of postmenopausal women with low bone mass. At 153 centers in 34 countries, 1908 otherwise healthy, postmenopausal women with lumbar spine BMD 2 standard deviations or more below the premenopausal adult mean were randomly assigned to receive oral alendronate 10 mg (n = 950) or placebo (n = 958) once daily for 1 year. All patients received 500 mg elemental calcium daily. Baseline characteristics of patients in the two treatment groups were similar. At 12 months, mean increases in BMD were significantly (p</=0.001) greater in the alendronate than the placebo group by 4.9% (95% confidence interval 4.6% to 5.2%) at the lumbar spine, 2.4% (2.0% to 2.8%) at the femoral neck, 3.6% (3.2% to 4.1%) at the trochanter and 3.0% (2.6% to 3.4%) for the total hip. The incidence of nonvertebral fractures was significantly lower in the alendronate than the placebo group (19 vs 37 patients with fractures), representing a 47% risk reduction for nonvertebral fracture for alendronate-treated patients (95% confidence interval 10% to 70%; p = 0.021). Incidences of adverse events, including upper gastrointestinal adverse events, were similar in the two groups. Therefore, for postmenopausal women with low bone mass, alendronate is well tolerated and produces significant, progressive increases in BMD at the lumbar spine and hip in addition to significant reduction in the risk of nonvertebral fracture.

Adult↗
PubMed1999

Gastrectomy in the rat using two modifications of esophagojejunal anastomosis. general status, local histological changes and relationships to bone density.

Gastrectomy (GX) was carried out in the male rat according to the Longmire and the Roux-en-Y procedure. The focus of the postoperative investigations was to evaluate the influence of post-GX morphological changes occurring at the site of two types of end-to-end esophagojejunal anastomosis (with and without invagination), in particular food intake, body weight gain, food efficiency, hematocrit and bone density. GX failed to alter food intake, fasting blood glucose, alpha-amino nitrogen, or free fatty acids, but led to uniformly decreased body weight, food efficiency and serum gastrin, and increased serum osteocalcin, indicating high turnover osteopenia. However, irrespective of the type of (digestive tract) reconstruction (Longmire or Roux-en-Y), the invagination anastomosis was associated with lower mortality, fewer complications, less early postoperative weight loss, less intensive tissue changes at the anastomotic site, and improvement of bone density and hematocrit. Bivariate and multivariate regression analysis revealed that bone density was negatively influenced by epithelial hyperplasia of the anastomotic tissue, while hematocrit was positively influenced by bone density. In contrast, food intake appeared to have no influence. It was concluded that (1) the histological status of the esophagointestinal anastomosis varies depending on the surgical technique applied and (2) the type of anatomical reconstruction of the digestive tract (Longmire vs. Roux-en-Y) and food intake may be of minor importance for the bone and hematological status of GX rats. Future investigations are justified to clarify whether esophagojejunal proinflammatory tissue factors may contribute to the GX-mediated damage of bone mineral and bone marrow, thereby leading to low body weight.

Anastomosis, Roux-en-Y↗
PubMed2000

Disc degeneration and bone density in monozygotic twins discordant for insulin-dependent diabetes mellitus.

The effects of insulin-dependent diabetes mellitus on bone density and connective tissue degeneration have theoretical interest and practical relevance. Several experimental studies in animals have demonstrated the harmful effects of insulin deficiency on connective tissues. However, clinical studies in humans have produced somewhat contradictory results, most likely due to difficulties controlling for general degeneration and factors associated with diabetes. In nine pairs of monozygotic twins discordant for insulin-dependent diabetes mellitus, we compared femoral and lumbar bone mineral density (assessed by dual-energy x-ray absorptiometry) and spinal degeneration (assessed by magnetic resonance imaging). The bone densities were, on average, 0.1-0.3% lower (p = 0.87-0.96) in diabetic patients. However, after controlling for smoking, we found that the bone density in the femoral neck was 2.5% (0.025 g/cm2) lower in diabetic individuals than in their twins (p = 0.09). The five magnetic resonance imaging parameters used to evaluate disc degeneration did not differ between diabetic patients and their twins. In conclusion, our results provide no evidence that insulin-dependent diabetes mellitus has any major effect on bone density or disc degeneration.

Absorptiometry, Photon↗
PubMed1991

[Bone density and biological markers in a population of 330 women].

A population of 330 non-selected women underwent determination of bone density by means of Bi X absorptiometry of the lumbar spine and femur. The findings showed a negative correlation with the time since the menopause and a positive correlation with the duration of genitally active life and with substitutive hormonal treatment. The determination of the L1 density can replace that of the entire lumbar spine in cases in which osteoarthritis, atheroma or crushing make this determination unreliable. Conclusions cannot yet be based on measurements of the neck of femur. Changes in the biological markers in function of bone density values are difficult to interpret. The measurement of bone density and the assay of biological markers reflect two distinct phenomena, both of which must be taken into consideration in assessing osteoporotic risk.

Adult↗
PubMed2003

Better bone density reporting: T-score report versus fracture risk report with outcome analysis.

OBJECTIVE: To determine whether different classification systems for bone fracture risk result in different diagnoses and treatments. STUDY DESIGN: Assessment of 2 diagnostic classification systems by physicians who routinely read bone density scans, using a survey administered by an audience response system. METHODS: At a professional meeting, 103 rheumatologists were asked to read bone density results from 9 case studies in 2 formats: a standard format using T-scores and a format using absolute fracture risk. As physicians were shown each of the 18 scans, they diagnosed each patient with (1) normal bone, (2) osteopenia, (3) osteoporosis, or (4) unknown, and provided a treatment recommendation. Test scans included hip dual-energy x-ray absorptiometry (DEXA) (60%), spine DEXA (10%), phalangeal DEXA (10%), and calcaneal ultrasound (20%). RESULTS: Approximately 1850 anonymous responses were recorded. For women, diagnostic agreement between physicians was 17% for the T-score report and 89% for the absolute risk report (P < .001). For men, diagnostic agreement also was better with the absolute risk report (66% vs 10%; P < .001). With DEXA, overall diagnostic agreement improved from 30% to 68% with the absolute risk report (P < .001). With ultrasound, diagnostic agreement improved from 4% to 63% with the absolute risk report (P < .001). Bisphosphonates were more likely to be prescribed in cases of increasing age and risk if scans were reported in terms of absolute fracture risk. CONCLUSION: A direct, risk-based bone density assessment may improve consistency and efficiency of diagnosis and treatment of osteoporosis.

Absorptiometry, Photon↗
PubMed1999

Non-association of estrogen receptor genotypes with bone mineral density and bone turnover in Korean pre-, peri-, and postmenopausal women.

Estrogen is known to play a critical role in both skeletal maturity and the rate of bone loss. This suggests the possibility that the estrogen receptor (ER) gene is one of the candidate genes that determines peak bone density and/or bone turnover rate. We investigated two established restriction fragment length polymorphisms (RFLPs) in intron 1 at the ER gene, represented as PvuII and XbaI. In 598 healthy Korean women aged 20-74 years, we examined the association of these ER genotypes with bone mineral density (BMD) and bone turnover status. The distribution of the PvuII and XbaI RFLPs was as follows: pp 205 (34.3%), Pp 308 (51.5%), PP 85 (14.2%) and xx 384 (64.2%), Xx 180 (30.1%), XX 34 (5.7%), respectively (where capital letters signify the absence of, and lower-case letters signify the presence of, the restriction site of each RFLP). No significant genotypic differences were found in BMD and bone markers. We grouped the subjects into three categories according to their menstrual status: 104 premenopausal women with regular menstruation, 182 perimenopausal women who had amenorrhea of not less than 3 months and not more than 12 months' duration, and 312 postmenopausal women whose last menstruation was at least 12 months previously. No significant genotypic difference in either BMD or bone markers was found in any of these three groups. Furthermore we categorized women in peri- and postmenopause into a high loser group and a normal loser group according to the level of bone resorption markers. There was no difference in genotypic proportions between the high and normal loser groups. Our data suggest that these ER polymorphisms are not associated with BMD or bone turnover in Korean women.

Absorptiometry, Photon↗
PubMed2002

Pediatric reference data for dual X-ray absorptiometric measures of normal bone density in the distal femur.

OBJECTIVE: Many children at risk for osteoporosis have substantial hip and knee contractures that prevent assessment of bone mineral density in the "usual" region, the proximal femur. As an alternative, bone density may be measured in the distal femur projected in the lateral plane. The purpose of this study was to provide normative reference data useful for interpretation of bone density measures in the distal femur of children and adolescents. SUBJECTS AND METHODS: The study was a cross-sectional, single-observational assessment of 256 healthy children and adolescents between the ages of 3 years and 18 years 6 months (mean, 10 years 5 months). Bone mineral density was measured in the nondominant proximal femur, lumbar spine, and both distal femurs using dual X-ray absorptiometry. RESULTS: We found that bone mineral density increases with age in the cortical, cancellous, and mixed regions of the distal femur, similar to the findings with other regional analyses of bone density. Bone density in the distal femur correlates very highly with bone density in the proximal femur and slightly less well with bone density in the lumbar spine. CONCLUSION: In pediatric patients who have deformities, have experienced trauma, or have undergone surgical procedures that prevent reliable measures of bone density in the proximal femur, bone mineral density may be measured in the distal femur and interpreted relative to the bone mineral density findings in healthy age- and sex-matched controls.

Absorptiometry, Photon↗
PubMed2005

Surgical approach influences periprosthetic femoral bone density.

Our hypothesis was that the bone mineral density of the proximal femur is altered significantly by surgical approach. The change in long-term periprosthetic bone mineral density in relation to the alteration of the musculature after the anterolateral (Group A) and transgluteal approaches (Group B) has been compared. There were 35 hips (30 patients) in Group A and 47 hips (37 patients) in Group B. No significant differences were seen between groups with respect to age, gender, diaphyseal bone mineral density distribution, or average stem size in a Wilcoxon-Mann-Whitney test. Measurement of bone mineral density in femoral Gruen zones revealed a significant bone loss in Group B compared with Group A in the multivariate analysis, which was confirmed by univariate post hoc tests in Zones I, II, VI, and VII (multiple significance according to Bonferroni-Holm's procedure). The functional outcome, however, showed no significant differences between the two groups postoperatively. A potential reason for the bone mineral density shift might have been a redistribution of the musculoskeletal loading across the hip after a transgluteal, compared with an anterolateral, surgical approach. A difference in the muscular damage caused by the two surgical approaches seems to have a significant influence on the long-term bone loss.

Adult↗
PubMed1989

Effect of physical activity on lumbar spine and femoral neck bone densities.

The lumbar spine and femoral neck densities of 123 and 141 normal adult women (50 +/- 10 years), respectively, measured by dual photon absorptiometry, were correlated with the number of hours of walking per day associated with their regular daily activities. This measure of exercise, obtained by detailed questionnaire and interview, was analyzed because it is regular, seasonally stable, and quantifiable. Both lumbar spine and femoral neck densities were significantly correlated with walking, with 0.8% and 1.9% increases in average bone density per hour of daily walking, respectively. This increase in density is substantial, considering that the age-related rate of bone loss in the same population is 0.7% and 0.5% per year of lumbar spine and femoral neck, respectively. This means that, on the average, a woman walking one additional hour per day has a femoral neck bone density comparable to that of a women 4 years younger who does not pursue this additional activity. This physical activity-associated enhancement of bone density may be critical at old age when osteoporosis is clinically manifested.

Adult↗
PubMed1981

The bone density of normal Ghanians.

The purpose of this study is to establish the normal value of bone density in average Ghanian. The method of measurement is that described by Doyle (Br. J. Radiol., 34: 698-712, 1961). The value obtained through the present research can be regarded as normal ranges of bone density of Ghanian in 1977. They will serve as a standard for estimation of the bone density of the morbid. Also it will be a useful aid for the diagnosis of severity in some diseases, such as nutritional, hormonal and hematological.

Absorptiometry, Photon↗
PubMed2001

Changes in bone density during childhood and adolescence: an approach based on bone's biological organization.

Bone densitometry has great potential to improve our understanding of bone development. However, densitometric data in children rarely are interpreted in light of the biological processes they reflect. To strengthen the link between bone densitometry and the physiology of bone development, we review the literature on physiological mechanisms and structural changes determining bone mineral density (BMD). BMD (defined as mass of mineral per unit volume) is analyzed in three levels: in bone material (BMD(material)), in a bone's trabecular and cortical tissue compartments (BMD(compartment)), and in the entire bone (BMD(total)). BMD(material) of the femoral midshaft cortex decreases after birth to a nadir in the first year of life and thereafter increases. In iliac trabecular bone, BMD(material) also increases from infancy to adulthood, reflecting the decrease in bone turnover. BMD(material) cannot be determined with current noninvasive techniques because of insufficient spatial resolution. BM(compartment) of the femoral midshaft cortex decreases in the first months after birth followed by a rapid increase during the next 2 years and slower changes thereafter, reflecting changes in both relative bone volume and BMD(material). Trabecular BMD(compartment) increases in vertebral bodies but not at the distal radius. Quantitative computed tomography (QCT) allows for the determination of both trabecular and cortical BMD(compartment), whereas projectional techniques such as dual-energy X-ray absorptiometry (DXA) can be used only to assess cortical BMD(compartment) of long bone diaphyses. BMD(total) of long bones decreases by about 30% in the first months after birth, reflecting a redistribution of bone tissue from the endocortical to the periosteal surface. In children of school age and in adolescents, changes in BMD(total) are site-specific. There is a marked rise in BMD(total) at locations where relative cortical area increases (metacarpal bones, phalanges, and forearm), but little change at the femoral neck and midshaft. BMD(total) can be measured by QCT at any site of the skeleton, regardless of bone shape. DXA allows the estimation of BMD(total) at skeletal sites, which have an approximately circular cross-section. The system presented here may help to interpret densitometric results in growing subjects on a physiological basis.

Absorptiometry, Photon↗
PubMedDate not supplied

[The effects of inhaled corticoids on bone density in asthmatic children].

OBJECTIVE: To evaluate bone status of asthmatic children on chronic inhaled corticoid therapy. METHODS: Bone densitometry was performed by Quantitative ultrasound (QUS) of the distal radius in 74 asthmatic children, evaluating Z-score; serum levels of 25 hydroxyvitamin D were measured in 10 cases. RESULTS: 28 of 74 children had osteopenia, defined as Z scores lower than -1. Statistic analyzes showed a significant correlation (p <0.05) of osteopenia with the duration of inhaled corticoid therapy (CSI), the absence of correlation with the dose of CSI, age, sex, severity step and duration of the disease. 25 hydroxyvitamin D was low in 8 of the 10 cases with osteopenia. Osteopenia was present in 7 children who were not under CSI, but have received multiple trials of oral corticoids for severe exacerbations. CONCLUSIONS: Osteopenia was present in 52% of children that were under inhaled corticoids for more than 12 months and it correlated with the duration of CSI, but not with the daily dose. Systemic corticoid use is a significant cause of osteopenia in asthmatic children.

Administration, Inhalation↗
PubMed1984

Bone density in women: a modified procedure for measurement of distal radial density.

This is a cross-sectional study of bone densitometry in greater than 700 normal healthy white women ranging in age from 18 to 98 years. A modified procedure for single-photon bone density analysis of the distal radius is described and compared with dual-photon densitometric measurements of the second through fourth lumbar vertebrae. The distal radial site measured was separated from the ulna by 5 mm. This "5 mm" site was characterized according to trabecular and cortical bone content, measurement reproducibility, positioning precision, and the effects of wrist pronation or supination. The radial site demonstrated a bone density loss of less than 0.1%/year for normal women 25-50 years of age, increasing to 0.7%/year after 50 years of age. In contrast to the variability and inconsistency obtained by us and others utilizing the standard "9/10" site, bone loss with age at the new "5 mm" site correlated closely with generalized bone mineral loss of the axial skeleton. We suggest that there is a unique role for single-beam densitometric measurements of the radius, permitting the rapid and relatively inexpensive evaluation of large populations of women without requiring a visit to a medical center. Such a process can select those requiring further evaluation or medical attention.

Adolescent↗
PubMed1997

Correlation of interleukin-6 serum levels with bone density in postmenopausal women.

In order to identify possible correlations between interleukin-6 (IL-6) and hormonal and biochemical parameters of bone metabolism, or bone density, 24 postmenopausal women were studied. Serum IL-6, estradiol, calcium, phosphorus, osteocalcin, alkaline phosphatase, the urinary secretion of calcium, phosphorus and hydroxyproline, and bone density of the lumbar spine, femur and radius were measured. No significant correlation was found between IL-6 and the biochemical parameters. A negative correlation was found between IL-6 and serum estradiol, as well as between IL-6 and bone density in 5 out of 6 sites studied. It is possible that women with high IL-6 levels, may develop lower bone mass.

Absorptiometry, Photon↗
PubMedDate not supplied

Decreased bone density in splenectomized Gaucher patients receiving enzyme replacement therapy.

Little is known about the effect of enzyme replacement therapy (ERT) on the bone abnormalities in Gaucher disease. Splenectomized Gaucher patients tend to suffer the most severe skeletal complications. We hypothesized that vitamin D supplementation would act synergistically with glucocerebrosidase infusions to increase bone density in splenectomized Gaucher patients. In a 24-month study, 29 splenectomized Gaucher patients were randomized to three groups: Group 1, calcitriol (1,25-dihydroxyvitamin D3; 0.25-3.0 microg/day) alone for the first 6 months with the addition of ceredase/cerezyme at 60 IU/kg every 2 weeks during months 7-12; Group 2, calcitriol together with ceredase/cerezyme at 60 IU/kg every 2 weeks during months 1-6; and Group 3, enzyme only at 60 IU/kg body wt every 2 weeks. In all three groups, enzyme dose was halved after the first 6 months of therapy. The primary outcome measure was bone mineral density of the lumbar spine measured by single-energy quantitative CT. Bone density by single-energy CT (P = 0.001) and by dual-energy CT (P = 0.06) declined overall, but there was no significant difference between the groups. Calcitriol had no significant effect on bone density. Fat fraction in lumbar spine increased (P = 0.000) and skeletal MRI scores improved. Bone-specific alkaline phosphatase (P = 0.002) and serum osteocalcin increased (P = 0.008), while blood cyclic AMP and urinary deoxypyridinoline did not change appreciably. Hemoglobin, platelet counts, and liver volume significantly improved. We conclude that ERT alone, or in combination with calcitriol, cannot repair the bone composition in splenectomized adult Gaucher patients. Alternatively, measuring trabecular bone density may be an inadequate marker of clinical efficacy for treating skeletal involvement in Gaucher disease.

Adult↗