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  • 1
    Electronic Resource
    Electronic Resource
    Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women (1993)
    Springer
    Osteoporosis international 3 (1993), S. 120-126 
    Details
    ISSN: 1433-2965
    Keywords: Bone density ; Prospective studies ; Risk factors ; Vertebral fracture incidence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the ability of bone density and vertebral fractures at baseline to predict vertebral fracture incidence in a cohort of postmenopausal women with osteoporosis. The study population was 380 postmenopausal women (mean age 65 years) treated for osteoporosis in a randomized, placebo-controlled, clinical trial of the bisphosphonate etidronate at seven geographic centers in the United States. Baseline measurements of bone mineral density were obtained in 1986 by quantitative computed tomography at the spine and dual-photon absorptiometry at the lumbar spine and hip. Vertebral fractures were documented on serial spine radiographs. Proportional hazards models were used to evaluate the ability to predict the risk of subsequent fractures during an average of 2.9 years of follow-up. Presence of one or two fractures increased the rate of new vertebral fractures 7.4-fold (95% confidence interval = 1.0 to 55.9). Additional fractures at baseline further increased the fracture rate. A decrease of 2 standard deviations in spinal bone density by absorptiometry was associated with a 5.8-fold increase in fracture rate (95% confidence interval = 2.9 to 11.6). The lowest and highest quintiles of bone density had absolute fracture rates of 120 and 6 cases per 1000 patient-years, respectively. In general, the simultaneous use of two predictors (bone density and prevalent fractures or two bone density measurements) improved fracture prediction, compared with the use of a single predictor. We conclude that both bone density and prevalent vertebral fractures are strong, complementary predictors of vertebral fracture risk. The results suggest that physicians can use bone density and prevalent vertebral fractures, individually or in combination, as risk factors to identify patients at greatest risk of new fractures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623272
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  • 2
    Electronic Resource
    Electronic Resource
    Slow wave sleep and 5-HT2 receptor sensitivity in generalised anxiety disorder: a pilot study with ritanserin (1992)
    Springer
    Psychopharmacology 108 (1992), S. 387-389 
    Details
    ISSN: 1432-2072
    Keywords: Anxiety ; Slow wave sleep ; Ritanserin ; 5-HT2 receptor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eight patients with generalised anxiety disorder (GAD) and eight matched healthy controls had their polysomnogram measured on two occasions separated by 1 week. On one occasion they received the 5-HT2 receptor antagonist, ritanserin (5 mg orally) and on the other matching placebo. The increase in slow wave sleep produced by ritanserin was the same in GAD patients as in healthy controls. These findings do not support the hypothesis that GAD is associated with a generalised hypersensitivity of brain 5-HT2 receptors; however, the present data cannot exclude the presence of a regionally specific change in this receptor subtype in anxiety disorders.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02245128
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  • 3
    Electronic Resource
    Electronic Resource
    Dose-related effects of selective 5-HT2 receptor antagonists on slow wave sleep in humans (1990)
    Springer
    Psychopharmacology 101 (1990), S. 568-569 
    Details
    ISSN: 1432-2072
    Keywords: Slow wave sleep ; 5-HT2/1c receptor ; Ritanserin ; ICI 169,369 ; Home sleep recordings
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of the selective 5-HT2 receptor antagonists, ritanserin (1, 5 and 10 mg) and ICI 169,369 (50 and 100 mg), were studied on the sleep EEG of healthy volunteers using home-based Medilog 9000 cassette monitoring. Ritanserin (5 and 10 mg) produced a significant increase in slow wave sleep (SWS) while ICI 169,369 also increased SWS but only at a dose of 100 mg. These findings are consistent with the proposal that selective 5-HT2 receptor blockade increases SWS in humans; however, the data cannot exclude involvement of the closely related 5-HT1c receptor in this effect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02244239
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  • 4
    Electronic Resource
    Electronic Resource
    The effect of antidiuretic hormone on the distribution of nephron filtration rates in rats with hereditary diabetes insipidus (1971)
    Springer
    Pflügers Archiv 330 (1971), S. 323-334 
    Details
    ISSN: 1432-2013
    Keywords: Nephron Filtration Rate ; Antidiuretic Hormone ; Diabetes Insipidus Rats ; Ferrocyanide Method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of antidiuretic hormone on the distribution of nephron filtration rates was studied in rats with hereditary diabetes insipidus using the Hanssen method for determination of nephron filtration rates as modified by de Rouffignacet al. [18]. Conversion of water diuresis to antidiuresis by infusion of ADH resulted in a moderate, but highly significant increase in the filtration rate of the juxtamedullary nephrons, while the nephrons of all other cortex regions filtered at an unaltered rate. A mechanism based on the action of ADH on distal nephron water permeability is proposed as an explanation: water inflow into the medulla very likely decreases when water diuresis is converted to antidiuresis. This occasions a rise in medullary osmolality which then causes an increase in the apparent viscosity of the blood flowing through the vasa recta. This is responsible for a rise in juxtamedullary postglomerular resistance which results in an increase in the effective filtration pressure and thus in the juxtamedullary nephron filtration rate. The results suggest that an increased juxtamedullary filtration rate participates in the establishment and maintenance of the inner medullary solute gradients, possibly as a consequence of an increased solute delivery to the ascending limbs of the long loops of Henle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588584
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  • 5
    Electronic Resource
    Electronic Resource
    The effect of experimental alterations in urine concentration on nephron filtration rate (1973)
    Springer
    Pflügers Archiv 344 (1973), S. 69-74 
    Details
    ISSN: 1432-2013
    Keywords: Nephron Filtration Rate ; Ferrocyanide Method ; Redistribution of GFR ; Urine Osmolarity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Experiments were performed to clarify the cause of the dependency of juxtamedullary nephron filtration rate (JN-GFR) on the diuretic state of the animal. Using the ferrocyanide technique of de Rouffignacet. al. [5] the distribution of nephron filtration rates was determined during selective modification of final urine osmolarity by papillary superfusion with concentrated or isotonic solutions. Papillary superfusion with a 2000 mosmolar solution led to a mean urine osmolarity of 1848±78 mOsm/l. JN-GFR displayed a mean increase of 66.6% over the superficial nephron filtration rate (SN-GFR). When the superfusion fluid was isotonic urine osmolarity averaged 754±53 mOsm/l and JN-GFR increased by a mean of only 26.3% over the SN-GFR. Using the micropuncture technique it was shown that SN-GFR in a given animal was not altered when the superfusion fluid was interchanged. We conclude therefore that the change in the percentage increase in GFR from superficial to juxtamedullary nephrons is caused by a change of juxtamedullary nephron filtration rate. Since plasma ADH concentration was not altered this effect appears to be elicited by the changed medullary solute concentration rather than by a vasomotor action of the antidiuretic hormone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00587442
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  • 6
    Electronic Resource
    Electronic Resource
    Relationship between salt loading and distribution of nephron filtration rates in the dog (1974)
    Springer
    Pflügers Archiv 350 (1974), S. 259-272 
    Details
    ISSN: 1432-2013
    Keywords: Dog Kidney ; Saline Infusion ; Nephron Filtration Rate ; Filtrate Distribution ; Ferrocyanide Method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The intrarenal distribution of nephron filtration rate (N-GFR) was assessed using the Hanssen ferrocyanide technique in dogs which were chronically salt loaded with or without an additional acute sodium load and in sodium depleted dogs. In 4 dogs fed 7–10 days on a high sodium diet, superficial nephron filtration rate (SN-GFR) was 56.7±13.1 nl/min, middle nephron filtration rate (MN-GFR) was 65.2±14.3 nl/min, and the juxtamedullary nephron filtration rate (JN-GFR) was 82.4±17.1 nl/min, a value 52.3% higher than the SN-GFR. Creatinine clearance in these animals averaged 22.0±3.9 ml/min. In 4 animals which received an additional infusion of 0.9% NaCl at 4.0–4.5 ml/min for 2.5 h, the mean creatinine clearance rose from 16.6±2.0 ml/min to 20.3±0.7 ml/min and the distribution of N-GFR was: SN-GFR 70.5±21.2 nl/min, MN-GFR 83.6±23.8 nl/min and JN-GFR 91.2±24.3 nl/min. In this case, the JN-GFR was 29.3% higher than the SN-GFR. In one sodium depleted dog, (creatinine clearance 15.7 ml/min) the distribution of N-GFR was: SN-GFR 41.1±10.5 nl/min, MN-GFR 48.0±16.5 nl/min, and JN-GFR 58.0±19.0 nl/min, a value exceeding SN-GFR by 41.1%. These results imply that acute saline infusion in dogs induces a proportionately greater change in GFR of superficial than of juxtamedullary nephrons.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00587805
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  • 7
    Electronic Resource
    Electronic Resource
    Spine fracture risk is predicted by non-spine fractures (1994)
    Springer
    Osteoporosis international 4 (1994), S. 1-5 
    Details
    ISSN: 1433-2965
    Keywords: Bone mass ; Bone density ; Fracture incidence ; Fracture prevalence ; Longitudinal studies ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective cohort study of 1098 postmenopausal Japanese-American women evaluated the relationship between baseline non-spine fractures and new (incident) spine fractures. At the baseline examination in 1981, prevalent non-spine fractures were ascertained by interview, and prevalent spine fractures by radiograph. Bone mass measurements of the distal radius, proximal radius, calcaneus (1981), the lumbar spine (1984) were obtained and repeated at 1- to 2-year intervals. Women with existing non-spine fractures have a threefold greater risk of subsequent spine fractures, independent of bone mass, and independent of the known association between prevalent spine fractures and subsequent spine fractures. Women with both a prevalent non-spine fracture and low bone mass (50th percentile or lower) have an eightfold greater risk of new spine fractures compared with women above the 50th percentile of bone mass and no prevalent fractures. In addition to low bone mass, both prevalent spine fractures and prevalent non-spine fractures are strong risk factors for subsequent spine fracture. These data suggest that not all osteoporotic risk factors are expressed via bone mass, and that other, unmeasured risk factors, such as bone quality defects, may explain these results. In clinical terms, women with both prevalent fractures and low bone mass should be recognized as being at extremely high risk, and treatment potency should be commensurate with this level of risk.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02352253
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