Response to "The Perspective of the International Osteoporosis Foundation on the Official Positions of the International Society for Clinical Densitometry," by John A. Kanis et al.
ABSTRACT We greatly appreciate the thoughtful perspective by Kanis and colleagues regarding the Official Positions of the International Society for Clinical Densitometry (ISCD), published in their entirety in the Journal of Clinical Densitometry (1) and summarized in the Journal of Clinical Endocrinology and Metabolism (2) and Osteoporosis International (3). A robust scientific debate on the clinical applications of bone density testing is desirable and necessary. It is only through open discussion of diverse viewpoints that we will coherently define the clinical utility of bone densitometry. The development of practical standards by which health care practitioners can be guided is a major step toward improving patient care worldwide.
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ABSTRACT: There is a variable body of evidence on adverse bone outcomes in HIV patients co-infected with hepatitis C virus (HCV). We examined the association of HIV/HCV co-infection on osteoporosis or osteopenia (reduced bone mineral density; BMD) and fracture.PLoS ONE 07/2014; 9(7):e101493. · 3.53 Impact Factor
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ABSTRACT: Oncologic emergencies can occur at any time during the course of a malignancy, from the presenting symptom to end-stage disease. Although some of these conditions are related to cancer therapy, they are by no means confined to the period of initial diagnosis and active treatment. In the setting of recurrent malignancy, these events can occur years after the surveillance of a cancer patient has been appropriately transferred from a medical oncologist to a primary care provider. As such, awareness of a patient's cancer history and its possible complications forms an important part of any clinician's knowledge base. Prompt identification of and intervention in these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness. This article reviews hypercalcemia, hyponatremia, hypoglycemia, tumor lysis syndrome, cardiac tamponade, superior vena cava syndrome, neutropenic fever, spinal cord compression, increased intracranial pressure, seizures, hyperviscosity syndrome, leukostasis, and airway obstruction in patients with malignancies. Chemotherapeutic emergencies are also addressed. CA Cancer J Clin 2011;. © 2011 American Cancer Society.CA A Cancer Journal for Clinicians 08/2011; · 153.46 Impact Factor
Article: T-Scores and Z-Scores[Show abstract] [Hide abstract]
ABSTRACT: Bone mineral density (BMD) can be measured by a variety of techniques at several skeletal sites. Once measured, the manufacturers’ software uses the BMD to calculate a T-score and/or Z-score. Both T-scores and Z-scores are derived by comparison to a reference population on a standard deviation scale. The recommended reference group for the T-score is a young gender-matched population at peak bone mass, while the Z-score should be derived from an age-matched reference population. T-scores and Z-scores are widely quoted in scientific publications on osteoporosis and BMD studies, and are the values used for DXA diagnostic criteria and current clinical guidelines for the management of osteoporosis. Errors in BMD measurement, differences in reference populations, and variations in calculation methods used, can all affect the actual T-score and Z-score value. Attempts to standardize these values have made considerable progress, but inconsistencies remain within and across BMD technologies. This can be a source of confusion for clinicians interpreting BMD results. A clear understanding of T-scores and Z-scores is essential for correct interpretation of BMD studies in clinical practice. KeywordsDXA-Bone mineral density- T-score- Z-scoreClinical Reviews in Bone and Mineral Metabolism 09/2009; 8(3):113-121.