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Bone status in multiple sclerosis: beyond corticosteroids

The aim of this study was to determine the possible factors affecting bone mineral density (BMD) in multiple sclerosis (MS). In this cross-sectional study, 65 clinically definite MS patients and 72 comparable controls were prospectively evaluated. To assess bone mineral metabolism in MS, the BMD of the lumbar spine and hip (femoral neck, trochanter and total) was measured by dual-energy X-ray absorptiometry, and serum vitamin D and parathyroid hormone levels and biochemical markers of bone turnover were also evaluated. MS patients had significantly lower BMD values than the control group at all measurement sites. There was a significant correlation between the disease duration and BMD values at the trochanter in women with MS. A correlation between femoral BMD values and functional status in women was also detected. There was no relationship between bone biochemical markers and BMD, except a negative correlation between bone alkaline phosphatase and trochanter BMD. Both disability and disease duration have an influence on BMD of the MS patients, whereas no significant correlation between glucocorticoid use and BMD was observed.

Impact of the Training on the Compliance and Persistence of Weekly Bisphosphonate Treatment in Postmenopausal Osteoporosis: A Randomized Controlled Study

Long-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. In the present national, multicenter, randomized controlled study, postmenopausal osteoporosis patients (45-75 years) who were on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed-up by 4 visits after the initial visit at 3 months interval during 12 months of the treatment. Both groups received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (at 2nd, 5th, 8th, and 11th months) and participated to four interactive social/training meetings held in groups of 10 patients (at 3rd, 6th, 9th, and 12th months). The primary evaluation criteria were self-reported persistence and compliance to the treatment and the secondary evaluation criteria was quality life of the patients assessed by 41-item Quality of Life European Foundation for Osteoporosis (QUALEFFO-41) questionnaire.. Of 448 patients (mean age 62.4±7.7 years), 226 were randomized to AT group and 222 were randomized to PT group. Among the study visits, the most common reason for not receiving treatment regularly was forgetfulness (54.9% for visit 2, 44.3% for visit 3, 51.6% for visit 4, and 43.8% for visit 5), the majority of the patients always used their drugs regularly on recommended days and dosages (63.8% for visit 2, 60.9% for visit 3, 72.1% for visit 4, and 70.8% for visit 5), and most of the patients were highly satisfied with the treatment (63.4% for visit 2, 68.9% for visit 3, 72.4% for visit 4, and 65.2% for visit 5) and wanted to continue to the treatment (96.5% for visit 2, 96.5% for visit 3, 96.9% for visit 4, and 94.4% for visit 5). QUALEFFO scores of the patients in visit 1 significantly improved in visit 5 (37.7±25.4 vs. 34.0±14.6, p<0.001); however, the difference was not significant between AT and PT groups both in visit 1 and visit 5. In conclusion, in addition to active training, passive training provided at the 1st visit did not improve the persistence and compliance of the patients for bisphosphonate treatment.

Quantitative Ultrasound Evaluation of the Hand: Side Dominance or Overuse?

Mechanical loading is considered a very important factor affecting bone mass. To investigate the effect of heavy hand use on bone status in the dominant and nondominant hands, 17 ironers and a control group were evaluated with a new quantitative ultrasound system measuring the speed of sound (SOS). Both the dominant and nondominant hands were measured in all subjects, at both the proximal III phalanx and distal one-third radius. The ironers had significantly (p = 0.001) higher SOS values at the proximal III phalanx of the dominant hand than at the nondominant hand, whereas no difference was found between the hands in this group when measured at the distal one-third radius. There was no significant difference in SOS values as related to hand dominance in the control group. In conclusion, the SOS differences of the hands seems to be related to overuse rather than to side dominance.

Original ArticleQuantitative Ultrasound Evaluation of the Hand: Side Dominance or Overuse?

Mechanical loading is considered a very important factor affecting bone mass. To investigate the effect of heavy hand use on bone status in the dominant and nondominant hands, 17 ironers and a control group were evaluated with a new quantitative ultrasound system measuring the speed of sound (SOS). Both the dominant and nondominant hands were measured in all subjects, at both the proximal III phalanx and distal one-third radius. The ironers had significantly (p = 0.001) higher SOS values at the proximal III phalanx of the dominant hand than at the nondominant hand, whereas no difference was found between the hands in this group when measured at the distal one-third radius. There was no significant difference in SOS values as related to hand dominance in the control group. In conclusion, the SOS differences of the hands seems to be related to overuse rather than to side dominance.

Étude multicentrique, randomisée, en double aveugle, contrôlée versus placebo évaluant l'efficacité de la thiocolchicoside au cours de la lombalgie aiguë

Resume Objectif de l’etude. – Evaluer l’efficacite d’injections intramusculaire de thiocolchicoside (4 mg–2 ml) par rapport a un placebo, administrees deux fois par jour pendant 5 jours chez des patients souffrant de lombalgie aigue. Patients et Methodes. – Etude multicentrique, randomisee, en double aveugle, controlee versus placebo. L’etude a ete menee de juillet 1998 a mars 2000 dans cinq centres. Ont ete inclus les patients hospitalises pour lombalgie aigue. Le principal critere d’evaluation etait la diminution des douleurs spontanees au repos evaluee par une echelle visuelle analogique (EVA). Les criteres secondaires etaient la distance main–sol, l’intensite de la contracture musculaire, l’appreciation globale du patient et la consommation d’antalgiques (paracetamol). Resultats. – Cent quarante-neuf (149) patients ont ete inclus. Les douleurs spontanees evaluees par l’EVA ont diminue dans les deux groupes a la fin de la premiere journee ; cependant l’amelioration etait significativement plus importante dans le groupe thiocolchicoside au troisieme jour ( p p p Conclusion. – L’administration biquotidienne de 4 mg de thiocolchicoside pendant 5 jours constitue un traitement efficace et sur de la lombalgie aigue avec contracture musculaire.