The SEPS1 -105G>A is associated with an increased risk of KBD and influences the expression of PI3K/Akt signaling pathway in KBD patients. Apoptosis induced by tBHP in chondrocyte might be mediated via up-regulation of PI3K/Akt, Na2SeO3 has an effect of anti-apoptosis by down-regulating of PI3K/Akt signaling pathway.
(index any site), 37.6% (CI95:36.1-39.1) after second, 21.2% (CI95:18.0-25.0) after third, with the majority of subsequent fractures occurring in the first 2 years post fracture. Risk of subsequent MOF was highest in the first 6 months following index fracture; the adjusted relative risk (RR) of MOF was 2.2 (CI95:2.1-2.2) following any fragility fracture, 4.5 (CI95:4.2-4.9) following a vertebral fracture and 1.9 (CI95:1.8-2.1) following a hip fracture. After a second fracture, these RRs were 2.6 (CI95:2.4-2.8), 3.8 (CI95:2.9-5.2) and 2.0 (CI95:1.9-2.1); and after the third fracture, the RR was 1.5 (CI95:1.5-1.5). ConClusions: Fracture risk significantly increases rapidly within 6 months following a fragility fracture, remains very elevated in the subsequent 2 years and persists over 5 years. The relative risk manifests within 6 months and gradually declines over 5 years following the fracture. A patient who has suffered any fragility fracture requires prompt intervention to minimize that risk and avoid significant personal, economic and societal burden.
OBJECTIVES: Assess the profile of use of immunobiological (IMB) in the service of rheumatology of a Health PlansOperator (HPO) located in Fortaleza,Ceará, Brazil. METHODS: This is a descriptive and retrospective study. The data was collected from the medical skills performed in the rheumatology service, as well as the revision of patients' charts in use of IMB from 2012 to 2016. RESULTS: Were analyzed 354 patients, with female predominance, 68.36% (n = 242) and the median of age was 50 years. The pathologies of higher incidence were rheumatoid arthritis with 42.37% (n = 150), ankylosing spondylitis with 39.27% (n = 139) anderythroderma arthritis with 8.76% (n = 31). 487 therapeutic schemes were used during the period. The inhibitors of the tumor necrosis factor (anti TNF) were the most used in relation to the other classes, representing 73.10% (n = 356). The other classes were interleukin-6 (12.32%) inhibitors, depletor of lymphocytes B (6.98%); T lymphocyte inhibitor (6.16%); interleukin-17 inhibitor (1.03%); interleukin inhibitor-12/23 (0.41%). The most prominent anti TNF were the infliximab, the adalimumab and the golimumabe representing 21.36%, 19.51% and 11.50% of the use, respectively. CONCLUSIONS: The knowledge of the profile and patient care information is the basis for any planning strategy. The high cost of these medicines shows the need for multiprofessional auditing to evaluate the correct use and impact that the IMBs possess in the healthcare provider. This is important to plan and offer the best care of the patient and intervene when necessary.
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