ABSTRACT
AIM: Compliance to pharmacological treatment for osteoporosis is crucial if the risk of fracture is to be reduced. Case series show that treatment with traditional bisphosphonates in the form of tablets has a compliance of between approximately 30% and 70%. The aims of this paper were to assess compliance to treatment with various formulations of bisphonates and to identify those at highest risk of discontinuation. METHODS: In this multicentre retrospective observational study, a population of 387 women diagnosed with postmenopausal osteoporosis under treatment with bisphosphonates (risedronate, ibandronate, alendronate in tablet form, alendronate in a fluid solution per os) was observed for at least a year. Demographic data and information pertaining to the type of drug taken, compliance to treatment, side effects, reasons for discontinuation, the basal examination and follow-up at 18 months and later were recorded. RESULTS AND CONCLUSION: Analysis of patient compliance to a prescribed treatment plan showed a significantly higher persistence (P<0.001) in the group taking alendronate in soluble solution form (83.3%) compared to the group taking any bisphosphonate in tablet form (66.7%). At the same time, patientspresenting comorbidity, receiving more than one therapy, not taking vitamin D, and in surgical menopause, risked discontinuation.
Subject(s)
Bone Density Conservation Agents/therapeutic use , Diphosphonates/therapeutic use , Medication Adherence/statistics & numerical data , Osteoporosis, Postmenopausal/drug therapy , Aged , Alendronate/administration & dosage , Diphosphonates/administration & dosage , Female , Humans , Ibandronic Acid , Middle Aged , Retrospective Studies , Risedronic Acid/administration & dosageABSTRACT
Three diabetic patients with leg or foot ulcers unresponsive to conventional therapies were treated with topical application of Nerve Growth Factor (NGF). The results showed that NGF promotes healing after 5-14 weeks of treatment. This study suggests that the use of topical application of NGF may represent a new useful tool for the management of difficult diabetic ulcers.
Subject(s)
Diabetic Foot/drug therapy , Nerve Growth Factor/administration & dosage , Administration, Topical , Aged , Diabetic Foot/physiopathology , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Nerve Growth Factor/therapeutic use , Treatment Outcome , Wound Healing/drug effectsABSTRACT
Nerve growth factor (NGF) is the first discovered and best known neurotrophic factor and is required for the survival and differentiation of a variety of neuronal cell types in both the peripheral and central nervous system. Recent studies indicate that NGF is synthesized by cells of immune system lineage and that its level increases during inflammatory responses, while cytokines such as interleukin-1 beta and tumor necrosis factor-alpha are potent inducers of NGF secretion. The role played by NGF on cells of the immune system was strengthened by recent evidence demonstrating that cells normally present in inflammatory tissues, such as mast cells and lymphocytes, express NGF receptors and are receptive to the action of NGF. Studies carried out in our and other laboratories showed that NGF is expressed in the synovial fluid of patients with rheumatoid arthritis and other forms of chronic arthritis, as well as in the synovium of pharmacologically-induced arthritis in animal models. Moreover, arthritic transgenic mice which carry and express the human tumor necrosis factor-gene also showed elevated levels of NGF. Significant increases in NGF levels have been found in the sera of patients with systemic lupus erythematosus and in the dermis of patients affected by systemic sclerosis. In this paper the hypothesis that NGF is involved in the pathophysiology of autoimmune rheumatic arthritis is discussed.
Subject(s)
Nerve Growth Factors/physiology , Rheumatic Diseases/physiopathology , Animals , Endocrine Glands/physiology , Humans , Immune System/physiology , Mice , Nervous System Physiological PhenomenaABSTRACT
Numerous studies reported in recent years have shown that withdrawal from chronic consumption of drugs induces high levels of anxiety, both in humans and in animal models. In the present study, we demonstrated that withdrawal from chronic consumption of either ethanol or heroin causes a significant increase in plasma nerve growth factor, suggesting that the resulting anxiety condition triggers the release of this molecule. Although the functional significance of this phenomenon needs to be better defined, it is hypothesized that the increased levels of circulating nerve growth factor might be involved in homeostatic adaptive and/or reparative mechanisms.
Subject(s)
Alcohol Withdrawal Delirium/blood , Alcoholism/blood , Nerve Growth Factors/blood , Adult , Aged , Alcoholism/rehabilitation , Animals , Anxiety/blood , Arousal/physiology , Corticotropin-Releasing Hormone/physiology , Female , Heroin/adverse effects , Heroin Dependence/blood , Heroin Dependence/rehabilitation , Homeostasis/physiology , Humans , Male , Middle Aged , Rats , Rats, Sprague-Dawley , Substance Withdrawal Syndrome/bloodABSTRACT
Nerve growth factor (NGF), a well-characterized neurotrophic factor, induces an increase in the number of mast cells (MCs) in the peripheral tissues of developing rats, as well as histamine release in fully differentiated MCs. Since MCs increase in the dermis of patients with early systemic sclerosis (SSc), we examined the distribution of NGF in the skin of patients affected by SSc. Immunohistochemical studies showed that NGF distribution was more intense in the dermis of patients with SSc than in the skin of controls. A possible correlation between MCs and NGF in disease activity is hypothesized.
Subject(s)
Mast Cells/pathology , Nerve Growth Factors/metabolism , Scleroderma, Systemic/metabolism , Scleroderma, Systemic/pathology , Skin/metabolism , Skin/pathology , Adult , Aged , Female , Humans , Immunohistochemistry , Male , Middle Aged , Tissue DistributionABSTRACT
Cytokines regulate nerve growth factor (NGF) synthesis during inflammatory processes. Since cytokines are also involved in the inflammatory processes of autoimmune rheumatic diseases, we examined levels of NGF in patients with rheumatoid or other types of chronic arthritis. NGF was present in the synovial fluid and synovium of patients with chronic arthritis, but was undetectable in control fluids. We conclude that NGF might be involved in the pathogenesis of arthritis.
Subject(s)
Arthritis/metabolism , Nerve Growth Factors/analysis , Synovial Fluid/chemistry , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Male , Middle Aged , Synovial Membrane/chemistrySubject(s)
Mast Cells/cytology , Nerve Growth Factors/pharmacology , Synovial Membrane/cytology , Animals , Cell Division/drug effects , Cell Division/physiology , Mast Cells/drug effects , Mast Cells/physiology , Nerve Growth Factors/physiology , Rats , Rats, Inbred Strains , Synovial Membrane/drug effects , Synovial Membrane/physiology , Synovitis/etiology , Synovitis/pathology , Synovitis/physiopathologyABSTRACT
Recent studies effected by our Institute indicate that various forms of human arthritis express both immunohistochemically and biologically active nerve growth factor (NGF) in the synovium. In the present study, we used a model of carrageenan-induced arthritis to further evaluate the effects of joint inflammation on NGF level. These studies showed that experimentally-induced arthritis in rats caused a significant increase in NGF in the perivascular area of the synovium. We also showed that injection into the synovium of purified NGF did not cause inflammation per se and that the destruction of peripheral sympathetic innervation significantly reduced both the inflammation and the level of NGF following carrageenan injection.
Subject(s)
Arthritis/metabolism , Nerve Growth Factors/physiology , Sympathetic Nervous System/physiopathology , Animals , Ankle Joint , Arthritis/chemically induced , Arthritis/physiopathology , Carrageenan , Female , Immunohistochemistry , Injections, Intra-Articular , Male , Rats , Rats, Sprague-Dawley , Sympathectomy , Synovial Membrane/innervation , Synovial Membrane/pathologyABSTRACT
Diffuse idiopathic skeletal hyperostosis (DISH) is a well-described disorder of middle-aged people, with a unique spinal pathology characterized by calcification and ossification of the antero-lateral aspect of at least four contiguous vertebral bodies, with the sparing of intervertebral spaces and sacroiliac joints. DISH has rarely been reported associated with ankylosing spondylitis (AS), a chronic inflammatory articular disease most commonly involving the spine and sacroiliac joints. A 63-year-old man with clinical and radiological findings of DISH with associated AS is described here. The authors conclude that these two diseases may, albeit rarely, coexist.
Subject(s)
Cervical Vertebrae , Hyperostosis, Diffuse Idiopathic Skeletal/complications , Spondylitis, Ankylosing/complications , Diagnosis, Differential , Humans , Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging , Male , Middle Aged , Radiography , Spondylitis, Ankylosing/diagnostic imagingABSTRACT
Antinuclear antibodies (ANA) and nailfold capillary microscopy have been evaluated as prognostic markers in patients with apparently idiopathic Raynaud's phenomenon. Results have shown that either ANA and peculiar alterations in nailfold capillaries are important risk factors as regard to the evolution into a connective tissue disease; furthermore, when both these markers are present in a patient with Raynaud's phenomenon, the risk of evolution is even greater. When sensibility and specificity have been compared, ANA appeared to be a more sensible test but nailfold capillary microscopy seemed to be more specific. Our data suggest that ANA and capillary microscopy are important tests in patients with Raynaud's phenomenon; they should be performed in order to identify those patients who are at greater risk of evolving to overt connective tissue disease.