Assessing population risk for postmenopausal osteoporosis: a new strategy using data from the Behavioral Risk Factor Surveillance System (BRFSS).

Osteoporosis public health measures are hindered by the inability to easily identify subclinical disease. We have now estimated state-specific osteoporosis prevalences using a simple formula (OST Index) to analyze age and weight of 62,882 older women; the prevalences determined are similar to those based on BMD. This new method has potential use for guiding implementation of osteoporosis prevention/treatment programs. INTRODUCTION: Although osteoporosis-related fractures are a major U.S. public health issue, population-based prevention programs have not yet been developed. One contributing factor has been lack of a suitable screening test to detect asymptomatic high-risk individuals. MATERIALS AND METHODS: We estimated state-specific prevalences of postmenopausal osteoporosis using the Osteoporosis Self-Assessment Tool Index (OST Index; [self-reported weight in kg - age] x 0.2) to analyze data from 62,882 women >or=50 yr of age who participated in the 2002 Behavioral Risk Factor Surveillance System (BRFSS). The OST Index, designed to assess an individual's risk of disease, has previously been shown to have modest positive and high negative predictive value for osteoporosis defined by BMD criteria. Based on this index, women from each state were distributed among high-, moderate-, and low-risk OST categories. Calculated percentages for each category were weighted to U.S. Census Bureau population projections for 2002. By adjusting results to reflect previously validated percentages of women with osteoporosis in each risk category, we estimated the prevalence of postmenopausal osteoporosis in each state. RESULTS: Our calculated weighted prevalence estimates agreed closely with those of the National Osteoporosis Foundation derived from actual femoral neck BMD measurements obtained in the third National Health and Nutrition Examination Survey (1988-1994) and projected to U.S. census state population predictions for 2002. Comparison of unweighted BRFSS-OST results and NHANES BMD data revealed similar percentages of osteoporosis among all women >or=50 yr of age (BRFSS, 18.5%; NHANES, 18.0%; p = 0.47) and also among white women (BRFSS, 19.0%; NHANES, 20.0%; p = 0.28). However, the percentages of osteoporosis among blacks and Hispanics did not correspond, at least partly because of the lack of race-specific reference standards for BMD measurements and OST index ranges. CONCLUSIONS: Analysis of readily available BRFSS data with the OST index formula is a simple, no-cost technique that provides state prevalence estimates of postmenopausal osteoporosis that could be used to guide allocation of resources to statewide osteoporosis prevention programs.     

Isolation of an abnormal protein C molecule from the plasma of a patient with thrombotic diathesis

Protein C has been purified from the plasma of a patient with thrombotic diathesis. Both before and after isolation, the protein showed reduced capacity to hydrolyze synthetic substrates and to anticoagulate plasma. Proteolysis with the soluble thrombin- thrombomodulin complex proceeded normally and to completion as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting. Approximately one-third of the protein is functional, indicating a heterozygous defect. Indirect studies suggest that the abnormal component can bind to protein S and phospholipids. Both forms of activated protein C can also incorporate radiolabeled diisopropylfluorophosphate.     

The evolution of Oregon's Public Psychiatry Training Program

Public psychiatry training in Oregon traces its roots to the community mental health movement of the 1960s and now includes a focus on training in the community and in state hospitals.     

Differential effects of apomorphine in 6-hydroxydopamine-treated and aged rats

Effects of dopamine depletion and old age were tested on the ability of rats to discriminate the interoceptive cue produced by IP administered apomorphine. In Experiment 1, rats were administered IC injections of 6-hydroxydopamine or its vehicle at 5 days of age. Administration of this dopamine neurotoxin resulted in significant depletion of whole-brain dopamine to 27.2% of controls as indicated when the brains of littermate rats, killed at 35 days of age, were analyzed by high-pressure liquid chromatography. Although this dopamine depletion was significant, toxintreated rats learned to discriminate 0.16 mg/kg apomorphine from saline at the same rate as control rats. However, the dose-response curve for apomorphine discrimination after doses of 0.04–0.24 mg/kg suggested hypersensitivity to the dopamine agonist in toxin-treated rats. In Experiment 2, senescent rats were similarly trained to discriminate apomorphine in the two-lever food-motivated operant task. Dose-response testing indicated hypersensitivity similar to that found in 6-OHDA-treated rats. This increased behavioral responsiveness of aged rats to dopamine agonists is discussed in relation to receptor supersensitivity, metabolic rates, and blood-brain barrier permeability.