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Rheumatology & Orthopaedics / Orthopedics

Welcome to the rheumatology and orthopaedics / orthopedics category for physicians and pharmacists. This category features links to clinical resources on guidelines for musculoskeletal and joint diseases, fracture risk tools, prescribing DMARDs (disease-modifying anti-rheumatic drugs) and analgesics and more.

The British Society for Rheumatology Guidelines

Source: rheumatology.org.uk
Clinical Resource: Guidelines
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Last Checked: 05/03/13 Link Error: Report It

 

American College of Rheumatology Clinical Practice Guidelines

Source: rheumatology.org
Clinical Resource: Guidelines
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Last Checked: 19/07/13 Link Error: Report It

 

Canadian Rheumatology Association Clinical Guidelines & Position Papers

Source: rheum.ca
Clinical Resource: Guidelines and Position Papers
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Last Checked: 19/07/13 Link Error: Report It

 

National Institute for Health and Care Excellence (NICE) Guidance > Musculoskeletal conditions

Source: nice.org.uk
Clinical Resource: Guidance
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Last Checked: 18/05/15 Link Error: Report It

 

Musculoskeletal - CLEAR: clinical enquiry and response service

The CLEAR service is delivered by a team of information professionals based at Healthcare Improvement Scotland and NHS Greater Glasgow and Clyde.

CLEAR aims to provide clinicians with summarised evidence relating to aetiology, diagnosis, prognosis and treatment queries about patient care.

Source: knowledge.scot.nhs.uk
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 22/04/13 Link Error: Report It

 

BestBETs

BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is.

Categories

Rheumatology
Orthopaedics

Source: bestbets.org
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 19/07/13 Link Error: Report It

 

The Cochrane Collaboration
Cochrane Reviews

The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.

Topics:

Orthopaedics & Trauma
Rheumatology

Source: cochrane.org
Clinical Resource: Systematic Reviews
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Last Checked: 13/07/15 Link Error: Report It

 

Musculoskeletal Care

This module focuses on a primary care approach to assessment of patients with a musculoskeletal problem. It covers diagnosis, investigations and treatment.

Specific conditions frequently encountered by GPs are described in more detail, including back pain, gout, inflammatory arthritis, polymyalgia rheumatica and osteoarthritis. The final session looks at musculoskeletal problems which can be exclusively managed within primary care and features useful exercises for patients.

Source: rcgp.org.uk
Clinical Resource: e-Learning
Register to Access Content: Yes - registration is FREE

Last Checked: 02/12/16 Link Error: Report It

 

Bandolier Knowledge
Arthritis, bones and joints

In these pages are collected the stories from Bandolier relating to arthritis and bone and joint problems.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

American College of Rheumatology
Hotline

The ACR Hotline is intended to provide a succinct, balanced, timely, evidence-based review of novel information relevant to rheumatologists and allied rheumatology professionals before it is readily available from other sources, such as peer-reviewed literature.

Source: rheumatology.org
Clinical Resource: Evidence Based Reviews
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Last Checked: 19/07/13 Link Error: Report It

 

Arthritis Research UK
Hands On, Synovium and Topical Reviews

Read the latest issues of our reports for health professionals, or browse the archives

Source: arthritisresearchuk.org
Clinical Resource: Reports
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Last Checked: 19/07/13 Link Error: Report It

 

The Johns Hopkins Arthritis Center

The mission of the Johns Hopkins Arthritis WebSite is to provide a high quality, interactive, educational program for health care professionals about diseases that cause arthritis and their treatments.

The Johns Hopkins Arthritis WebSite will focus primarily on rheumatoid arthritis and osteoarthritis since these diseases serve as prototypes for inflammatory and degenerative joint diseases, respectively. However, the editors may periodically add discussions of other types of arthritis (e.g., gout or spondyloarthropathies or psoriatic arthritis) as prompted by new therapies or other relevant issues.

Source: hopkinsarthritis.org
Clinical Resource: Various
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Last Checked: 19/07/13 Link Error: Report It

 

JointZone

This site is divided into five key contents sections about rheumatology and a section containing interactive case studies. The table of contents on your left serves as a navigational aid to help you move around the site. Try clicking on each subheading under each key section for a more detailed list.

Key Topics:-

  • Basic Science: Explore the scientific basis underlying rheumatology.
  • Rheumatic Disorders: Find out about various kinds of rheumatic disorders.
  • Approach To Patient: Learn the principles of history-taking and physical examination in relation to rheumatic disorders.
  • Investigations: Learn how to investigate rheumatic disorders using a variety of investigations including diagnostic imaging.
  • Disease Management: Learn about how to treat patients with rheumatic disorders.
  • Case Studies: Take part in a virtual clinical experience to investigate and diagnose a patient with rheumatic problems.
Source: jointzone.org.uk
Clinical Resource: CE / CPD / Learning
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Last Checked: 19/07/13 Link Error: Report It

 

A diagnostic approach to the common arthritic conditions

In this article we review the clinical approach to the diagnosis of some common rheumatic disorders and highlight some common pitfalls in the assessment of the patient presenting with musculoskeletal symptoms.

Source: safpj.co.za
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Treatment of Hypertension in Patients With Rheumatic Disease
European Society of Hypertension Newsletter

Among “rheumatic” diseases rheumatoid arthritis (RA) is the most common immune-inflammatory disorder characterized by symmetric polyarthritis affecting predominantly the small joints of the hands and feet. In patients with seropositive RA, the disease course is more aggressive, extra-articular manifestations are more frequent and their mortality is increased. Osteoarthritis (OA) is one of the most common causes of disability in adults. It is caused by chronic damage of the cartilage in joints - large ones are most frequently involved. Beyond them, gout deserves special attention since it has multiple interactions with hypertension or its treatment.

Source: eshonline.org
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Complementary and alternative medicines for the treatment of rheumatoid arthritis, osteoarthritis and fibromyalgia

This document, written and produced by Arthritis Research UK, is an evidence-based report on the use of complementary and alternative medicines for arthritis and musculoskeletal conditions. It uses data from randomised controlled trials (RCTs) – the type of studies that give the best evidence on whether a treatment is effective or not – and aims to help people with these conditions select which complementary medicines may be useful for them.

Practitioner-based complementary and alternative therapies for the treatment of rheumatoid arthritis, osteoarthritis, fibromyalgia and low back pain

Our first review, Complementary and alternative medicines for the treatment of rheumatoid arthritis, osteoarthritis and fibromyalgia, focused on products that are taken orally or applied to the skin. This second report considers practitioner-based therapies such as acupuncture, chiropractic, osteopathy and hypnotherapy, and other therapies such as magnet therapy and copper bracelets. The purpose is to provide a resource for patients and healthcare professionals by summarising current evidence on the effectiveness and safety of commonly used complementary or alternative therapies available within the UK.

Source: arthritisresearchuk.org
Clinical Resource: Reports
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Last Checked: 28/04/14 Link Error: Report It

 

Drug-induced muscle and joint pain

Drug-induced muscle and joint pains are severe adverse reactions.

Major drugs and drug classes associated with myalgia include suxamethonium, statins, fibrates, amiodarone, ciclosporin, colchicine, diuretics and danazol.

Source: adr.org.uk
Clinical Resource: Factsheet
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Last Checked: 19/07/13 Link Error: Report It

 

The British Pain Society - Pain Scales in Multiple Languages

The pain scales are recommended to be used by GP's and Accident and Emergency staff and may well also prove useful in a wider range of situations in which the communication of pain is necessary.

Source: britishpainsociety.org
Clinical Resource: Pain Scales
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Last Checked: 17/07/15 Link Error: Report It

 

American Society of Interventional Pain Physicians Guidelines

Source: asipp.org
Clinical Resource: Guidelines
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Last Checked: 19/07/13 Link Error: Report It

 

Pain Community Centre

This is a free learning resource for any healthcare professional, seeking evidence based information and education on pain and its management.

The content for this website has been developed by a multidisciplinary team of healthcare professionals and key opinion leaders with specialist clinical and academic roles in pain management.

Source: paincommunitycentre.org
Clinical Resource: Various
Register to Access Content: Yes - registration is FREE to healthcare professionals

Last Checked: 17/06/14 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Chronic Pain

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

Opioids for persistent pain: Good practice

A consensus statement prepared on behalf of the British Pain Society, the Faculty of Pain Medicine of the Royal College of Anaesthetists, the Royal College of General Practitioners and the Faculty of Addictions of the Royal College of Psychiatrists

This guidance has been written for all healthcare professionals who manage patients with persistent pain, to help their understanding of the role of opioids in pain management. The document outlines good practice regarding decision making in relation to opioid therapy, ongoing monitoring of treatment and identification and management of problems related to opioid use.

Source: britishpainsociety.org
Clinical Resource: Consensus Statement
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Last Checked: 17/07/15 Link Error: Report It

 

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain

Source: nationalpaincentre.mcmaster.ca
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

Opioids and Chronic Non-Malignant Pain: A Clinician's Handbook

Our goal in creating this handbook is to assist clinicians in managing adult patients with chronic non-malignant pain. We have attempted to provide information and resources that can be easily referenced as individual patient treatment plans are being developed. The information contained in this handbook is based on current consensus guidelines, expert opinion and studies when available. Despite an obvious need, the medical literature does not yet contain the high quality randomized controlled trials required to establish evidenced-based clinical standards for the management of chronic non-malignant pain.

Our discussion focuses on the use of long-term opioids because this is reported to be the area that is most challenging for clinicians, holding both the potential for benefit and the potential for social and medical adverse outcomes.

The handbook is organized in two major parts:

Part I: Principles of Prescribing Opioids—identifies basic issues relating to the use of opioids in chronic non-malignant pain.

Part II: Guide to Prescribing Opioids for Chronic Non-Malignant Pain—provides detailed prescribing information that can be referenced quickly while seeing patients.

Source: careoregon.org
Clinical Resource: Handbook
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Last Checked: 19/07/13 Link Error: Report It

 

A Clinical Guide to Opioid Analgesia

The intent of this book is to help clinicians make practical sense of the varied and often conflicting issues (pharmacological, clinical, and regulatory) surrounding opioid pharmacotherapy, in order to promote the most healthful outcomes possible for patients in pain. The aim is to improve knowledge and skills related to both the principles of prescribing and the management of risk. In this way, healthcare professionals and those they serve may benefit increasingly from the unique therapeutic potential of this drug class, and fear less the undeniable, yet manageable, potential for harm.

Source: stoppain.org
Clinical Resource: Book
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Last Checked: 08/07/13 Link Error: Report It

 

Opioid Advice: Detection and Management of Acute Opioid Withdrawal in Non-Pregnant Patients Prescribed Opioids for Chronic Pain

Withdrawal occurs in patients taking opioids regularly when:

  • the dose is reduced, missed or stopped
  • the patient is given a partial agonist or antagonist that precipitates withdrawal
  • opioids are switched or tapered
  • the patient voluntarily stops opioids.
Source: knowledgex.camh.net
Clinical Resource: Advice
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Last Checked: 19/07/13 Link Error: Report It

 

Pain and substance misuse: improving the patient experience

A consensus statement prepared by The British Pain Society in collaboration with The Royal College of Psychiatrists, The Royal College of General Practitioners and The Advisory Council on the Misuse of Drugs

This document aims to identify elements of good practice in the management of pain and in the prescription of opioid drugs. It provides non-specialists with appropriate information to assess the needs of and manage pain in patients who are or have previously been substance misusers. The document also gives guidance on models of collaborative working among relevant healthcare professionals involved in the care of patients with pain who are using, or are at risk of using, drugs inappropriately. It therefore aims to improve practice in managing this group of patients with complex needs.

Source: britishpainsociety.org
Clinical Resource: Consensus Statement
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Last Checked: 17/07/15 Link Error: Report It

 

Opioid Advice: Switching Opioids Safely to Prevent Overdose for Outpatients Prescribed Opioids for Chronic Pain

Patients who require opioids for chronic pain management might need to be switched to another opioid either due to:

  • lack of response or discontinuation of a particular opioid, or
  • lack of availability of the medication
Source: knowledgex.camh.net
Clinical Resource: Advice
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Last Checked: 19/07/13 Link Error: Report It

 

Management of Persistent Pain in Older Adults

Persistent pain—painful sensation that continues for a prolonged period of time and may or may not be associated with a well defined disease process—is prevalent in older adults. The American Geriatrics Society is pleased to provide tools to assist clinicians in providing optimal care to older adults who suffer from pain, as well as resources for patients and caregivers on pain management and treatment.

Source: americangeriatrics.org
Clinical Resource: Guideline
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Last Checked: 20/08/15 Link Error: Report It

 

Management of Pain in Acute Illness

The purpose of this article is to review acute illnesses that interact with the management of pain, where misuse of analgesic agents would be detrimental to the patient. Two broad etiologies can be applied to most of the discussion: increased drug toxicity due to acute illness and worsened acute illness due to improper analgesic selection.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Bandolier Knowledge
Topical analgesics

This site aims to gather together information on topical analgesics.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Achieving Appropriate Prescribing of Non-Steroidal Anti-inflammatory Drugs (NSAIDs): Briefing paper for secondary care providers

The purpose of this paper is to draw together information which will enable secondary care providers to make an informed choice about the strategies they could adopt to support safer prescribing of NSAIDs within their trusts.

Source: suffolkextranet.nhs.uk
Clinical Resource: Briefing Paper
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Last Checked: 19/07/13 Link Error: Report It

 

Cardiovascular and gastrointestinal safety of NSAIDs

This article summarises current evidence of relative CV and GI risks for non-aspirin NSAIDs and highly selective COX-2 inhibitors (coxibs), and provides prescribing advice which is consistent with previous advice from the Commission on Human Medicines.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Publication
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Last Checked: 24/04/15 Link Error: Report It

 

NSAID Selection: Consideration of Cardiovascular & Gastrointestinal Risk
Gwent Partnership Medicines & Therapeutics Committee

Source: wales.nhs.uk
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

American College of Gastroenterology Guidelines for Prevention of NSAID-Related Ulcer Complications

Source: gi.org
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

NSAIDs: minimising the risk

Pharmacy letter insert with advice on appropriate use of NSAIDs to minimise risk to patients from their use.

Source: nps.org.au
Clinical Resource: National Prescribing Service Publication
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Last Checked: 19/07/13 Link Error: Report It

 

Is there any evidence to support the use of enteric coated (EC) over uncoated prednisolone tablets?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

As the debate continues about whether the EC formulation provides gastro-protection compared with the uncoated tablets, in addition to the cost differential of the two products (three-fold difference at time of writing based on Drug Tariff June 2013), a summary of the findings of the DTB and an update of the literature with a focus on the implications of switching formulations are presented

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Early Rheumatoid Arthritis

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

Contemporary Management of Rheumatoid Arthritis

This bulletin will focus on the contemporary management of RA.

Source: stjames.ie
Clinical Resource: Medicines Information Centre Bulletin
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Last Checked: 19/07/13 Link Error: Report It

 

Treatment of Rheumatoid Arthritis in the Elderly

This review will focus on elderly-onset RA (EORA) but the principles of therapy are identical for RA in the elderly.

Source: shpa.org.au
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis

Table of disease-modifying antirheumatic drugs (DMARDs) includes contraindications and monitoring.

Source: nps.org.au
Clinical Resource: National Prescribing Service Publication
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Last Checked: 17/02/14 Link Error: Report It

 

Rheumatoid Arthritis - monitoring of DMARDs

This article covers important aspects of the care of patients taking DMARDs including monitoring requirements, adverse effects and drug interactions.

Source: bpac.org.nz
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Methotrexate - Safe Prescribing - Once a Week!

Low-dose oral methotrexate therapy, i.e. less than 25mg taken as a single dose once a week, is generally safe when prescribed for non-neoplastic diseases that are characterised by inflammation, such as rheumatoid arthritis. Compared to second-line disease-modifying anti-rheumatic drugs (DMARDs), methotrexate is usually well tolerated and its side-effects predictable.

Source: saferx.co.nz
Clinical Resource: Bulletin
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Last Checked: 19/07/13 Link Error: Report It

 

Folate supplementation and methotrexate in rheumatoid arthritis

Methotrexate is a folic acid antagonist with cytotoxic, immunosuppressive and anti-inflammatory actions. Due to its ease of use, low cost and favourable efficacy/toxicity profile, it has become established as the most commonly used disease-modifying anti-rheumatic drug (DMARD) for the treatment of rheumatoid arthritis (RA).

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 19/07/13 Link Error: Report It

 

Does Folic Acid Reduce the Toxicity of Methotrexate?

Source: medscape.com
Clinical Resource: Question and Response
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Last Checked: 19/07/13 Link Error: Report It

 

Q: What are the recommendations for folate supplementation in patients treated with methotrexate (MTX) for rheumatoid arthritis?

A: MTX continues to be one of the most important disease-modifying antirheumatic drugs (DMARDs) for the treatment of rheumatoid arthritis.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 19/07/13 Link Error: Report It

 

Drug interactions with methotrexate

Methotrexate (MTX) is an antimetabolite cytotoxic drug with immunosuppressant properties. It is used in high doses (>1g/m2 of body surface area) to treat malignant neoplasms, and in low doses (<25mg) in the treatment of psoriasis and rheumatoid arthritis. This bulletin aims to provide an overview of some clinically significant drug interactions of MTX.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 19/07/13 Link Error: Report It

 

Royal College of Nursing
Assessing, managing and monitoring biologic therapies for inflammatory arthritis

This guidance has been developed to support practitioners in the safe and effective assessment, screening and management of patients when biologic therapies are being considered. It provides practitioners with practical information to help them care for patients with different forms of inflammatory arthritis, in all care settings.

The aim of this document is to provide practitioners with an outline of current biologic therapies, both licensed and unlicensed, and refers the reader to additional key documents and resources that will support practitioners in the UK to develop a standardised approach to caring for patients receiving biologic therapies.

Source: rcn.org.uk
Clinical Resource: Guidance
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Last Checked: 22/02/17 Link Error: Report It

 

Gout: An Update

First-line therapy for acute gout is nonsteroidal anti-inflammatory drugs or corticosteroids, depending on comorbidities; colchicine is second line therapy.

Source: aafp.org
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Bandolier Knowledge
Gout

The Bandolier gout site seeks to build good evidence about gout and its treatment.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Understanding Treatments for Gout

This article reviews basic pathways in purine metabolism, uric acid handling, and the pathogenic mechanism of clinical gout, as well as the areas in those pathways amenable to intervention. Attention is also given to associated comorbidities, such as hyperuricemia and obesity, hypertension, hyperinsulinemia, and coronary artery disease. The significance of lifestyle modifications, such as weight loss and alcohol reduction, is discussed as an important adjunct to pharmacotherapy in gout. Current and investigational agents used in gout management are also reviewed. Finally, treatment recommendations for acute and chronic gout are suggested. 

Source: ajmc.com
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Gout in the Elderly

Even though gout is often thought of as a middle-age malady, it is the most common inflammatory arthritis seen in the elderly. Epidemiologic studies of aging populations have shown rises in the incidence and prevalence of gout in both sexes.

Source: clinicalgeriatrics.com
Clinical Resource: Journal Article
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Last Checked: 05/03/13 Link Error: Report It

 

Therapeutic challenges in gout

Inpatients with gout often have a wide variety of co-morbidities - including chronic renal failure, ischaemic heart disease, congestive heart failure, peptic ulcer disease, and diabetes mellitus. In addition, gout is often complicated by the concurrence of sepsis, thus presenting a diagnostic challenge and management problem.

Source: nzma.org.nz
Clinical Resource: Journal Article
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Last Checked: 13/05/16 Link Error: Report It

 

Management of Gout in the Presence of Chronic Kidney Disease

The purpose of this newsletter is to provide direction on the management of gout in patients with CKD, including pertinent updates from the new guidelines.

Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Managing gout: How is it different in patients with chronic kidney disease?

In this paper, we discuss approaches to and controversies in the management of gout and hyperuricemia in patients with CKD. Unfortunately, the evidence from clinical trials to guide treatment decisions is limited; therefore, decisions must often be based on experience and pathophysiologic principles.

Source: mdedge.com
Clinical Resource: Journal Article
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Last Checked: 19/06/17 Link Error: Report It

 

The management of hyperuricemia and gout in patients with heart failure

The treatment of gout in patients with heart failure is complicated by their fragile volume state and chronic renal failure, both of which prohibit the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. Moreover, drug interactions exist between drugs used for the treatment of hyperuricemia and gout and pharmacological agents used for the therapy of heart failure. This review therefore focuses on the treatment of hyperuricemia and gout in patients with heart failure.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 17/06/14 Link Error: Report It

 

Colchicine - Safe Prescribing - Toe the Line!!

Fatal poisonings have been reported in patients who have taken as little as 7mg, although some patients have taken up to 60mg and survived. Symptoms of acute colchicine toxicity usually appear 2 to 12 hours after ingestion, and often before the analgesic effects start. Toxic effects may include gastrointestinal (GI) symptoms, electrolyte derangement, haematological effects, renal failure, and hepatic damage.

Source: saferx.co.nz
Clinical Resource: Bulletin
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Last Checked: 19/07/13 Link Error: Report It

 

Colchicine Dosing for Acute Gout Attacks

Dosing guidelines vary according to the reference source, which may lead to confusion regarding safe and effective dosing.

Source: dpic.org
Clinical Resource: Drug and Poison Information Centre Newsletter
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Last Checked: 19/10/15 Link Error: Report It

 

Life-threatening Colchicine Drug Interactions

Colchicine can be very effective in the treatment of gout and familial Mediterranean fever. Unfortunately, however, its therapeutic effects (primarily on white blood cells) can lead to life-threatening toxicity if colchicine plasma concentrations become too high. One of the causes of dangerously elevated colchicine concentrations is interaction with other drugs.

Source: hanstenandhorn.com
Clinical Resource: Journal Article
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Last Checked: 05/06/15 Link Error: Report It

 

American Academy of Orthopaedic Surgeons Clinical Practice Guidelines

Source: aaos.org
Clinical Resource: Clinical Guidelines
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Last Checked: 20/08/15 Link Error: Report It

 

 

Management of osteoarthritis

Osteoarthritis is the most common arthropathy worldwide and the clinical and radiological prevalence increase with age. The aetiology is uncertain, but genetic and environmental factors are recognised. Symptoms predominantly occur in the spine, hips, knees, hands and feet, in isolation or combination, and may be relapsing – remitting or progressive. The signs may mimic inflammatory arthropathies or non-articular rheumatism, but clinical signs and appropriate investigations are discriminatory.

Source: rcpe.ac.uk
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Osteoarthritis: What are the Options?

Osteoarthritis (OA) is a common condition that causes significant morbidity. The average family doctor can become overwhelmed by both the number of people in their practice with this condition and frustrated with what seems to be a paucity of treatment options available to offer those who suffer from OA.

Source: stacommunications.com
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Symptomatic management of osteoarthritis

Osteoarthritis is the most common form of arthritis and a leading cause of pain and disability around the world. It affects approximately 50% of people aged over 60 years and almost all people aged over 80 years. However osteoarthritis is not just caused by ageing.

Source: bpac.org.nz
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Glucosamine in osteoarthritis: Update of the evidence

The rationale for the use of glucosamine in osteoarthritis (OA) is that it is a precursor for glycosaminoglycans and glycoproteins, which are a major constituent of joint cartilage and synovial fluid.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 24/02/14 Link Error: Report It

 

Glucosamine for osteoarthritis of the knee

Glucosamine is a normal constituent of the proteoglycans found in joint cartilage and synovial fluid. It has been recommended for many years by practitioners of complementary medicine for the treatment of osteoarthritis. Clinical trials have now shown that the use of oral glucosamine sulphate 1.5 g daily in patients with osteoarthritis of the knee results in a significant reduction in joint pain and an improvement in joint function.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Can patients with renal impairment take glucosamine?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Glucosamine is available in a variety of over-the-counter dietary supplements and as licensed prescription only medicines, therefore quality and content varies between products. Little information is available about herbs and dietary supplements in patients with renal impairment.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

Polymyalgia Rheumatica and Giant Cell Arteritis

Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA; also known as temporal arteritis) are common, interrelated inflammatory disorders that occur predominantly in persons older than 50 years. GCA most commonly involves the temporal artery, but arteries in other parts of the body also can be inflamed. It is the most common primary vasculitis among older persons and can lead to blindness if not diagnosed and treated in a timely manner.

Source: aafp.org
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Polymyalgia Rheumatica: A Severe, Self-Limiting Disease

Polymyalgia rheumatica (PMR) is an inflammatory condition of the muscles and joints and is characterized by stiffness and pain in the neck, shoulders, hips, and buttocks. Morning stiffness that lasts several hours is common. The onset of pain can be sudden or gradual and affects both sides of the body. Approximately 15% of patients with PMR develop giant cell arteritis (GCA), and nearly 50% of patients with GCA will develop PMR over time.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 19/07/13 Link Error: Report It

 

Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is a relatively common clinical syndrome of unknown etiology. It is characterized by proximal myalgia of the hip and shoulder girdles with accompanying morning stiffness that lasts for more than 1 hour. Approximately 15% of patients with polymyalgia rheumatica develop giant cell arteritis (GCA), and approximately 50% of patients with giant cell arteritis have associated polymyalgia rheumatica.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 19/07/13 Link Error: Report It

 

Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ system; thus, its presentation and course are highly variable, ranging from indolent to fulminant.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 19/07/13 Link Error: Report It

 

St. Thomas' Lupus Trust
Information for Medical Professionals

The American College of Rheumatology (ACR) criteria for the classification of lupus are, I understand up for renewal. For over two decades, they have provided the benchmark for clinico-pathological surveys worldwide and have (admittedly with some rust spots) stood the test of time.

Source: lupus.org.uk
Clinical Resource:
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Last Checked: 19/07/13 Link Error: Report It

 

Wheeless' Textbook of Orthopaedics

Welcome to WheelessOnline.com, the premier website for the busy orthopaedist. Duke University Medical Center's Division of Orthopaedic Surgery, in conjunction with Data Trace Internet Publishing, LLC is proud to present Wheeless' Textbook of Orthopaedics. This is the most comprehensive, unparalleled, dynamic online medical textbook in existence. Looking through our 11,000 pages with more than 5,000 images, you'll find this key reference in an easy to read outline format. Each topic is fully searchable by alphabetical, anatomical and keyword searches, or just click on a particular part of the Skeleton for easy access. Wheeless' Textbook of Orthopaedics is updated daily.

Source: wheelessonline.com
Clinical Resource: Textbook
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Last Checked: 19/07/13 Link Error: Report It

 

Osteoporosis and bone physiology

This is an educational site for physicians and patients.

Source: washington.edu
Clinical Resource: Various
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Last Checked: 05/01/15 Link Error: Report It

 

FRAX®
WHO Fracture Risk Assessment Tool

The FRAX® tool has been developed by WHO to evaluate fracture risk of patients. It is based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck.

The FRAX® models have been developed from studying population-based cohorts from Europe, North America, Asia and Australia. In their most sophisticated form, the FRAX® tool is computer-driven and is available on this site. Several simplified paper versions, based on the number of risk factors are also available, and can be downloaded for office use.

The FRAX® algorithms give the 10-year probability of fracture. The output is a 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture).

Source: shef.ac.uk
Clinical Resource: Various
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Last Checked: 17/05/13 Link Error: Report It

 

QFracture

QFracture is used to estimate an individual's risk of developing

  • hip fracture or
  • osteoporotic fracture (hip, spine, wrist or shoulder)

over the next 10 years.

The algorithms can be used to identify people at high risk of these fractures so they can be assessed in more detail to reduce their risk.

Source: qfracture.org
Clinical Resource: Various
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Last Checked: 17/05/13 Link Error: Report It

 

The Osteoporosis Risk Assessment Instrument (ORAI)

Osteoporosis Risk Assessment Instrument (ORAI) was developed and validated in a cohort of Canadian women and had a sensitivity of 94.4% and specificity of 41.4% in that population.

Source: washington.edu
Clinical Resource: Clinical Calculator
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Last Checked: 05/01/15 Link Error: Report It

 

S.C.O.R.E.

SCORE was developed by Lydick et al. to identify post-menopausal women who may have a T score of < -2 and should be screened.

Source: washington.edu
Clinical Resource: Clinical Calculator
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Last Checked: 05/01/15 Link Error: Report It

 

10-Year Fracture Risk Calculator

The FORE 10-Year Fracture Risk Calculator™ (FORE FRC) Version 2.0 published 12/4/2012 estimates 10-year fracture risk for postmenopausal women and men age 45 and older who are not receiving treatment for osteoporosis.

Source: fore.org
Clinical Resource: Calculator
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Last Checked: 17/05/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Hip Fracture in Older People

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Osteoporosis and the Prevention of Fragility Fractures

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

2010 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada
Osteoporosis Canada

Source: osteoporosis.ca
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

National Osteoporosis Foundation's Clinician’s Guide to Prevention and Treatment of Osteoporosis

The Clinician’s Guide to Prevention and Treatment of Osteoporosis was developed by an expert committee of the National Osteoporosis Foundation (NOF) in collaboration with a multispecialty council of medical experts in the field of bone health convened by NOF.

This Guide offers concise recommendations regarding prevention, risk assessment, diagnosis, and treatment of osteoporosis in postmenopausal women and men age 50 and older. It includes indications for bone densitometry and fracture risk thresholds for intervention with pharmacologic agents.

Source: nof.org
Clinical Resource: Guide
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Last Checked: 20/08/15 Link Error: Report It

 

Osteoporosis Australia | Research Papers & Position Papers

This section contains Osteoporosis-related research papers and a selection of recent position papers produced by the our Medical and Scientific Advisory Committee.

Source: osteoporosis.org.au
Clinical Resource: Research Papers and Position Papers
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Last Checked: 21/08/15 Link Error: Report It

 

OsteoED
Common Questions

Click on a category to see a list of common questions.

General Questions
Top Questions
Epidemiology
Bone Density Measurement
Male Osteoporosis

Drug Therapy
General
Bisphosphonates
Calcitonin
Estrogen
SERMs
Teriparitide
Thiazides

Prevention
Calcium and Vitamin D
Falls and Exercise

Risk Assessment
Screening Issues

Secondary Osteoporosis
Depot Medroxyprogesterone
Eating Disorders
Medication
Vitamin D Deficiency

Source: washington.edu
Clinical Resource: Questions and Answers
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Last Checked: 05/01/15 Link Error: Report It

 

Osteoporosis Update

Osteoporosis Update provides the most current, reliable information to support general practitioners and other health professionals involved in the daily clinical management of osteoporosis.

Source: osteoporosis.ca
Clinical Resource: Periodical
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Last Checked: 08/05/13 Link Error: Report It

 

Osteoporosis Online

These courses encompass information from the causes and diagnosis of osteoporosis through to a review of treatment strategies. Advice on overcoming barriers to improved care is provided. The target audience of this programme is qualified physicians in secondary care and specialist primary care.

Course 1: Understanding bone metabolism
Course 2: Risk assessment and diagnostic techniques
Course 3: Management strategies for osteoporosis
Course 4: Fracture healing and osteoporosis

Source: iofbonehealth.org
Clinical Resource: e-Learning
Register to Access Content: Yes - registration is FREE

Last Checked: 24/04/15 Link Error: Report It

 

Osteoporosis Resources for Primary Care

Osteoporosis Resources for Primary Care is a joint initiative of the National Osteoporosis Society and the Royal College of General Practitioners.

It seeks to provide GPs, Practice Nurses and other health professionals in the practice team with the clear, concise information they need to effectively manage osteoporosis and reduce fracture risk in older people.

Source: osteoporosis-resources.org.uk
Clinical Resource: Guide
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Last Checked: 08/05/13 Link Error: Report It

 

Guideline for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK

The National Osteoporosis Guideline Group gratefully acknowledges the collaboration of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the support of the Bone Research Society, British Geriatrics Society, British Orthopaedic Association, Bone Research Society, British Society of Rheumatology, National Osteoporosis Society, Osteoporosis 2000, Osteoporosis Dorset, Primary Care Rheumatology Society, Royal College of Physicians and Society for Endocrinology.

Source: shef.ac.uk
Clinical Resource: Guideline
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Last Checked: 08/05/13 Link Error: Report It

 

American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Postmenopausal Osteoporosis

Source: aace.com
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

European guidance for the diagnosis and management of osteoporosis in postmenopausal women

Source: iofbonehealth.org
Clinical Resource: Position Paper
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Last Checked: 08/05/13 Link Error: Report It

 

National Osteoporosis Society Position Statement on Hormone Replacement Therapy for the Treatment and Prevention of Osteoporosis

Source: nos.org.uk
Clinical Resource: Position Statement
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Last Checked: 08/05/13 Link Error: Report It

 

Management of post-menopausal osteoporosis

This bulletin focuses on the pharmacological management of patients with post-menopausal osteoporosis - both those with clinically evident disease (e.g. prior osteoporotic fracture) and those who are identified as being at high-risk of fracture.

Source: wemerec.org
Clinical Resource: Medicines Resource Centre Bulletin
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Last Checked: 08/05/13 Link Error: Report It

 

Royal College of Physicians Glucocorticoid guidelines 2002

This document presents evidence-based guidelines for the management of glucocorticoidinduced osteoporosis.

Source: nos.org.uk
Clinical Resource: Guideline
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Last Checked: 08/05/13 Link Error: Report It

 

Guidance for the Management of Breast Cancer Treatment-Induced Bone Loss

Reviewed and supported by the National Osteoporosis Society (NOS), the National Cancer Research Institute (NCRI) Breast Cancer Study Group and the International Osteoporosis Foundation (IOF)

Source: nos.org.uk
Clinical Resource: Consensus Position Statement
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Last Checked: 08/05/13 Link Error: Report It

 

Osteoporosis and Chronic Kidney Disease

This issue of “Osteoporosis Clinical Updates” provides tools and suggestions for identifying those CKD patients who would benefit from treatment for osteoporosis in a general practice setting and who would be better served by referral to a specialist with experience in renal-related bone disease.

Source: nof.org
Clinical Resource: Update
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Last Checked: 20/08/15 Link Error: Report It

 

Bisphosphonate Therapy: To Stop or Not to Stop?

Bisphosphonate therapy is now the mainstay of treatment for patients with primary and secondary forms of osteoporosis. This class of drugs has earned this role because of multiple studies documenting the reduction in the incidence of vertebral and other fragility fractures in older women with osteoporosis at moderate to high fracture risk and the prevention of bone loss in many other medical conditions with bisphosphonate therapy. After beginning therapy, clinicians then confront the question of how long therapy should be continued.

Source: sbdens.org.br
Clinical Resource: Publication
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Last Checked: 08/05/13 Link Error: Report It

 

Bisphosphonates: Forever or Five Years and stop?

Clinical Question: Can patients with osteoporosis who have been on bisphosphonates for 5 years discontinue treatment without increasing future fracture risk?

Source: acfp.ca
Clinical Resource: Article
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Last Checked: 21/08/15 Link Error: Report It

 

Q: Can patients take a drug holiday when using bisphosphonates for osteoporosis?

A. The bisphosphonates (alendronate, risedronate, and ibandronate) play an important role in the treatment and prevention of osteoporosis. Intravenous bisphosphonates (pamidronate and zoledronic acid) are also commonly used in the management of hypercalcemia associated with malignancy and in multiple myeloma. Although generally well tolerated, the long-term effect of these drugs on bone turnover has come into question.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 08/05/13 Link Error: Report It

 

Stopping medicines - bisphosphonates in postmenopausal osteoporosis

There has recently been considerable debate surrounding the required duration of treatment with bisphosphonates to produce the optimal antifracture activity without subjecting the patient to unnecessary treatment and its possible attendent adverse effects.

Source: wemerec.org
Clinical Resource: Medicines Resource Centre E-Note
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Last Checked: 08/05/13 Link Error: Report It

 

Bisphosphonate prescribing in chronic kidney disease

Bone disease is commonly associated with chronic kidney disease (CKD), and the prevalence of skeletal abnormalities in those with end-stage renal disease approaches 100%. While renal osteodystrophy is the collective term for various types of uraemia-related bone remodelling, including hyperparathyroid bone disease, adynamic bone disease and osteomalacia, persons with CKD can also develop osteoporosis.

Source: rcpe.ac.uk
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw—2014 Update

Source: aaoms.org
Clinical Resource: Position Paper
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Last Checked: 20/08/15 Link Error: Report It

 

Canadian Consensus Practice Guidelines for Bisphosphonate Associated Osteonecrosis of the Jaw
Canadian Association of Oral & Maxillofacial Surgeons

Source: caoms.com
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

Bisphosphonates and osteonecrosis of the jaw

On behalf of the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia, Medical Oncology Group of Australia, and the Australian Dental Association.

Source: racgp.org.au
Clinical Resource: Position Statement
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Last Checked: 19/07/13 Link Error: Report It

 

Scottish Dental Clinical Effectiveness Programme Guidance on Oral Health Management of Patients Prescribed Bisphosphonates

This guidance has been developed to inform dental practitioners about how to manage patients prescribed bisphosphonates. Prescribers and dispensers of bisphosphonates, as well as patients may also find the information in this guidance of relevance.

Source: sdcep.org.uk
Clinical Resource: Guidance
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Last Checked: 20/08/15 Link Error: Report It

 

Nutriceuticals: Over-the-Counter Products and Osteoporosis

Upon completion of this CE material, the participant should be able to:

  • Describe the impact of dietary calcium and vitamin D on bone health.
  • Teach patients how to calculate the amount of calcium in their diets.
  • List the nutriceuticals that may have potential, but unproven, benefit to bone.
  • Explain the effect of dietary phosphorus on bone (both excess and deficient).
  • Elicit information on nutriceutical use from patients and advise them regarding effectiveness.
Source: nof.org
Clinical Resource: Update
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Last Checked: 20/08/15 Link Error: Report It

 

The role of calcium and vitamin D in the management of osteoporosis

The role of calcium and vitamin D supplementation in the treatment of osteoporosis has been extensively studied. The aim of this paper was to reach, where possible, consensus views on five key questions relating to calcium and vitamin D supplementation in the management of osteoporosis.

Source: esceo.org
Clinical Resource: Paper
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Last Checked: 20/08/15 Link Error: Report It

 

Is there a suitable vitamin D product for a patient with a peanut or soya allergy?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

A document has been written which lists the available products for treating vitamin D deficiency and insufficiency, including cost, licensing status, and risk category.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

British Nutrition Foundation Briefing Paper on Dietary Calcium and Health

This briefing paper discusses both the skeletal and regulatory role of calcium, and also calcium homeostasis. This is followed by information on dietary reference values, sources of calcium in the diet and information on calcium intake in the UK, including trends in intake. Bioavailability of calcium from foods is also discussed as this is an important determinant of the relative value of food sources of calcium. Finally, calcium and bone health, and the evidence for a role of calcium in cancer, cardiovascular disease and weight management are discussed.

Source: nutrition.org.uk
Clinical Resource: Briefing Paper
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Last Checked: 19/07/13 Link Error: Report It

 

Does Calcium Supplementation Increase the Risk of MI?

Clinical Question: Does calcium (Ca+) supplementation contribute to increased risk of myocardial infarction (MI) and other cardiovascular disease (CVD)?

Source: acfp.ca
Clinical Resource: Article
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Last Checked: 21/08/15 Link Error: Report It

 

Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline

Source: endocrine.org
Clinical Resource: Guideline
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Last Checked: 07/06/13 Link Error: Report It

 

Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management
National Osteoporosis Society

Developed by a group of clinicians and scientists with expertise in vitamin D and osteoporosis to address three key areas: Who to test for vitamin D deficiency, How to interpret vitamin D measurements and How to treat vitamin D deficiency.

Source: nos.org.uk
Clinical Resource: Guideline
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Last Checked: 08/06/13 Link Error: Report It

 

Consensus Vitamin D position statement

This consensus statement represents the unified views of the British Association of Dermatologists, Cancer Research UK, Diabetes UK, the Multiple Sclerosis Society, the National Heart Forum, the National Osteoporosis Society and the Primary Care Dermatology Society.

Source: nos.org.uk
Clinical Resource: Position Statement
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Last Checked: 19/07/13 Link Error: Report It

 

Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management
National Osteoporosis Society

Developed by a group of clinicians and scientists with expertise in vitamin D and osteoporosis to address three key areas: Who to test for vitamin D deficiency, How to interpret vitamin D measurements and How to treat vitamin D deficiency.

Source: nos.org.uk
Clinical Resource: Guideline
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Last Checked: 08/05/13 Link Error: Report It

 

 

Update on Drug-Induced Osteoporosis (DIO)

Many commonly prescribed drugs are known to cause bone loss. The aim of this newsletter is to review drugs associated with osteoporosis (OP), the frequency of occurrence, prevention and management.

Source: usask.ca
Clinical Resource: Drug Information Service Newsletter
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Last Checked: 11/05/15 Link Error: Report It

 

Diagnosis and Management of Prosthetic Joint Infection: Clinical Practice Guidelines by the Infectious Diseases Society of America

Source: idsociety.org
Clinical Resource: Guideline
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Last Checked: 15/05/15 Link Error: Report It

 

 

European Guidelines for the Management of Acute Nonspecific Low Back Pain in Primary Care

Source: backpaineurope.org
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

European Guidelines for the Management of Chronic Non-Specific Low Back Pain in Primary Care

Source: backpaineurope.org
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

Bandolier Knowledge
Back pain

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Management of acute low back pain

This bulletin discusses the appropriate management of acute, uncomplicated or non-specific low back pain in the primary care setting. It focuses on overall management strategies, including appropriate first-line medicines.

Source: wemerec.org
Clinical Resource: Medicines Resource Centre Bulletin
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Last Checked: 19/07/13 Link Error: Report It

 

Canadian Guidelines for the Diagnosis and Management of Fibromyalgia Syndrome in Adults

Comprehensive, evidence-based and written by a panel of experts from across the country. Endorsed by both the Canadian Pain Society and the Canadian Rheumatology Association.

Source: canadianpainsociety.ca
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

Fibromyalgia: A Clinical Update

Most patients complain of widespread musculoskeletal pain. The pain is typically diffuse or multifocal, and its intensity varies over time. Patients also may complain of morning stiffness and swelling of joints or limbs, resembling symptoms of rheumatoid arthritis. Other frequently encountered symptoms are fatigue, reduced energy and drive, and disturbed sleep.

Source: iasp-pain.org
Clinical Resource: Newsletter
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Last Checked: 07/05/15 Link Error: Report It

 

Treatment of Fibromyalgia Syndrome (FMS)

The following is an evidence-based summary of available therapies for FMS. Generally, the evidence from clinical trials with these agents is limited by the relatively short duration of study and low subject count.

Source: usask.ca
Clinical Resource: Drug Information Services Newsletter
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Last Checked: 18/03/13 Link Error: Report It

 

Neuromuscular Disease Center
Washington University

The neuromuscular site is a welcome exception. It presents a huge amount of information in a way that allows the viewer to skim or delve as desired. Much of the content is in tabular form that is easy to understand and a link to a more detailed explanation is always available. It is an admirable mixture of molecular biology with clinical medicine. It is well illustrated-the photographs of muscle biopsies are worth a visit in themselves. As one gets deeper into a topic, links are provided to other worthwhile sources, such as the On-Line Mendelian Inheritance of Man.

Even though the focus of this site is a small subspecialty area, there is enough practical basic science to be useful to the general neurologist. The site is regularly updated.

Source: neuromuscular.wustl.edu
Clinical Resource: Various
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Last Checked: 19/07/13 Link Error: Report It

 

Myasthenia Gravis: A Manual for the Health Care Provider
James F. Howard, Jr., M.D., Editor

This handbook is written as an aide to all healthcare personnel who are involved in the care and management of patients with myasthenia gravis.

Source: myasthenia.org
Clinical Resource: Manual
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Last Checked: 19/07/13 Link Error: Report It

 

Medications and Myasthenia Gravis
(A Reference for Health Care Professionals)

Source: myasthenia.org
Clinical Resource: Educational Material
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Last Checked: 19/07/13 Link Error: Report It

 

What drugs should be avoided in myasthenia gravis?

Source: uic.edu
Clinical Resource: Frequently Asked Question
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Last Checked: 04/12/15 Link Error: Report It

 

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