Official Positions for FRAX® Bone Mineral Density and FRAX® simplification from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.

Tools to predict fracture risk are useful for selecting patients for pharmacological therapy in order to reduce fracture risk and redirect limited healthcare resources to those who are most likely to benefit. FRAX® is a World Health Organization fracture risk assessment algorithm for estimating the 10-year probability of hip fracture and major osteoporotic fracture. Effective application of FRAX® in clinical practice requires a thorough understanding of its limitations as well as its utility. For some patients, FRAX® may underestimate or overestimate fracture risk. In order to address some of the common issues encountered with the use of FRAX® for individual patients, the International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundation (IOF) assigned task forces to review the medical evidence and make recommendations for optimal use of FRAX® in clinical practice. Among the issues addressed were the use of bone mineral density (BMD) measurements at skeletal sites other than the femoral neck, the use of technologies other than dual-energy X-ray absorptiometry, the use of FRAX® without BMD input, the use of FRAX® to monitor treatment, and the addition of the rate of bone loss as a clinical risk factor for FRAX®. The evidence and recommendations were presented to a panel of experts at the Joint ISCD-IOF FRAX® Position Development Conference, resulting in the development of Joint ISCD-IOF Official Positions addressing FRAX®-related issues.

¿Cómo desarrollar la memoria en personas mayores desde la Teoría de las Inteligencias Múltiples de H. Gardner?

La falta de memoria suele ser una de las principales quejas de nuestros mayores. Tradicionalmente se han venido desarrollando distintos programas para mejorarla o mantenerla. En este artículo les presentamos una forma de abordar ese problema. Nuestro deseo es compartir nuestra experiencia. Les presentamos una unidad de programación desarrollada en el marco del Taller: Apuesta por tu Memoria que organiza el Ayuntamiento de Lleida, para los mayores de diferentes casales de la ciudad. La fundamentación teórica en la que enmarcamos nuestra intervención parte de la teoría de las inteligencias múltiples de Howard Gardner y del enfoque de las teorías del procesamiento de la información.

Chronic NSAID use and long-term decline of renal function in a prospective rheumatoid arthritis cohort study.

OBJECTIVES: Non-steroidal anti-inflammatory drugs (NSAIDs) may cause kidney damage. This study assessed the impact of prolonged NSAID exposure on renal function in a large rheumatoid arthritis (RA) patient cohort. METHODS: Renal function was prospectively followed between 1996 and 2007 in 4101 RA patients with multilevel mixed models for longitudinal data over a mean period of 3.2 years. Among the 2739 'NSAID users' were 1290 patients treated with cyclooxygenase type 2 selective NSAIDs, while 1362 subjects were 'NSAID naive'. Primary outcome was the estimated glomerular filtration rate according to the Cockroft-Gault formula (eGFRCG), and secondary the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration formula equations and serum creatinine concentrations. In sensitivity analyses, NSAID dosing effects were compared for patients with NSAID registration in ≤/>50%, ≤/>80% or ≤/>90% of assessments. FINDINGS: In patients with baseline eGFRCG >30 mL/min, eGFRCG evolved without significant differences over time between 'NSAID users' (mean change in eGFRCG -0.87 mL/min/year, 95% CI -1.15 to -0.59) and 'NSAID naive' (-0.67 mL/min/year, 95% CI -1.26 to -0.09, p=0.63). In a multivariate Cox regression analysis adjusted for significant confounders age, sex, body mass index, arterial hypertension, heart disease and for other insignificant factors, NSAIDs were an independent predictor for accelerated renal function decline only in patients with advanced baseline renal impairment (eGFRCG <30 mL/min). Analyses with secondary outcomes and sensitivity analyses confirmed these results. CONCLUSIONS: NSAIDs had no negative impact on renal function estimates but in patients with advanced renal impairment.

Torneå

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Ny-Carleby

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Avasaksa och Öfver-Torneå kyrka

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Nådendal

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Walamo

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Turholm

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Fiskars

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Åbo slott

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Lith. u. Druck. v.Adler u. Dietze

Ett torp vid Walkijärvi i Sammati kapell

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Strömsdal

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u. Dietze

Kyro fors

Helsingfors : A.W. Gröndahl & A.C. Öhman 1845 : Dresden, Adler u Dietze