ABSTRACT
The use of glucocorticoids in the treatment of medical disorders can lead to rapid bone loss and increased risk of fragility fracture. Updated clinical guidelines are needed that accommodate recent advances in fracture risk assessment and new pharmacological interventions to reduce fracture risk. This document serves as an appendix to the 2012 IOF-ECTS guidelines for the management of glucocorticoid-induced osteoporosis.
Subject(s)
Antirheumatic Agents/therapeutic use , Glucocorticoids/adverse effects , Osteoporosis/chemically induced , Osteoporosis/drug therapy , Rheumatic Diseases/drug therapy , Humans , Osteoporosis/prevention & controlABSTRACT
UNLABELLED: This paper provides a framework for the development of national guidelines for the management of glucocorticoid-induced osteoporosis in men and women aged 18 years and over in whom oral glucocorticoid therapy is considered for 3 months or longer. INTRODUCTION: The need for updated guidelines for Europe and other parts of the world was recognised by the International Osteoporosis Foundation and the European Calcified Tissue Society, which set up a joint Guideline Working Group at the end of 2010. METHODS AND RESULTS: The epidemiology of GIO is reviewed. Assessment of risk used a fracture probability-based approach, and intervention thresholds were based on 10-year probabilities using FRAX. The efficacy of intervention was assessed by a systematic review. CONCLUSIONS: Guidance for glucocorticoid-induced osteoporosis is updated in the light of new treatments and methods of assessment. National guidelines derived from this resource need to be tailored within the national healthcare framework of each country.
Subject(s)
Bone Density Conservation Agents/therapeutic use , Osteoporosis/drug therapy , Osteoporosis/epidemiology , Practice Guidelines as Topic , Aged , Aged, 80 and over , Bone Density , Female , Glucocorticoids/adverse effects , Humans , Male , Middle Aged , Osteoporosis/chemically induced , Risk Assessment/methods , Risk Factors , Treatment OutcomeABSTRACT
Experiments in juvenile house pigs with a valved uretero-ileosigmoidostomy were performed, and the advantages of this procedure as against common methods were assessed. Postoperative studies up to 6 months revealed encouraging results in respect of function, infection rate, kidney function, serum electrolyte pattern and as to macro- and microhistological appearances. The results were considered superior to those obtained by simple ureterosigmoidostomy as shown by control groups.
Subject(s)
Urinary Diversion/methods , Animals , Colon, Sigmoid/surgery , Female , Ileum/surgery , Postoperative Complications , Swine , Ureter/surgery , Urinary Tract Infections/etiologyABSTRACT
Based on the frequency of subclinical, postoperative thrombosis which we detected using radio-iodine-tagged fibrinogen (125I-fibrinogen) in 2 comparable test groups of 100 female patients each, we were able to compare the effectiveness of Aescin (Reparil) to the untreated group. Whereas only 16 patients in the Reparil group were thrombose-positive we found 27 such cases in the control group. The analysis of these data shows Reparil to be of distinct advantage when compared to the untreated group.
Subject(s)
Escin/therapeutic use , Saponins/therapeutic use , Thrombosis/prevention & control , Adolescent , Adult , Blood Coagulation Tests , Child , Drug Evaluation , Female , Fibrinogen/analysis , Humans , Middle Aged , Postoperative ComplicationsABSTRACT
Based on 5 individual cases over a period of 8 years (1 fibroma, 1 angiofibroma, 2 adenofibromas, 1 xanthous neurofibroma) the characteristics of the rare intrapulmonary fibroma and the therapeutic consequences are discussed. Any suspicious tumor demands a thoracotomy with careful preoperative treatment and the subsegment or segment resection depending on the histological diagnosis reported during the procedure.
