scholarly journals Evaluation of the nature and etiologies of risk factors for diaphyseal atypical femoral fractures

2021 ◽  
Author(s):  
Hiroyuki Tsuchie ◽  
Naohisa Miyakoshi ◽  
Yuji Kasukawa ◽  
Koji Nozaka ◽  
Kimio Saito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analyses ◽  
Femoral Fractures ◽  
Japanese Patients ◽  
High Serum ◽  
Control Group ◽  
Atypical Femoral Fractures ◽  
Factors Affecting ◽  
Lateral Curvature ◽  
Low Serum

Objectives: Differences in the mechanisms of subtrochanteric and diaphyseal atypical femoral fractures (AFFs) have been speculated in studies that have analyzed differences in the patients’ backgrounds. However, the etiologies of each type of AFF have not been investigated in detail. Therefore, this study aimed to investigate the nature and etiologies of the risk factors for diaphyseal AFFs. Materials and Methods: Eighty consecutive Japanese patients with 91 diaphyseal AFFs (the AFF group) and 110 age-matched female patients with osteoporosis (the non-AFF control group) were included. Their clinical data were compared and the factors affecting AFFs were investigated. Furthermore, the etiologies of the risk factors for diaphyseal AFFs were examined. Results: Multivariate analysis revealed that femoral serrated changes, bisphosphonate or denosumab usage, and lateral and anterior femoral curvatures were the risk factors for diaphyseal AFFs (p<0.0011, p=0.0137, and p<0.0001, respectively). Multivariate analyses also revealed that serrated changes and low serum 25(OH)D levels affected the lateral curvature (p=0.0088 and 0.0205, respectively), while serrated changes affected the anterior curvature (p=0.0006); each significantly affected the femoral curvature. In addition, a high serum calcium (Ca) level, lateral femoral curvature, and anterior femoral curvature were the predictors of serrated changes (p=0.0146, 0.0002, and 0.0098, respectively). Conclusion: The risk factors for diaphyseal AFFs were bone resorption inhibitor usage, a strong femoral curvature, and serrated changes. A low serum 25(OH)D level and serrated changes are the risk factors for lateral curvature, while a high serum Ca level is a risk factor for serrated changes.

scholarly journals The Relationship Between Genetic Variants Associated with Premature Menopause and Lipid Profile in Women Recruited from MASHAD Cohort Study

2021 ◽  
Author(s):  
Mohammad Reza Mirinezhad ◽  
Hamideh Ghazizadeh ◽  
Maliheh Aghsizadeh ◽  
Mohammad Zamiri Bidary ◽  
Alireza Naghipour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genetic Variants ◽  
Multivariate Logistic Regression Analysis ◽  
High Serum ◽  
Control Group ◽  
Premature Menopause ◽  
High Total Cholesterol ◽  
Multivariate Logistic Regression ◽  
The Relationship ◽  
Low Serum

Abstract Background and aim: Premature menopause (PM) is defined by the occurrence of the menopause before the age of 40 years. It is often associated with cardiovascular disease (CVD). The purpose of this study was to explore the relationship between PM-associated genotypes cardio metabolic disorder risk factors. Methods: One hundred seventeen women with PM and one hundred eighty-three healthy women without PM were recruited in this study. DNA was extracted and analyzed using ASO-PCR or Tetra ARMS-PCR. Lipid profiles were also assessed.Results: Multivariate logistic regression analysis showed that individuals with GG vs. TT genotype of the rs1046089 SNP were more likely to have high serum LDL risk (p = 0.03) compared to the control group. There was also a significant association between low serum HDL risk and rs2303369 and rs4806660 SNP genotypes in the PM group. In the PM group, the percentage of those with a high total cholesterol was lower in those with a CC genotype compared to those with a TT genotype (p = 0.03).Conclusion: Some SNPs reported to be associated with PM appear to be independently associated with dyslipidemia. These results may be helpful to identify subjects with PM who may be susceptible to CVD.

Risk factors for development of atypical femoral fractures in patients on long-term oral bisphosphonate therapy

Bone ◽  
2013 ◽  
Vol 56 (2) ◽  
pp. 426-431 ◽  
Author(s):  
Paola Franceschetti ◽  
Marta Bondanelli ◽  
Gaetano Caruso ◽  
Maria Rosaria Ambrosio ◽  
Vincenzo Lorusso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Fractures ◽  
Bisphosphonate Therapy ◽  
Atypical Femoral Fractures ◽  
Oral Bisphosphonate

scholarly journals Dr Effects of Adiponectin, Plasma D-Dimer, Inflammation and Tumor Markers on Clinical Characteristics and Prognosis of Patients with Ovarian Cancer

2021 ◽  
Author(s):  
Hui Li
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Tumor Markers ◽  
Inflammatory Factors ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Factors Affecting ◽  
Serum Tumor Markers ◽  
Related Risk ◽  
Hs Crp

 [Abstract] Objective: To investigate the effects of adiponectin (ADPN), plasma D-dimer (D-D), inflammation and tumor markers on clinical characteristics and prognosis of patients with ovarian cancer. Methods: A total of 80 patients with ovarian cancer treated in our hospital from April 2017 to November 2019 were enrolled as study subjects and evenly divided into observation group (patients with ovarian cancer) and control group (patients with benign ovarian tumor) based on the results of postoperative pathological biopsy. The levels of ADPN, plasma D-D, inflammatory factors and serum tumor markers [carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and risk of ovarian malignancy algorithm (ROMA)] were compared between the two groups. The diagnostic value of serum tumor markers CA125, HE4 and ROMA in ovarian cancer was explored. The correlations of the changes of ROMA with the changes in the levels of ADPN, plasma D-D, high-sensitivity C-reactive protein (hs-CRP), CA125 and HE4 were analyzed. Additionally, the related risk factors affecting the development of ovarian cancer were subjected to univariate and multivariate logistic regression analyses. Results: In comparison with control group, observation group exhibited a lowered ADPN level (p<0.05), notably raised levels of plasma D-D, inflammatory factors hs-CRP and interleukin-6 (IL-6) and serum tumor markers CA125 and HE4 and an evidently increased ROMA (p<0.05). Besides, the detection of serum ROMA showed the highest specificity and sensitivity and low false positive rate and false negative rate. The changes of ROMA were positively correlated with the changes in the levels of plasma D-D, hs-CRP, CA125 and HE4 (p<0.05), and negatively associated with the changes in ADPN level (p<0.05). The results of univariate analysis showed that abnormal ADPN, D-D, hs-CRP, IL-6, CA125 and HE4 levels were related risk factors affecting the development of ovarian cancer. It was found through multivariate logistic regression analysis that decreased ADPN level and increased D-D, hs-CRP, IL-6, CA125 and HE4 levels were independent risk factors affecting the development of ovarian cancer. Conclusion: In the case of ovarian cancer, the ADPN level declines, while the levels of plasma D-D, inflammatory factors, and serum tumor markers CA125, HE4 and ROMA rise obviously. Besides, the ROMA level displays a positive relation to the content of CA125, HE4, plasma D-D and inflammatory factors and a negative association with ADPN level.

scholarly journals Bilateral atypical femoral fractures during denosumab therapy in a patient with adult-onset hypophosphatasia

2021 ◽  
Vol 2021 ◽  
Author(s):  
Annabelle M Warren ◽  
Peter R Ebeling ◽  
Vivian Grill ◽  
Ego Seeman ◽  
Shoshana Sztal-Mazer
Keyword(s):  
Alkaline Phosphatase ◽  
Vitamin B6 ◽  
Serum Alkaline Phosphatase ◽  
Serum Vitamin ◽  
Femoral Fractures ◽  
Adult Onset ◽  
Antiresorptive Therapy ◽  
Atypical Femoral Fractures ◽  
Asfotase Alfa ◽  
Low Serum

Summary Hypophosphatasia (HPP) is a rare and under-recognised genetic defect in bone mineralisation. Patients presenting with fragility fractures may be mistakenly diagnosed as having osteoporosis and prescribed antiresorptive therapy, a treatment which may increase fracture risk. Adult-onset HPPhypophosphatasia was identified in a 40-year-old woman who presented with bilateral atypical femoral fractures after 4 years of denosumab therapy. A low serum alkaline phosphatase (ALP) and increased serum vitamin B6 level signalled the diagnosis, which was later confirmed by identification of two recessive mutations of the ALPL gene. The patient was treated with teriparatide given the unavailability of ALP enzyme-replacement therapy (asfotase alfa). Fracture healing occurred, but impaired mobility persisted. HPP predisposes to atypical femoral fracture (AFF) during antiresorptive therapy; hence, bisphosphonates and denosumab are contraindicated in this condition. Screening patients with fracture or ‘osteoporosis’ to identify a low ALP level is recommended. Learning points Hypophosphatasia (HPP) is a rare and under-recognised cause of bone fragility produced by impaired matrix mineralisation that can be misdiagnosed as a fragility fracture due to age-related bone loss. Antiresorptive therapy is contraindicated in HPP. Low serum alkaline phosphatase (ALP) provides a clue to the diagnosis. Elevated serum vitamin B6 (an ALP substrate) is indicative of HPP, while identification of a mutation in the ALPL gene is confirmatory. Enzyme therapy with recombinant ALP (asfotase alfa) is currently prohibitively costly. Treatment with anabolic bone agents such as teriparatide has been reported, but whether normally mineralized bone is formed requires further study.

scholarly journals Outcome Predictors of Biopsy-Proven Myeloperoxidase-Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yifei Ge ◽  
Guang Yang ◽  
Xiangbao Yu ◽  
Bin Sun ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Patient Survival ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Albumin Level ◽  
High Serum ◽  
Poor Renal Function ◽  
Low Serum

ObjectiveTo determine the prognostic values of histopathologic classification of myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis and other clinical and laboratory features at the time of presentation on renal and patient survival associated with myeloperoxidase-ANCA-associated glomerulonephritis (MPO-ANCA-GN).MethodsA total of 112 patients diagnosed with MPO-ANCA-GN from October 2005 to December 2018 were enrolled. The baseline clinical characteristics, renal histopathological data, and risk factors predictive of renal and patient survival were retrospectively analyzed.ResultsAll 112 patients underwent renal biopsy. Disease in 32 patients was classified as focal, 26 as mixed, 29 as crescentic, and 25 as sclerotic. Over a median follow-up period of 41.5 months, there were 44 patients dialysis-dependent. The renal survival rate was significantly higher in the focal group than the other groups (p &lt; 0.001) and significantly lower in the sclerotic group (p &lt; 0.05). In addition, disease histopathologically classified as sclerotic (p = 0.044), high serum creatinine level (≥320 μmol/L, p &lt; 0.001), low albumin (&lt;30 g/L, p = 0.024) and hemoglobin level (&lt;90 g/L, p = 0.044) were associated with a greater risk of ESRD. After follow-up, 70 (62.5%) of 112 patients survived. Old age (≥60 years, p = 0.018) and low serum albumin (&lt;30 g/L, p = 0.006) was significant risk factor for patient survival.ConclusionAmong patients with MPO-ANCA-GN, those with poor renal function, disease histopathologically classified as sclerotic, and lower albumin and hemoglobin levels were risk factors for ESRD, while older age and low serum albumin level were associated with a greater risk for all-cause mortality.

scholarly journals Comprehensive Study of the Risk Factors for Medication-Related Osteonecrosis of the Jaw Based on the Japanese Adverse Drug Event Report Database

2020 ◽  
Vol 13 (12) ◽  
pp. 467
Author(s):  
Shinya Toriumi ◽  
Akinobu Kobayashi ◽  
Yoshihiro Uesawa
Keyword(s):  
Risk Factors ◽  
Side Effects ◽  
Adverse Drug Event ◽  
Femoral Fractures ◽  
Principal Component ◽  
Osteonecrosis Of The Jaw ◽  
Drug Event ◽  
Event Report ◽  
Atypical Femoral Fractures ◽  
Antiresorptive Agents

Medication-related osteonecrosis of the jaw (MRONJ) is associated with many drugs, including bisphosphonates (BPs). BPs are associated with atypical femoral fractures and osteonecrosis of the external auditory canal. Thus, many drugs are reported to cause adverse effects on bone. This study aimed to investigate the effects of drugs and patient backgrounds regarding osteonecrosis-related side effects, including MRONJ. This study used a large voluntary reporting database, namely, the Japanese Adverse Drug Event Report database. First, we searched for risk factors related to MRONJ using volcano plots and logistic regression analysis. Next, we searched for bone-necrosis-related side effects using principal component and cluster analysis. Factors that were significantly associated with MRONJ included eight types of BPs and denosumab, prednisolone, sunitinib, eldecalcitol, raloxifene, letrozole, doxifluridine, exemestane, radium chloride, medroxyprogesterone, female, elderly, and short stature. Furthermore, antiresorptive agents (i.e., BPs and denosumab) tended to induce MRONJ and atypical femoral fractures by affecting osteoclasts. We believe these findings will help medical personnel manage the side effects of many medications.

Factors affecting fracture location in atypical femoral fractures: A cross-sectional study with 147 patients

Injury ◽  
2017 ◽  
Vol 48 (7) ◽  
pp. 1570-1574 ◽  
Author(s):  
Ji Wan Kim ◽  
Jung Jae Kim ◽  
Young-Soo Byun ◽  
Oog-Jin Shon ◽  
Hyoung Keun Oh ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Atypical Femoral Fractures ◽  
Factors Affecting ◽  
Fracture Location

scholarly journals Investigation of Risk Factors Affecting Lactate Levels in Japanese Patients Treated with Metformin

2016 ◽  
Vol 39 (12) ◽  
pp. 2022-2027 ◽  
Author(s):  
Shota Yokoyama ◽  
Hideyuki Tsuji ◽  
Sachiko Hiraoka ◽  
Masayuki Nishihara
Keyword(s):  
Risk Factors ◽  
Japanese Patients ◽  
Factors Affecting ◽  
Lactate Levels

Mid-term outcomes after the surgical treatment of atypical femoral fractures

2021 ◽  
Vol 103-B (11) ◽  
pp. 1648-1655
Author(s):  
Soo-Young Jeong ◽  
Kyu-Tae Hwang ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Oog Jin Sohn ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Femoral Fractures ◽  
Delayed Union ◽  
Fracture Site ◽  
High Grade ◽  
Atypical Femoral Fractures ◽  
Factors Affecting ◽  
The Mean

Aims The incidence of atypical femoral fractures (AFFs) continues to increase. However, there are currently few long-term studies on the complications of AFFs and factors affecting them. Therefore, we attempted to investigate the outcomes, complications, and risk factors for complication through mid-term follow-up of more than three years. Methods From January 2003 to January 2016, 305 patients who underwent surgery for AFFs at six hospitals were enrolled. After exclusion, a total of 147 patients were included with a mean age of 71.6 years (48 to 89) and 146 of whom were female. We retrospectively evaluated medical records, and reviewed radiographs to investigate the fracture site, femur bowing angle, presence of delayed union or nonunion, contralateral AFFs, and peri-implant fracture. A statistical analysis was performed to identify the significance of associated factors. Results The mean follow-up period was 70.2 months (36 to 191). There were 146 AFFs (99.3%) in female patients and the mean age was 71.6 years (48 to 89). The AFFs were located in the subtrochanter and shaft in 52 cases (35.4%) and 95 (64.6%), respectively. The preoperative mean anterior/lateral femoral bowing angles were 10.5° (SD 5.7°)/6.1° (SD 6.2°). The postoperative mean anterior/lateral bowing values were changed by 8.7° (SD 5.4°)/4.6° (SD 5.9°). Bisphosphonates had been used contemporarily in 115 AFFs (78.2%) for a mean of 52.4 months (1 to 204; SD 45.5) preoperatively. Nailing was performed in 133 AFFs (90.5%), and union was obtained at a mean of 23.6 weeks (7 to 85). Delayed union occurred in 41 (27.9%), and nonunion occurred in 13 (8.8%). Contralateral AFF occurred in 79 patients (53.7%), and the use of a bisphosphonate significantly influenced the occurrence of contralateral AFFs (p = 0.019). Peri-implant fractures occurred in a total of 13 patients (8.8%), and a significant increase was observed in cases with plating (p = 0.021) and high grade of postoperative anterolateral bowing (p = 0.044). Conclusion The use of a bisphosphonate was found to be a risk factor for contralateral AFF, and high-grade postoperative anterolateral bowing and plate fixation significantly increased the occurrence of peri-implant fractures. Long-term follow-up studies on the bilaterality of AFFs and peri-implant fractures are warranted. Cite this article: Bone Joint J 2021;103-B(11):1648–1655.

Childhood Onset Hypoceruloplasminemia Presenting as Early-Onset rebellar Ataxia

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Adel F. Hashish ◽  
Ayman Kilany ◽  
Shora Y. Darwish ◽  
Hanaa M. Rashad ◽  
Ehab R. Abdelraou ◽  
...  
Keyword(s):  
Retinal Degeneration ◽  
Cerebellar Ataxia ◽  
Serum Ferritin ◽  
Transferrin Saturation ◽  
Autosomal Recessive Disorder ◽  
Molecular Study ◽  
High Serum ◽  
Control Group ◽  
Serum Ceruloplasmin ◽  
Low Serum

The syndrome of hypoceruloplasminemia is a rare autosomal recessive disorder presenting mainly with neurogegeneration, retinal degeneration, and diabetes mellitus. The syndrome, to the best of our knowledge, is not yet recognized in pediatric age group. We screened cases presenting with unexplained cerebellar ataxia and anemia using serum ceruloplasmin, transferrin saturation, and ferritin as biomarkers for hypoceruloplasminemia. An age and sex matched control group was included. Thirty cases (age range 4–17 years) (18 male and 12 female) have been included. The results showed a statistically significant low serum ceruloplasmin and transferrin saturation (18.9±12.1mg/dl and 10.1±5.1%, respectively), and high serum ferritin (124.7±65.7 ng/ml) compared to control group. Four cases have retinal degeneration. The detection of low serum ceruloplasmin concentration and transferrin saturation with high serum ferritin in patients with unexplained cerebellar ataxia is highly suspicious of hypocerluplasminemia which should be subjected for further molecular study.

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