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| Author(s): |
Lívia Alves Amaral Santos
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Botucatu. 2019-04-05. |
| Institution: | Universidade Estadual Paulista (Unesp). Faculdade de Medicina. Botucatu |
| Defense date: | 2019-02-27 |
| Advisor: | Fernando Gomes Romeiro |
| Abstract | |
Introduction: The treatment of bone loss in patients with cirrhosis is not well defined, so that many patients do not receive effective therapy and develop complications such as fractures and chronic pain. Aim: To evaluate the safety and the efficacy of osteoporosis and osteopenia treatment in patients with liver cirrhosis and low-risk esophageal varices. Materials and methods: The osteoporosis treatment consisted of risedronate associated with calcium and vitamin D supplementation, while the osteopenia treatment comprised only the nutritional supplementation. The safety assessment was done by endoscopic exams before and during the treatment (6 and 12 months), as well as by outpatient appointments carried out 1 year after starting the treatment. These results were compared between the osteoporosis and osteopenia groups through the Fisher exact test. The efficacy analysis was measured through the T-score assessed by Dual Energy X-Ray Absorptiometry (DXA), which was performed before and at 2 years of treatment by calculating the 95% confidence interval and applying the t-Student test. Results: The endoscopic findings and the adverse events were similar between the groups. The osteoporosis group had a significant increase in the lumbar spine T-score (p <0.001), with no bone loss in the femoral neck. The osteopenia group had no improvement in vertebral bones and suffered a clear reduction in the femoral neck T-score (p = 0.019). Conclusion: The treatments were safe but only the one with risedronate promoted the improvement in vertebral bones and avoided a significant bone loss in the femoral neck, as a promising option for both groups. (AU) | |
| FAPESP's process: | 14/22572-9 - Bone changes in patients with liver cirrhosis treated for osteoporosis and osteopenia |
| Grantee: | Lívia Alves Amaral Santos |
| Support Opportunities: | Scholarships in Brazil - Doctorate |