Browsing by Author "Vujasinović-Stupar, Nada (24831218300)"

Introduction: Osteoporosis usually affects post-menopausal women. Treatment is individualized and requires an approach that will provide long-term compliance to prevent fractures. Studies conducted so far suggest inadequate compliance and persistence in weekly bisphosphonate treatment (under 43% after a year of treatment). Ibandronate, as a powerful bisphosphonate, has made it possible for the first time to treat osteoporosis with a single tablet per month. Objective: Study of efficacy, safety and tolerance of ibandronate applied once a month in female patients with decreased bone mineral density (BMD). Methods: The prospective study was conducted in 34 centres in Serbia covering the total of 370 women with reduced BMD with ibandronate once a month. Demographic data, risk factors for osteoporosis, mode of diagnosis establishment, previous treatment for osteoporosis and concomitant diseases were investigated. Efficacy of the treatment was evaluated by T-score value after 12 months versus the baseline values. Tolerance of the treatment, compliance and adverse effects were recorded. Results: The sample included 97.5% post-menopausal women, 92.7% with osteoporosis. In 80% of the cases, the diagnosis was established by DXA measurement. In more than 90% of the sample, the level of physical activity was unsatisfactory, and 70% had an accompanying risk factor for osteoporosis in addition to menopause. After 12 months of treatment, 100% compliance was recorded in 84% of the patients and significant reduction (p<0.0001) of the bone mineral loss, regardless of the previous aminobisphosphonate treatment. The treatment was tolerated well, with no serious adverse reactions. Some, mainly gastrointestinal complaints, registered in the first month (6%), were significantly relieved (p<0.0001) after 12 months of treatment (1%). Conclusion: Ibandronate manifested significant improvement of the BMD after 12 months of treatment of patients with decreased BMD, with good tolerance and excellent treatment compliance.

INTRODUCTION This is an open uncontrolled study about effects of physical treatment on disease activity parameters of patients with rheumatoid arthritis and psoriatic arthritis. OBJECTIVE The aim of the study was to establish if there was any improvement of disease activity parameters after four weeks of physical and spa treatment. METHOD We compared morning stiffness, tender and swollen joint count, body pain level and Disease Activity Score 28 (DAS-28) in patients with rheumatoid and psoriatic arthritis, and assessed the effect of physical and spa treatment on those parameters. The research encompassed 109 patients: 69 with rheumatoid arthritis (RA group) and 40 with psoriatic arthritis (PA group). They were from Norway, staying for four weeks in June-September 2003. The groups served as their own controls - "one group pre-test post test" study. Disease activity measurement was made twice: at the beginning and at the end of treatment. The therapeutic set consisted of mud applications, kinesitherapy, mineral water pool and electrotherapy. RESULTS At the beginning there was no significant difference in observed disease activity parameters between patients with rheumatoid and psoriatic arthritis (p>0.05). After four weeks of physical and spa treatment disease activity was significantly reduced in all observed parameters in both groups: morning stiffness (p<0.001 RA+PA), tender joint count (p<0.01RA+PA), swollen joint count (p<0.01 RA; p<0.05 PA), body pain(p<0.01 RA+PA) and DAS-28 score (p<0.01 RA+PA).CONCLUSION Physical and spa treatment, together with climatic factors in Igalo, lead to a significant reduction of disease activity parameters of patients suffering from rheumatoid arthritis and psoriatic arthritis.

Introduction Treatment of osteoporosis, in addition to a specific antiresorptive or anabolic treatment, requires supplementation with calcium and vitamin D. Widespread cultivation of pearl shells has made pearls available for commercial use for a very reasonable price. The main chemical compound of pearls from shells Pinctada maxima is calcium-carbonate (CaCO3). Recently developed technologies applied in a micronisation process have provided increased gastrointestinal resorption of calcium, estimated at over 90% of calcium intake. Objective The paper is aimed at monitoring of efficacy and tolerance of six-month bio-calcium supplementation in postmenopausal women with reduced bone mineral density. Methods Group I (30 patients) received, three times a day, capsules of pearl powder from shells Pinctada maxima (it is equal to 260 mg of elementary calcium); group II (20 patients) received a daily dose of 500 mg inorganic CaCO3. Both groups received 666 IU of cholecalciferol per day. In all patients, bone mineral density (BMD) of the spine or hip, serum blood and urine levels of Ca, phosphates and alkaline phosphatase, were measured before and after six months of the treatment. Results Group I/Group II: average age 61.7/61.7 years; beginning of menopause: 48.32 /48 years; menopause duration 13.4/13.7 years; average body mass index 27.2/27 kg/m2. These two groups did not different significantly before supplementation. Six-month supplementation with CaCO3 of the biological origin led to the increase of BMD from 0.901 g/cm2 to 0.948 g/cm2 (p=0.067), while BMD remained the same in the group supplemented with inorganic CaCO3. Gastrointestinal tolerability of bio-calcium was excellent, without any adverse events. Conclusion These data could not strongly support the hypothesis of better efficacy of bio-calcium taking into account a small number of patients and a short follow-up period in this pilot study. Tolerance of CaCO3 of the biological origin was excellent and free of any adverse events. The results of laboratory values were within normal range.

Hemophagocytic syndrome (HPS) may be provoked by infections, malignancies and autoimmune diseases. We report on a 56-year-old woman with long-lasting systemic lupus erythematosus (SLE) who presented with malar rash, inflammatory livedo reticularis, fever, weight loss, pancytopenia and mild splenomegaly with cervical lymphadenopathy. She had criteria for SLE flare-up (malar rash, high antinuclear antibody titer, complement consumption, pathological urinary sediment, and retinal vasculitis). Despite high-dose glucocorticoid therapy, pancytopenia and fever worsened. Important elevations of triglycerides and ferritin were also found. Bone marrow aspirate demonstrated hemophagocytosis, which confirmed the coexistence of HPS and SLE. The treatment with glucocorticoids, immunoglobulins, cyclophosphamide, filgrastim and antimicrobial therapy was unsuccessful. After one month, the patient developed Pneumocystis jirovecii pneumonia with fatal outcome. Bone marrow biopsy, taken 5 days before death, showed high grade diffuse large B-cell (CD20+, Ki-67+) non-Hodgkin's lymphoma (DLBCL). We are the first to report the association of both SLE and non-Hodgkin's lymphoma complicated by HPS. We showed that, based on clinical and laboratory data, it was difficult to distinguish the early phase of HPS from SLE flare-up and new-onset DLBCL. Therapy of such a complex case of HPS has not been standardized, and opportunistic infections remain a difficult issue.

Osteoporosis and hypertension are two frequent diseases among the aging population that share a similar etiopathology and often coexist. Moreover, treatment of hypertension affects bone mineral density and, therefore, can worsen osteoporosis. This narrative review considers the influence of the main etiologic factors that contribute to the development of hypertension and osteoporosis and examines the effect of the most often used antihypertensives on bones. A computerized literature search of relevant English publications regarding the etiology of hypertension and osteoporosis as well as the impact of antihypertensives on osteoporosis from 1996 to 2011 was completed in October 2011. The latest update in the search was performed from May to June 2012. The most relevant nongenetic factors in the etiology of osteoporosis and hypertension are low calcium intake, vitamin D and vitamin K deficiency, high consumption of sodium salt, and the effects of different forms of nitric oxide. Thiazide diuretics are the only antihypertensives that have a positive influence on bone mineral density. For other antihypertensive drugs, the data are conflicting, indicating that they may have a potentially negative or positive influence on bone mineral density and fracture risk reduction. Some studies did not find a correlation between the use of antihypertensives and bone mineral density. Due to the frequent coexistence of hypertension and osteoporosis, when selecting long-term antihypertensive therapy the potential effects of antihypertensive drugs on development, worsening, or improvement of osteoporosis should also be considered. © 2012 Springer Science+Business Media New York.

Osteoporosis and hypertension are two frequent diseases among the aging population that share a similar etiopathology and often coexist. Moreover, treatment of hypertension affects bone mineral density and, therefore, can worsen osteoporosis. This narrative review considers the influence of the main etiologic factors that contribute to the development of hypertension and osteoporosis and examines the effect of the most often used antihypertensives on bones. A computerized literature search of relevant English publications regarding the etiology of hypertension and osteoporosis as well as the impact of antihypertensives on osteoporosis from 1996 to 2011 was completed in October 2011. The latest update in the search was performed from May to June 2012. The most relevant nongenetic factors in the etiology of osteoporosis and hypertension are low calcium intake, vitamin D and vitamin K deficiency, high consumption of sodium salt, and the effects of different forms of nitric oxide. Thiazide diuretics are the only antihypertensives that have a positive influence on bone mineral density. For other antihypertensive drugs, the data are conflicting, indicating that they may have a potentially negative or positive influence on bone mineral density and fracture risk reduction. Some studies did not find a correlation between the use of antihypertensives and bone mineral density. Due to the frequent coexistence of hypertension and osteoporosis, when selecting long-term antihypertensive therapy the potential effects of antihypertensive drugs on development, worsening, or improvement of osteoporosis should also be considered. © 2012 Springer Science+Business Media New York.