scholarly journals Osteoporosis - a risk factor for cardiovascular diseases: A follow-up study

2015 ◽  
Vol 143 (1-2) ◽  
pp. 28-34 ◽  
Author(s):  
Ivan Tasic ◽  
Marina Rasic-Popovic ◽  
Sonja Stojanovic ◽  
Bojana Stamenkovic ◽  
Svetlana Kostic ◽  
...  
Keyword(s):  
Bone Density ◽  
Postmenopausal Women ◽  
Bone Fractures ◽  
Multivariate Logistic Regression Analysis ◽  
The Elderly ◽  
Group Iii ◽  
Normal Bone ◽  
Group I ◽  
Standard Assessment

Introduction. Cardiovascular (CV) diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly. Objective. The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events. Methods. Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I - 84 examinees with osteoporosis; Group II - 115 examinees with osteopenia; and Group III - 101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables. Results. After a 36-month follow-up, CV events occurred in 19 (6.3%) examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (?2=28.7; p<0.001), as well as between those with a high and low CV risk (?2=22.6; p<0.001). Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p=0.035), and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p<0.001) are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p=0.002). Conclusion. Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.

Correlation between total cardiovascular risk and bone density in postmenopausal women

Open Medicine ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. 795-803 ◽  
Author(s):  
Marina Popovic ◽  
Ivan Tasić ◽  
Aleksandar Dimić ◽  
Sonja Stojanović ◽  
Bojana Stamenković ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
High Risk ◽  
Bone Density ◽  
Postmenopausal Women ◽  
Evaluation System ◽  
Multivariate Logistic Regression Analysis ◽  
Mineral Density ◽  
Normal Bone Mineral Density ◽  
Group I ◽  
Score Risk

AbstractThe aim of the paper was to examine the correlation between the total risk of cardiovascular events, determined by the SCORE (Systematic Coronary Risk Evaluation) system, and bone density in postmenopausal women. Examinees and method: The research involved 300 postmenopausal women. On the basis of bone density measurements, the participants were divided into three groups: group I — 84 examinees had osteoporosis, group II — 115 examinees had osteopenia, and group III — 101 examinees had normal bone mineral density (BMD). Results: Participants with high SCORE risk were statistically significantly older compared to low-risk women (60±3 vs. 55±5; p<0.001). They had significantly lower BMD and T scores (−1.09±0.94 vs. −2.86±0.63; p<0.001). Elevation of the SCORE risk by 1% caused a BMD decrease of 0.033 g/cm2(0.029 to 0.036 gr/cm2). Multivariate logistic regression analysis showed that the following factors caused a significant increase in the risk of decreasing BMD: every year of life by 20%, menopause duration by 26%, increase in systolic blood pressure (BP) by 1 mm Hg by 7%, increase in SCORE risk by 1% by 5.31 times, physical inactivity by 5.96 times, and osteoporosis in the family history by 3.91 times. Conclusion: Postmenopausal women who are at high risk for cardiovascular diseases have a lower BMD than those who are not at high risk for cardiovascular diseases.

A four year follow up study of the effects of CA supplementation on bone density in elderly postmenopausal women

1996 ◽  
Vol 6 (S1) ◽  
pp. 250-250
Author(s):  
A. Devine ◽  
IM. Dick ◽  
SJ. Heal ◽  
RA. Criddle ◽  
RL. Prince
Keyword(s):  
Bone Density ◽  
Postmenopausal Women ◽  
Follow Up Study

Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders

2005 ◽  
Vol 15 (5) ◽  
pp. 619-626 ◽  
Author(s):  
H.K. Tewari ◽  
P. Sony ◽  
R. Chawla ◽  
S.P. Garg ◽  
P. Venkatesh
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Macular Thickness ◽  
Intravitreal Triamcinolone ◽  
Group Iii ◽  
Vein Occlusion ◽  
Group I ◽  
Group Ii

Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders. Methods This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions. Results Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis. Conclusions Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.

Comparison between three protocols of corneal collagen crosslinking in adults with progressive keratoconus: Standard versus accelerated CXL for keratoconus

2020 ◽  
pp. 112067212097263
Author(s):  
Boris Beloshevski ◽  
Sagi Shashar ◽  
Michael Mimouni ◽  
Victor Novack ◽  
Boris E Malyugin ◽  
...  
Keyword(s):  
P Value ◽  
Group Comparison ◽  
Group Iii ◽  
Group I ◽  
Before And After ◽  
Corneal Collagen Crosslinking ◽  
Larger Sample ◽  
Corneal Collagen ◽  
Anterior Corneal Astigmatism

Objective: The study aimed to compare eye outcomes between the standard and accelerated corneal cross-linking (CXL) protocols over a 1-year follow-up, and assess whether the accelerated protocols are non-inferior to the standard. Methods: A retrospective cohort study including patients older than 18 years diagnosed with progressive keratoconus who underwent a CXL procedure. The primary outcome was defined as an increase of more than 1.5 diopter (D) in Kmax. The analysis included intra- and inter-group comparisons assessing differences in eye characteristics before and 12 months after the procedure. Furthermore, we assessed whether the accelerated procedures were non-inferior to the standard regarding Kmax change after 12 months. Results: Eighty-four patients included in the study of which 23, 37 and 23 underwent the standard CXL (group I), 10-min. (group II) and the 3-min. (group III) accelerated procedures, respectively. Intra-group comparison before and after 12 months of mean Ksteep and anterior corneal astigmatism showed significant improvement only for group I (–0.3D decrease for both). Inter-group comparison showed better results after 12 months for group I (–0.9 ± 1.2) compared to group III (0.1 ± 0.8) in Ksteep, Kmean (–0.5+1. vs 0.1+0.7, respectively) and anterior astigmatism (–0.5 + 0.9 vs 0.3+1.1, respectively). We could not declare that the accelerated CXLs are non-inferior to the standard ( p-value = 0.11 and 0.15). Conclusion: The standard CXL showed better results for keratometry and astigmatism in comparison with the accelerated. Therefore, the wide use of the accelerated CXL should be considered and reviewed for longer follow-up time and larger sample size in focus on the visual acuity parameters.

Vincristine (V), dactinomycin (A), and lower doses of cyclophosphamide (C) with or without radiation therapy for patients with newly diagnosed low-risk embryonal rhabdomyosarcoma (ERMS): A report from the Children’s Oncology Group (COG).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9509-9509 ◽  
Author(s):  
David Walterhouse ◽  
Alberto S. Pappo ◽  
Jane L Meza ◽  
John C. Breneman ◽  
Andrea Anita Hayes-Jordan ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Complete Response ◽  
Low Risk ◽  
Phase Iii ◽  
Newly Diagnosed ◽  
Group Iii ◽  
Group I ◽  
Phase Iii Study ◽  
Stage 1

9509 Background: Intergroup Rhabdomyosarcoma Study (IRS) trials showed improved survival with VAC compared with VA for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II ERMS (see table). In COG ARST0331, we hypothesized that VA in combination with lower doses of C (total cumulative dose=4.8 g/m2) would produce the benefit of IRS-IV VAC with less toxicity for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II low-risk ERMS. Methods: This single arm, non-inferiority, phase III study enrolled newly diagnosed patients with Stage 1 Group III (non-orbit) ERMS or Stage 3 Group I/II ERMS onto Subset 2. Therapy was 4 cycles of VAC followed by 12 cycles of VA over 46 weeks (total cumulative doses: V=54 mg/m2, A=21.6 mg/m2, C=4.8 g/m2). The radiation therapy dose was 36 Gy for Group IIA patients, 41.4 Gy for Group IIB/C patients, and 50.4 Gy for Group III patients. From 2004–2008 girls with Group III vaginal RMS did not receive radiotherapy if a complete response was achieved with chemotherapy with or without delayed resection. The primary endpoint was failure-free survival (FFS), and results were compared with a fixed expected outcome. Results: With a median follow-up of 3.0 yrs, we observed 16 failures vs. 7.8 expected failures. Estimated 3-yr FFS was 63% (95% CI: 46%, 75%) (n=60), and overall survival (OS) was 84% (95% CI: 68%, 93%). Estimated 3-yr FFS was 46% (95% CI: 23%, 67%) for girls with non-bladder genitourinary tract ERMS (n=21) and 75% (95% CI: 53%, 88%) for all other Subset 2 patients (n=39). Conclusions: We observed suboptimal FFS of patients with Subset 2 low-risk RMS using reduced total cyclophosphamide (4.8 g/m2). Results were complicated by the choice of no radiation therapy for girls with vaginal tumors. Future studies for low-risk RMS Subset 2 patients could investigate a dose of C between 4.8 and 26.4 g/m2 with VA and local radiotherapy. [Table: see text]

Renal effects of cardiopulmonary bypass in the elderly

Perfusion ◽  
2002 ◽  
Vol 17 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Marius G Dehne ◽  
Armin Sablotzki ◽  
Jörg Mühling ◽  
Karl-Lorenz Dehne ◽  
Rainer Röhrig ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiopulmonary Bypass ◽  
Creatinine Clearance ◽  
The Elderly ◽  
Tubular Damage ◽  
Group Iii ◽  
Group I ◽  
Marker Proteins ◽  
Male Patients ◽  
Excretion Rates

Cardiopulmonary bypass is widely believed to be injurious to renal function. The unknown consequences of renal dysfunction with modern techniques of bypass in the elderly caused us to examine creatinine clearance and the excretion of sensitive marker proteins in older adult patients undergoing CABG. Thirty male patients were divided into three groups: group I with an age up to 60 years, group II with an age between 61 and 70 years, inclusive and group III 71 years and over. Serum creatinine and urea, creatinine clearance, and α1-micro-globulin (α1-MG), N-acetyl-β-D-glucosaminidase (NAG), Tamm -Horsfall protein (TH) and immunoglobulin G (IgG) were all measured daily, pre- and postoperatively. Creatinine clearance remained lower in the older patients without significant differences. Raised excretion rates of α1-MG, and IgG were seen after CPB. The increase in α1- MG and NAG during the postoperative period revealed tubular damage in all elderly patients. Measurements of α1-MG, NAG and IgG represent useful supplements to standard clinical tests for recognizing early and differentiated changes in renal function.

scholarly journals The Complete Normalization of the Adrenocortical Function as the Criterion of Cure after Transsphenoidal Surgery for Cushing’s Disease

2001 ◽  
Vol 86 (12) ◽  
pp. 5695-5699 ◽  
Author(s):  
Javier Estrada ◽  
José García-Uría ◽  
Cristina Lamas ◽  
José Alfaro ◽  
Tomás Lucas ◽  
...  
Keyword(s):  
Cushing’S Disease ◽  
Transsphenoidal Surgery ◽  
Plasma Cortisol ◽  
Cushing's Disease ◽  
Adrenocortical Function ◽  
Urinary Cortisol ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Transsphenoidal microsurgery is the standard treatment for patients with Cushing’s disease. However, there is general lack of agreement regarding the definition of cure. We studied 58 patients with corrected hypercortisolism after transsphenoidal surgery for Cushing’s disease. Plasma and urinary cortisol levels were measured after surgery. After the postsurgical hypocortisolism stage (or periodically in patients without hypocortisolism), urinary free cortisol, plasma cortisol at 0800 h and 2300 h, morning cortisol after 1 mg dexamethasone, and cortisol response to insulin-induced hypoglycemia were performed. Patients were classified in 3 groups: group I, patients with transient hypocortisolism and normal hypothalamus-pituitary-adrenal axis afterwards; group II, patients with transient hypocortisolism and abnormalities in the circadian rhythm or the stress response afterwards; and group III, patients without postoperative hypocortisolism. Thirty-three patients were included in group I, 8 in group II, and 17 in group III. Groups I and II were similar in postsurgical plasma cortisol (46.9 ± 30.3 vs. 60.7 ± 38.6 nm) and mean follow-up (69.8 vs. 68.8 months) but were significantly different in their recurrence rate (3.4% vs. 50%, P &lt; 0.001). Patients in group III had normal postsurgical plasma and urinary cortisol but persistent abnormalities in circadian rhythm and stress response. After a mean follow-up of 39.1 months, their recurrence rate was similar to that of group II (64.7% vs. 50%). The complete normalization of the adrenocortical function, which is always preceded by postsurgical hypocortisolism, is associated with a very low recurrence risk and should be considered, in our opinion, the main criterion of surgical cure in Cushing’s disease.

scholarly journals EFFICACY OF ATRIAL FIBRILLATION DETECTION IN CRYPTOGENIC STROKE ACCORDING TO DATA OF IMPLANTABLE LOOP RECORDERS: PILOT STUDY

2019 ◽  
Vol 34 (2) ◽  
pp. 47-53
Author(s):  
S. E. Mamchur ◽  
E. A. Ivanitskiy ◽  
O. M. Polikutina ◽  
T. Yu. Chichkova ◽  
I. N. Mamchur ◽  
...  
Keyword(s):  
Recurrent Stroke ◽  
Cryptogenic Stroke ◽  
Ecg Monitoring ◽  
Group Iii ◽  
External Monitoring ◽  
Group I ◽  
Monitoring Group ◽  
Group Ii

Aim. To estimate the efficacy of invasive and non-invasive long-term ECG monitoring in comparison with conventional follow-up for the detection of silent atrial fibrillation (AF)/atrial flutter (AFL)/atrial tachycardia (AT) in patients with a cryptogenic stroke.Methods. The randomized, prospective, two-center study enrolled 36 patients who suffered cryptogenic stroke (CS) or transient ischemic attack (TIA) without past history of AF/AFL/AT. Patients were randomized in a 1:1:1 ratio to one of the three ECG monitoring strategies: standard arrhythmia monitoring (group I, n=12), ECG-monitoring with implantable loop recorder (group II, n=12), and ambulatory noninvasive ECG monitoring (group III, n=12). The primary endpoint was the time to the first detection of AF/AFL/AT. Patients, assigned to the group I, underwent an assessment at scheduled and unscheduled visits and received ambulatory ECG monitoring 28 days and 1 year after randomization. Patients in the group II underwent implantation of Reveal XT (Medtronic, USA) with the daily remote data transmission to CareLink Network. In the group III, for long-term external monitoring, Spyder system (WEB Biotechnology, Singapore) was used for up to 28 days.Results. During the first 28 days of observation, there were no significant differences in AF detection rates between groups I, II, and III: 0 (0%), 1 (8%), and 2 (17%) cases, respectively, р=0.537. During the year of observation, AF/AFL/AT episodes were detected in 1 case (8%) in the group I, 6 cases (50%) in the group II, and 2 cases (17%) in the group III, p=0.0486. The mean time from enrollment into the study to detection of the first AF/AFL/AT episode was 67 days (15; 97) in all groups. In the groups II and III, the first arrhythmia episodes were detected by monitoring devices on days 24 and 6, respectively. In most cases, arrhythmia episodes detected by long-term monitoring were asymptomatic. Recurrent stroke or TIA events occurred in group I and III (1 case in each group), but not in the group with implantable cardiac monitors. Subgroup analysis showed that significantly higher AF/AFL/AT detection rate was associated with stroke, CHA2DS2VASc score ≥2, and the presence of hypertension. For the 12 months of follow-up, the mean AF burden in the group II was 0.4 (0.2; 0.5) hours per day (1.6%). In the patients with recurrent stroke, AF burden was 3.2% compared to 0.9% in the rest of patients.Conclusion. Detection of silent AF with implantable cardiac monitors is superior to standard and long-term external monitoring in cryptogenic stroke patients.

scholarly journals Keratorefractive Surgery for Residual Refractive Error Correction in Pseudophakic Patients

2020 ◽  
Vol 17 (2) ◽  
pp. 209-215
Author(s):  
Е. P. Gurmizov ◽  
К. B. Pershin ◽  
N. F. Pashinova ◽  
А. Iu. Tsygankov
Keyword(s):  
Refractive Error ◽  
High Efficiency ◽  
Group Iii ◽  
Spherical Component ◽  
Cylindrical Component ◽  
Group I ◽  
Keratorefractive Surgery ◽  
Group Ii ◽  
Target Refraction

Purpose. Evaluation of the visual and refractive results of additional correction using LASIK and PRK methods in patients with residual refractive error after previous cataract surgery. Patients and methods. The prospective open study included 57 patients (79 eyes) who previously underwent cataract phacoemulsification (n = 37) or refractive lensectomy (n = 42) with various IOL models implantation (2012–2017). The average age of patients was 50.8 ± 13.9 (19–79) years. Operations LASIK (91.1 %) and PRK (8.9 %) were carried out according to standard methods. In 6 cases, femtosecond laser supported by laser correction. The target refraction ranged from –0.25 to 0.25 D in most (97.5 %) cases. The follow-up period ranged from 6 to 9 months. Results. The patients were divided into groups according to the type of residual refractive error (Group 1 — myopia, group II — emmetropia and group III — hyperopia). Statistically significant differences were determined for the species of previously implanted IOLs — in group II, the frequency of monofocal IOLs was significantly higher (p < 0.05). In group II, the values of the cylindrical component of refraction were significantly higher compared with groups I and III (p < 0.05). In group I, a significant (p < 0.05) decrease in the spherical component of refraction from –1.36 ± 0.92 to –0.2 ± 0.8 D was observed. In patients of group II, there was a slight increase in the spherical component of refraction from 0 ± 0.20 to 0.25 ± 0.29 D (p > 0.05). In group III, a significant (p < 0.05) decrease was observed in the spherical component of refraction from 1.27 ± 0.69 to 0.43 ± 0.49 D. When analyzing the cylindrical component of refraction in group I, its decline was noted from –0.69 ± 0.5 to –0.38 ± 0.46 D (p > 0.05). In group II, the largest decrease in the cylindrical component was observed from –1.6 ± 1.0 to 0.03 ± 1.10 Dptr (p < 0.01). In all the studied groups, a statistically significant (p < 0.05) increase in UCFVA was revealed in the postoperative period. Indicators K1 and K2 did not significantly change. Conclusion. The high efficiency of the correction using the LASIK, PRK and femtoLASIK methods on pseudophakic eyes with the achievement of the target refraction in most of the studied cases was shown. This method can be used as an alternative to spectacle and contact correction in patients with residual refractive error after cataract phacoemulsification and refractive lensectomy with IOL implantation.

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