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Biomedical subjects

P Geusens

Publications and source records attributed to P Geusens.

At least 109 records · Page 6Linked to original sources
PubMed1989

Physical and histomorphological characteristics of iliac crest bone differ according to the grade of osteoarthritis at the hand.

The amount of cortical and trabecular bone was studied in 32 iliac crest necropsy specimens from women 60-75 years of age and examined according to the grade of osteoarthritis. Three different methods to evaluate bone mass were used: dual photon absorptiometry, physical assessment according to Archimedes' principle, and histomorphometry. Patients were divided into groups--with or without osteoarthritis--according to the presence of osteoarthritis on hand x rays. A significantly increased amount of cortical and trabecular bone mass was found in those who had osteoarthritis at the hands. Percent pure/crude bone volume and trabecular width were found to be increased with osteoarthritic grade, indicating that primary osteoarthritis is probably part of a generalized bone disease.

Absorptiometry, Photon↗
PubMed1989

[The risk of developing osteoporosis in rheumatic diseases].

Although osteoporosis is frequently associated with rheumatic diseases, at present it is not clear if osteoporosis is due to local factors as for example disease and inflammation, or to a systemic factor related to the rheumatic condition. In this review the present stage of knowledge on the inverse relationship between primary osteoarthritis and primary osteoporosis, bone metabolism in rheumatoid arthritis, the effect of corticosteroids on bone in rheumatoid arthritis, and preventive and curative therapy for osteoporosis is discussed.

Adrenal Cortex Hormones↗
PubMed1988

Mineral metabolism and bone mass at peripheral and axial skeleton in diabetes mellitus.

Bone mineral content (BMC), mineral homeostasis, and diabetes control were evaluated in 31 Caucasian insulin-dependent diabetic patients (disease duration 18.3 +/- 7.7 yr, mean +/- SD) with normal kidney function. To evaluate bone mass, we performed radiogrammetry and single- and dual-photon absorptiometry. In women, a significantly lower mean BMC was found in the distal radius, at a mixed trabecular-cortical (P less than .01) and a cortical (P less than .05) site, as well as in the lumbar spine (P less than .02). In diabetic men, mean BMC was significantly reduced at the trabecularcortical (P less than .01) and cortical (P less than .05) sites of the radius but not in the lumbar spine. When expressed as densities (i.e., BMC/width or lumbar BMC/area), only the BMC/width at the radius cortical area was significantly reduced in women (P less than .05). The results of the radiogrammetry showed a larger endosteal diameter in the diabetic women, resulting in a significantly lower cortical thickness (P less than .05). Diabetic men did not show abnormalities on radiogrammetry. Diabetic patients had diminished serum calcium and phosphorus concentrations (P less than .001), whereas serum parathyroid, 25-hydroxyvitamin D3, and concentrations of both total and free 1,25-dihydroxyvitamin D3 were normal. No correlation between parameters of diabetes control (HbA1, insulin dose, and triglycerides) or calcium-regulating hormones and BMC were found. These data confirm that, despite large overlap of individual values, mean bone mass at the peripheral skeleton is significantly decreased in diabetic patients. Moreover, we report that the BMC of the lumbar spine is significantly reduced in female diabetic patients.

Adult↗
PubMed1987

Genetic determinants of bone mineral content at the spine and radius: a twin study.

The possible role of genetic and/or environmental factors in determining bone mass has been investigated in 30 pairs of twins (16 monozygotic and 14 dizygotic) divided in two age groups (below and above 25 years of age). Bone mineral content was evaluated by single- and dual photon absorptiometry at the distol third of the radius for peripheral cortical bone and in the lumbar spine for the axial bone. The "within pair" variance has been used as an index of genetic influence. A significant (p less than 0.01) genetic determinant was found for the bone mass of the radius in adults and for the spinal bone mass in the age group younger than 25 years. The heritability index h2 was 0.75 for cortical BMC and 0.88 for axial BMC. Such a genetic determinant could not conclusively be demonstrated in adult twins for the spine and in youngsters for the cortical bone, suggesting that environmental factors may play a more dominant role in growth of cortical bone during adolescence and diminution of axial bone during adult life.

Adolescent↗
PubMed1986

Bone mineral content, cortical thickness and fracture rate in osteoporotic women after withdrawal of treatment with nandrolone decanoate, 1-alpha hydroxyvitamin D3, or intermittent calcium infusions.

Twenty-six post-menopausal osteoporosis patients were studied prospectively over a 2-yr period after the cessation of 2 yr of treatment with either nandrolone decanoate (anabolic steroid), 1 alpha hydroxyvitamin D3 or intermittent calcium infusions, the total observation period being 4 yr. Serial evaluations of bone mineral content in the radius, cortical thickness of the metacarpals and spinal roentgenograms were obtained. Nine patients who had been treated with 50 mg nandrolone decanoate every three weeks did not lose bone from the radius or the metacarpals during the 2 yrs following withdrawal of therapy. Eight patients who had received 1 microgram/day of oral 1 alpha hydroxyvitamin D3 retained a positive bone mineral content in the radius but lost cortical thickness from the metacarpals after withdrawal of therapy. Nine patients who had been treated with intermittent calcium infusions over 12 consecutive days annually did not lose further bone mineral content from the radius, but did lose cortical thickness at the expected rate during the 2-yr post-treatment period. The fracture rate at the end of the 4-yr observation period was 40% lower in the nandrolone decanoate group than in the 1-alpha-hydroxyvitamin D3 and calcium infusion groups. The results of this study indicate that, in contrast to oestrogen and calcium therapy, nandrolone decanoate and 1-alpha-hydroxyvitamin D3 have lasting beneficial effects, and that data obtained by photon absorptiometry do not always coincide with those obtained by radiogrammetry. These findings are highly relevant to the design of future therapeutic trials.

Aged↗
PubMed1986

Vertebral crush fracture syndrome and reflex sympathetic dystrophy.

The association of reflex sympathetic dystrophy in one or more extremities with vertebral crush fracture syndrome is reported in six cases. In two of them the reflex sympathetic dystrophy preceded the vertebral crush fractures. The 99mTc-methylene diphosphonate scintigraphy results of the skeletons of 42 consecutive patients suffering from vertebral collapse and of 30 matched controls without osteoporosis have been evaluated by three independent observers for abnormal uptakes in the extremities. An abnormal radioactive bone tracer uptake in the extremities has been observed in 15 osteoporotics (36%) and 8 controls (29%). In most cases, osteoporotics and controls, the abnormal uptake was of the zonal type in a localized area, probably reflecting bone remodeling due to localized degenerative changes. An abnormal uptake of the segmental type involving multiple joints and even multiple extremities, as seen in reflex sympathetic dystrophy, was observed in 7 patients of the osteoporotic group (17%) and in none of the control group (P less than 0.05). The patients with an abnormal segmental uptake were younger and had a significantly higher mean 24 h calcium:creatinine ratio as well as a higher urinary hydroxyproline excretion. These observations and results suggest that in some cases of idiopathic osteoporosis there might be a relation between reflex sympathetic dystrophy and vertebral crush fracture syndrome, the vertebral crush fracture syndrome being the axial type of reflex sympathetic dystrophy.

Adult↗
PubMed1986

Long-term effect of nandrolone decanoate, 1 alpha-hydroxyvitamin D3 or intermittent calcium infusion therapy on bone mineral content, bone remodeling and fracture rate in symptomatic osteoporosis: a double-blind controlled study.

A double-blind controlled study was performed in 60 patients with symptomatic osteoporosis with at least one vertebral crush fracture, comparing the effect of nandrolone decanoate, 1 alpha-hydroxyvitamin D3 and intermittent calcium infusions. Thirty-four out of 60 patients completed the 2 year observation period. Nandrolone decanoate statistically significantly increased the bone mineral content at the radius, reduced the endosteal bone loss at the metacarpals and statistically significantly reduced urinary calcium and hydroxyproline excretion. Calcium infusions and 1 alpha-hydroxyvitamin D3 inhibited further loss of bone mineral content, but endosteal bone loss continued. In the second year fracture rate was reduced in the nandrolone decanoate groups compared to the two other groups. We conclude that nandrolone decanoate is an active drug for increasing bone mineral content and reducing endosteal bone loss, while 1 alpha-hydroxyvitamin D3 and calcium infusions only stop further bone mineral loss at the radius but do not inhibit endosteal bone loss as measured at the metacarpals and that single photon absorptiometry and radiography are complementary in interpreting cortical bone mineral changes.

Aged↗
PubMed1986

Age-, sex-, and menopause-related changes of vertebral and peripheral bone: population study using dual and single photon absorptiometry and radiogrammetry.

Vertebral and peripheral bone mass have been measured with single and dual photon absorptiometry and radiogrammetry in 146 male and 220 female volunteers ranging in age from 20 to 85 yr. One hundred four subjects with interfering diseases, treatment, or x-ray manifestations of lumbar osteoarthritis were excluded for purposes of this study. Patterns of age-related bone gain and diminution differed between sexes and measuring sites. The effect of menopause on the peripheral and vertebral skeleton also differed. Men, at all measured sites, have more bone than women. In the fifth decade, however, women's lumbar bone mineral content was almost equal to the value found in men. Bone loss associated with aging was more marked in women than in men and started, for the lumbar spine, at about the age of 25 yr in both women and men and, for the peripheral bones, at the age of 55 in women and 65 in men. Bone loss in the spine in women was not linear. Women in the fifth and sixth decade, who still had menstruation, differed significantly from those who had not menstruated for at least the last 6 mo. Bone diminution at menopause was twice as great in the lumbar spine than elsewhere in the peripheral skeleton, 15% versus 7%. Of the 25% total bone loss of the spine during adult life in women, 60% was lost within 10 yr after menopause. Estrogen deficiency, not aging, is the predominant cause of bone loss in the spine. For the peripheral skeleton, there is a two-component decrease, a rapid loss induced by the menopause superimposed on a slower age-related loss. Although there was a significant correlation between peripheral and vertebral bone mass indices, it was clear that observations made at one site will not necessarily reflect changes observed at another site.

Adult↗
PubMed1980

Short and longterm experience with plasmapheresis in connective tissue diseases.

Plasmapheresis has been performed in eleven cases with connective tissue diseases, three with systemic lupus erythematosus, three with mixed connective tissue disease and five with rheumatoid arthritis. Plasmapheresis was in all cases instituted as an additional therapy during disease activity which was not under control with conventional modes of therapy. The best results were obtained in systemic lupus erythematosus and rheumatoid arthritis complicated with vasculitis. In mixed connective tissue disease with severe Raynaud's phenomenon, no striking and lasting results were obtained. Plasmapheresis seems to be a valuable adjunct in the management of acute exacerbation of connective tissue disease, especially when it is associated with drugs which can block antibody rebound.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Aging of the thoracic spine: distinction between wedging in osteoarthritis and fracture in osteoporosis--a cross-sectional and longitudinal study.

Thoracic kyphosis is clinically associated with osteoporosis as well as with osteoarthritis. Because misinterpretation of thoracic spine deformities on X-rays may lead to overdiagnosis of vertebral fracture, we studied morphological changes of the thoracic spine in a cross-sectional (n = 89) and longitudinal study (n = 38) in 30 women with established osteoporosis (OP), in 31 women with spinal osteoarthritis (OA), and in 28 normal women. Vertebral deformation was assessed on lateral roentgenograms of the thoracic spine from T-4-T-12. The anterior, middle, and posterior heights were measured using six points corresponding to the four corners of the vertebral body excluding osteophytes and the midpoints of the endplates. For the thoracic T-6-T-9 region, the mean anterior/posterior height ratio was 7.7% in the controls, 13% in osteoarthritis, and 21% in osteoporosis. For the mid-height/posterior height ratio the respective values were 13%, 12%, and 22%. The osteoporosis group differed significantly from the control and osteoarthritis group in anterior and in midheight reduction. The yearly mean anterior height reduction in the osteoarthritis group was 0.7% compared with 1.5% in the osteoporosis group. The mean yearly midheight reduction was, respectively, 0.5% versus 2.9%. The differences between the groups were significant. We conclude that vertebral deformity, in particular wedging, of the thoracic spine is not exclusively characteristic for osteoporosis and that certain vertebral deformities develop by mechanisms other than fracture. Osteoporotic fracture of the thoracic spine is characterized by an exaggerated reduction of the midheight to posterior height in addition to reduction of the anterior to posterior height.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗