scholarly journals The problem of low adherence to antiresorptive therapy with bisphosphonates: solutions

2022 ◽  
pp. 175-180
Author(s):  
O. V. Yakushevskaya
Keyword(s):  
Cost Effective ◽  
Rehabilitation Program ◽  
Antiresorptive Therapy ◽  
Mineral Density ◽  
Osteoporosis Therapy ◽  
Treatment Of Osteoporosis ◽  
Demographic Situation ◽  
Natural Result

Over the past several decades, there has been a global aging of the population around the world. The demographic situation in the Russian Federation is no exception, being a natural result of an increase in the life expectancy of the population. In clinical practice, geriatric diseases have been identified and are widely studied, which deserve priority attention due to a sharp decline in the quality of life of elderly patients. Osteoporosis is called a “silent epidemic” among elderly and senile patients. This disease is associated with a high risk of low-traumatic fractures of various localization. The imperfect rehabilitation program after complex fractures and its insufficient funding are forcing clinicians to focus on more cost-effective solutions to this problem  – the  prevention and treatment of  osteoporosis. Osteomodifying agents are widely used by physicians of  various specialties. Bisphosphonates effectively reduce the risk of low-traumatic fractures against the background of an increase in bone mineral density. The  level of  effectiveness of  bisphosphonates depends on the  patient’s adherence to antiresorptive therapy and the degree of compensation for vitamin D and serum calcium. Low adherence to osteoporosis therapy is based on the need for long-term use of bisphosphonates and a different spectrum of adverse events. In the article, using alendronate as an example, the problem of low adherence to antiresorptive therapy will be considered and ways to solve it are presented.

scholarly journals Glucocorticoid-induced osteoporosis in systemic lupus erythematosus

2018 ◽  
Vol 3 ◽  
pp. 205990211880251
Author(s):  
Kee Fong Phang ◽  
Jiacai Cho ◽  
Weixian Lee ◽  
Anselm Mak
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Bone Health ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Treatment Of Osteoporosis ◽  
Improvement In Survival ◽  
Prevalence Of Osteoporosis

Improvement in survival of systemic lupus erythematosus has been brought about with new advancement in treatment. However, glucocorticoids remain the sole cornerstone and as patients live longer, there is a need to address long-term complications brought by long-term glucocorticoid use such as osteoporosis. In this review, glucocorticoid-induced osteoporosis in systemic lupus erythematosus will be extensively discussed. This would include prevalence of osteoporosis in systemic lupus erythematosus patients, the difficulties in measuring fracture risk and pitfalls in using conventional methods such as bone mineral density. In addition, the mechanism of actions of glucocorticoids and evidence for glucocorticoids in the treatment of specific systemic lupus erythematosus manifestations would be explored and we also discussed specific pathophysiological mechanisms in the development of glucocorticoid-induced osteoporosis in systemic lupus erythematosus. We also reviewed the latest guidelines in the treatment of glucocorticoid-induced osteoporosis and the evidence for various osteoporosis medications. Finally, we recommend an approach in monitoring bone health and the treatment of osteoporosis specifically in systemic lupus erythematosus patients.

scholarly journals INNOVATIVE STRATEGIES AS A PROSPECTIVE DIRECTION OF PLANNING ACTIVITIES OF HOTEL AND RESTAURANT ENTERPRISES OF UKRAINE

2021 ◽  
Author(s):  
Ljudmila Neshchadym ◽  
Svetlana Тymchuk
Keyword(s):  
Internal State ◽  
Cost Effective ◽  
Restaurant Industry ◽  
Product Portfolio ◽  
Innovative Strategies ◽  
Reducing Costs ◽  
Fierce Competition ◽  
High Level

The article monitors and analyzes the main strategies for the development of hotel and restaurant enterprises and, accordingly, increase their efficiency and competitiveness; the process of organization and economic planning of hotel and restaurant enterprises has been improved. It is investigated that the enterprises of hotel and restaurant industry of Ukraine partially provide the necessary quality indicators for the provided services, and this is the reason for the insufficient level of competitiveness of services in the domestic market and in European countries. An urgent problem of planning and organizing the activities of hotel and restaurant enterprises is the use of innovative strategies and areas of long-term development to increase the level of competitiveness and quality of services provided. This will intensify innovation processes in Ukraine in the field of services. Innovative strategies and promising areas of development of hotel and restaurant enterprises are extremely important in the management of hotel and restaurant complexes. Innovative strategies in the hotel and restaurant industry are cost-effective and feasible provided a high level of profitability, improving the service process, expanding the range of services, reducing costs, increasing competitiveness, improve and optimize the work of all hotel or restaurant services. The application of innovative strategies in the process of hotel and restaurant enterprises allows them to compete in the field of service. In conditions of fierce competition and rapidly changing market conditions, it is very important not only to focus on the internal state of affairs of the enterprise, but also to develop a long-term strategy. Economic activity requires constant innovation. All services offered by hotel and restaurant enterprises must be introduced in modern innovative ways. This is the basis for successful business, maintaining a consistently high level of competitiveness and improving the quality of service. The selection of the optimal innovation strategy for a hotel or restaurant company is carried out by its management based on the analysis of key factors that characterize its condition and the state of the product portfolio.

scholarly journals Sarcopenia, obesity, osteoporosis and old age

2021 ◽  
Vol 11 (4) ◽  
pp. 23-35
Author(s):  
S. V. Topolyanskaya
Keyword(s):  
Body Composition ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Mineral Density ◽  
Term Care ◽  
Visceral Fat Accumulation ◽  
Age Related ◽  
Diagnostic Approaches

Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.

The economic benefits of rehabilitation for neurological conditions

2020 ◽  
pp. 23-30
Author(s):  
Rory J. O’Connor
Keyword(s):  
Psychological Functioning ◽  
Cost Effective ◽  
Economic Benefits ◽  
Economic Evaluations ◽  
Healthcare Intervention ◽  
Effective Interventions ◽  
Neurological Conditions ◽  
Economic Analyses

Rehabilitation programmes are highly cost-effective interventions that restore people’s independence, dignity, and quality of life. In the past there was an impression that they appeared expensive, which resulted in a lack of enthusiasm to develop them by funding bodies and commissioners. However, the evidence demonstrating the long-term cost-effectiveness of rehabilitation is robust. Many people with long-term neurological conditions will live for many years after the onset of the condition and investment in their physical and psychological functioning early on will, over that person’s lifetime, will result in substantial savings. Nevertheless, calculating economic evaluations can be complicated and the correct measure must be chosen to identify the change produced by the rehabilitation intervention. These data must then be handled appropriately, and any ancillary costs included. The economic impact of the rehabilitation programme is wider than a purely healthcare intervention and will include potential earnings and reduced costs to social care. The economic analyses will also include housing, education, and vocational outcomes, and the effect of the long-term condition on family members who may have a caring role.

The Role of Novel Bone Forming Agents in the Treatment of Osteoporosis

2020 ◽  
pp. 089719002096122
Author(s):  
Hansita B. Patel ◽  
Lynsie J. Lyerly ◽  
Cheryl K. Horlen
Keyword(s):  
Elderly Population ◽  
Cost Effective ◽  
The Elderly ◽  
Bisphosphonate Therapy ◽  
Evidence Based ◽  
First Line ◽  
Treatment Of Osteoporosis ◽  
Cost Effective Treatment

Osteoporosis is a growing epidemic that leads to significant morbidity and mortality among the elderly population due to associated fractures that lead to disabilities and reduced quality of life. Bisphosphonates are well-established as a first-line and cost-effective treatment for osteoporosis. Unfortunately, clinicians are often uncertain as to how to select treatments when bisphosphonates are ineffective as initial treatment or contraindicated. Romosozumab and abaloparatide are 2 alternative agents that have been recently FDA approved for the treatment of osteoporosis in postmenopausal women at high risk for fracture or patients who have failed or are intolerant to other osteoporosis therapies. Currently, the National Osteoporosis Foundation (NOF) has no formal recommendations in regard to these 2 novel agents. The purpose of this review is to help guide pharmacists on how to ensure appropriate utilization of these 2 novel bone-forming agents as potential alternatives to bisphosphonate therapy by providing evidence-based recommendations according to the current literature and key counseling points.

Rail Highway Grade Crossing Roughness Quantitative Measurement Using 3D Technology

2014 ◽  
Author(s):  
Teng (Alex) Wang ◽  
Reginald R. Souleyrette ◽  
Daniel Lau ◽  
Peng Xu
Keyword(s):  
Quantitative Method ◽  
Cost Effective ◽  
Actual Condition ◽  
Subjective Rating ◽  
3D Surface ◽  
Grade Crossing ◽  
Long Term Performance ◽  
Term Performance

Quality of surface is an important aspect affecting both the safety and the performance of at-grade rail-highway crossings. Roughness may increase the risk of crashes for both trains and automobiles. Varying grades in crossing profiles increase the likelihood of high-centered crossing collisions between train and truck [1]. The US DOT Railroad Highway Grade Crossing Handbook [2] suggests that rough surfaces could distract a driver’s attention from oncoming trains and that the unevenness of the crossing could result in a driver losing control of their vehicle resulting in a crash. No quantitative method currently exists to quickly and economically assess the condition of rail crossings in order to evaluate the long term performance of crossings and set a quantitative trigger for their rehabilitation. The conventional method to measure the surface of quality of crossings is based on expert judgment, whereby crossing surfaces are classified as poor, fair or good after an inspector visits and drives over the crossing. However, actual condition of the crossing could be different from the subjective rating. Poor condition rating crossings may not always present the most cost-effective locations for preventive maintenance to lower overall life-cycle costs. Conventional ratings may derive from driving a passenger car of pickup once over the crossing. Effects of various speed, on various vehicles (suspension), and at various places (laterally) cannot be determined or even estimated except at the smoothest of crossings. A quantifiable and extensible procedure is desired. With rapid advances in computer science, 3D sensing and imaging technologies, it seems logical that a cost-effective quantitative method could be developed to determine the need to rehabilitate rail crossings and assess long term performance. Fundamental to the quantification of crossing condition is the acquisition of an accurate 3D surface model of the crossing in its present state. This paper reports on the development of an accurate, low cost and readily deployable sensor capable of rapid collection of this 3D surface. The research is seen as a first step towards automating the crossing inspection process, ultimately leading to the quantification and estimation of future performance of rail crossing.

Risedronate for the Prevention of Fractures in Postmenopausal Osteoporosis

2002 ◽  
Vol 36 (4) ◽  
pp. 664-670 ◽  
Author(s):  
Jennifer M Sickels ◽  
Chi-Sing Nip
Keyword(s):  
Postmenopausal Osteoporosis ◽  
Bone Fragility ◽  
Mineral Density ◽  
Osteoporosis Therapy ◽  
Treatment Of Osteoporosis ◽  
Medline Search ◽  
Secondary Sources ◽  
Nonvertebral Fractures ◽  
Search Terms ◽  
Increased Risk

OBJECTIVE: To evaluate current scientific literature regarding the efficacy of risedronate in the prevention of vertebral and nonvertebral fractures in women with postmenopausal osteoporosis. DATA SOURCES: Primary research articles were identified by MEDLINE search (1966–May 2001) and through secondary sources. Key search terms were risedronate, postmenopausal osteoporosis, and fractures. DATA SYNTHESIS: Osteoporosis results in a reduction of bone mineral density, increased bone fragility, and increased risk of fractures. The goal of osteoporosis therapy is not only to increase bone mass, but also to reduce the rate of fractures. Risedronate is the newest bisphosphonate to be approved for the prevention and treatment of osteoporosis. An evaluation of clinical trials using risedronate in the treatment of postmenopausal osteoporosis was performed to determine its efficacy at decreasing fracture rates. CONCLUSIONS: Risedronate is an effective and safe option for the treatment of postmenopausal osteoporosis. Risedronate significantly decreases the risk of vertebral and nonvertebral fractures in women who have had ≥1 fractures in the past. More studies are warranted to evaluate the efficacy of risedronate in women without preexisting vertebral fractures.

scholarly journals Swimming as Treatment for Osteoporosis: A Systematic Review and Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yanlin Su ◽  
Zhe Chen ◽  
Wei Xie
Keyword(s):  
Meta Analysis ◽  
Relevant Literature ◽  
Premenopausal Women ◽  
Current Evidence ◽  
Spine Density ◽  
Mineral Density ◽  
Randomized Controlled ◽  
Premenopausal Osteoporosis

Osteoporosis is a chronic disease that seriously affects human health and quality of life. This study is aimed at determining whether swimming had an effect on the bone mineral density (BMD) of the spine and femoral neck in postmenopausal and premenopausal osteoporosis patients. We retrieved relevant literature and analyzed data from randomized controlled trials to assess the effect of swimming on BMD in postmenopausal and premenopausal women. Relevant studies, with no language restrictions, from inception to September 2019, were retrieved from the PubMed, Cochrane, EMBASE, and EBSCO databases independently by two investigators. The keywords used for the literature search were “osteoporosis” and “swimming.” The main results included BMD and T-score. We searched 256 relevant articles and finally screened five articles, including 263 participants. Lumbar spine density was mentioned in three articles. Although the heterogeneity of lumbar vertebral density is moderate, the analysis of swimmers to nonswimmers shows that the lumbar vertebral density in swimmers is improved [heterogeneity: chi2=5.16, df=2 (P=0.08); I2=61%]. We analyzed the following heterogeneous subgroups: subgroup 1 (3–6 hours) and subgroup 2 (<3 hours). The BMD in subgroup 1 was significantly higher than that in the placebo, while no effect on BMD was found in subgroup 2 [heterogeneity: chi2=0.15, df=3 (P=0.70); I2=0%]. According to the current evidence, swimming may improve the BMD of postmenopausal women participants, if the swimming time is between 3 and 6 hours, especially in long-term swimmers. However, the effectiveness of swimming does require further investigation.

Long-term outcomes of an integrative rehabilitation program on quality of life: A follow-up study

2006 ◽  
Vol 61 (6) ◽  
pp. 835-839 ◽  
Author(s):  
Renee R. Taylor ◽  
Sachi G. Thanawala ◽  
Yukiko Shiraishi ◽  
Michael E. Schoeny
Keyword(s):  
Quality Of Life ◽  
Rehabilitation Program ◽  
Long Term Outcomes ◽  
Follow Up Study
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