CiteULike: omalbams fractures http://www.citeulike.org/user/omalbam/tag/fractures CiteULike.org en-gb Copyright © 2004-2008 citeulike.org http://www.citeulike.org/user/omalbam/article/2582818 <i>Osteoporosis International, Vol. 19, No. 4. (14 April 2008), pp. 537-545.</i><br /><br />Abstract Summary  Trabecular bone microstructure was studied in 6 mm bone biopsies taken from the 10th thoracic and 2nd lumbar vertebra of 165 human donors and shown to not differ significantly between these sites. Microstructural parameters at the locations examined provided only marginal additional information to quantitative computed tomography in predicting experimental failure strength. Introduction  It is unknown whether trabecular microstructure differs between thoracic and lumbar vertebrae and whether it adds significant information in predicting the mechanical strength of vertebrae in combination with QCT-based bone density. Methods  Six mm cylindrical biopsies taken at mid-vertebral level, anterior to the center of the thoracic vertebra (T) 10 and the lumbar vertebra (L) 2 were studied with micro-computed tomography (μCT) in 165 donors (age 52 to 99 years). The segment T11-L1 was examined with QCT and tested to failure using a testing machine. Results  The correlation of microstructural properties was moderate between T10 and L2 (r ≤ 0.5). No significant differences were observed in the microstructural properties between the thoracic and lumbar spine, nor were sex differences at T10 or L2 observed. Cortical/subcortical density of T12 (r 2 = 48%) was more strongly correlated with vertebral failure stress than trabecular density (r 2 = 32%). BV/TV (of T10) improved the prediction by 52% (adjusted r 2) in a multiple regression model. Conclusion  Microstructural properties of trabecular bone biopsies displayed a high degree of heterogeneity between vertebrae but did not differ significantly between the thoracic and lumbar spine. At the locations examined, bone microstructure only marginally improved the prediction of structural vertebral strength beyond QCT-based bone density. Does thoracic or lumbar spine bone architecture predict vertebral failure strength more accurately than density? EM Lochmüller K Pöschl L Würstlin M Matsuura R Müller T Link F Eckstein doi:10.1007/s00198-007-0478-x Osteoporosis International, Vol. 19, No. 4. (14 April 2008), pp. 537-545. 2008-03-24T21:21:13-00:00 Osteoporosis International 19 4 537 545 bmd bone diagnosis fractures http://www.citeulike.org/user/omalbam/article/2209624 <i>N Engl J Med, Vol. 357, No. 18. (1 November 2007), pp. 1799-1809.</i><br /><br />BACKGROUND: Mortality is increased after a hip fracture, and strategies that improve outcomes are needed. METHODS: In this randomized, double-blind, placebo-controlled trial, 1065 patients were assigned to receive yearly intravenous zoledronic acid (at a dose of 5 mg), and 1062 patients were assigned to receive placebo. The infusions were first administered within 90 days after surgical repair of a hip fracture. All patients (mean age, 74.5 years) received supplemental vitamin D and calcium. The median follow-up was 1.9 years. The primary end point was a new clinical fracture. RESULTS: The rates of any new clinical fracture were 8.6% in the zoledronic acid group and 13.9% in the placebo group, a 35% risk reduction with zoledronic acid (P=0.001); the respective rates of a new clinical vertebral fracture were 1.7% and 3.8% (P=0.02), and the respective rates of new nonvertebral fractures were 7.6% and 10.7% (P=0.03). In the safety analysis, 101 of 1054 patients in the zoledronic acid group (9.6%) and 141 of 1057 patients in the placebo group (13.3%) died, a reduction of 28% in deaths from any cause in the zoledronic acid group (P=0.01). The most frequent adverse events in patients receiving zoledronic acid were pyrexia, myalgia, and bone and musculoskeletal pain. No cases of osteonecrosis of the jaw were reported, and no adverse effects on the healing of fractures were noted. The rates of renal and cardiovascular adverse events, including atrial fibrillation and stroke, were similar in the two groups. CONCLUSIONS: An annual infusion of zoledronic acid within 90 days after repair of a low-trauma hip fracture was associated with a reduction in the rate of new clinical fractures and with improved survival. (ClinicalTrials.gov number, NCT00046254 [ClinicalTrials.gov].). Zoledronic acid and clinical fractures and mortality after hip fracture. KW Lyles CS Colón-Emeric JS Magaziner JD Adachi CF Pieper C Mautalen L Hyldstrup C Recknor L Nordsletten KA Moore C Lavecchia J Zhang P Mesenbrink PK Hodgson K Abrams JJ Orloff Z Horowitz EF Eriksen S Boonen doi:10.1056/NEJMoa074941 N Engl J Med, Vol. 357, No. 18. (1 November 2007), pp. 1799-1809. 2008-01-09T04:24:55-00:00 N Engl J Med 1533-4406 357 18 1799 1809 fractures mortality osteoporosis therapy