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[PMID]:28449657
[Au] Autor:Adachi JD; Bone HG; Daizadeh NS; Dakin P; Papapoulos S; Hadji P; Recknor C; Bolognese MA; Wang A; Lin CJF; Wagman RB; Ferrari S
[Ad] Endereço:McMaster University, 501-25 Charlton Ave E., Hamilton, ON, L8N 1Y2, Canada. jd.adachi@sympatico.ca.
[Ti] Título:Influence of subject discontinuation on long-term nonvertebral fracture rate in the denosumab FREEDOM Extension study.
[So] Source:BMC Musculoskelet Disord;18(1):174, 2017 04 27.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Denosumab treatment for up to 8 years in the FREEDOM study and Extension was associated with low fracture incidence. It was not clear whether subjects who discontinued during the study conduct had a higher risk of fracture than those who remained enrolled, thereby underestimating the true fracture risk for the entire trial cohort. Thus, we explored the influence of early withdrawals on nonvertebral fracture incidence during the Extension study. METHODS: To understand the potential effect of depletion of susceptible subjects on fracture incidence, we first evaluated subject characteristics in patients who were enrolled in the Extension vs those who were not. We subsequently employed a Kaplan-Meier multiple imputation (KMMI) approach to consider subjects who discontinued as if they remained enrolled with a 0%, 20%, 50%, and 100% increase in fracture risk compared with participants remaining on study. RESULTS: Extension enrollees were generally similar to nonparticipants in median age (71.9 and 73.1 years, respectively), mean total hip bone mineral density T-score (-1.9 and -2.0, respectively), and probability of fracture risk by Fracture Risk Assessment Tool (FRAX ) at FREEDOM baseline (16.9% and 17.7% for major osteoporotic fracture and 6.7% and 7.4% for hip fracture, respectively). When we assumed a doubled fracture risk (100% increase) after discontinuation in KMMI analyses, nonvertebral fracture rate estimates were only marginally higher than the observed rates for both the crossover group (10.32% vs 9.16%, respectively) and the long-term group (7.63% vs 6.63%, respectively). CONCLUSION: The observation of continued denosumab efficacy over 8 years of treatment was robust and does not seem to be explained by depletion of susceptible subjects. TRIAL REGISTRATION: ClincalTrials.gov registration number NCT00523341 ; registered August 30, 2007.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/uso terapêutico
Denosumab/uso terapêutico
Fraturas do Quadril/tratamento farmacológico
Fraturas por Osteoporose/tratamento farmacológico
Pacientes Desistentes do Tratamento
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Fraturas do Quadril/diagnóstico por imagem
Fraturas do Quadril/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Fraturas por Osteoporose/diagnóstico por imagem
Fraturas por Osteoporose/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 4EQZ6YO2HI (Denosumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1520-6


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[PMID]:29390258
[Au] Autor:Di HX; Liu FY; Yang SD; Wang H; Yang DL; Ding WY
[Ad] Endereço:Department of Spinal Surgery, The Third Hospital of Hebei Medical University.
[Ti] Título:Short-segment fixation with a cement-augmented pedicle screw for Kummell disease: Case report.
[So] Source:Medicine (Baltimore);96(50):e8617, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Kummell disease is described as avascular necrosis of a vertebral body that occurred in a delayed fashion after a minor trauma. Anterior, posterior, and anterior-posterior approaches have been reported. Nevertheless, there is no standard treatment for patients with Kummell disease. PATIENT CONCERNS: We reported a successful cement-augmented pedicle screw placement in a patient with Kummell disease. A 63-year-old woman with serious osteoporosis complained persistent back pain with progressive lower extremities weakness for almost 2 years. DIAGNOSES: The diagnosis of Kummell disease was mainly depended on clinical symptoms and imaging examinations. INTERVENTIONS: The application of a cement-augmented pedicle screw was designed to treat this illness. OUTCOMES: The operation was successful without any complications. The patient stated that symptoms were obviously improved in 1 week after operation. LESSONS: The application of a cement-augmented pedicle screw is an effective treatment option for Kummell disease.
[Mh] Termos MeSH primário: Cimentos para Ossos
Fixação Interna de Fraturas/instrumentação
Osteonecrose/cirurgia
Parafusos Pediculares
[Mh] Termos MeSH secundário: Dor nas Costas/etiologia
Dor nas Costas/cirurgia
Feminino
Fixação Interna de Fraturas/métodos
Fraturas por Compressão/complicações
Fraturas por Compressão/diagnóstico por imagem
Fraturas por Compressão/cirurgia
Seres Humanos
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/lesões
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Meia-Idade
Osteonecrose/diagnóstico por imagem
Osteonecrose/etiologia
Fraturas por Osteoporose/complicações
Fraturas por Osteoporose/diagnóstico por imagem
Fraturas por Osteoporose/cirurgia
Fraturas da Coluna Vertebral/complicações
Fraturas da Coluna Vertebral/diagnóstico por imagem
Fraturas da Coluna Vertebral/cirurgia
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/lesões
Vértebras Torácicas/patologia
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008617


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[PMID]:29390438
[Au] Autor:Kao FC; Hsu YC; Liu PH; Yeh LR; Wang JT; Tu YK
[Ad] Endereço:Department of Orthopaedics, E-Da Hospital.
[Ti] Título:Osteoporotic sacral insufficiency fracture: An easily neglected disease in elderly patients.
[So] Source:Medicine (Baltimore);96(51):e9100, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sacral insufficiency fractures (SIFs) are easily neglected by clinical physicians.The incidence of SIFs remains unclear in patients with symptomatic osteoporotic compression fractures of the lumbar-sacral area.This retrospective study was conducted by reviewing the medical records and radiological reports and by reading magnetic resonance (MR) images from August 2013 to July 2016. We identified 1233 cases with symptomatic vertebral compression fractures for which surgical interventions were performed. A total of 1144 cases were eligible for this study. Neglected diagnoses by radiologists and clinical physicians were calculated, respectively.The MR imaging (MRI) findings of SIFs were divided into the body (S1, S2, S3, and S4 levels) and alar areas (unilateral, bilateral, transverse, and none).A total of 34 (3.00%) cases with SIFs were identified through MRI. A significant difference was observed between 19 (6.53%) patients aged >80 years and 15 (1.76%) aged <80 years (P < .0001). Eight (23.53%) and 26 (76.47%) cases of SIFs were neglected by radiologists and clinical physicians, respectively. The S2 and S3 levels were the predominantly involved area (23/34; 67.65%). Furthermore, the bilateral alar area was the most commonly involved (19/34; 55.88%), as observed in coronal views of MRI.While treating other levels of osteoporotic compression fractures, radiologists and clinical physicians should be aware of SIFs, particularly when the patients are aged >80 years. The coronal oblique MR images of the thoracolumbar region should be carefully read to avoid neglecting SIFs.
[Mh] Termos MeSH primário: Erros de Diagnóstico/estatística & dados numéricos
Fraturas por Compressão/diagnóstico por imagem
Fraturas por Osteoporose/diagnóstico por imagem
Sacro/diagnóstico por imagem
Sacro/lesões
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009100


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[PMID]:29339529
[Au] Autor:Adler RA
[Ad] Endereço:Endocrinology and Metabolism SectionMcGuire Veterans Affairs Medical Center, Division of Endocrinology,Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA Robert.adler@va.gov.
[Ti] Título:MANAGEMENT OF ENDOCRINE DISEASE: Atypical femoral fractures: risks and benefits of long-term treatment of osteoporosis with anti-resorptive therapy.
[So] Source:Eur J Endocrinol;178(3):R81-R87, 2018 Mar.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Modern osteoporosis treatment began in the mid-1990s with the approval of amino-bisphosphonates, anti-resorptive agents that have been shown to decrease osteoporotic fracture risk by about half. In 2005, the first cases of atypical femoral fractures (AFF), occurring in the shaft of the femur, were reported. Since then, more cases have been found, leading to great concern among patients and a dramatic decrease in bisphosphonate prescribing. The pathogenesis and incidence of AFF are reviewed herein. Management and an approach to prevention or early detection of AFF are also provided. Denosumab, a more recently approved anti-resorptive medication has also been associated with AFF. Long-term management of osteoporosis and prevention of fracture are challenging in light of this serious but uncommon side effect, yet with an aging population osteoporotic fracture is destined to increase in frequency.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/efeitos adversos
Fraturas do Fêmur/induzido quimicamente
Osteoporose/tratamento farmacológico
Fraturas por Osteoporose/prevenção & controle
[Mh] Termos MeSH secundário: Conservadores da Densidade Óssea/uso terapêutico
Denosumab/efeitos adversos
Denosumab/uso terapêutico
Difosfonatos/efeitos adversos
Difosfonatos/uso terapêutico
Seres Humanos
Medição de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Diphosphonates); 4EQZ6YO2HI (Denosumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-1002


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[PMID]:28740372
[Au] Autor:Vandenbroucke A; Luyten FP; Flamaing J; Gielen E
[Ad] Endereço:Clinical Department of Internal Medicine, UZ Leuven.
[Ti] Título:Pharmacological treatment of osteoporosis in the oldest old.
[So] Source:Clin Interv Aging;12:1065-1077, 2017.
[Is] ISSN:1178-1998
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70-75 years. However, in the last years, subgroup analyses of these landmark trials have been published investigating the efficacy and safety of osteoporosis treatment in the very elderly. Based on this evidence, this narrative review discusses the pharmacological management of osteoporosis in the oldest old (≥80 years). Because of the high prevalence of calcium and/or vitamin D deficiency in old age, these supplements are essential in the management of osteoporosis in the elderly people. Adding antiresorptive or anabolic treatments or combinations, thereof, reduces the risk of vertebral fractures even more, at least in the elderly with documented osteoporosis. The reduction of hip fracture risk by antiresorptive treatments is less convincing, which may be explained by insufficient statistical power in some subanalyses and/or a higher impact of nonskeletal risk factors in the occurrence of hip fractures. Compared with younger individuals, a larger absolute risk reduction is observed in the elderly because of the higher baseline fracture risk. Therefore, the elderly will benefit more of treatment. In addition, current osteoporosis therapies also appear to be safe in the elderly. Although more research is required to further clarify the effect of osteoporosis drugs in the elderly, especially with respect to hip fractures, there is currently sufficient evidence to initiate appropriate treatment in the elderly with osteoporosis and osteoporotic fractures.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/uso terapêutico
Osteoporose/tratamento farmacológico
Osteoporose/epidemiologia
Fraturas por Osteoporose/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Conservadores da Densidade Óssea/administração & dosagem
Conservadores da Densidade Óssea/efeitos adversos
Cálcio/deficiência
Cálcio na Dieta
Suplementos Nutricionais
Difosfonatos/uso terapêutico
Feminino
Fraturas do Quadril/prevenção & controle
Seres Humanos
Osteoporose Pós-Menopausa/tratamento farmacológico
Fatores de Risco
Fraturas da Coluna Vertebral/prevenção & controle
Deficiência de Vitamina D/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Calcium, Dietary); 0 (Diphosphonates); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.2147/CIA.S131023


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[PMID]:29390549
[Au] Autor:Yasuda T; Kawaguchi Y; Suzuki K; Nakano M; Seki S; Watabnabe K; Kanamori M; Kimura T
[Ad] Endereço:Departments of Orthopaedic Surgery, Faculty of Medicine, University of Toyama.
[Ti] Título:Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture.
[So] Source:Medicine (Baltimore);96(51):e9395, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Usually, after osteoporotic vertebral fracture (OVF), bone healing follows a normal clinical course leading to bone union with conservative treatment using a brace. However, some patients with OVF do not undergo the normal fracture healing process for a few months, possibly leading to delayed union and/or pseudoarthrosis. In these cases, we performed posterior surgery with combined decompression, vertebroplasty, and posterior spinal fusion with spinal instrumentation. This study aimed to determine the clinical results of posterior surgery for delayed neural disorder secondary to OVF over a 5-year follow-up.Forty-one Japanese patients who had posterior surgery for delayed paralysis secondary to OVF were enrolled in this study. All patients were followed for ≥5 years (mean, 67 months; range, 61-86 months). Patients comprised 12 men and 29 women with an average age of 76.3 ± 6.2 years (range 63-87 years) at the time of operation. We performed posterior fixation from 2 levels above to 1 level below the decompression and vertebroplasty as an all in one procedure. Vertebral height index (VHI) and kyphotic angle (KA) were evaluated on radiogram. For clinical symptoms, a visual analog scale of back and leg pain and the Frankel classification and Japanese Orthopaedic Association scores were used.During the operation and perioperative period, no serious complications occurred. In all patients, symptoms improved within 1 month and were maintained for 5 years postoperatively. In all patients, VHI and KA improved after surgery; however, reduction losses of 7.7% of VHI and 23% of KA were recognized. Five of 41 patients required reoperation due to adjacent vertebral fracture (AVF) and recollapse of the vertebral body.Operation time and blood loss were acceptable, even for elderly patients. In all patients, alignment and subjective symptoms improved. However, reoperation owing to AVF and recollapse was necessary within 1 year in 5 of 41 (12%) patients. Careful follow-up is required within 1 year after surgery for OVF.
[Mh] Termos MeSH primário: Laminectomia/métodos
Fraturas por Osteoporose/complicações
Paralisia/cirurgia
Pseudoartrose/complicações
Fraturas da Coluna Vertebral/complicações
Fusão Vertebral/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Fraturas por Osteoporose/cirurgia
Paralisia/etiologia
Pseudoartrose/cirurgia
Fraturas da Coluna Vertebral/cirurgia
Fusão Vertebral/instrumentação
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009395


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[PMID]:29390417
[Au] Autor:Ni Y; Fan D
[Ad] Endereço:Department of Orthopedics, Beijing Huaxin Hospital, The First Hospital of Tsinghua University.
[Ti] Título:Diabetes mellitus is a risk factor for low bone mass-related fractures: A meta-analysis of cohort studies.
[So] Source:Medicine (Baltimore);96(51):e8811, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diabetes mellitus (DM) is inconsistently associated with the risk of low bone mass-related fractures (LBMF). This study aimed to summarize available cohort studies regarding the strength of association between type 2 diabetes mellitus (T2DM) and LBMF. METHODS: Electronic searches of PubMed, Embase, and the Cochrane Library were performed to identify studies through April 2016. Cohort studies that reported effect estimates with 95% confidence intervals (CIs) of LBMF for T2DM and control comparison were included. RESULTS: The summary relative risks (RRs) for T2DM versus non-T2DM were associated with a higher risk of LBMF (RR: 1.24; 95% CI: 1.09-1.41; P = .001). Further, women with T2DM showed a harmful impact on the incidence of LBMF (RR: 1.19; 95% CI: 1.04-1.36; P = .010). However, in men, T2DM showed no significant impact on the risk of LBMF (RR: 1.14; 95% CI: 0.93-1.39; P = .215). Furthermore, the summary results suggested an association between T2DM and LBMF in studies that reported hazard ratio (HR) as an effect estimate in total cohorts (HR: 1.31; 95% CI: 1.17-1.46; P < .001), men (HR: 1.26; 95% CI: 1.11-1.43; P < .001), and women (HR: 1.32; 95% CI: 1.16-1.50; P < .001). However, these significant associations were not observed in studies that reported RR/odds ratio as an effect estimate. CONCLUSIONS: The present meta-analysis confirmed that T2DM was associated with an increased prevalence of LBMF compared with non-T2DM.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2
Fraturas por Osteoporose/epidemiologia
[Mh] Termos MeSH secundário: Índice de Massa Corporal
Estudos de Coortes
Seres Humanos
Fraturas por Osteoporose/etiologia
Prevalência
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008811


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[PMID]:29382020
[Au] Autor:Zhang C; Wang G; Liu X; Li Y; Sun J
[Ad] Endereço:Department of Spine, Shandong Provincial Hospital Affiliated to Shandong University,Shandong Province.
[Ti] Título:Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review.
[So] Source:Medicine (Baltimore);96(47):e8895, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Albeit it is rare, the authors report a stage 3 Kummell disease case. It is diagnosed by dynamic thoracic magnetic resonance imaging (MRI). Because there is no established strategy on stage 3 Kummell disease, we performed percutaneous kyphoplasty at first, but unfortunately made a revision surgery to remove the polymethylmethacrylate (PMMA) cement after the failure of percutaneous kyphoplasty. PATIENT CONCERNS: A 73-year-old lady with severe back pain due to osteoporosis vertebral fracture was admitted to our hospital on June 23, 2016. She underwent percutaneous kyphoplasty with the back pain improved shortly. Unfortunately, she went back to our hospital due to aggravated back pain and partial paralysis on July 25, 2016. DIAGNOSES: Kummell disease, lumbar stenosis, lacunar infarction. OUTCOMES: Specially, the compression of spinal cord was obvious in the hyperflexion position on dynamic MRI. Even though there was no improvement in muscle strength, the patient was satisfied with the back pain relief after percutaneous kyphoplasty. But, the same back pain reappeared after about 1 month. Then, we took out the PMMA cement and performed posterior vertebral column resection. At last, the back pain was relieved again but the muscle strength was improved not obviously after operation. At the same time, the kyphosis was corrected and the intravertebral stability was achieved. LESSONS: Dynamic MRI is helpful in Kummell disease with neurologic symptoms, even if there is no obvious compression in the neutral position. Furthermore, the intravertebral instability is probably the main reason of the neurologic symptoms in this case. Percutaneous kyphoplasty could not reconstruct the intravertebral stability. Stage 3 Kummell disease with obvious intravertebral instability should be treated by open surgery.
[Mh] Termos MeSH primário: Cifoplastia/efeitos adversos
Cifose/cirurgia
Reoperação/métodos
Fraturas da Coluna Vertebral/complicações
[Mh] Termos MeSH secundário: Idoso
Cimentos para Ossos
Feminino
Seres Humanos
Cifoplastia/métodos
Cifose/etiologia
Fraturas por Osteoporose/complicações
Polimetil Metacrilato
Falha de Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bone Cements); 9011-14-7 (Polymethyl Methacrylate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008895


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[PMID]:29310386
[Au] Autor:Guo Z; Wang W; Gao WS; Gao F; Wang H; Ding WY
[Ad] Endereço:Department of Spine Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang.
[Ti] Título:Comparison the clinical outcomes and complications of high-viscosity versus low-viscosity in osteoporotic vertebral compression fractures.
[So] Source:Medicine (Baltimore);96(48):e8936, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To compare the clinical outcomes and complications of high viscosity and low viscosity bone cement percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF).From September 2009 to September 2015, 100 patients with OVCF were randomly divided into 2 groups: group H, using high viscosity cement (n = 50) or group L, using low viscosity cement (n = 50). The clinical outcomes were assessed by the visual analog scale (VAS), Oswestry Disability Index (ODI), kyphosis Cobb angle, vertebral height, and complications.Significant improvements in the VAS, ODI, kyphosis Cobb angle, and vertebral height were noted in both groups, and the VAS score in the H group showed greater benefit than in the L group. Cement leakage was observed less in group H. Postoperative assessment using computed tomography identified cement leakage in 27 of 98 (27.6%) vertebrae in group H and in 63 of 86 (73.3%) vertebrae in group L (P = .025).Compared with PVP using low viscosity bone cement, PVP using high viscosity bone cement can provide the same clinical outcomes with fewer complications and is recommended for routine clinical use.
[Mh] Termos MeSH primário: Cimentos para Ossos/uso terapêutico
Fraturas por Compressão/cirurgia
Fraturas por Osteoporose/cirurgia
Coluna Vertebral/cirurgia
Vertebroplastia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cimentos para Ossos/química
Avaliação da Deficiência
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias
Resultado do Tratamento
Viscosidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008936


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[PMID]:28455735
[Au] Autor:Paskins Z; Jinks C; Mahmood W; Jayakumar P; Sangan CB; Belcher J; Gwilym S
[Ad] Endereço:Arthritis Research UK Primary Care Centre, Research Institute for Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK. z.paskins@keele.ac.uk.
[Ti] Título:Public priorities for osteoporosis and fracture research: results from a general population survey.
[So] Source:Arch Osteoporos;12(1):45, 2017 Dec.
[Is] ISSN:1862-3514
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This is the first national study of public and patient research priorities in osteoporosis and fracture. We have identified new research areas of importance to members of the public, particularly 'access to information from health professionals'. The findings are being incorporated into the research strategy of the National Osteoporosis Society. PURPOSE: This study aimed to prioritise, with patients and public members, research topics for the osteoporosis research agenda. METHODS: An e-survey to identify topics for research was co-designed with patient representatives. A link to the e-survey was disseminated to supporters of the UK National Osteoporosis Society (NOS) in a monthly e-newsletter. Responders were asked to indicate their top priority for research across four topics (understanding and preventing osteoporosis, living with osteoporosis, treating osteoporosis and treating fractures) and their top three items within each topic. Descriptive statistics were used to describe demographics and item ranking. A latent class analysis was applied to identify a substantive number of clusters with different combinations of binary responses. RESULTS: One thousand one hundred eighty-eight (7.4%) respondents completed the e-survey. The top three items overall were 'Having easy access to advice and information from health professionals' (63.8%), 'Understanding further the safety and benefit of osteoporosis drug treatments' (49.9%) and 'Identifying the condition early by screening' (49.2%). Latent class analysis revealed distinct clusters of responses within each topic including primary care management and self-management. Those without a history of prior fracture or aged under 70 were more likely to rate items within the cluster of self-management as important (21.0 vs 12.9 and 19.8 vs 13.3%, respectively). CONCLUSION: This is the first study of public research priorities in osteoporosis and has identified new research areas of importance to members of the public including access to information. The findings are being incorporated into the research strategy of the National Osteoporosis Society.
[Mh] Termos MeSH primário: Atitude Frente à Saúde
Pesquisa Biomédica/métodos
Participação da Comunidade/métodos
Osteoporose/terapia
Fraturas por Osteoporose/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Osteoporose/complicações
Fraturas por Osteoporose/epidemiologia
Atenção Primária à Saúde
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s11657-017-0340-5



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