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Blázquez Cabrera JA, Sosa Henriquez M, Diaz-Curiel M, Sánchez Molini P, Arranz Garcia F, Montoya MJ, Filgueira J, Olmos JM, Coco-Martín MB, Castrillón JLP. Profile of patients who consult with internists for an osteoporosis assessment: The OSTEOMED registry. Rev Clin Esp 2021; 221:9-17. [PMID: 33998484 DOI: 10.1016/j.rceng.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently. MATERIAL AND METHODS Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors. RESULTS In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; p<.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; p<.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; p<.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%). CONCLUSIONS These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.
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Affiliation(s)
| | - M Sosa Henriquez
- Servicio de Medicina Interna, Hospital Universitario Insular, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - M Diaz-Curiel
- Servicio de Medicina Interna, Fundación Jiménez Díaz, Madrid, Spain
| | - P Sánchez Molini
- Servicio de Medicina Interna, Hospital de la Princesa, Madrid, Spain
| | - F Arranz Garcia
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, Spain
| | - M J Montoya
- Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J Filgueira
- Servicio de Medicina Interna, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - J M Olmos
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - M B Coco-Martín
- Grupo de Investigación en Neurociencias Clínicas Aplicadas, Universidad de Valladolid, Valladolid, Spain
| | - J L Pérez Castrillón
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, Spain.
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Blázquez Cabrera JA, Sosa Henriquez M, Diaz-Curiel M, Sánchez Molini P, Arranz Garcia F, Montoya MJ, Filgueira J, Olmos JM, Coco-Martín MB, Castrillón JLP. Profile of patients who visit medical internists for an osteoporosis assessment: The OSTEOMED registry. Rev Clin Esp 2021; 221:9-17. [PMID: 32682689 DOI: 10.1016/j.rce.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently. MATERIAL AND METHODS Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors. RESULTS In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; P<.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; P<.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; P<.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%). CONCLUSIONS These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.
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Affiliation(s)
| | - M Sosa Henriquez
- Servicio de Medicina Interna, Hospital Universitario Insular, Las Palmas de Gran Canaria, Las Palmas, España
| | - M Diaz-Curiel
- Servicio de Medicina Interna, Fundación Jiménez Díaz, Madrid, España
| | - P Sánchez Molini
- Servicio de Medicina Interna, Hospital de la Princesa, Madrid, España
| | - F Arranz Garcia
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España
| | - M J Montoya
- Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España
| | - J Filgueira
- Servicio de Medicina Interna, Hospital Universitario Gregorio Marañón, Madrid, España
| | - J M Olmos
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - M B Coco-Martín
- Grupo de Investigación en Neurociencias Clínicas Aplicadas, Universidad de Valladolid, Valladolid, España
| | - J L Pérez Castrillón
- Servicio de Medicina Interna. Hospital Universitario Río Hortega, Valladolid, España.
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Candel Romero C, Forner Cordero Á, Sánchez Santos JC, Pereiró Berenguer I. Relationship between vitamin D, osteoporotic fracture and falls. Med Clin (Barc) 2017. [PMID: 28625513 DOI: 10.1016/j.medcli.2017.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Link low levels of vitamin D, osteoporotic fracture and falls. PATIENTS AND METHOD Transversal observational study with the study variables of age, levels of vitamin D, osteoporotic fracture and falls. The study population was patients evaluated by the Rehabilitation Department, Hospital of Sagunto, from January 2013 to December 2014. RESULTS Of the 242 patients who underwent vitamin D analysis, 70.6% showed levels under 30ng/ml. Forty-eight percent of the patients with below normal levels of vitamin D suffered a fracture, opposed to 32.4% patients with normal levels. Thus, controlling by age, patients with low levels of vitamin D are 4.8 times more likely to suffer a fracture than those with normal levels. Regarding falls, controlling by age, there is a higher risk of falling (adjusted OR 2.68) in those patients with low levels of vitamin D. CONCLUSIONS Patients with low vitamin D levels are more likely to suffer falls and fractures.
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Affiliation(s)
| | - Ángeles Forner Cordero
- Servicio de Rehabilitación, Hospital de Sagunto, Sagunto, Valencia, España; Facultad de Medicina, Valencia, España
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Annweiler C, Beauchet O. Questioning vitamin D status of elderly fallers and nonfallers: a meta-analysis to address a 'forgotten step'. J Intern Med 2015; 277:16-44. [PMID: 24697944 DOI: 10.1111/joim.12250] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Previous meta-analyses to determine the efficacy of vitamin D supplementation to prevent falls in the elderly have shown mixed results. Inconsistencies might depend on the dose of supplements, suggesting that serum 25-hydroxyvitamin D (25OHD) concentration could influence the risk of falling. Our objective was to systematically review and quantitatively analyse the relationship between serum 25OHD concentration and the occurrence of falls. METHODS A Medline search was conducted in December 2013, with no date limit, using the Medical Subject Heading terms 'Vitamin D' OR 'Ergocalciferols' OR 'Vitamin D deficiency' combined with 'Accidental Falls' OR 'Gait disorders, neurologic' OR 'Gait apraxia' OR 'Gait' OR 'Recurrent Falls' OR 'Falling'. Fixed and random-effects meta-analyses were performed to determine the following: (i) the effect size of the difference in 25OHD concentration between fallers and nonfallers and (ii) the risk of falling according to serum 25OHD concentration. RESULTS Of the 659 retrieved studies, 18 observational studies - including ten cross-sectional and eight cohort studies - met the selection criteria. All were of good quality. The number of participants ranged from 80 to 2957 (44-100% women); 11.0% to 69.3% were fallers. Serum 25OHD concentrations were 0.33 × SD lower in fallers compared to nonfallers [pooled effect size 0.33; 95% confidence interval (CI) 0.18-0.47]. The risk of falls was inversely associated with serum 25OHD concentration [summary odds ratio (OR) 0.97; 95% CI 0.96-0.99]. The association between falls and hypovitaminosis D varied according to the definition used; the summary OR for falls was 1.23 (95% CI 0.94-1.60) for 25OHD <10 ng mL(-1) , 1.44 (95% CI 1.17-1.76) for 25OHD <20 ng mL(-1) and 0.95 (95% CI 0.81-1.11) for 25OHD <30 ng mL(-1) . CONCLUSIONS Fallers have lower 25OHD concentrations, notably more often <20 ng mL(-1) , than nonfallers. These findings help to determine the profile of target populations that would most benefit from vitamin D supplements to prevent falls.
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Affiliation(s)
- C Annweiler
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital and UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, The University of Western Ontario, London, ON, Canada
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Bernad-Pineda M, de las Heras-Sotos J, Garcés-Puentes M. Quality of life in patients with knee and hip osteoarthritis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2014. [DOI: 10.1016/j.recote.2014.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Bernad-Pineda M, de Las Heras-Sotos J, Garcés-Puentes MV. [Quality of life in patients with knee and hip osteoarthritis]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2014; 58:283-9. [PMID: 25022212 DOI: 10.1016/j.recot.2014.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate the quality of life in patients with knee and hip osteoarthritis through self-assessment and those made by the physician. MATERIALS AND METHODS An observational and cross-sectional multicenter study in which 628 traumatologists or rheumatologists evaluated 1,849 patients with knee and/or hip osteoarthritis, aged ≥ 50 years old, and representative of 49 Spanish provinces. Each researcher evaluated three patients and also completed the SF-12v2 health questionnaire. The patients completed the WOMAC and SF-12v2 questionnaires. RESULTS The patients were 68.5 ± 9.5 years old, 61.5% had knee osteoarthritis, 19% had hip osteoarthritis, and 19.5% in both locations. Older patients and those who had both knee and hip osteoarthritis had a poorer quality of life, according to patients and researchers. Physical health perceived by the researchers was better than patients reported (36.74 ± 8.6 and 35.21 ± 8.53; respectively, p<0.001), and the mental health score was similar between physicians and patients. Kellgren/Lawrence scale and test Timed Up & Go predict better the quality of life, assessed by WOMAC and SF-12v2 questionnaires. DISCUSSION This is the Spanish study on quality of life in osteoarthritis of the knee and hip of larger amplitude and number of patients. CONCLUSION These results could be considered as reference values of Spanish population aged ≥ 50 years with knee or hip osteoarthritis.
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Affiliation(s)
- M Bernad-Pineda
- Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España.
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Chamizo Carmona E, Gallego Flores A, Loza Santamaría E, Herrero Olea A, Rosario Lozano MP. Systematic Literature Review of Biphosphonates and Osteonecrosis of the Jaw in Patients With Osteoporosis. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.reumae.2012.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Chamizo Carmona E, Gallego Flores A, Loza Santamaría E, Herrero Olea A, Rosario Lozano MP. Revisión sistemática de la literatura sobre la osteonecrosis maxilar con el uso de bisfosfonatos en pacientes con osteoporosis. ACTA ACUST UNITED AC 2013; 9:172-7. [DOI: 10.1016/j.reuma.2012.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 05/11/2012] [Accepted: 05/15/2012] [Indexed: 10/26/2022]
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