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Sample records for star released osteoporosis

  1. Osteoporosis

    MedlinePlus

    Osteoporosis makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women. As ... than 50 will break a bone due to osteoporosis. Risk factors include Getting older Being small and ...

  2. Osteoporosis

    MedlinePlus

    ... Home > ePublications > Our ePublications > Osteoporosis fact sheet ePublications Osteoporosis fact sheet This information in Spanish (en español) Print this fact sheet Osteoporosis fact sheet (PDF, 412 KB) Related information Menopause ...

  3. Osteoporosis

    SciTech Connect

    Riggs, B.L. Melton III, L.J. )

    1988-01-01

    This book contains 20 chapters. Some of the titles are: Radiology of asteoporosis; Quantitative computed tomography in assessment of osteoporosis; Nuclear medicine and densitometry; Assessment of bone turnover by histormorphometry in osteoporosis; and The biochemistry of bone.

  4. Osteoporosis

    MedlinePlus

    ... IT? HIV AND OSTEOPOROSIS ANTACIDS AND BONE MINERAL DENSITY HOW DO I KNOW IF I HAVE OSTEOPOROSIS? ... have unusually high rates of low bone mineral density and broken bones. This may be because of ...

  5. Osteoporosis

    MedlinePlus Videos and Cool Tools

    Osteoporosis is a condition that leads to loss of bone mass. From the outside, osteoporotic bone is shaped like normal bone. However, the inside of ... aware of the presence of the disease. Prevention is the best measure for treating osteoporosis by eating ...

  6. Osteoporosis

    MedlinePlus

    ... Having a family history of osteoporosis Taking certain medicines Being a white or Asian woman Having osteopenia, which is low bone density Osteoporosis is a silent disease. You might not know you have it until you break a ... medicines can also help. NIH: National Institute of Arthritis ...

  7. Osteoporosis

    MedlinePlus Videos and Cool Tools

    Osteoporosis is a condition that leads to loss of bone mass. From the outside, osteoporotic bone is shaped like normal bone. ... routine activities, like walking, standing, or bathing. Often, a person will sustain a fracture before becoming aware ...

  8. [Osteoporosis].

    PubMed

    Uebelhart, Brigitte; Rizzoli, René

    2015-01-14

    Bone events related to bariatric surgery remain controversial. Denosumab, used in osteoporosis treatment, is safe and efficient. Romosozumab, an antibody raised against sclerostin, is a promising bone anabolic agent. Odanacatib, a cathepsin-K inhibitor, decreases bone resorption and reduces osteoporotic fracture risk. Denosumab, as bone resorption inhibitor, and Teriparatide, as anabolic agent, have been tested together in patients with osteoporosis. Calcium supplements and cardiovascular risk are still debated. Drug holiday, after long-term treatment with bisphosphonates, is not associated with an increased fracture rate in patients with moderate risk. PMID:25799662

  9. [Osteoporosis].

    PubMed

    Hintze, Gerhard; Graf, Dieter

    2016-06-01

    Osteoporosis is among the main causes for bone fractures. In this overview we report on the prevalence of the disease, the diagnostic procedures, and the therapeutic options. The prevalence increases with age and women are more often affected than men. The diagnosis usually is made on the basis of dual X-ray absorptiometry. Prophylactic measures include a sufficient intake of calcium and vitamin D. Bisphosphonates play a central role in the pharmacotherapy of this disease. PMID:27439255

  10. [Osteoporosis].

    PubMed

    Al-Khawajah, F F

    2002-01-01

    It is well known that people, especially white people, are getting osteoporosis more often than previously thought. Until now, no direct causative factor has been determined, but genetic factors are very likely to be involved. Usually, affected individuals are initially asymptomatic while the disease process is going on, and they come to the attention of the medical profession only late when their bones are fractured as a result of a simple trauma. Also it is vital to let people know that heavy sports, at times, can be harmful. PMID:15339135

  11. Clinical utility of risedronate in postmenopausal osteoporosis: patient considerations with delayed-release formulation

    PubMed Central

    Kinov, Plamen; Boyanov, Mihail

    2012-01-01

    Bisphosphonates are the most widely prescribed treatment for postmenopausal osteoporosis, secondary osteoporosis, and male osteoporosis. Notwithstanding their high effectiveness and favorable safety profile, the adherence to bisphosphonate treatment remains low. Different treatment strategies aim to improve the clinical effectiveness of bisphosphonate therapy. This review paper assesses the clinical utility of oral intermittent risedronate in the treatment of postmenopausal osteoporosis. The new delayed-release risedronate formulation is a safer and easy to use alternative to other risedronate therapy. Oral risedronate, a potent nitrogen-containing bisphosphonate, has been extensively studied using daily regimens. A new intermittent (weekly) dosing regimen confirmed its clinical effectiveness in relation to vertebral and nonvertebral fracture prevention. The absence of significant differences in the incidence of adverse effects confirmed the favorable tolerability of the weekly dosage. In efforts to improve patient adherence to treatment, an innovative, delayed-release formulation of risedronate, which ensures adequate bioavailability of the active compound when taken with food, was introduced. The once-weekly delayed-release formulation of risedronate proved to be noninferior to the daily dosage of risedronate in terms of bone mineral density and markers of bone turnover. In addition, the incidence of new morphometric vertebral fractures was comparable in both treatment regimens. The new delayed-release formulation of risedronate showed a favorable safety profile. Delayed-release risedronate is a promising, new, effective, and convenient alternative to current bisphosphonate treatments. It appears to allow better patient adherence to antiresorptive treatment. PMID:22532780

  12. Osteoporosis (image)

    MedlinePlus

    Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency ...

  13. Secondary osteoporosis.

    PubMed

    Sheu, Angela; Diamond, Terry

    2016-06-01

    Secondary osteoporosis is less common than primary osteoporosis. It may be suspected in patients who present with a fragility fracture despite having no risk factors for osteoporosis. In addition, secondary osteoporosis should be considered if the bone density Z-score is -2.5 or less. Consider the fracture site and presence of other clinical clues to guide investigations for an underlying cause. The tests to use are those that are indicated for the suspected cause. Baseline investigations include tests for bone and mineral metabolism (calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D, parathyroid hormone), liver and kidney function, full blood count and thyroid-stimulating hormone. More detailed testing may be required in patients with severe osteoporosis. PMID:27346916

  14. Secondary osteoporosis

    PubMed Central

    Sheu, Angela; Diamond, Terry

    2016-01-01

    SUMMARY Secondary osteoporosis is less common than primary osteoporosis. It may be suspected in patients who present with a fragility fracture despite having no risk factors for osteoporosis. In addition, secondary osteoporosis should be considered if the bone density Z-score is –2.5 or less. Consider the fracture site and presence of other clinical clues to guide investigations for an underlying cause. The tests to use are those that are indicated for the suspected cause. Baseline investigations include tests for bone and mineral metabolism (calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D, parathyroid hormone), liver and kidney function, full blood count and thyroid-stimulating hormone. More detailed testing may be required in patients with severe osteoporosis. PMID:27346916

  15. Treating osteoporosis

    PubMed Central

    Gupta, Akhil; March, Lyn

    2016-01-01

    summary Osteoporotic fractures are common resulting in increased morbidity and mortality. Exercise can help prevent osteoporosis. It can also benefit patients with osteoporosis, but the exercises must be tailored to the patient. Most Australians should be able to obtain adequate calcium in their diet and vitamin D from the sun. Supplements may be needed in some patients and they are recommended for use with other drugs for osteoporosis. Bisphosphonates, and in some patients denosumab, are first-line drugs for osteoporosis. Raloxifene and strontium ranelate can be considered in patients who cannot take bisphosphonates or denosumab. Teriparatide is reserved for patients with severe osteoporosis and the use of strontium ranelate is declining because of cardiovascular safety concerns. PMID:27340321

  16. MALE OSTEOPOROSIS

    PubMed Central

    Oliveira, Lindomar Guimarães; Guimarães, Mara Lucia Rassi

    2015-01-01

    ABSTRACT Population aging is a reality that is being faced worldwide, and Brazil is no different. Osteoporosis was considered to be a postmenopausal women's disease for many years. Men have many development and hormonal factors that differentiate their skeletal maturation, which affects the incidence of osteoporosis and fractures. An up-to-date review of the specific literature within the Medline system is presented. PMID:27022584

  17. GOSSS-DR1: The First Data Release of the Galactic O-star Spectroscopic Survey

    NASA Astrophysics Data System (ADS)

    Sota, Alfredo; Maíz Apellániz, Jesús; Barbá, Rodolfo H.; Walborn, Nolan R.; Alfaro, Emilio J.; Gamen, Roberto C.; Morrell, Nidia I.; Arias, Julia I.; Gallego Calvente, A. T.

    2013-06-01

    Coinciding with this meeting, we are publishing the first data release of GOSSS. This release contains [a] revised spectral classifications and [b] blue-violet R~2500 spectra in FITS format for ~400 Galactic O stars, including all brighter than B=8. DR1 (and future releases) will take place through GOSC, the Galactic O-Star Catalog (http://gosc.iaa.es), which will be updated for the occasion. Since 2011 GOSC runs on a MySQL database and allows for queries based on coordinates, spectral class, photometry, and other parameters. Future data releases will include the rest of the stars observed in GOSSS (currently 1521 with ~1000 more planned in the next two years).

  18. New white dwarf stars in the Sloan Digital Sky Survey Data Release 10

    NASA Astrophysics Data System (ADS)

    Kepler, S. O.; Pelisoli, I.; Koester, D.; Ourique, G.; Kleinman, S. J.; Romero, A. D.; Nitta, A.; Eisenstein, D. J.; Costa, J. E. S.; Külebi, B.; Jordan, S.; Dufour, P.; Giommi, Paolo; Rebassa-Mansergas, Alberto

    2015-02-01

    We report the discovery of 9088 new spectroscopically confirmed white dwarfs and subdwarfs in the Sloan Digital Sky Survey Data Release 10. We obtain Teff, log g and mass for hydrogen atmosphere white dwarf stars (DAs) and helium atmosphere white dwarf stars (DBs), and estimate the calcium/helium abundances for the white dwarf stars with metallic lines (DZs) and carbon/helium for carbon-dominated spectra DQs. We found 1 central star of a planetary nebula, 2 new oxygen spectra on helium atmosphere white dwarfs, 71 DQs, 42 hot DO/PG1159s, 171 white dwarf+main-sequence star binaries, 206 magnetic DAHs, 327 continuum-dominated DCs, 397 metal-polluted white dwarfs, 450 helium-dominated white dwarfs, 647 subdwarfs and 6887 new hydrogen-dominated white dwarf stars.

  19. New white dwarf and subdwarf stars in the Sloan Digital Sky Survey Data Release 12

    NASA Astrophysics Data System (ADS)

    Kepler, S. O.; Pelisoli, I.; Koester, D.; Ourique, G.; Romero, A. D.; Reindl, N.; Kleinman, S. J.; Eisenstein, D. J.; Valois, A. D. M.; Amaral, L. A.

    2016-02-01

    We report the discovery of 6576 new spectroscopically confirmed white dwarf and subdwarf stars in the Sloan Digital Sky Survey Data Release 12. We obtain Teff, log g and mass for hydrogen atmosphere white dwarf stars (DAs) and helium atmosphere white dwarf stars (DBs), estimate the calcium/helium abundances for the white dwarf stars with metallic lines (DZs) and carbon/helium for carbon-dominated spectra (DQs). We found one central star of a planetary nebula, one ultracompact helium binary (AM CVn), one oxygen line-dominated white dwarf, 15 hot DO/PG1159s, 12 new cataclysmic variables, 36 magnetic white dwarf stars, 54 DQs, 115 helium-dominated white dwarfs, 148 white dwarf + main-sequence star binaries, 236 metal-polluted white dwarfs, 300 continuum spectra DCs, 230 hot subdwarfs, 2936 new hydrogen-dominated white dwarf stars, and 2675 cool hydrogen-dominated subdwarf stars. We calculate the mass distribution of all 5883 DAs with S/N ≥ 15 in DR12, including the ones in DR7 and DR10, with an average S/N = 26, corrected to the 3D convection scale, and also the distribution after correcting for the observed volume, using 1/Vmax.

  20. Male Osteoporosis

    PubMed Central

    Drake, Matthew T.; Khosla, Sundeep

    2013-01-01

    Synopsis Osteoporosis is now recognized as a major threat to health in aging men. Morbidity and mortality, particularly following hip fracture, are substantial. Whereas trabecular bone loss starts in early adulthood, loss of cortical bone only appears to occur from mid-life onwards. Declining bioavailable estradiol levels play an integral role in male age-associated bone loss. Both pharmacologic and supportive care interventions are important for optimal care in men at increased fracture risk. PMID:22877433

  1. Understanding osteoporosis.

    PubMed Central

    Marcus, R.

    1991-01-01

    Considerable progress has been achieved recently in our understanding of the normal process by which bone mass is regulated. Age-related trabecular bone loss is characterized not simply by a global loss of bone but also by cortical porosity and loss of trabecular connections. Because bone strength depends on architectural as well as material properties, bone quantity alone cannot define fracture risk with precision. Traditional therapies for osteoporosis increase bone mass, and estrogen therapy, in particular, profoundly decreases fracture risk. The pharmacologic restoration of bone quantity and quality, however, remains elusive. Modern biotechnology offers the hope that progress may come about through the development of growth factors and other osteotropic compounds for clinical use. Images PMID:1877231

  2. Osteoporosis and Hispanic Women

    MedlinePlus

    ... for the elderly, visit: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... Pub. No. 15-7924 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  3. Exercise and Osteoporosis

    MedlinePlus

    ... My Go4Life Get Free Stuff Be a Partner Exercise and Osteoporosis Osteoporosis is a disease that weakens ... calcium and vitamin D. Include regular weight-bearing exercise in your lifestyle. Stop smoking. Limit how much ...

  4. FastStats: Osteoporosis

    MedlinePlus

    ... this? Submit What's this? Submit Button NCHS Home Osteoporosis Recommend on Facebook Tweet Share Compartir Data are ... men 50 years of age and over with osteoporosis of the femur neck or lumbar spine: 4% ...

  5. Osteoporosis: An Overview.

    ERIC Educational Resources Information Center

    Johnston, C. Conrad; Slemenda, Charles

    1987-01-01

    An overview of osteoporosis, its types, causes, diagnosis, and treatment is presented. Risk factors and bone mass measurement are also discussed. This article serves as an introduction to a symposium on osteoporosis containing five other articles in this issue. (MT)

  6. Osteoporosis: Preventing Falls

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Preventing Falls Past Issues / Winter 2011 Table of ... next to your bed Free NIH Videos About Osteoporosis The NIHSeniorHealth Web site features five brief, informative ...

  7. International Osteoporosis Foundation

    MedlinePlus

    ... Websites IOF International IOF Latin America IOF Asia-Pacific IOF Microsites Capture the Fracture Osteoporosis Essentials course ... on FRAX CME accreditation confirmed for 6th Asia-Pacific Osteoporosis Meeting in Singapore Milk and other dairy ...

  8. Osteoporosis and Your Spine

    MedlinePlus

    ... Movement › Osteoporosis and Your Spine Osteoporosis and Your Spine Your spine is made up of small bones ... called kyphosis. Kyphosis and Bone Breaks in the Spine The bones in the spine are called vertebrae. ...

  9. Medicines for osteoporosis

    MedlinePlus

    ... Raloxifene (Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... to fracture (break). With osteoporosis, the bones lose density. Bone density measures the amount of bone tissue ...

  10. Characterizing the Variability of Stars with Early-release Kepler Data

    NASA Astrophysics Data System (ADS)

    Ciardi, David R.; von Braun, Kaspar; Bryden, Geoff; van Eyken, Julian; Howell, Steve B.; Kane, Stephen R.; Plavchan, Peter; Ramírez, Solange V.; Stauffer, John R.

    2011-04-01

    We present a variability analysis of the early-release first quarter of data publicly released by the Kepler project. Using the stellar parameters from the Kepler Input Catalog, we have separated the sample into 129,000 dwarfs and 17,000 giants and further sub-divided the luminosity classes into temperature bins corresponding approximately to the spectral classes A, F, G, K, and M. Utilizing the inherent sampling and time baseline of the public data set (30 minute sampling and 33.5 day baseline), we have explored the variability of the stellar sample. The overall variability rate of the dwarfs is 25% for the entire sample, but can reach 100% for the brightest groups of stars in the sample. G dwarfs are found to be the most stable with a dispersion floor of σ ~ 0.04 mmag. At the precision of Kepler, >95% of the giant stars are variable with a noise floor of ~0.1 mmag, 0.3 mmag, and 10 mmag for the G giants, K giants, and M giants, respectively. The photometric dispersion of the giants is consistent with acoustic variations of the photosphere; the photometrically derived predicted radial velocity distribution for the K giants is in agreement with the measured radial velocity distribution. We have also briefly explored the variability fraction as a function of data set baseline (1-33 days), at the native 30 minute sampling of the public Kepler data. To within the limitations of the data, we find that the overall variability fractions increase as the data set baseline is increased from 1 day to 33 days, in particular for the most variable stars. The lower mass M dwarf, K dwarf, and G dwarf stars increase their variability more significantly than the higher mass F dwarf and A dwarf stars as the time baseline is increased, indicating that the variability of the lower mass stars is mostly characterized by timescales of weeks while the variability of the higher mass stars is mostly characterized by timescales of days. A study of the distribution of the variability as a

  11. CHARACTERIZING THE VARIABILITY OF STARS WITH EARLY-RELEASE KEPLER DATA

    SciTech Connect

    Ciardi, David R.; Von Braun, Kaspar; Van Eyken, Julian; Kane, Stephen R.; Plavchan, Peter; RamIrez, Solange V.; Stauffer, John R.

    2011-04-15

    We present a variability analysis of the early-release first quarter of data publicly released by the Kepler project. Using the stellar parameters from the Kepler Input Catalog, we have separated the sample into 129,000 dwarfs and 17,000 giants and further sub-divided the luminosity classes into temperature bins corresponding approximately to the spectral classes A, F, G, K, and M. Utilizing the inherent sampling and time baseline of the public data set (30 minute sampling and 33.5 day baseline), we have explored the variability of the stellar sample. The overall variability rate of the dwarfs is 25% for the entire sample, but can reach 100% for the brightest groups of stars in the sample. G dwarfs are found to be the most stable with a dispersion floor of {sigma} {approx} 0.04 mmag. At the precision of Kepler, >95% of the giant stars are variable with a noise floor of {approx}0.1 mmag, 0.3 mmag, and 10 mmag for the G giants, K giants, and M giants, respectively. The photometric dispersion of the giants is consistent with acoustic variations of the photosphere; the photometrically derived predicted radial velocity distribution for the K giants is in agreement with the measured radial velocity distribution. We have also briefly explored the variability fraction as a function of data set baseline (1-33 days), at the native 30 minute sampling of the public Kepler data. To within the limitations of the data, we find that the overall variability fractions increase as the data set baseline is increased from 1 day to 33 days, in particular for the most variable stars. The lower mass M dwarf, K dwarf, and G dwarf stars increase their variability more significantly than the higher mass F dwarf and A dwarf stars as the time baseline is increased, indicating that the variability of the lower mass stars is mostly characterized by timescales of weeks while the variability of the higher mass stars is mostly characterized by timescales of days. A study of the distribution of the

  12. Osteoporosis: Therapeutic Options.

    PubMed

    Ivanova, Stefka; Vasileva, Liliya; Ivanova, Stanislava; Peikova, Lily; Obreshkova, Danka

    2016-01-01

    The definition of osteoporosis was originally formulated at a conference of the World Health Organization (WHO) in 1993 as 'a systemic skeletal disease characterized by decreased bone mass and altered micro-architecture of bone tissue, leading to enhanced bone fragility and risk of fractures'. Osteoporosis is characterized by low bone mineral density (BMD) and loss of the structural and bio-mechanical properties that are required to maintain bone homeostasis. This review aims to address the currently available options in prevention and treatment of osteoporosis. Management of osteoporosis includes non-pharmacological treatment - diet rich of calcium and vitamin D, healthy lifestyle, proper exercise plan, and pharmacological therapy. Combination of non-pharmacological and pharmacological treatment options have to be considered for prevention of osteoporosis and minimization of the risk of fractures. Given the heterogeneity of osteoporosis syndrome and lack of significant number of comparative studies, the choice of a pharmacological agents should be individualized. PMID:27180344

  13. Comparing Osteoporosis Drugs: The Bisphosphonates

    MedlinePlus

    Drugs to Treat Low Bone Density Comparing Osteoporosis Drugs: The Bisphosphonates What is osteoporosis (low bone density)? Osteoporosis is a condition in which the body does not build enough new bone. ...

  14. Osteoporosis: Build Up Your Bones!

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Build Up Your Bones! Past Issues / Winter 2011 ... special needs of people with osteoporosis. A Complete Osteoporosis Program Remember, exercise is only one part of ...

  15. Exercise, Eating, Estrogen, and Osteoporosis.

    ERIC Educational Resources Information Center

    Brown, Jim

    1986-01-01

    Osteoporosis affects millions of people, especially women. Three methods for preventing or managing osteoporosis are recommended: (1) exercise; (2) increased calcium intake; and (3) estrogen replacement therapy. (CB)

  16. Osteoporosis in Gastrointestinal Diseases.

    PubMed

    Krela-Kaźmierczak, Iwona; Szymczak, Aleksandra; Łykowska-Szuber, Liliana; Eder, Piotr; Linke, Krzysztof

    2016-01-01

    Secondary osteoporosis occurs as an isolated pathology or co-exists with types I and II osteoporosis. The gastroenterologist may come across osteoporosis or osteopenia in a patient with a gastrointestinal disease. This is often a young patient in whom investigations should be carried out and appropriate treatment initiated, aimed at preventing bone fractures and the formation of the best peak bone mass. Osteoporosis occurs in patients with the following conditions: Crohn's disease, ulcerative colitis, celiac disease, post gastrectomy patients, patients with short bowel syndrome, chronic hepatitis and cirrhosis, treated with steroids (steroid-induced osteoporosis) and patients using proton pump inhibitors chronically (state of achlorhydria). It is therefore necessary to approve a list of risk factors of secondary osteoporosis, the presence of which would be an indication for screening for osteoporosis, including a DXA study and the development of a separate algorithm for the therapeutic management of secondary osteoporosis accompanying gastrointestinal diseases, especially in premenopausal young women and young men, because there are currently no registered drugs with proven antifracture activity for this group of patients. PMID:26935513

  17. Pituitary Disorders and Osteoporosis

    PubMed Central

    Jawiarczyk-Przybyłowska, Aleksandra

    2015-01-01

    Various hormonal disorders can influence bone metabolism and cause secondary osteoporosis. The consequence of this is a significant increase of fracture risk. Among pituitary disorders such effects are observed in patients with Cushing's disease, hyperprolactinemia, acromegaly, and hypopituitarism. Severe osteoporosis is the result of the coexistence of some of these disorders and hypogonadism at the same time, which is quite often. PMID:25873948

  18. Osteoporosis in Men

    PubMed Central

    Khosla, Sundeep; Amin, Shreyasee; Orwoll, Eric

    2008-01-01

    With the aging of the population, there is a growing recognition that osteoporosis and fractures in men are a significant public health problem, and both hip and vertebral fractures are associated with increased morbidity and mortality in men. Osteoporosis in men is a heterogeneous clinical entity: whereas most men experience bone loss with aging, some men develop osteoporosis at a relatively young age, often for unexplained reasons (idiopathic osteoporosis). Declining sex steroid levels and other hormonal changes likely contribute to age-related bone loss, as do impairments in osteoblast number and/or activity. Secondary causes of osteoporosis also play a significant role in pathogenesis. Although there is ongoing controversy regarding whether osteoporosis in men should be diagnosed based on female- or male-specific reference ranges (because some evidence indicates that the risk of fracture is similar in women and men for a given level of bone mineral density), a diagnosis of osteoporosis in men is generally made based on male-specific reference ranges. Treatment consists both of nonpharmacological (lifestyle factors, calcium and vitamin D supplementation) and pharmacological (most commonly bisphosphonates or PTH) approaches, with efficacy similar to that seen in women. Increasing awareness of osteoporosis in men among physicians and the lay public is critical for the prevention of fractures in our aging male population. PMID:18451258

  19. Osteoporosis in women.

    PubMed

    Bowman, M A; Spangler, J G

    1997-03-01

    Many preventive and treatment strategies are now available for osteoporosis, offering many women the opportunity to forego its many complications. Exercise with calcium and vitamin D supplements is recommended for most patients. Estrogens are a preferred treatment but not acceptable to many women. Alendronate, a bisphosphonate, recently became available to treat osteoporosis. Calcitonin, subcutaneous or intranasal, also can be useful. PMID:9016728

  20. [Epidemiology of osteoporosis].

    PubMed

    Scheidt-Nave, C; Ziegler, R; Raspe, H

    1998-03-15

    Epidemiological studies have identified osteoporosis as a disease of significant public health impact and have delineated numerous potential risk factors. Nevertheless, it has proven difficult to establish preventive strategies for several reasons. First, there has been no final agreement on the definition of osteoporosis, which has hampered efforts to characterize the magnitude of the problem as a whole. Secondly, as osteoporosis is a multifactorial chronic disorder, effective programs for risk assessment and intervention depend on the development of complex disease models. In summarizing the contributions of epidemiological studies to the current understanding of osteoporosis this review intends to outline the scientific background for the European Vertebral Osteoporosis Study (EVOS) and its successors. PMID:9564151

  1. [Osteoporosis: a clinical perspective].

    PubMed

    Matikainen, Niina

    2016-01-01

    Osteoporosis is defined by decreased bone density and microarchitectural deterioration that predispose to fragility fractures. The WHO diagnostic criteria of osteoporosis require bone densitometry but treatment is possible on the basis of high clinical fracture risk and can be assessed by the FRAX risk algorithm. All those subject to fracture risk should be advised about proper basic treatment of osteoporosis, including exercise, prevention of falls, smoking cessation, avoidance of alcohol intake, and dietary or supplemental abundance of calcium and vitamin D. Underlying diseases must be studied after diagnosis of osteoporosis even if treatment is initiated without densitometry. When indicated, specific osteoporosis therapy includes bisphosphonates, denosumab, teriparatide, strontium ranelate or SERMs. In hypogonadism, gonadal steroids may be indicated alone or in addition to a specific treatment. Treatment effect and continuation are assessed after 2 to 5 years. PMID:27400591

  2. KEPLER ECLIPSING BINARY STARS. II. 2165 ECLIPSING BINARIES IN THE SECOND DATA RELEASE

    SciTech Connect

    Slawson, Robert W.; Doyle, Laurance R.; Prsa, Andrej; Engle, Scott G.; Conroy, Kyle; Coughlin, Jared; Welsh, William F.; Orosz, Jerome A.; Gregg, Trevor A.; Fetherolf, Tara; Short, Donald R.; Windmiller, Gur; Rucker, Michael; Batalha, Natalie; Fabrycky, Daniel C.; Jenkins, Jon M.; Mullally, F.; Seader, Shawn E.

    2011-11-15

    The Kepler Mission provides nearly continuous monitoring of {approx}156,000 objects with unprecedented photometric precision. Coincident with the first data release, we presented a catalog of 1879 eclipsing binary systems identified within the 115 deg{sup 2} Kepler field of view (FOV). Here, we provide an updated catalog augmented with the second Kepler data release which increases the baseline nearly fourfold to 125 days. Three hundred and eighty-six new systems have been added, ephemerides and principal parameters have been recomputed. We have removed 42 previously cataloged systems that are now clearly recognized as short-period pulsating variables and another 58 blended systems where we have determined that the Kepler target object is not itself the eclipsing binary. A number of interesting objects are identified. We present several exemplary cases: four eclipsing binaries that exhibit extra (tertiary) eclipse events; and eight systems that show clear eclipse timing variations indicative of the presence of additional bodies bound in the system. We have updated the period and galactic latitude distribution diagrams. With these changes, the total number of identified eclipsing binary systems in the Kepler FOV has increased to 2165, 1.4% of the Kepler target stars. An online version of this catalog is maintained at http://keplerEBs.villanova.edu.

  3. OSTEOPOROSIS DIAGNOSIS AND TREATMENT

    PubMed Central

    de Souza, Márcio Passini Gonçalves

    2015-01-01

    Articles that update the state of knowledge regarding osteoporosis run the risk of quickly becoming obsolete because research and studies on osteoporosis today are arousing great interest among researchers, the pharmaceutical and medical equipment industries, governments and even WHO. All orthopedists know about osteoporosis because of its most deleterious effect: osteoporotic fracture. Osteoporosis without fractures does not arouse suspicion because this is a pathological condition with a nonspecific clinical profile. Osteoporotic fractures have an economic cost (from treatment), a social cost (from its sequelae) and a medical cost (from deaths). Many fractures could be avoided through diagnosing osteoporosis prior to the first fracture and thus many temporary and permanent disabilities could be avoided and many lives saved. Awareness of the risk factors for osteoporosis raises suspicions and bone densitometry aids in diagnosis. Treatment should be based on the physiopathology of the disease. Hence, for prevention or treatment of osteoporosis, the activity of osteoclasts should be diminished or the activity of osteoblasts should be increased, or both. Treatment that reduces the incidence of fractures by improving the bone geometry and microarchitecture would be ideal. Newly formed bone tissue needs to have good cell and matrix quality, normal mineralization, a good ratio between mineralized (mechanically resistant) and non-mineralized (flexible) bone, and no accumulated damage. The ideal treatment should have a positive remodeling rate and fast and long-lasting therapeutic effects. Such effects need to be easily detectable. They need to be safe. PMID:27022545

  4. Rare causes of osteoporosis

    PubMed Central

    Marcucci, Gemma; Brandi, Maria Luisa

    2015-01-01

    Summary Osteoporosis is a metabolic bone disease characterized by loss of bone mass and strength, resulting in increased risk of fractures. It is classically divided into primary (post-menopausal or senile), secondary and idiopathic forms. There are many rare diseases, that cause directly or indirectly osteoporosis. The identification and classification of most of these rare causes of osteoporosis is crucial for the specialists in endocrinology and not, in order to prevent this bone complication and to provide for an early therapy. Several pathogenic mechanisms are involved, including various aspects of bone metabolism such as: decreased bone formation, increased bone resorption, altered calcium, phosphorus and/or vitamin D homeostasis, and abnormal collagen synthesis. In this review, less common forms of primary and secondary osteoporosis are described, specifying, if applicable: genetic causes, epidemiology, clinical features, and pathogenic mechanisms causing osteoporosis. A greater awareness of all rare causes of osteoporosis could reduce the number of cases classified as idiopathic osteoporosis and allow the introduction of appropriate and timely treatments. PMID:26604941

  5. [Endocrine disorders and osteoporosis].

    PubMed

    Kinoshita, Yuka

    2015-10-01

    Secondary osteoporosis is a bone disease characterized by decreased bone mass that predisposes fractures due to underlying disorders or medication. Disorders of the endocrine system, such as primary hyperparathyroidism, hyperthyroidism, hypogonadism, growth hormone deficiency, Cushing's syndrome, and anorexia nervosa frequently cause secondary osteoporosis. In those diseases, hormone excess or deficiency affects functions of osteoblasts, osteocyte, and osteoclasts, leading to aberrant bone remodeling. Bisphosphonates are the first-choice pharmacological agents for fracture prevention in most patients with secondary osteoporosis along with treatment of the underlying disease. PMID:26529938

  6. Medicines for osteoporosis

    MedlinePlus

    ... Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... Your doctor may prescribe medicines to help lower your risk of fractures. These medicines make the bones in your hips, spine, and other areas denser. ...

  7. Osteoporosis in Men

    MedlinePlus

    ... formation. Because it requires daily injections and is expensive, doctors usually prescribe it only for men with ... wine, or a single measure of spirits) • Quit smoking. If you already have osteoporosis, you should take ...

  8. Osteoporosis in anorexia nervosa.

    PubMed

    Treasure, J; Serpell, L

    1999-07-01

    Anorexia nervosa is a disorder characterized by low body weight and amenorrhoea (in females). These features lead to a risk of osteoporosis, a condition in which bone loss leads to weakening of bone structure and increased fracture risk. PMID:10605537

  9. What Is Osteoporosis?

    MedlinePlus Videos and Cool Tools

    ... easily. LAWRENCE RAISZ, M.D.: Osteoporosis and bone health have become enormous problems in the United States ... attention to. People ignore the issue of bone health-- they don't concern themselves about it until ...

  10. International Osteoporosis Foundation

    MedlinePlus

    ... Bosnia and Herzegovina - Brazil - Bulgaria - Cameroon - Canada - Chile - China - Colombia - Costa Rica - Croatia - Cuba - Cyprus - Czech Republic - ... warn of osteoporosis threat to Asia’s growing elderly population New drugs may help increase muscle strength and ...

  11. Diagnosis of Osteoporosis.

    ERIC Educational Resources Information Center

    Wahner, H. W.

    1987-01-01

    Early recognition of osteoporosis is difficult because symptoms are lacking and there are no distinct, readily accessible diagnostic features. This article reviews the standard approach, radiographic and laboratory diagnosis, bone mass measurement techniques, and interpretation of bone mineral data. (MT)

  12. Estrogen and Osteoporosis.

    ERIC Educational Resources Information Center

    Lindsay, Robert

    1987-01-01

    This article reviews the use of estrogen in the prevention and treatment of osteoporosis. Dosage levels, interactions with other factors, side effects, and the mechanism of estrogen action are discussed. (Author/MT)

  13. Osteoporosis in Men

    MedlinePlus

    ... talk to their doctor about having a bone mineral density (BMD) test. Men should also be tested ... tests. The doctor may also order a bone mineral density test. This test can identify osteoporosis, determine ...

  14. Secondary osteoporosis: pathophysiology & diagnosis.

    PubMed

    Emkey, Gregory R; Epstein, Sol

    2014-12-01

    Osteoporosis is a skeletal disease characterized by decreased bone mass and microarchitectural changes in bone tissue that increase the susceptibility to fracture. Secondary osteoporosis is loosely defined as low bone mineral density or increased risk of fragility fracture caused by any factor other than aging or postmenopausal status. The purpose of this review is to discuss the current understanding of the pathophysiology and contribution to fracture risk of many of the more common causes of secondary osteoporosis, as well as diagnostic considerations, outlined by organ system. While not comprehensive, included are a wide array of diseases, conditions, and medications that have been associated with bone loss and susceptibility to fractures. The hope is to highlight the importance to the general clinician of screening for and treating the osteoporosis in these patients, so to limit the resultant increased morbidity associated with fractures. PMID:25432361

  15. Nanoparticles based on star polymers as theranostic vectors: endosomal-triggered drug release combined with MRI sensitivity.

    PubMed

    Li, Yang; Duong, Hien T T; Laurent, Sophie; MacMillan, Alexandre; Whan, Renee Megan; Elst, Luce Vander; Muller, Robert N; Hu, Jinming; Lowe, Andrew; Boyer, Cyrille; Davis, Thomas P

    2015-01-01

    Dual-functional star polymers (diameters 15 nm) are synthesized producing nanoparticles with excellent colloidal stability in both water and serum. The nanoparticles are built with aldehyde groups in the core and activated esters in the arms. The different reactivity of the two functional groups to sequentially react with different amino compounds is exploited; doxorubicin (DOX) and 1-(5-amino-3-aza-2-oxypentyl)-4,7,10-tris(tert-butoxycarbonylmethyl)-1,4,7,10-tetraazacyclododecane (DO3A-tBu-NH2 )-a chelating agent effective for the complexation of Gadolinium ions (Gd). The activated ester group is employed to attach the DO3A chelating agent, while the aldehyde groups are exploited for DOX conjugation, providing a controlled release mechanism for DOX in acidic environments. DOX/Gd-loaded nanoparticles are rapidly taken up by MCF-7 breast cancer cells, subsequently releasing DOX as demonstrated using in vitro fluorescence lifetime imaging microscopy (FLIM). Endosomal, DOX release is observed, using a phasor plot representation of the fluorescence lifetime data, showing an increase of native DOX with time. The MRI properties of the stars are assessed and the relaxivity of Gd loaded in stars is three times higher than conventional organic Gd/DO3A complexes. The DOX/Gd-conjugated nanoparticles yield a similar IC50 to native DOX for breast cancer cell lines, confirming that DOX integrity is conserved during nanoparticle attachment and release. PMID:24985790

  16. THE NEAREST HIGH-VELOCITY STARS REVEALED BY LAMOST DATA RELEASE 1

    SciTech Connect

    Zhong, Jing; Chen, Li; Hou, Jinliang; Shen, Shiyin; Shao, Zhengyi; Li, Jing; Liu, Chao; Luo, Ali; Shi, Jianrong; Zhang, Haotong; Yang, Ming; Deng, Licai; De Grijs, Richard; Jin, Ge; Zhang, Yong; Hou, Yonghui; Zhang, Zhenchao

    2014-07-01

    We report the discovery of 28 candidate high-velocity stars (HVSs) at heliocentric distances of less than 3 kpc, based on the Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) Data Release 1. Our sample of HVS candidates covers a much broader color range than the equivalent ranges discussed in previous studies and comprises the first and largest sample of HVSs in the immediate solar neighborhood, at heliocentric distances less than 1-3 kpc. The observed as well as the derived parameters for all candidates are sufficiently accurate to allow us to ascertain their nature as genuine HVSs, of which a subset of 12 objects represents the most promising candidates. Our results also highlight the great potential of discovering statistically large numbers of HVSs of different spectral types in LAMOST survey data. This will ultimately enable us to achieve a better understanding of the nature of Galactic HVSs and their ejection mechanisms, and to constrain the structure of the Galaxy.

  17. Sarcopenia and Osteoporosis

    PubMed Central

    Ji, Hyung-Min; Han, Jun

    2015-01-01

    Public health strategies designed to accomodate the ever-increasing human lifespan are urgently required. A good clinical understanding of frailty, as well as knowledge regarding how to prevent it, will therefore be required in order to overcome this challenge. Sarcopenia is an important component of the frailty syndrome, and its association with osteoporosis can lead to fractures and incident disability. Therefore, this review examined the literatuire pertaining to the association of sarcopenia with osteoporosis in order to assess preventive strategies.

  18. Bisphosphonates for Osteoporosis: Benefits and Risks

    MedlinePlus

    ... o es sis : Benefits and Risks What is osteoporosis? Osteoporosis is a condition in which your bones become ... through menopause are especially at risk of developing osteoporosis. Osteoporosis is more common in women than in ...

  19. Stars

    NASA Astrophysics Data System (ADS)

    Capelato, Hugo Vicente

    1999-01-01

    We will begin our study with a more or less superficial inspection of the "forest" of stars that we see in the skies. The first thing we notice is that, as sources of light, they are much weaker than the Sun. Second, their apparent colors vary; from a bluish-white in most of them to a reddish-yellow, which is rarer. There is also a third aspect, though it is not very obvious to the naked eye: most of the stars group themselves in small families of two, three or more members. A good example is the Alpha Centauri, the closest star to us, which, in fact, is a triple system of stars. Another is the group of 7 stars that make up the Pleiades, which will be discussed later on. In fact, almost half of the stars are double systems with only two members, called binary stars. Most of these double stars, though together, are separated by several astronomical units (one astronomical unit, AU, is the distance from Earth to the sun: see Chapter 1), and revolve around each other over periods of several years. And yet the revolutions of some binary stars, separated by much smaller distances, occur in only a few hours! These stars are so close to each other that they can share enveloping material. Often this exchange occurs in a somewhat violent manner. Local explosions may occur, expelling matter away from the system. In other binary systems, where one of the components is a very compact, dense star, companion material flows more calmly, making up a light disk around the compact star.

  20. The Mass of the Galaxy from Large Samples of Field Horizontal-Branch Stars in the SDSS Early Data Release

    NASA Astrophysics Data System (ADS)

    Beers, T. C.; Chiba, M.; Sakamoto, T.; Wilhelm, R.; Allende Prieto, C.; Sommer-Larsen, J.; Newberg, H. J.; Yanny, B.; Marsteller, B.; Pier, J. R.

    2004-07-01

    We present a new estimate of the mass of the Milky Way, making use of a large sample of 955 field horizontal-branch (FHB) stars from the Early Data Release of the Sloan Digital Sky Survey. This sample of stars has been classified on the basis of an automated analysis approach, in combination with other methods, in order to obtain estimates of the physical parameters of the stars, i.e., T_eff, log g, [Fe/H], and should be relatively free of contamination from halo blue stragglers. The stars all have measured radial velocities and photometric distance estimates, and the sample includes objects as distant as ˜ 75 kpc from the Galactic center. Application of a Bayesian likelihood method, for a specific model of the Galaxy, indicates that the total mass of the Galaxy lies in the range 1.5-4.0 x 1012 M⊙. Our sample appears to reveal a clear signature of a dual halo population of FHB stars, with the boundary between the inner and outer halo around 20 kpc, and the possibility of rather striking differences in the rotational properties of the Galaxy at low metallicity.

  1. [Osteoporosis and stress].

    PubMed

    Kumano, Hiroaki

    2005-09-01

    There may be three ways of relationship between stress and osteoporosis. The first is that stress induces some physiological changes leading to osteoporosis. The second is that stress induces behavioral distortion of eating, drinking, exercise, and sleep habits, which leads to osteoporosis. The third is that osteoporosis, on the other hand, brings about anxiety, depression, loss of social roles, and social isolation, which leads to stress. The susceptible sex and age groups are postmenopausal women and young women. The abrupt decrease of estrogen in postmenopausal women promotes reabsorption of bone, and it was also reported that the increase of interleukin-6 (IL-6) that is downstream of estrogen was related to the production of osteoclast and to the development of disability of the aged. Regarding the association with stress, while it was reported that depression or depressive states directly increased inflammation-induced cytokines including IL-6, it was also pointed out that stress-induced easy infectious may produce chronic infection, which indirectly increases inflammation-induced cytokines. Anorexia Nervosa that is assumed to be associated with adolescent developmental stress is noteworthy in young women. Amenorrhea is always present in this disease, and in addition to bone reabsorption associated with estrogen deficiency, the decrease of bone formation associated with malnutrition may be related to the development of osteoporosis. PMID:16137956

  2. Glucocorticoid-induced osteoporosis

    PubMed Central

    Briot, Karine; Roux, Christian

    2015-01-01

    Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis and the first cause in young people. Bone loss and increased rate of fractures occur early after the initiation of corticosteroid therapy, and are then related to dosage and treatment duration. The increase in fracture risk is not fully assessed by bone mineral density measurements, as it is also related to alteration of bone quality and increased risk of falls. In patients with rheumatoid arthritis, a treat-to-target strategy focusing on low disease activity including through the use of low dose of prednisone, is a key determinant of bone loss prevention. Bone loss magnitude is variable and there is no clearly identified predictor of the individual risk of fracture. Prevention or treatment of osteoporosis should be considered in all patients who receive prednisone. Bisphosphonates and the anabolic agent parathyroid hormone (1–34) have shown their efficacy in the treatment of corticosteroid-induced osteoporosis. Recent international guidelines are available and should guide management of corticosteroid-induced osteoporosis, which remains under-diagnosed and under-treated. Duration of antiosteoporotic treatment should be discussed at the individual level, depending on the subject's characteristics and on the underlying inflammation evolution. PMID:26509049

  3. New anabolic therapies in osteoporosis.

    PubMed

    Rubin, Mishaela R; Bilezikian, John P

    2003-03-01

    Anabolic agents represent an important new advance in the therapy of osteoporosis. Their potential might be substantially greater than the anti-resorptives. Because the anti-resorptives and anabolic agents work by completely distinct mechanisms of action, it is possible that the combination of agents could be significantly more potent than either agent alone. Recent evidence suggests that a plateau in BMD might occur after prolonged exposure to PTH. Anti-resorptive therapy during or after anabolic therapy might prevent this skeletal adaptation. Protocols to consider anabolic agents as intermittent recycling therapy would be of interest. Of all the anabolics, PTH is the most promising. However, there are unanswered questions about PTH. More studies are needed to document an anabolic effect on cortical bone. More large-scale studies are needed to further determine the reduction in nonvertebral fractures with PTH, especially at the hip. In the future, PTH is likely to be modified for easier and more targeted delivery. Oral or transdermal delivery systems may become available. Recently, Gowen et al have described an oral calcilytic molecule that antagonizes the parathyroid cell calcium receptor, thus stimulating the endogenous release of PTH. This approach could represent a novel endogenous delivery system for intermittent PTH administration. Rising expectations that anabolic therapies for osteoporosis will soon play a major role in treating this disease are likely to fuel further studies and the development of even more novel approaches to therapy. PMID:12699304

  4. Osteoporosis and Asian American Women

    MedlinePlus

    ... ligand (RANKL) inhibitor. Resources NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... No. 15-7925-E NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  5. [Clinical characteristics of male osteoporosis].

    PubMed

    Yamauchi, Mika; Sugimoto, Toshitsugu

    2016-07-01

    As men are less likely than women to develop osteoporosis, male osteoporosis remains poorly understood. However, elderly men have a clearly reduced bone mineral density and increased risk for fractures. In Japan, one in four patients with osteoporosis is male. Male osteoporosis is associated with not only reduction in androgen, but also estrogen, and differs from postmenopausal osteoporosis in that decreased bone formation is involved and that age-related changes in cortical bone structure and perforation of the trabeculae of cancellous bone are unlikely to occur. The proportion of secondary osteoporosis is higher for men than women;therefore, differential diagnosis is important in the diagnosis of male osteoporosis. In addition, it is recommended that bone mineral density be measured at the femoral neck or total hip in men. Men have a worse prognosis following fractures than women, and management of male osteoporosis is highly important for extending healthy life expectancy. PMID:27346307

  6. New Horizons in Osteoporosis

    PubMed Central

    Rachner, Tilman D.; Khosla, Sundeep; Hofbauer, Lorenz C.

    2013-01-01

    Summary Osteoporosis is a common disease characterised by a systemic impairment of bone mass and microarchitecture that results in fragility fractures. With an ageing population, the medical and socioeconomic impact of osteoporosis in general and postmenopausal osteoporosis in particular, will increase further. A detailed knowledge of bone biology with molecular insights into the communication between bone-forming osteoblasts and bone-resorbing osteoclasts and the orchestrating signalling network has led to the identification of novel therapeutic targets. Based on this, therapeutic strategies have been developed aimed at (I) inhibiting excessive bone resorption and by (II) increasing bone formation. The most promising novel treatments include denosumab, a monoclonal antibody against receptor activator of NF-κB ligand, a key osteoclast cytokine, odanacatib, a specific inhibitor of the osteoclast protease cathepsin K, and antibodies against the proteins sclerostin and dickkopf-1, two endogenous inhibitors of bone formation. This review provides an overview on these novel therapies and explains their underlying physiology. PMID:21450337

  7. Pathophysiology of immobilization osteoporosis

    NASA Technical Reports Server (NTRS)

    Doty, S. B.; DiCarlo, E. F.

    1995-01-01

    The reduction of gravity-related forces on the skeleton creates a type of osteoporosis that is unique because its severity is dependent on the mechanical stress bearing function of the skeleton as well as the length of time that the forces are absent or reduced. Bones that bear weight under normal conditions are more affected than bones that normally do not bear weight. The cytokine environment and the cells in the affected bones are altered in time so that stem cells produce fewer new cells and the differentiated cells tend to be less active. These alterations in the local environment of the affected parts appear to resemble those of age- and disease-associated systemic forms of osteoporosis. The osteoporosis produced as a result of the loss of normal activity however, appears to be at least partially reversible through remobilization, strenuous exercise, and--possibly in the future--cytokine therapy.

  8. Male osteoporosis: A review.

    PubMed

    Herrera, Antonio; Lobo-Escolar, Antonio; Mateo, Jesús; Gil, Jorge; Ibarz, Elena; Gracia, Luis

    2012-12-18

    Osteoporosis in men is a heterogeneous disease that has received little attention. However, one third of worldwide hip fractures occur in the male population. This problem is more prevalent in people over 70 years of age. The etiology can be idiopathic or secondary to hypogonadism, vitamin D deficiency and inadequate calcium intake, hormonal treatments for prostate cancer, use of toxic and every disease or drug use that alters bone metabolism.Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis. However, risk factors in men are very heterogeneous. There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment. New treatments will offer new therapeutic prospects. The goal of this work is a revision of the present status knowledge about male osteoporosis. PMID:23362466

  9. Immunologic aspects of osteoporosis.

    PubMed

    Ershler, W B; Harman, S M; Keller, E T

    1997-01-01

    Osteoporosis is a major cause of morbidity in older people. There are a large number of risk factors for the development of osteoporosis. However, these risk factors eventually must mediate their effects through modulation of bone remodeling. A variety of compounds including hormones and nutrients modulate bone remodeling. In addition to these well-characterized substances, the immune system plays a role in bone remodeling through pro-inflammatory cytokines. Specifically, interleukin-1 (IL-1), IL-11, interferon-g are known to influence osteoclasts and osteoblasts. Recently, the cytokine IL-6 has joined ranks with these cytokines as a bone reactive agent. IL-6 has been shown to increase with age and menopause. Additionally, murine models suggest that IL-6 plays a central role in bone resorption. Finally, in vitro studies demonstrate that IL-6 induces osteoclast activity. In this review, we will discuss the pathogenesis of osteoporosis in the context of aging and IL-6. PMID:9463782

  10. Male osteoporosis: A review

    PubMed Central

    Herrera, Antonio; Lobo-Escolar, Antonio; Mateo, Jesús; Gil, Jorge; Ibarz, Elena; Gracia, Luis

    2012-01-01

    Osteoporosis in men is a heterogeneous disease that has received little attention. However, one third of worldwide hip fractures occur in the male population. This problem is more prevalent in people over 70 years of age. The etiology can be idiopathic or secondary to hypogonadism, vitamin D deficiency and inadequate calcium intake, hormonal treatments for prostate cancer, use of toxic and every disease or drug use that alters bone metabolism. Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis. However, risk factors in men are very heterogeneous. There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment. New treatments will offer new therapeutic prospects. The goal of this work is a revision of the present status knowledge about male osteoporosis. PMID:23362466

  11. [Epidemiology of osteoporosis].

    PubMed

    Grazio, Simeon

    2006-01-01

    Osteoporosis represents a major and increasing public health problem with the aging of population. Major clinical consequences and economic burden of the disease are fractures. Many risk factors are associated with the fractures including low bone mass, hormonal disorders, personal and family history of fractures, low body weight, use of certain drugs (e.g. glucocorticoids), cigarette smoking, elevated intake of alchohol, low physical activity, insufficient level of vitamin D and low intake of calcium. This epidemiological review describes frequency, importance of risk factors and impact of osteoporosis and osteoporotic fractures. Objective measures of bone mineral density along with clinical assessment of risk factors can help identify patients who will benefit from prevention and intervention efforts and eventually reduce the morbidity and mortality associated with osteoporosis-related fractures. PMID:17580550

  12. Emerging therapies for osteoporosis.

    PubMed

    Minisola, G; Iuliano, A; Prevete, I

    2014-01-01

    Currently available drugs for the treatment of osteoporosis can still be improved in terms of pharmacokinetics, pharmacodynamics and management. New approaches for the development of innovative drugs are possible thanks to our increasing understanding of the bone tissue biology and the cellular and molecular processes that regulate it. One of the new anti-bone resorption agents, odanacatib, a selective cathepsin-K inhibitor, is in late phase III clinical research. Among new bone anabolic drugs, those that have an action on the Wnt signaling pathway appear to be particularly promising. The development of new compounds for the treatment of osteoporosis represents an excellent example of translational medicine efforts aimed to extend the range of treatment options for osteoporosis, a very common disease with a high social and economic impact, particularly when causing fractures. PMID:25069493

  13. Lifestyle and osteoporosis.

    PubMed

    Zhu, Kun; Prince, Richard L

    2015-02-01

    Osteoporosis is associated with a number of lifestyle factors, including nutritional factors such as intake of calcium, protein, dairy food, fruits and vegetables and vitamin D status, and behavioural factors such as physical activity, smoking and alcohol consumption. Ensuring adequate calcium intake and vitamin D status and having regular weight-bearing physical activity throughout life are important for bone health and the prevention of osteoporosis and related fractures. Studies have shown that smoking and excessive alcohol intake have adverse effects on bone health and increase the risk of fracture. There is evidence suggesting that adequate protein intake and higher intake of fruits and vegetables are beneficial to bone health. PMID:25416958

  14. SECONDARY OSTEOPOROSIS: PATHOPHYSIOLOGY AND MANAGEMENT

    PubMed Central

    Mirza, Faryal; Canalis, Ernesto

    2015-01-01

    Osteoporosis is a skeletal disorder characterized by decreased bone mineral density and compromised bone strength predisposing to an increased risk of fractures. Although idiopathic osteoporosis is the most common form of osteoporosis, secondary factors may contribute to the bone loss and increased fracture risk in patients presenting with fragility fractures or osteoporosis. Several medical conditions and medications significantly increase the risk for bone loss and skeletal fragility. This review focuses on some of the common causes of osteoporosis, addressing the underlying mechanisms, diagnostic approach and treatment of low bone mass in the presence of these conditions. PMID:25971649

  15. Genetics of osteoporosis

    SciTech Connect

    Urano, Tomohiko; Inoue, Satoshi

    2014-09-19

    Highlights: • Single-nucleotide polymorphisms (SNPs) associated with osteoporosis were identified. • SNPs mapped close to or within VDR and ESR1 are associated with bone mineral density. • WNT signaling pathway plays a pivotal role in regulating bone mineral density. • Genetic studies will be useful for identification of new therapeutic targets. - Abstract: Osteoporosis is a skeletal disease characterized by low bone mineral density (BMD) and microarchitectural deterioration of bone tissue, which increases susceptibility to fractures. BMD is a complex quantitative trait with normal distribution and seems to be genetically controlled (in 50–90% of the cases), according to studies on twins and families. Over the last 20 years, candidate gene approach and genome-wide association studies (GWAS) have identified single-nucleotide polymorphisms (SNPs) that are associated with low BMD, osteoporosis, and osteoporotic fractures. These SNPs have been mapped close to or within genes including those encoding nuclear receptors and WNT-β-catenin signaling proteins. Understanding the genetics of osteoporosis will help identify novel candidates for diagnostic and therapeutic targets.

  16. Osteoporosis and Women's Health

    MedlinePlus

    ... down by the body (a process called bone turnover). Your highest bone mass (size and thickness) is reached between ages 20 and 25, and it declines after that. After menopause, however, women begin to lose bone at an even faster rate. Osteoporosis develops when your body cannot replace bone ...

  17. Animal models for osteoporosis.

    PubMed

    Turner, R T; Maran, A; Lotinun, S; Hefferan, T; Evans, G L; Zhang, M; Sibonga, J D

    2001-01-01

    Animal models will continue to be important tools in the quest to understand the contribution of specific genes to establishment of peak bone mass and optimal bone architecture, as well as the genetic basis for a predisposition toward accelerated bone loss in the presence of co-morbidity factors such as estrogen deficiency. Existing animal models will continue to be useful for modeling changes in bone metabolism and architecture induced by well-defined local and systemic factors. However, there is a critical unfulfilled need to develop and validate better animal models to allow fruitful investigation of the interaction of the multitude of factors which precipitate senile osteoporosis. Well characterized and validated animal models that can be recommended for investigation of the etiology, prevention and treatment of several forms of osteoporosis have been listed in Table 1. Also listed are models which are provisionally recommended. These latter models have potential but are inadequately characterized, deviate significantly from the human response, require careful choice of strain or age, or are not practical for most investigators to adopt. It cannot be stressed strongly enough that the enormous potential of laboratory animals as models for osteoporosis can only be realized if great care is taken in the choice of an appropriate species, age, experimental design, and measurements. Poor choices will results in misinterpretation of results which ultimately can bring harm to patients who suffer from osteoporosis by delaying advancement of knowledge. PMID:11704974

  18. Teriparatide for postmenopausal osteoporosis.

    PubMed

    2004-12-01

    Teriparatide (Forsteo - Eli Lilly) is the first parathyroid hormone derivative to be licensed for the treatment of women with postmenopausal osteoporosis. It is described as a "bone-formation agent", in contrast to established treatments, such as bisphosphonates, raloxifene, calcitriol and calcitonin, which reduce bone resorption. Here we consider whether teriparatide offers any worthwhile advantages over these other options. PMID:15587764

  19. Animal models for osteoporosis

    NASA Technical Reports Server (NTRS)

    Turner, R. T.; Maran, A.; Lotinun, S.; Hefferan, T.; Evans, G. L.; Zhang, M.; Sibonga, J. D.

    2001-01-01

    Animal models will continue to be important tools in the quest to understand the contribution of specific genes to establishment of peak bone mass and optimal bone architecture, as well as the genetic basis for a predisposition toward accelerated bone loss in the presence of co-morbidity factors such as estrogen deficiency. Existing animal models will continue to be useful for modeling changes in bone metabolism and architecture induced by well-defined local and systemic factors. However, there is a critical unfulfilled need to develop and validate better animal models to allow fruitful investigation of the interaction of the multitude of factors which precipitate senile osteoporosis. Well characterized and validated animal models that can be recommended for investigation of the etiology, prevention and treatment of several forms of osteoporosis have been listed in Table 1. Also listed are models which are provisionally recommended. These latter models have potential but are inadequately characterized, deviate significantly from the human response, require careful choice of strain or age, or are not practical for most investigators to adopt. It cannot be stressed strongly enough that the enormous potential of laboratory animals as models for osteoporosis can only be realized if great care is taken in the choice of an appropriate species, age, experimental design, and measurements. Poor choices will results in misinterpretation of results which ultimately can bring harm to patients who suffer from osteoporosis by delaying advancement of knowledge.

  20. Clinical Practice. Postmenopausal Osteoporosis.

    PubMed

    Black, Dennis M; Rosen, Clifford J

    2016-01-21

    Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture. PMID:26789873

  1. Management of osteoporosis

    PubMed Central

    Lewiecki, E Michael

    2004-01-01

    Osteoporosis or osteopenia occurs in about 44 million Americans, resulting in 1.5 million fragility fractures per year. The consequences of these fractures include pain, disability, depression, loss of independence, and increased mortality. The burden to the healthcare system, in terms of cost and resources, is tremendous, with an estimated direct annual USA healthcare expenditure of about $17 billion. With longer life expectancy and the aging of the baby-boomer generation, the number of men and women with osteoporosis or low bone density is expected to rise to over 61 million by 2020. Osteoporosis is a silent disease that causes no symptoms until a fracture occurs. Any fragility fracture greatly increases the risk of future fractures. Most patients with osteoporosis are not being diagnosed or treated. Even those with previous fractures, who are at extremely high risk of future fractures, are often not being treated. It is preferable to diagnose osteoporosis by bone density testing of high risk individuals before the first fracture occurs. If osteoporosis or low bone density is identified, evaluation for contributing factors should be considered. Patients on long-term glucocorticoid therapy are at especially high risk for developing osteoporosis, and may sustain fractures at a lower bone density than those not taking glucocorticoids. All patients should be counseled on the importance of regular weight-bearing exercise and adequate daily intake of calcium and vitamin D. Exposure to medications that cause drowsiness or hypotension should be minimized. Non-pharmacologic therapy to reduce the non-skeletal risk factors for fracture should be considered. These include fall prevention through balance training and muscle strengthening, removal of fall hazards at home, and wearing hip protectors if the risk of falling remains high. Pharmacologic therapy can stabilize or increase bone density in most patients, and reduce fracture risk by about 50%. By selecting high risk

  2. Rodent models of osteoporosis

    PubMed Central

    Sophocleous, Antonia; Idris, Aymen I

    2014-01-01

    The aim of this protocol is to provide a detailed description of male and female rodent models of osteoporosis. In addition to indications on the methods of performing the surgical procedures, the choice of reliable and safe anaesthetics is also described. Post-operative care, including analgesia administration for pain management, is also discussed. Ovariectomy in rodents is a procedure where ovaries are surgically excised. Hormonal changes resulting from ovary removal lead to an oestrogen-deprived state, which enhances bone remodelling, causes bone loss and increases bone fracture risk. Therefore, ovariectomy has been considered as the most common preclinical model for understanding the pathophysiology of menopause-associated events and for developing new treatment strategies for tackling post-menopausal osteoporosis. This protocol also provides a detailed description of orchidectomy, a model for androgen-deficient osteoporosis in rodents. Endocrine changes following testes removal lead to hypogonadism, which results in accelerated bone loss, increasing osteoporosis risk. Orchidectomised rodent models have been proposed to mimic male osteoporosis and therefore remain a valuable tool for understanding androgen deficiency in aged men. Although it would have been particularly difficult to assemble an internationally acceptable description of surgical procedures, here we have attempted to provide a comprehensive guide for best practice in performing ovariectomy and orchidectomy in laboratory rodents. Research scientists are reminded that they should follow their own institution's interpretation of such guidelines. Ultimately, however, all animal procedures must be overseen by the local Animal Welfare and Ethical Review Body and conducted under licences approved by a regulatory ethics committee. PMID:25852854

  3. A catalog of M-type star candidates in the LAMOST data release 1

    NASA Astrophysics Data System (ADS)

    Zhong, Jing; Lépine, Sébastien; Li, Jing; Chen, Li; Hou, Jinliang

    2016-08-01

    In this work, we present a set of M-type star candidates selected from the LAMOST DR1. A discrimination method with the spectral index diagram is used to separate M giants and M dwarfs. Then, we have successfully assembled a set of M giants templates from M0 to M6, using the spectra identified from the LAMOST spectral database. After combining the M dwarf templates in Zhong et al. (2015a) and the new created M giant templates, we use the M-type spectral library to perform the template-fit method to classify and identify M-type stars in the LAMOST DR1. A catalog of M-type star candidates including 8639 M giants and 101690 M dwarfs/subdwarfs is provided. As an additional results, we also present other fundamental parameters like proper motion, photometry, radial velocity and spectroscopic distance.

  4. Breastfeeding and postmenopausal osteoporosis.

    PubMed

    Grimes, Julia P; Wimalawansa, Sunil J

    2003-06-01

    Bone loss associated with osteoporosis occurs with high frequency among the elderly and often results in debilitating fractures. A combination of lifestyle behaviors, genetic predisposition, and disease processes contributes to bone metabolism. Therefore, any discussion regarding bone health must address these factors. The impact of menopause on bone turnover has been generally well studied and characterized. Breastfeeding places significant stress on calcium metabolism and, as a consequence, directly influences bone metabolism. The most significant factors affecting bone mineral density (BMD) and bone metabolism are the duration and frequency of lactation, the return of menses, and pre-pregnancy weight. Although transient, lactation is associated with bone loss. As clinical guidelines and public health policies are being formulated, there is a compelling need for further investigation into the relationship of lactation, BMD, and subsequent risk of osteoporosis. Better understanding of this relationship will provide new opportunities for early intervention and ultimately help in the prevention of bone loss in postmenopausal women. PMID:12734029

  5. Osteoporosis in anorexia nervosa.

    PubMed

    Mehler, Philip S; Cleary, Barbara S; Gaudiani, Jennifer L

    2011-01-01

    Osteoporosis is common in anorexia nervosa. It places these patients at increased lifetime risk for fractures. Bone loss may never recover completely even once weight is restored. The strongest predictors of osteoporosis include low body weight and amenorrhea. Loss of bone density can occur rapidly and very early in the course of anorexia nervosa. The etiology of bone loss in the patient with anorexia nervosa is multifactorial. In addition to reduced estrogen and progesterone, excess cortisol levels and low levels of insulin growth factor (IGF-1), a correlate for bone formation, are observed. Dual energy x-ray absorptiometry screening is important to assess bone density. However, successful treatments to reverse bone loss, in those with anorexia nervosa, are lacking. Early diagnosis and treatment of anorexia nervosa are paramount to prevent initial weight loss and subsequent loss of bone. PMID:21360368

  6. [Biological therapy for osteoporosis].

    PubMed

    Nakamura, Shinya; Tanaka, Sakae

    2014-06-01

    Osteoporosis is a disorder of bone formation and resorption balance. Advances in our knowledge of the molecular mechanisms of bone formation and resorption led to promising therapeutic targets for osteoporosis. In the novel biological drugs, denosumab, a monoclonal antibody against receptor activator of nuclear factor-κB ligand (RANKL) has been clinically applied by positive effect on bone mineral density, negative effect on bone resorption, preventive effect on fragility fractures and safety. Odanacatib, a cathepsin K inhibitor is drawing attention as an antiresorptive drug which has lower bone resorption potency than bisphosphoneate. On the other hand, BHQ-880, an anti-Dickkopf-1 (Dkk-1) antibody and romosozumab (AMG-785) , an anti-sclerostin antibody which activate Wnt/β-catenin signaling pathway are drawing attention as bone formation accelerators with no bone resorption acceleration. Clinical studies of these drugs are now ongoing and their clinical applications are expected. PMID:24870844

  7. The catalogue of radial velocity standard stars for Gaia. I. Pre-launch release

    NASA Astrophysics Data System (ADS)

    Soubiran, C.; Jasniewicz, G.; Chemin, L.; Crifo, F.; Udry, S.; Hestroffer, D.; Katz, D.

    2013-04-01

    The Radial Velocity Spectrograph (RVS) on board Gaia needs to be calibrated using stable reference stars known in advance. The catalogue presented here was built for that purpose. It includes 1420 radial velocity standard star candidates selected on strict criteria to fulfil the Gaia-RVS requirements. A large programme of ground-based observations has been underway since 2006 to monitor these stars and verify their stability, which has to be better than 300 m s-1 over several years. The observations were done on the echelle spectrographs ELODIE and SOPHIE on the 1.93-m telescope at Observatoire de Haute-Provence (OHP), NARVAL on the Télescope Bernard Lyot at Observatoire du Pic du Midi and CORALIE on the Euler-Swiss Telescope at La Silla. Data from the OHP and Geneva Observatory archives have also been retrieved as have HARPS spectra from the ESO archive. We provide a mean radial velocity in the SOPHIE scale for each star, derived from the combination of velocities measured with those instruments, after having carefully estimated their differences in zero points. In total, 10214 radial velocity measurements have been obtained for the 1420 stars. With a mean time baseline of 6.35 years, 92.9% of the candidates fulfil a target stability criterion of 300 m s-1. Three hundred forty-three stars are found to be constant at the level of 100 m s-1 over 10 years. Comparisons with earlier catalogues show excellent agreement for FGK stars, with zero-point differences lower than 100 m s-1 and a remarkably low rms scatter of 33 m s-1 in one case, suggesting that the precision of the catalogue presented here is better than this value. This catalogue will likely be useful for other large-scale spectroscopic surveys, such as APOGEE, Gaia-ESO, HERMES, and LAMOST. Based on data obtained within the Gaia DPAC (Data Processing and Analysis Consortium) and coordinated by the GBOG (Ground-Based Observations for Gaia) working group, at various telescopes; see abstract.Full Tables 3 and 4

  8. [Osteoporosis in phlebology].

    PubMed

    van der Molen, H R; Overvelde, S

    1993-01-01

    Patient often think that the pains of their extremities (especially during the night) are caused by a plebo or an angiopathy whereas they are in fact due to a vertebral or lumbar discal affection. 84 patients with osteoporosis were treated by an intramuscular injection of deca-durabolin (25 mg/month) and calcium phosphate (tertiare). Results were satisfactory: six months later, 62 patients no longer suffered, 13 had felt improvement and 2 remained unchanged. PMID:8362009

  9. [Prevention of osteoporosis].

    PubMed

    Dambacher, M A; Kissling, R; Neff, M

    1998-11-01

    The European Parliament presented June 10th in Brussels the 'Osteoporosis Report in EU--Means for Prevention'. It was emphasized that in the EU more than 3500 million Ecu have to be spent for hospitalization and that more than 500,000 hospitals beds are being used by osteoporotic patients. According to some calculations this number will double within the next 50 years. The EU has set up eight steps to be considered, e.g. have densitometric measurements available for persons with high risk and have these measurement paid by the insurances to further finance and support research for the very important areas of prevention and treatment. One distinguishes between primary, secondary and tertiary prevention of osteoporosis. Primary prevention aims at reaching at adolescent age a peak bone mass as high as possible. Secondary prevention aims at reducing bone loss peri- and postmenopausal. The tertiary prevention with manifest osteoporosis aims at preventing fractures. Emphasis of the primary prevention is, besides a sufficient calcium intake, to omit risk factors; with secondary prevention the use of medical treatments such as estrogens/gestagens, bisphosphonates, and recently also SERMs is applied. The tertiary prevention tries mostly to reduce the femur fractures. In addition to drugs such as vitamin D/calcium, vitamin D metabolites and bisphosphonates it is very important to create 'a fall-proof home'. Also very useful are hip protectors. PMID:9865147

  10. Osteoporosis and fragility fractures.

    PubMed

    Sànchez-Riera, Lídia; Wilson, Nicholas; Kamalaraj, Narainraj; Nolla, Joan M; Kok, Cindy; Li, Yang; Macara, Monique; Norman, Rosana; Chen, Jian Sheng; Smith, Emma U R; Sambrook, Philip N; Hernández, Carmen Santos; Woolf, Anthony; March, Lyn

    2010-12-01

    The prevalence of osteoporosis is expected to increase with the ageing of the world's population. This article reviews the epidemiology, risk factors and health burden of osteoporosis. In the Global Burden of Disease (GBD) Study 2005, osteoporosis is studied as a risk factor for fracture by considering the bone-mineral-density (BMD) measurement as the continuous exposure variable. We have performed a systematic review seeking population-based studies with BMD data measured by dual-X-ray absorptiometry (DXA). The femoral neck was selected as the unique location and all values were converted into Hologic(®) to enable inclusion of worldwide data for analysis. Provisional results on mean BMD values for different world regions are shown in age breakdowns for males and females 50 years or over, as well as mean T-scores using the young, white, female reference of National Health and Nutrition Examination Survey (NHANES) III. Results show remarkable geographical differences and a time trend towards improvement of the BMD values in Asian and European populations. PMID:21665127

  11. The societal burden of osteoporosis.

    PubMed

    Becker, David J; Kilgore, Meredith L; Morrisey, Michael A

    2010-06-01

    Osteoporosis currently affects 10 million Americans and is responsible for more than 1.5 million fractures annually. The financial burden of osteoporosis is substantial, with annual direct medical costs estimated at 17 to 20 billion dollars. Most of these costs are related to the acute and rehabilitative care following osteoporotic fractures, particularly hip fractures. The societal burden of osteoporosis includes these direct medical costs and the monetary (eg, caregiver time) and nonmonetary costs of poor health. The aging of the US population is expected to increase the prevalence of osteoporosis and the number of osteoporotic fractures. Growth of the older adult population will pose significant challenges to Medicare and Medicaid, which bear most of the cost of osteoporosis. Efforts to address the looming financial burden must focus on reducing the prevalence of osteoporosis and the incidence of costly fragility fractures. PMID:20425518

  12. Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention Past Issues / Winter 2011 Table of Contents Osteoporosis can strike at any age, although the risk ...

  13. Epidemiology of spinal osteoporosis.

    PubMed

    Melton, L J

    1997-12-15

    Approximately 30% of postmenopausal white women in the United States have osteoporosis, and 16% have osteoporosis of the lumbar spine in particular. Bone density of the spine is positively associated with greater height and weight, older age at menopause, a history of arthritis, more physical activity, moderate use of alcoholic beverages, diuretic treatment, and current estrogen replacement therapy, whereas later age at menarche and a maternal history of fracture are associated with lower levels of density. Low bone density leads to an increased risk of osteoporotic fractures. Fracture risk also increase with age. Vertebral fractures affect approximately 25% of postmenopausal women, although the exact figure depends on the definition used. Recent data show that vertebral fracture rates are as great in men as in women but, because women live longer, the lifetime risk of a vertebral fracture from age 50 onward is 16% in white women and only 5% in white men. Fracture rates are less in most nonwhite populations, but vertebral fractures are as common in Asian women as in those of European heritage. Other risk factors for vertebral fractures are less clear but include hypogonadism and secondary osteoporosis; obesity is protective of fractures as it is of bone loss. Compared with hip fractures, vertebral fractures are less disabling and less expensive, costing approximately $746 million in the United States in 1995. However, they have a substantial negative impact on the patient's function and quality of life. The adverse effects of osteoporotic fractures are likely to increase in the future with the growing number of elderly people. PMID:9431638

  14. Is postmenopausal osteoporosis related to pineal gland functions?

    PubMed

    Sandyk, R; Anastasiadis, P G; Anninos, P A; Tsagas, N

    1992-02-01

    There is currently considerable interest in the pathogenesis of postmenopausal osteoporosis, which is the most common metabolic bone disease. Osteoporosis affects approximately 20 million persons in the United States, 90% of whom are postmenopausal women. Although there is evidence that estrogen deficiency is an important contributory factor, the pathogenesis of osteoporosis is multifactorial and presently poorly understood. There is evidence that pineal melatonin is an anti-aging hormone and that the menopause is associated with a substantial decline in melatonin secretion and an increased rate of pineal calcification. Animal data indicate that pineal melatonin is involved in the regulation of calcium and phosphorus metabolism by stimulating the activity of the parathyroid glands and by inhibiting calcitonin release and inhibiting prostaglandin synthesis. Hence, the pineal gland may function as a "fine tuner" of calcium homeostasis. In the following communication, we propose that the fall of melatonin plasma levels during the early stage of menopause may be an important contributory factor in the development of postmenopausal osteoporosis. Consequently, plasma melatonin levels taken in the early menopause could be used as an indicator or perhaps as a marker for susceptibility to postmenopausal osteoporosis. Moreover, light therapy, administration of oral melatonin (2.5 mg at night) or agents which induce a sustained release of melatonin secretion such as 5-methoxypsoralen, could be useful agents in the prophylaxis and treatment of postmenopausal osteoporosis. Finally, since application of external artificial magnetic fields has been shown to synchronize melatonin secretion in experimental animals and humans, we propose that treatment with artificial magnetic fields may be beneficial for postmenopausal osteoporosis. PMID:1305608

  15. [Osteoporosis in males].

    PubMed

    Audran, M; Legrand, E; Chappard, D; Bigorgne, J C; Basle, M F

    2000-09-01

    A shorter life expectancy, a higher peak bone mass and the absence of distinct menopause equivalent explain the lower incidence of osteoporotic fractures in men. In contrast to women, osteoporosis in younger men is in most cases secondary. Causes such as prolonged glucocorticoid therapy, ethanol abuse, hypogonadism and gastrointestinal disorders are now well recognized. The impact of cigarette smoking, low calcium intake, vitamin D deficiency, hypercalciuria and thyrotoxicosis is more controversial but seems to constitute real risk factors for bone loss. Furthermore increased propensity to fall also plays a major role in fracture risk, particularly in alcoholic patients and in elderly men with neurologic disorders. PMID:11033475

  16. Male Osteoporosis in the Elderly

    PubMed Central

    D'Amelio, Patrizia; Isaia, Giovanni Carlo

    2015-01-01

    Osteoporosis is now recognized as an important public health problem in elderly men as fragility fractures are complicated by increased morbidity, mortality, and social costs. This review comprises an overview of recent findings in pathophysiology, diagnosis, and treatment of male osteoporosis, with particular regard to the old population. PMID:26457082

  17. MID-INFRARED PERIOD-LUMINOSITY RELATIONS OF RR LYRAE STARS DERIVED FROM THE WISE PRELIMINARY DATA RELEASE

    SciTech Connect

    Klein, Christopher R.; Bloom, Joshua S.; Richards, Joseph W.; Butler, Nathaniel R. E-mail: jwrichar@stat.berkeley.edu E-mail: jbloom@astro.berkeley.edu

    2011-09-10

    Interstellar dust presents a significant challenge to extending parallax-determined distances of optically observed pulsational variables to larger volumes. Distance ladder work at mid-infrared wavebands, where dust effects are negligible and metallicity correlations are minimized, has been largely focused on few-epoch Cepheid studies. Here we present the first determination of mid-infrared period-luminosity (PL) relations of RR Lyrae stars from phase-resolved imaging using the preliminary data release of the Wide-field Infrared Survey Explorer (WISE). We present a novel statistical framework to predict posterior distances of 76 well observed RR Lyrae that uses the optically constructed prior distance moduli while simultaneously imposing a power-law PL relation to WISE-determined mean magnitudes. We find that the absolute magnitude in the bluest WISE filter is M{sub W1} = (- 0.421 {+-} 0.014) - (1.681 {+-} 0.147)log{sub 10}(P/0.50118 day), with no evidence for a correlation with metallicity. Combining the results from the three bluest WISE filters, we find that a typical star in our sample has a distance measurement uncertainty of 0.97% (statistical) plus 1.17% (systematic). We do not fundamentalize the periods of RRc stars to improve their fit to the relations. Taking the Hipparcos-derived mean V-band magnitudes, we use the distance posteriors to determine a new optical metallicity-luminosity relation. The results of this analysis will soon be tested by Hubble Space Telescope parallax measurements and, eventually, with the GAIA astrometric mission.

  18. Osteoporosis, Fractures, and Diabetes

    PubMed Central

    2014-01-01

    It is well established that osteoporosis and diabetes are prevalent diseases with significant associated morbidity and mortality. Patients with diabetes mellitus have an increased risk of bone fractures. In type 1 diabetes, the risk is increased by ∼6 times and is due to low bone mass. Despite increased bone mineral density (BMD), in patients with type 2 diabetes the risk is increased (which is about twice the risk in the general population) due to the inferior quality of bone. Bone fragility in type 2 diabetes, which is not reflected by bone mineral density, depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers and examination methods are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. One of these methods can be trabecular bone score. The aim of the paper is to present the present state of scientific knowledge about the osteoporosis risk in diabetic patient. The review also discusses the possibility of problematic using the study conclusions in real clinical practice. PMID:25050121

  19. Novel therapies for osteoporosis.

    PubMed

    Biskobing, Diane M

    2003-04-01

    Osteoporosis remains a significant clinical problem despite effective therapies. Many patients cannot or will not take currently available therapies. For this reason research continues in search of more effective and more tolerable agents. Anabolic agents offer a unique mechanism of action. The anabolic agents parathyroid hormone and strontium will be discussed. The investigational bisphosphonates ibandronate, minodronate and zoledronic acid may offer the advantage of less frequent dosing. Arzoxifene, bazedoxifene, lasofoxifene, MDL-103,323 and ospemifene are investigational selective oestrogen receptor modulators shown to be effective in animal studies and are now in clinical studies. Tibolone is a tissue-specific steroid that is currently used in Europe for prevention and treatment of osteoporosis. Multiple studies have shown efficacy in improving bone mineral density, but no fracture studies have been conducted to date. While studies of the effect of isoflavones on bone mineral density have been encouraging, a large, multi-centre study in Europe showed no effect of isoflavones on fractures. The newly described agent osteoprotegerin has been shown in early studies to inhibit bone turnover. Other agents with unique mechanisms of action in early development include cathepsin K inhibitors, integrin receptor inhibitors, nitrosylated non-steroidal anti-inflammatory agents and Src inhibitors. The efficacy of statins in bone continues to be debated with no prospective, randomised studies yet to confirm the suggestion of benefit seen in epidemiological studies. PMID:12665416

  20. Osteoporosis and Lifestyle.

    PubMed

    Ishimi, Yoshiko

    2015-01-01

    Skeletal tissue is formed during the first two decades of life; then a constant bone mass is maintained until 40 y of age. In the case of women, the bone mass is rapidly reduced at menopause at around 50 y of age. After that, bone mass slowly decreases in both men and women who have passed the 70-y-old mark. The National Institute of Health Consensus Conference adopted the definition of osteoporosis as a skeletal disorder that is characterized by compromised bone strength leading to a predisposition for and an increased risk of fracture. Since osteoporotic fractures are the third-highest cause for becoming bedridden, the maintenance of healthy bones is an important factor in extending a person's healthy lifespan. Bone mass is influenced by many factors, such as nutrition, physical activity, smoking and alcohol intake, as well as by genetic factors. Thus, a healthy diet providing balanced nutrients including calcium, vitamin D, vitamin K and protein, regular physical activity, and not smoking help maintain bone health and delay or prevent osteoporosis. Some functional foods containing soy isoflavones, milk basic protein and n-3 fatty acid may help promote bone health. PMID:26598829

  1. Postmenopausal osteoporosis: microradiographic aspects.

    PubMed

    Dhem, A; Nyssen-Behets, C; Coppens, J

    1998-01-01

    A comparative microradiographic and histologic analysis of undecalcified bone samples was performed in men and women aged 18-98 years. These morphological methods showed that besides usual lamellar bone remodelling, all the so-called inert surfaces, namely both haversian and vascular canals as well as trabecular surfaces, were involved in weathering alterations of the superficial lamellae, resulting in eroded outlines devoid of osteoclast. These aspects, recorded in all pieces of our material, were visible from the earliest adult age and were randomly distributed. Except the grade of osteoporosis at a given age, the microradiographic and histologic aspects were similar in both aged men and women and did not allow sex distinction. These observations were consistent with the hypothesis of a particular destructive process affecting all the quiescent lamellar bone surfaces without osteoclast or cell participation. This kind of erosion, termed delitescence, could be at least partially responsible for the age-related and postmenopausal bone loss. In order to explain the increasing osteoporosis after menopause, it has been suggested that the estrogen deficiency could increase the percentage of dead osteocytes. Thereby the reduced cellular control on the bone surface could impair the remodeling process and fail to adapt the bone structure by repairing the microscopic lesions. PMID:11315966

  2. Novel therapies for osteoporosis.

    PubMed

    Makras, Polyzois; Delaroudis, Sideris; Anastasilakis, Athanasios D

    2015-10-01

    Since the identification of osteoporosis as a major health issue in aging populations and the subsequent development of the first treatment modalities for its management, considerable progress has been made in our understanding of the mechanisms controlling bone turnover and disease pathophysiology, thus enabling the pinpointing of new targets for intervention. This progress, along with advances in biotechnology, has rendered possible the development of ever more sophisticated treatments employing novel mechanisms of action. Denosumab, a monoclonal antibody against RANKL, approved for the treatment of postmenopausal and male osteoporosis, significantly and continuously increases bone mineral density (BMD) and maintains a low risk of vertebral, non-vertebral, and hip fractures for up to 8 years. Currently available combinations of estrogens with selective estrogen receptor modulators moderately increase BMD without causing the extra-skeletal adverse effects of each compound alone. The cathepsin K inhibitor odanacatib has recently been shown to decrease vertebral, non-vertebral, and hip fracture rates and is nearing approval. Romosozumab, an anti-sclerosin antibody, and abaloparatide, a PTH-related peptide analog, are at present in advanced stages of clinical evaluation, so far demonstrating efficaciousness together with a favorable safety profile. Several other agents are currently in earlier clinical and preclinical phases of development, including dickkopf-1 antagonists, activin A antagonists, β-arrestin analogs, calcilytics, and Src tyrosine kinase inhibitors. PMID:26277199

  3. Osteoporosis and sarcopenia: two diseases or one?

    PubMed Central

    Reginster, Jean-Yves; Beaudart, Charlotte; Buckinx, Fanny; Bruyère, Olivier

    2016-01-01

    Purpose of review This article reviews recently published evidence for common pathways explaining bone and muscle wasting in normal ageing and pathological conditions. Recent findings Numerous studies support the concept of a bone–muscle unit, where constant cross-talking between the two tissues takes place, involving molecules released by the skeletal muscle secretome, which affects bone, and osteokines secreted by the osteoblasts and osteocytes, which, in turn, impact muscle cells. Summary New chemical entities aiming at concomitantly treating osteoporosis and sarcopenia could be developed by targeting pathways that centrally regulate bone and muscle or emerging pathways that facilitate the communication between the two tissues. PMID:26418824

  4. Thermosensitive AB4 four-armed star PNIPAM-b-HTPB multiblock copolymer micelles for camptothecin drug release.

    PubMed

    Luo, Yan-Ling; Fu, Jing-Yu; Xu, Feng; Chen, Ya-Shao; Zhang, Bin

    2014-01-01

    Thermo-sensitive poly(N-isoproplacrylamide)m-block-hydroxyl-terminated polybutadiene-block-poly(N-isoproplacrylamide)m (PNIPAMm-b-HTPB-b-PNIPAMm, m = 1 or 2) block copolymers, AB4 four-armed star multiblock and linear triblock copolymers, were synthesized by ATRP with HTPB as central blocks, and characterization was performed by (1)H NMR, Fourier transform infrared, and size exclusion chromatography. The multiblock copolymers could spontaneously assemble into more regular spherical core-shell nanoscale micelles than the linear triblock copolymer. The physicochemical properties were detected by a surface tension, nanoparticle analyzer, transmission electron microscope (TEM), dynamic light scattering, and UV-vis measurements. The multiblock copolymer micelles had lower critical micelle concentration than the linear counterpart, TEM size from 100 to 120 nm, and the hydrodynamic diameters below 150 nm. The micelles exhibited thermo-dependent size change, with low critical solution temperature of about 33-35 °C. The characteristic parameters were affected by the composition ratios, length of PNIPAM blocks, and molecular architectures. The camptothecin release demonstrated that the drug release was thermo-responsive, accompanied by the temperature-induced structural changes of the micelles. MTT assays were performed to evaluate the biocompatibility or cytotoxicity of the prepared copolymer micelles. PMID:24236748

  5. Osteoporosis: Prevention and Management Strategies

    PubMed Central

    Evers, Susan; Myers, Anita

    1987-01-01

    Osteoporosis is a major cause of morbidity in post-menopausal women. Strategies to prevent or delay bone loss in normal post-menopausal women and to reduce the risk of fractures in women with osteoporosis are within the scope of family practice. Certain factors, such as inadequate calcium intake, estrogen deficiency, cigarette smoking and lack of physical activity can be modified in peri- and post-menopausal women. For patients with osteoporosis, there is potential for lowering the risk of fractures by means of calcium supplements or other therapies, physical training and rehabilitation, and modification of factors associated with risk of falling. PMID:21267348

  6. Pathogenesis of Osteoporosis

    PubMed Central

    Khosla, Sundeep

    2013-01-01

    As for most multifactorial disorders, the pathogenesis of osteoporosis is complex, and a different set of mechanisms may be operative in any given individual. However, there are certain common causes of bone loss and increased fracture risk with aging in most people. These include genetic factors contributing to the acquisition of peak bone mass, illnesses affecting skeletal growth and development, sex steroid deficiency following the menopause in women and with aging in men, and intrinsic, age-related changes in bone metabolism. Superimposed on these factors are specific secondary causes of bone loss, such as corticosteroid use or other illnesses affecting bone metabolism that may contribute to fracture risk in individuals exposed to these factors. The past decade has witnessed tremendous advances in our understanding of each of these various causes of bone loss, leading to the development of novel, mechanism-based therapeutic approaches to prevent and treat this important public health disorder. PMID:25243055

  7. [Osteoporosis in thyroid diseases].

    PubMed

    Kosińska, Agnieszka; Syrenicz, Anhelli; Kosiński, Bogusław; Garanty-Bogacka, Barbara; Syrenicz, Małgorzata; Gromniak, Elwira

    2005-01-01

    Thyroid hormones play the essential role in the regulation of metabolism and bone remodeling in physiological conditions and in the course of thyroid dysfunction. Introduction of densitometry to the diagnostics of osteoporosis has made possible the evaluation of influence of both hyperthyroidism and hypothyroidism and their treatment on bone mineral density. Moreover it became possible to estimate the influence of treatment with exogenous thyroid hormones on the skeletal system. Authors presented mechanisms of the thyroid hormones action on bone tissue and analysed current state of knowledge concerning the influence of the thyroxine treatment with replacement and suppressive doses on the bone mineral density. The influence of thyroid hormones on the skeletal system with respect to premenopausal and postmenopausal period was also discussed. Great discrepancies in literature data and its reasons were underlined. PMID:16335687

  8. New therapeutics for osteoporosis.

    PubMed

    Ng, Kong Wah; Martin, T John

    2014-06-01

    Two new approaches for the treatment of osteoporosis are summarized, each having arisen out of important new discoveries in bone biology. Odanacatib (ODN) inhibits the enzyme, cathepsin K, that is essential for the resorbing activity of osteoclasts. It is effective in preventing ovariectomy-induced bone loss in preclinical studies, and a phase II clinical study has shown inhibition of resorption sustained over five years. Outcome of a phase III study is awaited. The finding from mouse and human genetics that Wnt signaling is a powerful inducer of bone formation led to developments aimed at enhancing this pathway. Of the several approaches towards this, the most advanced is with a neutralizing antibody against sclerostin, the osteocyte-derived inhibitor of Wnt signaling. Preclinical studies show a powerful bone anabolic effect, and a clinical phase II study shows dose-dependent increases in bone formation and decreases in bone resorption markers. PMID:24699340

  9. Instrumental diagnosis of osteoporosis.

    PubMed

    Rossini, M; Viapiana, O; Adami, S

    1998-06-01

    Considerable progress in the development of methods for assessing the skeleton now makes it possible to detect osteoporosis non-invasively and early. There is a variety of techniques available at present: single-photon (SPA) and single X-ray absorptiometry (SXA), dual-photon (DPA) and dual X-ray absorptiometry (DXA), quantitative computed tomography (QCT), radiographic absorptiometry (RA), and quantitative ultrasound (QUS), and their development has certainly been driven by the need to overcome the inherent shortcomings of plain radiography for this purpose. Both SPA and SXA methods make a quantitative assessment of the bone mineral content (BMC) or density (BMD) at peripheral sites of the skeleton possible. Single energy measurements are not possible at sites with variable soft tissue thickness and composition, i.e., the axial skeleton. For these purposes, DPA and DXA techniques were introduced. The main advantages of an X-ray system over a radionuclide system are shortened examination time, greater accuracy and precision limited to higher resolution, and removal of errors due to source decay correction. Low radiation dose, availability, capacity to evaluate multiple sites, and ease of use have made DXA the most widely used technique for measuring bone mineral density. QCT can determine the true volumetric density of trabecular or cortical bone in three dimensions at any skeletal site. Recently developed new computer-assisted methods have improved RA precision, thus providing a simple and inexpensive technique for screening of bone mineral status of large populations. QUS was reported to provide information regarding the structural characteristics of bone, which may be relevant to the appearance of osteoporotic fractures; indeed, some studies suggest a relationship between QUS and bone strength beyond that which can be explained by BMD. Recent experimental studies suggested that magnetic resonance might also constitute a promising tool for assessing osteoporosis

  10. Osteoporosis treatment: a missed opportunity.

    PubMed

    Milat, Frances; Ebeling, Peter R

    2016-08-15

    Osteoporosis affects 1.2 million Australians and, in 2012, fractures due to osteoporosis and osteopenia in Australians aged over 50 years cost $2.75 billion. Even minor minimal trauma fractures are associated with increased morbidity and mortality. Despite increasing therapeutic options for managing osteoporosis, fewer than 20% of patients with a minimal trauma fracture are treated or investigated for osteoporosis, so under-treatment is extremely common. Fracture risk assessment is important for selecting patients who require specific anti-osteoporosis therapy. Post-menopausal osteoporosis is frequently due to an imbalance in bone remodelling, with bone resorption exceeding bone formation. Antiresorptive drugs reduce the number, activity and lifespan of osteoclasts, and include bisphosphonates, oestrogen, selective oestrogen receptor-modulating drugs, strontium ranelate, and the human monoclonal antibody denosumab. Teriparatide is the only anabolic agent currently available that stimulates osteoblast recruitment and activity; its antifracture efficacy for non-vertebral fractures increases with the duration of therapy for up to 2 years when it is associated with persisting increases in bone formation rate at the tissue level. Newer anabolic agents are imminent and include an analogue of parathyroid hormone-related protein, abaloparatide, and a humanised monoclonal antibody to an inhibitor of bone formation, romosozumab. Selection of anti-osteoporosis therapy should be individualised to patients, and the duration of bisphosphonate therapy has been covered in recent guidelines. The benefits of treatment far outweigh any risks associated with long term treatment. General practitioners need to take up the challenge imposed by osteoporosis and become champions of change to close the evidence-treatment gap. PMID:27510350

  11. Hyponatremia Is Associated With Increased Osteoporosis and Bone Fractures in a Large US Health System Population

    PubMed Central

    Usala, Rachel L.; Fernandez, Stephen J.; Mete, Mihriye; Cowen, Laura; Shara, Nawar M.; Barsony, Julianna

    2015-01-01

    Context: The significance of studies suggesting an increased risk of bone fragility fractures with hyponatremia through mechanisms of induced bone loss and increased falls has not been demonstrated in large patient populations with different types of hyponatremia. Objective: This matched case-control study evaluated the effect of hyponatremia on osteoporosis and fragility fractures in a patient population of more than 2.9 million. Design, Setting, and Participants: Osteoporosis (n = 30 517) and fragility fracture (n = 46 256) cases from the MedStar Health database were matched on age, sex, race, and patient record length with controls without osteoporosis (n = 30 517) and without fragility fractures (n = 46 256), respectively. Cases without matched controls or serum sodium (Na+) data or with Na+ with a same-day blood glucose greater than 200 mg/dL were excluded. Main Outcome Measures: Incidence of diagnosis of osteoporosis and fragility fractures of the upper or lower extremity, pelvis, and vertebrae were the outcome measures. Results: Multivariate conditional logistic regression models demonstrated that hyponatremia was associated with osteoporosis and/or fragility fractures, including chronic [osteoporosis: odds ratio (OR) 3.97, 95% confidence interval (CI) 3.59–4.39; fracture: OR 4.61, 95% CI 4.15–5.11], recent (osteoporosis: OR 3.06, 95% CI 2.81–3.33; fracture: OR 3.05, 95% CI 2.83–3.29), and combined chronic and recent hyponatremia (osteoporosis: OR 12.09, 95% CI 9.34–15.66; fracture: OR 11.21, 95% CI 8.81–14.26). Odds of osteoporosis or fragility fracture increased incrementally with categorical decrease in median serum Na+. Conclusions: These analyses support the hypothesis that hyponatremia is a risk factor for osteoporosis and fracture. Additional studies are required to evaluate whether correction of hyponatremia will improve patient outcomes. PMID:26083821

  12. The method of searching F/G/K type hyper-velocity star candidates from data release one of LAMOST survey

    NASA Astrophysics Data System (ADS)

    Yinbi, Li; Ali, Luo; Gang, Zhao

    2015-08-01

    Hyper-velocity stars are travelling so fast that they can be ejected out from the Galactic center from dynamical interactions between (binary) stars and the central massive black hole(s). In this paper, we report 19 low mass F/G/K type hyper-velocity star candidates from over one million stars of the data release one of the LAMOST general survey. We initially select over 500,000 F, G and K dwarfs from over one million LAMOST DR1 stars with Teff and logg, and then further select over 190,000 final F, G and K dwarf samples with a series of photometric criteria. Then, we obtain 3D phase space coordinates and escape velocities for each dwarf, and select 32 hyper-velocity star candidates through comparing their total velocities and escape velocities. Finally, we individually inspect spectra of the 32 HVS candidates, 19 of them have high quality spectra, and they are all new HVS finds.

  13. A spectroscopic study of the ancient milky way: f- and g-type stars in the third data release of the sloan digital sky survey

    SciTech Connect

    Allende Prieto, Carlos; Beers, T.C.; Wilhelm, R.; Newberg, H.J.; Rockosi, C.M.; Yanny, B.; Lee, Y.S.; /Michigan STate U.

    2005-09-01

    We perform an analysis of spectra and photometry for 22,770 stars included in the third data release (DR3) of the Sloan Digital Sky Survey (SDSS). We measure radial velocities and, based on a model-atmosphere analysis, derive estimates of the atmospheric parameters (effective temperature, surface gravity, and [Fe/H]) for each star. Stellar evolution models are then used to estimate distances. We thoroughly check our analysis procedures using three recently published spectroscopic libraries of nearby stars, and compare our results with those obtained from alternative approaches. The SDSS sample covers a range in stellar brightness of 14 < V < 22, primarily at intermediate galactic latitudes, and comprises large numbers of F- and G-type stars from the thick-disk and halo populations (up to 100 kpc from the galactic plane), therefore including some of the oldest stars in the Milky Way. In agreement with previous results from the literature, we find that halo stars exhibit a broad range of iron abundances, with a peak at [Fe/H] {approx_equal} -1.4. This population exhibits essentially no galactic rotation. Thick-disk G-dwarf stars at distances from the galactic plane in the range 1 < |z| < 3 kpc show a much more compact metallicity distribution, with a maximum at [Fe/H] {approx_equal} -0.7, and a median galactic rotation velocity at that metallicity of 157 {+-} 4 km s{sup -1} (a lag relative to the thin disk of 63 km s{sup -1}). SDSS DR3 includes spectra of many F-type dwarfs and subgiants between 1 and 3 kpc from the plane with galactic rotation velocities consistent with halo membership. A comparison of color indices and metal abundances with isochrones indicates that no significant star formation has taken place in the halo in the last {approx} 11 Gyr, but there are thick-disk stars which are at least 2 Gyr younger. We find the metallicities of thick-disk stars to be nearly independent of galactocentric distance between 5 and 14 kpc from the galactic center, in

  14. Emerging Therapies for Osteoporosis.

    PubMed

    McClung, Michael R

    2015-12-01

    Although several effective therapies are available for the treatment of osteoporosis in postmenopausal women and older men, there remains a need for the development of even more effective and acceptable drugs. Several new drugs that are in late-stage clinical development will be discussed. Abaloparatide (recombinant parathyroid hormone related peptide [PTHrP] analogue) has anabolic activity like teriparatide. Recent data from the phase 3 fracture prevention trial demonstrate that this agent is effective in reducing fracture risk. Inhibiting cathepsin K reduces bone resorption without decreasing the numbers or activity of osteoclasts, thereby preserving or promoting osteoblast function. Progressive increases in bone mineral density (BMD) have been observed over 5 years. Early data suggest that odanacatib effectively reduces fracture risk. Lastly, inhibiting sclerostin with humanized antibodies promotes rapid, substantial but transient increases in bone formation while inhibiting bone resorption. Marked increases in BMD have been observed in phase 2 studies. Fracture prevention studies are underway. The new therapies with novel and unique mechanisms of action may, alone or in combination, provide more effective treatment options for our patients. PMID:26354487

  15. Emerging Therapies for Osteoporosis

    PubMed Central

    2015-01-01

    Although several effective therapies are available for the treatment of osteoporosis in postmenopausal women and older men, there remains a need for the development of even more effective and acceptable drugs. Several new drugs that are in late-stage clinical development will be discussed. Abaloparatide (recombinant parathyroid hormone related peptide [PTHrP] analogue) has anabolic activity like teriparatide. Recent data from the phase 3 fracture prevention trial demonstrate that this agent is effective in reducing fracture risk. Inhibiting cathepsin K reduces bone resorption without decreasing the numbers or activity of osteoclasts, thereby preserving or promoting osteoblast function. Progressive increases in bone mineral density (BMD) have been observed over 5 years. Early data suggest that odanacatib effectively reduces fracture risk. Lastly, inhibiting sclerostin with humanized antibodies promotes rapid, substantial but transient increases in bone formation while inhibiting bone resorption. Marked increases in BMD have been observed in phase 2 studies. Fracture prevention studies are underway. The new therapies with novel and unique mechanisms of action may, alone or in combination, provide more effective treatment options for our patients. PMID:26354487

  16. Osteoporosis: Cloris Leachman Leads by Example

    MedlinePlus

    ... please turn Javascript on. Feature: Osteoporosis Cloris Leachman Leads By Example Past Issues / Winter 2011 Table of ... age discrimination! Read More "Osteoporosis" Articles Cloris Leachman Leads By Example / Preventing and Treating Brittle Bones and ...

  17. Diagnosis and management of osteoporosis.

    PubMed

    Ralston, Stuart H; Fraser, Jamie

    2015-12-01

    Osteoporosis is a common condition characterised by low bone mineral density (BMD) and an increased risk of fragility fractures. It affects up to 30% of women and 12% of men at some point in their lives. Two of the most important risk factors are increasing age and female gender, although other common and potentially modifiable risk factors include long-term corticosteroid therapy, chronic inflammatory disease, malabsorption and untreated premature menopause. The diagnosis of osteoporosis can be confirmed by DEXA but this should only be performed in patients who have an increased risk of fracture on the basis of clinical risk factors. DEXA should be considered if the 10-year risk of major osteoporotic fracture is > 10%. If the BMD T-score values by DEXA at the lumbar spine, femoral neck or total hip are at or below -2.5 then the diagnosis of osteoporosis is confirmed. Vertebral fractures are generally taken as diagnostic of osteoporosis, even if spine BMD values are not in the osteoporotic range. Oral bisphosphonates are the first-line treatment. If they are contraindicated or not tolerated then parenteral therapy should be considered. There is evidence that fractures occur in glucocorticoid-induced osteoporosis at higher levels of BMD than in postmenopausal osteoporosis so therapy should be considered in patients with a BMD T-score of <-1.5. Although it is useful to have a DEXA scan before starting treatment to provide a baseline value to assess response, this investigation is not absolutely necessary to initiate bone protective therapy, especially in those aged above 65 since the vast majority of these patients will have a T-score of -1.5 or below. In younger individuals where BMD is likely to be higher DEXA is useful in determining if bone protective treatment is needed immediately or if it could be delayed until the T score falls below -1.5. PMID:26882774

  18. Osteoporosis in liver disease: pathogenesis and management

    PubMed Central

    Handzlik-Orlik, Gabriela; Holecki, Michał; Wilczyński, Krzysztof; Duława, Jan

    2016-01-01

    Osteoporosis affects a substantial proportion of patients with chronic liver disease. Pathologic fracture in osteoporosis significantly affects quality of life and life expectancy. By some estimates, 40% of patients with chronic liver disease may experience osteoporotic fracture. In this study we review the pathogenesis, diagnosis and treatment of specific liver disease entities and their relation to osteoporosis. PMID:27293541

  19. Older Men's Explanatory Model for Osteoporosis

    ERIC Educational Resources Information Center

    Solimeo, Samantha L.; Weber, Thomas J.; Gold, Deborah T.

    2011-01-01

    Purpose: To explore the nature of men's experiences of osteoporosis by developing an understanding of men's explanatory models. Design and Methods: This descriptive study invited community-residing male osteoporosis patients aged 50+ to participate in interviews about osteoporosis. Participants were recruited from a hospital-affiliated bone…

  20. Evaluation and Treatment of Osteoporosis.

    PubMed

    O'Connor, Kim M

    2016-07-01

    As the population ages, the rates of osteoporotic fractures will increase, with postmenopausal women incurring most of these fractures. Diagnosis and treatment of osteoporosis are extremely important. Dual-energy x-ray absorptiometry scan screening is recommended in all women more than 65 years of age or in women aged 50 to 64 years with certain risk factors. Treatment should be considered if osteoporosis is present, there is a history of fragility fracture, or in the setting of osteopenia plus high risk for fracture. PMID:27235616

  1. New horizons in osteoporosis therapies.

    PubMed

    Harsløf, Torben; Langdahl, Bente L

    2016-06-01

    Efficient therapies are available for the treatment of osteoporosis, however, there are still unmet needs. Anti-resorptive therapies only increase bone mineral density to a certain extent and reduce the risk of non-vertebral fractures by 20%, only one anabolic option is available-the effect of which levels off over time, and the evidence for combination therapy targeting both resorption and formation is limited. The current review will focus on emerging treatments of osteoporosis with the potential of enhanced anabolic effects (romosozumab and abaloparatide) or uncoupling of resorption and formation (odanacatib and romosozumab) as well as the effect of combination therapy. PMID:26989807

  2. Osteoporosis in lysinuric protein intolerance.

    PubMed

    Parto, K; Penttinen, R; Paronen, I; Pelliniemi, L; Simell, O

    1993-01-01

    Lysinuric protein intolerance (LPI) is an autosomal recessive disease characterized by defective transport of cationic amino acids. Patients have an increased incidence of fractures and their skeletal radiographs show osteoporosis. The aim of the study was to characterize the osteopenia in LPI. Twenty-nine Finnish LPI patients (age range 3.7-44.4 years) were screened for parameters of bone metabolism. Morphometric analysis of bone was carried out in specimens of 9 patients. Collagen synthesis was studied with cultured skin fibroblasts (4 patients) and collagen fibril sizes (3 patients) were measured using electron microscopy. Most histological bone specimens (8/9) showed osteoporosis. Osteomalacia was excluded. Routine clinical laboratory tests were unrevealing. The concentrations of free hydroxyproline and type III procollagen N-propeptide in serum and the urinary excretion of hydroxyproline were increased in almost all patients during their growth and in about half of adult patients. Collagen synthesis in LPI fibroblast cultures was significantly decreased compared with that in age-matched controls at 5 (p < 0.01), 14 (p < 0.01) and still at 30 years (p < 0.01), whereas no difference was observed at the age of 44 years (p = N.S.). Osteoporosis in LPI might reflect defective matrix protein synthesis caused by protein deprivation and deficiency of cationic amino acids. Increased collagen turnover can also contribute to the osteoporosis. PMID:8412005

  3. [Osteoporosis secondary to various disorders].

    PubMed

    Yamaguchi, Toru

    2012-06-01

    Secondary osteoporosis is caused by various disorders, metabolic derangements, and drug administration. Among causative disorders, primary hyperparathyroidism, rheumatoid arthritis, type 2 diabetes mellitus, and chronic kidney disease are prevalent ones. Fractures in type 2 diabetes and chronic kidney disease tend to result from the reduction in bone quality rather than that in bone mass. PMID:22653018

  4. Research Advances: Onions Battle Osteoporosis

    ERIC Educational Resources Information Center

    King, Angela G.

    2005-01-01

    Researchers at the University of Bern in Switzerland have identified a compound in the popular vegetable that appears to decrease bone loss in laboratory studies using rat bone cells. It is suggested that eating onions might help prevent bone loss and osteoporosis, a disease, which predominantly affects older women.

  5. Osteoporosis Associated with Chronic Obstructive Pulmonary Disease

    PubMed Central

    Watanabe, Reiko; Inoue, Daisuke

    2016-01-01

    Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients. PMID:27622174

  6. Osteoporosis Associated with Chronic Obstructive Pulmonary Disease.

    PubMed

    Okazaki, Ryo; Watanabe, Reiko; Inoue, Daisuke

    2016-08-01

    Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis. COPD-associated osteoporosis is however extremely under-recognized, hence undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality compromise bone strength causing fractures in COPD. In COPD patients, various general clinical risk factors for osteoporosis are present including smoking, older age, low body weight, and physical inactivity. In addition, disease-related risk factors such as decreased pulmonary function, inflammation, glucocorticoid use and vitamin D deficiency/insufficiency have been linked to the development of osteoporosis in COPD. Increased awareness of osteoporosis in COPD, especially that of high prevalence of vertebral fractures is called upon among general physicians as well as pulmonologists. Routine screening for osteoporosis and risk assessment of fractures will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage. Timely prevention of developing osteoporosis together with appropriate treatment of established osteoporosis may improve QOL and ADL of the COPD patients, preserve their lung function and eventually result in better prognosis in these patients. PMID:27622174

  7. Osteoporosis across chronic liver disease.

    PubMed

    Guarino, M; Loperto, I; Camera, S; Cossiga, V; Di Somma, C; Colao, A; Caporaso, N; Morisco, F

    2016-06-01

    Osteoporosis is a complication of chronic liver disease, with impact on morbidity, quality of life, and survival. The progress of medicine and the new therapies stretched the disease's natural history and improved the survival of patients with liver disease. So, it is fundamental to make better the quality of life and to prevent complications. Metabolic bone disorders are common complications of chronic liver disease (CLD). Patients with CLD have an increased risk of bone fractures, with significant impact on morbidity, quality of life, and even on survival. Bone diseases, including osteomalacia, osteoporosis, and osteopenia, are frequently observed in many types of liver disease. The pathogenesis of damage and the mechanisms of bone loss are different in relation to the specific liver disease. The relevance of these conditions induced many authors to create a new nosographic entity known as "hepatic osteodystrophy", although this term is rarely used anymore and it is now commonly referred to as osteopenia or osteoporosis associated with chronic liver disease. This review is based on the personal experiences of the authors and upon research done of the available literature on this subject matter. The authors searched the PubMed database for publications containing the term "liver disease" in combination with "bone disease", "hepatic osteodistrophy", "osteoporosis", "osteopenia", "osteomalacia", and "fractures". They selected publications from the past 10 years but did not exclude older seminal publications, especially for colestatic liver diseases. This review of literature shows that osteoporosis crosses all CLD. It is important to underline that the progress of medicine and the new therapies stretched the disease's natural history and improved the survival of patients with CLD. It is fundamental to make better the quality of life and it is mandatory to prevent complications and in particular the osteoporotic ones, especially fractures. PMID:26846777

  8. Environmental risk factors for osteoporosis

    SciTech Connect

    Goyer, R.A.; Korach, K.S. ); Epstein, S. ); Bhattacharyya, M. ); Pounds, J. )

    1994-04-01

    Environmental risk factors for osteoporosis were reviewed at a conference held at the National Institute for Environmental Health Sciences 8-9 November 1993. The conference was co-sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Disease and the NIH Office of Research in Women's Health. The objective of the conference was to review what is known about risk factors for osteoporosis and to identify gaps in the present state of knowledge that might be addressed by future research. The conference was divided into two broad themes. The first session focused on current knowledge regarding etiology, risk factors, and approaches to clinical and laboratory diagnosis. This was followed by three sessions in which various environmental pollutants were discussed. Topics selected for review included environmental agents that interfere with bone and calcium metabolism, such as the toxic metals lead, cadmium, aluminum, and fluoride, natural and antiestrogens, calcium, and vitamin D.

  9. [Epidemiology of Osteoporosis in Men].

    PubMed

    Fujiwara, Saeko

    2016-07-01

    Estimated number of those with osteoporosis was about 12,800,000, and about 23%, 3,000,000 were male osteoporosis in Japan. Incidence of hip, vertebral, distal radius, and proximal humeral fracture in men was half of that in women. Lifetime risk of hip fracture was 5.6% in men. Risk factors for osteoporotic fracture in men were low bone mineral density(BMD), previous fracture, low body mass index, smoking, family history of fracture, glucocorticoid use and others. For osteoporotic fractures, the fracture risk in smokers was significantly higher in men than in women. There was no differences in fracture risks by BMD, previous fracture, glucocorticoid use, and family fracture history between men and women. PMID:27346311

  10. The natural approach to osteoporosis.

    PubMed

    Bartolozzi, Emanuela

    2015-01-01

    Osteoporosis is normally the result of a wrong life-style (diet, physical inactivity, smoke, dental hygiene, intestinal dysbiosis,…) and environmental toxicity which stimulate the chronic expression of inflammatory genes and alter the immuno-endocrine balance. A natural approch should face all the factors involved, leading the patients to become aware of their own responsability, and helping them with natural therapies, healthy food and life-style which support their body in the process of self-healing. PMID:26604935

  11. Bone tissue engineering in osteoporosis.

    PubMed

    Jakob, Franz; Ebert, Regina; Ignatius, Anita; Matsushita, Takashi; Watanabe, Yoshinobu; Groll, Juergen; Walles, Heike

    2013-06-01

    Osteoporosis is a polygenetic, environmentally modifiable disease, which precipitates into fragility fractures of vertebrae, hip and radius and also confers a high risk of fractures in accidents and trauma. Aging and the genetic molecular background of osteoporosis cause delayed healing and impair regeneration. The worldwide burden of disease is huge and steadily increasing while the average life expectancy is also on the rise. The clinical need for bone regeneration applications, systemic or in situ guided bone regeneration and bone tissue engineering, will increase and become a challenge for health care systems. Apart from in situ guided tissue regeneration classical ex vivo tissue engineering of bone has not yet reached the level of routine clinical application although a wealth of scaffolds and growth factors has been developed. Engineering of complex bone constructs in vitro requires scaffolds, growth and differentiation factors, precursor cells for angiogenesis and osteogenesis and suitable bioreactors in various combinations. The development of applications for ex vivo tissue engineering of bone faces technical challenges concerning rapid vascularization for the survival of constructs in vivo. Recent new ideas and developments in the fields of bone biology, materials science and bioreactor technology will enable us to develop standard operating procedures for ex vivo tissue engineering of bone in the near future. Once prototyped such applications will rapidly be tailored for compromised conditions like vitamin D and sex hormone deficiencies, cellular deficits and high production of regeneration inhibitors, as they are prevalent in osteoporosis and in higher age. PMID:23562167

  12. [Nutritional factors in preventing osteoporosis].

    PubMed

    Martín Jiménez, Juan Antonio; Consuegra Moya, Belkis; Martín Jiménez, María Teresa

    2015-01-01

    Osteoporosis, main risk factor for suffering fragility fractures, is an important public health problem which has undoubted social, health and economic impact; but mainly causes pain, functional limitation and severe alterations in the patient's quality of life. Its current prevalence is very high and a further increase is expected due to a higher life expectancy and the progressive ageing of the population. In the prevention of osteoporosis, the main goal is to prevent fragility fractures; for this reason, it is necessary to: 1) promote bone formation in youth, to get sufficient bone mass peak, 2) reduce bone loss in adulthood, especially after menopause, 3) maintain bone health throughout life, and 4) prevent falls. There is enough evidence that multifactorial strategies (assessment of risk factors, healthy lifestyle habits, smoking cessation, moderation in alcohol consumption, physical exercise, outdoor activity with prudent exposure to sunlight, and a varied and balanced diet), are effective in the population at risk. Regarding factors for the prevention of osteoporosis, current recommendations are: increased consumption of calcium, phosphorus, magnesium and fluoride; provide adequate vitamin D (even with fortified food if necessary); consumption of foods rich in omega-3 acids; reduction of salt and prepared ready meals; sufficient but moderate intake of protein and, in the absence of intolerance, promote the consumption of milk and dairy products, especially yogurt and fermented milk products. PMID:26267775

  13. Prevention and treatment of osteoporosis in women.

    PubMed

    Al-Azzawi, Farook; Barlow, David; Hillard, Tim; Studd, John; Williamson, Jenny; Rees, Margaret

    2007-12-01

    Osteoporosis affects one in three women. There has been some confusion among women and health professionals about the management of osteoporosis since the publication of the Women's Health Initiative and Million Women studies. This guidance regarding estrogen-based and non-estrogen-based treatments for osteoporosis responds to the controversies about the benefits and risks of individual agents. Treatment choice should be based on up-to-date evidence and targeted to individual women's needs. PMID:18088530

  14. The management of osteoporosis in children.

    PubMed

    Ward, L M; Konji, V N; Ma, J

    2016-07-01

    This article reviews the manifestations and risk factors associated with osteoporosis in childhood, the definition of osteoporosis and recommendations for monitoring and prevention. As well, this article discusses when a child should be considered a candidate for osteoporosis therapy, which agents should be prescribed, duration of therapy and side effects. There has been significant progress in our understanding of risk factors and the natural history of osteoporosis in children over the past number of years. This knowledge has fostered the development of logical approaches to the diagnosis, monitoring, and optimal timing of osteoporosis intervention in this setting. Current management strategies are predicated upon monitoring at-risk children to identify and then treat earlier rather than later signs of osteoporosis in those with limited potential for spontaneous recovery. On the other hand, trials addressing the prevention of the first-ever fracture are still needed for children who have both a high likelihood of developing fractures and less potential for recovery. This review focuses on the evidence that shapes the current approach to diagnosis, monitoring, and treatment of osteoporosis in childhood, with emphasis on the key pediatric-specific biological principles that are pivotal to the overall approach and on the main questions with which clinicians struggle on a daily basis. The scope of this article is to review the manifestations of and risk factors for primary and secondary osteoporosis in children, to discuss the definition of pediatric osteoporosis, and to summarize recommendations for monitoring and prevention of bone fragility. As well, this article reviews when a child is a candidate for osteoporosis therapy, which agents and doses should be prescribed, the duration of therapy, how the response to therapy is adjudicated, and the short- and long-term side effects. With this information, the bone health clinician will be poised to diagnose

  15. Health Beliefs about Osteoporosis and Osteoporosis Screening in Older Women and Men

    ERIC Educational Resources Information Center

    Nayak, Smita; Roberts, Mark S.; Chang, Chung-Chou H.; Greenspan, Susan L.

    2010-01-01

    Objective: To examine older adults' beliefs about osteoporosis and osteoporosis screening to identify barriers to screening. Design: Cross-sectional mailed survey. Setting: Western Pennsylvania. Methods: Surveys were mailed to 1,830 women and men aged 60 years and older. The survey assessed socio-demographic characteristics, osteoporosis and…

  16. 73 FR 56477 - Food Labeling: Health Claims; Calcium and Osteoporosis, and Calcium, Vitamin D, and Osteoporosis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2008-09-29

    ...The Food and Drug Administration (FDA) is amending its labeling regulation authorizing a health claim on the relationship between calcium and a reduced risk of osteoporosis to include vitamin D so that, in addition to the claim for calcium and osteoporosis, an additional claim can be made for calcium and vitamin D and osteoporosis; eliminate the requirement that the claim list sex, race, and......

  17. Kepler Eclipsing Binary Stars. I. Catalog and Principal Characterization of 1879 Eclipsing Binaries in the First Data Release

    NASA Astrophysics Data System (ADS)

    Prša, Andrej; Batalha, Natalie; Slawson, Robert W.; Doyle, Laurance R.; Welsh, William F.; Orosz, Jerome A.; Seager, Sara; Rucker, Michael; Mjaseth, Kimberly; Engle, Scott G.; Conroy, Kyle; Jenkins, Jon; Caldwell, Douglas; Koch, David; Borucki, William

    2011-03-01

    The Kepler space mission is devoted to finding Earth-size planets orbiting other stars in their habitable zones. Its large, 105 deg2 field of view features over 156,000 stars that are observed continuously to detect and characterize planet transits. Yet, this high-precision instrument holds great promise for other types of objects as well. Here we present a comprehensive catalog of eclipsing binary stars observed by Kepler in the first 44 days of operation, the data being publicly available through MAST as of 2010 June 15. The catalog contains 1879 unique objects. For each object, we provide its Kepler ID (KID), ephemeris (BJD0, P 0), morphology type, physical parameters (T eff, log g, E(B - V)), the estimate of third light contamination (crowding), and principal parameters (T 2/T 1, q, fillout factor, and sin i for overcontacts, and T 2/T 1, (R 1 + R 2)/a, esin ω, ecos ω, and sin i for detached binaries). We present statistics based on the determined periods and measure the average occurrence rate of eclipsing binaries to be ~1.2% across the Kepler field. We further discuss the distribution of binaries as a function of galactic latitude and thoroughly explain the application of artificial intelligence to obtain principal parameters in a matter of seconds for the whole sample. The catalog was envisioned to serve as a bridge between the now public Kepler data and the scientific community interested in eclipsing binary stars.

  18. Laboratory testing for secondary osteoporosis evaluation.

    PubMed

    Adler, Robert A

    2012-08-01

    Osteoporosis has been classified into primary and secondary forms. All patients with osteoporosis should have measurements of 25-hydroxyvitamin D, serum and urine calcium, and some estimation of renal function. There are a wide variety of disorders that lead to secondary osteoporosis, and the tests that confirm these diagnoses are described herein. Making the specific diagnosis is important because treatment of the underlying condition may be sufficient to lessen fracture risk, although some patients may also need usual treatment for osteoporosis. Laboratory testing in addition to a careful history and physical examination will often lead to diagnoses of treatable conditions. PMID:22333732

  19. [An update on glucocorticoid-induced osteoporosis].

    PubMed

    Krasselt, Marco; Baerwald, Christoph

    2016-03-01

    Glucocorticoid-induced osteoporosis is the most common cause of secondary osteoporosis. Moreover, it is the most common reason for an osteoporosis among young adults. The clinical use of oral glucocorticoids increases the fracture incidence already within three months after starting the therapy. There does not seem to be a lower threshold: even doses as low as 2,5 mg of prednisone equivalent increase the risk of fractures. Adequate diagnostic and therapy are able to significantly reduce the resulting fracture risk. This article will discuss the pathophysiology of glucocorticoid-induced osteoporosis and give a summary of the current recommendations including the recently updated German guidelines. PMID:26939107

  20. What Prostate Cancer Survivors Need to Know about Osteoporosis

    MedlinePlus

    ... information on osteoporosis, visit: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... Pub. No. 16-7905 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  1. What People with Lupus Need to Know about Osteoporosis

    MedlinePlus

    ... information on osteoporosis, contact: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... No. 16-7902-E NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  2. What Breast Cancer Survivors Need to Know about Osteoporosis

    MedlinePlus

    ... browser. Home Osteoporosis Osteoporosis and Other Conditions What Breast Cancer Survivors Need to Know About Osteoporosis Publication available ... Print-Friendly Page April 2016 The Impact of Breast Cancer Other than skin cancer, breast cancer is the ...

  3. What People with Anorexia Nervosa Need to Know about Osteoporosis

    MedlinePlus

    ... Osteoporosis Osteoporosis and Other Conditions What People With Anorexia Nervosa Need to Know About Osteoporosis Publication available ... focus(); */ } //--> Print-Friendly Page April 2016 What Is Anorexia Nervosa? Anorexia nervosa is an eating disorder characterized ...

  4. What People with Rheumatoid Arthritis Need to Know about Osteoporosis

    MedlinePlus

    ... increased risk for osteoporosis, are two to three times more likely than men to have rheumatoid arthritis as well. Osteoporosis Management Strategies Strategies for preventing and treating osteoporosis in ...

  5. What People with Asthma Need to Know about Osteoporosis

    MedlinePlus

    ... Osteoporosis Osteoporosis and Other Conditions What People With Asthma Need to Know About Osteoporosis Publication available in: ... focus(); */ } //--> Print-Friendly Page April 2016 What Is Asthma? According to the National Heart, Lung, and Blood ...

  6. What People with Diabetes Need to Know about Osteoporosis

    MedlinePlus

    ... Osteoporosis Osteoporosis and Other Conditions What People With Diabetes Need to Know About Osteoporosis Publication available in: ... focus(); */ } //--> Print-Friendly Page April 2016 What Is Diabetes? Diabetes is a disorder of metabolism, a term ...

  7. Thermosensitive tribrachia star-shaped s-P(NIPAM-co-DMAM) random copolymer micelle aggregates: Preparation, characterization, and drug release applications.

    PubMed

    Luo, Yan-Ling; Wang, Yuan; Wang, Xuan; Xu, Feng; Chen, Ya-Shao

    2016-01-01

    Tribrachia star-shaped random copolymers with tunable thermosensitive phase transition temperature were designed and synthesized via a simple one-pot ammonolysis reaction approach with trimesic acid as cores. The self-assembly micellization behavior of the copolymers in aqueous solution was examined by surface tension, UV-vis transmittance, transmission electron microscope, and dynamic light scattering measurements, etc. The results indicated that the resultant copolymers formed thermosensitive micelle aggregates through hydrophobic interactions among the isopropyl groups of poly(N-isopropylacrylamide) PNIPAM chains and inter-star association at a polymer concentration above critical aggregation concentrations from 4.06 to 6.55 mg L(-1), with a cloud point range from 36.6℃ to 52.1℃, and homogeneously distributed micelle size below 200 nm. The arm length and the compositional ratios of the two comonomers had effect on physicochemical properties of the polymer micelle aggregates. Particularly, the cloud point values were enhanced as the (N,N-dimethylacrylamide) DMAM monomer was introduced and reached to 36.6℃ and 41.0℃-44.7℃ when the mass ratio of NIPAM to DMAM was 90:10 and 80:20, respectively. The thermo-triggered drug release and cytotoxicity were evaluated to confirm the applicability of the random copolymer micelle aggregates as novel drug targeted release carriers. PMID:25926671

  8. A DIRECT MEASUREMENT OF THE HEAT RELEASE IN THE OUTER CRUST OF THE TRANSIENTLY ACCRETING NEUTRON STAR XTE J1709-267

    SciTech Connect

    Degenaar, N.; Miller, J. M.; Wijnands, R.

    2013-04-20

    The heating and cooling of transiently accreting neutron stars provides a powerful probe of the structure and composition of their crust. Observations of superbursts and cooling of accretion-heated neutron stars require more heat release than is accounted for in current models. Obtaining firm constraints on the depth and magnitude of this extra heat is challenging and therefore its origin remains uncertain. We report on Swift and XMM-Newton observations of the transient neutron star low-mass X-ray binary XTE J1709-267, which were made in 2012 September-October when it transitioned to quiescence after a {approx_equal}10 week long accretion outburst. The source is detected with XMM-Newton at a 0.5-10 keV luminosity of L{sub X} {approx_equal} 2 Multiplication-Sign 10{sup 34}(D/8.5 kpc){sup 2} erg s{sup -1}. The X-ray spectrum consists of a thermal component that fits to a neutron star atmosphere model and a non-thermal emission tail, each of which contribute {approx_equal}50% to the total flux. The neutron star temperature decreases from {approx_equal}158 to {approx_equal}152 eV during the {approx_equal}8 hr long observation. This can be interpreted as cooling of a crustal layer located at a column density of y {approx_equal} 5 Multiplication-Sign 10{sup 12} g cm{sup -2} ({approx_equal}50 m inside the neutron star), which is just below the ignition depth of superbursts. The required heat generation in the layers on top would be {approx_equal}0.06-0.13 MeV per accreted nucleon. The magnitude and depth rule out electron captures and nuclear fusion reactions as the heat source, but it may be accounted for by chemical separation of light and heavy nuclei. Low-level accretion offers an alternative explanation for the observed variability.

  9. Inflammatory eye reactions with bisphosphonates and other osteoporosis medications: what are the risks?

    PubMed

    Clark, Emma M; Durup, Darshana

    2015-02-01

    Inflammatory eye reactions (IERs) are rare but have been associated with medications to treat osteoporosis. The aim of this review is to summarize the current literature on the association between IERs and specific medications to treat osteoporosis (bisphosphonates, selective estrogen receptor modulators, strontium, denosumab and teriparatide). We cover the known epidemiology, potential pathogenic mechanisms and a resume of unanswered questions. Briefly, this review highlights that none of the existing randomized clinical trials were powered to identify these rare adverse events, and the majority of the information available is from spontaneous case reports and case series reporting associations between bisphosphonates and IERs. No case reports describe IERs after other anti-osteoporosis medications. Importantly, some case reports describe recurrence of the IER after affected patients were rechallenged with the same or another bisphosphonate, and that no reported cases resolved without discontinuation of the bisphosphonate. However, three large population-based cohort studies have shown conflicting results between osteoporosis treatments and IERs, but overall these studies suggest that IERs may actually be part of underlying inflammatory disease processes that also cause osteoporosis, rather than due to the medications used to treat osteoporosis themselves. There are no clear pathogenic mechanisms for how bisphosphonates could potentially cause IERs. However, the drug is secreted into the tears by the lacrimal gland and could cause irritation to the mucous membranes with subsequent release of inflammatory mediators, similar to the systemic response typically seen after infusion of bisphosphonates. However, in summary it is still not known whether there is a true causal association between bisphosphonates or other anti-osteoporosis medications and IERs, or whether it is confounding by indication and is actually due to underlying inflammatory diseases that cause both

  10. KEPLER ECLIPSING BINARY STARS. I. CATALOG AND PRINCIPAL CHARACTERIZATION OF 1879 ECLIPSING BINARIES IN THE FIRST DATA RELEASE

    SciTech Connect

    Prsa, Andrej; Engle, Scott G.; Conroy, Kyle; Batalha, Natalie; Rucker, Michael; Mjaseth, Kimberly; Slawson, Robert W.; Doyle, Laurance R.; Welsh, William F.; Orosz, Jerome A.; Seager, Sara; Jenkins, Jon; Caldwell, Douglas

    2011-03-15

    The Kepler space mission is devoted to finding Earth-size planets orbiting other stars in their habitable zones. Its large, 105 deg{sup 2} field of view features over 156,000 stars that are observed continuously to detect and characterize planet transits. Yet, this high-precision instrument holds great promise for other types of objects as well. Here we present a comprehensive catalog of eclipsing binary stars observed by Kepler in the first 44 days of operation, the data being publicly available through MAST as of 2010 June 15. The catalog contains 1879 unique objects. For each object, we provide its Kepler ID (KID), ephemeris (BJD{sub 0}, P{sub 0}), morphology type, physical parameters (T{sub eff}, log g, E(B - V)), the estimate of third light contamination (crowding), and principal parameters (T{sub 2}/T{sub 1}, q, fillout factor, and sin i for overcontacts, and T{sub 2}/T{sub 1}, (R{sub 1} + R{sub 2})/a, esin {omega}, ecos {omega}, and sin i for detached binaries). We present statistics based on the determined periods and measure the average occurrence rate of eclipsing binaries to be {approx}1.2% across the Kepler field. We further discuss the distribution of binaries as a function of galactic latitude and thoroughly explain the application of artificial intelligence to obtain principal parameters in a matter of seconds for the whole sample. The catalog was envisioned to serve as a bridge between the now public Kepler data and the scientific community interested in eclipsing binary stars.

  11. Medical treatment of vertebral osteoporosis.

    PubMed

    Lippuner, K

    2003-10-01

    Although osteoporosis is a systemic disease, vertebral fractures due to spinal bone loss are a frequent, sometimes early and often neglected complication of the disease, generally associated with considerable disability and pain. As osteoporotic vertebral fractures are an important predictor of future fracture risk, including at the hip, medical management is targeted at reducing fracture risk. A literature search for randomized, double-blind, prospective, controlled clinical studies addressing medical treatment possibilities of vertebral fractures in postmenopausal Caucasian women was performed on the leading medical databases. For each publication, the number of patients with at least one new vertebral fracture and the number of randomized patients by treatment arm was retrieved. The relative risk (RR) and the number needed to treat (NNT, i.e. the number of patients to be treated to avoid one radiological vertebral fracture over the duration of the study), together with the respective 95% confidence intervals (95%CI) were calculated for each study. Treatment of steroid-induced osteoporosis and treatment of osteoporosis in men were reviewed separately, based on the low number of publications available. Forty-five publications matched with the search criteria, allowing for analysis of 15 different substances tested regarding their anti-fracture efficacy at the vertebral level. Bisphosphonates, mainly alendronate and risedronate, were reported to have consistently reduced the risk of a vertebral fracture over up to 50 months of treatment in four (alendronate) and two (risedronate) publications. Raloxifene reduced vertebral fracture risk in one study over 36 months, which was confirmed by 48 months' follow-up data. Parathormone (PTH) showed a drastic reduction in vertebral fracture risk in early studies, while calcitonin may also be a treatment option to reduce fracture risk. For other substances published data are conflicting (calcitriol, fluoride) or insufficient

  12. The natural approach to osteoporosis

    PubMed Central

    Bartolozzi, Emanuela

    2015-01-01

    Summary Osteoporosis is normally the result of a wrong life-style (diet, physical inactivity, smoke, dental hygiene, intestinal dysbiosis,…) and environmental toxicity which stimulate the chronic expression of inflammatory genes and alter the immuno-endocrine balance. A natural approch should face all the factors involved, leading the patients to become aware of their own responsability, and helping them with natural therapies, healthy food and life-style which support their body in the process of self-healing. PMID:26604935

  13. Osteoporosis in adults with cystic fibrosis.

    PubMed Central

    Haworth, C S; Selby, P L; Webb, A K; Adams, J E

    1998-01-01

    Osteoporosis is prevalent in adults with CF Longitudinal data have not been collected and so the natural history is unknown. The aetiology is not known. There are no published randomized controlled trials evaluating treatments for osteoporosis in CF patients. Images Figure 1 PMID:9709383

  14. Update on the epidemiology of osteoporosis.

    PubMed

    Wolf, R L; Zmuda, J M; Stone, K L; Cauley, J A

    2000-02-01

    Osteoporosis is a major public health problem that affects the entire aging population. This report provides an update on the epidemiology of osteoporosis and its associated fractures. Published studies from 1997 to the present are highlighted. The current US prevalence estimates for osteoporosis, trends in fracture incidence rates, and latest reports on the morbidity, mortality, and costs attributable to osteoporotic fractures are discussed. Recent advances in our understanding of risk factors associated with osteoporosis and related fractures are reviewed. Special attention is paid to the rapid progress being made in the field of genetics, the growing importance of nutrition, and the new questions being raised as to the influence of hormonal factors on bone mineral density and fracture risk. New studies linking osteoporosis to several other important diseases in women including breast cancer, osteoarthritis, and stroke are also reviewed. PMID:11123043

  15. Bisphosphonates for treatment of osteoporosis

    PubMed Central

    Brown, Jacques P.; Morin, Suzanne; Leslie, William; Papaioannou, Alexandra; Cheung, Angela M.; Davison, Kenneth S.; Goltzman, David; Hanley, David Arthur; Hodsman, Anthony; Josse, Robert; Jovaisas, Algis; Juby, Angela; Kaiser, Stephanie; Karaplis, Andrew; Kendler, David; Khan, Aliya; Ngui, Daniel; Olszynski, Wojciech; Ste-Marie, Louis-Georges; Adachi, Jonathan

    2014-01-01

    Abstract Objective To outline the efficacy and risks of bisphosphonate therapy for the management of osteoporosis and describe which patients might be eligible for bisphosphonate “drug holiday.” Quality of evidence MEDLINE (PubMed, through December 31, 2012) was used to identify relevant publications for inclusion. Most of the evidence cited is level II evidence (non-randomized, cohort, and other comparisons trials). Main message The antifracture efficacy of approved first-line bisphosphonates has been proven in randomized controlled clinical trials. However, with more extensive and prolonged clinical use of bisphosphonates, associations have been reported between their administration and the occurrence of rare, but serious, adverse events. Osteonecrosis of the jaw and atypical subtrochanteric and diaphyseal femur fractures might be related to the use of bisphosphonates in osteoporosis, but they are exceedingly rare and they often occur with other comorbidities or concomitant medication use. Drug holidays should only be considered in low-risk patients and in select patients at moderate risk of fracture after 3 to 5 years of therapy. Conclusion When bisphosphonates are prescribed to patients at high risk of fracture, their antifracture benefits considerably outweigh their potential for harm. For patients taking bisphosphonates for 3 to 5 years, reassess the need for ongoing therapy. PMID:24733321

  16. Nanohydroxyapatite Application to Osteoporosis Management

    PubMed Central

    Noor, Zairin

    2013-01-01

    Hydroxyapatite is chemically related to the inorganic component of bone matrix as a complex structure with the formula of Ca10(OH)2(PO4)6. Previous studies have reported the application of microsized hydroxyapatite to bone regeneration, but the result is not satisfied. The limitation comes from the size of hydroxyapatite. In addition, the duration of treatment is very long. The advantages of hydroxyapatite nanocrystal are the osteoconduction, bioresorption, and contact in close distance. Crystal in osteoporotic bone is calcium phosphate hydroxide with the chemical formula of Ca10(OH)2(PO4)6. Crystal of normal bone is sodium calcium hydrogen carbonate phosphate hydrate with the chemical formula of Ca8H2(PO4)6·H2O–NaHCO3–H2O. The recent development is applying nanobiology approach to hydroxyapatite. This is based on the concept that the mineral atoms arranged in a crystal structure of hydroxyapatite can be substituted or incorporated by the other mineral atoms. In conclusion, the basic elements of hydroxyapatite crystals, composed of atomic minerals in a certain geometric pattern, and their relationship to the bone cell biological activity have opened opportunities for hydroxyapatite crystals supplement application on osteoporosis. Understanding of the characteristics of bone hydroxyapatite crystals as well as the behavior of mineral atom in the substitution will have a better impact on the management of osteoporosis. PMID:24288653

  17. The rising star of high-oleic Virginia peanuts: A summary of data supporting the release of 'VENUS'

    Technology Transfer Automated Retrieval System (TEKTRAN)

    'VENUS' is a large-seeded high-oleic Virginia-type peanut that has enhanced Sclerotinia blight and pod rot tolerance when compared to the cultivar Jupiter. 'VENUS' is the first high-oleic Virginia peanut developed for and proposed for release in the Southwestern US. 'VENUS' (experimental designati...

  18. Osteoporosis

    MedlinePlus

    ... with weak bones in their spine gradually lose height and their posture becomes hunched over. Over time a bent spine can make it hard to walk or even sit up. Broken hips are a very serious problem as we age. ...

  19. Osteoporosis

    MedlinePlus

    ... foods and regular exercise, such as walking or running, to strengthen bones. A doctor may also recommend ... In other words, play a lot! Playing sports, running, jumping, dancing — whatever you like to do. Don' ...

  20. [Osteoporosis].

    PubMed

    Reza-Albarrán, Alfredo Adolfo

    2016-09-01

    Calcium intake has a role on the development of peak bone mass, and has a mild impact on the maintenance of bone mass during adulthood and the reduction of bone loss rate in postmenopausal women and the elderly in both genders. Calcium dietary intake should be privileged over supplementation. Dairy products are the main calcium dietary sources. Prospective studies have not clearly demonstrated an effect on the prevention of fractures, because of the practical difficulties of a long follow-up in order to get to solid conclusions; however the physiological rationale is that an adequate calcium intake and 25(OH) vitamin D levels exceeding 20 ng/ml is beneficial for bone health and may decrease to certain extent the risk of fractures. PMID:27603893

  1. Osteoporosis

    MedlinePlus

    ... or she may suggest you have a bone density scan. A common test that measures bone density is called a dual energy X-ray absorptiometry (DEXA). This test measures the density of the bones in your hips, spine and ...

  2. Implant treatment in patients with osteoporosis.

    PubMed

    Mellado-Valero, Ana; Ferrer-García, Juan Carlos; Calvo-Catalá, Javier; Labaig-Rueda, Carlos

    2010-01-01

    Osteoporosis is very common, particularly in post-menopausal women and is characterized by a decrease in bone mass and strength. Osteoporosis also affects the jawbone and it is considered a potential contraindication to placement of dental implants. The present paper reviews the literature regarding the effect of osteoporosis on osseointegration of implants. Experimental models have shown that osteoporosis affects the process of osseointegration, which can be reversed by treatment. However, studies in subjects with osteoporosis have shown no differences in survival of the implants compared to healthy individuals. Therefore, osteoporosis cannot be considered a contraindication for implant placement. Oral bisphosphonates are the most commonly used pharmacological agents in the treatment of osteoporosis. Although there have been cases of osteonecrosis of the jaw in patients treated with bisphosphonates, they are very rare and it is more usually associated with intravenous bisphosphonates in patients with neoplasms or other serious diseases. Nevertheless, patients treated with bisphosphonates must be informed in writing about the possibility of this complication and must give informed consent. Ceasing to use bisphosphonates before implant placement does not seem to be necessary. PMID:19767691

  3. Secondary osteoporosis: differential diagnosis and workup.

    PubMed

    Diab, Dima L; Watts, Nelson B

    2013-12-01

    There are numerous causes of secondary osteoporosis including endocrine disorders, nutritional deficiencies, and other miscellaneous conditions and medications. It is essential to identify and address these factors to appropriately manage patients with osteoporosis. Failure to do so may result in further bone loss despite pharmacologic intervention for osteoporosis. The following diagnostic studies should be considered initially: complete blood count, complete metabolic panel, 25-hydroxyvitamin D level, testosterone level in men, and 24-hour urinary calcium, sodium, and creatinine. Further testing may be performed in selected patients depending on the clinical picture and results of the initial workup. PMID:24100597

  4. [Status and issues of medical treatment for osteoporosis].

    PubMed

    Yamauchi, Mika; Sugimoto, Toshitsugu

    2015-10-01

    Although various osteoporosis medications have become available with proven effects for protecting against bone fracture, such osteoporosis treatment is only given to 20 to 25% of those eligible in Japan. The most urgent task at present is to increase the treatment rate. The guidelines for prevention and treatment of osteoporosis were revised in 2015 and now include criteria for commencing medical treatment. However, guidelines for management of osteoporosis, including the duration of medical treatment for osteoporosis, are still under discussion. PMID:26529921

  5. 72 FR 497 - Food Labeling: Health Claims; Calcium and Osteoporosis, and Calcium, Vitamin D, and Osteoporosis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2007-01-05

    ...The Food and Drug Administration (FDA) is proposing to amend the regulation authorizing a health claim on the relationship between calcium and a reduced risk of osteoporosis to: Include vitamin D so that, in addition to claims for calcium and osteoporosis, additional claims can be made for calcium and vitamin D and osteoporosis; eliminate the requirement in Sec. 101.72(c)(2)(i)(A) (21 CFR......

  6. Star Power

    SciTech Connect

    2014-10-17

    The U.S. Department of Energy's Princeton Plasma Physics Laboratory has released ''Star Power,'' a new informational video that uses dramatic and beautiful images and thought-provoking interviews to highlight the importance of the Laboratory's research into magnetic fusion.

  7. Star Power

    ScienceCinema

    None

    2014-11-18

    The U.S. Department of Energy's Princeton Plasma Physics Laboratory has released ''Star Power,'' a new informational video that uses dramatic and beautiful images and thought-provoking interviews to highlight the importance of the Laboratory's research into magnetic fusion.

  8. Osteoporosis - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Arthritis and Musculoskeletal and Skin Diseases Osteoporosis and Asian American Women English 骨質疏鬆症與亞裔美國婦女 - 繁體中文 (Chinese - Traditional) PDF National Institute ...

  9. Glucocorticoid-Induced Osteoporosis and Osteonecrosis

    PubMed Central

    Weinstein, Robert S.

    2012-01-01

    SYNOPSIS Glucocorticoid administration is the most common cause of secondary osteoporosis and the leading cause of nontraumatic osteonecrosis. In patients receiving long-term therapy, glucocorticoids induce fractures in 30 to 50% and osteonecrosis in 9 to 40%. This article reviews glucocorticoid-induced osteoporosis and osteonecrosis addressing the risk factors, pathogenesis, evaluation, treatment, and uncertainties in the clinical management of these disorders. PMID:22877431

  10. [Therapy of osteoporosis: towards personalized treatment?].

    PubMed

    Harbeck, Birgit; Lehnert, Hendrik

    2015-11-01

    Osteoporosis is the most common clinical disorder of bone metabolism. With regard to the growing spectrum of therapy options, treatment decisions should be made on an individual basis, taking into account the relative benefits and risks in different patient populations. Prioritization of drugs should be based on the form (primary / secondary) and severity of osteoporosis, sex, age, the specific contraindications and precautions of use of the various available medications and in particular, existing comorbidities. PMID:26536644

  11. Preventing osteoporosis in every day life.

    PubMed

    Lau, E M C

    2004-03-01

    Osteoporosis is a condition characterized by low bone mineral density, microarchitectural deterioration of bone tissue, and a consequent increase in fracture risk. The public health impact of osteoporosis stems from its association with fractures of the hip, spine and forearm. Between 10 and 20 percent of hip fracture patients die within a year of the event, and among those who survive, almost two-thirds remain disabled. The medical costs of osteoporosis and its attendant fractures have been placed at 5.2 billion dollars each year in the US and 615 million pound sterling each year in the UK. In Asia, osteoporosis is rapidly becoming a major public health problem with an increasing incidence of hip fracture and a rapidly aging population. By the year 2050, more than half of the hip fracture around the world would occur in Asia, with the total number approaching 3.2 million. Osteoporosis can be attributed to both genetic factors and environmental factors. While it is difficult to modify genes, much can be done to prevent osteoporosis in our every day life. These are discussed below. PMID:15577003

  12. Mechanisms of osteocyte stimulation in osteoporosis.

    PubMed

    Verbruggen, Stefaan W; Vaughan, Ted J; McNamara, Laoise M

    2016-09-01

    Experimental studies have shown that primary osteoporosis caused by oestrogen-deficiency results in localised alterations in bone tissue properties and mineral composition. Additionally, changes to the lacunar-canalicular architecture surrounding the mechanosensitive osteocyte have been observed in animal models of the disease. Recently, it has also been demonstrated that the mechanical stimulation sensed by osteocytes changes significantly during osteoporosis. Specifically, it was shown that osteoporotic bone cells experience higher maximum strains than healthy bone cells after short durations of oestrogen deficiency. However, in long-term oestrogen deficiency there was no significant difference between bone cells in healthy and normal bone. The mechanisms by which these changes arise are unknown. In this study, we test the hypothesis that complex changes in tissue composition and lacunar-canalicular architecture during osteoporosis alter the mechanical stimulation of the osteocyte. The objective of this research is to employ computational methods to investigate the relationship between changes in bone tissue composition and microstructure and the mechanical stimulation of osteocytes during osteoporosis. By simulating physiological loading, it was observed that an initial decrease in tissue stiffness (of 0.425GPa) and mineral content (of 0.66wt% Ca) relative to controls could explain the mechanical stimulation observed at the early stages of oestrogen deficiency (5 weeks post-OVX) during in situ bone cell loading in an oestrogen-deficient rat model of post-menopausal osteoporosis (Verbruggen et al., 2015). Moreover, it was found that a later increase in stiffness (of 1.175GPa) and mineral content (of 1.64wt% Ca) during long-term osteoporosis (34 weeks post-OVX), could explain the mechanical stimuli previously observed at a later time point due to the progression of osteoporosis. Furthermore, changes in canalicular tortuosity arising during osteoporosis were shown

  13. 73 FR 66754 - Food Labeling: Health Claims; Calcium and Osteoporosis, and Calcium, Vitamin D, and Osteoporosis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2008-11-12

    ... Osteoporosis, and Calcium, Vitamin D, and Osteoporosis AGENCY: Food and Drug Administration, HHS. ACTION: Final... appeared in the Federal Register of Monday, September 29, 2008 (73 FR 56477). The final rule was published...-436-1450. SUPPLEMENTARY INFORMATION: In FR Doc. E8-22730, appearing on page 56477 in the...

  14. Osteoporosis in unstable adult scoliosis

    SciTech Connect

    Velis, K.P.; Healey, J.H.; Schneider, R.

    1988-12-01

    New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.

  15. Osteoporosis in survivors of early life starvation.

    PubMed

    Weisz, George M; Albury, William R

    2013-01-01

    The objective of this study was to provide evidence for the association of early life nutritional deprivation and adult osteoporosis, in order to suggest that a history of such deprivation may be an indicator of increased risk of osteoporosis in later life. The 'fetal programming' of a range of metabolic and cardiovascular disorders in adults was first proposed in the 1990s and more recently extended to disorders of bone metabolism. Localised famines during World War II left populations in whom the long-term effects of maternal, fetal and infantile nutritional deprivation were studied. These studies supported the original concept of 'fetal programming' but did not consider bone metabolism. The present paper offers clinical data from another cohort of World War II famine survivors - those from the Holocaust. The data presented here, specifically addressing the issue of osteoporosis, report on 11 Holocaust survivors in Australia (five females, six males) who were exposed to starvation in early life. The cases show, in addition to other metabolic disorders associated with early life starvation, various levels of osteoporosis, often with premature onset. The cohort studied is too small to support firm conclusions, but the evidence suggests that the risk of adult osteoporosis in both males and females is increased by severe starvation early in life - not just in the period from gestation to infancy but also in childhood and young adulthood. It is recommended that epidemiological research on this issue be undertaken, to assist planning for the future health needs of immigrants to Australia coming from famine affected backgrounds. Pending such research, it would be prudent for primary care health workers to be alert to the prima facie association between early life starvation and adult osteoporosis, and to take this factor into account along with other indicators when assessing a patient's risk of osteoporosis in later life. PMID:22951115

  16. Osteoporosis in paediatric patients with spina bifida

    PubMed Central

    Marreiros, Humberto Filipe; Loff, Clara; Calado, Eulalia

    2012-01-01

    The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Methods Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB. PMID:22330186

  17. Osteoporosis Prevention, Screening, and Treatment: A Review

    PubMed Central

    Kling, Juliana M.; Clarke, Bart L.

    2014-01-01

    Abstract Osteoporosis, defined as low bone mass leading to increased fracture risk, is a major health problem that affects approximately 10 million Americans. The aging U.S. population is predicted to contribute to as much as a 50% increase in prevalence by 2025. Although common, osteoporosis can be clinically silent, and without prevention and screening, the costs of osteoporotic fracture–related morbidity and mortality will burden the U.S. healthcare system. This is a particularly relevant concern in the context of diminishing health care resources. Dual-energy X-ray absorptiometry is the most widely used, validated technique for measuring bone mineral density (BMD) and diagnosing osteoporosis. Cost-effectiveness analyses support early detection and treatment of high-risk patients with antiresorptive medications such as bisphosphonates. Moreover, optimization of bone health throughout life can help prevent osteoporosis. Current guidelines recommend screening women by age 65 years, but because no guidelines for screening intervals exist, decisions are made on the basis of clinical judgment alone. Although the recent literature provides some guidance, this review further explores current recommendations in light of newer evidence to provide more clarity on prevention, screening, and management strategies for patients with osteoporosis in the primary care setting. PMID:24766381

  18. Management of osteoporosis in spine surgery.

    PubMed

    Lehman, Ronald A; Kang, Daniel Gene; Wagner, Scott Cameron

    2015-04-01

    Osteoporosis is a burgeoning clinical problem that is characterized by decreased bone strength and density. It predisposes patients to fragility fractures and debilitating spine deformities. Several complications are associated with spine surgery in patients with osteoporosis, and there is currently no treatment algorithm to guide the spine surgeon. A multidisciplinary approach to treatment of patients with osteoporosis and spine deformity or fracture is encouraged, and preoperative planning is crucial for successful surgical outcomes. Several surgical techniques have been developed to treat osteoporosis-related deformities, including posterior instrumentation with fusion. However, achieving fixation and fusion in these patients can be difficult secondary to poor bone stock. Augmentation methods to improve pedicle screw fixation have evolved, including instrumentation at multiple levels, bioactive cement augmentation, and fenestrated or expandable pedicle screws, but their impact on clinical outcomes remains unknown. Management of osteoporosis in patients undergoing spine surgery is challenging, but with appropriate patient selection, medical optimization, and surgical techniques, these patients can experience pain relief, deformity correction, and improved function. PMID:25808687

  19. Osteoporosis in the at-risk asthmatic.

    PubMed

    Aljubran, S A; Whelan, G J; Glaum, M C; Lockey, R F

    2014-11-01

    The effect of inhaled glucocorticosteroids (ICS) on bone metabolism and subsequent osteoporosis is controversial. Explanations for this controversy include various study designs, duration of use, outcome measures, and population demographics of research studies with intranasal or inhalational ICS. Patients with poorly controlled asthma are at greatest risk of osteoporosis because they are commonly treated with intermittent or continuous systemic corticosteroids (SCS) or high-dose ICS. A 45-year-old Caucasian woman presents with moderate-to-severe asthma with frequent albuterol use and nighttime awakenings at least once weekly. She is on fluticasone/salmeterol 500/50 μg one inhalation twice daily and montelukast 10 mg/day. She requires prednisone 15 mg three times per day for 5 days up to three times a year. Is this patient at greater risk of osteopenia, characterized by a T-score between -1.0 and -2.5, and subsequent osteoporosis and an increased risk of fractures? If she has osteopenia, should she be treated with a bisphosphonate? The risk of osteoporosis and fracture increases significantly with frequent administration of SCS, and patients on such medications should undergo preventative measures and treatment. This study discuses factors that contribute to an increased risk of osteoporosis/osteopenia in patients with asthma and suggests recommendations based on the current literature. PMID:25039444

  20. What Are Osteoporosis and Arthritis and How Are They Different?

    MedlinePlus

    ... and Other Related Conditions: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ... www.niams.nih.gov NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  1. For People with Osteoporosis: How to Find a Doctor

    MedlinePlus

    ... No. 15-7888-E NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ... another language, contact the NIH Osteoporosis and Related Bone Diseases ~ National Resource Center at NIHBoneInfo@mail.nih.gov . ...

  2. What People with Celiac Disease Need to Know about Osteoporosis

    MedlinePlus

    ... ligand (RANKL) inhibitor. Resources NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... Pub. No. 16-7897 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  3. A review of osteoporosis management in younger premenopausal women.

    PubMed

    McLendon, Amber N; Woodis, C Brock

    2014-01-01

    The purpose of this review is to describe the available evidence for osteoporosis treatments in young and premenopausal women. A review of articles evaluating the treatment or prevention of osteoporosis in young (age less than 50 years) or premenopausal women was conducted. Several trials evaluating the treatment of anorexia nervosa and use of hormone therapy in those women, the use of bisphosphonates in women undergoing chemotherapy for breast cancer and the use of bisphosphonates, teriparatide and vitamin D in women with glucocorticoid-induced osteoporosis are described. Limited data were found to support the treatment of osteoporosis in women with idiopathic osteoporosis or cystic fibrosis, or after kidney transplant. The evidence for treatment of osteoporosis in premenopausal women is not nearly as robust as that for postmenopausal osteoporosis. Although fracture risk in the premenopausal population is low, women with secondary osteoporosis may benefit from treatment with various agents, depending upon the condition. PMID:24328599

  4. Injected Drug May Help Fight Osteoporosis in Women

    MedlinePlus

    ... fullstory_160452.html Injected Drug May Help Fight Osteoporosis in Women Abaloparatide appears to reduce fractures better ... risk of bone fractures in postmenopausal women with osteoporosis better than a placebo and the currently available ...

  5. On the conversion of neutron stars into quark stars

    NASA Astrophysics Data System (ADS)

    Pagliara, Giuseppe

    2014-03-01

    The possible existence of two families of compact stars, neutron stars and quark stars, naturally leads to a scenario in which a conversion process between the two stellar objects occurs with a consequent release of energy of the order of 1053 erg. We discuss recent hydrodynamical simulations of the burning process and neutrino diffusion simulations of cooling of a newly formed strange star. We also briefly discuss this scenario in connection with recent measurements of masses and radii of compact stars.

  6. Osteoporosis in chronic obstructive pulmonary disease.

    PubMed

    Sarkar, Malay; Bhardwaj, Rajeev; Madabhavi, Irappa; Khatana, Jasmin

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a lifestyle-related chronic inflammatory pulmonary disease associated with significant morbidity and mortality worldwide. COPD is associated with various comorbidities found in all stages of COPD. The comorbidities have significant impact in terms of morbidity, mortality, and economic burden in COPD. Management of comorbidities should be incorporated into the comprehensive management of COPD as this will also have an effect on the outcome in COPD patients. Various comorbidities reported in COPD include cardiovascular disease, skeletal muscle dysfunction, anemia, metabolic syndrome, and osteoporosis. Osteoporosis is a significant comorbidity in COPD patients. Various risk factors, such as tobacco smoking, systemic inflammation, vitamin D deficiency, and the use of oral or inhaled corticosteroids (ICSs) are responsible for its occurrence in patients with COPD. This review will focus on the prevalence, pathogenesis, risk factors, diagnosis, and treatment of osteoporosis in COPD patients. PMID:25788838

  7. [Advances in the treatment of secondary osteoporosis].

    PubMed

    Galindo Zavala, R; Núñez Cuadros, E; Díaz Cordovés-Rego, G; Urda Cardona, A L

    2014-12-01

    Osteoporosis is being increasingly recognised in paediatric practice as a consequence of the increasing life expectancy of children who suffer from chronic diseases and other factors. There are many non-pharmacological measures that can improve children' bone health, for example, avoiding inflammatory activity and osteotoxic treatments; increasing sun exposure and weight-bearing exercise, and maintaining an adequate nutritional status. Vitamin D and calcium supplements have been proposed as a measure to increase bone mass, but their effect and therapeutic indications are not completely clear. On the other hand, bisphosphonates are currently the only pharmacological alternative for the patients with infantile secondary osteoporosis. However, more studies are required on the therapeutic indications, posology, and long term secondary effects of biphosphonates. The aim of this article is to analyze the scientific evidence of the effectiveness of the therapeutic alternatives for childhood secondary osteoporosis and their safety in children. PMID:25441207

  8. Osteoporosis in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Sarkar, Malay; Bhardwaj, Rajeev; Madabhavi, Irappa; Khatana, Jasmin

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a lifestyle-related chronic inflammatory pulmonary disease associated with significant morbidity and mortality worldwide. COPD is associated with various comorbidities found in all stages of COPD. The comorbidities have significant impact in terms of morbidity, mortality, and economic burden in COPD. Management of comorbidities should be incorporated into the comprehensive management of COPD as this will also have an effect on the outcome in COPD patients. Various comorbidities reported in COPD include cardiovascular disease, skeletal muscle dysfunction, anemia, metabolic syndrome, and osteoporosis. Osteoporosis is a significant comorbidity in COPD patients. Various risk factors, such as tobacco smoking, systemic inflammation, vitamin D deficiency, and the use of oral or inhaled corticosteroids (ICSs) are responsible for its occurrence in patients with COPD. This review will focus on the prevalence, pathogenesis, risk factors, diagnosis, and treatment of osteoporosis in COPD patients. PMID:25788838

  9. Treatment options for thalassemia patients with osteoporosis.

    PubMed

    Terpos, Evangelos; Voskaridou, Ersi

    2010-08-01

    Osteoporosis represents a prominent cause of morbidity in patients with thalassemia. The delay in sexual maturation, the presence of diabetes and hypothyroidism, the parathyroid gland dysfunction, the progressive marrow expansion, the iron toxicity on osteoblasts, the iron chelators, and the deficiency of growth hormone or insulin growth factors have been identified as major causes of osteoporosis in thalassemia. Adequate hormonal replacement, effective iron chelation, improvement of hemoglobin levels, calcium and vitamin D administration, physical activity, and smoking cessation are the main to-date measures for the management of the disease. During the last decade, novel pathogenetic data suggest that the reduced osteoblastic activity, which is believed to be the basic mechanism of bone loss in thalassemia, is accompanied by a comparable or even greater increase in bone resorption. Therefore, the role of bisphosphonates, potent inhibitors of osteoclast activation, arises as a major factor in the management of osteoporosis in thalassemia patients. PMID:20712799

  10. New Antiresorptive Therapies for Postmenopausal Osteoporosis

    PubMed Central

    2015-01-01

    Osteoporosis is a systemic skeletal disease whose risk increases with age and it is common among postmenopausal women. Currently, almost all pharmacological agents for osteoporosis target the bone resorption component of bone remodeling activity. Current antiresorptive agents are effective, but the effectiveness of some agents is limited by real or perceived intolerance, longterm adverse events (AEs), coexisting comorbidities, and inadequate long-term adherence. New antiresorptive therapies that may expand options for the prevention and treatment of osteoporosis include denosumab, combination of conjugated estrogen/bazedoxifene and cathepsin K inhibitors. However, the long-term efficacy and AEs of these antiresorptive therapies need to be confirmed in studies with a longer follow-up period. PMID:26046031

  11. The link between osteoporosis and cardiovascular disease

    PubMed Central

    Farhat, Ghada N.; Cauley, Jane A.

    2008-01-01

    Cardiovascular disease (CVD) and osteoporosis are common age-related conditions associated with significant morbidity, mortality, and disability. Traditionally, these two conditions were considered unrelated and their coexistence was attributed to independent age-related processes. However, an increasing body of biological and epidemiological evidence has provided support for a link between the two conditions that cannot be explained by age alone. Several hypotheses have been proposed to explain the link between osteoporosis and CVD including: 1) shared risk factors, 2) common pathophysiological mechanisms, 3) common genetic factors, or 4) a causal association. This review highlights the epidemiologic literature on the association of bone density with cardiovascular mortality, cardiovascular morbidity, and subclinical measures of atherosclerosis. It also summarizes the different potential mechanisms involved in the link between osteoporosis and CVD. PMID:22460842

  12. Osteoporosis Health Beliefs among Younger and Older Men and Women

    ERIC Educational Resources Information Center

    Johnson, C. Shanthi; McLeod, William; Kennedy, Laura; McLeod, Katherine

    2008-01-01

    The purpose of this study was to compare osteoporosis health beliefs among different age and gender groups. This study used a cross-sectional design, involved 300 participants that represent both genders and three age groups (18 to 25, 30 to 50, and 50-plus), and assessed osteoporosis health beliefs using the Osteoporosis Health Belief Scale…

  13. Osteoporosis and Arthritis: Two Common but Different Conditions

    MedlinePlus

    ... situation. Most people with arthritis will use pain management strategies at some time. This is not always true for people with osteoporosis. Usually, people with osteoporosis need pain relief when they ... pain management strategies are similar for people with osteoporosis, OA, ...

  14. Transient osteoporosis of the hip in pregnancy.

    PubMed

    Siva, S; Roach, V

    1997-08-01

    Transient osteoporosis of the hip (TOH) is an uncommon condition. This painful regional osteoporosis affects previously healthy women in the third trimester of pregnancy. It is characterized by pain in the affected hip and pronounced osteopenia of the femoral head and neck. It has a relatively short clinical course (average 6 months) and a predictably benign prognosis. Complete clinical and radiological recovery is the rule. The diagnosis is one of exclusion. The cause of the osteopenia is not known, although various aetiological factors have been implicated. A case of TOH occurring in the third trimester of pregnancy with complete recovery within 6 months postpartum is presented. PMID:9325501

  15. Premenopausal bone health: osteoporosis in premenopausal women.

    PubMed

    Abraham, Alice; Cohen, Adi; Shane, Elizabeth

    2013-12-01

    This article will discuss the diagnosis of osteoporosis in premenopausal women and the evaluation and management of those with low-trauma fractures and/or low bone mineral density. As secondary causes (glucocorticoid excess, anorexia nervosa, premenopausal estrogen deficiency, and celiac disease) are commonly the underlying cause of osteoporosis in this population, treatment of the underlying condition should be the focus of management. Additional management options, generally reserved for those with major or multiple fractures and/or ongoing bone loss, will also be described. PMID:24022503

  16. Osteoporosis-pseudoglioma syndrome in South Africa.

    PubMed

    Chetty, M; Stephen, L X G; Roberts, T

    2016-01-01

    The osteoporosis-pseudoglioma syndrome (MIM 259770) is a rare autosomal recessive disorder in which bone fragility and frequent fractures are associated with serious ocular changes. The skeletal manifestations resemble those of osteogenesis imperfecta while hyperplasia of the vitreous, eye and corneal opacities often mimics the appearance of intraocular glioma. This disorder was previously reported in a South African family of Indian stock as 'the ocular form of osteogenesis imperfecta'. Terminological discussion followed and it was suggested that these individuals had osteoporosis-pseudoglioma syndrome. This article describes and depicts the manifestations of the disorder and discusses the nosology. PMID:27245540

  17. Stars and star systems

    NASA Astrophysics Data System (ADS)

    Martynov, D. Ia.

    Topics examined include close binary systems, supernovae and their remnants, variable stars, young star groups (e.g., clusters and associations), spherical star clusters, and planetary nebulae. Also considered are the interstellar medium and star formation, systems of galaxies, and current problems in cosmology.

  18. Bone regeneration associated with nontherapeutic and therapeutic surface coatings for dental implants in osteoporosis.

    PubMed

    Alghamdi, Hamdan S; Jansen, John A

    2013-06-01

    Oral implantology is considered as the treatment of choice for replacing missing teeth in elderly people. However, implant complications may occur in patients with osteoporosis. The pathogenesis underlying osteoporosis is due to an alteration in bone cell response to hormonal, nutritional, and aging factors. For such challenging situations, improved bone regeneration has been shown around dental implants for certain surface modifications. These modifications include coatings of titanium implants with calcium phosphate (CaP) ceramics. Surface coating developments also allow for the addition of organic biomolecules, like growth factors, into the inorganic coatings that increase the bone formation process at the bone-implant interface. The application of therapeutic-based coatings is becoming a rapidly growing research field of interest. CaP-coated implants have the ability to incorporate anti-osteoporotic drugs, which then can be locally released over time from an implant surface in a controlled manner. Thus, it can be anticipated that nontherapeutic and/or therapeutic coated implants can significantly increase low bone density as well as improve impaired bone regeneration in osteoporosis. This review aims to provide a thorough understanding of the underlying mechanisms for impaired bone regeneration around dental implants in osteoporosis. Secondly, the review will focus on biological interactions and beneficial role of the surface-coated (i.e., nontherapeutics and therapeutics) bone implants in osteoporotic bone tissue. PMID:23088597

  19. Management of endocrine disease: Secondary osteoporosis: pathophysiology and management.

    PubMed

    Mirza, Faryal; Canalis, Ernesto

    2015-09-01

    Osteoporosis is a skeletal disorder characterized by decreased mass and compromised bone strength predisposing to an increased risk of fractures. Although idiopathic osteoporosis is the most common form of osteoporosis, secondary factors may contribute to the bone loss and increased fracture risk in patients presenting with fragility fractures or osteoporosis. Several medical conditions and medications significantly increase the risk for bone loss and skeletal fragility. This review focuses on some of the common causes of osteoporosis, addressing the underlying mechanisms, diagnostic approach and treatment of low bone mass in the presence of these conditions. PMID:25971649

  20. Bone mineral density: testing for osteoporosis

    PubMed Central

    Sheu, Angela; Diamond, Terry

    2016-01-01

    Summary Primary osteoporosis is related to bone loss from ageing. Secondary osteoporosis results from specific conditions that may be reversible. A thoracolumbar X-ray is useful in identifying vertebral fractures, and dual energy X-ray absorptiometry is the preferred method of calculating bone mineral density. The density of the total hip is the best predictor for a hip fracture, while the lumbar spine is the best site for monitoring the effect of treatment. The T-score is a comparison of the patient’s bone density with healthy, young individuals of the same sex. A negative T-score of –2.5 or less at the femoral neck defines osteoporosis. The Z-score is a comparison with the bone density of people of the same age and sex as the patient. A negative Z-score of –2.5 or less should raise suspicion of a secondary cause of osteoporosis. Clinical risk calculators can be used to predict the 10-year probability of a hip or major osteoporotic fracture. A probability of more than 5% for the hip or more than 20% for any fracture is abnormal and treatment may be warranted. PMID:27340320

  1. The Effect of Fluoride in Osteoporosis.

    ERIC Educational Resources Information Center

    Hedlund, L. R.; Gallagher, J. C.

    1987-01-01

    This article discusses the effect of fluoride on bone tissue and the possible role of fluoride in the treatment of osteoporosis. At present, fluoride treatment should be restricted to clinical trials until its risks and benefits have been further evaluated. (Author/MT)

  2. Better Bones Buddies: An Osteoporosis Prevention Program

    ERIC Educational Resources Information Center

    Schrader, Susan L.; Blue, Rebecca; Horner, Arlene

    2005-01-01

    Although osteoporosis typically surfaces in later life, peak bone mass attained before age 20 is a key factor in its prevention. However, most American children's diets lack sufficient calcium during the critical growth periods of preadolescence and adolescence to achieve peak bone mass. "Better Bones (BB) Buddies" is an educational program…

  3. Osteoporosis: What is the Role of Exercise?

    ERIC Educational Resources Information Center

    Munnings, Frances

    1992-01-01

    Research has not yet identified the best combination of estrogen replacement, calcium, and exercise for fighting osteoporosis, but clinical experience indicates all are needed to prevent the rapid bone loss that occurs in postmenopausal women. Physicians must encourage women to reduce their risk using all available options. (SM)

  4. Osteoporosis Risk Factors in Eighth Grade Students.

    ERIC Educational Resources Information Center

    Lysen, Victoria C.; Walker, Robert

    1997-01-01

    Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…

  5. [Drug therapy for primary osteoporosis in men].

    PubMed

    Soen, Satoshi

    2016-07-01

    Overall, drug therapies for osteoporosis in men are less defined than in women, mainly due to the fact that there are fewer RCTs performed in male populations, to the relatively smaller sample sizes, and to the lack of long-term extension studies. In a series of well-designed RCTs, alendronate, risedronate, zoledronic acid, and teriparatide were demonstrated to reduce the risk of new vertebral fractures in men presenting with primary osteoporosis(including osteoporosis associated with low testosterone levels)and to improve the bone mineral density(BMD). In preliminary studies, ibandronate and denosumab also showed their beneficial effects on surrogate outcomes(BMD and markers of bone turnover)in men with osteoporosis. Although direct evidence about their non-vertebral anti-fracture efficacy are lacking, the effects of bisphosphonates, denosumab and teriparatide on surrogate outcomes were similar to those reported in pivotal RCTs undertaken in postmenopausal women, in which vertebral and non-vertebral anti-fracture efficacy have been clearly demonstrated. PMID:27346317

  6. Osteoporosis: Its Prosthodontic Considerations - A Review

    PubMed Central

    Munagapati, Bharathi; Karnati, Rajeev K Reddy; Venkata, Giridhar Reddy Sirupa; Nidudhur, Simhachalam Reddy

    2015-01-01

    Osteoporosis is a disease of bone which is common in middle aged post-menopausal women. The osteoporotic bones will become weak and are prone to fractures. Osteoporosis means “porous bone” is a “silent disease”. Healthy bone microscopically appears like a honeycomb but, in osteoporotic patients the spaces are much bigger. The osteoporotic bone will have less density or mass and the structure of bone tissue is abnormal. As the bone becomes less dense, they become weaker and more likely to fracture. Women are four times more likely to develop osteoporosis than men. Oral health maintenance for adults with osteoporosis is important. Bone weakness and loss may also affect the ridges that hold dentures resulting in poor fitting dentures. The patients require new dentures more often than those who have strong, healthy bones. Best way to handle problems is avoid delaying or postponing the dental treatment. Regular dental visits and healthy lifestyle is necessary in strengthening and maintenance of good bone health. Well balanced diet with high amounts of vitamin-D & calcium with regular physical activity is recommended. PMID:26816999

  7. Management of beta-thalassemia-associated osteoporosis.

    PubMed

    Giusti, Andrea; Pinto, Valeria; Forni, Gian Luca; Pilotto, Alberto

    2016-03-01

    Beta-Thalassemia-associated osteoporosis is a multifactorial and complex condition. Different acquired and genetic factors are involved in its pathogenesis. These factors produce an imbalance in bone remodeling by inhibiting osteoblast activity and increasing osteoclast function, leading to bone loss and increased fracture risk. The management of patients presenting with thalassemia-associated osteoporosis should consist of the implementation of general measures and the prescription of a specific pharmacological agent, with the aim of reducing fracture risk and preventing disability and deterioration of quality of life. General measures include control of anemia, adequate chelation therapy, healthy nutrition and lifestyle, regular exercise, adequate management of comorbid conditions, hormone replacement therapy in patients with hypogonadism, and vitamin D supplementation/therapy. Among the pharmacological agents currently available for the management of osteoporosis in postmenopausal women and men, bisphosphonates have been shown to improve bone mineral density, to reduce bone turnover, and to decrease bone/back pain in patients with thalassemia-associated osteoporosis, with a good profile of safety and tolerability. On the other hand, there are limited experiences with other pharmacological agents (e.g., denosumab or teriparatide). The complexity of this condition presents diagnostic and therapeutic challenges and underscores the importance of a comprehensive and multidisciplinary approach. PMID:27060977

  8. Bisphosphonates adherence for treatment of osteoporosis

    PubMed Central

    2013-01-01

    Background Osteoporosis is a disease of bone metabolism in which bisphosphonates (BPS) are the most common medications used in its treatment, whose main objective is to reduce the risk of fractures. The aim of this study was to conduct a systematic review on BPs adherence for treatment of osteoporosis. Methods Systematic review of articles on BPs adherence for treatment of osteoporosis, indexed on MEDLINE (via PubMed) databases, from inception of databases until January 2013. Search terms were “Adherence, Medication” (MeSH term), “Bisphosphonates” (MeSH term), and “Osteoporosis” (MeSH term). Results Of the 78 identified studies, 27 met the eligibility criteria. Identified studies covered a wide range of aspects regarding adherence and associated factors, adherence and fracture, adherence and BPs dosage. The studies are mostly observational, conducted with women over 45 years old, showing low rates of adherence to treatment. Several factors may influence adherence: socio-economic and cultural, participation of physicians when guidance is given to the patient, the use of bone turnover markers, and use of generic drugs. The monthly dosage is associated with greater adherence compared to weekly dosage. Conclusions Considering the methodological differences between the studies, the results converge to show that adherence to treatment of osteoporosis with BPs is still inadequate. Further experimental studies are needed to evaluate the adherence and suggest new treatment options. PMID:23705998

  9. [New strategies for exercise training in osteoporosis].

    PubMed

    Winkelmann, A; Schilling, S; Neuerburg, C; Mutschler, W; Böcker, W; Felsenberg, D; Stumpf, U

    2015-11-01

    In the prevention and treatment of osteoporosis, movement with muscle strengthening and proprioceptive training plays a major role. This was taken into consideration in the guidelines by the governing body on osteoporosis (Dachverband Osteoporose, DVO) from 2014 on prophylaxis, diagnosis and treatment of osteoporosis and in the DVO guidelines from 2008 on physiotherapy and exercise therapy for osteoporosis. Increases in lumbar bone density of between 0.5 % and 2.5 % can be achieved in women by strengthening exercises with high resistance. With this combination and strengthening of the quadriceps muscle a reduction of falls and hence the fracture risk could also be achieved. In traumatology, training for muscle strengthening is not always possible, especially for elderly patients. Practically relevant alternatives are regular walking and aquatraining, which may also lead to a significant increase in bone mineral density. Furthermore, large effects can be achieved with alternating side whole-body vibration (WBV) training with whole body vibration plates with only 3 days of training per week and with short training periods (15-20 min). Rates of increase in leg strength between 20 % and almost 40 % and in bone density between 0.5 % and 4 % in 6 months have been described. Whether and with what intensity whole body vibration therapy could be used for e.g. more rapid healing of fractures, is currently unclear. Initial positive results have been described in animal models. PMID:26467265

  10. Immunology of Osteoporosis: A Mini-Review.

    PubMed

    Pietschmann, Peter; Mechtcheriakova, Diana; Meshcheryakova, Anastasia; Föger-Samwald, Ursula; Ellinger, Isabella

    2016-01-01

    Osteoporosis is a major cause of fractures and associated morbidity in the aged population. The pathogenesis of osteoporosis is multifactorial; whereas traditional pathophysiological concepts emphasize endocrine mechanisms, it has been recognized that also components of the immune system have a significant impact on bone. Since 2000, when the term 'osteoimmunology' was coined, novel insights into the role of inflammatory cytokines by influencing the fine-tuned balance between bone resorption and bone formation have helped to explain the occurrence of osteoporosis in conjunction with chronic inflammatory reactions. Moreover, the phenomenon of a low-grade, chronic, systemic inflammatory state associated with aging has been defined as 'inflamm-aging' by Claudio Franceschi and has been linked to age-related diseases such as osteoporosis. Given the tight anatomical and physiological coexistence of B cells and the bone-forming units in the bone marrow, a role of B cells in osteoimmunological interactions has long been suspected. Recent findings of B cells as active regulators of the RANK/RANKL/OPG axis, of altered RANKL/OPG production by B cells in HIV-associated bone loss or of a modulated expression of genes linked to B-cell biology in response to estrogen deficiency support this assumption. Furthermore, oxidative stress and the generation of advanced glycation end products have emerged as links between inflammation and bone destruction. PMID:26088283

  11. Osteoporosis in German men: a cost-of-illness study.

    PubMed

    Berghaus, Sabine; Müller, Dirk; Gandjour, Afschin; Civello, Daniele; Stock, Stephanie

    2015-06-01

    Costs of male osteoporosis may have increased due to population aging and change of treatment patterns. This cost-of-illness study provides a current estimate of the economic burden of male osteoporosis in Germany. Routine claims data from six German sickness funds were analyzed and extrapolated to the German statutory health insurance (SHI). For men above the age of 50 with at least one ICD-10 osteoporosis-related diagnosis or osteoporosis-related fracture in 2010, direct costs related to osteoporosis were considered based on a payer's perspective. Total direct costs attributable to osteoporosis amounted to €728 million in 2010. The majority of these costs (71%) resulted from inpatient treatment due to fractures. Patients aged 75 and older caused approximately 63% of costs. Male osteoporosis represents a non-negligible economic burden for the German health care system. Targeted prevention and promotion measures should be offered both to men and women. PMID:25495596

  12. Multiscale alterations in bone matrix quality increased fragility in steroid induced osteoporosis.

    PubMed

    Karunaratne, A; Xi, L; Bentley, L; Sykes, D; Boyde, A; Esapa, C T; Terrill, N J; Brown, S D M; Cox, R D; Thakker, R V; Gupta, H S

    2016-03-01

    A serious adverse clinical effect of glucocorticoid steroid treatment is secondary osteoporosis, enhancing fracture risk in bone. This rapid increase in bone fracture risk is largely independent of bone loss (quantity), and must therefore arise from degradation of the quality of the bone matrix at the micro- and nanoscale. However, we lack an understanding of both the specific alterations in bone quality n steroid-induced osteoporosis as well as the mechanistic effects of these changes. Here we demonstrate alterations in the nanostructural parameters of the mineralized fibrillar collagen matrix, which affect bone quality, and develop a model linking these to increased fracture risk in glucocorticoid induced osteoporosis. Using a mouse model with an N-ethyl-N-nitrosourea (ENU)-induced corticotrophin releasing hormone promoter mutation (Crh(-120/+)) that developed hypercorticosteronaemia and osteoporosis, we utilized in situ mechanical testing with small angle X-ray diffraction, synchrotron micro-computed tomography and quantitative backscattered electron imaging to link altered nano- and microscale deformation mechanisms in the bone matrix to abnormal macroscopic mechanics. We measure the deformation of the mineralized collagen fibrils, and the nano-mechanical parameters including effective fibril modulus and fibril to tissue strain ratio. A significant reduction (51%) of fibril modulus was found in Crh(-120/+) mice. We also find a much larger fibril strain/tissue strain ratio in Crh(-120/+) mice (~1.5) compared to the wild-type mice (~0.5), indicative of a lowered mechanical competence at the nanoscale. Synchrotron microCT show a disruption of intracortical architecture, possibly linked to osteocytic osteolysis. These findings provide a clear quantitative demonstration of how bone quality changes increase macroscopic fragility in secondary osteoporosis. PMID:26657825

  13. Multiscale alterations in bone matrix quality increased fragility in steroid induced osteoporosis

    PubMed Central

    Karunaratne, A.; Xi, L.; Bentley, L.; Sykes, D.; Boyde, A.; Esapa, C.T.; Terrill, N.J.; Brown, S.D.M.; Cox, R.D.; Thakker, R.V.; Gupta, H.S.

    2016-01-01

    A serious adverse clinical effect of glucocorticoid steroid treatment is secondary osteoporosis, enhancing fracture risk in bone. This rapid increase in bone fracture risk is largely independent of bone loss (quantity), and must therefore arise from degradation of the quality of the bone matrix at the micro- and nanoscale. However, we lack an understanding of both the specific alterations in bone quality n steroid-induced osteoporosis as well as the mechanistic effects of these changes. Here we demonstrate alterations in the nanostructural parameters of the mineralized fibrillar collagen matrix, which affect bone quality, and develop a model linking these to increased fracture risk in glucocorticoid induced osteoporosis. Using a mouse model with an N-ethyl-N-nitrosourea (ENU)-induced corticotrophin releasing hormone promoter mutation (Crh− 120/+) that developed hypercorticosteronaemia and osteoporosis, we utilized in situ mechanical testing with small angle X-ray diffraction, synchrotron micro-computed tomography and quantitative backscattered electron imaging to link altered nano- and microscale deformation mechanisms in the bone matrix to abnormal macroscopic mechanics. We measure the deformation of the mineralized collagen fibrils, and the nano-mechanical parameters including effective fibril modulus and fibril to tissue strain ratio. A significant reduction (51%) of fibril modulus was found in Crh− 120/+ mice. We also find a much larger fibril strain/tissue strain ratio in Crh− 120/+ mice (~ 1.5) compared to the wild-type mice (~ 0.5), indicative of a lowered mechanical competence at the nanoscale. Synchrotron microCT show a disruption of intracortical architecture, possibly linked to osteocytic osteolysis. These findings provide a clear quantitative demonstration of how bone quality changes increase macroscopic fragility in secondary osteoporosis. PMID:26657825

  14. Prevalence of osteoporosis in patients awaiting total hip arthroplasty

    PubMed Central

    Domingues, Vitor Rodrigues; de Campos, Gustavo Constantino; Plapler, Pérola Grimberg; de Rezende, Márcia Uchôa

    2015-01-01

    Objective: To evaluate the prevalence of osteoporosis in patients awaiting total hip arthroplasty. Method: Twenty-nine patients diagnosed with hip osteoarthritis awaiting primary total arthroplasty of the hip answered WOMAC questionnaire, VAS and questions about habits, osteoporosis and related diseases. Bone mineral densitometry of the lumbar spine and hips and laboratory tests (complete blood count and examination of calcium metabolism) were performed. Weight and height were measured to calculate body mass index (BMI). The evaluated quantitative characteristics were compared between patients with and without osteoporosis using the Mann-Whitney tests. Results: Thirteen men and 16 women with a mean age of 61.5 years old, WOMAC 51.4; EVA 6.4 and BMI 27.6 were evaluated. The prevalence of osteoporosis was 20.7%, and 37.9% had osteopenia. Patients with osteoporosis were older than patients without osteoporosis (p=0.006). The mean bone mineral density of the femoral neck without hip osteoarthritis was lower than the affected side (p=0.007). Thirty-five percent of patients did not know what osteoporosis is. Of these, 30% had osteopenia or osteoporosis. Conclusion: osteoarthritis and osteoporosis may coexist and the population waiting for total hip arthroplasty should be considered at risk for the presence of osteoporosis. Level of Evidence III, Observational Study. PMID:26327793

  15. Spaceflight osteoporosis: current state and future perspective.

    PubMed

    Cappellesso, R; Nicole, L; Guido, A; Pizzol, D

    2015-10-01

    Osteoporosis is one of the established major consequences of long-duration spaceflights in astronauts seriously undermining their health after their returning on Earth. Indeed, astronauts typically lose more bone mass during one month than postmenopausal women on Earth lose in one year. To date, countermeasures mainly consist in exercise and supplementation while pharmacological treatment as those used in postmenopausal women are not routine. However, it is evident that exercise and supplementation alone are not enough to maintain bone homeostasis. In this paper we describe the current countermeasures for bone loss during long-term spaceflight, review the modern treatment which are successfully employed to prevent osteoporosis on Earth and that could be quickly used also for astronauts and finally focus on the recent cellular and molecular understanding of bone homeostasis which might provide the basis for the development of future targeted therapies. PMID:26494042

  16. Osteoporosis diagnostics in patients with rheumatoid arthritis

    PubMed Central

    Dura, Marta; Blumfield, Einat; Żuchowski, Paweł; Waszczak, Marzena; Jeka, Sławomir

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease. The development of comorbidities often occurs in the course of RA. One of them is osteoporosis, which has serious social and economic effects and may contribute to the increase in the degree of disability and premature death of the patient. Due to the young age in which RA disease occurs, densitometry (DXA) of the lumbar spine is the basic examination in osteoporosis diagnostics. In the course of RA, much more frequently than in healthy persons of the same age, osteoporotic fractures of vertebral bodies occur, which hinder a correct assessment in the DXA test. Rheumatoid arthritis patients often undergo computed tomography (CT) examination of the abdominal cavity for other medical indications than suspected spinal injury. Then, CT examination may also serve for the assessment of bone density, especially in patients with osteoporotic fractures. PMID:27407274

  17. Osteoporosis: the emperor has no clothes

    PubMed Central

    Järvinen, T L N; Michaëlsson, K; Aspenberg, P; Sievänen, H

    2015-01-01

    Current prevention strategies for low-trauma fractures amongst older persons depend on the notions that fractures are mainly caused by osteoporosis (pathophysiology), that patients at high risk can be identified (screening) and that the risk is amenable to bone-targeted pharmacotherapy (treatment). However, all these three notions can be disputed. Pathophysiology Most fracture patients have fallen, but actually do not have osteoporosis. A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty. Screening Currently available fracture risk prediction strategies including bone densitometry and multifactorial prediction tools are unable to identify a large proportion of patients who will sustain a fracture, whereas many of those with a high fracture risk score will not sustain a fracture. Treatment The evidence for the viability of bone-targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65–80 years with osteoporosis, whereas the proof of hip fracture-preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real-life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20–25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment. PMID:25809279

  18. [Osteoporosis in men and androgen replacement therapy].

    PubMed

    Tsujimura, Akira; Okuyama, Akihiko

    2003-11-01

    Androgen plays an important role in bone maturation and maintenance of bone mass. Androgen deficiency associated with aging causes osteoporosis for men. With respect to this disease, androgen replacement treatment has been performed for aging male. However, available preparations of androgen are limited in Japan and each of them has both merit and demerit. Establishment of guideline for androgen replacement treatment including criteria of serum testosterone concentration is the problem, which now confronts us. PMID:15775234

  19. Clodronate news of efficacy in osteoporosis

    PubMed Central

    Nardi, Alfredo; Ventura, Lorenzo; Cozzi, Luisella; Tonini, Greta

    2016-01-01

    Summary Clodronate belongs to Bisphosphonates family and it has been studied especially for osteoporosis treatment, Paget’s disease, osteolytic metastases, hypercalcemia malignancy and some childhood skeletal diseases. Besides the osteoporosis treatment, it has been successfully used for treating tumoral osteolysis and for bone localization of multiple myeloma, hypercalcemia malignancy, primary hyperparathyroidism, Paget’s disease and algodystrophy. Filipponi study showed a statistically significant reduction of the incidence of vertebral fractures after 4 years of treatment with clodronate, intravenously administered at a dose of 200 mg every three weeks. Frediani study, published in 2003 on BONE, proved the clodronate efficacy in the prevention of fractures caused by glucocorticoid-induced osteoporosis (GIO). Clodronate doses of 800 mg/day per os and 100 mg i.m./week are substantially equivalent, because the oral absorption is about 1,9%. A higher efficacy on BMD was documented in various works, especially in cohorts of patients with a greater fracture risk, using higher doses (1600 mg per os). This has led to the hypothesis of using clodronate 200 mg i.m. formulation. Clodronate is an osteoporosis drug that can be assumed in different doses (100 mg i.m./week, clodronate 200 mg i.m. every 2 weeks) considering the risk band, identified by algorithms (FRAX o DeFRA), by BMD and by the presence of at least one risk factor. That means that it is possible to envisage a differentiated use of clodronate adapting the doses to the fracture risk and to the severity of pain symptoms, thus promoting a greater adherence to the therapy. To conclude clodronate is helpful in reducing fracture risk, is safe, well tolerated, and has a good rate cost/effectiveness in patients with fracture risk over 7% established with FRAX. PMID:27252741

  20. Osteoporosis and trace elements--an overview.

    PubMed

    Aaseth, Jan; Boivin, Georges; Andersen, Ole

    2012-06-01

    More than 200 million people are affected by osteoporosis worldwide, as estimated by 2 million annual hip fractures and other debilitating bone fractures (vertebrae compression and Colles' fractures). Osteoporosis is a multi-factorial disease with potential contributions from genetic, endocrine functional, exercise related and nutritional factors. Of particular considerations are calcium (Ca) status, vitamin D, fluoride, magnesium and other trace elements. Several trace elements such as zinc and copper are essential for normal development of the skeleton in humans and animals. Fluoride accumulates in new bone and results in a net gain in bone mass, but may be associated with a tissue of poor quality. Aluminum induces impairment of bone formation. Gallium and cadmium suppresses bone turnover. However, exact involvements of the trace elements in osteoporosis have not yet been fully clarified. Numerous investigators have evaluated the role of medications and supplementations with minerals and trace substances to reverse the progression of this disease. Although bisphosphonates are still the drugs of choice, low-dosed fluoride and strontium salts have shown promise for the future. PMID:22575536

  1. Nandrolone decanoate for men with osteoporosis.

    PubMed

    Hamdy, R C; Moore, S W; Whalen, K E; Landy, C

    1998-03-01

    To compare the efficacy and safety of nandrolone decanoate and calcium (NDC) with those of calcium alone (CAL) in men with idiopathic osteoporosis, a 12-month, randomized, prospective, controlled study, was performed in an outpatient clinic. Twenty-one men with idiopathic osteoporosis (as determined by radiological and dual energy x-ray absorptiometry findings) were randomly allocated to either 50 mg nandrolone decanoate intramuscularly (im) weekly and 1,000 mg oral calcium carbonate daily (NDC group) or to 1,000 mg oral calcium carbonate daily (CAL group). Bone densitometry (total body, left femur, and lumbar spine), serum, and urine biochemical parameters were measured at 3-month intervals. In the NDC group, bone mineral density initially increased, reached a plateau, and then decreased to near baseline levels at 12 months. Increases in lean muscle mass mirrored these changes. Free and total testosterone significantly decreased. Hemoglobin increased in all patients in this group. Patients in the CAL group exhibited no significant change in either total body or bone mineral density or biochemical parameters. Thus, nandrolone decanoate, 50 mg im weekly, transiently increases the bone mass of men with idiopathic osteoporosis in this preliminary study. Careful monitoring is necessary. PMID:10099043

  2. To prevent the osteoporosis playing in advance

    PubMed Central

    Colì, Giuseppe

    2013-01-01

    Summary There are several possibilities for the prevention of primary, secondary and tertiary osteoporosis but till now they have not been promoted enough and bone fragility is thought about only after the onset of a fracture (tertiary prevention). By recent studies and discoveries it is becoming increasingly clear that there is a relationship between growth and development in early childhood and bone health in old age. Suboptimal bone development leads to a reduction in peak bone mass, and a higher risk of osteoporotic fracture later in life. Preventative strategies against osteoporosis can be aimed at either optimizing the peak bone mass obtained, or reducing the rate of bone loss. Optimization of peak bone mass may be more amenable to public health strategies. Technological advances and our knowledge of osteoporosis have increased in the last decade and so tertiary prevention should be considered a failure in the field of public health. If we want to make advances in the osteoporotic field, we must start in childhood, before the bone mass peak is reached and the gold-standard is starting with prevention as soon as possible, also during fetal development. PMID:24133522

  3. Osteoporosis: an increasing concern in pediatric dentistry.

    PubMed

    da Fonseca, Marcio A

    2011-01-01

    Increasing numbers of children are being affected by low bone density and osteoporosis. Bone fractures are the main reason for hospitalization between 10 and 14 years of age and, over the past 3 decades, there has been an increase in the incidence of fractures in children. Childhood factors such as lifestyle, diet, chronic illness, and medications have a vital short-term impact on bone health and a long-term effect on the achievement of peak bone mass, with the potential for morbidity in adulthood. The primary forms of osteoporosis consist of rare inherited conditions, but the secondary forms are becoming more common given that chronically ill children are surviving longer. This subject should be of interest to pediatric dentists, because low mineral density and osteoporosis, together with drugs used to treat them (eg, bisphosphonates), may cause adverse effects in the oral cavity. Furthermore, the pediatric dentist is an important health care professional to counsel patients about healthy lifestyles that can help prevent the condition from an early age. PMID:21703077

  4. Postmenopausal osteoporosis - clinical, biological and histopathological aspects.

    PubMed

    Pavel, Oana Roxana; Popescu, Mihaela; Novac, Liliana; Mogoantă, LaurenŢiu; Pavel, LaurenŢiu Petrişor; Vicaş, Răzvan Marius; Trăistaru, Magdalena Rodica

    2016-01-01

    Osteoporosis is one of the most common disorders in postmenopausal women, affecting the quality of life and increasing the risk for fractures in minor traumas. Changes in the bone microarchitecture causes static changes in the body and affects motility. In this study, we analyzed two groups of women, one with physiological menopause and one with surgically induced menopause. The diagnosis of osteoporosis was suspected based on the clinical symptoms and confirmed by assessing bone mineral density by the dual-energy X-ray absorptiometry (DEXA). Comparing some clinical and biological aspects there was noted that a much higher percentage of women with surgically induced menopause exhibited increases in body mass index, changes in serum lipids, cholesterol, triglycerides, blood glucose, serum calcium, magnesemia and osteocalcin. In contrast, no significant differences were observed in the histopathological aspects of bone tissue examined from these two groups. In all patients, there was identified a significant reduction in the number of osteocytes and osteoblasts, the expansion of haversian channels, reducing the number of trabecular bone in the cancellous bone with wide areola cavities often full of adipose tissue, non-homogenous demineralization of both the compact bone and the cancellous bone, atrophy and even absence of the endosteal, and the presence of multiple microfractures. Our study showed that early surgically induced menopause more intensely alters the lipid, carbohydrate and mineral metabolism, thus favoring the onset of osteoporosis. PMID:27151697

  5. Denosumab for the Treatment of Osteoporosis

    PubMed Central

    Zaheer, Sarah; LeBoff, Meryl; Lewiecki, E. Michael

    2015-01-01

    Introduction Low trauma fractures due to osteoporosis are a major health concern worldwide. Despite the availability of many therapeutic compounds to reduce fracture risk, osteoporosis remains undertreated and the burden of osteoporotic fractures remains high. Denosumab is a novel agent that acts to reduce bone turnover, improve bone mineral density, and reduce fracture risk, offering a favorable efficacy and safety profile. Areas covered This review covers the pharmacology and major clinical trials with extension/post-marketing follow-up, including trials for all FDA-approved indications of denosumab to date. Expert Opinion Denosumab is an efficacious and safe osteoporosis treatment option, with current data up to 8 years of continued use showing continued improvement in bone density with sustained fracture risk reduction. Safety profiles overall are similar to placebo, with no new safety concerns in extension trials, though a theoretical increased risk of infection exists with RANKL inhibition. Future considerations include safety of prolonged treatment beyond 8 years, and efficacy/fracture risk after discontinuation or with non-adherence, given the characteristic pharmacodynamic profile of denosumab. PMID:25614274

  6. Studies on the pathophysiology and therapy of osteoporosis.

    PubMed

    Ambrus, J L; Ambrus, J L; Robin, J C; Ambrus, C M; Kahn, E A

    1984-01-01

    Etiologic and pathologic factors in clinical osteoporosis are reviewed. Techniques were developed to determine total skeletal calcium content with in vivo neutron activation analysis and to induce osteoporosis (in about three months) with low calcium diet, corticosteroid or heparin treatment in experimental animals. Genetic influence was demonstrated: C3H/St (Ha) mice were more susceptible to osteoporosis by all three modalities than C57B1/6 (J) mice. Fluoride was ineffective in preventing osteoporosis induced by either of these three modalities. Heparin induced osteoporosis was prevented by conjugated estrogens, progestins or their combinations. Progestins were shown in other studies to inhibit estrogen induced metaplasia and neoplasia. Combining estrogens with progestin may result in an increased therapeutic index for the prevention of postmenopausal osteoporosis. Human and salmon calcitonin, Deca - Durabolin, an anabolic steroid, Mopidamole, a pyrimidopyrimidine derivative, Trental, a methylxanthine derivative, certain 2-thiophene carboxylic acid derivatives and imidazoquinazolines exhibited anti-osteoporotic effects. PMID:6396359

  7. Decreased Bone Formation Explains Osteoporosis in a Genetic Mouse Model of Hemochromatosiss

    PubMed Central

    Doyard, Mathilde; Chappard, Daniel; Leroyer, Patricia; Roth, Marie-Paule; Loréal, Olivier; Guggenbuhl, Pascal

    2016-01-01

    Osteoporosis may complicate iron overload diseases such as genetic hemochromatosis. However, molecular mechanisms involved in the iron-related osteoporosis remains poorly understood. Recent in vitro studies support a role of osteoblast impairment in iron-related osteoporosis. Our aim was to analyse the impact of excess iron in Hfe-/- mice on osteoblast activity and on bone microarchitecture. We studied the bone formation rate, a dynamic parameter reflecting osteoblast activity, and the bone phenotype of Hfe−/− male mice, a mouse model of human hemochromatosis, by using histomorphometry. Hfe−/− animals were sacrificed at 6 months and compared to controls. We found that bone contains excess iron associated with increased hepatic iron concentration in Hfe−/− mice. We have shown that animals with iron overload have decreased bone formation rate, suggesting a direct impact of iron excess on active osteoblasts number. For bone mass parameters, we showed that iron deposition was associated with bone loss by producing microarchitectural impairment with a decreased tendency in bone trabecular volume and trabecular number. A disorganization of trabecular network was found with marrow spaces increased, which was confirmed by enhanced trabecular separation and star volume of marrow spaces. These microarchitectural changes led to a loss of connectivity and complexity in the trabecular network, which was confirmed by decreased interconnectivity index and increased Minkowski’s fractal dimension. Our results suggest for the first time in a genetic hemochromatosis mouse model, that iron overload decreases bone formation and leads to alterations in bone mass and microarchitecture. These observations support a negative effect of iron on osteoblast recruitment and/or function, which may contribute to iron-related osteoporosis. PMID:26829642

  8. Nigella Sativa reverses osteoporosis in ovariectomized rats

    PubMed Central

    2014-01-01

    Background Osteoporosis poses a significant public health issue. It is a skeletal disorder characterized by compromised bone strength that predisposes to increased risk of fracture. There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. About 33% of women over 50 will experience bone fractures as a result of osteoporosis. Nigella Sativa (NS) has been shown to have beneficial effects on bone and joint diseases. The present study was conducted to elucidate the protective effect of Nigella Sativa on osteoporosis produced by ovariectomy in rats. Methods Female Wistar rats aged 12–14 months were divided into three groups: sham-operated control (SHAM), ovariectomized (OVX), and ovariectomized supplemented with nigella sativa (OVX-NS) orally for 12 weeks; 4 weeks before ovariectomy and 8 weeks after. After 12 weeks, plasma levels of calcium (Ca+2), phosphorous (Pi), alkaline phosphatase (ALP), amino terminal collagen type 1 telopeptide, malondialdehyde (MDA), nitrates, nitric oxide surrogate, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured. Histological examination of the liver and the tibia was conducted. Histomorphometric analysis of the tibia was also performed. Results OVX rats showed significant decrease in plasma Ca+2, accompanied by a significant increase in plasma ALP, amino terminal collagen type 1 telopeptide, MDA, nitrates, TNF-α and IL-6. These changes were reversed by NS supplementation in OVX-NS group to be near SHAM levels. Histological examination of the tibias revealed discontinuous eroded bone trabeculae with widened bone marrow spaces in OVX rats accompanied by a significant decrease in both cortical and trabecular bone thickness compared to Sham rats. These parameters were markedly reversed in OVX-NS rats. Histological examination of the liver showed mononuclear cellular infiltration and congestion of blood vessels at the portal area in OVX rats which were not found

  9. Incidence of Osteoporosis in Patients with Urolithiasis

    PubMed Central

    Bijelic, Radojka; Milicevic, Snjezana; Balaban, Jagoda

    2014-01-01

    ABSTRACT Introduction. Clinical researches have shown an increased bone disintegration and lower bone mass in patients with calcium urolithiasis. Goal. The goal of our research was to establish the incidence of osteoporosis in adult patients with calcium urolithiasis, on the basis of measuring mineral bone density, using DEXA method, with a special reflection on age subgroups. Material and methods. Clinical research was prospective and it was implemented at the University Clinical Center of Banja Luka, at the Clinic for Endocrinology, Diabetes and Metabolic Diseases and at the Urology Clinic. Material in this research consisted of patients divided in two groups, a working and a control group. One hundred and twenty (120) patients were included in both these groups, divided in three age subgroups: 20-40, 40-60 and over 60. The working group consisted of the patients with calcium urolithiasis and the control group consisted of patients without calcium urolithiasis. Establishing of mineral bone density at L2-L4 of lumbal spine vertebrae and hip was done for the patients in both these groups, using DEXA method. Results. Analysis of mineral bone density using DEXA method in patients in age groups of working and control groups, as well as in the total sample of working and control groups, have shown that the patients of the working group, over 60, had a decreased mineral bone density (30% of osteopenia and 15% osteoporosis) significantly more expressed when compared to the other two age groups (12.5% in the subgroup 20-40 and 17.5% in the subgroup 40-60), which presents a statistically significant difference (p<0.05). In the control group, when taking into account age groups, osteopenia and osteoporosis were marked in 37.5% and 2.5% in the group of patients over 60, whereas in the youngest population, 5% of osteopenia was found, which presents a statistically significant difference (p<0.05). When observing the total sample of working and control group, there was a

  10. Biological agents in management of osteoporosis.

    PubMed

    Tella, Sri Harsha; Gallagher, J Christopher

    2014-11-01

    Osteoporosis is a skeletal disease associated with an imbalance between formation and resorption, leading to net loss of bone mass, loss of bone microarchitecture, and development of fractures. Bone resorption is primarily due to an activation of osteoclastogenesis and an increase in receptor activator of nuclear factor kappa-B ligand (RANKL) expression, a cytokine involved in the final pathway of the osteoclast cycle.Recent studies of genetic diseases led to the discovery of the wingless-type (Wnt) signaling pathway that plays a major role in bone formation. Further work showed that sclerostin produced by osteocytes and the Dickkopf (DKK1) protein secreted in bone were negative regulators of the Wnt signaling bone formation pathway that act directly by binding to the co-receptors LRP5 and LRP6 of WnT and thereby inhibiting the anabolic Wnt pathway. This understanding of the bone remodeling led to the discovery of new biological drugs that target these pathways and have been evaluated in clinical trials.The current article discusses the role of these newer "biological" agents in management of osteoporosis. Denosumab, a human monoclonal antibody that specifically binds RANKL, blocks the binding of RANK to its ligand markedly reducing bone resorption, increases bone density, and reduces fractures and is approved for osteoporosis. Parathyroid hormone PTH 1-34 (teriparatide) stimulates bone formation through inhibition of sclerostin, DKK1, and frizzled protein; increases BMD; improves microarchitecture; and decreases fractures and is approved for osteoporosis. The anti-sclerostin antibodies (romosozumab, blosozumab) increase bone mass by neutralizing the negative effects of sclerostin on the Wnt signaling pathway. These biologics are being evaluated now in a clinical trial and early data looks promising. Cathepsin K is a proteolytic enzyme that degrades bone matrix and inhibitors such as odanacatib show increasing bone density and perhaps decreased fractures. The

  11. [Diagnostic criteria for primary osteoporosis : year 2012 revision].

    PubMed

    Soen, Satoshi

    2014-03-01

    In 1995, the Japanese Society for Bone and Mineral Metabolism (now the Japanese Society for Bone and Mineral Research) established The Osteoporosis Diagnostic Criteria Review Committee. Following discussion held at the 13th scientific meeting of the Society in 1996, the Committee, with the consensus of its members, proposed diagnostic criteria for primary osteoporosis. The Committee revised those criteria in 1996 and again in 2000. Japanese Society for Bone and Mineral Research and Japan Osteoporosis Society Joint Review Committee for the Revision of the Diagnostic Criteria for Primary Osteoporosis aimed at obtaining international consistency and made a revised edition based on the new findings in 2012. PMID:24576928

  12. The position of strontium ranelate in today's management of osteoporosis.

    PubMed

    Reginster, J-Y; Brandi, M-L; Cannata-Andía, J; Cooper, C; Cortet, B; Feron, J-M; Genant, H; Palacios, S; Ringe, J D; Rizzoli, R

    2015-06-01

    Osteoporosis accounts for about 3 % of total European health-care spending. The low proportion of costs for the pharmacological prevention of osteoporotic fracture means that it is highly cost saving, especially in patient with severe osteoporosis or patients who cannot take certain osteoporosis medications due to issues of contraindications or tolerability. Following recent regulatory changes, strontium ranelate is now indicated in patients with severe osteoporosis for whom treatment with other osteoporosis treatments is not possible, and without contraindications including uncontrolled hypertension, established, current or past history of ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease. We review here today's evidence for the safety and efficacy of strontium ranelate. The efficacy of strontium ranelate in patients complying with the new prescribing information (i.e. severe osteoporosis without contraindications) has been explored in a multivariate analysis of clinical trial data, which concluded that the antifracture efficacy of strontium ranelate is maintained in patients with severe osteoporosis without contraindications and also demonstrated how the new target population mitigates risk. Strontium ranelate is therefore an important alternative in today's management of osteoporosis, with a positive benefit-risk balance, provided that the revised indication and contraindications are followed and cardiovascular risk is monitored. The bone community should be reassured that there remain viable alternatives in patients in whom treatment with other agents is not possible and protection against the debilitating effects of fracture is still feasible in patients with severe osteoporosis. PMID:25868510

  13. Senile osteoporosis: is it an immune-mediated disease?

    PubMed

    De Martinis, M; Di Benedetto, M C; Mengoli, L P; Ginaldi, L

    2006-10-01

    Osteoporosis is a major cause of morbidity in older people. There are a large number of risk factors for the development of senile osteoporosis. However, recent discoveries suggest that these risk factors could exert their effects through immunologically mediated modulation of bone remodelling. Inflamm-ageing itself plays a role in bone remodelling through pro-inflammatory cytokines, which are known to influence osteoclasts and osteoblasts, together with other more recently discovered immunological mediators and transcription factors. Senile osteoporosis is an example of the central role of immune-mediated inflammation in determining bone resorption. In this review, we will discuss the pathogenesis of osteoporosis in the context of immunosenescence. PMID:17109066

  14. What People with Inflammatory Bowel Disease Need to Know about Osteoporosis

    MedlinePlus

    ... information on osteoporosis, contact: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center Website: http://www.bones.nih. ... Pub. No. 16-7900 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD ...

  15. P1 - Maxillary Osteoporosis and Genetic Predisposition

    PubMed Central

    Biondi, E.; Delle Rose, G.; Duvina, M.; Civitelli, V.; Brancato, L.; Amunni, F.; Tonelli, P.

    2010-01-01

    Introduction: Osteoporosis is a form of dysmetabolic osteopathy of multifactorial origin, characterised by reduction of the bone matrix and mineral portion and, overall, of bone mass, leading to fragility and increased fracture risk. AETIOPATHOGENESIS -ENDOCRINE FACTORS: ACTH, glycocorticoids, PTH, thyroxine, oestrogen, testosterone-GENETIC FACTORS: Major genes that regulate fundamental characteristics of bone, such as density and quality, and minor genes that regulate individual genetic background [lipoprotein receptor related protein (LRP5), TGF1, BMP, VDR, COL1A1, ER]. The DIAGNOSIS is based on history, clinical findings (vertebral or appendicular fractures), blood chemistry, conventional radiology and bone mass measurement. For the latter, it is possible to use DUAL-ENERGY X-RAY DENSITOMETRY which measures bone mineral content: according to the WHO definition, in osteoporosis bone mineral density (BMD) is more than 2.5 standard deviations below normal. MAXILLARY OSTEOPOROSIS: because of their function as a support for teeth, which leads to the development of the alveolar process, and their role in mastication, the jawbones (maxilla and mandible) differ from all the other bones of the skeleton. This role, also involving the masticatory muscles, prompts bone trophism. In advancing age a marked reduction of the thickness of the maxillary cortical bone is observed, together with increased porosity and constant functional remodelling of the trabecular part, a phenomenon that, as it increases, leads to tooth loss. Only a mandibular area (a bucco-lingual area of cortical bone in front of the mental foramen) remains unmodified, independently of gender, age and tooth loss. Materials and methods: Kemifar® supplies a test which can be used to study several factors (Er, VDR, COL1A1) that predispose to the development of osteoporosis. OsteoResis®Type is a simple, non-invasive test that allows the complete determination, and interpretation, of several genotypes associated

  16. Managing osteoporosis in ulcerative colitis: Something new?

    PubMed Central

    Piodi, Luca Petruccio; Poloni, Alessandro; Ulivieri, Fabio Massimo

    2014-01-01

    The authors revise the latest evidence in the literature regarding managing of osteoporosis in ulcerative colitis (UC), paying particular attention to the latest tendency of the research concerning the management of bone damage in the patient affected by UC. It is wise to assess vitamin D status in ulcerative colitis patients to recognize who is predisposed to low levels of vitamin D, whose deficiency has to be treated with oral or parenteral vitamin D supplementation. An adequate dietary calcium intake or supplementation and physical activity, if possible, should be guaranteed. Osteoporotic risk factors, such as smoking and excessive alcohol intake, must be avoided. Steroid has to be prescribed at the lowest possible dosage and for the shortest possible time. Moreover, conditions favoring falling have to been minimized, like carpets, low illumination, sedatives assumption, vitamin D deficiency. It is advisable to assess the fracture risk in all UC patient by the fracture assessment risk tool (FRAX® tool), that calculates the ten years risk of fracture for the population aged from 40 to 90 years in many countries of the world. A high risk value could indicate the necessity of treatment, whereas a low risk value suggests a follow-up only. An intermediate risk supports the decision to prescribe bone mineral density (BMD) assessment and a subsequent patient revaluation for treatment. Dual energy X-ray absorptiometry bone densitometry can be used not only for BMD measurement, but also to collect data about bone quality by the means of trabecular bone score and hip structural analysis assessment. These two indices could represent a method of interesting perspectives in evaluating bone status in patients affected by diseases like UC, which may present an impairment of bone quality as well as of bone quantity. In literature there is no strong evidence for instituting pharmacological therapy of bone impairment in UC patients for clinical indications other than those that

  17. Role of estrogen in avian osteoporosis.

    PubMed

    Beck, M M; Hansen, K K

    2004-02-01

    One of the difficulties associated with commercial layer production is the development of osteoporosis in hens late in the production cycle. In light of this fact and because of hens' unique requirements for Ca, many studies have focused on the regulation of Ca and the role of estrogen in this process. The time course of estrogen synthesis over the productive life of hens has been well documented; increased circulating estrogen accompanies the onset of sexual maturity while decreases signal a decline in egg production prior to a molt. Numbers of estrogen receptors decrease with age in numerous tissues. The parallel changes in calcium-regulating proteins, primarily Calbindin D28K, and in the ability of duodenal cells to transport Ca, are thought to occur as a result of the changes in estrogen, and are also reversible by the molt process. In addition to the traditional model of estrogen action, evidence now exists for a possible nongenomic action of estrogen via membrane-bound receptors, demonstrated by extremely rapid surges of ionized Ca in chicken granulosa cells in response to 17beta-estradiol. Estrogen receptors have also been discovered in duodenal tissue, and tamoxifen, which binds to the estrogen receptor, has been shown to cause a rapid increase in Ca transport in the duodenum. In addition, recent evidence also suggests that mineralization of bone per se may not explain entirely the etiology of osteoporosis in the hen but that changes in the collagen matrix may contribute through decreases in bone elasticity. Taken together, these studies suggest that changes in estrogen synthesis and estrogen receptor populations may underlie the age-related changes in avian bone. As with postmenopausal women, dietary Ca and vitamin D are of limited benefit as remedies for osteoporosis in the hen. PMID:14979570

  18. Rabbiteye blueberry prevents osteoporosis in ovariectomized rats

    PubMed Central

    2014-01-01

    Objective It has been forecasted that the rabbiteye blueberry could inhibit osteoporosis. However, the inhibition and prevention of osteoporosis via rabbiteye blueberry are still elusive. This study was aim to evaluate the anti-osteoporosis effects of rabbiteye blueberry in ovariectomized rats. Methods Thirty rats were randomly divided into three groups of ten rats each as follows: sham-operated group (SG), ovariectomized model control group (OMG), and ovariectomized rabbiteye blueberry treatment group (OBG). The blood mineral levels, the alkaline phosphatase (ALP) activity, and osteoprotegerin (OPG) level were determined. The expression analyses of type I collagen, integrin-β1, and focal adhesion kinase (FAK) were performed. Besides, the bone mineral density (BMD) and bone histomorphometry (BH) were measured. Results The ALP activity in SG and OBG was significantly lower than that in OMG. For the OPG level, the significant increase of OPG level in OBG was indicated compared with the other groups. The mRNA expression levels of type I collagen, integrin-β1, and FAK in OMG were significantly lower than those in other groups. The BMD in OMG were all significantly lower than those in SG and OBG. For BH, blueberry significantly improved the trabecular bone volume fraction, trabecular thickness, mean trabecular bone number, and bone formation rate, and decreased the trabecular separation, the percent of bone resorption perimeter, and mean osteoclast number in OBG compared with OMG. Conclusions The rabbiteye blueberries had an effective inhibition in bone resorption, bone loss, and reduction of bone strength of ovariectomized rats and could improve the BMD, osteogenic activity, and trabecular bone structure. PMID:25102951

  19. Idiopathic Juvenile Osteoporosis: A Case Report.

    PubMed

    Altan, Halenur; Tosun, Gül; Şen, Yaşar

    2015-08-01

    Idiopathic Juvenile Osteoporosis (IJO) is a very rare disease, self restrictive and shows marked, spontaneous improvement during adolescence. The major clinical features were pain with difficulty walking, growth retardation, oral and dental abnormalities with radiographically porous bone structure. A 13-year-old male referred to paediatric dentistry clinic for toothache. The observations made with extra-intraoral clinic examination that one revealed short and skinny stature, diffuse caries in deciduous teeth, abraded lower incisor, deep bite and dysmorphic appearance in permanent incisor. This report emphasizes the recognized features of IJO as well as describes facio-dental findings that could aid in the diagnosis and management of these patients. PMID:26436063

  20. Exercise and osteoporosis: Methodological and practical considerations

    NASA Technical Reports Server (NTRS)

    Block, Jon E.; Friedlander, Anne L.; Steiger, Peter; Genant, Harry K.

    1994-01-01

    Physical activity may have important implications for enhancing bone density prior to the initiation of space flight, for preserving bone density during zero gravity, and for rehabilitating the skeleton upon return to Earth. Nevertheless, the beneficial effects of exercise upon the skeleton have not been proven by controlled trials and no consensus exists regarding the type, duration, and intensity of exercise necessary to make significant alterations to the skeleton. The following sections review our current understanding of exercise and osteoporosis, examine some of the methodological shortcomings of these investigations, and make research recommendations for future clinical trials.

  1. Idiopathic Juvenile Osteoporosis: A Case Report

    PubMed Central

    Tosun, Gül; Şen, Yaşar

    2015-01-01

    Idiopathic Juvenile Osteoporosis (IJO) is a very rare disease, self restrictive and shows marked, spontaneous improvement during adolescence. The major clinical features were pain with difficulty walking, growth retardation, oral and dental abnormalities with radiographically porous bone structure. A 13-year-old male referred to paediatric dentistry clinic for toothache. The observations made with extra-intraoral clinic examination that one revealed short and skinny stature, diffuse caries in deciduous teeth, abraded lower incisor, deep bite and dysmorphic appearance in permanent incisor. This report emphasizes the recognized features of IJO as well as describes facio-dental findings that could aid in the diagnosis and management of these patients. PMID:26436063

  2. A Practical Approach to Osteoporosis Management in the Geriatric Population

    PubMed Central

    Liberman, Dan; Cheung, Angela

    2015-01-01

    Osteoporosis is a medical condition that is seen commonly in elderly patients, and it is associated with a large burden of morbidity and mortality. This article provides a practical approach to the workup and management of osteoporosis in patients 65 years or older. PMID:25825609

  3. A Multidisciplinary Osteoporosis Service-Based Action Research Study

    ERIC Educational Resources Information Center

    Whitehead, Dean; Keast, John; Montgomery, Val; Hayman, Sue

    2004-01-01

    Objective: To investigate an existing Trust-based osteoporosis service's preventative activity, determine any issues and problems and use this data to reorganise the service, as part of a National Health Service Executive/Regional Office-commissioned and funded study. Setting: A UK Hospital Trust's Osteoporosis Service. Design & Method: A…

  4. Rural Women and Osteoporosis: Awareness and Educational Needs

    ERIC Educational Resources Information Center

    Matthews, Hollie L.; Laya, Mary; DeWitt, Dawn E.

    2006-01-01

    Context: Little is known about rural women's knowledge about osteoporosis. Purpose: To explore what women from high-prevalence rural communities know about osteoporosis and to assess their learning preferences. Methods: We surveyed 437 women in rural Washington and Oregon. Findings: The response rate was 93% (N = 406). The mean age of respondents…

  5. Epidemiology of Osteoporosis in Women with Cognitive Impairment

    ERIC Educational Resources Information Center

    Schrager, Sarina

    2006-01-01

    Osteoporosis is increasing due to the aging of the population. Women with cognitive impairment from childhood are at disproportionally high risk for osteoporosis and fractures. Suggested explanations for this increased risk include high use of anticonvulsant medications, lower peak bone densities, and higher rates of nonambulation. Down syndrome…

  6. Premenopausal osteoporosis, an overlooked consequence of anorexia nervosa.

    PubMed

    Teng, Kathryn

    2011-01-01

    Many young women with anorexia nervosa develop premenopausal osteoporosis. In particular, female athletes have a much higher incidence of disordered eating than their peers and therefore are at a much higher risk of stress fractures and other traumatic bone pathology. This review summarizes factors affecting the development of premenopausal osteoporosis in these patients and identifies potential targets for intervention. PMID:21199907

  7. Risk Factors for Osteoporosis Among Middle-Aged Women

    ERIC Educational Resources Information Center

    Turner, Lori W.; Wallace, Lorraine Silver; Perry, Blake Allen; Bleeker, Jeanne

    2004-01-01

    Objective: To investigate the risk factors for osteoporosis among a sample of middle-aged women. Methods: Adipose tissue and bone mineral density levels at the left femur, lumbar spine, and total body were assessed using dual-energy x-ray absorptiometry (DXA). Subjects (n=342) were surveyed regarding a variety of osteoporosis-related risk factors.…

  8. [Pharmacological treatment of other types of secondary osteoporosis].

    PubMed

    Okazaki, Ryo

    2015-10-01

    This article reviews the treatment strategy for the secondary osteoporosis excluding those caused by diabetes, CKD, endocrine disorders, or glucocorticoid, which proceeding articles deal with. Among numerous possible causes for such secondary osteoporosis, the author has selected osteogenesis imperfecta (OI), osteoporosis associated with gastrectomy or bariatric surgery, inflammatory bowel diseases (IBD), and chronic obstructive pulmonary disease (COPD). For OI, current standard treatment is bisphosphonates (BPs), of which efficacy for fracture inhibition has recently been of issue. Other treatment modalities, e.g. PTH, have just been explored. Osteoporosis associated with gastrectomy, bariatric surgery or IBD, have been treated with vitamin D, calcium, and BPs. Despite high fracture rates, there are almost no treatment data for osteoporosis associated with COPD. PMID:26529940

  9. Bisphosphonates for the prevention and treatment of osteoporosis.

    PubMed

    Maraka, Spyridoula; Kennel, Kurt A

    2015-01-01

    Osteoporosis is a systemic skeletal disorder characterized by bone loss, which leads to impaired bone strength and an increased risk of fractures. Two million fractures are attributed to osteoporosis annually in the United States and they are associated with serious morbidity and mortality. Bisphosphonates reduce the risk of fracture by suppressing bone resorption and increasing bone strength, and they have been widely used for the prevention and treatment of osteoporosis. However, the use of these drugs for the management of osteoporosis remains a clinical challenge. There are several important considerations including appropriate patient selection, pretreatment evaluation, potential adverse effects, patient preferences, and adherence. This review will discuss the evidence informing the clinical strategy for using bisphosphonates in patients with osteoporosis and those at high risk of fracture, focusing on the benefits and risks of treatment. We will also consider issues related to the monitoring and duration of treatment. PMID:26333528

  10. Osteoporosis management in older patients who experienced a fracture

    PubMed Central

    Oertel, Mark J; Graves, Leland; Al-Hihi, Eyad; Leonardo, Vincent; Hopkins, Christina; DeSouza, Kristin; Bhattacharya, Rajib K

    2016-01-01

    Background Fractures in older patients are common, morbid, and associated with increased risk of subsequent fractures. Inpatient and outpatient management and treatment of fractures can be costly. With more emphasis placed on quality care for Medicare beneficiaries, we studied if patients were receiving proper screening for osteoporosis and treatment after diagnosis of fracture. This study aims to determine if adequate screening and treatment for osteoporosis occurs in the postfracture period. Methods A retrospective analysis of Medicare beneficiaries aged 67 years or older was gathered from a single institution in both inpatient and outpatient visits. Based on International Classification of Diseases ninth revision codes, primary diagnosis of fractures of neck and trunk, upper limb, and lower limb were obtained in addition to current procedural terminology codes for fracture procedures. We studied patients who had been screened for osteoporosis with a bone mineral study or received osteoporosis treatment after their fracture. Results Medicare beneficiaries totaling 1,375 patients were determined to have an inclusion fracture between June 1, 2013 and November 30, 2014. At the time of our analysis on December 1, 2014, 1,219 patients were living and included in the analysis. Of these patients, 256 (21.0%) either received osteoporosis testing with bone mineral density or received treatment for osteoporosis. On sex breakdown, 208/820 (25.4%) females received proper evaluation or treatment of osteoporosis in comparison to 48/399 (12.0%) males. This is in comparison to the Centers for Medicare and Medicaid Services’ national average of 19.1% for osteoporosis management in females. Conclusion A minority of studied patients received evaluation or treatment for osteoporosis after their fracture. Postfracture investigation and treatment for osteoporosis in Medicare beneficiaries is inadequate. If improved, Medicare costs could be reduced by prevention of future fractures

  11. Cost-Effectiveness Osteoporosis Treatment Thresholds: The United States Perspective from the National Osteoporosis Foundation Guide Committee

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Introduction: Rapid growth of the elderly United States population will result in so many at risk of osteoporosis that economically efficient approaches to osteoporosis care warrant consideration.Methods: A Markov-cohort model of annual United States age-specific incidence of hip, wrist, clinical s...

  12. Osteoporosis and sarcopenia in older age.

    PubMed

    Edwards, M H; Dennison, E M; Aihie Sayer, A; Fielding, R; Cooper, C

    2015-11-01

    Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties include the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. This article is part of a Special Issue entitled "Muscle Bone Interactions". PMID:25886902

  13. Glucocorticoid-induced osteoporosis in growing rats.

    PubMed

    Lin, Sien; Huang, Jianping; Zheng, Liang; Liu, Yanzhi; Liu, Guihua; Li, Nan; Wang, Kuixing; Zou, Liyi; Wu, Tie; Qin, Ling; Cui, Liao; Li, Gang

    2014-10-01

    This study evaluated whether growing rats were appropriate animal models of glucocorticoid-induced osteoporosis. The 3-month-old male rats were treated with either vehicle or prednisone acetate at 1.5, 3.0, and 6.0 mg/kg/day by oral gavage, respectively. All rats were injected with tetracycline and calcein before sacrificed for the purpose of double in vivo labeling. Biochemistry, histomorphometry, mechanical test, densitometry, micro-CT, histology, and component analysis were performed. We found that prednisone treatments dose dependently decreased body weight, serum biomarkers, biomechanical markers, bone formation, and bone resorption parameters in both tibial and femoral trabecular bone without trabecular bone loss. We also found that significant bone loss happened in femoral cortical bone in the glucocorticoid-treated rats. The results suggested that prednisone not only inhibited bone formation, but also inhibited bone resorption which resulted in poor bone strength but with no cancellous bone loss in growing rats. These data also suggested that the effects of glucocorticoid on bone metabolism were different between cortical bone and trabecular bone, and different between tibia and femur. Growing rats may be a glucocorticoid-induced osteoporosis animal model when evaluated the effects of drugs upon juvenile patients exposed to GC for a long time. PMID:25086673

  14. PIXE studies of osteoporosis preventive treatments

    NASA Astrophysics Data System (ADS)

    Ynsa, M. D.; Pinheiro, T.; Ager, F. J.; Alves, L. C.; Millán, J. C.; Gómez-Zubelbia, M. A.; Respaldiza, M. A.

    2002-04-01

    Particle induced X-ray emission (PIXE) and nuclear microprobe (NMP) have been used in an exploratory work to study elemental alterations in tissues of experimental animals submitted to osteoporosis preventive treatments. Osteopathologies have been associated with several factors, such as hormonal disturbances, metabolic aberrations, low dietary Ca and vitamin D intake, excess of iron, among other possible factors. Hormonal treatments seem to be beneficial to the incorporation of Ca in bone but breast and endometrial cancers constitute significant side effects that cannot be ignored. Wistar female rats were used to test the effect of estrogen therapy in osteoporosis progression. The variations of elemental concentrations in uterus and the Ca content of femoral bones of ovariectomised rats under estrogen therapy were investigated. PIXE, Rutherford backscattering spectrometry and secondary electron microscopy techniques were applied for the characterisation of biological materials, with respect to morphology and trace element distribution determination. The increase of Ca and Fe concentrations in uterus and the variations for Ca distribution patterns in bone of rats submitted to estrogen therapy were the major features observed.

  15. Osteoporosis: Modern Paradigms for Last Century's Bones.

    PubMed

    Kruger, Marlena C; Wolber, Frances M

    2016-01-01

    The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a "brittle bone" disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture. PMID:27322315

  16. [Precautions before starting a treatment for osteoporosis].

    PubMed

    Breuil, Véronique

    2012-02-01

    To be optimal, the treatment of osteoporosis must be global, including nonpharmacological measures. At the initiation of the treatment, a personalized evaluation of the patient must be realized on diet, physical activity, risk of fall and adhesion of the patient. Dietary calcium is estimated and advices given to attain 1000 in 1200 mg/day and limit excessive coffee, soft drinks and salt intake. Dietary calcium is recommended, but if it is impossible, a complement is prescribed, adapted to the intensity of the deficiency. Serum 25-(OH)-vitamine D is measured and, if below 30 ng/ml, a supplementation prescribed. Low protein intake is looked for and corrected if necessary. Advises are given to limit the alcohol to 2 units/day, stop smoking and to have a regular and high impact physical activity. Subjects at risk of fall must be identified and risk factors corrected if possible. Dental recommandations for the use of bisphosphonates in osteoporosis must be apply. Finally, patient education could be used to optimize patient adherence to pharmacological and non pharmacological anti-osteoporotic treatments. PMID:22408863

  17. Osteoporosis and Sarcopenia in Older Age

    PubMed Central

    Edwards, MH; Dennison, EM; Sayer, A Aihie; Fielding, R; Cooper, C

    2015-01-01

    Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties including the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. PMID:25886902

  18. QUS devices for assessment of osteoporosis

    NASA Astrophysics Data System (ADS)

    Langton, Christian

    2002-05-01

    The acronym QUS (Quantitative Ultrasound) is now widely used to describe ultrasound assessment of osteoporosis, a disease primarily manifested by fragility fractures of the wrist and hip along with shortening of the spine. There is currently available a plethora of commercial QUS devices, measuring various anatomic sites including the heel, finger, and tibia. Largely through commercial rather than scientific drivers, the parameters reported often differ significantly from the two fundamental parameters of velocity and attenuation. Attenuation at the heel is generally reported as BUA (broadband ultrasound attenuation, the linearly regressed increase in attenuation between 200 and 600 kHz). Velocity derivatives include bone, heel, TOF, and AdV. Further, velocity and BUA parameters may be mathematically combined to provide proprietary parameters including ``stiffness'' and ``QUI.'' In terms of clinical utility, the situation is further complicated by ultrasound being inherently dependent upon ``bone quality'' (e.g., structure) in addition to ``bone quantity'' (generally expressed as BMD, bone mineral density). Hence the BMD derived WHO criteria for osteoporosis and osteopenia may not be directly applied to QUS. There is therefore an urgent need to understand the fundamental dependence of QUS parameters, to perform calibration and cross-correlation studies of QUS devices, and to define its clinical utility.

  19. Herbal treatment for osteoporosis: a current review.

    PubMed

    Leung, Ping-Chung; Siu, Wing-Sum

    2013-04-01

    Osteoporosis is an aging problem. The declining bone mineral density (BMD) enhances the chances of fractures during minor falls. Effective pharmaceuticals are available for a rapid improvement of BMD. However, hormonal treatment gives serious complications, and bisphosphonates may lead to odd fractures of long bones, resulting from excessive rigidity of the cortical components. Many medicinal herbs used in Traditional Chinese Medicine, known as kidney tonics, have been tested for their effects on bone metabolism in the laboratory and clinically. Three of these, viz. Herba epimedii (, Yín Yáng Huò), Fructus ligustri lucidi (, Nǚ Zhēn Zi), and Fructus psoraleae (, Bǔ Gǔ Zhī) were chosen to form a herbal formula, ELP. ELP was tested on in vitro platforms and was shown to have both osteoblastic and anti- osteoclastic action. ELP tested on ovariectomized rats also showed BMD protection. ELP was then put on a placebo- controlled randomized clinical trial. BMD protection was obvious among those women with the onset of menopause beyond 10 years (P < 0.05). A general protective trend was observed among all women under trial (P > 0.05). Although a thorough literature review on the herbal treatment effects did not give convincing answers to the use of Chinese herbs in osteoporosis, our study supports more research and trials in this area, while we are looking for safe and effective agents to keep the bone metabolism in a balanced state. PMID:24716161

  20. Idiopathic osteoporosis: an evolutionary dys-adaptation?

    PubMed Central

    Alexander, C

    2001-01-01

    Osteoporosis is characterised by simultaneous net bone growth and net resorption on different surfaces, suggesting that systemic factors are not the sole explanation for the findings. The main clinical consequence is fracturing in the largely trabecular bones of the spine, hip, and radius, and the key problem in these areas is finding an explanation for the preferential loss of transverse trabeculae. In normal bone, local maintenance depends on a negative feedback response to intermittent compression strain, and it is concluded, from biomechanical analysis of the response required to achieve negative feedback, that a preferential loss of transverse trabeculae is indicative of a selective deficiency of radial compression loading. The only significant source of radial compression in humans is the induced strain produced by axial tension. This is a necessary component of the lifestyles of quadrupeds and arboreal primates, but in humans occurs only on the convex side when the bone is offset loaded. The resulting strain is a function of the range of movement. It is suggested that the asymmetrical pattern of bone loss in cortical and trabecular osteoporosis reflects chronic underuse of movement range, resulting from the adoption of a bipedal lifestyle. Exercise regimens based on using the whole of the available movement range should better prepare the skeleton to adjust to other factors hostile to bone maintenance.

 PMID:11350841

  1. The Role of Calcium in Osteoporosis

    NASA Technical Reports Server (NTRS)

    Arnaud, C. D.; Sanchez, S. D.

    1991-01-01

    Calcium requirements may vary throughout the lifespan. During the growth years and up to age 25 to 30, it is important to maximize dietary intake of calcium to maintain positive calcium balance and achieve peak bone mass, thereby possibly decreasing the risk of fracture when bone is subsequently lost. Calcium intake need not be greater than 800 mg/day during the relatively short period of time between the end of bone building and the onset of bone loss (30 to 40 years). Starting at age 40 to 50, both men and women lose bone slowly, but women lose bone more rapidly around the menopause and for about 10 years after. Intestinal calcium absorption and the ability to adapt to low calcium diets are impaired in many postmenopausal women and elderly persons owing to a suspected functional or absolute decrease in the ability of the kidney to produce 1,25(OH)2D2. The bones then become more and more a source of calcium to maintain critical extracellular fluid calcium levels. Excessive dietary intake of protein and fiber may induce significant negative calcium balance and thus increase dietary calcium requirements. Generally, the strongest risk factors for osteoporosis are uncontrollable (e.g., sex, age, and race) or less controllable (e.g., disease and medications). However, several factors such as diet, physical activity, cigarette smoking, and alcohol use are lifestyle related and can be modified to help reduce the risk of osteoporosis.

  2. The Impact of Substance Abuse on Osteoporosis Screening and Risk of Osteoporosis in Women with Psychotic Disorders

    PubMed Central

    Kelly, Deanna L.; Myers, Carol S.; Abrams, Michael T.; Feldman, Stephanie; Park, Junyong; McMahon, Robert P.; Shim, Joo-Cheol

    2013-01-01

    Osteoporosis is a major public health concern. Substance abuse and psychosis may be risk factors, however frequency of screening and disease risk in women with psychotic disorders and substance use disorder (SUD) remains unknown. Methods This study examined rates (FY 2005) of osteoporosis screening and disease risk in Medicaid enrolled women aged 50 to 64 (N=18,953). Four diagnostic groups were characterized: 1) Psychosis; 2) SUD; 3) Major mood disorder and 4) Controls. The interaction of psychosis and SUD on screening and disease prevalence of osteoporosis was tested. Results The prevalence of osteoporosis across the entire population was 6.7%. Four percent of those without an osteoporosis diagnosis received osteoporosis screening with no notable differences between psychosis and controls. Those with SUD, however, had a significant reduction in screening compared to controls (OR=0.61, 95% CI 0.40–0.91, p=0.016). Women with a major mood disorder were more likely to have osteoporosis in their administrative record (OR=1.32, 95% CI=1.03–1.70, p=0.028) compared to controls. Those who were dually diagnosed (SUD and psychosis) in the oldest ages (55–64 years) had a markedly higher prevalence of osteoporosis compared to controls (OR=6.4 CI 1.51–27.6, p=0.012), whereas this interaction (SUD and psychosis) was not significant in the entire population over age 49. Conclusions Osteoporosis screening in the Medicaid population is significantly lower for women with SUD, after adjusting for age, race and Medicaid enrollment category. The prevalence of osteoporosis appears markedly elevated in those with major mood disorders and those over age 55 dually diagnosed with schizophrenia and SUD. PMID:20533029

  3. Star Light, Star Bright.

    ERIC Educational Resources Information Center

    Iadevaia, David G.

    1984-01-01

    Presents a technique for obtaining a rough measure of the brightness among different stars. Materials needed include a standard 35-mm camera, a plastic ruler, and a photo enlarger. Although a telescope can be used, it is not essential. (JN)

  4. 74 FR 22942 - Small Entity Compliance Guide: Health Claims; Calcium and Osteoporosis, and Calcium, Vitamin D...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2009-05-15

    ... Osteoporosis, and Calcium, Vitamin D, and Osteoporosis; Availability AGENCY: Food and Drug Administration, HHS..., Vitamin D, and Osteoporosis--Small Entity Compliance Guide.'' The small entity compliance guide (SECG) is... claim to be made for calcium and vitamin D and osteoporosis, and eliminate several requirements of...

  5. COPD and osteoporosis: links, risks, and treatment challenges.

    PubMed

    Inoue, Daisuke; Watanabe, Reiko; Okazaki, Ryo

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis and its related fractures are common and have significant impacts on quality of life and even respiratory function in patients with COPD. COPD-associated osteoporosis is however extremely undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Various clinical risk factors of osteoporosis in COPD patients, including older age, emaciation, physical inactivity, and vitamin D deficiency, have also been described. It is critically important for pulmonologists to be aware of the high prevalence of osteoporosis in COPD patients and evaluate them for such fracture risks. Routine screening for osteoporosis will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage and give them appropriate treatment to prevent fracture, which may lead to improved quality of life as well as better long-term prognosis. PMID:27099481

  6. Population-based osteoporosis education for older women.

    PubMed

    Curry, Linda C; Hogstel, Mildred O; Davis, Gail C; Frable, Pamela J

    2002-01-01

    With an increased focus on wellness and health promotion, there is a need for community-based strategies to complement traditional strategies aimed at improving individual and aggregate health. An educational program on the prevention, diagnosis, and treatment of osteoporosis was provided for 188 women age 60 and older in three different community settings: churches, retirement homes, and senior citizen centers. The major purposes of the study were to determine whether a community-based program might (a) contribute to older women's knowledge about osteoporosis and (b) promote their intent to use this knowledge. Each participant completed a demographic profile, the Osteoporosis Risk Checklist, and the Osteoporosis Knowledge Questionnaire (OKQ), with the OKQ serving as a pre- and post-test. Before post-testing, a 30-min educational program was provided. Differences among the three groups were risk factors, prior knowledge about osteoporosis, and knowledge at the completion of the program. A majority of the clients indicated an intent to increase calcium in their diet, discuss osteoporosis with their health care provider, check their home environment for safety/falls, and discuss what they had learned with others. Nurses need to plan educational programs in all settings to teach older clients about the risk factors, prevention, diagnosis, and treatment of osteoporosis. PMID:12406180

  7. Increased risk of osteoporosis in patients with erectile dysfunction

    PubMed Central

    Wu, Chieh-Hsin; Lu, Ying-Yi; Chai, Chee-Yin; Su, Yu-Feng; Tsai, Tai-Hsin; Tsai, Feng-Ji; Lin, Chih-Lung

    2016-01-01

    Abstract In this study, we aimed to investigate the risk of osteoporosis in patients with erectile dysfunction (ED) by analyzing data from the Taiwan National Health Insurance Research Database (NHIRD). From the Taiwan NHIRD, we analyzed data on 4460 patients aged ≥40 years diagnosed with ED between 1996 and 2010. In total, 17,480 age-matched patients without ED in a 1:4 ratio were randomly selected as the non-ED group. The relationship between ED and the risk of osteoporosis was estimated using Cox proportional hazard regression models. During the follow-up period, 264 patients with ED (5.92%) and 651 patients without ED (3.65%) developed osteoporosis. The overall incidence of osteoporosis was 3.04-fold higher in the ED group than in the non-ED group (9.74 vs 2.47 per 1000 person-years) after controlling for covariates. Compared with patients without ED, patients with psychogenic and organic ED were 3.19- and 3.03-fold more likely to develop osteoporosis. Our results indicate that patients with a history of ED, particularly younger men, had a high risk of osteoporosis. Patients with ED should be examined for bone mineral density, and men with osteoporosis should be evaluated for ED. PMID:27368024

  8. COPD and osteoporosis: links, risks, and treatment challenges

    PubMed Central

    Inoue, Daisuke; Watanabe, Reiko; Okazaki, Ryo

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis and its related fractures are common and have significant impacts on quality of life and even respiratory function in patients with COPD. COPD-associated osteoporosis is however extremely undertreated. Recent studies have suggested that both decreased bone mineral density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Various clinical risk factors of osteoporosis in COPD patients, including older age, emaciation, physical inactivity, and vitamin D deficiency, have also been described. It is critically important for pulmonologists to be aware of the high prevalence of osteoporosis in COPD patients and evaluate them for such fracture risks. Routine screening for osteoporosis will enable physicians to diagnose COPD patients with comorbid osteoporosis at an early stage and give them appropriate treatment to prevent fracture, which may lead to improved quality of life as well as better long-term prognosis. PMID:27099481

  9. Epidemiology and treatment of osteoporosis in women: an Indian perspective

    PubMed Central

    Khadilkar, Anuradha V; Mandlik, Rubina M

    2015-01-01

    The number of women with osteoporosis, ie, with reduced bone mass and the disruption of bone architecture, is increasing in India. While data on prevalence of osteoporosis among women in India come from studies conducted in small groups spread across the country, estimates suggest that of the 230 million Indians expected to be over the age of 50 years in 2015, 20%, ie, ~46 million, are women with osteoporosis. Thus, osteoporosis is a major public health problem in Indian women. Low calcium intakes with extensive prevalence of vitamin D deficiency, increasing longevity, sex inequality, early menopause, genetic predisposition, lack of diagnostic facilities, and poor knowledge of bone health have contributed toward the high prevalence of osteoporosis. Bone health may be optimized by creating an environment to achieve peak bone mass during adolescence, maintenance of healthy bone throughout the life cycle, and prevention of bone loss postmenopausal. In Indian women, calcium, vitamin D, and bisphosphonates are the commonest first-line therapies used. The use of other drugs such as hormone replacement therapy, estrogen agonists, calcitonin, parathyroid hormone, and denosumab is decided as per the affordability and availability of treatment options. Major gaps still remain in the diagnosis and management of osteoporosis, thus highlighting the need for more structured research in this area. This review focuses on the epidemiology of osteoporosis in Indian women and available treatments. PMID:26527900

  10. The Relationship between H. pylori Infection and Osteoporosis in Japan

    PubMed Central

    Asaoka, Daisuke; Nagahara, Akihito; Hojo, Mariko; Sasaki, Hitoshi; Shimada, Yuji; Yoshizawa, Takashi; Osada, Taro; Watanabe, Sumio

    2014-01-01

    Background and Objective. H. pylori infection causes a chronic inflammation in the gastric mucosa. However, this local inflammation may result in extra-digestive conditions. Our aim is to investigate the relationship between H. pylori infection and osteoporosis in Japan. Methods. This cross-sectional study was conducted among outpatients at the Juntendo University Hospital between 2008 and 2014. Participants for patient profile, H. pylori infection status, comorbidity, internal medical therapies, lumbar dual-energy X-ray absorptiometry (DXA), and bone turnover marker were collected and upper gastrointestinal endoscopy for reflux esophagitis, hiatal hernia, peptic ulcer disease (PUD), and endoscopic gastric mucosal atrophy (EGA) was performed. The diagnosis of osteoporosis was performed in accordance with the Japanese criteria. We investigated risk factors of osteoporosis. Results. Of the eligible 200 study subjects, 41 cases were of osteoporosis. Bivariate analysis showed that age, being female, BMI, alcohol, smoking, H. pylori, bone-specific ALP, PUD, and EGA were related to osteoporosis. Multivariate analysis showed that age (OR 1.13; 95%CI 1.07–1.20), being female (OR 4.77; 95%CI 1.78–12.77), BMI (OR 0.79; 95%CI 0.68–0.92), H. pylori (OR 5.33; 95%CI 1.73–16.42), and PUD (OR 4.98; 95%CI 1.51–16.45) were related to osteoporosis. Conclusions. H. pylori infection may be a risk factor of osteoporosis in Japan. PMID:25024699

  11. An outreach program improved osteoporosis management after a fracture.

    PubMed

    Feldstein, Adrianne C; Vollmer, William M; Smith, David H; Petrik, Amanda; Schneider, Jennifer; Glauber, Harry; Herson, Michael

    2007-09-01

    This longitudinal retrospective cohort study evaluated implementation of an intervention to improve management of osteoporosis after a fracture in a nonprofit group-model health maintenance organization (HMO) in the U.S. Pacific Northwest with 480,000 members and electronic medical record data. Participants were female HMO members aged 67 and older who sustained a qualifying clinical fracture(s) and who had not received a bone mineral density (BMD) measurement or osteoporosis treatment in the 12 months before the fracture (N=3,588). Phase 1 included outreach to clinicians and patients; Phase 2 added clinician and staff incentives. Primary outcome was "osteoporosis management"--receipt of a BMD measurement or osteoporosis medication in the 6 months after an index fracture. Before the intervention, 13.4% (95% confidence interval (CI)=12.0-14.8%) of patients had received osteoporosis management, and the time trend was not significant. Post-intervention, the probability of osteoporosis management increased on average 3.1% (95% CI=2.6-3.5%) every 2 months throughout both study phases without a significant added improvement in Phase 2. Improvement varied according to clinic and was less likely for patients with dementia. Overall, the probability of osteoporosis management increased from the baseline level of 13.4% to 44.0% (95% CI=40.0-48.0%) by the end of the study period (20 months post-intervention). The study found that an outreach program to primary care providers and patients improved the management of osteoporosis after a fracture. If widely implemented, this intervention could substantially improve the secondary prevention of osteoporosis. More-individualized interventions may be necessary for high-risk subgroups. PMID:17915345

  12. Fracture repair: general aspects and influence of osteoporosis and anti-osteoporosis treatment.

    PubMed

    Féron, Jean-Marc; Mauprivez, Raphaël

    2016-01-01

    Bone differs from other tissues in its capacity to self-repair after a fracture. The low bone mass and structural deterioration of bone associated with osteoporosis increases the risk of fragility fracture compared with healthy individuals. The intention of this article is to review the complex process of fracture repair and essential requirements for a successful fracture healing response summarized as the "diamond concept" in terms of aging and osteoporosis. The current preclinical and clinical evidence for a beneficial or harmful influence of anti-osteoporosis medications such as bisphosphonates, parathyroid hormone (PTH), strontium ranelate and antibodies of Wnt-inhibiting signaling proteins on bone healing is presented and discussed. Literature suggests that there are no detrimental consequences of such therapeutics on fracture repair processes. Following a fragility fracture, it seems that early start of preventive anti-osteoporotic treatment right after surgery does not delay the union of the fracture, except perhaps in the case of very rigidly fixed fracture requiring direct bone healing. There is some promising experimental and clinical evidence for possible enhancement of the bone repair process via administration of systemic agents. Further well designed studies in humans are necessary to accumulate more evidence on the positive effects and to translate this knowledge into valid therapeutic applications. PMID:26768282

  13. Osteoporosis services in secondary care: a UK survey.

    PubMed Central

    Rowe, R E; Cooper, C C

    2000-01-01

    A 1994 survey indicated that only 13 health authorities in the UK were purchasing access to dual X-ray absorptiometry (DXA), the most accurate measure of osteoporosis risk. By 1998 the number of centres (including private facilities providing DXA) was 161. All these were sent a questionnaire concerning their activities. 124 (77%) responded, and the survey found that DXA machines operate, on average, for only 3.6 days a week. Funding of and access to diagnostic services for osteoporosis varies greatly. There is clear scope for greater efficiency in the use of existing DXA machines and more equitable access to diagnostic services is required for effective management of osteoporosis. PMID:10700842

  14. How should clinicians manage osteoporosis in ankylosing spondylitis?

    PubMed

    Bessant, Rupa; Keat, Andrew

    2002-07-01

    Osteoporosis is a common complication of AS, with an incidence between 18.7% and 62%. The prevalence of osteoporosis is greater in males, and increases with increasing patient age and disease duration. Osteoporosis is also more common in patients with syndesmophytes, cervical fusion, and peripheral joint involvement. These variables are not all independent, as they may be indicators of disease duration. Osteoporosis in patients with AS is largely confined to the axial skeleton, in contrast to the pattern of osteoporosis seen in rheumatoid arthritis. BMD at the lumbar spine and femoral neck may be severely reduced, while most studies indicate that carpal and radial BMD remain within normal limits. The development of syndesmophytes in late AS can lead to difficulties in the use of DEXA scanning to determine lumbar BMD, as the extraspinal bone may obscure osteoporotic vertebrae. Under these circumstances more accurate assessment of lumbar BMD, and one that correlates better with femoral neck BMD, may be obtained by quantitative CT scanning or DEXA scanning of the lateral aspect of the L3 vertebra. Osteoporosis in AS significantly increases the risk of vertebral compression fractures within 5 years of the diagnosis of AS. The risk of a vertebral compression fracture occurring over a 30 year period following the diagnosis of AS is 14%, compared to 3.4% for population controls. In patients with vertebral osteoporosis relatively minor trauma, such as slipping, can lead to spinal fracture and dislocatior with subsequent damage to the spinal cord. There is a higher incidence of spinal cord injury following spinal fracture dislocations in patients with AS, and the resulting neurological deficit can range from mild sensory loss to complete paraplegia. Cytokines such as TNF-alpha and IL-6 may play an important part in the pathogenesis of osteoporosis in early AS, and IL-6 levels have been correlated with markers of disease activity and severity. In late AS, mechanical factors

  15. Association between Postmenopausal Osteoporosis and Experimental Periodontitis

    PubMed Central

    Luo, Kai; Ma, Souzhi; Guo, Jianbin; Huang, Yongling

    2014-01-01

    To investigate the correlation between postmenopausal osteoporosis (PMO) and the pathogenesis of periodontitis, ovariectomized rats were generated and the experimental periodontitis was induced using a silk ligature. The inflammatory factors and bone metabolic markers were measured in the serum and periodontal tissues of ovariectomized rats using an automatic chemistry analyzer, enzyme-linked immunosorbent assays, and immunohistochemistry. The bone mineral density of whole body, pelvis, and spine was analyzed using dual-energy X-ray absorptiometry and image analysis. All data were analyzed using SPSS 13.0 statistical software. It was found that ovariectomy could upregulate the expression of interleukin- (IL-)6, the receptor activator of nuclear factor-κB ligand (RANKL), and osteoprotegerin (OPG) and downregulate IL-10 expression in periodontal tissues, which resulted in progressive alveolar bone loss in experimental periodontitis. This study indicates that changes of cytokines and bone turnover markers in the periodontal tissues of ovariectomized rats contribute to the damage of periodontal tissues. PMID:24683547

  16. Prevention and treatment of postmenopausal osteoporosis

    PubMed Central

    Gallagher, J Christopher; Tella, Sri Harsha

    2014-01-01

    In the beginning, that is from the 1960's, when a link between menopause and osteoporosis was first identified; estrogen treatment was the standard for preventing bone loss, however there was no fracture data, even though it was thought to be effective. This continued until the Women's Health Initiative (WHI) study in 2001 that published data on 6 years of treatment with hormone therapy that showed an increase in heart attacks and breast cancer. Even though the risks were small, 1 per 1500 users annually, patients were worried and there was a large drop off in estrogen use. In later analyses the WHI study showed that estrogen reduced fractures and actually prevented heart attacks in the 50-60 year age group. Estrogen alone appeared to be safer to use than estrogen + the progestin medroxyprogesterone acetate and actually reduced breast cancer. PMID:24176761

  17. Premature menopause linked to CVD and osteoporosis.

    PubMed

    Park, Claire; Overton, Caroline

    2010-03-01

    Premature menopause affects 1% of women under the age of 40, the usual age of the menopause is 51. Most women will present with irregular periods or no periods at all with or without climacteric symptoms. Around 10% of women present with primary amenorrhoea. A careful history and examination are required. It is important to ask specifically about previous chemotherapy or radiotherapy and to look for signs of androgen excess e.g. polycystic ovarian syndrome, adrenal problems e.g. galactorrhoea and thyroid goitres. Once pregnancy has been excluded, a progestagen challenge test can be performed in primary care. Norethisterone 5 mg tds po for ten days or alternatively medroxyprogesterone acetate 10 mg daily for ten days is prescribed. A withdrawal bleed within a few days of stopping the norethisterone indicates the presence of oestrogen and bleeding more than a few drops is considered a positive withdrawal bleed. The absence of a bleed indicates low levels of oestrogen, putting the woman at risk of CVD and osteoporosis. FSH levels above 30 IU/l are an indicator that the ovaries are failing and the menopause is approaching or has occurred. It should be remembered that FSH levels fluctuate during the month and from one month to the next, so a minimum of two measurements should be made at least four to six weeks apart. The presence of a bleed should not exclude premature menopause as part of the differential diagnosis as there can be varying and unpredictable ovarian function remaining. The progestagen challenge test should not be used alone, but in conjunction with FSH, LH and oestradiol. There is no treatment for premature menopause. Women desiring pregnancy should be referred to a fertility clinic and discussion of egg donation. Women not wishing to become pregnant should be prescribed HRT until the age of 50 to control symptoms of oestrogen deficiency and reduce the risks of osteoporosis and CVD. PMID:20408329

  18. A sustained release gel formulation of doramectin for control of lone star ticks (Acari: Ixodidae) and horn flies (Diptera: Muscidae) on cattle.

    PubMed

    Lohmeyer, K H; Miller, J A; Pound, J M; Klavons, J A

    2009-04-01

    A gel formulation formed by incorporating technical doramectin into a 10% hydroxypropyl methylcellulose aqueous solution was used to subcutaneously inject steers at varying dosages. Doramectin serum concentration of steers receiving 600 microg (AI)/kg body weight declined from 21.9 ppb at 0.5 wk to below detectable at 8 wk postinjection. The 1,200 microg (AI)/kg injection resulted in serum concentrations of 29.1 ppb at 0.5 wk and declined to 0.5 ppb at 8 wk postinjection. Both the 600 and 1,200 microg (AI)/kg injections provided 100% inhibition of index of fecundity (IF) in adult lone star ticks, Amblyomma americanum L. (Acari: Ixodidae) through week 8, after which inhibition declined to 79.4 and 45.3%, respectively, during the 12th week posttreatment. For steers treated at 600 microg (AI)/kg, mortality of adult horn flies, Hematobia irritans L. (Diptera: Muscidae), declined from 16.9% during week 2 to 3.1% during week 7 postinjection. The blood from steers treated at 1,200 microg (AI)/kg resulted in a similar decline in mortality of blood fed adult horn flies from 29.4% during week 1 to 4.0% during week 7. The 600 microg (AI)/kg treatment provided complete control of larval horn flies in the manure for 9 wk, whereas the 1,200 microg (AI)/kg injection gave complete control for 14 wk posttreatment. The doramectin gel formulation provided long-lasting delivery of doramectin to cattle and extended control of lone star ticks and larval horn flies. Such a simple and inexpensive formulation could be useful in tick eradication programs by reducing the frequency of gathering cattle. PMID:19449664

  19. Recent genetic discoveries in osteoporosis, sarcopenia and obesity.

    PubMed

    Urano, Tomohiko; Inoue, Satoshi

    2015-01-01

    Osteoporosis is a skeletal disorder characterized by low bone mineral density (BMD) and an increased susceptibility to fractures. Evidence from genetic studies indicates that BMD, a complex quantitative trait with a normal distribution, is genetically controlled. Genome-wide association studies (GWAS) as well as studies using candidate gene approaches have identified single-nucleotide polymorphisms (SNPs) that are associated with BMD, osteoporosis and osteoporotic fractures. These SNPs have been mapped close to or within genes including those encoding WNT/β-catenin signaling proteins. Understanding the genetics of osteoporosis will help to identify novel candidates for diagnostic and therapeutic targets. Genetic factors are also important for the development of sarcopenia, which is characterized by a loss of lean body mass, and obesity, which is characterized by high fat mass. Hence, in this review, we discuss the genetic factors, identified by genetic studies, which regulate the body components related to osteoporosis, sarcopenia, and obesity. PMID:25866211

  20. How Long Should You Take Certain Osteoporosis Drugs?

    MedlinePlus

    ... For Consumers Home For Consumers Consumer Updates How Long Should You Take Certain Osteoporosis Drugs? Share Tweet ... FDA) have taken a close look at the long-term benefit of bisphosphonates, a class of medications ...

  1. Osteoporosis induced in mice by overproduction of interleukin 4.

    PubMed Central

    Lewis, D B; Liggitt, H D; Effmann, E L; Motley, S T; Teitelbaum, S L; Jepsen, K J; Goldstein, S A; Bonadio, J; Carpenter, J; Perlmutter, R M

    1993-01-01

    Osteoporosis is a common disease in which loss of bone mass results in skeletal fragility. The development of therapies for this disorder has been hampered by the lack of a convenient animal model. Here we describe a disorder in bone homeostasis in transgenic mice that inappropriately express the cytokine interleukin 4 (IL-4) under the direction of the lymphocyte-specific proximal promoter for the lck gene. Bone disease in lck-IL-4 mice appeared to result from markedly decreased bone formation by osteoblasts, features strikingly similar to those observed in cases of severe low-turnover human involutional osteoporosis. By 2 months of age, female and male lck-IL-4 mice invariably developed severe osteoporosis of both cortical and trabecular bone. Osteoporosis was observed in two independently derived founder animals, indicating that this phenotype was directly mediated by the IL-4 transgene. Images Fig. 1 Fig. 2 Fig. 3 PMID:8265598

  2. Neutron activation studies and the effect of exercise on osteoporosis

    SciTech Connect

    Harrison, J.E.

    1984-01-01

    A technique is described to measure calcium content by in vivo neutron activation analysis of the trunk and upper thighs. In postmenopausal women, estrogen and calcium or fluoride reversed osteoporosis.

  3. Effects of electromagnetic fields on osteoporosis: A systematic literature review.

    PubMed

    Wang, Rong; Wu, Hua; Yang, Yong; Song, Mingyu

    2016-01-01

    Electromagnetic fields (EMFs) as a safe, effective and noninvasive treatment have been researched and used for many years in orthopedics, and the common use clinically is to promote fracture healing. The effects of EMFs on osteoporosis have not been well concerned. The balance between osteoblast and osteoclast activity as well as the balance between osteogenic differentiation and adipogenic differentiation of bone marrow mesenchymal stem cells plays an important role in the process of osteoporosis. A number of recent reports suggest that EMFs have a positive impact on the balances. In this review, we discuss the recent advances of EMFs in the treatment of osteoporosis from basic research to clinical study and introduce the possible mechanism. In addition, we presented future perspectives of application of EMFs for osteoporosis. PMID:27356174

  4. Advances in Nanotechnology for the Treatment of Osteoporosis.

    PubMed

    Barry, Mikayla; Pearce, Hannah; Cross, Lauren; Tatullo, Marco; Gaharwar, Akhilesh K

    2016-06-01

    Osteoporosis is a degenerative bone disease commonly related to aging. With an increase in life expectancies worldwide, the prevalence of the disease is expected to rise. Current clinical therapeutic treatments are not able to offer long-term solutions to counter the bone mass loss and the increased risk of fractures, which are the primary characteristics of the disease. However, the combination of bioactive nanomaterials within a biomaterial scaffold shows promise for the development of a localized, long-term treatment for those affected by osteoporosis. This review summarizes the unique characteristics of engineered nanoparticles that render them applicable for bone regeneration and recaps the current body of knowledge on nanomaterials with potential for osteoporosis treatment and bone regeneration. Specifically, we highlight new developments that are shaping this emerging field and evaluate applications of recently developed nanomaterials for osteoporosis treatment. Finally, we will identify promising new research directions in nanotechnology for bone regeneration. PMID:27048473

  5. Side Effects of HIV Medicines: HIV and Osteoporosis

    MedlinePlus

    Side Effects of HIV Medicines HIV and Osteoporosis (Last updated 1/11/2016; last reviewed 1/11/2016) Key ... in HIV-1-Infected Adults and Adolescents: Adverse Effects of Antiretroviral Agents From the National Institutes of ...

  6. Current Clinical Practice Scenario of Osteoporosis Management in India

    PubMed Central

    Jhaveri, Shailesh; Upashani, Tejas; Bhadauria, Jitendra; Patel, Kamlesh

    2015-01-01

    Background Various osteoporosis guidelines are available for practice. Aim To understand the current clinical practice scenario from the perspective of Indian orthopaedicians, especially about the epidemiology, clinical manifestations, approach to diagnosis and management and patient compliance patterns to long term treatment. Materials and Methods A pre-validated structured questionnaire containing questions (mostly objective, some open-ended) catering to various objectives of the study was circulated amongst orthopaedic surgeons across India by means of post/courier, after giving a brief overview of the study telephonically. Data was extracted from the completed questionnaires, and analysed using Microsoft Excel software. Results The questionnaire was filled by a total of 84 orthopaedicians throughout India. The prevalence of osteoporosis in India according to the orthopaedic surgeons was 38.4% and there was a female preponderance. Most of the respondents felt out of every 100 osteoporosis patients in India, less than 20 patients are actually diagnosed and treated for osteoporosis. The most common initial presenting feature of established osteoporosis cases was general symptoms. Most respondents preferred Dual-energy X-ray absorptiometry (DEXA) as the initial investigation for the diagnosis of osteoporosis in a patient presenting with typical features. While most respondents preferred once-a-month oral over intravenous (IV) bisphosphonates, they agreed that IV administration had advantages such as lower gastrointestinal side effects and improved compliance. The average duration of therapy of oral bisphosphonates was the longest (27.04 months) among the other anti- osteoporosis therapies that they used. On an average, the patient compliance rate in osteoporosis management was around 64%. IV Zoledronic acid (ZA) and intranasal calcitonin were infrequently used than other anti- osteoporosis therapies. While concerns about cost and availability deterred more frequent

  7. Disuse osteoporosis of the upper limb: assessment of thirty patients

    PubMed Central

    Giannotti, Stefano; Bottai, Vanna; Dell’Osso, Giacomo; De Paola, Gaia; Bugelli, Giulia; Pini, Erica; Guido, Giulio

    2013-01-01

    Summary Osteoporosis is a multifactorial skeletal disorder characterized by the decrease of bone mass and the alteration of bone microarchitecture that leads to the increase of fracture risks. Traditionally, osteoporosis has been classified into primary and secondary osteoporosis. Primary osteoporosis refers to osteoporotic conditions which are not related to other chronic illnesses and is usually associated with aging and decreased gonadal function, such as decreased level of estrogen, whereas secondary osteoporosis is the type of osteoporosis caused by other health problems. Disuse is one of the many reasons inducing bone loss and resulting in secondary osteoporosis. The disuse osteoporosis appeared for the first time in the literature in 1974 when Minaire reported some histomorphometric analysis of iliac crest bone biopsies performed after a spinal cord injury. The most common skeleton sites in which disuse osteoporosis can be observed are knees and ankles. There are three clinical situation in which this disease can be observed: neurological or muscular disease that causes a pathological and prolonged immobilization. The most frequent is caused by a spinal cord injury, long term bed rest or space flight that causes the immobilization linked to changes in mechanical environment and experimental immobilizations in healthy subjects. Physical exercise is essential for increasing or maintaining bone mass and strength. In our study we wondered if the disuse of the upper limbs of a certain entity, lasting for a long time, can cause a decrease in BMD quantifiable with a densitometric evaluation of the distal radius and with an evaluation of the humeral cortical index such as to define a real osteoporosis from disuse. We analyzed 30 female patients without secondary osteoporosis older than 60 years: everyone underwent to vit D evaluation, densitometric exams of spine, hip and distal radius, Constant score and femoral and humeral cortical index evaluation. We observed

  8. Undertreatment of Osteoporosis Following Hip Fractures in Jeju Cohort Study

    PubMed Central

    Kim, Sang-Rim; Park, Yong-Geun; Kang, Soo Yong; Nam, Kwang Woo; Ha, Yong-Chan

    2014-01-01

    Background Osteoporosis treatment following hip fracture is well known to not enough. We previously performed intervention study for orthopaedic surgeon's education and reported twofold increase in osteoporosis detection and treatment rate observed between 2005 and 2007. This follow-up observational study was conducted to find out the rate in which a diagnostic workup and treatment for osteoporosis were done in patients with hip fracture. Methods Medical records and radiographs in patients who were older than 50 years and diagnosed as having femoral neck or intertrochanteric fractures at 8 hospitals in Jeju island, South Korea from 2008 to 2011 were reviewed. The numbers of patients who were studied with bone densitometry and who were treated for osteoporosis after the diagnosis of hip fracture were analyzed. Results Nine hundred forty five hip fractures (201 in 2008, 257 in 2009, 265 in 2010, and 304 in 2011) occurred in 191 men and 754 women during the study periods. The mean age of the patients was 79.7 years. The mean rate of osteoporosis detection using dual energy X-ray absorptiometry was 36.4% (344/945 hips) (ranged from 24.2% in 2009 to 40.5% in 2011). The mean initiation rate of osteoporosis treatment was 23.1% (218/945 hips) (ranged from 20% in 2009 to 29% in 2008). Conclusions Detection and treatment rate of osteoporosis following hip fracture during follow-up periods was still not enough. Additional intervention studies are required to further improvement of osteoporosis treatment rates after hip fracture. PMID:25489575

  9. Inhibition of osteoporosis in rats fed with sugar cane wax.

    PubMed

    Tamaki, Hajime; Man, Sun Li; Ohta, Yutaka; Katsuyama, Naofumi; Chinen, Isao

    2003-02-01

    Rats fed on a restricted, semi-purified diet containing a 50%-reduced level of carbohydrate and oil, but normal levels of protein, minerals and vitamins, exhibited osteoporosis. However, rats fed on this restricted diet, but containing sugar cane wax, did not exhibit this bone disease. Sugar cane wax, containing a long-chain carbohydrate with an OH radical, prevented the development of osteoporosis via a non-estrogenic mechanism. PMID:12729013

  10. Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease

    PubMed Central

    Wu, Chieh-Hsin; Tung, Yi-Ching; Chai, Chee-Yin; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Kuo, Keng-Liang; Lin, Chih-Lung

    2016-01-01

    Abstract To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset. This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531–534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model. During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19–142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03–1.34) compared to PUD patients without PPIs use. This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events. PMID:27100415

  11. Community based intervention to optimize osteoporosis management: randomized controlled trial

    PubMed Central

    2010-01-01

    Background Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multifaceted community-based care program aimed at optimizing evidence-based management in patients at risk for osteoporosis and fractures. Methods This was a 12-month randomized trial performed in Ontario, Canada. Eligible patients were community-dwelling, aged ≥55 years, and identified to be at risk for osteoporosis-related fractures. Two hundred and one patients were allocated to the intervention group or to usual care. Components of the intervention were directed towards primary care physicians and patients and included facilitated bone mineral density testing, patient education and patient-specific recommendations for osteoporosis treatment. The primary outcome was the implementation of appropriate osteoporosis management. Results 101 patients were allocated to intervention and 100 to control. Mean age of participants was 71.9 ± 7.2 years and 94% were women. Pharmacological treatment (alendronate, risedronate, or raloxifene) for osteoporosis was increased by 29% compared to usual care (56% [29/52] vs. 27% [16/60]; relative risk [RR] 2.09, 95% confidence interval [CI] 1.29 to 3.40). More individuals in the intervention group were taking calcium (54% [54/101] vs. 20% [20/100]; RR 2.67, 95% CI 1.74 to 4.12) and vitamin D (33% [33/101] vs. 20% [20/100]; RR 1.63, 95% CI 1.01 to 2.65). Conclusions A multi-faceted community-based intervention improved management of osteoporosis in high risk patients compared with usual care. Trial Registration This trial has been registered with clinicaltrials.gov (ID: NCT00465387) PMID:20799973

  12. Whole-body vibration exercise in postmenopausal osteoporosis

    PubMed Central

    Mieszkowski, Jan; Niespodziński, Bartłomiej; Ciechanowska, Katarzyna

    2015-01-01

    The report of the World Health Organization (WHO) of 2008 defines osteoporosis as a disease characterized by low bone mass and an increased risk of fracture. Postmenopausal osteoporosis is connected to the decrease in estrogens concentration as a result of malfunction of endocrine ovarian function. Low estrogens concentration causes increase in bone demineralization and results in osteoporosis. Physical activity, as a component of therapy of patients with osteoporosis, has been used for a long time now. One of the forms of safe physical activity is the vibration training. Training is to maintain a static position or execution of specific exercises involving the appropriate muscles on a vibrating platform, the mechanical vibrations are transmitted to the body of the patient. According to the piezoelectric theory, pressure induces bone formation in the electrical potential difference, which acts as a stimulant of the process of bone formation. Whole body vibration increases the level of growth hormone and testosterone in serum, preventing sarcopenia and osteoporosis. The aim of this study was to review the literature on vibration exercise in patients with postmenopausal osteoporosis based on the PubMed and Medline database. While searching the database, the following key words were used ‘postmenopausal osteoporosis’ and ‘whole-body vibration exercise’. PMID:26327887

  13. The association between osteoporosis and patient outcomes in Japan.

    PubMed

    Yamamoto, Luis A; DiBonaventura, Marco; Kawaguchi, Isao

    2016-07-01

    Objective To quantify the burden of osteoporosis and examine the interplay between osteoporosis and various comorbidities as it relates to patient outcomes. Methods Data from the 2011 Japan National Health and Wellness Survey (NHWS; n = 30 000), an internet health survey fielded to a nationally representative sample of the Japanese population were used. Only women between the ages of 50-90 years were included in the analyses (n = 6950). Results Compared with matched controls (n = 404), patients with osteoporosis (n = 404) had lower MCS scores (48.94 vs 51.63), PCS scores (45.57 vs 49.12) (all p < 0.05). The presence of osteoporosis was associated with worse patient outcomes among those with hypertension, high cholesterol, and insomnia, among other conditions. Conclusions The results suggest a significant quality-of-life and economic burden for patients with osteoporosis in Japan. Moreover, in a complex co-morbid environment, the presence of osteoporosis contributes more to patient outcomes than other chronic conditions. PMID:26929988

  14. Learning-based landmarks detection for osteoporosis analysis

    NASA Astrophysics Data System (ADS)

    Cheng, Erkang; Zhu, Ling; Yang, Jie; Azhari, Azhari; Sitam, Suhardjo; Liang, Xin; Megalooikonomou, Vasileios; Ling, Haibin

    2016-03-01

    Osteoporosis is the common cause for a broken bone among senior citizens. Early diagnosis of osteoporosis requires routine examination which may be costly for patients. A potential low cost diagnosis is to identify a senior citizen at high risk of osteoporosis by pre-screening during routine dental examination. Therefore, osteoporosis analysis using dental radiographs severs as a key step in routine dental examination. The aim of this study is to localize landmarks in dental radiographs which are helpful to assess the evidence of osteoporosis. We collect eight landmarks which are critical in osteoporosis analysis. Our goal is to localize these landmarks automatically for a given dental radiographic image. To address the challenges such as large variations of appearances in subjects, in this paper, we formulate the task into a multi-class classification problem. A hybrid feature pool is used to represent these landmarks. For the discriminative classification problem, we use a random forest to fuse the hybrid feature representation. In the experiments, we also evaluate the performances of individual feature component and the hybrid fused feature. Our proposed method achieves average detection error of 2:9mm.

  15. Guidelines for the diagnosis, prevention and management of osteoporosis.

    PubMed

    Rossini, M; Adami, S; Bertoldo, F; Diacinti, D; Gatti, D; Giannini, S; Giusti, A; Malavolta, N; Minisola, S; Osella, G; Pedrazzoni, M; Sinigaglia, L; Viapiana, O; Isaia, G C

    2016-01-01

    Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management. PMID:27339372

  16. Genetic Determinants of Osteoporosis: Common Bases to Cardiovascular Diseases?

    PubMed Central

    Marini, Francesca; Brandi, Maria Luisa

    2010-01-01

    Osteoporosis is the most common and serious age-related skeletal disorder, characterized by a low bone mass and bone microarchitectural deterioration, with a consequent increase in bone fragility and susceptibility to spontaneous fractures, and it represents a major worldwide health care problem with important implications for health care costs, morbidity and mortality. Today is well accepted that osteoporosis is a multifactorial disorder caused by the interaction between environment and genes that singularly exert modest effects on bone mass and other aspects of bone strength and fracture risk. The individuation of genetic factors responsible for osteoporosis predisposition and development is fundamental for the disease prevention and for the setting of novel therapies, before fracture occurrence. In the last decades the interest of the Scientific Community has been concentrated in the understanding the genetic bases of this disease but with controversial and/or inconclusive results. This review tries to summarize data on the most representative osteoporosis candidate genes. Moreover, since recently osteoporosis and cardiovascular diseases have shown to share common physiopathological mechanisms, this review also provides information on the current understanding of osteoporosis and cardiovascular diseases common genetic bases. PMID:20948561

  17. The effect of Apium Nodiflorum in experimental osteoporosis.

    PubMed

    Tsakova, Ana P; Surcheva, Slavina K; Bankova, Vasya S; Popova, Milena P; Peev, Dimitar R; Popivanov, Plamen R; Surchev, Kiril L; Ratkova, Mariya D; Surchev, Lachezar K; Vlaskovska, Mila V

    2015-01-01

    Treatment of osteoporosis remains a therapeutic challenge. The effect of Apium Nodiflorum extract on development of experimental osteoporosis, pain thresholds and carrageenan-induced inflammation has been studied in ovariectomized osteoporotic Wistar rats. After osteoporosis verification rats were randomized and received vehicle only, HPLC-standardized Apium extract (equal to 2.4 mg/kg Quercetin) or Genistein (2.5 mg/kg) for 8 weeks. To verify the effect of Apium on the development of osteoporosis, bone mineral density (BMD) and bone mineral content (BMC), bone histology and plasma levels of IL-6 and RANKL were measured 6 months after ovariectomy and 8 weeks after treatment with Apium extract or Genistein as comparator. Inflammatory hyperalgesia was induced by intraplantar injection of 1% Carrageenan. Apium extract and Genistein impeded the development of osteoporosis (significant differences were shown for BMC and BMD levels in drug vs. vehicle treated rats) and improved bone histology and histological score. Apium and Genistein decreased IL-6 level. Both treatments alleviated mechanical hyperalgesia, decreased exudative reaction and lowered inflammatory pain threshold. The results suggested that Apium extract could be an alternative therapy for post-menopausal osteoporosis. PMID:25543689

  18. Knowledge about osteoporosis prevention among women screened by bone densitometry

    PubMed Central

    Firlej, Ewelina; Żołnierczuk-Kieliszek, Dorota; Dziedzic, Małgorzata

    2016-01-01

    Introduction Osteoporosis is an illness characterized by the handicapped endurance of the bones, causing an increased risk of fracture. Aim of the study Aim of the study was to establish the level of knowledge about osteoporosis prevention among women screened by bone densitometry and to answer the question whether the level of knowledge is dependent on socio-demographic factors. Material and methods The research was realized by means of a survey method, a poll technique in 2014. The study involved 292 women aged 51-83. The examined women were patients undergoing bone densitometry in the healthcare centres in Lublin. The osteoporosis knowledge test (OKT, revised 2011) by Phyllis Gendler was used as a research tool. Gathered material was subject to descriptive and statistical analysis. Tukey's test, t-Student test and variance analysis (ANOVA) were all applied. A statistical significance level was set at α = 0.05. Results and conclusions Respondents presented the basic exercise knowledge (M = 9.97) and low knowledge concerning risk factors, screening and treatment of osteoporosis (M = 7.87). The calcium knowledge remained on an average level (M = 14.03). Better educated women, city inhabitants as well as women having very good or good social and welfare conditions showed a significantly higher level of knowledge about osteoporosis prevention. Even women undergoing bone densitometry examination present insufficient knowledge about osteoporosis prevention. PMID:27582684

  19. Theoretical and experimental investigation of multispectral photoacoustic osteoporosis detection method

    NASA Astrophysics Data System (ADS)

    Steinberg, Idan; Hershkovich, Hadas Sara; Gannot, Israel; Eyal, Avishay

    2014-03-01

    Osteoporosis is a widespread disorder, which has a catastrophic impact on patients lives and overwhelming related to healthcare costs. Recently, we proposed a multispectral photoacoustic technique for early detection of osteoporosis. Such technique has great advantages over pure ultrasonic or optical methods as it allows the deduction of both bone functionality from the bone absorption spectrum and bone resistance to fracture from the characteristics of the ultrasound propagation. We demonstrated the propagation of multiple acoustic modes in animal bones in-vitro. To further investigate the effects of multiple wavelength excitations and of induced osteoporosis on the PA signal a multispectral photoacoustic system is presented. The experimental investigation is based on measuring the interference of multiple acoustic modes. The performance of the system is evaluated and a simple two mode theoretical model is fitted to the measured phase signals. The results show that such PA technique is accurate and repeatable. Then a multiple wavelength excitation is tested. It is shown that the PA response due to different excitation wavelengths revels that absorption by the different bone constitutes has a profound effect on the mode generation. The PA response is measured in single wavelength before and after induced osteoporosis. Results show that induced osteoporosis alters the measured amplitude and phase in a consistent manner which allows the detection of the onset of osteoporosis. These results suggest that a complete characterization of the bone over a region of both acoustic and optical frequencies might be used as a powerful tool for in-vivo bone evaluation.

  20. Strange stars

    NASA Technical Reports Server (NTRS)

    Alcock, Charles; Farhi, Edward; Olinto, Angela

    1986-01-01

    Strange matter, a form of quark matter that is postulated to be absolute stable, may be the true ground stage of the hadrons. If this hypothesis is correct, neutron stars may convert to 'strange stars'. The mass-radius relation for strange stars is very different from that of neutron stars; there is no minimum mass, and for mass of 1 solar mass or less, mass is proportional to the cube of the radius. For masses between 1 solar mass and 2 solar masses, the radii of strange stars are about 10 km, as for neutron stars. Strange stars may have an exposed quark surface, which is capable of radiating at rates greatly exceeding the Eddington limit, but has a low emissivity for X-ray photons. The stars may have a thin crust with the same composition as the preneutron drip outer layer of a conventional neutron star crust. Strange stars cool efficiently via neutrino emission.

  1. Stars and Star Myths.

    ERIC Educational Resources Information Center

    Eason, Oliver

    Myths and tales from around the world about constellations and facts about stars in the constellations are presented. Most of the stories are from Greek and Roman mythology; however, a few Chinese, Japanese, Polynesian, Arabian, Jewish, and American Indian tales are also included. Following an introduction, myths are presented for the following 32…

  2. Be Stars

    NASA Astrophysics Data System (ADS)

    Peters, G.; Murdin, P.

    2000-11-01

    A Be star (pronounced `bee-ee' star) is a non-supergiant B-type star whose spectrum displays or has displayed one or more Balmer lines in emission and Be is the notation for the spectral classification of such a star (see also CLASSIFICATION OF STELLAR SPECTRA). `Classical' Be stars are believed to have acquired the circumstellar (CS) material that produces the Balmer emission through ejection of...

  3. Calcitonin treatment of immobilization osteoporosis in rats.

    PubMed

    Tuukkanen, J; Jalovaara, P; Väänänen, K

    1991-01-01

    We studied changes in bone mass induced by immobilization and the ability of salmon calcitonin to inhibit immobilization osteoporosis in rat. The bone mass of the immobilized hind leg of rat was compared with the contralateral non-treated leg. Neurectomy and cast immobilization reduced the bone mineral mass to an equal extent. However, the dose-response of calcitonin was different with these immobilization techniques. Calcitonin 15 IU kg-1 administered once daily reduced bone ash weight difference significantly after 2 weeks' neurectomy (P less than 0.001). This had no significant effect on the bone loss induced by cast immobilization, but the dose had to be delivered as two injections given every 12 h. Two weeks' immobilization decreased the incorporation of 45Ca into bones. Calcitonin could not prevent this. However, calcitonin tended to inhibit the overall incorporation of 45Ca into bones in immobilized rats but yet had no effect on 45Ca incorporation in non-immobilized rats. Immobilization decreased serum alkaline phosphatase activity in cast-immobilized animals. Neurectomy did not change serum alkaline phosphatase activity from a sham operation level. The tartrate-resistant acid phosphatase to total acid phosphatase ratio in the serum increased significantly in neurectomized rats and in cast-immobilized calcitonin-treated rats. PMID:2053438

  4. [Eating disorders as risk factors for osteoporosis].

    PubMed

    Rivera-Gallardo, Ma Teresa; Ma del Socorro, Parra-Cabrera; Barriguete-Meléndez, Jorge Armando

    2005-01-01

    Eating disorders (TCA per its abbreviation in Spanish) are common in young women, with an estimated prevalence of 4-5%. One of the physical complications of eating disorders, especially anorexia nervosa (AN) and eating disorder not otherwise specified (TANE) is bone mass loss, which affects both cortical and trabecular bone. The synergistic effect of malnutrition and estrogen deficiency produces significant bone mass loss, resulting from the uncoupling of bone turnover characterized by a decrease in osteoblastic bone formation and an increase in osteclastic bone resorption. The mechanisms implied in the pathogenesis of bone loss are the hypoestrogenism, hypercortisolism, serum leptin levels and insulin-like growth factor decrease. Severity of bone loss in anorexia nervosa varies depending on duration of illness, the minimal weight ever and sedentarism or strenuous exercise. Long term consequences occur, such as a fracture risk increase in patients who have suffered anorexia nervosa, compared with the general population. The first treatment line to recover bone mass is nutritional rehabilitation together with weight gain. Hormonal replacement therapy may be effective if combined with an anabolic method. Osteopenia and osteoporosis are terms adopted to define the deficiency of bone mass in adults. Authors have used these terms to define densitometric data in young subjects who have not reached their peak bone mass. We suggest the term "hypo-osteogenesia" to define the deficiency in the development of bone mass in adolescents or children. PMID:16259293

  5. Osteoporosis in the aging male: Treatment options

    PubMed Central

    Tuck, Stephen P; Datta, Harish K

    2007-01-01

    In elderly women, loss in bone mass and micro-architectural changes are generally attributed to the onset of menopause. Men do not experience menopause, they do, however, experience age-related acceleration in bone loss and micro-architecture deterioration. The incidence of osteoporotic fractures in elderly men, just as in aged women, increases exponentially with age; the rise in men, however, is some 5–10 years later than in women. Up to 50% of male osteoporotics have no identifiable etiology; however elderly males have much higher likelihood of having an identifiable secondary cause than younger men. Therefore, clinical and laboratory evaluation of aged male osteoporotics must be thorough and should be aimed at identifying lifestyle or conditions contributing to bone loss and fragility. It is essential to identify and treat secondary causes and ensure adequate vitamin D and calcium intake before embarking upon treatment with pharmacological agents. The evidence from a limited number of trials suggests that bisphosphonates, especially alendronate and risedronate, are effective in improving BMD, and seem to be the treatments of choice in aged men with osteoporosis. In cases where bisphosphonates are contra-indicated or ineffective, teriparatide or alternatives such as strontium should be considered. PMID:18225452

  6. Spine mineral change during osteoporosis therapy

    SciTech Connect

    Powell, M.R.; Kolb, F.O.; Meier, K.A.; Schafer, S.A.

    1985-05-01

    Osteoporosis therapy has been handicapped by lack of means to quantitate the process. Dual photon absorptiometry (DPA) offers accurate (4%) and precise (2%) estimation of lumbar spine mineral. The authors followed 42 osteoporotics to determine response to therapy. There were 17 patients with normal menopause (NM), 4 with surgical menopause (SM), 3 with premature menopause (PM), and 18 with idiopathic osteoporoses (10). Intervals between DPA spine mineral estimation were 16.5 +- 5.2 mo. for NM, 14.3 +- 8.4 mo. for SM, 14.0 +- 7.5 mo. for PM and 16.7 +- 5.8 mo. for 10. Observed average percent change of spine mineral under therapy for those intervals was 5.2 +- 7.9% for NM, +7.3 +- 1.7% for SM, -2.4 +- 6.3% for PM and +1.8 +- 12.3% for 10. Therapy invariably was with Ca, low dose Premarin in NM and PM, often with phosphates in IO, sometimes with thiazides, often with Vitamin D and with occasional other modalities, including NaF. The authors find DPA is a cost-effective way to measure osteopenia in the osteoporeses, document response to therapy, identify need for therapy change when there is continued bone loss under therapy, and to encourage the patient's compliance with long-term, complex therapies.

  7. Bone scintigraphy in fluoride treated osteoporosis

    SciTech Connect

    Froelich, J.W.; Kleerekoper, M.; Parker, D.A.

    1985-05-01

    Quantitative bone scintigraphy was performed on 23 white females with post-menopausal osteoporosis and vertebral compression fractures. These patients were then entered into a randomized, double-blind clinical trial or sodium fluoride therapy (NaF=14, placebo=9) which included repeat bone scintigraphy every six months. Scintigraphic images were acquired for 500K counts per image over the total body with computer acquisition over the posterior thoracic and lumbar spine. Images were obtained on a wide field-of-view gamma camera two hours after injecting 15 mCi of Tc-99m MDP. Data analysis showed a significant reduction in the activity ratio of abnormal vertebral body to normal vertebral body in those patients treated with sodium fluoride (paired t-test p=0.0095). No significant change was observed in the control group of (p=0.142). These results suggest that sodium fluoride therapy promotes more rapid healing of osteoporotic vertebral fractures. They also demonstrate the utility of serial quantitative bone scintigraphy in assessing osteoporotic patients with vertebral compression fractures.

  8. Affective Disorders, Bone Metabolism, and Osteoporosis

    PubMed Central

    2013-01-01

    The nature of the relationship between affective disorders, bone mineral density (BMD), and bone metabolism is unresolved, although there is growing evidence that many medications used to treat affective disorders are associated with low BMD or alterations in neuroendocrine systems that influence bone turnover. The objective of this review is to describe the current evidence regarding the association of unipolar and bipolar depression with BMD and indicators of bone metabolism, and to explore potential mediating and confounding influences of those relationships. The majority of studies of unipolar depression and BMD indicate that depressive symptoms are associated with low BMD. In contrast, evidence regarding the relationship between bipolar depression and BMD is inconsistent. There is limited but suggestive evidence to support an association between affective disorders and some markers of bone turnover. Many medications used to treat affective disorders have effects on physiologic systems that influence bone metabolism, and these conditions are also associated with a range of health behaviors that can influence osteoporosis risk. Future research should focus on disentangling the pathways linking psychotropic medications and their clinical indications with BMD and fracture risk. PMID:23874147

  9. Osteoporosis in the aging male: treatment options.

    PubMed

    Tuck, Stephen P; Datta, Harish K

    2007-01-01

    In elderly women, loss in bone mass and micro-architectural changes are generally attributed to the onset of menopause. Men do not experience menopause, they do, however, experience age-related acceleration in bone loss and micro-architecture deterioration. The incidence of osteoporotic fractures in elderly men, just as in aged women, increases exponen-tially with age; the rise in men, however, is some 5-10 years later than in women. Up to 50% of male osteoporotics have no identifiable etiology; however elderly males have much higher likelihood of having an identifiable secondary cause than younger men. Therefore, clinical and laboratory evaluation of aged male osteoporotics must be thorough and should be aimed at identifying lifestyle or conditions contributing to bone loss and fragility. It is essential to identify and treat secondary causes and ensure adequate vitamin D and calcium intake before embarking upon treatment with pharmacological agents. The evidence from a limited number of trials suggests that bisphosphonates, especially alendronate and risedronate, are effective in improving BMD, and seem to be the treatments of choice in aged men with osteoporosis. In cases where bisphosphonates are contra-indicated or ineffective, teriparatide or alternatives such as strontium should be considered. PMID:18225452

  10. Ultrasound-tagged light assessment of osteoporosis

    NASA Astrophysics Data System (ADS)

    Lev, A.; Rubanov, E.; Sfez, B.; Tsiplevich, Y.; Foldes, J.

    2007-02-01

    Last researches on Osteoporosis disease show's that the correlation between BMD information that come from DXA, and the fractual risk are not enough correlated. For this reason, new techniques that could be more sensitive and give different information's on the bone are being looking for. The key for success is to find a technique that could be detected changes in the micro-structure inside the trabecular bone, and supply more information on this structure. We have shown that pulse ultrasound light tomography could work in well reflection configuration and on living tissue to measure locally the "reduce scattering coefficient" inside the body. This technique could work deep inside the body (few cm) and could supply very good resolution. In the beginning on this research we show clinical results that justified planning more accurate and larger clinical study. The system suffers from mechanical and body interface problems that only very skill and professional physician could get a good results. This system also suffers from low signal to noise ratio, and irrevocable data on the same people. In this lecture we will present an upgrade and improved system. The mechanical and body interface changes will present and discusses. A good repeated data will be presented on phantoms and on peoples. Finally, large clinical data that operated in clinical technician on 60 Ultra distal bone peoples will present in compare to DXA data that was measure on the same peoples on the same place.

  11. New approaches to pharmacological treatment of osteoporosis.

    PubMed Central

    Akesson, Kristina

    2003-01-01

    Osteoporosis has been recognized as a major public health problem for less than two decades. The increasing incidence of fragility fractures, such as vertebral, hip, and wrist fractures, first became apparent from epidemiological studies in the early and mid-1980s, when effective treatment was virtually unavailable. Pharmacological therapies that effectively reduce the number of fractures by improving bone mass are now available widely in countries around the world. Most current agents inhibit bone loss by reducing bone resorption, but emerging therapies may increase bone mass by directly promoting bone formation--as is the case with parathyroid hormone. Current treatment alternatives include bisphosphonates, calcitonin, and selective estrogen receptor modulators, but sufficient calcium and vitamin D are a prerequisite. The availability of evidence-based data that show reductions in the incidence of fractures of 30-50% during treatment has been a major step forward in the pharmacological prevention of fractures. With all agents, fracture reduction is most pronounced for vertebral fracture in high-risk individuals; alendronate and risedronate also may protect against hip fracture in the elderly. New approaches to pharmacological treatment will include further development of existing drugs, especially with regard to tolerance and frequency of dosing. New avenues for targeting the condition will emerge as our knowledge of the regulatory mechanisms of bone remodelling increases, although issues of tissue specificity may be difficult to solve. In the long term, information gained through knowledge of bone genetics may be used to adapt pharmacological treatments more precisely to each individual. PMID:14710507

  12. Ophiopogonin D: A new herbal agent against osteoporosis.

    PubMed

    Huang, Qiang; Gao, Bo; Wang, Long; Zhang, Hong-Yang; Li, Xiao-Jie; Shi, Jun; Wang, Zheng; Zhang, Jin-Kang; Yang, Liu; Luo, Zhuo-Jing; Liu, Jian

    2015-05-01

    Excessive reactive oxygen species (ROS) play an important role in the development of osteoporosis. Ophiopogonin D (OP-D), isolated from the traditional Chinese herbal agent Radix Ophiopogon japonicus, is a potent anti-oxidative agent. We hypothesized that OP-D demonstrates anti-osteoporosis effects via decreasing ROS generation in mouse pre-osteoblast cell line MC3T3-E1 subclone 4 cells and a macrophage cell line RAW264.7 cells. We investigated OP-D on osteogenic and osteoclastic differentiation under oxidative status. Hydrogen peroxide (H2O2) was used to establish an oxidative damage model. In vivo, we established a murine ovariectomized (OVX) osteoporosis model. Then, we searched the molecular mechanism of OP-D against osteoporosis. Our results revealed that OP-D significantly promoted the proliferation of MC3T3-E1 cells and improved some osteogenic markers. Moreover, OP-D reduced TRAP activity and the mRNA expressions of osteoclastic genes in RAW264.7 cells. OP-D suppressed ROS generation in both MC3T3-E1 and RAW264.7 cells. OP-D treatment reduced the activity of serum bone degradation markers, including CTX-1 and TRAP. Further research showed that OP-D displayed anti-osteoporosis effects via reducing ROS through the FoxO3a-β-catenin signaling pathway. In summary, our results indicated that the protective effects of OP-D against osteoporosis are linked to a reduction in oxidative stress via the FoxO3a-β-catenin signaling pathway, suggesting that OP-D may be a beneficial herbal agent in bone-related disorders, such as osteoporosis. PMID:25582622

  13. [The significance of magnesium in orthopedics. V. Magnesium in osteoporosis].

    PubMed

    Ditmar, R; Steidl, L

    1989-04-01

    The authors submit an investigation of 60 patients with senile, post-menopausal and drug-induced osteoporosis. Using the method of absorption spectrophotometry, they found a reduced level of Mg in red blood cells in 63.6% of senile, 66.7% postmenopausal and only in 22.2% drug-induced osteoporoses. Also the mean level of red cell magnesium was significantly lower in the group of senile (1.94 mmol) and postmenopausal (1.85 mmol) osteoporosis as compared with drug-induced osteoporosis (2.25 mmol). The authors revealed moreover that the level of red cell magnesium in the former two groups declines in proportion to the severity of osteoporosis and correlates thus with the clinical and X-ray finding. For treatment of osteoporisis the authors used magnesium lactate alone (in 37 patients) and combined with sodium fluoride (in 23 patients). In the majority of patients they had very favourable results. Based on laboratory and therapeutic results, consistent with data in the experimental literature, the authors assume that magnesium as a catalyst of bone metabolism and as one of the most important factors controlling the formation of bone matrix and its mineralization plays a significant role in the aetiopathogenesis of senile and postmenopausal osteoporosis. The authors assume that Mg deficiency which is increasing in recent years in soil as well as in foodstuffs and water may be the main cause of the increasing number of patients with osteoporosis in civilized countries. Magnesium should have its firm place not only in therapy but also in prevention of the majority of osteoporosis. PMID:2750424

  14. Osteoporosis: the role of genetics and the environment.

    PubMed

    Ongphiphadhanakul, Boonsong

    2007-01-01

    Osteoporosis is partly genetically determined. The genetics of osteoporosis is polygenic in nature with multiple common polymorphic alleles interacting with each other and environmental factors to determine bone mass. A number of studies have attempted to dissect the genetic factors responsible for the pathogenesis of osteoporosis using genome-wide scanning and the candidate gene approach. However, the results of such studies among different populations have been mostly inconsistent, suggesting genetic heterogeneity of osteoporosis. It is likely that the cohort of genes indicating predisposition to the risk of osteoporosis may be different among populations with different ethnic backgrounds. The successful identification of susceptibility genes for osteoporosis should prove to be helpful in targeting preventive and therapeutic measures to individuals at higher risk and to render the effort more cost-effective. Information with regard to genetic variations is also likely to be useful in targeting preventive or therapeutic measures to subjects genetically determined to have better responsiveness. Intestinal calcium absorption is dependent on vitamin D receptor gene polymorphisms. Skeletal responsiveness to estrogen, particularly at lower doses, is related to polymorphisms in the estrogen receptor-alpha gene. Recently, circulating homocysteine levels have been shown to be associated with fracture risk. Folate and vitamin B supplements for reducing serum homocysteine and fractures in postmenopausal women have not been fully investigated. However, there is an interaction between folate status and methylenetetrahydrofolate reductase gene polymorphism on bone phenotypes. Due to recent technological advances, whole-genome association study is becoming more feasible. Genomic information with regard to the susceptibility to osteoporosis and the responsiveness to preventive or therapeutic modalities should supplement rather than replace conventional clinical information

  15. Dietary Patterns and Osteoporosis Risk in Postmenopausal Korean Women

    PubMed Central

    Park, Seon-Joo; Joo, Seong-Eun; Min, Haesook; Park, Jae Kyung; Kim, Yeonjung; Kim, Sung Soo; Ahn, Younjhin

    2012-01-01

    Objectives The prevalence of osteoporosis and related fractures has increased rapidly in Korean women. Proper nutrition intake is associated with the prevention of osteoporosis. We analyzed the association between dietary patterns and the risk of osteoporosis during a 4-year follow-up in postmenopausal Korean women. Methods Postmenopausal women (n = 1,725) who participated in the Korean Genome and Epidemiology Study were enrolled. Food intake was assessed using a validated semiquantitative food frequency questionnaire, and a quantitative ultrasound device was used to measure the speed of sound at the radius and tibia. Results Three major dietary patterns were identified using factor analysis based on baseline intake data: traditional (high intake of rice, kimchi, and vegetables), dairy (high intake of milk, dairy products, and green tea), and western (high intake of sugar, fat, and bread). Multivariate Cox proportional hazards models were used to estimate relative risk for osteoporosis. An inverse association was detected between the dairy dietary pattern and the osteoporosis incidence [relative risk (RR): 0.63, 95% confidence interval (CI): 0.42–0.93, p-trend=0.055 in radius; RR: 0.56, 95% CI: 0.35–0.90, p-trend=0.048 in tibia]. Individuals in the highest quintile for the traditional dietary pattern (p-trend = 0.009 in tibia) and western dietary pattern (p-trend = 0.043 in radius) demonstrated a higher risk of osteoporosis incidence than those in the lowest quintile. Conclusion These results suggested that high consumption of milk, dairy products, and green tea may reduce the risk of osteoporosis in postmenopausal Korean women. PMID:24159515

  16. The worldwide problem of osteoporosis: insights afforded by epidemiology.

    PubMed

    Riggs, B L; Melton, L J

    1995-11-01

    Osteoporosis is one of the major problems facing women and older people of both sexes. The morbid event in osteoporosis is fracture. However, the definition of osteoporosis should not require the presence of fractures but only a decrease in bone mass that is associated with an unacceptably high risk of fracture. In the USA, approximately 1.5 million fractures annually are attributable to osteoporosis: these include 700,000 vertebral fractures, 250,000 distal forearm (Colles') fractures, 250,000 hip fractures, and 300,000 fractures of other limb sites. The lifetime risk of fractures of the spine (symptomatic), hip, and distal radius is 40% for white women and 13% for white men from 50 years of age onwards. Following a hip fracture, there is a 10%-20% mortality over the subsequent 6 months, 50% of sufferers will be unable to walk without assistance, and 25% will require long-term domiciliary care. Contrary to prevailing opinion, the morbidity and suffering associated with wrist and spine fractures are also considerable. The annual cost of osteoporosis to the US healthcare system is at least $5-$10 billion with similar incidence and cost in other developed countries. These already high costs will increase further with continued aging of the population. In addition, the population explosion in underdeveloped countries will change the demography of osteoporosis; for example, the incidence of hip fracture, and, presumably, other osteoporotic fractures will increase four-fold worldwide during the next 50 years and the attendant costs will threaten the viability of the healthcare systems of many countries. Unless decisive steps for preventive intervention are taken now, a catastrophic global epidemic of osteoporosis seems inevitable. PMID:8573428

  17. Pulsating Stars

    NASA Astrophysics Data System (ADS)

    Catelan, M.; Smith, H. A.

    2015-03-01

    This book surveys our understanding of stars which change in brightness because they pulsate. Pulsating variable stars are keys to distance scales inside and beyond the Milky Way galaxy. They test our understanding not only of stellar pulsation theory but also of stellar structure and evolution theory. Moreover, pulsating stars are important probes of the formation and evolution of our own and neighboring galaxies. Our understanding of pulsating stars has greatly increased in recent years as large-scale surveys of pulsating stars in the Milky Way and other Local Group galaxies have provided a wealth of new observations and as space-based instruments have studied particular pulsating stars in unprecedented detail.

  18. Osteoporosis-related life habits and knowledge about osteoporosis among women in El Salvador: A cross-sectional study

    PubMed Central

    Hernandez-Rauda, Roberto; Martinez-Garcia, Sandra

    2004-01-01

    Background Osteoporosis is a systemic skeletal disorder, characterized by reduced bone mass, deterioration of bone structure, increased bone fragility, and increased fracture risk. It is more frequent to find among women than men at a 4:1 ratio. Evidence suggests that to adopt changes on some life habits can prevent or delay development of osteoporosis. Several osteoporosis-risk factors have been confirmed in the US and western Europe, but in El Salvador there are neither reliable epidemiological statistics about this skeletal disorder nor studies addressing osteoporosis-risk factors in women. The aim of this study was to determinate the extent of osteoporosis knowledge, the levels of both daily calcium intake and weight-bearing physical activity, and the influence of several osteoporosis-risk factors on these variables in three age groups of Salvadorean women. Methods In this exploratory cross-sectional study, an osteoporosis knowledge assessment questionnaire incluiding a food frequency and a physical activity record section were used to collect data and it was delivered through a face-to-face interview. A convenience sample (n = 197) comprised of three groups of women aged 25–35 years, 36–49 years, and over 49 years was taken. Among-group comparisons of means were analyzed by two-way ANOVA. To determinate the overall influence of osteoporosis-risk factors, the multivariate analysis was used. Results Study results indicated that better educated women had more knowledge about osteoporosis than women with a low education level, regardless of age, even though this knowledge was rather fair. Older women got more weight-bearing physical activity at home and less at place of employment than reported by the younger women; however, neither group performed sufficient high-intensity WBPA to improve bone mass. Regardless of age, the most women consumed 60% or less than the Dietary Reference Intake of calcium and depend on household income, lactose intolerance and coffee

  19. [Management of osteoporosis associated with rheumatoid arthritis and glucocorticoid-induced osteoporosis].

    PubMed

    Suzuki, Yasuo; Wakabayashi, Takayuki

    2015-12-01

    Mechanism of generalized osteoporosis associated with rheumatoid arthritis(RA)is multifactorial and following factors has been proposed:systemic effect of RA synovitis, glucocorticoids, weight loss, and endocrine changes. In addition to control of RA inflammation and management of glucocorticoid-induced osteoporosis(GIO), antiresorptive therapy, such as bisphosphonates is expected to show efficacy. Recently, anti-RANKL monoclonal antibodies have been shown to inhibit bone erosion and bone loss in combination with methotrexate in RA. GC-induced bone loss is most rapid during the initial 3 ~ 6 months and more slowly thereafter. Therefore, both primary and secondary prevention are important. The Japanese Society for Bone and Mineral Research(JSBMR)has updated the Guidelines on the Management and Treatment of GIO and has incorporated a new scoring method. By analyzing five GIO cohorts from primary and secondary prevention studies, age, GC dose, lumbar BMD, and prior fragility fractures were identified as risk factors and the fracture risk for an individual can be calculated as the sum of the scores for each risk factor. Pharmacological intervention should be started on the basis of a score of 3 as the optimal cut-off score. Both alendronate and risedronate are recommended as first-line treatment. Ibandronate,teriparatide, and active vitamin D3 derivatives are recommended as alternative option. PMID:26608858

  20. Chronic Psychological Stress as a Risk Factor of Osteoporosis.

    PubMed

    Azuma, Kagaku; Adachi, Yasuhiro; Hayashi, Haruki; Kubo, Kin-Ya

    2015-12-01

    Osteoporosis, the most common metabolic skeletal disease, is characterized by decreased bone mass and deteriorated bone quality, leading to increased fracture risk. With the aging of the population, osteoporotic fracture is an important public health issue. Organisms are constantly exposed to various stressful stimuli that affect physiological processes. Recent studies showed that chronic psychological stress is a risk factor for osteoporosis by various signaling pathways. The purpose of this article is to review the recent progress of the association between chronic psychological stress and osteoporosis. Increasing evidence confirms the physiological importance of the central nervous system, especially the hypothalamus, in the regulation of bone metabolism. Both animal and human studies indicate that chronic psychological stress induces a decrease of bone mass and deterioration of bone quality by influencing the hypothalamic-pituitary-adrenocortical (HPA) axis, sympathetic nervous system, and other endocrine, immune factors. Active mastication, proven to be an effective stress-coping behavior, can attenuate stress-induced neuroendocrine responses and ameliorate stress-induced bone loss. Therefore, active mastication may represent a useful approach in preventing and/or treating chronic stress-associated osteoporosis. We also discuss several potential mechanisms involved in the interaction between chronic stress, mastication and osteoporosis. Chronic stress activates the HPA axis and sympathetic nervous system, suppresses the secretion of gonadal hormone and growth hormone, and increases inflammatory cytokines, eventually leading to bone loss by inhibiting bone formation and stimulating bone resorption. PMID:26667192

  1. Phytate (myo-inositol hexaphosphate) and risk factors for osteoporosis.

    PubMed

    López-González, A A; Grases, F; Roca, P; Mari, B; Vicente-Herrero, M T; Costa-Bauzá, A

    2008-12-01

    Several risk factors seem to play a role in the development of osteoporosis. Phytate is a naturally occurring compound that is ingested in significant amounts by those with diets rich in whole grains. The aim of this study was to evaluate phytate consumption as a risk factor in osteoporosis. In a first group of 1,473 volunteer subjects, bone mineral density was determined by means of dual radiological absorptiometry in the calcaneus. In a second group of 433 subjects (used for validation of results obtained for the first group), bone mineral density was determined in the lumbar column and the neck of the femur. Subjects were individually interviewed about selected osteoporosis risk factors. Dietary information related to phytate consumption was acquired by questionnaires conducted on two different occasions, the second between 2 and 3 months after performing the first one. One-way analysis of variance or Student's t test was used to determine statistical differences between groups. Bone mineral density increased with increasing phytate consumption. Multivariate linear regression analysis indicated that body weight and low phytate consumption were the risk factors with greatest influence on bone mineral density. Phytate consumption had a protective effect against osteoporosis, suggesting that low phytate consumption should be considered an osteoporosis risk factor. PMID:19053869

  2. ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management.

    PubMed

    Saraff, Vrinda; Högler, Wolfgang

    2015-12-01

    Osteoporosis in children can be primary or secondary due to chronic disease. Awareness among paediatricians is vital to identify patients at risk of developing osteoporosis. Previous fractures and backaches are clinical predictors, and low cortical thickness and low bone density are radiological predictors of fractures. Osteogenesis Imperfecta (OI) is a rare disease and should be managed in tertiary paediatric units with the necessary multidisciplinary expertise. Modern OI management focuses on functional outcomes rather than just improving bone mineral density. While therapy for OI has improved tremendously over the last few decades, this chronic genetic condition has some unpreventable, poorly treatable and disabling complications. In children at risk of secondary osteoporosis, a high degree of suspicion needs to be exercised. In affected children, further weakening of bone should be avoided by minimising exposure to osteotoxic medication and optimising nutrition including calcium and vitamin D. Early intervention is paramount. However, it is important to identify patient groups in whom spontaneous vertebral reshaping and resolution of symptoms occur to avoid unnecessary treatment. Bisphosphonate therapy remains the pharmacological treatment of choice in both primary and secondary osteoporosis in children, despite limited evidence for its use in the latter. The duration and intensity of treatment remain a concern for long-term safety. Various new potent antiresorptive agents are being studied, but more urgently required are studies using anabolic medications that stimulate bone formation. More research is required to bridge the gaps in the evidence for management of paediatric osteoporosis. PMID:26041077

  3. Hormone replacement therapy and the prevention of postmenopausal osteoporosis

    PubMed Central

    Levancini, Marco

    2014-01-01

    Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR), is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs) such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC), is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence. PMID:26327857

  4. Application of the Dual-Frequency Ultrasonometer for Osteoporosis Detection

    PubMed Central

    Sarvazyan, Armen; Tatarinov, Alexey; Egorov, Vladimir; Airapetian, Souren; Kurtenok, Victor; Gatt, Charles J.

    2009-01-01

    The paper presents results of a clinical validation study of Bone UltraSonic Scanner (BUSS), a novel dual-frequency axial transmission ultrasonometer, developed by Artann Laboratories. Assessment of bone conditions is based on evaluating relative changes of the axial profiles of ultrasonic characteristics in long bones and utilizes bulk and guided acoustic waves. The objective of this study was to determine the ability of BUSS to discriminate osteoporosis development stages. A total of 93 menopausal and post-menopausal women divided into five groups from normal to advanced osteoporosis according to their DXA hip t-score were enrolled in the study. The 2D waveform profiles at low (0.1 MHz) and high (1 MHz) frequencies were obtained by scanning 15 cm along the proximal tibia. A multi-parametric linear classifier based on a set of the parameters derived from 2D acoustic waveform profiles has been developed. The efficiency of this classifier in differentiating osteoporosis from a normal sample was assessed using a Receiver Operating Characteristic (ROC) curve analysis. Based on the ROC analysis, BUSS demonstrated 76% sensitivity and 70% specificity to DXA-identified osteoporosis. The area under the ROC curve, which is a measure of how well a parameter can distinguish between the two diagnostic groups (diseased/normal) was 79.3%. The study confirmed BUSS’s capability to discriminate between stages of bone atrophy and in particular to distinguish early changes induced by osteoporosis. PMID:19036394

  5. Exercise interventions: defusing the world's osteoporosis time bomb.

    PubMed Central

    Kai, Ming Chan; Anderson, Mary; Lau, Edith M. C.

    2003-01-01

    Osteoporosis is a major public health problem, affecting millions of people worldwide. The associated health care costs are growing in parallel with increases in elderly populations, and it is expected that the number of osteoporotic fractures will double over the next 50 years. The best way to address osteoporosis is prevention. Some interventions to maximize and preserve bone mass have multiple health benefits and are cost-effective. For example, modifications to diet and lifestyle can help to prevent osteoporosis, and could potentially lead to a significant decrease in fracture rates; and exercise is a valuable adjunct to programmes aimed at alleviating the risks and symptoms of osteoporosis. Practising exercise at a young age helps maximize the mineral density of bones while they are still growing and maturing, and continuing to excercise minimizes bone loss later in life. Not only does exercise improve bone health, it also increases muscle strength, coordination, balance, flexibility and leads to better overall health. Walking, aerobic exercise, and t'ai chi are the best forms of exercise to stimulate bone formation and strengthen the muscles that help support bones. Encouraging physical activity at all ages is therefore a top priority to prevent osteoporosis. PMID:14758410

  6. Screening, diagnosis and treatment of osteoporosis: a brief review

    PubMed Central

    Bernabei, Roberto; Martone, Anna Maria; Ortolani, Elena; Landi, Francesco; Marzetti, Emanuele

    2014-01-01

    Summary Osteoporosis is a highly prevalent condition characterized by decreases in bone mass and microarchitectural alterations. Bone fractures, especially of the hip and vertebrae, are the most burdensome complications of osteoporosis, being associated with high risk of disability, institutionalization and mortality. The detection of osteoporosis relies on the quantification of bone mineral density via imaging techniques such as dual-energy X-ray absorptiometry. However, therapeutic decision-making should be based on a comprehensive fracture risk assessment, which may be obtained through validated algorithms. Once the decision of treating has been taken, non-pharmacological strategies should be implemented together with the prescription of anti-osteoporotic agents. Numerous drugs are currently available to treat osteoporosis and the choice of a specific compound should be guided by efficacy and safety considerations. The present review provides a concise synopsis of the current evidence in the management of osteoporosis, from screening to drug prescription. Novel anti-osteoporotic agents are also briefly presented. PMID:25568654

  7. Complementary and Alternative Medicine for Osteoporosis

    PubMed Central

    Hejazi, Zahra Alsadat; Namjooyan, Forough; Khanifar, Marjan

    2016-01-01

    Background: A systemic skeletal disease is characterized by low bone mass and micro-architectural deterioration with a consequent increase in bone fragility and susceptibility to fracture. Asia has the highest increment in the elderly population; therefore, osteoporotic fracture should be a noticeable health issue. The incidence rate of hip fractures in Asia could rise to 45% by the year 2050. Complementary and alternative medicine (CAM) is a group of various medical and health care systems, practices, and products that are not presently considered as part of formal medicine. CAMs have been described as “diagnosis, treatment, and/or prevention which complements mainstream medicine as a holistic, subjective and various natural approaches to medical problems by contributing to a common whole, satisfying claims not met by orthodoxy, or diversifying the conceptual frameworks of medicine”. Methods: Peer-reviewed publications were identified through a search in Scopus, Science Direct, Cochrane, PubMed, and Google scholar using keywords “osteopenia”, “osteoporosis”, “menopause”, “CAM”, “phytoestrogens”, “phytotherapy” and “herbal medicine”. The search was completed in July 2015 and was limited to articles published in English. Relevant articles were identified based on the expertise and clinical experience of the authors. Results: We categorized our results in different classifications including: lifestyle modifications (cigarette, alcohol, exercise and food regimen), supportive cares (intake supplements including vitamin D, C and K), treatments synthetic (routine and newer options for hormone replacement and none hormonal therapies) and natural options (different types of CAM including herbal medicines, yoga and chiropractic). Conclusion: Established osteoporosis is difficult to treat because bone density has fallen below the fracture threshold and trabecular elements may have been lost. Antiresorptive agents can be used to prevent further

  8. Role of nutrition and exercise in osteoporosis.

    PubMed

    Santora, A C

    1987-01-26

    Both adequate nutrition and exercise are essential for development of peak adult bone mass and maintenance of bone during aging. The optimal dietary level of a nutrient may vary from individual to individual and may change with age, intake of other nutrients, disease, drug therapy, or sex hormone status. Effects on spinal trabecular bone may not parallel effects on axial cortical bone. Calcium nutrition is important in the prevention of osteoporosis, as calcium is a major constituent of bone. The intake of calcium among most American adults is below the levels recommended by public health agencies. There have been no adequate prospective studies to determine the optimal intake of calcium for preservation of bone mass in young or middle-aged adults, although calcium balance studies indicate that premenopausal women require approximately 1,000 mg of calcium per day. The negative calcium balance of early menopause may be ameliorated by 1,000 mg of calcium per day; however, there is no proof that greater intakes fully reverse the effects of estrogen deficiency. Calcium requirements of both elderly men and women are likely to be greater (between 1,000 and 1,500 mg per day) due to an age-related decrease in the efficiency of intestinal calcium absorption. The optimal level of weight-bearing exercise for maintenance of bone mass in old age is probably similar to that of an active young adult. Maintenance of this activity level in middle and old age improves bone mass. An exercise prescription for elderly individuals must include an appraisal of cardiovascular and muscular-skeletal health and be designed to minimize the risk of trauma during exercise. PMID:3544836

  9. Massive Stars

    NASA Astrophysics Data System (ADS)

    Livio, Mario; Villaver, Eva

    2009-11-01

    Participants; Preface Mario Livio and Eva Villaver; 1. High-mass star formation by gravitational collapse of massive cores M. R. Krumholz; 2. Observations of massive star formation N. A. Patel; 3. Massive star formation in the Galactic center D. F. Figer; 4. An X-ray tour of massive star-forming regions with Chandra L. K. Townsley; 5. Massive stars: feedback effects in the local universe M. S. Oey and C. J. Clarke; 6. The initial mass function in clusters B. G. Elmegreen; 7. Massive stars and star clusters in the Antennae galaxies B. C. Whitmore; 8. On the binarity of Eta Carinae T. R. Gull; 9. Parameters and winds of hot massive stars R. P. Kudritzki and M. A. Urbaneja; 10. Unraveling the Galaxy to find the first stars J. Tumlinson; 11. Optically observable zero-age main-sequence O stars N. R. Walborn; 12. Metallicity-dependent Wolf-Raynet winds P. A. Crowther; 13. Eruptive mass loss in very massive stars and Population III stars N. Smith; 14. From progenitor to afterlife R. A. Chevalier; 15. Pair-production supernovae: theory and observation E. Scannapieco; 16. Cosmic infrared background and Population III: an overview A. Kashlinsky.

  10. STAR System.

    ERIC Educational Resources Information Center

    Doverspike, James E.

    The STAR System is a developmental guidance approach to be used with elementary school children in the 5th or 6th grades. Two basic purposes underlie STAR: to increase learning potential and to enhance personal growth and development. STAR refers to 4 basic skills: sensory, thinking, adapting, and revising. Major components of the 4 skills are:…

  11. Don't Let Osteoporosis Slow You Down | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Osteoporosis Cloris Leachman Leads By Example Past Issues / Winter ... new autobiography, Cloris , you mention that you have osteoporosis and asthma. Yet, at age 82 you were ...

  12. The Impact of Osteoporosis Continuing Education on Nurses' Knowledge and Attitudes.

    ERIC Educational Resources Information Center

    Berarducci, Adrienne; Lengacher, Cecile A.; Keller, Rosemary

    2002-01-01

    Of 81 nurses attending continuing education lecture/discussions on osteoporosis, 63 completed pre/posttests. A significant increase in osteoporosis knowledge and more awareness of their own health were found. (SK)

  13. Preventing and Treating Brittle Bones and Osteoporosis | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Javascript on. Feature: Osteoporosis Preventing and Treating Brittle Bones and Osteoporosis Past Issues / Winter 2011 Table of ... at high risk due to low bone mass. Bone and Bone Loss Bone is living, growing tissue. ...

  14. Bone Health and Osteoporosis: A Guide for Asian Women Aged 50 and Older

    MedlinePlus

    ... Bone Health for Lupus Patients Bone Health and Anorexia Nervosa Partner Resources Health Problems in Asian American/ ... medications such as corticosteroids and anticonvulsants history of anorexia nervosa. What Is Osteoporosis? Osteoporosis is a disease ...

  15. Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention | NIH MedlinePlus the Magazine

    MedlinePlus

    ... please turn Javascript on. Feature: Osteoporosis Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention Past Issues / Winter 2011 Table ... bump, or fall causes a bone to break. Diagnosis A bone mineral density test is the best ...

  16. Teriparatide treatment of osteoporosis in a patient with anorexia nervosa.

    PubMed

    Shibli-Rahhal, Amal; McCormick, Laurie

    2013-06-01

    Osteoporosis commonly occurs in patients with anorexia nervosa (AN) and is often irreversible even after weight restoration. We describe a 52-year-old woman with AN and severe osteoporosis, discovered after she sustained multiple fractures from a fall. She had low weight for most of her life, but was only formally diagnosed with AN 6 years prior to her presentation. She received therapy for her eating disorder and was able to restore weight, which led to a 4.1 % improvement in her bone density. We then treated her with teriparatide for 2 years, which lead to a further 21 % increase in bone density and she has had no recurrence of fractures. Since AN-associated osteoporosis is characterized by low bone formation, teriparatide may be a useful treatment option. PMID:23760852

  17. [The Importance of teriparatide in the treatment of osteoporosis].

    PubMed

    Yamauchi, Mika

    2016-06-01

    The anabolic agent teriparatide(TPTD)clearly increases bone mineral density both in daily and weekly formulations. In addition, the effectiveness of daily TPTD in reducing the risks of vertebral and non-vertebral fractures and of weekly TPTD in reducing the risk of vertebral fractures has been established. TPTD is indicated for severe osteoporosis, such as cases of multiple fractures, hip fractures, and fractures sustained during antiresorptive therapy. TPTD has also been shown to be effective for male osteoporosis and glucocorticoid-induced osteoporosis. Furthermore, TPTD can only be given for a limited duration, and requires sequential antiresorptive therapy following completion of administration. TPTD is the only anabolic agent that is currently available, and more effective methods of use such as combination and sequential therapies are being investigated. Moreover, clinical development of novel anabolic agents such as abaloparatide, a parathyroid hormone-related protein(PTHrP)analog, is being actively undertaken. PMID:27230847

  18. Secondary prevention of fractures and compliance to treatment in osteoporosis.

    PubMed

    Trevisan, Carlo

    2011-04-01

    Osteoporosis is a mechanical incompetence of bone which finally leads to fracture. The occurrence of a fracture for a minor trauma is the definitive evidence of bone fragility and an indication of an higher probability for other fractures. Fracture at any site is a strong risk factor for a subsequent fracture, therefore any patient with a prevalent fracture is an ideal candidate for treatment due to the high risk for recurrence and to a favourable cost-benefit ratio. Most of the available pharmacological agents approved for osteoporosis treatment are effective in reducing fracture risk in this class of patients. Unfortunately, poor compliance is very common in patients treated for osteoporosis and this leads to reduced benefits and ineffectual costs. Dose regimen simplification is neither the only nor the most important solution to improve compliance, and a multifaceted strategy targeting cognitive, behavioural and emotional factors should be employed. PMID:21970911

  19. CH Stars and Barium Stars

    NASA Astrophysics Data System (ADS)

    Bond, H.; Sion, E.; Murdin, P.

    2000-11-01

    The classical barium (or `Ba II') stars are RED GIANT STARS whose spectra show strong absorption lines of barium, strontium and certain other heavy elements, as well as strong features due to carbon molecules. Together with the related class of CH stars, the Ba II stars were crucial in establishing the existence of neutron-capture reactions in stellar interiors that are responsible for the synt...

  20. Osteoporosis guideline implementation in family medicine using electronic medical records

    PubMed Central

    Pritchard, Janet; Karampatos, Sarah; Ioannidis, George; Adachi, Jonathan; Thabane, Lehana; Nash, Lynn; Mehan, Upe; Kozak, Joseph; Feldman, Sid; Hirsch, Steve; Jovaisas, Algis V.; Cheung, Angela; Lohfeld, Lynne; Papaioannou, Alexandra

    2016-01-01

    Abstract Objective To identify family physicians’ learning needs related to osteoporosis care; determine family physicians’ preferred modes of learning; and identify barriers to using electronic medical records (EMRs) to implement osteoporosis guidelines in practice. Design Web-based survey. Setting Ontario. Participants Family physicians. Main outcome measures Quantitative and qualitative data about learning needs related to osteoporosis diagnosis and management; preferred mode of learning about guidelines; and barriers to using EMRs to implement guidelines. Results Of the 12 332 family physicians invited to participate in the survey, 8.5% and 7.0% provided partial or fully completed surveys, respectively. More than 80% of respondents agreed that the priority areas for education were as follows: selecting laboratory tests for secondary osteoporosis and interpreting the test results; interpreting bone mineral density results; determining appropriate circumstances for ordering anterior-posterior lumbar spine x-ray scans; and understanding duration, types, and adverse effects of pharmacotherapy. Qualitative analysis revealed that managing moderate-risk patients was a learning need. Continuing medical education was the preferred mode of learning. Approximately 80% of respondents agreed that the scarcity of EMR tools to aid in guideline implementation was a barrier to using guidelines, and 50% of respondents agreed that if EMR-embedded tools were available, time would limit their ability to use them. Conclusion This survey identified key diagnostic- and treatment-related topics in osteoporosis care that should be the focus of future continuing professional development for family physicians. Developers of EMR tools, physicians, and researchers aiming to implement guidelines to improve osteoporosis care should consider the potential barriers indicated in this study.

  1. Persistence with osteoporosis medication among newly-treated osteoporotic patients.

    PubMed

    van Boven, Job F M; de Boer, Pieter T; Postma, Maarten J; Vegter, Stefan

    2013-09-01

    Low persistence with osteoporosis medication is associated with higher fracture risk. Previous studies estimated that 1-year persistence with osteoporosis medication is low. Our aim was to study persistence with osteoporosis medication among patients with long-term follow-up (to 5 years). The InterAction Database (IADB) was used to analyze persistence of 8610 Dutch patients initiating osteoporosis drugs between 2003 and 2011. Drugs under study were alendronate, risedronate, ibandronate, etidronate, raloxifene and strontium ranelate. Cumulative persistence rates were calculated after different time frames (3 months-5 years) using survival analysis. Multivariate Cox proportional hazard analyses were used to identify determinants of non-persistence. Furthermore, switching rates of persistent patients who initiated bisphosphonate therapy were analyzed. Persistence with osteoporosis therapy was 70.7 % (95 % CI, 69.7-71.7), 58.5 % (95 % CI, 57.4-59.6 %), 25.3 % (95 % CI, 24.1-26.5) after 6 months, 1 and 5 years, respectively. Determinants associated with higher risk to non-persistence within the first year were daily dosing regimen [HR, 1.76 (95 % CI, 1.46-2.14)], age <60 years [HR, 1.26 (95 % CI, 1.19-1.34)] and use of glucocorticoids [HR, 1.16 (95 % CI, 1.07-1.26)]. Monthly dosing schedule and use of generic brands of alendronate did not show a significant association with non-persistence. Approximately 4.0 % of patients initiating therapy with weekly alendronate or weekly risedronate switched therapy. Persistence with osteoporosis medication is low. Because low persistence is strongly associated with higher fracture risk, interventions to improve persistence are recommended. This study identified several patient groups in whom such interventions may be most relevant. PMID:23575910

  2. Diagnosis and management of osteoporosis in the older senior

    PubMed Central

    Vondracek, Sheryl F; Linnebur, Sunny A

    2009-01-01

    The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weight-bearing exercise and smoking cessation if necessary. It is important to remember that falls play a very important role in the risk for osteoporotic fractures, especially in the older senior. All older seniors should be evaluated annually for falls and strategies should be implemented to reduce fall risk in this population. The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. Adequate intakes of calcium and vitamin D are important and deficiencies need to be treated. Data on osteoporosis drug therapy in the older senior are lacking. Based on data from subgroup analyses of large osteoporosis trials in postmenopausal women, current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies. Further studies are needed in older seniors, especially men, to better understand the risks and benefits of pharmacologic therapy for the management of osteoporosis. PMID:19503775

  3. Osteoporosis in celiac disease and in endocrine and reproductive disorders

    PubMed Central

    Stazi, Anna Velia; Trecca, Antonello; Trinti, Biagino

    2008-01-01

    As the increase in lifespan brings to light diseases that were previously not clinically detectable, osteoporosis has become an issue of worldwide significance. The disease is marked by a loss of bone mass; the bones become less dense, fragile and more prone to fracturing. Because it is regulated by endocrine and environmental factors, osteoporosis presents a multifactorial etiopathogenesis, with the genetic component accounting for 70% of an individual variation in bone mass density (BMD), the principal determinant, with age, of fracture risk. Pathological conditions such as celiac disease (CD) exacerbate the process of bone loss, so that the occurrence of osteoporosis in celiac subjects is of particular note: indeed, the screening of osteoporosis patients for this disease is advisable, since it may be the only sign of undiagnosed CD. An increase in interleukin IL-1β, of the IL-1 system, in the relatives of celiac patients confirms the genetic predisposition to osteoporosis and its presence is evidence of an association between the two conditions. The direct effect on the bones of CD is secondary to poor absorption of calcium and vitamin D. In women osteoporosis is indirectly associated with early menopause and amenorrhea, and it may follow prolonged breast-feeding and frequent pregnancies, while in men it is associated with hypogonadism and GH deficit. These endocrine and non-endocrine factors exert their effects on bones by modulating the RANK/RANK-L/OPG system. An appropriate lifestyle from adolescence onwards, together with early diagnosis of and treatment for CD and primary and secondary endocrine pathologies are important for the prevention of damage to the bones. PMID:18203279

  4. Association between the vitamin D receptor gene polymorphism and osteoporosis

    PubMed Central

    Wu, Ju; Shang, De-Peng; Yang, Sheng; Fu, Da-Peng; Ling, Hao-Yi; Hou, Shuang-Shuang; Lu, Jian-Min

    2016-01-01

    The influence of the vitamin D receptor (VDR) gene for the risk of osteoporosis remains to be elucidated. The aim of the present study was to understand the distribution of various single-nucleotide polymorphisms (SNPs) within the VDR gene and its association with the risk of osteoporosis. In total, 378 subjects without a genetic relationship were recruited to the study between January 2013 and July 2015. The subjects were divided into three groups, which were the normal (n=234), osteoporosis (n=65) and osteoporosis with osteoporotic fracture (n=79) groups. Three pertinent SNPs of the VDR gene rs17879735 (ApaI, Allele A/a, SNP C>A) were examined with polymerase chain reaction-restriction fragment length polymorphism. The bone mineral density (BMD) of the lumbar spine (L2-L4), femoral neck, Ward's and Tro was measured using dual-energy X-ray absorptiometry. The distributions of genotype frequencies aa, AA and Aa were 48.68, 42.86 and 8.46%, separately. Following analysis of each site, BMD, body mass index (BMI) and age, BMD for each site was negatively correlated with age (P<0.01) and positively correlated with BMI (P<0.01). Correction analysis revealed that there were significant differences in the Ward's triangle BMD among each genotype (P<0.05), in which the aa genotype exhibited the lower BMD (P<0.05). No significant difference was identified among the different genotypes in the occurrence of osteoporosis with osteoporotic fracture (P>0.05). In conclusion, these indicated that the VDR gene ApaI polymorphisms had an important role in the osteoporosis risk. PMID:27446548

  5. Symmetrical osteoporosis (spongy hyperostosis) in a prehistoric skull from New Mexico.

    PubMed

    Jarcho, S; Simon, N; Jaffe, H L

    1965-01-01

    Fragments of an Anasazi skull (Pueblo II-III) from New Mexico are described. Lesions of symmetrical osteoporosis were found and their anatomical and roentgenographic characteristics are discussed. The term symmetrical osteoporosis has led to confusion with the unrelated disease osteoporosis and should be replaced by the designation spongy hyperostosis. PMID:19588580

  6. COMMENTARY: A revised Clinician’s Guide to the Prevention and Treatment of Osteoporosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Osteoporosis is an important health problem now, and the incidence of fractures and their associated costs are rising rapidly as our population age. The National Osteoporosis Foundation (NOF) has estimated that by 2010, 12 million men and women in the U. S. will have osteoporosis and over 40 million...

  7. Inhaled corticosteroids can reduce osteoporosis in female patients with COPD

    PubMed Central

    Liu, Shih-Feng; Kuo, Ho-Chang; Liu, Guan-Heng; Ho, Shu-Chen; Chang, Huang-Chih; Huang, Hung-Tu; Chen, Yu-Mu; Huang, Kuo-Tung; Chen, Kuan-Yi; Fang, Wen-Feng; Lin, Meng-Chih

    2016-01-01

    Background Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without. Patients and methods This is a retrospective cohort and population-based study in which we extracted newly diagnosed female patients with COPD between 1997 and 2009 from Taiwan’s National Health Insurance (TNHI) database between 1996 and 2011 (International Classification of Diseases, Ninth Revision – Clinical Modification [ICD-9-CM] 491, 492, 496). The patients with COPD were defined by the presence of two or more diagnostic codes for COPD within 12 months on either inpatient or outpatient service claims submitted to TNHI. Patients were excluded if they were younger than 40 years or if osteoporosis had been diagnosed prior to the diagnosis of COPD and cases of asthma (ICD-9 CM code 493.X) before the index date. These enrolled patients were followed up till 2011, and the incidence of osteoporosis was determined. The Cox proportional hazards regression model was also used to estimate hazard ratios (HRs) for incidences of lung cancer. Results Totally, 10,723 patients with COPD, including ICS users (n=812) and nonusers (n=9,911), were enrolled. The incidence rate of osteoporosis per 100,000 person years is 4,395 in nonusers and 2,709 in ICS users (HR: 0.73, 95% confidence interval [CI]: 0.63–084). The higher ICS dose is associated with lower risk of osteoporosis (0 mg to ≤20 mg, HR: 0.84, 95% CI: 0.69–1.04; >20 mg to ≤60 mg, HR: 0.78, 95% CI: 0.59–1.04; and >60 mg, HR: 0.72, 95% CI: 0.55–0.96; P for trend =0.0023) after adjusting for age, income, and medications. The cumulative osteoporosis probability significantly decreased among the ICS users when compared with the nonusers (P<0.001). Conclusion Female patients with COPD using ICS have a dose–response protective effect for osteoporosis. PMID:27478374

  8. Medication-induced osteoporosis: screening and treatment strategies

    PubMed Central

    Panday, Keshav; Gona, Amitha

    2014-01-01

    Drug-induced osteoporosis is a significant health problem and many physicians are unaware that many commonly prescribed medications contribute to significant bone loss and fractures. In addition to glucocorticoids, proton pump inhibitors, selective serotonin receptor inhibitors, thiazolidinediones, anticonvulsants, medroxyprogesterone acetate, aromatase inhibitors, androgen deprivation therapy, heparin, calcineurin inhibitors, and some chemotherapies have deleterious effects on bone health. Furthermore, many patients are treated with combinations of these medications, possibly compounding the harmful effects of these drugs. Increasing physician awareness of these side effects will allow for monitoring of bone health and therapeutic interventions to prevent or treat drug-induced osteoporosis. PMID:25342997

  9. [Regulation of bone metabolism in osteoporosis : novel drugs for osteoporosis in development].

    PubMed

    Jakob, F; Genest, F; Baron, G; Stumpf, U; Rudert, M; Seefried, L

    2015-11-01

    Bone is continuously regenerated and remodeled as an adaptation to mechanical load. Bone mass and fracture resistance are maintained by a balanced equilibrium between bone formation and bone resorption. Regeneration and response to mechanical load are, however, impaired in osteoporosis and during aging. Bone resorption is enhanced by chronic inflammation while bone formation is altered by rising levels of inhibitors in the aging organism. Core molecular principles of the regulation of bone metabolism in health and disease have been characterized and developed as therapeutic targets. The receptor activator of nuclear factor kappaB ligand (RANKL) and osteoclast-derived protease cathepsin K are important regulators and effectors of osteoclast differentiation and bone resorption. Bone formation is stimulated by bone morphogenetic proteins (BMP) and via the parathyroid hormone receptor and the Wnt signaling pathway. The principles of osteoclast inhibition using bisphosphonates have now been known for almost three decades. Based on more recent knowledge RANKL and cathepsin K have been developed as new therapeutic targets to inhibit bone resorption. While denosumab, a RANKL antibody, has already been introduced into routine treatment strategies, the cathepsin K antagonist odanacatib is currently in the licensing process. Bone formation can also be stimulated by local administration of BMPs, by systemic treatment with the parathyroid hormone fragment teriparatide and by using antibodies targeting the Wnt inhibitor sclerostin. The latter are presently being tested in phase III clinical studies. In the near future a panel of traditional and novel treatment strategies will be available that will enable us to meet the individual clinical needs during aging and for the treatment of osteoporosis. PMID:26471379

  10. GRACE star camera noise

    NASA Astrophysics Data System (ADS)

    Harvey, Nate

    2016-08-01

    Extending results from previous work by Bandikova et al. (2012) and Inacio et al. (2015), this paper analyzes Gravity Recovery and Climate Experiment (GRACE) star camera attitude measurement noise by processing inter-camera quaternions from 2003 to 2015. We describe a correction to star camera data, which will eliminate a several-arcsec twice-per-rev error with daily modulation, currently visible in the auto-covariance function of the inter-camera quaternion, from future GRACE Level-1B product releases. We also present evidence supporting the argument that thermal conditions/settings affect long-term inter-camera attitude biases by at least tens-of-arcsecs, and that several-to-tens-of-arcsecs per-rev star camera errors depend largely on field-of-view.

  11. National Osteoporosis Society vitamin D guideline summary.

    PubMed

    Aspray, Terry J; Bowring, Claire; Fraser, William; Gittoes, Neil; Javaid, M Kassim; Macdonald, Helen; Patel, Sanjeev; Selby, Peter; Tanna, Nuttan; Francis, Roger M

    2014-09-01

    The National Osteoporosis Society (NOS) published its document, Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management, in 2013 as a practical clinical guideline on the management of vitamin D deficiency in adult patients with, or at risk of developing, bone disease. There has been no clear consensus in the UK on vitamin D deficiency its assessment and treatment, and clinical practice is inconsistent. This guideline is aimed at clinicians, including doctors, nurses and dieticians. It recommends the measurement of serum 25 (OH) vitamin D (25OHD) to estimate vitamin D status in the following clinical scenarios: bone diseases that may be improved with vitamin D treatment; bone diseases, prior to specific treatment where correcting vitamin D deficiency is appropriate; musculoskeletal symptoms that could be attributed to vitamin D deficiency. The guideline also states that routine vitamin D testing is unnecessary where vitamin D supplementation with an oral antiresorptive treatment is already planned and sets the following serum 25OHD thresholds: <30 nmol/l is deficient; 30-50 nmol/l may be inadequate in some people; >50 nmol/l is sufficient for almost the whole population. For treatment, oral vitamin D3 is recommended with fixed loading doses of oral vitamin D3 followed by regular maintenance therapy when rapid correction of vitamin D deficiency is required, although loading doses are not necessary where correction of deficiency is less urgent or when co-prescribing with an oral antiresorptive agent. For monitoring, serum calcium (adjusted for albumin) should be checked 1 month after completing a loading regimen, or after starting vitamin D supplementation, in case primary hyperparathyroidism has been unmasked. However, routine monitoring of serum 25OHD is generally unnecessary but may be appropriate in patients with symptomatic vitamin D deficiency or malabsorption and where poor compliance with medication is suspected. The guideline focuses

  12. What the Research Says About Exercise and Osteoporosis.

    ERIC Educational Resources Information Center

    White, Mary Kay; Rosenberg, Beth S.

    1985-01-01

    The effects of physical activity on the human skeleton are examined. Research studies are cited that indicate exercise may be beneficial in maintaining or increasing bone mineral content. Effects of exercise on the prevention or treatment of osteoporosis are uncertain. (DF)

  13. Osteoporosis: Implications for Risk Reduction in the College Setting.

    ERIC Educational Resources Information Center

    Leslie, Maryann; St. Pierre, Richard W.

    1999-01-01

    Examines risk factors for osteoporosis that are especially relevant to the college health setting, focusing on bone development, inadequate calcium and vitamin D intake, cigarette smoking and alcohol use, steroid use and high protein diets, and physical inactivity and excessive exercise. Also presents intervention strategies for college health…

  14. Prevention and treatment of senile osteoporosis and hip fractures.

    PubMed

    Duque, G; Demontiero, O; Troen, B R

    2009-02-01

    Osteoporosis is a major health issue worldwide, with significant economic consequences and adverse impacts on the quality of life. Hip fractures are the most devastating complication of osteoporosis, are likely to increase exponentially with an increasingly aged population, are associated with high recurrence rate, and lead to significant morbidity and mortality. This review discusses the prevalence and impact of hip fractures, the assessment of fracture risk, fall prevention, and treatment of osteoporosis with emphasis on evidence for hip fracture reduction among the various agents currently available. The aim is to provide recommendations to optimize hip fracture prevention and treatment. Ample evidence exists in the literature of many other risk factors independent from bone mineral density that increase fracture risk. These clinical risk factors have been validated in large cohorts and are incorporated into clinical tools that are invaluable in treatment decisions. In addition, strategies to prevent or reduce falls are integral to comprehensive osteoporosis management. Vitamin D combined with calcium has a role in primary prevention. Alendronate, residronate, strontium and zoledronic acid have proven efficacy in primary and secondary hip fracture prevention. An aggressive approach to investigate, assess and manage an individual's fracture risk and fall risk is paramount to reduce the high morbidity and mortality associated with hip fractures. The choice of therapy should be determined by the patient's calculated fracture risk and efficacy of the potential treatment, including long term compliance associated with the agent of choice. PMID:19277006

  15. Epigenetic influences in the developmental origins of osteoporosis.

    PubMed

    Holroyd, C; Harvey, N; Dennison, E; Cooper, C

    2012-02-01

    Osteoporosis is a major public health problem due to consequent fragility fractures; data from the UK suggest that up to 50% of women and 20% men aged 50 years will have an osteoporosis-related fracture in their remaining lifetime. Skeletal size and density increase from early embryogenesis through intrauterine, infant, childhood and adult life to reach a peak in the third to fourth decade. The peak bone mass achieved is a strong predictor of later osteoporosis risk. Epidemiological studies have demonstrated a positive relationship between early growth and later bone mass, both at peak and in later life, and also with reduced risk of hip fracture. Mother-offspring cohorts have allowed the elucidation of some of the specific factors in early life, such as maternal body build, lifestyle and 25(OH)-vitamin D status, which might be important. Most recently, the phenomenon of developmental plasticity, whereby a single genotype may give rise to different phenotypes depending on the prevailing environment, and the science of epigenetics have presented novel molecular mechanisms which may underlie previous observations. This review will give an overview of these latter developments in the context of the burden of osteoporosis and the wider data supporting the link between the early environment and bone health in later life. PMID:21656266

  16. Risedronate/zinc-hydroxyapatite based nanomedicine for osteoporosis.

    PubMed

    Khajuria, Deepak Kumar; Disha, Choudhary; Vasireddi, Ramakrishna; Razdan, Rema; Mahapatra, D Roy

    2016-06-01

    Targeting of superior osteogenic drugs to bone is an ideal approach for treatment of osteoporosis. Here, we investigated the potential of using risedronate/zinc-hydroxyapatite (ZnHA) nanoparticles based formulation in a rat model of experimental osteoporosis. Risedronate, a targeting moiety that has a strong affinity for bone, was loaded to ZnHA nanoparticles by adsorption method. Prepared risedronate/ZnHA drug formulation was characterized by field-emission scanning electron microscopy, X-ray diffraction analysis and fourier transform infrared spectroscopy. In vivo performance of the prepared risedronate/ZnHA nanoparticles was tested in an experimental model of postmenopausal osteoporosis. Therapy with risedronate/ZnHA drug formulation prevented increase in serum levels of bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase 5b better than risedronate/HA or risedronate. With respect to improvement in the mechanical strength of the femoral mid-shaft and correction of increase in urine calcium and creatinine levels, the therapy with risedronate/ZnHA drug formulation was more effective than risedronate/HA or risedronate therapy. Moreover, risedronate/ZnHA drug therapy preserved the cortical and trabecular bone microarchitecture better than risedronate/HA or risedronate therapy. Furthermore, risedronate/ZnHA drug formulation showed higher values of calcium/phosphorous ratio and zinc content. The results strongly implicate that risedronate/ZnHA drug formulation has a therapeutic advantage over risedronate or risedronate/HA therapy for the treatment of osteoporosis. PMID:27040198

  17. Understanding the Female Athlete Triad: Eating Disorders, Amenorrhea, and Osteoporosis.

    ERIC Educational Resources Information Center

    Beals, Katherine A.; Brey, Rebecca A.; Gonyou, Julianna B.

    1999-01-01

    Examines three disorders that can affect female athletes who focus on succeeding athletically and achieving a prescribed body weight: disordered eating, amenorrhea, and osteoporosis. The paper presents prevention and treatment suggestions for athletes with eating disorders, focusing on primary, secondary, and tertiary prevention. Recommends that…

  18. Project Healthy Bones: An Osteoporosis Prevention Program for Older Adults.

    ERIC Educational Resources Information Center

    Klotzbach-Shimomura, Kathleen

    2001-01-01

    Project Healthy Bones is a 24-week exercise and education program for older women and men at risk for or who have osteoporosis. The exercise component is designed to improve strength, balance, and flexibility. The education curriculum stresses the importance of exercise, nutrition, safety, drug therapy, and lifestyle factors. (SK)

  19. The Role of Calcium in Prevention and Treatment of Osteoporosis.

    ERIC Educational Resources Information Center

    Heaney, Robert P.

    1987-01-01

    Osteoporosis results from several factors. Calcium deficiency is only one, and high calcium intake will prevent only those cases in which calcium is the limiting factor. Calcium cannot reverse, but only arrest, bone loss. A high calcium intake for every member of the population is advocated. (Author/MT)

  20. Physician Educational Needs in Osteoporosis: An Approach to Needs Assessment.

    ERIC Educational Resources Information Center

    Lockyer, Jocelyn; Hanley, David; Fidler, Herta; Toews, John; Lysholm-Andrews, Elaine

    1998-01-01

    A literature review, focus groups (n=200), and questionnaire responses from 324 family physicians identified their learning needs related to osteoporosis. The three methods identified different learning issues, suggesting the importance of triangulation to ensure currency and relevance in continuing-education needs-assessment. (SK)

  1. Evaluation of the Osteoporosis Health Belief Scale in Korean Women

    PubMed Central

    Kim, Tae-Hee; Lee, Young-Sang; Byun, Dong Won; Jang, Seyeon; Jeon, Dong-Su

    2013-01-01

    Background The Osteoporosis Health Belief Scale (OHBS) is a 42-item questionnaire designed to assess susceptibility, seriousness, calcium benefits, calcium barriers, exercise benefits, exercise barriers, and health motivation related to osteoporosis. We aimed to evaluate its psychometric properties to enable the provision of educational tips regarding osteoporosis. Methods All women who had visited the department of obstetrics and gynecology (OBGYN) and whose bone mineral density was measured from January 2010 to December 2011 were enrolled by interview using the OHBS. We also evaluated the women's general clinical characteristics. Results One hundred seventy-seven women were enrolled in the present study. In the present study, the barriers to calcium intake subscale had the lowest mean score (15.03±3.02), and the Benefit of Exercise subscale had the highest (23.02±3.03). The scores for participants in their 20s were significantly higher than scores for those in their 70s on the Benefits of Exercise subscale and Barriers to Exercise subscale (P=0.014 and P=0.022, respectively). Conclusions Education for health motivation to prevent osteoporosis is important for young women. Additional systematic education programs are needed for the general population. PMID:24524052

  2. Pathogenesis and clinical aspects of pain in patients with osteoporosis.

    PubMed

    Mediati, Rocco Domenico; Vellucci, Renato; Dodaro, Lucia

    2014-09-01

    Bone pain is one of the most frequent kinds of chronic pain, mainly in elderly patients. It causes a significant worsening of functional capacity and deterioration in the quality of life in people affected. Mechanisms of pain in osteoporosis are poorly known and often extrapolated by other pathologies or other experimental model. One of principal causes would be a "hyper-remodeling" of bone, that involves osteoclasts activity and pathological modifications of bone innervation. Several studies show that osteoclasts play a significant role in bone pain etiology. Pain in osteoporosis is mainly nociceptive, if it become persistent a sensitization of peripheral and central nervous system can occur, so underlining the transition to a chronic pain syndrome. Central sensitization mechanisms are complex and involve several neuromediators and receptors (Substance P, NMDA, etc.). Most common manifestations of osteoporosis are vertebral compression fractures that cause persistent pain, though to differentiate from pain originating in structures as joint or muscle. First manifestation can be an acute pain due to pathological fracture, those of hip often causes disability. Pain in osteoporosis is an important clinical challenge. Often its complications and consequences on patient quality of life are underestimated with not negligible social implications. A balanced and early multimodal pain therapy including opioids as necessary, even in cases of acute pain, improve the functional capacity of patients and helps to prevent neurological alterations that seems to contribute in significant way in causing irreversible pain chronic syndromes. PMID:25568647

  3. Genetics of osteoporosis: searching for candidate genes for bone fragility.

    PubMed

    Rocha-Braz, Manuela G M; Ferraz-de-Souza, Bruno

    2016-08-01

    The pathogenesis of osteoporosis, a common disease with great morbidity and mortality, comprises environmental and genetic factors. As with other complex disorders, the genetic basis of osteoporosis has been difficult to identify. Nevertheless, several approaches have been undertaken in the past decades in order to identify candidate genes for bone fragility, including the study of rare monogenic syndromes with striking bone phenotypes (e.g. osteogenesis imperfecta and osteopetroses), the analysis of individuals or families with extreme osteoporotic phenotypes (e.g. idiopathic juvenile and pregnancy-related osteoporosis), and, chiefly, genome-wide association studies (GWAS) in large populations. Altogether, these efforts have greatly increased the understanding of molecular mechanisms behind bone remodelling, which has rapidly translated into the development of novel therapeutic strategies, exemplified by the tales of cathepsin K (CTSK) and sclerostin (SOST). Additional biological evidence of involvement in bone physiology still lacks for several candidate genes arisen from GWAS, opening an opportunity for the discovery of new mechanisms regulating bone strength, particularly with the advent of high-throughput genomic technologies. In this review, candidate genes for bone fragility will be presented in comprehensive tables and discussed with regard to how their association with osteoporosis emerged, highlighting key players such as LRP5, WNT1 and PLS3. Current limitations in our understanding of the genetic contribution to osteoporosis, such as yet unidentified genetic modifiers, may be overcome in the near future with better genotypic and phenotypic characterisation of large populations and the detailed study of candidate genes in informative individuals with marked phenotype. PMID:27533615

  4. Finite element analysis of osteoporosis models based on synchrotron radiation

    NASA Astrophysics Data System (ADS)

    Xu, W.; Xu, J.; Zhao, J.; Sun, J.

    2016-04-01

    With growing pressure of social aging, China has to face the increasing population of osteoporosis patients as well as the whole world. Recently synchrotron radiation has become an essential tool for biomedical exploration with advantage of high resolution and high stability. In order to study characteristic changes in different stages of primary osteoporosis, this research focused on the different periods of osteoporosis of rats based on synchrotron radiation. Both bone histomorphometry analysis and finite element analysis were then carried on according to the reconstructed three dimensional models. Finally, the changes of bone tissue in different periods were compared quantitatively. Histomorphometry analysis showed that the structure of the trabecular in osteoporosis degraded as the bone volume decreased. For femurs, the bone volume fraction (Bone volume/ Total volume, BV/TV) decreased from 69% to 43%. That led to the increase of the thickness of trabecular separation (from 45.05μ m to 97.09μ m) and the reduction of the number of trabecular (from 7.99 mm-1 to 5.97mm-1). Simulation of various mechanical tests with finite element analysis (FEA) indicated that, with the exacerbation of osteoporosis, the bones' ability of resistance to compression, bending and torsion gradually became weaker. The compression stiffness of femurs decreased from 1770.96 Fμ m‑1 to 697.41 Fμ m‑1, the bending and torsion stiffness were from 1390.80 Fμ m‑1 to 566.11 Fμ m‑1 and from 2957.28N.m/o to 691.31 N.m/o respectively, indicated the decrease of bone strength, and it matched the histomorphometry analysis. This study suggested that FEA and synchrotron radiation were excellent methods for analysing bone strength conbined with histomorphometry analysis.

  5. Identifying Older Chinese Immigrants at High Risk for Osteoporosis

    PubMed Central

    Lauderdale, Diane S; Kuohung, Victoria; Chang, Suey-Lee; Chin, Marshall H

    2003-01-01

    BACKGROUND Data about whether Asian Americans are a high-risk or a low-risk group for osteoporosis are limited and inconsistent. Few previous studies have recognized that the heterogeneity of the Asian American population, with respect to both nativity (foreign- vs U.S.-born) and ethnicity, may be related to osteoporosis risk. OBJECTIVE To assess whether older foreign-born Chinese Americans living in an urban ethnic enclave are at high risk of osteoporosis and to refer participants at high risk for follow-up care. DESIGN Cross-sectional survey and osteoporosis screening, undertaken as a collaborative project by the Chinese American Service League and researchers at the University of Chicago. SETTING Chicago's Chinatown. PARTICIPANTS Four hundred sixty-nine immigrant Chinese American men and women aged 50 and older. MEASUREMENTS AND MAIN RESULTS Chinese Americans in this urban setting are generally recent immigrants from south China with limited education and resources: mean age at immigration was 54, 56% had primary only or no education, and 57% reported “fair” or “poor” self-rated health. Eighteen percent are uninsured and 55% receive Medicaid. Bone mineral density (BMD) of the calcaneus was estimated using quantitative ultrasound. Immigrant Chinese women in the study had lower average BMD than reference data for white women or U.S.-born Asian Americans. BMD for immigrant Chinese men in the study was similar to white men at ages 50 to 69, and lower at older ages. Low body mass index, low educational attainment and older age at immigration were all associated with lower BMD. CONCLUSIONS Foreign-born Chinese Americans may be a high-risk group for osteoporosis. PMID:12848833

  6. Identifying risk groups for osteoporosis by digital panoramic radiography

    PubMed Central

    Alapati, Satish; Reddy, Reddy Sudhakara; Tatapudi, Ramesh; Kotha, Ramya; Bodu, Naveen Kumar; Chennoju, Saikiran

    2015-01-01

    Background: Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to bone fragility, and enhanced susceptibility to fractures. Dental radiographs, especially panoramic images, have been used to predict bone mineral density. A number of indices, (mandibular cortical index [MCI], mandibular cortical width [MCW], and panoramic mandibular index [PMI]) have been developed to assess and quantify the quality of mandibular bone mass and to observe the signs of resorption. Objectives: The objectives of the study were to assess mental index (MI), MCW index, and PMI with bone density in identifying risk group for osteoporosis and also to investigate influence of age and gender on MI, MCI, and PMI. Materials and Methods: After obtaining consent, details regarding age, gender, systemic health status, and oral parafunctional habits were recorded in each patient. Then a digital panoramic radiograph was taken. The image thus obtained was subjected to calibrations and morphometric analysis using Digora version 2.7. The obtained values of indices were compared with the mean values of indices, to evaluate subjects whether they are prone to osteoporosis or not. The obtained information was subjected to statistical analysis for the significance of the parameters. Results: Data analysis showed that calibration indices were highly significant in the assessment of risk group for osteoporosis than noncalibration index. The subjects at a higher risk for development of osteoporosis were old-aged adults with higher prevalence being reported in women compared to male subjects. Conclusion: In conclusion, our results suggest that higher percentage of subjects with undetected decreased bone mineral density may be identified based on trained general dental practitioners analyses of their panoramic radiographs using simple screening analytical calibration MI and MCI. PMID:26604582

  7. Prediction of osteoporosis using dental radiographs and age in females

    PubMed Central

    Vijay, Guduba; Chitroda, Parita K.; Katti, Girish; Shahbaz, Syed; Baba, Irfan; Bhuvaneshwari

    2015-01-01

    Aims and Objectives: To evaluate the role of dental radiograph as a screening tool for diagnosis of osteoporosis in females. Materials and Methods: In the present study, 50 women between the age group of 40-60 were recruited, and patients with systemic disorder and taking calcium supplements, and women who are not willing for investigation were excluded. Their detailed medical history was obtained and dental radiographs were made, bone mineral density was measured at left radial bone using ultrasound. The radiographs were subjected to image analysis method using manual tracing of gonial angle, antegonial angle, antegonial depth, antegonial index, mental index and mandibular cortical index. Statistical discrimination analysis was applied to predict the presence of osteoporosis. With use of these indices, the sensitivity and specificity of orthopantomograph (OPG) radiograph to assess age-related changes in bone were compared. Radiomorphometric indices (RMI) were also scrutinized to depict the sensitivity and specificity of each index in the prediction of osteoporosis. Results: Study results showed no significant differences between bone mineral density (BMD) and radiomorphometric analysis in the diagnoses of osteoporotic females. Out of 29, diagnosed as osteoporotic by radiograph 23 were confirmed by BMD and six were diagnosed as osteopenic. Among the six indices used, AGA and AGD showed more reproducible results. Conclusion: With our study results, we come to an arrival that OPG radiographs show overall sensitivity of 0.75 or 75% and specificity of 0.81 or 81% in the diagnosis of osteoporosis, and that anti gonial angle (AGA) and anti gonial depth (AGD) are the most reliable indices. Hence, we conclude that panoramic-based RMI can be used as an ancillary method in the diagnosis of osteoporosis. PMID:26167057

  8. Patients’ Response Toward an Automated Orthopedic Osteoporosis Intervention Program

    PubMed Central

    Varacallo, Matthew A.; Fox, Edward J.; Paul, Emmanuel M.; Hassenbein, Susan E.; Warlow, Pamela M.

    2013-01-01

    Osteoporosis is overshadowed in an era of chronic illnesses, and a care gap exists between physicians and patients. The aim of this study was to determine the effectiveness of implementing an automated system for identifying and sending a letter to patients at high risk for osteoporosis. Patients 50 years of age and older were tagged with an International Classification of Diseases, Ninth Revision, diagnostic code upon initial visit to the emergency department (ED), identifying potential fragility fractures. Automatically generated letters were sent via our osteoporosis database system to each patient 3 months after the initial visit to the ED. The letter indicated that he or she was at risk for osteoporosis and suggested that the patient schedule a follow-up appointment with a physician. Patients were subsequently telephoned 3 months after receiving the letter and asked about their current plan for follow-up. The control group did not receive a letter after departure from the ED. In the control group, 84 (85.71%) individuals of the total 98 did not have any follow-up but the remaining 14 (14.29%) sought a follow-up. In the intervention group, 62 (60.19%) individuals of 103 did schedule a follow-up, while the remaining 41 (39.81%) did not seek a follow-up. Thus, the patient follow-up response rate after fracture treatment improved with intervention (P < .0001). Current literature has demonstrated the low rate of follow-up care addressing osteoporosis in patients experiencing fragility fractures (1%-25% without intervention). Research has shown the effectiveness of various types of intervention programs for improving the continuum of care for these high-risk patients. Nonautomated intervention programs can have a multitude of human-related system failures in identifying these patients. Our study successfully implements an automated system that is able to be applied to most hospitals with minimal cost and resources. PMID:24319621

  9. Current and future treatments of osteoporosis in men.

    PubMed

    Kaufman, Jean-Marc; Lapauw, Bruno; Goemaere, Stefan

    2014-12-01

    One in three osteoporotic fractures occur in men and the consequences of a fracture in men tend to be more severe than in women. Still, only a small minority of men with high risk of fracture are detected and treated. Although there are gender differences in the pathophysiology of osteoporosis, such as in the pattern of bone loss, similarities predominate, which is also the case for clinical risk factors. It seems appropriate to consider treatment for men and women with a similar 10 year fracture risk. Drugs now approved for treatment of osteoporosis in men include the anti-resorptive bisphosphonates alendronate, residronate and zoledronic acid, the anti-resorptive drug denosumab, the bone-forming agent teriparatide, and (not in the US) strontium ranelate with mild opposite effects on resorption and formation. Although the evidence level for efficacy and safety of these drugs in men is still relatively limited, available data indicate that treatment effects in men are very similar to what has been observed in the treatment of postmenopausal osteoporosis. Denosumab is also approved for treatment in men receiving androgen deprivation therapy for non-metastatic prostate cancer; bisphosphonates and teriparatide are also available to clinicians for treatment of glucocorticoid-induced osteoporosis in men. Testosterone treatment may be indicated in men with documented symptomatic hypogonadism, but osteoporosis is neither a sufficient nor a specific indication for testosterone treatment. New compounds with well advanced clinical development include odanacatib, a selective inhibitor of the cysteine protease cathepsin-K, and romosozumab, a monoclonal antibody against sclerostin. PMID:25432358

  10. Labisia pumila Prevents Complications of Osteoporosis by Increasing Bone Strength in a Rat Model of Postmenopausal Osteoporosis.

    PubMed

    Fathilah, Siti Noor; Abdullah, Shahrum; Mohamed, Norazlina; Shuid, Ahmad Nazrun

    2012-01-01

    Estrogen replacement therapy (ERT) is the main treatment postmenopausal osteoporosis. However, ERT causes serious side effects, such as cancers and thromboembolic problems. Labisia pumila var. alata (LPva) is a herb with potential as an alternative to ERT to prevent complications of osteoporosis, especially fragility fractures. This study was conducted to determine the effects of LPva on the biomechanical strength of femora exposed to osteoporosis due to estrogen deficiency, using the postmenopausal rat model. Thirty-two female rats were randomly divided into four groups: Sham-operated (Sham), ovariectomized control (OVXC), ovariectomized with Labisia pumila var. alata (LP), and ovariectomized with ERT (Premarin) (ERT). The LPva and ERT were administered via oral gavage daily at doses of 17.5 mg/kg and 64.5 μg/kg, respectively. Following two months of treatment, the rats were euthanized, and their right femora were prepared for bone biomechanical testing. The results showed that ovariectomy compromised the femoral strength, while LPva supplementation to the ovariectomized rats improved the femoral strength. Therefore, LPva may be as effective as ERT in preventing fractures due to estrogen-deficient osteoporosis. PMID:22991574

  11. Labisia pumila Prevents Complications of Osteoporosis by Increasing Bone Strength in a Rat Model of Postmenopausal Osteoporosis

    PubMed Central

    Fathilah, Siti Noor; Abdullah, Shahrum; Mohamed, Norazlina; Shuid, Ahmad Nazrun

    2012-01-01

    Estrogen replacement therapy (ERT) is the main treatment postmenopausal osteoporosis. However, ERT causes serious side effects, such as cancers and thromboembolic problems. Labisia pumila var. alata (LPva) is a herb with potential as an alternative to ERT to prevent complications of osteoporosis, especially fragility fractures. This study was conducted to determine the effects of LPva on the biomechanical strength of femora exposed to osteoporosis due to estrogen deficiency, using the postmenopausal rat model. Thirty-two female rats were randomly divided into four groups: Sham-operated (Sham), ovariectomized control (OVXC), ovariectomized with Labisia pumila var. alata (LP), and ovariectomized with ERT (Premarin) (ERT). The LPva and ERT were administered via oral gavage daily at doses of 17.5 mg/kg and 64.5 μg/kg, respectively. Following two months of treatment, the rats were euthanized, and their right femora were prepared for bone biomechanical testing. The results showed that ovariectomy compromised the femoral strength, while LPva supplementation to the ovariectomized rats improved the femoral strength. Therefore, LPva may be as effective as ERT in preventing fractures due to estrogen-deficient osteoporosis. PMID:22991574

  12. Clinical practice guidelines proposed by the Hellenic Foundation of Osteoporosis for the management of osteoporosis based on DXA results.

    PubMed

    Baltas, C S; Balanika, A P; Raptou, P D; Tournis, S; Lyritis, G P

    2005-01-01

    In recent years guidelines for the testing and treatment of osteoporotic patients have been published by recognised organisations, including the World Health Organisation (WHO), the National Osteoporosis Foundation (NOF) and the International Osteoporosis Foundation (IOF). Dual Energy X-ray Absorptiometry (DXA) has been considered the technique of choice because of its excellent precision and ability to predict osteoporotic fractures. Last December, based on the Appraisal of the Guidelines for Research and Evaluation (AGREE), the Hellenic Foundation of Osteoporosis, in collaboration with other scientific societies, provided guidelines for the use of DXA for the diagnosis, monitoring and treatment of osteoporosis and Quality Assurance (QA) of these systems. According to these guidelines, the adequacy of the present number of DXA units in Greece was assessed. There are 367 DXA units in Greece, and almost 50% are located in the capital city, Athens, where 34.1% of the population lives. The distribution of DXA devices per resident in the Greek provinces (except Attica) is between 4.2 units/100,000 heads (Ionian Islands) and 1.6 units/100,000 heads (Sterea Hellas). These guidelines have resulted in a suggestive yearly repeat of the measurements, to ensure the precision of the method, but mainly for reasons of compliance. Finally, these guidelines are viewed as a work in progress and will be updated periodically in response to advances in this field. PMID:16340144

  13. Collapsing Enormous Stars

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2015-09-01

    One of the big puzzles in astrophysics is how supermassive black holes (SMBHs) managed to grow to the large sizes weve observed in the very early universe. In a recent study, a team of researchers examines the possibility that they were formed by the direct collapse of supermassive stars.Formation MysterySMBHs billions of times as massive as the Sun have been observed at a time when the universe was less than a billion years old. But thats not enough time for a stellar-mass black hole to grow to SMBH-size by accreting material so another theory is needed to explain the presence of these monsters so early in the universes history. A new study, led by Tatsuya Matsumoto (Kyoto University, Japan), poses the following question: what if supermassive stars in the early universe collapsed directly into black holes?Previous studies of star formation in the early universe have suggested that, in the hot environment of these primordial times, stars might have been able to build up mass much faster than they can today. This could result in early supermassive stars roughly 100,000 times more massive than the Sun. But if these early stars end their lives by collapsing to become massive black holes in the same way that we believe massive stars can collapse to form stellar-mass black holes today this should result in enormously violent explosions. Matusmoto and collaborators set out to model this process, to determine what we would expect to see when it happens!Energetic BurstsThe authors modeled the supermassive stars prior to collapse and then calculated whether a jet, created as the black hole grows at the center of the collapsing star, would be able to punch out of the stellar envelope. They demonstrated that the process would work much like the widely-accepted collapsar model of massive-star death, in which a jet successfully punches out of a collapsing star, violently releasing energy in the form of a long gamma-ray burst (GRB).Because the length of a long GRB is thought to

  14. Star Polymers.

    PubMed

    Ren, Jing M; McKenzie, Thomas G; Fu, Qiang; Wong, Edgar H H; Xu, Jiangtao; An, Zesheng; Shanmugam, Sivaprakash; Davis, Thomas P; Boyer, Cyrille; Qiao, Greg G

    2016-06-22

    Recent advances in controlled/living polymerization techniques and highly efficient coupling chemistries have enabled the facile synthesis of complex polymer architectures with controlled dimensions and functionality. As an example, star polymers consist of many linear polymers fused at a central point with a large number of chain end functionalities. Owing to this exclusive structure, star polymers exhibit some remarkable characteristics and properties unattainable by simple linear polymers. Hence, they constitute a unique class of technologically important nanomaterials that have been utilized or are currently under audition for many applications in life sciences and nanotechnologies. This article first provides a comprehensive summary of synthetic strategies towards star polymers, then reviews the latest developments in the synthesis and characterization methods of star macromolecules, and lastly outlines emerging applications and current commercial use of star-shaped polymers. The aim of this work is to promote star polymer research, generate new avenues of scientific investigation, and provide contemporary perspectives on chemical innovation that may expedite the commercialization of new star nanomaterials. We envision in the not-too-distant future star polymers will play an increasingly important role in materials science and nanotechnology in both academic and industrial settings. PMID:27299693

  15. Radio stars.

    PubMed

    Hjellming, R M; Wade, C M

    1971-09-17

    Up to the present time six classes of radio stars have been established. The signals are almost always very faint and drastically variable. Hence their discovery has owed as much to serendipity as to the highly sophisticated equipment and techniques that have been used. When the variations are regular, as with the pulsars, this characteristic can be exploited very successfully in the search for new objects as well as in the detailed study of those that are already known. The detection of the most erratically variable radio stars, the flare stars and the x-ray stars, is primarily a matter of luck and patience. In the case of the novas, one at least knows where and oughly when to look for radio emission. A very sensitive interferometer is clearly the best instrument to use in the initial detection of a radio star. The fact that weak background sources are frequently present makes it essential to prove that the position of a radio source agrees with that of a star to within a few arc seconds. The potential of radio astronomy for the study of radio stars will not be realized until more powerful instruments than those that are available today can be utilized. So far, we have been able to see only the most luminous of the radio stars. PMID:17836594

  16. THE RADIAL VELOCITY EXPERIMENT (RAVE): THIRD DATA RELEASE

    SciTech Connect

    Siebert, A.; Williams, M. E. K.; Siviero, A.; Boeche, C.; Steinmetz, M.; De Jong, R. S.; Enke, H.; Anguiano, B.; Reid, W.; Ritter, A.; Fulbright, J.; Wyse, R. F. G.; Munari, U.; Zwitter, T.; Watson, F. G.; Burton, D.; Cass, C. J. P.; Fiegert, K.; Hartley, M.; Russel, K. S.

    2011-06-15

    We present the third data release of the RAdial Velocity Experiment (RAVE) which is the first milestone of the RAVE project, releasing the full pilot survey. The catalog contains 83,072 radial velocity measurements for 77,461 stars in the southern celestial hemisphere, as well as stellar parameters for 39,833 stars. This paper describes the content of the new release, the new processing pipeline, as well as an updated calibration for the metallicity based upon the observation of additional standard stars. Spectra will be made available in a future release. The data release can be accessed via the RAVE Web site.

  17. Bone scaffolds loaded with siRNA-Semaphorin4d for the treatment of osteoporosis related bone defects

    PubMed Central

    Zhang, Yufeng; Wei, Lingfei; Miron, Richard J.; Shi, Bin; Bian, Zhuan

    2016-01-01

    Osteoporosis is a prominent disorder affecting over 200 million people worldwide. Recently, semaphorins have been implicated in the cell-cell communication between osteoclasts and osteoblasts and have been associated with the progression of osteoporosis. Previously, we demonstrated that knockdown of semaphorin4d (Sema4d) using siRNA delivered with a bone-targeting system prevented bone loss in an osteoporotic animal model. Here, we used this bone-specific technology containing siRNA-Sema4d and fabricated a PLLA scaffold capable of enhancing bone repair following fracture. We investigated the ability of the implant to release siRNA-Sema4d into the surrounding tissues over time and to influence new bone formation in a 3 mm femur osteoporotic defect model in ovariectomized rats. Delivery of the bone-targeting system released from PLLA scaffolds began 2 hours post-implantation, peaked at 1 day, and was sustained over a 21 day period. μCT analysis demonstrated a significantly higher bone volume/total volume bone mineral density and number of osteoblasts in the rats that were transplanted with scaffolds loaded with siRNA-Sema4d. These results confirm the specific role of Sema4d in bone remodeling and demonstrate that significant increases in the speed and quality of new bone formation occur when siRNA-Sema4d is delivered via a PLLA scaffold. PMID:27254469

  18. Bone scaffolds loaded with siRNA-Semaphorin4d for the treatment of osteoporosis related bone defects.

    PubMed

    Zhang, Yufeng; Wei, Lingfei; Miron, Richard J; Shi, Bin; Bian, Zhuan

    2016-01-01

    Osteoporosis is a prominent disorder affecting over 200 million people worldwide. Recently, semaphorins have been implicated in the cell-cell communication between osteoclasts and osteoblasts and have been associated with the progression of osteoporosis. Previously, we demonstrated that knockdown of semaphorin4d (Sema4d) using siRNA delivered with a bone-targeting system prevented bone loss in an osteoporotic animal model. Here, we used this bone-specific technology containing siRNA-Sema4d and fabricated a PLLA scaffold capable of enhancing bone repair following fracture. We investigated the ability of the implant to release siRNA-Sema4d into the surrounding tissues over time and to influence new bone formation in a 3 mm femur osteoporotic defect model in ovariectomized rats. Delivery of the bone-targeting system released from PLLA scaffolds began 2 hours post-implantation, peaked at 1 day, and was sustained over a 21 day period. μCT analysis demonstrated a significantly higher bone volume/total volume bone mineral density and number of osteoblasts in the rats that were transplanted with scaffolds loaded with siRNA-Sema4d. These results confirm the specific role of Sema4d in bone remodeling and demonstrate that significant increases in the speed and quality of new bone formation occur when siRNA-Sema4d is delivered via a PLLA scaffold. PMID:27254469

  19. Orthopedic Surgeon's Awareness Can Improve Osteoporosis Treatment Following Hip Fracture: A Prospective Cohort Study

    PubMed Central

    Kim, Sang-Rim; Park, Yong-Geun; Lee, Sung-Rak; Koo, Kyung-Hoi

    2011-01-01

    Through retrospective Jeju-cohort study at 2005, we found low rates of detection of osteoporosis (20.1%) and medication for osteoporosis (15.5%) in those who experienced hip fracture. This study was to determine the orthopedic surgeons' awareness could increase the osteoporosis treatment rate after a hip fracture and the patient barriers to osteoporosis management. We prospectively followed 208 patients older than 50 yr who were enrolled for hip fractures during 2007 in Jeju-cohort. Thirty four fractures in men and 174 in women were treated at the eight hospitals. During the study period, orthopedic surgeons who worked at these hospitals attended two education sessions and were provided with posters and brochures. Patients were interviewed 6 months after discharge using an evaluation questionnaire regarding their perceptions of barriers to osteoporosis treatment. The patients were followed for a minimum of one year. Ninety-four patients (45.2%) underwent detection of osteoporosis by dual energy x-ray absorptiometry and 67 (32.2%) were prescribed medication for osteoporosis at the time of discharge. According to the questionnaire, the most common barrier to treatment for osteoporosis after a hip fracture was patients reluctance. The detection and medication rate for osteoporosis after hip fracture increased twofold after orthopedic surgeons had attended the intervention program. Nevertheless, the osteoporosis treatment rate remains inadequate. PMID:22065908

  20. Proliferation and Differentiation of Rat Osteoporosis Mesenchymal Stem Cells (MSCs) after Telomerase Reverse Transcriptase (TERT) Transfection

    PubMed Central

    Li, Chao; Wei, Guojun; Gu, Qun; Wang, Qiang; Tao, Shuqin; Xu, Liang

    2015-01-01

    Background The aim of this study was to determine whether MSC are excellent materials for MSCs transplantation in the treatment of osteoporosis. Material/Methods We studied normal, osteoporosis, and TERT-transfected MSC from normal and osteoporosis rats to compare the proliferation and osteogenic differentiation using RT-PCR and Western blot by constructing an ovariectomized rat model of osteoporosis (OVX). The primary MSC from model rats were extracted and cultured to evaluate the proliferation and differentiation characteristics. Results MSCs of osteoporosis rats obviously decreased in proliferation ability and osteogenic differentiation compared to that of normal rats. In contrast, in TERT-transfected MSC, the proliferation and differentiation ability, and especially the ability of osteogenic differentiation, were significantly higher than in osteoporosis MSC. Conclusions TERT-transfected MSCs can help osteoporosis patients in whom MSC proliferation and osteogenic differentiation ability are weak, with an increase in both bone mass and bone density, becoming an effective material for autologous transplantation of MSCs in further treatment of osteoporosis. However, studies are still needed to prove the in vivo effect, biological safety, and molecular mechanism of TERT-osteoporosis treatment. Additionally, because the results are from an animal model, more research is needed in generalizing rat model findings to human osteoporosis patients. PMID:25796354

  1. Discovering New R Coronae Borealis Stars

    NASA Astrophysics Data System (ADS)

    Clayton, Geoffrey C.; Tisserand, Patrick; Welch, Douglas L.; LeBleu, Amy

    2016-01-01

    The R Coronae Borealis (RCB) stars are rare hydrogen-deficient, carbon-rich supergiants. Two evolutionary scenarios have been suggested, a double degenerate merger of two white dwarfs, or a final helium shell flash in a PN central star. The evidence pointing toward a white-dwarf merger or a final-flash origin for RCB stars is contradictory. The distribution on the sky and radial velocities of the RCB stars tend toward those of the bulge population but a much larger sample of stars is needed to determine the true population. We need to discover RCB stars much more efficiently. In order to do this, we have used a series of IR color-color cuts, using the recent release of the WISE All-Sky Catalog, to produce a sample of 2200 candidates that may yield over 200 new RCB star identifications. Most of these candidates do not have lightcurves, the traditional technique of identifying RCB stars from their characteristic large and irregular light variations. We have obtained optical spectra of several hundred candidates and have confirmed over 40 new RCB stars in the Galaxy. We are attempting to develop a quantitative spectral classification system for the RCB stars so that they can be identified without an accompanying light curve. The cooler RCB stars look like carbon stars with strong C2 bands, but they can be differentiated from carbon stars by their extreme hydrogen deficiency and very low 13C/12C ratio. Also, the red CN bands are much weaker in RCB stars than in carbon stars. The number of RCB stars in the Galaxy may be consistent with the predicted number of He/CO white-dwarf mergers. Solving the mystery of how the RCB stars evolve would be a watershed event in the study of stellar evolution that will lead to a better understanding of other important types of stellar merger events such as Type Ia SNe.

  2. Sounds of a Star

    NASA Astrophysics Data System (ADS)

    2001-06-01

    the models are necessarily quite uncertain (i.e., they are not well "constrained"). It is therefore imperative to enlarge the number of observables and this is possible with asteroseismology. Helioseismology has opened up the way. These observations severely constrain the possible models of the Sun's internal structure. But, depending on their mass and age, stars have very different internal structures, and may also harbour physical processes that are quite different from those in the Sun. Asteroseismological observations of stellar oscillations add crucial information that constrain the models of their inner structure, since the measured frequencies may be compared directly with those computed for the models. The observation of the full stellar disk allows to characterize certain (low degree) oscillation modes which penetrate deep inside the star and it is not necessary to resolve the stellar disk (as we can do for the Sun) in order to obtain useful seismological information. More stars to be observed Observations of bright solar-like stars are already planned with the CORALIE spectrograph. Even fainter stars can be observed with the HARPS spectrograph which will be installed on the 3.6-m telescope at La Silla Observatory at the end of 2002. It will be able to observe stars that are one hundred times fainter than those now reachable with CORALIE and with even better accuracy of the velocity measurements. While it will be mostly dedicated to the search of exoplanets, HARPS will be able to conduct an asteroseismological study of about 100 solar-like stars. More information The research reported in this Press Release is described in a scientific article ("P-mode observations on Alpha Cen A" by François Bouchy and Fabien Carrier) that has been accepted for publication as a Letter in the European journal "Astronomy & Astrophysics". Note [1]: Alpha Centauri was earlier known as Rigil Centauri , but that name is not much used because of the similarity with the name of the

  3. Clinical practice guidelines for the diagnosis and management of osteoporosis. Scientific Advisory Board, Osteoporosis Society of Canada.

    PubMed Central

    1996-01-01

    OBJECTIVE: To recommend clinical practice guidelines for the assessment of people at risk for osteoporosis, and for effective diagnosis and management of the condition. OPTIONS: Screening and diagnostic methods: risk-factor assessment, clinical evaluation, measurement of bone mineral density, laboratory investigations. Prophylactic and corrective therapies: calcium and vitamin D nutritional supplementation, physical activity and fall-avoidance techniques, ovarian hormone therapy, bisphosphonate drugs, other drug therapies. Pain-management medications and techniques. OUTCOMES: Prevention of loss of bone mineral density and fracture; increased bone mass; and improved quality of life. EVIDENCE: Epidemiologic and clinical studies and reports were examined, with emphasis on recent randomized controlled trials. Clinical practice in Canada and elsewhere was surveyed. Availability of treatment products and diagnostic equipment in Canada was considered. VALUES: Cost-effective methods and products that can be adopted across Canada were considered. A high value was given to accurate assessment of fracture risk and osteoporosis, and to increasing bone mineral density, reducing fractures and fracture risk and minimizing side effects of diagnosis and treatment. BENEFITS, HARMS AND COSTS: Proper diagnosis and management of osteoporosis minimize injury and disability, improve quality of life for patients and reduce costs to society. Rationally targeted methods of screening and diagnosis are safe and cost effective. Harmful side effects and costs of recommended therapies are minimal compared with the harms and costs of untreated osteoporosis. Alternative therapies provide a range of choices for physicians and patients. RECOMMENDATIONS: Population sets at high risk should be identified and then the diagnosis confirmed through bone densitometry. Dual-energy x-ray absorptiometry is the preferred measurement technique. Radiography can be adjunct when indicated. Calcium and vitamin D

  4. Recent advances in the pathogenesis and treatment of osteoporosis.

    PubMed

    Curtis, Elizabeth M; Moon, Rebecca J; Dennison, Elaine M; Harvey, Nicholas C; Cooper, Cyrus

    2016-08-01

    Over recent decades, the perception of osteoporosis has changed from that of an inevitable consequence of ageing, to that of a well characterised and treatable chronic non-communicable disease, with major impacts on individuals, healthcare systems and societies. Characterisation of its pathophysiology from the hierarchical structure of bone and the role of its cell population, development of effective strategies for the identification of those most appropriate for treatment, and an increasing armamentarium of efficacious pharmacological therapies, have underpinned this evolution. Despite this marked progress, individuals who experience a fragility fracture remain under-treated in many areas of the world, and there is substantial need for investment both in secondary and primary prevention globally. In this brief article, we give an overview of the pathogenesis of osteoporosis, and summarise current and future approaches to its assessment and -treatment. PMID:27481382

  5. Irreversibility of advanced osteoporosis: Limited role for pharmacologic intervention

    NASA Technical Reports Server (NTRS)

    Parfitt, A. M.

    1994-01-01

    Osteoporosis is of medical interest only because it increases bone fragility and risk of fracture, and except for relief of symptoms, preventing fracture is the only purpose of intervention. To prevent the first fracture, adequate bone density must be accumulated and conserved, but to prevent subsequent fracture, bone density must be augmented so that the supportive function of the skeleton can be restored. Almost 50 years after the recognition of post menopausal osteoporosis as a clinical entity, not one of the many treatments that have been used has been demonstrated to be efficacious in reducing subsequent fracture risk. My purpose is not to recite this chronicle of disappointment, but to account for it in terms of bone biology, to consider some possible exceptions, and to reiterate the importance of preventing damage to the skeleton rather than belatedly attempting its repair.

  6. Flemingia macrophylla Extract Ameliorates Experimental Osteoporosis in Ovariectomized Rats

    PubMed Central

    Ho, Hui-Ya; Wu, Jin-Bin; Lin, Wen-Chuan

    2011-01-01

    Flemingia macrophylla (Leguminosae), a native plant of Taiwan, is used as folk medicine. An in vitro study showed that a 75% ethanolic extract of F. macrophylla (FME) inhibited osteoclast differentiation of cultured rat bone marrow cells, and the active component, lespedezaflavanone A (LDF-A), was isolated. It was found that oral administration of FME for 13 weeks suppressed bone loss in ovariectomized rats, an experimental model of osteoporosis. In addition, FME decreased urinary deoxypyridinoline concentrations but did not inhibit serum alkaline phosphatase activities, indicating that it ameliorated bone loss via inhibition of bone resorption. These results suggest that FME may represent a useful remedy for the treatment of bone resorption diseases, such as osteoporosis. In addition, LDF-A could be used as a marker compound to control the quality of FME. PMID:19942664

  7. Flemingia macrophylla Extract Ameliorates Experimental Osteoporosis in Ovariectomized Rats.

    PubMed

    Ho, Hui-Ya; Wu, Jin-Bin; Lin, Wen-Chuan

    2011-01-01

    Flemingia macrophylla (Leguminosae), a native plant of Taiwan, is used as folk medicine. An in vitro study showed that a 75% ethanolic extract of F. macrophylla (FME) inhibited osteoclast differentiation of cultured rat bone marrow cells, and the active component, lespedezaflavanone A (LDF-A), was isolated. It was found that oral administration of FME for 13 weeks suppressed bone loss in ovariectomized rats, an experimental model of osteoporosis. In addition, FME decreased urinary deoxypyridinoline concentrations but did not inhibit serum alkaline phosphatase activities, indicating that it ameliorated bone loss via inhibition of bone resorption. These results suggest that FME may represent a useful remedy for the treatment of bone resorption diseases, such as osteoporosis. In addition, LDF-A could be used as a marker compound to control the quality of FME. PMID:19942664

  8. The role of microRNAs in osteoclasts and osteoporosis.

    PubMed

    Tang, Peifu; Xiong, Qi; Ge, Wei; Zhang, Lihai

    2014-01-01

    Osteoclasts are the exclusive cells of bone resorption. Abnormally activating osteoclasts can lead to low bone mineral density, which will cause osteopenia, osteoporosis, and other bone disorders. To date, the mechanism of how osteoclast precursors differentiate into mature osteoclasts remains elusive. MicroRNAs (miRNAs) are novel regulatory factors that play an important role in numerous cellular processes, including cell differentiation and apoptosis, by post-transcriptional regulation of genes. Recently, a number of studies have revealed that miRNAs participate in bone homeostasis, including osteoclastic bone resorption, which sheds light on the mechanisms underlying osteoclast differentiation. In this review, we highlight the miRNAs involved in regulating osteoclast differentiation and bone resorption, and their roles in osteoporosis. PMID:25692234

  9. Alveolar bone loss in osteoporosis: a loaded and cellular affair?

    PubMed Central

    Jonasson, Grethe; Rythén, Marianne

    2016-01-01

    Maxillary and mandibular bone mirror skeletal bone conditions. Bone remodeling happens at endosteal surfaces where the osteoclasts and osteoblasts are situated. More surfaces means more cells and remodeling. The bone turnover rate in the mandibular alveolar process is probably the fastest in the body; thus, the first signs of osteoporosis may be revealed here. Hormones, osteoporosis, and aging influence the alveolar process and the skeletal bones similarly, but differences in loading between loaded, half-loaded, and unloaded bones are important to consider. Bone mass is redistributed from one location to another where strength is needed. A sparse trabeculation in the mandibular premolar region (large intertrabecular spaces and thin trabeculae) is a reliable sign of osteopenia and a high skeletal fracture risk. Having dense trabeculation (small intertrabecular spaces and well-mineralized trabeculae) is generally advantageous to the individual because of the low fracture risk, but may imply some problems for the clinician. PMID:27471408

  10. Male osteoporosis: clinical approach and management in family practice

    PubMed Central

    Goh, Lay Hoon; How, Choon How; Lau, Tang Ching

    2014-01-01

    In Singapore, male osteoporosis is gaining greater importance due to our ageing population. Family physicians should screen for osteoporosis in elderly men and men with risk factors or secondary causes for the condition. A bone mineral density (BMD) test is used for diagnosis. FRAX® can be used to predict the absolute ten-year fracture risk. Management includes reduction of risk factors or secondary causes, fall prevention, appropriate physical activity and a diet adequate in calcium and vitamin D. Referrals to specialists for evaluation and therapy can be considered, particularly for younger men with more severe disease. Current first-line drug treatment includes bisphosphonates and teriparatide. Testosterone increases BMD of the spine, but data on fracture risk reduction is unavailable. Public and physician education with the involvement of health authorities can create greater awareness of this silent condition, which can lead to complications, morbidity and death, if left untreated. PMID:25091882

  11. Novel molecular targets for prevention of obesity and osteoporosis.

    PubMed

    Rayalam, Srujana; Yang, Jeong-Yeh; Della-Fera, Mary Anne; Baile, Clifton A

    2011-12-01

    Evidence from both epidemiological studies and basic research suggests that obesity and osteoporosis are interrelated. Though there is an increase in the prevalence of these disorders, a limited number of treatments are available, one of the reasons being the complexity of the pathways involved and difficulty in identifying a single molecular target. Due to adverse effects of pharmaceuticals, intake of herbal drugs by patients without a physician's recommendation is increasing globally. Lack of success with targeted monotherapy has encouraged scientists to determine whether combinations of phytochemicals that interfere with numerous cell-signaling pathways can be a more effective approach to treat complex diseases. For example, evidence is emerging that specific combinations of phytochemicals are far more effective than single compounds in decreasing adipogenesis and promoting bone formation. Since multiple pathways are dysfunctional in obesity and osteoporosis, an ideal approach for preventing and treating these diseases may be to use a combination of phytochemicals to address several targets simultaneously. PMID:21429725

  12. The role of MicroRNAs in Osteoclasts and Osteoporosis

    PubMed Central

    Tang, Peifu; Xiong, Qi; Ge, Wei; Zhang, Lihai

    2014-01-01

    Osteoclasts are the exclusive cells of bone resorption. Abnormally activating osteoclasts can lead to low bone mineral density, which will cause osteopenia, osteoporosis, and other bone disorders. To date, the mechanism of how osteoclast precursors differentiate into mature osteoclasts remains elusive. MicroRNAs (miRNAs) are novel regulatory factors that play an important role in numerous cellular processes, including cell differentiation and apoptosis, by post-transcriptional regulation of genes. Recently, a number of studies have revealed that miRNAs participate in bone homeostasis, including osteoclastic bone resorption, which sheds light on the mechanisms underlying osteoclast differentiation. In this review, we highlight the miRNAs involved in regulating osteoclast differentiation and bone resorption, and their roles in osteoporosis. PMID:25692234

  13. New Insights into Osteoporosis: The Bone-Fat Connection

    PubMed Central

    Kawai, Masanobu; de Paula, Francisco J. A.; Rosen, Clifford J

    2013-01-01

    Osteoporosis and obesity are chronic disorders that are increasing in prevalence. The pathophysiology of these diseases is multifactorial and includes genetic, environmental and hormonal determinants. Long considered as distinct disorders that rarely are found in the same individual, emerging evidence from basic and clinical studies support an important interaction between adipose tissue and the skeleton. Adiposity can influence bone remodeling through three possible mechanisms including secretion of cytokines that directly target bone, adipokines that influence the central nervous system thereby changing sympathetic impulses to bone, and paracrine influences on adjacent skeletal cells. This review will focus on our current understanding of bone-fat interactions and the clinical implications of recent studies linking obesity to osteoporosis. PMID:22702419

  14. Causes, consequences, and treatment of osteoporosis in men

    PubMed Central

    Banu, Jameela

    2013-01-01

    Men undergo gradual bone loss with aging, resulting in fragile bones. It is estimated that one in five men will suffer an osteoporotic fracture during their lifetime. The prognosis for men after a hip fracture is very grim. A major cause is reduction of free testosterone. Many other factors result in secondary osteoporosis, including treatment for other diseases such as cancer and diabetes. Patients should be screened not only for bone density but also assessed for their nutritional status, physical activity, and drug intake. Therapy should be chosen based on the type of osteoporosis. Available therapies include testosterone replacement, bisphosphonates, and nutritional supplementation with calcium, vitamin D, fatty acids, and isoflavones, as well as certain specific antibodies, like denosumab and odanacatib, and inhibitors of certain proteins. PMID:24009413

  15. Inhibition of cathepsin K for treatment of osteoporosis.

    PubMed

    Boonen, Steven; Rosenberg, Elizabeth; Claessens, Frank; Vanderschueren, Dirk; Papapoulos, Socrates

    2012-03-01

    Cathepsin K is the protease that is primarily responsible for the degradation of bone matrix by osteoclasts. Inhibitors of cathepsin K are in development for treatment of osteoporosis. Currently available antiresorptive drugs interfere with osteoclast function. They inhibit both bone resorption and formation, due to the coupling between these processes. Cathepsin K inhibitors, conversely, target the resorption process itself and may not interfere with osteoclast stimulation of bone formation. In fact, when cathepsin K is absent or inhibited in mice, rabbits, or monkeys, bone formation is maintained or increased. In humans, inhibition of cathepsin K is associated with sustained reductions in bone resorption markers but with smaller and transient reductions in bone formation markers. The usefulness of cathepsin K inhibitors in osteoporosis is now being examined in phase 2 and phase 3 clinical trials of postmenopausal osteoporotic women. PMID:22228398

  16. Causes, consequences, and treatment of osteoporosis in men.

    PubMed

    Banu, Jameela

    2013-01-01

    Men undergo gradual bone loss with aging, resulting in fragile bones. It is estimated that one in five men will suffer an osteoporotic fracture during their lifetime. The prognosis for men after a hip fracture is very grim. A major cause is reduction of free testosterone. Many other factors result in secondary osteoporosis, including treatment for other diseases such as cancer and diabetes. Patients should be screened not only for bone density but also assessed for their nutritional status, physical activity, and drug intake. Therapy should be chosen based on the type of osteoporosis. Available therapies include testosterone replacement, bisphosphonates, and nutritional supplementation with calcium, vitamin D, fatty acids, and isoflavones, as well as certain specific antibodies, like denosumab and odanacatib, and inhibitors of certain proteins. PMID:24009413

  17. Postmenopausal bone loss and the risk of osteoporosis.

    PubMed

    Christiansen, C

    1994-01-01

    The two most important risk factors for long-term skeletal health are the peak bone mass and the subsequent rate of bone loss. The rate of bone loss after skeletal maturity is determined by both genetic factors and environmental factors. Furthermore, all factors that impair estrogen production will increase bone loss. The present risk of developing osteoporosis and fractures may be assessed by bone mass measurements in the total skeleton, or in local parts of the skeleton such as the spine, hip and forearm, by single-photon/X-ray absorptiometry (SPA or SXA), dual-photon/energy X-ray absorptiometry (DPA or DXA), or quantitative computed tomography (QCT). Furthermore, the rate of bone loss in postmenopausal women may be assessed by means of a number of biochemical markers. The fútúre risk of developing osteoporosis may thus be determined by combining the values for bone mineral content and bone loss. PMID:8081059

  18. [Recent progress in orthopaedic managements of osteoporosis-related fractures].

    PubMed

    Yamamoto, Seizo

    2011-07-01

    Recent progress in orthopaedic treatment of osteoporosis-related fractures was reviewed. In the treatment of femoral neck fractures, impacted or nondisplaced type is treated by three cannulated cancellous pins. Displaced type of femoral neck fracture is treated by bipolar prosthesis. Results of femoral neck fractures are influenced by the complications of each patients. Osteoporotic spine fractures are commonly healed within 2 or 3 months. Spinal compression with paraparesis or paraplegia is unusual complication in burst type of spine fractures. Surgical decompression, bone grafting and stabilization with instrumentation can result in some correction of deformity and neurogenic recovery. Distal radius fractures are common fractures in the eldery. Recently advances includes external fixation and plate fixation for the comminuted fractures in the distal radius. Treatments of osteoporosis-related fractures are still difficult problems to be resolved. PMID:21774371

  19. Osteoporosis and adynamic bone in chronic kidney disease.

    PubMed

    Cannata-Andía, Jorge B; Rodriguez García, Minerva; Gómez Alonso, Carlos

    2013-01-01

    Among the chronic kidney disease-mineral bone disease (CKD-MBD) disorders, osteoporosis and adynamic bone are highly prevalent, and they have been consistently associated with low bone mass, bone fractures, vascular calcifications and greater mortality in general and CKD populations. Despite the fact that osteoporosis and adynamic bone have similar clinical outcomes, they have different pathogeneses and clinical management. In osteoporosis, there is a lack of balance between bone formation and bone resorption, and less new bone is formed to replace bone losses. Osteoporosis is defined by the World Health Organization as "a disease characterized by low bone mineral density and micro architectural deterioration leading to low bone strength and increased risk of fractures." In the general population, there is a good correlation between dual-energy X-ray absorptiometry measurements and bone fractures, but this is not the case with CKD patients. Despite the fact that we have a great number of active antiosteoporotic drugs, the experience in CKD patients is limited. Adynamic bone is suspected based on biochemical parameters, mainly parathyroid hormone (PTH) and bone alkaline phosphatase, but it needs to be proven using a bone biopsy, where a low or zero bone formation rate and a reduction or absence of osteoblasts and osteoclasts should be found. The clinical management of adynamic bone has important limitations and currently does not allow taking many active measures. Treatment is mainly based on the prevention of risk factors known to induce PTH oversuppression, such as aluminium and calcium load and very high doses of vitamin D receptor activators. Due to the limitations in the treatment of both conditions, prevention plays a key role in the management of these disorders. PMID:23023723

  20. Pain in the knee associated with osteoporosis of the patella.

    PubMed Central

    Corbett, M; Colston, J R; Tucker, A K

    1977-01-01

    Four patients, all of whom complained of pain in the knee, were found to have radiological evidence of osteoporosis particularly marked in the patella. In 3 a neurological lesion at the appropriate spinal segment was present, and the fourth patient, who was frankly hysterical, had an autonomic disturbance. If radiological porosis is isolated to the patella a distant cause such as nerve irritation should be sought. Images PMID:856068

  1. Improving Osteoporosis Screening: Results from a Randomized Cluster Trial

    PubMed Central

    Kolk, Deneil; Peterson, Edward L.; McCarthy, Bruce D.; Weiss, Thomas W.; Chen, Ya-Ting; Muma, Bruce K.

    2007-01-01

    Background Despite recommendations, osteoporosis screening rates among women aged 65 years and older remain low. We present results from a clustered, randomized trial evaluating patient mailed reminders, alone and in combination with physician prompts, to improve osteoporosis screening and treatment. Methods Primary care clinics (n = 15) were randomized to usual care, mailed reminders alone, or mailed reminders with physician prompts. Study patients were females aged 65–89 years (N = 10,354). Using automated clinical and pharmacy data, information was collected on bone mineral density testing, pharmacy dispensings, and other patient characteristics. Unadjusted/adjusted differences in testing and treatment were assessed using generalized estimating equation approaches. Results Osteoporosis screening rates were 10.8% in usual care, 24.1% in mailed reminder, and 28.9% in mailed reminder with physician prompt. Results adjusted for differences at baseline indicated that mailed reminders significantly improved testing rates compared to usual care, and that the addition of prompts further improved testing. This effect increased with patient age. Treatment rates were 5.2% in usual care, 8.4% in mailed reminders, and 9.1% in mailed reminders with prompt. No significant differences were found in treatment rates between those receiving mailed reminders alone or in combination with physician prompts. However, women receiving usual care were significantly less likely to be treated. Conclusions The use of mailed reminders, either alone or with physician prompts, can significantly improve osteoporosis screening and treatment rates among insured primary care patients (Clinical Trials.gov number NCT00139425). PMID:17356966

  2. Hypervelocity Stars

    NASA Astrophysics Data System (ADS)

    Brown, Warren R.

    2015-08-01

    Hypervelocity stars (HVSs) travel with such extreme velocities that dynamical ejection via gravitational interaction with a massive black hole (MBH) is their most likely origin. Observers have discovered dozens of unbound main-sequence stars since the first in 2005, and the velocities, stellar nature, spatial distribution, and overall numbers of unbound B stars in the Milky Way halo all fit an MBH origin. Theorists have proposed various mechanisms for ejecting unbound stars, and these mechanisms can be tested with larger and more complete samples. HVSs' properties are linked to the nature and environment of the Milky Way's MBH, and, with future proper motion measurements, their trajectories may provide unique probes of the dark matter halo that surrounds the Milky Way.

  3. Osteoporosis diagnosis in men: the T-score controversy revisited.

    PubMed

    Binkley, Neil; Adler, Robert; Bilezikian, John P

    2014-12-01

    Osteoporosis becomes common with aging in both sexes, but is often ignored in men. The 2013 International Society for Clinical Densitometry consensus conference endorsed a Caucasian female referent database for T-score calculation in men. This recommendation has generated controversy and concern. Accumulating data indicate that at the same DXA-measured body mineral density (BMD) (g/cm(2)), men and women are at approximately the same fracture risk. With this point in mind, using the same database to derive the T-score in men and women is reasonable. As a result, a greater proportion of men who sustain a fragility fracture will have T-scores that are higher than they would if a male database were used; in fact, many men will fracture at T-scores that are "normal." This highlights the importance of diagnosing osteoporosis not just by T-score, but also by the presence of fragility fracture and/or by estimations of fracture risk as generated by tools such as the FRAX calculator. The practical consequences of this change in densitometric definition of osteoporosis in men should be monitored, including the proportion of men at risk identified and treated as well as defining the response to treatment in those assessed by this more comprehensive approach. PMID:25255867

  4. The Relationship between Metabolic Syndrome and Osteoporosis: A Review.

    PubMed

    Wong, Sok Kuan; Chin, Kok-Yong; Suhaimi, Farihah Hj; Ahmad, Fairus; Ima-Nirwana, Soelaiman

    2016-01-01

    Metabolic syndrome (MetS) and osteoporosis are two major healthcare problems worldwide. Metabolic syndrome is a constellation of medical conditions consisting of central obesity, hyperglycemia, hypertension, and dyslipidemia, in which each acts on bone tissue in different ways. The growing prevalence of MetS and osteoporosis in the population along with the controversial findings on the relationship between both conditions suggest the importance for further investigation and discussion on this topic. This review aims to assess the available evidence on the effects of each component of MetS on bone metabolism from the conventional to the contemporary. Previous studies suggested that the two conditions shared some common underlying pathways, which include regulation of calcium homeostasis, receptor activator of NF-κB ligand (RANKL)/receptor activator of the NF-κB (RANK)/osteoprotegerin (OPG) and Wnt-β-catenin signaling pathways. In conclusion, we suggest that MetS may have a potential role in developing osteoporosis and more studies are necessary to further prove this hypothesis. PMID:27338453

  5. Eggshell calcium in the prevention and treatment of osteoporosis.

    PubMed

    Rovenský, J; Stancíková, M; Masaryk, P; Svík, K; Istok, R

    2003-01-01

    In this paper the most significant biological and clinical aspects of a biopreparation made of chicken eggshells are reviewed. Eggshell powder is a natural source of calcium and other elements (e.g. strontium and fluorine) which may have a positive effect on bone metabolism. Experimental and clinical studies performed to date have shown a number of positive properties of eggshell powder, such as antirachitic effects in rats and humans. A positive effect was observed on bone density in animal models of postmenopausal osteoporosis in ovariectomized female rats. In vitro eggshell powder stimulates chondrocyte differentiation and cartilage growth. Clinical studies in postmenopausal women and women with senile osteoporosis showed that eggshell powder reduces pain and osteoresorption and increases mobility and bone density or arrests its loss. The bioavailability of calcium from this source, as tested in piglets, was similar or better than that of food grade purified calcium carbonate. Clinical and experimental studies showed that eggshell powder has positive effects on bone and cartilage and that it is suitable in the prevention and treatment of osteoporosis. PMID:15018022

  6. Olives and Bone: A Green Osteoporosis Prevention Option.

    PubMed

    Chin, Kok-Yong; Ima-Nirwana, Soelaiman

    2016-01-01

    Skeletal degeneration due to aging, also known as osteoporosis, is a major health problem worldwide. Certain dietary components confer protection to our skeletal system against osteoporosis. Consumption of olives, olive oil and olive polyphenols has been shown to improve bone health. This review aims to summarize the current evidence from cellular, animal and human studies on the skeletal protective effects of olives, olive oil and olive polyphenols. Animal studies showed that supplementation of olives, olive oil or olive polyphenols could improve skeletal health assessed via bone mineral density, bone biomechanical strength and bone turnover markers in ovariectomized rats, especially those with inflammation. The beneficial effects of olive oil and olive polyphenols could be attributed to their ability to reduce oxidative stress and inflammation. However, variations in the bone protective, antioxidant and anti-inflammatory effects between studies were noted. Cellular studies demonstrated that olive polyphenols enhanced proliferation of pre-osteoblasts, differentiation of osteoblasts and decreased the formation of osteoclast-like cells. However, the exact molecular pathways for its bone health promoting effects are yet to be clearly elucidated. Human studies revealed that daily consumption of olive oil could prevent the decline in bone mineral density and improve bone turnover markers. As a conclusion, olives, olive oil and its polyphenols are potential dietary interventions to prevent osteoporosis among the elderly. PMID:27472350

  7. The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group.

    PubMed

    Cooper, C; O'Neill, T; Silman, A

    1993-01-01

    Vertebral fractures are recognised as a hallmark of osteoporosis, yet little is known of their epidemiology. This deficiency limits accurate characterisation of the public health importance of osteoporosis. Assessment of the impact of vertebral fractures has been hampered by the absence of formal criteria for identifying fractures on a thoracolumbar radiograph. Initial methods relying upon subjective radiological assessments have given way to morphometric measurements of vertebral heights, with deformities defined according to various algorithms. These methods have been used in a series of studies performed in Rochester, MN, to determine the incidence, outcome, and time trends of vertebral deformities. The results suggest a prevalence rate of vertebral deformity of 25.3 per 100 Rochester women aged 50 years and over (95% CI, 22.3-28.2), with an estimated incidence of 17.8 per 1,000 person-years. The incidence of clinically diagnosed vertebral fractures among women in the same population was 5.3 per 1,000 person-years, suggesting that around 30% of such deformities in women receive clinical attention. Morphometric measurement on the radiographs of women with clinically diagnosed fractures revealed that 80% had grade 2 ( > 4 SD) deformities. Comparable data on the occurrence and health impact of vertebral deformities throughout Europe are urgently required. The European Vertebral Osteoporosis Study (EVOS) is a multicentre epidemiological study that aims to address this issue. It is designed as a radiographic prevalence study in 34 European centres.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8110529

  8. Olives and Bone: A Green Osteoporosis Prevention Option

    PubMed Central

    Chin, Kok-Yong; Ima-Nirwana, Soelaiman

    2016-01-01

    Skeletal degeneration due to aging, also known as osteoporosis, is a major health problem worldwide. Certain dietary components confer protection to our skeletal system against osteoporosis. Consumption of olives, olive oil and olive polyphenols has been shown to improve bone health. This review aims to summarize the current evidence from cellular, animal and human studies on the skeletal protective effects of olives, olive oil and olive polyphenols. Animal studies showed that supplementation of olives, olive oil or olive polyphenols could improve skeletal health assessed via bone mineral density, bone biomechanical strength and bone turnover markers in ovariectomized rats, especially those with inflammation. The beneficial effects of olive oil and olive polyphenols could be attributed to their ability to reduce oxidative stress and inflammation. However, variations in the bone protective, antioxidant and anti-inflammatory effects between studies were noted. Cellular studies demonstrated that olive polyphenols enhanced proliferation of pre-osteoblasts, differentiation of osteoblasts and decreased the formation of osteoclast-like cells. However, the exact molecular pathways for its bone health promoting effects are yet to be clearly elucidated. Human studies revealed that daily consumption of olive oil could prevent the decline in bone mineral density and improve bone turnover markers. As a conclusion, olives, olive oil and its polyphenols are potential dietary interventions to prevent osteoporosis among the elderly. PMID:27472350

  9. Efficacy and Safety of Denosumab in Postmenopausal Women With Osteoporosis

    PubMed Central

    Gu, Hai-Feng; Gu, Ling-Jia; Wu, Yue; Zhao, Xiao-Hong; Zhang, Qing; Xu, Zhe-Rong; Yang, Yun-Mei

    2015-01-01

    Abstract The purpose of this study was to perform a meta-analysis to examine the efficacy and safety of denosumab in postmenopausal women with osteoporosis. Medline, Cochrane Library, EMBASE, and Google Scholar databases were searched until October 30, 2014 using combinations of the following search terms: osteoporosis, postmenopause, postmenopausal, women, denosumab. The primary outcome was bone mineral density (BMD) change, and secondary outcomes were change in the bone turnover markers β-isomerized carboxy-terminal cross-linking telopeptide of type I collagen (CTX) and serum procollagen type I amino-terminal propeptide (P1NP), and adverse events. Patients treated with denosumab had significantly increased BMD of the lumbar spine (7.58%), total hip (4.86%), and distal third of the radius (2.92%) than those treated with placebo (all, P < 0.001). Patients treated with denosumab had a significant decrease of CTX (−66.16%) and P1NP (−64.65%) as compared with those treated with placebo (both, P < 0.001). Adverse events were similar between the 2 groups (pooled odds ratio = 1.04, P = 0.625). Denosumab increases BMD and decreases markers of bone turnover in postmenopausal women with osteoporosis, and is not associated with significant side-effects. PMID:26554766

  10. [Osteoporosis and bone alterations in celiac disease in adults].

    PubMed

    Hoffmanová, Iva; Anděl, Michal

    2014-01-01

    Both celiac disease and osteoporosis are common diseases which are considered an emerging problem in medicine. Celiac disease is a condition at high risk for secondary osteoporosis. Osteoporosis or osteopenia are typically present in untreated adult symptomatic celiac disease with an overt malabsorption syndrome, but is found in about 50 % in suboptimally treated celiac patients, subclinical patients and asymptomatic adult celiac patients, too. Etiology of pathologic bone alteration in celiac disease is multifactorial; however, two main mechanisms are involved: intestinal malabsorption and chronic inflammation. The evaluation of bone mineral metabolism (total calcium/albumin, 25-OH vitamin D3 and parathormone levels in serum) and bone mineral density (densitometry) is recommended in the clinical management of celiac patients. Many studies have demonstrated that bone mineral density values in adults show a good improvement in the first period after the institution of gluten-free diet, the improvement is then unsatisfactory and treatment with a mineral-active drug should probably be considered. PMID:25130636

  11. Melting bones: The social construction of postmenopausal osteoporosis in Turkey.

    PubMed

    Erol, Maral

    2011-11-01

    The increased medicalization of different life stages, including menopause, is a subject studied mostly in the Western context. Examining medicalization in the non-Western world advances discussions of body, identity and health. In this paper, I analyze the discourses around postmenopausal osteoporosis in Turkey, focusing on the different constructions of risk in the medical and popular literature. The empirical basis of the paper draws on ethnographic research done in Istanbul, Turkey between June 2006 and March 2007. The research includes participant observation in gynecology clinics, interviews with clinicians and menopausal women and archival research on the representations of menopause in the Turkish media between 1999 and 2006. Referred to as kemik erimesi (melting of the bones) in colloquial Turkish, osteoporosis has been an essential component in the medicalization of menopause in Turkey. I argue that postmenopausal osteoporosis is defined as a combination of embodied risk, which is related to the definition of menopause as a risky period, and lifestyle risk, demonstrated in discussions around "traditional" vs. "modern" clothing and healthcare habits. The Turkish example emphasizes the importance of local conditions in defining medical risk and complicates the embodied vs. lifestyle risk categories. PMID:21967826

  12. Effects of Yogasanas on osteoporosis in postmenopausal women

    PubMed Central

    Motorwala, Zainab S; Kolke, Sona; Panchal, Priyanka Y; Bedekar, Nilima S; Sancheti, Parag K; Shyam, Ashok

    2016-01-01

    Background: Osteoporosis is commonly encountered by postmenopausal women. There is an increased need for a low cost and efficient treatment alternative to address this population. Aims: To study the effects of integrated yoga on bone mineral density (BMD) in postmenopausal women with osteoporosis. Settings and Designs: Experimental pre-post study conducted in a community setting. Materials and Methods: 30 females in the age group of 45–62 years suffering from postmenopausal osteoporosis with a dual-energy X-ray absorptiometry (DEXA) score of ≤−2.5 underwent a 6 months fully supervised yoga session. All the participants completed the study. Pretraining and posttraining BMD was calculated. Outcome measure: DEXA score at the lumbar spine. Statistical Analysis: The study was statistically analyzed using paired t-test to see the significance of pretraining and posttraining effects of a yoga session. Results: Improvement in T-score of DEXA scan of −2.55 ± 0.25 at posttraining as compared to a pretraining score of −2.69 ± 0.17. Conclusions: Integrated yoga is a safe mode of physical activity which includes weight bearing as well as not weight bearing asanas, Pranayama, and suryanamaskar, all of which helps induce improvement in BMD in postmenopausal osteoporotic females. PMID:26865770

  13. Safety of drugs used in the treatment of osteoporosis.

    PubMed

    McGreevy, Cora; Williams, David

    2011-08-01

    A number of drug classes are licensed for the treatment of osteoporosis including bisphosphonates, recombinant human parathyroid hormone (PTH), strontium, hormone replacement therapy (HRT), selective oestrogen receptor modulators (SERMS) and denosumab. This review discusses the safety of osteoporosis treatments and their efficacies. Recent concerns about the safety of calcium and high-dose vitamin D are discussed. Bisphosphonates have substantial postmarketing experience and a clearer picture of safety issues is emerging. Along with the well recognized effects on the gastrointestinal tract and kidney function, recently described adverse effects such as osteonecrosis of the jaw, oesophageal cancer, atrial fibrillation, subtrochanteric femur fractures and ocular complications of bisphosphonate therapy are discussed. Therapy with PTH is limited to two years' duration because of the development of osteogenic sarcomas in animal studies, which appeared related to dose, duration and timing of therapy. Strontium should be used with caution in patients with renal impairment and its use has been associated with venous thromboembolism. The role of HRT and SERMs in the treatment of postmenopausal osteoporosis is restricted as a result of an increased risk of stroke, venous thromboembolism and breast cancer. Postmarketing experience with denusomab is limited but a number of potential safety concerns including osteonecrosis of the jaw are emerging. All of these drugs have been proven to reduce fractures. The decision to use a drug to reduce fracture risk should be based on risk-benefit analysis of the drug and its suitability for individual patients. PMID:25083210

  14. Marketing disease: is osteoporosis an example of 'disease mongering'?

    PubMed

    Wright, Jane

    Osteoporosis is often described as a disease, yet the symptoms are imperceptible and reliable diagnostic criteria have not been formulated. It is probably better described as a potential risk factor in patients with underlying illness. However, the marketing of osteoporosis has created the impression that all women (and many men) are at risk of suffering fragile bones, hip fracture and death. Large sums of money have been spent on raising awareness, diagnosing and treating osteoporosis, yet its link to hip fracture is not strong and the drug therapies used may be of little benefit or cause actual harm. This article draws parallels in the development of such pseudo-illness with the medicalization of the menopause and the pathologizing of a number of phenomena, including blood pressure, unhappiness, cholesterol levels, sexual and social function. Similarly, in these cases, the manufacture of 'lifestyle' drugs has been costly without significant improvement in mortality or morbidity. Indeed, as was the case with hormone replacement therapy, which resulted in the unnecessary deaths of thousands of women, there may be significant risks attached to treating non-existent diseases. The influence of the medical profession and large drug manufacturers is evaluated and their vested interest in the manufacture of illness is explained. Finally, the crucial role of nursing in challenging these shibboleths is discussed. PMID:19798007

  15. The Relationship between Metabolic Syndrome and Osteoporosis: A Review

    PubMed Central

    Wong, Sok Kuan; Chin, Kok-Yong; Suhaimi, Farihah Hj; Ahmad, Fairus; Ima-Nirwana, Soelaiman

    2016-01-01

    Metabolic syndrome (MetS) and osteoporosis are two major healthcare problems worldwide. Metabolic syndrome is a constellation of medical conditions consisting of central obesity, hyperglycemia, hypertension, and dyslipidemia, in which each acts on bone tissue in different ways. The growing prevalence of MetS and osteoporosis in the population along with the controversial findings on the relationship between both conditions suggest the importance for further investigation and discussion on this topic. This review aims to assess the available evidence on the effects of each component of MetS on bone metabolism from the conventional to the contemporary. Previous studies suggested that the two conditions shared some common underlying pathways, which include regulation of calcium homeostasis, receptor activator of NF-κB ligand (RANKL)/receptor activator of the NF-κB (RANK)/osteoprotegerin (OPG) and Wnt-β-catenin signaling pathways. In conclusion, we suggest that MetS may have a potential role in developing osteoporosis and more studies are necessary to further prove this hypothesis. PMID:27338453

  16. Calcium citrate and vitamin D in the treatment of osteoporosis.

    PubMed

    Quesada Gómez, José Manuel; Blanch Rubió, Josep; Díaz Curiel, Manuel; Díez Pérez, Adolfo

    2011-01-01

    The combination of calcium with vitamin D (vitamin D(3) [colecalciferol]) forms the basis of preventive and therapeutic regimens for osteoporosis. A number of studies have suggested that the combination of calcium and vitamin D is effective when administered at respective dosages of at least 1200 mg and 800 IU per day, although efficacy is, as expected, affected by patient compliance. Overall, treatment with this combination appears to be effective in reducing the incidence of non-vertebral and hip fractures. Also, in all drug studies (of antiresorptive and anabolic agents and strontium ranelate) that demonstrated a reduction in risk of osteoporotic fractures, patients also took calcium and vitamin D supplements. An important finding in this regard is that vitamin D levels have been demonstrated to be inadequate in more than half of women treated for osteoporosis in the US and Europe. The capacity of the small intestine to absorb calcium salts depends on the solubility and ionization of the salts. These properties vary for different salts, with fasting calcium citrate absorption being greater than that of calcium lactogluconate and calcium carbonate. Calcium citrate formulations taken between meals may help to prevent abdominal distension and flatulence, as well as minimize the risk of renal calculus formation, thus helping to optimize patient compliance. Therefore, calcium citrate combined with vitamin D is the combination of choice for the prevention or treatment of osteoporosis. PMID:21405146

  17. Epigenetic Regulation of Bone Remodeling and Its Impacts in Osteoporosis.

    PubMed

    Ghayor, Chafik; Weber, Franz E

    2016-01-01

    Epigenetics describes mechanisms which control gene expression and cellular processes without changing the DNA sequence. The main mechanisms in epigenetics are DNA methylation in CpG-rich promoters, histone modifications and non-coding RNAs (ncRNAs). DNA methylation modifies the function of the DNA and correlates with gene silencing. Histone modifications including acetylation/deacetylation and phosphorylation act in diverse biological processes such as transcriptional activation/inactivation and DNA repair. Non-coding RNAs play a large part in epigenetic regulation of gene expression in addition to their roles at the transcriptional and post-transcriptional level. Osteoporosis is the most common skeletal disorder, characterized by compromised bone strength and bone micro-architectural deterioration that predisposes the bones to an increased risk of fracture. It is most often caused by an increase in bone resorption that is not sufficiently compensated by a corresponding increase in bone formation. Nowadays it is well accepted that osteoporosis is a multifactorial disorder and there are genetic risk factors for osteoporosis and bone fractures. Here we review emerging evidence that epigenetics contributes to the machinery that can alter DNA structure, gene expression, and cellular differentiation during physiological and pathological bone remodeling. PMID:27598138

  18. Risk factors for osteoporosis in inflammatory bowel disease patients

    PubMed Central

    Lima, Carla Andrade; Lyra, Andre Castro; Rocha, Raquel; Santana, Genoile Oliveira

    2015-01-01

    Inflammatory bowel disease (IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density (BMD), which leads to osteopenia and osteoporosis. This article reviewed each risk factor for osteoporosis in IBD patients. Inflammation is one of the factors that contribute to osteoporosis in IBD patients, and the main system that is involved in bone loss is likely RANK/RANKL/osteoprotegerin. Smoking is a risk factor for bone loss and fractures, and many mechanisms have been proposed to explain this loss. Body composition also interferes in bone metabolism and increasing muscle mass may positively affect BMD. IBD patients frequently use corticosteroids, which stimulates osteoclastogenesis. IBD patients are also associated with vitamin D deficiency, which contributes to bone loss. However, infliximab therapy is associated with improvements in bone metabolism, but it is not clear whether the effects are because of inflammation improvement or infliximab use. Ulcerative colitis patients with proctocolectomy and ileal pouches and Crohn’s disease patients with ostomy are also at risk for bone loss, and these patients should be closely monitored. PMID:26600979

  19. The effect of metyrosine/prednisolone combination to oophorectomy-induced osteoporosis

    PubMed Central

    Salman, Suleyman; Kumbasar, Serkan; Hacimuftuoglu, Ahmet; Ozturk, Berna; Seven, Bedri; Polat, Beyzagul; Gundogdu, Cemal; Demirci, Elif; Yildirim, Kadir; Akcay, Fatih; Uslu, Turan; Tuncel Daloglu, Ferrah; Suleyman, Halis

    2012-01-01

    Background: Osteoporosis is a chronic disease characterized by a decrease in bone mineral density (BMD) and corruption of the microarchitectural structure of bone tissue. Objective: It was investigated whether methylprednisolone had a favorable effect on osteoporotic bone tissue in Oophorectomy induced osteoporotic rats whose endogenous adrenaline levels are suppressed with metyrosine. Materials and Methods: Bone Mineral Density, number of osteoblast-osteoclast, bone osteocalcin levels and alkaline phosphatase (ALP) measurements were performed. Obtained results were compared with that of alendronate. Results: Oophorectomy induced osteoporosis was exacerbated by methylprednisolone. Alentronate prevented ovariectomised induced osteoporosis, but it couldn’t prevent methylprednisolone +ovariectomised induced osteoporosis in rats. Conclusion: Combined treatment with methylprednisolon and metyrosine was the best treatment for preventing osteoporosis but metyrosine alone couldn’t prevent osteoporosis in ovariectomised rats. PMID:25246899

  20. Eurycoma longifolia: Medicinal Plant in the Prevention and Treatment of Male Osteoporosis due to Androgen Deficiency

    PubMed Central

    Mohd Effendy, Nadia; Mohamed, Norazlina; Muhammad, Norliza; Naina Mohamad, Isa; Shuid, Ahmad Nazrun

    2012-01-01

    Osteoporosis in elderly men is now becoming an alarming health issue due to its relation with a higher mortality rate compared to osteoporosis in women. Androgen deficiency (hypogonadism) is one of the major factors of male osteoporosis and it can be treated with testosterone replacement therapy (TRT). However, one medicinal plant, Eurycoma longifolia Jack (EL), can be used as an alternative treatment to prevent and treat male osteoporosis without causing the side effects associated with TRT. EL exerts proandrogenic effects that enhance testosterone level, as well as stimulate osteoblast proliferation and osteoclast apoptosis. This will maintain bone remodelling activity and reduce bone loss. Phytochemical components of EL may also prevent osteoporosis via its antioxidative property. Hence, EL has the potential as a complementary treatment for male osteoporosis. PMID:22844328

  1. STARS no star on Kauai

    SciTech Connect

    Jones, M.

    1993-04-01

    The island of Kuai, home to the Pacific Missile Range Facility, is preparing for the first of a series of Star Wars rocket launches expected to begin early this year. The Strategic Defense Initiative plans 40 launches of the Stategic Target System (STARS) over a 10-year period. The focus of the tests appears to be weapons and sensors designed to combat multiple-warhead ICBMs, which will be banned under the START II Treaty that was signed in January. The focus of this article is to express the dubious value of testing the STARS at a time when their application will not be an anticipated problem.

  2. Osteoporosis in men: findings from the Osteoporotic Fractures in Men Study (MrOS)

    PubMed Central

    Cawthon, Peggy M.; Shahnazari, Mohammad; Orwoll, Eric S.; Lane, Nancy E.

    2016-01-01

    The lifespan of men is increasing and this is associated with an increased prevalence of osteoporosis in men. Osteoporosis increases the risk of bone fracture. Fractures are associated with increased disability and mortality, and public health problems. We review here the study of osteoporosis in men as obtained from a longitudinal cohort of community-based older men, the Osteoporotic Fractures in Men Study (MrOS). PMID:26834847

  3. Osteoporosis and polymorphisms of osteoprotegerin gene in postmenopausal women – a pilot study

    PubMed Central

    Grazio, Simeon; Kosovic, Pasezada; Uremovic, Melita; Nemcic, Tomislav; Bobic, Jasminka

    2016-01-01

    Objectives Osteoprotegerin (OPG) has an important role in bone remodeling, and it has been proposed that the OPG gene might be a candidate gene for osteoporosis predisposition. Several studies have already assessed the connection between OPG gene polymorphism and bone mineral density (BMD). In this study we wanted to analyze the association of two polymorphisms in the OPG gene with BMD and bone turnover markers in women with and without osteoporosis. Material and methods In 22 postmenopausal women with osteoporosis (aged 65.6 ±12.6) and 59 women without osteoporosis (aged 60.8 ±8.7) we analyzed the association of two polymorphisms in the OPG gene with BMD, measured by dual energy absorptiometry and with bone turnover markers (crosslaps and osteoprotegerin). A163G, G209A, T245G and G1181C polymorphisms were determined. Results No significant differences in age, anthropometry, number of fractures, osteocalcin and cross-laps were found between women with and without osteoporosis. Women with osteoporosis were significantly longer in postmenopause. Significantly more women with osteoporosis had AG polymorphism (p = 0.038) compared to women without osteoporosis, while no significant difference was found in prevalence of TT and GG polymorphism between patients with and without osteoporosis. No relationship was found between investigated polymorphism and bone turnover markers. A significant negative correlation between total hip BMD and crosslaps (p = 0.046) as well as between total hip T score and crosslaps (p = 0.044) was found in women without osteoporosis Conclusions Postmenopausal women with osteoporosis had AG polymorphism more frequently than women without osteoporosis. Our results indicate that A163G polymorphism could have an impact on higher bone loss in postmenopausal women. PMID:27407270

  4. Osteoporosis in men with idiopathic hypogonadotropic hypogonadism

    SciTech Connect

    Finkelstein, J.S.; Klibanski, A.; Neer, R.M.; Greenspan, S.L.; Rosenthal, D.I.; Crowley, W.F. Jr.

    1987-03-01

    To assess the effect of testosterone deficiency on skeletal integrity in men, we determined bone density in 23 hypogonadal men with isolated gonadotropin-releasing hormone deficiency and compared those values with ones from controls. Cortical bone density, as assessed by single-photon absorptiometry of the nondominant radius, ranged from 0.57 to 0.86 g/cm2 (mean +/- SE, 0.71 +/- 0.02) in patients with fused epiphyses and from 0.57 to 0.67 g/cm2 (mean, 0.61 +/- 0.01) in patients with open epiphyses, both of which were significantly (p less than 0.001) lower than normal. Spinal trabecular bone density, as assessed by computed tomography, was similarly decreased (p less than 0.0001) and ranged from 42 to 177 mg K2HPO4/cm3 (mean, 112 +/- 7). Cortical bone density was at least 2 SD below normal in 16 of 23 men, and 8 men had spinal bone densities below the fracture threshold of 80 to 100 mg K2HPO4/cm3. Osteopenia was equally severe in men with immature and mature bone ages, suggesting that abnormal bone development plays an important role in the osteopenia of men with idiopathic hypogonadotropic hypogonadism.

  5. Gender Representation of Osteoporosis in Patients with Urolithiasis

    PubMed Central

    Bijelic, Radojka; Balaban, Milorad; Milicevic, Snjezana

    2015-01-01

    Introduction: A great number of clinical studies has indicated that the patients with calcium urolithiasis have a reduced mineral bone density. Aim: The aim of our research was to establish representation of osteoporosis, by measuring mineral bone density using the DEXA method, in patients with calcium urolithiasis, by gender. Material and methods: The research was a prospective one, performed at the University Hospital of the Clinical Center of Banja Luka, at the Urology Clinic and Clinic for Endocrinology, Diabetes and Metabolic Diseases. The material in this research were the patients divided into two groups: a working group (the patients suffering from calcium urolithiasis) and a control group (the patients without calcium urolithiasis). One hundred and twenty (120) patients were included in both these groups, divided in three age subgroups: 20-40, 40-60 and over 60. The total working group consisted of 63 men (52.2%) and 57 (47.5%) women. In the control group, the number of women was 72 (60%) and 48 (40%) of men. Establishing of mineral bone density at L2-L4 of lumbal spine vertebrae and hip was done for the patients in both these groups, using DEXA method. Results: Analysis of mineral bone density using DEXA method in patients by gender of working and control groups has shown that osteoporosis and osteopenia in patients of the working group is significantly more present in women (14% and 22.8%) compared to men (1.6% and 17.5%). When compared by gender in the control group, osteoporosis was present a lot more in women (36.1%) compared to men (2.1%). When observed for the total sample of both the working and control group, there was a statistically significant difference (p<0,01) related to gender structure, where the share of women with osteoporosis/osteopenia was significantly higher (36.1%) compared to men (4.2%). Conclusion: Representation of osteoporosis in women with urolithiasis, particularly of older age, is very expressed and this is why prevention

  6. Cost-Effectiveness of Osteoporosis Screening Strategies for Men.

    PubMed

    Nayak, Smita; Greenspan, Susan L

    2016-06-01

    Osteoporosis affects many men, with significant morbidity and mortality. However, the best osteoporosis screening strategies for men are unknown. We developed an individual-level state-transition cost-effectiveness model with a lifetime time horizon to identify the cost-effectiveness of different osteoporosis screening strategies for US men involving various screening tests (dual-energy X-ray absorptiometry [DXA]; the Osteoporosis Self-Assessment Tool [OST]; or a fracture risk assessment strategy using age, femoral neck bone mineral density [BMD], and Vertebral Fracture Assessment [VFA]); screening initiation ages (50, 60, 70, or 80 years); and repeat screening intervals (5 years or 10 years). In base-case analysis, no screening was a less effective option than all other strategies evaluated; furthermore, no screening was more expensive than all strategies that involved screening with DXA or the OST risk assessment instrument, and thus no screening was "dominated" by screening with DXA or OST at all evaluated screening initiation ages and repeat screening intervals. Screening strategies that most frequently appeared as most cost-effective in base-case analyses and one-way sensitivity analyses when assuming willingness-to-pay of $50,000/quality-adjusted life-year (QALY) or $100,000/QALY included screening initiation at age 50 years with the fracture risk assessment strategy and repeat screening every 10 years; screening initiation at age 50 years with fracture risk assessment and repeat screening every 5 years; and screening initiation at age 50 years with DXA and repeat screening every 5 years. In conclusion, expansion of osteoporosis screening for US men to initiate routine screening at age 50 or 60 years would be expected to be effective and of good value for improving health outcomes. A fracture risk assessment strategy using variables of age, femoral neck BMD, and VFA is likely to be the most effective of the evaluated strategies within accepted cost

  7. Mathematical model for the assessment of fracture risk associated with osteoporosis

    NASA Astrophysics Data System (ADS)

    Dinis, Jairson; Pereira, Ana I.; Fonseca, Elza M.

    2012-09-01

    Osteoporosis is a skeletal disease characterized by low bone mass. It is considered a worldwide public health problem that affects a large number of people, in particularly for women with more than 50 years old. The occurrence pattern of osteoporosis in a population may be related to several factors, including socio-economic factors such as income, educational attainment, and factors related to lifestyle such as diet and physical activity. These and other aspects have increasingly been identified as determining the occurrence of various diseases, including osteoporosis. This work proposes a mathematical model that provides the level of osteoporosis in the patient. Preliminary numerical results are presented.

  8. Increased Levels of Circulating Advanced Glycation End-Products in Menopausal Women with Osteoporosis

    PubMed Central

    Yang, Deng-Ho; Chiang, Tsay-I; Chang, I-Chang; Lin, Fu-Huang; Wei, Cheng-Chung; Cheng, Ya-Wen

    2014-01-01

    Background: Advanced glycation end-products (AGEs) can accumulate in organs and tissues during ageing and diabetes. Increased levels of AGEs are found in the bone tissue of patients with osteoporosis. The purpose of this study was to evaluate circulating AGEs in patients with osteoporosis. Methods: We evaluated plasma AGEs, osteoporosis-related biomarkers, and bone mass in 82 menopausal women with osteoporosis or osteopenia, 16 young women with osteopenia, and 43 healthy women without osteoporosis or osteopenia. Results: Higher levels of serum AGEs were found in the osteoporosis or osteopenia group compared to healthy women (P < 0.0001). A negative correlation was observed between serum AGEs and lumbar spine bone density (BMD of lumbar spine, r = -0.249, P = 0.028; T-score of lumbar spine, r = -0.261, P = 0.021). Women with a increased level of serum AGEs (> 8.12 U/mL) had a 5.34-fold risk of osteopenia regarding lumbar spine T-score and a 3.31-fold risk of osteopenia regarding the hip T-score. Conclusion: Serum AGEs could be used to monitor the severity and progression of osteoporosis. An increased serum level of AGEs was associated with impaired bone formation and was a risk factor for the development of osteoporosis. Targeting AGEs may represent a novel therapeutic approach for primary or secondary osteoporosis. PMID:24688308

  9. Heel Ultrasound Scan in Detecting Osteoporosis in Low Trauma Fracture Patients

    PubMed Central

    Hashmi, Faiz R.; Elfandi, Khaled O.

    2016-01-01

    Osteoporosis is the most common metabolic disease with significant impact on the morbidity and mortality of affected patients. Osteoporosis has a significant impact on the economy worldwide. The aim of this study was to find out whether heel ultrasound is as good as central bone densitometry scanning in diagnosing osteoporosis in patients who are at high risk of osteoporosis. This was a prospective study of patients comparing heel ultrasound to central bone densitometry scanning (dual X-ray absorptiometry, DEXA) in patients. The recruited patients attended for a DEXA scan of the left hip and lumbar spine. All subjects had an ultrasound of the left heel using the quantitative heel ultrasound machine. The results of DEXA scan were blinded from the results of ultrasound and vice versa. There were 59 patients who took part in the study, 12 men and 47 women. The mean age was 66 years (SD 11.9) and mean weight was 62.5 kg (SD 10.7). The sensitivity and specificity of the ultrasound heel test to predict osteoporosis were 53% (95%CI: 29-77) and 86% (95%CI: 75-96) respectively. Specificity for predicting bone mineral density (BMD)-defined osteoporosis was high (86%), but sensitivity was low (53%). A heel ultrasound result in the osteoporotic range was highly predictive of BMD-defined osteoporosis. A positive ultrasound heel test in high risk patients is more useful in ruling in osteoporosis than a negative test to rule out osteoporosis. PMID:27433300

  10. Osteoporosis screening is unjustifiably low in older African-American women.

    PubMed Central

    Wilkins, Consuelo H.; Goldfeder, Jason S.

    2004-01-01

    BACKGROUND: More than one million Americans suffer osteoporotic fractures yearly, resulting in a marked increase in morbidity and mortality. Despite a decrease in bone mineral density with increasing age in all ethnic groups and both genders, preventative and therapeutics efforts in osteoporosis have been focused on caucasian and Asian women. This study assesses the osteoporosis screening practices and the frequency of low bone density in a primarily African-American population of older women. METHODS: Medical records of 252 women at risk for osteoporosis were reviewed for the diagnosis of osteoporosis, prior osteoporosis screening, prior breast cancer screening, and the use of calcium, vitamin D or estrogen. Subsequently, 128 women were assessed for risk factors for osteoporosis, and their bone mineral density was measured using a peripheral bone densitometer. RESULTS: Osteoporosis screening had been performed in 11.5% of the subjects. Of the women evaluated by peripheral bone densitometry, 44.5% of all women, 40.4% of African-American women, and 53.3% of caucasian women had abnormally low bone density measurements. The frequency of abnormal bone density increased with both increasing age and decreasing body mass index. CONCLUSIONS: Although few women in this population were previously screened for osteoporosis, low bone density occurred in African-American women at substantial rates. Increasing age and low body mass are important risk factors for low bone density in African-American women. Ethnicity should not be used as an exclusion criterion for screening for osteoporosis. PMID:15101666

  11. Heel Ultrasound Scan in Detecting Osteoporosis in Low Trauma Fracture Patients.

    PubMed

    Hashmi, Faiz R; Elfandi, Khaled O

    2016-06-27

    Osteoporosis is the most common metabolic disease with significant impact on the morbidity and mortality of affected patients. Osteoporosis has a significant impact on the economy worldwide. The aim of this study was to find out whether heel ultrasound is as good as central bone densitometry scanning in diagnosing osteoporosis in patients who are at high risk of osteoporosis. This was a prospective study of patients comparing heel ultrasound to central bone densitometry scanning (dual X-ray absorptiometry, DEXA) in patients. The recruited patients attended for a DEXA scan of the left hip and lumbar spine. All subjects had an ultrasound of the left heel using the quantitative heel ultrasound machine. The results of DEXA scan were blinded from the results of ultrasound and vice versa. There were 59 patients who took part in the study, 12 men and 47 women. The mean age was 66 years (SD 11.9) and mean weight was 62.5 kg (SD 10.7). The sensitivity and specificity of the ultrasound heel test to predict osteoporosis were 53% (95%CI: 29-77) and 86% (95%CI: 75-96) respectively. Specificity for predicting bone mineral density (BMD)-defined osteoporosis was high (86%), but sensitivity was low (53%). A heel ultrasound result in the osteoporotic range was highly predictive of BMD-defined osteoporosis. A positive ultrasound heel test in high risk patients is more useful in ruling in osteoporosis than a negative test to rule out osteoporosis. PMID:27433300

  12. Id4, a new candidate gene for senile osteoporosis, acts as a molecular switch promoting osteoblast differentiation.

    PubMed

    Tokuzawa, Yoshimi; Yagi, Ken; Yamashita, Yzumi; Nakachi, Yutaka; Nikaido, Itoshi; Bono, Hidemasa; Ninomiya, Yuichi; Kanesaki-Yatsuka, Yukiko; Akita, Masumi; Motegi, Hiromi; Wakana, Shigeharu; Noda, Tetsuo; Sablitzky, Fred; Arai, Shigeki; Kurokawa, Riki; Fukuda, Toru; Katagiri, Takenobu; Schönbach, Christian; Suda, Tatsuo; Mizuno, Yosuke; Okazaki, Yasushi

    2010-07-01

    Excessive accumulation of bone marrow adipocytes observed in senile osteoporosis or age-related osteopenia is caused by the unbalanced differentiation of MSCs into bone marrow adipocytes or osteoblasts. Several transcription factors are known to regulate the balance between adipocyte and osteoblast differentiation. However, the molecular mechanisms that regulate the balance between adipocyte and osteoblast differentiation in the bone marrow have yet to be elucidated. To identify candidate genes associated with senile osteoporosis, we performed genome-wide expression analyses of differentiating osteoblasts and adipocytes. Among transcription factors that were enriched in the early phase of differentiation, Id4 was identified as a key molecule affecting the differentiation of both cell types. Experiments using bone marrow-derived stromal cell line ST2 and Id4-deficient mice showed that lack of Id4 drastically reduces osteoblast differentiation and drives differentiation toward adipocytes. On the other hand knockdown of Id4 in adipogenic-induced ST2 cells increased the expression of Ppargamma2, a master regulator of adipocyte differentiation. Similar results were observed in bone marrow cells of femur and tibia of Id4-deficient mice. However the effect of Id4 on Ppargamma2 and adipocyte differentiation is unlikely to be of direct nature. The mechanism of Id4 promoting osteoblast differentiation is associated with the Id4-mediated release of Hes1 from Hes1-Hey2 complexes. Hes1 increases the stability and transcriptional activity of Runx2, a key molecule of osteoblast differentiation, which results in an enhanced osteoblast-specific gene expression. The new role of Id4 in promoting osteoblast differentiation renders it a target for preventing the onset of senile osteoporosis. PMID:20628571

  13. [Osteoporosis in rheumatoid arthritis--significance of alfacalcidol in prevention and therapy].

    PubMed

    Schacht, E

    2000-01-01

    Besides localised osteopenia, patients with rheumatoid arthritis (RA) with or without corticosteroids develop in 30-50% osteoporosis induced by several factors and thus a higher risk of fractures. Bone loss appears very early and correlates directly with disease activity and also later with the negative effects of restrictive mobility. Corticosteroids reduce as a pathogenetic co-factor intestinal calcium absorption and increase renal calcium excretion resulting in compensatory increased PTH-release and increased sensitivity of bone to PTH. In addition, corticosteroids inhibit osteoblast function as well as the favourable effects of growth factors and sex hormones on bone. It has recently been recognised that the expression of D-hormone receptors (VDRs) is suppressed by these medications and that corticosteroids probably induce VDR disorders. The negative influence of corticosteroids on muscle strength (indirectly--via increased PTH-levels, lowered IGF-1-levels or reduced D-hormone activity) is a feature which has been underestimated. The demonstrated drop in 1,25(OH)2D3 (D-hormone) levels in patients with RA in correlation with C-reactive protein (CRP) is of significance in the pathogenesis of RA-induced osteoporosis and could further promote the process of inflammation. There is a general consensus that cytokines (e.g. IL-1, IL-6, IL-12, TNF-alpha) induce bone resorption in inflammatory rheumatic diseases. There are, however, new findings which show that cytokines like TNF-alpha also interfere with bone formation by promoting apoptosis of osteoblasts and reduce the muscle strength, too. D-hormone preparations (alfacalcidol, calcitriol) possess immunoregulatory effects in vitro and in vivo by inhibiting the cytokines IL-1, IL-6, TNF-alpha and particularly IL-12. At the cellular level, D-hormone reduces the expression of Th1 helper cells directly or indirectly by inhibition of IL-12 from monocytes. Therapy with alfacalcidol or calcitriol results in increased

  14. Symbiotic stars

    NASA Technical Reports Server (NTRS)

    Kafatos, M.; Michalitsianos, A. G.

    1984-01-01

    The physical characteristics of symbiotic star systems are discussed, based on a review of recent observational data. A model of a symbiotic star system is presented which illustrates how a cool red-giant star is embedded in a nebula whose atoms are ionized by the energetic radiation from its hot compact companion. UV outbursts from symbiotic systems are explained by two principal models: an accretion-disk-outburst model which describes how material expelled from the tenuous envelope of the red giant forms an inwardly-spiralling disk around the hot companion, and a thermonuclear-outburst model in which the companion is specifically a white dwarf which superheats the material expelled from the red giant to the point where thermonuclear reactions occur and radiation is emitted. It is suspected that the evolutionary course of binary systems is predetermined by the initial mass and angular momentum of the gas cloud within which binary stars are born. Since red giants and Mira variables are thought to be stars with a mass of one or two solar mass, it is believed that the original cloud from which a symbiotic system is formed can consist of no more than a few solar masses of gas.

  15. Superflares on solar-type stars.

    PubMed

    Maehara, Hiroyuki; Shibayama, Takuya; Notsu, Shota; Notsu, Yuta; Nagao, Takashi; Kusaba, Satoshi; Honda, Satoshi; Nogami, Daisaku; Shibata, Kazunari

    2012-05-24

    Solar flares are caused by the sudden release of magnetic energy stored near sunspots. They release 10(29) to 10(32) ergs of energy on a timescale of hours. Similar flares have been observed on many stars, with larger 'superflares' seen on a variety of stars, some of which are rapidly rotating and some of which are of ordinary solar type. The small number of superflares observed on solar-type stars has hitherto precluded a detailed study of them. Here we report observations of 365 superflares, including some from slowly rotating solar-type stars, from about 83,000 stars observed over 120 days. Quasi-periodic brightness modulations observed in the solar-type stars suggest that they have much larger starspots than does the Sun. The maximum energy of the flare is not correlated with the stellar rotation period, but the data suggest that superflares occur more frequently on rapidly rotating stars. It has been proposed that hot Jupiters may be important in the generation of superflares on solar-type stars, but none have been discovered around the stars that we have studied, indicating that hot Jupiters associated with superflares are rare. PMID:22622572

  16. The Impact of Oral Hygiene Maintenance on the Association Between Periodontitis and Osteoporosis

    PubMed Central

    Huang, Yi-Fang; Chang, Chung-Ta; Liu, Shih-Ping; Muo, Chih-Hsin; Tsai, Chun-Hao; Hong, Hsiang-Hsi; Shen, Yu-Fu; Wu, Ching-Zong

    2016-01-01

    Abstract Both periodontitis and osteoporosis have similar sign of bone resorption in nature. However, the relationship of the severity between these 2 bone-loss diseases is still uncertain. The aim of this study was to investigate the association between the severity of osteoporosis and periodontitis regarding the impact of oral hygiene maintenance. In total, 35,127 osteoporosis patients and 50,498 comparisons were derived from the Longitudinal Health Insurance Database of Taiwan between 2000 and 2010. The population was subdivided into groups according to the different level oral hygiene maintenance and the severity of periodontitis and osteoporosis. The association between osteoporosis and periodontitis was estimated by multinomial logistic regression and rank correlation by Kendall rank correlation test, presented by odds ratio (OR), and 5% confidence intervals (CIs). After controlling the age, sex, and comorbidities, variables in the good oral hygiene maintenance population, we found that periodontitis raised 1.29-fold risk of osteoporosis (95% CI = 1.12–1.49); the risk of osteoporosis was increased with the elevated severity of periodontitis from 1.27 (95% CI = 1.08–1.48) to 1.38 (95% CI = 1.01–1.89). There is a positive correlation between the severity of periodontitis and osteoporosis occurrence in this population (OR = 1.27–1.46; Kendall rank correlation test P = 0.0003). In the poor oral hygiene maintenance population, periodontitis patients had 6.02-fold risk of osteoporosis than those who without periodontitis (95% CI = 4.65–7.81); the risk of osteoporosis was increased with periodontitis severity from 5.96 (95% CI = 4.48–7.92) to 6.37 (95% CI = 3.36–12.1). This result indicated the periodontitis and osteoporosis are conjunctive. The sudden periodontal breakdown of those who with good oral hygiene maintenance might be an indicator for the risk of osteoporosis; if those who were diagnosed as osteoporosis must pay

  17. Comparison in Adherence to Osteoporosis Guidelines according to Bone Health Status in Korean Adult

    PubMed Central

    Lim, Hee-Sook; Kim, Soon-Kyung; Lee, Hae-Hyeog; Byun, Dong Won; Kim, Tae-Hee

    2016-01-01

    Background Osteoporosis one of the most serious disease to decrease the quality of life and cause economic loss. Thus, prevention of osteoporosis has become an important health concern. The study examined in adherence to osteoporosis guidelines and compared the levels of adherence to osteoporosis guidelines between bone health status in Korean adult. Methods This study used data from a nationally represented sample of Koreans (n=3,419) from 2008 to 2011 Korea National Health and Nutrition Examination Survey. We were divided into three groups by T-score: normal, osteopenia and osteoporosis. Assessment of adherence level was based on 5 components of osteoporosis guidelines, considering intake of sodium, calcium and protein, smoking and regular exercise. Results The sex, body mass index, income and educational level did not significantly differ between three groups. Deficient intake of calcium was significantly associated with a threefold greater odds in osteoporosis group (OR 3.6; 95% confidence interval [CI] 2.52-5.22). Excessive protein intake was significantly increased the risk only in osteoporosis group compared to the normal group (OR 1.71; 95% CI 1.15-2.62). Smoking increased the risk in osteoporosis group compared to the normal group (OR 2.88; 95% CI 1.75-4.76), osteoporosis group compared to the osteopenia group (OR 2.69; 95% CI 1.61-4.55). Conclusions Nutritional factor (intake of calcium and protein) and lifestyle-related factor (smoking and exercise) must be accompanied the management for bone health. An adherence of guidelines is considered very important for the prevention of osteoporosis. PMID:27622178

  18. Access to Oral Osteoporosis Drugs among Female Medicare Part D Beneficiaries

    PubMed Central

    Lin, Chia-Wei; Karaca-Mandic, Pinar; McCullough, Jeffrey S.; Weaver, Lesley

    2014-01-01

    Background For women living with osteoporosis, high out-of-pocket drug costs may prevent drug therapy initiation. We investigate the association between oral osteoporosis out-of-pocket medication costs and female Medicare beneficiaries’ initiation of osteoporosis drug therapy. Methods We used 2007 and 2008 administrative claims and enrollment data for a 5% random sample of Medicare beneficiaries. Our study sample included age-qualified, female beneficiaries who had no prior history of osteoporosis but were diagnosed with osteoporosis in 2007 or 2008. Additionally, we only included beneficiaries continuously enrolled in standalone prescription drug plans. We excluded beneficiaries who had a chronic condition that was contraindicated with osteoporosis drug utilization. Our final sample included 25,069 beneficiaries. Logistic regression analysis was used to examine the association between the out-of-pocket costs and initiation of oral osteoporosis drug therapy during the year of diagnosis. Findings Twenty-six percent of female Medicare beneficiaries newly diagnosed with osteoporosis initiated oral osteoporosis drug therapy. Beneficiaries’ out-of-pocket costs were not associated with the initiation of drug therapy for osteoporosis. However, there were statistically significant racial disparities in beneficiaries’ initiation of drug therapy. African Americans were 3 percentage points less likely to initiate drug therapy than whites. In contrast, Asian/Pacific Islander and Hispanic beneficiaries were 8 and 18 percentage points respectively more likely to initiate drug therapy than whites. Additionally, institutionalized beneficiaries were 11 percentage points less likely to initiate drug therapy than other beneficiaries. Conclusions Access barriers for drug therapy initiation may be driven by factors other than patients’ out-of-pocket costs. These results suggest that improved osteoporosis treatment requires a more comprehensive approach that goes beyond payment

  19. Chameleon stars

    SciTech Connect

    Dzhunushaliev, Vladimir; Folomeev, Vladimir; Singleton, Douglas

    2011-10-15

    We consider a gravitating spherically symmetric configuration consisting of a scalar field nonminimally coupled to ordinary matter in the form of a perfect fluid. For this system we find static, regular, asymptotically flat solutions for both relativistic and nonrelativistic cases. It is shown that the presence of the nonminimal interaction leads to substantial changes both in the radial matter distribution of the star and in the star's total mass. A simple stability test indicates that, for the choice of parameters used in the paper, the solutions are unstable.

  20. The friendly stars

    NASA Astrophysics Data System (ADS)

    Martin, Martha Evans

    Describes prominent stars such as Vega, Arcturus, and Antares and means of identifying them, discusses the constellations in which they are located, and explains star names, stellar light, distances between stars, and types of stars.

  1. Genetic Approaches To Identifying Novel Osteoporosis Drug Targets.

    PubMed

    Brommage, Robert

    2015-10-01

    During the past two decades effective drugs for treating osteoporosis have been developed, including anti-resorptives inhibiting bone resorption (estrogens, the SERM raloxifene, four bisphosphonates, RANKL inhibitor denosumab) and the anabolic bone forming daily injectable peptide teriparatide. Two potential drugs (odanacatib and romosozumab) are in late stage clinical development. The most pressing unmet need is for orally active anabolic drugs. This review describes the basic biological studies involved in developing these drugs, including the animal models employed for osteoporosis drug development. The genomics revolution continues to identify potential novel osteoporosis drug targets. Studies include human GWAS studies and identification of mutant genes in subjects having abnormal bone mass, mouse QTL and gene knockouts, and gene expression studies. Multiple lines of evidence indicate that Wnt signaling plays a major role in regulating bone formation and continued study of this complex pathway is likely to lead to key discoveries. In addition to the classic Wnt signaling targets DKK1 and sclerostin, LRP4, LRP5/LRP6, SFRP4, WNT16, and NOTUM can potentially be targeted to modulate Wnt signaling. Next-generation whole genome and exome sequencing, RNA-sequencing and CRISPR/CAS9 gene editing are new experimental techniques contributing to understanding the genome. The International Knockout Mouse Consortium efforts to knockout and phenotype all mouse genes are poised to accelerate. Accumulating knowledge will focus attention on readily accessible databases (Big Data). Efforts are underway by the International Bone and Mineral Society to develop an annotated Skeletome database providing information on all genes directly influencing bone mass, architecture, mineralization or strength. PMID:25833316

  2. Vitamin D Repletion in Korean Postmenopausal Women with Osteoporosis

    PubMed Central

    Chung, Yoon-Sok; Chung, Dong Jin; Kang, Moo-Il; Kim, In-Ju; Koh, Jung-Min; Min, Yong-Ki; Oh, Han-Jin; Park, Il Hyung; Lee, Yil-Seob; Waterhouse, Brian; Fitzpatrick, Lorraine A.; Nino, Antonio

    2016-01-01

    Purpose Up to 71% of South Korean postmenopausal women have vitamin D deficiency {serum 25-hydroxyvitamin D [25(OH) D] level <50 nmol/L}. Data on vitamin D supplementation was collected during the screening phase of an efficacy/safety study of denosumab in Korean postmenopausal women with osteoporosis. This report describes the effect of vitamin D supplementation on repletion to 25(OH)D levels ≥50 nmol/L in Korean postmenopausal women with osteoporosis. Materials and Methods Vitamin D levels of Korean postmenopausal women (60–90 years old) were measured by extracting 25(OH)D2 and 25(OH)D3 from serum samples via protein precipitation and using liquid chromatography with tandem mass spectrometry detection. Calibration curves were constructed from the mass chromatograms to obtain total vitamin D levels. Subjects with serum 25(OH)D levels <50 nmol/L were supplemented with 1000 IU of vitamin D tablets during the 2.5-month-long screening period. Dose, frequency, and duration were determined by the investigator. If repletion was achieved (≥50 nmol/L) on retest, subjects were eligible to be rescreened for study entry. Results Of 371 subjects screened, 191 (52%) required vitamin D supplementation, and 88% (168 of 191) were successfully repleted. More than half of the subjects (58%) who were successfully repleted received doses of 2000 IU daily. The mean time to successful repletion was 31 days (standard deviation 8.4 days; range 11–48 days). Conclusion Supplementation with daily median doses of 2000 IU vitamin D successfully repleted 88% of Korean postmenopausal women with osteoporosis within 48 days to a serum vitamin D level of 50 nmol/L. PMID:27189286

  3. [Screening of celiac disease in patients with osteoporosis and osteopenia].

    PubMed

    Fojtík, P; Novosad, P; Kliment, M; Hrdý, P; Bóday, A; Richterová, R; Urban, O

    2011-12-01

    The celiac disease is traditionally viewed as the children's disease with a typical form accompanied mainly by intestinal symptoms and malabsorption. This opinion is still generally accepted by the medical community. Findings based on the area-wide screening show that the prevalence has risen from the original 1 : 1 000-1 500 to 1 : 70-550. The average prevalence in the western countries is nearly 1 : 100. The prevalence of the celiac disease in the Czech republic is estimated to be approximately 1 : 200-250. It means that the number of people in the Czech republic who are likely to be affected is about 40,000-50,000 people. Currently only 10-15% of the total number of the ill people are diagnosed and monitored. Adult patients represent the main diagnostic problem because their clinical pictures are individual and the main symptoms are atypical (nonenteral). These are anaemia (mainly sideropnic), early/premature osteoporosis, herpetiformic (Duhring) dermatitis, polyneurititis, ataxia, depression, behavioural disorders, menstrual cycle disorders and infertility. Therefore our attention is currently focused on the screening of these groups of subjects. The purpose of our study was to check the frequency of the celiac disease with patients with diagnosed osteoporosis and osteopenia. In our study we have confirmed the assumption that the prevalence ofthe celiac disease in the group of subjects was 1 : 50, which means that 2.2% of patients with osteoporosis and osteopenia are affected by celiac sprue and therefore screening examination of these patients with the subsequent causal treatment (gluten-free diet) is recommended. PMID:22277032

  4. Managing Osteoporosis Patients after Long-Term Bisphosphonate Treatment

    PubMed Central

    Adler, Robert A.; Fuleihan, Ghada El-Hajj; Bauer, Douglas C.; Camacho, Pauline M.; Clarke, Bart L.; Clines, Gregory A.; Compston, Juliet E.; Drake, Matthew T.; Edwards, Beatrice J.; Favus, Murray J.; Greenspan, Susan L.; McKinney, Ross; Pignolo, Robert J.; Sellmeyer, Deborah E.

    2016-01-01

    Bisphosphonates (BPs) are the most commonly used medications for osteoporosis, but optimal duration of therapy is unknown. This ASBMR report provides guidance on BP therapy duration with a risk benefit perspective. Two trials provided evidence for long-term BP use. In the Fracture Intervention Trial Long-term Extension (FLEX), postmenopausal women receiving alendronate for 10 years had fewer clinical vertebral fractures than those switched to placebo after 5 years. In the HORIZON extension, women who received 6 annual infusions of zoledronic acid had fewer morphometric vertebral fractures compared with those switched to placebo after 3 years. Low hip T-score between −2 and −2.5 in FLEX and below −2.5 in HORIZON extension predicted a beneficial response to continued therapy. Hence, the Task Force suggests that after 5 years of oral BP or 3 years of intravenous BP, women should be reassessed. Women with previous major osteoporotic fracture, those who fracture on therapy, or others at high risk should generally continue therapy for up to 10 years (oral) or 6 years (intravenous), with periodic risk-benefit evaluation. Older women, those with a low hip T-score or high fracture risk score are considered high risk. The risk of osteonecrosis of the jaw and atypical femoral fracture increases with BP therapy duration, but such rare events are far outweighed by fracture risk reduction with BPs in high risk patients. For women not at high fracture risk after 3–5 years of BP treatment, a drug holiday of 2–3 years can be considered, with periodic reassessment. The algorithm provided for long term BP use is based on limited evidence in mostly Caucasian postmenopausal women and only for vertebral fracture reduction. It is probably applicable to men and patients with glucocorticoid-induced osteoporosis, with some adaptations. It is unlikely that future osteoporosis trials will provide data for formulating definitive recommendations. PMID:26350171

  5. Current and emerging therapies for the treatment of osteoporosis

    PubMed Central

    Waalen, Jill

    2010-01-01

    Osteoporosis represents a weakening of bone tissue due to an imbalance in the dynamic processes of bone formation and bone resorption that are continually ongoing within bone tissue. Most currently available osteoporosis therapies are antiresorptive agents. Over the past decade, bisphosphonates, notably alendronate and risedronate, have become the dominant agents with newer bisphosphonates such as ibandronate and zoledronic acid following a trend of less frequent dosing regimens. Synthetic estrogen receptor modulators (SERMs) continue to be developed as drugs that maintain the bone-protective effects of estrogen while avoiding its associated adverse side effects. Currently available agents of this class include raloxifene, the only SERM available in the United States (US), and lasofoxifene and bazedoxifene, available in Europe. Calcitonin, usually administered as a nasal spray, completes the list of currently approved antiresorptive agents, while parathyroid hormone analogs represent the only anabolic agents currently approved in both the US and Europe. Strontium ranelate is an additional agent available in Europe but not the US that has both anabolic and antiresorptive activity. New agents expected to further expand therapeutic options include denosumab, a monoclonal antibody inhibitor of the resorptive enzyme cathepsin K, which is in the final stages of Food and Drug Administration approval. Other agents in preclinical development include those targeting specific molecules of the Wnt/β-catenin pathway involved in stimulating bone formation by osteoblast cells. This review discusses the use of currently available agents as well as highlighting emerging agents expected to bring significant changes to the approach to osteoporosis therapy in the near future.

  6. Management of osteoporosis in a pre-menopausal woman.

    PubMed

    Bhalla, Ashok K

    2010-06-01

    There is no agreed definition of osteoporosis in pre-menopausal women. The International Society for Clinical Densitometry recommends using Z-score, and women with Z-scores of -2.0 or lower should be defined as having a bone density that is 'below the expected range for age'. The diagnosis is more readily made in the presence of a low-trauma fracture. The relationship between low bone mineral density (BMD) in young pre-menopausal women and its associated fracture risk is not the same as in older women with a low BMD. Between 50% and 90% of pre-menopausal women will have an underlying secondary cause, the most common being eating disorders, anorexia nervosa and use of glucocorticoids. Management should focus on identifying the underlying cause and treating it where possible. The use of pharmacological therapy under other circumstances should be considered carefully. Women with only low BMD and no other risk factors probably require no pharmacological intervention. Those with low BMD and secondary causes or with a severely low BMD, or those who have fragility fractures, may require treatment with anti-resorptive agents, which can include oestrogen, bisphosphonates, calcitonin, calcitriol or anabolic therapy with teriparatide. Selective oestrogen receptor modulators (SERMs) should be avoided as they cause further bone loss in menstruating women. Alendronate and risedronate have been licensed for use in glucocorticoid-induced osteoporosis. These drugs accumulate in the human skeleton and have been shown to cross the placenta and accumulate in newborn rats. The effects on human pregnancy are unclear, although normal pregnancies have been reported. Pre-menopausal women with osteoporosis should be followed up until the BMD is stable, which can usually be ascertained by follow-up scans at 18-36-month intervals. PMID:20534366

  7. Plasma leptin values in postmenopausal women with osteoporosis.

    PubMed

    Kocyigit, Hikmet; Bal, Serpil; Atay, Ayşenur; Koseoglu, Mehmet; Gurgan, Alev

    2013-08-01

    Obesity has a protective effect against osteoporosis and this effect has been attributed to a high body fat content. It has been shown that the leptin concentration is higher in obese patients. Leptin, the protein product of obesity gene, is a hormone produced in adipose tissue. Some studies suggest that endogenous leptin might influence bone metabolism in postmenopausal women. In this study, we investigated plasma leptin concentrations in postmenopausal women with osteoporosis and also analyzed the relationship between plasma leptin levels and bone mineral density (BMD) in order to understand the potential role of leptin in maintaining bone mass. Forty-two postmenopausal women with osteoporosis and thirty seven age and BMI-matched healthy postmenopausal women were included in the study. The mean femoral neck BMD value in the patient group was significantly lower than that in the control group (0.691±0.1 g/cm2 and 0.863±0.1 g/cm2, respectively; p<0.001). The mean plasma leptin concentration in the patient group was not significantly different from that in the control group (p>0.05). Plasma leptin levels were correlated with BMI in both groups (p<0.001 in the patient group and p=0.001 in controls). There was also a strong positive correlation between plasma leptin levels and %fat in both groups (p<0.001 in the patient group and p<0.001 in controls). But there was no correlation between plasma leptin levels and femoral neck BMD values in both groups. Our results do not support the hypothesis that leptin itself plays an important role in maintaining bone mass in postmenopausal women. PMID:23988172

  8. Intestinal Absorption and Metabolism of Epimedium Flavonoids in Osteoporosis Rats.

    PubMed

    Zhou, Jing; Ma, Yi Hua; Zhou, Zhong; Chen, Yan; Wang, Ying; Gao, Xia

    2015-10-01

    Herba Epimdii is a traditional Chinese medicine used to treat osteoporosis. Its main pharmacological ingredients are flavonoids. In previous studies conducted in healthy animals, we showed that epimedium flavonoids could be hydrolyzed into secondary glycosides or aglycon by intestinal flora or enzymes, thereby enhancing their absorption and antiosteoporosis activity. To study the medicine in the pathologic state, epimedium flavonoids were incubated with intestinal mucosa and feces in vitro and intestinal perfusion in situ to explore the differences in absorption and metabolism between sham and osteoporosis rats. For osteoporosis rats, the hydrolysis rates of icariin, epimedin A, epimedin B, and epimedin C incubated with intestinal flora for 1 hour were reduced by 0.19, 0.26, 0.19, and 0.14, respectively, compared with that in sham rats. Hydrolysis rates were reduced by 0.21, 0.24, 0.08, and 0.31 for icariin, epimedin A, epimedin B, and epimedin C incubated with duodenal enzymes for 1 hour and by 0.13, 0.09, 0.07, and 0.47 for icariin, epimedin A, epimedin B, and epimedin C incubated with jejunum enzymes, respectively, compared with the sham group. In addition, the apparent permeability coefficient and elimination percentage of the four epimedium flavonoids in the duodenum, jejunum, ileum, and colon decreased by 29%-44%, 32%-50%, 40%-56%, and 27%-53% compared with that in sham rats, respectively. The main metabolites of the four epimedium flavonoids were the same for the two groups after intestinal perfusion, or flora and enzyme incubation. In conclusion, the amount and activity of intestinal flora and enzymes changed in ovariectomized rats, which affected the intestinal absorption and hydrolysis of epimedium flavonoids whose structures contain 7-glucose. PMID:26135008

  9. Treatment of post-menopausal osteoporosis: beyond bisphosphonates.

    PubMed

    Ishtiaq, S; Fogelman, I; Hampson, G

    2015-01-01

    Osteoporosis is a highly prevalent condition, characterized by compromised bone strength and fragility fractures and with an important associated socio-economic burden. Bisphosphonates are well established as the first line treatment for osteoporosis. However, while randomized control trials have in general demonstrated reasonable anti-fracture efficacy at the spine, they have shown moderate reduction in fracture incidence for non-vertebral sites. Furthermore, oral bisphosphonates are commonly associated with adverse gastrointestinal effects and both oral and parenteral bisphosphonates have been linked with osteonecrosis of the jaw and atypical femoral fracture, two rare but debilitating side effects. In addition, bisphosphonates are not recommended in patients with GFR <35 ml/min/1.73 m(2). Hence, there is a clear requirement for newer agents, which are able to reduce fracture risk further, whilst overcoming the limitations of bisphosphonates. Over the past 20 years, knowledge and a deeper understanding of the various signalling pathways involved in bone remodelling has increased, enabling identification of additional targets for therapy. This review focuses on these newer therapies and includes anti-resorptive agents such as raloxifene and other selective oestrogen receptor modulators, the monoclonal antibody denosumab (which inhibits the RANKL pathway), odanacatib, a cathepsin K inhibitor and the anabolic agents, PTH analogue; PTH (1-34) and anti-sclerostin antibodies (activator of the Wnt pathway). Strontium ranelate will not be reviewed as recent reports highlight concerns surrounding its cardiovascular safety and together with an apparent increased risk of thrombosis, its future use remains uncertain. Some of these agents such as raloxifene, denosumab and teriparatide are already in clinical use whilst others are at varying stages of development. This review will provide an overview of the mechanisms of action of these therapeutic agents on the skeleton and

  10. Heavy Metal Stars

    NASA Astrophysics Data System (ADS)

    2001-08-01

    strongly reinforce our current understanding of heavy element nucleosynthesis. But detecting the element Lead is not easy - the expected spectral lines of Lead in stellar spectra are relatively weak, and they are blended with many nearby absorption lines of other elements. Moreover, bona-fide, low-metallicity AGB stars appear to be extremely rare in the solar neighborhood . But if the necessary observations are so difficult, how is it then possible to probe nucleosynthesis in low-metallicity AGB stars? CH-stars in binary systems ESO PR Photo 26a/01 ESO PR Photo 26a/01 [Preview - JPEG: 350 x 400 pix - 232k] [Normal - JPEG: 700 x 800 pix - 616k] Caption : One of the three Lead stars, HD 196944 that was analyzed in the present research programme (at the center of the field). This star lies about 1600 light years away in the constellation Aquarius. At magnitude 9, it is not visible to the unaided eye, but easily seen through a small amateur telescope. Still, the detailed spectroscopic study reported in this Press release that revealed a high abundance of Lead in this star required a 4-m class telescope. This DSS-image are copyright by the UK SERC/PPARC (Particle Physics and Astronomy Research Council, formerly Science and Engineering Research Council), the Anglo-Australian Telescope Board and the Association of Universities for Research in Astronomy (AURA). The spikes seen in this photo are an optical effect in the telescope. In a determined effort in this direction, a team of Belgian and French astronomers [1] decided to try to detect the presence of Lead in some "CH-stars" [4] that are located about 1600 light-years away, high above the main plane of our Milky Way Galaxy. Over-abundance of some heavy elements has been observed in some "CH-stars". But CH-stars are not very luminous and have not yet evolved to the AGB phase. Hence they are totally unable to produce heavy elements. So how can there be heavy elements in the CH-stars? This mystery was solved when it was realized

  11. [Degenerative osteoarthritis, osteoporosis and fractures: controversies and evidences].

    PubMed

    Pagès-Castellà, Aina; Prieto Alhambra, Daniel

    2013-09-01

    Osteoarthritis and osteoporosis are both common conditions in the elderly but their association has long remained obscure. Recently published studies show that patients with osteoarthritis have higher bone mass but no corresponding decrease in fracture risk. This has been proposed to be due to an increased rate of falls in these patients. Multi-disciplinary interventions, vitamin D supplementation and bisphosphonates can play a role on preventing fractures among osteoarthritis patients, but evidence on their efficacy is scarce and of poor quality. PMID:23540390

  12. Steroid-induced osteoporosis monitored by Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Maher, Jason R.; Takahata, Masahiko; Awad, Hani A.; Berger, Andrew J.

    2011-03-01

    Glucocorticoids are frequently used to treat inflammatory disorders such as rheumatoid arthritis. Unfortunately, extended exposure to this steroid is the leading cause of physician-induced osteoporosis, leaving patients susceptible to fractures at rates of 30-50%. In this presentation, we report correlations between Raman spectra and biomechanical strength tests on bones of glucocorticoid- and placebo- treated mice. Both wild-type mice and a transgenic model of rheumatoid arthritis have been studied. A two-way ANOVA model reveals statistically significant spectral differences as influenced by glucocorticoid treatment and mouse type.

  13. Transcutaneous monitoring of steroid-induced osteoporosis with Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Maher, Jason R.; Inzana, Jason; Takahata, Masahiko; Awad, Hani A.; Berger, Andrew J.

    2012-01-01

    Although glucocorticoids are among the most frequently prescribed anti-inflammatory agents used in the treatment of rheumatoid arthritis, extended exposure to this steroid hormone is the leading cause of iatrogenic osteoporosis. Recently, Raman spectroscopy has been utilized to exploit biochemical differences between osteoporotic and normal bones in order to predict fracture risk. In this presentation, we report the results of ongoing research in our laboratory towards the clinical translation of this technique. We will discuss strategies for the transcutaneous acquisition of spectra from the tibiae of mice that are of sufficient quality to generate accurate predictions of fracture risk.

  14. [Osteoporosis: Diagnostics and Therapy According to the German Guidelines].

    PubMed

    Niedhart, C

    2016-06-01

    The S3 guideline on the diagnosis and therapy of osteoporosis has existed since 2003. This was last updated in 2014. The aim of the present article is to present the knowledge needed for the diagnosis and therapy in men aged 60 or more and in postmenopausal women. The contexts of the updated guideline 1 are presented, together with comments on recent literature that has appeared since the last version. Both abbreviated and long versions of the guideline are available in the Internet under "www.dv-osteologie.org". PMID:26844854

  15. Clinical impact of recent genetic discoveries in osteoporosis.

    PubMed

    Mitchell, Braxton D; Streeten, Elizabeth A

    2013-01-01

    Osteoporotic fracture carries an enormous public health burden in terms of mortality and morbidity. Current approaches to identify individuals at high risk for fracture are based on assessment of bone mineral density and presence of other osteoporosis risk factors. Bone mineral density and susceptibility to osteoporotic fractures are highly heritable, and over 60 loci have been robustly associated with one or both traits through genome-wide association studies carried out over the past 7 years. In this review, we discuss opportunities and challenges for incorporating these genetic discoveries into strategies to prevent osteoporotic fracture and translating new insights obtained from these discoveries into development of new therapeutic targets. PMID:24133373

  16. [The update progress of physical treatment for osteoporosis].

    PubMed

    Huang, Tingsheng; He, Chengqi

    2011-10-01

    Treatments for osteoporosis have many varieties, and the role, characteristics of them are also different. This paper investigates from the perspective of physical therapy pulsed electromagnetic fields (PEMFs), shock wave, and low-intensity pulsed ultrasound (LIPUS) therapy. Then comprehensive analysis of their mechanism of action, clinical application of new advances for more reasonable choice for clinical treatment and further trend of research are discussed. Through the research and discussions, we find out the strengths, weaknesses, and the best method of treatment in order to achieve better therapeutic effect. PMID:22097283

  17. Clinical impact of recent genetic discoveries in osteoporosis

    PubMed Central

    Mitchell, Braxton D; Streeten, Elizabeth A

    2013-01-01

    Osteoporotic fracture carries an enormous public health burden in terms of mortality and morbidity. Current approaches to identify individuals at high risk for fracture are based on assessment of bone mineral density and presence of other osteoporosis risk factors. Bone mineral density and susceptibility to osteoporotic fractures are highly heritable, and over 60 loci have been robustly associated with one or both traits through genome-wide association studies carried out over the past 7 years. In this review, we discuss opportunities and challenges for incorporating these genetic discoveries into strategies to prevent osteoporotic fracture and translating new insights obtained from these discoveries into development of new therapeutic targets. PMID:24133373

  18. [Unexplained pain in the ankle and foot. Consider transient osteoporosis].

    PubMed

    Snijders, G F; van Bokhoven, S C; van Zadelhoff, J T H; Swierstra, B A; Poelkens, F; Martens, H A

    2016-01-01

    Transient osteoporosis is an increasingly recognized condition that causes severe pain in weight-bearing joints and is characterized by otherwise unexplained bone-marrow oedema on MRI. We present two patients, a 40-year-old man and a 60-year-old woman, with longstanding severe pain in the foot and ankle. Both had invalidating pain with only mild swelling of the foot or ankle. Laboratory investigation was unremarkable, and conventional X-ray showed osteopenia of the bones involved. In both cases, consecutive MRIs showed migrating bone marrow oedema. The patients were treated with analgesics, immobilization of the body parts concerned and an intravenous bisphosphonate. PMID:27165454

  19. Osteoimmunology at the nexus of arthritis, osteoporosis, cancer, and infection

    PubMed Central

    Jones, Dallas; Glimcher, Laurie H.; Aliprantis, Antonios O.

    2011-01-01

    Over the past decade and a half, the biomedical community has uncovered a previously unappreciated reciprocal relationship between cells of the immune and skeletal systems. Work in this field, which has been termed “osteoimmunology,” has resulted in the development of clinical therapeutics for seemingly disparate diseases linked by the common themes of inflammation and bone remodeling. Here, the important concepts and discoveries in osteoimmunology are discussed in the context of the diseases bridging these two organ systems, including arthritis, osteoporosis, cancer, and infection, and the targeted treatments used by clinicians to combat them. PMID:21737885

  20. Diabetes mellitus, thyroid dysfunctions and osteoporosis: is there an association?

    PubMed Central

    2013-01-01

    Background Osteoporosis is the most common metabolic bone disease with complicated, multifactorial and heterogenic nature that has no known pathological cause. As the role of Diabetes Mellitus (DM) and thyroid dysfunctions in the prevalence of osteoporosis is not exactly known, therefore this study was designed to evaluate the probable association between osteoporosis with DM and thyroid dysfunctions in Iranian patients. Methods In this cross-sectional study, 300 subjects out of the total number of patients referring to Gorgan bone densitometry centers (3000subjects) were selected via random sampling method in 2009. Individual characteristics, DM, thyroid dysfunctions and densitometry results were collected from densitometry records. Data analysis was carried out by SPSS version 16 software and by using Chi square and T-test. The level of significance in all tests was considered 0.05. Results The mean of T-score in lumbar and femoral areas of diabetic patients were -0.87 ± 1.08 and -1.94 ± 1.33 and in patient with thyroid dysfunctions was -0.80 ± 1.09 and -1.64 ± 1.24 respectively. The mean of BMD in lumbar and femoral areas of diabetic patients were 0.96 ± 0.19 and 0.75 ± 0.19 and in patient with thyroid dysfunctions were 0.96 ± 0.17 and 0.76 ±0.19 respectively. The mean of BMI in osteoporotic subjects in the lumbar and femoral areas were 25.94 ± 5.62 and 26.95 ± 5.20 respectively. The association between BMI and BMD in the lumbar and femoral areas were statistically significant, but the association between DM and thyroid dysfunctions with BMD and T-score in the femoral and lumbar areas was not statistically significant (P-value > 0.05). Conclusion The results of current study show that there is no association between DM and thyroid dysfunctions with osteoporosis. PMID:23834744

  1. Dietary supplements and medical foods for osteopenia and osteoporosis.

    PubMed

    Morgan, Sarah L

    2013-01-01

    Dietary supplements, medical foods, and pharmaceutical agents are all used in the management of metabolic bone disease. The intended populations, governing regulations, safety standards scientific requirements, physician supervision, and distribution vary markedly between supplements, medical foods, and drugs. This article will review characteristics of dietary supplements and medical foods and their use in osteoporosis care. A study that compares the pharmacokinetics of a supplement and a medical food containing similar ingredients is used to contrast the categories of dietary supplements and medical foods. PMID:24095175

  2. New insights into treatment of osteoporosis in postmenopausal women

    PubMed Central

    Geusens, Piet

    2015-01-01

    For the prevention of fractures, antiresorptive drugs (bisphosphonates and denosumab) that decrease high bone resorption and, secondarily, also bone formation, are the mainstream of therapy. Osteoanabolic drugs, such as teriparatide, increase bone formation more than bone resorption, and are used in severe osteoporosis, including patients treated with antiresorptive drugs who still lose bone and have recurrent fractures. New potential drugs for fracture prevention that uncouple bone resorption from bone formation include odanacatib, a specific inhibitor of cathepsin-K, the enzyme that degrades bone collagen type I, that inhibits bone resorption and only temporarily bone formation, and monoclonal antibodies against sclerostin (romosozumab, blosozumab), that stimulate bone formation and decrease bone resorption. PMID:26557374

  3. New insights into treatment of osteoporosis in postmenopausal women.

    PubMed

    Geusens, Piet

    2015-01-01

    For the prevention of fractures, antiresorptive drugs (bisphosphonates and denosumab) that decrease high bone resorption and, secondarily, also bone formation, are the mainstream of therapy. Osteoanabolic drugs, such as teriparatide, increase bone formation more than bone resorption, and are used in severe osteoporosis, including patients treated with antiresorptive drugs who still lose bone and have recurrent fractures. New potential drugs for fracture prevention that uncouple bone resorption from bone formation include odanacatib, a specific inhibitor of cathepsin-K, the enzyme that degrades bone collagen type I, that inhibits bone resorption and only temporarily bone formation, and monoclonal antibodies against sclerostin (romosozumab, blosozumab), that stimulate bone formation and decrease bone resorption. PMID:26557374

  4. The potential impact of new National Osteoporosis Foundation guidance on treatment patterns

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Little information is available on prevalence of osteoporosis risk factors or proportions of U.S. men and women who are potential candidates for treatment. The prevalence of risk factors used in the new National Osteoporosis Foundation (NOF) FRAX (trademark) based Guide to the Prevention and Treatm...

  5. Osteoporosis Knowledge and Attitudes: A Cross-Sectional Study among College-Age Students

    ERIC Educational Resources Information Center

    Ford, M. Allison; Bass, Martha A.; Keathley, Roseanne

    2007-01-01

    Objective: The authors' purpose in this study was to investigate the influence of knowledge of osteoporosis, attitudes regarding osteoporosis, and knowledge of dietary calcium on dairy product intake in both male and female college-age students. Participants: The authors conducted this cross-sectional study on 911 men and women enrolled in 2…

  6. Screening for Osteoporosis in Community-Dwelling Adults with Mental Retardation.

    ERIC Educational Resources Information Center

    Tyler, Carl V., Jr.; Snyder, Clint W.; Zyzanski, Stephen

    2000-01-01

    Osteoporosis screening of 107 adults, ages 40 to 60, with mental retardation who attended community-based training centers found 21 percent had osteoporosis and 34 percent had osteopenia. The most significant predictor of lower bone mineral densities were Down syndrome, mobility status, and race. (Contains references.) (Author/DB)

  7. Osteoporosis Prevention in College Women: Application of the Expanded Health Belief Model.

    ERIC Educational Resources Information Center

    Wallace, Lorraine Silver

    2002-01-01

    Examined personal characteristics and expanded health belief model (EHBM) constructs associated with osteoporosis- protective behaviors among college women. Survey results indicated that the EHBM was useful in evaluating osteoporosis- protective behavior. High numbers of women did not meet current exercise and calcium guidelines. Exercise…

  8. The clinical diagnosis of Osteoporosis: A position statement from the National Bone Health Alliance working group

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Osteoporosis is a common disorder of reduced bone strength that predisposes to an increased risk for fractures in older individuals. In the United States, the standard criterion for the diagnosis of osteoporosis in postmenopausal women and older men is a T-score less than or equal to-2.5 at the lum...

  9. Does Patient Partnership in Continuing Medical Education (CME) Improve the Outcome in Osteoporosis Management.

    ERIC Educational Resources Information Center

    Pazirandeh, Mahmood

    2002-01-01

    Patients (n=672) were screened and instructed about osteoporosis; 53 of their physicians attended lectures, a control group did not. A survey of 258 patients showed doctor-ordered screening tests increased regardless of lecture attendance. Increased patient-initiated discussions about osteoporosis suggest that patient education is effective.…

  10. Do the Determinants of Bone Mineral Density Differ by Gender? The Framingham Osteoporosis Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Osteoporosis is a disease that affects both men and women yet it remains unclear whether determinants of bone mineral density (BMD) differ by gender since few population-based osteoporosis studies have included both men and women. Our study goal was to determine factors associated with BMD and wheth...

  11. Evaluation of a Computer-Tailored Osteoporosis Prevention Intervention in Young Women

    ERIC Educational Resources Information Center

    Lein, Donald H., Jr.; Clark, Diane; Turner, Lori W.; Kohler, Connie L.; Snyder, Scott; Morgan, Sarah L.; Schoenberger, Yu-Mei M.

    2014-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods: One hundred…

  12. Evaluation of Three Osteoporosis Prevention Programs for Young Women: Application of the Health Belief Model

    ERIC Educational Resources Information Center

    Lein, Donald H.; Turner, Lori; Wilroy, Jereme

    2016-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of theory-based osteoporosis prevention programs on calcium and vitamin D intakes and osteoporosis health beliefs in young women. Methods: Women (N = 152) aged 19 to 25 years were randomly assigned to one of 3 groups: a brochure group (n = 51), a computer-tailored program group…

  13. Star Numbers and Constellations.

    ERIC Educational Resources Information Center

    Francis, Richard L.

    1993-01-01

    A number for which the number of digits categorizes the number is called a star number. A set of star numbers having a designated property is called a constellation. Discusses nature and cardinality of constellations made up of star square, star prime, star abundant, and star deficient numbers. Presents five related problems for exploration. (MDH)

  14. Young Women's Knowledge and Beliefs about Osteoporosis: Results from a Cross-Sectional Survey of College Females

    ERIC Educational Resources Information Center

    Kasper, Mark J.; Garber, Michele; Walsdorf, Kristie

    2007-01-01

    Background: About 40% of White American women over age 50 experience osteoporosis-related fracture of the hip, spine, or wrist during their lives. Purpose: The purpose of this study was to determine the level of osteoporosis knowledge and beliefs among young women. Methods: University women (n=302) completed a self-administered osteoporosis risk…

  15. Women's Attitudes and Health Beliefs toward Osteoporosis Screening in a Community Pharmacy.

    PubMed

    Deo, Priyanka; Nayak, Rajesh; Rajpura, Jigar

    2013-01-01

    The aim of this study was to examine women's attitudes and health beliefs towards osteoporosis screening in a community pharmacy setting, utilizing the theoretical framework of Health Belief Model. A nonexperimental, cross-sectional research design, examining a convenience sample of women aged 18 and over, from several New York City senior care centers, a church, and a university campus in New York, was employed to assess the study objectives. Osteoporosis Health Belief Scale questionnaire was used to study the attitudes and health beliefs of participants towards bone mineral density screening in community pharmacy. From the study, it was observed that perceptions of severity and susceptibility towards osteoporosis and subjects' demographic characteristics did not seem to significantly influence the decision to screen in a community pharmacy setting. The perceptions of benefits of community pharmacy-based osteoporosis screening and the perceived barriers were found to be of greater importance in women's decisions to engage in osteoporosis-specific preventive behavior. PMID:23781392

  16. Increased Acquired Cholesteatoma Risk in Patients with Osteoporosis: A Retrospective Cohort Study

    PubMed Central

    Wang, Tang-Chuan; Lin, Che-Chen; Lin, Chia-Der; Chung, Hsiung-Kwang; Wang, Ching-Yuang; Tsai, Ming-Hsui; Kao, Chia-Hung

    2015-01-01

    Objective Clinically, we found the increased incidence of acquired colesteatoma in the patients with osteoporosis. In this study, we used a retrospective cohort to examine this association and to investigate the possible mechanism. Methods We conducted a population-based retrospective cohort study by using the National Health Insurance Research Database (NHIRD). We identified an osteoporosis cohort comprising 37 124 patients newly diagnosed with osteoporosis aged 20 years or older. Patients in the comparison cohort had no history of osteoporosis and were frequency matched with the patients in the osteoporosis cohort according to sex, age, and index year. Results The acquired cholesteatoma incidence rates for the osteoporosis and comparison cohorts were 1.12 and 0.83 per 1000 person-years, respectively. After we adjusted for confounding factors, the osteoporosis cohort exhibited a 1.32-fold increased acquired cholesteatoma risk relative to the comparison cohort (hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 1.11–1.57). In addition, patients with no history of otitis media (HR = 1.33, 95% CI = 1.11–1.59), cancer (HR = 1.34, 95% CI = 1.12–1.60), or COPD (HR = 1.26, 95% CI = 1.05–1.52) in the osteoporosis cohort exhibited an increased risk of subsequent acquired cholesteatoma relative to those in the comparison cohort. Conclusions Our cohort study indicated that patients with osteoporosis had a 1.31-fold increased acquired cholesteatoma risk relative to the comparison cohort. This risk was further increased in patients with comorbid otitis media. Hence, we recommend that otolaryngologists evaluate the condition of the middle ear of patients with osteoporosis. PMID:26171780

  17. Herpes zoster as a risk factor for osteoporosis: A 15-year nationwide population-based study.

    PubMed

    Wu, Chieh-Hsin; Chai, Chee-Yin; Tung, Yi-Ching; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Tzou, Rong-Dar; Lin, Chih-Lung

    2016-06-01

    The objective of this study was to investigate the risk of osteoporosis in patients with herpes zoster (HZ) infection using a nationwide population-based dataset. The Taiwan National Health Insurance Research Database was used to compare data between 11,088 patients aged 20 to 49 years diagnosed with HZ during 1996 to 2010 and a control group of 11,088 patients without HZ. Both cohorts were followed up until the end of 2010 to measure the incidence of osteoporosis. Cox proportional-hazards regression and Kaplan-Meier analyses were used to calculate hazard ratio and cumulative incidences of osteoporosis, respectively. The overall risk of osteoporosis was 4.55 times greater in the HZ group than in the control group (2.48 vs. 0.30 per 1000 person-years, respectively) after adjusting for age, gender, Charlson Comorbidity Index, and related comorbidities. Compared with controls, patients with HZ and subsequent postherpetic neuralgia had a 4.76-fold higher likelihood of developing osteoporosis (95% confidence interval: 2.44-9.29), which was a statistically significant difference (P <0.001). Osteoporosis risk factors included female gender, age, advanced Charlson Comorbidity Index, depression, and postherpetic neuralgia. This study identified HZ is associated with an increased osteoporosis risk. Further evaluation of the value of bone mineral density test in detecting osteoporosis after HZ may be suggested. HZ vaccination could also be evaluated to lower the incidence of HZ and possibly subsequent osteoporosis. Physicians should be alerted to this association to improve early identification of osteoporosis in patients with HZ. PMID:27336887

  18. Should we prescribe calcium supplements for osteoporosis prevention?

    PubMed

    Reid, Ian R

    2014-02-01

    Advocacy for the use of calcium supplements arose at a time when there were no other effective interventions for the prevention of osteoporosis. Their promotion was based on the belief that increasing calcium intake would increase bone formation. Our current understandings of the biology of bone suggest that this does not occur, though calcium does act as a weak antiresorptive. Thus, it slows postmenopausal bone loss but, despite this, recent meta-analyses suggest no significant prevention of fractures. In sum, there is little substantive evidence of benefit to bone health from the use of calcium supplements. Against this needs to be balanced the likelihood that calcium supplement use increases cardiovascular events, kidney stones, gastrointestinal symptoms, and admissions to hospital with acute gastrointestinal problems. Thus, the balance of risk and benefit seems to be consistently negative. As a result, current recommendations are to obtain calcium from the diet in preference to supplements. Dietary calcium intake has not been associated with the adverse effects associated with supplements, probably because calcium is provided in smaller boluses, which are absorbed more slowly since they come together with quantities of protein and fat, resulting in a slower gastric transit time. These findings suggest that calcium supplements have little role to play in the modern therapeutics of osteoporosis, which is based around the targeting of safe and effective anti-resorptive drugs to individuals demonstrated to be at increased risk of future fractures. PMID:24707464

  19. Osteoporosis and fracture risk in people with schizophrenia

    PubMed Central

    Kishimoto, Taishiro; De Hert, Marc; Carlson, Harold E.; Manu, Peter; Correll, Christoph U.

    2013-01-01

    Purpose of review Excessive bone mineral density (BMD) loss has been associated with schizophrenia, but its mechanisms and clinical implications are less clear. The aim of this review was to summarize the risk of osteoporosis and bone fractures in schizophrenia patients. Moreover, we aimed to examine the impact of antipsychotic-induced hyperprolactinemia on bone metabolism. Recent findings Fifteen of 16 studies (93.8%) reported lower BMD or higher prevalence of osteoporosis in at least one region, or in at least one subgroup of schizophrenia patients compared with controls, but results were inconsistent across measured areas. Higher fracture risk was associated with schizophrenia in 2/2 studies (independently: n = 1), and 3/4 studies with antipsychotics. Reasons for this difference include insufficient exercise, poor nutrition, smoking, alcohol use, and low vitamin D levels. Altogether, 9/15 (60.0%) studies examining the relationship between antipsychotic-induced hyperprolactinemia and BMD loss found some effects of hyperprolactinemia. However, results were mixed, samples and effects were small, and only two studies were prospective. Summary Schizophrenia is associated with reduced BMD and fracture risk. Prevention, early detection, and intervention are required. The relative contributions of antipsychotic-related hyperprolactinemia and unhealthy lifestyle behaviors remain unclear, needing to be assessed in well designed, prospective studies, including bone turnover markers as intermediary endpoints. PMID:22744405

  20. The early detection of osteoporosis by Compton gamma ray spectroscopy.

    PubMed

    Hazan, G; Leichter, I; Loewinger, E; Weinreb, A; Robin, G C

    1977-11-01

    The density of the distal end of the radius is one of the parameters used to determine the presence and degree of osteoporosis in patients. In this work the bone density has been determined by measuring the intensity of the Compton scattered photons, since this is proportional to the absolute density of the scatterer, in materials for which Z/A is constant. A collimated beam from a 500 mCi 137Cs source was used and the intensity of the scattered radiation measured at an angle of 90 degrees. The exact point of measurement was determined by a two-dimensional scanning technique. A plastic water phantom was used to calculate the correction needed for absorption and backscatter by the surrounding tissue. Bone density was measured by this method in 50 subjects. A good correlation was found between density of the radius and the degree of morphological change in the vertebrae. In a number of cases a low bone density was discovered without signs of osteoporosis in the spine. These findings were considered indicative of early osteoporotic change, not definable by routine X-ray techniques. This technique may be of value in the follow-up of patients and in controlling the effect of various treatment schedules. PMID:594139

  1. Medical Management of Osteoporosis for Elective Spine Surgery.

    PubMed

    Hassanzadeh, Hamid; Puvanesarajah, Varun; Dalkin, Alan C

    2016-05-01

    Over 50 million Americans have low bone mass. Poor bone quality is known to complicate spinal fusion surgery, which relies on strong bony purchase to be effective. Unfortunately, many spine surgeons do not perform routine workups for either osteoporosis or osteomalacia. Effective screening and risk factor assessment can allow for appropriate medical management of osteoporosis in the perioperative setting, improving outcomes. Medical management can be grouped into several different categories: vitamins and minerals, bisphosphonates, recombinant parathyroid hormone, estrogen replacement or modification, inhibitors of receptor activator of nuclear factor κ-B ligand (RANKL), and calcitonin. Calcium and vitamin D supplements are the least expensive to prescribe, with minimal side effects and promising animal studies, and thus should be provided to most osteoporotic patients. Recombinant parathyroid hormone can also be considered, as clinical studies have demonstrated impressive results in spine fusion patients. Bisphosphonates, estrogen therapy or selective estrogen receptor modulators, and calcitonin should all be avoided in this patient population given unproven benefit and potentially harmful side-effect profiles. Denosumab is potentially an option, but may not be first line given the general lack of supporting data for its use in perioperative management of spine surgery patients. PMID:27100945

  2. Parathyroid Hormone-Related Protein Analogs as Osteoporosis Therapies.

    PubMed

    Esbrit, Pedro; Herrera, Sabina; Portal-Núñez, Sergio; Nogués, Xavier; Díez-Pérez, Adolfo

    2016-04-01

    The only bone anabolic agent currently available for osteoporosis treatment is parathyroid hormone (PTH)-either its N-terminal 1-34 fragment or the whole molecule of 1-84 aminoacids-whose intermittent administration stimulates new bone formation by targeting osteoblastogenesis and osteoblast survival. PTH-related protein (PTHrP) is an abundant factor in bone which shows N-terminal homology with PTH and thus exhibits high affinity for the same PTH type 1 receptor in osteoblasts. Therefore, it is not surprising that intermittently administered N-terminal PTHrP peptides induce bone anabolism in animals and humans. Furthermore, the C-terminal region of PTHrP also elicits osteogenic features in vitro in osteoblastic cells and in various animal models of osteoporosis. In this review, we discuss the current concepts about the cellular and molecular mechanisms whereby PTHrP may induce anabolic actions in bone. Pre-clinical studies and clinical data using N-terminal PTHrP analogs are also summarized, pointing to PTHrP as a promising alternative to current bone anabolic therapies. PMID:26259869

  3. Detection of significant pathways in osteoporosis based on graph clustering.

    PubMed

    Xiao, Haijun; Shan, Liancheng; Zhu, Haiming; Xue, Feng

    2012-12-01

    Osteoporosis is the most common and serious skeletal disorder among the elderly, characterized by a low bone mineral density (BMD). Low bone mass in the elderly is highly dependent on their peak bone mass (PBM) as young adults. Circulating monocytes serve as early progenitors of osteoclasts and produce significant molecules for bone metabolism. An improved understanding of the biology and genetics of osteoclast differentiation at the pathway level is likely to be beneficial for the development of novel targeted approaches for osteoporosis. The objective of this study was to explore gene expression profiles comprehensively by grouping individual differentially expressed genes (DEGs) into gene sets and pathways using the graph clustering approach and Gene Ontology (GO) term enrichment analysis. The results indicated that the DEGs between high and low PBM samples were grouped into nine gene sets. The genes in clusters 1 and 8 (including GBP1, STAT1, CXCL10 and EIF2AK2) may be associated with osteoclast differentiation by the immune system response. The genes in clusters 2, 7 and 9 (including SOCS3, SOD2, ATF3, ADM EGR2 and BCL2A1) may be associated with osteoclast differentiation by responses to various stimuli. This study provides a number of candidate genes that warrant further investigation, including DDX60, HERC5, RSAD2, SIGLEC1, CMPK2, MX1, SEPING1, EPSTI1, C9orf72, PHLDA2, PFKFB3, PLEKHG2, ANKRD28, IL1RN and RNF19B. PMID:22992777

  4. Single- and dual-photon absorptiometry in osteoporosis and osteomalacia

    SciTech Connect

    Wahner, H.W.

    1987-10-01

    Single- and dual-photon absorptiometric methods have been used in the past to identify populations at risk for bone loss, to define the osteoporotic syndrome in terms of bone mass, and to evaluate treatment regimens to prevent bone loss. Technical improvements have made these procedures available for the nontraumatic measurement of bone mineral in the management of the individual patient suspected of having osteoporosis or other bone loss. This requires a different approach to data interpretation because decisions have to be made on the basis of a single measurement. Osteoporosis and osteomalacia cannot be distinguished by bone mineral measurements because both are characterized by a decrease in content of bone mineral. Bone mineral measurements can be used to assess the risk of fracture and, with it, the severity of bone loss. This allows treatment decisions to be made. Repeated measurements made under well-defined conditions allow estimation of long-term rate of bone loss and monitoring of treatment effect. 38 references.

  5. Multifractal analysis of radiographic bone structure in osteoporosis

    NASA Astrophysics Data System (ADS)

    Caligiuri, Philip; Giger, Maryellen L.; Favus, Murray; Doi, Kunio

    1993-06-01

    We are developing noninvasive methods to evaluate bone structure in osteoporosis as demonstrated on conventional radiographs of the spine. One of these methods involves the estimation of fractal dimension of vertebral bodies in the spine of osteoporotic patients with fracture(s) elsewhere in the spin compared to patients without spine fracture. Fractal dimension was estimated using a surface 'area' method based on pixel gray level 'heights'. Analysis of the data by this method suggested a multifractal model of bone structure yielding two fractal dimensions for each case. The ability of these fractal dimensions to distinguish between cases with fracture elsewhere in the spine from those with no spine fracture was evaluated using receiver operating characteristic (ROC) curve analysis. An Az value of 0.87 using one of these fractal dimensions was significantly better than the Az of 0.60 using bone mass measurements for the same patients. The results suggest a possible value of a method using fractal dimension method for the improved prediction of fracture risk in osteoporosis patients.

  6. Prevalence, pathogenesis, and treatment options for mastocytosis-related osteoporosis.

    PubMed

    Rossini, M; Zanotti, R; Orsolini, G; Tripi, G; Viapiana, O; Idolazzi, L; Zamò, A; Bonadonna, P; Kunnathully, V; Adami, S; Gatti, D

    2016-08-01

    Mastocytosis is a rare condition characterized by abnormal mast cell proliferation and a broad spectrum of manifestations, including various organs and tissues. Osteoporosis is one of the most frequent manifestations of systemic mastocytosis, particularly in adults. Osteoporosis secondary to systemic mastocytosis is a cause of unexplained low bone mineral density that should be investigated when accompanied by suspicious clinical elements. Bone involvement is often complicated by a high recurrence of fragility fractures, mainly vertebral, leading to severe disability. The mechanism of bone loss is the result of different pathways, not yet fully discovered. The main actor is the osteoclast with a relative or absolute predominance of bone resorption. Among the stimuli that drive osteoclast activity, the most important one seems to be the RANK-RANKL signaling, but also histamine and other cytokines play a significant role in the process. The central role of osteoclasts made bisphosphonates, as anti-resorptive drugs, the most rational treatment for bone involvement in systemic mastocytosis. There are a few small studies supporting this approach, with large heterogeneity of drug and administration scheme. Currently, zoledronate has the best evidence in terms of gain in bone mineral density and bone turnover suppression, two surrogate markers of anti-fracture efficacy. PMID:26892042

  7. [Diagnosing osteoporosis: what is new in the 2014 DVO guideline?].

    PubMed

    Pfeilschifter, Johannes

    2015-11-01

    Suitable diagnostic strategies beyond general measures of fracture prevention which allow the identification of those individuals who are likely to benefit most from medical treatment are of utmost importance for an efficient treatment of osteoporosis. Since 2003 the "Dachverband Osteologie" (DVO) provides recommendations for the diagnostics and treatment of osteoporosis in German speaking regions. The most recent update was in November 2014. The DVO guideline provides detailed recommendations for a diagnostic examination depending on age, gender, and the presence and strength of clinical risk factors. The number of clinical fractures risks on which the diagnostic and therapeutic recommendations of the DVO guideline 2014 are based has increased in comparison to the DVO guideline 2009. In addition to the fracture risks listed in the previous version of the DVO guideline the list now also includes monoclonal gammopathy of unknown significance, ankylosing spondylitis, COPD, heart failure, celiac disease, type 2 diabetes mellitus, long-term treatment with proton pump inhibitors and a treatment with high-dose inhaled glucocorticoids. For all persons with an increased fracture risk the guideline recommends a diagnostic workup, comprising medical history, clinical examination including assessment of fall risk, DXA measurements at the lumbar spine, proximal total femur and femoral neck, blood analysis and, if indicated, appropriate imaging procedures. The trabecular bone score offers a new diagnostic option for fracture prediction. PMID:26536643

  8. Late-onset psychosis and risedronate treatment for osteoporosis.

    PubMed

    Hirschmann, Shmuel; Gibel, Anatoly; Tsvelikhovsky, Irena; Lisker, Alexander

    2015-04-01

    As women age and enter menopause, they are sometimes more susceptible than men to certain physical and mental disorders such as osteoporosis and late-onset schizophrenia. Risedronate (Actonel©) is a bisphosphonate used for the treatment of osteopenia. Early initiation of pharmacotherapy for osteopenia is recommended to prevent greater bone loss. The most common side effects of risedronate include fever and flu-like symptoms, hypocalcemia, bone and joint pain, peripheral edema, fatigue, change in bowel movements, osteonecrosis of the jaw, and atrial fibrillation. Though reports in the professional literature of psychotic reactions to risedronate are scant, there have been FDA reports as well as patient discussions of psychiatric side effects from this medication on popular websites. We report the case of M, age 59, who was treated with risedronate for osteoporosis, and was subsequently diagnosed with atypical psychosis after other organic causes were excluded. Though it is conceivable that age-related psychosocial and physical factors triggered late-onset schizophrenia, the temporal relationship between the termination of treatment with risedronate and the improvement in her mental state suggests that the risedronate might have triggered a psychotic reaction that resolved following cessation of treatment. PMID:23644167

  9. Hibernating bears as a model for preventing disuse osteoporosis

    USGS Publications Warehouse

    Donahue, S.W.; McGee, M.E.; Harvey, K.B.; Vaughan, M.R.; Robbins, C.T.

    2006-01-01

    The hibernating bear is an excellent model for disuse osteoporosis in humans because it is a naturally occurring large animal model. Furthermore, bears and humans have similar lower limb skeletal morphology, and bears walk plantigrade like humans. Black bears (Ursus americanus) may not develop disuse osteoporosis during long periods of disuse (i.e. hibernation) because they maintain osteoblastic bone formation during hibernation. As a consequence, bone volume, mineral content, porosity, and strength are not adversely affected by annual periods of disuse. In fact, cortical bone bending strength has been shown to increase with age in hibernating black bears without a significant change in porosity. Other animals require remobilization periods 2-3 times longer than the immobilization period to recover the bone lost during disuse. Our findings support the hypothesis that black bears, which hibernate for as long as 5-7 months annually, have evolved biological mechanisms to mitigate the adverse effects of disuse on bone porosity and strength. ?? 2005 Elsevier Ltd. All rights reserved.

  10. Osteoporosis: Modern Paradigms for Last Century’s Bones †

    PubMed Central

    Kruger, Marlena C.; Wolber, Frances M.

    2016-01-01

    The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a “brittle bone” disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture. PMID:27322315

  11. [Treatment of osteoporosis in the elderly: what is the evidence?].

    PubMed

    Verhaar, H J J

    2008-10-01

    Many older people, especially women, and their doctors still see osteoporosis as part of the natural course of ageing instead of as a preventable or treatable disorder. Height loss, hyperkyphosis, back pain, and fractures are accepted as consequences of ageing. The notion that it is too late to start treatment in a late stage of the disease forms another barrier to treatment. Although most studies of fracture reduction with medical treatment were not designed for the "geriatric" population, the average age of participants in most clinical trials was about 70 years. In all major studies patients also received calcium and vitamin D supplements. Nowadays, clinicians can choose from several effective treatments for the prevention of osteoporotic fractures in high-risk postmenopausal women. Data on the anti-fracture potential of calcium/vitamin D, raloxifene, bisphosphonates, strontium ralenate, and parathyroid hormone are now available. Bisphosphonates and strontium ralenate are good choices for first- or second-line treatment, while for the time being parathyroid hormone should only be used for the second-line treatment of osteoporosis in the elderly. PMID:18975841

  12. Paradigm shift in the pathophysiology of postmenopausal and thyrotoxic osteoporosis.

    PubMed

    Zaidi, Mone; Iqbal, Jameel; Blair, Harry C; Zallone, Alberta; Davies, Terry; Sun, Li

    2009-10-01

    Bone loss is an inevitable result of getting older in both sexes. This loss is accelerated in women in the early years following menopause and in both sexes with drugs and diseases, prominently hyperthyroidism. Postmenopausal osteoporosis and hyperthyroid osteoporosis, both of which are widely recognized clinical entities, have been thought to arise from low estrogen levels and high thyroid hormone levels, respectively. However, when estrogen declines, follicle-stimulating hormone, an anterior pituitary hormone, rises. Likewise, when thyroid hormone levels rise in hyperthyroidism, thyroid-stimulating hormone levels fall. We have used a complement of mouse genetic, pharmacological, and cell biological approaches to unravel a direct action of follicle-stimulating hormone and thyroid-stimulating hormone on bone remodeling and bone mass. Apart from establishing a novel pituitary-bone axis of physiological significance, our studies challenge the existing 1-hormone, 1-disease paradigm in endocrinology and suggest that a plurality of hormonal disturbances involving pituitary hormones cause postmenopausal and hyperthyroid osteoporoses. New therapeutic targets thus emerge from these studies. Mt Sinai J Med 76:474-483, 2009. (c) 2009 Mount Sinai School of Medicine. PMID:19787657

  13. Implications of osteoblast-osteoclast interactions in the management of osteoporosis by antiresorptive agents denosumab and odanacatib.

    PubMed

    Sims, Natalie A; Ng, Kong Wah

    2014-03-01

    Antiresorptive agents, used in the treatment of osteoporosis, inhibit either osteoclast formation or function. However, with these approaches, osteoblast activity is also reduced because of the loss of osteoclast-derived coupling factors that serve to stimulate bone formation. This review discusses how osteoclast inhibition influences osteoblast function, comparing the actions of an inhibitor of osteoclast formation [anti-RANKL/Denosumab (DMAB)] with that of a specific inhibitor of osteoclastic cathepsin K activity [Odanacatib (ODN)]. Denosumab rapidly and profoundly, but reversibly, reduces bone formation. In contrast, preclinical studies and clinical trials of ODN showed that bone formation at some skeletal sites was preserved although resorption was reduced. This preservation of bone formation appears to be due to effects of coupling factors, secreted by osteoclasts and released from demineralized bone matrix. This indicates that bone resorptive activities of osteoclasts are separable from their coupling activities. PMID:24477416

  14. Converting neutron stars into strange stars

    NASA Technical Reports Server (NTRS)

    Olinto, A. V.

    1991-01-01

    If strange matter is formed in the interior of a neutron star, it will convert the entire neutron star into a strange star. The proposed mechanisms are reviewed for strange matter seeding and the possible strange matter contamination of neutron star progenitors. The conversion process that follows seeding and the recent calculations of the conversion timescale are discussed.

  15. Lead and osteoporosis: Mobilization of lead from bone in postmenopausal women

    SciTech Connect

    Silbergeld, E.K. ); Schwartz, J. ); Mahaffey, K. )

    1988-10-01

    Although it has been known that humans accumulate lead in bone, mineralized tissue has been considered primarily as a sequestering compartment and not as a site of toxic action for lead. However, experimental data indicate that bone lead can be released during conditions of demineralization, such as pregnancy and lactation. We have examined lead status in women, before and after menopause, using the NHANES II dataset compiled between 1976 and 1980. In 2981 black and white women there was a highly significant increase in both whole blood and calculated plasma lead concentrations after menopause. The results indicate that bone lead is not an inert storage site for absorbed lead. Moreover, lead may interact with other factors in the course of postmenopausal osteoporosis, to aggravate the course of the disease, since lead is known to inhibit activation of vitamin D, uptake of dietary calcium, and several regulatory aspects of bone cell function. The consequences of this mobilization may also be of importance in assessing the risks of maternal lead exposure to fetal and infant health.

  16. The Stars behind the Curtain

    NASA Astrophysics Data System (ADS)

    2010-02-01

    ESO is releasing a magnificent VLT image of the giant stellar nursery surrounding NGC 3603, in which stars are continuously being born. Embedded in this scenic nebula is one of the most luminous and most compact clusters of young, massive stars in our Milky Way, which therefore serves as an excellent "local" analogue of very active star-forming regions in other galaxies. The cluster also hosts the most massive star to be "weighed" so far. NGC 3603 is a starburst region: a cosmic factory where stars form frantically from the nebula's extended clouds of gas and dust. Located 22 000 light-years away from the Sun, it is the closest region of this kind known in our galaxy, providing astronomers with a local test bed for studying intense star formation processes, very common in other galaxies, but hard to observe in detail because of their great distance from us. The nebula owes its shape to the intense light and winds coming from the young, massive stars which lift the curtains of gas and clouds revealing a multitude of glowing suns. The central cluster of stars inside NGC 3603 harbours thousands of stars of all sorts (eso9946): the majority have masses similar to or less than that of our Sun, but most spectacular are several of the very massive stars that are close to the end of their lives. Several blue supergiant stars crowd into a volume of less than a cubic light-year, along with three so-called Wolf-Rayet stars - extremely bright and massive stars that are ejecting vast amounts of material before finishing off in glorious explosions known as supernovae. Using another recent set of observations performed with the SINFONI instrument on ESO's Very Large Telescope (VLT), astronomers have confirmed that one of these stars is about 120 times more massive than our Sun, standing out as the most massive star known so far in the Milky Way [1]. The clouds of NGC 3603 provide us with a family picture of stars in different stages of their life, with gaseous structures that are

  17. Really Hot Stars

    NASA Astrophysics Data System (ADS)

    2003-04-01

    the vicinity. Some astronomers have suggested that N44C is a "fossil X-ray nebula". What does that mean ? It may well be that this O-type star is not alone, but actually possesses a compact companion. The X-ray emission from such a binary may not be constant. During their orbital motion, the two stars can move away from each other, and the larger separation may cause the X-ray emission to stop (because of the cessation of accretion of matter onto the compact object). In this case, the observed high excitation nebula could still persist for a short period of time as a "fossil" of the previous X-ray ionized nebula. Later, that part of the nebula would then gradually disappear. However, to the astonishment of the astronomers, the present VLT observations show little or no variation in the HeII emission. Thus the above described "fossil X-ray nebula" explanation does not appear to be completely adequate and the cause of the high excitation in N44C remains a challenge to astronomers. "You can't win them all", says Yaël Nazé. "We were able to fully understand three nebulae, but we must now look more closely at N44C. I would not be surprised, if we will be able to solve this riddle by means of additional VLT observations." More information The information contained in this press release is based on two research articles to be published in the European research journal "Astronomy & Astrophysics", one of which is available at the preprint website at the Institut d'Astrophysique et de Géophysique de Liège (Belgium). Notes [1]: The team consists of Yaël Nazé, Grégor Rauw, Jean Manfroid and Jean-Marie Vreux (Liège Institute, Belgium), and You-Hua Chu (University of Illinois, USA). [2]: The names of these stars refer to the research papers in which they were first decribed. BAT99-2 and BAT99-49 are nos. 2 and 49 in the list published by Breysacher, Azzopardi and Testor (A&AS, 137, 117, 1999), AB7 is star no. 7 in the list by Azzopardi and Breysacher (A&A, 75, 120, 1979

  18. Christmas star.

    NASA Astrophysics Data System (ADS)

    Biała, J.

    There are continuous attempts to identify the legendary Christmas Star with a real astronomical event accompanying the birth of Jesus from Nazareth. Unfortunately, the date of birth is difficult to establish on the basis of historical records with better accuracy than a few years. During that period a number of peculiar astronomical events were observed and it seem to be impossible to identify the right one unambiguously.

  19. Symbiotic Stars

    NASA Astrophysics Data System (ADS)

    Munari, U.

    2012-06-01

    Symbiotic stars are interacting binary systems composed of a white dwarf (WD) accreting at high rate from a cool giant companion, which frequently fills its Roche lobe. The WD usually is extremely hot and luminous, and able to ionize a sizeable fraction of the cool giant wind, because it is believed the WD undergoes stable hydrogen nuclear burning on its surface of the material accreted from the companion. This leads to consider symbiotic stars as good candidates for the yet-to-be-identified progenitors of type Ia supernovae. Symbiotic stars display the simultaneous presence of many different types of variability, induced by the cool giant, the accreting WD, the circumstellar dust and ionized gas, with time scales ranging from seconds to decades. The long orbital periods (typically a couple of years) and complex outburst patterns, lasting from a few years to a century, make observations from professionals almost impossible to carry out, and open great opportunities to amateur astronomers to contribute fundamental data to science.

  20. Exceptional Stars

    NASA Astrophysics Data System (ADS)

    Kulkarni, S. R.; Hansen, B.; van Kerkwijk, M.; Phinney, E. S.

    2005-12-01

    As part of our Interdisciplinary Scientist effort (PI, Kulkarni) for the Space Interferometry Mission (SIM) we proposed an investigation with SIM of a number of exceptional stars. With SIM we plan to observe dozens of nearby white dwarfs and search for planets surviving the evolution away from the main sequence as well as (newly formed) planets formed in the circumbinary disks of post-AGB binaries or as a result of white dwarf mergers. We propose to measure the proper motion of a sample of X-ray binaries and Be star binaries with the view of understanding the originof high latitude objects and inferring natal kicks and pre-supernova orbits. We plan to observe several compact object binaries to determine the mass of the compact star. Of particular importance is the proposed observation of SS 433 (for which we propose to use the spectrometer on SIM to measure the proper motion of the emission line clumps embedded in the relativistic jets). Separately we are investigating the issue of frame tie between SIM and the ecliptic frame (by observing binary millisecond pulsars with SIM; the position of these objects is very well determined by pulsar timing) and the degree to which highly precise visibility amplitude measurements can be inverted to infer binary parameters.