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Article ; Online: Prehospital T-MACS and HEART scores in the prediction of myocardial infarction: a prospective evaluation.

Cooper, Jamie G / Donaldson, Lorna A / Coutts, Amanda J / Body, Richard / Mills, Nicholas L

2024 Volume 41, Issue 4, Page(s) 255–256

MeSH term(s)	Humans ; Myocardial Infarction/diagnosis ; Heart ; Emergency Medical Services ; Electrocardiography ; Thrombolytic Therapy
Language	English
Publishing date	2024-03-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2023-213639
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Article: Highlights from this issue

Body, Richard

Emerg. Med. J.

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #711640
Database	COVID19

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Article ; Online: The Diagnostic Accuracy of the Emergency Department Assessment of Chest Pain (EDACS) Score: A Systematic Review and Meta-analysis.

Boyle, Richard S J / Body, Richard

Annals of emergency medicine

2021 Volume 77, Issue 4, Page(s) 433–441

Abstract: Study objective: We evaluate current evidence for the diagnostic accuracy and safety of the Emergency Department Assessment of Chest Pain Score (EDACS) for patients presenting to the emergency department (ED) with possible acute coronary syndromes.: ... ...

Abstract	Study objective: We evaluate current evidence for the diagnostic accuracy and safety of the Emergency Department Assessment of Chest Pain Score (EDACS) for patients presenting to the emergency department (ED) with possible acute coronary syndromes. Methods: MEDLINE, EMBASE, and Cochrane databases were searched for publications reporting data on the EDACS score. No date restrictions were used. Two independent researchers assessed studies for eligibility, bias, and quality. The primary outcome was major adverse cardiac events occurring within 30 days. Heterogeneity was assessed and data were pooled by meta-analysis using a random-effects model. Results: Eight diagnostic test accuracy studies including 11,578 patients and 1 randomized controlled trial including 558 patients were eligible for inclusion. On meta-analysis, the EDACS score had a pooled sensitivity of 96.1% (95% confidence interval 89.6% to 98.6%) and specificity of 61.1% (95% confidence interval 55.5% to 66.3%). A total of 55.0% of patients (n=6,370/11,578) were identified as low risk and eligible for early discharge. Sixty-two patients (0.54%) identified as low risk had an outcome of major adverse cardiac events within 30 days. Conclusion: The EDACS score identified greater than 50% of patients with suspected acute coronary syndrome as suitable for discharge after serial troponin sampling during 2 hours. Sensitivity for major adverse cardiac events was relatively high overall and may be acceptable to clinicians.
MeSH term(s)	Acute Coronary Syndrome/diagnosis ; Chest Pain/diagnosis ; Emergency Service, Hospital ; Humans ; Risk Assessment/methods
Language	English
Publishing date	2021-01-16
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2020.10.020
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Zs.A 1344: Show issues

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Article ; Online: The pandemic body: the lived body during the COVID-19 pandemic.

Rodrigues, Jamila / Body, Kathryn / Carel, Havi

Medical humanities

2023 Volume 49, Issue 4, Page(s) 725–734

Abstract: ... meanings attached to the body have changed during the pandemic. Second, we use the concept of bodily doubt ...

Abstract	In this study, we conduct a detailed analysis of qualitative survey data focusing on adult populations in the UK, Japan and Mexico to address the following question: How has the COVID-19 pandemic changed people's lived experience of their bodies, other people's bodies and the world? We identify five themes: (i) fear and danger, (ii) bodily doubt and hypervigilance, (iii) risk and trust, (iv) adapting and enduring and (v) changes in perspective. We use two theoretical frameworks: first, Mary Douglas' anthropological work on purity, risk, danger and symbolism is applied to understand how social and cultural meanings attached to the body have changed during the pandemic. Second, we use the concept of bodily doubt developed by Havi Carel to interpret how people experience their bodies and other people's bodies differently during the pandemic. While we recognise the significant variation in people's embodied experience of the pandemic, our findings suggest there are commonalities that span different countries and cultures. Specifically, we look at responses to COVID-19 protective countermeasures such as national lockdowns and physical distancing which we suggest have reduced people's ability to put faith in their own bodies, trust other people and trust the political leadership. We conclude by proposing that the changes to our lived experience during the COVID-19 pandemic have prompted changes in perspective and a renewed focus on what people consider important in life from a social, moral, cultural and political point of view.
MeSH term(s)	Adult ; Humans ; COVID-19 ; Communicable Disease Control ; Pandemics ; Emotions ; Anthropology
Language	English
Publishing date	2023-12-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2018219-3
ISSN	1473-4265 ; 1468-215X
ISSN (online)	1473-4265
ISSN	1468-215X
DOI	10.1136/medhum-2022-012495
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Zs.A 5257: Show issues

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Article: The effect of fracture recency on observed 5-year fracture probability: A study based on the FRISBEE cohort.

Iconaru, L / Charles, A / Baleanu, F / Moreau, M / Surquin, M / Benoit, F / Body, J J / Bergmann, P

Bone reports

2023 Volume 18, Page(s) 101660

Abstract: Introduction: Prediction models, especially the FRAX®, are largely used to estimate the fracture risk at ten years, but the current algorithm does not take into account the time elapsed after a fracture. Kanis et al. recently proposed correction factors ...

Abstract	Introduction: Prediction models, especially the FRAX®, are largely used to estimate the fracture risk at ten years, but the current algorithm does not take into account the time elapsed after a fracture. Kanis et al. recently proposed correction factors allowing to adjust the FRAX® score for fracture recency. The objective of this work was to analyze the effect of fracture recency in the FRISBEE cohort. Methods: We identified in the FRISBEE cohort subjects who sustained a validated fracture during the first 5 years following an incident MOF. We calculated their estimated 5-year risk of fracture using FRAX® uncorrected, adjusted for recency and further adjusted for the MOF/hip ratios calibration factors previously derived for the Belgian FRAX®. We compared the fracture risk estimated by FRAX® before and after these corrections to the observed incidence of validated fractures in our cohort. Results: In our ongoing cohort, 376 subjects had a first non-traumatic incident validated MOF after inclusion; 81 had a secondary fracture during the 5 years follow-up period after this index fracture. The FRAX® score significantly under-evaluated the observed incidence of fractures in our cohort by 54.7 % (fracture rate of 9.7 %; 95 % CI, 6.8-12.9 %) if uncorrected (p < 0.001) and by 32.6 % after correction for recency (14.5 %; 95 % CI, 11.1-18.2 %) (p = 0.01). The calibration for MOF/hip ratios improved the prediction (17.5 %; 95 % CI: 13.7-21.4 %) (p = 0.2). After correcting for recency and for calibration, the predicted value was over-evaluated by 22 % (fracture rate of 26.1 %; 95 % CI, 21.6-30.5 %) but this over-evaluation was not significant (p = 0.1). Conclusion: Our data indicate that the correction of the FRAX® score for fracture recency improves fracture prediction. However, correction for calibration and recency tends to overestimate fracture risk in this population of elderly women.
Language	English
Publishing date	2023-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2821774-3
ISSN	2352-1872
ISSN	2352-1872
DOI	10.1016/j.bonr.2023.101660
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Article ; Online: Are there specific clinical risk factors for the occurrence of multiple fractures? The FRISBEE study.

Charles, A / Iconaru, L / Baleanu, F / Benoit, F / Surquin, M / Mugisha, A / Bergmann, P / Body, J J

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

2023 Volume 34, Issue 3, Page(s) 501–506

Abstract: This study showed additional clinical risk factors for the occurrence of multiple fractures with regards to a single fracture, with often higher hazard ratios. It would be important to include the risk of the occurrence of multiple fractures in future ... ...

Abstract	This study showed additional clinical risk factors for the occurrence of multiple fractures with regards to a single fracture, with often higher hazard ratios. It would be important to include the risk of the occurrence of multiple fractures in future prediction models. Purpose: To identify clinical risk factors (CRFs) which would specifically increase the risk of multiple fractures. Methods: Data of the 3560 postmenopausal women of the FRISBEE study were analysed. The CRFs and the fractures are collected annually. The cohort was divided into three groups: those who had no incident fracture, those who had a single incident fracture and those who had 2 two or more incident fractures (i.e. multiple fractures). Statistical analyses were performed using Cox proportional hazards models. Results: Among the 3560 subjects (followed for 9.1 (7.2-10.6) years), 261 subjects had two or more validated fractures during follow-up (146 were major osteoporotic fractures (MOFs)), 628 had one fracture (435 MOFs), 2671 had no fracture (2979 had no MOF); 157 subjects had two or more central fractures, 389 had only one and 3014 had none. The risk factors for those with multiple fractures at any site were age, history of fracture, history of fall, total hip bone mineral density (BMD), spine BMD and rheumatoid arthritis. For those with multiple MOFs, significant CRFs were age, history of fracture, parental hip fracture, total hip BMD and rheumatoid arthritis. Conclusion: We found in a prospective cohort study that there were more CRFs and higher hazard ratios for the occurrence of multiple fractures than for a single fracture.
MeSH term(s)	Humans ; Female ; Fractures, Multiple ; Prospective Studies ; Hip Fractures/epidemiology ; Hip Fractures/etiology ; Risk Factors ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/etiology ; Bone Density ; Arthritis, Rheumatoid ; Risk Assessment
Language	English
Publishing date	2023-01-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1064892-6
ISSN	1433-2965 ; 0937-941X
ISSN (online)	1433-2965
ISSN	0937-941X
DOI	10.1007/s00198-022-06663-w
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Zs.A 3163: Show issues

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Article: L'hyperparathyroïdie primaire: quand et comment la rechercher et la traiter?

Body, J J

Revue medicale de Bruxelles

2012 Volume 33, Issue 4, Page(s) 263–267

Abstract: The prevalence of primary hyperparathyroidism (HPT) varies between 1 and 4/1.000 in the general population. HPT is nowadays most often asymptomatic. The classical bone disease has been replaced by osteopenia or osteoporosis with a preferential bone loss ... ...

Title translation	Primary hyperparathyroidism: diagnosis and management.
Abstract	The prevalence of primary hyperparathyroidism (HPT) varies between 1 and 4/1.000 in the general population. HPT is nowadays most often asymptomatic. The classical bone disease has been replaced by osteopenia or osteoporosis with a preferential bone loss in cortical sites. The incidence of nephrolithiasis has been considerably lowered, but renal lithiasis is still the most frequent complication of HPT. The diagnosis is most often made by chance or during the workup of an abnormal bone mass. Hypercalcemia and an elevated PTH concentration, or at least a PTH level in the upper part of the normal range, generally point to a diagnosis of HPT. Additional tests include an evaluation of renal function, vitamin D measurement, determination of 24-hour urinary calcium and bone densitometry. Besides symptomatic HPT, classical recommendations for surgery include age less than 50, serum Ca at least 1 mg/dl above the upper limit of normal, creatinine clearance < 60 ml/min and osteoporosis. Surgical referral will, however, take into account patient age and comorbidities, as well as patient preferences. In the hands of an experienced surgeon, the success rate of parathyroidectomy is 95-98% and the rate of permanent complications is 1-3%. Parathyroid scintigraphy is the best preoperative localization technique of the adenoma. When surgery is contraindicated or refused by the patient, bisphosphonates or cinacalcet can be indicated in cases of osteoporosis or clinically significant hypercalcemia, respectively.
MeSH term(s)	Humans ; Hypercalcemia/diagnosis ; Hypercalcemia/epidemiology ; Hypercalcemia/etiology ; Hypercalcemia/therapy ; Hyperparathyroidism, Primary/complications ; Hyperparathyroidism, Primary/diagnosis ; Hyperparathyroidism, Primary/epidemiology ; Hyperparathyroidism, Primary/therapy ; Parathyroidectomy/utilization
Language	French
Publishing date	2012-09
Publishing country	Belgium
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	760217-0
ISSN	0035-3639
ISSN	0035-3639
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Zs.B 2387: Show issues

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Article ; Online: Prevention and treatment of side-effects of systemic treatment: bone loss.

Body, J-J

Annals of oncology : official journal of the European Society for Medical Oncology

2010 Volume 21 Suppl 7, Page(s) vii180–5

Abstract: Cancer treatment-induced bone loss (CTIBL) is generally more rapid and severe than bone loss associated with menopause in women or ageing in men and women. In premenopausal women with breast cancer, CTIBL is mainly caused by chemotherapy with resultant ... ...

Abstract	Cancer treatment-induced bone loss (CTIBL) is generally more rapid and severe than bone loss associated with menopause in women or ageing in men and women. In premenopausal women with breast cancer, CTIBL is mainly caused by chemotherapy with resultant ovarian failure, by GnRH agonists or by tamoxifen. In postmenopausal women, steroidal and non-steroidal aromatase inhibitors (AIs) increase bone turnover, decrease bone mass and increase fracture rate (hazard ratio increased to 1.38-1.55 compared with tamoxifen). Zoledronic acid can prevent bone loss in premenopausal women receiving adjuvant therapy with goserelin in combination with either anastrozole or tamoxifen and in postmenopausal women receiving AIs. Denosumab has been shown in a placebo-controlled study to significantly increase bone mineral density in postmenopausal women under AIs. More limited studies indicate that oral bisphosphonates used at licensed doses for the treatment of postmenopausal osteoporosis can also prevent AI-induced bone loss. In prostate cancer, bone loss that occurs with androgen deprivation therapy (ADT) also leads to an increased fracture rate. The bisphosphonates pamidronate and alendronate can prevent bone loss whereas zoledronic acid can increase bone mass under ADT. As for breast cancer, delay in bisphosphonate therapy is detrimental to bone health. The protective effects of denosumab on bone loss and incidental vertebral fractures have been demonstrated in a 3-year placebo-controlled trial.
MeSH term(s)	Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Bone Density Conservation Agents/therapeutic use ; Bone Diseases, Metabolic/chemically induced ; Bone Diseases, Metabolic/drug therapy ; Bone Diseases, Metabolic/prevention & control ; Breast Neoplasms/drug therapy ; Carcinoma/drug therapy ; Female ; Humans ; Male ; Prostatic Neoplasms/drug therapy
Chemical Substances	Antineoplastic Agents ; Bone Density Conservation Agents
Language	English
Publishing date	2010-10-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1025984-3
ISSN	1569-8041 ; 0923-7534
ISSN (online)	1569-8041
ISSN	0923-7534
DOI	10.1093/annonc/mdq422
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Zs.A 2862: Show issues

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Article: How to manage postmenopausal osteoporosis?

Body, J J

Acta clinica Belgica

2011 Volume 66, Issue 6, Page(s) 443–447

Abstract: Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased fracture risk. Several therapeutic agents are now available to treat postmenopausal osteoporosis and prevent fractures. Combined calcium and ... ...

Abstract	Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased fracture risk. Several therapeutic agents are now available to treat postmenopausal osteoporosis and prevent fractures. Combined calcium and vitamin D supplementation reduce the relative risk of non-vertebral fractures by about 18%. Hormone replacement therapy (HRT) should not be prescribed for osteoporosis in women who do not experience menopausal symptoms. The marked benefits of raloxifene on the reduction in invasive breast cancer and vertebral fracture risk are partially counterbalanced by a lack of effect on non-vertebral fracture risk, and an increased risk of venous thromboembolism and stroke. All four bisphosphonates available in Belgium, except ibandronate, have been shown to reduce the risk of vertebral, non-vertebral and hip fractures in prospective, placebo-controlled trials. Globally, the incidence of vertebral fractures is reduced by 41%-70%, and the incidence of non-vertebral fractures by 25%-39%. The anti-fracture efficacy of weekly or monthly doses of oral bisphosphonates has not been directly shown but is assumed from bridging studies based on BMD changes. To date, the various bisphosphonates have not been studied in head-to-head comparative trials with fracture endpoints. There are potential concerns that long-term suppression of bone turnover associated with bisphosphonate treatment may eventually lead to adverse effects, especially atypical femoral fractures and osteonecrosis of the jaw, but these cases are extremely rare. Teri-paratide (recombinant human 1-34 PTH) administered by daily subcutaneous injections decreases by 65% the relative risk of new vertebral fractures in patients with severe osteoporosis. Pivotal trials with strontium ranelate have shown a 41% reduction in new vertebral fractures and a 16% reduction in non-vertebral fractures over 3 years. Denosumab is a fully human monoclonal antibody to RANK Ligand that is administered as a 60-mg subcutaneous injection every 6 months. In the pivotal phase III trial, there was a 68% reduction in the incidence of new vertebral fractures, whereas the incidence of non-vertebral fractures was reduced by 20%. Several new approaches are being explored, including antibodies to sclerostin, cathepsin K inhibitors, src kinase inhibitors, and drugs that act on calcium sensing receptors.
MeSH term(s)	Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized ; Bone Density Conservation Agents/therapeutic use ; Calcium/therapeutic use ; Denosumab ; Diphosphonates/therapeutic use ; Female ; Fractures, Bone/prevention & control ; Humans ; Organometallic Compounds/therapeutic use ; Osteoporosis, Postmenopausal/drug therapy ; Selective Estrogen Receptor Modulators/therapeutic use ; Thiophenes/therapeutic use ; Vitamin D/therapeutic use
Chemical Substances	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Bone Density Conservation Agents ; Diphosphonates ; Organometallic Compounds ; Selective Estrogen Receptor Modulators ; Thiophenes ; strontium ranelate (04NQ160FRU) ; Vitamin D (1406-16-2) ; Denosumab (4EQZ6YO2HI) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2011-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	390201-8
ISSN	2295-3337 ; 1784-3286 ; 0001-5512
ISSN (online)	2295-3337
ISSN	1784-3286 ; 0001-5512
DOI	10.2143/ACB.66.6.2062612
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Article ; Online: An abstract lesson: Adopting the CONSORT-EA to improve the quality of reporting of emergency medicine research.

Weber, Ellen J / Body, Richard

Emergency medicine journal : EMJ

2019 Volume 37, Issue 11, Page(s) 658–659

MeSH term(s)	Emergency Medicine ; Emergency Service, Hospital ; Humans
Language	English
Publishing date	2019-11-06
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2019-209223
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