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Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Symptomatic fractures in systemic sclerosis: A case-control study.

Marília M Sampaio-Barros1, Adriana B Bortoluzzo2, Henrique Carriço da Silva1

  • 1Disciplina de Reumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil.

Journal of Scleroderma and Related Disorders
|February 6, 2023
PubMed
Summary

Symptomatic fractures in systemic sclerosis are linked to lower bone density and increased corticosteroid/bisphosphonate use. These findings highlight key risk factors for fracture prevention in this patient population.

Keywords:
Systemic sclerosisbisphosphonatescorticosteroidsfracturesosteoporosis

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Area of Science:

  • Rheumatology
  • Orthopedics
  • Endocrinology

Background:

  • Systemic sclerosis (SSc) is a chronic autoimmune disease with potential multi-organ involvement.
  • Fractures represent a significant complication, impacting patient morbidity and quality of life.
  • Understanding risk factors for fractures in SSc is crucial for targeted prevention strategies.

Purpose of the Study:

  • To identify risk factors associated with symptomatic fractures in patients with systemic sclerosis.
  • To compare fracture prevalence and related factors between SSc patients with and without fractures.

Main Methods:

  • A case-control study involving 52 SSc patients with fractures and 104 matched controls without fractures.
  • Data collected included demographics, disease characteristics, medication use, and bone mineral density (BMD) measurements.
  • Statistical analysis, including multivariate analysis, was performed to determine significant associations.

Main Results:

  • Fractures predominantly affected the vertebral, rib, and hip joints.
  • Significant associations were found with densitometric osteoporosis, lower weight, lower bone mineral index, anti-RNA polymerase III antibodies, corticosteroid use, and bisphosphonate use.
  • Multivariate analysis identified high-dose corticosteroids, bisphosphonates, negative anti-Scl70, and lower lumbar spine T-score as significant predictors of fractures.

Conclusions:

  • Symptomatic fractures in systemic sclerosis are associated with lower bone mineral density, particularly of the lumbar spine.
  • The use of high doses of corticosteroids and bisphosphonates are significant risk factors for fractures in this cohort.
  • These findings underscore the importance of bone health monitoring and management in SSc patients.