Effect of long-term tamoxifen therapy on cancellous bone remodeling and structure in women with breast cancer.

The effects of long-term tamoxifen therapy on bone remodeling were studied in 41 women with breast cancer, 22 treated with tamoxifen for a minimum of 15 months (mean 33) and 19 untreated. Transiliac crest bone biopsies were obtained and a comprehensive histomorphometric analysis performed using a semiautomatic image analysis system. There were no statistically significant differences between the two groups in bone area, osteoid perimeter and area, or osteoid width. Mineral appositional rate, adjusted appositional rate, and mineralization lag time were also similar in the two groups; however, tissue-based bone formation rate was significantly lower in the tamoxifen-treated women (p = 0.05) and the remodeling period significantly longer (p < 0.05). Mean and maximum resorption cavity depth and cavity area were significantly reduced in the tamoxifen-treated patients compared to the untreated patients (p < 0.01, p < 0.01, and p < 0.03, respectively). Calculated and directly measured indices of cancellous bone structure were similar in the two groups, although the data indicated a trend toward greater connectedness in the tamoxifen-treated group. These data indicate that tamoxifen does not exert an antiestrogenic effect on bone remodeling in the human and are consistent with a weak estrogenic effect.

Team approach: a necessity for treating young athletes.

The high school years, when viewed as the beginning of an athletic career, can be the most crucial period in an athlete's life. Thorough, proper, and professional medical care at this level is essential; improper management of the developing athlete can seriously impair the individual's future in competitive sports. This paper describes a case extending over an 18-month period involving a young athlete who experienced recurring pain and distress in the left groin. Continued acceptance of the pain as a simple muscular strain precluded a thorough examination of the case history and the disorder itself. Thus, accurate diagnosis and proper treatment were made more difficult.J Orthop Sports Phys Ther 1980;2(2):69-71.

Results of the task analysis study sports physical therapy section american physical therapy association.

A survey instrument containing 1 13 sports physical therapy job tasks was developed by a committee of experts at the Combined Sections Meeting, American Physical Therapy Association (APTA), in Orlando, FL, on February 8-1 1, 1978. The committee was assisted by the Committee on Competencies, APTA, and a representative from Courseware, Inc. The instrument was then sent to 1074 members of the Section for the purposes of identifying the clinical tasks in which competency is essential to practice effectively and of determining to what extent members are practicing these clinical tasks. Two major mailings were sent, in October 1978 and January 1979; 573 forms were returned for a response rate of 53.4%. Seventy returned forms were not used because they were incomplete or incorrectly filled out (35), were not deliverable (23), or were sent to those that were no longer members of the Section (12). The response rate of usable forms was 50.1 %.J Orthop Sports Phys Ther 1980;1(4):229-238.