Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females

Abstract. With the aim of preventing postmenopausal bone loss, a placebo-controlled double-blind trial of 2 years duration was performed. We randomized 315 healthy volunteers in their early natural menopause to seven treatment and three placebo groups: 17β-oestra-diol, oestriol and sequential norethisteron (hormones); bendroflumethiazide 5 mg/day (thiazide); hormones and thiazide; sodium fluoride 20 mg/day; vitamin D3 2000 IU/day (D₃); fluoride and D₃; and lα (OH) vitamin D3 0–25 μg/day (lαD₃). All participants were given daily calcium supplement of 500 mg. Every 3 months we measured the bone mineral content (BMC) of both forearms by photon absorptiometry and chemical quantities in blood and 48 h urinary collections. The study was completed by 264 (84%).
The combined placebo groups snowed a linear fall in BMC reaching 3-3 % after 2 years ( P < 0–001). Hormones and hormones and thiazide led to a 2–5% gain in BMC ( P < 001). Thiazide alone postponed the BMC fall for 6 months. After 2 years the thiazide group showed a BMC fall of 1–5% ( P < 0–05), less than that of the placebo group ( P < 0–05). BMC declined by 3–6%, 4–5%, 3–7% and 3–7% during the respective use of fluoride, D₃, fluoride and D₃ and lαD₃. Nevertheless, the urinary calcium excretion during lαD₃ and D₃ treatment was 1-1-5 mmol/day higher than in the placebo groups.
Apparently, there is no real alternative to oestro-gen/gestagen in the prevention of postmenopausal osteoporosis.     

Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females

Abstract With the aim of preventing postmenopausal bone loss, a placebo-controlled double-blind trial of 2 years duration was performed. We randomized 315 healthy volunteers in their early natural menopause to seven treatment and three placebo groups: 17β-oestra-diol, oestriol and sequential norethisteron (hormones); bendroflumethiazide 5 mg/day (thiazide); hormones and thiazide; sodium fluoride 20 mg/day; vitamin D3 2000 IU/day (D₃); fluoride and D₃; and lα (OH) vitamin D3 0–25 μg/day (lαD₃). All participants were given daily calcium supplement of 500 mg. Every 3 months we measured the bone mineral content (BMC) of both forearms by photon absorptiometry and chemical quantities in blood and 48 h urinary collections. The study was completed by 264 (84%).
The combined placebo groups snowed a linear fall in BMC reaching 3–3 % after 2 years ( P < 0–001). Hormones and hormones and thiazide led to a 2–5% gain in BMC ( P < 001). Thiazide alone postponed the BMC fall for 6 months. After 2 years the thiazide group showed a BMC fall of 1–5% ( P < 0–05), less than that of the placebo group ( P < 0–05). BMC declined by 3–6%, 4–5%, 3–7% and 3–7% during the respective use of fluoride, D₃, fluoride and D₃ and lαD₃. Nevertheless, the urinary calcium excretion during lαD₃ and D₃ treatment was 1–1–5 mmol/day higher than in the placebo groups.
Apparently, there is no real alternative to oestro-gen/gestagen in the prevention of postmenopausal osteoporosis.     

FREE FATTY ACIDS, GLYCEROL AND TRIGLYCERIDES DURING THE FIRST 24 HOURS IN INFANTS WITH A BIRTH WEIGHT ≤2 700 GRAMS

ABSTRACT. Christensen, N. C. (Departments of Obstetrics and Paediatrics, Odense University Hospital, Odense, Denmark). Free fatty acids, glycerol and triglycerides during the first 24 hours in infants with a birth weight <2 700 grams. Acta Paediatr Scand 70:485,.–The influence of birth weight and gestational age on the concentrations of free fatty acids, glycerol and triglycerides during the first 24 hours of life were studied in 86 healthy newborn infants with BW ≤2700 g. Very low FFA values were found in the first 6 hours in infants with GA ≤34 weeks, whereas FFA increased from the second hour in infants with higher GA. All infants had peak values at 12 h. Significant correlations were found between FFA and GA, most pronounced in the second hour after birth. No differences were seen between AGA and SGA infants of similar GA. High glycerol concentrations were found from the second hour in all infants irrespective of GA and BW. Triglyceride concentrations 24 hours after birth were not influenced by GA or BW. The finding of intact lipolysis but low FFA releases in the first hours in infants with GA ≤34 weeks could not be explained by differences in rectal temperature, blood glucose or caloric intake.     

The Relationship between Pacing Site and Induction or Termination of Sustained Monomorphic Ventricular Tachycardia by Antitachycardia Pacing

Background: With the development of left ventricular pacing for cardiac resynchronization, there is an interest in the possibility of improving ventricular antitachycardia pacing (ATP) efficacy by pacing from the LV electrode(s).
Objective: This study assessed the efficacy of pacing delivered from the left coronary vein (LCV) compared to that delivered from the right ventricular apex (RVA) upon ventricular tachycardia (VT) induction and termination.
Methods: Sixty patients undergoing provocative ventricular electrophysiology (EP) studies in three centers were enrolled. Multipolar EP catheters were placed in the atrium, the RVA, and LCV. VT induction was attempted from the RVA and LCV in random order. Upon detection of monomorphic VT, burst ATP for up to 10 pulses at 88% VT cycle length was delivered from the RVA or LCV, in a random order, and crossed over when possible. Identical VT morphologies were reinduced to allow paired comparison of RVA versus LCV ATP.
Results: Data from 55 patients were analyzed. Thirty-four morphologically distinct monomorphic VT types were induced in 22 patients. ATP succeeded in 18 (55%) and VTs in 13 patients. RVA ATP terminated 15 of 23 (65%) VTs, and LCV ATP terminated 10 of 23 (43%) VTs (P = 0.14). ATP delivered ipsilateral to the earliest activation site required 5.0 ± 2.6 pulses to terminate compared to 4.8 ± 1.7 pulses when delivered from the contralateral site (P = 0.90). Paired comparison was possible for 13 VT morphologies in 11 patients. Paired RVA and LCV ATP efficacy was identical (54 % vs 54%, P = 1.0).
Conclusion: ATP delivered from a LCV lead offers no efficacy advantage over pacing from the RVA. (PACE 2010; 27–32)