scholarly journals EFFECT OF ALENDRONATE ON THE HEALING TIME OF DISTAL RADIAL FRACTURES TREATED CONSERVATIVELY: AN OBSERVATIONAL STUDY

2017 ◽  
Vol 10 (11) ◽  
pp. 168
Author(s):  
Nidhin Koshy ◽  
Deepak Pinto ◽  
Premjit Sujir ◽  
Varghese Joe ◽  
Ghanashyam Kamath K
Keyword(s):  
Observational Study ◽  
Distal Radius ◽  
Healing Process ◽  
Tertiary Care ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Healing Time ◽  
Active Movement ◽  
Distal Radial Fractures ◽  
P Values

  Objective: Although fragility fractures of the distal radius are common, osteoporosis treatment requires exploration as attempts to improve postfracture investigations have been only partially successful. Bisphosphonates may help minimize the risk of secondary fractures but being a potent antiresorptive agent; it raises concerns about adverse effects on the healing process. This observational study examines the effect of bisphosphonate (alendronate) on healing of acute fractures of distal radius through 66 patients aged >45 years admitted to two tertiary care hospitals in Mangalore from May 2014 to September 2016.Methods: The methodology consists of purposive sampling from two groups: Control having 33 patients not on alendronate therapy and cases comprising 33 who are on alendronate as part of prophylaxis for osteoporosis before fracture occurrence, with outpatient reviews at 2-week intervals starting from the 6th till fracture union seen. At each visit, plain radiographs of the involved wrist were taken to yield time to cortical bridging, with range of active movement of the affected wrist taken using a goniometer. Data were analyzed using Statistical Package for the Social Sciences software version 17.0 for t values, p values and correlations and results were presented in the form of graphs and tables.Results: No significant differences were observed in the groups (as per p values) w.r.t. gender (0.804), age (0.835), time to healing (1.000), dorsiflexion (0.956), palmar flexion (0.670), ulnar deviation (0.441), radial deviation (1.000), supination (0.132), or pronation (0.302). Quick Disabilities of the Arm, Shoulder and Hand score did not differ by >95% between the groups over the analysis period.Conclusion: It was observed that alendronate administration in distal radius fractures did not appear to delay fracture healing times radiologically or clinically.

Wound With Diabetes: Present Scenario And Future

2020 ◽  
Vol 16 ◽  
Author(s):  
Kuldeep B. Pawar ◽  
Shivani Desai ◽  
Ramesh R. Bhonde ◽  
Ritesh P. Bhole ◽  
Atul A. Deshmukh
Keyword(s):  
Wound Healing ◽  
Blood Flow ◽  
Healing Process ◽  
Endocrine System ◽  
Healing Time ◽  
Special Focus ◽  
Diabetic Wound ◽  
Management Options ◽  
And Migration ◽  
Proliferation And Migration

: Diabetes is a chronic metabolic disorder of endocrine system characterized by increase in blood glucose level. Several factors such as pancreatic damage, oxidative stress, infection, genetic factor, obesity, liver dysfunction play a vital role in pathogenesis of diabetes which further lead to serious diabetic complications. Diabetic wound is one such complication where the wound formation occurs, especially due to pressure and its healing process is disrupted due to factors such as hyperglycemia, neuropathy, nephropathy, peripheral vascular disease, reduction of blood flow, atherosclerosis, impaired fibroblast. Process of wound healing is delayed due to different abnormalities like alteration in nitric oxide level, increase in aldose reductase, sorbitol and fructose. Therefore, diabetic wound requires more time to heal as compare to normal wound. Healing time is delayed in diabetic wound due to many factors such as stress, decreased oxygenation supply, infection, decreased blood flow, impaired proliferation and migration rate, impaired growth factor production, impaired keratinocytes proliferation and migration, and altered vascular endothelial mediators. The current treatment for diabetic wound includes wound patches, oxygenation therapy, hydrogel patches, gene therapy, laser therapy, and stem cell therapy. Medications with phytoconstituents is also one way to manage diabetic wound, but it is not more effective for quick healing. The objective of this review is to understand the potential of various management options which are available for diabetic wound, with a special focus on biological cells.

scholarly journals Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Functional Health ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Post Stroke ◽  
Self Rated Health ◽  
Modifying Factors ◽  
Study Results

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.

scholarly journals Diagnosis and Management of Osteoporosis During COVID-19: Systematic Review and Practical Guidance

2021 ◽  
Author(s):  
G. Hampson ◽  
M. Stone ◽  
J. R. Lindsay ◽  
R. K. Crowley ◽  
S. H. Ralston
Keyword(s):  
Clinical Care ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Healthcare Services ◽  
Urgent Care ◽  
Health Concern ◽  
Care Pathways ◽  
Long Term Conditions ◽  
Treatment Pathways ◽  
Diagnosis And Management

AbstractIt is acknowledged that the COVID-19 pandemic has caused profound disruption to the delivery of healthcare services globally. This has affected the management of many long-term conditions including osteoporosis as resources are diverted to cover urgent care. Osteoporosis is a public health concern worldwide and treatment is required for the prevention of further bone loss, deterioration of skeletal micro-architecture, and fragility fractures. This review provides information on how the COVID-19 pandemic has impacted the diagnosis and management of osteoporosis. We also provide clinical recommendations on the adaptation of care pathways based on experience from five referral centres to ensure that patients with osteoporosis are still treated and to reduce the risk of fractures both for the individual patient and on a societal basis. We address the use of the FRAX tool for risk stratification and initiation of osteoporosis treatment and discuss the potential adaptations to treatment pathways in view of limitations on the availability of DXA. We focus on the issues surrounding initiation and maintenance of treatment for patients on parenteral therapies such as zoledronate, denosumab, teriparatide, and romosozumab during the pandemic. The design of these innovative care pathways for the management of patients with osteoporosis may also provide a platform for future improvement to osteoporosis services when routine clinical care resumes.

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