羟氨苄青霉素引起大疱性类天疱疮样疹

The ovariectomized rat model of postmenopausal bone loss

Objective To review the effect of hormone replacement therapy (HRT) on bone density and fractures in postmenopausal women. Data source We searched MEDLINE and EMBASE from 1966 to 1999, the Cochrane Controlled Register, citations of relevant articles, and proceedings of international meetings for eligible randomized controlled trials. We contacted osteoporosis investigators to identify additional studies, and primary authors for unpublished data. Study selection We included 57 studies that randomized postmenopausal women to HRT or a control (placebo or calcium/vitamin D) and were of at least 1 yr in duration. Seven of these studies reported fractures. Data abstraction For each study, three independent reviewers assessed the methodological quality and abstracted the data. Data synthesis HRT showed a trend toward reduced incidence of vertebral fractures [relative risk (RR) 0.66, 95% confidence interval (CI) 0.41-1.07; 5 trials] and nonvertebral fractures (RR 0.87, 95% CI 0.71-1.08; 6 trials). HRT had a consistent effect on bone mineral density (BMD) at all sites. The difference between HRT and control in the percent change in bone density at 2 yr was 6.76 (5.83, 7.89; 21 trials) at the lumbar spine and 4.53 (3.68, 5.36; 14 trials) and 4.12 (3.45, 4.80; 9 trials) at the forearm and femoral neck, respectively. Conclusions HRT has a consistent, favorable and large effect on bone density at all sites. The data show a nonsignificant trend toward a reduced incidence in vertebral and nonvertebral fractures.

V. Meta-Analysis of the Efficacy of Hormone Replacement Therapy in Treating and Preventing Osteoporosis in Postmenopausal Women

Purpose:To review evidence that screening for osteoporosis by measuring bone mass in postmenopausal women would reduce fracture incidence. Data Identification:An English-language literatur...

Screening for osteoporosis.

OBJECTIVE--To examine the effects of taking drugs affecting bone metabolism on the risk of hip fracture in women aged over 50 years. DESIGN--Retrospective, population based, case-control study by questionnaire. SETTING--14 centres in six countries in southern Europe. SUBJECTS--2086 women with hip fracture and 3532 control women matched for age. MAIN OUTCOME MEASURES--Number of drugs affecting bone metabolism taken and length taken for. RESULTS--Women taking drugs affecting bone metabolism had a significantly decreased risk of hip fracture. After adjustment for differences in other risk factors, the relative risk of hip fractures was 0.55 (95% confidence interval 0.31 to 0.85) in women taking oestrogens, 0.75 (0.60 to 0.94) in those taking calcium, and 0.69 (0.51 to 0.92) in those taking calcitonin. The fall in risk was not significant for anabolic steroids (0.6 (0.29 to 1.22)). Neither vitamin D nor fluorides were associated with a significant decrease in the risk of hip fracture. The effect on hip fracture risk increased significantly with increasing duration of exposure (risk ratio 0.8 (0.61 to 1.05) for less than median exposure v 0.66 (0.5 to 0.88) for greater than median exposure). Drugs were equally effective in older and younger women, with the exception of oestrogen. CONCLUSIONS--Oestrogen, calcium, and calcitonins significantly decrease the risk of hip fracture. Short term intervention late in the natural course of osteoporosis may have significant effects on the incidence of hip fracture.

https://www.bmj.com/content/bmj/305/6862/1124.full.pdf

Evidence for efficacy of drugs affecting bone metabolism in preventing hip fracture.

Calcitonin for prevention of postmenopausal bone loss

Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia

D. Duda, W. Lorenz, W. Dick, I. Celik, A. Black, M. J. R. Healy and J. W. Black Clinic of Anaesthesiology, Johannes Gutenberg University, Langenbeckstr. 1, D-55131 Mainz, Germany, Fax +49 6131 175518, e-mail: duda@goofy.zdv.uni-mainz.de Institute of Theoretical Surgery, Philipps University, Baldingerstr., D-35033 Marburg, Germany Department of Anaesthesia, Bristol Royal Infirmary, Bristol BS2 8HW, UK Departments of Medical Statistics and Epidemiology, London School of Hygiene and Tropical Medicine, 23 Coleridge Court, Milton Road, Harpenden, Herts AL5 5LD, UK James Black Foundation, 68 Half Moon Lane, Dulwich, London SE24 9JE, UK

Can clinically relevant histamine release be accurately diagnosed in anaesthetised patients without plasma histamine measurements? Randomised study with nested sampling aimed to change paradigms

Truth and consequences in medical research.

A 2-year randomised pilot study was conducted in 70 patients to see whether the osteoclast-inhibiting effect of calcitonin would reduce postmenopausal vertebral bone loss. An oestradiol-treated group was included in the study as a positive control since oestrogens are known to be effective. Calcitonin reduced vertebral bone loss in doses above 250 ug human calcitonin (50 international units) a week, and at this dose was as effective as oestradiol.

M.J.R. Healy

Papers

Calcitonin for prevention of postmenopausal bone loss

Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia

Can clinically relevant histamine release be accurately diagnosed in anaesthetised patients without plasma histamine measurements? Randomised study with nested sampling aimed to change paradigms

Truth and consequences in medical research.

Calcitonin for Prevention of Postmenopausal Bone Loss