1,721,023 research outputs found
Vitamina D e artrite reumatoide
Full text linkRecentemente si è osservato che la vitamina D svolge un ruolo importante nella regolazione della risposta immune. Molte cellule del sistema immunnitario esprimono i recettori della vitamina D. Studi in vitro e in vivo hanno mostrato che i metabolici della vitamina D modulano la proliferazione dei linfociti T e l’attività delle cellule dendritiche. Inoltre dati epidemiologici mostrano che la carenza di vitamina D si associa ad un aumentato rischio di sviluppare malattie autoimmuni. La carenza di vitamina D è piuttosto frequente tra la popolazione anziana e si associa a sintomi muscoloscheletrici. Nell’ artite reumatoide la sua carenza parrebbe associarsi ad un aumentato rischio di disabilità e ad un aumentata attività di malattia. Abbiamo studiato 1191 pazienti affetti da AR (85% donne) provenienti da 22 Centri reumatologici italiani. Sono stati eseguiti dosaggi centralizzati della 25 OH vitamina D e del PTH, sono stati valutati i parametri di attività di malattia, lo stato funzionale di malattia, il tempo di esposizione al sole. Il 55% dei pazienti non assumevano supplementi di vitamina D, tra questi il 52% avevano livelli vitaminici D 0.000). The patients with the worse indices of disease activity were spending significantly less time at sunshine. The association between disease activity scores or functional sores and 25(OH)D levels remained statistically significant even adjusting 25(OH)D levels for both sun exposure time and BMI. In conclusion, in RA patients disease activity and disability scores are inversely related with 25(OH)D levels. The causality of these associations must be confirmed by longitudinal studies aimed at evaluating the clinical response of disease activity to large vitamin D supplementations
Osteoporosis Treatment: When to Discontinue and When to Re-start
No full textA number of effective therapies for the treatment of osteoporosis have become available in recent years. However, uncertainty exists regarding their long-term use and effectiveness. Bisphosphonate treatment, unlike hormone replacement, denosumab or teriparatide, is associated with benefits extended even after treatment discontinuation. The extended benefits are most apparent for alendronate (ALN) and zoledronate (ZOL). A drug holiday might be considered in patients at low-moderate risk and who have been fully compliant with treatment, and who have had a response to treatment. In patients at low-moderate risk of fractures the decision to consider a drug holiday should be balanced also with the safety profile of each treatment
Neridronic acid for the treatment of bone metabolic diseases
No full textneridronic acid; bisphosphonate; bone disease
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Profile of bazedoxifene/conjugated estrogens for the treatment of estrogen deficiency symptoms and osteoporosis in women at risk of fracture.
No full textDecreasing levels of estrogens during menopause are associated with reduced bone density and an increased risk of osteoporosis. Many women also experience bothersome vasomotor and vaginal symptoms during the menopausal transition. Results of systematic reviews and meta-analyses of randomized controlled trials have shown that both systemic estrogen therapy or hormone therapy (estrogen combined with a progestin) are useful to prevent bone loss, and they are the most effective treatment for such climacteric symptoms as hot flushes, sweating, vaginal dryness, and dyspareunia. Unfortunately, estrogen therapy and hormone therapy increase the risk of endometrial and breast cancer, respectively. The selective estrogen receptor modulators (SERMs) result in positive estrogenic effects on bone, with no negative effects on the endometrium and breast but do not provide relief from postmenopausal symptoms. The combination of a SERM with estrogen as a tissue selective estrogen complex (TSEC) is a new strategy for the prevention of bone loss and the treatment of climacteric symptoms. This combination is particularly interesting from a clinical point of view, taking into account that estrogen alone did not increase breast cancer risk by the Women's Health Initiative. TSEC is hypothesized to provide the benefits of estrogen-alone therapy, with an improved tolerability profile because the SERM component can make possible the elimination of progestin. The objective of this review was to critically evaluate the evidence from the reports published to date on the use of bazedoxifene (a third-generation SERM) in combination with conjugated estrogens in postmenopausal women. The conclusion is that effectively, the combination of bazedoxifene and conjugated estrogens may be a promising alternative to hormone therapy for the prevention of osteoporosis and the treatment of postmenopausal symptoms in non-hysterectomized postmenopausal women
Prednisone compared to methysprednisolone in the polymyalgia rheumatica treatment
No full textGlucocorticoids (GLs) are the sole therapeutic approach in polymyalgia rheumatica (PMR). An undefined proportion of patients respond only to very high doses of GLs and some seem to respond better to methylprednisolone (MPONE) than to prednisone (PN) or vice versa. Fifty-two PMR patients were randomized (ratio 1/1) to a fixed daily dose of PN (25 mg) or MPONE (20 mg), and the dose was tapered with a fixed scheme at the time of symptomatic relief. The clinical and biochemical assessments were obtained at fixed time points: 2 weeks, and 3, 6, 12 months. A clinical and biochemical remission of PMR was observed in 100 % of the patients on MPONE and in 89 % of the patients on PN. The mean time to achieve full remission after the first dose was significantly (p < 0.05) longer for PN (20.3 days) than for MPONE (15.2 days). This difference was mainly driven by 3 patients in whom the remission was achieved after 26-49 days. The mean levels of serum ACTH and cortisol were very similar in both treatment groups as the slope of their correlations for equivalent steroid doses. PN and MPONE have a similar therapeutic effect on suppression of the HPA axis in PMR patients. The results of this preliminary study suggest that a delayed response to PN may occur. Further studies are warranted in order to verify whether this might be related to variations in 11β-hydroxysteroid dehydrogenase activity
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