In this study different bioactive agents were used to investigate their single and combined effects on biomechanical properties of osteoporotic bone. Estrogen, the most common hormon replacement therapy (HRT) agent, was used in single and combined with raloxifen, a well known osteoporosis drug. Despite their high clinical uses, they have not been tried before, in combination. They act as agonist of each other in bone and antagonist of each other in uterus and mammary glands. Hence it was expected to prevent HRT side effects by using combinations while enhancing the healing on osteoporotic bone. So, the study was designed to see the interaction effects of these two agents on bone and uterus, to observe the mechanical behaviour upto fracture, and to investigate the bone mechanical properties by strain gauges and bending theory with ovariectomized rat model. Second approach to osteoporosis treatment, VitK2 was chosen to be used alone or in combination with raloxifen in same model. Although recent studies mentioned the effects of VitK2 on bone, its rebuilding or repair effect was not completely established. So, VitK2-bone relation was aimed to be clarified with the project.VitK2 raloxifen combination was also a new study, that has not been carried out so far. As a result of mechanical tests, it was found that E+R combination is the most effective treatment. All treatment&amp / #8217 / s were resulted in numerically (though not statistically significant) higher values on femur mechanical properties, and significantly better on tibia compared to the untreated controls. VitK2 performs well in energy absorption upto fracture, but worse in others (PL, YL etc.) compared to other treatments indicating that it plays a specific role in modifying bone structure thus, rendering bone stronger under high stress. However, similar to estrogen case, its combination with raloxifen performs better than its individual administration. With combinations it was aimed to reduce the adverse effects of estrogen on uterus and mammary glands by using raloxifen. This idea appears to be achieved with better histological results of uterus in combinations than estrogen groups. Additionally it was observed that direct strain data obtained by strain gauge experiments can be more informative than theoretical model in calculating modulus of elasticity, and shown that shear contribution can be neglected if depth/span ratio and set up dimensions properly chosen. Biochemical analysis of the blood showed an increment in bone formation (ALP activity) compared to both controls. ALP activity was the highest in R group, which was lower in combinations. Thus existence of a different mechanism in osteoporotic bone repair in combinations was suggested.

QUALITATIVE ASPECTS OF ADHERENCE TO ANTIRESORPTIVE TREATMENT IN WOMEN WITH POSTMENOPAUSAL OSTEOPOROSIS Author: Aneta Ravingerová Supervisor: Magda Vytřísalová Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy INTRODUCTION: Compliance is using of medication in accordance with a prescription drug regimen. Qualitative aspect of compliance represents use of drugs in correct way. significantly affects treatment outcomes.Suboptimal compliance The study aim was to assess qualitative compliance with bisphosphonates (BIS)AIMS: among Czech women with osteoporosis in common clinical practice. METHODS: Data collection was performed using anonymous questionnaire in five outpatient Compliance with fivecentres in the Czech Republic from November 2012 to March 2013. dosing instructions for safe use and adequate absorption of BIS was evaluated. : A total of 363 patients were involved in the analysisRESULTS (mean age 68.9 years). once a week dosing forms ofPatients were treated with BIS - alendronate, alendronate + once a month dosing formvitamine D in a fixed combination, risedronate (N = 36.6 %) or - Only 46.6 % of respondents from weekly subgroup were compliantibandronate (N = 63.4 %). with all five dosing recommendations in monthly subgroup....

Made available in DSpace on 2014-06-11T19:26:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-04Bitstream added on 2014-06-13T20:15:06Z : No. of bitstreams: 1 silverio_cd_me_botfm.pdf: 801515 bytes, checksum: 800c80178c3cab3d5fa837f2a33aa7e4 (MD5) / Fundação para o Desenvolvimento Médico e Hospitalar (Famesp) / Avaliar a densidade mamográfica de mulheres na pós-menopausa submetidas ao tratamento com Raloxifeno. Resultados: Na comparação estatística inicial os grupos foram considerados homogêneos para as variáveis idade, idade da menopausa, tempo de menopausa, paridade, amamentação, índice de massa corpórea. Correlacionando a densidade mamográfica inicial por ambos os métodos qualitativo e quantitativo houve correlação negativa com a idade nas duas classificações em ambos os grupos (p < 0,05) e no índice de massa corpórea inicial somente na avaliação quantitativa e nas pacientes pertencentes ao grupo controle (p < 0,05). Quanto as demais variáveis no grupo controle que foram tempo de menopausa, paridade e amamentação não obtivemos correlação. Após seis meses não foi observado alterações na densidade mamográfica das mulheres estudadas em ambos os grupos e métodos qualitativo e quantitativo. Analisando concordância entre a classificação da densidade mamográfica segundo os métodos qualitativo e quantitativo, obteve-se concordância em ambas classificações. Conclusão: Em mulheres na pós-menopausa com osteoporose, submetidas ao tratamento com Raloxifeno por seis meses, não se observou alterações dos padrões de densidade mamográfica. / Assessing the mamographic density of post-menopause women submitted to Raloxifen treatment. Results: On the initial statistical comparison, the groups were considered homogenous for the analysed variables: age, menopause age, menopause period, parity, breast feeding and body mass index (BMI). Correlating the initial mammographic density by both methods, qualitative and quantitative, there was a negative correlation with the age in both groups (p < 0,05). The quantitative initial assessment correlated only to the BMI of the control group patients (p < 0,05). Concerning the other variables, there was no correlation. After six months, no alteration was observed in the mammographic density of women studied in both groups and methods, qualitative (BI-RADS) and quantitative (image digitalization). It was observed an agreement between the mammographic density classifications according to the methods employed. Conclusion: In post-menopause women with osteoporosis, submitted to raloxifen treatment for six months, no alterations were observed on the mammographic density patterns.

Resumo: Avaliar a densidade mamográfica de mulheres na pós-menopausa submetidas ao tratamento com Raloxifeno. Resultados: Na comparação estatística inicial os grupos foram considerados homogêneos para as variáveis idade, idade da menopausa, tempo de menopausa, paridade, amamentação, índice de massa corpórea. Correlacionando a densidade mamográfica inicial por ambos os métodos qualitativo e quantitativo houve correlação negativa com a idade nas duas classificações em ambos os grupos (p < 0,05) e no índice de massa corpórea inicial somente na avaliação quantitativa e nas pacientes pertencentes ao grupo controle (p < 0,05). Quanto as demais variáveis no grupo controle que foram tempo de menopausa, paridade e amamentação não obtivemos correlação. Após seis meses não foi observado alterações na densidade mamográfica das mulheres estudadas em ambos os grupos e métodos qualitativo e quantitativo. Analisando concordância entre a classificação da densidade mamográfica segundo os métodos qualitativo e quantitativo, obteve-se concordância em ambas classificações. Conclusão: Em mulheres na pós-menopausa com osteoporose, submetidas ao tratamento com Raloxifeno por seis meses, não se observou alterações dos padrões de densidade mamográfica. / Abstract: Assessing the mamographic density of post-menopause women submitted to Raloxifen treatment. Results: On the initial statistical comparison, the groups were considered homogenous for the analysed variables: age, menopause age, menopause period, parity, breast feeding and body mass index (BMI). Correlating the initial mammographic density by both methods, qualitative and quantitative, there was a negative correlation with the age in both groups (p < 0,05). The quantitative initial assessment correlated only to the BMI of the control group patients (p < 0,05). Concerning the other variables, there was no correlation. After six months, no alteration was observed in the mammographic density of women studied in both groups and methods, qualitative (BI-RADS) and quantitative (image digitalization). It was observed an agreement between the mammographic density classifications according to the methods employed. Conclusion: In post-menopause women with osteoporosis, submitted to raloxifen treatment for six months, no alterations were observed on the mammographic density patterns. / Orientador: Jorge Nahás Neto / Coorientador: Eliana Aguiar Petri Nahás / Banca: Rogério Dias / Banca: Rogério Bonassi Machado / Mestre

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