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Biomedical subjects

B Ettinger

Publications and source records attributed to B Ettinger.

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

Assessment of metabolic bone diseases by quantitative computed tomography.

Advances in the radiologic sciences have permitted the development of numerous noninvasive techniques for measuring the mineral content of bone, with varying degrees of precision, accuracy, and sensitivity. The techniques of standard radiography, radiogrammetry, photodensitometry, Compton scattering, neutron activation analysis, single and dual photon absorptiometry, and quantitative computed tomography (QCT) are described and reviewed in depth. Results from previous cross-sectional and longitudinal QCT investigations are given. They then describe a current investigation in which they studied 269 subjects, including 173 normal women, 34 patients with hyperparathyroidism, 24 patients with steroid-induced osteoporosis, and 38 men with idiopathic osteoporosis. Spinal quantitative computed tomography, radiogrammetry, and single photon absorptiometry were performed, and a spinal fracture index was calculated on all patients. The authors found a disproportionate loss of spinal trabecular mineral compared to appendicular mineral in the men with idiopathic osteoporosis and the patients with steroid-induced osteoporosis. They observed roughly equivalent mineral loss in both the appendicular and axial regions in the hyperparathyroid patients. The appendicular cortical measurements correlated moderately well with each other but less well with spinal trabecular QCT. The spinal fracture index correlated well with QCT and less well with the appendicular measurements. Knowledge of appendicular cortical mineral status is important in its own right but is not a valid predictor of axial trabecular mineral status, which may be disproportionately decreased in certain diseases. Quantitative CT provides a reliable means of assessing the latter region of the skeleton, correlates well with the spinal fracture index (a semiquantitative measurement of end-organ failure), and offers the clinician a sensitive means of following the effects of therapy.

Aged↗
PubMed1982

Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy.

We assessed serially the bone mineral loss in 37 premenopausal women for 24 months after oophorectomy and determined the dose-response for conjugated estrogen therapy in preventing this loss. Spinal cancellous bone was measured by quantitative computed tomography and measurement of appendicular cortical bone by radial photon absorptiometry and metacarpal radiogrammetry. For the placebo and low-dose treatment groups, the mean annual bone mineral losses were 7% to 9% from the vertebral spongiosum and 1% to 3% from the peripheral cortex. The correlation between axial and appendicular loss was weak (r = 0.581), precluding a reliable estimate of spinal loss from peripheral measurements. For the maximal-dose group (0.6 mg/d), the mean annual bone mineral losses were less than 0.5% from the axial and appendicular sites, and were not significant. The results indicate that spinal quantitative computed tomography provides a highly sensitive measurement of bone mineral loss after oophorectomy, that bone mineral loss is five- to sevenfold greater from the spinal spongiosum than from the appendicular cortex, and that conjugated estrogen in doses of less than 0.6 mg/d are inadequate to prevent the vertebral mineral loss.

Adult↗
PubMed1982

Thyroid supplements: effect on bone mass.

Thyrotoxicosis and thyroid replacement therapy can cause osteopenia. The relative effects of such therapy and of aging, body size, menopausal status and smoking on bone mass were compared by measuring the combined cortical thickness (CCT) of the second metacarpal bone in 151 women taking thyroid hormone. Age was the single factor strongly related to CCT, with the mean CCT decreasing by 0.045 mm per year. Women who had taken estrogen replacement medications had a higher CCT measurement, while those who used thyroid hormone in a dose of at least 3 grains a day had a lower CCT. The rate of loss was reduced in those women using estrogen replacement therapy and increased in those women taking 3 grains or more of thyroid hormone. Women taking 3 grains or more of thyroid hormone should be advised that they are at higher risk for osteopenia.

Adult↗
PubMed1981

Triamterene stone: advantage of crystallographic analysis.

Microscopic crystallographic analysis of renal calculi provides clinically useful information concerning the pathogenesis of stone disease and is, therefore, superior to conventional chemical analysis of stones. The advantages of crystallography, performed at a centralized, experienced stone-analysis center, are highlighted by the recent discovery of triamterene deposits in kidney stones. Deposits of other medications and their metabolites have also been uncovered. Two case reports are presented, the clinical implications of these and related findings are discussed.

Adult↗
PubMed1980

Triamterene nephrolithiasis.

We identified triamterence in 181 renal calculi (o.4% of 50.000 calculi submitted for analysis). Triamterene formed the nucleus of the stone or was deposited with calcium oxalate or uric acid. One third of these stones were mainly or entirely triamterene, though a similar proportion had only minor amounts. A recommended dose of triamterene-hydrochlorothiazide sufficed to produce triamterene deposition in renal calculi. We estimate the annual incidence of the complication to be one per 1,500 users of triamterene-hydrochlorothiazide. Triamterene lithiasis develops particularly in persons who have had a renal stone, and they should not receive this drug.

Calcium Oxalate↗
PubMed1980

Spinal mineral loss in oophorectomized women. Determination by quantitative computed tomography.

Computed tomography (CT) provides precise anatomic localization coupled with quantitative x-ray attenuation information that can be used to determine bone mineral content. A precise and sensitive method for vertebral mineral measurement by CT is described and illustrated with results from an ongoing study of mineral loss in oophorectomized women. Spinal mineral loss measured by quantitative CT is compared with peripheral loss determined by photon absorptiometry and radiogrammetry. Vertebral cancellous bone loss was significant for the group as a whole at 12 months, while mean peripheral measurements showed no change. In two subjects in whom mineral change was significant at both sites, spinal loss was approximately five times greater than peripheral loss.

Adult↗
PubMed1979

Recurrence of nephrolithiasis. A six-year prospective study.

Retrospective studies of nephrolithiasis tend to overestimate the severity of the disease and mistakenly ascribe benefits to treatment regimens. The results of a three-year study of recurrent nephrolithiasis in three patient groups adhering to a calcium-restricted diet who were treated with phosphate therapy, placebo or diet alone are re-examined at the close of an additional three-year follow-up period. Nearly half the subjects in all groups remained free of stone for the six-year period. A reduction in the need for lithotomies occurred in all groups. The absence of renal calcification at entry into the study as well as increasing age were associated with a marked reduction in stone passage. Drug therapy should probably be avoided in older patients as well as in those who are free of renal calcifications.

Adolescent↗
PubMed1977

Medroxyprogesterone acetate for the evaluation of hypertestosteronism in hirsute women.

Twenty-three women with moderately elevated plasma testosterone levels (77 to 240 ng/dl) received 10 mg of medroxyprogesterone acetate (MPA) orally, three times daily, for 3 months or more. The testosterone levels were reduced to normal (less than 70 ng/dl) in 21 patients, suppressed partially in 1 patient, and unchanged in 1 patient. The removal of an ovarian teratoma normalized the testosterone level in the patient whose levels had failed to suppress with MPA. On therapy, the mean plasma testosterone concentration decreased 60%, apparent free testosterone decreased 31%, and dihydrotesterone decreased 34% (P less than 0.001, P = 0.05, and P = 0.01, respectively). A small decrease in the testosterone-binding capacity did not reach statistical significance. Experience with this simple trial suggests that extensive diagnostic testing may not be required in women with hirsutism and moderately elevated testosterone levels.

Adolescent↗
PubMed1976

Recurrent nephrolithiasis: natural history and effect of phosphate therapy. A double-blind controlled study.

In a double-blind controlled clinical study, 71 patients with recurrent calcium oxalate stones were divided into three treatment groups: those who received potassium acid phosphate, those who received an inert placebo, and those who received a low calcium diet only. Follow-up periods averaged 2.9 years. Although the mean urinary calcium level of the patients who received phosphate was reduced 33 per cent, their renal stone disease did not diminish. Mean urinary phosphorus increased 88 per cent with phosphate treatment but did not correlate with the decrease in urinary calcium, or with treatment success. The data did not suggest that phosphorus and its metabolites retard calcium oxalate crystallization in urine. No evidence appeared for an association of hypercalciuria with severe stone disease, or with a specific clinical or chemical response to phosphate therapy. Patients whose urinary calcium level fell more than 25 percent when dietary calcium was reduced may have excessive gastrointestinal calcium absorption, which appears to be associated with improved chemical response to phosphate therapy.

Adult↗