Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-two postmenopausal women (mean age 60 +/- 5 years) with low BMD (less than -2SD of young adult values) but who had not experienced previous crush fracture were treated with 50 mg of sodium fluoride (NaF), 1 g of calcium and 400 IU of vitamin D2 per day for 2 years. Repeated vertebral and femoral BMD measurements were made and compared with those of a control group consisting of 16 untreated women. Serum alkaline phosphatase and osteocalcin, blood and urinary fluoride levels were measured regularly to determine their predictive value on bone response. 18 of 52 (35%) of the treated patients experienced side effects (29% gastric, 4% lower extremity pain syndrome) but only in 6 cases (12%) was it necessary to discontinue treatment. In neither of the two groups was any fracture recorded (vertebral or otherwise). Among the 43 women who were treated for at least 2 years, 21 (49%) were considered to have responded (i.e., with an increase of vertebral BMD greater than 0.043 g/cm2). There was a mean linear increase in BMD in this group of 0.0041 g/cm2 per month (i.e., 5.5% per year). On the other hand in the non-responder group and in the control group, vertebral BMD either remained stable or decreased. However no difference was detected between the two groups (treated and controls) at the femoral site after 2 years; both groups showed a significant decrease in BMD. The responders had a lower initial osteocalcin level and treatment led to a relatively greater increase in osteocalcin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fluoride therapy in postmenopausal osteopenic women: effect on vertebral and femoral bone density and prediction of bone response. 179 Mar 90

Patients with osteoarthrosis suffer from disability and pain. We measured isokinetic and isometric peak torque in 20 women with gonarthrosis (GA) and in 26 healthy controls. Relationships between muscle strength, walking and stair climbing time, pain level and pain disability scores as assessed by the patients using an extensive questionnaire, radiological changes and subchondral sclerosis expressed as bone mineral density (BMD, g/cm2) of the proximal tibia were studied. Precision errors of the torque measurements in both GA patients and controls were approximately 6%. In the GA patients, isokinetic and isometric quadriceps strength was reduced by 40 and 15% (p < 0.01) respectively, and walking and stair climbing time was increased by 30% (p < 0.005). Isokinetic strength was a better predictor of pain level and pain disability scores than isometric strength and radiological stage. Walking time and stair climbing time were not associated with quadriceps strength, pain level, pain disability scores or radiological changes. Subchondral BMD was not predictive of pain. The study suggests that quadriceps strength assessed by isokinetic dynamometry in GA is a reliable measurement. Isokinetic strength was pronouncedly reduced compared to isometric strength and was a more important predictor of pain and pain disability than isometric strength. These findings should be taken into consideration when planning exercise studies and programmes in GA.
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PMID:Isometric and isokinetic quadriceps strength in gonarthrosis; inter-relations between quadriceps strength, walking ability, radiology, subchondral bone density and pain. 764 7

More than 25% of postmenopausal women are at risk of osteoporosis. In order to avoid its consequences, it is necessary to find an appropriate prevention and/or treatment. We studied: (1) 15 postmenopausal women treated with percutaneous estradiol (50 micrograms/24 h) plus MPA (10 mg/10 days/month); (2) 15 postmenopausal women treated with synthetic calcitonin nasal spray at the daily dose of 100 IU; (3) 10 postmenopausal women treated with nandrolone decanoate (50 mg every 3 weeks); (4) 10 postmenopausal women treated with ipriflavone (600 mg/day); and (5) 10 postmenopausal women treated with sodium fluoride (20 mg) plus calcium (600 mg). Clinical examination, bone mass measurement (total BMD), hematochemical and urinary parameters of bone metabolism (calcium, urinary hydroxyproline, PTH) and growth factors (as IGF-I and TNF-beta) were evaluated. After 6 months of therapy, a complete prevention of bone resorption was achieved. In agreement with current literature, we observed that the various therapeutic approaches have all some positive effect on BMD, with different results on pain, blood biochemical parameters and growth factors' concentrations.
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PMID:Management of postmenopausal osteoporosis. 798 17

The effects of recreational exercise and milk intake on BMD were assessed in Japanese men using analysis of covariance with significant predictor variables, selected from age, height, body weight and body mass index (BMI), as covariates. The influence of degenerative vertebral changes on these effects was also evaluated. Recreational exercise was found to be positively associated with BMD at the lumbar spine and the femoral neck, whereas milk intake, a possible indicator of calcium intake in the Japanese, was positively associated with BMD at the radius and the lumbar spine. Not only vertebral BMD but also radial and femoral neck BMD was higher in the subjects with osteophytosis or sclerosis in the lumbar vertebrae. Neither exercise nor lumbar pain was significantly related to these vertebral changes. These data suggest a protective effect of regular recreational exercise and milk intake on bone health in Japanese men.
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PMID:Influence of exercise and degenerative vertebral changes on BMD: a cross-sectional study in Japanese men. 896 23

Twenty four children with Scheuermann's disease (11 girls and 13 boys) aged 9-18 years measured for bone mineral density. The total skeleton (TB BMD) and lumbar spine (L2-L4 BMD) mineral density were investigated by dual energy X-ray absorptiometry (DEXA). In nine patients with Scheuermann's disease and backache we found lower levels of TB BMD and L2-L4 BMD in comparison with reference population of Lunar database. Osteopenia in these children may be caused by decreased physical activity due to vertebral pain.
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PMID:Assessment of bone density in children with Scheuermann's disease. 958 88

An increasing number of adult thalassaemics have been complaining of aches and pains of varying degrees of severity. In a minority the pains are debilitating and there is stiffness in movement. This study is an attempt to understand the osteoporosis of thalassaemia using DEXA and MRI as the main investigative tools. 122 patients with homozygous beta-thalassaemia were examined by DEXA. It was found that almost half had BMD below two standard deviations from the mean for the normal population, especially in the lumbar spine. There was no marked worsening with age. However the proportion of patients who had their first transfusion after the 3rd year (especially after the 6th) was significantly greater in those with the low BMD. There is also an excess of hypogonadic thalassaemics amongst those with low BMD. 72 thalassaemics were examined by MRI of marrow. Hypercellular, dark marrow on T1 weighted images found in young patients (20-30 yr) was replaced by fatty marrow in later life (30-40 yr). In a group of 21 older thalassaemics (33-62 yr) extreme bone marrow expansion was expressed by the reappearance of hypercellular areas, giving the impression of patchiness which affects not only the diaphyses but also the metaphyses. These patients mostly (66%) had thalassaemia intermedia and had started irregular transfusion after the 6th year of life. About 75% had a BMD below 2 SD. The conclusion is that patients who were late in receiving blood and especially those with thalassaemia intermedia had a more expanded bone marrow with pressure on cortical bone which caused pain in several cases. An attempt was made in 10 patients to reduce marrow hyperplasia by using hydroxyurea. Results showed a relief of pain and modification of magnetic signal intensity.
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PMID:Bone pain in thalassaemia: assessment of DEXA and MRI findings. 1009 Nov 46

Fractures and subsequent morbidity determine the impact of established postmenopausal osteoporosis. Health-related quality of life (HRQOL) has become an important outcome criterion in the assessment and follow-up of osteoporotic patients. As part of the baseline measurements of the Multiple Outcomes of Raloxifene Evaluation (MORE) study, HRQOL was assessed in 751 osteoporotic (bone mineral density [BMD] T score > or = -2.5) women from Europe with or without vertebral fractures (VFX). This was done using the quality of life questionnaire of the European Foundation for Osteoporosis (QUALEFFO), Nottingham Health Profile (NHP) and the EQ-5D (former EuroQol). QUALEFFO contains questions in five domains: pain, physical function, social function, general health perception, and mental function. Each domain score and QUALEFFO total scores are expressed on a 100-point scale, with 0 corresponding to the best HRQOL. In comparison with patients without VFX, those with VFX were older (66.2 +/- 5.9 years vs. 68.8 +/- 6.3 years; p < 0.001), had higher prevalence of nonvertebral fractures (25% vs. 36%; p = 0.002), and higher QUALEFFO scores (worse HRQOL; total score, 26 +/- 14 vs. 36 +/- 17; p < 0.001). QUALEFFO scores increased progressively with increasing number of VFX, especially lumbar fractures (p < 0.001). Patients with a single VFX already had a significant increase in QUALEFFO scores (p < 0.05). Similar, though weaker, associations were seen for NHP and EQ-5D scores. This study confirms decreased HRQOL for patients with prevalent VFX. In osteoporotic patients, QUALEFFO scores change in relation to the number of VFX. QUALEFFO is suitable for clinical studies in patients with postmenopausal osteoporosis.
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PMID:Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. 1089 88

Spontaneous fractures of the hip which developed after strenuous walking exercise in 8 elderly people are reported. All patients had Singh hip index 4 or below at the time of initial examination and walked from 8,000 to 10,000 steps per day. This presentation aims to arouse the attention of physicians, recreational sports coaches, and elderly people to the deleterious effects of strenuous walking exercise on bone, and it looks for an optimal level of walking exercise according to the elderly patient"s bone quality. Walking exercise should be stopped immediately if pain in the hip develops and continues without relief for several days or more. The optimal walking frequency per day should be prescribed on the basis of the Singh index or T-score of BMD. If the BMD is 1/3 to 1/2 of normal, walking frequency should be adjusted to 1/3 to 1/2 of those of the normal adult with good bone quality.
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PMID:Strenuous walking exercise and spontaneous fracture of the femoral neck in the elderly. 1246 59

Among the main areas of progress in osteoporosis research during the last decade or so are the general recognition that this condition, which is the cause of so much pain in the elderly population, has its antecedents in childhood and the identification of the structural basis accounting for much of the differences in bone strength among humans. Nevertheless, current understanding of the bone mineral accrual process is far from complete. The search for genes that regulate bone mass acquisition is ongoing, and current results are not sufficient to identify subjects at risk. However, there is solid evidence that BMD measurements can be helpful for the selection of subjects that presumably would benefit from preventive interventions. The questions regarding the type of preventive interventions, their magnitude, and duration remain unanswered. Carefully designed controlled trials are needed. Nevertheless, previous experience indicates that weight-bearing activity and possibly calcium supplements are beneficial if they are begun during childhood and preferably before the onset of puberty. Modification of unhealthy lifestyles and increments in exercise or calcium assumption are logical interventions that should be implemented to improve bone mass gains in all children and adolescents who are at risk of failing to achieve an optimal peak bone mass.
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PMID:Establishment of peak bone mass. 1269 92

Measures of musculoskeletal rehabilitation play an integral part in the management of patients with increased fracture risk because of osteoporosis or extraskeletal risk factors. This article delineates current scientific evidence concerning nonpharmacologic approaches that are used in conjunction with pharmacotherapy for prevention and management of osteoporosis. Fractures caused by osteoporotic fragility may be prevented with multidisciplinary intervention programs, including education, environmental modifications, aids, and implementation of individually tailored exercise programs, which are proved to reduce falls and fall-related injuries. In addition, strengthening of the paraspinal muscles may not only maintain BMD but also reduce the risk of vertebral fractures. Given the strong interaction between osteoporosis and falls, selection of patients for prevention of fracture should be based on bone-related factors and on risk factors for falls. Rehabilitation after vertebral fracture includes proprioceptive dynamic posture training, which decreases kyphotic posturing through recruitment of back extensors and thus reduces pain, improves mobility, and leads to a better quality of life. A newly developed orthosis increases back extensor strength and decreases body sway as a risk factor for falls and fall-related fractures. Hip fractures may be prevented by hip protectors, and exercise programs can improve strength and mobility in patients with hip fracture. So far, there is no conclusive evidence that coordinated multidisciplinary inpatient rehabilitation is more effective than conventional hospital care with no rehabilitation professionals involved for older patients with hip fracture. Further studies are needed to evaluate the effect of combined bone- and fall-directed strategies in patients with osteoporosis and an increased propensity to falls.
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PMID:Musculoskeletal rehabilitation in osteoporosis: a review. 1523 Oct 6


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