scholarly journals STUDY OF INCIDENCE OF OSTEOPOROSIS INDUCED FRACTURES IN THE ELDERLY AFTER ONCE YEARLY ZOLEDRONIC ACID INJECTION

2021 ◽  
pp. 1-2
Author(s):  
Raveendra Babu. Rayalapeta. Veerappa ◽  
Achyuth Babu. Rayalapeta Bodan
Keyword(s):  
Developing Countries ◽  
Placebo Group ◽  
Zoledronic Acid ◽  
Rural Areas ◽  
Osteoporotic Fractures ◽  
The Elderly ◽  
Mineral Density ◽  
Distal Radial Fractures ◽  
Neck Of Femur ◽  
Study Results

Introduction: In developing countries like India, the various socio-economic factors like anaemia, hypo proteinemia, early menopause, hysterectomy at younger age and loss of teeth at early age are leading causes of osteoporosis. The treatment for all the above problems at community level is difficult job. We advocated IV injections of Zoledronic acid once in a year which is feasible and possible way of preventing the progression of osteoporosis. This is evidenced by decrease in incidence of new fractures in our patients. Patients and Methods: We studied the efficacy of once yearly IV injection of Zoledronic acid -ZOLE to prevent osteoporotic fractures in the 130 elderly patients and compared the incidence of fractures in the placebo group of 150 patients who were not received the ZOLE injection. The age group ranges from 50 to 70 years who attended OP unit of our Orthopaedic department from January 2018 to December 2019 (2 years). These 280 patients presented with common fractures like fracture neck of femur-110, vertebral fractures-85, proximal tibial fractures-15, proximal humoral fractures-15 and distal radial fractures-55. IV Zoledronic acid was given to 130 patients in addition to fracture treatment. The remaining 150 patients who were not willing for IV injections for various reasons were included in the placebo group of our study. Results: We assessed the incidence of new fractures in both the groups patients, ZOLE group who received Zoledronic injection and placebo group who were not received injection for 2 years period. The incidence of new fractures was significantly diminished in ZOLE group compared to placebo group. We observed the incidence of all cumulative fractures were 30 fractures (24%) in the ZOLE group and in the placebo group the incidence was 110 fractures (76%). Bone mineral density (BMD) of Lumbar spine, femoral neck, proximal humerus and distal radius were done for all the patients at the time of starting of the study and at 2 years follow-up. We observed increased BMD in the ZOLE group. There were no adverse effects like osteonecrosis of jaw and others in our study. Conclusion: In rural areas of developing countries, with poor socioeconomic status, early osteoporosis is prevalent and causing the major fractures after trivial injury. Once yearly administration of Zoledronic acid 5 mg IV is safe and effective way of preventing the incidence of Fractures and subsequent morbidity and mortality.

scholarly journals 64 Association between Risk of Osteoporotic Fractures with Spinal Morphology, Muscle Strength and Physical Performance

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Siew Kuan Chua ◽  
Devinder ◽  
KA Singh ◽  
Bala S Rajaratnam ◽  
Sabarul Afian Mokhtar ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Fracture Risk ◽  
Physical Performance ◽  
Tracking System ◽  
Osteoporotic Fractures ◽  
Limited Information ◽  
Functional Impairments ◽  
Mineral Density ◽  
Increased Risk ◽  
Study Results

Abstract Osteoporotic related fractures (OF) are associated with functional impairments and declined quality of life. Low bone mineral density is one of the main risk factor for OF. However, there is limited information regarding the association of spinal morphology, muscle strength and physical performance with OF. The aim of the study was to examine association between risk of osteoporotic fractures with spinal morphology (thoracolumbar curvature and back extensors muscle strength), muscle strength and physical performance. 105 adults aged 50 years and above (69.3+ 8.5 years) were recruited for this cross-sectional study from a spine orthopaedic clinic. Thoracolumbar curvature, back extensors (BEMS) and handgrip (HGS) muscle strength were measured using an electromagnetic tracking system, a load-cell system and hand-held dynamometer respectively. Physical performance was assessed using Short Physical Performance Battery (SPPB). Participants were categorised for major osteoporotic fracture risk (major OF) with cut-point 10% using fracture risk calculator (FRAX®) with BMD. Student t-test analysis demonstrated that there is a significant (p<0.05) difference between participants with low risk and moderate to high risk of major OF for BEMS, HGS, and SPPB. Adjusted logistic models (forward and backward), showed that lower HGS and physical performance were associated with increased risk of major OF (HGS: OR = 0.18 [95% CI, 0.07–0.48]; SPPB: OR = 0.32[95% CI, 0.13–0.80]). Our study results suggest that declined muscle strength and physical performance is associated with higher risk of OF. It is important to promote optimum muscle strength and physical performance among older adults in the prevention of OF.

scholarly journals Zoledronic Acid Once-yearly: What Role in the Prevention of Non-vertebral Osteoporotic Fractures?

2010 ◽  
Vol 2 ◽  
pp. CMT.S4947
Author(s):  
Sheila Anne Doggrell
Keyword(s):  
Zoledronic Acid ◽  
Osteoporotic Fractures ◽  
Primary Osteoporosis ◽  
Mineral Density ◽  
Glucocorticoid Treatment ◽  
Oestrogen Treatment ◽  
Treatment Of Osteoporosis ◽  
Hormone Sensitive ◽  
Low Levels ◽  
Single Intravenous Administration

Osteoporosis is the most common bone disease. Low levels of oestrogens or testosterone are risk factors for primary osteoporosis. The most common cause of secondary osteoporosis is glucocorticoid treatment, but there are many other secondary causes of osteoporosis. Osteoporosis can be secondary to anti-oestrogen treatment for hormone-sensitive breast cancer and to androgen-deprivation therapy for prostate cancer. Zoledronic acid is the most potent bisphosphonate at inhibiting bone resorption. In osteoporosis, zoledronic acid increases bone mineral density for at least a year after a single intravenous administration. The efficacy and safety of extended release (once-yearly) zoledronic acid in the treatment of osteoporosis is reviewed.

Zoledronic Acid Increases Bone Mineral Density in Patients with Thalassemia Intermedia-Induced Osteoporosis Regardless of the Incessant Bone Marrow Expansion.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3813-3813
Author(s):  
Ersi Voskaridou ◽  
Dimitrios Christoulas ◽  
Lito Antoniadou ◽  
Panagiotis Tsaftaridis ◽  
Eleni Plata ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Marrow ◽  
Placebo Group ◽  
Zoledronic Acid ◽  
Bone Loss ◽  
Bone Pain ◽  
Bone Remodelling ◽  
Erythropoietic Activity ◽  
Mineral Density ◽  
Marrow Expansion

Abstract Osteoporosis represents an important cause of morbidity in adult patients with thalassemia. Its pathogenesis is multifactorial, and includes mainly bone marrow expansion, endocrine dysfunction and iron overload. Patients with thalassaemia intermedia (TI) seem to have a more expanded bone marrow with pressure on cortical bone, which causes pain and bone loss in several cases. The measurement of soluble transferrin receptor (sTfR) and erythropoietin (Epo) in the serum is considered as accurate marker of erythropoietic activity in thalassemia. Bisphosphonates are potent inhibitors of osteoclast activity and have been used for the management of thalassemia-induced osteoporosis. The aim of this study was to evaluate the effect of zoledronic acid, the most potent aminobisphosphonate, on bone mineral density (BMD) of patients with TI and explore possible correlations with bone marrow expansion and erythropoietic activity. Thirty-five patients with TI and osteopenia or osteoporosis (13M/22F, median age 45 years) were evaluated. Twenty-three were randomized to receive zoledronic acid, 4 mg, IV, every 3 months (n=12) or every 6 months (n=11) for one year, while 12 patients received placebo every 3 months. There was no difference in terms of the presence of gonadal dysfunction between the three studied groups. BMD of the lumbar spine (L), femoral neck and forearm was determined in all patients, using DEXA, before and 12 months after treatment. Bone marrow expansion was assessed by the measurement of sTfR and Epo serum levels, using an ELISA methodology (R&D Systems, Minneapolis, MN, USA), before and 12 months post zoledronic acid or placebo administration. In all patients markers of bone remodelling, such as C-telopeptide of collagen type-I (CTX) and bone specific alkaline phosphatase (bALP) were also measured by ELISA (Nordic Bioscience Diagnostics, Herlev, Denmark, and Quidel, San Diego, CA, USA, respectively). Patients were asked to quantify their degree of bone pain on Huskisson’s visual analogue scale and the McGill-Melzack scoring system before and 12 months post-therapy. All patients had increased values of sTfR, Epo, CTX, and bALP compared with 40 controls of similar age and gender (p<0.001). Patients who received zoledronic acid showed a significant increase in their L-BMD (p=0.01), which was accompanied by a dramatic reduction in CTX and bALP values ((p<0.001). There was no difference in terms of L-BMD changes between zoledronic acid groups. Placebo group showed an aggravation of L-BMD (p=0.041) and markers of bone remodelling at 12 months. No other changes were observed in the BMD of other sites. Zoledronic acid reduced bone pain, which remained stable in placebo group during the study period. There was only weak correlation between baseline sTfR levels and L-BMD, while there was no correlation between Epo or hemolytic parameters (indirect bilirubin, reticulocytes counts, and LDH) with BMD of all studied sites. Serum sTfR and Epo values showed a significant elevation after 12 months of therapy in all studied groups (p<0.01, p<0.02, and p<0.01, respectively); this elevation was irrespective of the L-BMD changes. This study suggests that the increase of BMD produced by zoledronic acid in TI is irrespective of the continuous increase of bone marrow expansion, which is considered a major cause of bone loss in this hemoglobinopathy.

scholarly journals Effect of Zoledronic Acid on Bone Mineral Density in Men with Prostate Cancer Receiving Gonadotropin-Releasing Hormone Analog

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Anoop Kapoor ◽  
Ankur Gupta ◽  
Nilay Desai ◽  
Hongshik Ahn
Keyword(s):  
Prostate Cancer ◽  
Bone Mineral Density ◽  
Placebo Group ◽  
Zoledronic Acid ◽  
Bone Turnover ◽  
Acid Group ◽  
Gonadotropin Releasing Hormone ◽  
Mineral Density ◽  
Hormone Analog ◽  
Markers Of Bone Turnover

Background. Loss of bone density with androgen deprivation therapy for prostate cancer is well recognized. We assessed the effects of quarterly infusion of zoledronic acid on bone mineral density (BMD) and markers of bone turnover over a one-year period in men receiving gonadotropin-releasing hormone analog (GnRH-a) for prostate cancer.Methods. 41 subjects were randomly assigned to treatment with zoledronic acid (4 mg) IV infusion or placebo every 3 months. The primary endpoint was the change in the lumbar spine BMD after 12 months of treatment.Results. The change in vertebral BMD in the zoledronic acid group () was significantly () greater than the change in the placebo group () as was the change in left femoral neck BMD ( for the zoledronic acid group versus for the placebo group). The decrease in biochemical markers of bone turnover was significantly () greater in the zoledronic acid group compared to the placebo group.Conclusion. Quarterly infusion of zoledronic acid for 1 year improved vertebral and left femoral neck BMD with a decrease in bone turnover markers in men on GnRH-a treatment. Zoledronic acid treatment appears to be promising in men with low BMD receiving GnRH-a treatment.

The Cambridge Cognitive Examination (CAMCOG): A validation study in outpatients suffering from dementia and non-demented elderly subjects (including Age Associated Cognitive Decline patients) in Greece

2000 ◽  
Vol 15 (5) ◽  
pp. 269-276 ◽  
Author(s):  
Magda Tsolaki ◽  
Konstantinos N. Fountoulakis ◽  
Helen Chantzi ◽  
Aristides Kazis
Keyword(s):  
Cognitive Function ◽  
Rural Areas ◽  
Social Background ◽  
Educational Status ◽  
The Elderly ◽  
Elderly Subjects ◽  
Greek Version ◽  
Study Results ◽  
Function Impairment ◽  
Uncertainty Zone

Introduction: The Cambridge Cognitive Examination for the elderly (CAMCOG) was first published in 1986 as a reliable instrument for the study of patients with cognitive function impairment. Objective: To standardize the Greek version of CAMCOG. Setting: Dementia Outpatient Clinic, 3rd Department of Neurology, Aristotle University of Thessaloniki. Participants: 150 nondemented controls and 100 patients suffering from mild to severe dementia of various types took part in the study. Results: CAMCOG manifests Cronbach's alpha=0.93. In the group of patients under 75, sensitivity (Sn) is 90.00 percent at the level of 76/77 and specificity is 91.89 percent at the level of 70/71. The respective scores for the group of patients over 74 are 68/69 (Sn=90.00 percent) and 60/61 (Sp=92.30 percent). It seems that CAMCOG shows an “uncertainty zone” in both groups between the scores of 71 to 76 for the first group and of 61 to 68 for the second. The MMSE cut-off point, for the two groups are 23/24 (Sn=94.28 percent, Sp=90.99 percent) and 22/23 (Sn=96.60 percent, Sp=94.87 percent), respectively. Conclusion: The Greek version of CAMCOG manifests different properties than the original British Version. This is probably due to differences in education and social background (e.g., cultural isolation of rural areas). MMSE performs better than CAMCOG mainly because diagnosis is based on the assessment of fundamental aspects of cognitive function, which is reflected in MMSE in a way that is less affected by the mental or educational status of the subject.

scholarly journals Radiographic predictors for bone mineral loss

2018 ◽  
Vol 7 (7) ◽  
pp. 468-475 ◽  
Author(s):  
Q-F. He ◽  
H. Sun ◽  
L-Y. Shu ◽  
Y. Zhu ◽  
X-T. Xie ◽  
...  
Keyword(s):  
Bone Mineral ◽  
Distal Femur ◽  
Osteoporotic Fractures ◽  
The Elderly ◽  
The Body ◽  
Screening Tools ◽  
Mineral Density ◽  
T Score ◽  
Bone Mineral Loss ◽  
Mineral Loss

Objectives Researchers continue to seek easier ways to evaluate the quality of bone and screen for osteoporosis and osteopenia. Until recently, radiographic images of various parts of the body, except the distal femur, have been reappraised in the light of dual-energy X-ray absorptiometry (DXA) findings. The incidence of osteoporotic fractures around the knee joint in the elderly continues to increase. The aim of this study was to propose two new radiographic parameters of the distal femur for the assessment of bone quality. Methods Anteroposterior radiographs of the knee and bone mineral density (BMD) and T-scores from DXA scans of 361 healthy patients were prospectively analyzed. The mean cortical bone thickness (CBTavg) and the distal femoral cortex index (DFCI) were the two parameters that were proposed and measured. Intra- and interobserver reliabilities were assessed. Correlations between the BMD and T-score and these parameters were investigated and their value in the diagnosis of osteoporosis and osteopenia was evaluated. Results The DFCI, as a ratio, had higher reliability than the CBTavg. Both showed significant correlation with BMD and T-score. When compared with DFCI, CBTavg showed better correlation and was better for predicting osteoporosis and osteopenia. Conclusion The CBTavg and DFCI are simple and reliable screening tools for the prediction of osteoporosis and osteopenia. The CBTavg is more accurate but the DFCI is easier to use in clinical practice. Cite this article: Q-F. He, H. Sun, L-Y. Shu, Y. Zhu, X-T. Xie, Y. Zhan, C-F. Luo. Radiographic predictors for bone mineral loss: Cortical thickness and index of the distal femur. Bone Joint Res 2018;7:468–475. DOI: 10.1302/2046-3758.77.BJR-2017-0332.R1.

scholarly journals Zoledronic acid versus placebo in pediatric glucocorticoid-induced osteoporosis: A randomized double-blind phase 3 trial

2021 ◽  
Author(s):  
Leanne M Ward ◽  
Anup Choudhury ◽  
Nathalie Alos ◽  
David A Cabral ◽  
Celia Rodd ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Least Squares ◽  
Osteoporotic Fractures ◽  
Z Score ◽  
Mineral Density ◽  
Phase 3 ◽  
Double Blind ◽  
Acid Versus ◽  
One Year ◽  
Pediatric Illnesses

Abstract Context Glucocorticoids (GC) prescribed for chronic pediatric illnesses are associated with osteoporotic fractures. Objective To determine the efficacy and safety of intravenous (IV) zoledronic acid (ZA) compared with placebo to treat pediatric GC-induced osteoporosis (GIO). Patients, Design and Setting Children 5-17 years of age with GIO were enrolled in this multi-national randomized, double-blind, placebo-controlled phase 3 trial (ClinicaTrials.gov NCT 00799266). Interventions and Main Outcome Measures Eligible children were randomized 1:1 to six monthly IV ZA 0.05 mg/kg or IV placebo. The primary endpoint was the change in lumbar spine bone mineral density Z-score (LSBMDZ) from baseline to month 12. Incident fractures and safety were assessed. Results Thirty-four children were enrolled (mean age 12.6 ± 3.4 years [18 on ZA, 16 on placebo]), all with low-trauma vertebral fractures. LSBMDZ increased from −2.13 ± 0.79 to −1.49 ± 1.05 on ZA, compared with −2.38 ± 0.90 to −2.27 ± 1.03 on placebo (least squares means difference 0.41 [95% confidence interval 0.02, 0.81; p=0.04]); when corrected for height Z-score, the least squares means difference in LBMDZ was 0.75 [0.27, 1.22; p=0.004]. Two children on placebo had new low-trauma VF versus none on ZA. Adverse events (AEs) were reported in 15/18 children (83%) on ZA, and in 12/16 (75%) on placebo, most frequently within 10 days after the first infusion. There were no deaths, nor treatment discontinuations due to treatment-emergent AEs. Conclusions LSBMDZ increased significantly on ZA compared with placebo over one year in children with GIO. Most AEs occurred after the first infusion.

scholarly journals Components of Elderly Long-term Care System in Iran and Selected Countries: A Comparative Study

Health Scope ◽  
2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Shabnam Ghasemyani ◽  
Mehdi Jafari ◽  
Ahmad Ahmadi Teymourlouy ◽  
Reza Faday-Vatan
Keyword(s):  
Developing Countries ◽  
Comparative Study ◽  
Health System ◽  
Long Term Care ◽  
The Elderly ◽  
Developed Countries ◽  
Term Care ◽  
Study Results ◽  
The Subject

Context: With the increasing number of the elderly suffering from chronic diseases and disabilities, elderly long-term care (LTC) has been the subject of attention by health and welfare policymakers. This study aimed to compare the components of LTC for the elderly in Iran and selected countries. Methods: This comparative study was conducted in 2020. The search was conducted in three databases (PubMed, Scopus, and Web of Science), two search engines (Google Scholar and Google), and the websites of WHO and the Ministry of Health and Welfare of the selected countries from 2000 to 2020 to find relevant documents on the subject. The selection of countries was based on three criteria: the type of health system, having the highest percentage of the elderly population, and the development status. Finally, Germany, France, Sweden, Japan, South Korea, Turkey, Thailand, and Iran were included in the study. The findings were organized using a common LTC framework. Results: In this study, the common framework of LTC systems, including beneficiaries, benefits packages, providers, and financing, was used. The study results showed that developed countries had formal LTC systems with specific mechanisms, but each country had differences in the implementation of different components of this system. On the other hand, in most developing countries, sporadic measures were taken in this field. Conclusions: In general, developed countries have adopted different LTC system approaches in the organization, financing, type of services, and generosity of benefits. In choosing the appropriate LTC model in developing countries, factors such as the health system, resource constraints, social, and cultural status should be considered.

scholarly journals Associations of IDUA and PTCH1 with Bone Mineral Density, Bone Turnover Markers, and Fractures in Chinese Elderly Patients with Osteoporosis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Qifei Wang ◽  
Chong Tang ◽  
Junxiu Jia ◽  
Guangwu Zhang ◽  
Zheng Liu
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Osteoporotic Fractures ◽  
The Elderly ◽  
Mineral Density ◽  
Chi Square ◽  
Genotype Frequencies ◽  
Elderly Chinese ◽  
Chi Square Test ◽  
Turnover Markers

Introduction. Osteoporosis (OP) is a common polygenic disorder in the aging population, and several single nucleotide polymorphisms (SNPs) in the alpha-L-iduronidase (IDUA) gene and patched homolog 1 (PTCH1) gene regulate bone metabolism and affect bone mass. The study aimed at investigating the relationships of rs3755955 and rs6831280 in the IDUA gene and rs28377268 in the PTCH1 gene with bone mineral density (BMD), bone turnover markers (BTMs), and fractures in the elderly Chinese subjects with OP. Materials and Methods. A cohort of 328 unrelated senile osteoporosis (SOP) patients with or without osteoporotic fractures was recruited. rs3755955, rs6831280, and rs28377268 polymorphisms were identified using SNaPshot technology. BTM levels were determined by electrochemiluminescence (ECL). Bone mineral densities (BMDs) at the lumbar spine (LS) and proximal femur sites were measured by dual-energy X-ray absorptiometry (DEXA) in all subjects. The Hardy-Weinberg equilibrium (HWE) test was performed. HWE P values and comparisons of genotype frequencies were estimated using the chi-square test. Analysis of covariance (ANCOVA) adjusted for confounding factors was performed to investigate associations of SNPs with BMDs and BTMs in subgroups. Results. The chi-square test indicated that genotype distributions in the control group conformed to HWE (P>0.05). The distributions of allele and genotype frequencies of rs6831280 between fracture and osteoporotic participants were significantly different (P-allele=0.002 and P-genotype=0.012, respectively). Concerning rs6831280, ANCOVA found BMDs at LS 2-4 (L2-4) and total hip (TH) among the study subjects suffering from SOP with GA genotype were lower than in those carrying GG or AA (P-L2-4=0.004 and P-TH=0.027, respectively). Conclusions. IDUA rs6831280 is associated with BMDs at L2-4 and TH in the elderly Chinese population with SOP and may serve as a marker for the genetic susceptibility to osteoporotic fractures.

scholarly journals In the choice between health and money, health comes first: an analysis of happiness among rural Chilean elderly

2016 ◽  
Vol 32 (5) ◽  
Author(s):  
German Lobos ◽  
Maria del Carmen Lapo ◽  
Berta Schnettler
Keyword(s):  
Rural Areas ◽  
Regression Models ◽  
The Elderly ◽  
Demographic Variables ◽  
Subjective Happiness ◽  
Central Chile ◽  
Logistic Regression Models ◽  
Study Results ◽  
The Relationship ◽  
Demographic Context

Abstract: We studied the relationship between happiness and individual socio-demographic context and health and dietary variables by interviewing 389 elderly individuals (age 60-90 years) living in rural areas in the Maule Region of Central Chile. The Lyubomirsky & Lepper (1999) subjective happiness scale was used. Ordinal logistic regression models were estimated. The discrete dependent variable was level of happiness. The following variables were significantly associated with happiness: (1) individual socio-demographic variables like age and satisfaction with the economic situation; (2) health variables like independence in activities of daily living, common activities, and self-rated health; and (3) dietary variables such as life satisfaction related to food and the frequency with which the elders shared dinner with others. The study results suggest more efficient efforts at healthy eating for the elderly in rural areas.

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