Pubblichiamo, in lingua originale, la lettera pubblicata dal dott. Sergio Stagnaro di Riva Trigoso, nostro collaboratore

Sir,

In order to identify women (and men, of course) at high risk of osteoporosis we need first of all a bed-side method, appliable rapidly on very large scale, i.e. a method which relies on the assessment of osteoporotic constitution as a clinical selection method for referral, e.g., for dual energy x ray absorptiometry.

A 46-year-long well-established clinical experience allowed me to suggest such as clinical method as well as an original theory onosteoporosis pathogenesis, I illustrated in previous papers (1,2). A congenital functional mitochondrial cytopathology, I called Congenital Acidosic Enzyme-Metabolic Histangiopathy (CAEMH)(2) represents the "conditio sine qua non" also of osteoporosis.

Moreover, all patients, affected by derangements in collagen metabolism of whatever nature as well as location,including perivascular GAG, I visited in the past 45 years, were or are CAEMH- positive.Consequently, mitochondrially altered cells, even from the functional view-point, due to low endocellular free energy, become a- social elements causing possibly the most common human disorders (2,3).

Interestingly, with the aid of a new physical semeiotics, i.e.Biophysical Semeiotics, I described earlier in 150 papers (See: BMJ.com 30 March 2001, Rapid Responses and Bibliography in my site: http://digilander.iol.it/semeioticabiofisica ), it is easy to recognize at the bed-side and "quantify" the osteoporotic risk in CAEMH-positive individuals as well as in osteoporotic patients. In fact, this original semeiotics allows doctors to diagnose also osteoporosis since its early stage, i.e. osteoportotic constitution . The original semeiotics, ie. Biophysical Semeiotics, useful to the doctor at the bed-side, is, unfortunately, overlooked until now. In a few words: in healthy, digital pressure on lumbar or caudal vertebrae brings about the Gastric Aspecific Reflex after a latency time of 8 sec. (in the stomach both fundus and body are dilated, while antral-pyloric region contracts). In addition, the preconditioning (after 5 sec. exactly doctors applies a second examination) brings about a favorable latency time: 10 or more sec. On the contary in both osteoporotic constitution and osteoporetic patient, basal latency time is < 8 sec. in relation to underlying disorders severity. Moreover, the bone preconditioning appears to be pathological, i.e. shorter than the basal one

1) Stagnaro-Neri M., Stagnaro S., Diagnosi Clinica Precoce dell’Osteoporosi con la Percussione Ascoltata. (Pub-Med) Clin.Ter. 137, 21 -27 1991.

2) Stagnaro S., Stagnaro-Neri M., Una patologia mitocondriale ignorata: la Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz. Med. It. Arch. Sci. Med. 149, 67, 1990.

3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Coenzyme Q deficiency Syndrome. VI Int.Symp., Biomedical and clinical aspects of Coenzyme Q. Rome, January 22-24, Chairmen K. Folkers, G.L. Littaru, T. Yamagani, Abs., pg. 105, 1990.