scholarly journals Treatment of postmenopausal osteoporosis in women: a systematic review

2008 ◽  
Vol 24 (suppl 4) ◽  
pp. s592-s606 ◽  
Author(s):  
Cristina Mariano Ruas Brandão ◽  
Marina Guimarães Lima ◽  
Anderson Lourenço da Silva ◽  
Graziele Dias Silva ◽  
Augusto Afonso Guerra Jr. ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Fractures ◽  
Randomized Clinical Trials ◽  
Hormone Replacement ◽  
National Health System ◽  
Public Health Problem ◽  
The Elderly ◽  
Inclusion Criteria ◽  
Mineral Density ◽  
Treatment Of Osteoporosis

Osteoporosis, a typical disease of the elderly, has become a frequent and relevant public health problem. Several drugs are available for treatment of osteoporosis, some of which are currently dispensed by the Brazilian Unified National Health System. The objective of this study was to present a systematic review of drugs for treatment of osteoporosis, focusing on the adequacy of clinical protocols based on existing evidence in the scientific literature. We conducted a search for randomized clinical trials in PubMed and LILACS that presented results for bone mineral density, incidence of vertebral fractures, and adverse effects. 32 articles met the review's inclusion criteria. Bisphosphonates were reported to have consistently reduced the risk of vertebral fractures. Hormone replacement therapy showed positive outcomes, but its use has been found to increase the risk of cardiovascular disease and breast cancer. Teriparatide and monofluorophosphate also showed efficacy against osteoporosis. Calcium and vitamin D were given to patients as food supplements.

scholarly journals Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

2020 ◽  
pp. 1-16
Author(s):  
David M. Robinson ◽  
Christine Eng ◽  
Steven Makovitch ◽  
Joshua B. Rothenberg ◽  
Stephanie DeLuca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Inclusion Criteria ◽  
Serious Adverse Events ◽  
Bias Risk ◽  
Glenohumeral Osteoarthritis ◽  
Functional Outcome Measures

BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.

scholarly journals Physical exercise, IGF-1 and cognition A systematic review of experimental studies in the elderly

2018 ◽  
Vol 12 (2) ◽  
pp. 114-122 ◽  
Author(s):  
Angelica Miki Stein ◽  
Thays Martins Vital Silva ◽  
Flávia Gomes de Melo Coelho ◽  
Franciel José Arantes ◽  
José Luiz Riani Costa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Longitudinal Studies ◽  
Web Of Science ◽  
Experimental Studies ◽  
The Elderly ◽  
Inclusion Criteria ◽  
Exercise Induced ◽  
Assessment Results

ABSTRACT One of hypothetical mechanisms related to cognition is exercise-induced IGF-1. Objective: The aim of this study was to analyze the effects of exercise on IGF-1 levels and cognition in the elderly. Methods: The article searches were conducted on Pubmed, Web of Science, PsycINFO and Scielo databases and reviewed according to PRISMA guidelines. The inclusion criteria were: [1] original articles published up to 2017; [2] samples including elderly; [3] protocols including physical exercise; [4] longitudinal studies having exercise as main outcome; [5] assessment of IGF-1; [6] cognition assessment. Results: Seven studies were included in this review. Three of the studies showed an exercise-induced increase in IGF-1; three found stable IGF-1 levels and one found a reduction in IGF-1; with and without improvement in cognition. Conclusion: Disparities in the type of physical exercise, protocols and samples under different conditions hinder the establishment of a consensus on IGF-1, cognition and physical exercise.

scholarly journals Predictive Factors for the First Recurrence of Clostridioides difficile Infection in the Elderly from Western Romania

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 439
Author(s):  
Iosif Marincu ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Bianca Cerbu ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Predictive Factors ◽  
Gastrointestinal Disease ◽  
National Health System ◽  
Public Health Problem ◽  
The Elderly ◽  
Control Group ◽  
The European Union ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Background and objectives: At present, Romania and parts of the European Union are facing an increasingly challenging public health problem consisting of nosocomial Clostridioides difficile infection (CDI), mostly in the elderly. Relapse cases have become more frequent, which present higher morbidity and mortality rates than the initial CDI infection. The aim of this study is to determine the predictive factors for recurrence, with the purpose of reducing the exposure of patients diagnosed with CDI, as well as aiming to initiate early treatment. Materials and Methods: In this retrospective descriptive study, we analyze a database from the First Department of Infectious Diseases at the Dr. Victor Babes Clinical Hospital for Infectious Diseases and Pulmonology in Timisoara, looking for patient history of CDI recurrences. We analyzed CDI recurrence in patients aged ≥65 years from 1 January 2016 to 31 December 2019, identifying 77 cases of CDI recurrence. The determination of predictive factors for recurrence involved the formation of a randomized control group, consisting of 74 patients aged ≥65 years who were diagnosed with C. difficile enterocolitis, but did not suffer a recurrence and survived ≥2 weeks after symptom onset. Results: Immunocompromised status, pre-existing gastrointestinal disease, and fever on initial hospitalization for CDI were all found to be significant independent positive predictive factors for the condition recurring in elderly Romanian patients. Conclusions: As the geriatric population in Romania grows, the national health system becomes increasingly overburdened, both from a financial standpoint and a human resources perspective. The analysis of factors predictive for CDI recurrence is, thus, of the utmost importance, particularly for the early identification of patients most at risk of CDI recurrence. Our findings could help physicians to identify recurrence early, consequently benefitting patients by a rapid intervention with a potential decrease in the associated complications and mortality.

Non HRT Options for the Treatment of Osteoporosis

1998 ◽  
Vol 4 (3) ◽  
pp. 96-101
Author(s):  
Michael Davies
Keyword(s):  
Vitamin D ◽  
Vertebral Fracture ◽  
Bone Fractures ◽  
The Elderly ◽  
Long Bone ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Supplemental Calcium ◽  
Treatable Condition

Osteoporosis is now a treatable condition with an abundance of evidence for the efficacy of certain therapeutic strategies in preventing recurrent fractures. Most of these treatments act by improving bone mineral density through inhibition or reduction of bone resorption. For those women who are unable to take HRT; bisphosphonates, calcium, vitamin D, calcitriol or calcitonin may confer certain benefits. The bisphosphonate alendronate reduces both vertebral and long bone fractures, an effect seen soon after starting treatment. The changes in BMD and fracture reduction are less with the use of etidronate but it is certainly beneficial in reducing recurrent vertebral fracture. In the elderly calcium and vitamin D in combination can reduce non-vertebral and hip fracture and supplemental calcium of 1 g/day has been predicted to reduce bone loss and thus hip fractures by 22%. Evidence that calcitriol or calcitonin reduce fracture incidence is not good but calcitonin has been shown to have analgesic properties in those with acute vertebral fracture. The role of calcitriol is less certain and should be reserved for women with vertebral fractures in whom HRT or bisphosphonates cannot be used.

scholarly journals The Role of Spinal Orthoses in Osteoporotic Vertebral Fractures of the Elderly Population (Age 60 Years or Older): Systematic Review

2020 ◽  
pp. 219256822094803
Author(s):  
Barry Ting Sheen Kweh ◽  
Hui Qing Lee ◽  
Terence Tan ◽  
Joost Rutges ◽  
Travis Marion ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Vertebral Fractures ◽  
Postural Stability ◽  
Elderly Population ◽  
The Elderly ◽  
Functional Improvement ◽  
Osteoporotic Vertebral Fractures ◽  
Spinal Orthoses

Study Design: Systematic review. Objective: Spinal orthoses have been generally used in the management of osteoporotic vertebral fractures in the elderly population with purported positive biomechanical and functional effects. To our knowledge, this is the first systematic review of the literature examining the role of spinal orthoses in osteoporotic elderly patients who sustain low energy trauma vertebral fractures. Methods: A systematic literature review adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Methodical searches utilizing MEDLINE, EMBASE, Google Scholar, and Cochrane Databases was performed. Results: Of the 2019 articles initially retrieved, 7 published articles (4 randomized controlled trials and 3 prospective cohort studies) satisfied the inclusion criteria. Five studies reported improvement in quantitative measurements of spinal column stability when either a rigid or semirigid orthosis was used, while 1 study was equivocal. The studies also showed the translation of biomechanical benefit into significant functional improvement as manifested by improved postural stability and reduced body sway. Subjective improvement in pain scores and quality of life was also noted with bracing. Conclusion: The use of spinal orthoses in neurologically intact elderly patients aged 60 years and older with osteoporotic compression vertebral fractures results in improved biomechanical vertebral stability, reduced kyphotic deformity, enhanced postural stability, greater muscular strength and superior functional outcomes.

scholarly journals EFFECT OF PILATES METHOD ON PHYSICAL FITNESS RELATED TO HEALTH IN THE ELDERLY: A SYSTEMATIC REVIEW

2019 ◽  
Vol 25 (1) ◽  
pp. 76-87
Author(s):  
Gabrielle Critine Moura Fernandes Pucci ◽  
Eduardo Borba Neves ◽  
Francisco José Félix Saavedra
Keyword(s):  
Systematic Review ◽  
Physical Fitness ◽  
The Elderly ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Quasi Experimental ◽  
Pilates Method ◽  
Functional Autonomy ◽  
Selection Of

ABSTRACT The objective of this review was to analyze the evidence of Pilates in physical fitness related to health in the elderly. The article indexing databases (Pubmed, Medline, Science Direct, Scielo, Lilacs, and Cochrane) were reviewed along with the Pilates, elderly and aging descriptors. A total of 41 studies with a randomized experimental and quasi-experimental design met the inclusion criteria. The selection of the studies was carried out by two researchers and the quality of the articles was assessed using the PEDro scale. Interventions ranged from 4-24 weeks with 1-3 sessions/week, and balance was the most investigated variable. The studies included in this review indicate that Pilates improves health status in the elderly, promoting gains in balance, muscle strength, flexibility, functional autonomy, muscular endurance, body composition and aerobic endurance. Despite these findings, some variables need to be further investigated. Level of Evidence II; Systematic review.

scholarly journals Prevalence and incidence of osteoporotic fractures in patients on long-term glucocorticoid treatment for rheumatic diseases: the Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) study

Reumatismo ◽  
2017 ◽  
Vol 69 (1) ◽  
pp. 30 ◽  
Author(s):  
M. Rossini ◽  
O. Viapiana ◽  
M. Vitiello ◽  
N. Malavolta ◽  
G. La Montagna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fractures ◽  
Chronic Treatment ◽  
Randomized Clinical Trials ◽  
Real Life ◽  
Connective Tissue Diseases ◽  
Specific Treatment ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Glucocorticoid Treatment

Osteoporosis and fractures are common and invalidating consequences of chronic glucorticoid (GC) treatment. Reliable information regarding the epidemiology of GC induced osteoporosis (GIOP) comes exclusively from the placebo group of randomized clinical trials while observational studies are generally lacking data on the real prevalence of vertebral fractures, GC dosage and primary diagnosis. The objective of this study was to evaluate the prevalence and incidence of osteoporotic fractures and to identify their major determinants (primary disease, GC dosage, bone mineral density, risk factors, specific treatment for GIOP) in a large cohort of consecutive patients aged >21 years, on chronic treatment with GC (≥5 mg prednisone - PN - equivalent) and attending rheumatology centers located all over Italy. Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) is a national multicenter cross-sectional and longitudinal observational study. 553 patients suffering from Rheumatoid Arthritis (RA), Polymyalgia Rheumatica (PMR) and Connective Tissue Diseases (CTDs) and in chronic treatment with GCs were enrolled. Osteoporotic BMD values (T score <-2.5) were observed in 28%, 38% and 35% of patients with CTDs, PMR or RA at the lumbar spine, and in 18%, 29% and 26% at the femoral neck, respectively. Before GC treatment, prevalent clinical fractures were reported by 12%, 37% and 17% of patients with CTDs, PMR, or RA, respectively. New clinical fragility fractures during GC treatment were reported by 12%, 10% and 23% of CTDs, PMR and RA patients, respectively. Vertebral fractures were the prevailing type of fragility fracture. More than 30% of patients had recurrence of fracture. An average of 80% of patients were in supplementation with calcium and/or vitamin D during treatment with GCs. Respectively, 64%, 80%, and 72% of the CTDs, PMR and RA patients were on pharmacological treatment for GIOP, almost exclusively with bisphosphonates. The GIOTTO study might provide relevant contributions to clinical practice, in particular by highlighting and quantifying in real life the prevalence of GIOP and relative fractures, the frequency of the main risk factors, and the currently sub-optimal prevention. Moreover, these results emphasize the importance of the underlying rheumatic disease on the risk of GIOP associated fractures.

scholarly journals The Effects of Nonpharmacological Treatment on Uremic Pruritus Patients: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Chiu-Feng Wu ◽  
Ya-Chu Hsiao ◽  
Pi-Chen Ko
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Inclusion Criteria ◽  
Uremic Pruritus ◽  
Jadad Scale ◽  
Analysis And Synthesis ◽  
Nonpharmacological Treatments

Background. Around 50–90% of hemodialysis patients develop pruritus. Although studies examining nonpharmacological treatments for itchy skin have been conducted, the conclusions have not been decisive. Purpose. Through a systematic review of the literature, this study aimed to understand nonpharmacological interventions carried out in clinical trials for uremic pruritus and to evaluate and consolidate the information regarding these improvements and their effectiveness. Methods. A literature search focusing on studies published between January 2004 and December 2013 was conducted from 5 electronic databases. After screening based on inclusion criteria and excluding duplicates, nonpharmacological treatments examined in randomized clinical trials were selected for further analysis and synthesis. A modified Jadad scale was used to evaluate the quality of the identified articles. Results. Seven nonpharmacological studies met the inclusion criteria. The interventions to improve uremic pruritus included using emollients, phototherapy, acupuncture, and thermal therapy. Research showed that using emollients, phototherapy, and acupuncture significantly reduces uremic pruritus. Conclusion. Nonpharmacological interventions are effective for hemodialysis patients with pruritus. Emollients were found to provide the most relief compared to the other methods and constitute a readily available and cost-effective intervention to improve pruritus symptoms.

scholarly journals The Effects of Physical Exercise on Balance and Prevention of Falls in Older People: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (8) ◽  
pp. 2595 ◽  
Author(s):  
Giuseppe Francesco Papalia ◽  
Rocco Papalia ◽  
Lorenzo Alirio Diaz Balzani ◽  
Guglielmo Torre ◽  
Biagio Zampogna ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Exercise ◽  
Randomized Clinical Trials ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Elderly ◽  
Risk Of Bias ◽  
Number Of Patients

The aims of this systematic review and meta-analysis were to evaluate the effects of physical exercise on static and dynamic balance in the elderly population, and to analyze the number of falls and fallers. A systematic literature search was conducted using PubMed–Medline, Cochrane Central, and Google Scholar to select randomized clinical trials that analyzed the role of exercise on balance and fall rate in patients aged 65 or older. Sixteen articles were included in this review. Applying the Cochrane risk-of-bias tool, three studies were determined to be at low risk of bias, nine at unclear risk of bias, and four at high risk of bias. The meta-analysis showed improvements in dynamic balance (p = 0.008), static balance (p = 0.01), participants’ fear of falling (p = 0.10), balance confidence (p = 0.04), quality of life (p = 0.08), and physical performance (p = 0.30) in patients who underwent physical exercise compared to controls. The analysis of the total numbers of falls showed a decreased likelihood of falls in patients who participated in exercise programs (p = 0.0008). Finally, the number of patients who fell at least once was significantly reduced in the intervention group (p = 0.02). Physical exercise is an effective treatment to improve balance and reduce fall rates in the elderly.

Sign in / Sign up

Export Citation Format

Share Document