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J D Ringe

Publications and source records attributed to J D Ringe.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Osteoporosis in men. Pathogenesis and clinical classification of 254 cases].

In a prospective study, 321 consecutive male patients, aged between 16 and 86 years, referred to the Department of Medicine of the Medical Centre at Leverkusen from many parts of Germany over a three-year period with the diagnosis of osteoporosis, underwent a standardized programme of clinical investigation: 254 (79%) were found to have the condition. The programme consisted of a detailed history, physical examination, a battery of laboratory tests, X-ray examination of the skeleton and osteodensitometry. Where, as a result, underlying disease or risk factors were suspected, further tests were performed. 98 patients (39%) were found by densitometric criteria to have preclinical, 156 (61%) manifest osteoporosis with one or more vertebral body fractures. There was no significant difference regarding bone density between the preclinical and manifest cases. 76 of the 254 (30%) patients had no detectable pathogenetic factors, i. e. their osteoporosis was classified as idiopathic (mean age 51 years), while as senile osteoporosis in 16 elderly patients (mean age 78 years). The remaining 162 patients had 286 risk factors within 24 different categories. Depending on duration, intensity and combination of these risk factors, the osteoporosis was classified as primary with few risk factors or as secondary osteoporosis of single or multiple aetiology (mean age of these three groups was 51, 56 and 52 years, respectively). The most important demonstrable risk factors were (in decreasing order of frequency) glucocorticoid treatment, alcohol consumption, smoking, hypogonadism, hypercalciuria, liver disease, Crohn's disease, low calcium nutrition, hyperthyroidism, physical inactivity, stomach operation and plasmacytoma.--This study indicates that if there is evidence of significant risk factors detailed bone densitometry should be performed so that any necessary treatment can be initiated early. If there is known osteoporosis, staging and exact analysis of risk factors is a precondition for any cause-oriented treatment.

Adolescent↗
PubMed1994

[Pathogenesis of postmenopausal osteoporosis].

Low peak bone mass and increased bone loss within the process of bone remodelling are the most important determinants for the manifestation of postmenopausal osteoporosis. Both are influenced during lifetime by a large number of risk factors additively leading to a critical low bone mass. Loss of bone substance and deterioration of architecture of bone tissue lead to an increased fragility of the skeleton. In this complex interactions menopausal decrease of endogenous estrogen secretion is of special importance. Decrease of estrogen induces by effects on calcitropic hormones and different local growth factors a high bone turnover with a high rate of bone loss. The resulting slight increase of serum calcium and the consequent decrease in the secretion of parathyroid hormones and activation of vitamin D in the kidneys lead to a decreased intestinal calcium absorption. In peri- and early postmenopausal women there is a large range of different degrees of bone turnover. It is unclear however, whether there are really two distinct groups of so-called rapid and slow bone losers. It remains to clarify which intrinsic mechanisms besides the risk factors are responsible for the individually different answer of calcium and bone metabolism to estrogen deficiency, which is the same in every women.

Adult↗
PubMed1993

[Current treatment concepts in primary osteoporosis: calcitonin].

The beneficial effect of calcitonin treatment on osteoporosis is generally accepted. Analgetic potency and inhibition of osteoclasts are well documented for both the injectable and the nasally applicable hormone. Preventive and therapeutic long-term application is followed by a significant increase in bone density at different axial and peripheral sites of the skeleton both in postmenopausal and in corticoid-induced osteoporosis. According to recent data these increases run parallel to a decrease in fracture incidence. When treating patients with calcitonin, different aspects must be taken into consideration, some of which need further clinical investigation. Patients with high-turnover osteoporosis generally show a better response to therapy. Data concerning the advantages and disadvantages of different calcitonins are lacking. Most clinical studies were done with salmon calcitonin. The lowest effective dosage of subcutaneously or nasally administered hormone should be further investigated. Secondary resistance after long-term use may be avoided by intermittent administration. An optimal schedule concerning treatment and free intervals has to be determined. A schedule with three months on an three months off is at present proposed by different groups. Combination with calcium can be recommended. Continuous or cyclical combinations with other drugs are under investigations.

Calcitonin↗
PubMed1993

[The avoidance of early postmenopausal bone substance losses by transdermal estrogen substitution].

The effect of transdermal oestrogen replacement therapy on prevention of osteoporosis was investigated in a controlled randomized study of 38 healthy women (mean age 49.6 [45-54] years) in the early postmenopausal period (< or = 3 years). 19 women (hormone group) continuously used oestrogen patches with a mean daily estradiol delivery of 0.05 mg with addition of medroxyprogesterone acetate, 5 mg orally, for 14 days per month. The other 19 women (calcium group), whose baseline levels were identical, took 500 mg calcium daily. Climacteric symptoms improved significantly in the hormone group, and serum and urinary calcium levels and total serum cholesterol all declined, while the HDL cholesterol levels increased slightly. Bone density was measured by single photon absorptiometry at two points (1/3 and 1/10 of the forearm length from the distal end of the radius). After 6 and 12 months, the values at the proximal site (1/3) had risen in the hormone group by 1.1% and 0.46% and had fallen in the calcium group by 1.96% and 2.42% respectively (both P < 0.05 vs hormone group). At the distal radial site (1/10), the values increased by 2.14% and 5.3% in the same period and fell by 3.59% and 5.67% in the calcium group. The overall difference after 12 months was 11% (P < 0.01). Transdermal oestrogen appears to be as effective as oral oestrogen replacement for prevention of osteoporosis, and should help to prevent vertebral and limb fractures in the elderly.

Absorptiometry, Photon↗