جستجوی مقالات مرتبط با کلیدواژه « آلندرونات » در نشریات گروه « پزشکی »

Bone fusion is a dynamic process and availability of calcium and balance of vitamin D can be effective in post spinal cord fusion. There are contradictory results on this issue, so, we decided to compare the effect of administration of vitamin D and alendronate on lumbosacral vertebral fusion in patients undergoing posterior spinal fusion surgery.

A single-blind clinical trial was carried out in 75 patients. Patients were divided into three groups (n=25 per group) using block randomization: Alendronate group who received 70 mg oral alendronate every two weeks, Vitamin D group to receive vitamin D 50,000 units per month for six months, and control group who received routine treatment after the surgery. After six months, the patients underwent CT scan of the lumbar region for clinical assessment of lumbar fusion. Pain intensity was assessed using Visual Analogue Scale (VAS), one and six months after the surgery. Data analysis was performed in SPSS V16.

Before surgery, pain intensity was higher in vitamin D group (6.36 ± 1.3) than the controls and alendronate group (P <0.0001). The last VAS in this group reached 2.12 ± 0.97 indicating decrease in pain intensity. Overall, there was a significant decrease in pain intensity in all three groups
(P<0.0001). Non-fusion was found to be more frequent in control group (16%) compared to the vitamin D (12%) and alendronate (8%) groups (P=0.900).

In current study, vitamin D and alendronate supplementation slightly improved lumbosacral fusion. Therefore, further studies are needed to investigate the effectiveness of combined treatment with alendronate and vitamin D on pain intensity and lumbosacral fusion in these patients.
 

Osteoporosis is the most common metabolic bone disease worldwide that is defined by lessened bone density. Osteoporosis progression is accompanied with increased risk of pathologic fractures. Osteopenia is attributed to the first steps of bone density loss process. Studies about treatment initiation while osteopenia is presented, and the treatment dose, are controversial. In this study, low dose versus high dose of alendronate among menopausal women with osteopenia was evaluated.

The current randomized clinical trial (RCT) study was conducted on 152 menopausal women with osteopenia referred to a rheumatology clinic during 2017-18. Patients were randomly divided into two groups of treatment with weekly doses of 35 mg and 70 mg alendronate, and then followed for two years. Bone mineral densitometry (BMD) was performed for all the patients prior to and after treatment, and findings were compared.

Two assessed groups were not statistically different regarding age, gender, height, weight, and body mass index (BMD) (P > 0.050 for all). BMD findings of two groups including hip and spine/wrist Fracture risk assessment system (FRAX), hip and spine T-score, and hip and spine Z-score significantly improved following two years (P < 0.001); but the comparison of two doses presented no statistical difference considering BMD findings improvement (P > 0.050).

Findings of this study are in favor of preventive treatment with alendronate in women with osteopenia. Furthermore, considering digestive irritability as the main complaint of alendronate, based on our findings, weekly 35 mg use of this agent can be considered.

Developmental dysplasia of the hip (DDH) includes a wide range of abnormalities of the hip that can emerge at any time including embryonic period, infancy, or childhood. The purpose of this study was to examine the clinical and radiographic outcomes of patients with DDH, treated with adductor tenotomy and closed reduction.

The study was retrospectively performed on 30 children (33 joints) with DDH,who were treated with adductor tenotomy, closed reduction and SpicaCast in Ahvaz Razi Hospital during 2015-2017. Inclusion criteria were patients diagnosed with DDH and below 2 years of age. Exclusion criteria were connective tissue diseases, secondary dislocation due to previous infection and acetabulum dysplasia in the context of specific syndrome. After the operation, the patients were evaluated for the severity of injuries associated with dislocation or subluxation of hip joint and hip joint congruity. Theradiographic results were studiedbased on Severin, Tonnis grading, McKay and acetabularindices.

The preoperative mean acetabular index of36.54 ± 3.27 degrees significantly dropped to postoperativeof 27.06 ± 2.15 degrees. According to McKay criteria, 90.9% of the patients had excellent and good therapeutic results after the surgery. According to Tonnis criteria, 93.9% of patients were in Class I and II after the surgery. Moreover, in radiographic evaluations,96.9% of the patients were in Class Ia and Ib  based on Severin criteria.In 1 patient (3.03%), osteonecrosis of the head was found, in 2 patients (6.06%), walking and lameness impaired walking, and in 3 patients (9.09%), sitting was reported. All patients were female in this study.

According to the clinical results and evaluations of this study, closed reduction along with adductor tenotomy can be used as an appropriate technique for the treatment of patients with DDH at an early age.

The patient is a 69 years old female presented with chest pain and rapidly progressive dysphagia. Then she suffered of hematemesis and aphagia. In evaluation of patient, a intramural hematoma obstructing esophageal lumen was demonstrated which was accompanied with mucosal ulceration and bleeding. It appears that this complication occurred in the context of concomitant use of alendronate with aspirin in this patient.