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Biomedical subjects

U S Barzel

Publications and source records attributed to U S Barzel.

At least 37 records · Page 2Linked to original sources
PubMed1987

Osteoporosis: the state of the art in 1987: a review.

Osteoporosis affects approximately 15 to 20 million people in the United States and is the underlying cause of 1.3 million new fractures per year in people over age 45. The more common risk factors recognized in this disorder are older age, female sex, white race, physical inactivity, and early menopause. We now have available equipment which can measure bone density at various sites. These include single- and dual-photon densitometry, and single and dual quantitative computed tomography. These procedures are a quantum improvement over plain x-ray in the assessment of the severity of osteoporosis, but measurement at one site may not reflect the density at other sites. The value of these techniques in screening the general population for osteoporosis remains to be demonstrated. They are valuable when used to monitor patients longitudinally to assess the progression of disease and the effects of specific therapeutic regimens. There is no established effective therapy for osteoporosis so prevention is the goal. The effectiveness of different programs of physical activity in preventing bone loss and fractures is unknown but isotonic exercises three times a week for thirty minutes is recommended. There is general agreement that adequate calcium intake is important for maintenance of skeletal integrity, but there is no proof that a high dietary calcium alone will prevent osteoporosis. Estrogen therapy clearly prevents the accelerated bone loss which occurs in all white women at the time of menopause, but the question still remains who should be started on estrogens, and within what period of time after menopause are estrogens still useful in preventing postmenopausal bone loss, and for how long do we continue hormone therapy. Many questions are left to be answered but at least now osteoporosis is recognized as a major medical problem and much research is being done to answer the above questions.

Aged↗
PubMed1986

Thyrotoxicosis in the very old.

The records of 25 patients older than 75 years of age with the diagnosis of hyperthyroidism were reviewed. The mean age of the group (22 women and three men) was 81.5 years, the eldest being 95 years old. Twenty-one patients had Graves' disease, three had multinodular goiter, and one had toxic adenoma. Major presenting symptoms included weight loss (44 percent), palpitations (36 percent), and weakness (32 percent). The average number of thyrotoxic symptoms was only two per patient. Two patients were asymptomatic. Clinical signs included fine skin (40 percent), tremor (36 percent), atrial fibrillation (32 percent), and tachycardia (28 percent). The thyroid was palpable in only three patients with Graves' disease. Mean blood thyroxine level was 15.6 micrograms/dl (range, 11.5 to 24); blood triiodothyronine level was elevated in only half of the patients. One patient had triiodothyronine toxicosis. Mean 24-hour radioiodine uptake was 52 percent. Five patients had normal uptake. No correlation could be established between age, clinical symptoms, signs, and hormone blood levels. Because signs and symptoms of hyperthyroidism in the very old may be too subtle for clinical diagnosis, all elderly subjects should have periodic screening of blood thyroxine levels.

Aged↗
PubMed1986

Ocular sarcoidosis and Graves' ophthalmopathy.

Sarcoidosis, a granulomatous disease first recognized as a dermatologic disorder, is now known to involve multiple organs, including the eye. Indeed, ocular involvement may be the only clinical manifestation of this protean disease; it may involve any part of the visual apparatus and its adnexal structures. In this paper we report on the concurrence of sarcoidosis of the lid with Graves' ophthalmopathy in the same patient.

Eye Diseases↗
PubMed1985

Thyroxine supplementation. Method for the prevention of clinical hypothyroidism.

Elevation in the blood level of thyroid-stimulating hormone (thyrotropin) is the earliest and most sensitive manifestation of thyroidal failure, and is detectable in clinically healthy and apparently euthyroid persons. Oral thyroxine supplementation designed to titrate thyrotropin back to normal levels, and readjustment of the supplementary dose as failure of the gland progresses and thyrotropin level rises again, may prevent the emergence of clinical hypothyroidism.

Adult↗
PubMed1984

Lean body mass is a predictor of the daily requirement for thyroid hormone in older men and women.

Levothyroxine (T4) replacement need in adults with primary hypothyroidism has recently been reported to fall with age. Previous studies have demonstrated that the resting metabolic rate falls with age in euthyroid adults and that this fall is proportional to a reduction in lean body mass (LBM). Since LBM is correlated also with 24-hour energy expenditure, this study examined the possibility that LBM might be an accurate predictor of T4 requirement. Seventy-five hypothyroid adults receiving full replacement therapy, ranging in age from 24 to 88 years, were studied retrospectively. Lean body mass was found to be a better predictor of T4 requirement than age or weight for the entire group as well as for subgroups of men and women 51 years old and older. The age-related reduction in LBM may be responsible for the reported decrease in the rate of fractional thyroxine degradation with age.

Age Factors↗
PubMed1983

Vitamin D deficiency: a risk factor for osteomalacia in the aged.

Deficiency of vitamin D is rare in the general population of the North American continent because of the availability of sunlight, vitamin D-fortified milk, and over-the-counter preparations containing the vitamin. Yet there are among the aged those who are at risk of developing a deficiency of the vitamin because of lack of exposure to sunlight and failure to ingest milk or vitamin supplements containing vitamin D. Four cases of vitamin D-deficiency osteomalacia are described, demonstrating the various findings in the patient history and the physical, radiologic, and laboratory evaluation. In all cases physiologic doses of the vitamin corrected the abnormality quickly and fully. Vitamin D deficiency can be prevented prophylactically once the gerontologist is alert to the fact that some elderly people, who are easily identifiable by history alone, are likely to develop such deficiencies.

Aged↗
PubMed1982

Levothyroxine replacement dose for primary hypothyroidism decreases with age.

We studied 23 elderly (other than 65) and 44 younger ambulatory adult patients with primary hypothyroidism to ascertain the dose of levothyroxine needed for complete replacement in relation to age. The elderly patients (average age, 75.7 years) needed an average 118 microgram/d whereas the younger patients (average age, 48.1 years) needed 158 microgram/d. The data indicate that thyroxine requirement may decrease continuously with age. This decrease probably reflects the progressive decrease in thyroxine degradation rate that occurs with age.

Age Factors↗