Glucocorticoid (GC) therapy and orbital radiotherapy represent the classic medical management of ... more Glucocorticoid (GC) therapy and orbital radiotherapy represent the classic medical management of Graves’ ophthalmopathy, either used separately or in association. Because of the lack of response for classic therapy, in some patients new immunosuppressive methods have been tried, one of them is cyclosporine, an selective immunomodulatory drug. This study has proposed to compare short time administration of cyclosporine with administration of iv methylprednisolone and combined therapy (methylprednisolone orbital radiotherapy). In this comparative and prospective study we followed 127 patients with Graves’ ophthalmopathy divided in 4 groups, treated with iv methylprednisolone, associated therapy (GC+RxT), cyclosporine and a control group. All patients were concomitantly treated with oral antithyroid drugs. At 0, 3 and 6 months, the patients were subjected to Hertel exophthalmometry, orbital ultrasonography, TSHR antibody and thyroid-peroxidase antibody assessment and to clinical activi...
Introduction. Vitamin D deficiency has been proven to have a deleterious effect on bone remodelin... more Introduction. Vitamin D deficiency has been proven to have a deleterious effect on bone remodeling and bone mineral density, by inducing secondary hyperparathyroidism. The lack of a present consensus on optimal serum 25(OH)D levels required for the preservation of physiologic bone metabolism renders its follow-up difficult. Materials and Methods. The cross-sectional study was performed on a sample of 69 healthy men aged 50-70. Serum 25(OH)D, total testosterone, sex hormone binding globulin, s-CTX (Crosslaps), and osteocalcin were assessed. BMD was measured by DXA at lumbar spine and hip levels. Statistical relationships between these parameters were calculated. Results. We found a significantly negative correlation between 25(OH)D and s-CTX (r = -0.30. p<0.05), but not between 25(OH)D and osteocalcin, although s-CTX correlated positively with osteocalcin (r = 0.49, p<0.001). Serum CTX was negatively correlated with lumbar BMD (r = -0.35, p<0.001), while osteocalcin was negatively correlated with total hip BMD (r = -0.26, p<0.01). Comparing mean s-CTX levels in insufficient and sufficient subjects at different cut-off points for 25(OH)D, significant differences appeared the strongest at 60 ng/ml. The percentage of 25(OH)D deficient or insufficient subjects was 50.7% at a 30 ng/ml cut-off point. Conclusions. The results of the present study confirm the benefit in maintaining a normal bone turnover offered by serum 25(OH)D in the upper normal range. The large percentage of patients with vitamin D insufficiency reinforce the necessity of a specific follow-up and of epidemiologic studies dedicated to our geographic area.
Glucocorticoid (GC) therapy and orbital radiotherapy represent the classic medical management of ... more Glucocorticoid (GC) therapy and orbital radiotherapy represent the classic medical management of Graves’ ophthalmopathy, either used separately or in association. Because of the lack of response for classic therapy, in some patients new immunosuppressive methods have been tried, one of them is cyclosporine, an selective immunomodulatory drug. This study has proposed to compare short time administration of cyclosporine with administration of iv methylprednisolone and combined therapy (methylprednisolone orbital radiotherapy). In this comparative and prospective study we followed 127 patients with Graves’ ophthalmopathy divided in 4 groups, treated with iv methylprednisolone, associated therapy (GC+RxT), cyclosporine and a control group. All patients were concomitantly treated with oral antithyroid drugs. At 0, 3 and 6 months, the patients were subjected to Hertel exophthalmometry, orbital ultrasonography, TSHR antibody and thyroid-peroxidase antibody assessment and to clinical activi...
Introduction. Vitamin D deficiency has been proven to have a deleterious effect on bone remodelin... more Introduction. Vitamin D deficiency has been proven to have a deleterious effect on bone remodeling and bone mineral density, by inducing secondary hyperparathyroidism. The lack of a present consensus on optimal serum 25(OH)D levels required for the preservation of physiologic bone metabolism renders its follow-up difficult. Materials and Methods. The cross-sectional study was performed on a sample of 69 healthy men aged 50-70. Serum 25(OH)D, total testosterone, sex hormone binding globulin, s-CTX (Crosslaps), and osteocalcin were assessed. BMD was measured by DXA at lumbar spine and hip levels. Statistical relationships between these parameters were calculated. Results. We found a significantly negative correlation between 25(OH)D and s-CTX (r = -0.30. p<0.05), but not between 25(OH)D and osteocalcin, although s-CTX correlated positively with osteocalcin (r = 0.49, p<0.001). Serum CTX was negatively correlated with lumbar BMD (r = -0.35, p<0.001), while osteocalcin was negatively correlated with total hip BMD (r = -0.26, p<0.01). Comparing mean s-CTX levels in insufficient and sufficient subjects at different cut-off points for 25(OH)D, significant differences appeared the strongest at 60 ng/ml. The percentage of 25(OH)D deficient or insufficient subjects was 50.7% at a 30 ng/ml cut-off point. Conclusions. The results of the present study confirm the benefit in maintaining a normal bone turnover offered by serum 25(OH)D in the upper normal range. The large percentage of patients with vitamin D insufficiency reinforce the necessity of a specific follow-up and of epidemiologic studies dedicated to our geographic area.
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