Effect of hypogonadism on bone mineral density in young males

A study of the relationship between bone mineral density and the level of testosterone in young hypogonadal males. The patients' group consisted of 20 hypogonadal men. A group of 20-euogonadal age matched men served as a control group. All were subjected to history taking, thorough clinical examination, measurement of serum testosterone levels with ELISA and assessment of bone mineral density [BMD] with dual energy X-ray absorptiometry [DEXA] for left femur, forearm and spine. The mean age of patients was 2 7.1 +/- 2.79 [years] with a mean body mass index [BMI] 24.23 +/- 4.67 kg/m[2]. Testosterone levels were highly significantly lower in patients vs. controls p<0.001. Patients showed highly significant reduction of BMD for left femur, forearm and spine than control group p<0.001. Testosterone levels and BMD were highly significantly lower in patients with delayed onset of puberty compared to those with normal onset puberty p<0.001. There was no significant difference in BMD or serum testosterone between patients with 1ry or 2ry hypogonadism p>0.05. A highly significant positive correlation was found between serum testosterone and T-score at all sites. Hypogonadal patients have lower serum testosterone level and lower BMD than age-matched controls. The more testosterone is deficient, the worse the BMD. Patients with history of delayed puberty have lower BMD than those with normal onset of puberty, and the more the delay the more the reduction in BMD. The spine is the most affected site with osteopenia in hypogonadal men

Effects of physical exercise on HCV chronic active hepatitis patients

Infection with HCV shows a high prevalence in our country and often becomes chronic and proceeds to a state of chronic active hepatitis, a condition which is not easy to treat and almost always end up in liver cirrhosis as well as a high risk of hepatocellular carcinoma. The aim of the this work was to study the effect of regular physical exercise over a period of 6 weeks on some parameters usually used to evaluate the liver condition and the activity of the disease. Patients were randomized into 3 groups; Group I: 20 patients with chronic active hepatitis due to infection with HCV and showed a significant reduction in ALT and AST levels over the period of the exercise program. Group II: 20 patients with decompensated liver condition due to HCV infection with at least one of the manifestations of liver cell failure and exhibited a bad exercise tolerance with non-significant changes in their laboratory data. Group III: 20 patients with compensated HCV liver disease were not included in the exercise program and were considered as a control group. It was concluded that physical exercise was well tolerated by HCV chronic active hepatitis patients and may be of benefit while in decompensated patients physical exercise should be restricted as much as possible

Melanoma inhibitory activity [MIA] and transforming growth factor- beta [TGF-beta] levels in the sera of juvenile arthritis

We measured serum levels of MIA and TGF-beta by means of ELISA and investigated whether they provide clinically relevant parameters in juvenile arthritis patients. We also evaluated their correlations with clinical and laboratory parameters. Serum was obtained from 10 poly-articular juvenile arthritis [pa-JRA [patients, 10 childhood systemic lupus erythematosus [ch-SLE] patients, 10 childhood systemic sclerosis]ch-SSC] patients and 10 apparently healthy children as a control group. Both MIA and TGF-beta serum concentrations were found to increase in both destructive [JRA] and non-destructive [ch-SLE and ch-SSc] juvenile arthritis. We found no correlation with disease activity, clinical or laboratory parameters except RF. MIA and TGF-beta are not serum markers of a specific disease. In addition, the presence of elevated MIA in the sera of juvenile arthritic patients very likely reflects passive release from necrotic or apoptotic chondrocytes and is partly due to chondrocyte activation. This is supported by the fact that MIA level was only associated with RF positivity and not with markers of inflammation

Biochemical markers of bone turnover in postmenopausal osteoporosis and relation to female sex hormone estradiol

To evaluate bone turnover in postmenopausal osteoporosis and its relation to female sex hormone estradiol, using biochemical markers of both bone formation and resorption. Thirty females suffering from postmenopausal osteoporosis were studied compared to ten apparently healthy females. Estimation of biochemical markers of bone formation including procollagen type 1 carboxy- terminal propeptide [PICP], osteocalcin and alkaline phosphatase was performed. Hydroxyproline was estimated in the urine as a marker of bone resorption. Also, serum estradiol values were assessed. Our results revealed an increase in the values of biochemical markers of bone formation PICP and osteocalcin, but no change in alkaline phosphatase was detected. Also, there was an increase in the biochemical marker of bone resorption, hydroxyproline. There were decreased estradiol values in our patients that were correlated with the biochemical markers of bone turnover. Regular estimation of biochemical markers of bone turnover may be valuable in early diagnosis, prevention and treatment of postmenopausal osteoporosis. Estradiol strongly affects bone turnover in postmenopausal osteoporosis that reflected on the values of biochemical markers of bone turnover

Prevalence of staphylococci in rheumatoid arthritis patients

Recent studies suggested that staphylococcal exotoxin may be involved in the pathogenesis of rheumatoid arthritis. The objective of this study was to determine the prevalence of oral staphylococcal carriage in patients with RA compared with healthy controls. This study was performed on 27 patients with RA and 25 healthy volunteers. Clinical and laboratory data of RA activity were studied. Tongue and anterior nasal swabs were obtained for culture on blood agar. Isolates of staphylococci were identified and collected from oral cavity of 96.3% of RA patients, 53.8% of whom carried staphy. aureus. On the other hand 88% of the healthy volunteers showed staphylococci, 36.4% of whom carried staph aureus. The carriage rate of staph aureus was significantly higher in RA patients than in healthy controls [P<0.05]. So we conclude that the oral carriage of staph. aureus was common in patients with RA. This may be the source of septic arthritis in such patients

Anti-neutrophil cytoplasmic antibodies in juvenile chronic arthritis and rheumatoid arthritis

To assess the incidence and clinical significance of ANCA in RA and JCA patients, and to study the relation between ANCA and granulocyte specific ANA. Serum antineutrophil cytoplasmic antibodies were determined with indirect immunofluoresescent [IIF] technique in 20 RA and 12 JCA patients. ANCA was detected in sera from 10 RA patients [50%] and their titer ranged from 110-350 and JCA patients [25%], their titer ranged from 70-230. ANCA titer was not correlated with RF, disease duration and the presence of ANA. p-ANCA were found in 25% RA patients and 8% of JCA patients, c- ANCA were seen in 25% of RA patients and 17% of JCA patients. The laboratory and histologically proven nephropathy were seen in 25% of RA patients 8% of JCA patients, they were associated with p- ANCA. We concluded that early diagnosis of ANCA associated vasculitides is a key to prevent renal failure, and to measure the serum ANCA titer not only for the diagnosis the clinical course, but also to early treatment of renal affection

Treatment of chronic rotator-cuff impingement with arthroscopic subacromial decompression

We made a prospective study on 29 patients who had arthroscopic subacromial decompression for chronic rotator-cuff impingement. All patients were diagnosed as having chronic rotator-cuff impingement on the basis of clinical and sonographic examination. All patients were assessed pre-operatively and at 3, 6 and 12 months post-operatively using the shoulder-rating scale of the University of California at Los Angeles [UCLA]. The dominant arm was affected in 24 patients. There were 26 males and only three females. Before operation, the UCLA shoulder score was poor or fair in all patients. After three months of the operation 48% of patients had satisfactory relief of symptoms but at one year 93% of patients examined had a good or excellent result We concluded that arthroscopic subacromial decompression is an effective form of treatment, but full recovery of function and relief of symptoms could take long time