Journal ArticleDOI
Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis.
B. Lawrence Riggs,Stephen F. Hodgson,W. Michael O'Fallon,Edmund Y. S. Chao,Heinz W. Wahner,Joan M. Muhs,Sandra L. Cedel,L. Joseph Melon +7 more
TLDR
It is concluded that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility, and the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.Abstract:
Although fluoride increases bone mass, the newly formed bone may have reduced strength. To assess the effect of fluoride treatment on the fracture rate in osteoporosis, we conducted a four-year prospective clinical trial in 202 postmenopausal women with osteoporosis and vertebral fractures who were randomly assigned to receive sodium fluoride (75 mg per day) or placebo. All received a calcium supplement (1500 mg per day). Sixty-six women in the fluoride group and 69 women in the placebo group completed the trial. As compared with the placebo group, the treatment group had increases in median bone mineral density of 35 percent (P less than 0.0001) in the lumbar spine (predominantly cancellous bone), 12 percent (P less than 0.0001) in the femoral neck, and 10 percent (P less than 0.0001) in the femoral trochanter (sites of mixed cortical and cancellous bone), but the bone mineral density decreased by 4 percent (P less than 0.02) in the shaft of the radius (predominantly cortical bone). The number of new vertebral fractures was similar in the treatment and placebo groups (163 and 136, respectively; P not significant), but the number of nonvertebral fractures was higher in the treatment group (72 vs. 24; P less than 0.01). Fifty-four women in the fluoride group and 24 in the placebo group had side effects sufficiently severe to warrant dose reduction; the major side effects were gastrointestinal symptoms and lower-extremity pain. We conclude that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility. Thus, under the conditions of this study, the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.read more
Citations
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Quantitation of incident spinal fractures: comparison of visual detection with quantitative morphometry.
TL;DR: If the visual detection of fractures by a consensus of experienced investigators is considered as the "gold standard," quantitative morphometry, based on minimum reduction in vertebral height of 20% accompanied by a minimum decline in area of 10%, provides an objective detection of incident new spinal fractures but not of recurrent fractures.
Journal ArticleDOI
Fluoridated drinking water, oestrogen therapy and residual ridge resorption.
TL;DR: In this paper, anamnestic and clinical investigations were made for 230 postmenopausal women to determine whether the alveolar height in edentulous jaws is associated with the time that the subjects have consumed artificially fluoridated drinking water.
Journal ArticleDOI
Osteoporosis and the jaws: questions remain to be answered.
T.J. Lockington,G.C.J.B. Bennett +1 more
TL;DR: Osteoporosis is a major health issue in later life, which translates the age-associated increased risk of falls into a hip, shoulder or wrist fracture into a vertebral crush fracture after minor loading of the axial skeleton.
Journal ArticleDOI
Determination of Gentamicin Pharmacokinetics by Bioelectrical Impedance in Critically Ill Adults
TL;DR: There is no apparent advantage of BIA‐derived predictive pharmacokinetic equations over an empiric method of predicting gentamicin Vd and k, and further study with variable frequency BIA technology is needed to assess BIA applications in the critically ill.
Journal ArticleDOI
Treatment of osteoporosis: Current status and recent advances
TL;DR: An overview of recent advances in treatment of osteoporosis is provided to provide an overview of new treatment choices.
References
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Estimation of the probability of an event as a function of several independent variables
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Journal ArticleDOI
Changes in Bone Mineral Density of the Proximal Femur and Spine with Aging: DIFFERENCES BETWEEN THE POSTMENOPAUSAL AND SENILE OSTEOPOROSIS SYNDROMES
B. L. Riggs,Heinz W. Wahner,Ego Seeman,Kenneth P. Offord,William L. Dunn,R. B. Mazess,K. A. Johnson,L. J. Melton +7 more
TL;DR: The data suggest the existence of two distinct syndromes: one form, "postmenopausal osteoporosis," is characterized by excessive and disproportionate trabecular bone loss, involves a small subset of women in the early postmenopausal period, and is associated with hip fractures or vertebral fractures or both.
Journal ArticleDOI
Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis: comparison with conventional therapy
TL;DR: The combination of calcium fluoride, and estrogen was more effective than any other combination and grounds for optimism about the efficacy of combinations of available agents with sodium fluoride for fracture in postmenopausal osteoporosis.
Journal ArticleDOI
Concurrent assays of circulating bone Gla-protein and bone alkaline phosphatase: effects of sex, age, and metabolic bone disease.
TL;DR: The serum concentrations of 2 biochemical markers of bone formation, bone Gla-protein (BGP) and bone alkaline phosphatase (BAP), in 164 normal subjects and 164 patients with metabolic bone disorders gave concordant results, however, in patients with glucocorticoid excess.