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1.
Osteoarthritis Cartilage ; 26(2): 154-164, 2018 02.
Article in English | MEDLINE | ID: mdl-29222056

ABSTRACT

OBJECTIVE: To clarify the effects of bisphosphonates in knee osteoarthritis (OA) using an up-to-date meta-analysis of randomized controlled trials (RCTs). DESIGN: The protocol is registered in PROSPERO (CRD42017073449). We searched MEDLINE, EMBASE, Google Scholar, Web of Science, and Cochrane Database from inception until August 2017. We included only RCTs comparing any bisphosphonates vs placebo in knee OA patients and reporting validated pain and function scales, radiographic progression, and adverse events (AEs) outcomes. We excluded studies using active comparators or concomitant medications besides non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. We calculated standardized mean differences (SMDs) to account for variation in outcome scales. Random effects meta-analyses were performed. RESULTS: We included seven RCTs (3013 patients, 69% female); most patients (N = 2767) received oral risedronate. No pain or function outcomes, regardless of dose, route, time point or measuring instrument, revealed statistically significant results (end of trial pain SMD = -0.16 [95% confidence interval (CI): -0.34, 0.02]). Similarly, we found no statistically significant effect on radiographic progression (risk ratio = 0.98 [95% CI: 0.77, 1.26]). One small RCT in patients with bone marrow lesions (BMLs) suggested a reduction in BML size at 6 months. Bisphosphonates displayed good tolerability, with no statistically significant differences in AE outcomes vs placebo. CONCLUSIONS: Contrary to prior reviews, our analysis showed that bisphosphonates neither provide symptomatic relief nor defer radiographic progression in knee OA. However, these agents may still be beneficial in certain subsets of patients who display high rates of subchondral bone turnover. Future studies should be directed at defining such OA subsets and investigating the effects of bisphosphonates in those patients.


Subject(s)
Bone Density Conservation Agents/therapeutic use , Diphosphonates/therapeutic use , Osteoarthritis, Knee/drug therapy , Bone Density Conservation Agents/adverse effects , Diphosphonates/adverse effects , Disease Progression , Humans , Osteoarthritis, Knee/diagnostic imaging , Osteoarthritis, Knee/physiopathology , Pain/prevention & control , Pain Management/methods , Radiography , Randomized Controlled Trials as Topic/methods
3.
Arch. med. interna (Montevideo) ; 33(2): 25-27, ago. 2011. graf
Article in Spanish | LILACS | ID: lil-645814

ABSTRACT

Los D-Dímeros por la técnica de ELISA aumentan progresivamente en eltranscurso del embarazo normal y en las pacientes con trombofilia. Son útilescomo control biológico en estas pacientes para detección precoz de complicacionesy poder ajustar dosis del tratamiento con heparina de bajo pesomolecular. El objetivo del trabajo es determinar si los D-Dímeros por otrastécnicas (D-Dímeros: BCS [Enol]) y D-Dímeros: STA Compact (Roche) sonde utilidad en la embarazada con trombofilia o con sospecha de ella. Resultados:de las 226 pacientes analizadas, 93 no presentaron complicacionesy, si bien existe un aumento leve de los valores de la mediana de D-Dímerohacia el final del embarazo, el aumento no alcanza los niveles esperados. Enlas 133 pacientes que presentaron complicaciones no se demostró aumentodestacable de D-Dímero vinculable a la presencia de ninguna de las complicaciones.Conclusión: no se demostró, con las técnicas utilizadas BCS (Enol)y STA Compact (Roche), la variación esperada del D-Dímero en los distintostrimestres del embarazo, ni con la presencia complicaciones, en pacientescon trombofilia, a diferencia de lo publicado sobre D-Dímero con la técnicade ELISA.


Subject(s)
Humans , Female , Pregnancy , Biomarkers/blood , Thrombophilia , Thrombophilia/complications , Thrombophilia/diagnosis , Enzyme-Linked Immunosorbent Assay , Fibrinolysis , Heparin, Low-Molecular-Weight , Biomarkers , Pregnancy Complications
6.
Acta Biomed Ateneo Parmense ; 71 Suppl 1: 615-20, 2000.
Article in Italian | MEDLINE | ID: mdl-11424816

ABSTRACT

The study analyses the incidence of the retinopathy of prematurity (ROP) and its correlation with the most important risk factors in neonates with gestational age (GE) < or = 32 weeks and/or with birth weight (BW) < or = 1500 g. The cohort of our study is composed by 305 preterms with Mean GE of 29.8 weeks and Mean BW of 1312 g, studied at the Neonatal Intensive Care Unit of the University of Parma during January 1993-December 1999. The incidence of ROP resulted 19.7% in our group and was inversely proportional to the GE and BW. No preterms with GE < or = 32 weeks presented retinopathy, while there has been an incidence of the 65% in the subjects with GE lower than 26 weeks. The most severe grade of ROP was mainly seen in the newborns with the lowest GE (31%), whilst only the 1.5% of the preterms with GE of 30-31 weeks developed ROP of stage 3 or 3+. Similar results were seen when the data were compared with the birth weight. However a direct relation was seen with the duration of the O2 therapy and with the typical pathologies of the prematurity, namely respiratory distress syndrome (RDS) and intraventricular haemorrhages (IVH). Among the other risk factors evaluated, the blood transfusion was the most relevant.


Subject(s)
Retinopathy of Prematurity/epidemiology , Humans , Incidence , Infant, Newborn , Risk Factors
7.
Acta Biomed Ateneo Parmense ; 71 Suppl 1: 681-5, 2000.
Article in Italian | MEDLINE | ID: mdl-11424829

ABSTRACT

Early discharge is often correlated with negative events such as feeding problems leading to hypernatremic dehydration and malnutrition and non initiation or premature cessation of breastfeeding. In the reality of Parma we have valued the impact of early discharge on breastfeeding, analyzing a cohort of 267 dyads, 134 of which were in the "late discharge" group and 133 in the "early discharge" group. Our study showed, according to the most recent literature, that early postpartum discharge did not negatively affect the start and length of breastfeeding: early discharge indeed, if associated with suppression of "hospital routines" and with home-based postpartum follow-up visits, is a determining factor for the success of breastfeeding.


Subject(s)
Breast Feeding/statistics & numerical data , Length of Stay , Patient Discharge/statistics & numerical data , Female , Humans , Infant, Newborn , Italy , Time Factors
8.
J Dev Behav Pediatr ; 20(6): 411-7, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10608370

ABSTRACT

This study investigated the behavioral and psychological differences between 39 uninfected children born to human immunodeficiency virus (HIV)-seropositive mothers (HIV-seroreverter [SR]) and 78 children with no family history of HIV infection. Caretakers completed the Child Behavior Checklist and the Gittelman modification of the Conners' Parent's Questionnaire, whereas children completed the Children's Manifest Anxiety Scale and the Children's Depression Inventory. In 14 SR children and 28 controls, narrative task was also evaluated. The personalities of SR children, as measured by the caretaker-completed scales, revealed significantly more problems of social adjustment and attention and more externalizing symptoms than did the personalities of control children. On the child-completed scales, SR children showed significantly more anxiety and depression than did controls. Caretakers reported consistently fewer symptoms of anxiety and depression in the children than did the children themselves. Difficulties in verbal recall included aspects of depressive and anxious feelings; on the narrative task measure, SR children showed poorer skill in free verbal recall than did control children, and they simplified episodes with mixed emotions. In addition, ambiguous episodes elicited significantly more negative feelings in SR children than in controls. These findings show that there is a great necessity for assisting SR children. It will be important to determine whether these children will remain at risk for emotional consequences in their adult lives.


Subject(s)
Child Behavior/psychology , Child Development , HIV Seropositivity/psychology , Adult , Anxiety/psychology , Child , Cohort Studies , Depression/psychology , Female , Follow-Up Studies , HIV Seropositivity/transmission , Humans , Infectious Disease Transmission, Vertical , Mental Recall/physiology , Pregnancy , Pregnancy Complications, Infectious/physiopathology , Social Adjustment , Surveys and Questionnaires
9.
Eur Neuropsychopharmacol ; 9(4): 361-6, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10422898

ABSTRACT

We assessed the clinical and biological effects of high-dose, long-term Naltrexone (NTX) treatment in 11 children (3-11 years), who had been diagnosed as autistic. The drug was given following an open design, for 12 weeks. Beta-Endorphin (beta-END) was assayed in peripheral blood mononuclear cells after 1 and 3 months of treatment, and 6 months after the completion of the course. Baseline beta-END levels were higher than in healthy age-matched controls. In seven patients treatment reduced beta-END, whose levels rose in four children. Autistic symptoms were considerably attenuated in all cases, with functional improvements involving several areas. There was a close correlation between the reduction in beta-END levels and the decrease of social withdrawal, and an evident--though weak--correlation between increases in beta-END and decreases in stereotypy and abnormal speech. Both effects persisted after treatment stopped.


Subject(s)
Autistic Disorder/metabolism , Leukocytes, Mononuclear/drug effects , Naltrexone/pharmacology , Narcotic Antagonists/pharmacology , beta-Endorphin/metabolism , Autistic Disorder/drug therapy , Child , Child, Preschool , Cognition/drug effects , Humans , Leukocytes, Mononuclear/metabolism , Naltrexone/therapeutic use , Narcotic Antagonists/therapeutic use , Stereotyped Behavior/drug effects
10.
Arch. med. interna (Montevideo) ; 18(2): 91-2, jun. 1996.
Article in Spanish | LILACS | ID: lil-208643

ABSTRACT

En los últimos 10 años se ha visto un aumento en el número de casos de Tuberculosis en pacientes HIV positivos en los cuales se ven presentaciones atípicas y resistencia antibióticas. Se describe un caso de Tuberculosis Sistémica con compromiso esternal en una paciente añosa HIV negativa con afectación ganglionar cervical, concomitante aún en ausencia de compromiso pulmonar típico


Subject(s)
Humans , Female , Aged , Sternum/pathology , Osteomyelitis/etiology , Tuberculosis/complications , Tuberculosis/diagnosis
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