Retrospective population-based survey in 2 regions of the Republic of Moldova determined the incidence of fractures at the hip, proximal humerus and distal forearm. The estimated number of such fractures nationwide for 2015 was 11,271 and is predicted to increase to 15,863 in 2050. The hip fracture rates were used to create a FRAX model to help guide decisions about treatment. Objective This paper describes the epidemiology of osteoporotic fractures in Republic of Moldova that was used to develop the country-specific fracture prediction FRAX® tool. Methods We carried out a retrospective population-based survey in 2 regions of the Republic of Moldova (Anenii Noi district and Orhei district) representing approximately 6% of the country's population. We identified hip, forearm and humerus fractures in 2011 and 2012 from hospital registers and primary care sources. Age-and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Moldova. Fracture probabilities were compared with those from neighbouring countries having FRAX models. Results The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 3911 and is predicted to increase by 60% to 6492 in 2050. Hip fracture incidence was a good predictor of forearm and humeral fractures. FRAX-based probabilities were higher in Moldova than neighbouring countries (Ukraine and Romania). Conclusion The FRAX model should enhance accuracy of determining fracture probability among the Moldavan population and help guide decisions about treatment.
Introduction. The incidence and prevalence of gout have increased worldwide in recent decades. Scientists at the Rochester Epidemiology Project (MN, USA) have seen a two-fold increase in the incidence of primary gout (patients without diuretic exposure) over a 20-year period, which ended in 1996. The increase of incidence may be related due to the difficulty and often unsatisfactory treatment options. The aim of the study was to systematize the recommendations on dietary treatment, and medication for patients with gout. Materials and methods. An analytical, qualitative, and secondary study was performed in the form of a synthesis article. 115 sources were identified and analyzed; from this list, 44 sources were selected according to the impact score during the publication period and according to the level of recommendations. Results. 44 articles were included. Most studies were small, retrospective analyses performed in single centers, with concerns for bias. Eleven studies (including five randomized controlled trials) reported improved patient outcomes following pharmacological interventions with known efficacy in gout, including allopurinol, prednisolone, NSAIDs and anakinra. Eight studies reported improved outcomes associated with non-pharmacological interventions: inpatient rheumatology consultation and a hospital gout management protocol. No studies to date have prospectively evaluated strategies designed to prevent re-admissions of patients hospitalized for gout flares. Conclusions. Urate crystals is completely soluble when we can lower the serum level of uric acid to normal values, but this often requires long-term treatment. The early onset of rehabilitation of affected joints helps to reduce the articular inflammatory process, the pain syndrome and it delays the progression of the underlying pathology while improving the quality of life in patients with gout. Further research is needed to enable healthcare providers to individualize and optimize gout treatment strategies, ensuring that patients with gout receive effective, safe, and high-quality care.
ObjectivesThe purpose of the study was to investigate the relationship between disease activity, structural lesions and physical function by testing the hypothesis that the level of structural lesions contributes independently to physical impairment.MethodsFor this analysis, the database of Rheumatology Department was used and included 78 consecutive SA patients who have been observed for many years, implying that they have used NSAID’s and DMARD for progression disease, no one has used TNF blocking agents.ResultsBASFI and DFI correlated significantly (r 0.88). The correlation coefficient for mSASSS and BASFI was 0.508 and for mSASSS and DFI equal to 0.464, suggesting a moderate correlation relationship. The correlation coefficient for the relationship between BASDAI and BASFI was equal to 0.79 and for BASDAI and DFI equal to 0.69 suggesting a moderate to significant correlation. The correlation between mSASSS and BASFI or DFI was dependent on the BASDAI level.To further investigate the relationship between mSASSS and BASFI/DFI, concurrently adjusting for BASDAI and other covariates, a multivariate analysis was performed using GEE with BASFI or DFI as dependent variables, and mSASSS and BASDAI as covariates, concurrently adjusting for age, sex, duration of illness, HLA-B27 status and hip involvement.Both BASDAI and mSASSS contributed independently to the BASFI and DFI explanations with significant parameter estimates. Regression coefficients describe the independent relationship between the explanatory variables and the dependent variable: in the environment, compared to a patient with mSASSS 40, a patient with the mSASSS score 50 has a BASFI of 0.57 times greater, independent of BASDAI.All mSASSS subscripts contributed independently to the explanation of BASFI variations (p<0.001). Compared to the mSASSS model, which had the best result, the model with the total score of the syndesmofite, the number of the affected vertebral units, the number of vertebral vertebral units, and the model with the non-syndesmophitary summary score, it was deduced that the syndesmophites are in much but not exclusively responsible for explaining variations in BASFI. A model with the sindesmophites summary score (p<0.001) and the non-syndesmophyte (p=0.002) shows that both components contribute significantly to the explanation of BASFI variations. Results with DFI were similar.Using mSASSS, the syndesmophyte subservices, the affected vertebral units or vertebral vertebral units, we showed that lumbar and cervical spine involvement contributed independently and almost similarly to explaining variations in BASFI and DFI.ConclusionsThe study conducted by us demonstrates that the patient‘s physical function is not only dependent on signs and symptoms reported by the patient (activity of the disease), but also on the degree of structural lesions. Optimal AS treatment should not only include strategies aimed at removing pain, redness and fatigue, but also strategies aimed at preventing the formation and growth of syndesmofite.Disclosure of ...
BackgroundOsteoporosis is a disease which is frequently asymptomatic until fragility fractures occur. The study of risk factors in osteoporosis is continuously developing, considering that there is a tremendous geoghraphic variety in osteoporosis occurrence. We present the results of an epidemiological study of fragility fracture cases in Republic of Moldova, trying to underlie differences in fragility fracture epidemiology, based on residence region, and possibly lifestyle factors, in a female population.ObjectivesThe purpose of the study was to determine the incidence and prevalence of fragility fractures in women, with comparison of epidemiological indexes between urban and rural areas in Republic of Moldova.MethodsApproximately 6% of the state population was included in the study. Data regarding peripheral fragility fracture cases was collected from all specialised and primary medical institutions from the defined area. Fragility fractures of proximal humerus, distal forearm, proximal femur and distal calf, in women aged over 40 years old were collected. Using population statistics provided by the National Bureau of Statistics, epidemiological indexes regarding fracture incidence and prevalence were derived, with further comparison of derived epidemiological indexes for urban and rural areas, as well as separate epidemiological indexes for the four fracture regions.ResultsA general incidence of 1033.4 peripheral fragility fractures per 1 00 000 female population >40 years was determined, with a significantly higher incidence in urban areas (1216.7 vs 980.1, p<0.05). The incidence of proximal humerus fracture was 149 per 1 00 000 female population >40 years, with a small, but significantly higher incidence in urban areas (159.5 vs 145.9, p<0,05). The incidence of distal forearm fractures was 393.4 per 1 00 000 population >40 years, significantly higher in urban areas (528.5 vs 354.1, p<0,05). The incidence of proximal femur fracture was 208.5 per 1 00 000 population >40 years, significantly higher in urban areas (227.9 vs 202.9, p<0,05). The incidence of distal calf fractures was 282.5 per 1 00 000 population >40 years, with a small, but significantly higher incidence in urban areas (300.7 vs 277.2, p<0,05).ConclusionsThere was an overall higher incidence of fragility fractures in the urban female population compared to the rural one, with a similar relationship in all four fracture groups. The association between urban residence and increased incidence of fragility fractures in women, could be attributed to a less active physical lifestyle (known risk factor in osteoporosis) in urban areas. Distal forearm fractures showed a greater prevalence both in urban and in rural areas, compared to other fracture types. Moreover, the incidence difference between urban and rural areas was most prevalent in the distal forearm fracture group. The latter observation was not determined in a similar study in men, in the same population and period of time.Disclosure of InterestNone declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.