Brži od reume Mayer, Miroslav
Medicus (Zagreb, Croatia : 1992),
10/2019, Letnik:
28, Številka:
2 Tjelesna aktivnost
Journal Article
Recenzirano
Odprti dostop
Upalne su reumatske bolesti prevalentne i znatan su teret oboljelima, ali i društvu u cjelini. Uz izravnu štetu kronične su bolesti opterećene posljedicama autoimunosne upale, a tu su i znatni i ...učestali komorbiditeti, komplikacije bolesti, diferentne terapije, zatim troškovi apsentizma, prezentizma, prerane smrtnosti i invaliditeta te visoke cijene lijekova, nemedikamentne terapije i pomagala. Gubitak godina i kvalitete života znatan je. Promoviranje fizičke aktivnosti i bavljenja sportom te borba protiv sedentarnog načina života mogu bitno pridonijeti primarnoj prevenciji. Redovito vježbanje dokazano pozitivno utječe na dugoročnu aktivnost upalnih reumatskih bolesti, održavanje stanja remisije, poboljšanje kvalitete života, teške komorbiditete te, posljedično, na konačne ishode. Poznavanje utjecaja vježbanja i fizičke aktivnosti na mehanizme, tijek i ishod upalnih reumatskih bolesti bitno je jer je i dalje nedostatna svijest pacijenata, ali i medicinskog osoblja o velikoj važnosti redovitog vježbanja i fizičke aktivnosti.
The aim of the paper was to show the diagnostic and therapeutic approaches to a patient suffering from osteomalacia, as well as differential diagnosis with osteoporosis.
Osteomalacia (OM) is a ...metabolic disease of bones which appears as a result of defective mineralization of newly formed bone matrix in adults. Diagnosis of disease may represent a big problem. A 67-year-old female patient from Pirot was examined in an outpatient unit by a rheumatologist in the Niška Banja Institute in December 2012. The patient reported pain along the vertebral column and inability to get out of bed. Radiography showed vertebral compression fractures and the patient had previously received surgical care at Orthopedics Ward of General Hospital Pirot due to the left femur fracture. Orthopedist, neurologist, physiatrist and practicing rheumatologist suspected osteoporosis. The diagnosis of osteomalacia was established in February, 2013. The treatment was initiated by introducing large doses of vitamin D and advising bisphosphonates. After eighth months, the patient's general condition was improved. This was demonstrated by her independent mobility.
Cij rada bio je prikaz dijagnostičkog i terapijskog pristupa bolesniku sa osteomalacijom, kao i diferencijalne dijagnoze sa osteoporozom.
Osteomalacija je metabolička bolest kostiju koja nastaje usled poremećene mineralizacije novoformiranog koštanog matriksa kod odraslih osoba. Postavljanje dijagnoze osteomalacije može predstavljati veliki problem. Bolesnica starosti 67 godina, iz Pirota, na pregled reumatologa je došla početkom decembra 2012. godine zbog bolova duž kičmenog stuba i nemogućnosti ustajanja iz kreveta. Radiografski su verifikovane kompresivne frakture lumbalnih pršljenova, a prethodno je operisana zbog preloma leve butne kosti. Ortoped, neurolog, fizijatar, kao i ordinirajući reumatolog posumnjali su na osteoporozu. Dijagnoza osteomalacije je postavljena februara 2013. godine, započeto je lečenje visokim dozama vitamina D (Vit D) i savetovana je terapija bisfosfonatima. Nakon osam meseci uočeno je značajno poboljšanje opšteg stanja, bolesnica je bila samostalno pokretna.
Jetrena osteodistrofi ja je česta i nerijetko neliječena komplikacija koja se manifestira kao osteoporoza ili osteopenija, a susreće se u bolesnika s kroničnim bolestima jetre. Ovaj narativni pregled ...jetrene osteodistrofi je preispituje učestalost, patofiziologiju, dijagnostiku i liječenje jetrene osteodistrofi je. Proveli smo pretragu medicinske literature u bazama podataka PubMed, Google Scholar, Wiley, Science Direct i Springer Link pomoću prikladnih ključnih riječi kako bismo dobili podatke o niskoj mineralnoj gustoći kosti povezanoj s kroničnim bolestima jetre. Mnoga istraživanja izvještavaju o povećanoj učestalosti osteoporoze/osteopenije u bolesnika s kroničnim jetrenim bolestima. Patogeneza je multifaktorijalna i uključuje genetske čimbenike, pomanjkanje raznih vitamina, proupalne citokine, hipogonadizam, hiperbilirubinemiju, protuvirusnu terapiju, kortikosteroidne lijekove te čimbenike povezane s načinom života. Liječenje ovih bolesnika treba obuhvatiti individualiziranu procjenu čimbenika rizika za prijelome te mineralnu gustoću kosti. Svim bolesnicima s kroničnim bolestima jetre i osteoporozom treba preporučiti uzimanje dodataka vitamina C i kalcija. Bisfosfonati su najučinkovitiji lijekovi za liječenje jetrene osteodistrofi je. Potrebno je bolje defi nirati zbrinjavanje i specifi čno liječenje jetrene osteodistrofi je kako bi se sprije čili prijelomi zbog krhkih kosti te poboljšala kvaliteta života ovih bolesnika.
Kompleksnost uzroka, patofiziologije i kliničke slike osteoporoze (OP) razlog je i posljedično kompleksnog liječenja bolesti. Stoga, osim farmakoterapije, u procesu liječenja OP-a veliku ulogu ima i ...prevencija i nefarmakološko liječenje. Pri tome najviše mislimo na liječenje najteže posljedice bolesti – prijeloma. U tu svrhu koriste se različiti oblici fizikalne terapije i različiti rehabilitacijski modeli usmjereni na smanjenje bola i povećanje funkcijskih mogućnosti bolesnica. Spomenutim metodama treba pridodati i korištenje različitih funkcijskih pomagala, koja značajno olakšavaju aktivnosti dnevnog življenja.
The chemokine C-C motif ligand 11, also known as eotaxin-1, has been identified as a novel mediator of inflammatory bone resorption. However, little is known regarding a potential role for ...CCL11/Eotaxin-1 in postmenopausal osteoporosis.
The scope of this study was to explore the relationship between serum CCL11/Eotaxin-1 concentrations and disease progression of postmenopausal females with osteoporosis.
A total of 83 postmenopausal women diagnosed with osteoporosis were enrolled. Meanwhile, 82 postmenopausal women with normal bone mineral density (BMD) and 85 healthy controls inner child-bearing age were enrolled as control. The Dual-energy X-ray absorptiometry was used to examine the BMDs at the femoral neck, lumbar spine 1-4 and total hip of all participants. Serum CCL11/Eotaxin-1 levels were examined by enzyme-linked immunosorbent assay. We also included inflammation marker interleukin-6 (IL-6) as well as a serum marker of bone resorption C-telopeptide cross-linked collagen type 1 (CTX-1). The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were recorded to evaluate the clinical severity in POMP females.
Serum CCL11/Eotaxin-1 levels were significantly elevated in postmenopausal osteoporotic patients PMOP patients compared with PMNOP and healthy controls. We observed a significant negative correlation of serum CCL11/Eotaxin-1 levels with lumbar spine, femoral neck and total hip BMD. Furthermore, serum CCL11/ Eotaxin-1 concentrations were also positively related to the VAS and ODI scores. Last, serum CCL11/ Eotaxin-1 concentrations were positively associated with IL-6 and CTX-1 levels. These correlations remain significant after adjusting for age and BMI. Multivariate linear regression analysis demonstrated that CCL11/Eotaxin-1 could serve as an independent marker.
Serum CCL 11/Eotaxin-1 may serve as a candidate biomarker for postmenopausal osteoporosis. Therapeutics targeting CCL11/Eotaxin-1 and its related signalling way to prevent and slow progression of PMOP deserve further study.
Utjecaj mlijeka na zdravlje čovjeka Lisak Jakopović, Katarina; Dorić, Iva; Barukčić, Irena ...
Hrvatski časopis za prehrambenu tehnologiju, biotehnologiju i nutricionizam,
09/2019, Letnik:
14, Številka:
1-2
Journal Article
Odprti dostop
Kravlje mlijeko je nutritivno bogata namirnica koja je u ljudskoj prehrani prisutna nekoliko tisuća godina. U zadnjih se nekoliko godina pojavilo pitanje o opravdanosti mlijeka kao sastavnog dijela ...pravilne prehrane čovjeka te potencijalnim štetnim učincima mlijeka na ljudskozdravlje. Mlijeko je jeftin i lako dostupan izvor važnih nutrijenata i svakodnevno je zastupljeno u ljudskoj prehrani te mu mnoge nacionalne prehrambene smjernice pridaju veliku važnost. Zato je važno poznavati njegov sastav te potencijalan pozitivan ili negativan utjecaj na ljudskozdravlje, kako djece tako i odraslih. Stoga je glavni cilj ovoga rada bio dati pregled najnovijih istraživanja o utjecaju mlijeka na rast djece, pretilost, rizik od osteoporoze i kroničnih bolesti, laktoza intolerancija te alergija na proteine mlijeka.
Osteoporosis is a highly prevalent public health problem with osteoporosis-related fractures that account for high morbidity and mortality. Therefore, prevention strategies and early detection of ...osteoporosis should be carried out in primary gynaecological care units, so as to substantially reduce the risk of fractures and allow the best treatment option for a particular woman.
From 2002 to 2011, we recruited 2956 women. Of the total number of women, we additionally extrapolated 1274 women aged 60-75 years, assumingly, the group of women at higher risk of osteoporosis. Demographic and anthropometrical data as well as the information regarding risk factors for osteoporosis were collected using a questionnaire.
The odds ratio for osteoporosis increased by 8% (p=0.001) with each additional year of life. The OP prevalence increased with age from 24.9% in 60-64 years to 37.4% in 70-75 years. In non-smokers the odds ratio for osteoporosis was 0.424, which was statistically significant (p<0.05). BMI <18.5 increased the odds ratio for osteoporosis by 2 times, which was not statistically significant. In women 60-75 years old (N=1274), the risk of fractures increased with increasing age, considering previous fractures in the last 5 years (p<0.001), hip fracture (p=0.001), wrist fracture (p=0.002) and observed height loss (p<0.001). Hormone therapy (HT) use decreased the prevalence of OP by 25% in comparison with non-users.
Primary care gynaecologist with a DXA centre has every opportunity for a holistic approach to the management of postmenopausal women, including the prevention and treatment of postmenopausal osteoporosis.
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