Determination of osteoporosis risk factors using a multiple logistic regression model in postmenopausal Turkish women

To determine the risk factors of osteoporosis using a multiple binary logistic regression method and to assess the risk variables for osteoporosis, which is a major and growing health problem in many countries. We presented a case-control study, consisting of 126 postmenopausal healthy women as control group and 225 postmenopausal osteoporotic women as the case group. The study was carried out in the Department of Physical Medicine and Rehabilitation, Dicle University, Diyarbakir, Turkey between 1999-2002. The data from the 351 participants were collected using a standard questionnaire that contains 43 variables. A multiple logistic regression model was then used to evaluate the data and to find the best regression model. We classified 80.1% [281/351] of the participants using the regression model. Furthermore, the specificity value of the model was 67% [84/126] of the control group while the sensitivity value was 88% [197/225] of the case group. We found the distribution of residual values standardized for final model to be exponential using the Kolmogorow-Smirnow test [p=0.193]. The receiver operating characteristic curve was found successful to predict patients with risk for osteoporosis. This study suggests that low levels of dietary calcium intake, physical activity, education, and longer duration of menopause are independent predictors of the risk of low bone density in our population. Adequate dietary calcium intake in combination with maintaining a daily physical activity, increasing educational level, decreasing birth rate, and duration of breast-feeding may contribute to healthy bones and play a role in practical prevention of osteoporosis in Southeast Anatolia. In addition, the findings of the present study indicate that the use of multivariate statistical method as a multiple logistic regression in osteoporosis, which maybe influenced by many variables, is better than univariate statistical evaluation

Complications of Brucellosis in Different Age Groups: A Study of 283 Cases in Southeastern Anatolia of Turkey

We carried out a retrospective analysis of 283 patients diagnosed with brucellosis in our hospital, which serves almost 5.5 million inhabitants in Southeastern Anatolia in Turkey. Our study focuses on the frequency of complications in cases with brucellosis across different age groups. Patients were classified into three groups according to age: less than 15 years old (group A), 15-45 years old (group B) and over 45 years old (group C). Of 283 patients, 138 (49%) were female and 145 (51%) male. Fifty-three (19%) were younger than 15 years old (group A), 178 (63%) were 15-45 (group B), and 52 (18%) were over 45 (group C). When the distribution of all cases was examined according to months of the year, an increase was seen in June. Osteoarticular complications were the most frequent, found in 195 (69%) cases, followed by cutaneous (17%), genitourinary (8%), nervous (7%), respiratory (5%) and hematological (4%) complications. Treatment failed in 15 patients (5%), owing to true relapse in ten and to non-compliance and drug side effects in the other five. Two hundred seventy-two patients received medical treatment alone and 11 required medical and surgical treatment as well (9 spondylitis and 2 carditis). Complications in brucellosis were frequent because 25% of all patients with brucellosis had more than one complication, more so in group C (38%) than in group A (28%) or B (20%). Cutaneous, hematological and respiratory complications in childhood; osteoarticular and cardiac complications in adults; and genitourinary, neurological and gastrointestinal complications in middle aged were more prominent. In conclusion, the frequency of brucella complications was variable in different age groups in Southeastern Anatolia of Turkey. Since brucellosis is a preventable disease, knowledge and early diagnosis of the complications are especially important. Therefore, population education and medical precautions are necessary to prevent the harmful effects of brucella and its complications. In addition, primary health care physicians should be alerted regarding the clinical and laboratory findings of brucella complications.

The Effects of Alendronate and Calcitonin on Cytokines in Postmenopausal Osteoporosis: A 6-Month Randomized and Controlled Study

The present study was designed to determine if levels of serum cytokines, such as interleukin (IL) -1beta, IL-2, IL-2r, IL-6, IL-6r, IL-8, IL-10, and TNF-alpha are different in osteoporotic and non-osteoporotic postmenopausal women, and to evaluate the effects of calcitonin and alendronate therapies over a six month period on serum cytokine levels in postmenopausal osteoporotic women. Serum levels of IL-2, TNF-alpha and IL-8 were found to be significantly higher (p < 0.05), and serum IL-10, and IL-6r significantly lower in the calcitonin (N=60) and the alendronate (N=60) treatment groups than in the control group (N=50) (p < 0.05). But, no significant difference was apparent between the calcitonin and alendronate treated groups before treatment. Statistically significant changes occurred in patients, with respect to the levels of serum IL-6r, and IL-8 after one month (p < 0.05), in IL-2r, IL-6r, IL-8, IL-10 after three months, and in IL-1beta, IL-6r, IL-8, IL-10 and TNF-alpha after six months of calcitonin therapy (p < 0.05). No significant difference was observed in IL-6r after one month, in IL-8 and IL-10 after three months, and in TNF-alpha after six months in the calcitonin treated group and in the control group, whereas these parameters were significantly different at baseline. In the alendronate treated group, statistically significant changes occurred in the levels of serum IL-1alpha and IL-6 after three months, and in IL-1beta, IL-6, IL-6r and TNF-alpha after six months (p < 0.05). No significant difference was observed in IL-6r after one month, in IL-10 after three months or in TNF-alpha after six months between the alendronate treatment group and the control group, whereas these parameters were significantly different at baseline. In conclusion, we suggest that; 1) not only IL-1, IL-6, TNF-alpha and IL-11 but also IL-2, IL-8 and IL-10 may have roles in the etiopathogenesis of osteoporosis, 2) calcitonin therapy have a more distinct influence on serum levels of some cytokines and have an earlier effect than alendronate therapy (especially upon IL-2r, IL-8, and IL-10). Nevertheless, further longitudinal studies are needed to identify the cytokines involved in the pathogenesis of postmenopausal osteoporosis and to evaluate the influence of different treatments on these cytokines.

Spinal Cord Compression by Primary Amyloidoma of the Spine

In this report, we presented a case of solitary spine amyloidoma, its clinical and radiological findings and management, and a review of the literature on vertebral amyloidosis.