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Biomedical subjects

A B Grey

Publications and source records attributed to A B Grey.

23 records · Page 2Linked to original sources
PubMed1994

Continuous combined oestrogen/progestin therapy is well tolerated and increases bone density at the hip and spine in post-menopausal osteoporosis.

OBJECTIVES: Although oestrogen/progestin therapy is effective prophylaxis against post-menopausal osteoporosis, its efficacy in the treatment of established disease is uncertain. In addition, cyclical oestrogen/progestin regimens are associated with low rates of patient acceptance. The present study assesses the acceptability of, and skeletal response to, continuous combined hormone replacement therapy in osteoporotic late post-menopausal women. DESIGN: Retrospective, controlled study. PATIENTS: One hundred and four osteoporotic late postmenopausal women treated with continuous combined hormone replacement therapy (5 mg medroxyprogesterone acetate daily and either 0.625 mg oral conjugated oestrogens for 50 micrograms transdermal oestradiol daily) were followed for an average of 1 year (range 2-38 months). Control subjects were 19 healthy normal women matched for menopausal age and weight. MEASUREMENTS: Adverse effects and compliance rate were monitored. Baseline and 1-year measurements of lumbar spine bone mineral density (BMD) were performed using dual-energy X-ray absorptiometry in 51 women, 22 of whom also had measurements at 2 years. Twenty-eight women had proximal femur scans at baseline and 1 year. RESULTS: Eighty-six per cent of women continued to take continuous combined hormone replacement therapy at the end of follow-up. Mastalgia (44%) and vaginal bleeding (29%), the most common side-effects, were minor and self-limiting in virtually all women. Spinal BMD increased by 7.1 +/- 0.8% (mean +/- SEM P < 0.001) at 1 year and by 8.9 +/- 1.5% (P < 0.001) at 2 years. In the proximal femur, BMD increased by 2.9 +/- 0.9% at the femoral neck (P = 0.01) and by 2.5 +/- 0.9% (P = 0.001) at the trochanter at 1 year. BMD tended to decline in the control group. Among the women taking hormone replacement therapy, the increase in spinal BMD was similar in those treated with 0.3-0.44 mg/day of conjugated equine oestrogens to those receiving 0.45-0.625 mg/day. CONCLUSION: Continuous combined hormone replacement therapy is an acceptable therapy to osteoporotic late post-menopausal women and produces substantial increases in lumbar spine and proximal femoral bone mineral density.

Adult↗
PubMed1993

Corticosteroid osteoporosis.

Glucocorticoids produce osteoporosis via a number of mechanisms, the most important of which is probably inhibition of bone formation. This results in reduction in bone mass of 10-20% at commonly assessed sites, but the bone loss is 30-40% when predominantly trabecular bone is measured. The dosage and duration of steroid treatment influence the extent of bone loss, but other factors are not predictive. At the present time, a patient who has demonstrable sex hormone deficiency should receive appropriate replacement therapy. Optimization of calcium intake is advisable. If bone loss is severe or continues in spite of these measures, the addition of a bisphosphonate, calcitonin, fluoride or a vitamin D metabolite may be appropriate, according to local availability. Thiazide diuretics can be combined with all of these regimens. If combined with vitamin D or its metabolites, careful monitoring of serum calcium levels should be undertaken. Bone density should be monitored annually until such time as it is stable.

Adrenal Cortex Hormones↗
PubMed1993

Bone mineral density and body composition in adult patients with cystic fibrosis.

BACKGROUND: Cystic fibrosis is a multisystem disease characterised by chronic pulmonary sepsis and malnutrition. To ascertain whether osteoporosis is a feature of cystic fibrosis in adult patients, total body and regional bone mineral density (BMD) was measured in a group of eight men and eight women aged 17-42 years. METHODS: Total body and regional BMD (lumbar spine L2-L4, femoral neck, trochanteric, and Ward's triangle), as well as total body fat and lean mass, were measured by dual energy x ray absorptiometry. A range of biochemical, lifestyle, and anthropometric variables was also assessed. RESULTS: Patients with cystic fibrosis had significantly reduced bone density at all sites compared with normal young adults. The mean reductions ranged from 7% at Ward's triangle to 13% at the trochanter. Body mass index (BMI) was positively correlated with BMD at four sites and disease severity negatively correlated with BMD at two sites. Other biochemical and anthropometric variables were not predictive of bone density. Total body fat mass was reduced by 30% compared with normal young adults. CONCLUSIONS: Bone density is decreased in adult patients with cystic fibrosis and BMI and disease severity are independent predictors of bone density.

Adolescent↗
PubMed1991

Cure of Salmonella hadar endovascular infection with medical therapy.

Endovascular infection due to salmonellae is an uncommon condition with an extremely poor prognosis. We describe a patient with endovascular infection due to Salmonella hadar who was cured by prolonged medical treatment with third generation cephalosporin and fluoroquinolone antibiotics.

Cephalosporins↗