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For treating a leading cause of osteoporosis, surgery is better than widely used medications

While most cases of osteoporosis are caused by normal aging, another leading cause of the bone-loss disease is a condition called hyperparathyroidism, in which the parathyroid glands release an excessive amount of a hormone that regulates the body’s calcium levels. Doctors commonly treat hyperparathyroidism using a class of prescription drugs called bisphosphonates, including alendronate (marketed under the brand name Fosamax) and ibandronate (Boniva), which are supposed to strengthen bones. Now, a study led by scientists at UCLA found that those drugs actually increase the risk of fracture, meaning that taking them is worse than doing nothing at all to treat the condition. The research also revealed that patients who have surgery to remove the overactive parathyroid glands have fewer subsequent bone fractures. The report appears in the April 5 issue of the Annals of Internal Medicine. About 400,000 people in the U.S. — 1 in 400 women and 1 in 1,200 men — have hyperparathyroidism; and osteoporotic fractures are a major public health and economic burden, said Dr. Michael Yeh, an associate professor of surgery and medicine, and the study’s first author. “Hip fractures in particular are associated with significant rates of mortality, disability and loss of independence,” said Yeh, who also is the chief of endocrine surgery at the UCLA David Geffen School of Medicine. “Before this study, there was no data that compared parathyroid surgery...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news

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Authors: Yue JK, Winkler EA, Sharma S, Vassar MJ, Ratcliff JJ, Korley FK, Seabury SA, Ferguson AR, Lingsma HF, Meeuws S, Adeoye OM, Rick JW, Robinson CK, Duarte SM, Yuh EL, Mukherjee P, Dikmen SS, McAllister TW, Diaz-Arrastia R, Valadka AB, Gordon WA, Okonkwo DO, Manley GT, , Hansen Deng Predictors of mTBI admission, referral and outcome, , and the TRACK-TBI Investigators Abstract OBJECTIVE: To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). METHODS: Overall, 168 adult patients with mTBI from the prospective...
Source: Brain Injury - Category: Neurology Tags: Brain Inj Source Type: research
We examined if COPM initial and change scores related to personal characteristics of gender, class-level (e.g., Sophomore), and STEM education; if personal characteristics predicted a student's follow-through with an AT service referral (n = 231); and if personal characteristics and initial COPM scores predicted dropout from AT services (n = 187). COPM ratings significantly increased in all common academic tasks (p  female ratings, p = .01). Gender also predicted Performance changes, with females being more likely to have a service-meaningful change (p = .02). Higher class-level...
Source: Assistive Technology - Category: Rehabilitation Tags: Assist Technol Source Type: research
This study aimed to optimize the formulation to develop stable preparation for the delivery of DTX. Single-factor test was used to evaluate the effects of the preparation concentration of DTX prodrug, stirring speed, the types of stabilizers and temperature on the prescription process of DSNPs. The particle size and polydispersity index were selected as the evaluation indexes. The entrapment efficiency, drug-loading, size distribution and zeta potential were characterized by UPLC and Zetasizer, respectively. The stability and cellular behavior of DSNPs were investigated by Zetasizer, LC-MS/MS and confocal laser scanning mi...
Source: Drug Development and Industrial Pharmacy - Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research
CONCLUSIONS: It is important that clinicians managing gastroparesis are aware of the arrhythmogenic potential of drugs used clinically and risk factors that contribute to QT prolongation to safeguard patients at risk for drug-induced cardiac arrhythmia. PMID: 29157021 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Loss‐of function mutations in NALCN on chromosome 13q, a sodium leak channel that maintains baseline neuronal excitability, cause infantile hypotonia with psychomotor retardation and characteristic faces 1 (IHPRF1, OMIM #615419). Here, we document two individuals with early onset hypotonia with poor feeding and intellectual disability who were compatible with a diagnosis of IHPRF1. The two patients had bi‐allelic mutations in NALCN through two different genetic mechanisms: Patient 1 had bi‐allelic splice site mutations, that is c.1267‐2A>G, derived from heterozygous parents, while Patient 2 had a partial materna...
Source: American Journal of Medical Genetics Part A - Category: Genetics & Stem Cells Authors: Tags: CLINICAL REPORT Source Type: research
Intramuscular botulinum toxin (BoTX) injection is the first-line treatment of cervical dystonia. Poor treatment outcomes and some side effects, however, have been reported after BoTX applications. One of the most important reasons is incorrect localization of the needle during toxin injections. Without imaging, it is impossible to verify precise needle positioning in the proper muscle. Ultrasound has been recommended because of its high capability in illustrating most of the neck muscles. This review article discusses how ultrasound imaging can be used to scan/access neck muscles, mainly from the perspective of BoTX injections.
Source: Physical Medicine and Rehabilitation Clinics of North America - Category: Rehabilitation Authors: Source Type: research
Intra-articular hip and knee pain is a common cause of physical and psychosocial disability. Many conservative treatment options provide only short-term relief. Recent research studies have shown improvement in pain and function with minimal complications after radiofrequency neurotomy of the hip and the knee, especially in patients who have failed conservative treatment or are not surgical candidates. More quality research studies are needed to establish the efficacy and safety of these procedures in patients with refractory hip and knee pain.
Source: Physical Medicine and Rehabilitation Clinics of North America - Category: Rehabilitation Authors: Source Type: research
Conclusion: CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy. PMID: 29159167 [PubMed]
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Chante Karimkhani and colleagues1 highlighted the substantial burden of scabies, reporting that scabies accounted for 0 ·21% of disability-adjusted life-years (DALYs) from all conditions globally in 2015. Although the documentation of global morbidity is timely, the contribution of scabies to mortality is yet to be elucidated. Karimkhani and colleagues' DALY calculations were unable to take into account years of lif e lost (YLL); instead, a null mortality was assumed. Furthermore, scabies was attributed a maximum disability severity of 1, corresponding to itch or pain, which potentially under-represents its severity...
Source: The Lancet Infectious Diseases - Category: Infectious Diseases Authors: Tags: Correspondence Source Type: research
Authors: Briganti SI, Gaspa G, Tabacco G, Naciu AM, Cesareo R, Manfrini S, Palermo A Abstract In humans, irisin is produced mainly by skeletal muscle in response to physical activity. It has been demonstrated that irisin plays a pivotal role in inducing fat browning and regulating energy expenditure. New findings from various studies conducted in both animals and humans suggest that irisin can affect bone and glucose metabolism. In particular, irisin is able to increase bone cortical mass by stimulating the osteoblast pathways, and irisin levels are inversely correlated with the incidence of fragility fractures amo...
Source: Minerva Endocrinologica - Category: Endocrinology Tags: Minerva Endocrinol Source Type: research
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