Actinic prurigo.
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Biomedical subjects
Publications and source records attributed to E Vega.
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Since osteoporotic fractures are mainly related to the diminution of the bone mineral density (BMD), the effect of pamidronate (3-amino-1-hydroxy-propylidene) 1,1-bisphosphonate on the BMD of the spine, proximal femur and radius shaft was evaluated in an initial cohort of 35 postmenopausal women with at least one vertebral fracture due to involutional osteoporosis. Pamidronate was given continuously during 18 months in a daily oral dose of 4.8 to 6.0 mg/kg supplemented with calcium (1 g/day). BMD--measured by dual photon absorptiometry--increased after one year 5.3 +/- 1.0% (P less than 0.001) in lumbar spine and 5.3 +/- 1.5% (P less than 0.001) over trochanter. However no significant changes were observed in the BMD of the femoral neck, Ward's triangle or in the cortical bone of the radius shaft measured by single photon absorptiometry. Pamidronate also decreased significantly urinary hydroxyproline-creatinine excretion after 6 months and thereafter maintained a plateau. After 18 months of treatment the diminution was 42.6 +/- 4.9% (P less than 0.001). The differing effects of pamidronate on the BMD of lumbar spine and proximal femur might be ascribed to dissimilarities between the proportions of trabecular and cortical bone in these. These results suggest that pamidronate may be prescribed to prevent fractures in cases of involutional osteoporosis with a significant decrease of BMD in lumbar spine and/or trochanter.
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)
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)
We report the clinical characteristics and course of 38 children with fulminant liver failure. A viral etiology was demonstrated in 19 patients out of 25 with serologic screening (virus A in 17 patients, B in 2 patients). One patient had toxic liver damage from ingestion of a caustic substance. Mean age was 4 years and 6 months. Jaundice was present in all but 2 patients at admission. Encephalopathy developed at a mean of 13 days and 17 children were admitted with stage 3 or 4 coma. Evidence of severe liver failure was present in every patient. A lower prothrombin time and higher bilirrubin concentration were shown by non survivors. Hypoglycemia developed in 37% of patients, seizures in 37%, gastrointestinal bleeding in 45%, respiratory failure in 32% and severe infection in 32%. Overall mortality rate was 42% raising to 83% in patients with stage 3 coma at admission. Thus, although the etiology of fulminant liver failure differs in children as compared to adults, mortality rate and complications are similar.
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.
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)
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.
We studied the effect of the intravenous administration of the bisphosphonate APD in 9 patients with Paget's bone disease. The medication was given in a daily dose of 25 mg for 7 days in 0.9% saline infusion over 2 hours. At the end of treatment a significant fall of serum calcium and phosphate was observed. The urinary excretion of calcium decreased markedly and the serum levels of the mid-molecule PTH fragment increased from (mean +/- SE) 85 +/- 11 to 122 +/- 16 pg/ml (p less than 0.05). A marked and rapid decline in the hydroxyprolinuria was observed from 297 +/- 61 mg/24 h to 194 +/- 51 mg/24 h (p less than 0.01); meanwhile the serum alkaline phosphatase decreased from 102 +/- 22 to 84 +/- 21 KAU (p less than 0.05). The effect of ADP on suppression of hydroxyprolinuria varied markedly from +1 to -81% and was negatively related to the basal hydroxyprolinuria (r = -0.90; p less than 0.001). The duration of the bone turnover suppression was short. A relapse greater than 30% in hydroxyprolinuria was observed in 6 of 8 patients 2 to 3 months after APD withdrawal. The short-term intravenous administration of ADP is a useful means to rapidly suppress the activity of Paget's bone disease. However, further studies should determine the optimum dose, the length of treatment, and the need to associate oral therapy to induce a prolonged remission.
On 7 patients with mild-to-moderately active Paget's disease, 200 IU of salmon calcitonin (SCT) nasal spray (NS), induced a significant decrease of the total urinary hydroxyproline excretion (THP) during the 8-16 hour and the 0-24 hour (P less than 0.05) periods after treatment as compared to control day. However, the administration of 100 IU of SCT intramuscularly (i.m.) caused a significantly greater effect than 200 IU-NS during the second 8 hour period after its administration (P less than 0.01) and on the over-all 24 hour effect (P less than 0.05). On 3 patients with severe Paget's disease, SCT-NS was essentially ineffective whereas the injection of SCT induced a marked diminution of the THP excretion.
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