ABSTRACT
Objective: The purpose of the present study was to clarify the efficacy of alendronate and raloxifene for preventing bone loss in patients with hip fracture by monitoring bone mineral densities (BMDs) and biochemical markers during the 9-month period after fracture. Patients and Methods: Eighty-two female hip fracture patients from 50 to 99 years old (mean ± SD: 81.6 ± 9.5) were randomly divided into two groups; there were 46 patients in the alendronate-treated group (group ALN) and 36 patients in the raloxifene-treated group (group RLX). Drugs were administered to patients six weeks after their operations. Lumbar spine BMD and neck, trochanter, Ward's and total BMDs of the contralateral proximal femur, serum intact osteocalcin (intact OC), bone-specific alkaline phosphatase (BAP) and urinary N-terminal telopeptide of type I collagen (NTX) were measured just before the start of drug administration and at 9 months thereafter. Results: Twenty-two out of 46 patients in group ALN and 23 out of 36 patients in group RLX completed the study. The most common reason for dropping out was the patient's failure to visit the outpatient clinic. Trochanter BMD in group ALN tended to increase by 8.4% compared with the baseline, and total hip BMD in group RLX showed a significant increase (5.7%), although neck BMD in both groups decreased during the 9 months of treatment (–8.7% for group ALN and –4.2% for group RLX compared with the baseline). Spine BMD did not change significantly in eithr group. Serum BAP and urinary NTX decreased significantly in both groups. Serum intact OC did not change significantly. Conclusions: Both alendronate and raloxifene have a favorable effect on trochanter and total BMDs of the contralateral proximal femur in the short period after hip fracture. However, both drugs could not prevent bone loss in the femoral neck during the 9 months of treatment.
ABSTRACT
Objective: The purpose of the present study is to clarify the efficacy of etidronate and vitamin K2 in sustaining bone mineral density (BMD) in patient with hip fracture by monitoring metabolic bone markers and BMD during the 36-week period after fracture.Materials and Methods: Forty-seven hip fracture patients from 51 to 93 years old (77.2±9.6) were randomly divided into three groups: 14 patients in the intermittent cyclical etidronate-treated group (group E), 16 patients in the vitamin K2-treated group (group K), and 17 patients in the control (group C). Drugs were administered to patients in groups E and K six weeks after their operations. Blood and urine samples were obtained just before the start of drug administration and at 12, 24, and 36 weeks thereafter. Urinary type I collagen C-terminal telopeptide (uCTx), pyridinoline (PYR), deoxypyridinoline (DPD), serum CTx (sCTx), osteocalcin (OCN-mid), and undercarboxylated osteocalcin (ucOC) were measured. The contra-lateral proximal femur and lumbar spine BMDs were measured at baseline and at 36 weeks.Results: Deoxypyridinoline at 12 weeks and OCN-mid at 36 weeks after treatment were lower in group E than those in group C. N-mid osteocalcin and ucOC at 24 and 36 weeks were lower in group K than those in group C. Although femoral neck BMD in groups C and E decreased compared to the baseline values at 36 weeks, femoral neck BMD in group K tended to increase. Specifically, in group K the BMD of Ward's triangle increased significantly after treatment. Bone mineral density of the lumbar spine in each group did not change significantly during the 42 weeks following hip fracture.Conclusion: Vitamin K2 prevented further bone loss in the contralateral proximal femur. The administration of vitamin K2 to patients with hip fractures in the early period after fracture is potentially useful in preventing a second hip fracture on the contralateral side.
Subject(s)
Hip FracturesABSTRACT
Objective: The aim of the present study was to clarify whether patients with Graves' disease who have lost bone mass can restore bone mass to age-matched control levels by antithyroid drug therapy.Patient/Materials and Methods: One male and 16 female patients (aged 21-71 years, mean±SE 39.9±16.5) with untreated Graves' disease were included in the study. Methimazole or propylthiouracil was given to all of the patients. Biochemical markers (serum N-mid osteocalcin (OCN-mid), alkaline phosphatase (ALP), type I collagen C-terminal telopeptide (sCTx), urinary pyridinoline (Pyr), deoxypyridinoline (Dpyr) and type I collagen C-terminal telopeptide (uCTx) and bone mineral density at the distal one third of the radius were assessed prior to treatment, and in the first, third, sixth and twelfth months of treatment.Results: All biochemical markers had increased significantly 12 months after treatment compared with the baseline values (OCN-mid, p<0.05; ALP, p<0.01; sCTx, p<0.05; Pyr, Dpyr, uCTx, p<0.01). Among the biochemical markers, urinary Pyr and Dpyr had decreased the most prominently 12 months after treatment. However, BMD at the distal one third of the radius did not improve after 12 months of treatment.Conclusion: Based on assessments of BMD at the distal one third of the radius, one year is not enough to restore bone mass using antithyroid drug therapy in patients with Graves' disease.
Subject(s)
BiomarkersABSTRACT
Up until the present, the primary treatment for threatened premature labor has been bed rest, with drug therapy as a supplement. However, with drug therapy the problems of side effects and dosage limitations have made it difficult to achieve therapeutic effectiveness. In this paper, the authors report the favorable results obtained in such cases when moxibustion and a microwave emitter were used for stimulation therapy based on Oriental medical theory. Moxibustion was carried out on Shim, Yusen and Saninko (acupuncture points) in cases of threatened premature labor beyond the 24th week. Despite the short duration of treatment, uterine tension was relieved, fetal movement increased, and resistance in the umbilical artery and uterine artery reduced. Similar results were achieved with multiple microwave stimulation treatments; the effects lasted for long periods and were not accompanied by side effects. Thus, the results showed that through the use of moxibustion therapy in conjunction with drug therapy, the dosage could be reduced, and the frequency of side-effect appearance lowered. These results suggest that moxibustion therapy has potential as an effective and safe new treatment for threatened premature labor.