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Biomedical subjects

T C Durbridge

Publications and source records attributed to T C Durbridge.

8 recordsLinked to original sources

Effects of oophorectomy on biochemical and bone variables in the rat.

The metabolic effects of oophorectomy (Oophx) were studied in 6-month-old rats maintained on a normal chow diet. Nine weeks following operation, Oophx animals had a significantly lower femoral trabecular bone volume (BV/TV) than sham-operated animals; mean (SD) Oophx 8.5 (3.8)%; Sham 13.4 (2.5)%; P = 0.013). They also had a higher urine hydroxyproline (P less than 0.001), serum alkaline phosphatase activity (P less than 0.001), serum phosphate (P less than 0.001) and lower serum albumin (P less than 0.001) than the controls. Serum osteocalcin was inversely related to the BV/TV in the Oophx animals at 9 weeks post operation (r = -0.85, P = 0.007, n = 8). A fall in serum ionized calcium from 3 to 9 weeks post operation correlated with a fall in urinary hydroxyproline in the Oophx animals (r = 0.57, P = 0.002, n = 27). The data are consistent with a model of ovarian hormones acting directly to modulate bone cell activity as well as exerting an effect on the renal handling of phosphate.

Alkaline Phosphatase

Trabecular spacing in post-menopausal Australian women with and without vertebral fractures.

Histomorphometric measurements were made from iliac crest biopsies of 32 women with vertebral fractures and 37 women without fracture. All were post-menopausal Australian women who had presented with back pain to a hospital out-patient endocrinology clinic. Bone from the fracture cases was characterised by loss of individual trabecular elements, with the remaining trabeculae being spaced further apart than those in the non-fracture women (p less than 0.0001). This resulted in a significant decrease in trabecular bone volume (p less than 0.01). In addition osteoid surface was reduced (p less than 0.01). Dynamic parameters of bone turnover were not significantly different between the two groups. These data should be useful for the assessment of iliac bone histomorphometry in Australian post-menopausal women suspected of having osteoporosis.

Aged

The diagnostic utility index.

A method for quantifying the value placed on diagnostic accuracy is described. Named the Diagnostic Utility Index (DUI), it was completed by fifty subjects (including pathologists, physicians and medical students). Analysis of the responses reveals that attitudes to diagnostic perfectionism differ from one disease to another. It is suggested that the DUI may be useful in the clarifying of subjective factors which influence medical attitudes to the diagnosis and investigation of disease.

Attitude

An evaluation of multiphasic screening on admission to hospital. Precis of a report to the National Health and Medical Research Council.

A controlled study of admission multiphasic screening (AMS) at a large general hospital showed that AMS had no significant effect on a variety of indices of inpatient progress. Owing to a 64% increase in estimated cost of investigations with AMS, the total hospital admission cost was increased by approximately 5%. Under the conditions of this study, AMS added to the cost of hospitalization without associated evidence of benefit to the patient.

Australia

Evaluation of benefits of screening tests done immediately on admission to hospital.

Evidence was sought of improved inpatient progress and reduced hospital costs when a battery of investigations were done at the time a patient was admitted to hospital. The outcome in 500 admission-tested patients was compared with that in two other groups of 500 control patients. No significant differences were found among the three groups in a variety of indices of inpatient progress. Because of an estimated 64% increase in the cost of investigating inpatients with admission testing, the total cost of hospital care was increased by about 5%. Under the conditions of this study, admission testing added to the cost of hospitalization, without associated evidence of benefit to the patient.

Australia