Incident vertebral fractures 12 months following glucocorticoid initiation in children with rheumatic disorders
Notice bibliographique
Résumé
Children (< 17 years) initiating GC for treatment of RD between January 2005 and December 2007 in ten participating Canadian tertiary pediatric centers were enrolled in the Steroid-Associated Osteoporosis in the Pediatric Population (STOPP) study. Enrolled patients had baseline (within 30 days of initiating GC) and 6- monthly spine areal (a) BMD studies. Additionally, radiographs of the thoracolumbar spine at baseline and 12 months (m) were evaluated using the Genant semi-quantitative method. Fractures present at baseline (prevalent VFs) were documented. An incident VF was defined as a new VF or worsening of an existing fracture. Patients also had baseline and 3 monthly assessment of GC exposure, clinical status including disease activity (measured on a 10 cm visual analogue scale by the patient’s rheumatologist), and questionnaires to determine physical activity and vitamin D/calcium intake. Of 135 patients enrolled, data were available on 118 (64% female, median age 10.8 years) at 12 m. Diagnoses included juvenile dermatomyositis (JDM) (23%), juvenile idiopathic arthritis (JIA) (36 %), systemic lupus (SLE) and related conditions (18%), systemic vasculitis (14%), and other ( 9%). At 12 m, 7 patients (6%) had 12 incident VFs (3 SLE, 2 JDM, 1 vasculitis, 1 overlap). All incident VFs were new fractures; 5 patients had a single VF, one had 2 VFs and one had 5 VFs. Three patients had mild and 4 had moderate VFs. Nine (75%) of the incident VFs were thoracic and 11 (92%) had wedge morphology. Patients with and without incident VFs were similar for age, gender, pubertal status, disease activity, physical activity, vitamin D/calcium intake and presence of back pain. The decrease in spine aBMD and increase in BMI in the first 6 months was larger in those with incident VFs (Δ spine aBMD Z-score mean -0.8, SD 0.4; Δ BMI Z-score +1.7, SD 1.0) versus those without (Δ spine aBMD Z-score -0.4, SD 0.5; Δ BMI Z-score +0.5 SD 0.8). Cumulative GC dose (g/m ) was almost double in those with incident VFs (median 9.3 g/m , range 3.0-12.5) versus those without (median 5.4, range 0.01-27.5); with the greatest difference in GC dose seen within the first 6m. None of the 9 children with baseline prevalent VFs had incident fractures. In 8 of these 9 patients, spine status had improved overall at 12 m. Incident VFs occurred in a small proportion of our cohort (6%); however one patient was more severely affected. Children with incident VFs received almost twice as much GC therapy as those without, had a greater decline in spine BMD, and manifested greater increases in BMI. Back pain and baseline prevalent VFs did not appear to be associated with incident VFs. Funded by CIHR.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».