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Papakonstantinou, Georgios I., Dimitrios A. Gougoulis, Nikolaos Voulgarakis, Georgios Maragkakis, Dimitrios Galamatis, Labrini V. Athanasiou, and Vasileios G. Papatsiros. "Effects of Injectable Administration of Dexamethasone Alone or in Combination with Vitamin E/Se in Newborn Low Birth Weight Piglets." Veterinary Sciences 10, no. 2 (February 9, 2023): 135. http://dx.doi.org/10.3390/vetsci10020135.
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Increasing litter size may lead to low-birth-weight piglets (LBW) and further negative long-term effects. This study aimed to evaluate the effects of intramuscular administration (IM) of dexamethasone (Dexa) alone or in combination with vitamin E/Se on LBW piglets during the early postnatal period. The study included a total of 100 LBW piglets that were divided into 5 groups (20 LBW piglets per group) and treated with IM Dexa alone or in combination with vitamin E/Se (Vit E/Se) after birth as follows: (a) Group A-Cont: Control group, (b) Group B-Dexa1: Dexa on D1 (1st day of life), (c) Group C-Dexa3: Dexa on D1, D2, D3 (D2: 2nd day of life, D3: 3rd day of life), (d) Group D-Dexa + VitE/S1: Dexa + Vit E/Se on D1, and (e) Group E-Dexa + VitE/S3: Dexa + Vit E/Se (IM) on D1, D2, D3. Body weight (BW) and the Average Daily Weight Gain (ADWG) were recorded for all piglets on days 1, 7, 14, and 25, and vitality score (VS) was recorded on days 1, 2, 3, 4, and 14. A significant increase in BW and ADWG in Group E-Dexa + VitE/S3 and a significant reduction in Group C-Dexa3 were noticed in comparison to other groups. VS in groups Group B-Dexa1 and Group C-Dexa3 were significantly lower in comparison to other groups. Furthermore, piglets of Group C-Dexa3 had a significantly higher frequency of clinical findings compared to other groups. In conclusion, the administration of Dexa and vitamin E/Se combined after the birth of LBW piglets for 1–3 days has beneficial effects on their growth and survival scores.
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Borner, W. "DEXA." JAMA: The Journal of the American Medical Association 268, no. 4 (July 22, 1992): 474–75. http://dx.doi.org/10.1001/jama.268.4.474.
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Börner, Wilhelm. "DEXA." JAMA: The Journal of the American Medical Association 268, no. 4 (July 22, 1992): 474. http://dx.doi.org/10.1001/jama.1992.03490040050022.
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Kellie, Shirley E. "DEXA-Reply." JAMA: The Journal of the American Medical Association 268, no. 4 (July 22, 1992): 475. http://dx.doi.org/10.1001/jama.1992.03490040048023.
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Blake, G. M. "Replacing DEXA scanners." Nuclear Medicine Communications 16, no. 4 (April 1995): 237. http://dx.doi.org/10.1097/00006231-199504000-00101.
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Lambert, Brad S., Jonathan M. Oliver, Gilbert R. Katts, John S. Green, Steven E. Martin, and Stephen F. Crouse. "DEXA or BMI." Clinical Journal of Sport Medicine 22, no. 5 (September 2012): 436–38. http://dx.doi.org/10.1097/jsm.0b013e31825d5d65.
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Oh, Seyeon, Chang Hu Choi, Bae-Jin Lee, Joung-Hyun Park, Kuk-Hui Son, and Kyunghee Byun. "Fermented Oyster Extract Attenuated Dexamethasone-Induced Muscle Atrophy by Decreasing Oxidative Stress." Molecules 26, no. 23 (November 25, 2021): 7128. http://dx.doi.org/10.3390/molecules26237128.
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It is well known that oxidative stress induces muscle atrophy, which decreases with the activation of Nrf2/HO-1. Fermented oyster extracts (FO), rich in γ-aminobutyric acid (GABA) and lactate, have shown antioxidative effects. We evaluated whether FO decreased oxidative stress by upregulating Nrf2/HO-1 and whether it decreased NF-κB, leading to decreased IL-6 and TNF-α. Decreased oxidative stress led to the downregulation of Cbl-b ubiquitin ligase, which increased IGF-1 and decreased FoxO3, atrogin1, and Murf1, and eventually decreased muscle atrophy in dexamethasone (Dexa)-induced muscle atrophy animal model. For four weeks, mice were orally administered with FO, GABA, lactate, or GABA+Lactate, and then Dexa was subcutaneously injected for ten days. During Dexa injection period, FO, GABA, lactate, or GABA+Lactate were also administered, and grip strength test and muscle harvesting were performed on the day of the last Dexa injection. We compared the attenuation effect of FO with GABA, lactate, and GABA+lactate treatment. Nrf2 and HO-1 expressions were increased by Dexa but decreased by FO; SOD activity and glutathione levels were decreased by Dexa but increased by FO; NADPH oxidase activity was increased by Dexa but decreased by FO; NF-κB, IL-6, and TNF-α activities were increased by Dexa were decreased by FO; Cbl-b expression was increased by Dexa but restored by FO; IGF-1 expression was decreased by Dexa but increased by FO; FoxO3, Atrogin-1, and MuRF1 expressions were increased by Dexa but decreased by FO. The gastrocnemius thickness and weight were decreased by Dexa but increased by FO. The cross-sectional area of muscle fiber and grip strength were decreased by Dexa but increased by FO. In conclusion, FO decreased Dexa-induced oxidative stress through the upregulation of Nrf2/HO-1. Decreased oxidative stress led to decreased Cbl-b, FoxO3, atrogin1, and MuRF1, which attenuated muscle atrophy.
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Levine, James A., Lana Abboud, Mitchel Barry, Judd E. Reed, Patrick F. Sheedy, and Michael D. Jensen. "Measuring leg muscle and fat mass in humans: comparison of CT and dual-energy X-ray absorptiometry." Journal of Applied Physiology 88, no. 2 (February 1, 2000): 452–56. http://dx.doi.org/10.1152/jappl.2000.88.2.452.
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Dual-energy X-ray absorptiometry (DEXA) is reported to be inferior to computed tomography (CT) to measure changes in appendicular soft tissue composition. We compared CT- and DEXA-measured thigh muscle and fat mass to evaluate the random and systematic discrepancies between these two methods. Thigh skeletal muscle area (single-slice CT) was suboptimally ( r 2= 0.74, P < 0.0001) related to DEXA-measured thigh fat-free mass (FFM). In contrast, thigh muscle and adipose tissue volumes (multislice CT) were highly related to DEXA-measured thigh FFM and fat (both r 2 = 0.96, P < 0.0001). DEXA-measured leg fat was significantly less than multislice-CT-measured leg adipose tissue volume, whereas multislice-CT-measured leg muscle mass was less ( P < 0.0001) than DEXA-measured leg FFM. The systematic discrepancies between the two approaches were consistent with the 10–15% nonfat components of adipose tissue. In conclusion, CT and DEXA measures of appendicular soft tissue are highly related. Systematic differences between DEXA and CT likely relate to the underlying principles of the techniques.
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Musee, Ndeke, Lemme Prica Kebaabetswe, Shepherd Tichapondwa, Gosaitse Tubatsi, Ntombikayise Mahaye, Samuel Keeng Leareng, and Philiswa Nosizo Nomngongo. "Occurrence, Fate, Effects, and Risks of Dexamethasone: Ecological Implications Post-COVID-19." International Journal of Environmental Research and Public Health 18, no. 21 (October 27, 2021): 11291. http://dx.doi.org/10.3390/ijerph182111291.
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The recent outbreak of respiratory syndrome-coronavirus-2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), has led to the widespread use of therapeutics, including dexamethasone (DEXA). DEXA, a synthetic glucocorticoid, is among the widely administered drugs used to treat hospitalized COVID-19 patients. The global COVID-19 surge in infections, consequent increasing hospitalizations, and other DEXA applications have raised concerns on eminent adverse ecological implications to aquatic ecosystems. Here, we aim to summarize published studies on DEXA occurrence, fate, and effects on organisms in natural and engineered systems as, pre-COVID, the drug has been identified as an emerging environmental contaminant. The results demonstrated a significant reduction of DEXA in wastewater treatment plants, with a small portion, including its transformation products (TPs), being released into downstream waters. Fish and crustaceans are the most susceptible species to DEXA exposure in the parts-per-billion range, suggesting potential deleterious ecological effects. However, there are data deficits on the implications of DEXA to marine and estuarine systems and wildlife. To improve DEXA management, toxicological outcomes of DEXA and formed TPs should entail long-term studies from whole organisms to molecular effects in actual environmental matrices and at realistic exposure concentrations. This can aid in striking a fine balance of saving human lives and protecting ecological integrity.
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Aldaz, Paula, Jaione Auzmendi-Iriarte, Maika Durántez, Irene Lasheras-Otero, Estefania Carrasco-Garcia, M. Victoria Zelaya, Laura Bragado, et al. "Identification of a Dexamethasone Mediated Radioprotection Mechanism Reveals New Therapeutic Vulnerabilities in Glioblastoma." Cancers 13, no. 2 (January 19, 2021): 361. http://dx.doi.org/10.3390/cancers13020361.
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(1) Background: Despite the indisputable effectiveness of dexamethasone (DEXA) to reduce inflammation in glioblastoma (GBM) patients, its influence on tumour progression and radiotherapy response remains controversial. (2) Methods: We analysed patient data and used expression and cell biological analyses to assess effects of DEXA on GBM cells. We tested the efficacy of tyrosine kinase inhibitors in vitro and in vivo. (3) Results: We confirm in our patient cohort that administration of DEXA correlates with worse overall survival and shorter time to relapse. In GBM cells and glioma stem-like cells (GSCs) DEXA down-regulates genes controlling G2/M and mitotic-spindle checkpoints, and it enables cells to override the spindle assembly checkpoint (SAC). Concurrently, DEXA up-regulates Platelet Derived Growth Factor Receptor (PDGFR) signalling, which stimulates expression of anti-apoptotic regulators BCL2L1 and MCL1, required for survival during extended mitosis. Importantly, the protective potential of DEXA is dependent on intact tyrosine kinase signalling and ponatinib, sunitinib and dasatinib, all effectively overcome the radio-protective and pro-proliferative activity of DEXA. Moreover, we discovered that DEXA-induced signalling creates a therapeutic vulnerability for sunitinib in GSCs and GBM cells in vitro and in vivo. (4) Conclusions: Our results reveal a novel DEXA-induced mechanism in GBM cells and provide a rationale for revisiting the use of tyrosine kinase inhibitors for the treatment of GBM.
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Oh, Seyeon, Jinyoung Yang, Chulhyun Park, Kukhui Son, and Kyunghee Byun. "Dieckol Attenuated Glucocorticoid-Induced Muscle Atrophy by Decreasing NLRP3 Inflammasome and Pyroptosis." International Journal of Molecular Sciences 22, no. 15 (July 28, 2021): 8057. http://dx.doi.org/10.3390/ijms22158057.
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Dexamethasone (Dexa), frequently used as an anti-inflammatory agent, paradoxically leads to muscle inflammation and muscle atrophy. Receptor for advanced glycation end products (RAGE) and Toll-like receptor 4 (TLR4) lead to nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome formation through nuclear factor-κB (NF-κB) upregulation. NLRP3 inflammasome results in pyroptosis and is associated with the Murf-1 and atrogin-1 upregulation involved in protein degradation and muscle atrophy. The effects of Ecklonia cava extract (ECE) and dieckol (DK) on attenuating Dexa-induced muscle atrophy were evaluated by decreasing NLRP3 inflammasome formation in the muscles of Dexa-treated animals. The binding of AGE or high mobility group protein 1 to RAGE or TLR4 was increased by Dexa but significantly decreased by ECE or DK. The downstream signaling pathways of RAGE (c-Jun N-terminal kinase or p38) were increased by Dexa but decreased by ECE or DK. NF-κB, downstream of RAGE or TLR4, was increased by Dexa but decreased by ECE or DK. The NLRP3 inflammasome component (NLRP3 and apoptosis-associated speck-like), cleaved caspase -1, and cleaved gasdermin D, markers of pyroptosis, were increased by Dexa but decreased by ECE and DK. Interleukin-1β/Murf-1/atrogin-1 expression was increased by Dexa but restored by ECE or DK. The mean muscle fiber cross-sectional area and grip strength were decreased by Dexa but restored by ECE or DK. In conclusion, ECE or DK attenuated Dexa-induced muscle atrophy by decreasing NLRP3 inflammasome formation and pyroptosis.
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Chrysis, Dionisios, Farasat Zaman, Andrei S. Chagin, Masaharu Takigawa, and Lars Sävendahl. "Dexamethasone Induces Apoptosis in Proliferative Chondrocytes through Activation of Caspases and Suppression of the Akt-Phosphatidylinositol 3′-Kinase Signaling Pathway." Endocrinology 146, no. 3 (March 1, 2005): 1391–97. http://dx.doi.org/10.1210/en.2004-1152.
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Although glucocorticoids are known to induce apoptosis in chondrocytes, the mechanisms for this effect and the potential antiapoptotic role of IGF-I are unknown. To address this, we studied the effects of dexamethasone (Dexa) on apoptosis in the HCS-2/8 chondrocytic cell line. Dexa (25 μm) increased apoptosis (cell death ELISA) by 39% and 45% after 48 and 72 h, respectively (P < 0.01 and P < 0.05, respectively). IGF-I (100 ng/ml) decreased Dexa-induced apoptosis to levels similar to control cells. Apoptosis was associated with cleavage of poly-ADP-ribose polymerase (PARP) and α-fodrin and activation of caspases-8, -9, and -3 (Western), an effect that was counteracted when chondrocytes were cocultured with Dexa + IGF-I. Inhibitors for caspases-8, -9, and -3 (50 μm each) equally suppressed Dexa-induced apoptosis (P < 0.01). Time-response experiments showed that caspase-8 was activated earlier (at 12 h) than caspase-9 (at 36 h). We studied the phosphatidylinositol 3′-kinase (PI3K) pathway to further investigate the mechanisms of Dexa-induced apoptosis. Dexa decreased Akt phosphorylation by 93% (P < 0.001) without affecting total Akt and increased the p85α subunit 4-fold. The Akt inhibitor SH-6 (10 μm) increased apoptosis by 54% (P < 0.001). When combining Dexa with SH-6, apoptosis was not further increased, showing that Dexa-induced apoptosis is mediated through inhibition of the PI3K pathway. Addition of IGF-I to SH-6- or Dexa + SH-6-treated cells decreased apoptosis by 21.2% (P < 0.001) and 20.6% (P < 0.001), respectively. We conclude that Dexa-induced apoptosis is caspase dependent with an early activation of caspase-8. IGF-I can rescue chondrocytes from Dexa-induced apoptosis partially through the activation of other pathways than the PI3K signaling pathway. Based on our in vitro data, we speculate that in vivo treatment with glucocorticoids may diminish longitudinal growth by increasing apoptosis of proliferative growth plate chondrocytes.
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Hong, Boohwi, Chahyun Oh, Yumin Jo, Woosuk Chung, Eunhye Park, Hanmi Park, and Seokhwa Yoon. "The Effect of Intravenous Dexamethasone and Dexmedetomidine on Analgesia Duration of Supraclavicular Brachial Plexus Block: A Randomized, Four-Arm, Triple-Blinded, Placebo-Controlled Trial." Journal of Personalized Medicine 11, no. 12 (December 1, 2021): 1267. http://dx.doi.org/10.3390/jpm11121267.
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Intravenous dexamethasone and dexmedetomidine, in conjunction with peripheral nerve blockade, have each been reported to prolong the duration of analgesia. This study tested whether combined use further prolongs analgesia duration after supraclavicular brachial plexus block (BPB) in patients undergoing orthopedic upper extremity surgery. One hundred twenty patients were randomized 1:1:1:1 to Control (saline bolus and midazolam infusion [0.05 mg/kg loading, 20 µg/kg/h thereafter]); DMED (saline bolus and dexmedetomidine infusion [1 μg/kg loading, 0.4 μg/kg/h thereafter]); DEXA (dexamethasone [10 mg] bolus and midazolam infusion); and DMED-DEXA (dexmedetomidine infusion and dexamethasone bolus) groups. The primary outcome was the duration of postoperative analgesia, defined as the time from the end of the BPB to the first dose of analgesia via a patient-controlled device. Median (interquartile range) times to first dose of analgesia in the Control, DMED, DEXA, and DMED-DEXA groups were 8.1 (6.2–11.6), 9.0 (8.1–11.3), 10.7 (8.1–20.5), and 13.2 (11.5–19.1) hours, respectively (p < 0.001). Pairwise comparisons showed significant prolongation of analgesia in the DEXA included groups compared with the non-DEXA included groups (DEXA vs. control, p = 0.045; DEXA vs. DMED, p = 0.045; DMED-DEXA vs. control, p < 0.001; DMED-DEXA vs. DMED, p < 0.001). A mixed effect model showed that dexamethasone was the only significant factor for the prolongation of analgesia (p < 0.001). Intravenous dexamethasone prolonged the analgesia duration of supraclavicular BPB after orthopedic upper extremity surgery. The concurrent use of mild to moderate sedation dose of intravenous dexmedetomidine in addition to intravenous dexamethasone showed no additional benefit to the prolongation of analgesia.
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Kumar, Rebecca Nirmal, Mary Clare Masters, and Karen Krueger. "760. Assessment of DEXA Scan Ordering Among Infectious Disease Providers at a Large Tertiary-Care Urban Academic Center in the Midwest." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S339. http://dx.doi.org/10.1093/ofid/ofz360.828.
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Abstract Background Osteoporosis is compromised bone strength that predisposes to fracture. It can be diagnosed by Dual-energy x-ray absorptiometry (DEXA) measurement of bone mineral density (BMD). Persons with HIV (PWH) are at higher risk for the development of osteoporosis. As such, the HIV Medicine Association’s (HIVMA) primary care guidelines recommend DEXA screening for all HIV-infected postmenopausal women and men aged ≥50 years. The purpose of this study was to asses the frequency of DEXA utilization within a tertiary-care urban academic center in the Midwest and to identify prevalence of osteoporosis. Methods A representative sample PWH age ≥50 from our institution’s outpatient infectious disease (ID) clinic were included. All subjects had at least one clinic visit in the last year, were on antiretroviral therapy (ART), and virally suppressed. Unblinded chart review was performed to assess if DEXA was ordered, was DEXA ordered by an ID physician, was DEXA completed, results of DEXA, and whether patients were on a tenofovir disoproxil fumarate (TDF)-containing regimen. Results 225 charts were reviewed. 186 (83%) patients were men, with a median age of 58 (range of 50–85). DEXA scans were ordered on 39 (17%) patients, 9 (23%) of which were ordered by their ID provider. Twenty-eight (72%) DEXA scans were performed. Of scans completed, 11 (39%) diagnosed osteoporosis, 15 (54%) osteopenia, and 2 (7%) showed normal BMD. Of all charts reviewed, 29 (13%) were on TDF-containing regimens. Of those individuals with diagnosed abnormal BMD (26), only 1 (4%) was on a TDF-containing regimen. Conclusion Despite HIVMA’s recommendation for osteoporosis screening in PWH, only 17% of eligible patients with well-controlled HIV in our clinic had been referred for DEXA. Of those who had undergone DEXA screening, nearly all (93%) had abnormal BMD. Further investigation is necessary to explore provider and patient barriers for osteoporosis screening in PWH. Disclosures All authors: No reported disclosures.
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Ruol, Piero, Barbara Zanuttigh, Luca Martinelli, Peter Kofoed, and Peter Frigaard. "NEAR-SHORE FLOATING WAVE ENERGY CONVERTERS: APPLICATIONS FOR COASTAL PROTECTION." Coastal Engineering Proceedings 1, no. 32 (January 27, 2011): 61. http://dx.doi.org/10.9753/icce.v32.structures.61.
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Aim of this note is to analyse the possible application of a Wave Energy Converter (WEC) as a combined tool to protect the coast and harvest energy. Physical model tests are used to evaluate wave transmission past a near-shore floating WEC of the wave activated body type, named DEXA. Efficiency and transmission characteristics are approximated to functions of wave height, period and obliquity. Their order of magnitude are 20% and 80%, respectively. It is imagined that an array of DEXA is deployed in front of Marina di Ravenna beach (IT), a highly touristic site of the Adriatic Coast. Based on the CERC formula, long-shore sediment transport is evaluated in presence and in absence of this array of DEXAs. The sediment transport in this site is quite large and frequently changes directions during the year. The larger North directed contribution and the more persistent South directed one are similar in magnitude and almost compensate each other, with the latter only slightly prevailing. It is shown that the DEXA could be designed so that the effect on sediment transport becomes quite significant and the direction of the net transport can be reversed.
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Kohan, Eitan M., Venu M. Nemani, Stuart Hershman, Daniel G. Kang, and Michael P. Kelly. "Lumbar computed tomography scans are not appropriate surrogates for bone mineral density scans in primary adult spinal deformity." Neurosurgical Focus 43, no. 6 (December 2017): E4. http://dx.doi.org/10.3171/2017.9.focus17476.
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OBJECTIVEThe authors examined the correlation between lumbar spine CT Hounsfield unit (HU) measurements and bone mineral density measurements in an adult spinal deformity (ASD) population.METHODSPatients with ASD were identified in the records of a single institution. Lumbar CT scans were reviewed, and the mean HU measurements from L1–4 were recorded. Bone mineral density (BMD) was assessed using femoral neck and lumbar spine dual-energy x-ray absorptiometry (DEXA). The number of patients who met criteria for osteoporosis was determined for each imaging modality.RESULTSForty-eight patients underwent both preoperative DEXA and CT scanning. Forty-three patients were female and 5 were male. Forty-seven patients were Caucasian and one was African American. The mean age of the patients was 62.1 years. Femoral neck DEXA was more likely to identify osteopenia (n = 26) than lumbar spine DEXA (n = 8) or lumbar CT HU measurements (n = 6) (p < 0.001). There was a low-moderate correlation between lumbar spine CT and lumbar spine DEXA (r = 0.463, p < 0.001), and there was poor correlation between lumbar spine CT and femoral neck DEXA (r = 0.303, p = 0.036).CONCLUSIONSDespite the opportunistic utility of lumbar spine CT HU measurements in identifying osteoporosis in patients undergoing single-level fusion, these measurements were not useful in this cohort of ASD patients. The correlation between femoral neck DEXA and HU measurements was poor. DEXA assessment of BMD in ASD patients is essential to optimize the care of these complicated cases.
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Hossain, M. A., J. Park, S. H. Choi, and G. Kim. "Dexamethasone induces apoptosis in proliferative canine tendon cells and chondrocytes." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 04 (2008): 337–42. http://dx.doi.org/10.3415/vcot-07-06-0060.
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SummaryDexamethasone (Dexa) has been commonly used in humans and domestic animals, particularly in the treatment of tendon injuries and cartilage degeneration. However, it is often associated with tendon rupture and impaired tendon and cartilage healing. In the present study, we investigated Dexa’s in vitro effects on the growth of cell proliferation and the induction of apoptosis in canine Achilles tendon cells and chondrocytes. Cell proliferation after treatment with Dexa for two to six days was quantified by a 2,3-bis{2-methoxy- 4-nitro-5-sulfophenyl}-2H-tetrazolium-5-carboxyanilide inner salt assay (XTT). The results showed that Dexa could inhibit the proliferation of tendon cells and chondrocytes at increasing concentrations (0.1–50 μg/ml) compared with untreated cells. Cell apoptosis was induced by Dexa, as evidenced by the typical nuclear apoptosis using Hoechst 33258 staining. Dexa increased the apoptosis of canine tendon cells and chondrocytes in a time-dependent manner. In canine tendon cells and chondrocytes that were treated with 25 and 50 μg/ml concentration of Dexa, the number of condensed apoptotic nuclei was significantly increased. In addition, culturing with Dexa and the glucocorticoid receptor blocker, mifepristone, significantly arrested apoptosis of tendon cells and chondrocytes. Based on our in vitro data, we hypothesized that in vivo treatment with glucocorticoids may diminish the proliferation of tendon and cartilage cells by increasing apoptosis and suppressing the proliferation. Our findings suggest that Dexa could be used with caution in dogs with articular or tendon problems.
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Alsamarraie, Henin, and Alexandra Clark. "ODP092 Guideline Adherence for Age-based Screening of Osteoporosis in Men at a Veterans Affairs Medical Center." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A163. http://dx.doi.org/10.1210/jendso/bvac150.335.
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Abstract Background Osteoporosis is one of the leading causes of morbidity and mortality in older women and men. Men with osteoporosis have higher fracture-related morbidity and mortality rates compared to women, but screening rates in men remain much lower. Moreover, there is limited veteran-specific data despite the suggestion that veterans may be at higher risk for osteoporosis. (1) Objective: To assess current dual energy X-ray absorptiometry (DEXA) ordering practices within a veteran cohort. Design: A retrospective cohort study of male veterans aged71-75 years who were evaluated by a primary care provider (PCP) within the last 5 years (n = 13,174). Results DEXAs wereordered for ∼7% of the population (920/13,174), and 91.6% were completed (843/920). Over 60% of completed DEXAs were ordered due to the presence of risk factors (308/843, 36.5%), history of fractures (60/843, 7%), known osteopenia or osteoporosis (59/843, 7%), or osteopenia mentioned on another imaging modality (78/843, 9.3%), while only 33.5% (282/843) were ordered for screening purposes. Of those with DEXA results reported (838/843, 99.4%), 34.5% (289/838) were normal, 51% (427/838) were in the osteopenia range and 14.5% (122/838) were in the osteoporosis range. Regarding DEXAs obtained for screening purposes, 42% (118/282) were normal, 48% (136/282) were in the osteopenia range, and 10% (28/282) were in the osteoporosis range. Conclusions Despite the Endocrine Society and National Osteoporosis Foundation recommending screening men aged ≥70 years, less than 10% of male veterans eligible for osteoporosis screening based on age alone had a DEXA scan. Of those male veterans who received a DEXA for screening purposes, almost 60% were found to have an abnormal result. The lack of screening for osteoporosis in this population has the potential to worsen the disparity in bone health between men and women, and between veterans and non-veterans, making it difficult to determine the scope of a problem which has the potential to cause significant morbidity and mortality. References 1. Nahm ES et al. Osteoporosis Preventive Practice Between Veteran and Nonveteran Older Adults: Findings From Patient-Reported Data. Orthopedic Nursing. 2016 Nov/Dec;35(6): 401-410. Presentation: No date and time listed
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Visser, Marjolein, Thomas Fuerst, Thomas Lang, Loran Salamone, Tamara B. Harris, For The Health, Aging,body Composition Study Dual-E. Absorptiometry, and Body Composition Working Group. "Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass." Journal of Applied Physiology 87, no. 4 (October 1, 1999): 1513–20. http://dx.doi.org/10.1152/jappl.1999.87.4.1513.
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The aim of the study was to examine the accuracy of fan-beam dual-energy X-ray absorptiometry (DEXA) for measuring total body fat-free mass (FFM) and leg muscle mass (MM) in elderly persons. Participants were 60 men and women aged 70–79 yr and with a body mass index of 17.5–39.8 kg/m2. FFM and MM at four leg regions were measured by using DEXA (Hologic 4500A, v8.21). A four-compartment body composition model (4C) and multislice computed tomography (CT) of the legs were used as the criterion methods for FFM and MM, respectively. FFM by DEXA was positively associated with FFM by 4C ( R 2 = 0.98, SE of estimate = 1.6 kg). FFM by DEXA was higher [53.5 ± 12.0 (SD) kg] than FFM by 4C (51.6 ± 11.9 kg; P < 0.001). No association was observed between the difference and the mean of the two methods. MM by DEXA was positively associated with CT at all four leg regions ( R 2 = 0.86–0.96). MM by DEXA was higher than by CT in three regions. The results of this study suggest that fan-beam DEXA offers considerable promise for the measurement of total body FFM and leg MM in elderly persons.
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Kohrt, Wendy M. "Preliminary evidence that DEXA provides an accurate assessment of body composition." Journal of Applied Physiology 84, no. 1 (January 1, 1998): 372–77. http://dx.doi.org/10.1152/jappl.1998.84.1.372.
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Kohrt, Wendy M. Preliminary evidence that DEXA provides an accurate assessment of body composition. J. Appl. Physiol. 84(1): 372–377, 1998.—It was previously found that dual-energy X-ray absorptiometry (DEXA) underestimated central body fat. The purposes of this study were to determine whether an updated version (enhanced version 5.64) of the analysis program corrected this problem ( experiment 1) and to compare body composition assessed by DEXA and hydrodensitometry (HD) in women ( n= 225) and men ( n = 110) across a 21- to 81-yr age range ( experiment 2). For experiment 1, 10 subjects underwent DEXA procedures in a control condition and with packets of lard positioned over either the thighs or the truncal region. DEXA accurately quantified the additional mass as ∼96% fat, regardless of position. For experiment 2, DEXA yielded higher ( P < 0.001) estimates of fatness than did HD (32.1 ± 12.0 vs. 31.2 ± 10.1%). The mean difference between the two methods was similar in young, middle-aged, and older subjects, but was different in men (HD − DEXA, 1.6 ± 3.4% of body wt) than in women (−2.1 ± 3.8% of body wt). Correcting the density of fat-free mass for variance in the bone mineral fraction of fat-free mass reduced the difference between the methods in men from 1.6 ± 3.4 to −0.7 ± 2.9% but widened it in women from −2.1 ± 3.8 to −3.5 ± 3.4%. A second correction procedure that adjusted for variance in water, protein, and mineral fractions of fat-free mass eliminated the differences in estimates of fat content by DEXA and HD in both men (21.1 ± 9.3 vs. 20.6 ± 8.4%, respectively) and women (37.5 ± 9.3 vs. 36.8 ± 8.0%, respectively). These results provide encouraging, but not definitive, evidence that the assessment of body composition by DEXA is accurate under the specified conditions.
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Brommage, Robert. "Validation and calibration of DEXA body composition in mice." American Journal of Physiology-Endocrinology and Metabolism 285, no. 3 (September 2003): E454—E459. http://dx.doi.org/10.1152/ajpendo.00470.2002.
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Validated methods of determining murine body composition are required for studies of obesity in mice. Dual-energy X-ray absorptiometry (DEXA) provides a noninvasive approach to assess body fat and lean tissue contents. Similar to DEXA analyses in other species, body fat measurements in mice show acceptable precision but suffer from poor accuracy. Because fat and lean tissues each contain various components, these inaccuracies likely result from selection of inappropriate calibration standards. Analysis of solvents showed that the PIXImus2 DEXA gave results consistent with theoretical calculations. Male mice weighing 26-60 g and having body fat percentages ranging from 3 to 49% were analyzed by both PIXImus2 DEXA and chemical carcass analysis. DEXA overestimated mouse fat content by an average of 3.3 g, and algorithms were generated to calculate body fat from both measured body fat values and the measured ratio of high- to low-energy X-ray attenuations. With calibration to mouse body fat content measured by carcass analysis, the PIXImus2 DEXA gives accurate body composition values in mice.
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Rangan, Amar, Stephen P. Tuck, Paul D. Scott, Lucksy Kottam, Maya Jafari, Terence Watson, Ben Lopez, Ben Crone, Tim Whitbread, and Adam Ratcliffe. "Prospective comparative study of quantitative X-ray (QXR) versus dual energy X-ray absorptiometry to determine the performance of QXR as a predictor of bone health for adult patients in secondary care." BMJ Open 11, no. 12 (December 2021): e051021. http://dx.doi.org/10.1136/bmjopen-2021-051021.
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ObjectivesTo evaluate a method of quantitative X-ray (QXR) for obtaining bone health information from standard radiographs aimed at identifying early signs of osteoporosis to enable improved referral and treatment. This QXR measurement is performed by postexposure analysis of standard radiographs, meaning bone health data can be acquired opportunistically, alongside routine imaging.DesignThe relationship between QXR and dual energy X-ray absorptiometry (DEXA) was demonstrated with a phantom study. A prospective clinical study was conducted to establish areal bone mineral density (aBMD) prediction model and a risk prediction model of a non-normal DEXA outcome. This was then extrapolated to a larger patient group with DEXA referral data.SettingSecondary care National Health Service Hospital.Participants126 consenting adult patients from a DEXA clinic.InterventionsAll participants underwent a DEXA scan to determine BMD at the lumbar spine (L2–L4) and both hips. An additional Antero-Posterior pelvis X-ray on a Siemens Ysio, fixed digital radiograph system was performed for the study.OutcomePerformance of QXR as a risk predictor for non-normal (osteoporotic) BMD.ResultsInterim clinical study data from 78 patients confirmed a receiver operator curve (area under the ROC curve) of 0.893 (95% CI 0.843 to 0.942) for a risk prediction model of non-normal DEXA outcome. Extrapolation of these results to a larger patient group of 11 029 patients indicated a positive predictive value of 0.98 (sensitivity of 0.8) for a population of patients referred to DEXA under current clinical referral criteria.ConclusionsThis study confirms that the novel QXR method provides accurate prediction of a DEXA outcome.Trial registration numberISRCTN98160454; Pre-results.
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Igarashi, Shunji, Atsushi Manabe, Akira Ohara, Masaaki Kumagai, Tomohiro Saito, Yuri Okimoto, Takehiko Kamijo, et al. "No Advantage of Dexamethasone Over Prednisolone for the Outcome of Standard- and Intermediate-Risk Childhood Acute Lymphoblastic Leukemia in the Tokyo Children's Cancer Study Group L95-14 Protocol." Journal of Clinical Oncology 23, no. 27 (September 20, 2005): 6489–98. http://dx.doi.org/10.1200/jco.2005.01.982.
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Purpose To evaluate whether dexamethasone (DEXA) yields a better outcome than prednisolone (PRED) in a prospective, randomized, controlled trial for the treatment of childhood acute lymphoblastic leukemia (ALL). Patients and Methods Two hundred thirty-one standard-risk (SR) patients and 128 intermediate-risk (IR) non–B-cell ALL patients were registered from March 1995 to March 1999. After random assignment in each group, the PRED arm patients received PRED 60 mg/m2 during induction followed by PRED 40 mg/m2 over four intensifications in the SR group and three intensifications in the IR group. DEXA arm patients received DEXA 8 mg/m2 during induction and DEXA 6 mg/m2 during the intensifications. The maintenance phase was continued until week 104. Results Event-free survival rates at 8 years in the DEXA and PRED arms were 81.1% ± 3.9% (n = 117) and 84.4% ± 5.2% (n = 114), respectively, in the SR group (P = .217) and 84.9% ± 4.6% (n = 62) and 80.4% ± 5.1% (n = 66), respectively, in the IR group (P = .625). The primary reason for treatment failure was marrow relapse. Only two extramedullary relapses occurred in the DEXA arm compared with seven relapses in the PRED arm. Although complications were more prevalent in the DEXA arm than in the PRED arm, fatal toxicity was rare both groups. Conclusion DEXA administered at 8 mg/m2 during induction and 6 mg/m2 during intensification showed no advantage over PRED administered at 60 mg/m2 during induction and 40 mg/m2 during intensification in both the SR and IR groups.
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Wang, Wei, Zimian Wang, Myles S. Faith, Donald Kotler, Rick Shih, and Steven B. Heymsfield. "Regional skeletal muscle measurement: evaluation of new dual-energy X-ray absorptiometry model." Journal of Applied Physiology 87, no. 3 (September 1, 1999): 1163–71. http://dx.doi.org/10.1152/jappl.1999.87.3.1163.
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Although there is growing interest in studying muscle distribution, regional skeletal muscle (SM) mass measurement methods remain limited. The aim of the present study was to develop a new dual-energy X-ray absorptiometry (DEXA) model for estimating regional adipose tissue-free skeletal muscle mass (AT-free SM). Relationships were derived from Reference Man data between tissue-system- level components (i.e., AT-free SM, AT, skeleton, and skin) and molecular-level components including fat-free soft tissue, fat, and bone mineral. The proposed DEXA-SM model was evaluated by multiscan computerized axial tomography (CT). Twenty-seven male subjects [age, 36 ± 12 (SD) yr; body mass, 73.2 ± 12.4 kg; 20 were healthy, and 7 had acquired immunodeficiency syndrome] completed DEXA and CT studies. Identical landmarks for DEXA and CT measurements were selected in three regions, including calves, thighs, and forearms. There was a strong correlation for AT-free SM estimates between the new DEXA and CT methods (e.g., sum of three regions, r= 0.86, P < 0.001). Regional AT-free SM measured in the 27 subjects by DEXA and CT, respectively, were 3.44 ± 0.60 and 3.47 ± 0.55 kg (difference 0.9%, P > 0.05) for calves, 10.49 ± 1.77 and 10.05 ± 1.79 kg (difference 4.4%, P < 0.05) for thighs, 1.36 ± 0.49 and 1.20 ± 0.41 kg (difference 13.3%, P < 0.01) for forearms, and 15.29 ± 2.33 and 14.72 ± 2.33 kg (difference 3.9%, P < 0.05) for the sum all three regions. Although the suggested DEXA-SM model needs minor refinements, this is a promising in vivo approach for measurement of regional SM, because DEXA is widely available, relatively inexpensive, and radiation exposure is low.
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Sauter, Stephanie N., Edgar Ontsouka, Bettina Roffler, Yolande Zbinden, Chantal Philipona, Michael Pfaffl, Bernhard H. Breier, Jürg W. Blum, and Harald M. Hammon. "Effects of dexamethasone and colostrum intake on the somatotropic axis in neonatal calves." American Journal of Physiology-Endocrinology and Metabolism 285, no. 2 (August 2003): E252—E261. http://dx.doi.org/10.1152/ajpendo.00557.2002.
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Glucocorticoids and colostrum feeding influence postnatal maturation of the somatotropic axis. We have tested the hypothesis that dexamethasone (Dexa) affects the somatotropic axis in neonatal calves dependent on colostrum intake. Calves were fed either with colostrum or with a milk-based formula ( n = 14/group), and, in each feeding group, one-half of the calves were treated with Dexa (30 μg · kg body wt-1 · day-1). Pre- and postprandial blood samples were taken on days 1, 2, 4, and 5, and liver samples were taken on day 5 of life. Dexa increased insulin-like growth factor (IGF)-I, but decreased growth hormone (GH) and IGF-binding protein (IGFBP)-1 and -2 plasma concentrations and increased GH receptor (GHR) mRNA levels in liver. Dexa increased IGF-I mRNA levels only in formula-fed calves and increased hepatic GHR binding capacity, but only in colostrum-fed calves. Colostrum feeding decreased IGFBP-1 and -2 plasma concentrations and hepatic IGFBP-2 and -3 mRNA levels. In conclusion, Dexa and colostrum feeding promoted maturation of the somatotropic axis. Dexa effects partly depended on whether colostrum was fed or not.
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Machado, Eleuza R., Marlene T. Ueta, Rosângela Maria Rodrigues, Simone G. Ramos, Virgínia Vilhena, Anna Maly de Leão e. Neves Eduardo, Leandro Junio Barreto dos Reis, Raphael da Silva Affonso, and Lúcia Helena Faccioli. "Effects of dexamethasone, cyclosporine and betamethasone on inflammatory cell recruitment in mice infected with Strongyloides venezuelensis." Journal of Lung, Pulmonary & Respiratory Research 6, no. 4 (December 26, 2019): 108–14. http://dx.doi.org/10.15406/jlprr.2019.06.00219.
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The objective of this study was verified effect of immunosuppressant activities of Dexametasone (Dexa), Cyclosporine (CsA) and Betamethasone (Beta) in the synhteses of inflammatory cell and dissemination of Strongyloides venezuelensis. S. venezuelensis- infected mice increased total leucocytes (TL), eosinophil (EO), mononuclear cells (MC), and neutrophil (NE) numbers in the blood. The infection induced recruitment of TL, EO and MC to peritoneal cavity (PCF) and space bronchoalveolar (BALF), exception for NE. Dexa, CsA and Beta treatments inhibited TL, EO and MC production. However, Dexa treatment was associated with NE accumulation in the blood. Dexa and Beta tratments reductions migration of inflammatory cells from the blood to PCF and BALF. Infected mice and treated with Dexa and Beta worm parasites, eggs/g/feces and larvae recovered were higher than CsA. The results showed that glucocorticoid treatment may induce strongyloidiasis dissemination while CsA induced mice protection against S. venezuelensis infection.
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Braverman, Eric R. "From Leptin, DEXA, and Beyond." American Journal of Medicine 129, no. 8 (August 2016): e163. http://dx.doi.org/10.1016/j.amjmed.2016.01.052.
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Alrawashdh, Neda, Abdulaali Almutairi, Ali McBride, and Ivo Abraham. "Economic Evaluation of Daratumumab and Pomalidomide and Dexamethasone Versus Isatuximab and Pomalidomide and Dexamethasone for Patients with Relapsed or Refractory Multiple Myeloma." Blood 136, Supplement 1 (November 5, 2020): 19–20. http://dx.doi.org/10.1182/blood-2020-136348.
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Background. Although several new treatments are available for patients with multiple myeloma (MM), most patients eventually relapse at a median time of 8.0 months (95%CI: 6.3-8.9). Patients with relapsed and refractory MM (R/R MM) who have had several lines of previous therapy or who are refractory to lenalidomide and proteasome inhibitors require alternative options. Daratumumab and isatuximab are monoclonal antibodies that bind to the human CD38 receptor. Phase II/III clinical trials showed that isatuximab (ISA) or daratumumab (DARA) in combination with pomalidomide (POM-d) and low-dose dexamethasone (DEXA) significantly improve progression-free survival (PFS) in patients with R/R MM. No studies have assessed the comparative efficacy and cost-effectiveness of both regimens in management of R/R MM. We performed an indirect comparison of both regimens in terms of PFS and overall survival (OS) and evaluated the cost-effectiveness and cost-utility of DARA+POM-d+DEXA and ISA+POM-d+DEXA from a US payer's perspective. Methods. A partitioned survival model was developed to create three health states (pre-progression, progression, and death). The model was run three times with different time horizons (one, three and five years). To simulate health outcomes for each treatment regimen, transition probabilities between the three health states were derived from parametric exponential and lognormal distributions fitted to Kaplan-Meier (KM) curves of PFS and OS of the phase Ib clinical trial (Chari et al.; Blood 2017) for DARA+POM-d+DEXA and the phase III clinical trial (Attal et al.; Lancet 2019) for ISA+POM-d+DEXA. Wholesale acquisition costs (WAC) were obtained from RedBook for each regimen. Pre-progression costs included costs of regimens; premedication (50 mg diphenhydramine, 650 mg acetaminophen, 50 mg ranitidine); managing side effects; routine care and monitoring; and medication administration. Costs were inflated based on the medical consumer price index to the second quarter of 2020. Utilities were obtained from literature and assumed the same for both interventions. Annual discount rate of 3.5% was applied for costs and outcomes beyond the first year. The life years (LY) and quality adjusted LY (QALY) for each treatment, and the incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) were estimated in both base and probabilistic sensitivity analyses (PSA:10,000 simulations). The cost-effectiveness plane (CEP) and cost-effectiveness acceptability curves (CEAC) were plotted. Results. In the naïve patient simulation, median PFS and OS were estimated to be 9.5 months and 18 months for DARA+POM-d+DEXA, and 14.5 months and 26 months for ISA+POM-d +DEXA. As shown in the table below, ISA+POM-d+DEXA is associated with greater LY and QALY gains at one-, three- and five-year time horizons. The costs of ISA+POM-d+DEXA at one- and three- year time horizons are less than that of DARA+POM-d+DEXA, which resulted in saving (decremental) ICERs. At 5 years' time horizon, ISA+POM-d+DEXA was associated with incremental benefits (0.57 LY, 0.35 QALY) and incremental costs of $88,271 when compared with DARA+POM-d+DEXA. Per the CEAC plot, the probability that ISA+POM-d+DEXA is cost-effective was 100%, 65% and 23% at a willingness to pay threshold (WTP) of $100,000 per QALY in one-, three- and five-year time horizons. Conclusions. Clinically, ISA+POM-d+DEXA is associated with incremental survival gains of ~1 month and quality-adjusted survival gains of 0.5 month than DARA+POM-d+DEXA when patients are treated for one year. The benefits increase with treatment duration to reach ~7 months life year gains and 4 months quality-adjusted life year gains if patients treated for 5 years. Due to its lower total costs, Isatuximab based-regimen yielded saving ICERs at one and three years. However, ISA+POM-d+DEXA cost exceeded DARA+POM-d+DEXA at 5 years' time horizon to yield an ICER above the WTP. Disclosures McBride: Merck: Speakers Bureau; Pfizer: Consultancy; Sandoz: Consultancy; MorphoSys: Consultancy; Bristol-Myers Squibb: Consultancy; Coherus BioSciences: Consultancy, Speakers Bureau. Abraham:Celgene: Consultancy; Terumo: Consultancy; Rockwell Medical: Consultancy; Janssen: Consultancy; Mylan: Consultancy; Sandoz: Consultancy; Coherus BioSciences: Research Funding, Speakers Bureau; MorphoSys: Consultancy.
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Kim, Kyung Joon, Dong Hwan Kim, Jae Il Lee, Byung Kwan Choi, In Ho Han, and Kyoung Hyup Nam. "Hounsfield Units on Lumbar Computed Tomography for Predicting Regional Bone Mineral Density." Open Medicine 14, no. 1 (July 19, 2019): 545–51. http://dx.doi.org/10.1515/med-2019-0061.
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AbstractObjectiveBone mineral density (BMD) is a very important factor in spinal fusion surgery using instrumentation. Our aim was to investigate the utility of Hounsfield units (HU) obtained from preoperative lumbar computed tomography (CT) to predict osteoporosis coupling with data of quantitative computed tomography (QCT) and dual X-ray absorptiometry (DEXA).MethodsWe reviewed 180 patients that underwent both QCT and lumbar CT for spine surgery. HU was retrospectively calculated on the lumbar CT of 503 lumbar vertebrae from L1 to L3. Femur DEXA was performed in all patients and spine DEXA was tested in 120 patients (331 vertebrae). BMD was grouped as osteoporosis (QCT<80mg/cm3, DEXA T score≤-2.5) and non-osteoporosis (QCT≥80mg/cm3, DEXA T score>-2.5) for comparison of HU value.ResultsHU value and BMD showed significant correlations. The optima cut-off value based on QCT was higher than that of DEXA scans which had the best correlation for predicting osteoporosis. ROC curve analysis demonstrated that HU value with QCT of 146 has a sensitivity of 94.3% and a specificity of 87.5% for osteoporosis.ConclusionsSignificant correlation was found between HU measurement and BMD value. These findings provide evidence that HU measurement can be established as a means for predicting osteoporosis before spine fusion surgery with reduced radiation hazard.
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Candra, Lissiani, Arief Iskandar, Indrastuti Normahayu, Putra Suryana, and Nanik Setijowati. "Akurasi Indeks Singh Dibandingkan Dual Energy X-Ray Absorptiometry (DEXA) dalam Evaluasi Osteoporosis." Jurnal Radiologi Indonesia 1, no. 1 (May 1, 2015): 1–9. http://dx.doi.org/10.33748/jradidn.v1i1.1.
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Background: Osteoporosis is a metabolic bone disease that commonly occurs, characterized by decreased bone mass and prone to fracture. Breast carcinoma patients have a higher risk developing osteoporosis, due to a decrease in estrogen levels resulting from the e?ect of a given treatment, thus early detection of osteoporosis is needed.Objective: To compare the accuracy of the Singh Index with DEXA as the gold standard in the evaluation of osteoporosis in breast carcinoma patients with positive estrogen receptor.Materials and method: This is a diagnostic test, comparing the accuracy of the Singh Index on hip joints radiography with DEXA in the evaluation of osteoporosis in 35 breast carcinoma patients with positive estrogen receptors who have been getting therapy. All patients were examined by hip joints radiography and DEXA. The result of hip joints radiography are read double-blindedly by 3 observers.Results: Examination of Singh Index compared with DEXA by using limit values of osteoporosis of ? 3 on Singh Index and ? -2.5 SD on T-score DEXA achieves the best sensitivity on total hip but low positive predictive value, whereas with the limit values of osteoporosis of ? 4 on Singh Index and ? -1 SD on T-score DEXA achieves most excellent sensitivity and accuracy at the femoral collum showing low bone mineral density.Conclusion: Singh Index has a low diagnostic value in screening osteoporosis, but can be used to assess low bone mineral density in breast carcinoma patients with estrogen receptor positive, especially in areas that do not have DEXA equipment
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Alibhai, S. M., M. Duong-Hua, R. Sutradhar, A. M. Cheung, N. E. Fleshner, P. Warde, and L. Paszat. "Bone health practices in men on androgen deprivation therapy (ADT): A population-based analysis of 25,802 patients." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 9631. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.9631.
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9631 Background: ADT is used in up to 1 in 2 men with prostate cancer. Osteoporosis and fragility fractures are important side effects of ADT. Guidelines recommend 2 important bone health practices for men on ADT - measurement of bone mineral density with dual x-ray absorptiometry (DEXA) and use of bisphosphonates in men at risk of osteoporosis. The implementation of these guidelines in practice is not well known. Methods: Using linked administrative databases, we identified 25,802 men (mean age 75.9 y, range 66–100 y) with prostate cancer who were treated with at least 6 months of ADT or who underwent bilateral orchiectomy in Ontario, Canada between 1995 and 2005. Performance of DEXA and prescription of bisphosphonates were captured using specific procedure codes and drug identification numbers, respectively. Prior use of DEXA and bisphosphonates, as well as prior diagnoses of osteoporosis and fragility fracture, were captured with specific diagnostic codes and a 3 y look-back period. Annual rates per 100 person-years were determined for both outcomes. Results: Among 25,802 men, 3.09% had a DEXA more than one year prior to starting ADT, and 3.14% had a prior diagnosis of osteoporosis. Within 2 years of starting ADT, the rate of undergoing DEXA rose from 0.50 per 100 person-years in 1995 to 19.47 in 2005. Rates of DEXA testing were higher among those with a prior diagnosis of osteoporosis, prior DEXA test, or prior fragility fracture but did not reach rates above 50 per 100 person-years in any of these groups. Bisphosphonate use increased from 0.27 per 100 person-years in 1995 to 3.18 in 2005 among prior non-users. More men on ADT were started on a bisphosphonate in the third year after starting ADT as compared to the second year, and rates were higher in year 2 than year 1. Less than one-third of men starting a bisphosphonate underwent any DEXA testing within 12 months of bisphosphonate initiation. Conclusions: Rates of DEXA testing and bisphosphonate use have increased over time among older men starting ADT, but significant gaps and delays remain in the quality of bone health care in this population. No significant financial relationships to disclose.
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Mawby, Dianne I., Joseph W. Bartges, Andre d’Avignon, Dorothy P. Laflamme, Tamberlyn D. Moyers, and Tamorah Cottrell. "Comparison of Various Methods for Estimating Body Fat in Dogs." Journal of the American Animal Hospital Association 40, no. 2 (March 1, 2004): 109–14. http://dx.doi.org/10.5326/0400109.
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Obesity is considered one of the most common forms of malnutrition occurring in dogs. Laboratory methods of evaluation of body composition in live dogs have included dual-energy X-ray absorptiometry (DEXA) and deuterium oxide (D2O) dilution. Clinical methods of evaluation include assigning a body condition score (BCS) based on visual observation, palpation, and morphometric measurements. This study used these four methods to evaluate 23 healthy, adult, client-owned dogs. Good correlation (coefficient of determination [r2]=0.78) was found between measurements of percent body fat (%BF) determined by the D2O dilution method and the DEXA scan. Percent body fat can also be estimated using BCS (r2=0.92 comparison with DEXA) or by using morphometric measurements with simple calculations (r2=0.92 comparison with DEXA).
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Labar, Boris, Stefan Suciu, Petra Muus, Roelof Willemze, Jean-Pierre Marie, Georges Fillet, Zwi Berneman, et al. "Dexamethasone Versus Methyl-Prednisolone in Induction Therapy for Adult Acute Lymphoblastic (ALL) and Non-Hodgkin Lymphoma (NHL) Patients ≤ 60 Yrs Old: Final Results of the Eortc All-4 Phase III Trial." Blood 106, no. 11 (November 16, 2005): 1834. http://dx.doi.org/10.1182/blood.v106.11.1834.1834.
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Abstract In some recent trials high dose of Dexamethasone (Dexa) combined with chemotherapy has been used for induction therapy in adults with ALL because it may exert higher antileukemic activity. Increased level of drug in the cerebrospinal fluid might also prevent meningeal leukemic infiltration. However, high dose of Dexa may be associated with an increased risk of sepsis and fungal infections. By using a lower dose of dexamethasone these serious infections may be circumvented without jeopardize the antileukemic activity. The main aim of the EORTC ALL-4 study was to determine the efficacy and toxicity of a lower dose of Dexa administered during the induction therapy, as vs the ones of conventional dose of prednisone (Pred). In the ALL-4 study, patients (pts) ≤ 60 years had to receive either dexamethasone (10 mg/m2/day) or 6-methyl-prednisolone (60 mg/m2/day) on days 1–8 and 15–22 with standard induction chemotherapy (cyclophosphamide i.v. 750 mg/m2 on day 1 and 8; daunorubicine 30 mg/m2 on day 1–3 and 15–16; vincristine 1.4 mg/m2 (maximum 2 mg) and methotrexate /MTX/ i.t. 15 mg on days 1, 8, 15 and 22). All pts than receive the HAM consolidation course (HD-AraC 3 g/m2 every 12 hours on days 1–4; mitoxantrone 10 mg/m2 on days 5–7 and MTX 15 mg i.t. on day 1). Pts in CR received two courses of MA consolidation (MTX 1.5 g/m2 i.v on day 1 and L-asparaginase 104 IU/m2 on day 2). All pts with a family donor were assigned to undergo allo-SCT. Pts without the donor were randomized either to receive autologous stem cells from peripheral blood or continuous standard high maintenance chemotherapy. After a median follow-up of 4.9 years, 198 pts died. Between 1996 and 2003 a total of 325 pts were randomized in the ALL-4 study: 163 in the Dexa arm and 162 in the Pred arm. CR after induction/HAM was achieved in 128 (78.5%) pts receiving Dexa and in 120 (74.1%) pts treated with Pred. Among them, in Dexa group 61 pts relapsed, 19 died in CR and 48 are still in CCR, whereas in the Pred group, 58 pts relapsed, 8 died in CR and 54 are in CCR. The 5-year DFS rates was 32.7% in the Dexa group vs. 34% in the Pred group, the HR=1.15, 95% CI 0.83–1.59, p=0.40. The relapse rates were extremely similar (HR=0.99, p=0.96), whereas the death in CR rate was higher in the Dexa group compared to Pred group: HR=2.33, 95% CI 1.02–5.33, p=0.04. The overall 5-year survival rate in Dexa vs Pred group was 30.7% and 32.5% respectively (HR=1.11, 95% CI 0.84–1.43, p=0.46). The incidence of infection was similar during induction (Dexa: 55% vs Pred: 59%) and during HAM consolidation (Dexa: 85% vs Pred: 78%). More pts were allografted in CR1 in the Dexa than in the Pred arm (45 vs 33), and the mortality post allo-SCT was higher in the Dexa group (12/45=26.7%) than in the Pred group (5/33=15.2%). The results of ALL-4 trial indicate that there is no benefit of dexamethasone compared to 6-methyl prednisone during induction therapy in adult ALL-NHL pts.
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Kim, Tae Nyun. "Use of Dual-Energy X-ray Absorptiometry for Body Composition in Chronic Disease Management." Journal of Korean Diabetes 23, no. 2 (June 30, 2022): 97–105. http://dx.doi.org/10.4093/jkd.2022.23.2.97.
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Aging and chronic disease are often accompanied by changes in body composition that lead to decreased muscle mass and increased fat mass, even in weight-stable individuals. Both obesity and sarcopenia are important causes of frailty, disability, morbidity, and mortality. Diminished skeletal muscle and expanded visceral fat can act synergistically, which might maximize their effects on physical impairments and metabolic disorders. Dual-energy X-ray absorptiometry (DEXA) was regarded as one of the most versatile imaging techniques for evaluation of sarcopenia and obesity as well as osteoporosis. Whole-body DEXA allows total and regional assessment of the three compartments for fat mass, non-bone lean mass, and bone mineral content. Moreover, DEXA is accurate, reproducible, fast, relatively inexpensive, and involves very low radiation dose to the patient. Developments in DEXA equipment and software allow an accurate and differential estimate of visceral adipose tissue. This review summarizes the clinical practical application of whole-body DEXA values, with use of muscle and fat mass indices in the diagnostic workup of low muscle mass, sarcopenia, and sarcopenic obesity according to the most recent studies and guidelines.
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Hansen, N. J., T. G. Lohman, S. B. Going, M. C. Hall, R. W. Pamenter, L. A. Bare, T. W. Boyden, and L. B. Houtkooper. "Prediction of body composition in premenopausal females from dual-energy X-ray absorptiometry." Journal of Applied Physiology 75, no. 4 (October 1, 1993): 1637–41. http://dx.doi.org/10.1152/jappl.1993.75.4.1637.
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Four methods for predicting body composition were compared in premenopausal females (n = 100), 28#x2013;39 yr old, by using underwater weighing (UWW) as the criterion method. The four methods were dual energy X-ray absorptiometry (DEXA), skinfolds, bioelectrical impedance, and body mass index. The sample had a mean percent fat (%fat) of 29.7 +/- 6.8% (SD) by DEXA and 29.9 +/- 5.8% measured by UWW. DEXA yielded a standard error of estimate (SE) of 2.4% (r = 0.91) for the prediction of %fat from UWW. When %fat was estimated from other methods, larger SEs were obtained: 3.0% for skin-folds, 3.3% for body mass index, and 2.9% for bioelectrical impedance (height2/resistance) plus weight. Individual body density values derived from UWW were corrected for bone mineral variation. DEXA predicted the corrected body density with a lower SE (0.0040 vs. 0.0053 g/ml) than the original density values. We conclude that DEXA was a precise method and correlated highly with fat-free body weight and %fat from UWW in this homogeneous female sample.
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Salamone, Loran M., Thomas Fuerst, Marjolein Visser, Marialice Kern, Thomas Lang, Maurice Dockrell, Jane A. Cauley, Michael Nevitt, Francis Tylavsky, and Tim G. Lohman. "Measurement of fat mass using DEXA: a validation study in elderly adults." Journal of Applied Physiology 89, no. 1 (July 1, 2000): 345–52. http://dx.doi.org/10.1152/jappl.2000.89.1.345.
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The accuracy of total body fat mass and leg fat mass measurements by fan-beam dual-energy X-ray absorptiometry (DEXA) was assessed in 60 healthy elderly subjects (aged 70–79 yr). Total fat and leg fat mass at four leg regions (total leg, thigh, midthigh, and calf) were measured with the QDR 4500A (Hologic, Waltham, MA). The four-compartment model and multislice computed tomography scans were selected as criterion methods for total fat and leg fat mass, respectively. Total fat mass from DEXA was positively associated with fat mass from the four-compartment model with a standard error of the estimate ranging from 1.4 to 1.6 kg. DEXA fan-beam tended to overestimate fat mass for total leg and total thigh fat mass, whereas only marginal differences in fat mass measurements at the midthigh and calf were demonstrated (≤0.08 kg, P< 0.0005). Although there were significant differences between DEXA fan beam and the criterion methods, these differences were of small magnitude, suggesting that DEXA is an accurate method for measurement of fat mass for the elderly.
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Pineau, Jean-Claude, Jean Robert Filliard, and Michel Bocquet. "Ultrasound Techniques Applied to Body Fat Measurement in Male and Female Athletes." Journal of Athletic Training 44, no. 2 (March 1, 2009): 142–47. http://dx.doi.org/10.4085/1062-6050-44.2.142.
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Abstract Context: For athletes in disciplines with weight categories, it is important to assess body composition and weight fluctuations. Objective: To evaluate the accuracy of measuring body fat percentage with a portable ultrasound device possessing high accuracy and reliability versus fan-beam, dual-energy X-ray absorptiometry (DEXA). Design: Cross-validation study. Setting: Research laboratory. Patients or Other Participants: A total of 93 athletes (24 women, 69 men), aged 23.5 ± 3.7 years, with body mass index = 24.0 ± 4.2 and body fat percentage via DEXA = 9.41 ± 8.1 participated. All participants were elite athletes selected from the Institut National des Sports et de l'Education Physique. These participants practiced a variety of weight-category sports. Main Outcome Measure(s): We measured body fat and body fat percentage using an ultrasound technique associated with anthropometric values and the DEXA reference technique. Cross-validation between the ultrasound technique and DEXA was then performed. Results: Ultrasound estimates of body fat percentage were correlated closely with those of DEXA in both females (r = 0.97, standard error of the estimate = 1.79) and males (r = 0.98, standard error of the estimate = 0.96). The ultrasound technique in both sexes had a low total error (0.93). The 95% limit of agreement was −0.06 ± 1.2 for all athletes and did not show an overprediction or underprediction bias. We developed a new model to produce body fat estimates with ultrasound and anthropometric dimensions. Conclusions: The limits of agreement with the ultrasound technique compared with DEXA measurements were very good. Consequently, the use of a portable ultrasound device produced accurate body fat and body fat percentage estimates in relation to the fan-beam DEXA technique.
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Hayasaka, Naomi, Tsuyoshi Yaita, Tomoyuki Kuwaki, Sato Honma, Ken-ichi Honma, Takashi Kudo, and Shigenobu Shibata. "Optimization of Dosing Schedule of Daily Inhalant Dexamethasone to Minimize Phase Shifting of Clock Gene Expression Rhythm in the Lungs of the Asthma Mouse Model." Endocrinology 148, no. 7 (July 1, 2007): 3316–26. http://dx.doi.org/10.1210/en.2007-0010.
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Glucocorticoid receptor agonists such as dexamethasone (DEXA) have been recommended for the treatment of asthma. An increased frequency of dosing with these drugs seems preferable for cases of severe or uncontrolled asthma. The purpose of this experiment was to find the appropriate dosing schedule (frequency and timing) for DEXA inhalation based on chronotherapeutic dosing to minimize phase shifts of clock function in the lungs of the ovalbumin-treated asthmatic mouse. The daily rhythm of clock gene expression was similar between control and ovalbumin-treated mice. Acute inhalation of DEXA significantly increased mPer1 gene expression in the lungs but not the liver of mice. Daily exposure of DEXA at zeitgeber time 0 (lights on) or at zeitgeber time 18 (6 h after lights off) for 6 d caused a phase advance or phase delay of bioluminescence rhythm in the lungs, respectively, similar to light-induced phase shifts in locomotor activity rhythm. Daily zeitgeber time 0 exposure to DEXA attenuated the expression level of the mClca3 gene, which is associated with mucus overproduction, and there was a phase-advancing peak time of the mClca3 rhythm. The present results denote the importance of selecting the most appropriate time of day for nebulizer administration of DEXA to minimize adverse effects such as the phase shifting of clock function in asthmatic lungs. This is the first report of a successful protocol that could obtain phase shifts of clock gene expression rhythm in isolated peripheral organs in vivo.
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Yang, Hye-Won, Seyeon Oh, Dong-Min Chung, Minyoung Seo, Shin Jae Park, You-Jin Jeon, Kyunghee Byun, and BoMi Ryu. "Ishophloroglucin A, Isolated from Ishige okamurae, Alleviates Dexamethasone-Induced Muscle Atrophy through Muscle Protein Metabolism In Vivo." Marine Drugs 20, no. 5 (April 22, 2022): 280. http://dx.doi.org/10.3390/md20050280.
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The in vitro capacity of Ishige okamurae extract (IO) to improve impaired muscle function has been previously examined. However, the mechanism underlying IO-mediated muscle protein metabolism and the role of its component, Ishophloroglucin A (IPA), in mice with dexamethasone (Dexa)-induced muscle atrophy remains unknown. In the present study, we evaluated the effect of IO and IPA supplementation on Dexa-induced muscle atrophy by assessing muscle protein metabolism in gastrocnemius and soleus muscles of mice. IO and IPA supplementation improved the Dexa-induced decrease in muscle weight and width, leading to enhanced grip strength. In addition, IO and IPA supplementation regulated impaired protein synthesis (PI3K and Akt) or degradation (muscle-specific ubiquitin ligase muscle RING finger and atrogin-1) by modulating mRNA levels in gastrocnemius and soleus muscles. Additionally, IO and IPA upregulated mRNA levels associated with muscle growth activation (transient receptor potential vanilloid type 4 and adenosine A1 receptor) or inhibition (myostatin and sirtuin 1) in gastrocnemius and soleus muscle tissues of Dexa-induced mice. Collectively, these results suggest that IO and IO-derived IPA can regulate muscle growth through muscle protein metabolism in Dexa-induced muscle atrophy.
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Chanda, Ernest, Osward Bwanga, and Roy Mulenga. "Dual-Energy X-ray Absorptiometry (DEXA) Medical Imaging Services in Zambia." South Asian Research Journal of Nursing and Healthcare 4, no. 1 (February 9, 2022): 1–7. http://dx.doi.org/10.36346/sarjnhc.2022.v04i01.001.
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: Dual-energy X-ray absorptiometry (DEXA) is a medical imaging technique that uses low radiation for the diagnosis of osteoporosis. Millions of people are suffering from osteoporosis globally. The disease causes the bones to lose their strength and become more fragile and susceptible to fractures. The common risk factors of developing osteoporosis include aging, antiretroviral therapy (ARV) medication, and long-term corticosteroid medication. The morbidity and mortality of the disease arises from the associated fractures and medical complications. Although DEXA imaging services are available in the country, they remain underutilised. This article aims at bringing awareness and reviewing the DEXA imaging services in Zambia. The review found a lack of data on the prevalence of osteoporosis in Zambia. To improve the DEXA imaging services, research is required on epidemiology of the disease, associated fractures and projected costs incurred due to hospitalisation of patients.
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McCarley, Matthew R., Kelsey L. Wise, Daniel C. Jupiter, Ronald W. Lindsey, and Gordon L. Klein. "The utility of serum 25-Hydroxyvitamin-D and body mass index in the work-up of patients presenting to a bone health clinic." F1000Research 6 (August 29, 2017): 1588. http://dx.doi.org/10.12688/f1000research.12484.1.
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Background: 25-hydroxyvitamin-D (25[OH]D) and Dual-energy x-ray absorptiometry (DEXA) are routinely evaluated in bone health clinics, but existing literature is conflicting with regard to whether these factors predict fragility fractures. We hypothesized that both serum 25(OH)D levels and bone density are lower in patients who have sustained fragility fracture(s) prior to initial presentation compared to those patients who have not. Methods: We reviewed the charts of 102 consecutive patients presenting to a single-center Bone Health Clinic, comprising 11 males and 91 females with a mean age of 68 and range of 50 to 92. Demographic data, serum 25(OH)D levels, fracture history, and DEXA scans were obtained at the initial visit. Results: 64 patients had previously sustained a fragility fracture, and 38 patients had not. 25(OH)D levels were similar in the fracture and non-fracture groups (37.12±17.02 ng/mL versus 38.55±16.42, p=0.676). DEXA T-scores were similar between fracture and non-fracture groups (-2.28±1.33 versus -1.82±1.1, p=0.075). Patients with rheumatoid arthritis (RA) (n=7) had lower 25(OH)D levels upon presentation (mean 22.57±8.46 versus 38.77±16.67, p=0.001). BMI was inversely correlated with 25(OH)D level (Pearson correlation [R] =-0.211, p=0.033). Age was inversely correlated with DEXA T-score (R=-0.269, p-0.009), whereas BMI was positively correlated with DEXA T-score (R=0.259, p=0.013). The other demographic variables and risk factors studied were not significantly associated with either 25(OH)D levels or DEXA T-scores. Within the fracture group, DEXA T-scores were lower for patients who had sustained a hip fracture (n=15) compared to those who had sustained a fragility fracture elsewhere (-3.12±1.02 versus -2.03±1.32, p=0.004), but their 25(OH)D levels did not differ (34.33±25.49 versus 37.98±13.69, p=0.602). Conclusions: In this cohort of patients referred to a Bone Health Clinic, serum 25(OH)D levels and DEXA T-scores did not differ between those patients who had sustained a fragility fracture from those who had not.
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Mikula, Anthony L., Ross C. Puffer, Jeffery D. St Jeor, James T. Bernatz, Jeremy L. Fogelson, A. Noelle Larson, Ahmad Nassr, et al. "Teriparatide treatment increases Hounsfield units in the lumbar spine out of proportion to DEXA changes." Journal of Neurosurgery: Spine 32, no. 1 (January 2020): 50–55. http://dx.doi.org/10.3171/2019.7.spine19654.
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OBJECTIVEThe authors sought to assess whether Hounsfield units (HU) increase following teriparatide treatment and to compare HU increases with changes in bone mineral density (BMD) as measured by dual-energy x-ray absorptiometry (DEXA).METHODSA retrospective chart review was performed from 1997 to 2018 across all campuses at our institution. The authors identified patients who had been treated with at least 6 months of teriparatide and compared HU and BMD as measured on DEXA scans before and after treatment.RESULTSFifty-two patients were identified for analysis (46 women and 6 men, average age 67 years) who underwent an average of 20.9 ± 6.5 months of teriparatide therapy. The mean ± standard deviation HU increase throughout the lumbar spine (L1–4) was from 109.8 ± 53 to 133.9 ± 61 HU (+22%, 95% CI 1.2–46, p value = 0.039). Based on DEXA results, lumbar spine BMD increased from 0.85 to 0.93 g/cm2 (+9%, p value = 0.044). Lumbar spine T-scores improved from −2.4 ± 1.5 to −1.7 ± 1.5 (p value = 0.03). Average femoral neck T-scores improved from −2.5 ± 1.1 to −2.3 ± 1.0 (p value = 0.31).CONCLUSIONSTeriparatide treatment increased both HU and BMD on DEXA in the lumbar spine, without a change in femoral BMD. The 22% improvement in HU surpassed the 9% improvement determined with DEXA. These results support some surgeons’ subjective sense that intraoperative bone quality following teriparatide treatment is better than indicated by DEXA results. To the authors’ knowledge, this is the first study demonstrating an increase in HU with teriparatide treatment.
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Menezes, Luciana Gomes, Cláudia Sobreira, Luciano Neder, Antonio Luis Rodrigues-Júnior, and José A. Baddini Martinez. "Creatine supplementation attenuates corticosteroid-induced muscle wasting and impairment of exercise performance in rats." Journal of Applied Physiology 102, no. 2 (February 2007): 698–703. http://dx.doi.org/10.1152/japplphysiol.01188.2005.
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The objective of the present study was to investigate whether creatine (Cr) could attenuate the deleterious effects of high doses of dexamethasone (Dexa) on body mass, exercise performance, and respiratory variables of rodents. Forty-four Wistar rats performed incremental maximal exercise tests. They were then assigned to four groups: G1: subcutaneous (SC) and intraperitoneal (IP) saline; G2: SC saline and IP Cr (250 mg·kg−1·day−1); G3: SC Dexa (7.5 mg·kg−1·day−1) and IP saline; G4: SC Dexa and IP Cr. New exercise tests and analysis of the respiratory pattern under resting conditions and after stimulation with doxapram (2 mg/kg IP) were performed after 18 days. Post- minus pretreatment differences were compared between groups. G3 and G4 showed a significant impairment in body mass gain compared with G1 and G2 ( P < 0.05) (G1: 65.3 ± 26.1, G2: 93.1 ± 27.4, G3: −18.4 ± 20.1, G4: 9.8 ± 23.1 kg × 10−3). Similar results were observed for maximal oxygen consumption (G1: 9.5 ± 8.5, G2: 25.8 ± 14.5, G3: −25.5 ± 6.0, G4: −4.8 ± 9.5 ml·kg−1·min−1) and test duration (G1: 43.0 ± 45.0, G2: 72.0 ± 59.5, G3: −165.0 ± 60.6, G4: −48.0 ± 48.5 s). Simultaneous use of Cr significantly attenuated the Dexa-induced impairment of the last two variables. Cr attenuated Dexa-induced gastrocnemius and diaphragm muscle weight losses and the atrophy of gastrocnemius type IIb fibers. Cr supplementation had only small effects on Dexa-induced respiratory changes. These results suggest that Cr may play a role in the prophylaxis or treatment of steroid-induced myopathy.
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Praveen B Gautam, Arunesh Kumar, Babu Lal Kannojia, and Rajendra Chaudhary. "A comparative study of the efficacy and outcome of methylprednisolone and dexamethasone in moderate to severe COVID-19 disease." Asian Journal of Medical Sciences 12, no. 12 (December 1, 2021): 17–22. http://dx.doi.org/10.3126/ajms.v12i12.39294.
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Background: COVID-19 disease is caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). In the first half of 2020 COVID-19 disease has already converted into a global pandemic. Many treatment options were explored through the world. Aims and Objectives: To compare the efficacy and outcome of methylprednisolone (MTP) and dexamethasone (DEXA) in moderate-to-severe COVID-19 disease. Materials and Methods: In this prospective study, a total of 140 moderate to severe COVID-19 patients were enrolled from 15 April to June 15, 2021. These patients were randomly allocated into two groups, 70 patients were received MTP 2 mg/kg/day for 3 days followed by 1.0 mg/kg/day for 3 days in divided doses while 70 patients received DEXA 8 mg/day in divided dose up to 10 days. Results: The mean age was 45.5 years in MTP group whereas 45.34 years in DEXA group. The clinical outcome in MTP group and DEXA group was assessed in terms of clinical improvement (92.85% vs. 81.42%), radiological improvement (82.85% vs. 68.57%), transfer to ICU (5.71 vs. 14.57%), needs of ventilatory support (2.85% vs. 8.57%) and mortality (7.14% vs. 18.57%) respectively. Conclusion: In this study, MTP demonstrated better outcome as compared to DEXA in COVID-19 patients.
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Saleh, Samar R., Doaa A. Ghareeb, Aliaa A. Masoud, Eman Sheta, Mohamed Nabil, Inas M. Masoud, and Adham M. Maher. "Phoenix dactilyfera L. Pits Extract Restored Bone Homeostasis in Glucocorticoid-Induced Osteoporotic Animal Model through the Antioxidant Effect and Wnt5a Non-Canonical Signaling." Antioxidants 11, no. 3 (March 6, 2022): 508. http://dx.doi.org/10.3390/antiox11030508.
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Oxidative stress associated with long-term glucocorticoids administration is a route through which secondary osteoporosis can be developed. The therapeutic potential of Phoenix dactilyfera L. pits is offered by their balanced, valuable and diverse phytochemical composition providing protective potential against oxidative reactions, making it a good candidate to treat glucocorticoid-induced osteoporosis (GIO). This study evaluates the possible anti-osteoporotic effect of date pit extract (DPE) against dexamethasone (DEXA)-induced osteoporosis. Male rats were allocated into three control groups, which received saline, low and high doses of DPE (150 and 300 mg/kg/day), respectively. Osteoporosis-induced groups that received DEXA (1 mg/kg/day) were divided into DEXA only, DPE (2 doses) + DEXA, and ipriflavone + DEXA. Femoral bone minerals density and bone mineral content, bone oxidative stress markers, Wnt signaling, osteoblast and osteoclast differentiation markers, and femur histopathology were evaluated. DPE defeated the oxidative stress, resulting in ameliorative changes in Wnt signaling. DPE significantly reduced the adipogenicity and abolished the osteoclastogenic markers (RANKL/OPG ratio, ACP, TRAP) while enhancing the osteogenic differentiation markers (Runx2, Osx, COL1A1, OCN). In Conclusion DPE restored the balanced proliferation and differentiation of osteoclasts and osteoblasts precursors. DPE can be considered a promising remedy for GIO, especially at a low dose that had more potency.
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Rossi, Francesca, Chiara Tortora, Giuseppe Palumbo, Francesca Punzo, Maura Argenziano, Maddalena Casale, Alessandra Di Paola, Franco Locatelli, and Silverio Perrotta. "CB2 Receptor Stimulation and Dexamethasone Restore the Anti-Inflammatory and Immune-Regulatory Properties of Mesenchymal Stromal Cells of Children with Immune Thrombocytopenia." International Journal of Molecular Sciences 20, no. 5 (February 28, 2019): 1049. http://dx.doi.org/10.3390/ijms20051049.
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Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by antibody-mediated platelet destruction, with a complex and unclear pathogenesis. The impaired immunosuppressive capacity of mesenchymal stromal cells in ITP patients (ITP-MSCs) might play a role in the development of the disease. Correcting the MSC defects could represent an alternative therapeutic approach for ITP. High-dose dexamethasone (HD-Dexa) is the mainstay of the ITP therapeutic regimen, although it has several side effects. We previously demonstrated a role for cannabinoid receptor 2 (CB2) as a mediator of anti-inflammatory and immunoregulatory properties of human MSCs. We analyzed the effects of CB2 stimulation, with the selective agonist JWH-133, and of Dexa alone and in combination on ITP-MSC survival and immunosuppressive capacity. We provided new insights into the pathogenesis of ITP, suggesting CB2 receptor involvement in the impairment of ITP-MSC function and confirming MSCs as responsive cellular targets of Dexa. Moreover, we demonstrated that CB2 stimulation and Dexa attenuate apoptosis, via Bcl2 signaling, and restore the immune-modulatory properties of MSCs derived from ITP patients. These data suggest the possibility of using Dexa in combination with JWH-133 in ITP, reducing its dose and side effects but maintaining its therapeutic benefits.
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Tornero-Aguilera, José Francisco, Bella Esperanza Villegas-Mora, and Vicente Javier Clemente-Suárez. "Differences in Body Composition Analysis by DEXA, Skinfold and BIA Methods in Young Football Players." Children 9, no. 11 (October 28, 2022): 1643. http://dx.doi.org/10.3390/children9111643.
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The most widely used method in professional sports for fat percentage assessment is the skinfold method. However, there is the chance of bias and human error. For this reason, other more precise methods are used, such as single-frequency bioelectrical impedance analysis (BIA) or dual energy X-ray absorptiometry (DEXA). However, there are limited data that demonstrate the methodological shortcomings or congruences in fat and fat-free mass estimates including gender differences and differences in athlete populations. Thus, the aim of the present study was to compare total body fat (%BF) estimated by six skinfold thickness measurement (SKF) and single-frequency bioelectrical impedance analysis (BIA) methods, using three different sets of equations, to that assessed by the dual energy X-ray absorptiometry (DEXA) method using a DEXA Hologic Serie Discovery QDR. For this aim, 76 males and 70 females belonging to the professional Spanish football federation were evaluated. We found significant differences between the three measures. BIA significantly underestimates the fat percentage, followed by skinfolds. With DEXA being the more objective or accurate method, an equation is established by means of linear regression analysis that allows the percentage of adipose tissue to be obtained either through anthropometry or electrical bioimpedance and adjusted to that which would be obtained by the DEXA system.
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Rajouria, Alark Devkota, Madhur Dev Bhattarai, Manil Ratna Bajracharya, and Buddha Bahadur Karki. "COMPARATIVE STUDIES OF BONE DENSITY BY QUANTITATIVE ULTRASOUND (QUS) WITH DUAL-ENERGY X-RAY ABSORPTIOMETRY (DEXA) SCAN." Journal of Chitwan Medical College 9, no. 1 (March 9, 2021): 8–12. http://dx.doi.org/10.54530/jcmc.384.
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Background: The aim of the study was to establish the correlation quantitative ultrasound (QUS) between and dual-energy X-ray absorp¬tiometry (DEXA) and to assess the ability of QUS as a screening tool for osteoporosis.Methods: The study was conducted on 115 patients. All the patients underwent QUS of radius using Sunlight MiniOmni bone sonometer and DEXA screening for measurement of bone mineral density (BMD) at lumbar spine, total left & femoral neck and radius.Results: Significant correlations were observed between QUS and DEXA T score.Conclusions: QUS is a sensitive screening tool to detect changes in the bone mass and risk of osteoporosis.
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Dunford, Lauren M., David M. Roy, Theresa Hahn, Karen Brown, Pamela Paplham, Dominick M. Lamonica, Minoo Battiwalla, Swaminathan Padmanabhan, and Philip L. McCarthy. "High Frequency and Early Onset of Bone Mineral Density Loss Following Allogeneic Stem Cell Transplantation." Blood 106, no. 11 (November 16, 2005): 2011. http://dx.doi.org/10.1182/blood.v106.11.2011.2011.
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Abstract Bone mineral density (BMD) loss has been recently associated with allogeneic stem cell transplantation (alloSCT). It is not certain whether BMD loss in alloSCT patients (pts) occurs primarily within the first six months, since some reports cite continuing BMD loss up to six years post-transplant. Furthermore, it has been suggested that alloSCT-BMD loss is more likely to manifest in the femoral neck (FN), as opposed to the lumbar spine (LS). There are no studies that have detailed the incidence of alloSCT-BMD loss. We retrospectively reviewed 90 alloSCT pts who underwent a single alloSCT between 7/1/2001 and 2/26/2005 to assess the frequency of DEXA scan use and alloSCT-BMD loss. 7/1/2001 was chosen as the start date since this was when DEXA scans were first available at RPCI. 50 patients did not have DEXA scans following BMT: 15/50 pts died before day 130, 21/50 pts died after day 130 post BMT, and 14/50 pts are alive post day 130 without DEXA scans (median 1.1 yrs, range 0.34–3.0 yrs). Clinical criteria for obtaining DEXA scans were a medically stable condition with a good KPS and alive at day 130. 37 pts met this criteria. The median survival of the non-DEXA scan pts was 180 (7–1296) days and 571 (110–1282) days for the DEXA scan pts. DEXA scan pt characteristics in this sample included: Median age 39 years (range 7–66); AML (n=12), Lymphoma (n=12), CML (n=5), MDS/MPD (n=5), ALL (n=2), or Aplastic Anemia (n=1); Flu+Mel (n=14), Bu+Cy (n=8), Cy+TBI (n=7), non-myeloablative regimen (n=6), or other regimens (n=2); FK+Mt (n=28), FK+/− other (n=4), Mt (n=2), Cs+Mt (n=2), or Cs+FK+Mt (n=1). Approximately half (n=18/37) of alloSCT pts were found to have BMD loss at day 130 post-transplant. Results were stratified by year, and no trends regarding the frequency of DEXA scans in the population or the frequency of abnormal results over time were noted. There were no differences in terms of conditioning regimens or GVHD prophylaxis between the normal and low BMD groups. Contrary to previously published reports, we did not find a marked difference between the LS and FN T scores of the 18 pts with BMD loss at baseline (LS median T score = −1.4, FN median T score = −1.55). Also, BMD improvement following oral bisphosphonates was seen in six pts with available follow-up scans (LS median T score improved from −1.15 to −0.55, FN median T score improved from −1.45 to −1.1). The day 130 incidence of BMD loss in our alloSCT population was higher than we expected. Therefore, we recommend that all future alloSCT pts undergo DEXA scans as part of the day 100 workup. Further study may elucidate risk factors for BDM loss post BMT. Bisphosphonate use may reverse alloSCT BDM loss.
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Rech, Cassiano Ricardo, Edio Luiz Petroski, Rosane Carla Rosendo da Silva, and João Carlos Nunes da Silva. "Indicadores antropométricos de excesso de gordura corporal em mulheres." Revista Brasileira de Medicina do Esporte 12, no. 3 (June 2006): 119–24. http://dx.doi.org/10.1590/s1517-86922006000300002.
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O objetivo deste estudo foi determinar a sensibilidade, a especificidade e a concordância entre dois indicadores de excesso de gordura em mulheres. Foram avaliadas 65 mulheres (50-77 anos de idade), com massa corporal média de 70,3 ± 11kg, estatura de 158,0 ± 5,5cm, permitindo o cálculo do índice de massa corporal (IMC) e do recíproco do índice ponderal (RIP). O percentual de gordura, mensurado através da absortometria radiológica de dupla energia (%G DEXA), foi utilizado como o método de referência. A estatística descritiva, a correlação de linear de Pearson (r) e o índice de Kappa (k) foram utilizados para análise dos dados. O IMC, o RIP e o %G DEXA apresentaram escores médios de 28 ± 4,2kg.m-2; 38 ± 1,9cm.kg-1/3; e 38,1 ± 6,0%, respectivamente. A prevalência de excesso de gordura foi de 89,2% para o %G DEXA. O RIP e o IMC apresentaram prevalências de excesso de gordura de 83,1% e 73,8%, respectivamente. Os coeficientes de correlação linear de Pearson entre %G DEXA e o RIP (r = -0,76) e entre %G DEXA e o IMC (r = 0,72) foram significativos (p < 0,01). O índice de Kappa identificou associação de k = 0,31 entre as medidas de %G DEXA e IMC, e de k = 0,48 entre %G DEXA e RIP. Os indicadores antropométricos apresentaram índices de sensibilidade e especificidade altos (IMC = 79,3% e 71,4%; RIP = 90% e 71,4% respectivamente). A análise através da curva ROC (receiver operator characteristic curve) apresentou áreas sobre a curva de 0,80 para o IMC e de 0,83 para o RIP que não diferiram significativamente (p < 0,05). Os pontos de corte de 26,2kg.m-2 para o IMC e 39,3cm.kg-1/3 para o RIP demonstraram a melhor relação entre sensibilidade e especificidade na identificação de excesso de gordura. Assim, conclui-se que os indicadores antropométricos analisados não diferem em relação à identificação de excesso de gordura e que ambos apresentam valores de sensibilidade e especificidade altos na avaliação do excesso de gordura em mulheres acima de 50 anos de idade.