No abstract

Of 203 patients who underwent cardiac transplantation and were given long-term treatment with cyclosporine and 0.3 mg/kg per day prednisone, 123 were studied prospectively for at least 6 months and 46 for up to 2 years to evaluate the effects on lumbar bone mineral density (BMD) and calcium metabolism of a combined therapy with calcium, calcidiol and disodium monofluorophosphate (MFP). The population was arbitrarily assigned to one of two groups. Group I consisted of patients who had a lumbar spine BMD Z score above -1.5 SD as compared with an age- and sex-matched population and no vertebral fractures. They received daily 1 g elemental calcium and 25 micrograms (1000 IU) calcidiol. Group II consisted of patients who received daily the same doses of calcium and calcidiol combined with 200 mg MFP, and was divided into two subgroups: (a) osteopenic subjects who had a lumbar spine BMD Z score below -1.5 SD without vertebral fractures and (b) osteoporotic subjects with vertebral fractures. If serum creatinine was higher than 140 mumol/l the daily dose of MFP was tapered to 100 mg. Fifty-four and 27 patients from group I and 38 and 19 patients from group II were followed respectively for 12 and 24 months. In both groups serum parathyroid hormone levels were significantly reduced from the twelfth month in parallel with a significant increase in serum 25-OHD levels. No decline in lumbar BMD occurred in non-osteopenic and non-osteoporotic patients (group 1) who received the calcium and calcidiol supplement. In group II, where MFP was added, a significant and linear increase in lumbar BMD was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

The value of a new computerized radiogrammetric method of assessment of the second metacarpal has been evaluated, and its results have been compared with those of single (SPA) and dual photon absorptiometry measurements (forearm and spine) in 74 and 79 postmenopausal women, respectively. Standard hand X-rays were digitized by a video-camera connected to a microcomputer. The combined cortical thickness (CCT) was automatically calculated in a zone of 10 mm around the midpart of the second metacarpal. The intra- and interobserver coefficients of variation were close to 1%. The correlation between CCT and SPA of the proximal and midforearm (with a significant amount of cortical bone) was satisfactory (r = 0.62 and 0.50, respectively; P < 0.001). The correlation between CCT and osteodensitometry of sites comprising more trabecular bone were not so good (0.50 for lumbar and 0.44 for distal forearm bone mineral density, respectively), but still significant (P < 0.001). Radiogrammetry proved unaffected by a change of X-ray apparatus, as measurements of 48 metacarpals radiographed by two different kinds of X-ray apparatus were not significantly different. Radiogrammetry is by no means the best method to evaluate bone mass. Its automation did not improve the correlation with osteodensitometric values. Radiogrammetry is still of interest in mass screening, particularly when other more expensive techniques such as osteodensitometric methods of bone mass measurement are not readily available. Its automation makes it simpler, faster, and more precise, rendering its use easier on a larger scale.