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202. Long-term survival of a cohort of community residents with asthma

Author

Silverstein, Marc D., Reed, Charles E., O'Connell, Edward J., Melton, L. Joseph, III, O'Fallon, W. Michael, and Yunginger, John W.

Subjects
Asthma -- Prognosis
Abstract

Patients with long-term asthma appear to have survival rates similar to the expected rate of survival based on vital statistics tables. A study of 2499 asthma patients in the Rochester, Minnesota area who were diagnosed in the years 1964 to 1983 revealed that of the 140 patients who died, only 4% died as a result of asthma. None of these patients were children. The combination of asthma and another lung disease, particularly chronic obstructive pulmonary disease, was associated with a lower than expected rate of survival. Most patients with this combination were over the age of 35. Asthma patients living in the community rather than in institutions may experience good health and expected survival. Population-based studies of asthma patients may provide explanations for variations of rates of asthma-related deaths in different communities.

Published
1994

203. Risk of connective-tissue diseases and other disorders after breast implantation

Author

Gabriel, Sherine E., O'Fallon, W. Michael, Kurland, Leonard T., Beard, C. Mary, Woods, John E., and Melton, L. Joseph

Subjects
Breast implants -- Health aspects, Connective tissue diseases -- Causes of
Abstract

There appears to be no link between breast implants and connective tissue disease. The main reason silicon breast implants were removed from the market by the FDA in 1992 was concern over the relationship between the implants and connective tissue diseases, including rheumatoid arthritis and systemic lupus erythematosus. The medical histories of 749 women who had received breast implants (silicone, saline and polyurethane types) were compared to the histories of 1498 women who had not received implants. The percentage of women in both groups who showed signs and symptoms of connective tissue disease was identical. Morning stiffness was the only symptom to occur more often in breast implant recipients. Most of the patients in both groups who complained of morning stiffness had undergone mastectomies for breast cancer, however.

Published
1994

205. Eleventh all Ireland social medicine meeting: Proceedings of meeting held on October 6th to 8th, 1989

Author

Dunn-Lane, J., Herity, B., Moriarty, M., Conroy, R., Lee, F., Collins, B., Patterson, C., Gavin, A. T., Lowry, S., Blaney, R., Bridges, J. M., Nevin, N. C., Donaldson, S. N., McKenzie, G., Telford, A. M., Shelley, Emer, Robinson, K., Clarke, R., Daly, L., Graham, I., Tohani, V. K., Radic, A., Delaney, V., McCrum, Evelyn, Wilde, Jane, Evans, Alan, Lonergan, M., Lyons, R., Howell, F., Codd, M. B., Sugrue, D. D., Gersh, B. J., Melton, L. J., Gutierrez, Jose Fco Garcia, Hynes, M., Jennings, S., Bury, G., O’Kelly, F. D., Coughlan, H., Jackson, T. M. R., O’Connell, E., Colwell, N., O’Neill, T., Tyrrell, J., Evans, A. E., Patterson, C. C., Mathewson, Zelda M., Wales, Heartbeat, Donnelly, M. D. I., Dowding, V. M., and Barry, C.

Published
1990
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215. Temporal Trends in BMI Among Adults With Diabetes

Author

Leibson, Cynthia L., Williamson, David F., Melton, L. Joseph, III, Palumbo, Pasquale J., Smith, Steven A., Ransom, Jeanine E., Schilling, Peter L., and Narayan, K. M. Venkat

Published
2001

224. The prevention and treatment of osteoporosis

Author

Riggs, B. Lawrence and Melton, L. Joseph, III

Subjects
Osteoporosis -- Drug therapy, Aged -- Diseases, Fractures -- Prevention
Abstract

Low bone mass is the most important preventable cause of fractures. These fractures affect 1.5 million Americans yearly with an annual cost to the United States health care system of at least $10 billion. This decrease in bone mass, osteoporosis, is concentrated in the spinal column and at the ends of the long bones, particularly in women. During their lifetimes, women lose about 50% of reticular bone while men lose only 30%. Women lose 30% of cortical bone, and men, 20%. Drugs can either prevent bone mass decrease, as estrogen replacement and calcium supplements after menopause or increase bone formation, as sodium fluoride or parathyroid hormone. Postmenopausal women can prevent osteoporosis by weight bearing exercise to increase lumbar spine density plus estrogen therapy for women under age 75. High dosages of calcium supplements for both men and postmenopausal women are also recommended.

Published
1992

229. Epidemiology of Sarcopenia

Author

Melton, L Joseph, III, Khosla, Sundeep, Crowson, Cynthia S, O'Connor, Michael K, O'Fallon, W Michael, and Riggs, B Lawrence

Published
2000

238. Clinical use of bone densitometry

Author

Johnston, C. Conrad, Slemenda, Charles W., and Melton, L. Joseph

Subjects
Hyperparathyroidism -- Evaluation, Bone densitometry -- Usage, Osteoporosis -- Diagnosis
Abstract

Often, technical methods introduced for research purposes start being adopted for general clinical practice. This transition from research technique to clinical procedure is sometimes awkward. This is the case with bone densitometry. Bone densitometry uses gamma rays of X-rays to estimate the density of bone mineral, and this method has been instrumental in establishing reduced bone mass as a risk factor for fractures. Reduced bone mass is a common contributor to fractures in the elderly, especially among menopausal white women. However, it is far from clear that physicians treating such patients should begin relying heavily upon bone densitometry for diagnostic purposes. The Scientific Advisory Board of the National Osteoporosis Foundation has prepared a set of guidelines indicating the four situations in which the use of bone densitometry is justified by the scientific evidence. Menopausal women are at high risk for osteoporosis, but screening all menopausal women with bone densitometry is not recommended. Women should be counselled on the risks and benefits of estrogen replacement therapy; not all will choose replacement therapy. For women who express concern about osteoporosis but will take estrogen only if the risk is high, bone densitometry may prove useful in establishing the risk for a particular patient. Bone densitometry is also recommended for patients with bone abnormalities. Often, such patients are treated on the basis of radiographs, which are poor estimators of bone density. Without densitometry, misclassified patients will be unnecessarily treated. Bone densitometry is also appropriate for monitoring patients on long-term glucocorticoid therapy, since chronic administration of these drugs may result in a loss of bone mass. Bone densitometry may also be important for the evaluation of primary hyperparathyroidism. Hyperparathyroidism is often asymptomatic, and is discovered only on the basis of excess calcium found in a blood test. Bone densitometry can identify patients with asymptomatic hyperparathyroidism who are, in fact, at high risk for fracture and for whom medical intervention might be most appropriate. Of course, as more experience with bone densitometry accumulates, the recommendations for its use may change. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

244. Hip Fractures among Infertile Women

Author

Hesdorffer, Dale C., Melton, L. Joseph, III, Malkasian, George D., Atkinson, Elizabeth J., Brinton, Louise A., and O'Fallon, W. Michael

Published
1999

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