We investigated the relation between computed tomography measures of aortic calcification and values for bone density and the number of fragility fractures in 2348 healthy, postmenopausal women. To determine whether increases in vascular calcification and bone loss progress in parallel, baseline values were compared with measurements obtained 9 months to 8 yr later in a subgroup of 228 women. Of the 2348 subjects studied, 70% had osteoporosis, 30% had at least one vertebral fracture, and 9% had at least one hip fracture. Aortic calcifications were inversely related to bone density and directly related to fractures. After adjusting for age and potential confounders, measures for aortic calcification predicted 26.1% of the variance in bone density (P < 0.001). Compared with women without calcification, the odds ratios for vertebral and hip fractures in those with calcification were estimated to be 4.8 (95% confidence interval, 3.6-6.5) and 2.9 (95% confidence interval, 1.8-4.8), respectively. The subgroup analysis of 228 women longitudinally studied showed that the percentage of yearly increase in aortic calcification accounted for 47% of the variance in the percentage rate of bone loss (P < 0.001). Moreover, a strong graded association was observed between the progression of vascular calcification and bone loss for each quartile. Women in the highest quartile for gains in aortic calcification had four times greater yearly bone loss (5.3 vs.1.3% yearly; P < 0.001) than women of similar age in the lowest quartile. Smaller, but highly significant differences were also found between all other quartiles. We conclude that aortic calcifications are a strong predictor for low bone density and fragility fractures.
To determine changes in bone density during growth, trabecular vertebral density and an index of spinal cortical bone were measured with quantitative computed tomography in 101 children. The children were divided by age into three groups: prepubertal, indeterminate, and pubertal. Compared with prepubertal children, pubertal adolescents had significantly higher trabecular bone density and more compact bone in the spine (P less than .001). After controlling for puberty, vertebral bone density failed to correlate significantly with age, sex, weight, height, surface area, and body mass index. The results indicate that bone density increases markedly during puberty.
patients with signs of vascular injury had injury confirmed by angiography. Using angiography as the gold standard in the 59 patients, the overall sensitivity of physical examination to detect vascular injury in stable patients with gunshot wounds to the neck was 57%. Specificity was 53%, with positive and negative predictive values of 43% and 66%.Comment: In recent years, there has been a trend towards more conservative use of catheter-based angiography in patients with possible vascular injury. This trend has been most marked in the evaluation of patients with posterior knee dislocation and in the evaluation of stable patients with penetrating trauma to an extremity. The current data, however, suggest that hemodynamically stable patients with gunshot wounds to the neck should still undergo routine imaging evaluation. In some centers, this may be duplex scanning or computed tomography angiography rather than a catheter-based angiogram.
To determine the effect of sex hormones on bone density (BD) during growth, longitudinal quantitative computed tomography (QCT) measurements were obtained in growing, castrated New Zealand White rabbits following administration of normal saline, testosterone, or estrogen from 6 wk of age until the time of skeletal maturity. Vertebral QCT densities increased during growth, were highest at the time of epiphyseal closure, and were significantly greater (P less than 0.001) in hormone-treated animals. In vivo QCT measurements in 12 vertebraes correlated strongly (r = 0.92) with percentage of calcium per weight assessed in vitro by neutron activation analysis.
To determine when spinal bone density reaches its peak, the trabecular vertebral density was assessed, via quantitative computed tomography, among females from two age groups: (1) adolescents (aged 14-19 years; N = 24); and (2) young adults (aged 25-35 years; n =24). The adolescent girls had a higher mean trabecular vertebral density (P less than 0.01), suggesting that spinal density reaches its peak around the time of cessation of longitudinal growth and epiphyseal closure.
Reductions in bone density are a major determinant of vertebral fractures in the elderly population. However, women have a greater incidence of fractures than men, although their spinal bone densities are comparable. Recent observations indicate that women have 20-25% smaller vertebrae than men after accounting for differences in body size. To assess whether elderly women with vertebral fractures have smaller vertebrae than women who do not experience fractures, we reviewed 1,061 computed tomography bone density studies and gathered 32-matched pairs of elderly women, with reduced bone density, whose main difference was absence or presence of vertebral fractures. Detailed measurements of the dimensions of unfractured vertebrae and the moment arm of spinal musculature from T12 to L4 were calculated from computed tomography images in the 32 pairs of women matched for race, age, height, weight, and bone density. The cross-sectional area of unfractured vertebrae was 4.9-11.5% (10.5±1.4 vs 9.7±1.5 cm2; P < 0.0001) smaller and the moment arm of spinal musculature was 3.2-7.4% (56.4±5.1 vs 53.1±4.4 mm; P < 0.0001) shorter in women with fractures, implying that mechanical stress within intact vertebral bodies for equivalent loads is 5-17% greater in women with fractures compared to women without fractures. Such significant variations are very likely to contribute to vertebral fractures in osteoporotic women. (J. Clin. Invest. 1995. 95:2332-2337
Purpose-The purpose of this study was to assess dietary intake habits of Mexican American Hispanic adults participating in the En Balance diabetes education program. Methods-EnBalance is a 3-month culturally sensitive diabetes education intervention for Spanish-speaking Hispanics. Of the 46 participants enrolled, 39 mainly Mexican American Hispanic adults with type 2 diabetes completed the En Balance program. Participants lived in the Riverside and San Bernardino counties of California, and all participants completed the program by June 2008. Dietary intake was assessed at baseline and at 3 months using the validated Southwest Food Frequency Questionnaire.Results-Clinically important decreases in glycemic control and serum lipid levels were observed at the end of the 3-month program. The baseline diet was characterized by a high intake of energy (2478 ± 1140 kcal), total fat (87 ± 44 g/day), saturated fat (28 ± 15 g/day), dietary cholesterol (338 ± 217 mg/day), and sodium (4236 ± 2055 mg/day). At 3 months, the En Balance group mean intake of dietary fat (P = .045) and dietary cholesterol (P = .033) decreased significantly. Low dietary intakes of docosahexaenoic acid, eicosapentaenoic acid, and vitamin E were also observed in these adults with type 2 diabetes. Conclusions-TheEn Balance program improved glycemic control and lipid profiles in a group of Hispanic diabetic participants. En Balance also promoted decreases in dietary fat and dietary cholesterol intake.According to 2007 prevalence statistics, diabetes affected about 24 million people nationwide, or about 7.4% of the US population. 1 Diabetes disproportionately affects minority groups such as Native Americans and Alaska Natives, Blacks, and Hispanics. In 2007, the nationwide prevalence rate for physician-diagnosed diabetes in Hispanics was 10.4% overall and 11.9% for Mexican Americans. 1 Hispanics suffer more from diabetic complications when compared to national rates and when compared to non-Hispanic whites. In light of the projected Hispanic population growth and because alarming diabetes health disparities continue to exist, it is imperative to design effective, culturally competent diabetes intervention programs that address the lifestyle habits that are at the core of the diabetes and obesity epidemics in Hispanics. The purpose of this study was to assess the dietary intake habits of Mexican American Hispanic adults participating in the En Balance diabetes education program. The program objectives are to improve glycemic control, change dietary habits, and increase physical activity in underserved San Bernardino County Hispanics with type 2 diabetes. Methods Sample and SettingA total of 39 Hispanic adults between 25 and 75 years of age with self-reported type 2 diabetes completed this 3-month intervention study. The Southern California En Balance participants were all San Bernardino and Riverside county residents. Program recruitment efforts specifically targeted Hispanic disadvantaged adults with type 2 diabetes by posting recruitment flyer...
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