Abstract:
OBJECTIVES:Osteopenia is considerably more common than osteoporosis and accounts for most of the fracture burden in women older than 50 years. It is uncertain when to initiate treatment in osteopenia. We sought to determine in women with osteopenia what effect transitioning to lower categories had on subsequent fracturing. METHODS:We surveyed 1150 women from office-based practices who had initial normal or osteopenic bone mineral densities (BMDs) and who were retested after 5.75 years. We classified categories related to baseline T scores as follows: normal (>-1.0), mild osteopenia (-1.0 to -1.49), moderate osteopenia (-1.5 to -1.99), and severe osteopenia (-2.0 to -2.49). We determined during a 9.6-year follow-up period the fracture occurrence in those who maintained their initial category status or transitioned into lower categories. RESULTS:Transitioning to lower categories was not significantly different among baseline osteopenic categories but significantly more than normal baseline BMDs. Total fractures, individuals fracturing, and major fractures were significantly more, with baseline T scores of ≤-1.5 (<0.001). Although only 10.2% transitioned to osteoporosis, 90.5% of these transitions occurred with baseline T scores ≤-1.5 and accounted for significantly more fractures than baseline T scores of >-1.5. CONCLUSIONS:Most subsequent fractures and transitions to osteoporosis occurred with baseline T scores ≤-1.5. Clinical risk factors need to be used to determine at what T score threshold treatment would be cost effective.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Pfister AK,Welch CA,John M,Emmett MKdoi
10.14423/SMJ.0000000000000410subject
Has Abstractpub_date
2016-02-01 00:00:00pages
118-23issue
2eissn
0038-4348issn
1541-8243pii
SMJ50136journal_volume
109pub_type
杂志文章abstract::A "life stress" scale is applied to the antecedent events motivating 179 patients to seek outpatient psychiatric help. Intake evaluation reports of patients who kept their appointments at the Adult Psychiatric Outpatient Clinic of Vanderbilt University Hospital over a three-month period were reviewed. Almost half of t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197602000-00016
更新日期:1976-02-01 00:00:00
abstract::Transchondral talar dome fractures are a rare but not unknown cause of continued disability following a "sprained ankle." The diagnosis is made with standard ankle roentgenograms and an awareness of the lesion. Surgical treatment is recommended in acute and chronic cases, based on the amount of displacement of the fra...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198405000-00007
更新日期:1984-05-01 00:00:00
abstract::Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198802000-00014
更新日期:1988-02-01 00:00:00
abstract::The cost of managing chronic ulcers, both venous leg and decubiti (sacral pressure), was reviewed using 36 randomized, controlled studies with a focus on saline, hydrocolloid, and a human skin construct. When one includes the labor intensiveness of dressing changes three to four times per day, the application of hydro...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000082011.70728.8C
更新日期:2004-02-01 00:00:00
abstract::We compared a "cardiac profile" test with standard creatine kinase (CK) and lactic dehydrogenase (LD) electrophoresis in 798 cases of possible acute myocardial infarction (MI). The cardiac profile enzyme screen (CK-B, CK, LD) used on 495 patients who came to the emergency department with chest pain suggestive of acute...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Chlamydia is the most commonly reported infectious disease in the United States, yet many women at risk for chlamydia infection are not being tested. METHODS:We conducted a chlamydia screening study (Phase I) and retrospective medical chart review (Phase II) of 199 women from 16 to 40 years of age attending...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053673.13882.00
更新日期:2003-09-01 00:00:00
abstract::This is a case which highlights unique diagnostic challenges in the evaluation of a previously healthy patient presenting with a myelopathy initially most concerning for malignancy. However, timely recognition and nonoperative therapy of unexpected spinal sarcoidosis with corticosteroidal therapy was crucial in averti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181e90745
更新日期:2010-09-01 00:00:00
abstract::The role of antibiotics in large bowel surgery was established by experimental studies indicating that antibiotics could protect a colonic anastomosis subjected to unusual stress. A number of different agents were studied to patients to determine which ones significantly altered the bacterial flora of the colon. Clini...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198212000-00019
更新日期:1982-12-01 00:00:00
abstract::Although d-penicillamine has a wide range of benefits in many clinical conditions, various side effects have also been reported and preclude its further use in certain patients. In this case, d-penicillamine-induced reversible airway obstruction developed, despite the "go slow--go low" regimen as suggested to reduce t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198006000-00032
更新日期:1980-06-01 00:00:00
abstract::The majority of abnormalities at the foramen of Monro identified by computed tomography (CT) are colloid cysts, but a number of other diseases in this location may produce a similar CT appearance. In a series of 21 patients the radiologic findings included six colloid cysts, two neoplasms, five vascular lesions, three...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198312000-00016
更新日期:1983-12-01 00:00:00
abstract::Transrectal ultrasonography (TRUS) was used to guide 277 biopsies of the prostate in 182 patients. The Bard Biopty system was used. Of these 182 patients, 107 (59%) had benign changes, and 75 (41%) had malignant lesions. Of those with cancer, 40% (30/75) had negative results of digital rectal examination (DRE). The ca...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::All indexed cases of typhoid fever occurring in children over a ten-year period in Jacksonville, Fla, were studied retrospectively. This review revealed that anorexia was the most common gastrointestinal complaint and that neurologic symptoms and signs were nearly as common as gastrointestinal signs. There was a signi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197902000-00008
更新日期:1979-02-01 00:00:00
abstract::Patients with sickle cell disease are predisposed to infection caused by Streptococcus pneumoniae. However, there has been only one published case of bacteremic pneumococcal meningitis in an adult with sickle cell anemia. We report here the cases of six adults with sickle cell disease, pneumococcal sepsis, and meningi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199009000-00005
更新日期:1990-09-01 00:00:00
abstract::Phantom sensation and phantom limb pain are two recognized sequelae of limb amputation. In most previous surveys, amputations were done for arteriosclerotic or trauma related conditions. We studied 25 patients who had lower extremity amputation for neoplasia. In studying the features of pain before and after amputatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198501000-00009
更新日期:1985-01-01 00:00:00
abstract::Nitrogen, derived from breakdown of dietary amino acids as ammonia, is normally converted to urea and excreted. Impairment in the conversion process (called the urea cycle) can occur, either as a consequence of primary genetic defects or through secondary suppression of enzyme activity. Either process results in hyper...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199307000-00004
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Our objective was to improve breastfeeding initiation rates at an urban medical center. METHODS:A breastfeeding educational program for health care providers was developed and implemented in 1995. The outcome variable of interest was the change in breastfeeding initiation rate during 2 periods, 1993-1994 an...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-08-01 00:00:00
abstract::In 1979 more than 54% of women with children less than 18 years old were in the labor force. The purpose of this study was to study the attitudes of pediatricians toward maternal employment and substitute child care arrangements. To survey their attitudes toward maternal employment and substitute child care, we sent a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198406000-00016
更新日期:1984-06-01 00:00:00
abstract::We have recently developed a Data Bank for Digestive Disorders, with primary data derived from the performance of upper gastrointestinal endoscopy. By using this system to analyze the clinical characteristics of patients with atypical chest pain, we found information from the patient's history (reflux, dysphagia, abdo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198301000-00007
更新日期:1983-01-01 00:00:00
abstract::"Sick building syndrome" (SBS) is one of the more colorful terms describing an increasingly common pattern of symptoms found among workers in modern office buildings. Core symptoms include lethargy, mucous membrane irritation, headache, eye irritation, and dry skin. To prompt a diagnosis of SBS, these otherwise common...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199101000-00015
更新日期:1991-01-01 00:00:00
abstract::Intraorbital hydatid disease (IHD) is quite rare and represents < 1% of the Echinococcus cases. In our current communication, we report two children with solitary, primary intraorbital hydatid cysts. Both children presented with nontender, nonpulsatile proptosis. Imaging workup, including CT and MRI scans of the head ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000217492.03019.16
更新日期:2006-06-01 00:00:00
abstract::Coronary heart disease remains the major cause of mortality and morbidity in the United States and other western countries despite major advances in its treatment. During the last decades, many markers of coronary artery disease have been found which help predict future risk of cardiovascular events. High-sensitivity ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e31816c0195
更新日期:2008-05-01 00:00:00
abstract::We have described a patient with portal hypertension and retrocardiac paramediastinal density on upright PA chest x-ray film. Splenoportograms showed this density to be paraesophageal collateral veins. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198511000-00030
更新日期:1985-11-01 00:00:00
abstract::Chemonucleolysis and lumbar laminectomy after unsuccessful chemonucleolysis are now common and accepted surgical procedures that require precise perioperative management based on a thorough understanding of the pathophysiology of chymopapain-induced anaphylaxis and the herniating nucleus pulposus syndrome. Preoperativ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198612000-00019
更新日期:1986-12-01 00:00:00
abstract::Twenty-eight women were tested with a standard three-hour oral glucose tolerance test before and after three years of using a combination-type oral contraceptive containing mestranol and ethynodiol diacetate (Ovulen). At the three-year test time there was a significant elevation of the patients' weights and their 1-, ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197710000-00010
更新日期:1977-10-01 00:00:00
abstract::During a recent five-year period 14 patients had pseudoaneurysms as late complications of aortic bifurcation grafts. Severe atherosclerosis had been present at the time of the aortic grafts, and subsequent progression of arterial disease appeared to be the usual cause of the pseudoaneurysms which occurred from two to ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198012000-00016
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:To explore breast cancer beliefs among a cohort of low-income, urban, English-speaking women in Miami, Florida, who had undergone screening mammography. METHODS:Four focus groups of 34 women were conducted. Discussions were transcribed verbatim and transcripts were analyzed separately by two investigators u...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0000000000000022
更新日期:2013-12-01 00:00:00
abstract::This report describes a case of warm-antibody-mediated hemolytic anemia associated with a hypernephroma. Only four patients with renal cell carcinoma and Coombs'-positive hemolytic anemia have been reported previously. Although rare, the occurrence of autoimmune hemolytic anemia in association with a hypernephroma sho...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198509000-00023
更新日期:1985-09-01 00:00:00
abstract::A 50-year-old black man was admitted with a diagnosis of a ruptured rotator cuff syndrome two weeks after an injury to the right shoulder and treatment by intra-articular steroid injection. At operation pus and necrotic debris were found in the shoulder joint, but the rotator cuff was anatomically intact. Surgical deb...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198206000-00037
更新日期:1982-06-01 00:00:00
abstract::Documented fetal inactivity is strongly suggestive of fetal jeopardy, but the significance of excessive activity over a prolonged period has not been reported. Using data gathered from fetal movement charts recorded by 931 patients, fetal hyperactivity was defined statistically as 40 or more movements perceived per ho...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198302000-00005
更新日期:1983-02-01 00:00:00
abstract::Catheter emboli are a significant risk to patient well-being. With a 49% complication rate for indwelling catheter emboli, the consensus is that these foreign bodies should be removed. Preferably, the emboli are removed by percutaneous extraction; however, if the emboli are in the heart or central vasculature and perc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199607000-00013
更新日期:1996-07-01 00:00:00