All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%), hemorrhagic diathesis (13/87%), vomiting (11/73%), abdominal pain (10/67%), myalgia
(7/47%) and hypotension (7/47%) also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1 +/- 24.1 mmol/L) and serum creatinine (mean 347.6 +/- 179.8 mu mol/L). Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6 +/- 210.7 mu mol/L) and slightly elevated aminotransferases (ASAT mean 125.8 +/- 61.6 IU/L; ALAT mean 131.3 +/- 126.5 IU/L). Five cases (33%) had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment.
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“Background: Several previous studies have demonstrated that bone mineral density loss find more around femoral implants is common, particularly in the proximal part of the femur, soon after total hip arthroplasty. The purpose of the present study was to compare the effects of alendronate and alfacalcidol on bone mineral density loss around the femoral implant and in the lumbar spine after total hip arthroplasty.
Methods: The present study included sixty patients with osteoarthritis of the hip who had undergone a primary cementless total hip arthroplasty. We assigned these individuals to treatment with alendronate (n = 20), alfacalcidol (n = 18), or no medication (n = 22). Periprosthetic and lumbar https://www.selleckchem.com/products/ch5183284-debio-1347.html spine bone mineral density was measured one week after surgery, and biochemical markers (bone-specific alkaline phosphatase and serum N-terminal telopeptides of type-1 collagen) were measured before surgery as a reference baseline. Subsequent measurements were performed at twelve, twenty-four, and forty-eight weeks
after surgery. The periprosthetic measurement area in the femur was defined as Regions 1 to 7, which are consecutively located around the implant from the greater trochanter to the lesser trochanter and calcar.
Results: Bone mineral density in the alendronate group was maintained in all regions. selleck inhibitor In the alfacalcidol and no-medication groups, bone mineral density in Region 7 was lower than in Regions 3 to 6 throughout the study period (p < 0.0001 as a result of repeated measures analysis of variance). Bone mineral density in the lumbar spine in the alendronate and alfacalcidol groups was higher than in the no-medication group at forty-eight weeks. The serum level of N-terminal telopeptides of type-1 collagen in the alendronate group was lower than that in the no-medication group throughout the study period (p = 0.003, 0.02 and 0.005).
Conclusions: Alendronate prevented bone mineral density loss around femoral implants, particularly in Region 7 (calcar), but alfacalcidol did not show any effects in any regions.