Browsing by Author "Dennison EM"

Now showing 1 - 5 of 5
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    Bone health among premenopausal female alcoholics: A pilot study
    (27/01/2014) Clynes MA; Wyawahare P; Robinson G; Denison HJ; Evans G; Gilmour M; Dennison EM
    We report a pilot study of bone health of alcohol dependent women. Women admitted to an alcohol-withdrawal unit (cases) and a convenience sample of controls (nursing staff) were recruited and asked to complete a lifestyle questionnaire before undergoing heel ultrasound measurements. Fasting blood samples were obtained on the day of admission (day 1) and at 5 days. Bone turnover markers (P1NP and CTX) and vitamin D levels were measured in a subset of the alcohol dependent population. Cases were less physically active than controls. Alcoholic women had lower heel ultrasound derived Stiffness Index scores [mean 85.2 (17.6)] compared with controls [mean 95.5 (18.7)] (p=0.07). P1NP rose significantly over the detoxification programme [day 1: 28.35 ng/l (12.25); day 5: 34.19 ng/l (13.16), p=0.003] but CTX change was not significant. Lifestyle factors associated with poor bone health are prevalent in female alcoholics. Significant increase in bone formation was observed 5 days after alcohol withdrawal.
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    Clinical risk factors, bone density and fall history in the prediction of incident fracture among men and women
    (2013) Edwards MH; Jameson K; Denison H; Harvey NC; Sayer AA; Dennison EM; Cooper C
    The FRAX(tr) algorithm uses clinical risk factors (CRF) and bone mineral density (BMD) to predict fracture risk but does not include falls history in the calculation. Using results from the Hertfordshire Cohort Study, we examined the relative contributions of CRFs, BMD and falls history to fracture prediction. We studied 2299 participants at a baseline clinic that included completion of a health questionnaire and anthropometric data. A mean of 5.5years later (range 2.9-8.8years) subjects completed a postal questionnaire detailing fall and fracture history. In a subset of 368 men and 407 women, bone densitometry was performed using a Hologic QDR 4500 instrument. There was a significantly increased risk of fracture in men and women with a previous fracture. A one standard deviation drop in femoral neck BMD was associated with a hazards ratio (HR) of incident fracture (adjusted for CRFs) of 1.92 (1.04-3.54) and 1.77 (1.16-2.71) in men and women respectively. A history of any fall since the age of 45years resulted in an unadjusted HR of fracture of 7.31 (3.78-14.14) and 8.56 (4.85-15.13) in men and women respectively. In a ROC curve analysis, the predictive capacity progressively increased as BMD and previous falls were added into an initial model using CRFs alone. Falls history is a further independent risk factor for fracture. Falls risk should be taken into consideration when assessing whether or not to commence medication for osteoporosis and should also alert the physician to the opportunity to target falls risk directly.
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    Ecological study of fractures in paedatric Melanesian communities with varying endemic environmental fluoride exposure
    (MDPI (Basel, Switzerland), 2021-09) Webb E; Elmansouri A; Ross R; Clynes M; Tangis J; Stewart C; Dennison EM; Bahamonde RG
    Introduction: Osteoporotic fracture is a major public health burden worldwide, causing significant mortality and morbidity. Studies that have reported bone health in areas of high endemic fluorosis have commonly reported adverse skeletal, as well as dental effects. Vanuatu, sited in the Pacific, and never previously studied with regard to bone health, has six continuous degassing volcanoes on separate islands, resulting in a natural experiment for an ecological study of relationships between naturally occurring fluoride exposure and fracture incidence in paediatric populations. Methods: This ecological study recruited 1026 lifetime residents of the rural Vanuatu islands. A short questionnaire was administered detailing gender, age, and residential history. Participants were asked if they had broken a bone and, if so, were asked to mark its location on a questionnaire manikin. Dental fluorosis was assessed using Dean’s index. Community drinking-water samples were sampled for fluoride concentration. Results: The measured water fluoride concentration and recorded dental fluorosis displayed expected gradients from Aneityum (low) to Ambrym (high) (p < 0.001). The age of participants studied varied from 7.8 (SD 1.2) in Aneityum to 10.6 (3.7) in Lamap/Uliveo. The highest self-reported fracture rates were recorded in the area with medium fluoride levels (Lamap/Uliveo), where 14.9% of boys and 15.6% of girls sampled reported a fracture. In Ambrym, where the mean age of participants was similar, corresponding fracture rates were 4.5% and 2.6%. (p value for differences all < 0.05). Conclusions: Reports of fractures were common in children living in Vanuatu, but demonstrably higher in Lamap, the region with medium fluoride concentrations, rather than Ambrym which had very high rates of naturally occurring fluoride levels. Longer term studies that report validated fracture after peak bone mass acquisition are required.
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    The importance of fall history in fracture risk assessment
    (2013) Edwards MH; Jameson KA; Denison H; Harvey NC; Sayer AA; Dennison EM; Cooper C
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    The incidence of sexually acquired reactive arthritis: A systematic literature review
    (Springer, 2016) Denison HJ; Curtis EM; Clynes MA; Bromhead C; Dennison EM; Grainger R
    Reactive arthritis (ReA) is an inflammatory spondyloarthritis occurring after infection at a distant site. Chlamydia trachomatis is proposed to be the most common cause of ReA, yet the incidence of sexually acquired ReA (SARA) has not been well established. We therefore carried out a systematic literature review to collate and critically evaluate the published evidence regarding the incidence of SARA. MEDLINE and EMBASE databases were searched using free-text and MeSH terms relating to infection and ReA. The title and abstract of articles returned were screened independently by two reviewers and potentially relevant articles assessed in full. Data was extracted from relevant articles and a risk of bias assessment carried out using a validated tool. Heterogeneity of study methodology and results precluded meta-analysis. The search yielded a total of 11,680 articles, and a further 17 were identified from review articles. After screening, 55 papers were assessed in full, from which 3 met the relevant inclusion criteria for the review. The studies reported an incidence of SARA of 3.0-8.1 % and were found to be of low to moderate quality. More studies are required to address the lack of data regarding the incidence of SARA. Specific and sensitive classification criteria must be developed in order for consistent classification and valid conclusions to be drawn. In clinical practice, it is recommended clinicians discuss the possibility of ReA developing at the time of STI diagnosis and to encourage patients to return if they experience any relevant symptoms.