Objective: To explore the clinical efficacy of Zoledronic Acid Injection in the treatment of postmenopausal osteoporosis with different bone turnover rates. Methods: A total of 63 patients diagnosed with postmenopausal osteoporosis were included in this study. Each patient was administrated 5 mg/100mL Zoledronic Acid (Aclasta) intravenously once and then given a one-year prescription of 600 mg/d oral Caltrate. The bone turnover parameters (PINP, β-cross, N-MID) were measured prior to the injection of Zoledronic Acid while the bone mineral density (BMD) and the pain scores of each patient were tested before treatment and after the one-year medication. On this basis, the patients were divided into several groups according to their bone turnover rates for intergroup comparison of treatment outcomes. Results: BMD results and pain scores of all participants were significantly improved at different levels after treatment. However, these improvements had no significant differences between the patients with high and low bone turnover rates. Conclusion: Zoledronic Acid Injection can relieve bone pain, enhance the quality of life and increase the BMD in patients with postmenopausal osteoporosis, regardless of the bone turnover status.
Objective: To investigate whether sequential regimen such as traditional anti-reabsorption medications followed by zoledronic acid could reduce the side effects after initiation of zoledronic acid in postmenopausal osteoporosis patients. Methods: A total of 156 postmenopausal osteoporosis patients who presented at our osteoporosis outpatient clinic were enrolled in this study. They were randomly divided into four groups: the control group, alendronate group, calcitonin group, and raloxifene group. All participants were treated with Caltrate 600 mg per day and calcitriol 0.25 ug per day as a baseline treatment, followed by administrating 5 mg/100 mL of zoledronic acid intravenously for one single time three months afterwards. During the abovementioned course of three months, the alendronate group received 70 mg of alendronate sodium orally once a week, the calcitonin group received nasal spray form of salmon calcitonin 10iu daily, the raloxifene group received 60mg of raloxifene orally daily, and the control group received nothing but only the baseline treatment. We tested parameters such as β-cross, blood calcium level, renal function both pre and post zoledronic acid treatment. We also documented those side effects that typically occurred within one week of treatment initiation, which included the proportion, severity, onset time, and duration of the fever, demand for pain medication, severity of bone and joint pain, flu-like symptoms, arrhythmia, blood calcium level, and kidney function impairment. We also evaluated how willing the patients were to receive a second dose of zoledronic acid. Then we did comparative analysis between control group and sequential group. Results: The side effects such as fever, bone and joint pain, flu-like symptoms after zoledronic acid treatment in alendronate group and calcitonin group were all significantly lower than that in control group, while raloxifene group showed no significant difference compared to that in the control group. The proportions of patients who needed NSAIDs in the alendronate group and the calcitonin group were significantly lower than that in control group. However, the raloxifene group showed no significant difference in the NSAIDs demand from that of the control group. The percentages of patients who consented to a second dose of zoledronate therapy in the alendronate, calcitonin and raloxifene groups were significantly higher than that in the control group. Conclusions: Sequential treatment with alendronate sodium or calcitonin can significantly reduce the side effects such as fever, bone/joint pain, flu-like symptoms caused by first-time zoledronic acid therapy. Raloxifene sequential treatment does not seem to have decreased or increased the side effects of zoledronic acid treatment. Also, sequential treatment can improve the patient compliance with a second dose of zoledronic acid.
Osteoporosis is commonly seen in aged people, but not much attention is paid to it. Patient compliance is challenged by many factors, including long-time treatment and high rates of fatality and disability caused by fragility fractures. With age-related changes, the treatment will last for a lifetime. A clinical case of postmenopausal patient who had received incontinuous treatment of alendronate for 20 years was studied in this article. As the level of compliance varied in different treatment phases, the curative outcome of this patient was altered. This study also presented a literature review to discuss the current situation, treatment and compliance of osteoporosis in China and the corresponding influences on bone mineral density (BMD) and prognosis. Hopefully, this study can increase physicians' awareness of osteoporosis in clinical treatment and its pharmacotherapy and treatment course.
Objective: To demonstrate the effect of empathy on reducing the recurrence rate of venipuncture-induced syncope among patients with a history of fainting. Methods: A total of 300 patients with a history of fainting at the sight of blood or a needle who visited our outpatient department for blood draws during December 2013 and December 2018 participated in this study and were randomly divided into a control group (98 cases of mild syncope and 52 of severe syncope) and an experimental group (95 cases of mild syncope and 55 of severe syncope). The control group followed the traditional procedure for drawing blood; in addition to the traditional procedure, a psychological nursing intervention was applied to the experimental group. Results: The experimental group had a recurrence rate significantly lower than the control group (6.7% vs 37.3%, P = 0.001); particularly, there was a statistically significant difference between the recurrence rates of the mild-syncope subgroups (0.1% vs 12.2%, P = 0.02). In terms of severe syncope, the patients in the experimental group showed a lower recurrence risk compared to those in the control group (16.4% vs 84%, P = 0.0001), and the difference has statistical significance. Conclusion: Empathy is an effective psychological nursing intervention against the recurrence rate of venipuncture-induced syncope among patients with a history of fainting.
Objective: To study the health information assistance needs of junior high school students in 8 different regions of Guangdong Province in a cluster, to understand the current situation of junior high school students' health information assistance needs, and to collect feasibility data for hospitals and schools to jointly promote the healthy development of students. Methods: In June 2019, a group of junior high school students from 8 different regions in Guangdong Province [678 students (in 2 towns), 352 students (in 2 counties and prefecture-level cities), and 1098 students (in 4 provincial-level cities)] were selected in a group. A questionnaire survey was conducted by 2128 people, the results of the questionnaire survey were collected, and statistical analysis was performed. Results: Of the 2128 junior high school students in 8 different regions, only 52.07% had confidence in their health, and there were no regional differences. Health information for students seeking professional medical assistance includes: 1578 person-times (74.15%) of nutritional diets, 1084 person-times (50.94%) to eliminate tiredness, 1190 person-times (55.92%) to improve sleep quality, 1002 person-times (47.09%) to reduce anxiety, making him happier and stronger 1164 person-times ( 54.70%). Students in different regions asked for help on how to make their hearts happier and stronger. The results suggest that provincial and county-level students have greater needs than urban students. Conclusion: The results of this research show that junior high school students in different regions of Guangdong Province have insufficient awareness of health, and there is a large demand for various health help information, and the focus is on prevention. It is of practical significance to strengthen and meet the health information needs of junior high school students.
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