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Superheroes Against Superbugs (SaS).
This study investigated the efficacy of annual zoledronic acid (ZOL) administration against previously treated recompression vertebral fractures (RVF) and new vertebral fractures (NVF) in initial percutaneous kyphoplasty (PKP) patients with osteoporotic vertebral compression fractures (OVCF) over a 3-year follow-up period.
Although PKP achieves a satisfactory outcome, previously treated RVF and NVF can limit its effectiveness. The annual infusion of ZOL over 3 years can improve fracture protection, particularly in the vertebrae. We hypothesized that ZOL can reduce the incidence of RVFs and/or NVFs, and improve the clinical outcomes of PKP.

This was a placebo-controlled, double-blind prospective trial of 154 PKP patients (mean age 70 years) with OVCFs. Patients were randomly assigned to receive a single infusion of ZOL (5 mg) or placebo (78 ZOL vs. 76 placebo) at 1 week, 12 months, and 24 months after surgery. Patients were followed-up for 36 months.

ZOL treatment lowered the risk of RVF by ~ 65% over the 36-month period when compared to placebo controls (6.41% in ZOL vs. 18.42% in placebo groups; relative risk, 0.35; 95% CI, 0.13 to 0.92). ZOL also reduced the risk of NVF by ~ 73% (3.85% in ZOL vs. 14.47% in placebo groups; relative risk, 0.27; 95% CI, 0.08 to 0.92). ZOL also significantly reduced the vertebral height lost rate (HLR) at 12, 24, and 36 months. ZOL also improved the visual analog scale (VAS), Oswestry disability index (ODI) scores, and bone mineral density (BMD).

Annual ZOL administration significantly lowers the risk of RVFs and NVFs, improving the clinical outcome of initial PKP in patients with OVCFs over a 3-year follow-up period.

ChiCTR2000029307.
ChiCTR2000029307.Group medical visits for osteoporosis can improve access to care while being highly accepted by patients. In this study, a similar proportion of women planned to initiate pharmacotherapy after attending a group or traditional one-on-one osteoporosis consultation, indicating that the group consultation model does not produce unexpected treatment decisions.
Group medical consultations for osteoporosis are time-efficient and highly accepted by patients, but effects on treatment decisions are unknown. We aimed to compare women's decisions to initiate or decline osteoporosis pharmacotherapy after attending either a group or transitional one-on-one osteoporosis consultation.

In this observational study, we prospectively evaluated postmenopausal women referred to an osteoporosis clinic who attended a group medical visit and compared their decisions regarding pharmacologic osteoporosis treatment with retrospective data from a cohort of women who attended a traditional consultation. Both consultation types involvedrapy after the group consultation (18% vs 0%, p = 0.009).

Patient decisions to initiate pharmacologic treatment made during a group visit are similar to those made during traditional one-on-one consultation. The group consultation model represents an alternative to one-on-one assessment for delivering osteoporosis consultative services.
Patient decisions to initiate pharmacologic treatment made during a group visit are similar to those made during traditional one-on-one consultation. The group consultation model represents an alternative to one-on-one assessment for delivering osteoporosis consultative services.Neck of femur fracture is a common consequence of falls in the elderly with a large burden of morbidity and mortality. Derangement in liver function tests (LFTs) is frequently seen in elderly people with neck of femur (NOF) fracture in the peri-operative period and can indicate serious and treatable underlying pathology as well as prognosis.On admission, raised alkaline phosphatase (ALP) levels with normal gamma-glutamyl transferase (GGT) suggest underlying bone pathology such as osteomalacia or Paget's disease but do not confirm or exclude osteoporosis. ALP can also be raised by non-bone pathology such as congestive cardiac failure and chronic kidney disease. LFT derangement in cardiac failure is associated with poorer prognosis. Post-operatively, ALP levels rise after the first week with a peak at 3-4 weeks and then fall thereafter. The rate at which they fall may help indicate bone healing in trochanteric fractures. Derangement in other LFTs is commonly due to hepatic injury; causes include trauma, alcohol, and viral hepatitis. There are also iatrogenic causes including surgery and commonly prescribed medication such as beta-lactam antibiotics, non-steroidal anti-inflammatories, and paracetamol.The differential diagnosis for deranged LFTs in the elderly peri-operatively is wide; however, most causes can be elicited through careful history and examination with occasional need for further investigations.The city of Litvínov (North Bohemia, Czech Republic) is seriously affected by coal mining, coal processing, and intensive industrial activities. Within the urban area, the potential environmental hazard of risk elements (in soil and vegetation) and polycyclic aromatic hydrocarbons (PAHs, in soils) was estimated using selected environmental and human health hazard indices. In total, 24 sites were sampled, including the city center, residential areas, industrialized zone, and areas close to operating and/or abandoned coal mines. The results showed elevated values of As, Cd, Cu, Ni, Pb, and Zn in soils (the maximum levels of individual pollution indices varied between 3 and 5 for As, Pb, and Zn); the risk assessment code (RAC) values indicated high bioaccessibility of Cd and Zn. The high mobility of Cd was confirmed by their bioaccumulation factors (BAF) in the aboveground biomass of Taraxacum sect. Ruderalia and Polygonum aviculare, reaching up to 1.9 and 2.9, respectively. The Cd content in plants presents a substantial health hazard for herbivores such as Oryctolagus cuniculus living within the urban area. The PAH levels in the soils also showed elevated values; the contents of benzo(a)pyrene exceeded more than 2-fold the indicative values for potential health risk for biota, especially near the abandoned coal mines. Triptolide The incremental lifetime cancer risks (ILCR) for ingestion of the contaminated soil showed only low or negligible cancerogenic risk, varying between 6.7 × 10-7 and 1.6 × 10-5 for children, and between 9.9 × 10-7 and 2.7 × 10-6 for adults. However, the potential health impact of the inhalation of the contaminated particulate matter should be included in the further research. Although the contamination level in the investigated area does not represent an imminent environmental and health risk, the potential remediation measures should be considered in the future.
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