PubMed · 8941255
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
1996-11-22. Bone densitometry.. https://pubmed.ncbi.nlm.nih.gov/8941255/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: A major barrier to wider use of bone densitometry has been a lack of reports that are comprehensible to primary care physicians. OBJECTIVE: To compare the effect of short technical reports and longer clinical reports on use, understanding, and acceptance of bone densitometry by primary care physicians and on management of osteoporosis. DESIGN: Randomized trial. SETTING: Osteoporosis center of a community teaching hospital. SUBJECTS: 57 primary care physicians ordering bone mineral density tests with dual x-ray absorptiometry. INTERVENTION: Physicians were randomly assigned to receive short technical reports or long clinical reports written by endocrinologists with access to clinical information. MEASUREMENTS: Physicians were interviewed by telephone after receiving at least two reports. RESULTS: Before being interviewed, physicians receiving short reports ordered a mean +/- SD of 0.72 +/- 0.71 tests per month; those receiving long reports ordered 1.30 +/- 1.21 tests per month (P = 0.002). At the first interview, 30% of physicians receiving short reports and 86% of those receiving long reports understood the bone mineral density definition of osteoporosis (P < 0.001). Receiving long reports led to more modifications in the pharmacologic treatment of osteoporosis by gynecologists (19% of patients whose reports were short and 61% of patients whose reports were long; P = 0.021) and less confusion about reports by all physicians (36% of physicians receiving short reports and 1% of those receiving long reports; P = 0.003). CONCLUSIONS: Clinical reporting of bone densitometry to primary care physicians increased use and understanding of bone densitometry, changed management of osteoporosis, and was well accepted. It may help achieve appropriate use of bone densitometry and may allow convenient dissemination of information on osteoporosis.
BACKGROUND: The osteolytic activity of metastases of prostate cancer was evaluated in relation to total body bone mineral content (TBBMC) and regional bone mineral content (RBMC). METHODS: Bone mass was determined by dual-energy X-ray absorptiometry (DXA). Tartrate-resistant acid phosphatase (TRAP) was measured as a biochemical marker of bone resorption. RESULTS: In 32 patients (mean age 72+/-4 years) compared with 32 controls (mean age 73+/-5 years), there were significant differences in TRAP (P < 0.0001), TBBMC (P < 0.0001), and RBMC in the pelvis (P < 0.0001), legs (P=0.0001), and trunk (P<0.05), but not in the arms and head (P=ns). In the overall group of subjects, the correlation between TBBMC and TRAP was r=-0.68, P < 0.0001. The correlations remained significant in the patient and control groups separately. CONCLUSIONS: The loss of bone mass observed in patients with metastatic prostate cancer was caused mainly by the predominance of bone resorption in the osteoblastic metastases.
STUDY DESIGN: Moments and forces during pedicle screw insertion were measured in vivo and in vitro and were correlated to several parameters of the screw-bone interface. OBJECTIVES: To compare the in vitro and in vivo screw insertion loads and to relate these measurements to bone mineral density, pedicle size, and other screw parameters (material, diameter). SUMMARY OF BACKGROUND DATA: The in vitro screw insertion torque has been correlated to the screw pullout forces and the number of cycles to ultimate interface failure. However, there are no comparable in vivo data. METHODS: One hundred three pedicle screws were included in the study, 43 in vivo and 60 in vitro. Duel-energy x-ray absorptiometry boen mineral density data were available for 20 in vivo and 32 in vitro specimens. A custom-made sterilizable six-axis load cell was integrated into a torque wrench, enabling the recording of the applied moments and forces during screw insertion. Statistical analysis was performed to detect differences and correlations. RESULTS: The mean in vivo insertion torque (1.29 Nm) was significantly greater than the in vitro value (0.67 Nm). The linear correlation between insertion torque and bone mineral density was significant for the in vitro data but not for the in vivo data. No correlation was observed between insertion torque and pedicle diameter. Two patterns of torque were observed during the insertion process. CONCLUSIONS: There is a significant difference between the insertion loads measured in vivo and those measured in vitro. Additional research is needed to verify whether this method provides an indication of screw fixation quality.