Audit on follow-up of patients with primary Osteoporosis

Aim: To document the frequency of Dual-energy X- ray absorptiometry (DEXA) scanning and Rheumatology clinic follow-up visits of patients with primary osteoporosis, and compare these with recommended guidelines. Method: Medical notes of all primary osteoporotic patients attending a hospital Rheumatology clinic were reviewed over a period of four months. Data was collected on age, gender, frequency of follow up visits, frequency of DEXA scanning, osteoporosis treatment, any changes in such treatment during the last visit, and comparison of the last two DEXA scan results. Frequency of follow up DEXA scans was compared to Group Health Osteoporosis Screening Diagnosis and Treatment guidelines.1 Results: Eighty-two patients were included, 6 males (7.3%) and 76 females (92.7%). The age range was 35-87 years (mean age was 68.6 years). In total, 42.7% of all the patients were on combined calcium and vitamin D, with added Bisphosphonates, Strontium ranelate, or Denosumab. During their last clinic visit, 61% showed improvement in T score since their previous result, and 64.6% of patients had no change in treatment. In this audit, 29.3% were being followed up on a 13 monthly basis, and 72% had annual bone mineral density scans or more frequently Conclusion: According to the guidelines, none of the patients included in this audit should have had a repeat DEXA scan within less than two years. Patients attending the clinic have too frequent DEXA scans and therefore, too frequent follow up appointments.peer-reviewe

The first wave of COVID-19 in Malta; a national cross-sectional study

INTRODUCTION: The COVID-19 pandemic has posed major challenges to all aspects of healthcare. Malta’s population density, large proportion of elderly and high prevalence of diabetes and obesity put the country at risk of uncontrolled viral transmission and high mortality. Despite this, Malta achieved low mortality rates compared to figures overseas. The aim of this paper is to identify key factors that contributed to these favorable outcomes. METHODS: This is a retrospective, observational, nationwide study which evaluates outcomes of patients during the first wave of the pandemic in Malta, from the 7th of March to the 24th of April 2020. Data was collected on demographics and mode of transmission. Hospitalization rates to Malta’s main general hospital, Mater Dei Hospital, length of in-hospital stay, intensive care unit admissions and 30-day mortality were also analyzed. RESULTS: There were 447 confirmed cases in total; 19.5% imported, 74.2% related to community transmission and 6.3% nosocomially transmitted. Ninety-three patients (20.8%) were hospitalized, of which 4 were children. Patients with moderate-severe disease received hydroxychloroquine and azithromycin, in line with evidence available at the time. A total of 4 deaths were recorded, resulting in an all-cause mortality of 0.89%. Importantly, all admitted patients with moderate-severe disease survived to 30-day follow up. CONCLUSION: Effective public health interventions, widespread testing, remote surveillance of patients in the community and a low threshold for admission are likely to have contributed to these favorable outcomes. Hospital infection control measures were key in preventing significant nosocomial spread. These concepts can potentially be applied to stem future outbreaks of viral diseases. Patients with moderate-severe disease had excellent outcomes with no deaths reported at 30-day follow up

Development of a cell transducible RhoA inhibitor TAT-C3 transferase and its encapsulation in biocompatible microspheres to promote survival and enhance regeneration of severed neurons

10.1007/s11095-007-9454-6Pharmaceutical Research24122297-230