RESUMO
OBJECTIVE: Osteoporosis (OP), osteoarthritis (OA) and vitamin D deficiency are age-related disorders. We investigated the association between bone mineral density (BMD), vitamin D and OA in patients undergoing total hip or knee replacements. METHOD: In total, 82 women and 35 men with mean ages of 70 and 68 years, respectively, were recruited for the study. The BMD of the lumbar spine and the proximal femur were measured by dual-energy X-ray absorptiometry. The vitamin D status was assessed by 25(OH)D levels, with a cut-off of Assuntos
Densidade Óssea
, Osteoartrite do Quadril/metabolismo
, Osteoartrite do Joelho/metabolismo
, Vitamina D/análogos & derivados
, Absorciometria de Fóton
, Adulto
, Fatores Etários
, Idoso
, Idoso de 80 Anos ou mais
, Índice de Massa Corporal
, Doenças Ósseas Metabólicas/complicações
, Feminino
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Osteoartrite do Quadril/sangue
, Osteoartrite do Quadril/complicações
, Osteoartrite do Quadril/patologia
, Osteoartrite do Joelho/sangue
, Osteoartrite do Joelho/complicações
, Osteoartrite do Joelho/patologia
, Osteoporose/complicações
, Caracteres Sexuais
, Vitamina D/sangue
, Deficiência de Vitamina D/complicações
RESUMO
Provision of sufficient post-operative pain therapy is an obligation in the clinical management of patients. A wide range of medical, technical and organizational options is used to improve post-operative pain management in orthopaedic surgery. Measurement of pain is as important as the correct use of analgesics and application techniques. Standardized pain therapy algorithms should facilitate autonomous treatment of patients. Additional procedures like patient-controlled analgesia or local catheter for pain are necessary for individualized or operation-specific pain therapy. The balanced combination in postoperative pain therapy could reduce side effects and complication rates, increase mobility and enhance patient satisfaction.
Assuntos
Analgésicos Opioides/uso terapêutico , Analgésicos/uso terapêutico , Procedimentos Ortopédicos , Dor Pós-Operatória/tratamento farmacológico , Ferimentos e Lesões/cirurgia , Analgesia Epidural , Analgésicos/efeitos adversos , Analgésicos Opioides/efeitos adversos , Anestesia por Condução , Humanos , Bombas de Infusão , Assistência de Longa Duração , Medição da DorRESUMO
In order to treat patients with postoperative acute pain effectively, we have developed a standardised algorithm for analgesia. This process includes three levels and the appropriate supply of medication. The therapy level is defined based on the scale of the operation. Accordingly, the prescription and handling of the pain medication is simplified for the attending physician and nurses. The pain level has to be measured by the nursing staff sing a visual analogue scale (VAS). Thus, the efficiency of the analgesics will be continuously evaluated and controlled. The standardised supply medication can be applied in those cases with pain levels > or = 4 (VAS). It is possible to up- or down-grade the level within the system depending on the actual pain experienced by the patient. With this structured pain therapy algorithm we now have a guideline for the consistent postoperative analgesic treatment of patients.
Assuntos
Algoritmos , Analgesia/métodos , Analgesia/normas , Analgésicos/administração & dosagem , Ortopedia/métodos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Sistemas de Apoio a Decisões Clínicas , Alemanha , Humanos , Medição da Dor/métodos , Medição da Dor/normas , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normasRESUMO
Provision of sufficient post-operative pain therapy is an obligation in the clinical management of patients. A wide range of medical, technical and organizational options is used to improve post-operative pain management in orthopaedic surgery. Measurement of pain is as important as the correct use of analgesics and application techniques. Standardized pain therapy algorithms should facilitate autonomous treatment of patients. Additional procedures like patient-controlled analgesia or local catheter for pain are necessary for individualized or operation-specific pain therapy. The balanced combination in postoperative pain therapy could reduce side effects and complication rates, increase mobility and enhance patient satisfaction.
Assuntos
Analgésicos/administração & dosagem , Procedimentos Ortopédicos/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Procedimentos de Cirurgia Plástica/efeitos adversos , Ferimentos e Lesões/complicações , Ferimentos e Lesões/cirurgia , Humanos , Dor Pós-Operatória/etiologiaRESUMO
INTRODUCTION: This study investigated the influence of concentration and activity of several markers of the collagen and bone metabolism and their impact on ingrowth of non-cemented total hip arthroplasty. METHODS: 40 patients underwent an implantation of a ABG-prosthesis. Before surgery and 1, 2, 12 and 24 weeks after it serum concentrations of PICP, ICTP, IGF-1, ON, b-AP, Calcium, Phosphate, GPT and Creatinin were measured and a collagen ratio (CQ) was calculated. RESULTS: PICP decreased until 1st week, increased at 2nd week and decreased again after that time. ICTP increased significantly in 1st week, reached a maximum in 2nd week and decreased after that. b-AP decreased in 1st week but increased after that time. IGF-1 and ON decreased significantly after surgery but increased later. Calcium and Phosphate always showed normal values. CQ decreased in 1st week in males (45%) and females (60%), but increased later on. CONCLUSION: These markers investigated made it possible to estimate the osteointegration of non-cemented total hip arthroplasty and confirm radiologic and histomorphometric results of the literature.