Osteoporosis and bone densitometry

Osteoporosis, a clinically detectable decrease in bone density, affects 24 million Americans, placing them at increased risk for fractures. This article describes the anatomy and physiology of bones and the detection, treatment and prevention of osteoporosis. Techniques for bone densitometry are emphasized, including conventional radiography, single photon and single energy x-ray absorptiometry, dual photon absorptiometry, dual energy x-ray absorptiometry, quantitative CT and ultrasound.     

Recurrent and repeated infectious endocarditis: causes and preconditions (lecture)

A way of reducing the cost price of hospital automation is proposed. It is not necessary for it to update the whole equipment, but only a small part--the workstations used by programmers for their work, which support the stability of hospital automation; the working places of operators should be kept without modifications, but to allot them properties to inherit a potency and modernity of the purchased equipment; for this purpose they should be equipped with virtual machines copying properties of workstations being arrange in accordance with the pyramidal structure. A UNIX which represents a multi-user, multitask operational operative system providing an access on several pseudoterminals is simultaneously installed on the PENTIUM 100/133 workstation. A graphic terminal of the AMR "UnTerminal" firm (USA) is proposed for use as working places. Their advantage is that they have a special adapter connected directly to the bus of PC extension. Each user is allotted a video adapter, a keyboard controller, sequential and parallel interfaces for connection of the printer and manipulator. Each working place supports multitasking and it can be equipped with a printer, a "mouse" or modem. The image is transmitted on work places with a very high velocity-77 mehabits/sec that supports not only a text mode, but also VGA or SVGA graphics. Certainly, graphic terminals are more expensive than text terminals, but their capacities are similar to those of the main computer, here, the workstation. They may be located from the main computer at a distance of up to 75 meters or more and do not require adjustment during their installation.     

Sleep disorders: diagnosis and treatment

Disturbed or inadequate sleep is a frequent complaint with a great impact on daily functions and an often chronic course requiring adequate treatment. To choose an appropriate therapy it is necessary to develop a useful, reliable, valid and specific diagnostic procedure. Primary care physicians can recognize and treat most sleep disorders. For special diagnostic cases sleep centers are recommended. Sleep disorders may be managed by adequate pharmacological as well as nonpharmacological treatment. Besides specific pharmacological means, education in sleep/wake physiology and hygiene and several psychotherapeutic strategies may be valuable.     

Eyelid disorders: diagnosis and management

Eyelid problems range from benign, self-resolving processes to malignant, possibly metastatic, tumors. Inflammation, infection, benign and malignant tumors, and structural problems such as ectropion, entropion and blepharoptosis may occur. Fortunately, most eyelid disorders are not vision-threatening or life-threatening; however, many cause irritative symptoms such as burning, foreign-body sensation or pain. Blepharitis, or eyelid inflammation, one of the most common problems, is characterized by erythematous eyelids with accumulation of debris along the eyelid margin. Malignant eyelid tumors may be associated with lash loss and erosion of normal eyelid structures. Recognition and diagnosis of these problems are crucial to their proper management. Warm compresses and antibiotics suffice for many conditions, while excision, cryotherapy or laser treatment are required for some.     

Calcium bioavailability of a total bone extract (TBE) and its effects on bone metabolism in rats

The effects of a total bone extract (TBE), a new mineral preparation made from bovine bone rendered soluble by lactic acid and citric acid under decompression, on the bone metabolism and apparent calcium absorption were examined for an ovariectomized (OVX) rat model of osteoporosis. The apparent calcium absorption from TBE was significantly higher than that from calcium carbonate. There were no significant differences in serum biochemical indices. Although there were no significant differences in the dry weight, ash and calcium content in the tibia, or in the bone mineral density of the femur, TBE feeding increased the cortical thickness index of the femur. A positive effect of TBE on bone formation is thus suggested.     

Osteoporosis: pathogenesis, diagnosis, and treatment in older adults

Prevention of osteoporosis is a major health concern. Bone loss occurs throughout life in both women and men due to calcium deficiency, hormonal deficiency, and changes in bone formation. The diagnosis of osteoporosis can now be made prior to fragility fracture, allowing for prevention as well as treatment. Criteria for diagnosis of osteoporosis are reviewed, and a plan for the evaluation of secondary causes of osteoporosis is discussed. Also reviewed are prevention and treatment options such as exercise, calcium supplementation, hormone replacement, and new and investigational drugs.