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Al Zadjali F, Brooks J, O'Neill TW, Stanmore E. Experiences of postmenopausal osteoporosis: a narrative review. Disabil Rehabil 2024; 46:828-840. [PMID: 36705072 DOI: 10.1080/09638288.2023.2169770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE A narrative review was conducted to identify, critically appraise, and synthesise primary research on the lived experiences of postmenopausal women with osteoporosis. MATERIALS AND METHODS A systematic search of qualitative studies published between January 1960 and August 2021 was conducted across seven databases. The selected qualitative studies reported the lived experiences of postmenopausal women with osteoporosis, both with and without a history of fragility fractures. RESULTS A total of 17 publications (n = 334) were identified. These results suggest that osteoporosis and fragility fractures significantly affected postmenopausal women's lives. They reported difficulties in carrying out daily activities due to pain and change in their routines to cope with health problems. Some women were satisfied with the information provided by healthcare professionals. Their medicine adherence was also determined by their belief in the importance of their scheduled treatment for osteoporosis. CONCLUSION Qualitative studies that explored the lived experiences of postmenopausal women with osteoporosis can provide important insights into the impact of the disease on women's lives and potential pathways for improving care and management.Implications for rehabilitationOsteoporosis and fragility fractures affect the quality of life of postmenopausal women worldwide.The provision of targeted and tailored health information for postmenopausal women with osteoporosis is paramount in improving their health literacy and aiding in the long-term management of their bone health.What is already knownOsteoporosis and related fragility fractures are common, affecting more than 200 million people worldwide, including three million people in the UK.Osteoporotic fractures have significant clinical and public health impacts.What this study addsOsteoporosis, particularly fragility fractures, has a significant impact on the lives of postmenopausal women, including pain and functional impairment.Women's belief in the importance of their scheduled treatment plays a significant role in their concordance with the prescribed medications for osteoporosis.Provision of targeted health information for postmenopausal women with osteoporosis is key to their involvement in decision-making and disease management.
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Affiliation(s)
- Faiza Al Zadjali
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Jane Brooks
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma Stanmore
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
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Chirayath A, Dhaniwala N, Kawde K. A Comprehensive Review on Managing Fracture Calcaneum by Surgical and Non-surgical Modalities. Cureus 2024; 16:e54786. [PMID: 38529440 PMCID: PMC10961470 DOI: 10.7759/cureus.54786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
This comprehensive review delves into the multifaceted landscape of calcaneal fractures, thoroughly examining their aetiology, clinical presentation, and diverse management strategies. Encompassing surgical and non-surgical approaches, the review scrutinises critical aspects such as patient compliance, rehabilitation protocols, and long-term follow-up considerations. Surgical modalities, propelled by recent innovations like minimally invasive techniques and advanced fixation materials, are juxtaposed with non-surgical interventions, emphasising the pivotal role of patient education and adherence to optimise outcomes. The synthesis of critical findings underscores the need for individualised care and multidisciplinary collaboration in clinical practice. Moreover, the review outlines recommendations for healthcare practitioners and identifies promising areas for future research, including biomechanical studies and telerehabilitation. This comprehensive exploration aims to contribute to the ongoing evolution of calcaneal fracture management, ultimately enhancing patient care and outcomes in this complex orthopaedic realm.
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Affiliation(s)
- Aditya Chirayath
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nareshkumar Dhaniwala
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kevin Kawde
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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3
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Lyu FF, Ramoo V, Chui PL, Ng CG. Perceptions Toward Exercise or Mindful Exercise Participation Among Patients With Primary Osteoporosis: A Qualitative Study. Clin Nurs Res 2024; 33:40-50. [PMID: 37970808 DOI: 10.1177/10547738231198561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Exercise is significantly beneficial for patients with osteoporosis. However, physiological and psychological factors such as pain and kinesiophobia prevent patients from participating in exercise. Therefore, it is important to understand how these patients perceive participation in exercise. This qualitative study was conducted in China using conventional content analysis. Using a purposeful sampling method, 17 patients with primary osteoporosis were recruited. Data were collected through a semi-structured interview and managed using ATLAS.ti 21. Nine generic categories were developed from 26 subcategories and two main categories were identified: Barriers and facilitators, support systems, network resources, positive emotions, and reactions were the facilitators for exercise in this study. In addition, mindful exercise was positively viewed by the patients. Inefficient awareness, weak support systems, and burdens were identified as barriers. To improve compliance in clinical practice, targeted exercise protocols should be developed for patients based on these perceptions.
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Affiliation(s)
- Fang Fei Lyu
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Vimala Ramoo
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ping Lei Chui
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chong Guan Ng
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Pickering ME, Javier RM, Malochet S, Pickering G, Desmeules J. Osteoporosis treatment and pain relief: A scoping review. Eur J Pain 2024; 28:3-20. [PMID: 37403555 DOI: 10.1002/ejp.2156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 05/11/2023] [Accepted: 06/17/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Anti-osteoporosis (OP) drugs have been suggested to contribute to pain reduction during OP management. This scoping review aimed at mapping the literature on pain relief with anti-OP drugs in OP treatment. DATABASES AND DATA TREATMENT Medline, Pubmed and Cochrane databases were searched by two reviewers with keywords combinations. Randomized controlled and real-life English studies, pain as an endpoint, antiosteoporosis drugs were inclusion criteria. Case reports, surveys, comment letters, conference abstracts, animal studies and grey literature were excluded. Predetermined data were extracted by two reviewers and disagreement solved through discussion. RESULTS A total of 130 articles were identified, 31 publications were included, 12 randomized clinical trials and 19 observational studies. Pain reduction was assessed by different tools: Visual Analogue Scale, Verbal Rating Scale, Facial Scale or as a domain of quality of life questionnaires including Short form 8, 36, mini-OP, Japanese OP, Qualeffo, Roland Morris Disability questionnaires. Collective data show that anti-OP drugs may display an analgesic effect that may be linked to the local mode of action of drugs on bone and consecutive modulation of pain sensitization. The methodology of the studies showed a heterogeneity of endpoints, comparators, statistical approaches and follow-up duration. CONCLUSION Considering the limitations of the literature, there is a need for more rigorous trials and larger real-life studies taking into account the recommendations published for research in rheumatology and in pain medicine. The identification of responders, patient subtypes, and of analgesic-effect doses would allow optimization and individualization for pain relief in patients with OP. SIGNIFICANCE STATEMENT This scoping review shows that anti-OP drugs may improve pain and quality of life of patients with OP. The heterogeneity in design, choice of endpoints, methodology, comparators and follow-up duration of included randomized clinical trials and real-life studies does not allow so far to identify a predominant antiosteoporosis drug or an optimal dosage for pain relief. These gaps need to be addressed and warrant further research in the future for optimizing pain improvement in the course of OP drug treatment.
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Affiliation(s)
| | - Rose-Marie Javier
- Centre d'Evaluation et de Traitement de la Douleur et Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sandrine Malochet
- Rheumatology Department, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Gisele Pickering
- Clinical Investigation Center, PIC/CIC, University Hospital, CHU, Clermont-Ferrand, France
| | - Jules Desmeules
- Service de Pharmacologie et Toxicologie Cliniques, Centre multidisciplinaire de la douleur, Hôpitaux Universitaires de Genève, Geneva, Switzerland
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5
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Yang Q, Cheng H, Qin J, Loke AY, Ngai FW, Chong KC, Zhang D, Gao Y, Wang HH, Liu Z, Hao C, Xie YJ. A Machine Learning-Based Preclinical Osteoporosis Screening Tool (POST): Model Development and Validation Study. JMIR Aging 2023; 6:e46791. [PMID: 37986117 PMCID: PMC10686208 DOI: 10.2196/46791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 09/16/2023] [Accepted: 10/02/2023] [Indexed: 11/22/2023] Open
Abstract
Background Identifying persons with a high risk of developing osteoporosis and preventing the occurrence of the first fracture is a health care priority. Most existing osteoporosis screening tools have high sensitivity but relatively low specificity. Objective We aimed to develop an easily accessible and high-performance preclinical risk screening tool for osteoporosis using a machine learning-based method among the Hong Kong Chinese population. Methods Participants aged 45 years or older were enrolled from 6 clinics in the 3 major districts of Hong Kong. The potential risk factors for osteoporosis were collected through a validated, self-administered questionnaire and then filtered using a machine learning-based method. Bone mineral density was measured with dual-energy x-ray absorptiometry at the clinics; osteoporosis was defined as a t score of -2.5 or lower. We constructed machine learning models, including gradient boosting machines, support vector machines, and naive Bayes, as well as the commonly used logistic regression models, for the prediction of osteoporosis. The best-performing model was chosen as the final tool, named the Preclinical Osteoporosis Screening Tool (POST). Model performance was evaluated by the area under the receiver operating characteristic curve (AUC) and other metrics. Results Among the 800 participants enrolled in this study, the prevalence of osteoporosis was 10.6% (n=85). The machine learning-based Boruta algorithm identified 15 significantly important predictors from the 113 potential risk factors. Seven variables were further selected based on their accessibility and convenience for daily self-assessment and health care practice, including age, gender, education level, decreased body height, BMI, number of teeth lost, and the intake of vitamin D supplements, to construct the POST. The AUC of the POST was 0.86 and the sensitivity, specificity, and accuracy were all 0.83. The positive predictive value, negative predictive value, and F1-score were 0.41, 0.98, and 0.56, respectively. Conclusions The machine learning-based POST was conveniently accessible and exhibited accurate discriminative capabilities for the prediction of osteoporosis; it might be useful to guide population-based preclinical screening of osteoporosis and clinical decision-making.
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Affiliation(s)
- Qingling Yang
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Huilin Cheng
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jing Qin
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Alice Yuen Loke
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Fei Wan Ngai
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ka Chun Chong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dexing Zhang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong SAR, China
| | - Harry Haoxiang Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Zhaomin Liu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Chun Hao
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Yao Jie Xie
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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6
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Manning FM, Mughal F, Ismail HASM, Baines LM, Chew-Graham CA, Paskins Z, Prior JA. Osteoporosis and fracture as risk factors for self-harm and suicide: a systematic review and meta-analysis. Br J Gen Pract 2023; 73:e735-e743. [PMID: 37722857 PMCID: PMC10523335 DOI: 10.3399/bjgp.2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/03/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Increase in presentations of self-harm to primary care, a risk factor of suicide, has led to a growing interest in identifying at-risk populations. AIM To examine whether osteoporosis or fractures are risk factors for self-harm, suicidal ideation, and suicide. DESIGN AND SETTING This was a systematic review of observational studies in adults (>18 years) that had examined the role of osteoporosis and/or fractures in subsequent self-harm, suicidal ideation, and/or suicide. METHOD Six databases were searched from inception to July 2019. Additional citation tracking of eligible studies was undertaken in November 2022. Screening, data extraction, and quality assessment of full-text articles were performed independently by at least two authors. Where possible, meta-analysis was run on comparable risk estimates. RESULTS Fifteen studies were included: two examined the outcome of self-harm, three suicidal ideation, and 10 suicide. In approximately half of studies on osteoporosis, the risk of suicidal ideation and suicide remained significant. However, pooling of adjusted odds ratios from three studies indicated no association between osteoporosis and suicide (1.14, 95% confidence interval = 0.88 to 1.49). Nine studies examined the risk of a mixture of fracture types across different outcomes, limiting comparisons. However, all studies examining vertebral fracture (n = 3) reported a significant adjusted negative association for self-harm and suicide. CONCLUSION Patients with vertebral fractures, a risk potential factor for suicide, may benefit from clinical case finding for mood disorders with personalised primary care management. However, because of the limited number and quality of studies and mixed findings, further examination of these associations is warranted.
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Affiliation(s)
- Fay M Manning
- School of Medicine, Keele University, Keele, and Department of Medical Imaging, University of Exeter, Exeter, UK
| | - Faraz Mughal
- School of Medicine, Keele University, Keele; Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, Manchester; and honorary clinical research fellow, Warwick Medical School, Warwick, UK
| | | | | | | | - Zoe Paskins
- Keele University, Keele, and Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stoke-on-Trent, UK
| | - James A Prior
- School of Medicine, Keele University, Keele, and Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stoke-on-Trent, UK
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Noh HM, Choi YH, Wee JH, Song HJ, An HJ, Kim KJ, Lee SK, Jang MS, Yeon N. Association of age-related hearing loss, tinnitus, and chronic low back pain in middle-aged and older Korean adults. PLoS One 2023; 18:e0291396. [PMID: 37682980 PMCID: PMC10490886 DOI: 10.1371/journal.pone.0291396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
This was a cross-sectional study conducted to evaluate the association between hearing impairment and low back pain (LBP) using data from the Korean National Health and Nutrition Examination Survey. A total of 5,504 middle-aged and older Korean adults (aged ≥50 years old) who underwent plain radiography of the lumbar spine and pure tone audiometry were included. The presence of LBP was evaluated using a questionnaire, which included a question on whether the patient had experienced LBP that lasted for more than 30 days during the past three months. Patients with age-related hearing loss (ARHL) were defined as those with bilateral hearing impairment who met the following criteria: 1) normal otologic examination results, 2) average pure-tone hearing thresholds of ≤15 dB in both ears, and 3) no occupational noise exposure. Multivariable logistic regression analysis showed that ARHL was not associated with LBP (odds ratio, 1.33; 95% CI, 0.94-1.89) after adjusting for potential confounders in the final model. However, when participants without both ARHL and tinnitus were defined as the reference group, the results showed that the participants with both ARHL and tinnitus were more likely to have LBP (OR, 1.86; 95% CI, 1.11-3.11). These results indicate that ARHL with tinnitus is significantly associated with LBP. We recommend that elderly patients with ARHL and tinnitus increase their daily physical activities and engage in more muscle-strengthening exercises to prevent LBP.
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Affiliation(s)
- Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Yi Hwa Choi
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Jee Hye Wee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Hye-Ji An
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Keum Ji Kim
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Soo Kyung Lee
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Min Soo Jang
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Nayoung Yeon
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
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Lam PY, Cheung PWH, Lau ST, Cheung JPY. Quality of life of postmenopausal women with teriparatide, denosumab and alendronate: One-year prospective study with a propensity score-matched comparison. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2023. [DOI: 10.1177/22104917221136282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background/purpose: To evaluate and compare the effects of parathyroid hormone analogues, receptor activators of nuclear factor kappa-B ligand inhibitors and bisphosphonates on the quality of life of postmenopausal women. Methods: A prospective observational study of 23 matched postmenopausal women was conducted with propensity score analysis on quality of life at one-year follow-up. Visual analogue scale for back pain and outcome scores were carried out as the quality of life or treatment adherence measurements. Results: Teriparatide use was associated with significant improvements in visual analogue scale, EuroQol 5-level 5-dimension general health status and Osteoporosis Assessment Questionnaire physical function, whereas denosumab and alendronate groups only demonstrated improved Osteoporosis Assessment Questionnaire scores but worsened back pain. Baseline average visual analogue scale back pain predicted one-year average back pain progression (partial eta squared = 0.617, p = 0.001). Conclusions: One-year continuous teriparatide treatment is most effective in improving quality of life outcomes in postmenopausal osteoporotic women. Baseline average visual analogue scale back pain remained the only predictive factor for one-year back pain progression.
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Affiliation(s)
- Pun Yuet Lam
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | | | - Sin Ting Lau
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
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Chen X, Li Y, Zhang Z, Chen L, Liu Y, Huang S, Zhang X. Xianling Gubao attenuates high glucose-induced bone metabolism disorder in MG63 osteoblast-like cells. PLoS One 2022; 17:e0276328. [PMID: 36548302 PMCID: PMC9778583 DOI: 10.1371/journal.pone.0276328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 10/04/2022] [Indexed: 12/24/2022] Open
Abstract
Diabetes mellitus (DM) patients are prone to osteoporosis, and high glucose (HG) can affect bone metabolism. In the present study, we investigated the protective effects of traditional Chinese herbal formulation Xianling Gubao (XLGB) on HG-treated MG63 osteoblast-like cells. MG63 cells were incubated with control (mannitol), HG (20 mM glucose) or HG + XLGB (20 mM glucose+200 mg/L XLGB) mediums. Cell proliferation, apoptosis, migration and invasion were examined using CCK8, colony-formation, flow cytometry, Hoechst/PI staining, wound-healing and transwell assays, respectively. ELISA, RT-PCR and western blot analysis were used to detect the levels of osteogenesis differentiation-associated markers such as ALP, OCN, OPN, RUNX2, OPG, and OPGL in MG63 cells. The levels of the PI3K/Akt signaling pathway related proteins, cell cycle-related proteins, and mitochondrial apoptosis-related proteins were detected using western blot analysis. In HG-treated MG63 cells, XLGB significantly attenuated the suppression on the proliferation, migration and invasion of MG63 cells caused by HG. HG downregulated the activation of the PI3K/Akt signaling pathway and the expressions of cell cycle-related proteins, while XLGB reversed the inhibition of HG on MG63 cells. Moreover, XLGB significantly reduced the promotion on the apoptosis of MG63 cells induced by HG, the expressions of mitochondrial apoptosis-related proteins were suppressed by XLGB treatment. In addition, the expressions of osteogenesis differentiation-associated proteins were also rescued by XLGB in HG-treated MG63 cells. Our data suggest that XLGB rescues the MG63 osteoblasts against the effect of HG. The potential therapeutic mechanism of XLGB partially attributes to inhibiting the osteoblast apoptosis and promoting the bone formation of osteoblasts.
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Affiliation(s)
- Xinlong Chen
- Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, Jinan, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yan Li
- Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Zhongwen Zhang
- Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, Jinan, China
| | - Liping Chen
- Department of Endocrinology and Metabology, Weifang Medical University, Shandong Provincial Qianfoshan Hospital, Weifang, China
| | - Yaqian Liu
- Department of Endocrinology and Metabology, Weifang Medical University, Shandong Provincial Qianfoshan Hospital, Weifang, China
| | - Shuhong Huang
- Institute of Basic Medicine, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Xiaoqian Zhang
- Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, Jinan, China
- * E-mail:
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10
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Oh KK. Network pharmacology-based analysis of signaling pathways of an anti-osteoporotic triterpenoid from Acyranthes bidentata Blume root. 3 Biotech 2022; 12:312. [PMID: 36276446 PMCID: PMC9537396 DOI: 10.1007/s13205-022-03362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/12/2022] [Indexed: 11/01/2022] Open
Abstract
In Korea folk remedies, Acyranthes bidentata Blume is a functional food plant to treat bone diseases; especially, its roots have been used to alleviate osteoporosis (OP), but its key chemical compound(s) and mechanism of action against osteoporosis have not reported yet. This study suggests that Acyranthes bidentata Blume root (ABBR) has promising compound(s) against OP. We utilized network pharmacology to evaluate the therapeutic value. The chemical compounds from Acyranthes bidentata Blume root (ABBR) were identified by gas chromatography-mass spectrum (GC-MS); their physicochemical properties have been evaluated by SwissADME. Next, the target(s) related to a triterpenoid or OP-related targets were investigated by public databases. The signaling pathways from final targets were visualized, constructed, and analyzed by RPackage. Finally, we performed a molecular docking (MD) to explore key target(s) and compound(s) by employing AutoDockVina tools; the residues of amino acids interacted with ligands were identified by LigPlot + v.22. A total of 24 chemicals were accepted by the Lipinski's rules. We found a sole triterpenoid from ABBR via GC-MS, suggesting that might be a potent ligand to alleviate OP. Thereby, the 42 targets were associated with the triterpenoid; the 19 targets among them were connected to OP-targets (1426). The final 19 targets were related directly to 8 signaling pathways on STRING database. On Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, and a key signaling pathway (PPAR signaling pathway), four key targets (PPARA, PPARD, FABP3, and FABP4) and a key compound (Methyl 3β-hydroxyolean-18-en-28-oate) were selected via MD. Collectively, the triterpenoid from ABBR might have potent anti-osteoporotic efficacy by activating PPARA, PPARD, FABP3, and FABP4 on PPAR signaling pathway. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-022-03362-5.
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Affiliation(s)
- Ki Kwang Oh
- Department of Bio-Health Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, 24341 South Korea
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11
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LeBoff MS, Greenspan SL, Insogna KL, Lewiecki EM, Saag KG, Singer AJ, Siris ES. The clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int 2022; 33:2049-2102. [PMID: 35478046 PMCID: PMC9546973 DOI: 10.1007/s00198-021-05900-y] [Citation(s) in RCA: 253] [Impact Index Per Article: 126.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022]
Abstract
Osteoporosis is the most common metabolic bone disease in the USA and the world. It is a subclinical condition until complicated by fracture(s). These fractures place an enormous medical and personal burden on individuals who suffer from them and take a significant economic toll. Any new fracture in an adult aged 50 years or older signifies imminent elevated risk for subsequent fractures, particularly in the year following the initial fracture. What a patient perceives as an unfortunate accident may be seen as a sentinel event indicative of bone fragility and increased future fracture risk even when the result of considerable trauma. Clinical or subclinical vertebral fractures, the most common type of osteoporotic fractures, are associated with a 5-fold increased risk for additional vertebral fractures and a 2- to 3-fold increased risk for fractures at other sites. Untreated osteoporosis can lead to a vicious cycle of recurrent fracture(s), often resulting in disability and premature death. In appropriate patients, treatment with effective antifracture medication prevents fractures and improves outcomes. Primary care providers and medical specialists are critical gatekeepers who can identify fractures and initiate proven osteoporosis interventions. Osteoporosis detection, diagnosis, and treatment should be routine practice in all adult healthcare settings. The Bone Health and Osteoporosis Foundation (BHOF) - formerly the National Osteoporosis Foundation - first published the Clinician's Guide in 1999 to provide accurate information on osteoporosis prevention and treatment. Since that time, significant improvements have been made in diagnostic technologies and treatments for osteoporosis. Despite these advances, a disturbing gap persists in patient care. At-risk patients are often not screened to establish fracture probability and not educated about fracture prevention. Most concerning, the majority of highest risk women and men who have a fracture(s) are not diagnosed and do not receive effective, FDA-approved therapies. Even those prescribed appropriate therapy are unlikely to take the medication as prescribed. The Clinician's Guide offers concise recommendations regarding prevention, risk assessment, diagnosis, and treatment of osteoporosis in postmenopausal women and men aged 50 years and older. It includes indications for bone densitometry as well as fracture risk thresholds for pharmacologic intervention. Current medications build bone and/or decrease bone breakdown and dramatically reduce incident fractures. All antifracture therapeutics treat but do not cure the disease. Skeletal deterioration resumes sooner or later when a medication is discontinued-sooner for nonbisphosphonates and later for bisphosphonates. Even if normal BMD is achieved, osteoporosis and elevated risk for fracture are still present. The diagnosis of osteoporosis persists even if subsequent DXA T-scores are above - 2.5. Ongoing monitoring and strategic interventions will be necessary if fractures are to be avoided. In addition to pharmacotherapy, adequate intake of calcium and vitamin D, avoidance of smoking and excessive alcohol intake, weight-bearing and resistance-training exercise, and fall prevention are included in the fracture prevention armamentarium. Where possible, recommendations in this guide are based on evidence from RCTs; however, relevant published data and guidance from expert clinical experience provides the basis for recommendations in those areas where RCT evidence is currently deficient or not applicable to the many osteoporosis patients not considered for RCT participation due to age and morbidity.
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Affiliation(s)
- M. S. LeBoff
- grid.38142.3c000000041936754XBrigham and Women’s Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA 02115 USA
| | - S. L. Greenspan
- grid.412689.00000 0001 0650 7433University of Pittsburgh Medical Center, 1110 Kaufmann Building, 3471 Fifth Ave, Pittsburgh, PA 15213 USA
| | - K. L. Insogna
- grid.47100.320000000419368710Yale School of Medicine, 333 Cedar St, New Haven, CT 06520 USA
| | - E. M. Lewiecki
- grid.266832.b0000 0001 2188 8502University of New Mexico Health Sciences Center, 300 Oak St NE, Albuquerque, NM 87106 USA
| | - K. G. Saag
- grid.265892.20000000106344187University of Alabama at Birmingham, 1720 2nd Avenue South, FOT 820, Birmingham, AL 35294 USA
| | - A. J. Singer
- grid.411663.70000 0000 8937 0972MedStar Georgetown University Hospital and Georgetown University Medical Center, 3800 Reservoir Road NW, 3rd Floor, Washington, DC 20007 USA
| | - E. S. Siris
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, 180 Fort Washington Ave, Suite 9-903, New York, NY 10032 USA
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12
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Moretti A, Liguori S, Paoletta M, Toro G, Aulicino M, Gimigliano F, Iolascon G. Characterization of neuropathic component of back pain in patients with osteoporotic vertebral fractures. NeuroRehabilitation 2022; 51:325-331. [PMID: 35599506 PMCID: PMC9535576 DOI: 10.3233/nre-220040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND: Osteoporotic vertebral fractures (OVFs) are often followed by chronic back pain which may have a nociceptive, neuropathic, or mixed component. However, literature on this topic is lacking. OBJECTIVE: The objective of this cross-sectional study is to characterize the neuropathic component of chronic back pain in patients with OVFs. METHODS: Spine fractures were detected by morphometric examination. Pain severity and its impact on activities of daily living (ADL) were evaluated through the Brief Pain Inventory (BPI). Neuropathic pain was investigated through the Italian versions of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale (LANSS) and the painDETECT questionnaire (PD-Q). RESULTS: We included 72 patients, mainly women (88.8%), with mean age of 69.2 years. The 70.8% of patients had multiple OVFs, of which 47% located at the thoracic spine, 43.1% at the thoracic and at lumbar spine, and 9.8% at the lumbar spine. The BPI showed moderate back pain in 23.6% of cases and severe in 8.3% of cases, with high interference with ADL in 38.9% of patients. The PD-Q revealed the presence of neuropathic pain in 5.5% of cases, while the LANSS in 23.6% of cases. CONCLUSIONS: In our study, the prevalence of neuropathic component of chronic back pain ranged from 5.5% to 23.6%, according to PD-Q and LANSS respectively, in patients with OVFs. Further studies should investigate if the characterization of chronic back pain might contribute to appropriateness of interventions for this population.
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Affiliation(s)
- Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Milena Aulicino
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
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13
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Rehmanniae Radix Preparata (RRP) improves pain sensitization and suppresses PI3K/Akt/TRPV1 signaling pathway in estrogen deficient rats. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Analysis of the physiological load on lumbar vertebrae in patients with osteoporosis: a finite-element study. Sci Rep 2022; 12:11001. [PMID: 35768481 PMCID: PMC9243026 DOI: 10.1038/s41598-022-15241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/21/2022] [Indexed: 11/08/2022] Open
Abstract
This study aims to investigate the difference in physiological loading on the spine in three different motions (flexion-extension, lateral bending, and axial rotation) between osteoporotic and normal spines, using finite element modelling. A three-dimensional finite element (FE) model centered on the lumbar spine was constructed. We applied two different material properties of osteoporotic and normal spines. For the FE analysis, three loading conditions (flexion-extension, lateral bending, and axial rotation) were applied. The von Mises stress was higher on the nucleus pulposus at all vertebral levels in all movements, in the osteoporosis group than in the normal group. On the annulus fibrosus, the von Mises stress increased at the level of L3-L4, L4-L5, and L5-S in the flexion-extension group and at L4-L5 and L5-S levels in the lateral bending group. The values of two motions, flexion-extension and lateral bending, increased in the L4 and L5 cortical bones. In axial rotation, the von Mises stress increased at the level of L5 of cortical bone. Additionally, the von Mises stress increased in the lower endplate of L5-S and L4-L5 in all movements, especially lateral bending. Even in the group with no increase, there was a part that received increased von Mises stress locally for each element in the three-dimensional reconstructed view of the pressure distribution in color. The von Mises stress on the lumbar region in the three loading conditions, was greater in most components of osteoporotic vertebrae than in normal vertebrae and the value was highest in the nucleus pulposus. Considering the increase in the measured von Mises stress and the local increase in the pressure distribution, we believe that these results can contribute to explaining discogenic pain and degeneration.
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15
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Fu JL, Perloff MD. Pharmacotherapy for Spine-Related Pain in Older Adults. Drugs Aging 2022; 39:523-550. [PMID: 35754070 DOI: 10.1007/s40266-022-00946-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 12/12/2022]
Abstract
As the population ages, spine-related pain is increasingly common in older adults. While medications play an important role in pain management, their use has limitations in geriatric patients due to reduced liver and renal function, comorbid medical problems, and polypharmacy. This review will assess the evidence basis for medications used for spine-related pain in older adults, with a focus on drug metabolism and adverse drug reactions. A PubMed/OVID search crossing common spine, neck, and back pain terms with key words for older adults and geriatrics was combined with common drug classes and common drug names and limited to clinical trials and age over 65 years. The results were then reviewed with identification of commonly used drugs and drug categories: nonsteroidal anti-inflammatories (NSAIDs), acetaminophen, corticosteroids, gabapentin and pregabalin, antispastic and antispasmodic muscle relaxants, tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tramadol, and opioids. Collectively, 138 double-blind, placebo-controlled trials were the focus of the review. The review found a variable contribution of high-quality studies examining the efficacy of medications for spine pain primarily in the geriatric population. There was strong evidence for NSAID use with adjustments for gastrointestinal and renal risk factors. Gabapentin and pregabalin had mixed evidence for neuropathic pain. SNRIs had good evidence for neuropathic pain and a more favorable safety profile than TCAs. Tramadol had some evidence in older patients, but more so in persons aged < 65 years. Rational therapeutic choices based on geriatric spine pain diagnosis are helpful, such as NSAIDs and acetaminophen for arthritic and myofascial-based pain, gabapentinoids or duloxetine for neuropathic and radicular pain, antispastic agents for myofascial-based pain, and combination therapy for mixed etiologies. Tramadol can be well tolerated in older patients, but has risks of cognitive and classic opioid side effects. Otherwise, opioids are typically avoided in the treatment of spine-related pain in older adults due to their morbidity and mortality risk and are reserved for refractory severe pain. Whenever possible, beneficial geriatric spine pain pharmacotherapy should employ the lowest therapeutic doses with consideration of polypharmacy, potentially decreased renal and hepatic metabolism, and co-morbid medical disorders.
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Affiliation(s)
- Jonathan L Fu
- Department of Neurology, Boston University School of Medicine, Boston Medical Center, 85 E. Concord St, 1122, Boston, MA, 02118, USA
| | - Michael D Perloff
- Department of Neurology, Boston University School of Medicine, Boston Medical Center, 85 E. Concord St, 1122, Boston, MA, 02118, USA.
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16
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Barańska A, Religioni U, Kłak A, Merks P, Bogdan M, Firlej E, Sokołowska A, Kowalska W, Drop B. Coping Strategies Preferred by Patients Treated for Osteoporosis and Analysis of the Difficulties Resulting from the Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095677. [PMID: 35565072 PMCID: PMC9104136 DOI: 10.3390/ijerph19095677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022]
Abstract
Osteoporosis has been recognized as a civilization disease. This chronic condition needs a long-term management plan with a holistic approach to patients. The specificity of the patient’s response to the disease and coping strategies are very important in the treatment process. The aim of this research was to analyze the strategies of coping with disease preferred by patients treated for osteoporosis, and to determine the relationship between the self-assessment of patients’ health, time of treatment, sociodemographic variables, and strategies of coping with a chronic disease such as osteoporosis. The study was conducted from August 2016 to July 2018 at an osteoporosis clinic in eastern Poland. Coping Orientations to Problems Experienced (COPE) by C.S. Carver, M. F. Scheier, and J. K. Weintraub in the Polish adaptation and our own questionnaire were used. The study participants were 312 patients treated for osteoporosis. The respondents treated in the osteoporosis clinic used the strategies of seeking support and focusing on emotions to the greatest extent, and avoidance strategies the least. Sociodemographic features and self-assessment of health condition significantly differentiate the strategies of coping with the disease. The analysis showed that the higher the assessment of the individual perception of one’s own health, the more often the respondents used active coping strategies.
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Affiliation(s)
- Agnieszka Barańska
- Department of Medical Informatics and Statistics with e-Health Lab, Medical University of Lublin, 20-059 Lublin, Poland;
- Correspondence:
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826 Warsaw, Poland;
- Collegium of Business Administration, Warsaw School of Economics, 02-513 Warsaw, Poland
| | - Anna Kłak
- Department of Environmental Hazards Prevention, Allergology and Immunology, Warsaw Medical University, 02-091 Warsaw, Poland;
| | - Piotr Merks
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland;
| | - Magdalena Bogdan
- Department of Social Medicine and Public Health, Warsaw Medical University, 02-007 Warsaw, Poland;
| | - Ewelina Firlej
- Department of Cosmetology and Aesthetic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (E.F.); (A.S.)
| | - Anna Sokołowska
- Department of Cosmetology and Aesthetic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (E.F.); (A.S.)
| | - Wioleta Kowalska
- Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Bartłomiej Drop
- Department of Medical Informatics and Statistics with e-Health Lab, Medical University of Lublin, 20-059 Lublin, Poland;
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17
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Shahrestani S, Chen XT, Ballatori AM, Ton A, Bakhsheshian J, Hah RJ, Wang JC, Buser Z. Complication Trends and Costs of Surgical Management in 11,086 Osteoporotic Patients Receiving Lumbar Fusion. Spine (Phila Pa 1976) 2021; 46:1478-1484. [PMID: 33813581 DOI: 10.1097/brs.0000000000004051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE The aim of this study was to compare different aspects of fusion surgery in patients with osteoporosis with regard to graft subtype and surgical approach. SUMMARY OF BACKGROUND DATA Osteoporosis and chronic lower back pain are common in elderly populations and significantly increase the risk of compression fractures within the spine. METHODS Using the 2016-2017 National Readmission Database we identified 11,086 osteoporotic patients who received lumbar fusion using ICD-10 coding. Information regarding biologic graft type and surgical approach was collected. Patients were stratified by number of levels fused. Perioperative complications were collected at 30-, 90-, and 180-day follow-up intervals. Statistical analysis included univariate testing and multivariate regression modeling, controlling for patient demographics and comorbidities. RESULTS Patients receiving single-level fusion with autologous grafts had higher rates of hardware failure (P = 0.00014) at 30-day follow-up and 90-day follow-up (P < 0.0001) and higher rates of lumbar vertebral fractures at 90-day follow-up (P = 0.045) compared to those treated with nonautologous grafts. Patients receiving lumbar fusion with anterior and posterior approaches had no difference in readmission or infection rates, but the anterior approach was associated with a higher cost. CONCLUSION In this study, osteoporotic patients treated with autologous grafts had higher rates of complications compared to those treated with nonautologous grafts. Anterior and posterior approaches had similar complication rates; however, the anterior approach was associated with a higher total cost.Level of Evidence: 4.
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Affiliation(s)
- Shane Shahrestani
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Medical Engineering, California Institute of Technology, Pasadena, CA
| | - Xiao T Chen
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Alexander M Ballatori
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Andy Ton
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Joshua Bakhsheshian
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Raymond J Hah
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jeffrey C Wang
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Zorica Buser
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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18
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Dai W, Qiu E, Chen Y, Xing X, Xi W, Zhang M, Li K, Tian L, Dong Z, Yu S. Enhanced functional connectivity between habenula and salience network in medication-overuse headache complicating chronic migraine positions it within the addiction disorders: an ICA-based resting-state fMRI study. J Headache Pain 2021; 22:107. [PMID: 34503441 PMCID: PMC8428097 DOI: 10.1186/s10194-021-01318-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
Background Medication-overuse headache (MOH) is a relatively frequently occurring secondary headache caused by overuse of analgesics and/or acute migraine medications. It is believed that MOH is associated with dependence behaviors and substance addiction, in which the salience network (SN) and the habenula may play an important role. This study aims to investigate the resting-state (RS) functional connectivity between the habenula and the SN in patients with MOH complicating chronic migraine (CM) compared with those with episodic migraine (EM) and healthy controls (HC). Methods RS-fMRI and 3-dimensional T1-weighted images of 17 patients with MOH + CM, 18 patients with EM and 30 matched healthy HC were obtained. The RS-fMRI data were analyzed using the independent component analysis (ICA) method to investigate the group differences of functional connectivity between the habenula and the SN in three groups. Correlation analysis was performed thereafter with all clinical variables by Pearson correlation. Results Increased functional connectivity between bilateral habenula and SN was detected in patients with MOH + CM compared with patients with EM and HC respectively. Correlation analysis showed significant correlation between medication overuse duration and habenula-SN connectivity in MOH + CM patients. Conclusions The current study supported MOH to be lying within a spectrum of dependence and addiction disorder. The enhanced functional connectivity of the habenula with SN may correlate to the development or chronification of MOH. Furthermore, the habenula may be an indicator or treatment target for MOH for its integrative role involved in multiple aspects of MOH.
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Affiliation(s)
- Wei Dai
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Chinese PLA Medical School, 100853, Beijing, China
| | - Enchao Qiu
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Yun Chen
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Chinese PLA Medical School, 100853, Beijing, China
| | - Xinbo Xing
- Department of Radiology, Fourth Medical Center of Chinese PLA General Hospital, 100048, Beijing, China
| | - Wei Xi
- Department of Radiology, Fourth Medical Center of Chinese PLA General Hospital, 100048, Beijing, China
| | - Meichen Zhang
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Ke Li
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Chinese PLA Medical School, 100853, Beijing, China
| | - Lixia Tian
- School of Computer and Information Technology, Beijing Jiaotong University, 100044, Beijing, China
| | - Zhao Dong
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.
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19
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Singh N, Kumar D, Yadav G, Srivastava MK, Mishra SR, Gupta AK, Jauhari S, Roy MS. Comparison of Quality of Life and Bone Mass Density among Postmenopausal Women: A Cross-sectional Study. J Midlife Health 2021; 11:224-230. [PMID: 33767563 PMCID: PMC7978055 DOI: 10.4103/jmh.jmh_107_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/17/2020] [Accepted: 10/01/2020] [Indexed: 11/04/2022] Open
Abstract
Background Postmenopausal women are at highest risk of developing osteoporosis, since their bone mineral density is reduced due to decrease in estrogen level. Various other physiological, emotional, and psychological changes jeopardize the health of these vulnerable females in total and reduce their quality of life (QoL). Aims and Objectives To compare the QoL and bone mass density (BMD) among normal BMD, osteopenic, and osteoporotic postmenopausal women. Setting and Design A cross-sectional observational study was conducted in the outpatient department of physical medicine and rehabilitation at a tertiary care center of northern India from August 2019 to February 2020. Materials and Methods Baseline sociodemographic characteristics of all postmenopausal women were collected using a quantitative tool. Assessment of QoL was done by pretested and validated QUALEFFO-41 scale. For all the women, a bone mineral densitometry test was performed on the L1-L4 lumbar spine, femoral neck, and forearm by the dual-energy X-ray absorptiometry method. Statistical Analysis One-way ANOVA test was used to compare the mean BMD values across the three groups. Determination of predictive factors for QoL was performed using stepwise logistic regression analysis. Results Significant differences were noted for the mean values of the three domains, i.e., pain, physical, and social function (P < 0.01). Women with osteoporosis had significantly higher pain scores as compared to others. Among those with osteoporosis, the pain scores have significantly increased gradually as age increases. Conclusion Postmenopausal women with osteopenia and osteoporosis have poor QoL as compared to those with normal BMD.
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Affiliation(s)
- Neetu Singh
- Department of Obstetrics and Gynaecology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Dileep Kumar
- Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ganesh Yadav
- Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Mohit Kishore Srivastava
- Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Ramkishore Mishra
- Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Kumar Gupta
- Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sugandha Jauhari
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Madhumita Singha Roy
- Department of Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, Uttar Pradesh, India
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20
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SADE I, Çİ̇FÇİ̇ E, İNANIR M, SELÇUK B. Postmenopozal Kadınlarda Kemik Mineral Yoğunluğunun Yaşam Kalitesi Üzerine Etkisi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.844831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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McArthur C, Ziebart C, Laprade J. What do we know about spinal manual therapy for people with osteoporosis? A narrative review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1852906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Caitlin McArthur
- Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Judi Laprade
- Anatomy, University of Toronto, Toronto, Ontario, Canada
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22
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Bahouq H, Soulaymani A. Depression, Quality of Life, and Self-Esteem of Moroccan Postmenopausal Women with Osteoporosis before the Occurrence of Fractures. J Menopausal Med 2020; 26:121-129. [PMID: 32893513 PMCID: PMC7475288 DOI: 10.6118/jmm.19008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/17/2020] [Accepted: 06/18/2020] [Indexed: 11/27/2022] Open
Abstract
Objectives Previous researches have investigated depression in postmenopausal women (PMW) with osteoporosis and fractures, but little is known regarding Moroccan PMW without fractures. We investigated depression prevalence and severity in Moroccan PMW with osteoporosis without fractures and its relationship with quality of life (QoL) and physical and psychological state. Methods This cross-sectional study enrolled 100 PMW with osteoporosis without fractures. Depressive symptoms, QoL, self-esteem, and fatigue were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Arabic version of ECOS-16 questionnaire, Rosenberg self-esteem scale, and Arabic version of the Multidimensional Assessment of Fatigue scale, respectively. A questionnaire including sociodemographic factors, bone density features, pain intensity, and sleep disturbance was completed. Results Overall, 58% patients suffered from depression and 55% from pain (63.8% depressed women vs. 42.9% nondepressed patients; P = 0.03). Bone mineral density, lumbar spine T-score, ECOS-16, and self-esteem in depressed and nondepressed women were 0.791 (0.738–0.840) vs. 0.835 (0.790–0.866); −3.25 (−3.8 to −2.875) vs. −2.9 (−3.425 to −2.700), P = 0.02; 2.338 ± 0.605 vs. 1.638 ± 0.455; and 13.517 ± 5.487 vs. 18.404 ± 5.771, P < 0.0001, respectively. Depression severity correlated with pain, QoL, self-esteem, and fatigue (r = 0.367, r = −0.390, r = −0.390, and r = 0.369, respectively; P < 0.0001) as well as lumbar spine bone mineral density and T-score (r = −0.258 and r = −0.255, respectively; P = 0.01). Multiple linear regression analysis revealed impaired QoL (β = 0.526; P < 0.0001), fatigue (β = 0.177; P = 0.02), and lower self-esteem (β = −2.170; P = 0.005) as the strongest risk factors of depression. Conclusions Our study shows that even without fractures, Moroccan PMW with osteoporosis suffered from depression, pain, impaired QoL, and lower self-esteem.
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Affiliation(s)
- Hanane Bahouq
- Genetic and Biometric Laboratory, Biology Department, Faculty of Science, University Ibn Tofail Kenitra, Kenitra, Morocco.,Regional Public Hospital of Specialities, Tanger, Morocco.
| | - Abdelmajid Soulaymani
- Genetic and Biometric Laboratory, Biology Department, Faculty of Science, University Ibn Tofail Kenitra, Kenitra, Morocco
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Takayama S, Tomita N, Arita R, Ono R, Kikuchi A, Ishii T. Kampo Medicine for Various Aging-Related Symptoms: A Review of Geriatric Syndrome. Front Nutr 2020; 7:86. [PMID: 32766269 PMCID: PMC7381143 DOI: 10.3389/fnut.2020.00086] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/12/2020] [Indexed: 12/12/2022] Open
Abstract
With the continued growth of the aging population in Japan, geriatric syndrome (GS), which is associated with aging-related symptoms, has become a social problem. GS is caused by physiological and pathological aging and may manifest various symptoms. Physicians use multidisciplinary approaches to provide treatment for individual GS symptoms. Kampo medicine, a Japanese traditional medicine that uses multiple pharmacologically active substances, is useful for many syndromes, conditions, disorders, and diseases associated with GS. Evidence of the effectiveness of Kampo medicine for GS has accumulated in recent years. The effects of Kampo treatment for symptoms related to functional decline of the cardiovascular, respiratory, and digestive systems, cognitive impairment and related disorders, pain and other sensory issues, among others, support the use of Kampo medicine for the management of GS. The role of Kampo medicine for GS is summarized in this review.
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Affiliation(s)
- Shin Takayama
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Naoki Tomita
- Department of Geriatrics and Gerontology, Institue of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryutaro Arita
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Rie Ono
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Akiko Kikuchi
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Tadashi Ishii
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
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24
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Heuchemer L, Emmert D, Bender T, Rasche T, Marinova M, Kasapovic A, Conrad R, Mücke M. [Pain management in osteoporosis]. DER ORTHOPADE 2020; 49:363-376. [PMID: 32193562 DOI: 10.1007/s00132-020-03898-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Osteoporosis is a very common disease all over the world, in which a reduction in bone density can lead to an increased risk of fractures and a diminished physical height. Osteoporosis is also associated with acute and chronic pain, which especially occurs in the back and can significantly reduce the quality of life. To provide sufficient care for affected patients, it is essential to know the particularities of pain management in osteoporosis, such as pharmacological and nonpharmacological treatment options. This article gives a comprehensive review of pain management in osteoporosis and also explains the underlying pathomechanisms, risk factors, and diagnostic procedures.
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Affiliation(s)
- L Heuchemer
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - D Emmert
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - T Bender
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - T Rasche
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - M Marinova
- Radiologische Klinik, Universitätsklinikum Bonn, Bonn, Deutschland
| | - A Kasapovic
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - R Conrad
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Mücke
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
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Heuchemer L, Emmert D, Bender T, Rasche T, Marinova M, Kasapovic A, Conrad R, Mücke M. [Pain management in osteoporosis]. Schmerz 2020; 34:91-104. [PMID: 32065297 DOI: 10.1007/s00482-020-00445-1] [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] [Indexed: 02/06/2023]
Abstract
Osteoporosis is a very common disease all over the world, in which a reduction in bone density can lead to an increased risk of fractures and a diminished physical height. Osteoporosis is also associated with acute and chronic pain, which especially occurs in the back and can significantly reduce the quality of life. To provide sufficient care for affected patients, it is essential to know the particularities of pain management in osteoporosis, such as pharmacological and nonpharmacological treatment options. This article gives a comprehensive review of pain management in osteoporosis and also explains the underlying pathomechanisms, risk factors, and diagnostic procedures.
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Affiliation(s)
- L Heuchemer
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - D Emmert
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - T Bender
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - T Rasche
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - M Marinova
- Radiologische Klinik, Universitätsklinikum Bonn, Bonn, Deutschland
| | - A Kasapovic
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - R Conrad
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Mücke
- Zentrum für Seltene Erkrankungen (ZSEB), Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
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Borisovskaya A, Chmelik E, Karnik A. Exercise and Chronic Pain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:233-253. [DOI: 10.1007/978-981-15-1792-1_16] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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27
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Peters CM, Muñoz-Islas E, Ramírez-Rosas MB, Jiménez-Andrade JM. Mechanisms underlying non-malignant skeletal pain. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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28
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Wang J, Lu HX, Wang J. Cannabinoid receptors in osteoporosis and osteoporotic pain: a narrative update of review. ACTA ACUST UNITED AC 2019; 71:1469-1474. [PMID: 31294469 DOI: 10.1111/jphp.13135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/15/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Osteoporosis is a skeletal disease with decreased bone mass and alteration in microarchitecture of bone tissue, and these changes put patients in risk of bone fracture. As a common symptom of osteoporosis and complication of osteoporotic fracture, chronic pain is a headache for clinicians. Nonsteroidal anti-inflammatory drugs (NSAIDs), selective COX-2 inhibitors and opioid drugs can temporarily reduce osteoporotic pain but have relevant side effects, such as addiction, tolerability and safety. The review summarized the recent advancements in the study of CB receptors in osteoporosis and osteoporotic pain and related mechanisms. KEY FINDINGS Recent studies indicated the two nociceptive receptors, cannabinoid receptor (CB) and transient receptor potential vanilloid type 1 (TRPV1) channel, are co-expressed in bone cells and play important role in the metabolism of bone cells, suggesting that dualtargeting these 2 receptors/channel may provide a novel approach for osteoporotic pain. In addition, both CB receptor and TRPV1 channel are found to be expressed in the glial cells which play vital role in mediating inflammation, chronic pain and metabolism of bone cells, suggesting a role of glial cells inosteoporotic pain. SUMMARY Multiple-targeting against glial cells, CB receptors and TRPV1 channel may be one effective therapeutic strategy for osteoporotic pain in the future, following the elucidation of the complicated mechanism.
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Affiliation(s)
- Jing Wang
- Department of Osteoporosis, The Second Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China
| | - Hong-Xia Lu
- Department of Ultrasound, The Second Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China
| | - Jing Wang
- Department of Nephrology, The Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China
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Chen C, Winterstein AG, Fillingim RB, Wei YJ. Body weight, frailty, and chronic pain in older adults: a cross-sectional study. BMC Geriatr 2019; 19:143. [PMID: 31126233 PMCID: PMC6534872 DOI: 10.1186/s12877-019-1149-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/26/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There exists limited data on the association between unhealthy body weight and chronic pain, and whether this association is explained by frailty status of older adults. METHODS We included older adults aged ≥65 years from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Chronic pain was defined by self-reported pain lasting for ≥3 months in the past year. Body mass index (BMI) was categorized as underweight, normal, overweight, and obese. Participants were dichotomized as frail or non-frail based on a validated frailty index calculated as the proportion of the number of deficits present to a total of 45 possible deficits ascertained in NHANES. We used modified Poisson regression models to estimate prevalence ratios (PRs) and their 95% confidence intervals (CIs). RESULTS Of 3693 older participants, one in six (15.9%) experienced chronic pain, with higher prevalence among the underweight (24.6%) and obese (20.2%) group. Frailty versus non-frailty was independently associated with BMI (PR = 1.25, 95% CI = 1.16-1.36 for underweight; and PR = 1.15, 95% CI = 1.07-1.22 for obese), and chronic pain (PR = 2.84, 95% CI = 2.18-3.69). After adjustment for frailty, the association between BMI and chronic pain decreased from PR = 1.82 to 1.64 for the underweight and 1.41 to 1.33 for the obese group. We did not observe an interaction effect between frailty and BMI. CONCLUSIONS Unhealthy body weight was associated with increased chronic pain and the associations were partially explained by frailty status of older adults. Our findings generate hypotheses for further investigations of the interplay of these chronic conditions in older adults.
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Affiliation(s)
- Cheng Chen
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, USA
| | - Almut G Winterstein
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, USA.,Center for Drug Evaluation and Safety, College of Pharmacy, University of Florida, Gainesville, USA.,Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, USA
| | - Yu-Jung Wei
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, USA. .,Center for Drug Evaluation and Safety, College of Pharmacy, University of Florida, Gainesville, USA.
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Mehta P, Kaur M, Smith CM, Mani R, Baxter GD. Ageing well with chronic musculoskeletal pain: protocol for a systematic review of non-pharmacological interventions aimed at reducing pain in an ageing population. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1540167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Poonam Mehta
- Ageing Well National Science Challenge, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Mandeep Kaur
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Catherine M. Smith
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - G. David Baxter
- Ageing Well National Science Challenge, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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31
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Růžičková O, Killinger Z, Kasalický P, Hamilton L, Tyl R, Tomková S, Kalouche-Khalil L. Real-world Management of Women with Postmenopausal Osteoporosis Treated with Denosumab: A Prospective Observational Study in the Czech Republic and Slovakia. Adv Ther 2018; 35:1713-1728. [PMID: 30191465 PMCID: PMC6182647 DOI: 10.1007/s12325-018-0779-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Indexed: 12/14/2022]
Abstract
Introduction Osteoporosis is characterized by low bone mineral density (BMD) and an increased risk of fracture. In randomized controlled trials, denosumab has been shown to significantly reduce the fracture risk in women with osteoporosis. However, little is known about the real-world management of women who are prescribed denosumab. Methods This multicenter, prospective, observational real-world study in the Czech Republic and Slovakia evaluated the baseline characteristics and clinical management of women with postmenopausal osteoporosis prescribed denosumab for 24 months. Results A total of 600 women were included (300 in each country). In the Czech Republic and Slovakia, respectively, mean age at enrollment was 69.0 and 64.3 years, 67.7% and 30.0% of patients had a previous osteoporotic fracture, and 85.0% and 48.7% had previously received osteoporosis medication. In both countries, ‘low BMD T score’ and ‘a history of osteoporotic fracture’ were the main reasons for prescribing denosumab. Most patients received all four post-baseline denosumab injections (Czech Republic, 82.0%; Slovakia, 81.0%), and more than 98% of patients in both countries received all injections at the prescribing center. At 24 months, most patients experienced an increase in BMD T score for the lumbar spine, total hip, or femoral neck (Czech Republic, 69.7–91.7%; Slovakia, 67.1–92.9%). Adverse drug reactions were consistent with the known safety profile of denosumab. Conclusion Baseline characteristics of patients receiving denosumab in the Czech Republic and Slovakia reflect the reimbursement criteria for this agent in each country. The findings of our study in patients who are at high risk for fracture are consistent with the growing body of evidence demonstrating the effectiveness of denosumab in real-world clinical practice. Trial Registration ClinicalTrials.gov identifier, NCT01652690. Funding Amgen Inc. Electronic supplementary material The online version of this article (10.1007/s12325-018-0779-9) contains supplementary material, which is available to authorized users.
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Abstract
PURPOSE OF REVIEW Physical activity is increasingly recommended for chronic pain. In this review, we briefly survey recent, high-quality meta-analyses on the effects of exercise in human chronic pain populations, followed by a critical discussion of the rodent literature. RECENT FINDINGS Most meta-analytical studies on the effects of exercise in human chronic pain populations describe moderate improvements in various types of chronic pain, despite substantial variability in the outcomes reported in the primary literature. The most consistent findings suggest that while greater adherence to exercise programs produces better outcomes, there is minimal support for the superiority of one type of exercise over another. The rodent literature similarly suggests that while regular exercise reduces hypersensitivity in rodent models of chronic pain, exercise benefits do not appear to relate to either the type of injury or any particular facet of the exercise paradigm. Potential factors underlying these results are discussed, including the putative involvement of stress-induced analgesic effects associated with certain types of exercise paradigms. Exercise research using rodent models of chronic pain would benefit from increased attention to the role of stress in exercise-induced analgesia, as well as the incorporation of more clinically relevant exercise paradigms.
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Affiliation(s)
- Mark Henry Pitcher
- Pain and Integrative Neuroscience Laboratory, National Center for Complementary and Integrative Health, National Institutes of Health, Room 1E-420, 35A Convent Drive, Bethesda, MD, 20892, USA.
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Manage osteoporotic pain by treating osteoporosis and taking a multidimensional approach to pain management. DRUGS & THERAPY PERSPECTIVES 2018. [DOI: 10.1007/s40267-018-0504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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A Feasibility Study of Acupuncture for Chronic Pain in Patients with Osteoporotic Thoracolumbar Compression Fracture: A Prospective Case Series. JOURNAL OF ACUPUNCTURE RESEARCH 2018. [DOI: 10.13045/jar.2018.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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35
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Chantrapromma S, Boonnak N, Pitakpornpreecha T, Yordthong T, Chidan Kumar CS, Fun HK. Absolute Configuration of Andrographolide and Its Proliferation of Osteoblast Cell Lines. CRYSTALLOGR REP+ 2018. [DOI: 10.1134/s1063774518030069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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36
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Abstract
The high worldwide prevalence of osteoporosis means it is considered a serious public health concern, possibly leading to physical disability and an increased mortality rate. Although osteoporosis is known as a silent disease affecting aging populations, its primary symptom remains pain. Acute pain is reported by patients with osteoporosis-related fractures, but chronic pain, mainly back pain, is also a characteristic of severe osteoporosis. Pain is associated not only with fractures but also with bodily changes in patients with osteoporosis that may include sensory, affective, and cognitive aspects. Chronic pain leads to progressive loss of independence and the need for long-term care, especially in the elderly. Pain prevention is linked to the appropriate treatment of osteoporosis, and pain management in patients with osteoporosis requires a multidimensional approach to preserve and improve quality of life. Our aim was to review and discuss the main causes of pain in patients with osteoporosis and suggest possible strategies for its management and prevention.
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Orita S, Inage K, Suzuki M, Fujimoto K, Yamauchi K, Nakamura J, Matsuura Y, Furuya T, Koda M, Takahashi K, Ohtori S. Pathomechanisms and management of osteoporotic pain with no traumatic evidence. Spine Surg Relat Res 2017; 1:121-128. [PMID: 31440622 PMCID: PMC6698492 DOI: 10.22603/ssrr.1.2016-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/06/2017] [Indexed: 12/31/2022] Open
Abstract
Introduction Osteoporosis is a pathological state with an unbalanced bone metabolism mainly caused by accelerated osteoporotic osteoclast activity due to a postmenopausal estrogen deficiency, and it causes some kinds of pain, which can be divided into two types: traumatic pain due to a fragility fracture from impaired rigidity, and pain derived from an osteoporotic pathology without evidence of fracture. We aimed to review the concepts of osteoporosis-related pain and its management. Methods We reviewed clinical and basic articles on osteoporosis-related pain, especially with a focus on the mechanism of pain derived from an osteoporotic pathology (i.e., osteoporotic pain) and its pharmacological treatment. Results Osteoporosis-related pain tends to be robust and acute if it is due to fracture or collapse, whereas pathology-related osteoporotic pain is vague and dull. Non-traumatic osteoporotic pain can originate from an undetectable microfracture or structural change such as muscle fatigue in kyphotic patients. Furthermore, basic studies have shown that the osteoporotic state itself is related to pain or hyperalgesia with increased pain-related neuropeptide expression or acid-sensing channels in the local tissue and nervous system. Traditional treatment for osteoporotic pain potentially prevents possible fracture-induced pain by increasing bone mineral density and affecting related mediators such as osteoclasts and osteoblasts. The most common agent for osteoporotic pain management is a bisphosphonate. Other non-osteoporotic analgesic agents such as celecoxib have also been reported to have a suppressive effect on osteoporotic pain. Conclusions Osteoporotic pain has traumatic and non-traumatic factors. Anti-osteoporotic treatments are effective for osteoporotic pain, as they improve bone structure and the condition of the pain-related sensory nervous system. Physicians should always consider these matters when choosing a treatment strategy that would best benefit patients with osteoporotic pain.
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Affiliation(s)
- Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Miyako Suzuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuki Fujimoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuyo Yamauchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Junichi Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Matsuura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhisa Takahashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Abstract
BACKGROUND Previous reports have suggested a potential association of tea consumption with the risk of osteoporosis. As such association is controversial, we conducted a meta-analysis to assess the relationship between tea consumption and osteoporosis. METHODS AND FINDINGS We systematically searched PubMed, EMBASE and WanFang databases until March 30, 2016, using the keywords "tea and osteoporosis," without limits of language. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were derived by using random-effects models throughout the analyses. We conducted the analysis of the statistical heterogeneity using Cochrane I. The funnel plot was used to speculate the publication bias, while the subgroup analysis and multiround elimination method were employed. RESULTS Our study was based on 17 journal articles, including 2 prospective cohort studies, 4 case-control studies, and 11 cross-sectional studies. In the present study, the total OR of osteoporosis for the highest versus the lowest categories of tea consumption was 0.62 (95% CI, 0.46-0.83), with significant heterogeneity among studies (I = 94%, P < .01). There was, however, no publication bias of the meta-analysis about tea consumption and osteoporosis. Subgroup analysis showed that tea consumption could reduce the risk of osteoporosis in all examined subgroups. CONCLUSION In the present study, it can be concluded from the results that tea consumption can reduce the risk of osteoporosis.
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Affiliation(s)
- Kang Sun
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Le Wang
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Qingping Ma
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Qiaoyun Cui
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Qianru Lv
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Wenzheng Zhang
- Center of Cell Biology and Cancer Research, Albany Medical College, Albany, NY
| | - Xinghui Li
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
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Vannucci L, Fossi C, Gronchi G, Brandi ML. Low-dose diclofenac in patients with fragility fractures. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2017; 14:15-17. [PMID: 28740519 DOI: 10.11138/ccmbm/2017.14.1.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Most osteoporotic patients complain of back pain one year after a fragility vertebral fracture and the frequency of chronic back pain increases with increasing age. The use of the lowest effective dose of an analgesic which is able to control symptoms seems to be a possible solution in order to limit potential side effects in multi-treated elderly patients. Non-steroidal anti-inflammatory drugs (NSAIDs) have a proven efficacy in the treatment of back pain associated with fragility vertebral fractures and diclofenac is available at low-dose subcutaneous injective formulation. This is the rational of ImPAVeDic study, acronym of Improvement of back Pain Associated with fragility Vertebral fractures with low-dose Diclofenac, an observational study that will be performed in a group of 50 elderly (≥ 65 years), male and female osteoporotic patients with symptomatic fragility vertebral fractures. The objective of the study is to evaluate the improvement of back pain in the study population treated with low-dose diclofenac and regularly monitored for 2-6 months. Visual Analogic Scale (VAS) and Numerical Rating Scale (NRS) will be used for pain monitoring. The reduction of the risk of occurrence of drug side effects can favour the optimization of elderly patients' care.
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Affiliation(s)
- Letizia Vannucci
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Caterina Fossi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Giorgio Gronchi
- Department of Neurosciences, Psychology, Drug Research, and Child Health (section of Psychology), University of Florence, Florence, Italy
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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Chronic Osteoporotic Pain in Mice: Cutaneous and Deep Musculoskeletal Pain Are Partially Independent of Bone Resorption and Differentially Sensitive to Pharmacological Interventions. J Osteoporos 2017; 2017:7582716. [PMID: 28299231 PMCID: PMC5337358 DOI: 10.1155/2017/7582716] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 01/26/2017] [Indexed: 01/06/2023] Open
Abstract
Although the pathological changes in osteoporotic bones are well established, the characterization of the osteoporotic pain and its appropriate treatment are not fully elucidated. We investigated the behavioral signs of cutaneous and deep musculoskeletal pain and physical function; time-dependent changes in bone mineral density (BMD) and the emergence of the behavioral phenotype; and the effects of pharmacological interventions having different mechanisms of action (chronic intraperitoneal administration of pamidronate [0.25 mg/kg, 5x/week for 5 weeks] versus acute treatment with intraperitoneal morphine [10 mg/kg] and pregabalin [100 mg/kg]) in a mouse model of ovariectomized or sham-operated mice 6 months following surgery. We observed reduced BMD associated with weight gain, referred cutaneous hypersensitivity, and deep musculoskeletal pain that persisted for 6 months. Chronic bisphosphonate treatment, 6 months after ovariectomy, reversed bone loss and hypersensitivity to cold, but other behavioral indices of osteoporotic pain were unchanged. While the efficacy of acute morphine on cutaneous pain was weak, pregabalin was highly effective; deep musculoskeletal pain was intractable. In conclusion, the reversal of bone loss alone is insufficient to manage pain in chronic osteoporosis. Additional treatments, both pharmacological and nonpharmacological, should be implemented to improve quality of life for osteoporosis patients.
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Li JY, Jia YS, Chai LM, Mu XH, Ma S, Xu L, Wei X. Effects of Chinese herbal formula Erxian decoction for treating osteoporosis: a systematic review. Clin Interv Aging 2017; 12:45-53. [PMID: 28115834 PMCID: PMC5221555 DOI: 10.2147/cia.s117597] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Jin-Yu Li
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yu-Song Jia
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Li-Min Chai
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Xiao-Hong Mu
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Sheng Ma
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Lin Xu
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Correspondence: Lin Xu, Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No 5 Haiyuncang Street, Dongcheng District, Beijing 100700, People’s Republic of China, Tel +86 10 8401 5571, Email
| | - Xu Wei
- Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
- Xu Wei, Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, People’s Republic of China, Tel +86 13 4887 16557, Email
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Schiller J, Korallus C, Bethge M, Karst M, Schmalhofer ML, Gutenbrunner C, Fink MG. Effects of acupuncture on quality of life and pain in patients with osteoporosis-a pilot randomized controlled trial. Arch Osteoporos 2016; 11:34. [PMID: 27766596 DOI: 10.1007/s11657-016-0288-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 09/29/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED In this sham-controlled study, 53 patients received 10 sessions of acupuncture treatment over 5 weeks to investigate the effects of acupuncture on the pain and quality of life of patients with osteoporosis. The results showed significant favorable effects of verum acupuncture on quality of life. Both interventions showed sustained and clinically relevant effects on pain. PURPOSE Standard analgesic treatment is associated with adverse events in patients with osteoporosis, especially elderly and/or comorbid patients. As acupuncture has gained widespread acceptance as a complementary treatment modality with few side effects, the aim of this study was to evaluate the effects of acupuncture on the pain and quality of life of patients with osteoporosis. METHODS In total, 53 patients with vertebral compression fractures, osteoporosis-associated spinal deformities, and resultant pain were randomly allocated to the verum acupuncture with deep needling of specific points following the principles of traditional Chinese medicine (n = 29) or control acupuncture group with superficial needling of non-acupuncture points (n = 24). All patients received 10 sessions of standardized verum or control acupuncture treatment over 5 weeks. Pain (VAS score 1-100) and quality of life (QUALEFFO-41) were measured at the start of treatment (T0), before each acupuncture session (T1), and at 1 (T2) and 3 months (T3) post-treatment. RESULTS Both acupuncture treatments significantly reduced activity-related pain and pain at rest over time. The verum acupuncture group experienced a significantly greater reduction in mean pain intensity at rest than the control group. In the control group, quality of life improved only temporarily post-treatment (T2) and slightly declined at the end of the follow-up period (T3). In contrast, patients in the verum acupuncture group experienced continuous and significant improvements in quality of life up to 3 months after treatment (T3). CONCLUSIONS Both types of acupuncture were equally effective in producing sustained, clinically relevant pain relief in patients with osteoporosis. Verum acupuncture had stronger and longer-lasting effects on quality of life and pain at rest. The possible reasons for these findings include the specificity of acupuncture point selection and the performance of needle stimulation.
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Affiliation(s)
- Joerg Schiller
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30655, Hannover, Germany.
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30655, Hannover, Germany
| | - Matthias Bethge
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30655, Hannover, Germany.,Institute of Social Medicine and Epidemiology, Section Rehabilitation and Work, University of Lübeck, Lübeck, Germany
| | - Matthias Karst
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
| | - Marie-Lena Schmalhofer
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30655, Hannover, Germany
| | - Christoph Gutenbrunner
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30655, Hannover, Germany
| | - Matthias Georg Fink
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30655, Hannover, Germany.
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