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  • 1
    Electronic Resource
    Electronic Resource
    Influence of Inflammation-Mediated Osteopenia on the Regional Acceleratory Phenomenon and the Systemic Acceleratory Phenomenon During Healing of a Bone Defect in the Rat (1998)
    Springer
    Calcified tissue international 63 (1998), S. 160-166 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Regional acceleratory phenomenon — Systemic acceleratory phenomenon — Inflammation-mediated osteopenia — Bone healing — Woven bone.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. We have previously shown that restoration of a local bone defect in the rat not only leads to a regional acceleratory phenomenon (RAP), but also to a systemic acceleration of osteogenesis (SAP) at distant sites of the skeleton. In this study, we investigated whether specific inhibition of osteoblasts would affect the local RAP and the systemic acceleratory phenomenon (SAP) healing sites. Systemic inhibition of osteoblasts was induced by inflammation-mediated osteopenia (IMO), a nonspecific type of inflammation initiated by S.C. injections of sterile talc. A drill hole defect 1.2 mm in diameter was performed at the midshaft of the left tibia of female rats. On day 7, during the formation phase of the local healing process, IMO did not influence the number of osteoblasts or the bone volume in the marrow cavity of the local healing site, whereas it did lead to a significant reduction of osteoblast number and bone volume at the systemic site (subepiphyseal spongiosa of the tibia). By contrast, on days 14 and 21, during the resorption phase of bone healing, IMO led to a significant reduction in both osteoblast number and bone volume in the marrow cavity of the local healing site. At the same time, however, it did not influence the cortical area of the bone defect where newly formed bone is needed to ensure mechanical stability. In summary, our model of bone healing reveals that a humoral noxious osteoblast stimulus such as IMO is able to inhibit systemically osteoblasts stimulated by SAP, whereas it is not able to inhibit osteoblasts either from producing woven bone during a RAP or from producing bone that is needed to mechanically stabilize a defect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900508
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  • 2
    Electronic Resource
    Electronic Resource
    Comparison of a semiquantitative and a quantitative method for assessing vertebral fractures in osteoporosis (1994)
    Springer
    Osteoporosis international 4 (1994), S. 154-161 
    Details
    ISSN: 1433-2965
    Keywords: Deformity Index ; Fracture assessment ; Osteoporosis ; Osteoporosis progression ; Spine ; Vertebra
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There is no agreed definition for the assessment of vertebral fractures and deformities in patients with osteoporosis. Radiographs of 66 patients randomized for therapy with etidronate or placebo were analyzed at baseline and during follow-up (60/120/150 weeks) independently using two procedures. The first method of spinal deformity index (SDIG) and vertebral deformity score (VDSG) is based on a semiquantitative visual reading of each vertebra between T4 and L4. The second method of spine deformity index (SDIM) and vertebral deformity index (VDIM) is based on vertebral height measurements of T4 through L5 and each measurement from T5 to L5 (anterior, middle and posterior height) is related to T4 and compared with the respective T4-related normal range. There was good agreement between the mean vertebral deformation from T5 to L4 graded by VDSG and VDIM, with correlation coefficients betweenR=0.52 (p〈0.0001) andR=0.9 (p〈0.0001) respectively. Spinal deformation at baseline as measured by SDIM and SDIG was correlated withR=0.76 (p〈0.0001). For diagnosing a vertebra as fractured or not, VDIM reached a sensitivity of 82% and a specificity of 85% using VDSG as a standard, and on the other hand VDSG reached a sensitivity of 78% and a specificity of 88% in relation to VDIM. The changes in spinal deformation from week 0 to 150 were correlated withR=0.58 (p〈0.0002) between SDIM and SDIG. To detect vertebral fracture progression the sensitivity of VDIM was 74% and the specificity 86%, when changes in VDSG were used as a standard. On the other hand sensitivity for VDSG was 56% and specificity 95% to detect vertebral fracture progression, when changes in VDIM were used as a standard. The comparison of changes in spinal deformation in the etidronate and placebo group during the 3-year study demonstrated that changes in SDIM during follow-up confirmed the results found by the changes in SDIG. As an independent standard for vertebral deformity and fracture definition is not available, the present study does not allow a decision as to whether semiquantitative reading (SDIG) or vertebral height measurements (SDIM) are closer to the biological truth. We conclude that in clinical studies the assessment of vertebral fractures or deformations should be validated by the comparison between two different established techniques, performed independently.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623062
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  • 3
    Electronic Resource
    Electronic Resource
    Reduced Pulmonary Function in Patients with Spinal Osteoporotic Fractures (1998)
    Springer
    Osteoporosis international 8 (1998), S. 261-267 
    Details
    ISSN: 1433-2965
    Keywords: Key words:: Osteoporosis – Pulmonary function, Quality of life – Vertebral fractures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Vertebral deformation in spinal osteoporosis results in spinal and thoracic deformation, causing pain, disability and an overall decrease in quality of life. We sought to determine whether thoracic spinal deformation may lead to impaired pulmonary function. We studied expiratory relaxed vital capacity (VC) and forced expiratory volume in 1 s (FEV1) in 34 patients with spinal osteoporotic fractures and 51 patients with chronic low back pain (CLBP) due to reasons other than osteoporosis. Measurements of pulmonary function tests were calculated as a percentage of the normal range adjusting for age, sex, and height using the equations for normal values of the EKGS (Europäische Gesellschaft für Kohle und Stahl). Severity of osteoporosis was determined by calculation of the spine deformity index (SDI-total and SDI-anterior) on lateral radiographs of the spine and clinical measures of body stature (height reduction, distance from lowest ribs to iliac crest and distance from the occiput to the wall). Patients with osteoporosis had a lower vital capacity (%VC of the reference value) than patients with CLBP. The differences were more prominent (p〈0.05) when the previous body height, at age 25 years, was used as reference for calculation of VC (mean ± SD: 93.6%± 15.3% in patients with osteoporosis v 105.6%± 15.1% in patients with CLBP). FEV1 was significantly (p〈0.05) lower in patients with osteoporosis when previous body height was considered, in comparison with patients with CLBP (mean ± SD: 85.0%± 14.2% in patients with osteoporosis v 92.4%± 13.6% in patients with CLBP). In patients with osteoporosis VC (standardized on previous body height) was significantly negatively correlated with SDI-anterior (r=–0.4, p〈0.03). Furthermore, VC standardized on previous body height showed a weak but significant negative correlation with some clinical measures of osteoporosis (height reduction vs %VC: r=–0.34, p〈0.05; distance from the lowest ribs to iliac crest vs %VC: r= 0.35, p〈0.04). In conclusion, we found that pulmonary function is significantly diminished in patients with spinal osteoporotic fractures as compared with CLBP patients without evidence of manifest osteoporosis. Reduction of pulmonary function is correlated significantly with clinical and radiological measures of severity of spinal deformation due to osteoporotic fractures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050063
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  • 4
    Electronic Resource
    Electronic Resource
    Time since Vertebral Fracture: An Important Variable Concerning Quality of Life in Patients with Postmenopausal Osteoporosis (1999)
    Springer
    Osteoporosis international 10 (1999), S. 26-33 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Pain – Postmenopausal osteoporosis – Quality of life – Rehabilitative care – Vertebral fractures – Well-being
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The aim of the study was to identify factors affecting patients with postmenopausal osteoporosis who had experienced one or more vertebral fractures. The overall hypothesis was that time after fracture would influence patients’ perception of pain and well-being. The sample (50 patients) was split into two groups (group A, time after fracture ≤24 months; group B, time after fracture 〉24 months). A fracture was defined as a vertebral height reduction of more than 20% or at least 4 mm. The assessment was carried out using the Spine Deformity Index and was confirmed by an experienced radiologist. To assess quality of life (QoL) the following measures were used: ‘well-being scale’ including social extroversion as a subscale, pain scale, and limitations in everyday life. The Sense of Coherence questionnaire developed by Antonovsky measures the ability of a person to see life meaningful, manageable and explicable. This questionnaire may reflect patients’ coping abilities and was introduced to establish whether these influence the perception of pain and well-being after vertebral fracture. Variance and covariance analysis was carried out using SPSS (version 6.1). Differences between groups A and B were found for perception of average pain (p = 0.017), social extroversion (p = 0.003) and well-being (p = 0.024). No differences were found for limitations in everyday life (p = 0.607), Sense of Coherence (p = 0.638), the Spine Deformity Index (p = 0.171) and loss of height (p = 0.619). All analyses were corrected for age. Concurrent medication was not found to influence the results. Findings suggest that time after fracture is an important variable when considering QoL and well-being after vertebral fracture and should, therefore, be considered in future studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050190
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  • 5
    Electronic Resource
    Electronic Resource
    Randomized Trial of the Effects of Risedronate on Vertebral Fractures in Women with Established Postmenopausal Osteoporosis (2000)
    Springer
    Osteoporosis international 11 (2000), S. 83-91 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bisphosphonates – Bone mineral density – Osteoporosis – Postmenopausal women – Risedronate – Vertebral fracture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The purpose of this randomized, double-masked, placebo-controlled study was to determine the efficacy and safety of risedronate in the prevention of vertebral fractures in postmenopausal women with established osteoporosis. The study was conducted at 80 study centers in Europe and Australia. Postmenopausal women (n= 1226) with two or more prevalent vertebral fractures received risedronate 2.5 or 5 mg/day or placebo; all subjects also received elemental calcium 1000 mg/day, and up to 500 IU/day vitamin D if baseline levels were low. The study duration was 3 years; however, the 2.5 mg group was discontinued by protocol amendment after 2 years. Lateral spinal radiographs were taken annually for assessment of vertebral fractures, and bone mineral density was measured by dual-energy X-ray absorptiometry at 6-month intervals. Risedronate 5 mg reduced the risk of new vertebral fractures by 49% over 3 years compared with control (p〈0.001). A significant reduction of 61% was seen within the first year (p= 0.001). The fracture reduction with risedronate 2.5 mg was similar to that in the 5 mg group over 2 years. The risk of nonvertebral fractures was reduced by 33% compared with control over 3 years (p= 0.06). Risedronate significantly increased bone mineral density at the spine and hip within 6 months. The adverse-event profile of risedronate, including gastrointestinal adverse events, was similar to that of control. Risedronate 5 mg provides effective and well-tolerated therapy for severe postmenopausal osteoporosis, reducing the incidence of vertebral fractures and improving bone density in women with established disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050010
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  • 6
    Electronic Resource
    Electronic Resource
    Superior local tolerability of human versus salmon calcitonin preparations in young healthy volunteers (1991)
    Springer
    European journal of clinical pharmacology 41 (1991), S. 211-215 
    Details
    ISSN: 1432-1041
    Keywords: Hypocalcaemic effects ; human calcitonin ; salmon calcitonin ; tolerability ; adverse reactions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Possible local and systemic adverse effects following administration of salmon (sCT) and human (hCT) calcitonin (CT) have been evaluated in a double-blind, within-subject, comparative trial in 30 young, healthy volunteers. Each subject received 0.25 and 0.5 mg hCT and 100 IU sCT s.c.. Adverse effects and hypocalcaemia were recorded 1, 3 and 6 h after each injection. Significantly fewer local adverse reactions were observed after hCT (20 or 33%) than after sCT (80%), possibly due to the different vehicles employed (mannitol solution and acetic acid). The most frequent systemic adverse effects were gastrointestinal (nausea, vomiting), which occurred in 80% after 1 h, independently of the CT — preparation used. Hypocalcaemic changes were generally small and lasted longer after sCT. It is concluded that the hCT preparations were better tolerated locally than sCT in young, healthy volunteers, and that there were no differences in the systemic side effects or hypocalcaemic activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00315432
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  • 7
    Electronic Resource
    Electronic Resource
    The dexamethasone suppression test and thyroid stimulating hormone response to TRH in RDC schizoaffective patients (1984)
    Springer
    European archives of psychiatry and clinical neuroscience 234 (1984), S. 264-267 
    Details
    ISSN: 1433-8491
    Keywords: RDC schizoaffective disorder ; Dexamethasone suppression test ; Thyrotrophin releasing hormone test ; DSM-III
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The dexamethasone suppression test (DST) brought to light significantly more non-suppression of cortisol secretion in RDC schizoaffectives of the depressed (89%) and of the manic type (67%) than in RDC schizophrenia (25%). However, only in the RDC endogenous depressives, whose pathological DST rate was 57%, was the thyroid stimulating hormone (TSH) response to thyrotrophin releasing hormone (TRH) found to be significantly “blunted”. It is suggested that the DST results can be interpreted as partially validating DSM-III's wide major affective disorder since this concept also encompasses all cases with mood-incongruent psychotic features. Furthermore, it is hypothesized that the coupling of DST non-suppression and TSH “blunting” may be important for defining a valid depressive subgroup within these extended clinical boundaries for affective illness.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00381358
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