Objective. To assess the impact of disease activity on acquired peak bone mass and bone turnover in young adult patients with either persistent juvenile arthritis (JA) or a history of JA (JA in remission), Methods, Tw...
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Objective. To assess the impact of disease activity on acquired peak bone mass and bone turnover in young adult patients with either persistent juvenile arthritis (JA) or a history of JA (JA in remission), Methods, Two hundred twenty-nine patients with JA were studied after a mean a SD of 15.6 +/- 2.4 years in women and 14.9 +/- 2.1 years in men since disease onset. One hundred forty-five women and 84 men were over the age of 20 at the Lime of examination (mean a SD age 24.9 +/- 2.9 years for women and 25.2 +/- 3.1 years for men), Forty-one healthy women (mean a SD age 27.4 +/- 3.1 years) and 55 healthy men (mean a SD age 25.7 +/- 3.1 years) served as a reference group. Bone mineral density (BMD) was analyzed by dual x-ray absorptiometry, Serum osteocalcin concentrations and urinary concentrations of deoxypyridium (D-Pyd) were measured. Linear regression analyses were performed to evaluate the impact of disease on BMD, Results, Patients with persistent disease had significantly lower BMD compared with healthy subjects (P < 0.001 for women at all measured sites and for men at the femoral neck and total body;P < 0.05 for men at the radius and lumbar spine), Of the patients with a history of JA, only women had significantly lower BMD at the femoral neck and total body (P < 0.05), Patients with persistent JA had significantly more osteopenia and osteoporosis than healthy subjects, while patients with a history of JA had more frequent osteopenia only in the total body. Weight, urinary concentration of D-Pyd, and belonging to the patient group significantly affected BMD at all measured sites in the entire study population, while analysis of all patients found that only the number of months taking corticosteroids significantly affected BMD at all measured sites, However, the impact of the variables differed from site to site. Conclusion, Our findings imply that most young adults with JA attain the same BMD as healthy subjects if the disease goes into remission, while young
The observation that bone mineral is lost in patients who are either immobilized or remain in bed for extended periods of time formed the basis for the concern that large amounts of bone mineral may be lost during lon...
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The observation that bone mineral is lost in patients who are either immobilized or remain in bed for extended periods of time formed the basis for the concern that large amounts of bone mineral may be lost during long periods of weightlessness. This concern was magnified when early X-ray densitometry studies suggested that rather large amounts of mineral could be lost during rather short periods of weightlessness (4-14 days). Even though these Gemini results have recently been modified, they still reflect substantial losses in the upper extremity. This led to a series of prolonged bed-rest studies (30-36 weeks) which, in addition to careful calcium balance, also employed a newer, more precise method of estimating bone mineral in the radius, ulna, and os calcis. It employed an essentially monoenergetic photon source (125I) and a scintillation detector operating in a rectilinear scanning mode to measure bone mineral by the absorptiometric technique. Bed-rest studies revealed variable mineral losses but suggested that little if any is lost during 4-6 weeks, with variable amounts being lost in 8 weeks. Losses up to 40% were noted in the os calcis after 9 months, with essentially none in the radius and ulna. When this technique was employed during the Apollo 14, 15, and 16 missions, only one crewman (CMP Apollo 15) showed significant losses in the os calcis and none in the radius or ulna. These results were, therefore, in concert with the bed-rest data but at variance with the earlier Gemini data. The variability observed during bed rest was reconciled when it was observed that the rate of loss could be correlated with the initial 24-hour urinary hydroxyproline excretion and the initial os calcis mineral content. Prediction terms were established. Measurements of the SL-II crew after 28 days of weightlessness revealed no significant bone mineral losses. The Skylab data lie within the predicted limits obtained from the bed-rest data. The relevance of the prediction terms
Bone density measurements by peripheral quantitative CT (pQCT) of the distal radius in 87 women (age 38.4+/-12.3 years) were obtained on a both a Stratec XCT 900 and an updated version XCT 1400. Axial area, and total ...
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Bone density measurements by peripheral quantitative CT (pQCT) of the distal radius in 87 women (age 38.4+/-12.3 years) were obtained on a both a Stratec XCT 900 and an updated version XCT 1400. Axial area, and total and trabecular bone mineral density (BMD) results from both scanners were compared for all patients using linear regression analysis. To achieve scanner calibration we used the intercept and slope of the patients' correlations. The correlations of the patients' values were good for area (r=0.83) as well as total BMD (r=0.90) and excellent for trabecular BMD (r=0.97). The cross-calibration approach in our study provided compatibility of pQCT for trabecular and total ROIs, the clinically mostly utilized volumes of measurement.
Isolated dislocation of the radial bead in children is a rare injury. We report an isolated posterolateral dislocation of the radial head in a boy after a fall on the outstretched arm. Immediate closed reduction and e...
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Isolated dislocation of the radial bead in children is a rare injury. We report an isolated posterolateral dislocation of the radial head in a boy after a fall on the outstretched arm. Immediate closed reduction and early active motion achieved satisfactory results.
We present a case of a patient with complaints in both elbows, due to a prominent bicipital tuberosity with an enlarged bursa, in which operative resection was successful.
We present a case of a patient with complaints in both elbows, due to a prominent bicipital tuberosity with an enlarged bursa, in which operative resection was successful.
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