scholarly journals A case of atypical femur fracture during long-term treatment with bisphosphonates in patient with postmenopausal osteoporosis

2019 ◽  
Vol 22 (1) ◽  
pp. 18-23
Author(s):  
Kira E. Zotkina ◽  
Olga M. Lesnyak ◽  
Aleksandr Yu. Kochish ◽  
Ivan V. Sushkov
Keyword(s):  
Postmenopausal Osteoporosis ◽  
Femur Fracture ◽  
Term Treatment ◽  
Atypical Femur Fracture ◽  
First Line Therapy ◽  
Oral Bisphosphonate ◽  
Long Term Treatment ◽  
Rare Side Effect ◽  
The Right

Bisphosphonates is a first-line therapy for treatment of osteoporosis. In the last decade, the number of atypical femur fracture (AFF) cases during long-term treatment with bisphosphonates has increased. The aim of this article was to analyze the literature data on this problem, to define the diagnostic criteria of AFF and to present the case of AFF in the patient who received treatment with alendronate for 3.5 years. A 78-year-old woman, receiving oral bisphosphonate for severe postmenopausal osteoporosis for 3.5 years, suddenly started feeling pain in her right thigh while walking. Three months later, she had got a fracture in middle third of the right femur after falling from her standing height. According to instrumental diagnostics, this fracture had all criteria of AFF. Blocking intramedullary osteosynthesis with shafts was performed. A retrospective analysis of soft tissue magnetic resonance imaging in the area of right thigh, done before the fracture, showed the presence of undiagnosed incomplete right femur fracture in the middle third, which subsequently led to a complete fracture. Presented clinical case demonstrates the complexity of AFF diagnostics. The purpose of the publication is to draw attention of medical specialists to the issue of this rare side effect of bisphosphonate treatment.

Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders

2021 ◽  
Vol 79 (3) ◽  
pp. 229-232
Author(s):  
Ana Beatriz Ayroza Galvão Ribeiro GOMES ◽  
Milena Sales PITOMBEIRA ◽  
Douglas Kazutoshi SATO ◽  
Dagoberto CALLEGARO ◽  
Samira Luisa APÓSTOLOS-PEREIRA
Keyword(s):  
Neuromyelitis Optica ◽  
Sao Paulo ◽  
Term Treatment ◽  
São Paulo ◽  
Duration Of Treatment ◽  
International Consensus ◽  
First Line Therapy ◽  
Long Term Treatment ◽  
Record Review

ABSTRACT Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical record review of all patients at the School of Medicine of the University of São Paulo (São Paulo, Brazil) who fulfilled the 2015 international consensus diagnostic criteria for NMOSD and were treated with azathioprine for at least 10 years. Results: Out of 375 patients assessed for eligibility, 19 were included in this analysis. These patients’ median age was 44 years (range=28-61); they were mostly female (17/19) and AQP4-IgG seropositive (18/19). The median disease duration was 15 years (range=10-39) and most patients presented a relapsing clinical course (84.2%). The median duration of treatment was 11.9 years (range=10.0-23.8). The median annualized relapse rates (ARR) pre- and post-treatment with azathioprine were 1 (range=0.1-2) and 0.1 (range=0-0.35); p=0.09. Three patients (15.7%) had records of adverse events during the follow-up, which consisted of chronic B12 vitamin deficiency, pulmonary tuberculosis and breast cancer. Conclusion: Azathioprine may be considered a safe agent for long-term treatment (>10 years) of NMOSD, but continuous vigilance for infections and malignancies is required.

scholarly journals A rare case of bilateral obstructive megaureter with a giant uretal ureterocele on the left

2020 ◽  
Vol 24 (3) ◽  
pp. 205-209
Author(s):  
G. N. Rumyantseva ◽  
V. N. Kartashev ◽  
Marina V. Dolinina ◽  
I. B. Osipov ◽  
A. I. Osipov ◽  
...  
Keyword(s):  
Left Kidney ◽  
Boarding School ◽  
Term Treatment ◽  
Ectopic Ureterocele ◽  
Surgical Department ◽  
Long Term Treatment ◽  
Obstructive Megaureter ◽  
The Right ◽  
Medical University

The article discusses a case of 4-year-old patient with a bilateral obstructive megaureter of a non-functioning left kidney and with the opening of this kidney ureter into the urethra with extravasal location of a giant ureterocele. The malformation of the urinary system was accompanied by a comorbid disease of bronchopulmonary system in the form of tuberculosis of the lungs and intra-thoracic lymph nodes. At the age of one month, due to decompensation of the only functioning right kidney, urine was withdrawn by applying a ureterostomy. Later, a proximal lateral cutaneous ureterostomy was put because of social reasons (mother refused of her baby). In two months, the next step was performed - a ureterocystoneostomy by the Cohen’s antireflux technique. After a long-term treatment for tuberculosis in clinics of Tver and St. Petersburg, at the age of 4, the girl was operated on at the first surgical department at St-Petersburg State Pediatric Medical University. Laparoscopic nephroureterectomy on the left with conversion to lower-middle laparotomy and resection of the terminal part of the left ureter with a giant ectopic ureterocele as well as closure of the ureterocutaneostomy on the right were performed. After stabilization, the child was transferred to a children’s boarding school in Tver, and currently is supervised by pediatric urologists and TB specialists.

scholarly journals Extensive skull base osteomyelitis, devastating complication of otitis externa: A case report and review of the literature

2021 ◽  
Vol 2 (3) ◽  
pp. 1-7
Author(s):  
Khadija El Bouhmadi ◽  
◽  
Myriam Loudghiri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Skull Base ◽  
Otitis Externa ◽  
Delayed Diagnosis ◽  
Petrous Bone ◽  
Term Treatment ◽  
Skull Base Osteomyelitis ◽  
Long Term Treatment ◽  
Orbital Wall ◽  
The Right

Skull base osteomyelitis (SBO), also referred to as malignant otitis externa (MOE) in its typical form, is usually a complication of otitis externa and severe uncommon and life-threatening condition requiring early diagnosis and long-term treatment in order to avoid its neurologic sequelae. We report the case of 69 years old female with a history of uncontrolled type 2 diabetes, who presented refractory and chronic right-sided purulent otorrhea with temporal headaches for 6 months, treated with no improvement by multiple attempts of ambulatory empiric therapy. After the appearance of grade III facial palsy and painful swelling in the right periorbital and zygomatic areas, the patient consulted in our department where a CT scan showed massive cortical and trabecular destruction of the right petrous bone and the mastoid extended to the lateral orbital wall, the zygomatic arch and the greater sphenoid wing realising extensive osteomyelitis of the skull base and the lateral face. The treatment was started immediately based on intravenous broad-spectrum antibiotics. Despite aggressive long-term treatment, the patient passed away, underlying the increased SBO morbidity and mortality secondary to delayed diagnosis.

Long-term treatment of postmenopausal osteoporosis with sodium etidronate or calcitonin

1996 ◽  
Vol 6 (S1) ◽  
pp. 254-254
Author(s):  
C. Lozano-Tonkin ◽  
M. A. González ◽  
L. García ◽  
J. Jareño
Keyword(s):  
Postmenopausal Osteoporosis ◽  
Term Treatment ◽  
Long Term Treatment

A review of the efficacy and tolerability of venlafaxine

1997 ◽  
Vol 12 (S4) ◽  
pp. 307s-313s ◽  
Author(s):  
M Dierick
Keyword(s):  
Major Depression ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Activity ◽  
Term Treatment ◽  
Selective Serotonin ◽  
First Line Therapy ◽  
Long Term Treatment ◽  
Norepinephrine Reuptake Inhibitor ◽  
Short And Long Term

SummaryVenlafaxine is a selective serotonin norepinephrine reuptake inhibitor with no activity at muscarinic, histaminergic or adrenergic receptors. The antidepressant activity of venlafaxine has been demonstrated in placebo-controlled and active comparator-controlled clinical trials. Venlafaxine was effective in outpatients and hospitalized patients with major depression and in those with melancholia, agitated or retarded symptoms, and refractory or treatment-resistant depression. Venlafaxine was at least as effective as comparative antidepressants and was more effective than fluoxetine or imipramine in some trials. A positive dose-response relationship has been shown with venlafaxine. When doses of venlafaxine are titrated rapidly upward, an onset of antidepressant action has been detected within one week in some studies. Venlafaxine is well tolerated during short- and long-term treatment. The most common adverse effects are nausea, somnolence and dry mouth. The overall tolerability of venlafaxine appears to exceed that of tricyclic antidepressants and compares favorably with that of selective serotonin reuptake inhibitors. Venlafaxine is a novel antidepressant that is appropriate for first-line therapy in patients with major depression.

scholarly journals Predictive Factors for Achievement of Treatment Goals in Patients with Postmenopausal Osteoporosis Treated with Denosumab

2021 ◽  
Author(s):  
Kyosuke Hattori ◽  
Nobunori Takahashi ◽  
Toshihisa Kojima ◽  
Shiro Imagama
Keyword(s):  
Bone Mineral Density ◽  
Multivariate Analysis ◽  
Postmenopausal Osteoporosis ◽  
Predictive Factors ◽  
Term Treatment ◽  
Treatment Goals ◽  
Mineral Density ◽  
T Score ◽  
Long Term Treatment

Abstract Objectives To investigate efficacy of long-term treatment with denosumab and predictive factors for achievement of treatment goals in patients with postmenopausal osteoporosis (PMO). Methods We enrolled 111 PMO patients who had T-scores ≤ -2.5 either at the lumbar spine (L-) or femoral neck (FN-), who had never been treated for osteoporosis, and who could be followed for at least 3 years. We first evaluated changes in bone mineral density (BMD) for up to 7 years. We next defined the treatment goal as the achievement of a T-score > -2.5 at month 36 and performed multivariate analysis to identify predictive factors for achievement of the goal. Results L- and FN-BMD increased yearly for 7 years. Among 87 patients with baseline L-T-scores ≤ -2.5, better baseline L-T-scores predicted achievement of L-T-scores > -2.5 at month 36. The cut-off value for baseline L-T-score was -3.4. Among 76 patients with baseline FN-T-scores ≤ -2.5, better baseline FN-T-scores predicted achievement of FN-T-scores > -2.5 at month 36. The cut-off value for baseline FN-T-scores was -2.8. Conclusions Long-term treatment with denosumab was effective in PMO patients. As better baseline T-score predicted achievement of T-scores > -2.5, early initiation of treatment will contribute to better outcome.

Long-term treatment with calcitriol in postmenopausal osteoporosis

Metabolism ◽  
1990 ◽  
Vol 39 (4) ◽  
pp. 43-49 ◽  
Author(s):  
A. Caniggia ◽  
R. Nuti ◽  
F. Lore ◽  
G. Martini ◽  
V. Turchetti ◽  
...  
Keyword(s):  
Postmenopausal Osteoporosis ◽  
Term Treatment ◽  
Long Term Treatment
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