Fragility fracture is a worldwide problem and a main cause of disability and impaired quality of life. It is primarily caused by osteoporosis, characterized by impaired bone quantity and or quality. Proper diagnosis of osteoporosis is essential for prevention of fragility fractures. Osteoporosis can be primary in postmenopausal women because of estrogen deficiency. Secondary forms of osteoporosis are not uncommon in both men and women. Most systemic illnesses and organ dysfunction can lead to osteoporosis. The kidney plays a crucial role in maintaining physiological bone homeostasis by controlling minerals, electrolytes, acid-base, vitamin D and parathyroid function. Chronic kidney disease with its uremic milieu disturbs this balance, leading to renal osteodystrophy. Diabetes mellitus represents the most common secondary cause of osteoporosis. Thyroid and parathyroid disorders can dysregulate the osteoblast/osteoclast functions. Gastrointestinal disorders, malnutrition and malabsorption can result in mineral and vitamin D deficiencies and bone loss. Patients with chronic liver disease have a higher risk of fracture due to hepatic osteodystrophy. Proinflammatory cytokines in infectious, autoimmune, and hematological disorders can stimulate osteoclastogenesis, leading to osteoporosis. Moreover, drug-induced osteoporosis is not uncommon. In this review, we focus on causes, pathogenesis, and management of secondary osteoporosis.

Our results proposed a diagnostic approach for VMs of the head and neck. MRI, venography, and clinical examination had important impact in decision-making, whereas histopathology had no impact. A management approach has been suggested for each type and its subtypes.

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The outbreak of coronavirus disease 2019 (COVID‐19) has rapidly evolved into a global pandemic. A significant proportion of COVID‐19 patients develops severe symptoms, which may include acute respiratory distress syndrome and acute kidney injury as manifestations of multi‐organ failure. Acute kidney injury (AKI) necessitating renal replacement therapy (RRT) is increasingly prevalent among critically ill patients with COVID‐19. However, few studies have focused on AKI treated with RRT. Many questions are awaiting answers as regards AKI in the setting of COVID‐19; whether patients with COVID‐19 commonly develop AKI, what are the underlying pathophysiologic mechanisms? What is the best evidence regarding treatment approaches? Identification of the potential indications and the preferred modalities of RRT in this context, is based mainly on clinical experience. Here, we review the current approaches of RRT, required for management of critically ill patients with COVID‐19 complicated by severe AKI as well as the precautions that should be adopted by health care providers in dealing with these cases. Electronic search was conducted in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases. We searched the terms relevant to this review to identify the relevant studies. We also searched the conference proceedings and ClinicalTrials.gov database.

Background Coronavirus disease 2019 (COVID-19) is a contagious disease that is associated with significant morbidity and mortality especially among maintenance hemodialysis (MHD) patients. COVID-19 vaccination is important to decrease risk and severity of COVID-19 infection. However, vaccine hesitancy is a significant barrier to vaccination. Thus, the aim of this study was to investigate the vaccine acceptability among Egyptian MHD patients. Methods We conducted a paper-based survey on 237 MHD patients in 2 tertiary Egyptian hemodialysis (HD) centers. The survey consisted of a questionnaire that addressed demographic and clinical data, knowledge and attitudes towards COVID-19 infection and vaccines, beliefs regarding both conventional and COVID-19 vaccines, intention of COVID-19 vaccination together with motivators for and barriers against vaccination, sources of information regarding COVID-19 vaccines. Results According to intention to be vaccinated, the patients were divided into vaccine acceptant (VA), hesitant (VH), and resistant (VR) groups who comprised 58.3%, 26.5%, and 15.2%, respectively. Only occupational status and residency were significantly different between the three groups. In 60% of VA group, fear of infection was the main motivator for vaccination. Meanwhile, 40% of VH and VR groups reported that fear of serious side effects of vaccines was the main barrier against vaccination. Television was the primary information source (58.6%) about COVID-19 vaccination while only 18% of patients got their COVID-19 vaccine information from their nephrologists. Conclusions More than half of MHD patients accept to receive COVID-19 vaccine. Vaccine acceptability is not associated with age, gender, educational level, but rather with employment status and residency.