Risk factors for perimenopausal distal forearm fracture.

This prospective population-based cohort study investigated factors predicting distal forearm fracture (DFF) in perimenopausal women. The study population consisted of 11,798 women from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) Study in Finland. Mean baseline age of these women was 52.3 (SD 2.9) years (range 47-56 years) and 68% were postmenopausal. Three hundred and sixty-eight women (3.1%) had a validated DFF during the 5-year follow-up. Previous wrist fracture, postmenopausal state, age and nulliparity were independent predictors of DFF, while hormone replacement therapy (HRT), dairy calcium and overweight protected against it in multivariate Cox regression analysis: previous wrist fracture increased the DFF risk by 158% (p < 0.0001), menopause by 69% (p = 0.002) and age by 6% per year (p = 0.010), whereas the continuous use of HRT decreased the risk by 63% (p = 0.0001), the use of dairy calcium at 1000-1499 mg/day (vs < 500 mg/day) by 39% (p = 0.004), overweight (BMI > 25 kg/m2) by 36% (p = 0.0002) and parity by 29% (p = 0.031). Combining dichotomous low weight, low use of calcium, non-use of HRT and previous wrist fracture into a risk score gave a dose-response effect by score level: the presence (vs absence) of all four risk factors resulted in a 12-fold DFF risk. Nevertheless, the sensitivity and specificity of the score for detecting DFF remained low. It was concluded that HRT, high nutritional calcium intake and overweight protect against but a history of wrist fracture predisposes to perimenopausal distal forearm fracture. A simple risk factor inquiry would help to identify perimenopausal women at high risk of distal forearm fracture.

Validity of self-reports of fractures in perimenopausal women.

The validity of self-report of fractures in postal inquiry among perimenopausal women was evaluated. Self-reports of fractures in the 1989 baseline postal inquiry data of the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) were compared with information in patient records. The study population consisted of 373 women who reported fractures sustained during the last 10 years and 200 randomly selected women who did not report fractures from a population base of 2,007 women aged 47-56 years. Self-report as a screening test for fracture was evaluated in the total sample of 2,007 women by estimating the number of false negative reports in all the women who did not report a fracture with the information on these 200 women. Of the self-reports of fractures, 84% proved to be true fractures, 12% soft tissue injuries, and the rest either self-diagnoses or misnomers. Self-report of wrist fracture was more accurate (95%). The sensitivity of self-report to detect fracture was 78% for all fractures and 95% for wrist fracture, while the respective specificities were 96 and 99%. Self-report is a relatively accurate way to obtain information about past major fractures in perimenopausal women. However, it is rather insensitive in the detection of minor fractures, if the reporting period is several years.

Effect of pentylenetetrazol-induced convulsions on somatostatin-like immunoreactivity in rat cerebrospinal fluid.

Somatostatin is a neuropeptide that in several experimental models of epilepsy has been suggested to modulate epileptic activity. The purpose of the present study was to investigate the role of somatostatin in seizure phenomena. We measured the somatostatin-like immunoreactivity (SLI) by radioimmunoassay of the cisternal CSF of rats. A polyethylene cannula had before-hand been inserted into the cisterna magna. Thereafter seizures were induced by pentylenetetrazol (PTZ). The nonconvulsive group of rats received a single subconvulsive dose of PTZ (30 mg/kg, i.p.). This group of rats exhibited only clonic jerks but not generalized clonic-tonic convulsion (GC). The CSF samples were taken 2 and 10 minutes after the jerks began. The convulsive group of rats received a single convulsive dose of PTZ (50 mg/kg, i.p.), and each of those animals had GC. From those rats the CSF samples were collected 5, 30, and 60 minutes and 4 and 24 h after the GC began. The values were compared with the SLI levels in controls, from which CSF was collected 10 minutes after injection of 0.9% NaCl. In the convulsion group the SLI levels increased 241% (p less than 0.01) five minutes after GC and returned to control level in 30 minutes. In the nonconvulsion group, where the rats expressed only jerks but not GC, SLI levels remained constant. These data suggest that somatostatin is released into CSF after the generalized clonic-tonic phase of the PTZ-induced convulsion.