n de voordracht zullen de volgende items aan bod komen.
De definitie van jicht is : een inflammatoire arthritis , veroorzaakt door een ophoping van urinezuurkristallen in gewrichten en/of in andere weefsels.
Het voorkomen van jicht : in 2.80 % van de mannelijke populatie en in 0.60% van de vrouwelijke populatie. Het voorkomen stijgt met de leeftijd.
Jicht is de meest voorkomende vorm van arthritis ter wereld.
De risicofactoren voor het ontwikkelen van jicht kunnen worden onderverdeeld in beïnvloedbare en niet-beïnvloedbare.
Niet-beïnvloedbaar zijn leeftijd , geslacht , ras , genetisch en chronisch nierlijden.
De beïnvloedbare risicofactoren zijn : te hoge spiegel aan urinezuur in de bloedbaan , obesitas, alcoholgebruik, voeding met veel urinezuurrijke bestanddelen zoals schaaldieren-wild-blauwe kazen etc , en bepaalde geneesmiddelen.
We gaan het hebben over co-morbiditeit , zijnde bepaalde aandoeningen die hand in hand gaan met jicht , zoals daar zijn nierinsufficientie , coronaire hartziekten en metabool syndroom. Hieronder verstaan we obesitas , hyperlipemie , hoge bloeddruk en type 2 diabetes.
Er zijn socio-economische factoren, zoals vastgesteld bij jichtpatiënten die minder uren presteren , meer afwezig zijn t.g.v. ziekte en meer hun werkschema aanpassen t.g.v pijnopstoten.
Ook zal worden besproken hoe jicht ontstaat ; hoe urinezuurkristallen worden gevormd , hoe de nieren urinezuur ‘verwerken’en wat het verband is met de urinezuurspiegel in het bloed.
We gaan natuurlijk ook in op de behandeling van jicht.
Dit houdt in de behandeling van de acute jichtaanval en de onderhoudsbehandeling.
Deze laatste is gericht op een behandeling die de urinezuurspiegel op een constante wijze laag houdt , beneden een bepaalde grens , en die aldus het optreden van schade aan de gewrichten gaat voorkomen.
Daarnaast ook het voorkomen van schade aan andere organen , vnl. schade aan de niere
n de voordracht zullen de volgende items aan bod komen.
De definitie van jicht is : een inflammatoire arthritis , veroorzaakt door een ophoping van urinezuurkristallen in gewrichten en/of in andere weefsels.
Het voorkomen van jicht : in 2.80 % van de mannelijke populatie en in 0.60% van de vrouwelijke populatie. Het voorkomen stijgt met de leeftijd.
Jicht is de meest voorkomende vorm van arthritis ter wereld.
De risicofactoren voor het ontwikkelen van jicht kunnen worden onderverdeeld in beïnvloedbare en niet-beïnvloedbare.
Niet-beïnvloedbaar zijn leeftijd , geslacht , ras , genetisch en chronisch nierlijden.
De beïnvloedbare risicofactoren zijn : te hoge spiegel aan urinezuur in de bloedbaan , obesitas, alcoholgebruik, voeding met veel urinezuurrijke bestanddelen zoals schaaldieren-wild-blauwe kazen etc , en bepaalde geneesmiddelen.
We gaan het hebben over co-morbiditeit , zijnde bepaalde aandoeningen die hand in hand gaan met jicht , zoals daar zijn nierinsufficientie , coronaire hartziekten en metabool syndroom. Hieronder verstaan we obesitas , hyperlipemie , hoge bloeddruk en type 2 diabetes.
Er zijn socio-economische factoren, zoals vastgesteld bij jichtpatiënten die minder uren presteren , meer afwezig zijn t.g.v. ziekte en meer hun werkschema aanpassen t.g.v pijnopstoten.
Ook zal worden besproken hoe jicht ontstaat ; hoe urinezuurkristallen worden gevormd , hoe de nieren urinezuur ‘verwerken’en wat het verband is met de urinezuurspiegel in het bloed.
We gaan natuurlijk ook in op de behandeling van jicht.
Dit houdt in de behandeling van de acute jichtaanval en de onderhoudsbehandeling.
Deze laatste is gericht op een behandeling die de urinezuurspiegel op een constante wijze laag houdt , beneden een bepaalde grens , en die aldus het optreden van schade aan de gewrichten gaat voorkomen.
Daarnaast ook het voorkomen van schade aan andere organen , vnl. schade aan de niere
Incidence of and risk factors for clinical fractures in patients with systemic lupus erythematosus and matched controls: a population-based study in the United Kingdom door Mw. Dr. I.E.M. Bultink, reumatoloog, VUMC
Determinants of dyspnea and its predictive value for adverse outcomes in the ...Chiel Hex
Determinants of dyspnea and its predictive value for adverse outcomes in the cohort of very old adults.
Determinanten van dyspnea en de predicatieve waarde ervan bij ouderen.
IWO Meeting 1 November 2023 - Stopping with Denosumab and Romosozumab, basic mechanisms and clinical aspects door Prof. dr. S. Ferrari, Geneva, Switzerland. (Engelstalige lezing)
1) DXA scanning is a reliable and low-radiation method to measure bone mineral density (BMD) at the lumbar spine, hip, and wrist to diagnose osteoporosis.
2) DXA can also detect vertebral fractures (VFA) and measure whole body composition, abdominal fat, and aortic calcification.
3) Interpretation of DXA results requires attention to potential variability between devices, accurate placement of regions of interest, and use of appropriate reference data since BMD can be under or overestimated in certain patients.
This document summarizes osteonecrosis of the jaw (ONJ) associated with antiresorptive agents. It defines ONJ and stages its severity. It discusses the pathogenesis of ONJ and risk factors like underlying disease, treatment duration, and dental procedures. Cancer patients on intravenous bisphosphonates have the highest ONJ risk of 1-8% due to higher drug doses and worse oral/general health. Management involves conservative measures like mouthwashes for early stages and surgery with antibiotics for later stages. Discontinuing antiresorptives may help healing but risks fractures. Teriparatide may help healing in some cases but its use in cancer is uncertain. More research is needed on preventing and treating established ON
This systematic review analyzed 895 cases of tumor-induced osteomalacia (TIO) from case reports. TIO is caused by tumors that produce excess fibroblast growth factor 23 (FGF23), which causes hypophosphatemia and osteomalacia. The review found that TIO mostly affects adults aged 40-60 years old, with long diagnostic delays of several years on average. The tumors were located variably but most commonly in the lower limbs or head and neck region. Higher FGF23 levels correlated with larger tumor size. Patients experienced significant bone fragility and fracture rates as high as 60% due to long-term hypophosphatemia. Early tumor detection and removal are important to improve outcomes for
This document discusses real-world evidence on denosumab for osteoporosis treatment and fracture prevention. It summarizes several studies, including one that found denosumab reduced fracture risk by 38% compared to placebo in over 25,000 postmenopausal women. Another study showed good long-term persistence with denosumab therapy in over 800 patients. Additional studies observed that zoledronic acid can prevent bone loss following denosumab discontinuation, and bisphosphonate treatment after denosumab provides protection against new vertebral fractures.
IWO Meeting 16 November 2022 - ASBMR young talent: Silvia Storoni (Amsterdam): Prevalence and Hospital Admissions in Patients With Osteogenesis Imperfecta in The Netherlands: A Nationwide Registry Study
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3) Interpretation of DXA results requires attention to potential variability between devices, accurate placement of regions of interest, and use of appropriate reference data since BMD can be under or overestimated in certain patients.
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5. Vrouw 40 jaar
• Voorgeschiedenis: blanco
• Medicatie: PCM en diclofenac 3x 50 mg, CBD olie
• Intoxicaties: rookt, nauwelijks alcohol, geen drugs
• Familie: RA, CVA
• Al jaren last van schouder en borstbeen
• Zwelt soms ook op
• Komt en gaat
• Linkszijdig benige zwelling SC
• Ook warm, rood
• Linker arm beweging 110 graden
5
17. Tevens
• Gestoorde slaap
• Beperking dagelijks functioneren
• Frequent uitval werk
• Irreversibele schade op termijn (vaak diagnose delay)
• Vermindering kwaliteit van leven
vd Kloot et al Arhtritis Care Res 2010 + vd Kloot et al Health Qual Life Outcomes 2010
20. Trigger
Suppression of bone resorption
by apoptosis of osteoclasts
Normalisation of
osteoblast activity
Decrease in
inflammation
Pamidronate
xx
Pain Functio Laesa Arrest Progression
Normalisation of local
bone turnover
NSAIDs
Anti-TNF