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At least 253 records · Page 14Linked to original sources
PubMed1993

Fluoride treatment of osteoporosis: cyclical non-blinded or continuous blinded studies?

The future of sodium fluoride (NaF), the most potent osteoblast stimulator known to man, is in the balance. Of three recent randomized trials of continuous NaF only one found a significant in vertebral fractures in the NaF group. When data from the first year were excluded, two of the studies (those with the largest numbers) showed a significantly reduced risk of vertebral fracture on NaF. The effect of NaF on cortical bone is poorly documented. Two studies have shown reduced forearm cortical bone density with continuous NaF. A further two (histomorphometric) studies have shown the development of increased cortical porosity on continuous NaF treatment. In one, this was selectively at the external cortex and was linearly correlated with cancellous volume increase. Our pilot study using NaF administered cyclically has shown an encouraging (though non-significant) reduction in vertebral fracture rates (excluding year 1) and no fall in forearm cortical density. Another (US) cyclical study has shown no increase in cortical porosity. A current W. Australian randomized study of 50 patients is described where NaF dosage is varied proportional to the osteoblast response, and duration is dependent on densitometric and radiographic response. The future of NaF should involve cyclical administration, in cautious initial dosage (50-60 mg/day) of enteric-coated NaF, in conjunction with a potent inhibitor of resorption such as hormone replacement, bisphosphonates or calcitonin.

Aged↗
PubMed1997

When it comes to information systems, too often the blind lead the blind.

A new survey of health care systems' chief information officers (CIOs) indicates that most are not able to collect the cost information they need to make decisions. Some 60% admit that they cannot calculate whether their managed care contracts are profitable or not. While 70% of these organizations benchmark other health care organizations, only 8% go outside the industry. Leading health system CIOs and benchmarking experts say systems managers must benchmark outside the health care industry if they want current and competitive information technology.

Administrative Personnel↗