Fluoride therapy for vertebral crush fracture syndrome
Article Abstract:
Fluoride has been proposed as a treatment for vertebral crush fracture syndrome, based on observations that fluoride intoxication is associated with increased mass of the skeleton and bony overgrowth. Fluoride increases bone density by increasing bone formation, and has more effect on the axial skeleton, specifically the spine, than the appendicular skeleton, which consists of the shoulders, the upper and lower extremities, and the pelvis. In one study, the fracture rate in patients receiving fluoride was 39 percent, while it was 50 percent in patients receiving other therapies. Fluoride therapy for vertebral crush syndrome is widely used and has been formally approved in eight European countries. It has not been associated with adverse consequences over a period of 20 years of clinical experience, and alternative treatments for vertebral crush syndrome have not been shown to be as effective. Currently, fluoride therapy is recommended for treating vertebral osteoporosis, a decrease in bone mass, in adults with symptoms of crush fracture syndrome, and should be supplemented with calcium and vitamin D. Fluoride should not be used in conditions of impaired kidney function, pregnancy, peptic ulcers, osteomalacia (a bone softening disease), and previous hip fracture. Effects of fluoride should be monitored by measuring bone mass each year. Adverse effects include nausea, vomiting, mild gastrointestinal bleeding, lower extremity pain, and possible hip fracture. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1989
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Breast cancer screening in women younger than 50 years of age: what's next?
Article Abstract:
Hopefully lessons learned in the heated debate about the effectiveness of early breast cancer screening will be transferred to the debate about its cost-effectiveness. It may be advisable to initially decide whether resource use discussions will be limited to women in their 40's or to broader medical populations and whether effectiveness discussions will be based on scientific findings or some current practices. Scientific studies have shown that early mammography screening is quite expensive and may result in few lives saved. This money may be better put to use for more mammographies in older women or for other medical conditions.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1997
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