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DEXA management for the diagnosis of osteoporosis – a worldwide perspective

The definition of osteoporosis is a systematic skeletal disease characterized by low bone mass and micro-architectural deteri­oration of bone tissue, with a subsequent increase in bone fragility and susceptibility to fracture (Anonymous, 1993). This description is both concerning bone mineral density (BMD) and bone quality, but at present we can only measure BMD. Thus, the [...]

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DXA: state of the art. Dosimetry

DXA examination has always involved low radiation dose both to patients and operators. With modern machines the dose to patients varies from 20 to 100 micro Sv, according to different exam typology; at these exposures, operators distant more than 2 meters from the x-ray source do not need any protection. The vast majority of machines [...]

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DXA: state of the art. Machine used

DXA densitometers have undergone remarkable technological improvements both in the process of x-ray emission and x-ray absorption. These facts have allowed a shorter scan time, increased diag­nostic accuracy (accuracy of density measurements) and a re­duction of the dose to the patient. In first generation DXA densitometers the x-ray beam is ex­tremely thin (pencil beam), as [...]

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DXA: state of the art

Introduction Dual x-ray absorpiometry (DXA) was introduced in 1987 and, to date, it still represents the most widely used technique for the diagnosis of osteoporosis in the clinical practice. The World Health Organization (WHO) has defined the threshold levels for the diagnosis of osteopenia and osteoporosis using DXA technique. DXA machines consist of a mobile [...]

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Aggressive Intensive Care Treatment of Very Elderly Patients with Tetanus Is Justified: DISCUSSION

Generalized tetanus has become very rare in devel­oped countries because of successful active immuni­zation programs. For instance, by September 1986, only 46 cases had been reported to the Centers for Disease Control for 1985 in the United States, infor­mation quite consistent with our incidence of 0.07 cases per 100,000 per year in Geneva between 1968 [...]

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Aggressive Intensive Care Treatment of Very Elderly Patients with Tetanus Is Justified: RESULTS

According to previous studies showing an increased mortality in elderly patients, we divided the study group according to age (Tables 2 and 3). There was no difference between groups in terms of duration of intubation, hospital stay, and frequency of cardiovas­cular complications. Infectious complications were fairly common in both groups. Two patients died: a 63-year-old [...]

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Aggressive Intensive Care Treatment of Very Elderly Patients with Tetanus Is Justified: MATERIAL AND METHODS part 2

Case 3 An 81-year-old female patient was hospitalized on March 28, 1989, for progressive cervical and dorsal muscle contractures, trismus, and swallowing difficulty for eight days before hospitaliza­tion. A superficial wound on the left foot was noted, tetanus was diagnosed, and she was transferred to the medical intensive care unit. She had never been vaccinated [...]

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