Pregnancy-associated plasma protein A (PAPP-A) was measured in 159 patients with various nontrophoblastic tumors. In three patients with trophoblastic tumors, PAPP-A and human chorionic gonadotropin (hCG) were measured before operation and weekly thereafter. Circulating levels of PAPP-A in patients with nontrophoblastic tumors were not significantly different from the levels in the matched control groups. Circulating levels of PAPP-A and hCG were significantly elevated preoperatively in patients with trophoblastic tumors, whereas the postoperative concentrations of both proteins gradually decreased. The conclusion is that, probably, PAPP-A cannot be considered to be a marker for nontrophoblastic disease, and that measurements of PAPP-A in patients with trophoblastic cancers do not provide any advantage over measurements of hCG.

Chorionic Gonadotropin↗

PubMed1982

Biochemical findings in blood of aged patients with femoral neck fractures: a contribution to the detection of occult osteomalacia.

A study was made in Geneva of 44 patients with femoral neck fractures and no risk factor of osteomalacia to determine concentrations of 25OHD3, calcium, phosphorus, alkaline phosphatase, albumin, and globulins in blood. The results were compared with those obtained for control groups of adult and aged subjects, as well as of 21 subjects operated on for hip osteoarthritis. For the detection of occult osteomalacia, femoral head bone tissue from 14 patients with fractures was examined by histomorphometric methods. In more than a third of the cases, 25OHD3 and serum albumin values were lower than those found for adult and even aged control subjects. Some slight histological signs of osteomalacia were observed in 1 patient with a femoral neck fracture, but there was no correlation between the histologic and the blood data. In practice, when dealing with aged people with no obvious risk of osteomalacia, it is important that a systematic antiosteomalacia treatment consisting of large supplements of vitamin D be avoided and that the conditions of diet and living be carefully controlled.

Adult↗

PubMed1982

Age-related blood changes in hip osteoarthritis patients: a possible indicator of bone quality.

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Adult↗

PubMed1979

[is there an osteomalacia component in femur neck fractures?].

In 29 patients with fractures of the femoral neck (group A) and 22 patients operated on for osteoarthritis of the hip (group) B), plasma levels of 25-hydroxycholecalciferol (25-OH-D3) were compared with the results of histological bone tests. A third group of 19 patients at the Geriatric hospital served as a control in this age group for 25-OH-D3 values (group C). The average level of 25-OH-D3 was 9.64 +/- 5.8 micrograms/l in group A and 13.25 +/- 7.6 micrograms/l in group B. This difference is not significant. On the other hand, the difference between groups B and C (9.31 +/- 4.04) is significant (2 p less than 0.05). Evaluation of the histological sections did not reveal evidence of osteomalacia. Generally speaking, the levels of plasma 25-OH-D3 in these patients were low, but without signs of osteomalacia on histological evaluation.

Aged↗

PubMedDate not supplied

Prognostic role of serum albumin and prealbumin levels in elderly patients at admission to a geriatric hospital.

The incidence of biological malnutrition is very high in geriatric hospitalized patients. The aim of the present study was to investigate the nutritional status of elderly patients at the time of hospital admission in an effort to identify variables which influence the outcome of hospital stay. Forty-six percent (244/552) of the admitted patients had a serum albumin level less than 35 g/l. Cancer patients had a significantly (p < 0.0001) lower serum albumin and prealbumin values than other patients. The patients, who died, had even lower albumin values as compared to the cancer patients. None of the studied nutritional and social parameters showed correlation with the length of hospital stay in any group of patients. No significant correlation could be found between age and nutritional values. No significant correlation could be established between the social parameters and nutritional variables. By using variance analysis statistically significant association was found between cancer and serum albumin (p < 0.0001) as well as between the death occurring during the hospital stay and nutritional values (p < 0.0001). By the discriminant analysis model, the mortality during hospital stay could be predicted with 78.8% certainty when the presence of cancer, the albumin and prealbumin values were known. In addition, cancer status may be suspected in the case of low nutritional values at admission in these elderly patients. Our results indicate that by the measurement of these simple parameters an accurate prediction can be achieved in the prognosis of hospitalized geriatric patients already at the time of admission.

Journal Article↗

PubMedDate not supplied

Comparative blood chemical data related to aging, femoral neck fracture and hip osteoarthrosis.

Fifteen blood parameters were studied in 73 men and 97 women divided into four groups: 66 blood donors; 36 aged subjects with various cerebral, cardiovascular or infectious illnesses; 43 patients with femoral neck fracture; 25 patients with severe hip osteoarthrosis. The parameters measured were: serum total proteins, albumin, total, alpha 1, alpha 2, beta and gamma globulins, total calcium, phosphates, alkaline phosphatase, creatinine, bilirubin, hemoglobin, 25 OHD3 and 1.25(OH)2D3. Each group differed significantly from the others, with regard to age and also to pathological conditions. Among the more discriminant variables, albumin was retained as the main parameter reflecting the nutritional status related to skeleton quality. Significantly higher albumin values were found for the hip osteoarthrosis patients (i.e., in a condition associated with well known bone solidity).

Adult↗

PubMedDate not supplied

Is a certain degree of osteomalacia involved in femoral neck fractures of the elderly? Histological approach to the problem and practical applications.

A study was made in Geneva of 14 patients with femoral neck fractures (7 subcapital and 7 trochanteric) to determine whether a certain degree of osteomalacia might be involved (group I). No patients with risks factors for osteomalacia were used. For ethical reasons, double tetracycline labelling was not possible and osteomalacia criteria were based on osteoid tissue values determined in a histomorphometric study directly on cancellous bone samples of the femoral head. A comparison was made with femoral head bone tissue taken from 12 patients with hip osteoarthritis at a distance from the remodelled territory (group II) and with iliac crest bone tissue taken from 6 patients with clinically and biochemically determined osteomalacia (group III). The patients were part of a larger group of subjects used for a biochemical blood study in which levels of albumin, calcium and 25 OHD3 as an index of vitamin D content were determined. Based on the data of the literature and the results obtained for group II, slight signs of osteomalacia were diagnosed for only one case (group I), although 25 OHD3 deficiency was found in more than a third of the subjects in that group as well as in some subjects of group II and in some of the aged controls. Skeletal aging must be considered not only in terms of unavoidable physiological factors but also within the context of living conditions. Hence the necessity of controlling calcium and vitamin D intake in the elderly, and of a histological examination for signs of osteomalacia in surgical specimens from patients with femoral neck fractures.

Aged↗