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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Depression and bone mineral density

Govender, Catherine Olly 24 October 2008 (has links)
The aim of the study was to investigate the association between depression and low bone mineral density (BMD) in premenopausal females. The rationale for the study was that depression is often characterized by cortisol hypersecretion. The role of cortisol includes effects on bone metabolism and the immune system: cortisol is a bone resorption agonist through its support of osteoclastogenesis. The release of pro-inflammatory cytokines, (especially IL-1, IL-6 and TNF-alpha) which induce cortisol secretion, also pushes the balance of bone remodelling in favour of resorption, consequently causing loss of bone mineral density. Significant results have been reported in studies of various groups across the USA, Europe and Asia, indicating a causal role for depression in osteoporosis. However, some studies could not support this association. With both osteoporosis and depression representing growing public health concerns in South Africa, the aim of this study was to examine the association between depression and loss of BMD in a South African sample with varying levels of depression. The study was approached from two starting points: the first used low BMD as the departure point and the second was undertaken from the diagnosis of depression. This was achieved by first investigating women where the primary concern was possible low BMD (referred to as Study 1) and secondly by assessing women whose primary diagnosis was clinically confirmed major depression (Study 2). Study 1 involved investigation of BMD in a volunteer-based sample of 40 premenopausal women drawn from three different sources. All volunteers underwent a DEXA scan, were assessed for depression and supplied saliva for cortisol analysis. Study 2 examined the BMD of five psychiatric patients diagnosed with severe, recurrent major depression and four healthy controls. These volunteers were required to undergo the same testing as subjects in Study 1. In addition, blood and urine samples were taken to examine bone turnover markers (bone specific alkaline phosphate, osteocalcin, urine pyridinoline cross-linked C-telopeptide and deoxypyridinoline). The pro-inflammatory status of the psychiatric patients was compared to reference ranges. The latter served as a small exploratory study and an introduction to further avenues of research. Study 1 revealed no clear general association between depression and bone density on DEXA scores. However, a correlation was found between left femoral neck BMD and depression in those women with low BMD only. Significant differences were found though between subjects with normal and low BMD in terms of body mass index (BMI) and contraception use. Study 2 on the other hand, indicated a trend of association between depression and low BMD: subjects suffering with severe major depression were noted to have lower bone density (on DEXA) and higher bone turnover (as measured by markers of bone turnover) as well as higher cortisol levels than healthy controls. In addition, depressed subjects exhibited elevated IL-1-alpha levels but normal TNF-alpha levels when compared to normative data. In conclusion, the study indicated that the effect of depression on bone density is dependent on the intensity and duration of depression. IL-1-alpha and cortisol may be instrumental in this loss of BMD. / Dissertation (MSc)--University of Pretoria, 2008. / Physiology / unrestricted
102

Determinants of Bone Mineral Density Changes in Women Transitioning to Menopause: A MONET Group Study

Elnefily, Rasha January 2013 (has links)
Menopause is an important period for bone health in women. Objective: To assess the determinants of bone mineral density (BMD) changes in women transitioning to menopause. Method: A secondary data analysis of the MONET (Montreal-Ottawa New Emerging Team) study. Outcome measures included yearly assessment of menopause status, body composition, BMD, physical activity energy expenditure (PAEE) and dietary calcium and vitamin D intakes. Results: 84 of the original 102 women had complete data for the purpose of the present study. Repeated measures analysis revealed significant decreases in lumbar spine and femoral neck BMD (P< 0.01). Regression analysis revealed that baseline femoral neck BMD, changes in PAEE and trunk fat explained 31% of the variation of BMD changes at the femoral neck, while changes in both PAEE and trunk fat account for 27% of BMD change at lumbar spine. Conclusion: Baseline femoral neck and changes in physical activity energy expenditure and trunk fat are determinants of the reduction of bone mineral density in women transitioning to menopause.
103

Effets sur le tissu osseux (microarchitecture, densitométrie, biomécanique et remodelage) et sur le métabolisme lipidique de l'acide zolédronique et de l'exercice physique chez la rate ovariectomisée / Specific and combined effects of zoledronic acid and physical exercice in ovariectomized rats

Lespessailles, Eric 20 January 2009 (has links)
L’objectif de ce travail était d’examiner chez la rate adulte ovariectomisée les effets osseux et sur le métabolisme lipidique de l’acide zolécronique et de l’exercice physique. Dans une première étude, les effets individuels et combinés de l’acide zolédronique 20 µg/kg une injection unique et de l’exercice physique (course dur tapis roulant pendant 12 semaines) ont été examinés sur la densité osseuse au corps entier et au fémur, l’analyse de la microarchitecture trabéculaires, les propriétés biomécaniques et le remodelage osseux. Les résultats montrent globalement que l’acide zolédronique prévient la dégradation microarchitecturale et l’hyperresorption induite par l’ovariectomie, que l’exercice physique maintient partiellement les propriétés biomécaniques et agit sur le remodelage osseux en augmentant la formation osseuse mais qu’aucun bénéfice additionnel ou synergique n’est trouvé sur le squelette osseux de la combinaison des deux interventions. La deuxième étude s’est intéressée aux effets sur le profil lipidique de l’action spécifique et combinée des deux interventions ci-dessus mentionnées. Si l’acide zolédronique et l’exercice de course sur tapis roulant modifient les taux de cholestérol total et de HDL cholestérol dans le sens d’une amélioration du risque d’athérosclérose, leurs effets associés ne sont pas synergiques et ont eu un effet paradoxal inverse possiblement expliqué par un effet pro-inflammatoire de la combinaison des deux interventions. / The aim of this study was to investigate in mature ovariectomized rats the effects on bone tissue and on the lipids metabolism of zoledronic acid and physical exercise. In this first study, the individual and combined effects of zoledronic acid (20 µg/kg a single injection) and physical exercise (treadmill running exercise during twelve week) have been examined on whole body and femur bone mineral density, on trabecular microarchitecture analysis, on bone strength parameters and on bone turnover. Results showned globally that zoledronic acid prevented the trabecular microarchitectural changes and the increase in resorption induced by ovariectomy. Treadmill running exercise particully maintained the bone strength and exerted its action by an increase in bone formation. However we dit not found any additive or synergistic effect of the two interventions combined on the rat skeletal status. The second study aimed to assess the specific and combined effects of zoledronic acid and treadmill running exercise on the lipid profile in this model of ovariectomized mature rats. If both zoledronic acid and treadmill running exercise modified total cholesterol and HDL cholesterol with an improvement of the atherosclerosis risk, their combined effects were not synergistic and furthermore they produced a paradoxical inverse effect possibly explained by a pro-inflammatory effect of the two interventions combined.
104

Osteoporose na doença de Cushing: valor preditivo da quantificação de adiposidade visceral e óssea sobre a remodelação e densidade mineral óssea / Osteoporosis in Cushing\'s disease: predictive value of measurement of visceral and bone fat on bone remodeling and mineral density

Sergio Luchini Batista 23 November 2016 (has links)
As propriedades anti-inflamatórias e imunossupressoras dos glicocorticoides (GC) justificam o uso destes esteroides em diversas condições clínicas, apesar dos seus importantes efeitos adversos. A osteoporose induzida por glicocorticoide (OIG) é considerada a causa mais importante de osteoporose secundária. Trata-se de uma doença multifatorial que envolve alterações sistêmicas, teciduais e da sinalização das células ósseas. Além disso, o hipercortisolismo também se associa à obesidade, redistribuição de gordura, resistência insulínica e diabetes mellitus. Curiosamente, nestes distúrbios metabólicos em que a massa óssea está preservada, há maior fragilidade óssea. Nos últimos anos, diversas evidências mostram complexa interação entre o metabolismo mineral e o energético, em particular entre o tecido adiposo e ósseo. Neste cenário, a doença de Cushing (DC) é um modelo clínico conveniente para avaliar diversos mecanismos envolvidos no complexo processo de desenvolvimento de osteoporose. O objetivo deste trabalho foi avaliar, em um estudo basal e em um estudo prospectivo, diversos aspectos da interação entre o metabolismo mineral e energético em mulheres com DC e o seu possível impacto sobre a massa óssea, bem como a associação entre a massa óssea e os diversos tipos de tecido adiposo. No estudo basal, avaliamos três grupos de indivíduos, pareados por sexo e idade: grupo controle (C; n=27), grupo obeso (O; n=16) e grupo doença de Cushing (DC; n=16). No estudo prospectivo, avaliamos o grupo DC em três momentos: pré-operatório (Pré-op; n=11), 6º mês pós-operatório (6º mês PO; n=10) e 12º mês pósoperatório (12º mês PO; n= 10). No estudo basal, os grupos O e DC diferiram em relação ao C quanto ao peso e IMC (p<0,05). O grupo DC apresentou valores significativamente maiores de glicemia, insulinemia, hemoglobina glicosilada (HbA1c), HOMA-IR e leptina em relação aos grupos C e O (p<0,05). Adicionalmente, o grupo DC mostrou níveis baixos de osteocalcina em relação aos grupos C e O (p<0,05) e também de PTH, 25-OH vitamina D (25(OH)D) e adiponectina em relação ao grupo C (p<0,05). Não houve diferença entre os grupos em relação às dosagens de IGF-I e preadipocyte factor 1 (Pref-1). O grupo DC apresentou menor massa óssea em coluna lombar em relação aos grupos C e O (p<0,05) e menor massa óssea em corpo total quando comparado ao grupo O (p<0,05). O Trabecular bone score (TBS) foi capaz de evidenciar prejuízo na qualidade óssea nos grupos O e DC, mostrando comprometimento maior no grupo DC (p<0,05). A adiposidade de medula óssea (AMO) de L3 foi significativamente maior no grupo DC em relação aos grupos C e O (p<0,05). O grupo DC apresentou maior teor de tecido adiposo subcutâneo (SAT), visceral (VAT), relação VAT/SAT e de lipídeos intra-hepáticos (IHL) em relação ao grupo C (p<0,05). Adicionalmente, o grupo DC apresentou maior teor de VAT em relação ao grupo O (p<0,05). A osteocalcina se correlacionou de maneira positiva com TBS (r=0,5, p<0,0001) e negativa com HOMA-IR (r=-0,4, p<0,01) e AMO de L3 (r=-0,4, p<0,01). O TBS apresentou correlação negativa com HOMA-IR (r=-0,6, p<0,0001) e AMO de L3 (r=-0,5, p<0,001). A AMO de L3 se correlacionou positivamente com IMC (r=0,4, p<0,01), HOMA-IR (r=0,3, p<0,05), leptina (r=0,3, p<0,05), relação VAT/SAT (r=0,6, p<0,0001) e IHL (r=0,5, p<0,05). No estudo prospectivo, houve redução do peso e IMC e dos níveis de glicemia, insulinemia, HOMA-IR, hemoglobina glicada e leptina (p<0,05). Adicionalmente, houve aumento dos níveis de 25(OH)D, osteocalcina e deoxipiridinolina (p<0,05). Não houve diferenças significativas entre os níveis de Pref-1 e adiponectina. O TBS manteve-se estável e não houve aparecimento de novas fraturas pelo vertebral fracture assessment (VFA). Na composição corporal por dual-energy X-ray absorptiometry (DXA), houve redução da massa gorda total e melhora no índice de massa magra apendicular pelo Foundation for the National Institutes of Health (FNIH) (p<0,05). A AMO de L3 reduziu significativamente no 6º mês PO, mantendo-se estável no 12º mês PO (p<0,05). Houve redução significativa do VAT, relação VAT/SAT e IHL no seguimento prospectivo (p<0,05). O presente estudo reafirma dados anteriores que mostram que o hipercortisolismo endógeno exerce profundo efeito negativo sobre o esqueleto, em particular sobre o osso trabecular. Além disto, é o primeiro estudo a mostrar que existe correlação negativa entre o TBS com HOMA-IR e AMO; é possível que as alterações do metabolismo energético sejam, pelo menos em parte, responsáveis pelo maior risco de fratura na DC. / The anti-inflammatory and immunosuppressive properties of glucocorticoids (GC) justify the use of these steroids in various clinical conditions, despite its significant adverse effects. Osteoporosis induced by glucocorticoids (OIG) is considered the most important cause of secondary osteoporosis. It is a multifactorial disease involving systemic, tissue and bone cell signaling changes. Furthermore, hypercortisolism is also associated with obesity, redistribution of fat, insulin resistance and diabetes mellitus. Interestingly, these metabolic disorders in which bone mass is preserved, there is increased bone fragility. In recent years, evidence shows various complex interaction between the mineral and energy metabolism, in particular between adipose tissue and bone. In this scenario, Cushing\'s disease (CD) is a desirable clinical model to evaluate various mechanisms involved in the complex process of developing osteoporosis. The objective of this study was to evaluate, in a baseline study and a prospective study, various aspects of the interaction between the mineral and energy metabolism in women with DC and their possible impact on bone mass, as well as the association between bone mass and different types of adipose tissue. In the baseline study, we evaluated three groups of individuals, matched by sex and age: control group (C, n = 27), obese (O; n = 16) and Cushing\'s disease group (CD, n = 16). In the prospective study, we evaluated the CD group at three time points: preoperative (Pre-op; n = 11), 6 months postoperative (6th month PO; n = 10) and 12 months postoperatively (12th month PO; n = 10). In the baseline study, the O and CD groups differed in relation to C as the weight and BMI (p <0.05). The CD group showed significantly higher blood glucose, insulin, glycosylated hemoglobin (HbA1c), HOMA-IR and leptin in relation to the C and O groups (p <0.05). Additionally, the CD group showed lower levels of osteocalcin in relation to the C and O groups (p <0.05) as well as PTH, 25-OH vitamin D (25 (OH) D), and adiponectin in relation to the C group (P <0.05). There was no difference between the groups regarding dosages of IGF-I and preadipocyte factor 1 (Pref-1). The CD group had lower bone mass in the lumbar spine in relation to the C and O groups (p <0.05) and lower bone mass in the total body when compared to the O group (P <0.05). The Trabecular bone score (TBS) was able to show impaired bone quality in groups O and CD, showing greater involvement in CD group (p <0.05). Bone marrow adiposity (BMA) in L3 was significantly higher in the CD group compared to the C and O groups (p <0.05). The CD group showed increased subcutaneous fat content (SAT), visceral (VAT), VAT/SAT ratio and intrahepatic lipid (IHL) in relation to the C group (p<0.05). Additionally, the CD group had a higher content of VAT in relation to the O group (p<0.05). Osteocalcin correlated positively with TBS (r = 0.5, p <0.0001) and negatively with HOMA-IR (r = -0.4, p <0.01) and AMO of L3 (r = - 0.4, p <0.01). The TBS was negatively correlated with HOMA-IR index (r = -0.6, p <0.0001) and AMO of L3 (r = - 0.5, p <0.001). The AMO of L3 positively correlated with BMI (r = 0.4, p <0.01), HOMA-IR (r = 0.3, p <0.05), leptin (r = 0.3, p < 0.05), VAT/SAT ratio (r = 0.6, p <0.0001) and IHL (r = 0.5, p <0.05). In the prospective study, there was a reduction in weight and BMI and blood glucose, insulin, HOMA-IR, glycated hemoglobin and leptin (p <0.05). Additionally, there was increased levels of 25(OH)D, osteocalcin and deoxypyridinoline (p <0.05). There were no significant differences between the levels of adiponectin and Pref-1. The TBS was stable and there was no occurance of new fractures by vertebral fracture assessment (VFA). In body composition by dual-energy X-ray absorptiometry (DXA), threre was a reduction of total fat mass and improvement in apendicular lean body mass index by Foundation for the National Institutes of Health (FNIH) (p <0.05). The BMA of L3 significantly reduced in the 6th month PO, remaining stable on the 12th month PO (p <0.05). There was a significant reduction of VAT, VAT/SAT ratio and IHL in the prospective follow-up (p <0.05). This study confirms previous data showing that endogenous hypercortisolism has a profound negative effect on the skeleton, in particular on trabecular bone. Moreover, it is the first study to show that there is a negative correlation between TBS with HOMA-IR and BMA; it is possible that changes in energy metabolism are at least partly responsible for the increased risk of fracture in DC.
105

Aspectos morfológicos e biométricos da mão e densitométricos do metacarpo de ovinos da raça Santa Inês /

Jimenez, Karla Negrão. January 2009 (has links)
Resumo: Considerando-se a falta de informações sobre a morfologia óssea da mão de ovinos, o presente trabalho teve como objetivo descrever os aspectos anatômicos e biométricos da mão de 14 ovinos, machos castrados, da raça Santa Inês como também investigar os valores densitométricos do metacarpo destes animais de diferentes idades. Para isso dissecou-se 14 mãos do membro torácico desses animais, para realização da descrição morfológica após a aplicação da técnica de maceração. A Densidade Mineral Óssea (DMO) do metacarpo foi determinada por meio da técnica de densitometria em imagens radiográficas, após a obtenção dos raios X dos animais vivos aos 12°, 13°, 14° e 15° meses de idade. Para a obtenção das medidas da DMO foi utilizado um software computacional Pró Plus, Média Cybernetics, versão 4.1. Após as análises morfológicas e biométricas das mãos pode-se verificar a semelhança das estruturas ósseas da mão dos ovinos com os bovinos, levando-se em conta o porte médio desta espécie. Além disso, foi observado que os valores densitométricos permaneceram estáveis no decorrer do período experimental. Diante disto sugere-se uma avaliação densitométrica por um período de tempo maior do que foi utilizado neste estudo / Abstract: Considering few information of bone morphology in sheep hand, this study aimed to describe the anatomy and biometric of the hand of 14 sheep, castrated male, Santa Inês also investigate the densitometric values of metacarpus in animals of different ages. For this 14 hands was dissect of the thoracic limb of these animals to the morphological description after applying the technique of maceration and the bone mineral density (BMD) of the metacarpal was determined using the technique of optical densitometry in radiographic images. To measure BMD it was used computer software Pró Plus, Media Cybernetics, version 4.1. After the morphological and biometric hands analyses was verify the similarity of the bony hand of sheep with cattle, taking into account the medium size of this species. Furthermore, it was observed that the bone mineral density values remained stable during the experimental period, it is suggested valuation for a longer period than realized in this study / Orientador: Silvana Martinez Baraldi Artoni / Coorientador: José Wanderley Cattelan / Banca: Mário Jefferson Quirino Louzada / Banca: Vanessa Sobue Franzo / Mestre
106

The Effect of 4 Months Whole Body Vibration of on Bone Mineral Density of Division I Cross Country/Distance Runners

Kavanaugh, Ashley A., South, Mark A., Hamdy, Ronald C., Stone, Margaret E., Stone, Michael H., Ramsey, Michael W. 01 July 2010 (has links)
Abstract available in the Journal of Strength and Conditioning Research
107

Characterizing Osteologic Effects of Cholesteatoma and Oncolytic Virotherapy

Pinkl, Joseph T. 29 August 2021 (has links)
No description available.
108

Prevention and Treatment of Bone Loss in Patients With Nonmetastatic Breast or Prostate Cancer Who Receive Hormonal Ablation Therapy

Limburg, Connie, Maxwell, Cathy, Mautner, Beatrice 01 January 2014 (has links)
Hormone ablation therapy is a mainstay in the treatment of breast and prostate cancers. However, aromatase inhibitors (AIs) used in postmenopausal women with breast cancer and androgen-deprivation therapy (ADT) used in men with prostate cancer contribute to substantial bone loss, thereby increasing the risk of osteoporotic fractures. Evidence-based guidelines, therefore, urge oncology practices to screen these patients for bone loss and, if needed, provide treatment to maintain bone health. In addition to lifestyle modification and calcium or vitamin D supplementation, bone protection strategies include treatment with bisphosphonates and denosumab, a monoclonal antibody against RANK ligand. Identification of patients at greater risk for bone loss and fracture and proper interventions can reduce fracture rates. Oncology nurses can play an important role in screening these patients. The purpose of this article is to inform oncology nurses about the effects of cancer treatment on bone health, review current prevention and treatment options for cancer treatment-induced bone loss, and discuss recommendations for identifying high-risk individuals.
109

Effect of Precision Error on T-scores and the Diagnostic Classification of Bone Status

Kiebzak, Gary M., Faulkner, Kenneth G., Wacker, Wynn, Hamdy, Ronald, Seier, Edith, Watts, Nelson B. 01 July 2007 (has links)
We quantified confidence intervals (CIs) for T-scores for the lumbar spine and hip and determined the practical effect (impact on diagnosis) of variability around the T-score cutpoint of -2.5. Using precision data from the literature for GE Lunar Prodigy dual-energy X-ray absorptiometry (DXA) systems, the 95% CI for the T-score was ±0.23 at the lumbar spine (L1-L4), ± 0.20 at the total hip, and ±0.41 at the femoral neck. Thus, T-score variations of ±0.23 or less at the spine, ±0.20 at the total hip, and ±0.41 at the femoral neck are not statistically significant. When diagnosing osteoporosis, T-scores in the interval -2.3 to -2.7 for spine or total hip (after rounding to conform to guidelines from the International Society for Clinical Densitometry) and -2.1 to -2.9 for femoral neck are not statistically different from -2.5. Better precision values resulted in smaller 95% CIs. This concept was applied to actual clinical data using Hologic DXA systems. The study cohort comprised 2388 white women with either normal or osteopenic spines in whom the densitometric diagnosis of osteoporosis would be determined by hip T-scores. When evaluating actual patient T-scores in the range -2.5 ± 95% CI, we found that the diagnosis was indeterminate in approximately 12% of women when T-scores for femoral neck were used and in 4% of women when T-scores for total hip were used, with uncertainty as to whether the classification was osteopenia or osteoporosis. We conclude that precision influences the variability around T-scores and that this variability affects the reliability of diagnostic classification.
110

The Prevalence of Significant Left-Right Differences in Hip Bone Mineral Density

Hamdy, R., Kiebzak, G. M., Seier, E., Watts, N. B. 01 December 2006 (has links)
Introduction: We determined the prevalence of left-right differences in hip bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) and the resultant consequence, namely: the frequency at which patients would be classified differently if lumbar spine and only one hip (rather than both hips) were measured. Methods: This was a retrospective DXA scan reanalysis of 3012 white women ≥50 yrs who had scans of both hips using Hologic DXA systems. The difference between left and right hips was considered significant if it exceeded the least significant change (LSC) for any of three hip subregions (total hip, femoral neck, trochanter). The number of women with osteoporosis in both hips, the left hip only, or the right hip only was determined by lowest T-score from total hip, femoral neck, or trochanter. Results: Despite high left-right correlations of subregion BMD, significant left-right differences in BMD were common: the difference exceeded the LSC for 47% of women at total hip, 31% at femoral neck, and 56% at trochanter. Left-right differences in BMD that exceeded the LSC affected the percent agreement of left-right hip classification: for all women irrespective of spine status, there was 77% classification (diagnostic) agreement in hip pairs in which the left-right hip BMD difference exceeded the LSC versus 87% agreement in which LSC was not exceeded (significant difference in proportions, P<0.0001). The greatest risk of different classification would occur in women with normal spines as the diagnosis might be determined by hip T-scores. Using L1-4 lumbar spine T-scores, 1229 women were normal at the spine. Twenty-four (2%) were osteoporotic at both hips. However, 12 women (1%) were osteoporotic only in the left hip (significantly different from zero, P<0.001) and 11 (1%) only in the right hip (P<0.001); of these 23 women, the difference in BMD between the osteoporotic hip and the contralateral hip exceeded the LSC in 16 (70% of those with osteoporosis in only one hip). Using L1-4 lumbar spine T-scores, 1159 women were osteopenic at the spine. Of these, 126 (11%) were osteoporotic at both hips, 54 (5%) only in the left hip (P<0.001), and 42 (4%) only in the right hip (P<0.001); of these 96 women, the difference in BMD between the osteoporotic hip and the contralateral hip exceeded the LSC in 56 (58% of those with osteoporosis in only one hip). Conclusions: A statistically significant number of women with osteoporosis are potentially classified differently when scanning only one hip as a result of the high prevalence of left-right differences in BMD. Although the percentages are low, the total number of women affected may be large. From a public health perspective, the practice of scanning both hips could potentially identify more women with osteoporosis and may help prevent future hip fractures. © 2006 International Osteoporosis Foundation and National Osteoporosis Foundation.

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