Effect of treadmill gait on bone markers and bone mineral density of quadriplegic subjects.

Quadriplegic subjects present extensive muscle mass paralysis which is responsible for the dramatic decrease in bone mass, increasing the risk of bone fractures. There has been much effort to find an efficient treatment to prevent or reverse this significant bone loss. We used 21 male subjects, mean age 31.95 +/- 8.01 years, with chronic quadriplegia, between C4 and C8, to evaluate the effect of treadmill gait training using neuromuscular electrical stimulation, with 30-50% weight relief, on bone mass, comparing individual dual-energy X-ray absorptiometry responses and biochemical markers of bone metabolism. Subjects were divided into gait (N = 11) and control (N = 10) groups. The gait group underwent gait training for 6 months, twice a week, for 20 min, while the control group did not perform gait. Bone mineral density (BMD) of lumbar spine, femoral neck, trochanteric area, and total femur, and biochemical markers (osteocalcin, bone alkaline phosphatase, pyridinoline, and deoxypyridinoline) were measured at the beginning of the study and 6 months later. In the gait group, 81.8% of the subjects presented a significant increase in bone formation and 66.7% also presented a significant decrease of bone resorption markers, whereas 30% of the controls did not present any change in markers and 20% presented an increase in bone formation. Marker results did not always agree with BMD data. Indeed, many individuals with increased bone formation presented a decrease in BMD. Most individuals in the gait group presented an increase in bone formation markers and a decrease in bone resorption markers, suggesting that gait training, even with 30-50% body weight support, was efficient in improving the bone mass of chronic quadriplegics.

Effect of treadmill gait on bone markers and bone mineral density of quadriplegic subjects

Quadriplegic subjects present extensive muscle mass paralysis which is responsible for the dramatic decrease in bone mass, increasing the risk of bone fractures. There has been much effort to find an efficient treatment to prevent or reverse this significant bone loss. We used 21 male subjects, mean age 31.95 ± 8.01 years, with chronic quadriplegia, between C4 and C8, to evaluate the effect of treadmill gait training using neuromuscular electrical stimulation, with 30-50 percent weight relief, on bone mass, comparing individual dual-energy X-ray absorptiometry responses and biochemical markers of bone metabolism. Subjects were divided into gait (N = 11) and control (N = 10) groups. The gait group underwent gait training for 6 months, twice a week, for 20 min, while the control group did not perform gait. Bone mineral density (BMD) of lumbar spine, femoral neck, trochanteric area, and total femur, and biochemical markers (osteocalcin, bone alkaline phosphatase, pyridinoline, and deoxypyridinoline) were measured at the beginning of the study and 6 months later. In the gait group, 81.8 percent of the subjects presented a significant increase in bone formation and 66.7 percent also presented a significant decrease of bone resorption markers, whereas 30 percent of the controls did not present any change in markers and 20 percent presented an increase in bone formation. Marker results did not always agree with BMD data. Indeed, many individuals with increased bone formation presented a decrease in BMD. Most individuals in the gait group presented an increase in bone formation markers and a decrease in bone resorption markers, suggesting that gait training, even with 30-50 percent body weight support, was efficient in improving the bone mass of chronic quadriplegics.

[Measuring cyclosporine levels in whole blood in kidney transplantation]. / Monitoramento dos níveis de ciclosporina em sangue total em transplantes renais.

BACKGROUND: Cyclosporin A is a potent immunosuppressive drug effective in combatting rejection following organ transplantation. In na effort to replace a radioimmunoassay (RIA) for whole blood determination of cyclosporine (Cya) we compared RIA with fluorescence polarization immunoassay (FPIAm). METHOD: 65 blood samples were analysed from kidney transplanted patients. The samples were collected into tubes containing EDTA as anticoagulant and analysed by RIA and FPIAm. RESULTS: The statistical analysis revealed a difference between both methods (p < 0.05). The linear-regression comparison of Cya concentration measured by RIA and FPIAm showed the following relationship: Cya(FPIAm) = 1.06 x Cya(RIA) + 5.8 (r = 0.9817). CONCLUSION: We conclude that FPIAm provides na alternative method for measuring cyclosporine in whole blood with the added advantages of being reasonably rapid, precise and easy to perform.

Monitoramento dos níveis de ciclosporina em sangue total en transplantes renais / Measuring cyclosporine in whole blood in kidney transplantation176-8

Introduçao e Objetivos. Ciclosporina A é uma droga imunossupressora potente e efetiva no combate à rejeiçao de órgaos transplantados. No presente estudo, os autores avaliaram o emprego de um imunoensaio monoclonal com fluorescência polarizada (FPIAm), como um método alternativo ao radioimunoensaio (RIA) para determinaçao dos níveis de ciclosporina em sangue total. Material e Métodos. Amostras de sangue de 65 pacientes submetidos a transplante renal foram colhidas em frascos com EDTA 12 horas após a última dose de ciclosporina, via oral. Os níveis de cilcosporina foram avaliados por meio de radioimunoensaio com anticorpo monoclonal e imunoensaio monoclonal com fluorescência polarizada. Resultados e Conclusao. A análise estatística revelou um coeficiente de correlaçao entre os métodos de r = 0,9817 e o teste t de Student pareado mostrou haver diferença estatisticamente significante entre eles (p<0,05). A análise da regressao revelou que os métodos poderiam ser comparáveis por meio da equaçao Cya(FPIAm) = 1,06xCya(RIA) + 5,8, mostrando que FPIAm é um excelente método alternativo ao RIA, com as vantagens de ser rápido, de fácil execuçao, reprodutível e com resultados comparavéis aos obtidos por RIA.

Comparaçåo entre radioimunoensaio e imunoturbidimetria para determinaçåo da microalbumina / A comparasion of radioimmunoassay and immunoturbidimetry for determination of microalbuminuria

Microalbuminuria é a excreçåo urinária de pequenas quantidades de albumina, insuficiente para serem detectadas por métodos usais de dosagem de proteínas e possui valor preditivo para o desenvolvimento de proteinúria e insuficiência renal crônica. Radioimunoensaio com duplo anticorpo (RIA) é usualmente considerado como um método-padråo para esta dosagem. Com o objetivo de comparar as dosagens de albumina urinária por radioimunoensaio e por imunoturbidimetria (IT), foram analisadas 91 amostras de urina de pacientes diabéticos ou nåo. Verificamos nåo haver diferença estatisticamente significativa entre os valores obtidos por ambos os métodos e um coeficiente de correlaçåo r=0,99874, mostrando que a IT pode ser utilizada como um método alternativo ao RIA