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Physical activity programs for promoting bone mineralization and growth in preterm infants

Babies born too early (premature babies) are often cared for in a fashion that minimizes physical activity to reduce stress and stress‐related complications. However, lack of physical activity might lead to poor bone development and growth, as seen in bedridden children and adults. It is believed that physical activity programs (moving and pressing all joints on all limbs for several minutes a day) may promote bone development and growth in premature babies. This review found that physical activity might provide a small benefit for bone development and growth over a short term. Data were inadequate to allow assessment of long‐term benefits and harms. Based on current knowledge, physical activity programs cannot be recommended as a standard procedure for premature babies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Phosphate binders for preventing and treating bone disease in chronic kidney disease patients

People with chronic kidney disease (CKD) develop impaired excretion of the dietary phosphorus. This results in a condition known as mineral and bone disorder in chronic kidney disease (CKD‐MBD). CKD‐MBD is characterized by high bone turnover, increased musculoskeletal morbidity including bone pain and muscle weakness, and vascular calcification which may contribute to the high incidence of cardiovascular disease and associated deaths. Several agents such as phosphate binders, vitamin D compounds, and calcimimetics are widely used to slow the development and progression of CKD‐MBD complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Vitamin D compounds for people with chronic kidney disease not requiring dialysis

People with lower kidney function (chronic kidney disease; CKD) develop changes in circulating blood levels of calcium and phosphorus. The kidney gradually loses the ability to remove phosphorus from the blood and cannot activate adequate amounts of vitamin D to maintain normal levels of calcium. The parathyroid gland senses these changes and compensates to increase calcium by elevating production and release of parathyroid hormone (PTH). These metabolic changes alter bone metabolism to release calcium and accordingly lead to bone abnormalities including altered bone production. In turn, bony changes may result in bone deformation, bone pain, and altered risks of fracture.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Interventions for bone disease in children with chronic kidney disease

Chronic kidney disease (CKD) resulting in reduced kidney function and the need for dialysis and kidney transplant is associated with abnormalities in blood calcium and phosphorus levels leading to high levels of the parathyroid hormone (PTH) and to bone disease. This may result in bone deformities, bone pain, fractures and reduced growth rates. Commonly used treatments (Vitamin D compounds and phosphate binders) aim to prevent or correct these outcomes. However these treatments may raise levels of blood calcium, allow calcium and phosphorus deposition in blood vessels and lead to early cardiovascular disease, which is known to be a problem in adults with CKD. This review identified only 15 small RCTs involving 369 children comparing different vitamin D compounds, different routes and frequencies of administration of vitamin D compounds and different phosphate binders. Only five RCTs reported on growth rates and no differences were detected between treatments. Renal bone disease, as assessed by changes in PTH levels, was improved by all vitamin D preparations regardless of preparation used or the route or frequency of administration. Fewer episodes of high blood calcium levels and lower overall serum calcium levels occurred with the non calcium‐containing binder, sevelamer, compared with calcium‐containing binders. As newer treatments for renal bone disease are developed, comparisons with the current standard therapies will be required in well designed RCTs in children using outcome measures including those of direct clinical relevance to children and their families such as rates of growth, reduction in bone fractures and bone pain and reduction in calcification in blood vessels.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

What is cholesterol and how does arteriosclerosis develop?

The human body needs cholesterol to work properly. For example, cholesterol is needed to make certain hormones and it is an important building block for cell walls.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 29, 2013

Vitamin D compounds for people with chronic kidney disease requiring dialysis

People with reduced kidney function (chronic kidney disease; CKD) develop changes in circulating blood levels of calcium and phosphorus. The kidney gradually loses the ability to remove phosphorus from the blood and cannot activate adequate amounts of vitamin D, to maintain normal levels of calcium. The parathyroid gland senses these changes and compensates to increase calcium by elevating production and release of parathyroid hormone. These metabolic changes alter bone metabolism to release calcium and accordingly lead to bone abnormalities including altered bone production. Consequently bone deformation, bone pain, and altered risks of fracture may occur.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Skin puncture versus exposing the femoral artery for minimally invasive repairs of abdominal aortic aneurysms

Abdominal aortic aneurysms are a ballooning of the largest blood vessel in the abdomen, the abdominal aorta, due to weakness of the vessel wall. This ballooning may lead to life threatening rupture. Repair of the aneurysm is recommended if it is felt to pose a significant risk. All repairs involve putting in an artifical graft, a tube composed of fabric, to help reinforce the artery wall. There are two main methods for repair. One is an open technique in which the whole abdomen is opened and the graft is put inside the blood vessel. The other technique is an endovascular aneurysm repair. With this technique the graft is fed into the abdominal aorta through an artery in the groin (the femoral artery) and it avoids the large abdominal incision. This review looked at an alternative method for introducing the graft into the femoral artery, percutaneous access. Instead of making an incision in the groin to expose the femoral artery (a cut‐down), a small hole is made in the skin and then a needle with a plastic tube sitting over it is introduced into the femoral artery. Once introduced, the needle can be pulled back up the tube leaving the tube in place in the artery. The graft and all other materials can then be fed into the artery via the plastic tube. Once the procedure is complete the tube can be withdrawn. The surface incision can usually be closed with one stitch.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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