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Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry

100%

Bolanowski M., Pluskiewicz W., Syrycka J.

Open Medicine

2007

vol. 2

issue 3

341-345

We have previously reported a case of a 36-year-old woman who was diagnosed with primary hyperparathyroidism following initial skeletal abnormalities in the hand phalanges and calcaneus revealed by quantitative ultrasound (QUS). Successful parathyroid adenoma surgery resulted in progressive increase of bone mineral density and QUS parameters within 6 months, 1 year and 2 years of follow-up. Now, 5 years after the last measurement and at the onset of her menopause, the study was repeated. It has shown further increase in some ultrasonic and densitometric parameters but decrease in others. This discrepancy could be associated with the early influence of perimenopause on trabecular bone. Based on the current report one can conclude that peripheral QUS used on the hand phalanges and calcaneus is a useful tool for the diagnosis and monitoring of skeletal alterations due to parathyroid dysfunction. Moreover, it can detect early changes associated with perimenopause.

Skeletal status in subjects with poor visual acuity in independent and institutionalized subjects

75%

Drozdzowska B., Pluskiewicz W., Lyssek-Boroń A., Czekajło A., Wiktor K., Adamczyk P.

Annales Academiae Medicae Silesiensis

2010

vol. 64

issue 1-2

16-21

AIM The aim of the study was to evaluate skeletal status in subjects with poor vision. MATERIAL AND METHODS Skeletal status was assessed in a group of subjects with poor visual acuity living independently in general community or institutionalized in a nursing home. A group of 91 subjects (47 females - 29 living independently and 18 from nursing home and 44 males - 19 and 25, respectively) were studied. Mean age was 61.3+/-16.8 y. in females and 61.4+/-10.9 y. in males. Binocular visual acuity was evaluated using a Snellen acuity chart. Skeletal status was assessed by dual-energy X-ray absorptiometry at the calcaneus and forearm using PIXI (Lunar, USA) which measures bone mineral density (BMD) and by quantitative ultrasound at hand phalanges using DBM Sonic 1200 (IGEA, Italy) measuring Amplitude-dependent Speed of Sound (Ad-SoS [m/s]). RESULTS Binocular visual acuity was 0.179+/-0.2 in females and 0.09+/-0.14 in males and was signifi cantly lower in males (p<0.01). A visual acuity did not correlate with skeletal variables in either of sexes and was signifi - cantly lower in males from nursing home in comparison to males living independently (p<0.001) what was not observed in females. Z-scores were used in order to obtain age-adjusted comparisons of skeletal variables between subjects living independently and in nursing home. In females Z-scores for forearm (-0.304+/-0.92 vs –1.044+/-0.74, p<0.01) and calcaneus (-0.017+/-0.97 vs –1.38+/-0.63, p<0.00001) were signifi cantly higher in individuals living independently than in nursing home, and Z-score for Ad-SoS did not diff er signifi cantly. In males no signifi cant diff erences in Z-scores were noted. CONCLUSION The results of the study suggest that in both genders fracture risk in institutionalized subjects may be increased; in females due to aff ected skeletal status, and in males as a consequence of poor vision.

CEL PRACY Celem pracy była ocena stanu szkieletu u osób z niedowidzeniem. MATERIAŁ I METODY Stan szkieletu oceniano w grupie osób żyjących samodzielnie oraz mieszkańców domów pomocy społecznej (DPS). Zbadano 91 osób (47 kobiet – 29 mieszkających samodzielnie i 18 z DPS -ów oraz 44 mężczyzn – odpowiednio 19 i 25). Średni wiek to 61,3+/-16,8 u kobiet i 61,4+/-10,9 lat u mężczyzn. Obuoczną ostrość wzroku badano przy pomocy tablicy Snellena. Badania szkieletu obejmowały pomiar densytometryczny przy pomocy dwuwiązkowej absorpcjometrii rentgenowskiej (DXA) pięty i przedramienia (Lunar, USA) oraz pomiar metodą ultradźwiękową paliczków dłoni DBM Sonic 1200 (IGEA, Italy), mierząc prędkość fali ultradźwiękowej zależnej od amplitudy (Amplitude-dependent Speed of Sound (Ad-SoS [m/s]). WYNIKI Obuoczna ostrość wzroku wyniosła 0,179+/-0,2 u kobiet i 0,09+/-0,14 u mężczyzn i była istotna statystycznie mniejsza u mężczyzn (p<0,01). Ostrość wzroku nie korelowała z parametrami szkieletowymi i była istotnie niższa u mężczyzn z DPS-ów w porównaniu do mężczyzn żyjących samodzielnie (p<0,001), czego nie zanotowano u kobiet. Z-score, jako parametr niezależący od wieku zastosowano dla porównania. U kobiet Z-score przedramienia (-0,304+/-0,92 versus –1,044+/-0,74, p<0,01) i pięty (-0,017+/-0,97 versus –1,38+/-0,63, p<0,00001) były istotnie wyższe u kobiet żyjących samodzielnie względem kobiet z DPS-ów, a Z-score dla Ad-SoS nie różnił się. U mężczyzn brak było różnic ze względu na miejsce zamieszkania. WNIOSKI Wyniki pracy sugerują, że u kobiet i mężczyzn żyjących w domach opieki społecznej ryzyko złamań może być zwiększone; u kobiet w wyniku zaburzeń szkieletu, a u mężczyzn w efekcie niedowidzenia.

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1 Annales Academiae Medicae Silesiensis

1 Open Medicine

1 2010

1 2007

2 Pluskiewicz W.

1 Adamczyk P.

1 Bolanowski M.

1 Czekajło A.

1 Drozdzowska B.

1 Lyssek-Boroń A.

1 Syrycka J.

1 Wiktor K.

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Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry

Skeletal status in subjects with poor visual acuity in independent and institutionalized subjects