Widespread breakdown in masting in European beech due to rising summer temperatures

Climate change effects on tree reproduction are poorly understood, even though the resilience of populations relies on sufficient regeneration to balance increasing rates of mortality. Forest-forming tree species often mast, i.e. reproduce through synchronised year-to-year variation in seed production, which improves pollination and reduces seed predation. Recent observations in European beech show, however, that current climate change can dampen interannual variation and synchrony of seed production and that this masting breakdown drastically reduces the viability of seed crops. Importantly, it is unclear under which conditions masting breakdown occurs and how widespread breakdown is in this pan-European species. Here, we analysed 50 long-term datasets of population-level seed production, sampled across the distribution of European beech, and identified increasing summer temperatures as the general driver of masting breakdown. Specifically, increases in site-specific mean maximum temperatures during June and July were observed across most of the species range, while the interannual variability of population-level seed production (CVp) decreased. The declines in CVp were greatest, where temperatures increased most rapidly. Additionally, the occurrence of crop failures and low seed years has decreased during the last four decades, signalling altered starvation effects of masting on seed predators. Notably, CVp did not vary among sites according to site mean summer temperature. Instead, masting breakdown occurs in response to warming local temperatures (i.e. increasing relative temperatures), such that the risk is not restricted to populations growing in warm average conditions. As lowered CVp can reduce viable seed production despite the overall increase in seed count, our results warn that a covert mechanism is underway that may hinder the regeneration potential of European beech under climate change, with great potential to alter forest functioning and community dynamics.

Facultative myiasis caused by rat-tailed maggots in a dog in Belgium

A two-year-old cavalier King Charles spaniel was presented with accidentally observed larvae in fresh feces, which were identified as rat-tailed larvae of the common drone fly (Eristalis tenax). This common drone fly can cause facultative myiasis in both humans and animals. Although facultative myasis has already been described in humans, to the authors’ knowledge, this is the first description of such a case in an animal in Belgium.

Simulating tree growth response to climate change in structurally diverse oak and beech forests

This study aimed to simulate oak and beech forest growth under various scenarios of climate change and to evaluate how the forest response depends on site properties and particularly on stand characteristics using the individual process-based model HETEROFOR. First, this model was evaluated on a wide range of site conditions. We used data from 36 long-term forest monitoring plots to initialize, calibrate, and evaluate HETEROFOR. This evaluation showed that HETEROFOR predicts individual tree radial growth and height increment reasonably well under different growing conditions when evaluated on independent sites. In our simulations under constant CO₂ concentration ([CO₂]_cst) for the 2071-2100 period, climate change induced a moderate net primary production (NPP) gain in continental and mountainous zones and no change in the oceanic zone. The NPP changes were negatively affected by air temperature during the vegetation period and by the annual rainfall decrease. To a lower extent, they were influenced by soil extractable water reserve and stand characteristics. These NPP changes were positively affected by longer vegetation periods and negatively by drought for beech and larger autotrophic respiration costs for oak. For both species, the NPP gain was much larger with rising CO₂ concentration ([CO₂]_var) mainly due to the CO₂ fertilisation effect. Even if the species composition and structure had a limited influence on the forest response to climate change, they explained a large part of the NPP variability (44% and 34% for [CO₂]_cst and [CO₂]_var, respectively) compared to the climate change scenario (5% and 29%) and the inter-annual climate variability (20% and 16%). This gives the forester the possibility to act on the productivity of broadleaved forests and prepare them for possible adverse effects of climate change by reinforcing their resilience.

Responses of forest ecosystems in Europe to decreasing nitrogen deposition

Average nitrogen (N) deposition across Europe has declined since the 1990s. This resulted in decreased N inputs to forest ecosystems especially in Central and Western Europe where deposition levels are highest. While the impact of atmospheric N deposition on forests has been receiving much attention for decades, ecosystem responses to the decline in N inputs received less attention. Here, we review observational studies reporting on trends in a number of indicators: soil acidification and eutrophication, understory vegetation, tree nutrition (foliar element concentrations) as well as tree vitality and growth in response to decreasing N deposition across Europe. Ecosystem responses varied with limited decrease in soil solution nitrate concentrations and potentially also foliar N concentrations. There was no large-scale response in understory vegetation, tree growth, or vitality. Experimental studies support the observation of a more distinct reaction of soil solution and foliar element concentrations to changes in N supply compared to the three other parameters. According to the most likely scenarios, further decrease of N deposition will be limited. We hypothesize that this expected decline will not cause major responses of the parameters analysed in this study. Instead, future changes might be more strongly controlled by the development of N pools accumulated within forest soils, affected by climate change and forest management.

The response of soil solution chemistry in European forests to decreasing acid deposition

Acid deposition arising from sulphur (S) and nitrogen (N) emissions from fossil fuel combustion and agriculture has contributed to the acidification of terrestrial ecosystems in many regions globally. However, in Europe and North America, S deposition has greatly decreased in recent decades due to emissions controls. In this study, we assessed the response of soil solution chemistry in mineral horizons of European forests to these changes. Trends in pH, acid neutralizing capacity (ANC), major ions, total aluminium (Al_tot ) and dissolved organic carbon were determined for the period 1995-2012. Plots with at least 10 years of observations from the ICP Forests monitoring network were used. Trends were assessed for the upper mineral soil (10-20 cm, 104 plots) and subsoil (40-80 cm, 162 plots). There was a large decrease in the concentration of sulphate (SO42-) in soil solution; over a 10-year period (2000-2010), SO42- decreased by 52% at 10-20 cm and 40% at 40-80 cm. Nitrate was unchanged at 10-20 cm but decreased at 40-80 cm. The decrease in acid anions was accompanied by a large and significant decrease in the concentration of the nutrient base cations: calcium, magnesium and potassium (Bc = Ca²⁺  + Mg²⁺  + K⁺ ) and Al_tot over the entire dataset. The response of soil solution acidity was nonuniform. At 10-20 cm, ANC increased in acid-sensitive soils (base saturation ≤10%) indicating a recovery, but ANC decreased in soils with base saturation >10%. At 40-80 cm, ANC remained unchanged in acid-sensitive soils (base saturation ≤20%, pHCaCl2 ≤ 4.5) and decreased in better-buffered soils (base saturation >20%, pHCaCl2 > 4.5). In addition, the molar ratio of Bc to Al_tot either did not change or decreased. The results suggest a long-time lag between emission abatement and changes in soil solution acidity and underline the importance of long-term monitoring in evaluating ecosystem response to decreases in deposition.

Environment and host as large-scale controls of ectomycorrhizal fungi

Explaining the large-scale diversity of soil organisms that drive biogeochemical processes-and their responses to environmental change-is critical. However, identifying consistent drivers of belowground diversity and abundance for some soil organisms at large spatial scales remains problematic. Here we investigate a major guild, the ectomycorrhizal fungi, across European forests at a spatial scale and resolution that is-to our knowledge-unprecedented, to explore key biotic and abiotic predictors of ectomycorrhizal diversity and to identify dominant responses and thresholds for change across complex environmental gradients. We show the effect of 38 host, environment, climate and geographical variables on ectomycorrhizal diversity, and define thresholds of community change for key variables. We quantify host specificity and reveal plasticity in functional traits involved in soil foraging across gradients. We conclude that environmental and host factors explain most of the variation in ectomycorrhizal diversity, that the environmental thresholds used as major ecosystem assessment tools need adjustment and that the importance of belowground specificity and plasticity has previously been underappreciated.

Increasing trends of dissolved organic nitrogen (DON) in temperate forests under recovery from acidification in Flanders, Belgium

We evaluated trends (2005-2013) and patterns of dissolved organic nitrogen (DON) and its ratio with dissolved organic carbon (DOC), DOC:DON in atmospheric deposition and soil solution of five Level II plots of the International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests (ICP Forests) in Flanders, Northern Belgium. The primary aim was to confirm positive postulated trends in DON levels and DOC:DON under on-going recovery from acidification. The DON concentrations (0.95-1.41 mg L(-1)) and fluxes (5.6-8.3 kg ha(-1)y(-1)) in throughfall were about twice as high compared to precipitation in the open field (0.40-0.48 mg L(-1), 3.0-3.9 kg ha(-1)y(-1)). Annual soil profile leaching losses of DON varied between 1.2 and 3.7 kg ha(-1)y(-1). The highest soil DON concentrations and fluxes were observed beneath the O horizon (1.84-2.36 mg L(-1), 10.1-12.3 kg ha(-1)y(-1)). Soil solution concentrations and fluxes of DON showed significant increasing trends. Temporarily soil solution DOC:DON rose following an exceptionally long spring drought in 2007, suggesting an effect of drying and rewetting on DOM composition. Further research is needed to test the dependence of DON and DOC:DON on factors such as latitude, forest cover, length of the growing season, hydrology and topography. Nonetheless, even with considerable variation in soil type, level of base saturation, and soil texture in the five included ICP Forests Level II plots, all data revealed a proportionally larger positive response of DON flux than DOC to recovery from acidification.

Tree mineral nutrition is deteriorating in Europe

The response of forest ecosystems to increased atmospheric CO2 is constrained by nutrient availability. It is thus crucial to account for nutrient limitation when studying the forest response to climate change. The objectives of this study were to describe the nutritional status of the main European tree species, to identify growth-limiting nutrients and to assess changes in tree nutrition during the past two decades. We analysed the foliar nutrition data collected during 1992-2009 on the intensive forest monitoring plots of the ICP Forests programme. Of the 22 significant temporal trends that were observed in foliar nutrient concentrations, 20 were decreasing and two were increasing. Some of these trends were alarming, among which the foliar P concentration in F. sylvatica, Q. Petraea and P. sylvestris that significantly deteriorated during 1992-2009. In Q. Petraea and P. sylvestris, the decrease in foliar P concentration was more pronounced on plots with low foliar P status, meaning that trees with latent P deficiency could become deficient in the near future. Increased tree productivity, possibly resulting from high N deposition and from the global increase in atmospheric CO2, has led to higher nutrient demand by trees. As the soil nutrient supply was not always sufficient to meet the demands of faster growing trees, this could partly explain the deterioration of tree mineral nutrition. The results suggest that when evaluating forest carbon storage capacity and when planning to reduce CO2 emissions by increasing use of wood biomass for bioenergy, it is crucial that nutrient limitations for forest growth are considered.

Necrotising sarcoid granulomatosis: clinical, functional, endoscopical and radiographical evaluations

Necrotising sarcoid granulomatosis (NSG) is a rare disease diagnosed on the basis of pathological features. The present study reports the characteristics of 14 cases of NSG. The mean age at the appearance of first symptoms was 37 yrs and the mean delay between first symptoms and diagnosis was 1 yr. Extrarespiratory symptoms were more common (12 out of 14) than respiratory symptoms (eight out of 14). Seven patients had inflammatory syndrome. Bronchoalveolar lavage was performed in eight patients and found to be normal in three cases. Respiratory function was normal in 13 patients, but carbon monoxide diffusing capacity was slightly decreased in eight of the 11 patients tested. A computed tomography scan showed a solitary nodule in four out of 14 cases, bilateral nodules in three and infiltrates in seven. One patient died from neurological complications despite treatment with corticosteroids and immunosuppressive drugs. Two cases of relapse were observed in patients initially treated with corticosteroids, and there were two cases of relapse after surgery. No relapse occurred in the five untreated patients. During the follow-up, lung cancer was detected at 26 months and 8 yrs, respectively, after NSG diagnosis in two patients. In conclusion, no one treatment is associated with a better outcome than the others, although lung biopsy might be necessary in case of isolated nodule or cavitation. Greater vigilance is required during the follow-up.

Cauda equina syndrome complicating ankylosing spondylitis: role of computed tomography and magnetic resonance imaging

We present two cases of cauda equina syndrome in ankylosing spondylitis. Cauda equina syndrome is a rare complication of ankylosing spondylitis, the pathogenesis of which is not well understood. The onset is insidious with pain and sensory symptoms; sphincter disturbances are common. After a period of increasing neurological symptoms, the condition tends to stabilize. The degree of nerve involvement is variable and can be accurately defined by electromyography. The diagnosis has to be confirmed by computed tomography (CT) or magnetic resonance imaging (MRI); myelography must be avoided. There is no specific treatment, except for pain control. The different clinical presentations and the role of new imaging techniques, CT and MRI, are demonstrated.

CA 125 half-life in ovarian cancer: a multivariate survival analysis

Serum CA 125 regression after cytoreductive surgery and during the first three courses of chemotherapy was studied in 60 ovarian cancer patients and compared to known prognostic factors. Various methods reported in the literature to calculate a CA 125 half-live value were compared. Using two exponential regression models (Van der Burg et al., 1988; Buller et al., 1991), mean half-lives in stage I-II patients after complete cytoreductive surgery were respectively 10.7 days (range: 5-23) and 9.8 days (range: 7-15). Within stage III-IV patients, a significant positive correlation was seen between survival and (a) stage III (P = 0.002), (b) residual tumour < or = 1 cm (P = 0.02), (c) CA 125 normalisation after three courses (P = 0.003) and (d) CA 125 half-life < or = 20 days (P = 0.02-0.004, depending on the method used for half-life calculation). The median survival times of patients with and without a CA 125 normalisation after three courses were 27 and 14 months respectively (P = 0.003). When using the model of Buller et al. patients with a CA 125 half-life < or = 20 days had a median survival of 28 months compared to a median survival of 19 months for patients with CA 125 half-lives > 20 days (P = 0.004). Half-life calculations only showed a significant correlation with survival, if pre-surgery CA 125 levels were used as a baseline. In a survival analysis using the Cox proportional hazards model, stage of disease was the most predictive variable for survival (P = 0.006). The only additional independent prognostic factor for survival was the CA 125 half-life calculated according to Buller [derived from the formula: CA 125 = exp. [i-s x (days after surgery)], in which i is the y-axis intercept and s is the slope of the CA 125 regression curve]. A CA 125 half-life < or = 20 days vs > 20 days calculated using this formula, provides an independent prognostic factor for survival in stage III-IV patients early in the course of therapy (P = 0.04).

Metastatic prostatic adenocarcinoma-diagnosed by bronchoalveolar lavage and tumour marker determination

We report a patient who presented with a diffuse interstitial lung disease in whom clinical and radiologic investigation led to the suspicion of lymphangitis carcinomatosa. Bronchoalveolar lavage (BAL) was performed and revealed the presence of prostatic specific antigen (PSA) positive cells. A prostatic needle aspiration confirmed the diagnosis of adenocarcinoma. This case demonstrates the value of tumour marker determination in BAL.

Metastatic prostatic adenocarcinoma-diagnosed by bronchoalveolar lavage and tumour marker determination

We report a patient who presented with a diffuse interstitial lung disease in whom clinical and radiologic investigation led to the suspicion of lymphangitis carcinomatosa. Bronchoalveolar lavage (BAL) was performed and revealed the presence of prostatic specific antigen (PSA) positive cells. A prostatic needle aspiration confirmed the diagnosis of adenocarcinoma. This case demonstrates the value of tumour marker determination in BAL.

Short-term course of 1,25(OH)2D3 stimulates osteoblasts but not osteoclasts in osteoporosis and osteoarthritis

We investigated the effect of short-term, 1,25-dihydroxyvitamin D3 therapy (4 micrograms/day for 4 days) on calcium metabolism in 27 postmenopausal women (11 cases with osteoporosis and 16 cases with osteoarthritis). Bone mass at the axial and appendicular skeleton was higher in osteoarthritis than in osteoporosis. Initial values of calcium metabolism were similar. Osteoporotic and osteoarthritic patients responded with a similar significant increase in serum osteocalcin (+61% and +54%, respectively), fasting urinary calcium excretion (+178% and +124%, respectively) and 24 hour calcium excretion (+148% and +142%, respectively). Parathyroid hormone (PTH) levels decreased significantly in both groups (-30% and -18%, respectively). Osteoclastic bone resorption, evaluated by urinary hydroxyproline excretion, was not stimulated in either group. We conclude that in osteoporosis and also in osteoarthritis (1) 1,25-dihydroxy-vitamin D3 (1,25(OH)2D3) stimulation of osteoblast function is similar in production of osteocalcin; (2) the vitamin D target tissues react adequately to 1,25(OH)2D3 stimulation; (3) short-term high dose of 1,25(OH)2D3 does not stimulate bone resorption; and (4) the differences in bone mass between osteoarthritis and osteoporosis are not related to an alteration of the responsiveness to stimulation by 1,25 (OH)2D3.

[Significance of an increase of total IgE]

Under normal condition, serum IgE concentrations are low and controlled by complex regulating mechanisms. Increased IgE synthesis may be associated with a response of IgE antibodies to allergens or parasites. It may also betray a wider disorder in the regulation of IgE production, resulting in a rise of total IgEs of unknown specificity. Broadly speaking, high IgE levels are observed in two main circumstances: allergic ans parasitic diseases. In allergic diseases the diagnostic value of high IhE concentrations is modest, since a search for specific IgEs by cutaneous tests ot laboratory techniques (RAST) is more rewarding than total IgE determination. However, total IgE assays are useful in the detection of atopy in neonates at risk and the identification and therapeutic follow-up of allergic pulmonary aspergillosis. High IgE levels are frequently associated with parasitic diseases, especially helminthiasis. They also reflect a disorder of IgE homeostasis in some types of immunodeficiency, including the classical IgE hyperproduction syndrome. Except for this syndrome, high IgE concentrations merely constitute a secondary diagnostic factor in a wide pathology, but they often bear witness to a subjacent dysregulation of T-cell function.

Osteoarthrosis retards the development of osteoporosis. Observation of the coexistence of osteoarthrosis and osteoporosis

The clinical, roentgenographic, and biochemical features of the dorsal and lumbar spine were reviewed in 72 postmenopausal women. Nineteen women had both osteoporosis (vertebral collapse) and osteoarthrosis. These patients were compared with 26 patients who had only osteoarthrosis of the spine and 27 who had only vertebral collapse. The patients who had both spinal osteoporosis and osteoarthrosis were older, more advanced in menopause, and physically smaller in stature and body weight than the other groups. They also had higher serum parathyroid hormone level, used nonthiazide diuretics more frequently, and had more nulliparity than the other two groups. These patients had osteoarthrosis of the hip to a lesser degree than patients affected by osteoarthrosis alone, and they had fewer fractures of the forearm and other sites than patients with osteoporosis alone. The incidence of femoral neck fractures in both groups, however, was comparable. These results suggest that osteoarthrosis or a related factor might have a protective effect on the progression of osteoporosis. These results confirm earlier observations that postmenopausal osteoporosis and osteoarthrosis are two distinct diseases and not the result of normal aging.

Diclofenac potassium for the treatment of traumatic joint distortions: an open multicentre study

In an open multicentre study, 410 patients presenting with traumatic joint distortions, predominantly involving the ankle, were recruited for treatment with 50 mg diclofenac potassium given orally three times daily for 7 days. Due to various protocol violations, the number of patients eligible for efficacy and tolerability analysis were 340 and 344, respectively. Significant (P less than 0.001) improvement in mobility, swelling, local tenderness, functional impairment and pain intensity occurred after both 3 and 7 days of therapy. Overall efficacy was assessed as excellent/good in 83% and 87% of cases by the investigator and patient, respectively. Altogether, 66 (19.2%) patients complained of adverse effects, which were generally mild or moderate in severity. Gastrointestinal complaints accounted for around 70% of the reported side-effects. Premature discontinuation of therapy due to poor tolerability was necessary in 15 (4.4%) patients. In conclusion, diclofenac potassium was both effective and well-tolerated when used for the short-term treatment of traumatic joint distortions.

Prevention and treatment of osteopenia in the ovariectomized rat: effect of combined therapy with estrogens, 1-alpha vitamin D, and prednisolone

The effects of estrogens and 1-alpha were studied in young animals after ovariectomy (OVX) and/or prednisolone (PDN). These medications were given separately or in combination as preventive therapy from the start of the experiment, and as curative therapy starting 3 months later. Changes in bone mass were evaluated by single photon absorptiometry of the femur at the diaphysis (containing mostly cortical bone) and at the distal end of the femur (containing mostly trabecular bone). Radiogrammetry was performed at 50% of the length of the femur. Estrogens prevented further bone loss after OVX and OVX + PDN, given either at the beginning of the experiment or started 3 months later, except for trabecular bone loss immediately after OVX + PDN. After 1-alpha vitamin D, a highly significant increase in BMC and BMD was found in controls, in animals treated with PDN, and after OVX and OVX + PDN. The combination of 1-alpha with estrogens was less effective than 1-alpha but more effective than estrogens alone. After correction for body weight changes globally the same results were found. We conclude that (1) estrogens prevent bone changes after ovariectomy and ovariectomy + prednisolone; and (2) 1-alpha vitamin D highly significantly increased bone mass in male and female rats, and after prednisolone treatment, ovariectomy, and ovariectomy + prednisolone treatment.

Predictive value of bronchoalveolar lavage in pulmonary sarcoidosis

We investigated whether analysis of cellular composition (including lymphocyte subsets) in bronchoalveolar lavage (BAL) fluid at the start of follow-up in patients with untreated sarcoidosis has any predictive value for further evolution of the disease. The outcome was evaluated by the chest roentgenograms, the lung volumes, and the single breath diffusing capacity for CO (DCO) after 22 to 36 months. In contrast to the general belief, patients who improved radiologically had a significantly higher T4 cell count (as percentage of BAL lymphocytes) (p less than 0.02) and a higher T4-T8 ratio in the initial BAL sample (9.3 vs 3.2; p less than 0.05) than those whose chest roentgenogram showed deterioration or remained unchanged. Total cell count and the percentage of lymphocytes in BAL fluid were not different between both groups. The change in DCO at the end of the follow-up period correlated positively with the baseline BAL T4 cells (Rs = 0.44; p less than 0.05) and with the BAL T4-T8 ratio (Rs = 0.51; p less than 0.03) and negatively with the baseline BAL T8 cells (Rs = -0.48; p less than 0.04). In only three patients progression of the disease necessitated steroid therapy, and they all had a low to normal T4-T8 ratio in the initial BAL sample. Bronchoalveolar lavage was repeated at least once in ten patients. Improvement of the chest roentgenograms in these patients was accompanied by a decrease of the BAL T4 cell count (as percentage of lymphocytes) and of the T4-T8 ratio. We conclude that a high lymphocyte count, a high T4 cell count (as percentage of lymphocytes), and a high T4-T8 ratio in BAL fluid reflect an intense alveolitis at the time of the procedure, but they are not indicators of poor prognosis on which therapeutic decisions can be based.

OM-8980 and D-penicillamine in the treatment of rheumatoid arthritis. A 12-month double-blind randomized study

Forty patients with active rheumatoid arthritis were included in this monocentre double-blind study comparing the therapeutic efficacy and safety of the immunomodulator OM-8980 with that of D-penicillamine. After 12 months of treatment, the parameters of Ritchie index, duration of morning stiffness, pain assessed by a visual analogue scale and categories, number of swollen joints, grip strength and erythrocyte sedimentation rate (ESR) were all significantly improved with OM-8980, as was the case for the Ritchie index, number of swollen joints and ESR with D-penicillamine. Significant intergroup differences were recorded for pain categories in favour of OM-8980 and for the Ritchie index and number of swollen joints in favour of D-penicillamine. The need for concomitant anti-inflammatory therapies and the assessment of efficacy by physicians and patients did not differ significantly between the two groups. OM-8980 was significantly better tolerated than D-penicillamine (5 patients with 5 side effects as compared with 12 patients with 16 side effects). OM-8980 can thus be regarded as an efficient and well-tolerated slow-acting drug for the treatment of rheumatoid arthritis.

Prevention of postmenopausal bone loss in rheumatoid arthritis patients. A two-year prospective study

The effect of three different therapeutic regimens on bone mineral content at the radius and lumbar spine was studied in a group of 60 postmenopausal rheumatoid arthritis patients. Results were compared to those in a group of controls matched for sex, age, disease duration and menopausal state. Serum and urinary parameters of calcium metabolism were also evaluated in the three treatment groups. The three treatment regimens were: 1 alpha hydroxyvitamin D + calcium + placebo; 1 alpha hydroxyvitamin D + calcium + lynestrenol; and 1 alpha hydroxyvitamin D + calcium + sodium fluoride. In all treatment groups there was a positive effect of therapy compared to controls, though this was only significant in the 1 alpha hydroxyvitamin D + calcium + lynestrenol group at the axial skeleton after 1 and 2 years of treatment. Serum calcium rose significantly in the 1 alpha hydroxyvitamin D + calcium + placebo group and serum creatinin was raised in all the treatment groups during therapy. In the 1 alpha hydroxyvitamin D + calcium + lynestrenol group, serum alkaline phosphatase activity and urinary hydroxyproline excretion decreased significantly.

Quantitative determination by high-performance liquid chromatography of acetylsalicylic acid and related substances in tablets

High-performance liquid chromatography on a Zorbax C8 7-micron column (25 cm X 0.46 cm I.D.) with methanol-water-1 M phosphoric acid (59:36:5) as the mobile phase has been used for the analysis of several naturally aged batches of fourteen brands of acetylsalicyclic acid tablets. The extraction solvent is methanol, containing 2% v/v of formic acid. Salicylic acid is the main impurity. Acetylsalicylsalicylic acid is the second most important impurity, and the corresponding salicylsalicylic acid is rarely present. Buffered or dispersible tablets contain relatively more of the latter two impurities and eventually also the corresponding higher oligomers. Acetylsalicylic anhydride is always a minor impurity. Comparison is made with classical spectrophotometric methods, which are observed to be selective for salicylic acid.

Genetic determinants of bone mineral content at the spine and radius: a twin study

The possible role of genetic and/or environmental factors in determining bone mass has been investigated in 30 pairs of twins (16 monozygotic and 14 dizygotic) divided in two age groups (below and above 25 years of age). Bone mineral content was evaluated by single- and dual photon absorptiometry at the distol third of the radius for peripheral cortical bone and in the lumbar spine for the axial bone. The "within pair" variance has been used as an index of genetic influence. A significant (p less than 0.01) genetic determinant was found for the bone mass of the radius in adults and for the spinal bone mass in the age group younger than 25 years. The heritability index h2 was 0.75 for cortical BMC and 0.88 for axial BMC. Such a genetic determinant could not conclusively be demonstrated in adult twins for the spine and in youngsters for the cortical bone, suggesting that environmental factors may play a more dominant role in growth of cortical bone during adolescence and diminution of axial bone during adult life.

Bone mineral content, cortical thickness and fracture rate in osteoporotic women after withdrawal of treatment with nandrolone decanoate, 1-alpha hydroxyvitamin D3, or intermittent calcium infusions

Twenty-six post-menopausal osteoporosis patients were studied prospectively over a 2-yr period after the cessation of 2 yr of treatment with either nandrolone decanoate (anabolic steroid), 1 alpha hydroxyvitamin D3 or intermittent calcium infusions, the total observation period being 4 yr. Serial evaluations of bone mineral content in the radius, cortical thickness of the metacarpals and spinal roentgenograms were obtained. Nine patients who had been treated with 50 mg nandrolone decanoate every three weeks did not lose bone from the radius or the metacarpals during the 2 yrs following withdrawal of therapy. Eight patients who had received 1 microgram/day of oral 1 alpha hydroxyvitamin D3 retained a positive bone mineral content in the radius but lost cortical thickness from the metacarpals after withdrawal of therapy. Nine patients who had been treated with intermittent calcium infusions over 12 consecutive days annually did not lose further bone mineral content from the radius, but did lose cortical thickness at the expected rate during the 2-yr post-treatment period. The fracture rate at the end of the 4-yr observation period was 40% lower in the nandrolone decanoate group than in the 1-alpha-hydroxyvitamin D3 and calcium infusion groups. The results of this study indicate that, in contrast to oestrogen and calcium therapy, nandrolone decanoate and 1-alpha-hydroxyvitamin D3 have lasting beneficial effects, and that data obtained by photon absorptiometry do not always coincide with those obtained by radiogrammetry. These findings are highly relevant to the design of future therapeutic trials.

Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids

Peripheral and axial bone mass and fracture incidence were studied in a group of 104 postmenopausal patients with rheumatoid arthritis (RA). Patients were divided into non-corticosteroid and low dose corticosteroid treated groups after elimination of patients with concomitant disease or therapy which might affect bone mass. Results were compared with those obtained in controls matched for age and sex. Bone mass at the distal radius was significantly reduced compared with that of controls in both patient groups. Axial bone mass, however, was normal in both treatment groups, non-corticosteroid treated patients having even a significantly higher bone mass than controls (p less than 0.05) and corticosteroid treated patients (p less than 0.05). Fracture incidence (vertebral and femoral neck) was significantly (p less than 0.01) higher in corticosteroid treated patients than in the non-corticosteroid treated group. The mean lumbar bone mineral content and the body weight of the fracture group were significantly lower than in the controls. There were no significant differences in biochemical markers of bone turnover between the RA groups.

Age-, sex-, and menopause-related changes of vertebral and peripheral bone: population study using dual and single photon absorptiometry and radiogrammetry

Vertebral and peripheral bone mass have been measured with single and dual photon absorptiometry and radiogrammetry in 146 male and 220 female volunteers ranging in age from 20 to 85 yr. One hundred four subjects with interfering diseases, treatment, or x-ray manifestations of lumbar osteoarthritis were excluded for purposes of this study. Patterns of age-related bone gain and diminution differed between sexes and measuring sites. The effect of menopause on the peripheral and vertebral skeleton also differed. Men, at all measured sites, have more bone than women. In the fifth decade, however, women's lumbar bone mineral content was almost equal to the value found in men. Bone loss associated with aging was more marked in women than in men and started, for the lumbar spine, at about the age of 25 yr in both women and men and, for the peripheral bones, at the age of 55 in women and 65 in men. Bone loss in the spine in women was not linear. Women in the fifth and sixth decade, who still had menstruation, differed significantly from those who had not menstruated for at least the last 6 mo. Bone diminution at menopause was twice as great in the lumbar spine than elsewhere in the peripheral skeleton, 15% versus 7%. Of the 25% total bone loss of the spine during adult life in women, 60% was lost within 10 yr after menopause. Estrogen deficiency, not aging, is the predominant cause of bone loss in the spine. For the peripheral skeleton, there is a two-component decrease, a rapid loss induced by the menopause superimposed on a slower age-related loss. Although there was a significant correlation between peripheral and vertebral bone mass indices, it was clear that observations made at one site will not necessarily reflect changes observed at another site.

Mineral metabolism in postmenopausal women with active rheumatoid arthritis

Serum and urinary variables of bone mineral metabolism were studied in 49 postmenopausal women with rheumatoid arthritis (RA). Results were compared to those in a sex, age and menopausal age matched control group. No patient took corticosteroids, or had any disease other than RA which might affect bone. Total serum calcium was low in patients with RA compared to controls (9.0 +/- 0.5 mg% vs 9.3 +/- 0.3 mg%, p less than 0.005), but was normal when corrected for albumin (9.5 +/- 0.6 mg% vs 9.3 +/- 0.4 mg%, NS). Serum phosphorus was significantly higher in patients with RA than in controls (3.6 +/- 0.3 mg% vs 3.3 +/- 0.4 mg%, p less than 0.001) as well as serum alkaline phosphatase activity (107.6 +/- 27.2 IU/l vs. 9.6 +/- 28.91 IU/l). Serum creatinine, vitamin D and parathyroid hormone levels were comparable in both groups. Urinary hydroxyproline and mucopolysaccharide excretions were higher in patients with RA than controls, both for fasting (respectively 0.089 +/- 0.028 vs 0.039 +/- 0.023, p less than 0.001 and 0.072 +/- 0.027 vs 0.047 +/- 0.019, p less than 0.001) and for 24 h values (50.3 +/- 17.9 mg vs 36.2 +/- 15.4 mg, p less than 0.001 and 54.6 +/- 26.0 mg vs 41.7 +/- 16.5 mg, p less than 0.05). Urinary calcium excretion was comparable in the 2 groups. Our findings of raised serum phosphorus and alkaline phosphatase activity, raised urinary hydroxyproline and mucopolysaccharides excretion suggest that in patients with RA there is a higher metabolic activity of bone. In none of the patients could any indication of osteomalacia or of parathyroid overactivity be found.

Osteoarthritis of the hip: the patient behind the disease

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