| 1. |
- Weber, David R., et al.
(författare)
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The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: The 2019 Official Pediatric Positions of the ISCD
- 2019
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Ingår i: Journal of Clinical Densitometry. - : Elsevier BV. - 1094-6950 .- 1559-0747. ; 22:4, s. 567-589
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Forskningsöversikt (refereegranskat)abstract
- © 2019 Dual-energy X-ray absorptiometry (DXA) is widely used in the evaluation of bone fragility in children. Previous recommendations emphasized total body less head and lumbar spine DXA scans for clinical bone health assessment. However, these scan sites may not be possible or optimal for all groups of children with conditions that threaten bone health. The utility of DXA scans of the proximal femur, forearm, and radius were evaluated for adequacy of reference data, precision, ability of predict fracture, and applicability to all, or select groups of children. In addition, the strengths and limitations of vertebral fracture assessment by DXA were evaluated. The new Pediatric Positions provide guidelines on the use of these additional measures in the assessment of skeletal health in children.
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| 2. |
- Wilczek, Michael L., et al.
(författare)
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Mammography and Osteoporosis Screening-Clinical Risk Factors and Their Association With Digital X-Ray Radiogrammetry Bone Mineral Density
- 2015
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Ingår i: Journal of clinical densitometry. - : Elsevier. - 1094-6950 .- 1559-0747. ; 18:1, s. 22-29
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to study the association between digital X-ray radiogrammetry (DXR) T-score and clinical risk factors for osteoporosis. Women were recruited 2 d per wk at a single mammography screening center between year 2010 and 2012. Included women answered a questionnaire about risk factors for osteoporosis, and a radiograph of the nondominant hand was obtained for DXR analysis. Univariate associations between DXR T-score and risk factors were examined. A generalized linear regression model was fitted to independent variables with univariate associations at p less than 0.05. The multivariable model was reduced through manual backward elimination, with p greater than 0.1 as the exclusion criterion. Seventy-six percent of the women chose to participate in the study (n = 8810). The difference in number of daily mammograms performed on study vs nonstudy days was not significant. All univariate associations between DXR T-score and potential risk factors were highly significant. The multivariable model included height, weight, age, right-handedness, menopause before age 45, alcohol consumption, cortisone treatment, rheumatic disease, and age x smoking status. The coefficient of determination of the model was 0.37. The association between risk factors for osteoporosis and DXR T-score is similar to previously reported associations with dual-energy X-ray absorptiometry.
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| 3. |
- Kanis, J. A., et al.
(författare)
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FRAX Update
- 2017
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Ingår i: Journal of Clinical Densitometry. - : Elsevier BV. - 1094-6950. ; 20:3, s. 360-367
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Tidskriftsartikel (refereegranskat)abstract
- The fracture risk assessment tool, FRAX, was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, models are now available for 63 countries, covering 79% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide. However, the application of FRAX in guidelines has been heterogeneous with the adoption of several different approaches to setting intervention thresholds. The relationship between FRAX and efficacy of intervention has been explored and is expected to influence treatment guidelines in the future. A more unified approach to setting intervention thresholds with FRAX is a research priority.
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| 4. |
- Kanis, J. A., et al.
(författare)
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Overview of Fracture Prediction Tools
- 2017
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Ingår i: Journal of Clinical Densitometry. - : Elsevier BV. - 1094-6950. ; 20:3, s. 444-450
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Tidskriftsartikel (refereegranskat)abstract
- The characterization of risk factors for fracture that contribute significantly to fracture risk, over and above that provided by the bone mineral density, has stimulated the development of risk assessment tools. The more adequately evaluated tools, all available online, include the FRAX (R) tool, the Garvan fracture risk calculator and, in the United Kingdom only, QFracture (R). Differences in the input variables, output, and model construct give rise to marked differences in the computed risks from each calculator. Reasons for the differences include the derivation of fracture probability (FRAX) rather than incidence (Garvan and QFracture), limited calibration (Garvan), and inappropriate source information (QFracture). These differences need to be taken into account in the evaluation of assessment guidelines.
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| 5. |
- Karlsson, Magnus, et al.
(författare)
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An Increase in Forearm Cortical Bone Size After Menopause May Influence the Estimated Bone Mineral Loss-A 28-Year Prospective Observational Study.
- 2016
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Ingår i: Journal of Clinical Densitometry. - : Elsevier BV. - 1094-6950. ; 19:2, s. 174-179
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Tidskriftsartikel (refereegranskat)abstract
- Areal bone mineral density (aBMD) is the most common estimate of bone mass, incorporated in the World Health Organization definition of osteoporosis. However, aBMD depends on not only the amount of mineral but also the bone size. The estimated postmenopausal decline in aBMD could because of this be influenced by changes in bone size.We measured bone mineral content (BMC; mg), aBMD (mg/cm(2)), and bone width (mm) by single-photon absorptiometry at the cortical site of the forearm in a population-based sample of 105 Caucasian women. We conducted 12 measurements during a 28-yr period from mean 5 yr (range: 2-9) before menopause to mean 24 yr (range: 18-28) after menopause. We calculated individual slopes for changes in the periods before menopause, 0-<8, 8-<16, and 16-28 yr after menopause. Data are presented as means with 95% confidence intervals. The annual BMC changes in the 4 periods were -1.4% (-0.1, -2.6), -1.1% (-0.9, -1.4), -1.2% (-0.9, -1.6), and -1.1% (-0.8, -1.4) and the annual increase in bone width 0.4% (-1.2, 1.9), 0.7% (0.5, 0.9), 0.1% (-0.2, 0.4), and 0.1% (-0.2, 0.4). BMC loss was similar in all periods, whereas the increase in bone width was higher in the first postmenopausal period than in the second (p = 0.003) and the third (p = 0.01) postmenopausal periods. Menopause is followed by a transient increase in forearm bone size that will influence the by aBMD estimated cortical loss in bone minerals.
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| 6. |
- Lindgren, Erik, et al.
(författare)
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Bone Traits Seem to Develop Also During the Third Decade in Life-Normative Cross-Sectional Data on 1083 Men Aged 18-28 Years
- 2017
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Ingår i: Journal of clinical densitometry. - : Elsevier BV. - 1094-6950. ; 20:1, s. 32-43
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Tidskriftsartikel (refereegranskat)abstract
- By identifying individuals with low peak bone mass (PBM) at young age, early targeted interventions to reduce future fracture risk could be possible. Peripheral quantitative computed tomography (pQCT) is in many ways superior to the gold standard dual-energy X-ray absorptiometry (DXA), as cortical and trabecular compartments as well as the volumetric density and bone structure can be examined separately. Because each of these traits contributes independently to bone strength, it is probable that pQCT provides an even better fracture risk estimation than DXA. Currently, the clinical applications of pQCT are limited partly because comprehensive normative pQCT data, especially in young men, are not readily available. We therefore set up a study in young men with the following objectives: (1) to identify peak ages in pQCT bone traits with special reference to PBM and peak bone strength; and (2) to provide normative pQCT data. We measured volumetric bone mineral density and structural parameters at ultradistal (trabecular bone) and diaphyseal radius and tibia (cortical bone) by pQCT scans (Stratec XCT2000(R); Stratec Medizintechnik GmbH, Pforzheim, Germany) in a population-based age-stratified sample of 1083 men aged 18-28 yr residing in greater Malmo, Sweden. Group differences in 1-yr classes were evaluated by analysis of variance. We found similar bone traits in age groups at ultradistal sites whereas most bone traits at diaphyseal sites were higher with higher ages, however with different increment patterns depending on the specific trait. In Swedish young adult men, we found that different bone traits continued to change after age 18, but at different rates, indicating that peak areal bone mineral density (as measured by DXA) and peak bone strength may be reached at different ages.
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| 7. |
- Sandström, Linnéa, et al.
(författare)
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Peak Bone Mass and Quantitative Ultrasound Bone Properties in Young Adulthood : A Study in the PEAK-25 Cohort of Women
- 2016
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Ingår i: Journal of Clinical Densitometry. - : Elsevier BV. - 1094-6950. ; 19:4, s. 477-484
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Tidskriftsartikel (refereegranskat)abstract
- Peak bone mass is normally reached in the third decade of life. Previously, in the population-based PEAK-25 cohort (n = 1061, age 25.5 ± 0.2), we demonstrated that bone mineral density in the population-based PEAK-25 cohort is comparatively high; therefore, this study aimed to determine if the calcaneus microarchitecture mirrored this. In the process, we describe normative quantitative ultrasound (QUS) values for 25-yr-old women and the relationship between QUS values and extremes of body weight. QUS variables speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index were measured. Young adult values were based on the manufacturer-supplied QUS reference values. Analyses were performed in the cohort as a whole, and additionally, to understand the relationship between body weight and QUS values in young women, the variables were categorized into octiles for weight or body mass index (BMI) and the lowest and highest octiles were compared. In the cohort, SOS values, reflecting bone density, were higher (108 ± 18%), whereas BUA values, reflecting bone complexity, were lower (90 ± 14%) compared to the young adult reference population. SOS did not correlate with body weight or BMI. In the cohort, overall correlations between BUA weight, and BMI were small and positive (Pearson's r coefficients 0.261 and 0.197, respectively; p <0.001), although in the low-weight group, r coefficients were higher (r = 0.313 and 0.268; p <0.05). In contrast, in the high-weight group, correlation with BUA values tended to be small, negative, and nonsignificant. Correlation between QUS and dual-energy X-ray absorptiometry-measured bone mineral density was low to moderate and significant at all skeletal sites (r = 0.37-0.52). Whereas coefficients tended to be higher in the low-weight group, the reverse was apparent for the low-BMI group. In these 25-yr-old women, a comparatively high dual-energy X-ray absorptiometry-measured bone mass is offset by less complex bone structures assessed by QUS. This may have implications for later osteoporosis assessment and future fracture risk.
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| 8. |
- Ozkizilcik, Asya, et al.
(författare)
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Timed Release of Cerebrolysin Using Drug-Loaded Titanate Nanospheres Reduces Brain Pathology and Improves Behavioral Functions in Parkinson's Disease
- 2018
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Ingår i: Molecular Neurobiology. - : HUMANA PRESS INC. - 0893-7648 .- 1559-1182. ; 55:1, s. 359-369
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies from our laboratory show that intraperitoneal injections of 1-metyl-4-phenyl-1,2,3,6-tetrahydropyridin (MPTP, 20 mg/kg) daily within 2-h intervals for 5 days in mice induce Parkinson's disease (PD)-like symptoms on the 8th day. A significant decrease in dopamine (DA) and its metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) along with a marked decrease in the number of tyrosine hydroxylase (TH)-positive cells in the substantia nigra pars compacta (SNpc) and striatum (STr) confirms the validity of this model for studying PD. Since cerebrolysin (CBL) is a well-balanced composition of several neurotrophic factors and active peptide fragments, in the present investigation we examined the timed release of CBL using titanate nanospheres (TiNS) in treating PD in our mouse model. Our observations show that TiNS-CBL (in a dose of 3 ml/kg, i.v.) given after 2 days of MPTP administration for 5 days resulted in a marked increase in TH-positive cells in the SNpc and STr as compared to normal CBL. Also, TiNS-CBL resulted in significantly higher levels of DA, DOPAC, and HVA in SNpc and STr on the 8th day as compared to normal CBL therapy. TiNS-CBL also thwarted increased alpha-synuclein levels in the brain and in the cerebrospinal fluid (CSF) as well as neuronal nitric oxide synthase (nNOS) in the in PD brain as compared to untreated group. Behavioral function was also significantly improved in MPTP-treated animals that received TiNS-CBL. These observations are the first to demonstrate that timed release of TiNS-CBL has far more superior neuroprotective effects in PD than normal CBL.
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