ABSTRACT
Vertebral fractures are a hallmark of postmenopausal osteoporosis and an important end point in trials of osteoporosis treatment, but the clinical significance of vertebral deformities remains uncertain. We examined the prevalence of vertebral deformity and associations of vertebral deformities and other characteristics with physical functioning among 584 Japanese women ages 40 to 89 years. Lateral spine radiographs were obtained and radiographic vertebral deformities were assessed by quantitative morphometry, defined as vertebral heights more than 3 SD below the normal mean. A self-administered questionnaire was used to survey participants about difficulty in performing selected basic and instrumental activities of daily living (ADL). Overall, 15% of women had at least one vertebral deformity, and 8% had 2 or more. The prevalence of vertebral deformities increased progressively with age. Half of women ages 80 and over had vertebral deformities. Impaired function was defined as difficulty performing 3 or more ADLs. After adjusting for age, the odds of impaired function were increased by 1.4 times (95% CI: 0.7, 2.9) in women with a single vertebral deformity, and 3.1 times (1.4, 6.8) in those with two or more deformities. Additional adjustment for number of painful joints, number of comorbidities, body mass index, and back pain did not materially alter these findings. In conclusion, women with multiple vertebral deformities had significantly greater impaired function. The association was independent of age, back pain and the number of painful joints, suggesting that deformities may impair function even when back pain is not present.
Subject(s)
Aging , Spinal Fractures/diagnostic imaging , Spine/abnormalities , Spine/diagnostic imaging , Activities of Daily Living , Adult , Aged , Aged, 80 and over , Back Pain/diagnostic imaging , Chi-Square Distribution , Cross-Sectional Studies , Female , Humans , Japan , Middle Aged , Prevalence , Radiography , Regression AnalysisABSTRACT
The susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) to vancomycin (VC) is excellent, but excessive dosing of VC leads to severe side effects. In this study, we present a way of administration planning for each patient based on personal data. To this end, we employed the Sawchuck-Zaske equation to calculate VC clearance (CL) and volume of distribution (Vd) on the basis of three different plasma concentrations of VC, and we used CL and Vd values as prior information before employing the parameter estimation and dosage adjustment program to treat a patient with postsurgical endophthalmitis caused by MRSA and a patient with acute dacryocystitis also caused by MRSA. They had good remissions without any severe side effects.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Eye Infections/drug therapy , Eye Infections/microbiology , Methicillin Resistance , Staphylococcus aureus/physiology , Vancomycin/administration & dosage , Acute Disease , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Dacryocystitis/microbiology , Dose-Response Relationship, Drug , Endophthalmitis/microbiology , Female , Humans , Infant , Middle Aged , Postoperative Complications , Staphylococcal Infections/drug therapy , Vancomycin/blood , Vancomycin/therapeutic useABSTRACT
An 84-year-old Japanese woman had cavernous sinus thrombosis (CST) due to abdominal wall abscess. The diagnosis was delayed because abdominal wall abscess is an unfamiliar cause of CST, but a definite diagnosis was reached with the use of magnetic resonance imaging. We started intravenous antibiotic therapy against gram-positive and gram-negative organisms and the patient responded well, although the diagnosis was delayed.
