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  • 1
    Electronic Resource
    Electronic Resource
    Relationship between bone fluoride content and histological evidence of calcification defects in osteoporotic women treated long term with sodium fluoride (1993)
    Springer
    Osteoporosis international 3 (1993), S. 204-208 
    Details
    ISSN: 1433-2965
    Keywords: Bone ; Bone fluoride content ; Calcification defects ; Osteoporosis ; Sodium fluoride treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fluoride treatment is used to increase bone formation and cancellous bone mass in patients suffering from postmenopausal osteoporosis with vertebral fractures. Patients submitted to similar therapeutic protocols have shown various histological responses to the treatment, some developing calcification defects and others not. In fact, the bone histological response to fluoride salts depends on the cumulative uptake of fluoride by bone. To clarify the relationship between the presence of calcification defects (identified by the presence of mottled bone and linear formation defects) and the bone fluoride content, a retrospective study was performed on 29 women with type 1 osteoporosis and treated for several months (11–24) with sodium fluoride (50 mg/day), calcium and vitamin D. Bone fluoride content always significantly increased after treatment, but it was significantly higher in patients showing calcification defects than in those having no defects. These differences between the two groups of patients were not due to differences in clinical details (no significant differences concerning age, duration of treatment, total amount of fluoride ingested, renal function) or in their bone remodelling activity. Thus, it may be hypothesized that the high bone fluoride uptake is due to different individual responses from one patient to another concerning the bioavailability of the same dose of fluoride. This is difficult to predict, except by testing the individual bioavailability of the compound to be used in each patient before starting long-term treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623677
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  • 2
    Electronic Resource
    Electronic Resource
    Bone loss after cardiac transplantation: Effects of calcium, calcidiol and monofluorophosphate (1993)
    Springer
    Osteoporosis international 3 (1993), S. 322-329 
    Details
    ISSN: 1433-2965
    Keywords: Calcium ; Cardiac transplantation ; Fluoride ; Glucocorticoid-induced osteoporosis ; Parathyroid hormone ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Of 203 patients who underwent cardiac transplantation and were given long-term treatment with cyclosporine and 0.3 mg/kg per day prednisone, 123 were studied prospectively for at least 6 months and 46 for up to 2 years to evaluate the effects on lumbar bone mineral density (BMD) and calcium metabolism of a combined therapy with calcium, calcidiol and disodium monofluorophosphate (MFP). The population was arbitrarily assigned to one of two groups. Group I consisted of patients who had a lumbar spine BMDZ score above −1.5 SD as compared with an age-and sex-matched population and no vertebral fractures. They received daily 1 g elemental calcium and 25 µg (1000 IU) calcidiol. Group II consisted of patients who received daily the same doses of calcium and calcidiol combined with 200 mg MFP, and was divided into two subgroups: (a) osteopenic subjects who had a lumbar spine BMD Z score below −1.5 SD without vertebral fractures and (b) osteoporotic subjects with vertebral fractures. If serum creatinine was higher than 140 µmol/l the daily dose of MFP was tapered to 100 mg. Fifty-four and 27 patients from group I and 38 and 19 patients from group II were followed respectively for 12 and 24 months. In both groups serum parathyroid hormone levels were significantly reduced from the twelfth month in parallel with a significant increase in serum 25-OHD levels. No decline in lumbar BMD occurred in non-osteopenic and non-osteoporotic patients (group I) who received the calcium and calcidiol supplement. In group II, where MFP was added, a significant and linear increase in lumbar BMD was observed. The average increase reached 12.5% after 12 months and 29.5% after 24 months (p〈0.0001). The magnitude of the response was similar to the response previously reported in patients suffering from vertebral fractures due to postmenopausal osteoporosis and treated with the same daily dose of MFP. Because osteoporosis and fractures are not rare in patients after cardiac transplantation, these pilot results may be useful for further prevention and treatment trials of bone loss in this condition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637318
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  • 3
    Electronic Resource
    Electronic Resource
    Fluoride salts for vertebral osteoporosis: The benefit-to-risk ratio depends on the cumulative dose reaching bone (1993)
    Springer
    Osteoporosis international 3 (1993), S. 211-214 
    Details
    ISSN: 1433-2965
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion In conclusion, until recently the message concerning the benefit-to-risk ratio of fluoride therapy in established vertebral osteoporosis has been rather confusing because ‘fluoride’ has been considered globally, without taking into account the fact that quite different therapeutic strategies have used different fluoride salts, doses, durations of treatments and preparations with very different bioavailabilities of fluoride ion. Low daily doses (50 mg) of sodium fluoride given in enteric-coated tablets for 2 years correspond to a safe therapeutic window. They provide a valid benefit-to-risk ratio when administered concomitantly with calcium supplements and when the classical contraindications of renal failure and osteomalacia are taken into account.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01621910
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  • 4
    Electronic Resource
    Electronic Resource
    Influence of anthropometric parameters on ultrasound measurements of os calcis (1995)
    Springer
    Osteoporosis international 5 (1995), S. 371-376 
    Details
    ISSN: 1433-2965
    Keywords: Anthropometric parameters ; BUA ; SOS ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Few data have been published concerning the influence of height, weight and body mass index (BMI) on broadband ultrasound attenuation (BUA), speed of sound (SOS) and Lunar “stiffness” index, and always in small population samples. The first aim of the present cross-sectional study was to determine whether anthropometric factors have a significant influence on ultrasound measurements. The second objective was to establish whether these parameters have real effect on bone or whether their infuence is due only to measurement errors. We measured, in 271 healthy French women (mean age 77±11 years; range 31–97 years), the following parameters: age, height, weight, lean and fat body mass, heel width, foot length, knee height and height of the external malleolus (HEM). Simple linear regression analyses between ultrasound and anthropometric parameters were performed. Age, height and heel width were significant predictors of SOS; age, height, weight, foot length, heel width, HEM, fat mass and lean mass were significant predictors of BUA; age, height, weight, heel width, HEM, fat mass and lean mass were significant predictors of stiffness. In the multiple regression analysis, once the analysis had been adjusted for age, only heel width was a significant predictor for SOS (p=0.0007), weight for BUA (p=0.0001), and weight (p=0.0001) and heel width (p=0.004) for the stiffness index. Besides their statistical meaning, the regression coefficients have a more clinically relevant interpretation which is developed in the text. These results confirm the influence of anthropometric factors on the ultrasonic parameter values, because BUA and SOS were in part dependent on heel width and weight. The influence of the position of the transducer on the calcaneus should be taken into account to optimize the methods of measurement using ultrasound.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01622259
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  • 5
    Electronic Resource
    Electronic Resource
    How Hip and Whole-Body Bone Mineral Density Predict Hip Fracture in Elderly Women: The EPIDOS Prospective Study (1998)
    Springer
    Osteoporosis international 8 (1998), S. 247-254 
    Details
    ISSN: 1433-2965
    Keywords: Key words: Aging – Bone mineral density – Hip fracture – Osteoporosis – Prospective study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We conducted a population-based cohort study in 7598 white healthy women, aged 75 years and over, recruited from the voting lists. We measured at baseline bone mineral density (BMD g/cm2) of the proximal femur (neck, trochanter and Ward's triangle) and the whole body, as well as fat and lean body mass, by dual-energy X-ray absorptiometry (DXA). One hundred and fifty-four women underwent a hip fracture during an average 2 years follow-up. Each standard deviation decrease in BMD increased the risk of hip fracture adjusted for age, weight and centre by 1.9 (95% CL 1.5, 2.3) for the femoral neck, 2.6 times (2.0, 3.3) for the trochanter, 1.8 times (1.4, 2.2) for Ward's triangle, 1.6 times (1.2, 2.0) for the whole body, and 1.3 times (1.0, 1.5) for the fat mass. The areas under the receiver operating characteristic (ROC) curves were not significantly different between trochanter and femoral neck BMD, whereas ROC curves of femoral neck and trochanter BMD were significantly better than those for Ward's triangle and whole-body BMD. emsp;Women who sustained an intertrochanteric fracture were older (84 ± 4.5 years) than women who had a cervical fracture (81 ± 4.5 years) and trochanter BMD seemed to be a stronger predictor of intertrochanteric ([RR = 4.5 (3.1, 6.5)] than cervical fractures ([RR = 1.8 (1.5, 2.3]). emsp;In very elderly women aged 80 years and more, hip BMD was still a significant predictor of hip fracture but the relative risk was significantly lower than in women younger than 80 years. emsp;In the 48% of women who had a femoral neck BMD T-score less than –2.5, the relative risk of hip fracture was increased by 3, and the unadjusted incidence of hip fracture was 16.4 per 1000 woman-years compared with 1.1 in the population with a femoral neck BMD T-score 5–1.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050061
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  • 6
    Electronic Resource
    Electronic Resource
    Human parathyroid peptide treatment of vertebral osteoporosis (1993)
    Springer
    Osteoporosis international 3 (1993), S. 199-203 
    Details
    ISSN: 1433-2965
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies have shown that treatment with daily injections of human parathyroid peptide (hPTH) 1-34 increase axial cancellous bone mass partially at the expense of peripheral cortical bone. In the present work the same hPTH 1-34 regime given for 12 months has been combined with oestrogen or nandrolone therapy to control peripheral bone resorption. Spinal and iliac cancellous (but not cortical) bone increased by 40%–50% above initial values while no perceptible changes occurred in radial cortical or cancellous bone. The evidence of radiokinetic and histomorphometric studies performed before and in the last months of treatment suggested that bone remodeling had proceeded through a transient anabolic phase with increased activation, but that activation had become normal after 11–12 months in the cancellous bone of the ilium whereas it continued to be raised elsewhere in the skeleton. It is concluded that in combination with oestrogens, hPTH peptides given daily injections hold great promise for the treatment of patients with osteoporosis who have already lost substantial amounts of spinal cancellous bone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01621906
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  • 7
    Electronic Resource
    Electronic Resource
    Calcium, Vitamin D and Vitamin K in the Prevention of Fractures due to Osteoporosis (1999)
    Springer
    Osteoporosis international 9 (1999), S. S48 
    Details
    ISSN: 1433-2965
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00004161
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  • 8
    Electronic Resource
    Electronic Resource
    Influence of fat on ultrasound measurements of the Os calcis (1994)
    Springer
    Calcified tissue international 54 (1994), S. 91-95 
    Details
    ISSN: 1432-0827
    Keywords: Fat ; Ultrasound attenuation ; Speed-of-sound ; Os calcis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Measurements of the speed-of-sound (SOS) and of the broadband ultrasound attenuation (BUA) on the os calcis were recently proposed to assess osteoporotic fragility. Velocity and attenuation were measured through the heel which can be divided in three phases including hydroxyapatite, soft tissue, and fat. The aim of this study was to evaluate the influence of fat composition and heel width on SOS and BUA. This influence was determined from both in vitro investigations examining fat samples, phantoms, and cadaver heels, and in vivo ones observing adult volunteers as well as a wide sample section of healthy elderly women. Ultrasound velocities on various fat samples were significantly lower than those on distilled water (-65 m/second to -123 m/second). The excision of the surrounding soft tissue from cadaver heels made SOS steadily increase whereas the insertion of a 10 mm piece of lard in the lateral face of cadavers' and volunteers' heels os calcis lowered SOS about 30 m/second. ond. Furthermore, a difference of SOS was estimated at 15 m/second for a 12.5% variation of the marrow fat weight. Among 334 elderly and healthy women aged 75 and over, a significant negative correlation was found between SOS and heel width (r=-0.27; P〈0.0001). On the other hand, fat composition had no significant effect on BUA measurement, and no significant relationship was found between BUA and heel width. This study demonstrates that an increase of heel width and fat thickness provides an underestimation of os calcis SOS, but has no significant effect on BUA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296057
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  • 9
    Electronic Resource
    Electronic Resource
    Ultrasound measurements on the os calcis in a prospective multicenter study (1994)
    Springer
    Calcified tissue international 55 (1994), S. 94-99 
    Details
    ISSN: 1432-0827
    Keywords: Broadband ultrasound attenuation ; Speed-of-sound ; Stiffness index ; Interunit precision
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Ultrasonic assessment is a new approach to assess both quality and density. Two ultrasonic parameters are measured on the os calcis: the attenuation or broadband ultrasound attenuation (BUA) and the velocity or speed of sound (SOS). The interunit variations in vitro and in vivo of an ultrasound instrument, the Lunar AchillesR system, used in a French multicenter study named EPIDOS, were calculated and the stability of these intruments over a 12-month period was evaluated. A third parameter called “stiffness index”, calculated from the SOS and BUA, was also used in this study. The average CV in vitro for the BUA and SOS was 0.92% and 0.12%, respectively, and the average CV in vivo for the BUA, the SOS, and the stiffness index was 1.83%, 0.23%, and 1.9%, respectively. The interunit (or inter-machines) variations were calculated by a one-way analysis of variance. We detected small but significant measurement differences among centers on a phantom for both SOS (maximum significant difference 0.4%) and stiffness (maximum significant difference 3.5%) but not for BUA. Similar diffrences were found in vivo. The precision over 12 months of the interunit variations in vitro was evaluated by measuring a single phantom traveling from one center to another several times. The range of the CV for the BUA (1.54–0.51%), for the SOS (0.25–0.14%), and for the stiffness index (2.26–1.10%) are explained in part by technical failures. The variation among the five Achilles was estimated by the combined CV which was 1.42% for the BUA, 0.32% for the SOS, and 2.33% for the stiffness index. In conclusion, our findings indicate that equipment from one manufacturer appears to be consistent between machines for the BUA, but not completely for the SOS. The results for this stiffness index are necessarily influenced by both SOS and BUA. The shortterm and long-term interunit precision is good, both in vitro and in vivo. Such results provide increased confidence in multicenter clinical trials where ultrasonic data are pooled.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00297182
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  • 10
    Electronic Resource
    Electronic Resource
    Fractal Analysis of Bone Texture on Os Calcis Radiographs Compared with Trabecular Microarchitecture Analyzed by Histomorphometry (1998)
    Springer
    Calcified tissue international 63 (1998), S. 121-125 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Fractal analysis—Os calcis—Radiographs—Histomorphometry—Microarchitecture.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Microarchitecture of trabecular bone is an important determinant of bone fragility; to date, its evaluation requires bone biopsy with histomorphometry analysis. Methods of noninvasive characterization of trabecular bone microarchitecture are in development and we have developed and validated a bone texture analysis applied to bone radiographs and based on fractal geometry. The aim of our study was to compare this fractal analysis of trabecular bone texture on radiographs to the trabecular microarchitecture analyzed by bone histomorphometry on os calcis biopsies. Thirty eight ossa calcis from 19 human cadavers were studied. Fractal analysis of the trabecular bone of os calcis radiographs was performed by the maximum likelihood estimator following the fractional brownian motion model. The ossa calcis were dissected, then transcortical biopsy cores focused on the fractal analysis region of interest were obtained. Structural and connectivity parameters were measured with both automatic and semiautomatic analyzers. We have found a significant relationship between the fractal Hmean parameter and structural histomorphometric indices; the best correlation was found with trabecular separation (r =−0.55; P= 0.0004). Based on a stepwise regression analysis, trabecular spacing and trabeculae number together would explain 38% of the variance of the fractal parameter. Although the relationship with connectivity indices was poor, our fractal analysis of os calcis trabecular bone texture on radiographs seemed to partially reflect the trabecular bone microarchitecture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900501
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