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  • 1
    Electronic Resource
    Electronic Resource
    Fracture protection provided by long-term estrogen treatment (1995)
    Springer
    Osteoporosis international 5 (1995), S. 23-29 
    Details
    ISSN: 1433-2965
    Keywords: Bone density ; Estrogen replacement therapy ; Hip fractures ; Osteoporosis, postmenopausal ; Spinal fractures ; Wrist fractures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of the study was to determine the incidence rate of osteoporotic fractures among elderly women who had long-term postmenopausal estrogen replacement therapy (ERT) and to compare this with the incidence rate in women who had not used estrogen. In a previous retrospective cohort study based on medical record review in 1982, we showed that long-term ERT was associated with lower incidence of wrist and vertebral fractures. We have extended our follow-up of 490 women by adding a mean 8 years to the observation period, which more than triples the number of osteoporotic fractures. At the Kaiser Permanente Medical Center, San Francisco, a large health maintenance organization, a review of computer pharmacy records from 1968 through 1971 identified 245 postmenopausal women; all had begun estrogen within 3 years of menopause and had used estrogen for at least 5 years. From the same pharmacy records, 245 age-matched postmenopausal non-users were identified. Among estrogen users, mean length of use was 17.0 years, mean follow-up after treatment was 7.3 years and mean dose of conjugated oral estrogen was 0.9 mg daily. We found statistically significant reduction in the incidence of wrist and vertebral fractures in users compared with non-users. The age-adjusted incidence ratios (95% confidence intervals for wrist fractures were 0.55 (0.32–0.92) and for vertebral fractures were 0.57 (0.41 –0.80). These results were not statistically significantly altered after adjustment for age of menopause, body mass index and smoking. It is concluded that long-term ERT confers statistically significant protection against wrist and vertebral fractures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623654
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  • 2
    Electronic Resource
    Electronic Resource
    Evaluation of adverse health outcomes associated with vertebral fractures (1991)
    Springer
    Osteoporosis international 1 (1991), S. 134-140 
    Details
    ISSN: 1433-2965
    Keywords: Osteoporosis ; Pain and disability ; Psychosocial problems ; Risk analysis ; Statistical methods ; Vertebral fractures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Little is known about the frequency or degree to which vertebral fractures cause pain and physical disability. The purpose of this investigation was to examine the advantages of risk analysis over other statistical techniques (e.g., correlation analysis) for quantifying relationships between vertebral fractures and outcomes such as pain and disability. Subjects who volunteered to participate in studies of osteoporosis were asked about pain and disability. The number and degree of vertebral deformities were assessed from radiographs. Strong associations were observed between the most severe vertebral deformities and the risk of high pain or disability scores, while weaker associations were observed for moderate deformities. There did not appear to be any association between vertebral deformity and risk of moderate levels of pain or disability. Because of the potential for bias in cross-sectional studies such as this, the magnitude of these findings must be considered tentative. We conclude that risk analysis is an appropriate method for quantifying the relationship of vertebral fractures with pain and disability, but that prospective studies are now needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01625442
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Calcium enhances the bone-sparing effects of low-dosage estrogen in postmenopausal women (1993)
    Springer
    Osteoporosis international 3 (1993), S. 157-158 
    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/BF01621894
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Kyphosis in older women and its relation to back pain, disability and osteopenia: The study of osteoporotic fractures (1994)
    Springer
    Osteoporosis international 4 (1994), S. 55-60 
    Details
    ISSN: 1433-2965
    Keywords: Aging ; Kyphosis ; Osteoporosis ; Pain measurement ; Posture ; Thoracic vertebrae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To test the hypothesis that thoracic kyphosis is associated with substantial pain, disability, and height loss, we measured thoracic curvature, using an architect's flexicurve, of 610 women aged 65–91 years who were recruited from population-based listings. We assessed study subjects for back pain, back-related disability, height loss since age 25 years, perceived state of health, and bone mineral density (BMD) at the spine, calcaneus, proximal radius, and distal radius. Compared with the rest of the cohort, the 10% of women with the most severe kyphosis had 7% –17% lower BMD (p〈0.001) and had lost an additional 2.4 cm height (p〈0.001). However, kyphotic women had no greater back pain, disability caused by back problems, or poorer health. This cross-sectional study suggests that kyphosis is associated with decreased BMD and loss of height but does not cause substantial chronic back pain, disability, or poor health in older women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02352262
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  • 5
    Electronic Resource
    Electronic Resource
    Spinal bone mineral loss in estrogen-replete, calcium-replete premenopausal women (1995)
    Springer
    Osteoporosis international 5 (1995), S. 228-233 
    Details
    ISSN: 1433-2965
    Keywords: Bone density ; Calcium ; Estrogen ; Lumbar vertebrae ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract After peak bone mass in women is attained, the benefits of increased dietary calcium or supplemental calcium are uncertain. In a longitudinal, 4-year study we have investigated the effect of calcium intake on bone mineral in a group of 41 premenopausal women, aged 38–42 years at entry. Skeletal density was measured four times during the 4-year follow-up; spinal trabecular bone density (STBD) was measured by quantitative computed tomography, and midradius bone mineral density (RBMD) was measured by single photon absorptiometry. At baseline, no differences in bone density were observed among subjects in the highest and lowest quartiles of habitual dietary intake. Overall, STBD declined −0.86±0.15% per year (p〈0.001), but RBMD did not decline. Total calcium intake (dietary calcium plus supplemental calcium) did not correlate with the rate of STBD loss. Serum estradiol level did not decrease during the study, and bone loss did not correlate with the mean estradiol level. We conclude that premenopausal women in the fifth decade lose about 1% of spinal trabecular mineral yearly, in spite of a normal serum estradiol level and ample calcium intake.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01774011
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Comparison of serum fructosamine vs glycohemoglobin as measures of glycemic control in a large diabetic population (1998)
    Springer
    Acta diabetologica 35 (1998), S. 48-51 
    Details
    ISSN: 1432-5233
    Keywords: Key words Blood glucose ; Glycosylated hemoglobin A ; Hexosamines ; Fructosamine ; Glycemic control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In diabetic patients, measurement of glycohemoglobin (HbA1c) is widely accepted as the standard method for determining long-term glycemic control. Another test, the serum fructosamine test, has been suggested as a less costly alternative. To compare these two tests, we evaluated how well each correlated with fasting blood glucose and how well each could predict the degree of glycemic control perceived by treating physicians. Among 222 diabetic subjects, fructosamine (r=0.74) and fructosamine corrected for serum albumin (c-fructosamine) (r=0.79) correlated better with fasting blood glucose than did HbA1c (r=0.68) (P〈0.05). Among 450 diabetic subjects, fructosamine, c-fructosamine, and HbA1c showed similar error rates (23%–26%) when discriminating between subjects who had either poor vs not-poor control or poor-to-fair versus good-to-excellent control. However, receiver operating characteristic curves for these tests indicated that HbA1c was the best discriminator because it showed a 9% to 10% greater area under the curve (P〈0.05).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005920050100
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