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  • 1.
    Bejhed, Rebecca S.
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Solid State Physics.
    Kharazmi, Mohammad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Cent Hosp Vasteras, Vasteras, Sweden..
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Identification of Risk Factors for Bisphosphonate-Associated Atypical Femoral Fractures and Osteonecrosis of the Jaw in a Pharmacovigilance Database2016In: The Annals of Pharmacotherapy, ISSN 1060-0280, E-ISSN 1542-6270, Vol. 50, no 8, p. 616-624Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Atypical femoral fractures (AFs) and osteonecrosis of the jaw (ONJ) are well-known adverse drug reactions (ADRs) associated with bisphosphonates. To prevent these ADRs and to aid in the search for pathogenic mechanisms, knowledge of risk factors can be helpful. Objective: To identify risk factors for bisphosphonate-related ONJ and AF. Methods: In this case-control study of reports of bisphosphonate-related ADRs from February 16, 1984, to October 16, 2013, in the Swedish national database of ADRs, we compared characteristics for cases of ONJ (n = 167) and AF (n = 55) with all other bisphosphonate-related ADRs (n = 565) with regard to demographic variables, clinical characteristics, and concomitant drug treatments. We adjusted for multiple comparisons with Bonferroni correction. Results: Time to onset of ADRs differed statistically significantly between cases of AF and controls (2156 vs 111 days). For ONJ versus controls, differences were statistically significant for time to onset (1240 vs 111 days), intravenous administration (40% vs 20%), dental procedures (49% vs 0.2%) and prostheses (5% vs 0%), cancer disease (44% vs 12%), multiple myeloma (21% vs 1%), rheumatoid arthritis (14% vs 5%), and treatment with antineoplastic agents and oxycodone. Conclusion: These results lend further evidence to previously identified risk factors for ONJthat is, intravenous bisphosphonate administration; invasive dental procedures and dental prostheses; cancer disease, in particular multiple myeloma; and possibly, long-term bisphosphonate treatment. A putative further risk factor is rheumatoid arthritis. Only long-term bisphosphonate treatment was more common among AF cases. The lack of overlap of risk factors between ONJ and AF suggests different pathogenic mechanisms.

  • 2.
    Carlsson, Anders-Petter
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Kharazmi, Mohammad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Surgical pneumatization through maxillary sinus wall and the schneiderian membrane: A new technique to facilitate augmentation of the maxillary sinus.2017In: Indian Journal of Dental Research, ISSN 0970-9290, E-ISSN 1998-3603, Vol. 28, no 2, p. 207-208Article in journal (Refereed)
    Abstract [en]

    A minimum subantral bone height in the posterior maxilla may require a bone augmentation where a sinus lift procedure is the most commonly used technique, either preceding or simultaneously with the implant installation. While elevating the Schneiderian membrane ruptures are common, possibly resulting in less bone formation. In this paper, we propose the surgical pneumatization of the Schneiderian membrane as a new technique to minimize the risk of such complications. This can be achieved mainly by creating a hole for the immediate and increased passage of air through the Schneiderian membrane and the maxillary sinus wall above the region of augmentation.

  • 3.
    Grybauskas, Simonas
    et al.
    Vilnius Implantol Ctr, LT-01205 Vilnius, Lithuania..
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Razukevicius, Dainius
    Kaunas Implantol Ctr, Kalnieciu 247, Kaunas, Lithuania..
    Kharazmi, Mohammad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Cent Hosp Vasteras, Dept Oral & Maxillofacial Surg, SE-72189 Vasteras, Sweden..
    Entrapment of soft tissue: a new technique to improve the stability of malar augmentation with hydroxyapatite2016In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 54, no 7, p. 826-827Article in journal (Refereed)
  • 4.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Bjornstad, Lillemor
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Wanbro, Jonas
    Carlsson, Anders-Petter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Habib, Samandar
    Uppsala University.
    Warfvinge, Gunnar
    Mandibular bone exposure and osteonecrosis as a complication of general anaesthesia2015In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 120, no 3, p. 215-216Article in journal (Refereed)
  • 5.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Carlsson, Anders-Petter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Mandibular Bone Exposure and Osteonecrosis in a Patient With an Uncomplicated Medical History2015In: The Journal of craniofacial surgery (Print), ISSN 1049-2275, E-ISSN 1536-3732, Vol. 26, no 5, p. 1719-1720Article in journal (Refereed)
  • 6.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Carlsson, Anders-Petter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Oral surgery: Prominent bone shelves2014In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 216, no 10, p. 544-545Article in journal (Refereed)
  • 7.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Carlsson, Anders-Petter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Modig, Maria
    Bjornstad, Lillemor
    Hirsch, Jan-Michael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Surgical approach to snus-induced injury of the oral mucosa2014In: Journal of Oral Science, ISSN 1343-4934, E-ISSN 1880-4926, Vol. 56, no 1, p. 91-94Article in journal (Refereed)
    Abstract [en]

    Snus (Swedish moist snuff) causes lesions in the oral mucosa at the location where pinches are regularly placed. In addition, some patients develop irreversible local gingival recession and sometimes ulcers with perforations to the roots. Such injuries lead to denuded roots that are at risk for caries and periodontal disease, with subsequent esthetic consequences. Therapy for irreversible local gingival recession is currently lacking. In the present report, we describe two cases of successful surgical treatment for irreversible lesions caused by snus.

  • 8.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Bisphosphonate-associated atypical femoral fractures and one-year mortality2014In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 119, no 4, p. 357-358Article in journal (Refereed)
  • 9.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Gender related difference in the risk of bisphosphonate associated atypical femoral fracture and osteonecrosis of the jaw2014In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, no 8, p. 1594-1594Article in journal (Refereed)
  • 10.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Persson, Ulf
    Warfvinge, Gunnar
    Bisphosphonate-associated osteonecrosis of the auditory canal2013In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 51, no 8, p. E285-E287Article in journal (Refereed)
    Abstract [en]

    Only rare cases of osteonecrosis of the auditory canal associated with bisphosphonates, have been published. Our results confirm that similar reports can also be encountered in databases of adverse drug reactions.

  • 11.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Schilcher, Jörg
    Linkoping Univ, Fac Hlth Sci, Sect Orthoped, Dept Clin & Expt Med, Linkoping, Sweden.
    Aspenberg, Per
    Linkoping Univ, Fac Hlth Sci, Sect Orthoped, Dept Clin & Expt Med, Linkoping, Sweden.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Mortality After Atypical Femoral Fractures: A Cohort Study2016In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 31, no 3, p. 491-497Article in journal (Refereed)
    Abstract [en]

    Although osteoporotic fracture rates can be reduced by bisphosphonates, prolonged therapy is associated with higher risk of atypical femoral fractures. Ordinary fragility fractures are linked to high mortality rates. We aimed to determine whether atypical femoral fractures also confer excess mortality. Radiographs were reviewed for all patients ≥55 years of age who had experienced a subtrochanteric or femoral shaft fracture in Sweden in 2008-2010. The fractures were classified as either atypical or ordinary. Data on medication use, coexisting conditions, and date of death were obtained from national registers. We estimated multivariable-adjusted relative risks of death after atypical femoral fractures compared with ordinary subtrochanteric or femoral shaft fractures and calculated age- and sex-standardized mortality ratios (SMRs) for atypical and ordinary fractures compared with the population average. During a mean of 4 years of follow-up, 39 of 172 (23%) patients with an atypical fracture had died compared with 588 of 952 (62%) with an ordinary fracture, corresponding to a relative risk of 0.51 (95% CI 0.38-0.68). The lower risk was evident in both users and non-users of bisphosphonates. No patient with atypical fracture died in the first year after fracture. Individuals with an ordinary fracture had a higher mortality risk than the general population (SMR 1.82; 95% CI 1.69-1.99) but no excess risk was found in patients with atypical fracture (SMR 0.92; 95% CI 0.65-1.26). We conclude that in contrast to ordinary subtrochanteric and femoral shaft fractures, atypical femoral fractures are not associated with excess mortality.

  • 12.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Warfvinge, Gunnar
    Bisphosphonate-associated osteonecrosis of the external auditory canal.2013In: The Journal of craniofacial surgery (Print), ISSN 1049-2275, E-ISSN 1536-3732, Vol. 24, no 6, p. 2218-20Article in journal (Refereed)
  • 13.
    Kharazmi, Mohammad
    et al.
    Department of Oral and Maxillofacial Surgery, Central Hospital, Västerås, Sweden.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Warfvinge, Gunnar
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Risk of atypical femoral fractures and osteonecrosis of the jaw associated with alendronate use compared with other oral bisphosphonates2014In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 53, no 10, p. 1911-1913Article in journal (Refereed)
  • 14.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Prodromal Symptoms in Patients with Bisphosphonate-Associated Atypical Fractures of the Femur2015In: Journal of Bone and Mineral Metabolism, ISSN 0914-8779, E-ISSN 1435-5604, Vol. 33, no 5, p. 516-522Article in journal (Refereed)
    Abstract [en]

    Symptoms have been reported to precede bisphosphonate-associated atypical fractures (AFs) of the femoral shaft. We aimed to determine the frequency and clinical characteristics of such prodromal symptoms. We searched the Swedish national database of spontaneously reported adverse drug reactions for all cases of AF associated with bisphosphonates from January 2006 to March 2013. To confirm diagnostic accuracy and to characterize and determine the frequency of any prodromal symptoms we retrieved copies of medical journals and radiographs for patients who consented to participate in the study. The frequency of prodromal symptoms was compared with that of patients where information was based only on narratives from the adverse drug reaction case reports. A total of 45 reports of AF were identified. We were able to obtain medical records and x-rays for 21 cases and diagnostic accuracy was confirmed for all. Medical records revealed prodromal symptoms in 86 % (n = 18), most commonly pain in the ipsilateral thigh (14 out of 18 patients) preceding the fracture for weeks or longer. Awareness of such symptoms may facilitate early diagnosis and possible prevention of the AF.

  • 15.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hallberg, Pär
    Schilcher, Jörg
    Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures.2017In: European Journal of Orthopaedic Surgery & Traumatology, ISSN 1633-8065, E-ISSN 1432-1068Article in journal (Refereed)
    Abstract [en]

    Little evidence is available on how to treat incomplete atypical fractures of the femur. When surgery is chosen, intramedullary nailing is the most common invasive technique. However, this approach is adopted from the treatment of other types of ordinary femoral fracture and does not aim to prevent the impending complete fracture by interrupting the mechanism underlying the pathology. We suggest a different surgical approach that intends to counteract the underlying biomechanical conditions leading to a complete atypical fracture and thus could be better suited in selected cases. Here, we share an alternative surgical approach and present two cases treated accordingly.

  • 16.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Nilsson, U
    Hallberg, P
    Case report: Oral surgery2017In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 223, no 9, article id 622Article in journal (Refereed)
  • 17.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Nilsson, U
    Hallberg, P
    Case report: Osteonecrosis as a complication of GA.2017In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 222, no 9, article id 645Article in journal (Refereed)
  • 18.
    Kharazmi, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Vastmanland Hosp Vasteras, Dept Oral & Maxillofacial Surg, SE-72189 Vasteras, Sweden..
    Scheer, Hakan
    Vastmanland Hosp Vasteras, Dept Anaesthesiol & Intens Care, SE-73130 Vasteras, Sweden..
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Reduced obstacles, maximized vision (ROMV): a new technique to facilitate laryngoscopy for endotracheal intubation2017In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 1, p. 68-69Article in journal (Refereed)
1 - 18 of 18
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