Osteoporosis and vascular calcification in postmenopausal women: a cross-sectional study.

Objectives To estimate the correlation between osteoporosis and vascular calcification in postmenopausal women and the influence of calcium/vitamin D supplements on vascular calcification. Methods A cross-sectional study was performed including 29 women with osteoporosis (15 not taking supplements) and 18 age-matched, non-osteoporotic women. They were evaluated for cardiovascular risk factors and blood tests, lateral X-ray of lumbar spine (assessment of abdominal aorta calcification, AAC) and carotid ultrasound (increased intima media thickness (iIMT) or calcified plaques) were performed. Results In univariate analysis, osteoporotic women were 16 times more likely to develop AAC (odds ratio (OR) 15.8, 95% confidence interval (CI) 1.9-135.4) and seven times more likely to develop iIMT (OR 6.8, 95% CI 1.8-25.4) compared to normal individuals. The odds of developing AAC and iIMT were increased each year after menopause (OR 1.11, 95% CI 1.01-1.2 and OR 1.18, 95% CI 1.05-1.3, respectively) and with aging (OR 1.27, 95% CI 1.1-1.47 and OR = 1.17, 95% CI 1.04-1.3, respectively). Calcified plaques were significantly correlated with osteoporosis (p = 0.014). In multivariate analysis, osteoporosis was an independent risk factor for AAC (OR 13.3, 95% CI 1.3-134.4) and iIMT (OR 4.7, 95% CI 1.1-19.9). Low doses of supplements did not appear to affect vascular calcification (p = 0.6). Conclusions Osteoporosis is associated with increased calcification of the abdominal aorta and carotids. Low doses of supplements do not appear to cause any increase in vascular calcification in osteoporotic women.

Evaluation of sufentanil as a supplement to anaesthesia in lengthy spinal surgery.

The efficacy of sufentanil citrate as a supplement to anaesthesia was studied in 31 patients undergoing lengthy spinal surgery (mean duration 150 min). Anaesthesia was induced with 1 microgram/kg sufentanil (bolus) and 2 mg/kg thiopental, followed by 1.5 mg/kg succinylcholine to facilitate intubation, all given intravenously; after intubation, administration of N2O:O2 (70:30) was started. Further doses of sufentanil (10-25 micrograms) were given, on average 2.3 times, depending on the length of the operation, systolic blood pressure, pulse rate and other autonomous signs; the mean total amount of sufentanil administered was 126.3 micrograms. Our findings showed that sufentanil provided good cardiovascular stability and rapid recovery. More specifically mean arterial blood pressure and heart rate were significantly reduced 1 min after intubation (P < or = 0.001). Thereafter mean arterial blood pressure increased, returning to preanaesthesia values and remaining constant while heart rate remained constant throughout the operation at values similar to the value immediately after induction of anaesthesia. Recovery was rapid, awakening time was 6 min or less in 50% of patients and 10 min or less in 90% of patients, while the corresponding values for response time were 8 and 12 min, for extubation time, 9 and 13 min, and for orientation time, 15 and 19 min. Two patients experienced nausea and vomiting and one patient mild chest-wall rigidity. Finally, respiratory depression was not observed in any of the patients.