Systemic evaluation of the relationship between psoriasis, psoriatic arthritis and osteoporosis: observational and Mendelian randomisation study.

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With 432 513 samples from UK Biobank dataset, multivariable linear/logistic regression were used to estimate the relationship between psoriasis/psoriatic arthritis (PsA) and estimated bone mineral density (eBMD)/osteoporosis, controlling for potential confounders. […]

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Comparable or higher prevalence of comorbidities in antiphospholipid syndrome vs rheumatoid arthritis: a multicenter, case-control study.

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Evidence on comorbidity prevalence in antiphospholipid syndrome (APS) and its difference from high comorbidity burden rheumatic diseases is limited. Herein, we compare multiple comorbidities between APS and RA.A total of […]

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Clinical phenotypes of IgG4-related disease reflect different prognostic outcomes.

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Four clinical phenotypes of IgG4-related disease (IgG4-RD) have been recently identified by latent class analysis (LCA): pancreato-biliary (group 1); retroperitoneum/aortitis (group 2); head and neck limited (group 3); and Mikulicz/systemic […]

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Handgrip strength is a comorbidity marker in systemic necrotizing vasculitides and predicts the risk of fracture and serious adverse events.

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Sarcopenia has been associated with poor outcomes in various medical and surgical conditions. However, its impact in systemic necrotizing vasculitides (SNV) had never been characterized. We aimed to assess the […]

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2019 EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older.

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To establish European League Against Rheumatism (EULAR) points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older.Points to consider were developed […]

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The risk and consequences of vertebral fracture in patients with Ankylosing Spondylitis: a population-based data linkage study.

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To compare the long-term prevalence, incidence and outcomes of vertebral fracture (VF) between ankylosing spondylitis (AS) patients and matched controls, including the role of extra-articular manifestations (EAM) and osteoporosis.State-wide observational […]

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Validation of the self-administered comorbidity questionnaire adjusted for spondyloarthritis: results from the ASAS-COMOSPA study.

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To confirm validity of the Self-administered Comorbidity Questionnaire modified for patients with SpA (mSCQ), and assess whether validity improves when adding items on extra-articular manifestations (EAMs), i.e. uveitis, psoriasis, and […]

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Trabecular bone score improves fracture risk assessment in glucocorticoid-induced osteoporosis.

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Abstract: To analyse the clinical utility of trabecular bone score (TBS) evaluation for fracture risk assessment in glucocorticoid (GC)-treated patients compared with BMD assessment.One hundred and twenty-seven patients on GC […]

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Analysis of bone impairment by 3D DXA hip measures in patients with primary hyperparathyroidism: a pilot study.

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Abstract: primary hyperparathyroidism (PHPT) has been related to bone loss. Dual-energy X-ray absorptiometry (DXA) cannot distinguish between trabecular and cortical bone compartments but the recently developed 3D-DXA software might overcome […]

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Development of CROMRIS (ChRonic nonbacterial Osteomyelitis MRI Scoring) Tool and Evaluation of its Interrater Reliability.

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Abstract: Serial MRI exams are often needed in chronic nonbacterial osteomyelitis (CNO) to determine the objective response to treatment. Our objectives were: 1) to develop a consensus-based MRI scoring tool […]

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The prevalence of osteoporosis tested by quantitative computed tomography in patients with different glucose tolerances.

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Abstract: The objectives of the present study were to compare bone characteristics with QCT and other metabolic factors relevant to bone health in subjects with normal glucose tolerance, impaired glucose […]

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Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline.

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Abstract: The aim of this work is to provide evidence-based guidance on the management of osteoporosis in survivors of adult cancer.ASCO convened a multidisciplinary Expert Panel to develop guideline recommendations […]

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High Expression of Acid-Sensing Ion Channel 2 (ASIC2) in Bone Cells in Osteoporotic Vertebral Fractures.

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Abstract: Little is known about the function of acid-sensing ion channels (ASICs) in bone cells or osteoporotic vertebral fractures (OVF). This study delineated ASICs expression in adult human bone marrow-mesenchymal […]

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Efficacy and Safety of First- and Second-Line Drugs to Prevent Glucocorticoid-Induced Fractures: A Network Meta-Analysis.

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Abstract: The evidence about benefits and harms of drugs for glucocorticoid-induced osteoporosis (GIOP) is limited, and the comparative efficacy and safety of first-line and second-line agents to prevent glucocorticoid-induced (GI) […]

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National Audit on the Management of Bullous Pemphigoid.

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Abstract: Bullous pemphigoid (BP) is an autoimmune sub-epidermal blistering condition which typically affects the elderly population.To undertake a national clinical audit based on standards derived from the British Association of […]

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Gut microbiota alterations associated with reduced bone mineral density in older adults.

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Abstract: To investigate compositional differences in the gut microbiota associated with bone homeostasis and fractures in a cohort of older adults.Faecal microbiota profiles were determined from 181 individuals with osteopenia […]

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Prevalence and risk factors for osteoporosis in individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

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Osteoporosis is prevalent in individuals with chronic obstructive pulmonary disease (COPD). Updated evidence is required to complement the previous systematic review on this topic in order to provide best practice. The aim of this systematic review and meta-analysis was to quantitatively synthesize data from studies with respect to the prevalence and risk factors for osteoporosis among individuals with COPD.EMBASE, CINAHL MEDLINE, and PubMed databases were searched for articles containing the keywords “COPD”, “osteoporosis”, “prevalence”, and “risk factor”. Eligibility screening, data extraction, and quality assessment of the retrieved articles were conducted independently by two reviewers. Meta-analyses were performed to determine osteoporosis prevalence and risk factors in individuals with COPD. Meta-regression analyses were conducted to explore the sources of heterogeneity.The pooled global prevalence from 58 studies was 38% (95% CI= 34, 43). The presence of COPD increased the likelihood of having osteoporosis (OR= 2.83). Other significant risk factors for osteoporosis in COPD patients were body mass index < 18.5 kg/m2 (OR=4.26) and the presence of sarcopenia (OR= 3.65).Osteoporosis is prevalent in individuals with COPD and the prevalence appears to be high and similar in many countries. COPD patients should be screened for osteoporosis and contributing risk factors.

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Neglected bodily senses in women living with vertebral fracture: a focus group study.

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Older women are at particular risk of osteoporosis. Among women with osteoporosis, fractures of the vertebra (vertebral fracture) are common, hard to detect and associated with risk of further fracture. Identifying vertebral fracture in a timely manner allows instigation of preventive measures to reduce the risk of further fracture. Although detection of vertebral fracture requires spinal radiograph, many women do not receive referral. To begin development of a screening tool to identify women in need of referral we undertook a qualitative study to characterize women’s experiences of vertebral fracture, using Eccleston’s ‘Ten Neglected Bodily Senses’.Four qualitative focus groups were conducted with women who had been diagnosed with vertebral fracture (n = 19, age 60-91 years). Data were audio-recorded, transcribed and analysed thematically using the ‘Ten Neglected Bodily Senses’.Women’s experiences of vertebral fractures related to seven senses: pain, movement, fatigue, balance, pressure, appetite and breathing. Pain was the dominant sense and all participants explained how pain increased with activity, reaching a crescendo, and described strategies to minimize this disruption. Most participants had become physically shorter, making some feel ‘squashed’, putting pressure on other body parts. Some described appetite loss or a sense of restricted breathing. Participants experienced a sense of being ‘pulled’ forwards, impacting on balance and exacerbating fear of falling.The study found senses that have not been previously described in the experiences of women with vertebral fracture. These will be used to inform the design of a new screening tool for use in primary care.

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Predictors of Poor Bone Microarchitecture Assessed by Trabecular Bone Score (TBS) in Postsurgical Hypoparathyroidism.

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The effects of parathyroid hormone deprivation on bone are still unclear. Our objective was to report the characteristics of patients with postsurgical hypoparathyroidism (PsH) at a specialized outpatient service and correlate their trabecular bone score (TBS) values to clinical, densitometric, and laboratory findings. A secondary objective was to evaluate the fracture rates and look for associations between these events and the collected data.Eighty-two patients were enrolled, of whom 70 (85.4%) were female and 17 (20.7%) had type 2 diabetes mellitus (T2DM). The median body mass index (BMI) was 27.7 kg/m2 and the median age was 59 years. Of 68 DXA scans performed, osteopenia and osteoporosis were present in 32.4% and 2.9%, respectively. In all, 62 lumbar scans were analyzed using TBS. The mean TBS value was 1.386±0.140, and 32.2% of the results were below 1.310. TBS values correlated negatively with BMI (mainly above 30kg/m2), age (mainly above 60 years), and glycemia, while abnormal TBS correlated with osteopenia, T2DM, low impact fracture, and menopause. Six female patients had low impact fractures, which were associated with a lower TBS (1.178±0.065 vs. 1.404±0.130 in the group without fractures, p<0.001), greater age, higher BMI, impaired renal function, abnormal glycemia, and osteopenia.This study suggested that known risk factors for bone loss compromise the bone microarchitecture of individuals with PsH, despite DXA results. PsH menopausal women, PsH patients who are older, osteopenic and have a higher BMI or T2DM may be candidates for a more detailed assessment using, for example, TBS.

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Endocrine and metabolic disorders in survivors of childhood cancers and health-related quality of life and physical activity.

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Childhood cancer survivors experience chronic health conditions that impact health related quality of life (HRQOL) and participation in optimal physical activity.The study aimed to determine independent effects of endocrine and metabolic disorders on HRQOL and physical activity.Retrospective cohort with longitudinal follow-up of survivors of childhood cancer enrolled in the North American Childhood Cancer Survivor Study.Medical Outcomes Short Form-36 estimated HRQOL while participation in physical activity was dichotomized as meeting or not meeting recommendations from the Center for Disease Control and Prevention. Log binomial regression evaluated the association of each endocrine/metabolic disorder with HRQOL scales and physical activity.Of 7,287 survivors, median age 32 years (18-54) at their last follow-up survey, 4,884 (67%) reported one or more endocrine/metabolic disorders. Survivors with either disorder were significantly more likely to be male, older, received radiation treatment, and experience other chronic health conditions. After controlling for covariates, survivors with any endocrine/metabolic disorder were more likely to report poor physical function risk ratio ([RR] 1.25; 95% confidence interval [CI] 1.05-1.48), increased bodily pain (RR 1.27; CI 1.12-1.44), poor general health (RR 1.49; CI 1.32-1.68) and lower vitality (RR 1.21; CI 1.09-1.34) compared to survivors without. The likelihood of meeting recommended physical activity was lower among survivors with growth disorders (RR 0.90; CI=0.83-0.97), osteoporosis (RR 0.87; CI=0.76-0.99), and overweight/obesity (RR 0.92; CI 0.88-0.96).Endocrine and metabolic disorders are independently associated with poor HRQOL and sub-optimal physical activity among childhood cancer survivors.

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Comparison of Teriparatide and Denosumab in Patients Switching from Long-Term Bisphosphonate Use.

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Teriparatide and denosumab are effective treatments for osteoporosis and typically reserved as second-line options after patients have used bisphosphonates. However, limited head-to-head comparative effectiveness data exist between teriparatide and denosumab.We compared changes in bone mineral density (BMD) between groups treated with teriparatide or denosumab after using bisphosphonates, focusing on the change in BMD while on either drug over 2 years.Observational cohort study using electronic medical records from two academic medical centers in the US.The study population included osteoporotic patients > 45 years who received bisphosphonates over one year prior to switching to teriparatide or denosumab.Annualized BMD change from baseline at the lumbar spine, total hip and femoral neck.Patients treated with teriparatide (n=110) were compared to those treated with denosumab (n=105); the mean (SD) age was 70 (10) years and median duration (IQR) of bisphosphonate use was 7.0 (5.6-9.7) years. Compared to denosumab users, teriparatide users had higher annualized BMD change at the spine by 1.3% (95% CI 0.02, 2.7%), but lower at the total hip by -2.2% (95% CI -2.9 to -1.5%) and the femoral neck by -1.1% (95% CI -2.1 to -0.1%). Those who switched to teriparatide had a transient loss of hip BMD for the first year, with no overall increase in the total hip BMD over two years.Among patients who use long-term bisphosphonates, the decision of switching to teriparatide should be made with caution, especially for patients at high risk of hip fracture.

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Association between urinary triclosan with bone mass density and osteoporosis in the US adult women, 2005-2010.

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Abstract: Laboratory studies have demonstrated that Triclosan (TCS) could result in significant interstitial collagen accumulation and an increase in trabecular bone. However, little is known about the relationship between TCS […]

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Testing and management for monoclonal gammopathy of uncertain significance and myeloma patients presenting with osteoporosis and fragility fractures.

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Abstract: Multiple myeloma, the second most frequent blood cancer, and its precursor, monoclonal gammopathy of uncertain significance, are associated with an increased risk of fragility fractures. However, current guidelines fail […]

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