92167189 Effects of protracted administration of estriol on the lower genito urinary tract in postmenopausal women

256 OBSTET. GYNECOL. 1992 79/5 I (747-751) Because a close relationship between estrogen deficiency and osteoporosis has been proven, it is possible that lifelong estrogen deficiency might be the cause of osteopenia in Turner syndrome. This study was done to characterize the effect of estrogen therapy on bone mineralization in girls with Turner syndrome. Radial bone mineral content values were found to be below the 95% normal confidence interval in 44 of 49 untreated patients, aged 10.82 * 3.45 years. An inverse correlation was found between the patients’ ages and their Delta bone mineral content values. The effect of beginning estrogen treatment early or late was studied in 16 girls who started the treatment before and 11 who started after age 12. Although they were still deficient compared with controls, the first group had better mineralization than the second (P = 0.0005). Finally, nine patients were followed prospectively during replacement therapy; their bone mineral content Delta values changed significantly (P = 0.02) during the follow-up period (3.17 f 0.33 years), but the bone mineral content did not normalize. Our data show that estrogen deficiency per se does not cause osteoporosis in young girls with Turner syndrome. In fact, estrogen therapy prevented bone loss but failed to normalize the low bone mineral content values. Early treatment is preferable because it reduces the bone density deficit present in untreated patients. 92164896 Asses&g bip fracture risk ia a populatiw based kealtk survey: The NHANES III osteoporosis component Looker A.C.; Harris T.B.; Wahner H.W. National Cent. for Health Statistics, 4.525 Belcrest Road, Hyattsville, IUD 20782

AGING 1992 4/l (53-60) A unique study of osteoporotic hip fracture risk, currently being conducted as part of a national health survey of the United States population, is described. The osteoporosis component of the third National Health and Nutrition Examination Survey (NHANES III) will provide data on multiple risk factors for hip fracture, including bone density of the proximal femur, from a nationally representative sample of adults that includes the very old. The minimum age for inclusion in the component is 20 years, so risk factors can be examined across the adult age range. The component includes men as well as women, and blacks and Mexican Americans as well as non-Hispanic whites. Finally, a longitudinal follow-up of the cohort will allow risk factor data to be related to subsequent hip fracture occurrence. 92165021 New evidence that tamoxifeo does not induce osteoporosis: A noelear activation analysis and absorptiometry study

Kalef-Ezra J.; Glaros D.; Klouvas G.; Hatzikonstantinou J.; Karantanas A.; Siamopoulos K.C.; Pavhdis N. Medical Physics Department, Medical School, University of loannina, 451 10 Ioannina BR. J. RADIOL. 1992 65/773 (417-420) The possibility of increased risk for osteoporosis in breast cancer patients treated with tamoxifen was investigated. 26 patients aged 41-65 years without skeletal metastases were studied. All patients were treated with 20 mg/d tamoxifen for a mean time of 22 months. The data obtained by in vivo neutron activation analysis of the phosphorus content in hands, were supplemented with data obtained by single photon absorptiometry in the forearm and radiographic morphometry. Comparison of the data with that of age and sex matched normal controls showed that breast cancer patients treated with tamoxifen are not prone to osteoporosis. 92167189 Effects of protracted administration of estriol on tke lower genito urinary tract in postmenopausal women Iosif C.S. Dept of Obstetrics and Gynecology, University of Lund, S-221 85 Lund

ARCH. GYNECOL. OBSTET. 1992 251/3 (115-120) We investigated 80 postmenopausal women, 48 of whom (60%) agreed to undergo long-term treatment

257 with estriol suppositories. All had symptoms of vaginal atrophy and urinary incontinence. Endometrial samples were taken after 8-10 years of therapy. Estriol had induced slight proliferative changes in the endomethm in 7 of 48 patients studied by endometrial sampling. 75%of the women reported significant subjective improvement of stress incontinence. Estriol supplementation did not produce any significant change in urethral pressure, functional length, or cystometric parameters. However, a significant increase in pressure transmission ratio to the proximal urethra was noted after vaginal medication with estriol. Replacement therapy in post menopausal women must take into account the patients perception of risks and benefits. The risk of estriol treatment is insignificant. 92172829 ~raryof~~~of~~ise~~w~:Evideeeefrolra~ve~y Nevitt M.C.; Cummings S.R.; Browner W.S.; Seeley D.G.; Cauley J.A.; Vogt T.M.! Black D.M. Division of Clinical Epiahiology, University of California, 74 New Montgomery St., San Francisco, CA 94105 AM. J. EPIDEMIOL. 1992 13515(490-499) The authors compared self-reports of non-spine fractures in a cohort of elderly white women with radiologic reports and medical records. Subjects (n = 9,784) were recruited between 1986 and 1988 in Baltimore, Pittsburgh, Minneapolis, and Portland, Oregon. Eleven percent (95% confIdewe interval 913%) of self-reports of fracture were false-positive (radiographs were negative) and a total of 20% (18-23%) could not be confirmed (radiographs were negative, uncertain, or not available). Report by proxy respondent was more accurate than self-report. There were no contInned fractures in the medical records of a random sample of 283 participants who did not report a fracture. The percent of falsepositives varied by the site of the injury and was low for self-reported fractures of the shoulder or upper arm (5%; l-13%), wrist (8%; 4-l I%), and hip (11%; 5-N%), but was high for hand or finger (20%; 12-30%), rib (23%; 15-32%), and face or skull (33%; 17-54%). Having a college education was associated with increased accuracy, while a history of falls and self-reported osteoporosis were associated with decreased accumcy. The authors conclude that elderly women overreport fractures, but that self- report is relatively accurate for several important osteoporotic fractures, including those of the hip, wrist, and humerus. Self-report of ‘any’ fracture, rib, distal extremity, and head fracture, and fractures in women with a tendency to fall or with osteoporosis should be verified by a radiologic diagnosis. 92179856 l?4mgead~Asblyofaporhl~aad-nceptor~in~oateoartMtkkllea Tsai C.L.; Liu T.K.; Chen T.J. Department of Orthopaedic Surgery, School of Medicine. National Taiwan University, Taipei BIOCHEM. BIOPHYS. RES. COMMUN. 1992 183/3 (1287-1291) Estrogen appears to be a risk factor in knee osteoarthritis (OA). Results from 21 patients revealed that synovial estradiol level was highly related to the severity of OA. Increased estradiol receptor bindings in the medial compartment of the femoral condylar and tibia plateau cartilages were observed, the increase was significantly higher in the medial than in the lateral compartment (P < 0.05). Although the synovial estradiol level was significantly lower in women with OA than in men with OA (P < O.Ol), postmenopausal women were hypothesimd to be more susceptible to OA, since the possible existence of synovial testosterone might counteract the high estradiol synoviai level in men, which results in a lower incidence of knee OA in men than in postmenopausal women. We suggest that excessive synovial estradiol and higher estradiol receptor bindings may be involved in the development of knee OA, particularly in postmenopausal women. 92179864 pregnMqasriskfactar!?forrhemMtoidarrJwf&lm& Amexam&thnoftherokoffemlelwmooesd 8makpa@atbnaseentrdgoap Pritchard M.H. Department of Rheumatology, University Hospital of Wales, Cardiff CF4 4XW