Evaluation of secondary causes that may lead to bone loss in women with osteoporosis: a retrospective study.

OBJECTIVE: Secondary causes (SC) that may lead to bone loss and their frequencies have been rarely studied among the population with osteoporosis. In this study, we aimed to describe the frequencies of SC in women with osteoporosis based on outpatient clinic data. METHODS: This is a retrospective chart review of 1,004 osteoporotic women (947 postmenopausal; 57 premenopausal) attended to our outpatient clinic at a tertiary-care centre between March 1998-July 2005. SC and their frequencies were detected in their patient data. RESULTS: At least one SC was observed in 221 patients (22%). A total of 200 of them were at postmenopausal stage and 21 of them were at premenopausal stage. Hypercalciuria (n = 94), thyrotoxicosis (n = 39), and glucocorticoid therapy (n = 29) were the most common disorders in our patient group. CONCLUSIONS: The frequency of SC that may lead to bone loss among women with osteoporosis is not as low as estimated. All premenopausal osteoporosis patients should be examined for SC. SC should be also taken into account postmenopausal patients as well.

Does mud pack treatment have any chemical effect? A randomized controlled clinical study.

OBJECTIVE: The aim of this study was to reveal the efficacy of mud pack treatment in patients with knee osteoarthritis and to find the contribution of chemical factors to the build up of these effects. METHODS: Sixty patients were randomly assigned to directly applied mud pack (study) group or to nylon-covered mud pack (control) group. Thirty patients in the study group had mud application 15 times to both knees: heated mud, up to 43 degrees C, was applied to skin directly for 30 minutes. Thirty patients in the control group had the same treatment as the study group except heated mud was applied over an impermeable nylon pack. Primary outcome measures of the study were the Western Ontario and McMaster Universities (WOMAC) index, pain intensity on a visual analog scale (VAS), patient's assessment of disease severity index, physician's assessment of disease severity index, and analgesic consumption. The patients were evaluated before and after (end of 15th application) the intervention and followed up for 24 weeks at 4-week intervals. The results were assessed on an intent-to-treat basis. RESULTS: As compared to the baseline, significant decreases were observed in WOMAC, pain intensity, disease severity index scores, and analgesic consumption in both groups after the intervention. Observed improvements in the study group were found to be superior to the control during the whole postintervention follow-up, except for analgesic consumption in the third week. A significant number of patients in the study group showed minimal clinically important improvement as compared to the control group. CONCLUSION: Mud pack treatment significantly improved the pain and functional status of patients with knee osteoarthritis, whether applied directly or coated with nylon. Direct application was found to be superior, which implies chemical properties of the mud contribute to the build up of therapeutic effect.

Smoking prevalence in military men, and factors affecting this.

The aim of the present study was to determine smoking prevalence among noncommissioned officers and privates and the factors affecting it. This study was carried out in a division of 20,000 soldiers. One of every 10 names on the roster was chosen at random. Responses were received from 1,822 subjects (91.1%), all male, in the final month of their 18-month military service with a mean age of 20.3 +/- 2.2 years. Individuals performing their military service were surveyed using a self-administered, anonymous, personal, and voluntary questionnaire. It was determined that 1,160 (63.7%) of the participants were smokers: 180 (9.9%) were occasional smokers, and 980 (53.8) were heavy smokers. For the fathers of the participants, these rates were 15.4% and 40.5%, respectively. The frequency of smoking was found to be higher in subjects who had high incomes, who had high levels of education, whose fathers smoked, and who were raised in environments in which there were many smokers. It was determined that 31.4% of subjects had begun smoking within the previous 2 years during their period of military service.