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  • 1
    Electronic Resource
    Electronic Resource
    The assessment of vertebral deformity: A method for use in population studies and clinical trials (1993)
    Springer
    Osteoporosis international 3 (1993), S. 138-147 
    Details
    ISSN: 1433-2965
    Keywords: Incidence ; Morphometry ; Prevalence ; Sensitivity ; Specificity ; Vertebral fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The absence of specific criteria for the definition of vertebral fracture has major implications for assessing the apparent prevalence and incidence of vertebral deformity. Also, little is known of the effect of using different criteria for new vertebral fractures in clinical studies. We therefore developed radiological criteria for vertebral fracture in women for assessing both the prevalence and the incidence of vertebral osteoporosis in population and in prospective studies and compared these with several other published methods. Normal ranges for vertebral shape were obtained from radiographs in 100 women aged 45–50 years. These included ranges for the ratios of anterior/posterior, central/posterior and posterior/predicted posterior vertebral heights from T4 to L5. The predicted posterior height was calculated from adjacent vertebrae. In contrast to other methods, our definition of fracture required the fulfilment of two criteria at each vertebral site, and was associated with a lower apparent prevalence of fracture in the control women due to a lower false positive rate. The prevalence and incidence of vertebral deformity using different criteria were then compared in a series of women with skeletal metastases from breast cancer in whom radiographs were obtained 6 months apart. The prevalence of vertebral deformity and the specificity for deformity varied markedly with differing criteria. Using a cut-off of 3 standard deviations the prevalence of vertebral deformity in the women with breast cancer was 46%. Using other methods, the prevalences of deformity ranged from 33% to 74%. Over a 6-month interval 25% of patients with breast cancer sustained 61 deformities using our method, of which only 8% resulted from errors in reproducibility. The number of patients sustaining new deformities was increased twofold when assessed by other methods (45%–53%), but errors of reproducibility may have accounted for 21% of the new deformities. The magnitude and distribution of these errors have important implications for the apparent therapeutic efficacy of agents in clinical trials of osteoporosis. The rapid semi-automated technique for assessing vertebral deformities on lateral spine radiographs that we have developed has a high specificity, and reduces the impact of errors of reproducibility on estimates of prevalence and incidence. The method should prove a value in assessing vertebral deformity both in population studies and in prospective clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623275
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    The variable incidence of hip fracture in Southern Europe: The MEDOS study (1994)
    Springer
    Osteoporosis international 4 (1994), S. 253-263 
    Details
    ISSN: 1433-2965
    Keywords: Doubling time ; Excess female morbidity ; Gonadal function ; Hip fracture ; Incidence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We assessed the incidence of hip fracture and ecological correlates in residents of 14 communities in six countries of Southern Europe. Hip fracture cases were recorded prospectively in defined catchment areas over a 1-year interval. A retrospective questionnaire was used to assess ecological differences between communities. During a 1-year period of observation a total of 3629 men and women over the age of 50 years were identified with hip fracture from a catchment of 3 million. In all communities the fracture rate increased exponentially with age. There were large and significant differences between centres in the doubling time for hip fracture risk with age and in crude and age-standardized rates. Greater than 4-fold and 13-fold differences in age-standardized risk were found amongst men and women respectively. The lowest rates were observed from Turkey and the highest from Seville, Crete and Porto. Fractures were significantly more frequent among women than men with the exception of three rural Turkish centres. Indeed, in rural Turkey the normal female/male ratio was reserved. Variations in incidence between regions were greater than the differences within centres between sexes, and there was a close and significant correlation between incidence rates for men and those for women in the regions studied. Excess female morbidity increased progressively from the age of 50 years but attained a plateau after the age of 80 years, suggesting a finite duration of the effect of the menopause. The retrospective questionnaire completed by 80% of cases suggested that differences in incidence between the communities studied could not be explained by differences in gonadal status in women. In both men and women cross-cultural associations were found with factors related to age or socioeconomic prosperity, the majority of which disappeared after adjustment for age. We conclude that there are marked and sizeable differences in the incidence rates of hip fracture throughout Southern Europe. The reasons for these differences are not known but affect both men and women, and are likely to be related to lifestyle or genetic factors rather than to differences in endocrine status.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623349
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The hospital burden of vertebral fracture in Europe: A study of national register sources (1997)
    Springer
    Osteoporosis international 7 (1997), S. 138-141 
    Details
    ISSN: 1433-2965
    Keywords: Hip fracture ; Osteoporosis ; Vertebral fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aims of this study were to quantify the hospital burden of vertebral fracture in Europe and to compare this with that of hip fracture. Information on hospital discharges was sought by age and sex from Ministries of Health in Europe. Discharge rates for vertebral fracture, available from 12 countries, varied by more than 4-fold between countries, which was greater than the differences between sexes. Where the discharge rate was high for vertebral fracture the incidence of hip fracture was also high. Since nearly all cases of hip fracture are hospitalized, this suggests a relationship between hip and vertebral fracture risk that is not explained by different admission policies for vertebral fracture in different European countries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623689
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Acute effects of deflazacort and prednisone on rates of mineralization and bone formation (1995)
    Springer
    Calcified tissue international 56 (1995), S. 109-112 
    Details
    ISSN: 1432-0827
    Keywords: Glucocorticoid ; Histomorphometry ; Bone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract The aims of this study were to determine (1) whether acute suppression of bone formation could be evaluated after the administration of corticosteroids in man by quantitative bone histomorphometry; and (2) whether there were significant differences between the effects of prednisone and its analog deflazacort. Thirteen patients who needed high-dose corticosteroid therapy were randomly allocated to two groups of treatment (prednisone or deflazacort). Quantitative bone histomorphometry, using the technique of triple labeling, and biochemical measurements of bone turnover were studied. There were no differences in biochemical indices of bone turnover between prednisone and deflazacort at the beginning and end of the 15 days of treatment course. During corticosteroid treatment, there were no significant changes in biochemical indices of bone turnover but a significant decline in total alkaline phosphatase (P〈0.01). Histomorphometric indices, as revealed by measurements of tetracycline interval and extent of labeling, showed no significant differences in either mineral apposition rate or bone formation rate in the two groups. We conclude that the acute glucocorticoid suppression of bone turnover by glucocorticoids is not detectable within the first 2 weeks of treatment by histomorphometric techniques. No differences in bone effects of prednisone and deflazacort were detected in this short-term study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296340
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    Paper (German National Licenses)
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