Analysis of skeletal status by quantitative ultrasonometry in a cohort of postmenopausal women with high blood cholesterol without documented osteoporosis.

Osteoporosis and atherosclerosis are leading causes of mortality and morbidity in the Western world. A link between osteoporosis and atherosclerosis was proposed by epidemiologic and laboratory data. In the present study, we investigated skeletal status in postmenopausal women with hypercholesterolemia using quantitative ultrasonometry (QUS). Six hundred healthy postmenopausal subjects were enrolled within a 2-mo period by primary care physicians. Information on lifestyle and calcium intake was collected for each enrolled subject. Subjects (n = 256) were divided into two groups according to lipid profile: normal (n = 180) with serum cholesterol <200 mg/dL and hypercholesterolemic (n = 76) with serum cholesterol >or=200 mg/dL. Hypercholesterolemic subjects were further stratified into two groups, one receiving dietary treatment (n = 34) and the other receiving statin treatment (n = 42). We found a statistically significant reduction in amplitude dependent speed of sound (AD-SoS) in hypercholesterolemic subjects compared with subjects with normal cholesterol (p = 0.006). Calcium intake behaved similarly to AD-SoS (p = 0.0001). No statistical significant difference in AD-SoS were observed between the group on diet treatment versus the group on statin (p = 0.52). Calcium intake was lower in patients on statins treatment compared with subjects on diet treatment only (p < 0.0001). Our data suggest that hypercholesterolemia per se is a risk factor for impaired skeletal status. Our data also call attention to the risk of a poor calcium intake in patient receiving diet to lower plasma cholesterol. Moreover, our data suggest that statins per se may exert a protective effect on bone independently from calcium intake.

Usefulness of multislice computed tomography to assess patency of coronary artery stents versus conventional coronary angiography.

BACKGROUND: The aim of the present study was to assess the in-stent restenosis and occlusion of coronary artery stents by multislice computed tomography (MSCT) compared with conventional coronary angiography in patients with atypical chest pain and not practicable/non-conclusive stress test. METHODS: Between December 2004 and March 2006, 81 patients were scheduled and of these 72 (65 men, mean age 61 years) with 90 stents underwent MSCT angiography using a 16-slice scanner, Toshiba Aquilion 16, 8-12 months after stent placement. RESULTS: Of the 90 stents, 71 (79%) could be assessed and 19 (21%) were excluded because the image quality at the stent level was incompatible with diagnostic assessment. This results in sensitivity, specificity, and positive and negative predictive values for all assessable stents in the identification of occlusion and/or in-stent restenosis of 82, 96, 87, and 94%, respectively. When the 19 uninterpretable stents were included in the analysis, the diagnostic accuracy of MSCT in detecting in-stent restenosis and occlusion resulted in a sensitivity of 82%, specificity of 71%, positive predictive value of 40%, and negative predictive value of 94%. CONCLUSION: The results of the study suggest that MSCT angiography is a useful method for evaluating patency/occlusion of large (>or=3 mm) coronary stents in symptomatic patients with atypical chest pain and concomitant not practicable/non-conclusive exercise or stress imaging test.

Ogilvie's syndrome (acute colonic pseudo-obstruction): review of the literature and report of 6 additional cases.

PURPOSE: Ogilvie's syndrome is defined as an acute pseudo-obstruction of the colon, characterized by the signs, symptoms and radiological pattern of a large-bowel obstruction, but without a detectable organic cause. The aetiology of Ogilvie's syndrome appears to be multifactorial, with a series of possibly interacting pathogenic noxae all resulting in colon inactivity. Our study reports on six cases of Ogilvie's syndrome diagnosed and treated between 1997 and 2002. MATERIALS AND METHODS: From October 1997 to September 2002 we studied six patients affected by pseudo-obstruction of the colon. The pseudo-obstruction was recurrent in two cases. Acute dilatation of the colon without radiologically-detectable organic obstruction was the inclusion criterion for the study. RESULTS: Plain abdominal radiography revealed colon dilatation that extended to the splenic flexure in three patients, to the hepatic flexure in two patients, and confined to the transverse colon in one patient. None of the patients showed air-fluid levels of the small intestine. CONCLUSIONS: The most relevant clinical finding in Ogilvie's syndrome is abdominal distension, which arises suddenly, has a progressive course and reaches massive levels. The first-line diagnostic investigation is plain abdominal radiography which shows extreme colon dilation without air-fluid levels of the small intestine. In three of our patients, conservative therapy alone was able to restore normal conditions within five days; two patients required decompressive colonoscopy, and one patient died from cardio-circulatory arrest after 48 hours.