Spinal and peripheral bone mineral densities in acromegaly: the effects of excess growth hormone and hypogonadism

Article Abstract:

Acromegaly is caused by an excess of growth hormone beginning in adulthood, characterized by bone enlargement in the face, jaw, arms and legs. Tumors in the pituitary can alter production of growth hormones and hormones needed to release sex steroids, which are released from the other glands in the body. Growth hormone affects bone cells by stepping up the formation of proteins. It would be expected that bone densities would be similarly altered in all bone structures. However, a discrepancy exists in acromegalic patients. Growth hormone increases bone density in forearm bones while decreasing the density of the bones of the spine. Bone density measurements on the spine and forearms of 24 acromegalic patients were compared with measurements made on healthy subjects. The disease was considered active (17 patients) if growth hormone or somatomedin C (proteins involved in bone growth) were elevated, or inactive if those proteins were originally elevated at diagnosis but were normal at the beginning of the study. Patients with active disease were subdivided further into patients having normal (eugonadal) or low (hypogonadal) sex hormone production. The bone density in the forearms of patients with active disease (regardless of gonadal status) was higher than among normal or inactive-disease participants. The bone density of the spine bones was generally lower in acromegalic patients than in normal participants. The bone density increased 1.5 percent in the forearm in patients with active disease and 1.0 percent in patients with inactive disease. The higher the somatomedin C activity, the greater the yearly increase in forearm bone density. The decreased bone density in the spinal bones was related to the degree of decreased gonadal sex hormone production. A discrepancy between the bone densities of the forearm and spine in acromegalic patients is related to the amount of sex steroids and growth hormone excess. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Measurement, Complications and side effects, Bone diseases, Hormones, Bone resorption, Somatotropin, Hypogonadism, Bone densitometry

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Preventing the work-related carpal tunnel syndrome: physician reporting and diagnostic criteria

Article Abstract:

The carpal tunnel syndrome is characterized by soreness, tenderness, and weakness of the muscles of the thumb, and is caused by pressure on the median nerve which runs into a passage-like structure called the carpal tunnel of the wrist. This syndrome is common and may be associated with diabetes, thyroid disorders, inflammatory arthritis or joint disease of the wrist, alcohol use, or the patient's occupation. As many as 47 percent of the cases of carpal tunnel syndrome may be caused by work-related factors, particularly job activities that require repetitive movements of the hand and wrist. Work-related carpal tunnel syndrome can be prevented by evaluating certain risk factors in the workplace, and redesigning tools, work stations, and job tasks that cause the problem. Most physicians receive limited training in occupational health, and may not always consider occupational factors in the cause of their patients' problems. In addition, physicians often fail to report occupational disorders, possibly to avoid complex interactions with the patient's employer and the legal system. Improved recognition and reporting of occupational diseases by physicians can help to prevent work-related diseases. Physicians and public health agencies should collaborate to prevent occupational disorders such as work-related carpal tunnel syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Diagnosis, Prevention, Occupational diseases, editorial

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Carpal tunnel syndrome in persons with acromegaly

Article Abstract:

Carpal tunnel syndrome in patients with acromegaly appears to be caused by swelling of the nerve rather than pressure on the nerve. This was the conclusion of a study of nine acromegaly patients. Acromegaly is caused by excessive growth hormone levels.

Causes of

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