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Biomedical subjects

J Dequeker

Publications and source records attributed to J Dequeker.

At least 181 records · Page 10Linked to original sources
PubMed1992

Opinions of patients with rheumatoid arthritis about their own functional capacity: how valid is it?

Self assessment health status questionnaires are increasingly used to measure health status or the effect of treatment in patients with rheumatoid arthritis (RA). Most of these questionnaires measure functional (physical) disabilities. The question arises, however, as to how well self assessment questionnaires reflect the true functional status of patients or whether they only reflect their imaginary functional capacities. How valid is the opinion of patients with RA about their own functional capacity? To answer this question an investigation was performed in 80 patients with RA. Forty Dutch and 40 Belgian patients with RA completed the functional items of the DUTCH-AIMS, the Dutch version of the Arthritis Impact Measurement Scales (AIMS), a self assessment questionnaire specific to arthritis. Their scores on the functional scales were compared with the scores on the same scales completed by two experienced physiotherapists after evaluation of the functional ability of these patients. This was achieved by observing the patients perform the tasks given in the questionnaire. Correlation coefficients between the scores of the patients and the physiotherapists were highly significant for all the scales. No significant differences were found between the patients' and physiotherapists' mean scale scores except for the mobility scale in the Dutch patients. The strength of agreement (Cohen's kappa) of most scale scores of the patients and physiotherapists was substantial. The estimates of the overall functional capacity (the mean of the five scale scores) of the Belgian and Dutch patients show high correlations between the patients and the physiotherapists. It is concluded that patients' opinion about their functional ability is valid in that it is in agreement with their real functional abilities. This study provides further evidence for the validity of the DUTCH-AIMS as a measure of functional disability and health status in Dutch and Belgian patients with RA.

Activities of Daily Living↗
PubMed1991

Calcium-deficient diet in ovariectomized dogs limits the effects of 17 beta-estradiol and nandrolone decanoate on bone.

Postmortem measurements by dual-photon absorptiometry of the femur and the second lumbar vertebra in adult dogs indicated bone loss after ovariectomy, which was more pronounced when calcium-deficient diet was given in ovariectomized dogs. This bone loss was nonhomogeneous throughout the femur. Ovariectomy resulted in trabecular and cortical bone loss, and additional calcium-deficient diet resulted in a further highly significant trabecular bone loss at the proximal epiphysis of the femur and in the vertebra. This bone loss was presumably the result of increased bone turnover, as reflected by the highly significant increase in serum alkaline phosphatase. Estrogens could only partially prevent the bone loss induced by calcium deficiency after ovariectomy, and nandrolone decanoate was not effective. We conclude that (1) ovariectomy results in bone loss in adult dogs, (2) this bone loss is more pronounced after calcium-deficient diet, (3) calcium deficiency could be a limiting factor for the preventive effect of estrogens and nandrolone decanoate, and (4) dual-photon absorptiometry allows the evaluation of nonhomogeneous bone loss throughout excised bones.

Absorptiometry, Photon↗
PubMed1991

Relative risk factors for osteoporotic fracture: a pilot study of the MEDOS questionnaire.

This study tested selected elements of a questionnaire devised to detect risk factors for osteoporosis in a large case-control study of hip fracture. The questions were applied to two separate studies. The first utilised a hospital sample of postmenopausal women with established vertebral osteoporosis, and responses were compared to woman with primary osteoarthritis. In a second study, the questionnaire was applied to apparently healthy women participating in a study of bone density. Significant differences between patients with osteoporosis and osteoarthritis were observed in body mass index, the prevalence of appendicular fractures, the degree of immobilisation, the age of menarche, exposure to sunlight and indices of physical activity. Significant differences were found in bone mass in healthy women divided according to the age of menarche, parity and duration of lactation. These data identify previously established risk factors for osteoporosis and suggest that the MEDOS questionnaire will provide a powerful tool for the future assessment of risk factors in osteoporosis.

Adult↗
PubMed1991

The Mediterranean Osteoporosis (MEDOS) Study questionnaire.

The Mediterranean osteoporosis study (MEDOS) questionnaire was designed by a group of specialists in bone disease from Southern Europe (MAB Group) and the WHO Collaborating Centre for the Epidemiology of Rheumatic Conditions, assisted by experts from WHO in Geneva and from the European Foundation for Osteoporosis and Bone Disease. The purpose of the questionnaire was to identify putative risk factors for hip fracture in a retrospective case control study applied during a prospective study of the incidence of hip fracture in 14 regions of Europe.

Aged↗
PubMed1991

Prevention and treatment of osteopenia in the ovariectomized rat: effect of combined therapy with estrogens, 1-alpha vitamin D, and prednisolone.

The effects of estrogens and 1-alpha were studied in young animals after ovariectomy (OVX) and/or prednisolone (PDN). These medications were given separately or in combination as preventive therapy from the start of the experiment, and as curative therapy starting 3 months later. Changes in bone mass were evaluated by single photon absorptiometry of the femur at the diaphysis (containing mostly cortical bone) and at the distal end of the femur (containing mostly trabecular bone). Radiogrammetry was performed at 50% of the length of the femur. Estrogens prevented further bone loss after OVX and OVX + PDN, given either at the beginning of the experiment or started 3 months later, except for trabecular bone loss immediately after OVX + PDN. After 1-alpha vitamin D, a highly significant increase in BMC and BMD was found in controls, in animals treated with PDN, and after OVX and OVX + PDN. The combination of 1-alpha with estrogens was less effective than 1-alpha but more effective than estrogens alone. After correction for body weight changes globally the same results were found. We conclude that (1) estrogens prevent bone changes after ovariectomy and ovariectomy + prednisolone; and (2) 1-alpha vitamin D highly significantly increased bone mass in male and female rats, and after prednisolone treatment, ovariectomy, and ovariectomy + prednisolone treatment.

Animals↗
PubMed1991

Short-term course of 1,25(OH)2D3 stimulates osteoblasts but not osteoclasts in osteoporosis and osteoarthritis.

We investigated the effect of short-term, 1,25-dihydroxyvitamin D3 therapy (4 micrograms/day for 4 days) on calcium metabolism in 27 postmenopausal women (11 cases with osteoporosis and 16 cases with osteoarthritis). Bone mass at the axial and appendicular skeleton was higher in osteoarthritis than in osteoporosis. Initial values of calcium metabolism were similar. Osteoporotic and osteoarthritic patients responded with a similar significant increase in serum osteocalcin (+61% and +54%, respectively), fasting urinary calcium excretion (+178% and +124%, respectively) and 24 hour calcium excretion (+148% and +142%, respectively). Parathyroid hormone (PTH) levels decreased significantly in both groups (-30% and -18%, respectively). Osteoclastic bone resorption, evaluated by urinary hydroxyproline excretion, was not stimulated in either group. We conclude that in osteoporosis and also in osteoarthritis (1) 1,25-dihydroxy-vitamin D3 (1,25(OH)2D3) stimulation of osteoblast function is similar in production of osteocalcin; (2) the vitamin D target tissues react adequately to 1,25(OH)2D3 stimulation; (3) short-term high dose of 1,25(OH)2D3 does not stimulate bone resorption; and (4) the differences in bone mass between osteoarthritis and osteoporosis are not related to an alteration of the responsiveness to stimulation by 1,25 (OH)2D3.

Aged↗
PubMed1991

Seasonal variation in bone metabolism in young healthy subjects.

Serum vitamin D metabolites and urinary calcium excretion; parameters of bone formation (serum alkaline phosphatase, serum osteocalcin); parameters of bone resorption (24 hour hydroxyprolinuria, 2 hour fasting urinary hydroxyproline/creatinine ratio); and parameters of cortical and trabecular bone density, parathyroid hormone (iPTH, COOH terminal assay), and serum minerals (calcium, phosphorus) were followed serially in 55 young adults (21 women and 34 men) from December 1985 until January 1987 at four different times during the year. The effect of a low-dose cyclooxygenase inhibitor (piroxicam 5 mg daily) on the same parameters of bone density and bone turnover when given from December until May, was also evaluated in this study. At the end of the treatment period parameters of bone turnover and bone density were comparable between placebo and piroxicam-treated groups. Therefore, the results of all subjects were pooled in order to investigate seasonal variation. In both sexes, seasonal variation was found not only for 250HD3 but also for 1,25(OH)2D3, serum calcium and phosphorus, urinary calcium excretion, and for bone density at the lumbar spine. Parameters of bone formation (serum osteocalcin and alkaline phosphatase), bone resorption (24 hour urinary hydroxyprolinuria and fasting urinary hydroxyproline/creatinine ratio) and PTH were influenced by this seasonal variation. We conclude that in young adults, a significant seasonal variation occurs, with low winter and high summer values, for serum 25 and 1,25(OH)2D3 for urinary calcium apparently without important influence on parameters of bone turnover or parathyroid activity and for lumbar spine density. Treatment with a low-dose cyclooxygenase inhibitor was without influence on the observed changes.

Adult↗
PubMed1991

Non-linear increase in vertebral density induced by a synthetic steroid (Org OD 14) in women with established osteoporosis.

The results of a 2-year placebo-controlled study in 38 female patients with osteoporosis are presented. This study was conducted to evaluate the efficacy of a daily oral dose of 2.5 mg Org OD 14 ((7 alpha, 17 alpha)-17-hydroxy-7-methyl-19-norpregn-5(10)-en-20-yn-3-one) in the treatment of established osteoporosis. Org OD 14 is a steroid which shows combined weak oestrogenic, androgenic and progestational activity. A total of 31 patients completed a 12-month study period (17 placebo, 14 Org OD 14) and 25 of these went on to complete the full 24-months (15 placebo, 10 Org OD 14). A significant increase in bone mineral density as measured by dual photon absorptiometry was recorded in the lumbar spine in the Org OD 14-treated patients at 8, 16 and 24 months. The gain in bone mass after 8 months averaged 4% (P less than 0.01) and after 24 months 8% (P less than 0.001). In the control group, a bone loss rate of 2% per year was recorded in the lumbar spine. No significant changes in bone density in the forearm as assessed by single photon absorptiometry were found in either group. The increase in spinal bone density in the Org OD 14 group was non-linear and followed an S-shaped upward pattern. Org OD 14, while inducing no appreciable endometrial stimulation, was found to be a bone-active compound with anti-resorbing as well as anabolic activity. Org OD 14 warrants consideration not only for the long-term prevention of bone loss but also for curative treatment of post-menopausal osteoporosis.

Absorptiometry, Photon↗
PubMed1991

Art, history, and rheumatism: the case of Erasmus of Rotterdam 1466-1536 suffering from pustulotic arthro-osteitis.

Pustulotic arthro-osteitis probably associated with retroperitoneal fibrosis has been diagnosed in Erasmus of Rotterdam, based on paintings of Quentin Massys (1517) and Hans Holbein the younger (1523), historical letters of Erasmus, and postmortem examination of the skeleton. This case report is a description of the earliest known case of pustulotic arthro-osteitis, a syndrome reported for the first time in 1967 and seen more commonly in Japan than in Europe. Works of art of many different kinds may provide an important source of evidence of disease and contribute to a better understanding of the natural history of a disease.

Europe↗
PubMed1991

Heterogeneity of growth of bone in children at the spine, radius and total skeleton.

Bone mineral content (BMC), density (BMD), and size were measured in 202 subjects ranging from 3 to 25 years of age (106 males and 96 females), half of which were children and half young adults. BMC and BMD were measured using single photon absorptiometry at the proximal and distal radius and dual photon absorptiometry at the lumbar spine and the total body. In the pre-pubertal age group (3-9 yrs), no differences were found in BMC nor BMD between males and females at any site. Growth of bone during puberty was characterized by an increase in BMC, bone size and BMD. The percent increase in BMC was greater at the lumbar spine and the total body (+200 to +390 %) than at the radius (+90 to +270 %). The increase in BMC was higher than the increase in BMD (+50 to +90 %). Overall bone growth in the total body was not reflected by changes in BMC of the appendicular skeleton. The increase in BMD was heterogeneous and was higher in the legs than in the arms. In males, the increase in BMC and size during growth was greater than in females resulting in a higher peak bone mass and size in males. The increase in BMD was similar between males and females at the distal radius, the lumbar spine and the total body, but higher at the proximal radius, the arms and the legs in males.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1991

1,25-Dihydroxyvitamin D3 stimulation test and the effect of a prostaglandin synthesis inhibitor (piroxicam) in young adults.

This study was performed to assess whether the 1,25(OH)2 vitamin D3 stimulation test for osteoblastic function is influenced by a prostaglandin synthesis inhibitor (piroxicam). Thirty-four healthy male young adults had a 1,25(OH)2 vitamin D3 (Rocaltrol) stimulation test. After a baseline day, the subjects received 2 micrograms Rocaltrol every 12 h for 4 days. Serum and urinary parameters of bone turnover were assessed before and after stimulation. The subjects were randomly allocated to placebo or piroxicam 5-, 10- and 20-mg treatment groups. After stimulation, serum and urinary calcium increased significantly, and immunoreactive PTH decreased significantly in the control group. In the piroxicam group, serum calcium, phosphate, osteocalcin and urinary calcium increased significantly, and PTH and glycosaminoglycan excretion significantly decreased. The piroxicam treatment group did not differ from controls, except for a nonsignificant minor increase in serum calcium and phosphorus after calcitriol stimulation. Since the major effect of nonsteroidal anti-inflammatory drugs is to decrease prostaglandin synthesis, these data suggest that prostaglandins do not mediate the effects of calcitriol on bone and other target tissues, because no alteration in intestinal calcium absorption, calcium-phosphorus-PTH interaction, bone turnover and renal handling of calcium and phosphorus in normal subjects was found.

Adult↗
PubMed1991

Lymphedema of the leg associated with rheumatoid arthritis.

A 14-year-old boy with a two year history of seronegative rheumatoid arthritis developed left leg lymphedema and subsequently a severe episode of lymphangitis. The diagnosis of "rheumatoid lymphedema" was confirmed by lymphscintigraphy and conventional lymphography. Treatment consisted of bedrest and antibiotic drugs. When the signs of inflammation had subsided, therapy with corticosteroids was started with improvement of both joint pain and leg swelling. Whereas lymphedema associated with rheumatoid arthritis has been described in the upper limb of adults, to our knowledge this is the first report of the coexistent condition in the lower leg of a child.

Adolescent↗
PubMed1991

Osteoarthrosis retards the development of osteoporosis. Observation of the coexistence of osteoarthrosis and osteoporosis.

The clinical, roentgenographic, and biochemical features of the dorsal and lumbar spine were reviewed in 72 postmenopausal women. Nineteen women had both osteoporosis (vertebral collapse) and osteoarthrosis. These patients were compared with 26 patients who had only osteoarthrosis of the spine and 27 who had only vertebral collapse. The patients who had both spinal osteoporosis and osteoarthrosis were older, more advanced in menopause, and physically smaller in stature and body weight than the other groups. They also had higher serum parathyroid hormone level, used nonthiazide diuretics more frequently, and had more nulliparity than the other two groups. These patients had osteoarthrosis of the hip to a lesser degree than patients affected by osteoarthrosis alone, and they had fewer fractures of the forearm and other sites than patients with osteoporosis alone. The incidence of femoral neck fractures in both groups, however, was comparable. These results suggest that osteoarthrosis or a related factor might have a protective effect on the progression of osteoporosis. These results confirm earlier observations that postmenopausal osteoporosis and osteoarthrosis are two distinct diseases and not the result of normal aging.

Aged↗