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Biomedical subjects

A G Need

Publications and source records attributed to A G Need.

At least 109 records · Page 6Linked to original sources
PubMed1985

The effect of calcium supplements on plasma alkaline phosphatase and urinary hydroxyproline in postmenopausal women.

Although calcium supplements are widely used in the treatment of osteoporosis, their beneficial effect is not conclusively established. We now report some effects of a calcium supplement (1 g/day) given for 6 to 12 weeks to 15 postmenopausal osteoporotic women. The mean fasting urinary hydroxyproline/creatinine ratio decreased from 0.021 +/- 0.002 to 0.015 +/- 0.001 (P less than 0.0025), indicating a significant reduction in bone resorption. The mean plasma alkaline phosphatase fell from 123 +/- 5 U/l to 104 +/- 3.1 U/l (P less than 0.01), probably representing some secondary reduction in bone formation following the inhibition of bone resorption. These results support the concept that calcium supplementation is useful in the treatment of postmenopausal osteoporosis.

Aged↗
PubMed1985

The relation between calcium absorption, serum dehydroepiandrosterone, and vertebral mineral density in postmenopausal women.

Vertebral mineral density, measured by computerized axial tomography, radiocalcium absorption, serum dehydroepiandrosterone (DHA), and serum cortisol (C) were measured in 98 postmenopausal women aged 56-70 yr. On the basis of spine radiographs and fracture history, the women were classified into 49 normal subjects (mean age, 60.5 yr) and 49 with osteoporosis (mean age, 63.1 yr). Vertebral mineral density (VMD), radiocalcium absorption (alpha), serum DHA, and the ratio of DHA to cortisol (DHA/C) were all significantly lower in the osteoporotic than in the normal subjects. DHA was significantly related to C in both groups but the regression was significantly flatter in the osteoporotic than in the normal subjects. Calcium absorption did not fall significantly with age in either group. In the normal group VMD, DHA, and DHA/C fell with age but VMD was not related to alpha, DHA, or DHA/C. In the osteoporotic group, VMD did not fall significantly with age but was significantly related to alpha and DHA/C. Stepwise regression analysis showed that in the normal subjects, age was the only variable significantly related to VMD (P less than 0.05). In the osteoporotic group, calcium absorption was the main determinant of VMD, with age and DHA/C contributing much less to the variance. Discriminant function analysis showed a theoretical misclassification of 45% of cases using DHA, 39% using DHA/C, 32% using alpha, and 18% when alpha and DHA or DHA/C were both taken into account. It is concluded that malabsorption of calcium is a significant risk factor for postmenopausal osteoporosis, probably because of a secondary increase in bone resorption to maintain serum calcium. The severity of the osteoporosis is directly related to the severity of the calcium malabsorption. Low serum DHA appears to represent a further risk factor, either because of its role as estrogen precursor or (possibly) because it promotes bone formation. However, the severity of the osteoporosis was not related to the serum DHA level and only weakly to the DHA/C ratio.

Aged↗
PubMed1985

1,25-Dihydroxycalciferol and calcium therapy in osteoporosis with calcium malabsorption. Dose response relationship of calcium absorption and indices of bone turnover.

We have studied some effects of small doses of 1,25-dihydroxycalciferol (calcitriol) and calcium, either combined or separately, in 45 patients with osteoporosis and malabsorption of calcium. In 24 patients on 0.25 micrograms/d of calcitriol the hourly fractional rate of radiocalcium absorption rose from 0.37 +/- 0.02 to 0.55 +/- 0.04 (p less than 0.001) and in 21 patients on 0.50 micrograms/d it rose from 0.36 +/- 0.02 to 0.69 +/- 0.05 (p less than 0.001). These responses were seen within 5 days and were not increased further at 6 weeks to 3 months. The combined therapy significantly reduced the fasting urinary hydroxyproline/creatine ratio (OHPr/Cr) and plasma alkaline phosphatase activity (ALP) in 6-12 weeks, the smaller dose of calcitriol (0.25 micrograms/d) being as effective as the larger one (0.50 micrograms/d) in this respect. Calcium alone (1 g/d) had no effect and calcitriol alone (0.25 mcg/d) had a lesser effect on both OHPr/Cr and ALP than the combined therapy. The falls in OHPr/Cr and ALP tended to be greatest in the cases with the highest initial levels but constituted only partial suppression of these variables towards the theoretical non-bone components. These results suggest that treatment with calcitriol and calcium suppresses bone resorption in osteoporosis associated with malabsorption of calcium and is more effective than calcium or calcitriol given alone.

Alkaline Phosphatase↗
PubMed1985

New approaches to the problems of osteoporosis.

Professor Urist's contributions to the understanding of osteoporosis are worthy of reevaluation at this time, when interest in the field has reached unprecedented heights. Recent advances in technology have greatly increased our understanding of osteoporosis by showing that there is no loss of bone in normal premenopausal women, and that the loss which starts at the menopause can be attributed to an increase in bone resorption. It is suggested that the primary event is a rise in plasma calcium that leads to a rise in obligatory urinary calcium loss, which in turn increases the calcium requirement. The subset of the postmenopausal population who develop fractures (particularly in the spine) show additional risk factors, which include malabsorption of calcium (which further increases bone resorption) and reduced adrenal androgen production (which may produce a fall in bone formation). The treatment of established cases requires control of bone resorption by calcium supplementation and/or hormone therapy, with the addition of calcitriol if malabsorption of calcium is present. Stimulation of bone formation is more difficult, but there is a suggestion that this may be possible with the use of anabolic steroids.

17-Ketosteroids↗
PubMed1984

Effect of calcium supplementation on urinary hydroxyproline in osteoporotic postmenopausal women.

Although calcium supplements are widely used to reduce bone resorption in osteoporosis, their beneficial effect is not conclusively established. We studied the effect of a calcium supplement (1 g/day for 8 days) in 14 postmenopausal osteoporotic women. The fasting urinary hydroxyproline/creatinine ratio decreased from 0.022 +/- 0.001 to 0.017 +/- 0.001 (p less than 0.005) indicating a significant reduction in bone resorption. Both the tubular maximum for phosphate reabsorption (1.12 +/- 0.06 to 1.34 +/- 0.07, p less than 0.005) and plasma phosphate concentration (1.04 +/- 0.04 to 1.14 +/- 0.04, p less than 0.01) increased, consistent with suppression of parathyroid hormone activity. These results support the concept that calcium supplementation is useful in the treatment of postmenopausal osteoporosis.

Aged↗
PubMed1984

Immobilization hypercalcaemia with severe bone mineral loss and hypogonadism.

Moderate hypercalcaemia occurred in a 17-year-old male who was immobilized with abdominal and right hip sepsis for 9 months after a motor vehicle accident. The hypercalcaemia was due to bone resorption, with a urine hydroxyproline:creatinine ratio of 0.203 (normal less than 0.017) and a urine calcium loss of 22.9 mmol/24 hr, associated with impaired renal function. There was radiological evidence of severe bone demineralization in the pelvis over 42 weeks. Radiocalcium absorption, using 47Ca, was decreased (0.17, normal range 0.35-1.30), renal tubular maximum for calcium reabsorption was decreased (1.61 mmol/1 glomerular filtrate, normal range 1.8-2.2), the serum parathyroid hormone concentration was in the low normal range (3.2, 3.6 u/l, normal range 2-6) and the plasma 1,25-dihydroxy-vitamin D concentration was decreased despite a normal 25-hydroxy-vitamin D concentration, indicating suppression of the parathyroid, 1,25-dihydroxy-vitamin D axis. The patient was found to be hypogonadal at 41 weeks after admission and testosterone therapy was begun, with associated improvement in mobilization and a reduction of the hypercalcaemia.

Adolescent↗
PubMed1983

Albumin I.M.V.S.: a variant detected by a Bromcresol Green dye binding method.

A unique variant of human albumin was discovered in a family following routine multiple biochemical analysis. Their sera demonstrated increased Bromcresol Green (BCG) dye binding under certain reaction conditions (excess amounts of the detergent Pegosperse in the presence of Merthiolate). This effect was also seen with a structurally similar dye, Bromcresol Purple (BCP). The variant sera also showed an altered pattern of BCG dye binding (in the presence of Merthiolate and excess Pegosperse) compared to normal sera when the temperature or the pH of the dye reagent was changed. Decreased binding of the dye 2-(4'-hydroxybenzeneazo)benzoic acid (HABA) was also noted. Similar findings were observed in six other patients over a period of 21 months. Column chromatography of the variant sera on a DEAE-Sepharose column separated the albumin into two fractions, one showing normal dye binding properties, the other showing the more extreme pattern of dye binding seen for the whole variant serum.

Autoanalysis↗
PubMed1982

Hypercalcemia associated with parenteral amino acid and dextrose infusion.

A patient receiving parenteral nutrition with an amino acid dextrose solution developed hypercalcemia which seemed related to the rate of nutrient infusion. In a retrospective study of patients receiving parenteral nutrition over a 3-month period six of 72 (8%) developed hypercalcemia. After changes in infusion rate there were corresponding changes in the serum calcium concentration. There was a significant correlation between the serum calcium concentration and the average infusion rate over the preceding four days (p = 0.012). This was even more significant (p less than 0.005) when ionized calcium was calculated to diminish the effects of calcium binding by proteins.

Adolescent↗
PubMed1980

Rifampicin associated renal dysfunction during antituberculous therapy.

Intermittent rifampicin therapy has been reported to commonly cause a flu-like illness with chills and fever sometimes associated with acute renal failure. This report describes a fourth case of partially reversible insidious renal damage associated with continuous rifampicin therapy and provides evidence that it is not the results of light chain proteinuria as previously suggested. A retrospective review of data relating to renal function in 89 tuberculous patients indicated that increased plasma urate concentration was commonly associated with ethambutol therapy.

Acute Kidney Injury↗