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Biomedical subjects

C Mautalen

Publications and source records attributed to C Mautalen.

At least 55 records · Page 3Linked to original sources

Body composition and bone mineral density in untreated and treated patients with celiac disease.

Body composition and bone mineral density (BMD) were studied by X-ray absorptiometry in 20 untreated and 12 treated women with celiac disease, as well as in 85 age-matched control women. Untreated patients had a significantly lower body weight, fat mass, lean tissue mass and BMD at the lumbar spine and total skeleton compared to controls (p < 0.001 for all parameters). Treated patients had also a significantly lower body weight (p < 0.01) fat mass (p < 0.05) and bone mineral density at lumbar spine and total skeleton (p < 0.05) compared with controls, but lean tissue mass was not diminished. However, treated patients had a significantly higher body weight, fat mass and BMD of the total skeleton compared with untreated celiac patients (p < 0.01 for all parameters). Serum alkaline phosphatase levels were increased in untreated patients but serum 250HD was normal. In conclusion, celiac disease causes a global and almost universal reduction of fat mass and BMD. The results of this cross-sectional study suggest that osteopenia does not seem to be completely restored by adequate treatment. Alteration of vitamin D metabolism was not the cause of osteopenia in the majority of patients.

Absorptiometry, Photon↗

Bone mineral density in a native population of Argentina with low calcium intake.

OBJECTIVE: To determine the bone mineral density (BMD) of a group of natives from Tafi del Valle, Argentina, to examine possible differences compared to other populations. METHODS: BMD of lumbar spine and proximal femur was evaluated by dual x-ray absorptiometry (DEXA), in volunteer natives of El Potrerillo y El Rincon (descendants of the Amaichas and Quilmes). Forty-seven women and 31 men between 20 and 80 years of age were assessed. Average daily intake of calcium, physical activity level, serum levels of 25-OH vitamin D (25-OH-D), calcium, phosphorus and alkaline phosphatase were also determined. RESULTS: Average calcium intake was 345 +/- 22.4 mg/day (mean +/- SD). The average sunlight exposure was 3.8 +/- 0.44 h. Degree of physical activity was moderate/hard (grade 4) to very hard (grade 6) in those 60 yrs of age or younger. Laboratory values were normal except for 25-OH-D levels, which were significantly greater in Tafi del Valle (26.8 ng/ml) than in Buenos Aires (20.7 ng/ml); (p < 0.05) BMD of the proximal femur of both sexes was significantly greater compared to the reference groups; Z score of the female population was femoral neck: +/- 0.64 (p < 0.05); Ward's triangle: +/- 0.64 (p < 0.001); trochanter: +/- 0.90 (p < 0.001). Among men, femoral neck: +/- 0.53 (p < 0.01); Ward's triangle: +/- 1.45 (p < 0.001); trochanter: +/- 0.95 (p < 0.001). No significant differences were observed in the lumbar spine BMD. The high physical activity required by the mountainous land of Tafi del Valle may be the cause of increased BMD at the proximal femur among these people. High values of vitamin D produced by increased sun exposure can lead to greater absorption of calcium despite low calcium intake. CONCLUSION: Greater physical activity, higher levels of vitamin D, and racial factors in the native population could explain the greater BMD seen in the proximal femur despite low calcium intake.

Absorptiometry, Photon↗

Normalization of spine densitometry.

We investigated several transformations of bone mineral content (BMC) and area density (BMD), in particular volumetric density (BMAD), to ascertain the influence on (1) body size dependence, (2) diagnostic sensitivity, and (3) precision. These transformations were examined in a group of 657 normal postmenopausal women and 327 women with osteoporotic fracture. First, expression of results as BMAD removed some of the slight dependence on body size; 21% of the variation in BMC and 15% of the variation i BMD were associated with body weight, but only 8% with BMAD. Second, the Z scores compared with those for age-matched controls for BMD and BMC were -1.85 and -1.71, respectively; the Z score for BMAD was -1.64. Third, the precision error for BMC was reduced by expressing results as BMD (1.1 versus 0.5%); BMAD degraded precision slightly (0.7%). BMD appeared to be the optimal expression for bone densitometry because it provided the best diagnostic sensitivity and lowest precision error; there was a minimal influence of body size on BMD results. This study also showed that osteoporotic women, even in the first postmenopausal decade, had low spine BMD, small vertebral area, and low body weight. Such women may be particularly at risk of crush fracture.

Absorptiometry, Photon↗

Epidemiology of hip fractures in an urban population of central Argentina.

The epidemiology of fractures of the proximal femur was studied over a 1-year period in the city of La Plata, Argentina (population 288,000, latitude 35 degrees S). One hundred and ninety-five patients (164 women and 31 men) aged 50 years or over suffered a fracture of the proximal femur. The median age was 80 years in women and 77 years in men. The incidence of hip fractures per 100,000 inhabitants aged 50 years or over was 379.4 in women and 100.9 in men (female/male ratio 3.76). The age-adjusted ratio was 2.90. In women the incidence increased from 11.3 in the sixth to 2807.3 in the ninth decade.

Age Distribution↗

Age dependence of the normal/abnormal difference of bone mineral density in osteoporotic women.

Bone mineral density (BMD) is the major factor in bone strength and in the risk of suffering osteoporotic fractures. The aim of this study was to examine the normal/abnormal difference for antero-posterior (AP) spine, lateral spine, proximal femur and total body BMD to assess if age influences discrimination at three different decades between 50 and 80 years of age. The BMD was determined in 61 control women and 60 osteoporotic women (at least one vertebral wedge fracture readily visible in the lateral X-rays of the thoracic or lumbar spine). Measurements were made by DEXA with a total body scanner. The BMD of the whole group of osteoporotic women was markedly lower than that of age-matched controls at all skeletal areas (P < 0.001) except at the arms where the difference was smaller (P < 0.02). The Z-score (the difference between osteoporotic patients and age-matched control divided by the intrapopulation S.D.) was similar (approximately -1.7) over the AP spine, femoral neck, Ward's triangle, total body and legs. It was significantly lower at the arms (-0.8, P < 0.001), lateral spine (-1.4, P < 0.01) and trochanter (-1.3, P < 0.001) compared with the Z-score of the AP spine. The analysis of the results by decades of age disclosed that the higher Z-score on the 6th and 7th decades corresponded to the AP lumbar spine (approximately -2.0). A high descrimination was also observed for the femoral neck, Ward's triangle and legs while the Z-score of the lateral lumbar spine, total body, trochanter and arms were significantly lower than that of the AP lumbar spine. However on the 8th decade the Z-score of the AP lumbar spine diminished to -1.2 and was only significantly higher than the Z-score of the arms (P < 0.01). The study showed that, in women 50-60 years of age--the period where the majority of studies are made for prevention of osteoporosis, none of the other skeletal areas were superior to the AP spine in discrimination for spinal osteoporosis. Proximal femur and legs densitometry gave lower but not significantly different Z-score than the AP spine, while the remaining areas were significantly inferior to AP spine in separating osteoporotic and normal women.

Aged↗

Serum levels of 25-hydroxyvitamin D in a year of residence on the Antarctic continent.

OBJECTIVE: Since exposure to sunlight is the main source of vitamin D in human beings and skin photosynthesis decreases markedly as the latitude increases, we studied the changes in serum 25-hydroxyvitamin D (25(OH)D) levels in young healthy men who lived in the Antarctic Continent during 1 year. DESIGN: Blood was drawn in the fasting state every 2 months from March 1990 to January 1991 to determine the serum levels of calcium, alkaline phosphatase and 25(OH)D. SUBJECTS: 19 healthy volunteers, who left Buenos Aires (34 degrees S) during the 1990 summer, arriving at the Antarctic bases at the end of January (Belgrano) and in mid-March (San Martín) and stayed there up to summer 1991. RESULTS: Serum calcium did not change significantly throughout the year. Serum alkaline phosphatase levels were not different comparing the beginning to the end of the year, but autumn and winter levels were lower (P < 0.05). At Belgrano Base the serum 25(OH)D levels (ng/ml) decreased from (mean +/- SD) 18.7 +/- 7.4 (March) to 10.0 +/- 4.3 (July) (P < 0.005) and did not recover for the rest of the year. At San Martín Base the serum 25(OH)D levels descended from 22.0 +/- 5.4 in March to 12.2 +/- 3.7 in August (P < 0.02) and did not increase even at the beginning of summer (January) except in two men with frequent outdoor activities. CONCLUSIONS: The levels of 25(OH)D of healthy men living in the Antarctic continent decreased to approximately 46% of the initial values and did not increase even at the onset of summer. Further studies should determine the effect of these changes upon calcium-regulating hormones and bone metabolism.

Adult↗

Preliminary study of multiple increasing oral doses of dimethyl-APD on bone metabolism dynamics and safety profile.

A random block study, with 50, 100, 200 and 400 mg of 3-dimethylamino-1-hydroxypropylidene-1, 1-bisphosphonate or dimethyl APD and 300, 600 and 900 mg of 3-amino-1-hydroxypropylidene-1, 1-bisphosphonate or pamidronate (APD), in daily oral doses, showed that all doses were active when assessed in patients with Paget's bone disease. Dimethyl APD administration was followed by an increase in 1.25 (HO)2D levels, an effect that must be confirmed. Neither severe side effects nor significant laboratory abnormalities were detected despite some decrease in white blood cell count seen with the higher dose of APD. Gastrointestinal tolerance of dimethyl APD was acceptable but further investigation is required.

Aged↗

Bone mineral affection in asymptomatic adult patients with celiac disease.

OBJECTIVES: Osteopenia is a well-known complication of overt celiac disease, but whether such defective bone mineralization is present among asymptomatic or silent patients is not known. Our objectives were: 1) to examine bone mineralization of a group of asymptomatic celiac patients; 2) to compare these results with those of symptomatic patients. METHODS: Bone mineral density of the spine and total skeleton by dual energy x-ray absorptiometry and serum parameters of mineral metabolism of eight recently diagnosed asymptomatic patients with celiac disease were studied. Results were compared with those obtained in 20 untreated symptomatic celiacs, 14 patients treated with gluten-free diet for a mean time of 15 yr, and 153 healthy adult subjects, matched by sex and age. RESULTS: Four and five out of eight asymptomatic patients presented with reduced mineralization of the spine and the total skeleton, respectively (> 1 SD below normal values for sex and age). Two patients presented with severe osteopenia of the spine, and the other three presented with severe osteopenia of the whole skeleton (> 2 SD below mean normal values). Osteopenia at plane bone level (total skeleton) was significantly lower when compared to healthy controls (p < 0.02). Symptomatic untreated patients had significantly more severe deterioration of bone mineralization than did asymptomatics (p < 0.05) and treated patients (p < 0.05). No difference in bone mineral density was observed between treated patients and asymptomatic celiacs. Serum levels of calcium, alkaline phosphatase, 25-OH vitamin D, and parathormone did not show conclusive abnormalities. CONCLUSIONS: Our findings provide direct evidence that reduced bone mineralization occurs in asymptomatic celiac patients before any other symptom becomes evident. Only early diagnosis and treatment of celiac disease can avoid the deterioration of the bone structure observed in all clinical status of celiac disease.

Absorptiometry, Photon↗

Chronic idiopathic hyperphosphatasia. Report of a case treated with pamidronate and a review of the literature.

We describe the case of a 38-year-old woman with 24 years of progressive skeletal deformities. Radiologic survey showed evidence of generalized skeletal involvement. She presented with secondary osteoarthritis, and her hands showed Heberden's and Bouchard's nodes. Light microscopic examination showed many reversed lines in the trabeculae and increased bone resorption and bone forming areas. On electron microscopic study there were intranuclear inclusions in the osteoclasts. To our knowledge, she is the oldest patient described in the English literature, and the first treated with (3-amino-1-hydroxypropilidene)-1,1 biphosphonate (Pamidronate). She showed a decrease in serum alkaline phosphatase, urinary hydroxyproline. Clinical variables showed good response to medication.

Adult↗

Bone mineral density in patients with cervical and trochanteric fractures of the proximal femur.

The bone mineral density (BMD) of the proximal femur, spine and radius shaft was determined in 75 women with atraumatic fractures of the proximal femur (FXf) (average age: 70.1 +/- 9.6 years) and 51 controls of similar age. Fractures were classified as either cervical (n = 36) or trochanteric (n = 39) on the basis of radiographic and surgical finding. The BMD of spine and proximal femur was determined by dual-photon absorptiometry (Lunar DP3) and the BMD of the radius shaft by single photon absorptiometry. The BMD of patients with FXf was significantly decreased over all skeletal sites compared to controls of similar age. No significant correlation was found between age and the BMD of the femoral neck in patients with FXf. Patients with trochanteric FXf were older and thinner (average: age, 72.9 +/- 9.4 years; weight, 53.1 +/- 7.8 kg) compared with patients with cervical fractures (age, 67.2 +/- 8.9 years; weight, 59.3 +/- 8.3 kg). Likewise the BMD of trochanteric FXf was lower at all measured sites: femoral neck, 0.548 +/- 0.066 g/cm2 vs 0.624 +/- 0.055 g/cm2 (P less than 0.001); L2-L4, 0.799 +/- 0.115 g/cm2 vs 0.925 +/- 0.106 g/cm2 (P less than 0.001); radius shaft, 0.454 +/- 0.057 g/cm2 vs 0.502 +/- 0.083 g/cm2 (P less than 0.05). Of the patients with trochanteric fractures 66% had concomitant vertebral fractures, while this occurred in only 28% of the patients with cervical fractures (P (Fisher) = 0.0007). In summary, females with trochanteric FXf are older, thinner, have less bone mass in all measured sites and suffer with a significantly greater frequency of vertebral fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Bone diminution of osteoporotic females at different skeletal sites.

The bone mineral density (BMD) of the radius and spine was determined by photo absorptiometry in a large number of controls (radius: n = 111; spine: n = 85; age range: 50-79 years) and osteoporotic women (radius: n = 98; spine n = 140; age range: 50-79 years) with at least one "atraumatic" vertebral compression fracture. Compared to age-matched controls, the BMD of the osteoporotic women showed the following diminutions: sixth decade: radius: -9.1%; spine: -25%; femur: -33%; seventh decade: radius: -16%; spine: -19%; femur: -23%; eighth decade: radius: -21%; spine: -20%; femur: -24%. The BMD was significantly diminished at all sites in all decades but in contrast to the radius, the difference from controls was bigger in the spine and femur in the sixth decade than in the seventh and eighth decade. In the osteoporotic women there was a significant correlation between radius BMD and age (r = -0.56; P less than 0.01) but not between spine or femoral BMD and age. The femoral neck BMD was also determined in a subset group of female controls (n = 68), patients with crush fractures of the spine without a fracture of the hip (n = 46), and in patients with fractures of the proximal femur (n = 21). There was no difference among these groups in mean age (64 +/- 7, range: 50-79 years). Patients with hip fracture and spine fracture showed bone diminution in all three regions that was significantly below controls (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

[Winter serum levels of 25-hydroxy-vitamin D in Ushuaia and Buenos Aires].

Public Health Annals recording diagnosis of nutritional rickets in patients admitted in Public Hospitals disclosed that from birth to age 14, in the period 1980-1981, the incidence was 2.7 higher in the Patagonia (latitude 39 degrees S to 55 degrees S) compared with the Pampeana Region and 8.5 higher than in the rest of the country. After informed parental consent 37 healthy children of Buenos Aires (34 degrees S) with an age of (Av +/- 1 SD) 7.0 +/- 1.2 years, 29 with an age of 13.1 +/- 1.5 years and 63 of Ushuaia (55 degrees S) with an age of 7.1 +/- 0.8 years were studied at the end of winter (August). Serum levels of 25-OH-D were as follows (mean +/- SE): Buenos Aires: 21.1 +/- 2.03 ng/ml (Average: seven years old), 19.0 +/- 1.18 ng/ml (children of thirteen years old) and Ushuaia: 9.3 +/- 0.64 ng/ml (p less than 0.001) (Fig. 2). Serum levels were below 8 ng/ml in 52% of the children in Ushuaia but only in 9% in Buenos Aires. Serum calcium and alkaline phosphatase levels were similar in the two groups but serum phosphate was higher in Ushuaia (Table 1). The calcium intake was greater in Ushuaia (811 +/- 49 mg/day) than in Buenos Aires (634 +/- 61 mg/day) and was correlated with 25-OH-D levels in children of Ushuaia (r = 0.50, p less than 0.001) but not in Buenos Aires (r = 0.08). The main source of calcium intake was vitamin D fortified milk. These results disclosed a significantly diminished level of serum 25-OH-D in Ushuaia.(ABSTRACT TRUNCATED AT 250 WORDS)

25-Hydroxyvitamin D 2↗

[Bone mineral density of the lumbar spine and proximal femur of normal females in Buenos Aires].

The bone mineral density (BMD) of the lumbar spine and proximal femur was determined in 170 and 131 respectively normal females from 20 to 79 years of age. The BMD was determined by dual photon absorptiometry with a Lunar DP3 equipment. The results per decade of age are shown on table 2. The percentage fall between the 3rd and 8th decades of age at different skeletal sites is summarized on table 3. Meanwhile the bone loss at the lumbar spine and mid-radius from a previous study was approximately 3% before the menopause, the BMD of proximal femur diminished approximately 14% over the neck and 19% at the Ward's triangle during the same period. From age 50 to 80 the average bone loss was similar at the spine and femoral neck (approximately 15%) but it was more severe at the Ward's triangle (approximately 24%). The results obtained in the Buenos Aires females were compared to the values observed in studies performed in United States and Australia using the same equipment. No differences were found among the three populations using the Bonferroni's analysis for multiple comparisons. The BMD appears to be similar in different caucasian populations when the same type of equipment is used, but the values cannot be compared with the results obtained with other equipment. A sustained diminution of the proximal femur BMD was observed from age 20 to 80, whereas over the spine a distinct difference before and after the menopause was found.

Absorptiometry, Photon↗

[Bone mineral density in climacteric. Identification of patients with risk of developing osteoporosis].

The bone mineral density (BMD) of the lumbar spine was determined by dual photon absorptiometry in 98 normal females: 26 premenopausal between 40 and 48 years of age and 72 unselected women 1 to 20 years after the onset of menopause, all of them attending the Menopause Clinic of the Hospital. The results were as follows: Premenopause 1.20 +/- 0.09; Postmenopause: 1.8 years: 1.16 +/- 0.10; 5.3 years: 1.10 +/- 0.12; 9.0 years: 1.06 +/- 0.12; 15.1 years: 1.01 +/- 0.11 g/cm2. The total bone loss during the period of observation was 16%. The cross-sectional data appears to fit an exponential curve with approximate diminution of 2.0%/year at the onset and 1%/year 10 years after the menopause. The individual values obtained in 45 females between 1 and 10 years postmenopause are plotted in Figure 2. Two patients with BMD below 0.9 g/cm2 were specially studied. One of them had asymptomatic primary hyperparathyroidism and the other overt osteoporosis with a crush fracture of a dorsal vertebra. Following the average bone loss of the group and assuming that the BMD should not fall at age 65 below the theoretical threshold for spine fractures (0.98 g/cm2) a risk curve was designed: 58% of the women were above and 42% below. This percentage is similar to the number of females who suffer osteoporotic fractures at age 70. Considering the Quetelet index (weight in kg/height in m2) the females were divided in 3 groups: above 30, between 30 and 23 and below 23.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Acute effect of the intranasal administration of salmon calcitonin in osteoporotic women.

Eleven women with primary osteoporosis (mean age, 63.1 years; range, 57-78) received in a random schema: placebo, 200 and 400 IU of salmon calcitonin nasal spray (sCT-NS) during 3 successive days. Total and ionized calcium and phosphate in serum were determined before and 5 h after calcitonin. Total hydroxyproline (THP) and creatinine excretion were measured in urine in three periods of 8 h each after calcitonin administration. The THP excretion after placebo administration showed a circadian rhythm with peak excretion during the night. This rhythm was not altered by sCT-NS administration at 8 a.m. but a sustained diminution of the THP/creatinine excretion was observed. The average decrease after 400 IU of sCT-NS was 9, 16 and 6% during the first, second and third periods of urine collection. Although the average effect of the 200 and 400 IU doses was similar, only the diminution induced by the latter dose on the 24-h period was statistically significant: placebo, 24.8 +/- 2.9; 200 IU, 20.8 +/- 2.9 (P n.s.); 400 IU, 20.1 +/- 2.2 mg/24 h (P less than 0.01). No significant changes were observed on serum except a fall provoked by the 400 IU dose upon ionized calcium (4.44 +/- 0.08 to 4.37 +/- 0.06 mg/dl; P less than 0.05). The administration of 200 or 400 IU of sCT-NS provoked a sustained but moderate decrease of bone resorption on osteoporotic females of a lesser degree than the one observed in a previous study after the parenteral administration of 100 IU.

Administration, Intranasal↗

Calcitonin is a competitive inhibitor of the hydrosmotic effect of oxytocin in toad bladder.

The effects of calcitonin (CT) on the water transfer in the toad (Bufo arenarum) urinary bladder, an epithelial barrier commonly employed as a model of the mammalian nephron, were studied. The net transmembrane water flux was measured at minute intervals, while the endogenous adenosine 3',5'-cyclic monophosphate (cAMP) levels were determined in isolated epithelial cells. It was observed that 1) CT, up to 10(-6) M, did not have any effect on water permeability. 2) Preincubation with CT, between 10(-7) and 10(-8) M, inhibited the hydrosmotic response to a supramaximal dose of oxytocin (OXT; 2 x 10(-8) M), used here as an antidiuretic hormone (ADH) analogue. This inhibition was reversible and concentration related. Nevertheless, although the magnitude of the response was reduced, its time course of evolution did not change. 3) When CT was added on the previously developed response to OXT, inhibition was also dose dependent with a time course not distinguishable from hormonal washout. 4) CT, up to 10(-6) M, did not modify the hydrosmotic response to 8-bromo cAMP, a potent analogue of the ADH second messenger. 5) CT and OXT increased the intracellular cAMP levels, but both effects were not cumulative. The increase induced by CT plus OXT was significantly lower than the one elicited by OXT alone. It is concluded that CT is a competitive inhibitor to the hydrosmotic effect of OXT in toad urinary bladder. Its action must be located prior to cAMP formation.

Animals↗