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Actonel<sup>®</sup>(risedronate) therapy for the maintenance of alveolar bone in adult chronic periodontitis

Health 2013年第7期5卷 12-17页

作者： Nipul k. Tanna marjorie k. jeffcoat School of Dental Medicine The University of Pennsylvania Philadelphia USA

Introduction: The primary objective of this study was to determine whether risedronate sodium (Actonel?) therapy, in conjunction with conventional non-surgical periodontal treatment, reduces the rate of alveolar bone loss. Secondary aims were to compare the incidence of patient dropouts in the risedronate and placebo groups, and to document adverse events. Methods: This double-blind randomized placebo-controlled trial was conducted in 125 patients with moderate to severe periodontitis. At baseline, three, and nine months, standardized vertical bite-wing radiographs were tak.n and used to measure bone loss. Clinical periodontal examinations were tak.n at three-month intervals to assess whether or not the patient was experiencing rapid periodontal break.own, in which case suitable treatment could be planned and delivered. Patients received scaling and root planing at baseline and periodontal maintenance at three-month intervals thereafter. At three months, subjects were randomly assigned to risedronate (35 mg/week.by mouth) or placebo in block. based on the severity of periodontitis (moderate, mean bone loss 2 -4 mm;or severe, mean bone loss >4 mm);smok.ng;and diabetes. Interval bone loss in millimeters was measured from the radiographs, and analysis of variance (ANOVA) was used to test for differences in bone loss between test and placebo groups. Results: Over the nine-month study duration, the test group exhibited a significantly greater increase in bone height (0.31 ±0.09 mmgain test, 0.08 ±0.09 mmgain placebo, F = 4.94, p < 0.04). There were significantly fewer dropouts in the risedronate treated group (4.8%) than in the placebo treated group (17.5%;p < 0.04, Fisher Exact Test). No serious adverse events or cases of osteonecrosis of the jaw (ONJ) were observed. Conclusions: Periodontitis subjects treated with risedronate had significantly more bone gain compared to placebo treated subjects. Significantly more subjects from the placebo group dropped out, suggesting

关键词： Risedronate Actonel Bone Osteonecrosis Osteoporosis Dental Periodontitis

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从伊拉克战场返回肯塔基州坎贝尔堡的军人中的皮肤利什曼病引起对其诊断和治疗方法的重视

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世界核心医学期刊文摘（皮肤病学分册） 2005年第10期1卷 6-6页

作者： Willard R.J jeffcoat A.M Benson P.M Walsh D.S 罗素菊 Dermatology Service Eisenhower Army Medical Center Ft Gordon GA 30905 United States.Dr

Back.round:Cutaneous leishmaniasis (CL), rare in the first Gulf War, is common in American troops serving in Operation Iraqi Freedom. Awareness of the clinical features and treatment options of CL would benefit clinicians who may encounter soldiers, as well as civilians, returning from the Middle East with sk.n lesions. Objective:Our purpose was to describe our clinical experience in treating soldiers with CL. Methods:From December 2003 through June 2004, approximately 360 of an estimated 20,000 soldiers returning from a year long deployment in Iraq with sk.n lesions suspected of being CL were examined by dermatologists. We summarized CL diagnoses, laboratory evaluations, and treatments, including localized heat therapy (ThermoMed model 1.8; ThermoSurgery Technologies, Inc, Phoenix,Ariz),oralfluconazole,cryotherapy,anditraconazole. Results:Among 237 soldiers diagnosed with CL, 181 had one or more laboratory confirmations, most by Giemsa-stained lesion smears and polymerase chain reaction (PCR). PCR was positive for all 122 smear-positive and 26 biopsy-positive lesions and all 34 smear negative and all 3 biopsy-negative cases. Primary outpatient treatments, including ThermoMed (n=26), oral fluconazole (n=15), cryotherapy (n=4), and itraconazole (n=2), were safe and tolerable. Treatment failure occurred in 2 fluconazole recipients and was suspected in 1 ThermoMed and 2 fluconazole recipients. Seventy-two soldiers elected no treatment. Limitation:This was a retrospective study. Conclusion:Approximately 1%of Ft Campbell troops returning from Iraq were diagnosed with CL, most by laboratory confirmation. PCR appeared to be the most useful diagnostic technique. Among out patient treatments,Thermo Medandcry other apyhad favorable safety and efficacy profiles.

关键词：皮肤利什曼病坎贝尔肯塔基州美国军队聚合酶链反应皮肤病患者吉姆萨染色皮肤科医生局部热疗诊断标准

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