Clinical diagnosis of vertebral fractures in osteoporosis (literature review)

2021 ◽  
pp. 20-25
Author(s):  
L. P. Evstigneeva
Keyword(s):  
Clinical Diagnosis ◽  
Vertebral Fractures ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Height Loss ◽  
Mineral Density ◽  
Adequate Treatment ◽  
Osteoporotic Vertebral Fractures ◽  
Wrong Diagnosis

Background. Osteoporosis is a common pathology among older age groups. Vertebral fractures are one of the most severe complications of osteoporosis, as they lead to a decrease in the quality of life, disability and increased mortality. The risk of vertebral fractures increases with age, especially in those who have already has a fracture of this localization. To improve the prognosis in this category of patients, early detection, treatment of patients with fractures, as well as prevention of new fractures, are important. At the same time, the diagnosis of osteoporotic vertebral fractures presents certain difficulties due to the variability of their clinical manifestations, which often leads to insufficient detection, wrong diagnosis and, as a consequence, to the lack of adequate treatment.Purpose of the review. To conduct a literature search to evaluate the clinical diagnosis of osteoporotic vertebral fractures.Conclusion. There was no single highly specific and at the same time sensitive clinical symptom of osteoporotic vertebral fractures. Back pain remains a relatively nonspecific symptom in vertebral fractures. The most specific symptoms: kyphosis and height loss have a high predictive value only when they are significantly changed. Thus, vertebral fractures should be suspected if height decreased more than 2.0 cm per year or more than 4.0 cm per life, if the patient does not reach the wall with his head or if the «rib to pelvis» distance is two fingers or less. The combination of clinical symptoms with the assessment of risk factors and bone mineral density has the greatest clinical significance. If a vertebral fracture is clinically suspected, it is advisable to perform an X-ray of the thoracic and lumbar spine, since the localization of pain indicated by the patient may not correspond to the localization of the fracture.

scholarly journals Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study

2011 ◽  
Vol 129 (3) ◽  
pp. 139-145 ◽  
Author(s):  
Daniela Fodor ◽  
Cosmina Bondor ◽  
Adriana Albu ◽  
Laura Muntean ◽  
Siao-pin Simon ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Atherosclerotic Plaque ◽  
Vertebral Fractures ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Osteoporotic Vertebral Fractures ◽  
The Relationship

CONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS: We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS: IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS: In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.

scholarly journals FEATURES OF CLINICAL SYMPTOMS AND THE INFLUENCE OF RISK FACTORS ON THE OCCURRENCE OF BRONCHIAL ASTHMA IN CHILDREN OF LVIV REGION OF DIFFERENT AGES

2021 ◽  
pp. 96-101
Author(s):  
O. R. Trutiak ◽  
O. L. Lychkovska ◽  
R. R. Holovyn ◽  
M. I. Dats-Opoka
Keyword(s):  
Risk Factors ◽  
Preschool Children ◽  
Bronchial Asthma ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Physical Development ◽  
Shortness Of Breath ◽  
Different Ages ◽  
Asthma In Children

Bronchial asthma (BA) is a common chronic pathology of the lower respiratory tract in children. The first manifestations of the disease can begin at any age, but the clinical features, of the course, are different in different periods of childhood. Manifestations and course of asthma may disappear or progress with age. Therefore, it is likely that there are differences in the pathophysiology, inflammatory response of the body and the features of the clinic of asthma in children of different ages, which affects the diagnosis and treatment. The aim of the study was to determine the features of clinical symptoms and the influence of risk factors for asthma on its occurrence in children of different ages. Materials and methods. We analyzed the anamnesis and clinical symptoms of 57 children aged 3 to 18 years, who were treated from September 2020 to June 2021 in the Lviv Regional Children's Clinical Hospital “OHMATDYT” and in the Lviv Municipal City Children's Clinical Hospital. The age groups did not differ statistically in the severity of asthma (P> 0.05). Thus, in group 1 was 1 patient (9.09%) with mild form, 1 patient (9.09%) - moderate persistent form, 8 patients (72.73%) - with severe persistent form. Among patients of age group 2 was 1 patient (3.85%) with mild persistent form, 3 children (11.54%) - moderate and 21 children (80.77%) - with severe persistent form. In group 3 was 1 patient (5%) with a mild persistent form, 6 patients (30%) - moderate and 12 children (80%) - with a severe persistent form. The vast majority of patients were boys (84.21 ± 4.83%). All patients underwent general clinical examinations, spirometry, and allergy tests. We used the clinical-anamnestic method to perform the tasks of the work, which consisted in collecting a detailed somatic and genealogical anamnesis during the parents` questionnaire. Physical development of children was assessed using centile tables. Statistics were evaluated by calculating Student's t-test and Pearson's consistency test. Preschool children with asthma were more likely to experience shortness of breath during exercise and a wet low-yielding cough, and children of primary and secondary school age were more characterized by concomitant allergic rhinitis. Autumn was more unfavorable period for the exacerbation of clinical manifestations of asthma in children of Lviv region was period. We did not find correlation of birth weight on the timing of asthma. However, a burdensome obstetric history contributed to the early development of clinical manifestations of asthma. Preschool children were more likely to be exposed to nicotine during the antenatal period and had a shorter duration of breastfeeding, which may be a probable risk factor for asthma in preschool children. In 77% of children from different age groups were burdened with a history of allergies, with 66% of cases more pronounced in the maternal line. An analysis of physical development revealed that most preschool children were overweight. Conclusions. Asthma has features of clinical symptoms in children of different ages - shortness of breath during exercise and whooping cough are characteristic of preschool children, and concomitant chronic persistent rhinitis - for older age groups. Seasonal exacerbations are characteristic of asthma in children; in particular, the autumn period is more unfavorable, common for asthmatics in children of all ages among patients in Lviv region. Maternal smoking during pregnancy has a significant effect on the risk of developing asthma in children. Also, a burdened maternal allergy history and overweight child contributes to the development of asthma in children.

scholarly journals COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes

2020 ◽  
Author(s):  
Mohammad Ali Ashraf ◽  
Nasim Shokouhi ◽  
Elham Shirali ◽  
Fateme Davari-tanha ◽  
Omeed Memar ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Treatment Options ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Post Discharge ◽  
Reactive Protein ◽  
Presenting Symptoms ◽  
Discharged Patients ◽  
Symptom Relapse

Abstract Background There is a growing need for information regarding the recent coronavirus disease of 2019 (Covid-19). We present a comprehensive report of Covid-19 patients in Iran.Methods One hundred hospitalized patients with Covid-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and post-discharge follow-up were analyzed.Results The median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), lymphocytopenia (74.2 %) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in CT scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom relapse, (8.6%) were readmitted to the hospital, and 3 patients (4.3%) died.Conclusions This report demonstrates a heterogeneous nature of clinical manifestations in patients affected with Covid-19. The most common presenting symptoms are non-specific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom relapse.

scholarly journals COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes

2020 ◽  
Author(s):  
Mohammad Ali Ashraf ◽  
Nasim Shokouhi ◽  
Elham Shirali ◽  
Fateme Davari-tanha ◽  
Omeed Memar ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Treatment Options ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Post Discharge ◽  
Reactive Protein ◽  
Presenting Symptoms ◽  
Discharged Patients ◽  
Symptom Relapse

AbstractPurposeThere is a growing need for information regarding the recent coronavirus disease of 2019 (Covid-19). We present a comprehensive report of Covid-19 patients in Iran.MethodsOne hundred hospitalized patients with Covid-19 were studied. Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and post-discharge follow-up were analyzed.ResultsThe median age of the patients was 58 years, and the majority of the patients (72.7%) were above 50 years of age. Fever was present in 45.2% of the patients on admission. The most common clinical symptoms were shortness of breath (74%) and cough (68%). Most patients had elevated C-reactive protein (92.3%), elevated erythrocyte sedimentation rate (82.9%), lymphocytopenia (74.2 %) on admission. Lower lobes of the lung were most commonly involved, and ground-glass opacity (81.8%) was the most frequent finding in CT scans. The administration of hydroxychloroquine improved the clinical outcome of the patients. Lopinavir/ritonavir was efficacious at younger ages. Of the 70 discharged patients, 40% had symptom relapse, (8.6%) were readmitted to the hospital, and 3 patients (4.3%) died.ConclusionThis report demonstrates a heterogeneous nature of clinical manifestations in patients affected with Covid-19. The most common presenting symptoms are non-specific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. Hydroxychloroquine and lopinavir/ritonavir (in younger age group) can be potential treatment options. Finally, patients discharged from the hospital should be followed up because of potential symptom relapse.

scholarly journals Comparison of the clinical manifestations between different age groups of patients with overseas imported COVID-19

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243347
Author(s):  
Yujuan Han ◽  
Zujin Luo ◽  
Wenliang Zhai ◽  
Yue Zheng ◽  
Huan Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
Disease Onset ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Symptom Improvement ◽  
Group A ◽  
Group B

The current study investigated the clinical manifestations and outcomes of different age groups of patients with overseas imported COVID-19. In total, 53 COVID-19 patients admitted to the designated Beijing Xiaotangshan Hospital between March 16 and April 15 of 2020 were included. Based on the percentage of disease aggravation during hospital stay according to CT, the patients were divided into two groups: ≤40 years (group A; n = 41) and >40 years (group B; n = 12). The demographic data, epidemiological history, disease courses, potential complications, clinical symptoms, lab indices, chest CT outcomes, treatment protocols and turnovers of the two groups were compared. According to clinical typing, compared with group A, group B had a significantly greater proportion of the common type of COVID-19 (P<0.05) and greater comorbidity of type 2 diabetes (P<0.001). The two groups presented significantly different lab indices. Group B showed significantly more frequent CT abnormalities, with greater proportions of multiple lesions and bilateral lung involvement (P<0.05). During hospitalization, group B had a greater proportion of disease aggravation according to CT (P<0.01). Compared with group A, group B received a significantly greater proportion of antiviral therapy and presented a significantly greater occurrence of adverse drug reactions (P<0.05). The two groups did not significantly differ in time from admission to clinical symptom improvement or from disease onset to negative outcomes according to nucleic acid testing, the appearance of IgG or the appearance of IgM. They also did not significantly differ in length of stay. Older imported COVID-19 patients, particularly those with type 2 diabetes, showed a broader pulmonary extent and faster development of the disease, more severe pathogenetic conditions and a greater risk of developing a critically severe type. Increased attention should be given to this population in clinical practice.

Vertebral Fractures: Which Radiological Criteria Are Better Associated With the Clinical Course of Osteoporosis?

2020 ◽  
pp. 084653712094352
Author(s):  
Brian C. Lentle ◽  
Claudie Berger ◽  
Jacques P. Brown ◽  
Linda Probyn ◽  
Lisa Langsetmo ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Population Based ◽  
Mineral Density ◽  
Radiological Criteria ◽  
Osteoporotic Vertebral Fractures ◽  
Morphometric Methods ◽  
Hip Bmd ◽  
Logistic Regressions ◽  
Lumbar Spinal

Study Purpose: Morphometric methods categorize potential osteoporotic vertebral fractures (OVF) on the basis of loss of vertebral height. A particular example is the widely used semiquantitative morphometric tool proposed by Genant (GSQ). A newer morphologic algorithm-based qualitative (mABQ) tool focuses on vertebral end-plate damage in recognizing OVF. We used data from both sexes in the Canadian Multicentre Osteoporosis Study (CaMos) to compare the 2 methods in identifying OVF at baseline and during 10 years of follow-up. Materials and Methods: We obtained lateral thoracic and lumbar spinal radiographs (T4-L4) 3 times, at 5-year intervals, in 828 participants of the population-based CaMos. Logistic regressions were used to study the association of 10-year changes in bone mineral density (BMD) with incident fractures. Results: At baseline, 161 participants had grade 1 and 32 had grade 2 GSQ OVF; over the next 10 years, only 9 of these participants had sustained incident GSQ OVF. Contrastingly, 21 participants at baseline had grade 1 and 48 grade 2 mABQ events; over the next 10 years, 79 subjects experienced incident grade 1 or grade 2 mABQ events. Thus, incident grades 1 and 2 morphologic fractures were 8 times more common than morphometric deformities alone. Each 10-year decrease of 0.01 g/cm2 in total hip BMD was associated with a 4.1% (95% CI: 0.7-7.3) higher odds of having an incident vertebral fracture. Conclusions: This analysis further suggests that morphometric deformities and morphologic fractures constitute distinct entities; morphologic fractures conform more closely to the expected epidemiology of OVF.

scholarly journals Clinical manifestations in primary ciliary dyskinesia: systematic review and meta-analysis

2016 ◽  
Vol 48 (4) ◽  
pp. 1081-1095 ◽  
Author(s):  
Myrofora Goutaki ◽  
Anna Bettina Meier ◽  
Florian S. Halbeisen ◽  
Jane S. Lucas ◽  
Sharon D. Dell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Ciliary Dyskinesia ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Explanatory Factors ◽  
Symptom Prevalence ◽  
Meta Analyses ◽  
Ciliary Dyskinesia

Few original studies have described the prevalence and severity of clinical symptoms of primary ciliary dyskinesia (PCD). This systematic review and meta-analysis aimed to identify all published studies on clinical manifestations of PCD patients, and to describe their prevalence and severity stratified by age and sex.We searched PubMed, Embase and Scopus for studies describing clinical symptoms of ≥10 patients with PCD. We performed meta-analyses and meta-regression to explain heterogeneity.We included 52 studies describing a total of 1970 patients (range 10–168 per study). We found a prevalence of 5% for congenital heart disease. For the rest of reported characteristics, we found considerable heterogeneity (I2 range 68–93.8%) when calculating the weighted mean prevalence. Even after taking into account the explanatory factors, the largest part of the between-studies variance in symptom prevalence remained unexplained for all symptoms. Sensitivity analysis including only studies with test-proven diagnosis showed similar results in prevalence and heterogeneity.Large differences in study design, selection of study populations and definition of symptoms could explain the heterogeneity in symptom prevalence. To better characterise the disease, we need larger, multicentre, multidisciplinary, prospective studies that include all age groups, use uniform diagnostics and report on all symptoms.

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