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https://www.readbyqxmd.com/read/28431568/a-case-report-of-severe-calciphylaxis-suggested-approach-for-diagnosis-and-treatment
#1
Margret Patecki, Gabriele Lehmann, Jan Hinrich Bräsen, Jessica Schmitz, Anna Bertram, Lars Daniel Berthold, Hermann Haller, Wilfried Gwinner
BACKGROUND: Calciphylaxis is a serious complication in patients with chronic kidney disease associated mineral and bone disorder. It can occur in conditions with low and high bone turnover. So far, there are no definite diagnostic and therapeutic guidelines which may prevent the devastating outcome in many calciphylaxis patients. We report a case which clearly illustrates that knowledge of the underlying bone disorder is essential for a directed treatment. Based on this experience we discuss a systematic diagnostic and therapeutic approach in patients with calciphylaxis...
April 21, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28422848/teriparatide-as-a-nonoperative-treatment-for-tibial-and-femoral-fracture-nonunion-a-case-report
#2
Li Xiaofeng, Xu Daxia, Chen Yunzhen
RATIONALE: Fracture nonunion is a great challenge for orthopedic surgeons. Many surgical interventions are associated with significant pain and heavy economic burden. Therefore, our aim was to evaluate the outcomes of a new nonoperative treatment for fracture nonunion. PATIENT CONCERNS: A 44-year-old man suffered closed fractures of the right tibia and left femur. Eleven months after surgery, there was no radiographic healing between fracture fragments. DIAGNOSES: Fracture nonunion of the right tibia and left femur...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28409215/high-and-pointed-type-of-femoral-localized-reaction-frequently-extends-to-complete-and-incomplete-atypical-femoral-fracture-in-patients-with-autoimmune-diseases-on-long-term-glucocorticoids-and-bisphosphonates
#3
H Sato, N Kondo, T Nakatsue, Y Wada, J Fujisawa, J J Kazama, T Kuroda, Y Suzuki, M Nakano, N Endo, I Narita
Once a localized reaction (beaking) was detected, discontinuation of bisphosphonates (BPs) and switching to vitamin D supplementation or teriparatide therapy effectively improved its shape. When the localized reaction was high, of the pointed type, and/or accompanied by prodromal pain, the risks of complete and incomplete atypical femoral fracture increased and consideration of prophylactic fixation for such patients was required. INTRODUCTION: Femoral localized reaction (localized periosteal thickening of the lateral cortex, beaking) is reported to precede atypical femoral fractures (AFFs) and to develop in 8-10% of patients with autoimmune diseases taking BPs and glucocorticoids...
April 13, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28401495/cessation-rate-of-anti-osteoporosis-treatments-and-risk-factors-in-spanish-primary-care-settings-a-population-based-cohort-analysis
#4
Elisa Martín-Merino, Consuelo Huerta-Álvarez, Daniel Prieto-Alhambra, Dolores Montero-Corominas
Among 95,057 patients ≥50 years with new anti-osteoporosis medications (AOM) (2001-2013) in primary care, 1-year cessation was 51% (28%-68%), higher in men, smokers, patients with missing lifestyle data, and out normal BMI, and lower in those aged 60-79, with recent fractures or other anti-osteoporotics, suggesting non-severe osteoporosis and less risk awareness. PURPOSE: Low compliance to anti-osteoporosis medications (AOM) has been previously reported. We aimed to estimate 1-year cessation rates of different AOMs as used in Spanish healthcare settings, and to identify associated risk factors...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28395318/benefits-and-harms-of-osteoporosis-medications-in-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#5
Lisa M Wilson, Casey M Rebholz, Ermias Jirru, Marisa Chi Liu, Allen Zhang, Jessica Gayleard, Yue Chu, Karen A Robinson
Background: Complications of chronic kidney disease (CKD) include weak bones and increased fracture risk. Purpose: To review the benefits and harms of osteoporosis medications (bisphosphonates, teriparatide, raloxifene, and denosumab) compared with placebo, usual care, or active control in terms of bone mineral density (BMD), fractures, and safety in patients with CKD. Data Sources: PubMed and the Cochrane Central Register of Controlled Trials from December 2006 through December 2016...
April 11, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28394900/acute-development-of-cortical-porosity-and-endosteal-na%C3%A3-ve-bone-formation-from-the-daily-but-not-weekly-short-term-administration-of-pth-in-rabbit
#6
Hiroshi Yamane, Aya Takakura, Yukari Shimadzu, Toshiyuki Kodama, Ji-Won Lee, Yukihiro Isogai, Toshinori Ishizuya, Ryoko Takao-Kawabata, Tadahiro Iimura
Teriparatide [human parathyroid hormone (1-34)], which exerts an anabolic effect on bone, is used for the treatment of osteoporosis in patients who are at a high risk for fracture. That the once-daily administration of teriparatide causes an increase in cortical porosity in animal models and clinical studies has been a matter of concern. However, it is not well documented that the frequency of administration and/or the total dose of teriparatide affect the cortical porosity. The present study developed 4 teriparatide regimens [20 μg/kg/day (D20), 40 μg/kg/day (D40), 140 μg/kg/week (W140) and 280 μg/kg/week (W280)] in the rabbit as a model animal with a well-developed Haversian system and osteons...
2017: PloS One
https://www.readbyqxmd.com/read/28394826/osteoporosis-in-premenopausal-women
#7
Bente L Langdahl
PURPOSE OF REVIEW: The scope of this review was to review the newest developments in the context of the existing knowledge on premenopausal bone fragility. Fragility fractures are common in postmenopausal women and men and diagnostic criteria for osteoporosis have been agreed and multiple pharmacological treatments have been developed over the last 25 years. In premenopausal women, fragility fractures and very low bone mass are uncommon and osteoporosis in premenopausal women has therefore attracted much less interest...
April 7, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28388910/effect-of-teriparatide-rh-pth-1-34-versus-bisphosphonate-on-the-healing-of-osteoporotic-vertebral-compression-fracture-a-retrospective-comparative-study
#8
Akira Iwata, Masahiro Kanayama, Fumihiro Oha, Tomoyuki Hashimoto, Norimasa Iwasaki
BACKGROUND: Teriparatide (recombinant human parathyroid hormone 1-34) is increasingly used for the treatment of severe osteoporosis because it stimulates bone formation and may potentially enhance fracture healing. The objective of this study was to investigate the effects of teriparatide versus a bisphosphonate on radiographic outcomes in the treatment of osteoporotic vertebral compression fractures (OVCF). METHODS: A total of 98 patients undergoing non-operative treatment for recent single-level OVCF were reviewed retrospectively...
April 7, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28387378/elevation-of-pro-inflammatory-cytokine-levels-following-anti-resorptive-drug-treatment-is-required-for-osteonecrosis-development-in-infectious-osteomyelitis
#9
Mayu Morita, Ryotaro Iwasaki, Yuiko Sato, Tami Kobayashi, Ryuichi Watanabe, Takatsugu Oike, Satoshi Nakamura, Yosuke Keneko, Kana Miyamoto, Kazuyuki Ishihara, Yoichiro Iwakura, Ken Ishii, Morio Matsumoto, Masaya Nakamura, Hiromasa Kawana, Taneaki Nakagawa, Takeshi Miyamoto
Various conditions, including bacterial infection, can promote osteonecrosis. For example, following invasive dental therapy with anti-bone resorptive agents, some patients develop osteonecrosis in the jaw; however, pathological mechanisms underlying these outcomes remain unknown. Here, we show that administration of anti-resorptive agents such as the bisphosphonate alendronate accelerates osteonecrosis promoted by infectious osteomyelitis. Potent suppression of bone turnover by these types of agents is considered critical for osteonecrosis development; however, using mouse models we found that acceleration of bone turnover by teriparatide injection did not prevent osteonecrosis but rather converted osteoclast progenitors to macrophages expressing inflammatory cytokines, which were required for osteonecrosis development...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28377979/a-new-contralateral-atypical-femoral-fracture-despite-sequential-therapy-with-teriparatide-and-strontium-ranelate
#10
Hanh H Nguyen, Frances Milat, Peter R Ebeling
Atypical femoral fractures (AFFs) are a rare association of anti-resorptive therapy for osteoporosis. Limited evidence-based management guidelines on their optimal treatment exist, with observational studies suggesting a role for teriparatide (TPTD) in AFF healing. We report a case of a 65-year-old woman with postmenopausal osteoporosis who sustained an AFF following long-term bisphosphonate therapy, and who subsequently developed a new contralateral AFF after completion of TPTD therapy and initiation of strontium ranelate (SR) treatment...
June 2017: Bone Reports
https://www.readbyqxmd.com/read/28361376/treatment-with-teriparatide-for-advanced-bisphosphonate-related-osteonecrosis-of-the-jaw-around-dental-implants-a-case-report
#11
Yusuke Zushi, Kazuki Takaoka, Joji Tamaoka, Miho Ueta, Kazuma Noguchi, Hiromitsu Kishimoto
We report a case of a 66-year-old severely osteoporotic woman with bisphosphonate-related osteonecrosis of the jaw (BRONJ) around her dental implants, who was treated successfully with teriparatide and sequestrectomy of the mandible. After 5 months of teriparatide therapy, the sequestrum separation had progressed and a sequestrectomy was performed under general anesthesia. Five months after the operation, new bone formation was observed around the bone defect in the region of the sequestrectomy. A repeat computed tomographic image revealed improvement in the bone defect in the mandible...
December 2017: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/28337514/effect-of-sequential-treatment-with-bisphosphonates-after-teriparatide-in-ovariectomized-rats-a-direct-comparison-between-risedronate-and-alendronate
#12
Tetsuo Yano, Mei Yamada, Daisuke Inoue
Teriparatide (TPTD), a recombinant human parathyroid hormone N-terminal fragment (1-34), is a widely used bone anabolic drug for osteoporosis. Sequential treatment with antiresorptives such as bisphosphonates after TPTD discontinuation is generally recommended. However, relative effects of bisphosphonates have not been determined. In the present study, we directly compared effects of risedronate (RIS) and alendronate (ALN) on bone mineral density (BMD), bone turnover, structural property and strength in ovariectomized (OVX) rats, when administered after TPTD...
March 23, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28326673/benefits-of-intralesional-injections-of-sodium-thiosulfate-in-the-treatment-of-calciphylaxis
#13
Kirsi Isoherranen, Laura Bouchard, Nicolas Kluger
Calciphylaxis (CPX) is a rare calcifying thrombotic vasculopathy responsible for painful necrotic ulcers, with a high mortality rate, and its management is often difficult. Recently, intravenous infusions of sodium thiosulfate (STS) have shown efficacy. The aim of this study was to assess the efficacy of intralesional STS (IL STS) in four patients. Our aim was to assess the efficacy of IL STS in a prospective mono-centric open study that included four patients with a biopsy-proven cutaneous CPX. Four women (55-84 years old, mean age: 71·2 years) with a uremic (n = 1) or non-uremic CPX (n = 3) and primary hyperparathyroidism induced by teriparatide or after the initiation of oral anti-vitamin K were treated by IL STS (250 mg/ml)...
March 21, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28326338/predictors-of-teriparatide-treatment-failure-in-patients-with-low-bone-mass
#14
Tarig Elraiyah, Adil H Ahmed, Zhen Wang, Joshua N Farr, Mohammad H Murad, Matthew T Drake
INTRODUCTION: While teriparatide is the only skeletal anabolic agent approved in the United States, treatment failure is a major concern which complicates its clinical utility. We sought to identify factors that predict response failure in patients with low bone mass. METHOD: We performed a retrospective study of adults with osteopenia or osteoporosis (T-scores < - 1.0 and - 2.5 SD below normal, respectively, at the total hip or lumbar spine) treated with teriparatide at the Mayo Clinic (Rochester, Minnesota) between November 2002-December 2012...
June 2016: Bone Reports
https://www.readbyqxmd.com/read/28326303/current-role-and-application-of-teriparatide-in-fracture-healing-of-osteoporotic-patients-a-systematic-review
#15
Sang-Min Kim, Kyung-Chung Kang, Ji Wan Kim, Seung-Jae Lim, Myung Hoon Hahn
BACKGROUND: The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients. METHODS: We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab]. RESULTS: This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis...
February 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28323910/progressive-development-of-pth-resistance-in-patients-with-inactivating-mutations-on-the-maternal-allele-of-gnas
#16
Alessia Usardi, Asmaa Mamoune, Elodie Nattes, Jean-Claude Carel, Anya Rothenbuhler, Agnès Linglart
Background: PTH resistance is characterized by hypocalcaemia, hyperphosphatemia and elevated PTH in absence of vitamin D deficiency. Pseudohypoparathyroidism (PHP) type 1A (or iPPSD2, inactivating Signaling PTH/PTHrp Disorder 2 according to the new classification) is caused by mutations in the maternal GNAS allele. Objective: To assess PTH resistance over time in 20 patients affected by iPPSD2 (PHP1A), diagnosed because of family history, ectopic ossification or short stature and carrying a GNAS mutation...
February 21, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323145/increased-cortical-porosity-is-associated-with-daily-not-weekly-administration-of-equivalent-doses-of-teriparatide
#17
Roger Zebaze, Ryoko Takao-Kawabata, Yu Peng, Ali Ghasem Zadeh, Kyoko Hirano, Hiroshi Yamane, Aya Takakura, Yukihiro Isogai, Toshinori Ishizuya, Ego Seeman
INTRODUCTION: The pharmacokinetic profile of parathyroid hormone (PTH) determines its effects on bone resorption and formation. When administered intermittently, anabolic effects are favored in comparison with the continuous treatment. Among the intermittent treatment regimens, lower frequency of administration may have a lower effect on bone remodeling. We therefore hypothesized that weekly administration of teriparatide will produce less increase in intracortical remodeling and porosity than reported using daily treatment...
March 18, 2017: Bone
https://www.readbyqxmd.com/read/28314897/transient-osteoporosis-of-the-hip-review-of-the-literature
#18
REVIEW
K Asadipooya, L Graves, L W Greene
Transient osteoporosis of the hip (TOH) is a temporary clinical condition of unknown etiology which usually resolves with conservative therapy though may be complicated by fracture or progression to avascular necrosis (AVN). TOH may be slightly more prevalent in men but when it occurs in women, it is most often seen in the latter part of pregnancy. Though fracture is a rare complication of TOH when it occurs, it is most often associated with TOH occurring in pregnancy. Magnetic resonance imaging (MRI) is the best method to diagnosis TOH...
March 17, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28303448/parathyroid-hormone-and-parathyroid-hormone-related-protein-analogs-in-osteoporosis-therapy
#19
REVIEW
Benjamin Z Leder
PURPOSE OF REVIEW: The purpose is to review the efficacy and optimal use of parathyroid hormone and parathyroid hormone-related protein analogs in osteoporosis treatment. RECENT FINDINGS: The parathyroid hormone analog teriparatide, a potent stimulator of bone remodeling, increases hip and spine bone mineral density and reduces the risk of vertebral and non-vertebral fractures in postmenopausal osteoporotic women. The parathyroid hormone-related protein analog, abaloparatide, also reduces fracture incidence but has pharmacological effects that differ from teriparatide, particularly in cortical bone...
March 16, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28293779/effect-of-osteoporosis-medication-on-changes-in-bone-mineral-density-and-bone-turnover-markers-after-24-month-administration-of-daily-teriparatide-comparison-among-minodronate-raloxifene-and-eldecalcitol
#20
Shinichi Nakatoh
This study reveals the changes in bone mineral density (BMD), the turnover rate, and the balance [multiple of median formation/multiple of median resorption (MoMf/MoMr)] affected by the selection of different bone resorption inhibitors after 24-month daily teriparatide (20 µg/day) administration. The turnover rate was calculated as √(MoMf(2) + MoMr(2)), where MoMf = bone-specific alkaline phosphatase (BAP) value/18.6 and MoMr = tartrate-resistant acid phosphatase 5b (TRACP-5b) value/463. One hundred and twenty-one osteoporotic women (mean age 82...
March 14, 2017: Journal of Bone and Mineral Metabolism
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