在DXA报告和解释中的陷和错误来源:与年龄相关的并发病,结构变化和人工物所起的作用 - - 描述性关注的是老年人
1Department of Medical Ecology and Hydroclimatology, Usak University Faculty of Medicine, Atatürk Avenue, 1.Eylül Campus, Usak 6400, Turkey.
概括
由于定位和退行性变化,DXA扫描错误很常见,特别是在老年人中. 提高质量控制和培训对于准确的骨质疏松症诊断至关重要.
科学领域:
- 老年学是指老年学的学科.
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 使用双能X射线吸收计 (DXA) 的骨密度计对于骨质疏松症诊断至关重要.
- 对DXA扫描的质量评估对于准确的患者管理至关重要,特别是在老年人群中.
研究的目的:
- 评估DXA扫描和关于大腿骨和腰椎的报道中的错误频率和类型.
- 与年轻人相比,专门评估老年人群中的这些错误.
主要方法:
- 一位物理医生使用ISCD-2023指南审查了6826份DXA报告 (腰部和部).
- 错误被分类为定位,分析和与文物相关的问题.
- 为了进行比较分析,参与者被分为年轻人 (<65岁) 和老年人 (≥65岁) 两类.
主要成果:
- 在所有DXA扫描中观察到总体高错误率87.5%,在所有DXA扫描中观察到高错误率.
- 老年人表现出更高的定位错误率 (脊柱错位和部旋转) 和与文物相关的错误,通常是由于退行性变化.
- 腰椎扫描的无错率为12.1%,而部扫描的无错率为11.5%.
结论:
- DXA扫描和报告错误很普遍,影响年轻人和老年人,但不成比例地影响老年人.
- 退行变化,人工物和定位问题是导致老年人DXA扫描错误的重要原因.
- 建议进行标准化,加强员工培训和量身定制的质量控制协议,以提高DXA的准确性,特别是在高风险的骨质疏松症患者中.
相关概念视频
Pharmacodynamics in Geriatric Patients: Effects of Age
284
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
284
Drug Dosing: Geriatric Patients
327
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
327
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
288
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
288
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
299
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
299
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
273
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
273
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
765
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
765


