[Paget's disease--diagnostic and therapeutic aspects].
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Biomedical subjects
Publications and source records attributed to J Menczel.
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Acetaminophen levels were determined in 1,176 sera separated from donated blood. The analysis was performed by both a colorimetric method and by high performance liquid chromatography. 6.12% of the samples contained acetaminophen levels ranging from 18 to 58 microgram/ml. The possible clinical significance of such a high incidence of this drug among healthy blood donors is discussed.
Salicylate concentrations in 3819 sera of apparently healthy voluntary blood donors were determined in view of the significance of this drug in the induction of allergic reactions and its possible interference in platelet function. Two hundred and ninety-five sera were found by a modified colorimetric determination to contain salicylates. The colorimetric determination was compared with a high performance liquid chromatography (HPLC) analysis of salicylate-containing sera. Drug concentrations detected were mostly in the range of 20-100 mg/l. Such concentrations have been reported to evoke allergic reactions and to affect the haemostatic action of platelets.
The prevalence of osteoarthritis of the hip and osteoporosis of the pelvis were examined in a random population sample in Jerusalem. Of the subjects reviewed, 16.1% showed osteoporosis of the pelvis, while osteoarthritis was noted in 4.1%. In only 0.5% did osteoarthritis and osteoporosis coexist in the same individual. Osteoporosis was more prevalent in the Far East population, while osteoarthritis appeared to bear no relationship to ethnic origin. It is suggested that osteoarthritis may be associated with high levels of physical activity, a characteristic of some Eastern populations.
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A simple radiological grading of osteoporosis of the hand using a postero-anterior radiograph is presented as a screening technique. Five gradings are discussed, and the relationship of osteoporosis between the hand and axial portions of the skeleton is underlined.
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The Singh index was used to measure the degree of osteoporosis in patients with fracture of the neck of the femur and to compare its prevalence with a random population sample in Jerusalem. The frequency of osteoporosis was 22.7% among women in the fracture series as compared with 1% in the control group. These figures are much lower than those in comparable series. The Singh index was not as sensitive an indicator of spinal osteoporosis as a direct measurement of vertebral bone density and could not be correlated with the incidence of hip fractures.
The density of cancellous bone in the nondominant radius of healthy subjects has been observed by the Compton scattering method as a function of age and sex. The average density for males is higher than for females. In males the density does not change up to the age of 80 years, while in females the density decreases beginning at age 50. A significant decrease in the bone mineral content of the distal radius is observed at earlier ages as measured by the Cameron-Sorenson technique. The average value of the cortical index of the third metacarpal shows some difference between the sexes over the age of 50, the index in males being higher than in the females. Between 30 and 50 years the female cortical index is greater than in the males. Little correlation was found among the three parameters studied, suggesting that they measure different phases of the pathophysiological processes involved in aging bone.
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Hospital admissions of diabetic patients were analyzed in relation to total hospital admissions, during a period of 7 years in a general hospital. The prevalence of hospitalization of diabetic patients was 2.5%. The female to male ratio was 1.4:1.0. Admissions of diabetic patients to hospital are mainly in the older age groups. By the age of 40 years, 73.4% of the total hospitalizations occur but only 13.0% of these hospital admissions are diabetics. The age at time of death of admissions ending fatally is similar in both the total and the diabetic admission groups to hospital. When the percentages of hospital admissions which terminated in death are calculated for age groups, an increase is specifically demonstrated in the diabetic group compared to the total admission group. Thus, diabetes is a complicating factor which increases mortality in people over 50 years of age.
The intestinal absorption of 47Ca was studied in elderly patients. A standard dose of 10 muCi of 47Ca was given orally. The radioactivity was measured in the plasma, and expressed as percentage of the administered dose per litre plasma. As a control group served 12 patients aged 60-80 years, hospitalized for observation for various reasons, receiving no medical treatment and not suffering from any known metabolic bone diseases or other metabolic pathological conditions. Results of kinetic curves demonstrate in elderly patients a decreased absorption with maximum specific activity in plasma reached at 120 min, when compared to data from the literature referring to a group of young people with a mean age of 35 years. Oestrogen treatment, given as ethinyl oestradiol 10 mug once daily per os for 10 days proved to increase 47Ca absorption as was demonstrated in 2 patients with osteoporosis. The effect of calcitonin (160 MRC units given 45 min before the test) on calcium absorption, in 5 patients with Paget's disease or osteoporosis appears as biphasic: in the first hour depressing calcium absorption and then in the second and third hours increasing the absorption, suggesting a hyperparathyroid state secondary to the calcitonin effect. The vitamin D2 treatment proved to increase calcium absorption.
In an epidemiological survey on fractures of the femur in Jerusalem, the highest incidence occurred in Oriental males and the next highest in European females. In the same series of patients the frequency of senile osteoporosis was noted to be higher in the Oriental group (both male and female) as compared with that in the European group. Similarly in a randomly chosen sample of the population, osteoporosis in the Oriental sector was twice as high as in the European sector. Osteoporosis was also seen to be three to four times more common in each age group when the fracture series was compared with the randomly chosen sample. No evidence of osteomalacia was noted in these patients.