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Females Had a Worse T-Score at lumbar region and Males Had a Worse T-Score at Femoral region among Chronic Kidney Disease

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Open Journal of Nephrology 2022年第1期12卷 60-74页

作者： Hilal Al Kalbani Issa Al Salmi Fatma Al Rahbi Sumaiya Al Siyabi Suad Hannawi Rheumatology Department The Royal Hospital Muscat Oman The Renal Medicine Department The Royal Hospital Muscat Oman Department of Nuclear Medicine The Royal Hospital Muscat Oman Department of Medicine Ministry of Health and Prevention Dubai UAE

Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.

关键词： Bone-Mineral-Density-BMD Dual-Energy X-Ray Absorptiometry-DEXA Chronic-Kidney-Disease-CKD T-Score lumbar region Femoral region Gender

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Postoperative pain due to an occult spinal infection:A case report

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World Journal of Clinical Cases 2021年第15期9卷 3637-3643页

作者： Michiel Frederik Vande Kerckhove Vincent Fiere Thais Dutra Vieira Sami Bahroun Marc Szadkowski Henrid'Astorg Centre Orthopédique Santy Hopital PrivéJean MermozRamsay-Générale de SantéLyonFrance

BACKGROUND A high degree of vigilance is warranted for a spinal infection,particularly in a patient who has undergone an invasive procedure such as a spinal *** average delay in diagnosing a spinal infection is 2-4 *** our patient,the diagnosis of a spinal infection was delayed by 1.5 *** SUMMARY A 60-year-old male patient with a 1-year history of right-sided lumbar radicular pain failed conservative *** weeks to prior to surgery he received a spinal injection,which was followed by increasing lumbar radicular pain,weight loss and *** went unnoticed and surgery took place with right-sided L4-L5 combined microdiscectomy and foraminotomy via a posterior *** day after surgery,the patient developed left-sided lumbar radicular *** cultures grew Staphylococcus aureus(***).Magnetic resonance imaging showed inflammatory aberrations,revealing septic arthritis of the left-sided L4/L5 facet joint as the probable *** surgery took place and *** was isolated from bacteriological *** patient received postoperative antibiotic treatment,which completely eradicated the *** The development of postoperative lower back pain and/or lumbar radicular pain can be a sign of a spinal infection.A thorough clinical and laboratory work-up is essential in the preoperative evaluation of patients with spinal pain.

关键词： Arthritis Septic lumbar region Disc herniated Spinal injections Case report

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