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Sample records for star released osteoporosis

  1. Osteoporosis

    MedlinePlus

    ... Emergency Room? What Happens in the Operating Room? Osteoporosis KidsHealth > For Kids > Osteoporosis A A A What's ... you're in your mid-20s. What Is Osteoporosis? If someone has osteoporosis (say: oss-tee-oh- ...

  2. Osteoporosis

    MedlinePlus

    ... Too Tall or Too Short All About Puberty Osteoporosis KidsHealth > For Kids > Osteoporosis Print A A A ... you're in your mid-20s. What Is Osteoporosis? If someone has osteoporosis (say: oss-tee-oh- ...

  3. Osteoporosis

    MedlinePlus

    Osteoporosis is a condition that leads to loss of bone mass. From the outside, osteoporotic bone is ... disease. Prevention is the best measure for treating osteoporosis by eating a recommended balanced diet including foods ...

  4. Osteoporosis

    MedlinePlus

    Osteoporosis is a disease that thins and weakens the bones. Your bones become fragile and break easily, ... United States, millions of people either already have osteoporosis or are at high risk due to low ...

  5. 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.

  6. Osteoporosis.

    PubMed

    Nieves, Jeri W; Mosner, Michelle; Silverstein, Shari

    2012-01-01

    Osteoporosis is a skeletal disorder characterized by compromised bone strength that predisposes a person to increased risk of fracture. Fractures have severe consequences, so fracture prevention is imperative. Risk factor assessment and bone density testing are important tools in the diagnosis of osteoporosis. Actions to promote strong bones include adequate intakes of calcium and vitamin D; being physically active; not smoking; and avoiding excessive alcohol use. There are several FDA-approved medications for the treatment of osteoporosis. The recent attention to osteonecrosis of the jaw (ONJ) and the association between dental and skeletal health speak to the importance of osteoporosis awareness for dental professionals.

  7. Osteoporosis

    MedlinePlus

    ... is at its highest level. After bone mass peaks, all adults start to lose some bone mass.Osteoporosis occurs if you lose too much bone or don't make enough bone to begin with.What are the risk factors for osteoporosis?The following things put you at ...

  8. Osteoporosis.

    PubMed

    Nanes, Mark S; Kallen, Caleb B

    2014-01-01

    Osteoporotic fractures are common and result in extensive morbidity and mortality. It is possible to decrease the risk of fracture in postmenopausal, male, and glucocorticoid-induced osteoporosis with appropriate screening and treatment. The assessment of fracture risk, for which bone densitometry is only 1 component, should be the main focus of patient evaluation. Epidemiologically derived risk-assessment tools such as World Health Organization Fracture Risk Assessment Tool (FRAX) provide physicians with a way to determine the 10-year risk of osteoporotic fracture and effectively choose candidates for therapy. A number of potent skeletal antiresorptive and anabolic drugs have become available to treat osteoporosis and prevent up to 70% of fractures. Here, we provide a detailed update on clinical osteoporosis, the contribution of bone densitometry, and the approach to patients using risk assessment in the consideration of treatments. Progress in osteoporosis is an example of successful bench-to-bedside research benefitting populations worldwide.

  9. Osteoporosis

    MedlinePlus

    ... Prevention and Treatment The good news is that osteoporosis can often be prevented and treated. Healthy lifestyle choices such as proper diet, exercise, and treatment medications can help prevent further bone ...

  10. Osteoporosis.

    PubMed

    Ensrud, Kristine E; Crandall, Carolyn J

    2017-08-01

    Osteoporosis is a common systemic skeletal disorder resulting in bone fragility and increased fracture risk. However, management of osteoporosis and fracture prevention strategies are often not addressed by primary care clinicians, even in older patients with recent fractures. Evidence-based screening strategies will improve identification of patients who are most likely to benefit from drug treatment to prevent fracture. In addition, careful consideration of when pharmacotherapy should be started and choice of medication and duration of treatment will maximize the benefits of fracture prevention while minimizing potential harms of long-term drug exposure.

  11. [Osteoporosis].

    PubMed

    Pilipović, N

    2001-01-01

    Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue, leading to enhanced bone fracture risk. Due to its increasing prevalence (affects more than 10 percent of population) and consequences (bone fractures), osteoporosis is a growing medical, social and economic problem. Of particular importance is hip fracture, with increasing incidence and lethal outcome in 20 percent, and less than 33 percent of patients with complete recovery. For better prevention of such undesired consequences, accurate diagnosis in the early phase of bone loss is necessary. Bone loss is a silent process, without signs and symptoms of the disease, and so active screening of persons at risk is needed, particulary among the postmenopausal women with some of the recognized risk factors for the development of osteoporotic bone fracture. In such persons, for early detection of bone mass loss, diagnostic measurement of bone density should be done, preferably dual-energy x-ray absorptiometry (DEXA). Prevention of osteoporosis is the best approach to the problem, and it should be started in early childhood with general measures (diet with sufficient calcium intake, life style with physical exercise) in a involved national program. Treatment of osteoporosis lasts for many years and includes general measures and medication with osteodensitometric assessment over a two-year period.

  12. Osteoporosis.

    PubMed

    Lane, J M; Russell, L; Khan, S N

    2000-03-01

    Osteoporosis is a disorder of decreased bone mass, microarchitectural deterioration, and fragility fractures. Osteoporosis is widespread and can affect people of all ethnic backgrounds and many older women and men. An essential element in preventing osteoporosis is the achievement of normal peak bone mass. Adequate nutrition, appropriate calcium and vitamin D intake, regular menstrual cycles and a well balanced exercise program of exercise are essential elements in achieving peak bone mass. At menopause women undergo accelerated bone loss. Thereafter, women and men gradually lose bone mass. A loss of one standard deviation give rise to an enhanced twofold risk of spine fractures or a 2.5 risk of hip fracture. Bone mass is determined by dual energy x-ray absorptiometry, quantitative computed tomography scan, and a peripheral ultrasound. Dual energy x-ray absorptiometry has outstanding precision (within 1% to 2%), and has the ability to show the efficacy of drug intervention. Peripheral measurements may identify osteoporosis but only have a 70% correlation with hip and spine bone mass. Dual energy x-ray absorptiometry determines bone mass in a patient but the bone collagen breakdown products (N-telopeptide crosslinks) establish the current rate of bone loss. Major risk factors leading to fragility fracture include low body weight, history of fracture, family history of osteoporosis, and smoking. All individuals should ingest adequate calcium and vitamin D, exercise, and prevent falls. Women with low bone mass, high urinary bone collagen breakdown products, and/or major risk factors should consider hormone replacement therapy or a selective estrogen receptor modulator (Evista), calcitonin and bisphosphonates (alendronate). These agents successfully increase bone mass and limit fracture risk. Men at risk for fragility fractures respond similarly as women to alendronate and calcitonin. Although vertebral compression fractures can occur spontaneously, hip fractures are

  13. 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

  14. [Osteoporosis].

    PubMed

    Ziegler, R

    1994-09-20

    Liver cirrhosis may be accompanied by osteoporosis and, rarely, osteomalacia. Normal liver function is required for normal digestion and absorption of calcium-containing nutrients. The liver plays an important role for the metabolisation of vitamin D: the 25-hydroxylation takes place in the liver. However, the respective enzymatic capacity is not limited by liver diseases except for almost complete liver insufficiency. Therefore, true hypovitaminosis D only rarely plays a role in hepatic osteopenia, but direct toxic effects on bone forming cells (osteoblasts) are discussed: e.g. by bile salts. Coexisting hypogonadism leads to further bone loss. Patients with primary biliary cirrhosis in part present with osteoporosis and fractures. Bone histology reveals normal resorption, but decreased formation. Calcitropic hormones are generally normal. Chronic alcoholism induces the same histologic picture in bone, i.e. normal resorption and diminished formation. These changes are reversible after abstinence and as long as of cirrhosis has not yet developed. Patients undergoing liver transplantation due to end stage liver insufficiency including cirrhosis present with diminished bone mass before receiving a new liver, and they show further bone loss after the transplantation due to immunosuppressive treatment including glucocorticoids. There is no specific treatment of bone loss or osteoporosis due to liver cirrhosis. Preventive efforts should be devoted to the avoidance of suboptimal calcium and vitamin D supply, immobilization, and hypogonadism. Fluorides may increase bone mass after liver transplantation--perhaps they are also useful in liver cirrhosis. Antiresorption agents like calcitonins or bisphosphonates may be cautiously tried.

  15. Osteoporosis.

    PubMed

    Sambrook, Philip; Cooper, Cyrus

    2006-06-17

    Osteoporosis is a serious public health issue. The past 10 years have seen great advances in our understanding of its epidemiology, pathophysiology, and treatment, and further advances are rapidly being made. Clinical assessment will probably evolve from decisions mainly being made on the basis of bone densitometry, to use of algorithms of absolute fracture risk. Biochemical markers of bone turnover are also likely to become more widely used. Bisphosphonates will probably remain the mainstay of therapy, but improved understanding of the optimum amount of remodelling suppression and duration of therapy will be important. At the same time, other diagnostic and therapeutic approaches, including biological agents, are likely to become more widespread.

  16. Prolonged bisphosphonate release after treatment in women with osteoporosis. Relationship with bone turnover.

    PubMed

    Peris, P; Torra, M; Olivares, V; Reyes, R; Monegal, A; Martínez-Ferrer, A; Guañabens, N

    2011-10-01

    Bisphosphonates (BP), especially alendronate and risedronate, are the drugs most commonly used for osteoporosis treatment, being incorporated into the skeleton where they inhibit bone resorption and are thereafter slowly released during bone turnover. However, there are few data on the release of BP in patients who have received treatment with these drugs for osteoporosis. This information is essential for evaluating the possibility of BP cyclic therapy in these patients and for controlling their long-term presence in bone tissue. This study evaluated the urinary excretion of alendronate and risedronate in patients treated with these drugs for osteoporosis and analysed its relationship with bone turnover, time of previous drug exposure and time of treatment discontinuation. We included 43 women (aged 65±9.4 years) previously treated with alendronate (36) or risedronate (7) during a mean of 51±3 and 53±3 months, respectively, who had not been treated with other antiosteoporotic treatment and with a median time of discontinuation of 13.5 and 14 months, respectively. Both BP were detected in 24-hour urine by HPLC. In addition, bone formation (PINP) and resorption (NTx) markers were analysed. Both BP were also determined in a control group of women during treatment. Alendronate was detected in 41% of women previously treated with this drug whereas no patient previously treated with risedronate showed detectable urinary values. All control patients showed detectable values of both BP. In patients with detectable alendronate levels, the time of drug cessation was shorter than in patients with undetectable values (12 [6-19] versus 31 [7-72] months, p<0.001). Alendronate was not detected in any patient 19 months after treatment cessation. Alendronate levels were inversely related to time of treatment discontinuation (r=-0.403, p=0.01) and the latter was directly related to NTx (r=0.394, p=0.02). No relationship was observed with age, length of drug exposure, renal

  17. Osteoporosis Overview

    MedlinePlus

    ... supported by your browser. Home Osteoporosis Osteoporosis Basics Osteoporosis Overview Publication available in: PDF (23 KB) Related ... products. NIH Pub. No. 15-AR-8004 NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 ...

  18. VentureStar by Lockheed Martin Releasing Satellite - Computer Graphic

    NASA Technical Reports Server (NTRS)

    1996-01-01

    This is an artist's conception of the NASA/Lockheed Martin Single-Stage-To-Orbit (SSTO) Reusable Launch Vehicle (RLV) releasing a satellite into orbit around the Earth. NASA's Dryden Flight Research Center, Edwards, California, expected to play a key role in the development and flight testing of the X-33, which was a technology demonstrator vehicle for a possible RLV. The RLV technology program was a cooperative agreement between NASA and industry. The goal of the RLV technology program was to enable significant reductions in the cost of access to space, and to promote the creation and delivery of new space services and other activities that would improve U.S. economic competitiveness. The X-33 was a wedged-shaped subscale technology demonstrator prototype of a potential future Reusable Launch Vehicle (RLV) that Lockheed Martin had dubbed VentureStar. The company had hoped to develop VentureStar early this century. Through demonstration flight and ground research, NASA's X-33 program was to have provided the information needed for industry representatives such as Lockheed Martin to decide whether to proceed with the development of a full-scale, commercial RLV program. A full-scale, single-stage-to-orbit RLV was to have dramatically increased reliability and lowered the costs of putting a pound of payload into space, from the current figure of $10,000 to $1,000. Reducing the cost associated with transporting payloads in Low Earth Orbit (LEO) by using a commercial RLV was to have created new opportunities for space access and significantly improved U.S. economic competitiveness in the world-wide launch marketplace. NASA expected to be a customer, not the operator, of the commercial RLV. The X-33 design was based on a lifting body shape with two revolutionary 'linear aerospike' rocket engines and a rugged metallic thermal protection system. The vehicle also had lightweight components and fuel tanks built to conform to the vehicle's outer shape. Time between X-33

  19. Dendritic star polymers for efficient DNA binding and stimulus-dependent DNA release.

    PubMed

    Yin, Meizhen; Ding, Ke; Gropeanu, Radu A; Shen, Jie; Berger, Rüdiger; Weil, Tanja; Müllen, Klaus

    2008-11-01

    Water-soluble core-shell star polymers consisting of a dendritic polyphenylene core and an outer shell containing a defined number of amino groups have been synthesized via atom transfer radical polymerization (ATRP). All macromolecules efficiently interacted with a diverse set of DNA fragments, and stable complexes were formed and visualized by atomic force microscopy. The observed tight binding of DNA, which was found in the sub-nanomolar range, was mainly attributed to strong electrostatic interactions. Complex stoichiometries between the polyelectrolytes were controlled via the number of amino groups of the star polymers, and well-defined nanoscopic architectures were formed. DNA was released from the complexes after treatment with high concentrations of sodium chloride in aqueous solution. Such star polymers, which allow the binding and release of DNA, represent attractive candidates for the development of novel anion-exchange resins for DNA purification or as nonviral vector systems for gene delivery.

  20. 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 ...

  1. 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 ...

  2. [Hypertension and osteoporosis].

    PubMed

    Nakagami, Hironori; Morishita, Ryuichi

    2013-04-01

    The number of patients with high blood pressure and osteoporosis are increased year by year in our society. In hypertension patients, excess urinary calcium secretion induces secondary parathyroidism to increase serum calcium level by calcium release from bone, which may accelerate osteoporosis. In this aspect, there are several reports that anti-hypertensive drugs, especially thiazides, increase bone mineral density and decrease the incidence of bone fracture. In addition, we demonstrated that renin-angiotensin system can be involved in the process of osteoporosis. Angiotensin II significantly induced the expression of RANKL (receptor activator of NF-κB ligand) in osteoblasts, leading to the activation of osteoclasts, while these effects were completely blocked by an Ang II type 1 receptor blockade. Recently, it has been reported that angiotensin receptor blockade clinically decreased the incidence of bone fracture. Renin-angiotensin system might be common molecule to regulate both hypertension and osteoporosis.

  3. Acid-Cleavable Unimolecular Micelles from Amphiphilic Star Copolymers for Triggered Release of Anticancer Drugs.

    PubMed

    Zhang, Shan; Xu, Jianbin; Chen, Heng; Song, Zhangfa; Wu, Yalan; Dai, Xingyi; Kong, Jie

    2017-03-01

    In this contribution, amphiphilic star copolymers (H40-star-PCL-a-PEG) with an H40 hyperbranched polyester core and poly(ε-caprolactone)-a-poly(ethylene glycol) copolymer arms linked with acetal groups are synthesized using ring-opening polymerization and a copper (I)-catalyzed alkyne-azide cycloaddition click reaction. The acid-cleavable acetal groups between the hydrophilic and hydrophobic segments of the arms endow the amphiphilic star copolymers with pH responsiveness. In aqueous solution, unimolecular micelles can be formed with good stability and a unique acid degradability, as is desirable for anticancer drug carriers. For the model drug of doxorubicin, the in vitro release behavior, intracellular release, and inhibition of proliferation of HeLa cells show that the acid-cleavable unimolecular micelles with anticancer activity can be dissociated in an acidic environment and efficiently internalized by HeLa cells. Due to the acid-cleavable and biodegradable nature, unimolecular micelles from amphiphilic star copolymers are promising for applications in intracellular drug delivery for cancer chemotherapy.

  4. NUV Star Catalog from the Lunar-based Ultraviolet Telescope Survey: First Release

    NASA Astrophysics Data System (ADS)

    Meng, Xian-Min; Han, Xu-Hui; Wei, Jian-Yan; Wang, Jing; Cao, Li; Qiu, Yu-Lei; Wu, Chao; Deng, Jin-Song; Cai, Hong-Bo; Xin, Li-Ping

    2016-11-01

    We present a star catalog extracted from the Lunar-based Ultraviolet Telescope (LUT) survey program. LUT's observable sky area is a circular belt around the Moon's north pole, and the survey program covers a preferred area of about 2400 deg2 which includes a region of the Galactic plane. The data are processed with an automatic pipeline which copes with stray light contamination, artificial sources, cosmic rays, flat field calibration, photometry and so on. In the first release version, the catalog provides high confidence sources which have been cross-identified with the Tycho-2 catalog. All the sources have signal-to-noise ratio larger than 5, and the corresponding magnitude limit is typically 14.4 mag, but can be as deep as ˜16 mag if stray light contamination is at the lowest level. A total of 86 467 stars are recorded in the catalog. The full catalog in electronic form is available online.

  5. Postmenopausal osteoporosis.

    PubMed

    Diab, Dima L; Watts, Nelson B

    2013-12-01

    The aim of this study is to provide a thorough updated review of the diagnosis and treatment of postmenopausal osteoporosis. There have been several important findings in the field of postmenopausal osteoporosis over the past 1-2 years. Fewer morphometric vertebral fractures were found in women treated for 6 years with zoledronic acid compared with those who stopped treatment after 3 years. Longer duration of bisphosphonate therapy is associated with a higher risk of atypical femur fractures. Combination therapy with teriparatide and denosumab appears to increase bone mineral density to a greater extent than either therapy alone in postmenopausal women at high risk for fracture. There are several novel therapies under investigation for the treatment of osteoporosis, which are in various stages of development. Nonadherence to osteoporosis therapies continues to be a major problem in clinical practice. There are numerous effective pharmacologic treatment options for postmenopausal osteoporosis. Bisphosphonate drug holidays continue to be an area of significant debate.

  6. 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

  7. 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

  8. Gaia Data Release 1. Testing parallaxes with local Cepheids and RR Lyrae stars

    NASA Astrophysics Data System (ADS)

    2017-09-01

    Context. Parallaxes for 331 classical Cepheids, 31 Type II Cepheids, and 364 RR Lyrae stars in common between Gaia and the Hipparcos and Tycho-2 catalogues are published in Gaia Data Release 1 (DR1) as part of the Tycho-Gaia Astrometric Solution (TGAS). Aims: In order to test these first parallax measurements of the primary standard candles of the cosmological distance ladder, which involve astrometry collected by Gaia during the initial 14 months of science operation, we compared them with literature estimates and derived new period-luminosity (PL), period-Wesenheit (PW) relations for classical and Type II Cepheids and infrared PL, PL-metallicity (PLZ), and optical luminosity-metallicity (MV-[Fe/H]) relations for the RR Lyrae stars, with zero points based on TGAS. Methods: Classical Cepheids were carefully selected in order to discard known or suspected binary systems. The final sample comprises 102 fundamental mode pulsators with periods ranging from 1.68 to 51.66 days (of which 33 with σϖ/ϖ< 0.5). The Type II Cepheids include a total of 26 W Virginis and BL Herculis stars spanning the period range from 1.16 to 30.00 days (of which only 7 with σϖ/ϖ< 0.5). The RR Lyrae stars include 200 sources with pulsation period ranging from 0.27 to 0.80 days (of which 112 with σϖ/ϖ< 0.5). The new relations were computed using multi-band (V,I,J,Ks) photometry and spectroscopic metal abundances available in the literature, and by applying three alternative approaches: (i) linear least-squares fitting of the absolute magnitudes inferred from direct transformation of the TGAS parallaxes; (ii) adopting astrometry-based luminosities; and (iii) using a Bayesian fitting approach. The last two methods work in parallax space where parallaxes are used directly, thus maintaining symmetrical errors and allowing negative parallaxes to be used. The TGAS-based PL,PW,PLZ, and MV- [Fe/H] relations are discussed by comparing the distance to the Large Magellanic Cloud provided by

  9. Acceleration of bone regeneration by activating Wnt/β-catenin signalling pathway via lithium released from lithium chloride/calcium phosphate cement in osteoporosis.

    PubMed

    Li, Li; Peng, Xiaozhong; Qin, Yongbao; Wang, Renchong; Tang, Jingli; Cui, Xu; Wang, Ting; Liu, Wenlong; Pan, Haobo; Li, Bing

    2017-03-24

    By virtue of its excellent bioactivity and osteoconductivity, calcium phosphate cement (CPC) has been applied extensively in bone engineering. Doping a trace element into CPC can change physical characteristics and enhance osteogenesis. The trace element lithium has been demonstrated to stimulate the proliferation and differentiation of osteoblasts. We investigated the fracture-healing effect of osteoporotic defects with lithium-doped calcium phosphate cement (Li/CPC) and the underlying mechanism. Li/CPC bodies immersed in simulated body fluid converted gradually to hydroxyapatite. Li/CPC extracts stimulated the proliferation and differentiation of osteoblasts upon release of lithium ions (Li(+)) at 25.35 ± 0.12 to 50.74 ± 0.13 mg/l through activation of the Wnt/β-catenin pathway in vitro. We also examined the effect of locally administered Li(+) on defects in rat tibia between CPC and Li/CPC in vivo. Micro-computed tomography and histological staining showed that Li/CPC had better osteogenesis by increasing bone mass and promoting repair in defects compared with CPC (P < 0.05). Li/CPC also showed better osteoconductivity and osseointegration. These findings suggest that local release of Li(+) from Li/CPC may accelerate bone regeneration from injury through activation of the Wnt/β-catenin pathway in osteoporosis.

  10. Acceleration of bone regeneration by activating Wnt/β-catenin signalling pathway via lithium released from lithium chloride/calcium phosphate cement in osteoporosis

    NASA Astrophysics Data System (ADS)

    Li, Li; Peng, Xiaozhong; Qin, Yongbao; Wang, Renchong; Tang, Jingli; Cui, Xu; Wang, Ting; Liu, Wenlong; Pan, Haobo; Li, Bing

    2017-03-01

    By virtue of its excellent bioactivity and osteoconductivity, calcium phosphate cement (CPC) has been applied extensively in bone engineering. Doping a trace element into CPC can change physical characteristics and enhance osteogenesis. The trace element lithium has been demonstrated to stimulate the proliferation and differentiation of osteoblasts. We investigated the fracture-healing effect of osteoporotic defects with lithium-doped calcium phosphate cement (Li/CPC) and the underlying mechanism. Li/CPC bodies immersed in simulated body fluid converted gradually to hydroxyapatite. Li/CPC extracts stimulated the proliferation and differentiation of osteoblasts upon release of lithium ions (Li+) at 25.35 ± 0.12 to 50.74 ± 0.13 mg/l through activation of the Wnt/β-catenin pathway in vitro. We also examined the effect of locally administered Li+ on defects in rat tibia between CPC and Li/CPC in vivo. Micro-computed tomography and histological staining showed that Li/CPC had better osteogenesis by increasing bone mass and promoting repair in defects compared with CPC (P < 0.05). Li/CPC also showed better osteoconductivity and osseointegration. These findings suggest that local release of Li+ from Li/CPC may accelerate bone regeneration from injury through activation of the Wnt/β-catenin pathway in osteoporosis.

  11. Acceleration of bone regeneration by activating Wnt/β-catenin signalling pathway via lithium released from lithium chloride/calcium phosphate cement in osteoporosis

    PubMed Central

    Li, Li; Peng, Xiaozhong; Qin, Yongbao; Wang, Renchong; Tang, Jingli; Cui, Xu; Wang, Ting; Liu, Wenlong; Pan, Haobo; Li, Bing

    2017-01-01

    By virtue of its excellent bioactivity and osteoconductivity, calcium phosphate cement (CPC) has been applied extensively in bone engineering. Doping a trace element into CPC can change physical characteristics and enhance osteogenesis. The trace element lithium has been demonstrated to stimulate the proliferation and differentiation of osteoblasts. We investigated the fracture-healing effect of osteoporotic defects with lithium-doped calcium phosphate cement (Li/CPC) and the underlying mechanism. Li/CPC bodies immersed in simulated body fluid converted gradually to hydroxyapatite. Li/CPC extracts stimulated the proliferation and differentiation of osteoblasts upon release of lithium ions (Li+) at 25.35 ± 0.12 to 50.74 ± 0.13 mg/l through activation of the Wnt/β-catenin pathway in vitro. We also examined the effect of locally administered Li+ on defects in rat tibia between CPC and Li/CPC in vivo. Micro-computed tomography and histological staining showed that Li/CPC had better osteogenesis by increasing bone mass and promoting repair in defects compared with CPC (P < 0.05). Li/CPC also showed better osteoconductivity and osseointegration. These findings suggest that local release of Li+ from Li/CPC may accelerate bone regeneration from injury through activation of the Wnt/β-catenin pathway in osteoporosis. PMID:28338064

  12. [Postmenopausal osteoporosis].

    PubMed

    László, Adám

    2004-01-04

    Due to its incidence and clinical consequences osteoporosis followed by vertebral, hip, and forearm fractures represents an outstanding problem of nowadays' health care. Because of its high mortality rate hip fractures are of special interest. The number of fractures caused by postmenopausal osteoporosis increases with age. Costs of examinations and treatment of women with postmenopausal osteoporosis and fractures are also increasing and represent a significant amount all over the world. Organization of Osteoporosis Centres in Hungary was founded in 1995 and has been since functioning, however, only the one-sixth of osteoporotic patients are treated. Several risk factors are known in the pathogenesis of osteoporosis, first of all the lack of sufficient calcium and vitamin D intake, age, genetic factors, and circumstances known to predispose falling. Estrogen deficiency is the most likely cause of postmenopausal osteoporosis. Osteodensitometry by DEXA is the most important method to evaluate osteoporosis, since decrease in bone mineral density strongly correlates with fracture incidence. Physical, radiologic, and laboratory examination are also required at the first visit and during follow-up. The quantity of bone can hardly be influenced after the 35th year of age, thus prevention of osteoporosis has special significance: appropriate calcium and vitamin D supplementation, weight-bearing sports and physical activity can prevent fractures. According to the results from studies fulfilling the criteria of evidence-based medicine, first choice treatment of osteoporosis involves hormone replacement therapy, bisphosphonates, the tissue specific tibolone, raloxifen and calcitonin. Calcium and vitamin D supplementation are always necessary to be added to any antiporotic treatment. Other combinations of different antiporotic drugs are useless and make the treatment more expensive. Other treatments like massage, physiotherapy, hip-protecting pants, etc. as well as

  13. 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

  14. Transient osteoporosis.

    PubMed

    Korompilias, Anastasios V; Karantanas, Apostolos H; Lykissas, Marios G; Beris, Alexandros E

    2008-08-01

    Transient osteoporosis is characterized primarily by bone marrow edema. The disease most commonly affects the hip, knee, and ankle in middle-aged men. Its cause remains unknown. The hallmark that separates transient osteoporosis from other conditions presenting with a bone marrow edema pattern is its self-limited nature. Laboratory tests usually do not contribute to the diagnosis. Plain radiographs may reveal regional osseous demineralization. Magnetic resonance imaging is used primarily for early diagnosis and monitoring disease progression. Early differentiation from more aggressive conditions with long-term sequelae is essential to avoid unnecessary treatment. Clinical entities such as transient osteoporosis of the hip and regional migratory osteoporosis are spontaneously resolving conditions. However, early differential diagnosis and surgical treatment are crucial for the patient with osteonecrosis of the hip or knee.

  15. 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

  16. What Is Osteoporosis?

    MedlinePlus

    ... your browser. Home Osteoporosis Osteoporosis Basics What Is Osteoporosis? Fast Facts: An Easy-to-Read Series of ... in the hip, spine, and wrist. Who Gets Osteoporosis? In the United States, millions of people either ...

  17. Osteoporosis guidelines.

    PubMed

    Barlow, D H

    2007-10-01

    The Position Statement from the International Menopause Society (IMS) in 2004 recommends the use of hormone therapy for the 'avoidance of bone-wasting and fractures'. It also states that 'prevention, not treatment, is the most feasible goal'. In updating the Statement, this paper considers the relevance of Osteoporosis Guidelines. Relevant documents will be of two broad types. These may be consensus statements/position statements that summarize the 'state of the art' for practitioners, based on the work of expert groups, or they may be formal Guidelines generated through formal 'evidence-based' methodology. The former approach is generally used by Societies and can be generated through relatively efficient consensus processes. The latter approach will normally involve extensive work and cost, necessarily becomes very detailed, involving systematic review and technology appraisal and can lead to highly specific recommendations on intervention thresholds. For the revision of the general IMS Position Statement, the specific IMS Paper on Postmenopausal Osteoporosis (2005) must be a key reference document. This provides a description of the international consensus on the management of osteoporosis up to late 2004 and which remains relevant today. Additionally, other consensus statements and systematic guidelines need to be considered. Across these documents providing guidance, the substantial influence of the International Osteoporosis Foundation/National Osteoporosis Foundation Position Paper, defining a 'New approach to the development of assessment guidelines for osteoporosis', can be seen. This flagged the importance of a shift from guidance, tying the diagnostic threshold to the intervention threshold, and instead advised linking the intervention threshold to estimated fracture risk probability. This moves the intervention decision away from a simple bone density threshold to a more complex, but more realistic, threshold estimate, taking into account a range of

  18. Postmenopausal osteoporosis.

    PubMed

    Eastell, Richard; O'Neill, Terence W; Hofbauer, Lorenz C; Langdahl, Bente; Reid, Ian R; Gold, Deborah T; Cummings, Steven R

    2016-09-29

    Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population. Postmenopausal osteoporosis, resulting from oestrogen deficiency, is the most common type of osteoporosis. Oestrogen deficiency results in an increase in bone turnover owing to effects on all types of bone cells. The imbalance in bone formation and resorption has effects on trabecular bone (loss of connectivity) and cortical bone (cortical thinning and porosity). Osteoporosis is diagnosed using bone density measurements of the lumbar spine and proximal femur. Preventive strategies to improve bone health include diet, exercise and abstaining from smoking. Fractures may be prevented by reducing falls in high-risk populations. Several drugs are licensed to reduce fracture risk by slowing down bone resorption (such as bisphosphonates and denosumab) or by stimulating bone formation (such as teriparatide). Improved understanding of the cellular basis for osteoporosis has resulted in new drugs targeted to key pathways, which are under development.

  19. The Guide Star Catalog II: Properties of the GSC 2.3 Release

    NASA Astrophysics Data System (ADS)

    Spagna, A.; Lattanzi, M. G.; McLean, B.; Bucciarelli, B.; Drimmel, R.; Greene, G.; Loomis, C.; Morbidelli, R.; Pannunzio, R.; Smart, R.; Volpicelli, A.

    2006-08-01

    The Guide Star Catalog II (GSC-II) is a joint project of the STScI (Baltimore) and INAF-OATo (Italy) for the construction of an all-sky astronomical catalogue containing position, multicolour photometry, classification and proper motions for 1 billion of stars and galaxies down to R˜20 mag. Astrometric and photometric data have been derived from the analysis and calibrations of about 8000 digitized Schmidt plates of the Palomar and AAO surveys. The last release, GSC 2.3, contains positions, photographic photometry B,R,I, and classification for approximately 997,028,547 entries extracted from the complete GSC-II database. GSC 2.3 is currently used for HST Bright Object Protection and it replaces GSC-I for HST pointing since cycle 15. Public access to this catalog is available through a web form at STScI and OATo, or via the services provided by the National VO and the Italian VO. Here we describe the properties of GSC 2.3 and discuss its astrometric and photometric accuracy with respect the other large surveys.

  20. Premenopausal Osteoporosis.

    PubMed

    Cohen, Adi

    2017-03-01

    Most premenopausal women with low trauma fracture(s) or low bone mineral density have a secondary cause of osteoporosis or bone loss. Where possible, treatment of the underlying cause should be the focus of management. Premenopausal women with an ongoing cause of bone loss and those who have had, or continue to have, low trauma fractures may require pharmacologic intervention. Clinical trials provide evidence of benefits of bisphosphonates and teriparatide for bone mineral density in several types of premenopausal osteoporosis, but studies are small and do not provide evidence regarding fracture risk reduction.

  1. [Osteoporosis treatment].

    PubMed

    Uebelhart, B; Rizzoli, R

    2006-01-04

    As for any chronic disease, adherence to osteoporosis treatment is low. Folates and vitamin B12 decrease hip fracture risk in elderly Japanese with stroke. Raloxifene (Evista) decreases the incidence of positive estrogen receptor breast cancer and could prevent cardiovascular events in patients at high risk. Strontium ranelate (Protélos) prevents hip fracture in elderly women. The action of alendronate (Fosamax) on bone mineral density and markers of bone remodelling is of higher amplitude than that of risedronate (Actonel). Once monthly ibandronate (Bonviva) increases bone mineral density in post menopausal women with osteoporosis. Excessive suppression of bone remodelling and osteonecrosis of the yaws could be related to bisphosphonate intake.

  2. NO CONFIRMED NEW ISOLATED NEUTRON STARS IN THE SDSS DATA RELEASE 4

    SciTech Connect

    Agueeros, Marcel A.; Newsom, Emily R.; Posselt, Bettina; Anderson, Scott F.; Rosenfield, Philip; Homer, Lee; Haberl, Frank; Voges, Wolfgang; Margon, Bruce

    2011-06-15

    We report on follow-up observations of candidate X-ray-bright, radio-quiet isolated neutron stars (INSs) identified from correlations of the ROSAT All-Sky Survey (RASS) and the Sloan Digital Sky Survey (SDSS) Data Release 4 in Agueeros et al. We obtained Chandra X-ray Observatory exposures for 13 candidates in order to pinpoint the source of X-ray emission in optically blank RASS error circles. These observations eliminated 12 targets as good INS candidates. We discuss subsequent observations of the remaining candidate with XMM-Newton, the Gemini North Observatory, and the Apache Point Observatory. We identify this object as a likely extragalactic source with an unusually high log (f{sub X}/f{sub opt}) {approx} 2.4. We also use an updated version of the population synthesis models of Popov et al. to estimate the number of RASS-detected INSs in the SDSS Data Release 7 footprint. We find that these models predict {approx}3-4 INSs in the 11,000 deg{sup 2} imaged by SDSS, which is consistent with the number of known INSs that fall within the survey footprint. In addition, our analysis of the four new INS candidates identified in the SDSS footprint implies that they are unlikely to be confirmed as INSs; together, these results suggest that new INSs are not likely to be found from further correlations of the RASS and SDSS.

  3. 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.

  4. Energy release from hadron-quark phase transition in neutron stars and the axial w mode of gravitational waves

    SciTech Connect

    Lin Weikang; Li Baoan; Xu Jun; Ko Cheming; Wen Dehua

    2011-04-15

    Describing the hyperonic and quark phases of neutron stars with an isospin- and momentum-dependent effective interaction for the baryon octet and the MIT bag model, respectively, and using the Gibbs conditions to construct the mixed phase, we study the energy release from a neutron star owing to the hadron-quark phase transition. Moreover, the frequency and damping time of the first axial w mode of gravitational waves are studied for both hyperonic and hybrid stars. We find that the energy release is much more sensitive to the bag constant than the density dependence of the nuclear symmetry energy. Also, the frequency of the w mode is found to be significantly different with or without the hadron-quark phase transition and depends strongly on the value of the bag constant. Effects of the density dependence of the nuclear symmetry energy become, however, important for large values of the bag constant that lead to higher hadron-quark transition densities.

  5. Osteoporosis and Hispanic Women

    MedlinePlus

    ... not supported by your browser. Home Osteoporosis Women Osteoporosis and Hispanic Women Publication available in: PDF (54 KB) Related Resources Women Fitness: Overtraining Risks Pregnancy, Nursing and Bone Health Osteoporosis and African American ...

  6. Male osteoporosis.

    PubMed

    Giusti, A; Bianchi, G

    2014-07-28

    As a result of population ageing worldwide, osteoporotic fractures are becoming a serious problem in the western world. Osteoporotic fractures are associated with a significant burden in terms of morbidity, mortality, and economic costs. Although less frequent than in women, male osteoporosis is also a relatively common problem. Since bone loss and fragility fractures in men have been recognized as a serious medical condition, over the last two decades several studies have investigated a number of aspects related to the pathogenesis, diagnosis and assessment, prevention and treatment of male osteoporosis. A better understanding of factors underlying increased bone fragility in men has led to the definition of appropriate screening and diagnostic strategies, and the development of treatments that have shown to improve bone mineral density and, in some cases, reduce fracture risk in men as well as in women. This review will summarize recent findings on male osteoporosis with a particular focus on risk factors and causes of bone loss, and available therapeutic options.

  7. Corticosteroid osteoporosis.

    PubMed

    Sambrook, P; Lane, N E

    2001-07-01

    Corticosteroids are widely used and effective agents for the control of many inflammatory diseases, but corticosteroid osteoporosis is a common problem associated with their long term high dose use. Prevention of corticosteroid osteoporosis is preferable to treatment of established corticosteroid bone loss. Several large double-blind controlled clinical trials in patients with corticosteroid osteoporosis have recently been published that provide new insights into its treatment. Based upon available evidence, the rank order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or an oestrogen type medication. Calcium alone appears to be unable to prevent rapid bone loss in patients starting corticosteroids, especially with prednisolone doses at 10 mg a day or greater. If an active vitamin D metabolite is used, calcium supplementation should be avoided unless dietary calcium intake is low. Hormone replacement therapy should be considered if hypogonadism is present. Since vertebral fracture is a common and important complication of high dose corticosteroid therapy, these findings suggest that rapid bone loss and hence fractures, can be prevented by prophylactic treatment. Although the follow-up data is limited, it is likely that such therapy needs to be continued beyond 12 months whilst patients continue significant doses of corticosteroid therapy.

  8. Investigation of Energy Release from X-ray Flares on Young Stellar Objects with NuSTAR

    NASA Astrophysics Data System (ADS)

    Vievering, Juliana; Glesener, Lindsay; Grefenstette, Brian; Smith, David M.

    2017-08-01

    Young stellar objects (YSOs), which tend to flare more frequently and at higher temperatures than what is typically observed on Sun-like stars, are excellent targets for studying the nature of energy release and transport in large flaring events. Multiple star-forming regions have been observed in the past by soft x-ray missions such as Chandra and XMM-Newton, but the energy ranges of these missions fall off prior to the hard x-ray regime, where it would be possible to search for a crossover from thermal to nonthermal emission. To investigate this hard x-ray emission, three 50ks observations of the star-forming region rho Ophiuchi have been taken with the Nuclear Spectroscopic Telescope Array (NuSTAR), which is optimized over the energy range of 3-79 keV. Multiple stellar flares have been identified in the observations; here we present the current spectral and timing analyses of the brightest of the these events, exploring the way energy is released as well as the effects of these large flares on the surrounding environment. We compare these results to what is typically observed for solar flares.

  9. Gender Disparities in Osteoporosis

    PubMed Central

    Alswat, Khaled A.

    2017-01-01

    Osteoporosis is a growing health concern worldwide and its complications are as prevalent as other common chronic disease complications such as hypertension and diabetes. In this review, we will discuss the role of gender in osteoporosis, especially related to peak bone mass and maturation, rate of annual bone loss, screening, prevalence of osteoporosis and its related fractures, mortality after osteoporosis-related fracture, fracture risk predication using different technologies and the impact of gender on osteoporosis management. PMID:28392857

  10. Glucocorticoid osteoporosis.

    PubMed

    Sambrook, Philip N

    2002-01-01

    Postmenopausal women are at greatest risk of rapid bone loss and fracture with glucocorticoids and should be actively considered for prophylactic measures. In men and premenopausal women receiving glucocorticoids, the decision to use anti-osteoporosis prophylaxis is less clear and depends upon baseline bone mineral density [BMD], anticipated dose and duration of glucocorticoids. Based upon evidence the order of choice for prophylaxis would be a bisphosphonate followed by a vitamin D metabolite or hormone replacement therapy [HRT]. Calcium alone appears unable to prevent rapid bone loss in patients starting glucocorticoids. HRT should clearly be considered if hypogonadism is present. In patients receiving chronic low dose glucocorticoids, treatment with calcium and vitamin D may be sufficient to prevent further bone loss. However since fracture risk is a function of multiple factors including the degree of reduction in BMD as well as the duration of exposure, treatment with therapy to increase BMD will reduce fracture risk even in patients receiving chronic low dose glucocorticoids.

  11. 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

  12. Osteoporosis and Asian American Women

    MedlinePlus

    ... not supported by your browser. Home Osteoporosis Women Osteoporosis and Asian American Women Publication available in: PDF ( ... Are Available? Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  13. 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.

  14. 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)

  15. 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. ...

  16. 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)

  17. Osteoporosis in Men

    MedlinePlus

    Osteoporosis in Men A Patient’s Guide In osteoporosis, bones become weak and are more likely to fracture (break). It is a “ ... osteoporosis or osteopenia (mildly low bone mass) are men. The lifetime risk of having a fracture due ...

  18. Gaia Data Release 1. The Cepheid and RR Lyrae star pipeline and its application to the south ecliptic pole region

    NASA Astrophysics Data System (ADS)

    Clementini, G.; Ripepi, V.; Leccia, S.; Mowlavi, N.; Lecoeur-Taibi, I.; Marconi, M.; Szabados, L.; Eyer, L.; Guy, L. P.; Rimoldini, L.; Jevardat de Fombelle, G.; Holl, B.; Busso, G.; Charnas, J.; Cuypers, J.; De Angeli, F.; De Ridder, J.; Debosscher, J.; Evans, D. W.; Klagyivik, P.; Musella, I.; Nienartowicz, K.; Ordóñez, D.; Regibo, S.; Riello, M.; Sarro, L. M.; Süveges, M.

    2016-11-01

    Context. The European Space Agency spacecraft Gaia is expected to observe about 10 000 Galactic Cepheids and over 100 000 Milky Way RR Lyrae stars (a large fraction of which will be new discoveries), during the five-year nominal lifetime spent scanning the whole sky to a faint limit of G = 20.7 mag, sampling their light variation on average about 70 times. Aims: We present an overview of the Specific Objects Study (SOS) pipeline developed within the Coordination Unit 7 (CU7) of the Data Processing and Analysis Consortium (DPAC), the coordination unit charged with the processing and analysis of variable sources observed by Gaia, to validate and fully characterise Cepheids and RR Lyrae stars observed by the spacecraft. The algorithms developed to classify and extract information such as the pulsation period, mode of pulsation, mean magnitude, peak-to-peak amplitude of the light variation, subclassification in type, multiplicity, secondary periodicities, and light curve Fourier decomposition parameters, as well as physical parameters such as mass, metallicity, reddening, and age (for classical Cepheids) are briefly described. Methods: The full chain of the CU7 pipeline was run on the time series photometry collected by Gaia during 28 days of ecliptic pole scanning law (EPSL) and over a year of nominal scanning law (NSL), starting from the general Variability Detection, general Characterization, proceeding through the global Classification and ending with the detailed checks and typecasting of the SOS for Cepheids and RR Lyrae stars (SOS Cep&RRL). We describe in more detail how the SOS Cep&RRL pipeline was specifically tailored to analyse Gaia's G-band photometric time series with a south ecliptic pole (SEP) footprint, which covers an external region of the Large Magellanic Cloud (LMC), and to produce results for confirmed RR Lyrae stars and Cepheids to be published in Gaia Data Release 1 (Gaia DR1). Results: G-band time series photometry and characterisation by the

  19. [Osteoporosis in premenopausal women].

    PubMed

    Mitringer, Antje; Pietschmann, P

    2002-01-01

    Osteoporosis is a systemic disease of bone, which is characterized by decreased bone mass and changes in the microarchitecture of bone tissue followed by brittleness of bones and increased risk of fractures. Osteoporosis frequently is a disease of postmenopausal women, nevertheless, in rare cases, osteoporosis can also occur in young adults. There are only few studies on the pathophysiology of "premenopausal osteoporosis"; in addition to idiopathic forms, osteoporosis in young women can be caused by glucocorticoid treatment, by eating disorders or can be associated with pregnancy.

  20. Osteoporosis and Gastrointestinal Disease

    PubMed Central

    Weinerman, Stuart

    2010-01-01

    Gastrointestinal disease is often overlooked or simply forgotten as a cause of osteoporosis. Yet, the consequences of osteoporotic fractures can be devastating. Although the bulk of the published experience regarding osteoporosis is derived from the postmenopausal population, this review will focus on gastrointestinal disorders implicated in osteoporosis, with an emphasis on inflammatory bowel disease and celiac disease. The unique aspects of gastrointestinal diseases associated with osteoporosis include early onset of disease (and, therefore, prolonged exposure to risk factors for developing osteoporosis, particularly with inflammatory bowel disease and celiac disease), malabsorption, and maldigestion of nutrients necessary for bone health and maintenance (eg, calcium, vitamin D), as well as the impact of glucocorticoids. These factors, when added to smoking, a sedentary lifestyle, hypogonadism, and a family history of osteoporosis, accumulate into an imposing package of predictors for osteoporotic fracture. This paper will review the identification and treatment strategies for patients with gastrointestinal disorders and osteoporosis. PMID:20978554

  1. [QOL evaluation for osteoporosis].

    PubMed

    Endo, Naoto

    2012-06-01

    It is important to evaluate the Health Related QOL (HRQOL) in the treatment of the patients with osteoporosis. In 1999, the Japanese Society for Bone and Mineral Research made Japanese Osteoporosis Quality of Life Questionnaire (JOQOL) to evaluate the osteoporosis specific HRQOL of the Japanese patients. This JOQOL 1999-version was revised in 2000. JOQOL 2001 version consists of six domain 38 items, using five-point scale ranging from 0 to 4, scored from 0 to 152. Osteoporosis is a bone disorder with decreased bone strength, resulting in bone fragility and consequently fractures. The vertebral fractures cause a change in the spinal column (kyphosis) and the decline of the physical function due to the back pain. This is the decrease in QOL of the patients with osteoporosis compared to cases without osteoporosis. Therefore, assessment of QOL are recommended in the prevention and treatment for osteoporosis.

  2. Interlayer-crosslinked micelles prepared from star-shaped copolymers via click chemistry for sustained drug release

    NASA Astrophysics Data System (ADS)

    Zhang, Xiaojin; Wang, Hongquan; Dai, Yu

    2017-05-01

    To balance the stability and the particle size of polymeric micelles, star-shaped copolymers Hx-yne-N3-PEG containing both alkynyl and azido groups were synthesized from hyperbranched 2,2-bismethylolpropionic acid polyester (H20 with 16 hydroxyl, H30 with 32 hydroxyl, H40 with 64 hydroxyl) to develop interlayer-crosslinked micelles by click chemistry. The results of dynamic light scattering indicate that the crosslinking could enhance the stability of polymeric micelles. The crosslinked micelles are regular nanosized (approximately 20 nm) spheres observed by a transmission electron microscope. The crosslinked micelles have better drug loading capacity and more sustained drug release behavior than the un-crosslinked micelles.

  3. 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.

  4. Primary osteoporosis in children.

    PubMed

    Tan, Lay Ong; Lim, Soo Yen; Vasanwala, Rashida Farhad

    2017-09-01

    Osteoporosis in childhood is uncommon, and it may be secondary to a spectrum of diverse conditions. Idiopathic juvenile osteoporosis is a primary osteoporosis of unknown aetiology present in previously well children and is a diagnosis of exclusion. We describe a 10-year-old prepubertal boy who presented with back pain of 1-week duration. His spinal X-ray showed generalised loss of vertebral body heights in keeping with osteoporosis. Endocrine and haematological work-up were normal. He was treated with vitamin D supplement and intravenous pamidronate. This case illustrates the general work-up and causes for paediatric osteoporosis, and the management for idiopathic juvenile osteoporosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Osteoporosis: Therapeutic Options.

    PubMed

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

    2015-01-01

    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.

  6. 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. ...

  7. Gender specificity and osteoporosis.

    PubMed

    Bilezikian, J P

    2000-10-01

    To a certain extent, the emphasis placed on women in light of the predominance of osteoporosis in this sex is well-justified. As researchers are appreciating the potential size of the male population at risk for osteoporosis, increasing interest is becoming apparent on the part of investigators and the pharmaceutical companies that are developing therapies. As more is learned about osteoporosis in men, experts will then be in a position to better understand the similarities and differences between genders.

  8. [Secondary osteoporosis in gynecology].

    PubMed

    Taguchi, Y; Gorai, I

    1998-06-01

    Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

  9. Perspectives on osteoporosis.

    PubMed

    Kaltenborn, K C

    1992-12-01

    The goal of this chapter was to provide enough information so that the following questions could be answered in a clinical context: 1. Does the patient have osteoporosis or a risk for it? Is densitometry needed? 2. Why does the patient have osteoporosis? Is the diagnosis "the tip of the iceberg" because of an occult secondary cause? 3. Is the patient receiving adequate calcium? Can the patient benefit from estrogen? 4. What clinical information or tests are required to follow a patient with osteoporosis? 5. What drugs are indicated for osteoporosis? Which are promising and which require further research?

  10. 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)

  11. 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)

  12. Osteoporosis prevention, diagnosis, and therapy.

    PubMed

    The objective of this NIH Consensus Statement is to inform the biomedical research and clinical practice communities of the results of the NIH Consensus Development Conference on Osteoporosis Prevention, Diagnosis, and Therapy. The statement provides state-of-the-art information and presents the conclusions and recommendations of the consensus panel regarding these issues. In addition, the statement identifies those areas of study that deserve further investigation. The target audience of clinicians for this statement includes, but is not limited to, family practitioners, internists, gerontologists, orthopaedic surgeons, rheumatologists, obstetricians and gynecologists, and preventive medicine specialisits. A nonfederal, nonadvocate, 13-member panel representing the fields of internal medicine, family and community medicine, endocrinology, epidemiology, orthopaedic surgery, gerontology, rheumatology, obstetrics and gynecology, preventive medicine, and cell biology. In addition, 32 experts from these same fields presented data to the panel and a conference audience of approximately 700. The literature was searched using MEDLINE and an extensive bibliography of references was provided to the panel. Experts prepared abstracts for their conference presentations with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference

  13. The final data release of ALLSMOG: a survey of CO in typical local low-M∗ star-forming galaxies

    NASA Astrophysics Data System (ADS)

    Cicone, C.; Bothwell, M.; Wagg, J.; Møller, P.; De Breuck, C.; Zhang, Z.; Martín, S.; Maiolino, R.; Severgnini, P.; Aravena, M.; Belfiore, F.; Espada, D.; Flütsch, A.; Impellizzeri, V.; Peng, Y.; Raj, M. A.; Ramírez-Olivencia, N.; Riechers, D.; Schawinski, K.

    2017-08-01

    We present the final data release of the APEX low-redshift legacy survey for molecular gas (ALLSMOG), comprising CO(2-1) emission line observations of 88 nearby, low-mass (108.5star-forming galaxies carried out with the 230 GHz APEX-1 receiver on the APEX telescope. The main goal of ALLSMOG is to probe the molecular gas content of more typical and lower stellar mass galaxies than have been studied by previous CO surveys. We also present IRAM 30 m observations of the CO(1-0) and CO(2-1) emission lines in nine galaxies aimed at increasing the M∗< 109M⊙ sample size. In this paper we describe the observations, data reduction and analysis methods and we present the final CO spectra together with archival Hi 21 cm line observations for the entire sample of 97 galaxies. At the sensitivity limit of ALLSMOG, we register a total CO detection rate of 47%. Galaxies with higher M∗, SFR, nebular extinction (AV), gas-phase metallicity (O/H), and Hi gas mass have systematically higher CO detection rates. In particular, the parameter according to which CO detections and non-detections show the strongest statistical differences is the gas-phase metallicity, for any of the five metallicity calibrations examined in this work. We investigate scaling relations between the CO(1-0) line luminosity (L'CO(1-0)) and galaxy-averaged properties using ALLSMOG and a sub-sample of COLD GASS for a total of 185 sources that probe the local main sequence (MS) of star-forming galaxies and its ± 0.3 dex intrinsic scatter from M∗ = 108.5M⊙ to M∗ = 1011M⊙. L'CO(1-0) is most strongly correlated with the SFR, but the correlation with M∗ is closer to linear and almost comparably tight. The relation between L'CO(1-0) and metallicity is the steepest one, although deeper CO observations of galaxies with AV< 0.5 mag may reveal an as much steep correlation with AV. Our results suggest that star-forming galaxies across more than two orders of magnitude in M∗ obey similar

  14. [Pathophysiology of immobilization osteoporosis.

    PubMed

    Menuki, Kunitaka; Sakai, Akinori

    Enhancement of bone resorption and suppression of bone formation in response to reduced mechanical stress cause rapid bone loss. pharmacotherapy for immobilization osteoporosis in motor paralysis and long-term bedrest is effective therapy. Early intervention for rapid bone loss is important for immobilization osteoporosis.

  15. 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

  16. Animal models for osteoporosis.

    PubMed

    Komori, Toshihisa

    2015-07-15

    The major types of osteoporosis in humans are postmenopausal osteoporosis, disuse osteoporosis, and glucocorticoid-induced osteoporosis. Animal models for postmenopausal osteoporosis are generated by ovariectomy. Bone loss occurs in estrogen deficiency due to enhanced bone resorption and impaired osteoblast function. Estrogen receptor α induces osteoclast apoptosis, but the mechanism for impaired osteoblast function remains to be clarified. Animal models for unloading are generated by tail suspension or hind limb immobilization by sciatic neurectomy, tenotomy, or using plaster cast. Unloading inhibits bone formation and enhances bone resorption, and the involvement of the sympathetic nervous system in it needs to be further investigated. The osteocyte network regulates bone mass by responding to mechanical stress. Osteoblast-specific BCL2 transgenic mice, in which the osteocyte network is completely disrupted, can be a mouse model for the evaluation of osteocyte functions. Glucocorticoid treatment inhibits bone formation and enhances bone resorption, and markedly reduces cancellous bone in humans and large animals, but not consistently in rodents.

  17. [Osteoporosis in collagen diseases].

    PubMed

    Momohara, S; Aritomi, H

    1994-09-01

    The pathogenesis of osteoporosis in patients with rheumatic diseases, especially rheumatoid arthritis (RA), is poorly understood. The duration of the disease, the severity of the inflammatory process, gender, age, steroid therapy and menopause have been suggested as risk factors for osteoporosis in patients with RA. Although these factors may contribute to the development of osteoporosis, the influence of one specific factor is difficult to evaluate. It is said that the treatment with steroids has a deleterious effect on bone turnover, but this effect has been controversial. The dose margin of prednisone that will lead to osteoporosis is not known but has been estimated to be 10 mg per day. Fractures and stress fractures in patients with RA are probably much more common. Further study concerning osteoporosis in rheumatic diseases is necessary.

  18. [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.

  19. Management of severe osteoporosis.

    PubMed

    Miller, Paul D

    2016-01-01

    Severe osteoporosis represents a disease of high mortality and morbidity. Recognition of what constitutes and causes severe osteoporosis and aggressive intervention with pharmacological agents with evidence to reduce fracture risk are outlined in this review. This review is a blend of evidence obtained from literature searches from PubMed and The National Library of Medicine (USA), clinical experience and the author's opinions. The review covers the recognition of what constitutes severe osteoporosis, and provides up-to-date references on this sub-set of high risk patients. Severe osteoporosis can be classified by using measurements of bone densitometry, identification of prevalent fractures, and, knowledge of what additional risk factors contribute to high fracture risk. Once recognized, the potential consequences of severe osteoporosis can be mitigated by appropriate selection of pharmacological therapies and modalities to reduce the risk for falling.

  20. 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

  1. 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

  2. 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

  3. [Genetics of osteoporosis].

    PubMed

    Cohen-Solal, M; de Vernejoul, M C

    2004-12-01

    Osteoporosis is a multifactorial disease involving genetic component and several environmental factors. Some rare diseases that are associated with osteoporosis such as Lobstein disease or the "pseudoglial osteoporosis" syndrom are monogenetic. Nevertheless common osteoporosis is a polygenic affection resulting from the interaction between the polymorphism of different genes and the environmental factors. The genetic component of osteoporosis encompasses roughly 60 to 70% of bone mineral density, whereas the effect on fracture risk seems lower because of the importance of other environmental factors as falls. Many polymorphisms of candidate genes involved in the regulation of bone mass have been correlated to bone density. It is likely that many genes participate to the regulation of bone density although the existence of a major gene is highly suspected. Moreover linkage analysis after genome-wide search in populations with severe osteoporosis has focused on some regions of interest (QTL) on the chromosomes. This will allow to localize one or more specific genes. The current genetic studies on different populations affected by osteoporosis or not will be useful in order to better predict the fracture risk in association with bone density and biochemical markers of bone turnover. Moreover, this will lead to the development of new treatments of osfeoporosis and will help to adapt the therapy for individual patients.

  4. OSTEOPOROSIS DIAGNOSIS AND TREATMENT.

    PubMed

    de Souza, Márcio Passini Gonçalves

    2010-01-01

    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.

  5. POST-MENOPAUSAL OSTEOPOROSIS

    PubMed Central

    Hogg, C. Alison

    1997-01-01

    Millions of women will be prescribed hormone replacement therapy (HRT) and be told that it will prevent osteoporosis occuring, despite the fact that there is doubt about its long term usefulness. Preventive measures outlined in this article are much more preferable, but need to be directed towards the whole population, not just menopausal women. The prevention of osteoporosis is an important public health issue which needs to be addressed now, not in the next century. This article explores the issues that surround the medicalisation of post-menopausal osteoporosis. PMID:17987149

  6. Ethanol induction of steroidogenesis in rat adrenal and brain is dependent upon pituitary ACTH release and de novo adrenal StAR synthesis

    PubMed Central

    Boyd, Kevin N.; Kumar, Sandeep; O'Buckley, Todd K.; Porcu, Patrizia; Morrow, A. Leslie

    2011-01-01

    The mechanisms of ethanol actions that produce its behavioral sequelae involve the synthesis of potent GABAergic neuroactive steroids, specifically the GABAergic metabolites of progesterone, (3α,5α)-3-hydroxypregnan-20-one (3α,5α-THP), and deoxycorticosterone, (3α,5α)-3,21-dihydroxypregnan-20-one. We investigated the mechanisms that underlie the effect of ethanol on adrenal steroidogenesis. We found that ethanol effects on plasma pregnenolone, progesterone, 3α,5α-THP and cortical 3α,5α-THP are highly correlated, exhibit a threshold of 1.5 g/kg, but show no dose dependence. Ethanol increases plasma adrenocorticotropic hormone (ACTH), adrenal steroidogenic acute regulatory protein (StAR), and adrenal StAR phosphorylation, but does not alter levels of other adrenal cholesterol transporters. The inhibition of ACTH release, de novo adrenal StAR synthesis or cytochrome P450 side chain cleavage activity prevents ethanol-induced increases in GABAergic steroids in plasma and brain. ACTH release and de novo StAR synthesis are independently regulated following ethanol administration and both are necessary, but not sufficient, for ethanol-induced elevation of plasma and brain neuroactive steroids. As GABAergic steroids contribute to ethanol actions and ethanol sensitivity, the mechanisms of this effect of ethanol may be important factors that contribute to the behavioral actions of ethanol and risk for alcohol abuse disorders. PMID:20021565

  7. Nanotechnology Treatment Options for Osteoporosis and Its Corresponding Consequences.

    PubMed

    Wei, Donglei; Jung, Jinsuh; Yang, Huilin; Stout, David A; Yang, Lei

    2016-10-01

    Unfortunately, osteoporosis, as a worldwide disease, is challenging human health with treatment only available for the symptoms of osteoporosis without managing the disease itself. Osteoporosis can be linked as the common cause of fractures and increased mortality among post-menopausal women, men, and the elderly. Regrettably, due to osteoporosis, incidents of fractures are more frequent among the presented populations and can be afflictive for carrying out everyday life activities. Current treatments of osteoporosis encompass changing lifestyles, taking orthopedic drugs, and invasive surgeries. However, these treatment options are not long lasting and can lead to complications after post-surgical life. Therefore, to solve this impairment, researchers have turned to nanotechnologies and nanomaterials to create innovative and alternative treatments associated with the consequences of osteoporosis. This review article provides an introduction to osteoporotic compression vertebral fractures (OVCFs) and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. The methods of applying bioactive agents (bone morphogenetic protein-2 (BMP-2), parathyroid hormone 1-34 (PTH 1-34)), as well as 3D printing will be presented from an osteoporosis treatment perspective. Additionally, the application of nanoparticles and nanotube arrays onto the current surgical treatments and orthopedic drug administration methods addressed will show that these systems reinforce a better mechanical performance and provide precise and slow-releasing drug delivery for better osseointegration, bone regeneration, and bone strength. In summary, nanomaterials can be seen as an alternative and more effective treatment for individuals with osteoporosis.

  8. Protein tyrosine phosphatases regulate arachidonic acid release, StAR induction and steroidogenesis acting on a hormone-dependent arachidonic acid-preferring acyl-CoA synthetase.

    PubMed

    Cano, Florencia; Poderoso, Cecilia; Cornejo Maciel, Fabiana; Castilla, Rocío; Maloberti, Paula; Castillo, Fernanda; Neuman, Isabel; Paz, Cristina; Podestá, Ernesto J

    2006-06-01

    The activation of the rate-limiting step in steroid biosynthesis, that is the transport of cholesterol into the mitochondria, is dependent on PKA-mediated events triggered by hormones like ACTH and LH. Two of such events are the protein tyrosine dephosphorylation mediated by protein tyrosine phosphatases (PTPs) and the release of arachidonic acid (AA) mediated by two enzymes, ACS4 (acyl-CoA synthetase 4) and Acot2 (mitochondrial thioesterase). ACTH and LH regulate the activity of PTPs and Acot2 and promote the induction of ACS4. Here we analyzed the involvement of PTPs on the expression of ACS4. We found that two PTP inhibitors, acting through different mechanisms, are both able to abrogate the hormonal effect on ACS4 induction. PTP inhibitors also reduce the effect of cAMP on steroidogenesis and on the level of StAR protein, which facilitates the access of cholesterol into the mitochondria. Moreover, our results indicate that exogenous AA is able to overcome the inhibition produced by PTP inhibitors on StAR protein level and steroidogenesis. Then, here we describe a link between PTP activity and AA release, since ACS4 induction is under the control of PTP activity, being a key event for AA release, StAR induction and steroidogenesis.

  9. Osteoporosis prevention, diagnosis, and therapy.

    PubMed

    2001-02-14

    To clarify the factors associated with prevention, diagnosis, and treatment of osteoporosis, and to present the most recent information available in these areas. From March 27-29, 2000, a nonfederal, nonadvocate, 13-member panel was convened, representing the fields of internal medicine, family and community medicine, endocrinology, epidemiology, orthopedic surgery, gerontology, rheumatology, obstetrics and gynecology, preventive medicine, and cell biology. Thirty-two experts from these fields presented data to the panel and an audience of 699. Primary sponsors were the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institutes of Health Office of Medical Applications of Research. MEDLINE was searched for January 1995 through December 1999, and a bibliography of 2449 references provided to the panel. Experts prepared abstracts for presentations with relevant literature citations. Scientific evidence was given precedence over anecdotal experience. The panel, answering predefined questions, developed conclusions based on evidence presented in open forum and the literature. The panel composed a draft statement, which was read and circulated to the experts and the audience for public discussion. The panel resolved conflicts and released a revised statement at the end of the conference. The draft statement was posted on the Web on March 30, 2000, and updated with the panel's final revisions within a few weeks. Though prevalent in white postmenopausal women, osteoporosis occurs in all populations and at all ages and has significant physical, psychosocial, and financial consequences. Risks for osteoporosis (reflected by low bone mineral density [BMD]) and for fracture overlap but are not identical. More attention should be paid to skeletal health in persons with conditions associated with secondary osteoporosis. Clinical risk factors have an important but poorly validated role in determining who should have BMD measurement, in

  10. 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)

  11. 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)

  12. Medicines for osteoporosis

    MedlinePlus

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

  13. 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)

  14. 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)

  15. Periodontitis and osteoporosis.

    PubMed

    Straka, Michal; Straka-Trapezanlidis, Michaela; Deglovic, Juraj; Varga, Ivan

    2015-01-01

    Today's knowledge and studies show a firm correlation between osteoporosis and periodontitis, particularly in postmenopausal women. This review study deals with epidemiological and etiopathogenetic association between chronic periodontitis and an osteoporosis. A special emphasis is put on explanation of possible relations between a premature tooth loss and decrease of length and density of jaw bones, particularly their alveolar prolongations. The second part of the paper deals with principles of treatment in patients suffering of osteoporosis. Osteoporosis reduces density of jaw bones and decreases a number of teeth in jaws, but it does not affect other clinical signs and markers of periodontitis such as inflammation, bleeding and the depth of periodontal pockets and microbial plaque.

  16. Osteoporosis: diagnosis and prevention.

    PubMed

    Woodhead, G A; Moss, M M

    1998-11-01

    Osteoporosis affects about 8 million Americans, mostly women. The incidence and cost of the disease are rising as the population and its life expectancy increase. Each year 1.5 million individuals with osteoporosis suffer debilitating fractures of the spine, hip, or forearm. The primary health care provider is positioned to detect osteoporosis and its risk factors before signs and symptoms occur. Early detection can be achieved through any one of several diagnostic modalities, including bone mineral density tests and the use of biochemical markers. Once a clinician determines that a patient has many risk factors, bone mineral density testing should be performed. If the test results confirm the clinician's suspicion, therapeutic options should be discussed. Although treatment options exist, the most effective method of dealing with osteoporosis is prevention, including modification of risk factors (for example, diet and lifestyle) and the use of hormone replacement therapy, raloxifene, or alendronate therapy.

  17. Management of postmenopausal osteoporosis.

    PubMed

    Murphy, Frederick T; Kivitz, Alan J; Sands, Earl E

    2003-10-01

    Postmenopausal osteoporosis is associated with significant morbidity, mortality, reduction in quality of life, and increasing health care costs. It is estimated that 1.5 million women in the United States have one or more osteoporosis-related fractures annually. Fractures may occur at any site, but vertebral fractures are the most common. Longitudinal studies have demonstrated a decreased life expectancy associated with both vertebral and nonvertebral fractures. Once an initial fracture occurs, there is a fivefold increased risk of a second fracture within 1 year. The management of osteoporosis today incorporates multiple modalities of therapy. In addition to early detection, patient education, exercise, and nutritional supplementation, multiple therapeutic agents should be implemented early in an attempt to prevent initial and subsequent fractures. This article reviews currently approved modalities of therapy for the prevention and treatment of postmenopausal osteoporosis.

  18. Wnt signaling and osteoporosis

    PubMed Central

    Manolagas, Stavros C.

    2014-01-01

    Major advances in understanding basic bone biology and the cellular and molecular mechanisms responsible for the development of osteoporosis, over the last 20 years, have dramatically altered the management of this disease. The purpose of this mini-review is to highlight the seminal role of Wnt signaling in bone homeostasis and disease and the emergence of novel osteoporosis therapies by targeting Wnt signaling with drugs. PMID:24815296

  19. [Osteoporosis and Colles' fracture].

    PubMed

    Hindsø, K; Lauritzen, J B

    2001-10-01

    We describe the connection between osteoporosis and Colles' fractures of the distal radius from an epidemiological and aetiological point of view. In addition, the value of these fractures as markers of osteoporosis and future risk of fracture is assessed. Several studies have clearly shown an epidemiological association between osteoporosis and fractures of the distal radius, with the association strongest for women up to 65 years of age and for osteoporosis located in the forearm. The association weakens for other locations and for older women. Osteoporosis may have some aetiologic significance for the development of Colles' fractures, but several extraskeletal factors are of equal or further importance. The occurrence of a Colles' fracture in the first 10-15 years after the postmenopause indicates an increased relative risk of sustaining another fracture in the future. However the relative risk approaches one after a few years and, because of the comparatively low absolute risk in this age-group, Colles' fracture as a risk factor contributes little to an assessment of the lifetime fracture risk. In a few longitudinal studies, Colles' fractures could not predict the long-term risk of osteoporosis. The presence of a Colles' fracture should lead to considerations concerning the skeletal and extraskeletal causes of the fracture for the purpose of initiating preventive and therapeutic measures.

  20. 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 ...

  1. Osteoporosis: therapeutic guidelines. Guidelines for practice management of osteoporosis.

    PubMed

    Khan, Sana N; Craig, Latasha; Wild, Robert

    2013-12-01

    Therapeutic guidelines of osteoporosis are reviewed from North American Menopause Society, American Association of Clinical Endocrinologists, American College of Obstetrics and Gynecology, and the National Osteoporosis Foundation. The various guidelines are compared and discussed.

  2. Osteoporosis: the need for comprehensive treatment guidelines.

    PubMed

    Abbott, T A; Lawrence, B J; Wallach, S

    1996-01-01

    Osteoporosis is a debilitating disease that results in nearly 1.3 million fractures per year in the United States. The cost of treating these fractures has been estimated to be as high as $10 billion per year. These costs are expected to more than double during the next 50 years unless comprehensive programs of prevention and treatment are initiated. Both pharmacologic and nonpharmacologic interventions (eg, diet and exercise) have been shown to have a significant impact on the incidence of osteoporosis, depending on the time of their application. Unfortunately, osteoporosis is often not diagnosed until after fractures have occurred, when it may be too late for treatment to have a major impact. To be most effective, therapy should be started early, before serious bone loss has occurred. Because of its efficacy and relatively low acquisition cost, long-term hormone replacement therapy (HRT) is considered first-line pharmacologic therapy for the prevention of osteoporosis. However, for various reasons, less than 25% of US women who might benefit from HRT are receiving it. Aside from HRT, the only other products approved by the US Food and Drug Administration for the treatment of osteoporosis are salmon calcitonin and alendronate. Several other agents are under development, including sustained-release fluoride and other products in the bisphosphonate class. The development and adoption of early detection programs and treatment guidelines are crucial to help ease the economic burden of osteoporosis. These guidelines should incorporate preventive measures such as diet and exercise, risk assessment through proper screening programs, and the appropriate use of pharmaceutical products. The purpose of this paper is to discuss relevant economic issues associated with osteoporosis and discuss the need for a management algorithm that could be used to more efficiently prevent and treat this disease. We conclude that further modeling is needed to determine which programs and

  3. Osteoporosis and Arthritis: Two Common but Different Conditions

    MedlinePlus

    ... your browser. Home Osteoporosis Osteoporosis and Other Conditions Osteoporosis and Arthritis: Two Common but Different Conditions Publication ... between these conditions. Osteoporosis Arthritis For Your Information Osteoporosis Osteoporosis is a condition in which the bones ...

  4. 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

  5. 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.

  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. Emerging therapies for osteoporosis.

    PubMed

    Minisola, G; Iuliano, A; Prevete, I

    2014-07-28

    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.

  8. [Steroid-induced osteoporosis].

    PubMed

    Perrot, Serge; Le Jeunne, Claire

    2012-04-01

    Bone-related steroid involvement is one of the most frequent complications of steroid treatment. Epidemiological data demonstrate that osteoporosis starts early during the treatment, predominantly involves trabecular bone and is correlated to dosage and treatment duration. Mechanisms and consequences of steroid bone involvement are related to osseous and extra-osseous mechanisms. In clinical practice, steroid-induced osteoporosis remains underdiagnosed and undertreated both in preventive and curative approaches. Recently, new molecules as teriparatide and zoledronic acid got indication for the treatment of steroid-induced osteoporosis. To guide treatment strategies, several recommendations are available: French, not updated recommendations since 2003 (Afssaps, 2003), European elaborated by the EULAR in 2007 and those of the ACR updated in 2010. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  9. Genetics of osteoporosis.

    PubMed

    Jin, Huilin; Ralston, Stuart H

    2005-03-01

    Genetic factors play an important role in regulating bone mineral density and other phenotypes relevant to the pathogenesis of osteoporosis such as ultrasound properties of bone, skeletal geometry, and bone turnover. Progress has been made in identifying quantitative traits for regulation of bone mineral density by linkage studies in man and mouse, but relatively few causal genes have been identified. Dramatic progress has been made in identifying the genes responsible for monogenic bone diseases and it appears that polymorphisms in many of these genes also play a role in regulating bone mineral density in the general population. Advances in knowledge about the genetic basis of osteoporosis and other bone diseases offer the prospect of developing new markers for assessment of fracture risk and the identification of novel molecular targets for the design of new drug treatments for osteoporosis.

  10. 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.

  11. [Therapy of postmenopausal osteoporosis].

    PubMed

    Keck, E

    2003-12-01

    The therapy of postmenopausal osteoporosis is based on a few comprehensible assumptions. High bone resorption should be reduced by treatment with bisphosphonates, raloxifene or seldom with calcitonins. After reduction of high bone turnover and in low bone turnover situations, an osteoinductive combination therapy should be started, inducing collagen type I with parathyroid hormone or fluorides. This collagen can then be mineralized by calcium, vitamin D, and vitamin D metabolites. In addition, bone resorption should be reduced during menopause with estrogens and gestagens, in the case of a receptor-positive breast cancer with tamoxifen, and after menopause with raloxifene or a bisphosphonate. In elderly patients a depletion of vitamin D often induces an osteoporomalacia instead of an osteoporosis. In this situation, mineralization of the osteoid by calcium and vitamin D is sufficient for therapy. A daily osteoporosis gymnastic program is required and physical activity should be enhanced to increase muscle mass because bone adapts to the individual situation.

  12. [Treatment of postmenopausal osteoporosis].

    PubMed

    Chapurlat, Roland; Delmas, Pierre D

    2004-12-15

    The treatment of postmenopausal osteoporosis relies on management of some risk factors for fracture, e.g., risk factors for falls, improvement of calcium and vitamin D intake, and on various medications. All elderly women with calcium and vitamin D deficiency should receive calcium and vitamin D supplements. Estrogen replacement therapy should not longer be used to prevent or treat postmenopausal osteoporosis, owing to its poor long-term risk/benefit ratio. Raloxifene, biphosphonates (alendronate, risedronate) are well tolerated compounds with proven anti-fracture efficacy. Teriparatide is a new bone forming agent to treat severe osteoporosis. Strontium ranelate is a new drug also reducing the risk of fractures that should be available soon.

  13. Osteoporosis Prevention and Management.

    PubMed

    Pai, Muralidhar V

    2017-08-01

    Osteoporosis, defined by BMD at the hip or lumbar spine that is less than or equal to 2.5 standard deviations below the mean BMD of a young-adult reference population, is the most common bone disease in humans affecting both sexes and all races. It's a silent killer affecting the quality of life due to fractures and postural changes. In osteoporosis there is an imbalance between bone formation and bone resorption in favor of latter. Preventive measures and treatments are available to combat this evil. Counseling is the integral part of prevention as well as treatment of osteoporosis. Preventive strategy includes life style changes, exercise, intake of calcium and vitamin D, avoiding alcohol, smoking and excessive intake of salt. Estrogen therapy/estrogen+progesterone therapy (ET/EPT) is no longer recommended as a first-line therapy for the prevention of osteoporosis. They may be used in the therapy for osteoporosis in women under 60. Diagnosis and classification are made by assessment of BMD using DEXA or ultrasound and laboratory investigations. Management includes estimation of 10-year fracture risk using FRAX, life style and diet modification and pharmacological therapy. The drugs used in osteoporosis may be those that inhibit bone resorption-bisphosphonates, denosumab, calcitonin, SERMs, estrogen and progesterone-or that stimulate bone formation-PTH, Teriparatide. Combination therapies are not recommended as they do not have proven additional BMD/fracture benefits. No therapy should be indefinite in duration. There are no uniform recommendations to all patients. Duration decisions need to be individualized. While on treatment monitoring should be done with BMD assessment by DEXA/ultrasound and bone turnover markers.

  14. [Osteoporosis: Optimizing treatment strategy].

    PubMed

    Thomas, Thierry

    2006-10-01

    Selection of patients for treatment is based on the assessment of their absolute fracture risk over 10 years. Assessment of fracture risk includes not only DXA measurement and age, the two principal risk factors, but also other clinical risk factors. The main goal of postmenopausal osteoporosis treatment is to reduce the risk of fragility fractures. Choice of treatment is based on drug properties, demonstrated in clinical trials, and patients' specific fracture risks. The minimum duration of treatment is 4-5 years, after which individual fracture risk must be reevaluated. Combinations of available drugs are not recommended for treatment of postmenopausal osteoporosis.

  15. [Radiological diagnosis of osteoporosis].

    PubMed

    Issever, A S; Link, T M

    2011-02-01

    Having at their disposal a wide range of imaging techniques, radiologists play a crucial role in the diagnostic evaluation of patients with osteoporosis. The radiological tests range from dual energy X-ray absorptiometry (DXA), which is the only reference method accepted by the WHO, to conventional radiographs for fracture characterization, to more recent techniques for analyzing trabecular structure, and the findings are decisive in initiating correct management of osteoporosis patients. This review provides an overview of established radiological techniques and an outline of new diagnostic approaches.

  16. Bone Health and Osteoporosis.

    PubMed

    Lupsa, Beatrice C; Insogna, Karl

    2015-09-01

    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  17. [Osteoporosis treatment by gynecologist].

    PubMed

    Mizunuma, Hideki

    2003-02-01

    Postmenopausal bone loss is accelerated since women experience menstrual irregularity. Postmenopausal women lose their bone mineral density by 20 to 25% during 10 years after menopause, therefore early detection of risks for postmenopausal osteoporosis is mandatory for prevention of the disease. Because estrogen deficiency is the primary cause of postmenopausal bone loss, hormone replacement therapy can be a reasonable choice for the first treatment of osteoporosis. However, to those who have contraindications against estrogen or who complain severe estrogen-related symptoms, other medication using SERM and bisphosphonate should be considered.

  18. 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

  19. [Osteoporosis in children and adolescents].

    PubMed

    Marcelli, Christian

    2007-01-01

    There is currently no consensus definition of osteopenia and osteoporosis in children according to bone mineral density (BMD) values measured by dual energy x-ray absorptiometry (DXA); interpretation of BMD measures must take into account the child's weight and pubertal status. In children, primary forms of osteoporosis--juvenile idiopathic osteoporosis and osteogenesis imperfecta--are rare; on the other hand, the frequency of secondary osteoporosis is increasing. Fractures, especially of the forearm, are frequent in children. During the peak growth period, bone growth and mineralization are dissociated; in consequence temporary bone fragility promotes fractures. Several recent studies show that children with fractures have reduced BMD and that the occurrence of fractures in children may constitute a risk factor for osteoporosis and fracture during adulthood. In cases of secondary osteoporosis, close monitoring of the causal disease is the key element of treatment; there are very few controlled studies of the prevention or treatment of osteoporosis in children.

  20. Osteoporosis in childhood.

    PubMed

    Vierucci, Francesco; Saggese, Giuseppe; Cimaz, Rolando

    2017-09-01

    The aim of this review is to highlight recent findings in prevention, diagnosis, and treatment of pediatric osteoporosis. Several genes are involved in bone mass acquisition, and various monogenic bone disorders characterized by reduced bone mineral density and increased bone fragility have been recently described. Moreover, many chronic diseases and/or their treatment have been associated with impaired bone mass acquisition. Pediatric osteoporosis should be adequately suspected and properly diagnosed in children at risk of fractures. Particularly, detection of vertebral fracture allows the diagnosis regardless of densitometric evaluation. Dual X-ray absorptiometry remains the most widely used densitometric technique in childhood, but interpretation of results should be made with caution because of different confounding factors. Bisphosphonates represent one of the main medical treatments of pediatric osteoporosis, and many different protocols have been proposed. Bisphosphonates administration should be characterized by a first phase, followed by a period of maintenance. Optimal route of administration, duration of therapy, and long-term safety of bisphosphonates treatment require further investigation. Careful monitoring of children at risk of fractures is essential to pose early diagnosis of osteoporosis. In children with persistent risk factors and reduced probability of spontaneous recovery, medical treatment with bisphosphonates should be considered.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Osteoporosis: an update.

    PubMed

    el-Hajj Fuleihan, G

    1998-01-01

    Prevention is the therapy of choice for optimizing skeletal health and preventing osteoporosis. Attempts directed at increasing peak bone mass (e.g., good calcium intake during preadolescence, adolescence, and adulthood), reducing risk factors for bone loss such as menstrual abnormalities, thin body habitus, decreased physical activity or excessive alcohol intake, and slowing down bone loss and reversing any causes of secondary bone loss should be pursued vigorously. In practice, all patients should be encouraged to get regular exercise, as well as adequate vitamin D and calcium intake. In the absence of contraindications, estrogen is the mainstay therapy for the prevention and treatment of osteoporosis. Other antiresorptive agents are available as alternative therapies to estrogen. Of equal importance to elderly women with established osteoporosis is counseling on how to prevent falls. Therapies that increase bone formation (aside from fluoride), including growth factors, are not currently available. However, such interventions used in conjunction with an antiresorptive therapy, offer the potential to greatly enhance and therefore normalize bone mass and may hold a promise for the treatment of osteoporosis in the future.

  6. Management of osteoporosis.

    PubMed

    Lewiecki, E Michael

    2004-07-14

    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

  7. Strontium ranelate in osteoporosis.

    PubMed

    Reginster, J-Y

    2002-01-01

    Strontium ranelate is composed of an organic moiety (ranelic acid) and of two atoms of stable non-radioactive strontium. In vitro, strontium ranelate increases collagen and non-collagenic proteins synthesis by mature osteoblast enriched cells. The effects of strontium ranelate on bone formation were confirmed as strontium ranelate enhanced pre-osteoblastic cells replication. The stimulation by strontium ranelate of the replication of osteoprogenitor cells and collagen as well as non-collagenic protein synthesis in osteoblasts provides substantial evidence to categorise SR ranelate as a bone forming agent. In the mouse calvaria culture system, SR ranelate induces a dose-dependent inhibition of labelled calcium release. The inhibitory effects of SR ranelate on bone resorption were close to those of salmon calcitonin. In the isolated rat osteoclast assay, a pre-incubation of bone slices with SR ranelate induced a dose-dependent inhibition of the bone resorbing activity of a treated rat osteoclast. SR ranelate also dose-dependently inhibited, in a chicken bone marrow culture, the expression of both CA II and the alpha-subunit of the vitronectin receptor. These effects showing that SR ranelate significantly affects bone resorption due to direct and/or matrix-mediated inhibition of osteoclast activity and also inhibits osteoclasts differentiation are compatible with the profile of an anti-resorptive drug. In normal rats, administration of SR ranelate induces an improvement in the mechanical properties of the humerus and/or the lumbar vertebra associated with a commensurate increase in bone dimension, shaft and volume. This was not related to any change in the stiffness, suggesting the absence of a mineralisation defect. After oral administration of SR ranelate in humans, the absolute bio-availability of SR ranelate is 27 % after a dose of 2g is given as sachets. The simultaneous intake of SR ranelate and calcium remarkably reduces the bio-availability of SR. SR ranelate

  8. Novel star-type methoxy-poly(ethylene glycol) (PEG)-poly(ɛ-caprolactone) (PCL) copolymeric nanoparticles for controlled release of curcumin

    NASA Astrophysics Data System (ADS)

    Feng, Runliang; Zhu, Wenxia; Song, Zhimei; Zhao, Liyan; Zhai, Guangxi

    2013-06-01

    To improve curcumin's (CURs) water solubility and release property, a novel star methoxy poly(ethylene glycol)-poly(ɛ-caprolactone) (MPEG-PCL) copolymer was synthesized through O-alkylation, basic hydrolysis and ring-opening polymerization reaction with MPEG, epichlorohydrin, and ɛ-caprolactone as raw materials. The structure of the novel copolymer was characterized by 1H NMR, FT-IR, and GPC. The results of FT-IR and differential scanning calorimeter of CUR-loaded nanoparticles (NPs) prepared by dialysis method showed that CUR was successfully encapsulated into the SMP12 copolymeric NPs with 98.2 % of entrapment efficiency, 10.91 % of drug loading, and 88.4 ± 11.2 nm of mean particle diameter in amorphous forms. The dissolubility of nanoparticulate CUR was increased by 1.38 × 105 times over CUR in water. The obtained blank copolymer showed no hemolysis. A sustained CUR release to a total of approximately 56.13 % was discovered from CUR-NPs in 40 % of ethanol saline solution within 72 h on the use of dialysis method. The release behavior fitted the ambiexponent and biphasic kinetics equation. In conclusion, the copolymeric NPs loading CUR might serve as a potential nanocarrier to improve the solubility and release property of CUR.

  9. 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.

  10. Miktoarm star copolymers from D-(-)-salicin core aggregated into dandelion-like structures as anticancer drug delivery systems: synthesis, self-assembly and drug release.

    PubMed

    Mielańczyk, Anna; Odrobińska, Justyna; Grządka, Sebastian; Mielańczyk, Łukasz; Neugebauer, Dorota

    2016-12-30

    The β-glucoside-based heterofunctional initiator was used in the synthesis of well-defined eight-armed miktopolymers by sequential ring opening polymerization (ROP) of ε-caprolactone (CL) and atom transfer radical (co)polymerization (ATRP) of methyl methacrylate (MMA) and/or tert-butyl methacrylate (tBMA). Consequently, methacrylic acid (MAA) repeating units were introduced via selective cleavage of pendant tert-butyl protecting groups. Both the amphiphilic copolymers and miktoarm copolymers were self-assembled at 37°C and pH 7.4. The aggregates of miktoarm polymers were larger than that formed by polymethacrylate homoarm stars (≥250nm vs ≤200nm). The critical aggregation concentrations (CAC) of (mikto)stars were relatively low (0.006-0.411mg/mL) and decreased with the increase in MAA fraction content. Both MAA-based mikto- and homoarmed (co)polymers with shorter arms exhibited lower doxorubicin (DOX) loading capacity, whereas camptothecin (CPT) was encapsulated preferably by miktostars. The kinetic profiles of drug release showed that the rate of release was higher at acidic environment (pH 5.0) than in neutral pH. In the most cases the studied miktopolymer systems demonstrated the well-controlled delivery of the model anticancer drugs, which can be adjusted by structural parameters of polymeric carriers.

  11. The SUPERBLINK all-sky catalog of 2.8 million stars with proper motions larger than 40 mas/yr, enhanced with data from the first GAIA release

    NASA Astrophysics Data System (ADS)

    Lepine, Sebastien

    2017-01-01

    An updated version of the SUPERBLINK all-sky catalog of 2.8 million stars with proper motions larger than 40 mas/yr is presented. This version incorporates data from the GAIA first release (DR1), and identifies the photometric counterparts of the stars in variety of other catalogs including ROSAT, GALEX, APASS, SDSS, 2MASS and WISE. All bright stars (0stars in the faint magnitude range (12stars with no current GAIA parallaxes. In addition, photometric distances are provided for stars with no trigonometric parallax measurement, using color-magnitude relationships recalibrated with the new GAIA parallaxes; these stars constitute the majority of objects in the SUPERBLINK catalog, and overwhelmingly consist of M dwarfs and white dwarfs in the Solar vicinity. We examine the completeness and magnitude limit of the GAIA first data release for stars with large proper motions.

  12. 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.

  13. 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.

  14. Management of postmenopausal osteoporosis.

    PubMed

    Andreopoulou, Panagiota; Bockman, Richard S

    2015-01-01

    A hallmark of menopause, which follows the decline in the ovarian production of estrogen, is the aggressive and persistent loss of bone mineral and structural elements leading to loss of bone strength and increased fracture risk. This review focuses on newer methods of diagnosing osteoporosis and assessing fracture risk, as well as on novel management strategies for prevention and treatment. Fracture-risk prediction has been significantly enhanced by the development of methods such as the trabecular bone score, which helps assess bone microarchitecture and adds value to standard bone densitometry, and the Fracture Risk Assessment Tool (FRAX) algorithm techniques. The treatment of osteoporosis, which has the goals of fracture prevention and risk reduction, is moving beyond traditional monotherapies with antiresorptives and anabolic agents into new combination regimens.

  15. Translating Osteoporosis Prevention Guidelines.

    PubMed

    Brennan-Olsen, Sharon L; Hosking, Sarah M; Dobbins, Amelia G; Pasco, Julie A

    2017-04-01

    In Australia, the social gradient of chronic disease has never been as prominent as in current times, and the uptake of preventive health messages appears to be lower in discrete population groups. In efforts to re-frame health promotion from addressing behavior change to empowerment, we engaged community groups in disadvantaged neighborhoods to translate published preventive guidelines into easy-to-understand messages for the general population. Our research team established partnerships with older aged community groups located in disadvantaged neighborhoods, determined by cross-referencing addresses with the Australian Bureau of Statistics, to translate guidelines regarding osteoporosis prevention. We developed an oversized jigsaw puzzle that we used to translate recommended osteoporosis prevention guidelines. Successful participatory partnerships between researchers, health promotion professionals, and community groups in disadvantaged neighborhoods build capacity in researchers to undertake future participatory processes; they also make the best use of expert knowledge held by specific communities.

  16. 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.

  17. Genetics of Osteoporosis in Children.

    PubMed

    van Dijk, Fleur S

    2015-01-01

    In the pathogenesis of paediatric osteoporosis, genetic causes may play an important role. The most prevalent monogenic cause of paediatric osteoporosis is osteogenesis imperfecta, a disorder characterised primarily by liability to fractures. With regard to diagnosis or exclusion of a monogenic cause of paediatric osteoporosis, clinical practice has changed rapidly in recent years. This is largely due to the discovery of many new genetic causes in patients with a clear clinical diagnosis of osteogenesis imperfecta but also due to the identification of genetic causes in patients with isolated or non-syndromal osteoporosis with fractures. In this chapter, known monogenic causes of syndromal and non-syndromal osteoporosis in children will be described. Furthermore, we will discuss when to refer for clinical genetic evaluation as well as the current and future merits of genetic evaluation of children with osteoporosis. © 2015 S. Karger AG, Basel.

  18. Severe low turnover osteoporosis.

    PubMed

    Pietrogrande, Luca

    2007-08-01

    Severe osteoporosis, a situation with fractures, can worsen in the case of poor response to usual therapies, such as bisphosphonates associated with calcium and vitamin D, especially if bone turnover is strongly suppressed. One way of inverting the poor evolution of non-responders is to use Teriparatide. The case of a non-responder is reported, with considerations about the possibility of detecting these patients before a new fracture takes place.

  19. [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.

  20. Osteoporosis and psoriatic arthritis.

    PubMed

    Del Puente, Antonio; Esposito, Antonella; Parisi, Anna; Atteno, Mariangela; Montalbano, Simona; Vitiello, Maria; Esposito, Carmela; Bertolini, Nicoletta; Foglia, Francesca; Costa, Luisa; Scarpa, Raffaele

    2012-07-01

    Osteoporosis (OP) is a skeletal disorder characterized by compromised bone strength that predisposes to an increased risk of fracture. The prevalence of OP in the general population is very high as established in several studies, and OP represents one of the possible aspects of bone involvement in arthritis. In psoriatic arthritis this involvement is particularly complex because it affects not only mechanisms of bone loss but also of bone formation. We will discuss these aspects and the available epidemiological data.

  1. Genetics Home Reference: juvenile primary osteoporosis

    MedlinePlus

    ... Home Health Conditions juvenile primary osteoporosis juvenile primary osteoporosis Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Juvenile primary osteoporosis is a skeletal disorder characterized by thinning of ...

  2. Transient osteoporosis of the hip.

    PubMed

    McWalter, Patricia; Hassan, Ahmed

    2009-01-01

    Transient osteoporosis of the hip is an uncommon cause of hip pain, mostly affecting healthy middle-aged men and also women in the third trimester of pregnancy. We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain.

  3. Osteoporosis in Parkinson's disease.

    PubMed

    Invernizzi, Marco; Carda, Stefano; Viscontini, Giovanni Sguazzini; Cisari, Carlo

    2009-06-01

    Patients affected by Parkinson's disease are at a high risk for fractures, mainly of the hip. These fractures are caused by falls due to postural imbalance, neurological impairment and reduced bone mass. The purpose of this study was (1) to investigate the correlations and the pathophysiological mechanisms underlying bone loss in Parkinson's disease and appraise bone loss or fracture risk reduction interventions; (2) to develop a research agenda that informs the design and development of risk reduction strategies. Osteoporosis and osteopenia are very common findings in patients with Parkinson's disease, affecting up to 91% of women and 61% of men. Reduced bone mass in Parkinsonian patients seems to be caused mainly by reduced mobility through a mechanism similar to that observed in other neurological diseases. Endocrine (such as vitamin D deficiency), nutritional and iatrogenic factors also play an important role in bone mass depletion. Female gender, disease duration and severity (Hoehn and Yahr stages III and IV), old age and low body mass index are related to more severe osteoporosis. Vitamin D supplementation and bisphosphonates seem to be effective in reducing the risk of nonvertebral fractures in patients affected by Parkinson's disease. Prevention and evaluation of osteoporosis through bone mass density assessment should be considered in all patients with Parkinson's disease.

  4. [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.

  5. Overview of osteoporosis.

    PubMed Central

    Riggs, B. L.

    1991-01-01

    Osteoporosis is a common age-related disorder manifested clinically by skeletal fractures, especially fractures of the vertebrae, hip, and distal forearm. The major cause of these fractures is low bone mass, although an increase in trauma due to falls in the elderly also contributes. There are multiple causes for the low bone mass which, in any given individual, may contribute differently to the development of the osteopenia. The most important groups of causes are failure to achieve adequate peak bone mass, slow bone loss due to processes relating to aging, the menopause in women, and a variety of sporadic behavioral, nutritional, and environmental factors that affect bone mass in some but not in other individuals. The most important approach is prevention. Drugs and behavioral factors known to cause bone loss should be eliminated and perimenopausal women should be evaluated for possible preventive administration of estrogen. For patients with fractures due to established osteoporosis, the only drugs approved by the Food and Drug Administration are the antiresorptive agents calcium, estrogen, and calcitonin. Formation-stimulating regimens, however, are being developed and may be available for clinical use in the foreseeable future. These regimens may be capable of increasing bone mass to above the fracture threshold, thereby resulting in a clinical cure of the osteoporosis. Images PMID:2024511

  6. Osteoporosis in Inflammatory Bowel Disease

    PubMed Central

    Ali, Tauseef; Lam, David; Bronze, Michael S.; Humphrey, Mary Beth

    2010-01-01

    Osteoporosis commonly afflicts patients with inflammatory bowel disease, and many factors link the 2 states together. A literature review was conducted about the pathophysiology of osteoporosis in relation to inflammatory bowel disease. Screening guidelines for osteoporosis in general as well as those directed at patients with inflammatory bowel disease are reviewed, as are currently available treatment options. The purpose of this article is to increase physician awareness about osteopenia and osteoporosis occurring in patients with inflammatory bowel disease and to provide basic, clinically relevant information about the pathophysiology and guidelines to help them treat these patients in a cost-effective manner. PMID:19559158

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

    MedlinePlus

    ... Home Osteoporosis Osteoporosis and Other Conditions What Are Osteoporosis and Arthritis and How Are They Different? Fast ... and Arthritis Cope? What About Pain? What Is Osteoporosis? Osteoporosis is a disease that makes bones weak ...

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

    USDA-ARS?s Scientific Manuscript database

    '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...

  9. Osteoporosis in chronic liver disease.

    PubMed

    Yadav, Anitha; Carey, Elizabeth J

    2013-02-01

    Osteoporosis is a common skeletal complication seen in patients with chronic liver disease. Osteoporosis is usually asymptomatic and, if untreated, can result in fractures and impaired quality of life. For this review, we performed a systematic search of the PubMed database, and all recent peer-reviewed articles regarding the prevalence, pathophysiology, diagnosis, and management of osteoporosis in chronic liver disease were included. The prevalence of osteoporosis varies between 11% and 58% in patients with chronic liver disease and in transplant recipients. The etiology of osteoporosis is multifactorial and only partially understood. Various factors linked to the pathogenesis of bone loss are vitamin D, calcium, insulin growth factor-1, receptor activation of nuclear factor-κB ligand (RANKL), bilirubin, fibronectin, leptin, proinflammatory cytokines, and genetic polymorphisms. Management of osteoporosis involves early diagnosis, identifying and minimizing risk factors, general supportive care, nutrition therapy, and pharmacotherapy. Osteoporosis is diagnosed based on the bone mineral density (BMD) assessment using dual-energy X-ray absorptiometry scan. Measurement of BMD should be considered in all patients with advanced liver disease and in transplant recipients. Vitamin D and calcium supplementation is recommended for all patients with osteoporosis. Specific agents used for treatment of osteoporosis include bisphosphonates, calcitonin, hormonal therapy, and raloxifene. Bisphosphonates have become the mainstay of therapy for osteoporosis prevention and treatment. Prolonged suppression of bone remodeling resulting in atypical fractures has emerged as a significant complication with long-term use of bisphosphonates. Newer treatment agents and better fracture prevention strategies are necessary to prevent and treat osteoporosis.

  10. 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

  11. Novel Therapies for Postmenopausal Osteoporosis.

    PubMed

    Bandeira, Leonardo; Bilezikian, John P

    2017-03-01

    Recently discovered mechanisms have assisted in developing new therapies for osteoporosis. New classes of drugs have been developed for the treatment of postmenopausal osteoporosis. Although there have been numerous advances over the past 2 decades, the search for newer therapies continues.

  12. Star Power

    ScienceCinema

    None

    2016-07-12

    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.

  13. 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.

  14. Opportunistic Osteoporosis Screening

    PubMed Central

    Ziemlewicz, Timothy J.; Binkley, Neil; Lubner, Meghan G.; Pickhardt, Perry J.

    2017-01-01

    Purpose For patients undergoing CT colonography, an opportunity exists for concurrent osteoporosis screening without additional radiation exposure or patient time using proximal femur quantitative CT (QCT) “CTXA”. Materials and Methods This cohort included 129 female and 112 male adults (mean age, 60.1±8.2 years; range, 50–95 years) who underwent CT colonography between March 2013 and September 2014. Areal BMD in g/cm2 and resultant left femoral neck T-score was prospectively measured on the supine CT series using QCT Pro Version 5.1 (Mindways Software, Austin, TX). QCT results were reported with the CT colonography. Chart review evaluated if the patients were eligible for BMD screening according to the United States Preventative Service Task Force (USPSTF) and National Osteoporosis Foundation (NOF) guidelines, had undergone prior BMD testing, and to assess if QCT results changed patient management. Results Overall, 68.0% (164/241) of patients from this cohort had not previously undergone BMD screening. According to the NOF guidelines, 44.0% (106/241) of patients were eligible for screening. T-scores within the osteopenic and osteoporotic range were detected in 32.3% (78/241) and 5.0% (12/241) of patients respectively. Of these patients with low bone mineral density, 66.7% (60/90) had not previously undergone screening or were eligible for BMD testing. Reporting of CTXA T-scores altered management in 9 patients (3.7%) with low bone mineral density. Conclusion Maximizing the pre-existing value from imaging studies is crucial in the current era of healthcare reform. We demonstrate the ability to combine colorectal and osteoporosis screening at CT, adding clinical and likely economic value. PMID:26435117

  15. The Developmental Origins of Osteoporosis

    PubMed Central

    Wood, Claire L; Stenson, Charlotte; Embleton, Nicholas

    2015-01-01

    Osteoporosis is one of the most prevalent skeletal disorders and has enormous public health consequences due to the morbidity and mortality of the resulting fractures. This article discusses the developmental origins of osteoporosis and outlines some of the modifiable and non-modifiable risk factors in both intrauterine and postnatal life that contribute to the later onset of osteoporosis. Evidence for the effects of birth size and early growth in both preterm and term born infants are discussed and the role of epigenetics within the programming hypothesis is highlighted. This review provides compelling evidence for the developmental origins of osteoporosis and highlights the importance of osteoporosis prevention at all stages of the life course. PMID:27018386

  16. Drug release behaviors of a pH sensitive semi-interpenetrating polymer network hydrogel composed of poly(vinyl alcohol) and star poly[2-(dimethylamino)ethyl methacrylate].

    PubMed

    Wu, Wei; Liu, Jing; Cao, Shuqin; Tan, Hong; Li, Jianshu; Xu, Fujian; Zhang, Xiao

    2011-09-15

    A series of pH sensitive semi-interpenetrating polymer network (semi-IPN) structural hydrogels composed of poly(vinyl alcohol) (PVA) and 21-arm star poly[2-(dimethylamino)ethyl methacrylate] (star PDMAEMA) with different molecular weight were prepared. Riboflavin was used as a model drug to evaluate the drug loading capacities and drug release behaviors of the semi-IPN structural hydrogels. The molecular weight of the star PDMAEMA polymers was calculated by GPC, and the formation of semi-IPN structure was confirmed by FTIR and SEM. It was found that the molecular weight of star PDMAEMA has significant effect on the structure, swelling ratio and drug release behaviors of the semi-IPN hydrogel at different pH conditions. The results suggested that the PVA/star PDMAEMA-50,000 hydrogel exhibited highest swelling ratio and drug loading capacity. The pH-sensitive semi-IPN hydrogel based on star PDMAEMA could be a promising drug delivery system due to the controllable porous structure.

  17. Osteoporosis and biomaterial osteointegration.

    PubMed

    Fini, M; Giavaresi, G; Torricelli, P; Borsari, V; Giardino, R; Nicolini, A; Carpi, A

    2004-11-01

    Biomaterial osteointegration depends not only on the properties of the implanted material but also on the characteristics and regenerative capability of the host bone. For this reason, researchers involved in biomaterial evaluation now place great importance on the various pathologies often present in orthopaedic patients which can negatively affect the success of surgical implants. Osteoporosis is undoubtedly one of the most frequently encountered of such diseases. Models reproducing the osteoporotic condition can be useful to understand the influence of the pathology on cell behaviour, bone regeneration and osteointegration processes, thus increasing our basic knowledge and allowing the development of surgical techniques and implant biomaterials more suitable for use in the surgical treatment of fractures in osteoporotic patients. The present paper is a literature review and, after a short description of how the presence of osteoporosis could influence bone regenerative processes, the results of the main studies on biomaterial biocompatibility and osteointegration both in vitro and in vivo in the presence of osteoporotic condition are reported. Both cell cultures and animal models are able to demonstrate the different response of bone to biomaterials by comparing healthy and pathological conditions. The use of pathological bone-derived cells and pathological animals is therefore recommended to test candidate orthopaedic materials.

  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. Transient regional osteoporosis.

    PubMed

    Cano-Marquina, Antonio; Tarín, Juan J; García-Pérez, Miguel-Ángel; Cano, Antonio

    2014-04-01

    Transient regional osteoporosis (TRO) is a disease that predisposes to fragility fracture in weight bearing joints of mid-life women and men. Pregnant women may also suffer the process, usually at the hip. The prevalence of TRO is lower than the systemic form, associated with postmenopause and advanced age, but may be falsely diminished by under-diagnosis. The disease may be uni- or bilateral, and may migrate to distinct joints. One main feature of TRO is spontaneous recovery. Pain and progressive limitation in the functionality of the affected joint(s) are key symptoms. In the case of the form associated with pregnancy, difficulties in diagnosis derive from the relatively young age at presentation and from the clinical overlapping with the frequent aches during gestation. Densitometric osteoporosis in the affected region is not always present, but bone marrow edema, with or without joint effusion, is detected by magnetic resonance. There are not treatment guidelines, but the association of antiresorptives to symptomatic treatment seems to be beneficial. Surgery or other orthopedic interventions can be required for specific indications, like hip fracture, intra-medullary decompression, or other.

  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.

  1. Differential diagnosis and secondary causes of osteoporosis.

    PubMed

    Taxel, P; Kenny, A

    2000-01-01

    Secondary osteoporosis refers to osteoporosis in which an underlying cause or factor other than those attributable to the postmenopausal state or aging can be identified. Primary, or idiopathic, osteoporosis implies that a secondary cause cannot be found. Secondary osteoporosis occurs not only in postmenopausal women but also in men and premenopausal women. In series reported from specialized centers, as many as 30% of postmenopausal women and 50% to 80% of men have an identifiable secondary cause of osteoporosis, although the frequency of secondary osteoporosis is probably much lower in the general population. In assessing the patient with osteoporosis, it is important to look for secondary causes and aggravating factors that are reversible and amenable to therapy. In addition to secondary forms, 2 metabolic bone diseases, osteomalacia and primary hyperparathyroidism, can mimic or aggravate osteoporosis. This paper will summarize the differential diagnosis and management of osteoporosis, osteomalacia, and hyperparathyroidism and review the most common causes of secondary osteoporosis.

  2. Recognizing and treating secondary osteoporosis.

    PubMed

    Walker-Bone, Karen

    2012-08-01

    Osteoporosis, through its association with fragility fracture, is a major public health problem, costing an estimated $34.8 billion worldwide per annum. With projected demographic changes, the burden looks set to grow. Therefore, the prevention of osteoporosis, as well as its identification and treatment once established, are becoming increasingly important. Osteoporosis is secondary when a drug, disease or deficiency is the underlying cause. Glucocorticoids, hypogonadism, alcohol abuse and malnutrition are among the most frequently recognized causes of secondary osteoporosis but the list of implicated diseases and drugs is growing and some of the more recently recognized associations, such as those with haematological conditions and acid-suppressing medications, are less well publicized. In some cases, advancement in treatment of the primary disease has led to people living long enough to develop secondary osteoporosis; for example, successful treatment for breast and prostate malignancies by hormonal manipulation, improved survival in HIV with the advent of anti-retroviral therapies, and improved treatment for cystic fibrosis. This Review emphasizes the importance of secondary osteoporosis, discusses familiar and less well-known causes and what is known of their mechanisms, provides guidance as to the pragmatic identification of secondary osteoporosis and summarizes treatment options, where available.

  3. Osteoporosis and jawbones in women.

    PubMed

    Gulsahi, Ayse

    2015-01-01

    Osteoporosis is a major health problem affecting one in three women over the age of 50 and may not be detected until fractures occur. Since osteoporotic fractures are a health burden worldwide, identifying subjects with a high risk of osteoporosis and preventing osteoporosis-related mortality and morbidity are a very important health strategy. Women show an estrogen-related bone loss starting at menopause, predominantly occurring in trabecular bone. Diagnosis of osteoporosis is usually based on the bone mineral density measurement, but this is not a practical and economical technique for early detection. Therefore, investigators are interested in the possibility of detecting osteoporosis from the panoramic radiographs. Mandibular cortical bone undergoes resorptive activity in osteoporotic patients, leading to a decreased thickness and more porous inferior border. Therefore, studies have demonstrated the usefulness of cortical width and shape, determined from panoramic radiographs, in identifying elderly individuals with undetected osteoporosis, especially postmenopausal women. In conclusion, postmenopausal women with C3 category, Mental Index (MI) <3 mm, and panoramic mandibular index (PMI) <0.3 may be considered for further osteoporosis investigation.

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

    PubMed

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

    2015-08-01

    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. 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. 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. Incidence of diagnosis of osteoporosis and fragility fractures of the upper or lower extremity, pelvis, and vertebrae were the outcome measures. 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(+). 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.

  5. Bone density screening for osteoporosis.

    PubMed

    2002-06-01

    Bone mineral density (BMD) testing is an effective approach for the early detection of osteopenia and osteoporosis. The American College of Obstetricians and Gynecologists Committee on Gynecologic Practice recommends BMD testing for all postmenopausal women aged 65 years or older and for all postmenopausal women who present with fractures. The Committee also concludes that BMD testing may be recommended to post-menopausal women younger than 65 years who have one or more risk factors for osteoporosis. Bone mineral density testing also may be useful for pre-menopausal and postmenopausal women who present with certain diseases or medical conditions and those who take certain drugs associated with an increased risk of osteoporosis.

  6. Compression fracture in postpartum osteoporosis.

    PubMed

    Kim, Tae-Hee; Lee, Hae-Hyeog; Jeon, Dong-Su; Byun, Dong Won

    2013-11-01

    Osteoporosis is mainly a problem in postmenopausal women. However, we had a case of postpartum compression fracture associated with osteoporosis. A 42-year-old multiparous woman had undergone tertiary cesarean section without complications 1 month before. She was breast-feeding her baby and had no other bone-related complication history. She did not exercise on a regular basis. She experienced back pain abruptly and was diagnosed with a recent compression fracture of T12, L1, and L3. We evaluated this rare case of postpartum osteoporosis and compression fracture.

  7. [Phosphorus intake and osteoporosis].

    PubMed

    Omi, N; Ezawa, I

    2001-10-01

    Phosphorus (P) is one of the most important nutrients for bone metabolism, such as calcium. In general, P intake is usually adequate in our daily diet, and there is a risk of over-consumption from processed food. On the other hand, Ca intake is not always adequate from the Japanese daily diet. When Ca/P is taken from the daily diet at a level of 0.5 - 2.0, the P intake level dose not affect intestinal Ca absorption. Therefore, it is important not only to pay attention to preventing the over-consumption of P, but also to obtain a sufficient intake of Ca. For the prevention of osteoporosis, it is important to consume sufficient Ca and to maintain and appropriate Ca/P balance from diet.

  8. Transient osteoporosis of pregnancy.

    PubMed

    Maliha, George; Morgan, Jordan; Vrahas, Mark

    2012-08-01

    Transient osteoporosis of pregnancy (TOP) is a rare yet perhaps under-reported condition that has affected otherwise healthy pregnancies throughout the world. The condition presents suddenly in the third trimester of a usually uneventful pregnancy and progressively immobilizes the mother. Radiographic studies detect drastic loss of bone mass, elevated rates of turnover in the bone, and oedema in the affected portion. Weakness of the bone can lead to fractures during delivery and other complications for the mother. Then, within weeks of labour, symptoms and radiological findings resolve. Aetiology is currently unknown, although neural, vascular, haematological, endocrine, nutrient-deficiency, and other etiologies have been proposed. Several treatments have also been explored, including simple bed rest, steroids, bisphosphonates, calcitonin, induced termination of pregnancy, and surgical intervention. The orthopedist plays an essential role in monitoring the condition (and potential complications) as well as ensuring satisfactory outcomes for both the mother and newborn. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. [A guide for osteoporosis management].

    PubMed

    Zárate, Arturo; Saucedo, Renata; Basurto, Lourdes

    2004-01-01

    Osteoporosis has to be considered only as a risk factor for bone fractures and its measurement by the bone mass index has some limitations. The aim of treatment of osteoporosis is to reduce the frequency of fractures (especially at the vertebral and the hip) which are responsible for morbidity and mortality with the osteoporosis. It has been demonstrated that antiresorptive drugs (bisphosphonates, estrogens, raloxifen) as well as anabolic agents (synthetic parathormone) are useful for preventing fractures. Calcium and vitamin D supplementation is not sufficient to treat persons with osteoporosis. Choice of treatment depends of age, the presence or absence of prevalent fractures, and the degree of bone mineral density measured at the spine and hip. The main inconvenient for the adherence of treatment is the high cost of the medicaments and agents as well as the poor information given to the patients.

  10. Osteopenia and osteoporosis in children.

    PubMed

    Cassidy, J T

    1999-01-01

    The purpose of this paper is to review the normal physiologic processes of skeletal accretion, abnormalities that may occur in children with chronic illnesses, and therapeutic maneuvers that the clinician may be able to employ to prevent or partially correct abnormalities of skeletal growth. Skeletal maturation in children is dependent upon bone formation exceeding resorption, whereas in adults these two fundamental processes of homeostasis are closely balanced. Skeletal growth is effectively completed at the end of the period of adolescent growth acceleration with closure of the epiphyses. An important determinant of future fracture risk and osteoporosis is the peak bone mass achieved during this second decade of life. If the hereditarily determined peak bone mass is not established during that time, the patient will enter young adulthood with osteopenia, an increased fracture risk, and accelerated postmenopausal osteoporosis or involutional osteoporosis. Thus osteopenia and osteoporosis have their origins in childhood and adolescence.

  11. Management of osteoporosis in children.

    PubMed

    Shaw, Nicholas J

    2008-12-01

    Osteoporosis is being increasingly recognised in paediatric practice as a consequence of several factors. These include the increasing complexity of chronic conditions and the associated treatments managed by paediatricians. In addition, the improved care provided to children with chronic illness has led to many of them living long enough to develop osteoporosis. The availability of methods to assess bone density in children as a surrogate marker of bone strength and the possibility of medical treatment to increase bone density have also resulted in an increased awareness of groups of children who may be at risk of osteoporosis. This article reviews the current definition of osteoporosis in children, aetiological factors and the evidence for effective treatment.

  12. [Osteoporosis and intake of vitamins].

    PubMed

    Hirota, Takako; Hirota, Kenji

    2005-05-01

    Subclinical vitamins deficiency is common in the elderly, especially in osteoporotic patients. However, most physicians in this area are just focused on drugs for the treatment of osteoporosis. It is already established that several vitamins influence bone turnover, bone mineral density, or even the risk of hip fractures. Improving these vitamins status may help to treat and prevent osteoporosis in elderly people. Recently higher vitamin D intake is recognized to be needed to keep not only bone health but also muscle strength. More sun exposure might be needed for improved bone health in the elderly. Deficiency of Vitamin K, C, or B(12) may be also important modifiable risk factors for osteoporosis and bone fracture. Excessive retinal supplementation may become associated with higher bone loss. Thus such diet rich in fruit and vegetables together with fish and meat could fulfill a balance among these vitamins and should be recommended for prevention or treatment of osteoporosis.

  13. Treatment of osteoporosis in men

    PubMed Central

    Kaufman, J.-M.; Reginster, J.-Y.; Boonen, S.; Brandi, M. L.; Cooper, C.; Dere, W.; Devogelaer, J.-P.; Diez-Perez, A.; Kanis, J. A.; McCloskey, E.; Mitlak, B.; Orwoll, E.; Ringe, J.D.; Weryha, G.; Rizzoli, R.

    2013-01-01

    Summary Aspects of osteoporosis in men, such as screening and identification strategies, definitions of diagnosis and intervention thresholds, and treatment options (both approved and in the pipeline) are discussed. Introduction Awareness of osteoporosis in men is improving, although it remains under-diagnosed and under-treated. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) workshop was convened to discuss osteoporosis in men and to provide a report by a panel of experts (the authors). Methods A debate with an expert panel on preselected topics was conducted. Results and Conclusions Although additional fracture data are needed to endorse the clinical care of osteoporosis in men, consensus views were reached on diagnostic criteria and intervention thresholds. Empirical data in men display similarities with data acquired in women, despite pathophysiological differences, which may not be clinically relevant. Men should receive treatment at a similar 10-year fracture probability as in women. The design of mixed studies may reduce the lag between comparable treatments for osteoporosis in women becoming available in men. PMID:23201268

  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.

  15. Osteoporosis in ankylosing spondylitis.

    PubMed

    Magrey, Marina; Khan, Muhammad Asim

    2010-10-01

    Osteoporosis (OP) is a frequent complication of ankylosing spondylitis (AS), even in early stages of the disease, and is associated with elevated levels of biochemical markers of bone turnover, proinflammatory cytokines, and acute-phase reactants. This suggests that systemic inflammatory mediators, such as interleukin-6 and tumor necrosis factor-alpha, may be involved. Various factors that conceivably work in conjunction with one another also cause bone loss in AS (eg, genetic polymorphisms of vitamin D, low levels of osteoprotegerin and sex steroid hormones, and impaired calcium and vitamin D absorption). Dual x-ray absorptiometry for assessing bone mineral density (BMD) has limitations in patients with AS because of unreliability of spinal measurements, particularly in advanced disease with new bone formation. Femoral neck BMD is reduced and correlates with increased risk of vertebral fractures. Hence, measurement of BMD at the femoral neck may provide the most accurate means of detecting osteopenia and OP and could assess fracture risk in AS patients. No guidelines are available for detection and treatment of OP in AS, and most patients are young men, who are less likely to be screened. The only evidence-based recommendation is that optimal control of disease activity in AS prevents bone loss. A recent study showed a beneficial effect of infliximab therapy on bone turnover markers and BMD in AS. Also, bisphosphonates may be useful in managing OP in AS.

  16. Nutrition and osteoporosis.

    PubMed

    Lau, E M; Woo, J

    1998-07-01

    Nutritional factors have a significant influence on the cause of osteoporosis. Calcium supplementation may be particularly effective in populations with a low calcium diet. Supplementations of 500 mg/d may produce about 4% gain in skeletal calcium in adolescents. Supplementations of 800 mg/d may prevent bone loss in postmenopausal women. The results of clinical trials also suggested that such supplementation may prevent hip and vertebral fractures in the elderly. The largest effect of calcium supplementation occurs in the first year of treatment, whereas sustained effects are not proven. Vitamin D supplementation may be particularly useful in vitamin D-deficient elderly. In this group, hip fractures may be prevented by vitamin D administration. Urinary sodium excretion is correlated with urinary calcium excretion in humans, and a direct effect of high sodium intake on loss at the hip has been demonstrated. Observational epidemiologic studies suggested a negative effect of a high protein intake on bone density, although there are no results from clinical trials to support this view. Dietary fiber, phytate, oxalate, and caffeine intake may have a small negative effect on calcium absorption.

  17. [Pharmacologic treatment of osteoporosis--2011].

    PubMed

    Lakatos, Péter

    2011-08-14

    Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis.

  18. [Secondary osteoporosis induced by anticoagulants?].

    PubMed

    Riess, H; Loew, A; Himmelreich, G

    2001-07-01

    Generalized osteoporosis is a result of different causes and pathogenic mechanisms, which often combine forces to become clinically relevant. Among the different exogenic factors, drugs play an important role, frequently in connection with other factors such as immobilization or pregnancy. It has been suggested that anticoagulation therapy with heparins or coumarins may induce osteoporotic changes or enhance the development of osteoporosis for other reasons. According to in vitro experiments, preclinical trials, and clinical investigations, it seems reasonable to assume that heparins induce increased bone loss in a time- and dose-related manner. Low-molecular-weight heparins most likely have less effect on bone turnover when compared to unfractionated heparin. Oral anticoagulation therapy with vitamin K-antagonists is believed to have a weak effect on induction of osteoporosis, but clinical studies are contradictory. In spite of the fact that a relevant effect of these drugs on the induction of osteoporosis is questionable, it must be taken into consideration that anticoagulant drugs may enhance the negative effects on bone density of other risk factors capable of inducing osteoporosis such as immobilization, pregnancy, or endocrinological disorders.

  19. [On "2015 Guidelines for Prevention and Treatment of Osteoporosis". CKD and osteoporosis].

    PubMed

    Yamada, Shinsuke; Inaba, Masaaki

    2015-09-01

    Many patients with osteoporosis have complicated with CKD. It was reported that the risk of hip and vertebral fracture is higher in osteoporosis patients with CKD than without CKD. Because the drugs for osteoporosis are excreted by kidney, there are no drugs that the efficacy and safety were established for the CKD patient. I give an outline about the relationship between CKD and osteoporosis, and the note on the medical care of osteoporosis patients with CKD.

  20. 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…

  1. 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…

  2. Prevention and rehabilitation of osteoporosis.

    PubMed

    Kerschan-Schindl, Katharina

    2016-02-01

    Osteoporosis is a frequent disease in postmenopausal women. Despite the fact that fragility fractures cause many problems, osteoporosis is still underdiagnosed and undertreated. This manuscript outlines the topics diagnosis of osteoporosis, fracture risk prevention, and therapy after fracture. Regular physical activities, a sufficient intake of calcium, and a normal vitamin D level are important for bone health. Depending on the personal fracture risk, the patient may also be prescribed bone-specific medication to prevent fragility fractures. In case of a prevalent osteoporotic fracture, the initiation or adaptation of bone-specific therapy is indispensable. Since most osteoporotic fractures occur during a fall, fall risk reduction is an important measure to inhibit a new fracture. Rehabilitation of patients with fragility fractures varies with different localizations of the fracture and should be performed by a multidisciplinary team.

  3. Fish as osteoporosis research models

    NASA Astrophysics Data System (ADS)

    Goerlich, Roland; Renn, Jörg; Aleström, Peter; Muller, Marc; Schartl, Manfred; Winkler, Christoph; Midtlyng, Paul; Eberius, Matthias; Slenzka, Klaus

    2005-10-01

    Osteoporosis, characterised by a progressive loss of bone density, is one of the most important bone diseases of humans worldwide. During spaceflight, astronauts also suffer bone loss that strongly resembles osteoporosis in patients on Earth. In addition to these human disorders, skeletal malformations often cause problems in industrial animal production. Although the alterations of bone homeostasis that lead to osteoporosis are well-documented at the cellular level, the molecular events underlying this disease are still poorly understood. Moreover, most of our knowledge is derived from in vitro studies using cell culture systems. Recent findings indicate a remarkable conservation of key regulators of bone development and bone homeostasis between fish and mammals, both at the sequence and expression levels.

  4. Causes of secondary pediatric osteoporosis.

    PubMed

    Bianchi, Maria Luisa

    2013-06-01

    Secondary osteoporosis is increasingly observed in both adult and pediatric patients affected by many heterogeneous diseases. Most forms of secondary osteoporosis derive from one or more of the following causes: malnutrition, malabsorption, immobilization and/or reduced mechanical load, vitamin D deficiency, chronic inflammation, hormonal derangements, and chronic use of glucocorticoids and other drugs. Considering the lack of symptoms in the early phases, both the risk and the presence of secondary osteoporosis tend to be underestimated, and as a consequence, appropriate prevention/treatment measures are often delayed or not taken at all. Failure to accumulate an appropriate bone mass for gender and age or to build an architecturally "strong" bone must always be suspected when a child or adolescent presents with frequent and/or low-trauma fractures, chronic bone pain, or an incidental finding of "osteopenia" on plain X-rays. Known risk factors must always be considered.

  5. 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.

  6. Health technology assessment in osteoporosis.

    PubMed

    Hiligsmann, Mickael; Kanis, John A; Compston, Juliet; Cooper, Cyrus; Flamion, Bruno; Bergmann, Pierre; Body, Jean-Jacques; Boonen, Steven; Bruyere, Olivier; Devogelaer, Jean-Pierre; Goemaere, Stefan; Kaufman, Jean-Marc; Rozenberg, Serge; Reginster, Jean-Yves

    2013-07-01

    We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe's six largest countries spent €31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources.

  7. Transient osteoporosis of the hip.

    PubMed

    Mirza, Rabeea; Ishaq, Saliha; Amjad, Hira

    2012-02-01

    Transient Osteoporosis of Hip (TOH) is an uncommon disorder of idiopathic nature, particularly in the Asian population. It has been described to mostly occur in middle aged men and women in their third trimester of pregnancy. A distinctive hallmark of this condition is that it is self limiting and resolves in a few months. The patient presents to the physician with pain on movement and impaired mobility of the affected joint, developing without any history of trauma. MRI is the main diagnostic tool. We report herein a case of a forty five year old male, who developed transient osteoporosis of the hip, and was managed conservatively.

  8. 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.

  9. Office practice of osteoporosis evaluation.

    PubMed

    Lacativa, Paulo Gustavo S; de Farias, Maria Lucia F

    2006-08-01

    Osteoporosis is a metabolic disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Bone fragility depends on bone density, turnover and microarchitectural features, such as relative trabecular volume, spacing, number and connectivity. Previous fragility fractures increase the fracture risk irrespective of bone density. Other risk factors must also be considered as many fractures occur in patients with osteopenia on densitometry. On the other hand, the diagnosis of osteoporosis and increased fracture risk should not be based on densitometric data alone when young populations such as men below 65 years, premenopausal women, adolescents and children are considered.

  10. Localized drugs delivery hydroxyapatite microspheres for osteoporosis therapy

    NASA Astrophysics Data System (ADS)

    Lee, J. H.; Ko, I. H.; Jeon, S.-H.; Chae, J. H.; Lee, E. J.; Chang, J. H.

    2011-10-01

    This study describes the preparation of hydroxyapatite microspheres for local drugs delivery. The formation of the hydroxyapatite microspheres was initiated by enzymatic decomposition of urea and accomplished by emulsification process (water-in-oil). The microspheres obtained were sintered at 500°C. Scanning electron microscope (SEM) indicated that the microspheres have various porous with random size, which maximizes the surface area. Cytotoxicity was not observed after sintering. Osteoporosis drugs, alendronate and BMP-2, were loaded into HAp microspheres and the releases of both molecules showed sustained releasing profiles.

  11. 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

  12. Calcium and osteoporosis.

    PubMed

    Nordin, B E

    1997-01-01

    Calcium is an essential nutrient that is involved in most metabolic processes and the phosphate salts of which provide mechanical rigidity to the bones and teeth, where 99% of the body's calcium resides. The calcium in the skeleton has the additional role of acting as a reserve supply of calcium to meet the body's metabolic needs in states of calcium deficiency. Calcium deficiency is easily induced because of the obligatory losses of calcium via the bowel, kidneys, and skin. In growing animals, it may impair growth, delay consolidation of the skeleton, and in certain circumstances give rise to rickets but the latter is more often due to deficiency of vitamin D. In adult animals, calcium deficiency causes mobilization of bone and leads sooner or later to osteoporosis, i.e., a reduction in the "amount of bone in the bone" or apparent bone density. The effects of calcium deficiency and oophorectomy (ovariectomy) are additive. In humans, osteoporosis is a common feature of aging. Loss of bone starts in women at the time of the menopause and in men at about age 55 and leads to an increase in fracture rates in both sexes. Individual fracture risk is inversely related to bone density, which in turn is determined by the density achieved at maturity (peak bone density) and the subsequent rate of bone loss. At issue is whether either or both of these variables is related to calcium intake. The calcium requirement of adults may be defined as the mean calcium intake needed to preserve calcium balance, i.e., to meet the significant obligatory losses of calcium through the gastrointestinal tract, kidneys, and skin. The calcium allowance is the higher intake recommended for a population to allow for individual variation in the requirement. The mean requirement defined in this way, calculated from balance studies, is about 20 mmol (800 mg) a day on Western diets, implying an allowance of 25 mmol (1000 mg) or more. Corresponding requirements and allowances have been calculated for

  13. The histopathological study of osteoporosis.

    PubMed

    Marcu, Fl; Bogdan, Fl; Muţiu, Gabriela; Lazăr, L

    2011-01-01

    The osteoporosis is characterized by the imbalance between the activity of the osteoblasts, the bone forming cells, and the osteoclasts, the cells that resorb the bone tissue, imbalance that favors the osteoclasts. As a conclusion, in the case of osteoporosis, for the same volume, the bone is less compact and more fragile. The objective of our study is to make a histological evaluation of the different elements of the bone tissue in many 47 bone samples: 27 bone fragments were collected from the head and the femoral head of patients who required hip arthroplasty and 20 bone fragments were collected from the vertebral body of dead patients. The results of our study emphasized the thinned trabeculae of the bone that lost continuity, the preferential resorption of the horizontal trabeculae, the consecutive trabecular anisotropy and the reduction of the trabecular connectivity with enlarged areolae and the adipose degeneration of the marrow. One notices in the osteoporosis a reduction of the trabecular network connectivity directly proportional with the stage of the illness; thus, we determined a strong reduction of the trabecular connectivity in advanced osteoporosis stages. The growth aspects of the medular adiposity, associated with the intratrabecular connectivity concurs to highlight the functional connection between bone and marrow. The diminution of the medullar cellularity together with its enrichment in fat cells has negative outcomes on the bone.

  14. Quantitative imaging methods in osteoporosis.

    PubMed

    Oei, Ling; Koromani, Fjorda; Rivadeneira, Fernando; Zillikens, M Carola; Oei, Edwin H G

    2016-12-01

    Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features. Further, novel quantitative techniques are being developed to appraise additional characteristics of osteoporosis including three-dimensional bone architecture with quantitative computed tomography (QCT). Dedicated high-resolution (HR) CT equipment is available to enhance image quality. At the other end of the spectrum, by utilizing post-processing techniques such as the trabecular bone score (TBS) information on three-dimensional architecture can be derived from DXA images. Further developments in magnetic resonance imaging (MRI) seem promising to not only capture bone micro-architecture but also characterize processes at the molecular level. This review provides an overview of various quantitative imaging techniques based on different radiological modalities utilized in clinical osteoporosis care and research.

  15. 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.

  16. 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.

  17. Quantitative imaging methods in osteoporosis

    PubMed Central

    Oei, Ling; Koromani, Fjorda; Rivadeneira, Fernando; Zillikens, M. Carola

    2016-01-01

    Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features. Further, novel quantitative techniques are being developed to appraise additional characteristics of osteoporosis including three-dimensional bone architecture with quantitative computed tomography (QCT). Dedicated high-resolution (HR) CT equipment is available to enhance image quality. At the other end of the spectrum, by utilizing post-processing techniques such as the trabecular bone score (TBS) information on three-dimensional architecture can be derived from DXA images. Further developments in magnetic resonance imaging (MRI) seem promising to not only capture bone micro-architecture but also characterize processes at the molecular level. This review provides an overview of various quantitative imaging techniques based on different radiological modalities utilized in clinical osteoporosis care and research. PMID:28090446

  18. Osteoporosis and ischemic cardiovascular disease.

    PubMed

    Laroche, Michel; Pécourneau, Virginie; Blain, Hubert; Breuil, Véronique; Chapurlat, Roland; Cortet, Bernard; Sutter, Bruno; Degboe, Yannick

    2016-11-09

    Osteoporosis and cardiovascular disease were long viewed as independent of each other. However, numerous epidemiological studies, which are discussed in the first part of this review, have provided incontrovertible evidence of a link. Thus, the risk of coronary artery disease and stroke is higher in patients with a history of osteoporotic fracture or low bone mineral density than in non-osteoporotic patients. In the other direction, patients with cardiovascular disease are at higher risk for bone loss and osteoporotic fracture. The link between osteoporosis and cardiovascular disease is due in part to shared conventional risk factors such as estrogen deprivation in women, smoking, low physical activity, and diabetes. In addition, atheroma plaque calcification involves cytokines and growth factors that also play a role in bone turnover, including proinflammatory cytokines (IL-6 and TNFα), osteoprotegerin, sclerostin, matrix GLA protein, and FGF-23. Several recent studies have provided support for these pathophysiological hypotheses. Thus, elevation of osteoprotegerin, sclerostin, or FGF-23 levels may explain and predict the occurrence of both osteoporotic fractures and cardiovascular events. The association between osteoporosis and cardiovascular disease found in most epidemiological and pathophysiological studies suggests a need for evaluating potential benefits from routine bone absorptiometry and osteoporotic fracture detection in patients with cardiovascular disease and from exercise testing and arterial Doppler imaging in patients with osteoporosis.

  19. The Pharmacological Management of Osteoporosis

    PubMed Central

    Riek, Amy E.; Towler, Dwight A.

    2013-01-01

    Pharmacotherapy is effective in decreasing the incidence of osteoporotic fracture, morbidity, and mortality. This benefit is pronounced in patients at highest risk for fracture: those with prior osteoporotic fracture, very low bone mineral density, or receiving chronic corticosteroid treatment. We review the best pharmacotherapeutic options currently available for treating osteoporosis. PMID:21568234

  20. Pharmacogenomics in osteoporosis: Steps toward personalized medicine.

    PubMed

    Greene, Robert; Mousa, Shaymaa S; Ardawi, Mohamed; Qari, Mohamed; Mousa, Shaker A

    2009-01-01

    Osteoporosis is a complicated and preventable disease with major morbidity complications that affects millions of people. In the last 15 years, there have been numerous studies and research in the new fields of pharmacogenetics and pharmacogenomics related to osteoporosis. Numerous "candidate genes" have been identified and have been found to be associated with osteoporosis as well as the treatment of osteoporosis. Many studies have found conflicting results on different polymorphisms and whether or not they are related to bone mineral density and osteoporosis. There is a need for larger and better designed pharmacogenomic studies related to osteoporosis incorporating a greater variety of candidate genes. The evaluation of osteoporosis and fracture risk is moving from a risk stratification approach to a more individualized approach, in which an individual's absolute risk of fracture is evaluable as a constellation of the individual's environmental exposure and genetic makeup. Therefore, the identification of gene variants associated with osteoporosis phenotypes or response to therapy might help individualize the prognosis, treatment, and prevention of fracture. This review focuses on major candidate genes and what needs to be done to take the genetics of osteoporosis and incorporate them into the pharmacogenomics of the management of osteoporosis.

  1. Pharmacogenomics in osteoporosis: Steps toward personalized medicine

    PubMed Central

    Greene, Robert; Mousa, Shaymaa S; Ardawi, Mohamed; Qari, Mohamed; Mousa, Shaker A

    2009-01-01

    Osteoporosis is a complicated and preventable disease with major morbidity complications that affects millions of people. In the last 15 years, there have been numerous studies and research in the new fields of pharmacogenetics and pharmacogenomics related to osteoporosis. Numerous “candidate genes” have been identified and have been found to be associated with osteoporosis as well as the treatment of osteoporosis. Many studies have found conflicting results on different polymorphisms and whether or not they are related to bone mineral density and osteoporosis. There is a need for larger and better designed pharmacogenomic studies related to osteoporosis incorporating a greater variety of candidate genes. The evaluation of osteoporosis and fracture risk is moving from a risk stratification approach to a more individualized approach, in which an individual’s absolute risk of fracture is evaluable as a constellation of the individual’s environmental exposure and genetic makeup. Therefore, the identification of gene variants associated with osteoporosis phenotypes or response to therapy might help individualize the prognosis, treatment, and prevention of fracture. This review focuses on major candidate genes and what needs to be done to take the genetics of osteoporosis and incorporate them into the pharmacogenomics of the management of osteoporosis. PMID:23226036

  2. Osteoporosis in a young woman after 6 years of levonorgestrel administration from intrauterine devices?

    PubMed Central

    Greiner, Christine Ursula; Brune, Kay; Haen, Ekkehard

    2009-01-01

    This report describes a young woman who developed dysmenorrhoea at the age of 12. She received a levonorgestrel (LNg)-releasing intrauterine device at the age of 21, and this was replaced twice within 8 years. At the age of 28, she started to have multiple bone and joint pain (predominantly low back pain), which, after intensive diagnostic of blood parameters and bone CT, turned out to result – from a manifest (mild) osteoporosis. Since the woman developed very low (postmenopausal) oestradiol levels during the presence of the gestagen-releasing device and encountered normalisation of oestradiol production after removal, suppression of the hypophysial–ovarian axis is proposed as the cause of both lack of oestradiol and osteoporosis. This poses the question of whether long-term use of such devices in young women may result in reduced bone density in the early phases of life, paving the way to serious osteoporosis at menopause. PMID:21686786

  3. Osteoporosis: a disease management opportunity.

    PubMed

    Taft, L B; Looker, P A; Cella, D

    2000-01-01

    Advances in the ability to detect and effectively treat osteoporosis lead to questions about when testing and treatment should be initiated. Disease management provides answers with the promise of both cost-effective use of resources and improved health outcomes. Applying the characteristics and principles of disease management to osteoporosis provides a powerful rationale for a population-based approach to this disease. Disease management makes it possible to systematically identify persons at risk, intervene with prevention and treatment programs, and measure clinical, quality of life, and economic outcomes. Clinical guidelines are a critical element in disease management. This article presents clinical guidelines developed recently by national medical and public health experts based on a review of available research and clinical evidence.

  4. Review of postmenopausal osteoporosis pharmacotherapy.

    PubMed

    Mayes, Stacey L

    2007-06-01

    The degradation of bone tissue leading to osteoporosis is often silent and unrecognized until a postmenopausal woman develops a bone fracture. The costs of medical treatment and subsequent changes in the quality of life of a patient are significant, and avoidance via proper nutrition, exercise, and pharmacologic therapy may be the key to decreasing healthcare costs associated with this disease state. A periodic review of current literature is necessary to update the reader of current therapeutic options for the treatment and prevention of osteoporosis. A number of medications exist, and new options are ongoing. Clinicians now have access to antiresorptive and anabolic therapy in addition to lifestyle modification as options for patients. This article consists of a review of established guidelines for screening, diagnosis, and pharmacologic modalities and will provide a comprehensive assessment of therapeutic options.

  5. 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.

  6. Public Health Impact of Osteoporosis

    PubMed Central

    2013-01-01

    Objective. To describe the public health impact of osteoporosis including the magnitude of the problem and important consequences of osteoporotic fractures. Methods. Literature review of key references selected by author. Results. Current demographic trends leading to an increased number of individuals surviving past age 65 will result in an increased number of osteoporotic fractures. Important consequences of osteoporotic fractures include an increased mortality that for hip fractures extends to 10 years after the fracture. Increased mortality risk also extends to major and minor fractures, especially, in those over 75 years. Hip and vertebral fractures have important functional consequences and reductions in quality of life. The economic impact of osteoporotic fractures is large and growing. Significant health care resources are required for all fractures. Conclusions. To alleviate the public and private burden of osteoporosis related fractures, assessment of risk and reduction of individual risk is critical. PMID:23902935

  7. [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.

  8. Intravenous bisphosphonates for postmenopausal osteoporosis

    PubMed Central

    Mottaghi, Peyman

    2010-01-01

    Numerous clinical studies have shown bisphoshonates (BPs) to be useful and cost-effective options for the fractures prevention and postmenopausal bone loss. The use of oral bisphoshonates is an established option for managment of osteoporosis in postmenopausal women, but many of them complaint from gastrointestinal side effect or frequently dosed oral regimens. To improve upon the suboptimal therapeutic compliance in postmenopausal women, newer, longer-acting intravenous formulations of BPs has been approved for intermittent administration in postmenopausal women. These preparations would become an option for patients who can not tolerate oral BPs or it was ineffective in increasing their bone density. This article proposed to review effectiveness and tolerability of intravenous BPs in postmenopausal women with osteoporosis. PMID:21526078

  9. Mining MEDLINE for the treatment of osteoporosis.

    PubMed

    Yildirim, Pinar; Ceken, Cinar; Hassanpour, Reza; Esmelioglu, Sadik; Tolun, Mehmet Resit

    2012-08-01

    In this paper, we consider the importance of osteoporosis disease in terms of medical research and pharmaceutical industry and we introduce a knowledge discovery approach regarding the treatment of osteoporosis from a historical perspective. Osteoporosis is a systemic skeletal disease in which osteoporotic fractures are associated with substantial morbidity and mortality and impaired quality of life. Osteoporosis has also higher costs, for example, longer hospital stays than many other diseases such as diabetes and heart attack and it is an attractive market for pharmaceutical companies. We use a freely available biomedical search engine leveraging text-mining technology to extract the drug names used in the treatment of osteoporosis from MEDLINE articles. We conclude that alendronate (Fosamax) and raloxifene (Evista) have the highest number of articles in MEDLINE and seem the dominating drugs for the treatment of osteoporosis in the last decade.

  10. Osteoporosis: primary prevention in the community.

    PubMed

    Loh, K Y; Shong, H K

    2007-10-01

    The incidence of osteoporosis is increasing worldwide. It has great impact on the life of the elderly population. The most significant medical consequence of osteoporosis is fragility fracture which without proper treatment will cause severe medical and psychosocial complications. The overall cost in managing osteoporosis and its related fractures is escalating. Using bone densitometry to measure bone mineral density is useful in the diagnosis of osteoporosis but it is costly and not feasible in the community. Drugs such as estrogen replacement, raloxifene and calcitonin are effective in prevention and treatment of osteoporosis but they are also expensive. Identifying modifiable risk factors such as smoking, lack of exercise, low dietary calcium and vitamin D intake and healthy life style remain strategy in the primary prevention of osteoporosis in the community.

  11. "Osteoporosis and orthopods" incidences of osteoporosis in distal radius fracture from low energy trauma.

    PubMed

    Bahari, Syah; Morris, Seamus; Lenehan, Brian; McElwain, John P

    2007-07-01

    Fracture of the distal radius from low energy trauma is a common presentation to orthopaedic trauma services. This fragility type fracture is associated with underlying osteoporosis. Osteoporosis is a 'silent disease' where fragility fracture is a common presentation. Orthopaedic surgeons may be the only physician that these patients encounter. We found a high percentage of female patients who sustained a fragility fracture of the distal radius have an underlying osteoporosis. Further management of osteoporosis is important to prevent future fragility fractures.

  12. Osteoporosis in erythropoietic protoporphyria patients.

    PubMed

    Biewenga, M; Matawlie, R H S; Friesema, E C H; Koole-Lesuis, H; Langeveld, M; Wilson, J H P; Langendonk, J G

    2017-08-17

    Erythropoietic protoporphyria is a rare metabolic disease with painful photosensitivity due to protoporphyrin IX accumulation, resulting in lifelong light avoidance behaviour. The aim of this study was to evaluate bone mineral density and known osteoporosis risk factors in erythropoietic protoporphyria patients. In this cross-sectional study all erythropoietic protoporphyria patients attending the Erasmus MC outpatient clinic that had undergone bone mineral density measurements were included. Plasma 25 OH-vitamin D, alkaline phosphatase, parathyroid hormone and total protoporphyrin IX levels were measured and information on life style, sun light exposure and a bone relevant physical exercise index (BPAQ score) was obtained using questionnaires. Bone mineral density scores and the prevalence of osteopenia and osteoporosis in the erythropoietic protoporphyria population were compared to a reference population. Twenty-three female and twenty-one male erythropoietic protoporphyria patients with a mean age of 37.6 years were included. The mean SD of the T-scores were -1.12 for the lumbar spine and -0.82 for the femoral neck (p<0.001 for both). Osteopenia was present in 35.9% and osteoporosis in 23.1%. Based on the reference population the expected prevalence was 15% and 0.6%, respectively. The prevalence of vitamin D deficiency was 50% (defined as a 25-OH vitamin D level under 50 nmol/l). The mean self-reported BPAQ score was 19.4 units (reference 19-24 units). Multiple linear regression analysis showed a significant influence of vitamin D deficiency and bone relevant physical exercise score on bone mineral density in erythropoietic protoporphyria patients. The prevalence of osteoporosis and osteopenia is greatly increased in erythropoietic protoporphyria patients. Factors that significantly correlate with low bone mineral density in this population are alkaline phosphatase (related to vitamin D deficiency) and the amount of weight bearing exercise. This article is

  13. Osteoporosis in children and adolescents.

    PubMed

    Bianchi, Maria Luisa

    2007-10-01

    In recent years, the issue of low bone density in children and adolescents has attracted much attention. The classical definition of osteoporosis should be valid at any age, yet its practical applicability to children and adolescents remains a matter of debate and there is no consensus on a diagnosis based solely on the BMD value. The clinical relevance of uncomplicated low bone density in the young and its long-term consequences remain difficult to evaluate and there is only preliminary evidence that the BMD value is a predictor of fracture risk in growing subjects. Moreover, the interpretation of densitometric data in the young is difficult because the "normal" BMD values to be used for comparison are continuously changing with age, and in addition, depend on several variables, such as gender, body size, pubertal stage, skeletal maturation and ethnicity. Although Z-score values below -2 are generally considered a serious warning, most bone specialists make a diagnosis of osteoporosis in children and adolescents only in the presence of low BMD and at least one fragility fracture. The scope of this review is limited to presenting a picture of the available knowledge. The literature on fractures will be presented in detail, since fractures are one of the key elements in the debate. There are countless papers on fractures in childhood and adolescence, but very few of them attempt to identify fragility fractures, and still fewer develop the concept of osteoporosis in the young in relation to fractures. The different forms of primary and secondary osteoporosis, the more technical aspects of bone densitometry in pediatrics, and the delicate issue of treatment will be discussed only briefly.

  14. 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 ...

  15. 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 ...

  16. What People with Lupus Need to Know about Osteoporosis

    MedlinePlus

    ... What People With Lupus Need to Know About Osteoporosis Publication available in: PDF (87 KB) Espanol Chinese ( ... Management Strategies Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

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

    MedlinePlus

    ... People With Celiac Disease Need to Know About Osteoporosis Publication available in: PDF (98 KB) Related Resources ... Management Strategies Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  18. What Prostate Cancer Survivors Need to Know about Osteoporosis

    MedlinePlus

    ... What Prostate Cancer Survivors Need to Know About Osteoporosis Publication available in: PDF (86 KB) Related Resources ... Management Strategies Resources For Your Information Facts About Osteoporosis Osteoporosis is a condition in which bones become ...

  19. What People with Lactose Intolerance Need to Know about Osteoporosis

    MedlinePlus

    ... People With Lactose Intolerance Need to Know About Osteoporosis Publication available in: PDF (88 KB) Chinese ( 繁體中文 ) ... Health Strategies Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which bones become ...

  20. 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 ...

  1. [Osteoporosis associated with spinal cord lesion].

    PubMed

    Miladinović, Ksenija; Vavra-Hadziahmetović, Narcisa; Muftić, Mirsad; Sakota, Slavica

    2007-01-01

    One of the complications caused by spinal lesion is osteoporosis which development is induced by lesion itself, and its mechanism is not explained enough. Risk factor of this kind of osteoporosis is fracture which management is difficult and is cause of further complications which aggravate already damaged quality of life of patients with spinal cord injury, and demand additional health insurance expenses. Importance of prevention and treatment of spinal cord injury induced osteoporosis is enlightened by case report.

  2. [Nutritional factors in preventing osteoporosis].

    PubMed

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

    2015-07-18

    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.

  3. 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.

  4. 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…

  5. 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…

  6. Denosumab for the management of postmenopausal osteoporosis.

    PubMed

    Singer, Andrea; Grauer, Andreas

    2010-11-01

    View the National Osteoporosis Foundation Clinician's Guide Postmenopausal osteoporosis is a major concern to public health. Fractures are the major clinical consequence of osteoporosis and are associated with substantial morbidity, mortality, and health care costs. Despite the availability of screening and treatment guidelines, osteoporosis diagnosis and treatment remain low. Health care providers may consult guidelines in the clinical management of their patients with osteoporosis, including those from the National Osteoporosis Foundation, and the new fracture risk assessment tool from the World Health Organization. Bisphosphonates are the most commonly used treatment for postmenopausal osteoporosis. Although these agents are effective in preventing fractures and bone loss, the benefits of treatment may be limited by suboptimal adherence and compliance. Denosumab is a human monoclonal antibody that targets and inhibits RANK ligand, an essential mediator of bone resorption. In clinical trials in postmenopausal women with osteoporosis, denosumab 60 mg given subcutaneously every 6 months was well tolerated and statistically significantly reduced the risk of vertebral, nonvertebral, and hip fractures. The introduction of denosumab into clinical practice provides physicians with another option for the treatment of postmenopausal osteoporosis, and the twice-yearly dosing regimen has the potential to improve adherence.

  7. [Fetal programming and the etiology of osteoporosis].

    PubMed

    Pieńkowski, Wojciech; Wolski, Hubert; Drews, Krzysztof; Seremak-Mrozikiewicz, Agnieszka

    2015-08-01

    Osteoporosis is a multifactorial skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, resulting in increased risk of fracture. Peak bone mass is an important predictor of later risk of osteoporosis. Epidemiological studies revealed that the risk of osteoporosis might be modified by exposure to environmental factors during intrauterine life and early postnatal period. This review summarizes the influence of fetal programming on the development of osteoporosis based on the epidemiological studies and potential mechanisms of epigenetic regulation of gene expression.

  8. Osteoporosis in menopause.

    PubMed

    Khan, Aliya; Fortier, Michel; Fortier, Michel; Reid, Robert; Abramson, Beth L; Blake, Jennifer; Desindes, Sophie; Dodin, Sylvie; Graves, Lisa; Guthrie, Bing; Johnston, Shawna; Khan, Aliya; Rowe, Timothy; Sodhi, Namrita; Wilks, Penny; Wolfman, Wendy

    2014-09-01

    Objectif : Offrir aux fournisseurs de soins de santé des lignes directrices quant à la prévention, au diagnostic et à la prise en charge clinique de l’ostéoporose postménopausique. Issues : Stratégies visant à identifier et à évaluer les femmes exposées à des risques élevés; utilisation de la densité minérale osseuse et des marqueurs du renouvellement des cellules osseuses pour l’évaluation du diagnostic et de la réaction à la prise en charge; et recommandations quant à la nutrition, à l’activité physique et au choix du traitement pharmacologique en vue de prévenir l’ostéoporose et d’en assurer la prise en charge. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans MEDLINE et The Cochrane Library le 30 août et le 18 septembre 2012, respectivement, au moyen d’un vocabulaire contrôlé (p. ex. « osteoporosis », « bone density », « menopause ») et de mots clés (p. ex. « bone health », « bone loss », « BMD ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles publiés en anglais ou en français. Les résultats ont été restreints aux documents publiés à partir de 2009. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en mars 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques, auprès de sociétés de spécialité médicale nationales et internationales, et dans des collections de directives cliniques Valeurs : La qualité des résultats est évaluée au moyen des critères d

  9. Dust and star formation properties of a complete sample of local galaxies drawn from the Planck Early Release Compact Source Catalogue

    NASA Astrophysics Data System (ADS)

    Clemens, M. S.; Negrello, M.; De Zotti, G.; Gonzalez-Nuevo, J.; Bonavera, L.; Cosco, G.; Guarese, G.; Boaretto, L.; Salucci, P.; Baccigalupi, C.; Clements, D. L.; Danese, L.; Lapi, A.; Mandolesi, N.; Partridge, R. B.; Perrotta, F.; Serjeant, S.; Scott, D.; Toffolatti, L.

    2013-07-01

    We combine Planck High Frequency Instrument data at 857, 545, 353 and 217 GHz with data from Wide-field Infrared Survey Explorer (WISE), Spitzer, IRAS and Herschel to investigate the properties of a well-defined, flux-limited sample of local star-forming galaxies. A 545 GHz flux density limit was chosen so that the sample is 80 per cent complete at this frequency, and the resulting sample contains a total of 234 local, star-forming galaxies. We investigate the dust emission and star formation properties of the sample via various models and calculate the local dust mass function. Although single-component-modified blackbodies fit the dust emission longward of 80 μm very well, with a median β = 1.83, the known degeneracy between dust temperature and β also means that the spectral energy distributions are very well described by a dust component with dust emissivity index fixed at β = 2 and temperature in the range 10-25 K. Although a second, warmer dust component is required to fit shorter wavelength data, and contributes approximately a third of the total infrared emission, its mass is negligible. No evidence is found for a very cold (6-10 K) dust component. The temperature of the cold dust component is strongly influenced by the ratio of the star formation rate to the total dust mass. This implies, contrary to what is often assumed, that a significant fraction of even the emission from ˜20 K dust is powered by ongoing star formation, whether or not the dust itself is associated with star-forming clouds or `cirrus'. There is statistical evidence of a free-free contribution to the 217 GHz flux densities of ≲20 per cent. We find a median dust-to-stellar mass ratio of 0.0046; and that this ratio is anticorrelated with galaxy mass. There is good correlation between dust mass and atomic gas mass (median Md/MHI = 0.022), suggesting that galaxies that have more dust (higher values of Md/M*) have more interstellar medium in general. Our derived dust mass function

  10. Subclinical hypercortisolism among outpatients referred for osteoporosis.

    PubMed

    Chiodini, Iacopo; Mascia, Maria Lucia; Muscarella, Silvana; Battista, Claudia; Minisola, Salvatore; Arosio, Maura; Santini, Stefano Angelo; Guglielmi, Giuseppe; Carnevale, Vincenzo; Scillitani, Alfredo

    2007-10-16

    Hypercortisolism is known to cause osteoporosis. To evaluate the prevalence of subclinical hypercortisolism in participants referred for evaluation of osteoporosis. Cross-sectional study. Two community hospitals and research institutes in Italy. 219 patients without clinically overt hypercortisolism or other secondary causes of osteoporosis who were referred for evaluation of osteoporosis between January 2005 and December 2005. Bone mineral density was measured by using dual-energy x-ray absorptiometry, and hypercortisolism was assessed with serum cortisol levels after a dexamethasone suppression test. Also measured were 24-hour urinary free cortisol levels and midnight plasma cortisol levels. Seven of 65 patients with T-scores of 2.5 or less and vertebral fractures had subclinical hypercortisolism (prevalence, 10.8% [95% CI, 3.23% to 18.31%]). This prevalence was 4.8% (CI, 1.32% to 8.20%) among patients with osteoporosis. In multivariable analyses adjusted for age, sex, and body mass index, a positive dexamethasone suppression test result was associated with the presence of osteoporosis (odds ratio, 3.37 [CI, 1.78 to 6.43]; P < 0.001) and vertebral fractures (odds ratio, 1.70 [CI, 1.04 to 2.79]; P = 0.035). The study was conducted in a referral setting; its findings may not apply to the general population. Subclinical hypercortisolism may be more common than is generally recognized in patients with osteoporosis in whom secondary causes of osteoporosis have been excluded.

  11. 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

  12. [Secondary osteoporosis: pathogenesis, types, diagnostics and therapy].

    PubMed

    Bartl, C; Bartl, R

    2011-04-01

    Due to increasing knowledge on pathogenetic factors causing osteoporosis and increasingly more detailed investigations, the diagnosis of secondary osteoporosis is being made increasingly more often. A rational search for the underlying disease or the bone-damaging medication is indicated particularly in adolescents, premenopausal women, men and postmenopausal women with rapidly decreasing bone tissue. The early detection of the causative disease in the preclinical stage of osteoporosis and the current therapeutic options allow not only normalization of the bone structure and the risk of fracture but also targeted therapy of the cause of the osteoporosis. The focal point in the diagnostics of secondary osteoporosis is still dual energy X-ray absorptiometry (DXA) measurement together with the manifold imaging procedures in radiology and additional clinical, laboratory chemical and bioptic findings.

  13. Osteoporosis in pregnancy: more than postural backache.

    PubMed

    Topping, J; Black, A J; Farquharson, R G; Fraser, W D

    1998-01-01

    Though uncommon, osteoporosis can occur in pregnancy or shortly after delivery. The most common feature is back pain, often severely disabling. Suspect osteoporosis if pain of sudden onset in the upper lumbar or thoracic spine is not relieved by simple analgesia, or if there is a noticeable loss of height. X-rays reveal low bone density and fractures of the vertebrae. 70% of cases occur in first pregnancies. Recurrence is unusual. Most cases resolve spontaneously; a minority cause disability lasting months or years. If osteoporosis is diagnosed, breast feeding should be discouraged because of its effect on bone mineral density. Anyone who has had osteoporosis of pregnancy is at risk of postmenopausal osteoporosis and should take medical advice.

  14. DXA, health beliefs, and osteoporosis prevention behaviors.

    PubMed

    Sedlak, Carol A; Doheny, Margaret O; Estok, Patricia J; Zeller, Richard A; Winchell, Janice

    2007-10-01

    This experimental longitudinal study was designed to examine the relationship between having a bone density through dual energy X ray absorptiometry (DXA) and osteoporosis preventing behaviors (OPB) among healthy postmenopausal women. Subjects were 203 healthy community-based women 50-65 years of age. Mediating variables were general knowledge of osteoporosis and revised health belief model variables. Treatment group women (n = 101) had a DXA screen and control group women (n = 102) did not. Study questionnaires were completed at three time points; initially and at 6 months and 12 months. Repeated measures ANOVA revealed treatment group women scored significantly higher on perceived susceptibility and calcium intake. Wilks's Lambda F revealed a significant difference in use of osteoporosis preventing medications. Personal knowledge gained from DXAs increased perceived susceptibility to osteoporosis, calcium intake, and use of osteoporosis preventing medications and appears to be an effective intervention in promoting OPB in younger postmenopausal women.

  15. Balance control in elderly people with osteoporosis.

    PubMed

    Hsu, Wei-Li; Chen, Chao-Yin; Tsauo, Jau-Yih; Yang, Rong-Sen

    2014-06-01

    Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population. Copyright © 2014. Published by Elsevier B.V.

  16. Older Men's Explanatory Model for Osteoporosis

    PubMed Central

    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 clinic. Men completed a questionnaire on demographic, medication, and fracture-related information, and descriptive statistics were calculated using Statistical Package for the Social Sciences. Interviews elicited the 5 domains of men’s explanatory model (Kleinman, 1987) and open-ended information regarding men’s experiences living with this disorder. Narrative data were analyzed both for content and inductively. Results: Men’s narratives demonstrate that an osteoporosis diagnosis is accompanied by negative psychosocial sequelae in this population. Men defined it as a disease of the bone that may increase the likelihood of fracture and that may cause pain. Participants reported that osteoporosis is diagnosed by bone mineral density (BMD) score and that disease progression is measured by a decrease in BMD and an increase in pain or new fractures. Men described a reluctance to take medications, dissatisfaction with side effects, and a perception that osteoporosis treatment in men had little basis in long-term medication efficacy or safety data. They viewed osteoporosis as a degenerative chronic disease with an overall stable course. Implications: Participants’ explanatory models for osteoporosis are substantively different than clinical models. These differences provide a foundation for exploring the importance of gender to osteoporosis outcomes, a context for making sense of men’s bone health behavior, and a clear case for an increase in advocacy and educational efforts for men who have or are at risk for osteoporosis. PMID:21310768

  17. Underuse of procedures for diagnosing osteoporosis and of therapies for osteoporosis in older nursing home residents.

    PubMed

    Gupta, Gayatri; Aronow, Wilbert S

    2003-01-01

    To investigate the prevalence of osteoporosis, the prevalence of utilization of bone mineral density (BMD) measurements for diagnosis of osteoporosis, and prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis in postmenopausal women in an academic nursing home. The charts of all women aged 56 years and older residing in an academic nursing home were analyzed by one of the authors for the prevalence of osteoporosis, the prevalence of use of BMD measurements to diagnose osteoporosis, and the prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis. Of 136 postmenopausal women, mean age 79 +/- 10 years, 66 (49%) had measurements of BMD. Of these 66 women, 31 (47%) had osteoporosis, 21 (32%) had osteopenia, and 14 (21%) had normal BMD. Elemental calcium carbonate 1500 mg daily was prescribed to 17 of 31 women (55%) with osteoporosis, to 12 of 21 women (57%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 27 of 70 women (39%) with no BMD obtained. Any dose of calcium was prescribed to 78 of 136 elderly women (58%). Vitamin D supplements were prescribed to 13 of 31 women (42%) with osteoporosis, to 9 of 21 women (43%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 20 of 70 women (29%) with no BMD obtained. Vitamin D supplements were prescribed to 44 of 136 elderly women (32%). Biphosphonates were prescribed to 19 of 31 women (61%) with osteoporosis. Of 20 women on medications that increased the risk of osteoporosis, 6 (30%) had BMD measured. Nine of these 20 women (45%) were on calcium supplements. Older postmenopausal women in an academic nursing home have a high prevalence of osteoporosis and osteopenia, a low prevalence of measurement of BMD, and underuse of calcium, vitamin D supplements, and other antiresorptive therapies for treatment of osteoporosis.

  18. Transient osteoporosis of the hip.

    PubMed

    Vernon, L F; Dooley, J C; Neidorf, D L

    1997-06-01

    Transient osteoporosis of the hip is an uncommon but probably underdiagnosed condition. There appears to be a predisposition for the condition in middle-aged males and in women in their third trimester of pregnancy. The etiology remains unclear, with theories that include vascular and neurologic disturbances. Clinical signs are usually pain in the hip area with functional disability of the affected limb. Plane film radiographs may be completely normal or show only minimal osteopenia. This report describes a 40-year-old male in whom transient osteoporosis of the hip was diagnosed. The patient's symptoms were initially interpreted as being due to sciatica; however, careful evaluation, further diagnostic work-up in the form of magnetic resonance imaging, and the clinical course of the disease ultimately led to the correct diagnosis. Resolution occurred gradually with non-steroidal anti-inflammatory drug therapy and rest. This case demonstrates the need for further evaluation of patients with hip-area pain who may have negative x-rays of the hip joint but continue to be symptomatic.

  19. Evaluation of osteoporosis using ultrasound

    NASA Astrophysics Data System (ADS)

    Maia, Joaquim M.; Costa, Eduardo T.; Nantes Button, Vera L. d. S.; Dantas, Ricardo G.

    2000-04-01

    We have developed an equipment using ultrasound transducers to help in the diagnosis of osteoporosis. The equipment consists of an X-Y axes displacement system controlled by a microcomputer and uses two ultrasound transducers in opposite sides to inspect the calcaneus region of the patient. We have used two pairs of transducers with 500 kHz and 1 MHz central frequencies. Each pair of transducers was fixed in the X-Y displacement system submerged in a small water tank with a support for the foot of the patient. The transmitter was excited with pulses of 400 - 600 kHz or 800 - 1200 kHz and the ultrasound waves propagating through the bone in the calcaneus region are received by the opposite transducer, amplified and acquired in a digital oscilloscope. The data are transferred to the microcomputer and the ultrasound attenuation and the ultrasound transmission velocity are determined. The system was tested in patients, selected from a group that had already been diagnosed using a DEXA equipment. The results showed that there is a decrease in the ultrasound transmission velocity and the ultrasound attenuation in osteoporotic patients when compared to healthy patients of the same sex and age group. The conclusion is that ultrasound attenuation and the transmission velocity in the calcaneus region may be used as parameters in the evaluation of osteoporosis using our new system.

  20. 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

  1. Osteoporosis: the role of micronutrients.

    PubMed

    Nieves, Jeri W

    2005-05-01

    Osteoporosis and low bone mass are currently estimated to be a major public health threat. Adequate nutrition plays a major role in the prevention and treatment of osteoporosis; the micronutrients of greatest importance are calcium and vitamin D. Calcium has been shown to have beneficial effects on bone mass at all ages, although the results are not always consistent. Higher doses than the current US recommendation (600 IU) of vitamin D in the elderly (age > or = 65 y) may actually be required for optimal bone health (800-1000 IU/d). The elderly can clearly benefit from increased vitamin D intakes; however, the potential importance of vitamin D in peak bone mass is just being investigated. Vitamin D has been related to falls, with supplementation reducing the number of falls. There are clear fracture benefits demonstrated in randomized clinical trials of calcium and vitamin D supplementation. The other micronutrient needs for optimizing bone health can be easily met by a healthy diet that is high in fruits and vegetables to ensure adequate intakes for magnesium, potassium, vitamin C, vitamin K, and other potentially important nutrients. Healthcare professionals need to be aware of the importance of adequate calcium and vitamin D intakes (easily monitored by serum 25(OH)D) for optimal bone health, as well as the prevention of falls and fractures. In addition, a healthy diet that includes 5 servings a day of fruits and vegetables should optimize the intake of micronutrients required for bone health.

  2. [Treatment of osteoporosis with Denosumab].

    PubMed

    Ferrari, Serge

    2012-03-01

    Denosumab is the first human monoclonal antibody for the treatment of osteoporosis. By inhibiting RANK Ligand, Denosumab prevents the development, activation and survival of osteoclasts. The FREEDOM study reported a 68 % reduction of vertebral fractures, 20 % of non-vertebral fractures and 40 % of hip fractures after 3 years in post-menopausal women with osteoporosis receiving denosumab 60 mg sc every six months vs. placebo. Five years extension of the denosumab group showed a further decrease in the rate of both vertebral and non-vertebral fractures, whereas BMD at spine and hip increased continuously. There was no increase in the rate of adverse events year after year, including of infections, cancer, atypical fractures, delayed fracture healing or ONJ. Clinical hypocalcemia was rare in the context of calcium and vitamin D supplementation. Pre-planned and post-hoc subgroup analyses have further shown the anti-fracture efficacy of denosumab in high-risk subgroups, such as older women and those with low T-scores and/or prevalent vertebral fractures. Denosumab withdrawal is accompanied by a transient rebound of bone turnover markers and a proportional BMD loss. Smaller randomized controlled studies have shown that denosumab further improves BMD after one year compared to alendronate.

  3. A STAR in the making

    NASA Astrophysics Data System (ADS)

    2017-05-01

    Entrepreneur Richard Dinan - a former star of the UK reality-TV programme Made in Chelsea - founded the firm Applied Fusion Systems in 2014. The company has now released its first blueprint for a spherical fusion tokamak.

  4. An overview and management of osteoporosis

    PubMed Central

    Sözen, Tümay; Özışık, Lale; Başaran, Nursel Çalık

    2017-01-01

    Osteoporosis -related to various factors including menopause and aging- is the most common chronic metabolic bone disease, which is characterized by increased bone fragility. Although it is seen in all age groups, gender, and races, it is more common in Caucasians (white race), older people, and women. With an aging population and longer life span, osteoporosis is increasingly becoming a global epidemic. Currently, it has been estimated that more than 200 million people are suffering from osteoporosis. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime. Every fracture is a sign of another impending one. Osteoporosis has no clinical manifestations until there is a fracture. Fractures cause important morbidity; in men, in particular, they can cause mortality. Moreover, osteoporosis results in a decreased quality of life, increased disability-adjusted life span, and big financial burden to health insurance systems of countries that are responsible for the care of such patients. With an early diagnosis of this disease before fractures occur and by assessing the bone mineral density and with early treatment, osteoporosis can be prevented. Therefore, increasing awareness among doctors, which, in turn, facilitates increase awareness of the normal populace, will be effective in preventing this epidemic. PMID:28293453

  5. An overview and management of osteoporosis.

    PubMed

    Sözen, Tümay; Özışık, Lale; Başaran, Nursel Çalık

    2017-03-01

    Osteoporosis -related to various factors including menopause and aging- is the most common chronic metabolic bone disease, which is characterized by increased bone fragility. Although it is seen in all age groups, gender, and races, it is more common in Caucasians (white race), older people, and women. With an aging population and longer life span, osteoporosis is increasingly becoming a global epidemic. Currently, it has been estimated that more than 200 million people are suffering from osteoporosis. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime. Every fracture is a sign of another impending one. Osteoporosis has no clinical manifestations until there is a fracture. Fractures cause important morbidity; in men, in particular, they can cause mortality. Moreover, osteoporosis results in a decreased quality of life, increased disability-adjusted life span, and big financial burden to health insurance systems of countries that are responsible for the care of such patients. With an early diagnosis of this disease before fractures occur and by assessing the bone mineral density and with early treatment, osteoporosis can be prevented. Therefore, increasing awareness among doctors, which, in turn, facilitates increase awareness of the normal populace, will be effective in preventing this epidemic.

  6. Strontium ranelate for the management of osteoporosis.

    PubMed

    Lam, Sum; Zouzias, Katerina

    2008-07-01

    To evaluate the role of strontium ranelate in the management of osteoporosis. A MEDLINE (January 1966 to May 2007) search using the terms osteoporosis, strontium ranelate, bonemineral density, and fractures. All English-language articles identified from the data sources were evaluated. Strontium ranelate stimulates bone formation and inhibits bone resorption. Its safety and efficacy for osteoporosis were evaluated in four prospective, randomized, double-blind, placebo-controlled trials. The PREVOS (Prevention of Early Postmenopausal Bone Loss by Strontium Ranelate) trial suggested that 1 g daily is the optimal dose for preventing postmenopausal bone loss and was associated with a 1.41% increase in lumbar bone-mineral density (BMD). However, the STRATOS (Strontium Administration for Treatment of Osteoporosis) study found that a 1 g daily regimen was associated with a higher incidence of new vertebral deformities, and a 2 g daily regimen reduced lumbar BMD by 3% in postmenopausal, osteoporotic women. The SOTI (Spinal Osteoporosis Therapeutic Intervention) and TROPOS (Treatment of Peripheral Osteoporosis) studies suggested that a 2 g daily regimen reduced vertebral fractures by 39% to 41%, nonvertebral fractures by 16%, in postmenopausal, osteoporotic women. Most common adverse events reported were nausea and diarrhea. Four clinical trials demonstrated the efficacy and safety of strontium ranelate for the management of postmenopausal osteoporosis; however, the Food and Drug Administration has not approved it for this indication.

  7. Causes, mechanisms and management of paediatric osteoporosis.

    PubMed

    Mäkitie, Outi

    2013-08-01

    Osteoporosis, a skeletal disorder characterized by compromised bone strength and an increased risk of fractures, is an important paediatric disorder that involves almost all paediatric subspecialties. Osteogenesis imperfecta is the most common form of childhood-onset primary osteoporosis, but several other forms are also known. Secondary osteoporosis is caused by an underlying chronic illness or its treatment. The most common causes of secondary osteoporosis include chronic systemic inflammation, glucocorticoid use and neuromuscular disabilities. The skeletal sequelae can present in childhood as low-energy peripheral and vertebral fractures, or become evident in adulthood as low bone mass and an increased propensity to develop osteoporosis. Management should aim at prevention, as interventions to treat symptomatic osteoporosis in the paediatric age group are scarce. Bisphosphonates are the principal pharmacological agents that can be used in this setting, but data on their efficacy and safety in paediatric populations remain inadequate, especially in patients with secondary osteoporosis. Consequently, it is important to understand the potential skeletal effects of paediatric illnesses and their therapies in order to institute effective and timely prevention of skeletal complications.

  8. Recognition and treatment of postmenopausal osteoporosis.

    PubMed

    Hannafon, Freda; Cadogan, Mary P

    2014-03-01

    Osteoporosis is a common but often silent condition among older adults. The characteristic pathological changes associated with osteoporosis may go unnoticed until a fracture occurs or a bone density test is performed. Although osteoporosis occurs in men and among premenopausal women, it is most prevalent among postmenopausal women who are the focus of this article. Within the subpopulation of postmenopausal women, there are major differences in risk status, disease severity, and response to treatment. Two individual examples are presented to highlight these differences and to illustrate appropriate assessment and treatment strategies in each scenario. In addition, general nonpharmacological recommendations for postmenopausal women across risk status and disease severity are presented.

  9. Osteoporosis: screening and treatment in women.

    PubMed

    Pollycove, Ricki; Simon, James A

    2012-09-01

    Osteoporosis is frequently called the silent disease because it lacks symptoms or signs until a fracture has occurred. Osteoporosis is common in aging women because of progressive postmenopausal bone loss. Fractures related to bone loss can result in reduced quality of life, lengthy hospital stays, long-term institutionalization, and death. Early diagnosis and treatment of low bone mass to reduce fracture risk is a cost-effective element of routine health care for women. With appropriate patient screening, ObGyn care providers can implement effective interventions before fractures occur, thereby improving patients' quality of life and reducing society's osteoporosis-related costs.

  10. Osteoporosis: identifying high-risk persons.

    PubMed

    McMahon, M A; Peterson, C; Schilke, J

    1992-10-01

    Osteoporosis is the most common systemic bone disorder causing thousands of injuries and deaths each year. The pathogenesis of osteoporosis is a complex puzzle that contains many interlocking pieces involving both genetic and environmental factors. The prevention of age-related bone loss, which could be gained through health teaching by the nurse, should be optimized. Nurses and other caregivers can make significant contributions toward the initial identification of those persons at risk or who may already have the debilitating disease by using the Osteoporosis Risk Questionnaire.

  11. [Evidence of dietary therapy for osteoporosis].

    PubMed

    Uenishi, Kazuhiro

    2008-10-01

    A significant point of dietary therapy for osteoporosis is that calcium, vitamin D and vitamin K are recommended to be actively administered on top of sufficient intake of energy and the other nutrients including protein. In Japanese guidelines for the prevention and treatment of osteoporosis 2006 edition, daily intake of calcium and vitamin D is encouraged at least 800mg and 400 to 800IU (10 to 20microg) , respectively. Calcium and vitamin D are also important for maximizing the effect of drug for osteoporosis. Calcium and vitamin D supplementation could be a supportive measure, when their necessary requirement is difficult to be consumed.

  12. Bisphosphonate therapy in children with secondary osteoporosis.

    PubMed

    Papapoulos, Socrates E

    2011-01-01

    Increased bone fragility requiring effective treatments is a complication of various chronic conditions in children. Bisphosphonates, highly effective in the treatment of adults with osteoporosis, have also been used in children with secondary osteoporosis. However, results obtained in adults cannot be readily extrapolated to children due to differences in the pathophysiology and progression of the disease as well as in the pharmacokinetics of bisphosphonates. Available results of studies of bisphosphonates in children with secondary osteoporosis do not yet support their recommendation as standard therapy. Their use should be restricted to patients with fragility fractures and low bone mass. Copyright © 2011 S. Karger AG, Basel.

  13. [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.

  14. Osteoporosis

    MedlinePlus

    ... in your skin when it is exposed to sunlight. You need 10 to 15 minutes of sunlight to the hands, arms, and face, two to ... your doctor or nurse about the risks and benefits of medicines for bone loss. Return to top ...

  15. Estrogen therapy for postmenopausal osteoporosis.

    PubMed

    Fitzpatrick, Lorraine A

    2006-08-01

    Osteoporosis is a worldwide problem that results in fractures that lead to disability and high costs to society. Estrogen therapy is frequently utilized for postmenopausal symptoms, but also has proven protective effects on the skeleton. The main action of estrogen at the cellular level is to inhibit the osteoclast by increasing levels of osteoprotegerin (OPG). OPG binds to the receptor activator of NFkB and prevents osteoclast differentiation, activity and survival. Numerous trials have demonstrated the positive effect estrogen has on the improvement of bone mineral density, and lower doses have also proven efficacious with fewer side effects. Both observational and randomized clinical trials have demonstrated the ability of estrogen treatment to prevent fractures. Topics that remain controversial include the appropriate length of estrogen treatment for postmenopausal women and the appropriate follow-up after treatment discontinuation.

  16. [Osteoporosis and the thalassemia "trait"].

    PubMed

    Orzincolo, C; Castaldi, G; Scutellari, P N; Vita, F; Bagni, B

    1993-01-01

    The authors evaluated the prevalence of the thalassemia trait in a general population affected with femoral neck fractures. Our research was aimed at assessing whether hemoglobinopathy might affect osteoporosis, which is responsible for femoral fractures. Two hundred and thirty-eight patients admitted to St. Anna Hospital, Ferrara, for proximal femoral fractures, were retrospectively studied. The patients were 68 males and 170 females, aged 58 to 83 years (mean age: 70.4 years). The thalassemia trait was seen in 11.76% of cases, versus in 7-8% of the general population. The high prevalence of heterozygous beta-thalassemic subjects probably means that the beta-thalassemia condition is a further "variable" which is responsible for the more frequent occurrence of fractures of the proximal femur and is certainly related to an osteopenic condition much more severe than usual.

  17. 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.

  18. Validation of the male osteoporosis knowledge quiz.

    PubMed

    Gaines, Jean M; Marx, Katherine A; Narrett, Matthew; Caudill, JoAnn; Landsman, Jeffrey; Parrish, John M

    2011-01-01

    The purpose of this study was to validate the six-item Men's Osteoporosis Knowledge Quiz (MOKQ). The MOKQ asks questions about risk factors that are pertinent to men, such as the risk for developing low bone mass related to hormone treatment for prostate cancer and the importance of testosterone for bone mass. A survey was sent to 242 men with a mean age of 83.2 years. The mean number of questions answered correctly in response to the six-item MOKQ was 2.37. Convergent validity was examined by correlating the score achieved on the MOKQ with the score achieved on the total Facts on Osteoporosis Quiz. The Pearson correlation coefficient for the MOKQ and the Facts on Osteoporosis Quiz was r = .76. Reliability was demonstrated by computing a Cronbach's alpha for the MOKQ (r = .72). The MOKQ was found to have adequate reliability and validity in assessing older men's knowledge about osteoporosis.

  19. The burden of osteoporosis in Brazil.

    PubMed

    Marinho, Bruna Coelho Galvão; Guerra, Luiza Paulino; Drummond, Juliana Beaudette; Silva, Barbara C; Soares, Maria Marta Sarquis

    2014-07-01

    Osteoporotic fractures impose severe physical, psychosocial, and financial burden both to the patient and the society. Studies on the prevalence of osteoporosis and fragility fractures in Brazil show a wide variation, due to differences in sample size, the population studied, and methodologies. Few studies have been conducted in Brazil about the cost-effectiveness analyses of different intervention options aimed at the diagnosis and treatment of osteoporosis. Investigation and treatment strategies based on cost-effectiveness and scientific evidence are essential in the preparation of public health policies with the ultimate goal of reducing the incidence of fractures and, consequently, the direct and indirect costs associated with them. This article reviews the Brazilian burden of osteoporosis in terms of the prevalence and fractures attributable to the disease, the costs related to the investigation and management, as well as the impact of osteoporosis on the population as a whole and on affected individuals.

  20. Prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Lewiecki, E Michael

    2008-06-01

    Osteoporosis is a common skeletal disease characterized by reduced bone strength and increased risk for fractures. Fragility fractures are associated with serious clinical consequences, including chronic pain, skeletal deformities, loss of independence, and increased mortality. Although osteoporosis is underdiagnosed and undertreated, many who are treated take medication incorrectly or do not continue it long enough to benefit. Measures to prevent osteoporosis include a healthy lifestyle, with regular physical activity, adequate intake of calcium and vitamin D, and avoidance of cigarette smoking and excess alcohol. Patients at risk for osteoporosis can be diagnosed with a simple bone density test before the first fracture occurs. Pharmacologic agents for patients at high risk for fracture can reduce the burden of osteoporotic fractures.

  1. Osteoporosis in Children with Chronic Disease.

    PubMed

    Högler, Wolfgang; Ward, Leanne

    2015-01-01

    Serious illness in children and its therapy can cause osteoporosis, manifesting as vertebral and nonvertebral fractures, pain, skeletal deformity and temporary or even permanent loss of ambulation. In contrast to adults, skeletal growth in children offers tremendous potential to recover bone mineral density and to reshape fractured vertebral bodies, even without bone-targeted therapy, provided that bone health threats are transient and residual growth is sufficient. Here, we outline the principles of bone strength development and the risk factors for osteoporosis due to various paediatric systemic illnesses. We also explain why the approach to the diagnosis and monitoring of childhood osteoporosis has moved away from a bone density-centric focus to a more functional assessment. Finally, we discuss the best candidates for and current approaches to the treatment of osteoporosis in children. © 2015 S. Karger AG, Basel.

  2. New horizons in treatment of osteoporosis.

    PubMed

    Tabatabaei-Malazy, Ozra; Salari, Pooneh; Khashayar, Patricia; Larijani, Bagher

    2017-02-07

    Prevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects. This review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines. As well, the effect of combination therapy and recommendations for future research will be further discussed. The use of current antiresorptive and anabolic agents alone or in combinations for the treatment of osteoporosis entails several limitations. Mainly, their efficacy on non-vertebral fracture reduction is lower than that observed on vertebral fracture. In addition, they have potential adverse events on long time usage. Development of newer agents such as cathepsin k inhibitor and strontium ranelate not only have increased the available options for treating osteoporosis, but also have opened doors of opportunity to improvements in the effective treatment. However, the high cost of new agents have restricted their usage in selective patients who are at high risk of fracture or whom failed response to first line treatment options. Thus, personalized medicine should be considered for future evaluation of genetic risk score and also for environmental exposure assessment. In addition to permanent attention to early diagnosis of osteoporosis and understanding of the pathophysiology of osteoporosis for novel approach in drug discovery, there seems a need to more well-designed clinical

  3. Treatment of primary osteoporosis in men

    PubMed Central

    Giusti, Andrea; Bianchi, Gerolamo

    2015-01-01

    With the aging of the population worldwide, osteoporosis and osteoporotic fractures are becoming a serious health care issue in the Western world. Although less frequent than in women, osteoporosis in men is a relatively common problem. Hip and vertebral fractures are particularly relevant, being associated with significant mortality and disability. Since bone loss and fragility fractures in men have been recognized as serious medical conditions, several randomized controlled trials (RCTs) have been undertaken in males with osteoporosis to investigate the anti-fracture efficacy of the pharmacological agents commonly used to treat postmenopausal osteoporosis. Overall, treatments 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. However, the key question is whether men are expected to respond differently to osteoporosis therapies than women. The pharmacological properties of bisphosphonates, teriparatide, denosumab, and strontium ranelate make such differentiation unlikely, and available clinical data support their efficacy in men with primary osteoporosis as well as in women. 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, denosumab, and strontium ranelate 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, teriparatide, and strontium ranelate on surrogate outcomes (BMD and markers of bone turnover

  4. 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…

  5. 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…

  6. 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

  7. Osteoporosis and its implications for dental patients.

    PubMed

    Edwards, Beatrice J; Migliorati, Cesar A

    2008-05-01

    Osteoporosis is a common disease in middle-aged and older Americans. The risk of sustaining fractures is a concern, and mortality rates after hip or vertebral fractures are high. Oral health maintenance for adults with osteoporosis is important. The authors conducted a MEDLINE search of the medical and dental literature with the objective of reviewing osteoporosis, its effect on public health in the population in the United States and the implications in providing dental care for these patients. They selected studies by performing a content search with National Library of Medicine medical subject headings (epidemiology, public health impact, treatment, adverse drug reactions, cost-effectiveness of osteoporosis therapy, oral health, periodontal disease, adverse drug reactions, bisphosphonates and osteonecrosis of the jaw). They then performed a study design search with a filter so that only randomized clinical trials were included. Osteoporosis and related fractures are more common than coronary disease, stroke and breast cancer. Fractures resulting from osteoporosis can affect a patient's quality of life severely, and fractures result in functional impairment and increased health care cost and mortality. Medical management of osteoporosis includes diet control, with appropriate intake of calcium and vitamin D, weight-bearing exercise, discontinuation of tobacco and alcohol intake, and use of medications, including selective estrogen receptor modulators, calcitonin, anabolic agents and bisphosphonates. Bisphosphonates have been associated with the development of osteonecrosis of the jaws. Oral health maintenance is important in patients with osteoporosis. Bisphosphonate therapy or other medical treatment for these people should be discontinued only after consultation with the patient's physician.

  8. [Osteoporosis--current diagnostics and therapy].

    PubMed

    Pfeilschifter, Johannes

    2009-08-01

    Osteoporotic fractures are a frequent cause of disability and a loss of quality of life in old age. Maintenance of muscle function and balance, a daily calcium intake of 1,000 mg, sufficient vitamin D, and a prudent use of fall- and osteoporosis-associated drugs are key components of fracture prevention. The German guideline recommends to initiate a specific long-term osteoporosis medication in individuals with a 30% 10-year risk for hip fractures and vertebral fractures.

  9. Osteoporosis and osteoarthritis: shared mechanisms and epidemiology.

    PubMed

    Geusens, Piet P; van den Bergh, Joop P

    2016-03-01

    Osteoporosis and osteoarthritis are different diseases, with differences in risk factors, bone mineral density (BMD), BMI, phenotype, morbidity and mortality. We review new data on the role of bone metabolism in osteoporosis and osteoarthritis. The insights in the common convergent and divergent risk factors between osteoarthritis and osteoporosis have resulted in new findings on the role of BMD, BMI, falls, genetics and epigenetics in the pathophysiology of both diseases and on the increased fracture risk in osteoporosis and osteoarthritis. The relation between BMD, BMI and fracture risk in osteoarthritis is dependent on the stage, definition and location of the osteoarthritis and method of BMD measurement. It has been suggested that osteoarthritis should be further specified in terms of bone involvement. These new findings open the way to better understand the bone subtypes of osteoarthritis (osteoporotic, bone forming and erosive) and the common and different ways bone is involved in osteoporosis and osteoarthritis. Much can be expected from further prospective studies, when taking into account the heterogeneous nature of both osteoporosis and osteoarthritis.

  10. [Idiopathic and secondary osteoporosis in childhood].

    PubMed

    Rossi, F; Perrotta, S; Falcone, E; Gimigliano, F; Iodice, M; Vetrella, S; Iolascon, G

    2005-10-01

    Osteoporosis is a common disease characterized by reduced bone mass, with a consequent increase in bone fragility and susceptibility to fracture risk. Bone mineral density (BMD) measurement is used to make the diagnosis of osteoporosis prior to incident fracture, and to predict fracture risk. BMD is determined by the peak bone mass achieved, and the rate and timing of subsequent bone loss. Dual-energy X-ray absorptiometry (DEXA) is the most popular and effective method utilized for osteoporosis screening. Bone disease is a side effect of concern regarding chronic glucocorticoid (GC) administration. Most GC-treated patients exhibit a process of bone loss, frequently leading to osteoporosis, with increased fracture risk, especially in spinal vertebrae. Osteogenesis imperfecta is an inherited and generalized connective tissue disorder characterized mainly by bone fragility. Idiopathic osteoporosis of childhood or adolescence without blue sclerae and other stigmata of osteogenesis imperfecta is occasionally observed and sometimes more than one sib is affected. Beta-thalassemia major is associated with significant bone disease. The etiology of the bone disease is still debatable, many factors can adversely affect bone accretion in thalassemic patients. These include delayed puberty, bone marrow expansion, the deleterious effects of desferrioxamine, iron overload and genetic factors. Current treatment alternatives of osteoporosis include bisphosphonates, calcitonin, and selective estrogen receptor modulators.

  11. Renal Osteodystrophy or Kidney-Induced Osteoporosis?

    PubMed

    Moe, Sharon M

    2017-06-01

    Chronic kidney disease (CKD) affects nearly 10% of the population. The incidence of fractures in population studies demonstrate an increase with worsening stages of kidney disease suggesting specific CKD related causes of fracture. The increase in fractures with CKD most likely represents disordered bone quality due to the abnormal bone remodeling from renal osteodystrophy. There is also an increase in fractures with age in patients with CKD, suggesting that patients with CKD also have many fracture risk factors common to patients without known CKD. Osteoporosis is defined by the National Institutes of Health as "A skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Bone strength reflects the integration of two main features: bone quantity and bone quality." Thus, CKD-related fractures can be considered a type of osteoporosis-where the bone quality is additionally impaired above that of age/hormonal-related osteoporosis. Perhaps using the term CKD-induced osteoporosis, similar to steroid-induced osteoporosis, will allow patients with CKD to be studied in trials investigating therapeutic agents. In this series, we will examine how CKD-induced osteoporosis may be diagnosed and treated.

  12. Relationship between adolescent amenorrhea and climacteric osteoporosis.

    PubMed

    Csermely, Tamás; Halvax, László; Vizer, Miklós; Drozgyik, István; Tamás, Péter; Göcze, Péter; Szabó, István; Jeges, Sára; Szilágyi, András

    2007-04-20

    The relationship between climacteric osteoporosis and disturbances in menstrual cycle during adolescence was examined. Seven hundred and seventy-one questionnaires were shared out among women visiting the outpatient department for climacteric complaints for the first time between 2001 and 2004. Questions revealed the age, age at menarche and menopause, the regularity or irregularity of menstrual cycle during adolescence and adult ages. The bone mineral density was examined using the Dual Energy X-ray Absorptiometry (DEXA) method on the lumbar spine. Six hundred and thirty-five of the 771 questionnaires were suitable for analysis. Osteoporosis was observed in 30.1% of the cases. Age, age at the menarche or at the menopause did not alter in the subgroups with or without osteoporosis. The incidence and severity of osteoporosis were significantly higher in patients reporting secondary amenorrhea during adolescent ages (42.1%; average BMD of the lumbar spine 71.6+/-3.9), as compared to the patients with normal cycle (30.4%; average BMD of the lumbar spine 84.8+/-7.8). No correlation between the occurrence of osteoporosis and the frequency of menstrual cycle during adulthood was observed. Secondary amenorrhea during the years of adolescence might play a role in the development of more severe osteoporosis in menopause.

  13. Osteoporosis in elderly: prevention and treatment.

    PubMed

    Srivastava, Manish; Deal, Chad

    2002-08-01

    Osteoporosis is a major clinical problem in older women and men. Almost any bone can fracture as a result of the increased bone fragility of osteoporosis. These fractures are associated with higher health care costs, physical disability, impaired quality of life, and increased mortality. Because the incidence of osteoporotic fracture increases with advancing age, measures to diagnose and prevent osteoporosis and its complications assume a major public health concern. BMD is a valuable tool to identify patients at risk for fracture, to make therapeutic decisions, and to monitor therapy. Several other modifiable and nonmodifiable risk factors for osteoporosis have also been identified. Treatment of potentially modifiable risk factors along with exercise and calcium and vitamin D supplementation forms an important adjunct to pharmacologic management of osteoporosis. Improved household safety can reduce the risk of falls. Hip protectors have been found to be effective in nursing home population. The pharmacologic options include bisphosphonates, HRT, SERMs and calcitonin. PTH had received FDA advisory committee approval. Alendronate has been approved for treatment of osteoporosis in men, and other treatments for men are under evaluation.

  14. Managing elderly people's osteoporosis. Why? Who? How?

    PubMed Central

    Juby, A.

    1999-01-01

    OBJECTIVE: To guide family physicians through assessment of why treating elderly people's osteoporosis is necessary, who to treat, and how to treat in a practical way. QUALITY OF EVIDENCE: Evidence of the efficacy of treatment for osteoporosis is shown by a reduced probability of fracture. This can be ascertained by direct evaluation for bisphosphonates, calcium, and calcitonin, or indirectly by ascertaining benefit to bone mineral density for hormone replacement therapy (HRT) and exercise. MAIN MESSAGE: Unless medically contraindicated, all elderly people should take supplementary vitamin D (800 IU/d) and calcium (1500 mg/d). Those with risk factors for osteoporosis (e.g., smoking, thinness, previous fracture when older than 50 years, fracture in first-degree relatives older than 50 years, and steroid use) should have a bone density measurement. Those meeting World Health Organization criteria for osteoporosis should also be treated with HRT or bisphosphonates or possibly with selective estrogen receptor modulators. CONCLUSIONS: Good evidence indicates that adequate treatment of osteoporosis can prevent fractures and thus reduce associated morbidity and mortality among vulnerable elderly people. Because of the prevalence of osteoporosis, the onus falls on family physicians to be the front-line managers. PMID:10386218

  15. Osteoporosis in patients with inflammatory bowel disease.

    PubMed Central

    Compston, J E; Judd, D; Crawley, E O; Evans, W D; Evans, C; Church, H A; Reid, E M; Rhodes, J

    1987-01-01

    Bone mineral content in spinal trabecular and peripheral cortical bone was measured in 75 unselected patients with small and/or large intestinal inflammatory bowel disease. Osteoporosis, defined as a bone mineral content greater than 2 SD below the age and sex matched normal mean value was present in 23 patients (30.6%). Three amenorrhoeic females aged 34, 38, and 42 years had severe clinical osteoporosis and a further three patients had one or more vertebral crush fractures. Eighteen of the 23 patients with osteoporosis had small intestinal disease with one or more resections and the mean lifetime steroid dose in those with osteoporosis was significantly higher than in those with normal bone mineral content. Bone mineral content in spinal trabecular bone showed significant negative correlations with lifetime steroid dose and serum alkaline phosphatase and a significant positive correlation with serum albumin. Peripheral cortical bone mineral content was positively correlated with body weight, height and body mass index. We conclude that the prevalence of osteoporosis is increased in patients with inflammatory bowel disease, severe clinical osteoporosis developing in some relatively young patients. The pathogenesis of this bone loss is probably multifactorial; steroid therapy is likely to be an important contributory factor. PMID:3583068

  16. Non-response to osteoporosis treatment.

    PubMed

    Francis, Roger M

    2004-06-01

    There are now a number of effective treatments for osteoporosis, which increase bone mineral density (BMD) and decrease the risk of fractures. There is no clear consensus on the optimal method for assessing response to treatment in the individual patient. The goal of osteoporosis treatment is to prevent fractures after minimal trauma, but these are relatively uncommon events and cannot be totally avoided by the use of currently available therapies. Alternative methods of assessing response to treatment include serial measurement of BMD or the biochemical markers of bone turnover, but the observed changes may be misleading if they do not exceed the least significant change. The proportion of patients who fail to respond to osteoporosis treatments is difficult to quantify. Clinical trials show continuing bone loss in up to 15% of participants on hormone replacement therapy or bisphosphonates. Non-response to treatment is probably more common in clinical practice, but may be due to poor adherence to treatment recommendations. Other potential causes of an apparent failure to respond to treatment include the use of a weak antiresorptive agent, differences in bioavailability, low dietary calcium intake, vitamin D insufficiency and underlying causes of secondary osteoporosis. The management of patients who fail to respond to treatment includes confirmation that they are adhering to treatment and have an adequate dietary calcium intake and vitamin D status and excluding causes of secondary osteoporosis. Consideration should also be given to the addition of calcium and vitamin D supplementation and the use of alternative treatments for osteoporosis.

  17. Neutron star evolutionary sequences

    NASA Technical Reports Server (NTRS)

    Richardson, M. B.; Van Horn, H. M.; Ratcliff, K. F.; Malone, R. C.

    1982-01-01

    Detailed numerical calculations which are solutions of the full set of general relativistic equations describing the evolution of a spherical star are presented, for the case of the evolution of neutron stars that are cooling over the central temperatures range of 10 to the 10th to 10 to the 7th K. The effects of nucleon superfluidity in the inner crust and core are included, and models are constructed with and without a pion condensate at high densities. It is found that the localized neutrino cooling which dominates the early evolution of neutron stars is so rapid that heat transport within the star cannot keep pace, and temperature distribution is not isothermal. The residual contraction of the neutron star during the early cooling phase contributes little to the heat budget of the star, and most of the gravitational energy released raises the Fermi energy of the degenerate nucleons. It is concluded that since calculations with and without pion condensate are consistent with the upper limits of current observations, these are not sufficient in distinguishing between the various models of neutron star cooling.

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

    MedlinePlus

    ... your browser. Home Osteoporosis Women Bone Health and Osteoporosis: A Guide for Asian Women Aged 50 and ... and anticonvulsants history of anorexia nervosa. What Is Osteoporosis? Osteoporosis is a disease that makes bones fragile ...

  19. Characterization of a novel light-cured star-shape poly(acrylic acid)-composed glass-ionomer cement: fluoride release, water sorption, shrinkage, and hygroscopic expansion.

    PubMed

    Zhao, Jun; Platt, Jeffrey A; Xie, Dong

    2009-12-01

    This study evaluated the fluoride release, water sorption, curing shrinkage, and hygroscopic expansion of a novel experimental light-cured glass-ionomer cement. The effects of glycidyl methacrylate (GM) grafting, polymer : water (P : W) and powder : liquid (P : L) ratios were investigated. Commercial Fuji II and Fuji II LC cements were used as controls for comparison. All the specimens were conditioned in deionized water at 37 degrees C before testing. The results demonstrated that the experimental cement showed lower burst and slower bulk fluoride release than Fuji II and Fuji II LC. The experimental cement absorbed more water than Fuji II and Fuji II LC as a result of its hydroxyl and carboxyl functional group content. The lower water-diffusion rate and reduced hygroscopic expansion of the experimental cement suggest that it had a highly crosslinked network. Both Fuji II and Fuji II LC exhibited much higher shrinkage values (2.8% and 4.7%) than the experimental cement (0.8%). It appears that this novel cement will be a clinically attractive dental restorative because not only has it shown superior mechanical strength, it has also demonstrated satisfactory physical properties.

  20. 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.

  1. Pharmacological management of severe postmenopausal osteoporosis.

    PubMed

    Gaudio, Agostino; Morabito, Nancy

    2005-01-01

    The most devastating consequence of osteoporosis is bone fracture, particularly at the vertebral or femoral level. As defined by the WHO, patients with osteoporosis who have had one or more fragility fractures have severe osteoporosis. Those who sustain a vertebral fracture represent a particularly vulnerable group whose risk of another vertebral fracture within the following year is increased by a factor of 3-5. In addition, the presence of a vertebral fracture is associated with an increased risk of hip fracture. In light of these data, treatment of established osteoporosis is extremely important to prevent other fragility fractures. This review examines the therapies approved by the US FDA for the treatment of osteoporosis that have been shown to reduce the incidence of new fractures in patients with established osteoporosis. We evaluated the mechanisms of action, available formulations, efficacy in preventing fractures and increasing bone mineral density (BMD), duration of treatment, adverse effects and contraindications to use of alendronic acid (alendronate), risedronic acid (risedronate), calcitonin, raloxifene and teriparatide. All these drugs are able to prevent new vertebral fractures in patients with established osteoporosis. Only alendronic acid and risedronic acid have also been shown to reduce the risk of fracture at the femoral level, but they are contraindicated in patients with upper gastrointestinal diseases. Calcitonin is a good option in subjects with back pain because of its analgesic effect. Raloxifene is useful when patients have high plasma lipid levels or a family history of breast cancer. Teriparatide is indicated in subjects with very low BMD and multiple vertebral fractures. Patient characteristics should determine selection of therapy but the decision is always difficult and fraught with uncertainty.

  2. 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.

  3. New anabolic therapies for osteoporosis.

    PubMed

    Minisola, Salvatore; Cipriani, Cristiana; Occhiuto, Marco; Pepe, Jessica

    2017-08-05

    Osteoporosis is characterized by low bone mass and qualitative structural abnormalities of bone tissue, leading to increased bone fragility that results in fractures. Pharmacological therapy is aimed at decreasing the risk of fracture, mainly correcting the imbalance between bone resorption and formation at the level of bone remodeling units. Anabolic therapy has the capability to increase bone mass to a greater extent than traditional antiresorptive agents. The only currently available drug licensed is parathyroid hormone 1-34 (teriparatide); new drugs are on the horizon, targeting the stimulation of bone formation, and therefore improving bone mass, structure and ultimately skeletal strength. These are represented by abaloparatide (a 34-amino acid peptide which incorporates critical N-terminal residues, shared by parathyroid hormone and parathyroid hormone-related protein, followed by sequences unique to the latter protein) and romosozumab (an antibody to sclerostin). In the future, the availability of new anabolic treatment will allow a more extensive utilization of additive and sequential approach, with the goal of both prolonging the period of treatment and, more importantly, avoiding the side effects consequent to long-term use of traditional drugs.

  4. How Long Should You Take Certain Osteoporosis Drugs?

    MedlinePlus

    ... Consumer Updates How Long Should You Take Certain Osteoporosis Drugs? Share Tweet Linkedin Pin it More sharing ... put both men and women at risk for osteoporosis, including age, race, family history, and a sedentary ...

  5. Side Effects of HIV Medicines: HIV and Osteoporosis

    MedlinePlus

    ... osteoporosis is often a broken bone. A bone mineral density test is used to measure bone strength ... above the age of 65 have a bone mineral density test to screen for osteoporosis. Women who ...

  6. 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.

  7. Osteoporosis prevention, screening, and treatment: a review.

    PubMed

    Kling, Juliana M; Clarke, Bart L; Sandhu, Nicole P

    2014-07-01

    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.

  8. Cross sectional study of osteoporosis among women.

    PubMed

    Agrawal, Tripti; Verma, A K

    2013-04-01

    Osteoporosis is a major public health problem, associated with substantial morbidity and socio-economic burden. An early detection can help in reducing the fracture rates and overall socio-economic burden. The present study was carried out to screen the bone status (osteopenia and osteoporosis) above the age of 35 yrs in the women. A community based cross sectional study was carried out in 158 women by calculating WHO T-scores utilizing calcaneal QUS as diagnostic tool. The prevalence of osteoporosis and osteopenia was found to be 13.3% ± 5.29% and 48.1% ± 7.79% respectively. Statistical association of prevalence of osteopenia and osteoporosis was found to be significant with age group; gravida status; attainment of menopause; body weight and physically active status of the women. The statistical association was not significant in relation to the rank status of their husband, as well as dietary pattern of the women but still it has to be substantiated by conducting larger community based trials in future. The present study found that there was statistically significant relationship between age group and the prevalence of osteopenia and osteoporosis. There was a negative correlation between age of the women and BMD. Besides age, gravida status and menopausal status have negative correlation with BMD while positive correlation with physically active lifestyle. The results were found to be non-significant in relation to rank status of husband and dietary pattern.

  9. Modern Rehabilitation in Osteoporosis, Falls, and Fractures

    PubMed Central

    Dionyssiotis, Yannis; Skarantavos, Grigorios; Papagelopoulos, Panayiotis

    2014-01-01

    In prevention and management of osteoporosis, modern rehabilitation should focus on how to increase muscular and bone strength. Resistance exercises are beneficial for muscle and bone strength, and weight-bearing exercises help maintain fitness and bone mass. In subjects at higher risk for osteoporotic fractures, particular attention should be paid to improving balance – the most important element in falls prevention. Given the close interaction between osteoporosis and falls, prevention of fractures should be based on factors related to bone strength and risk factors for falls. Fractures are the most serious complication of osteoporosis and may be prevented. The use of modern spinal orthosis helps to reduce pain and improve posture. Vibration platforms are used in rehabilitation of osteoporosis, based on the concept that noninvasive, short-duration, mechanical stimulation could have an impact on osteoporosis risk. Pharmacologic therapy should be added for those at high risk of fracture, and vitamin D/calcium supplementation is essential in all prevention strategies. Success of rehabilitation in osteoporotic and fractured subjects through an individualized educational approach optimizes function to the highest level of independence while improving the overall quality of life. PMID:24963273

  10. 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

  11. 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

  12. Vitamin K₂ therapy for postmenopausal osteoporosis.

    PubMed

    Iwamoto, Jun

    2014-05-16

    Vitamin K may play an important role in the prevention of fractures in postmenopausal women with osteoporosis. Menatetrenone is the brand name of a synthetic vitamin K2 that is chemically identical to menaquinone-4. The present review study aimed to clarify the effect of menatetrenone on the skeleton in postmenopausal women with osteoporosis, by reviewing the results of randomized controlled trials (RCTs) in the literature. RCTs that investigated the effect of menatetrenone on bone mineral density (BMD), measured by dual-energy X-ray absorptiometry and fracture incidence in postmenopausal women with osteoporosis, were identified by a PubMed search for literature published in English. Eight studies met the criteria for RCTs. Small RCTs showed that menatetrenone monotherapy decreased serum undercarboxylated osteocalcin (ucOC) concentrations, modestly increased lumbar spine BMD, and reduced the incidence of fractures (mainly vertebral fracture), and that combined alendronate and menatetrenone therapy enhanced the decrease in serum ucOC concentrations and further increased femoral neck BMD. This review of the literature revealed positive evidence for the effects of menatetrenone monotherapy on fracture incidence in postmenopausal women with osteoporosis. Further studies are required to clarify the efficacy of menatetrenone in combination with bisphosphonates against fractures in postmenopausal women with osteoporosis.

  13. The pathology of transient regional osteoporosis.

    PubMed

    McCarthy, E F

    1998-01-01

    Biopsy specimens from 19 patients with transient regional osteoporosis were studied. All patients presented with pain. There were nine patients with transient osteoporosis of the hip. Six of these specimens were therapeutic core biopsies, and three were femoral heads removed during total hip replacement. The other patients with osteoporosis in different locations had biopsies to rule out infection or neoplasm. Five of these patients had transient osteoporosis of the knee. Three had ankle involvement and two had involvement of the tibial shaft. Plain radiographs were available for study in all cases, and either a bone scan or an MRI was studied in each case. Except for one patient who was lost to follow-up, all had resolution of symptoms and radiographic changes. The histologic changes in the biopsies were distinctive, although they were present in varying degrees. There was edema and reactive bone formation in the marrow spaces. In addition, osteoclastic bone resorption was active in 14 of the 19 cases. Although lipid cysts were sometimes found in the marrow spaces, there was no evidence of fat necrosis or bone necrosis. The high bone turnover and absence of fat necrosis suggests that this disorder is a vasomotor response rather than an early stage of osteonecrosis. Awareness of these characteristic histologic changes should enable the pathologist to make a specific diagnosis of transient regional osteoporosis when a biopsy is required.

  14. Management of glucocorticoid-induced osteoporosis.

    PubMed

    Rizzoli, R; Adachi, J D; Cooper, C; Dere, W; Devogelaer, J P; Diez-Perez, A; Kanis, J A; Laslop, A; Mitlak, B; Papapoulos, S; Ralston, S; Reiter, S; Werhya, G; Reginster, J Y

    2012-10-01

    This review summarizes the available evidence-based data that form the basis for therapeutic intervention and covers the current status of glucocorticoid-induced osteoporosis (GIOP) management, regulatory requirements, and risk-assessment options. Glucocorticoids are known to cause bone loss and fractures, yet many patients receiving or initiating glucocorticoid therapy are not appropriately evaluated and treated. An European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis workshop was convened to discuss GIOP management and to provide a report by a panel of experts. An expert panel reviewed the available studies that discussed approved therapeutic agents, focusing on randomized and controlled clinical trials reporting on bone mineral density and/or fracture risk of at least 48 weeks' duration. There is no evidence that GIOP and postmenopausal osteoporosis respond differently to treatments. The FRAX algorithm can be adjusted according to glucocorticoid dose. Available antiosteoporotic therapies such as bisphosphonates and teriparatide are efficacious in GIOP management. Several other agents approved for the treatment of postmenopausal osteoporosis may become available for GIOP. It is advised to stop antiosteoporotic treatment after glucocorticoid cessation, unless the patient remains at increased risk of fracture. Calcium and vitamin D supplementation as an osteoporosis-prevention measure is less effective than specific antiosteoporotic treatment. Fracture end-point studies and additional studies investigating specific subpopulations (pediatric, premenopausal, or elderly patients) would strengthen the evidence base and facilitate the development of intervention thresholds and treatment guidelines.

  15. Dilemmas in the management of osteoporosis.

    PubMed

    2015-02-01

    Fragility fracture is the clinically apparent and relevant outcome in osteoporosis. Osteoporotic fragility fractures occur most commonly in the vertebrae, hip and wrist, and are associated with substantial disability, pain and reduced quality of life. It is estimated that more than 2 million women have osteoporosis in England and Wales. In the UK, there are over 300,000 fractures each year, causing severe pain and disability to individuals at an estimated annual cost to the NHS of over £1.73 billion. As a result of increased bone loss after the menopause in women, and age-related bone loss in both women and men, the prevalence of osteoporosis increases markedly with age, from 2% at 50 years to more than 25% at 80 years in women. Despite the development of a number of guidelines for the diagnosis and treatment of osteoporosis, management of the condition is not straightforward. Here we provide a reminder of some specific dilemmas facing generalists in regards to the management of osteoporosis, including diagnosis and investigation for reversible secondary causes; the effectiveness and duration of pharmacological management with oral bisphosphonates; and the role of calcium and vitamin D.

  16. Controlled release levodopa in Parkinson's disease: influence of selection criteria and conversion recommendations in the clinical outcome of 450 patients. STAR Study Group.

    PubMed

    Linazasoro, G; Grandas, F; Martínez Martín, P; Bravo, J L

    1999-01-01

    We present the results of an open, prospective, multicentric study including 450 patients with mild to moderate Parkinson's disease (PD) converted from standard Sinemet to Sinemet CR (controlled release; Dupont Pharma, Pavia, Italy). Patients with complex fluctuations and diphasic dyskinesias were excluded and the conversion was made after some recommendations, depending on the clinical problems and the daily dosage and administration schedule of standard (STD) Sinemet. The condition of more than 60% of the patients improved after the change and 80% of them preferred the CR formulation by the end of the study. We found a moderate, but significant, improvement in most of the efficacy parameters used, such as the Unified Parkinson's Disease Rating Scale (UPDRS), the Schawb and England scale, and dyskinesias and sleep questionnaires. Forty-five patients (10%) discontinued the study due to adverse effects (mainly gastrointestinal disturbances, functional deterioration, and dyskinesias). We conclude that Sinemet CR is a useful and safe therapeutic option in patients with mild and moderate PD. Selection of the patients is the most important outcome factor.

  17. Pulsating star research and the Gaia revolution

    NASA Astrophysics Data System (ADS)

    Eyer, Laurent; Clementini, Gisella; Guy, Leanne P.; Rimoldini, Lorenzo; Glass, Florian; Audard, Marc; Holl, Berry; Charnas, Jonathan; Cuypers, Jan; Ridder, Joris De; Evans, Dafydd W.; de Fombelle, Gregory Jevardat; Lanzafame, Alessandro; Lecoeur-Taibi, Isabelle; Mowlavi, Nami; Nienartowicz, Krzysztof; Riello, Marco; Ripepi, Vincenzo; Sarro, Luis; Süveges, Maria

    2017-09-01

    In this article we present an overview of the ESA Gaia mission and of the unprecedented impact that Gaia will have on the field of variable star research. We summarise the contents and impact of the first Gaia data release on the description of variability phenomena, with particular emphasis on pulsating star research. The Tycho-Gaia astrometric solution, although limited to 2.1 million stars, has been used in many studies related to pulsating stars. Furthermore a set of 3,194 Cepheids and RR Lyrae stars with their times series have been released. Finally we present the plans for the ongoing study of variable phenomena with Gaia and highlight some of the possible impacts of the second data release on variable, and specifically, pulsating stars.

  18. Osteoporosis in men treated with androgen suppression therapy for prostate cancer.

    PubMed

    Gholz, Ruth Canty; Conde, Francisco; Rutledge, Dana N

    2002-01-01

    Men with advanced or metastatic prostate cancer commonly receive long-term treatment with luteinizing hormone-releasing hormone (LHRH) agonist therapy. This prolonged treatment causes a hypogonadal state of chronic testosterone deficiency. Similar to estrogen deficiency in postmenopausal women, testosterone deficiency among these men negatively affects bone metabolism through a complex self-regulating, negative feedback system and subsequent reduction in bone formation. If left undetected or untreated, the risk for osteoporosis rises. Osteoporosis increases the likelihood of fracture, especially of the hips. Researchers are studying the effects of LHRH agonist therapy on osteoporosis and other related conditions to determine whether interventions, such as pharmacologic agents (e.g., bisphosphonates), dietary supplements (e.g., calcium, vitamin D), and exercise, can slow or prevent the process and assist healthcare providers in knowing how to counsel patients. Current recommendations are found in the literature on glucocorticoid-induced and menopausal osteoporosis. Nurses need to stay abreast of current knowledge in this area, as it is expanding rapidly.

  19. Prevalence and predictors of osteoporosis treatment in nursing home residents with known osteoporosis or recent fracture.

    PubMed

    Colón-Emeric, C; Lyles, K W; Levine, D A; House, P; Schenck, A; Gorospe, J; Fermazin, M; Oliver, K; Alison, J; Weisman, N; Xie, A; Curtis, J R; Saag, K

    2007-04-01

    We studied nursing home residents with osteoporosis or recent fracture to determine the frequency and predictors of osteoporosis treatment. There was wide variation in performance, and both clinical and systems variables predicted use. This study shows that improvement in osteoporosis care is possible and important for many nursing homes. We determined the prevalence and predictors of osteoporosis evaluation and treatment in high-risk nursing home residents. We identified 67 nursing facilities in North Carolina and Arizona with > 10 residents with osteoporosis or recent hip fracture. Medical records (n=895) were abstracted for osteoporosis evaluation [dual-energy X-ray absorptiometry (DXA), vitamin D level, serum calcium), treatment (calcium, vitamin D, osteoporosis medication, hip protectors), clinical, and systems covariates. Data were analyzed at the facility level using mixed models to account for the complex nesting of residents within providers and nursing facilities. Calcium and vitamin D was prescribed for 69% of residents, bisphosphonates for 19%, calcitonin for 14%, other pharmacologic therapies for 6%, and hip protectors for 2%. Overall, 36% received any bone protection (medication or hip protectors), with wide variation among facilities (0-85%). Factors significantly associated with any bone protection included female gender [odds ratio (OR) 2.4, (1.5-3.7)] and nonurban/suburban location [1.5, (1.1-2.2)]. Residents with esophagitis, peptic ulcer disease (PUD), or dysphagia [0.6, (0.4-0.9)] and alcohol abuse [0.2, (0.0-0.9)] were less likely to receive treatment. There is substantial variation in the quality of osteoporosis treatment across nursing homes. Interventions that improve osteoporosis quality of care are needed.

  20. 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...

  1. Emerging anabolic treatments in osteoporosis.

    PubMed

    Mosekilde, Leif; Tørring, Ove; Rejnmark, Lars

    2011-04-01

    Anabolic treatment that remodels bone tissue and restores bone biomechanical competence is essential in the treatment of osteoporosis. In addition, long term antiresorptive therapy may have limitations because of the reduced renewal of bone tissue. The only pure anabolic drugs available at present are intact PTH (1-84) (Preotact®) and the truncated PTH (1-34) (Teriparatide, Forteo®) while strontium ranelate may possess antiresorptive as well as anabolic properties. The marketed antiresorptive and anabolic antiosteoporotic drugs have limitations in their use due to adverse effects or to the occurrence of rare but severe late complications. Furthermore, indications may be restricted by co-existing diseases or treatment duration may be limited. However, new anabolic drugs are being developed mimicking the effect of PTH, or targeting the calcium sensing receptor (CaSR) or the Wnt/β-catenin signalling pathway. The PTH mimetics are truncated or altered PTH fragments, parathyroid hormone related peptide (PTHrP) and calcilytics stimulating endogenous PTH secretion. Calcimimetics (e.g. strontium) and calcilytics (e.g. lithium) may also affect bone cells directly through the CaSR. The Wnt pathway that stimulates osteoblastic proliferation, differentiation and function may be activated by neutralizing antibodies to secreted inhibitors of Wnt signalling (e.g. Sclerostin or Dickkopf) or by small molecules (e.g. lithium) that inhibits the glycogen synthase kinase 3β mediated degradation of β-catenin. Finally, blocking of activin A by soluble receptor fusion proteins has been shown to increase bone mass by a dual anabolic-antiresorptive action. The present paper summarises the physiological background and the present evidence for these effects.

  2. 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…

  3. 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…

  4. 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

  5. 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

  6. Pregnancy-related osteoporosis and spinal fractures

    PubMed Central

    Yun, Ka Yeong; Han, Si Eun; Kim, Seung Chul; Lee, Kyu Sup

    2017-01-01

    Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain. The management and natural history are still poorly defined. Traditional medications for osteoporosis are calcium/vitamin D and bisphosphonate. Concerns with bisphosphonate include accumulation in bone and fetal exposure in subsequent pregnancies. The newly developed medication, teriparatide, has shown good results. We report six cases of pregnancy-related osteoporosis and spinal fracture with literature review. PMID:28217686

  7. Canadian Quality Circle pilot project in osteoporosis

    PubMed Central

    Ioannidis, George; Papaioannou, Alexandra; Thabane, Lehana; Gafni, Amiram; Hodsman, Anthony; Kvern, Brent; Johnstone, Dan; Plumley, Nathalie; Baldwin, Alanna; Doupe, M.; Katz, Alan; Salach, Lena; Adachi, Jonathan D.

    2007-01-01

    PROBLEM ADDRESSED Family physicians are not adequately following the 2002 Osteoporosis Canada guidelines for providing optimal care to patients with osteoporosis. OBJECTIVE OF PROGRAM The Canadian Quality Circle (CQC) pilot project was developed to assess the feasibility of the CQC project design and to gather informationfor implementing a national study of quality circles (QCs). The national study would assess whether use ofQCs could improve family physicians’ adherence to the osteoporosis guidelines. PROGRAM DESCRIPTION The pilot project enrolled 52 family physicians and involved 7 QCs. The project had 3 phases: training and baseline data collection, educational intervention and follow-up data collection, and sessions on implementing strategies for care. CONCLUSION Findings from the pilot study showed that the CQC project was well designed and well received. Use of QCs appeared to be feasible for transferring knowledge and giving physicians an opportunity to analyze work-related problems and develop solutions to them. PMID:17934033

  8. Refractory Rheumatic Disorder: Atypical Postpregnancy Osteoporosis

    PubMed Central

    Mourgues, Cindy; Malochet-Guinamand, Sandrine; Soubrier, Martin

    2015-01-01

    This is a case report on a young patient with severe osteoporosis that was initially revealed when she presented with polyarthralgia during her second pregnancy. Postpartum, the pain increased and her X-ray did not show any abnormalities. A bone scintigraphy was performed. It indicated an inflammatory rheumatic disorder. Six months after partum, an investigation of right coxalgia revealed a spontaneous basicervical fracture. Given the persistent polyarthralgia, the patient underwent a new scintigraphy, which revealed areas of what looked to be old rib and L1 fractures. A subsequent full body magnetic resonance imaging (MRI) scan revealed signal abnormalities that could indicate multiple lower limb bone fractures. Despite exhaustive biological, radiological, and histological testing, no secondary cause for the osteoporosis was found. The patient was started on teriparatide. We finally concluded that, despite the atypical presentation, the patient was suffering from postpregnancy osteoporosis. It is possible that the frequency of occurrence of this still poorly understood disease is underestimated. PMID:25785219

  9. Pharmacogenomics of osteoporosis: a pathway approach.

    PubMed

    Riancho, José A; Hernández, José L

    2012-05-01

    Osteoporosis is frequent in postmenopausal women and old men. As with other prevalent disorders, it is the consequence of complex interactions between genetic and acquired factors. Candidate gene and genome-wide association studies have pointed to several genes as determinants of the risk of osteoporosis. Some of them were previously unsuspected and may help to find new therapeutic targets. Several drugs already available are very effective in increasing bone mass and decreasing fracture risk. However, not all patients respond properly and some of them suffer fragility fractures despite therapy. Investigators have tried to identify the genetic features influencing the response to antiosteoporotic therapy. In this article we will review recent data providing insight into new genes involved in osteoporosis and the pharmacogenetic data currently available.

  10. Genetic and environmental factors in human osteoporosis.

    PubMed

    Özbaş, Halil; Tutgun Onrat, Serap; Özdamar, Kazım

    2012-12-01

    Osteoporosis is a common disorder, with prolongation of the average life span it has become a major public health problem. On the formation of osteoporosis genetic factors and environmental influences could play a role then it is considered as multi-factorial. Because a variety of functions to affect susceptibility to the formation of osteoporosis VDR-F, VDR-B, COL1A1, ESR1X, ESR1P and CTR are thought to be candidate genes. In this study, the aim is to investigate the relationship between these genes polymorphism and bone mineral density (BMD) values of lumbar vertebra and femoral neck in 188 Turkish people. Lumbar spine and femoral neck BMD of the individuals included in the study were measured by the dual X-ray absorptiometry method. The genotyped polymorphisms by simultaneous amplification of five regions of the genome, containing six SNPs of interest and detecting the amplified product, using the kit MetaBone Clinical Arrays(®). Statistical analyses indicated that; VDR-B gene polymorphisms major (P = 0.013), VDR-F polymorphisms have minor (P = 0.082) effect on femur BMD. None of the other genes has any significant effect on spinal BMD. Patient age, body mass index and diet has significant effect on femoral and spinal BMD. Osteoporosis is a multi-factorial disease and many genetic and non-genetic risk factors contribute to the development of osteoporosis. Early detection of a genetic predisposition to osteoporosis should allow delay and/or limit unfavorable changes in the bone tissue.

  11. Osteoporosis in rheumatoid arthritis and ankylosing spondylitis.

    PubMed

    Vosse, D; de Vlam, K

    2009-01-01

    Bone is a target in many inflammatory rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The generalized effect of inflammation on bone may result in a decreased quality of bone and is associated with an increased risk of fractures and deformities, both in RA and AS. RA is characterized by periarticular osteopenia, systemic osteoporosis and bone erosions. Periarticular osteopenia and bone erosions are mainly correlated with disease activity. Unlike postmenopausal osteoporosis, osteoporosis in RA is more characterised by marked loss of bone in the hip and the radius, while the axial bone is relatively preserved. In general, several cross-sectional studies documented a lower bone mineral density in patients with RA, with a two-fold increase in osteoporosis compared to age- and sex-matched controls and relates to an increased fracture risk. Several factors contribute to the increased risk: older age, little exercise, long-term use of corticosteroids, and high disability index. AS is characterized by an increase in bone fragility due to reduced bone mineral density. The reported prevalence of osteoporosis in AS patients varies largely. The large variation reflects the difficulties in assessing BMD in AS due to new bone formation. Bone fragility is also due to changes in structural properties resulting from inflammation-induced bone failure in the spine in combination with reduced capacity of shock absorption leading to vertebral fractures. Different types of spinal fractures in patients with AS are described, including wedging. Wedging vertebral fractures contribute to hyperkyphosis and impaired physical function. In contrast to RA , bone loss in AS is accompanied by new bone formation. The pathophysiology of osteoporosis in RA and AS probably is fundamentally similar, but with different clinical phenotypes. The implications for therapeutically intervening in its occurrence and progression might be fundamentally different.

  12. Preventing osteoporosis-related fractures: an overview.

    PubMed

    Gass, Margery; Dawson-Hughes, Bess

    2006-04-01

    Osteoporosis is a skeletal disorder characterized by compromised bone strength, which predisposes a person to increased risk of fracture. In the United States, 26% of women aged > or =65 years and >50% of women aged > or =85 years have osteoporosis. Over 1.5 million fractures per year are attributable to osteoporosis; these fractures result in 500,000 hospitalizations, 800,000 emergency room visits, 2.6 million physician visits, 180,000 nursing home placements, and 12 billion dollars to 18 billion dollars in direct healthcare costs each year. Fracture also results in loss of function and has a negative impact on psychological status. In recognition of the importance of bone health, the US Surgeon General has, for the first time, issued a comprehensive report on bone health and treatment. The report recommends a pyramidal approach to osteoporosis treatment that includes calcium and vitamin D supplementation, physical activity, and fall prevention as the first line in fracture prevention. The second level consists of treating secondary causes of osteoporosis; the third and top level consists of pharmacotherapy. Pharmacotherapeutic interventions (e.g., bisphosphonates, selective estrogen receptor modulators, calcitonin, and teriparatide) in women with postmenopausal osteoporosis provide substantial reduction in fracture risk over and above risk reduction with calcium and vitamin D supplementation alone. Despite the effectiveness of therapy, most patients who receive treatment do not remain on treatment for >1 year. An important approach to reducing the rate of fractures is first to target our treatments to patients at high risk for fracture and then to develop strategies to improve treatment continuation rates.

  13. DEPRESSION AS A RISK FACTOR FOR OSTEOPOROSIS

    PubMed Central

    Cizza, Giovanni; Primma, Svetlana; Csako, Gyorgy

    2009-01-01

    Osteoporosis is a major public health threat. Multiple studies have reported an association between depression and low bone mineral density, but a causal link between these two conditions is disputed. Here we review the endocrine and immune alterations secondary to depression that might affect bone mass. We also discuss the possible role of poor lifestyle in the etiology of osteoporosis in subjects with depression and the potential effect of antidepressants on bone loss. We propose that depression induces bone loss and osteoporotic fractures, primarily via specific immune and endocrine mechanisms, with poor lifestyle habits and use of specific antidepressants also potential contributory factors. PMID:19747841

  14. Statistical shape and appearance models in osteoporosis.

    PubMed

    Castro-Mateos, Isaac; Pozo, Jose M; Cootes, Timothy F; Wilkinson, J Mark; Eastell, Richard; Frangi, Alejandro F

    2014-06-01

    Statistical models (SMs) of shape (SSM) and appearance (SAM) have been acquiring popularity in medical image analysis since they were introduced in the early 1990s. They have been primarily used for segmentation, but they are also a powerful tool for 3D reconstruction and classification. All these tasks may be required in the osteoporosis domain, where fracture detection and risk estimation are key to reducing the mortality and/or morbidity of this bone disease. In this article, we review the different applications of SSMs and SAMs in the context of osteoporosis, and it concludes with a discussion of their advantages and disadvantages for this application.

  15. Pharmacoeconomic analysis of osteoporosis treatment with risedronate.

    PubMed

    Brecht, J G; Kruse, H P; Felsenberg, D; Möhrke, W; Oestreich, A; Huppertz, E

    2003-01-01

    Hip fracture is an important and costly problem. Therapy with the bisphosphonate risedronate effectively prevents hip and other fractures among women with established osteoporosis. Risedronate is a first-choice therapy option in the German Guidelines of the Dachverband Osteologie for Osteoporosis according to evidence-based medicine criteria for the treatment of postmenopausal osteoporosis, osteoporosis of the elderly (women aged > 75 years) and glucocorticoid-induced osteoporosis. There are few published economic evaluations of bisphosphonates in Germany. Therefore, an assessment of the cost-effectiveness of risedronate utilizing a state transition Markov model of established postmenopausal osteoporosis based on randomized clinical trial data was developed. Uncertainty underlying model parameters and outcomes was dealt with using traditional sensitivity analysis and stochastic sensitivity analysis to produce quasi-95% Cls. We focused on patients aged 70 years, since this population most closely matches the randomized controlled trial and is typical of osteoporosis patients in Germany. The baseline model was a cohort of 1,000 70-year-old women, who received risedronate for 3 years and were followed up for an overall observation period of 10 years, modelling transitions through estimated health states and evaluating outcomes. Over the 3-year treatment period and 10-year observation period, risedronate dominated the current average basic treatment in Germany. In the risedronate group 33 hip fractures were averted and 32 quality-adjusted life years (QALYs) were gained (discounted values). Risedronate treatment saves costs for German social insurance: the present net value of the associated costs from the perspective of German social insurance is [symbol: see text]10.66 million if risedronate treatment is used versus [symbol: see text]11 million if basic treatment is used. Thus, net savings of [symbol: see text]340,000 for the treatment group per 1,000 treated women

  16. [Management of osteoporosis: room for improvment].

    PubMed

    Roux, Christian

    2010-11-01

    The objective of anti-osteoporotic treatments is the prevention of the first or recurrent fractures. Screening of at risk patients is the basis of improvement of osteoporosis management. Prevalent fractures are strong determinants of incident fractures. In patients without fractures screening of risk factors, and quantification of risk using FRAX tool, allows detection of patients who should receive highest priority for treatment. Several drugs have shown that they are able to decrease the risk of fracture, providing persistence and compliance. Non pharmacological approach (including nutrition and physical activity) is part of optimal management of osteoporosis.

  17. Pathophysiology of osteoporosis: new mechanistic insights.

    PubMed

    Armas, Laura A G; Recker, Robert R

    2012-09-01

    Understanding of the pathophysiology of osteoporosis has evolved to include compromised bone strength and skeletal fragility caused by several factors: (1) defects in microarchitecture of trabeculae, (2) defective intrinsic material properties of bone tissue, (3) defective repair of microdamage from normal daily activities, and (4) excessive bone remodeling rates. These factors occur in the context of age-related bone loss. Clinical studies of estrogen deprivation, antiresorptives, mechanical loading, and disuse have helped further knowledge of the factors affecting bone quality and the mechanisms that underlie them. This progress has led to several new drug targets in the treatment of osteoporosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Osteoporosis, osteopenia, and atherosclerotic vascular disease

    PubMed Central

    Aronow, Wilbert S.

    2011-01-01

    Older women with low bone mineral density (BMD) have a higher prevalence of atherosclerotic vascular disease (coronary artery disease, ischemic stroke, or peripheral arterial disease) than older women with normal BMD. Three coronary angiographic studies have shown that low BMD is associated with obstructive coronary artery disease. Low BMD has been shown to be associated with stress test-induced myocardial ischemia, reduced exercise capacity, and with aortic valve calcification. Women with osteoporosis have an increased risk for cardiovascular events. Treatment of osteoporosis or osteopenia should include therapeutic measures to prevent cardiovascular events. PMID:22291728

  19. Diagnosis and treatment of osteoporosis in Brazil.

    PubMed

    Eis, S R; de Souza, A C

    2001-04-01

    The definition of Osteoporosis as proposed by WHO is widely accepted amongst Brazilian physicians. The main diagnostic tool in Brazil is Bone Densitometry (DXA). Both public and private health insurance systems reimburse the densitometry test. DXA have been used also for monitoring changes in BMD. Biochemical markers and peripheral methods of bone assessment are not widely used in Brazil. Estrogens, Vitamin D and its metabolites, Salmon Calcitonin, Ipriflavone, Tibolone, Etidronate, Alendronate, Raloxifene and Risendronate are currently available for treating osteoporosis. Since 1995, Brazilian Society of Clinical Densitometry have been educating Bone Densitometry Professionals and all clinicians in order to improve their ability to turn DXA results into adequate clinical decisions.

  20. Study design in osteoporosis: a European perspective.

    PubMed

    Kanis, J A; Alexandre, J M; Bone, H G; Abadie, E; Brasseur, D; Chassany, O; Durrleman, S; Lekkerkerker, J F F; Caulin, F

    2003-06-01

    The advent of effective agents for the treatment of osteoporosis has led to the view that placebo-controlled trials to test new agents for efficacy are no longer appropriate. Rather, studies of superiority, equivalence, or non-inferiority have been recommended. Such studies require very large sample sizes, and the burden of osteoporotic fracture in a trial setting is substantially increased. Studies of equivalence cannot be unambiguously interpreted because the variance in effect of active comparator agents is too large in osteoporosis. If fracture studies are required by regulatory agencies, there is still a requirement for placebo-controlled studies, although perhaps of shorter duration than demanded at present.

  1. Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan.

    PubMed

    Moriwaki, K; Noto, S

    2017-02-01

    A model-based cost-effectiveness analysis was performed to evaluate the cost-effectiveness of secondary fracture prevention by osteoporosis liaison service (OLS) relative to no therapy in patients with osteoporosis and a history of hip fracture. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture.

  2. Estrogen, cytokines, and pathogenesis of postmenopausal osteoporosis.

    PubMed

    Pacifici, R

    1996-08-01

    In summary, available data demonstrate that IL-1 and TNF are the causative agents underlying the bone loss induced by estrogen deficiency. Indeed, these factors are produced in bone and the bone marrow, released in larger amounts from cells of estrogen-deficient subjects, and indispensable for reproducing the effects of estrogen deficiency in bone. These observations support the hypothesis that the bone sparing effect of estrogen is due to the ability of the hormone to block osteoclastogenesis, the activation of mature osteoclasts and, as recently demonstrated, the rate of apoptotic osteoclast death. Although IL-1 and TNF play a prominent causal role in these events, the bone-sparing effect of estrogen is mediated by numerous cytokines which, by simultaneously stimulating multiple target cells, induce effects that are not accounted for by any one single factor (Fig. 2). The ability of estrogen to regulate some, but not all, the cytokines involved in this process is not inconsistent with this hypothesis because cytokines have potent synergistic effects. Thus, a considerable increase in bone resorption may result from a relatively small increase in the concentration of only a few of the bone-resorbing factors present in the bone microenvironment. This concept is best illustrated by the study of Miyaura et al. demonstrating that the concentrations of either IL-1, IL-6, IL-6 receptor, or prostaglandins detected in the bone marrow of OVX mice are insufficient to account for the increased bone resorption caused by estrogen withdrawal. In contrast, the increase in bone resorption induced by OVX can be explained by the cumulative effects of these cytokines. Thus, a better understanding of the cooperative effects of cytokines and a recognition that the contribution of individual cytokines to postmenopausal bone loss varies with the passage of time after menopause are necessary to fully understand the mechanism of action of estrogen in bone. Although the relevance of

  3. 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.

  4. Drug-Related Adverse Events of Osteoporosis Therapy.

    PubMed

    Khan, Moin; Cheung, Angela M; Khan, Aliya A

    2017-03-01

    Postmenopausal osteoporosis is associated with microarchitectural deterioration and increased risk of fracture. Osteoporosis therapy effectively reduces the risk of vertebral, nonvertebral, and hip fracture and has been associated with increased survival. Currently approved treatments for osteoporosis include bisphosphonates, denosumab, selective estrogen receptor modulators, and teriparatide. This article reviews the adverse events of therapy associated with these medical interventions. Hormone replacement therapy is not included, because it is no longer indicated for the treatment of osteoporosis in all countries. Calcitonin and strontium ranelate are also not included, because their indication for osteoporosis has recently been limited or withdrawn.

  5. Identification of the risk for osteoporosis in dental patients.

    PubMed

    Devlin, Hugh

    2012-10-01

    This article describes how dentists can recognize osteoporosis before fractures develop, and discusses whether osteoporosis affects tooth loss or inhibits implant osseointegration. Some success in diagnosing osteoporosis has been obtained using clinical questionnaires that attempt to identify those who have strong risk factors for the disease, and analysis of the sparse trabeculation and thinning of the mandibular cortex often seen in dental panoramic radiographs. The role of osteoporosis in periodontal disease is unclear as there are many conflicting reports, but the evidence suggests that tooth loss may be more prevalent in patients with osteoporosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. 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

  7. Osteoporosis: incidence, prevention, and treatment of the silent killer.

    PubMed

    Parsons, Lynn C

    2005-03-01

    Osteoporosis is a nationwide health care concern affecting millions of Americans. Health care dollars to prevent and treat osteoporosis are needed. Osteoporosis-related injuries and resulting disabilities, and consequent admissions to hospitals, nursing homes, and long-term care facilities is costing billions of dollars for care and treatment. Healthy lifestyle choices including vitamin and mineral therapy; safe home environments; a diet replete with calcium, vitamin D, and protein; weight-bearing and resistance exercises; and fall prevention programs for home-bound and hospitalized elders are needed to prevent osteoporosis-related fractures and injuries. Nurses must educate the public on osteoporosis and osteoporosis-prevention activities. Research in nursing, pharmacy, and allied health fields such as physical therapy and nutrition must expand to improve understanding of the risks associated with osteoporosis and to evaluate health-promotion and disease- prevention activities. Interdisciplinary partnerships should be established to study the issues, prevention, and treatment modalities of this "silent killer."

  8. The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada

    PubMed Central

    Hawker, G.; Cameron, C.; Canavan, J.; Beaton, D.; Bogoch, E.; Jain, R.; Papaioannou, A.

    2016-01-01

    In the last decade, there have been a number of action plans published to highlight the importance of preventing osteoporosis and related fractures. In the province of Ontario Canada, the Ministry of Health provided funding for the Ontario Osteoporosis Strategy. The goal is to reduce morbidity, mortality, and costs from osteoporosis and related fractures through an integrated and comprehensive approach aimed at health promotion and disease management. This paper describes the components of the Ontario Osteoporosis Strategy and progress on implementation efforts as of March 2009. There are five main components: health promotion; bone mineral density testing, access, and quality; postfracture care; professional education; and research and evaluation. Responsibility for implementation of the initiatives within the components is shared across a number of professional and patient organizations and academic teaching hospitals with osteoporosis researchers. The lessons learned from each phase of the development, implementation, and evaluation of the Ontario Osteoporosis Strategy provides a tremendous opportunity to inform other jurisdictions embarking on implementing similar large-scale bone health initiatives. PMID:20309525

  9. 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

  10. 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…

  11. 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)

  12. 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…

  13. 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)

  14. Efficacy of Osteoporosis Therapies in Diabetic Patients.

    PubMed

    Schwartz, Ann V

    2017-02-01

    Diabetes is characterized by increased fracture risk and by reduced bone strength for a given density. Contributing factors may include lower bone turnover and accumulation of advanced glycation endproducts. There are concerns that the pharmacological therapies for osteoporosis, particularly anti-resorptive therapies that suppress bone turnover, may not be as effective in the setting of diabetes. This review considers clinical trials and observational studies that have assessed the efficacy of anti-resorptive and anabolic therapies in diabetic patients. Post hoc analyses of randomized trials indicate that raloxifene has similar efficacy for prevention of vertebral fractures in diabetic compared with non-diabetic patients. Evidence from randomized clinical trials is lacking for anti-fracture efficacy of other osteoporosis therapies in diabetes. However, observational studies suggest that bisphosphonates are effective in preventing fractures in diabetic patients. The great majority of diabetic patients in studies to date have been type 2, and efficacy of osteoporosis therapies in type 1 diabetic patients remains to be addressed. Further evaluation of the efficacy of osteoporosis therapies in the setting of diabetes is needed to provide optimal fracture prevention for this population.

  15. The role of nutrition in osteoporosis.

    PubMed

    Bunker, V W

    1994-09-01

    Osteoporosis-related bone fractures are a significant cause of mortality and morbidity, with women being particularly affected. Osteoporosis is a condition of bone fragility resulting from micro-architectural deterioration and decreased bone mass; adult bone mass depends upon the peak attained and the rate of subsequent loss; each depends on the interaction of genetic, hormonal, environmental and nutritional factors. An adequate supply of calcium is essential to attain maximum bone mass, and adult intakes below about 500 mg/day may predispose to low bone mass. Supplementation with calcium may conserve bone at some skeletal sites, but whether this translates into reduced fracture rates is not clear. Chronically low intakes of vitamin D--and possibly magnesium, boron, fluoride and vitamins K, B12, B6 and folic acid (particularly if co-existing)--may pre-dispose to osteoporosis. Similarly, chronically high intakes of protein, sodium chloride, alcohol and caffeine may also adversely affect bone health. The typical Western diet (high in protein, salt and refined, processed foods) combined with an increasing sedentary lifestyle may contribute to the increasing incidence of osteoporosis in the elderly.

  16. Correlation between osteoporosis and cardiovascular disease.

    PubMed

    Sprini, Delia; Rini, Giovam Battista; Di Stefano, Laura; Cianferotti, Luisella; Napoli, Nicola

    2014-05-01

    Several evidences have shown in the last years a possible correlation between cardiovascular diseases and osteoporosis. Patients affected with osteoporosis, for example, have a higher risk of cardiovascular diseases than subjects with normal bone mass. However, the heterogeneous approaches and the different populations that have been studied so far have limited the strength of the findings. Studies conducted in animal models show that vascular calcification is a very complex mechanism that involves similar pathways described in the normal bone calcification. Proteins like BMP, osteopontin, osteoprotegerin play an important role at the bone level but are also highly expressed in the calcified vascular tissue. In particular, it seems that the OPG protect from vascular calcification and elevated levels have been found in patients with CVD. Other factors like oxidative stress, inflammation, free radicals, lipids metabolism are involved in this complex scenario. It is not a case that medications used for treating osteoporosis also inhibit the atherosclerotic process, acting on blood pressure and ventricular hypertrophy. Given the limited amount of available data, further studies are needed to elucidate the underlying mechanisms between osteoporosis and cardiovascular disease which may be important in the future also for preventive and therapeutic approaches of both conditions.

  17. [Osteoporosis in Super-aged society.

    PubMed

    Suzuki, Atsushi

    2017-01-01

    Osteoporosis could contribute to increase other chronic diseases such as cardiovascular events, resulting in higher mortality in these patients. Antiresorptive agents such as bisphosphonates has been reported to reduce not only the number of fragile fracture but also all causes mortality. These agents are also expected to improve quality of life and activity of daily life with longer life expectancy.

  18. Glucocorticoid-induced osteoporosis: 2013 update.

    PubMed

    Mazzantini, M; Di Munno, O

    2014-07-28

    Glucocorticoids are the most common cause of secondary osteoporosis leading to the so-called glucocorticoid-induced osteoporosis (GIO). A treatment with 10 mg/d of prednisone or equivalent for more than 3 months leads to a 7-fold increase in hip fractures and a 17-fold increase in vertebral fractures. The difference between bone quantity and quality in GIO makes bone mineral density measurements inadequate to detect patients at risk of fracture. The adverse effects of glucocorticoids on the skeleton derive from a direct impact on bone cells with a severe impairment of mechanical competence. Crucial to prevention of GIO is early timing of intervention. The World Health Organization has adopted a fracture prevention algorithm (FRAX) intended to estimate fracture risk in GIO. The American College of Rhematology modified its prevention and treatment guidelines taking into account the individual risk of fracture calculated in GIO on the basis of the FRAX algorithm. Recently, also a joint Guideline Working Group of the International Osteoporosis Foundation (IOF) and the European Calcified Tissue Society (ECTS) published a framework for the development of national guidelines for the management of GIO. Bisphosphonates are the first-line drugs to treat GIO; teriparatide counteracts several fundamental pathophysiologic aspects of GIO; denosumab is useful in patients with renal failure and in potentially pregnant young women. Vertebroplasty and kyphoplasty may be less beneficial in GIO than in primary involutional osteoporosis.

  19. 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)

  20. 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)

  1. 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…

  2. 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.

  3. [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.

  4. Diagnosis and treatment of pediatric osteoporosis.

    PubMed

    Bachrach, Laura K

    2014-12-01

    Progress toward identifying and treating disorders of bone fragility in pediatric patients has been considerable in recent years. This article will summarize several key advances in the management of osteoporosis in children and adolescents. Recommendations from the 2013 pediatric Position Development Conference provide expert guidance for evaluating bone health in younger patients. The diagnosis of pediatric osteoporosis can be made in a child with low-trauma vertebral fractures or a combination of low bone mass and long bone fractures. Management of bone fragility includes optimizing nutrition, activity, and treatment of the underlying disease. Pharmacologic agents can be considered if these measures fail to prevent further bone loss or fractures. Although the efficacy and safety of several intravenous and oral bisphosphonates have been examined, there is still no consensus on the optimal drug, dose, or duration of treatment. Observational studies of children with secondary osteoporosis provide insight into risk factors for fracture or the potential for recovery. Despite advances in the diagnosis and treatment of pediatric osteoporosis, more research is needed. Randomized controlled trials of pharmacologic agents should be defined to target those identified at the highest risk by observational studies. http://links.lww.com/COE/A9

  5. 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…

  6. Osteoporosis: a review and its dental implications.

    PubMed

    Mattson, John S; Cerutis, D Roselyn; Parrish, Lawrence C

    2002-11-01

    Osteoporosis is a disease that affects primarily women, but can also occur in men. It is characterized by a loss of bone mineral density (BMD), and often culminates in a fracture of the hip, wrist, and/or vertebrae. The diagnosis of osteoporosis is often made by using bone density measurements. They are often expressed in relative terms (T-scores and Z-scores); the Z-score is the number of standard deviations from the age-matched average value of healthy women. A low Z-score indicates the bone density is lower than it should be for a patient's age and sex. Osteoporosis is defined as a BMD loss of 2.5 standard deviations or more below the established mean. Osteoporosis can be treated by a variety of methods, the most common being the use of estrogen, with or without progestin or progesterone. The use of estrogen alone is referred to as estrogen replacement therapy (ERT), and the combination hormone replacement therapy (HRT). Other drugs used in the treatment of osteoporosis are the selective estrogen receptor modulators (SERMs) and the bisphosphonates. The SERMs appear to offer many of the positive benefits of estrogen with fewer adverse effects on the breast or uterus. Recently, a randomized, double blind study of nearly 3,000 women found no overall benefit in reducing heart disease for those taking estrogen. In fact, in the first year of estrogen use, heart disease was higher in this group than in those taking placebo. The relationship between systemic BMD and periodontal status has been investigated. In some patients, there is a correlation between a decrease of mandibular bone mass and tooth loss. In others, there is no such correlation. Those postmenopausal women taking HRT had greater tooth retention and a reduced likelihood of edentulism. A recent study has found no correlation between clinical attachment levels and the BMD of the lumbar spine. Many possible factors contribute to the development of osteoporosis and periodontal diseases. It is difficult to

  7. Neutron Stars

    NASA Technical Reports Server (NTRS)

    Cottam, J.

    2007-01-01

    Neutron stars were discovered almost 40 years ago, and yet many of their most fundamental properties remain mysteries. There have been many attempts to measure the mass and radius of a neutron star and thereby constrain the equation of state of the dense nuclear matter at their cores. These have been complicated by unknown parameters such as the source distance and burning fractions. A clean, straightforward way to access the neutron star parameters is with high-resolution spectroscopy. I will present the results of searches for gravitationally red-shifted absorption lines from the neutron star atmosphere using XMM-Newton and Chandra.

  8. Osteoporosis in the Women's Health Initiative: Another Treatment Gap?

    PubMed

    Sattari, Maryam; Cauley, Jane A; Garvan, Cynthia; Johnson, Karen C; LaMonte, Michael J; Li, Wenjun; Limacher, Marian; Manini, Todd; Sarto, Gloria E; Sullivan, Shannon D; Wactawski-Wende, Jean; Beyth, Rebecca J

    2017-08-01

    Osteoporotic fractures are associated with high morbidity, mortality, and cost. We performed a post hoc analysis of the Women's Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis were evaluated for medication use. A full logistic regression model was used to identify factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years. Among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, 21.6% reported taking an osteoporosis medication other than estrogen. Higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with White/Caucasian), higher income, and hormone therapy use (past or present) were associated with significantly higher likelihood of osteoporosis pharmacotherapy. Women with Black/African American race/ethnicity (compared with White/Caucasian), body mass index ≥30 (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and history of arthritis were less likely to use osteoporosis treatment. Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study. Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. Specific attention needs to be paid to

  9. X-rays from stars.

    PubMed

    Güdel, Manuel

    2002-09-15

    More than two years of observation with Chandra and XMM-Newton has provided a rich harvest of new results on the physics of stellar coronae and winds. High-resolution X-ray spectroscopy in particular has opened new windows to the structure, the dynamics and the composition of stellar atmospheres. The present paper presents selected results from the areas of hot and cool stars and star formation, summarizing new views of the thermal structure and energy release in stellar coronae, observations of magnetically active brown dwarfs, the structure of winds in hot stars, the physics in colliding-wind binary systems, and X-rays from protostars and stellar jets.

  10. Management recommendations for osteoporosis in clinical guidelines.

    PubMed

    Wang, Michael; Bolland, Mark; Grey, Andrew

    2016-05-01

    Numerous guidelines advise about management of osteoporosis, but little research has been conducted on their recommendations. We analysed recommendations on management of bone health in clinical guidelines. We surveyed recommendations on assessment, treatment and monitoring of bone health in 78 clinical guidelines (22 primary focus osteoporosis, 56 primary focus not osteoporosis) lodged at the Agency for Health Research and Quality National Guidelines Clearinghouse between 1/1/2009 and 12/31/2014. Governance of guidelines; discussion of fracture risk in the target population; recommendations for assessment, treatment and monitoring of bone health. Only 14% of guidelines discussed fracture risk in the target population. When guidelines discussed assessment, 98% recommended bone mineral density (BMD) measurement but only 27% recommended estimation of fracture risk. When guidelines discussed treatment, 63-71% recommended calcium and/or vitamin D, while <12% recommended avoiding low body weight or smoking cessation. When guidelines discussed intervention, 53% did so on the basis of BMD measurement, and only 27% on the basis of estimated fracture risk. When guidelines discussed monitoring, >90% recommended BMD measurements, and only 3% recommended estimation of fracture risk. About 65% of guidelines that suggested a BMD monitoring interval recommended one of ≤3 years. Compared to guidelines with a primary focus on osteoporosis, guidelines whose primary focus was not osteoporosis were less likely to discuss fracture risk in the target population (2% vs 45%), recommend estimation of fracture risk (11% vs 55%) and recommend intervention on the basis of estimated fracture risk (10% vs 67%) (all P < 0·005). Our findings highlight a strong focus in clinical guidelines on BMD, a surrogate measure, rather than fracture risk, the clinically important outcome, particularly when bone health is not the primary focus. Addressing this issue might facilitate more rational use of

  11. Osteoporosis: radiologic and nuclear medicine procedures.

    PubMed Central

    Weissman, B N

    1987-01-01

    A number of radiographic and nuclear medicine techniques are available for the assessment of patients suspected of having osteoporosis or at risk for the development of osteoporosis. Spinal radiographs are insensitive indicators of osteoporosis. They can document the presence of metastatic tumors or other lesions that may produce compression fracture. The Singh index assesses the trabecular pattern of the proximal femur. As bone loss occurs, the trabeculae disappear in a definite sequence. Radiogrammetry refers to the measurement of bone and cortical widths in the peripheral skeleton, usually the second metacarpal. The method is low cost and most useful for population studies. It does not reflect early osteoporosis. Photodensitometry entails radiography of a part of a bone with inclusion of a standard reference wedge on the radiograph. The density of the bone is compared with the wedge. In some laboratories, precision is good (1.5 percent) and the radiation dose is low. Peripheral cortical bone is measured primarily, which is a disadvantage. Single photon absorptiometry uses the transmission of 27.5 keV photons emitted from an iodine-125 source to assess bone density. In most instances, measurements of the radial shaft are made, which reflect primarily cortical bone rather than the more reactive trabecular bone. The distal end of the radius and the calcaneus may also be measured; these areas contain primarily trabecular bone. Radiation dose is low (less than 10 mrad), but when cortical bone is evaluated, the results correlate poorly with spinal bone mineral. Thus, the test is an insensitive indicator of spinal osteoporosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3120210

  12. Physical parameters for TGAS stars

    NASA Astrophysics Data System (ADS)

    Masana, E.; Solano, E.

    2017-03-01

    The Tycho-Gaia Astrometric Solution (TGAS) catalogue contains positions, parallaxes, proper motions and G magnitudes for more than 2 million stars. It was released in September 2016 as part of the Gaia Data Release 1 (DR1). In this work we investigated some methods to get additional information, in particular the effective temperature, the surface gravity and metallicity, but also reddening, absolute magnitudes or bolometric corrections, for TGAS stars. We have also searched for radial velocities in the Gaia-ESO Survey (GES).

  13. 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

  14. 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

  15. 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.

  16. Radio stars

    NASA Astrophysics Data System (ADS)

    Hjellming, Robert M.

    The state of knowledge on continuum radio emission from the stars is considered. Fundamental radio emission process and stellar radiative transfer are reviewed, and solar radio emission is examined. Flare stars and active binaries are addressed, and stellar winds and cataclysmic variables are considered. Radio-emitting X-ray binaries are discussed.

  17. 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.

  18. 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

  19. Osteoporosis Knowledge Among Individuals With Recent Fragility Fracture

    PubMed Central

    Giangregorio, L.; Thabane, L.; Cranney, A.; Adili, A.; deBeer, J.; Dolovich, L.; Adachi, J. D.; Papaioannou, A.

    2016-01-01

    BACKGROUND To evaluate osteoporosis knowledge among patients with fractures and to evaluate factors associated with osteoporosis knowledge. METHODS Patients with fragility fractures participated in a telephone interview. Participants were asked what they thought osteoporosis was. Unadjusted odds ratios (OR, 95% CI) were calculated to identify factors associated with a correct definition. Predictors identified in univariate analysis were entered into multivariable logistic regression models. A subset also completed the Facts on Osteoporosis Quiz. RESULTS One hundred twenty-seven patients (82% women) participated in the study, with mean (SD) age being 67.5 (12.7) years. Ninety-five (75%) respondents gave correct osteoporosis definitions. The odds of an individual providing a correct definition of osteoporosis were higher for those who reported a diagnosis of osteoporosis or those who reported higher education levels, but the odds decreased with increasing age. A total of 49 (39%) respondents completed the Facts on Osteoporosis Quiz; the average score was 13.6 (3.8) of 21. Areas that respondents scored poorly on were related to key risk factors. CONCLUSION Many patients with fractures are unaware of important risk factors. Education initiatives aimed at improving osteoporosis knowledge should be directed at individuals at high risk of fracture. Nurses and other allied healthcare providers working in fracture clinics, acute care, and rehabilitation settings are in an ideal position to communicate information about osteoporosis and fracture risk to individuals with a recent fragility fracture. PMID:20335769

  20. Osteoporosis: an ignored complication of CVID.

    PubMed

    Baris, Safa; Ozen, Ahmet; Ercan, Hulya; Karakoc-Aydiner, Elif; Cagan, Hasret; Ozdemir, Cevdet; Barlan, Metin; Bahceciler, Nerin N; Barlan, Isil B

    2011-11-01

    Multiple factors in common variable immunodeficiency (CVID) might interfere with optimal growth and maturation and potentially compromise bone health. We aimed to evaluate bone mineral density (BMD) of patients with CVID using dual energy X-ray absorptiometry (DEXA) and investigate risk factors associated with decreased bone density. Twenty-two patients were included (M: 16, F: 6) with a mean age of 15.6 ± 9.0 yr. DEXA revealed osteopenia in 6/22 (27.3%) and osteoporosis in 9/22 (40.9%) at lumbar spine and osteopenia in 7/19 (37%) and osteoporosis in 3/19 (16%) at femoral neck sites. The age of subjects with osteoporosis was significantly higher than those without (21.6 ± 8.0 vs. 9.0 ± 5.7 yr; p < 0.0001). BMD z-scores were significantly lower in patients with bronchiectasis compared with those without (p = 0.03). Patients with osteoporosis at femoral neck site had lower forced expiratory volume in 1 s (FEV(1) ) (p = 0.024), FEV(1) /forced vital capacity (FVC) (p < 0.0001), PEF (p = 0.008), and FEF 25-75 (p = 0.013) values compared with the patients with normal BMD z-scores. Low serum 25(OH) vitamin D levels were detected in 13/22 patients and low dietary calcium intake in 17/22 patients. BMD z-scores at femoral neck were lower in patients with low B-cell percentage (p = 0.03). BMD z-score at lumbar spine was correlated with folate (r = +0.63, p = 0.004) and serum immunoglobulin G levels (r = +0.430, p = 0.04). Osteoporosis appeared as an emerging health problem of patients with CVID, the risk increasing with older age and poorer lung function. Nutritional, biochemical, and immunologic factors appeared to take part in decreased BMD. Insight into the mechanisms of osteoporosis in CVID is crucial to develop preventive strategies. © 2011 John Wiley & Sons A/S.

  1. [Treatment of osteoporosis: current data and prospects].

    PubMed

    Reginster, J Y; Deroisy, R; Franchimont, P

    1994-12-15

    Postmenopausal osteoporosis is characterized not only by a reduction in bone mass but also by bone microarchitecture alterations, which result in greater bone frailty and in an increased fracture risk. Many drugs have been studied to determine whether they prevent bone loss or reduce the incidence of additional fractures in patients with established osteoporosis. Primary prevention of osteoporosis rests on regular exercising and adequate intake of dietary calcium. For secondary prevention in women undergoing menopause, replacement estrogen therapy given for at least ten years is associated with substantial reductions in fractures of the radius, hip, and spine. Other drugs capable of arresting postmenopausal bone loss include parenteral, nasal or rectal calcitonin and diphosphonates. However, the long-term safety of the latter requires further evaluation. Current studies are evaluating new molecules with potential preventive efficacy, such as ipriflavone. There is no general consensus about the efficacy of treatments for established osteoporosis with fractures. To date, no controlled studies have demonstrated a reduction in the incidence of further fractures in patients given calcium alone. Studies of hydroxylated vitamin D derivatives have been disappointing, although daily administration of vitamin D3 in combination with calcium significantly reduced the incidence of nonvertebral fractures in a population of elderly institutionalized subjects. Plausible explanations for this effect include increased vitamin D levels and reduced parathyroid levels in the bloodstream. Parenteral or nasal calcitonin stabilizes or increases bone mineral content in both cancellous and cortical bone. This effect is especially marked in high-turn-over patients. Several lines of evidence suggest that calcitonin therapy has a protective effect against vertebral and hip fractures. In patients with osteoporosis, oral or intravenous diphosphonates are associated with a significant increase in

  2. The Creation of Titanium in Stars

    NASA Image and Video Library

    2014-02-19

    This diagram illustrates why NASA NuSTAR can see radioactivity in the remains of exploded stars for the first time. The observatory detects high-energy X-ray photons that are released by a radioactive substance called titanium-44.

  3. Stability properties of Q-stars

    NASA Astrophysics Data System (ADS)

    Becerril, R.; Bernal, A.; Guzmán, F. S.; Nucamendi, U.

    2007-12-01

    We present the evolution of Q-star configurations using numerical methods. We solve the full Einstein-Klein-Gordon system of equations and show that: Q-stars can be stable and unstable. The unstable branch is two fold: configurations with negative binding energy that collapse and form black holes, and others with positive binding energy that explode and release the scalar field.

  4. The fracture and osteoporosis outpatient clinic: an effective strategy for improving implementation of an osteoporosis guideline.

    PubMed

    van Helden, Svenhjalmar; Cauberg, Evelyne; Geusens, Piet; Winkes, Bjorn; van der Weijden, Trudy; Brink, Peter

    2007-10-01

    Clinical screening for osteoporosis in women aged over 50 years following a fracture is advocated by all guidelines on osteoporosis, but such attitude is widely reported to be inadequate. The aim of this study was to evaluate the effect of a strategy comparing referral for a dual-energy X-ray absorptiometry (DXA) scan as part of the osteoporosis guideline by a dedicated osteoporosis nurse with referral in hospitals without the presence of an osteoporosis nurse. We retrospectively compared one reference hospital with five surrounding hospitals in the Netherlands. During a 2-week period, all female patients aged over 50 years who presented with a fracture at the emergency department of the six hospitals were included. Follow-up was minimal 11 weeks. The primary outcome was the referral for DXA measurement. In total, 135 patients were included, of whom 33 were seen in the reference hospital and 102 in the surrounding hospitals. In both groups, mean age and fracture location were similar. In the reference hospital, 14 patients qualified for DXA measurement, of whom 10 patients effectively underwent a DXA scan (71%). In the surrounding hospitals, 78 patients qualified for DXA measurement, of whom only three effectively underwent a DXA scan (4%). Taking into account a refusal percentage for DXA of 33% as was found in the reference centre, 47 patients in the surrounding hospitals should have been qualified for DXA measurement. Thus, successful referral in the surrounding hospitals was three out of 47 (6%) patients. The presence of an osteoporosis nurse did have a significant influence on the amount of DXA scans after fractures [RR 11 (95% CI: 3.6-35.1)]. This study indicates that referral for DXA is low in surrounding hospitals, and suggests that the presence of an osteoporosis nurse in the reference hospital significantly increased the number of patients receiving adequate osteoporosis screening with DXA measurement after a recent fracture. With this strategy patients

  5. Osteoporosis - prevention and detection in general practice.

    PubMed

    Ewald, Dan

    2012-03-01

    Osteoporosis causes a large and growing health burden in Australia. Effective treatments are available, but these are inconsistently implemented. There is some inconsistency in expert advice on who should be recommended to have bone densitometry. This review draws on the available high level evidence for what works in prevention and discusses the rationale for using absolute risk estimations for decision making. Effective interventions for the prevention and early intervention of osteoporosis have not been delivered as widely as they should be. Efforts should be focused on offering treatment to those groups with the highest risk of fracture, particularly those that have had a fragility fracture. There is synergy in the lifestyle recommendations for bone health with other aspects of health, so these should be addressed as thoroughly as possible.

  6. [Osteoporosis as a lifestyle-related disease].

    PubMed

    Hata, Motohide; Miyao, Mariko; Mizuno, Yuzo

    2003-02-01

    Although genetic factors determine the limits of peak bone mass, environmental factors can modify the outcome. Relation between lifestyle and osteoporosis is discussed, in terms of nutrition and habits. Significant link between calcium intake and bone mass has been reported. Although recommended daily allowance of calcium is 600 mg/day for adults, 850 mg/day or more shall be recommended later in life. Vitamin D insufficiency may lead to secondary hyperparathyroidism in the elderly, the condition that facilitates bone loss. Other nutrients that affect bone turnover include vitamin K, vitamin C, protein, potassium, salt, magnesium and phosphorus. Too much intake of caffeine or alcohol, as well as smoking is a risk factor of osteoporosis. Mechanical loading on the skeleton increases bone mass, therefore weight-bearing activity is recommended to gain or preserve bone mass.

  7. [Pregnancy and lactation-associated osteoporosis].

    PubMed

    Gehlen, M; Lazarescu, A D; Hinz, C; Boncu, B; Schmidt, N; Pfeifer, M; Schwarz-Eywill, M; Pollähne, W; Minne, H W

    2017-01-13

    Pregnancy and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis, which occurs in the last trimester or postpartum. So far 100 cases have been published. The leading symptoms are severe low back pain or less frequently hip pain. Many patients develop postpartum depression due to inability to care for the baby and vertebral fractures. The therapeutic decision has to be made individually but teriparatid and bisphosphonates seem to be the best option. We report the clinical course (16 years) of a 37-year-old patient with PLO, who suffered 6 vertebral fractures. There were severe physical limitations and mental problems caused by the disease. The patient was treated by multimodal therapy including physiotherapy and psychotherapy and bisphosphonates were given. The time between the onset of symptoms and diagnosis was 5 months. No further fractures occurred in the following 16 years. The physical and mental condition significantly improved.

  8. The role of cytokines in postmenopausal osteoporosis.

    PubMed

    Brincat, S D; Borg, M; Camilleri, G; Calleja-Agius, J

    2014-08-01

    Postmenopausal osteoporosis is a silent systemic progressive disease characterised by a decrease in bone mass per unit volume. This condition compromises the physical strength of the skeleton and increases the susceptibility to fractures on minor trauma. The imbalance between bone formation and bone resorption is known to be responsible for postmenopausal bone loss. Estrogen deficiency contributes to bone loss by increasing the production of pro-inflammatory cytokines by bone marrow and bone cells. Clinical and molecular evidence indicates that estrogen-regulated cytokines exert regulatory effects on bone turnover implicating their role as being the primary mediators of the accelerated bone loss at menopause. The current perspective on the role and interaction of cytokines such as IL-1, IL-4, IL-6, IL-17, TNF, IFN-γ and TGF-β in bone loss linked with estrogen deficiency is reviewed. Current treatment options and emerging drug therapies in the management of postmenopausal osteoporosis are also evaluated.

  9. Review of treatment modalities for postmenopausal osteoporosis.

    PubMed

    Hamdy, Ronald C; Chesnut, Charles H; Gass, Margery L; Holick, Michael F; Leib, Edward S; Lewiecki, Michael E; Maricic, Michael; Watts, Nelson B

    2005-10-01

    This review summarizes and updates data presented at recent annual Southern Medical Association conferences on postmenopausal osteoporosis. As part of any osteoporosis treatment program, it is important to maintain adequate calcium and 25-hydroxyvitamin D levels either through diet or supplementation. Among the available pharmacologic therapies, the bisphosphonates alendronate and risedronate have demonstrated the most robust fracture risk reductions-approximately 40 to 50% reduction in vertebral fracture risk, 30 to 40% in nonvertebral fracture risk, and 40 to 60% in hip fracture risk. Ibandronate, a new bisphosphonate, has demonstrated efficacy in reducing vertebral fracture risk. Salmon calcitonin nasal spray and raloxifene demonstrated significant reductions in vertebral fracture risk in pivotal studies. Teriparatide significantly reduced vertebral and nonvertebral fracture risk. Drugs on the horizon include strontium ranelate, which has been shown to reduce vertebral and nonvertebral fracture risk, and zoledronic acid, an injectable bisphosphonate that increased bone density with once-yearly administration.

  10. Identification, diagnosis, and prevention of osteoporosis.

    PubMed

    Levine, Jeffrey P

    2011-05-01

    Prevention of osteoporotic fractures is of major importance from a public health perspective. Despite the large burden the disease exacts on individuals and society, not all patients with osteoporosis receive optimal treatment. Since only 1 in 3 patients with osteoporosis is diagnosed, clinicians need to improve their ability to identify patients who are candidates for bone mineral density (BMD) screening. Although limited data exist about the direct correlation between effective screening and fracture morbidity and mortality, it has been proved that increases in fractures are associated with increases in morbidity and mortality. Therefore, identifying patients at risk, making a timely diagnosis, implementing prevention measures (ie, calcium, vitamin D, exercise, fall precautions, etc), and initiating pharmacologic therapy for appropriate patients can all help to minimize fracture risk.

  11. Osteoporosis: a paradox in ankylosing spondylitis.

    PubMed

    Carter, Shea; Lories, Rik J

    2011-09-01

    Ankylosing spondylitis is a chronic and severe inflammatory disease of the axial skeleton and the joints. Inflammation is associated with trabecular bone loss leading to osteoporosis but also with corcal new bone formation leading to progressive ankylosis of the spine and sacroiliac joints. This results in an apparent paradox of bone formation and loss taking place at sites closesly located to each other. Osteoporosis can be explained by the impact of inflammation of the bone remodeling cycle. In contrast, new bone formation has been linked to aberrant acvaon of bone morphogenec protein and Wnt signaling. In this commentary, we review recent data on this bone paradox and highlight recent advances including the effect of current drug therapies and the idenfication of new therapeutic targets.

  12. 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.

  13. Osteoporosis diagnostics in patients with rheumatoid arthritis.

    PubMed

    Węgierska, Małgorzata; 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.

  14. 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.

  15. Pig calcitonin in the treatment of localised osteoporosis.

    PubMed

    De Bastiani, G; Nogarin, L; Perusi, M

    1976-08-01

    On the basis of positive results obtained in the treatment of Sudeck's atrophy with calcitonin, the authors extended their investigation to other forms of localised osteoporosis. Six patients were examined affected by osteoporosis secondary to immobilisation, three patients with osteoporosis of the lower limbs from paralysis of the sciatic nerve and six patients with migrant osteoporosis. Treatment was as follows: pig calcitonin (Calcitar) in doses of 160 u MRC/daily + calcium gluconate in doses of 3 gr/daily. The duration of treatment averaged forty five days. In osteoporosis from immobilisation and nerve lesions the calcitonin treatment did not influence the condition and there was no change in radiographic appearances nor was there any analgesic action. On the other hand, the results were clearly positive in migrant osteoporosis: in all the patients treated there was complete regression of pain, cutaneous trophic changes, and functional loss. At a later stage, normal radiographic appearances were restored.

  16. 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

  17. [Hormones and osteoporosis update. Glucocorticoids and bone].

    PubMed

    Ikeda, Kyoji

    2009-07-01

    Glucocorticoids are a class of vital steroid hormone which exhibit permissive effects on transactivation in a variety of cells, including those in bone. Glucocorticoid-induced osteoporosis, on the other hand, predisposes to fragility fracture by compromising bone strength and can be understood as a disease primarily characterized by a deficiency in bone quality. It is a major challenge in bone biology to understand these two contrasting sides of glucocorticoid activity in bone.

  18. Osteoporosis in postmenopausal women living with HIV.

    PubMed

    Finnerty, Fionnuala; Walker-Bone, Karen; Tariq, Shema

    2017-01-01

    The widespread availability of effective antiretroviral therapy (ART) has transformed HIV from a life-limiting condition to one with near-normal life expectancy. HIV is associated with an increased risk of osteopenia and osteoporosis, with people living with HIV (PLHIV) potentially experiencing these conditions at a younger age than their HIV-negative counterparts. The mechanisms driving bone disease in HIV are complex and include: an increased prevalence of traditional risk factors; other comorbid conditions; and HIV-associated factors such as viral effects, systemic inflammation, and ART-related factors. One-third of PLHIV in the United Kingdom are female, and increasing numbers of women living with HIV (WLHIV) are reaching menopausal age. Oestrogen decline in the context of an elevated background risk of poor bone health results in WLHIV being at greater risk of osteoporosis than women without HIV. European HIV guidelines therefore recommend routine screening of postmenopausal WLHIV using FRAX(©) for clinical risk factors, with or without bone mineral density scanning. Data support the use of calcium and vitamin D supplementation, and bisphosphonates in the treatment of osteoporosis in PLHIV. Additionally, some patients with confirmed osteoporosis may benefit from a switch to an ART agent with a better bone safety profile. However, there remains a notable paucity of data on HIV and menopause, including the impact of hormone replacement therapy on the bone health of WLHIV. In conclusion, it is important that clinicians are aware that postmenopausal WLHIV are a group at particular risk of bone disease, who require proactive screening and advice about preventative measures.

  19. 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

  20. Senile osteoporosis. The effects of exercise.

    PubMed

    Yeater, R A; Martin, R B

    1984-02-01

    The available literature indicates that a high level of physical activity throughout life can result in increased skeletal mass during the fourth decade. Such a large reservoir of bone mass at midlife may delay the clinical manifestations of osteoporosis in later life. Furthermore, the published studies of animal models and humans strongly suggest that physical activity retards or prevents involutional bone loss in both recently postmenopausal and very elderly women.

  1. 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

  2. Novel Advances in the Treatment of Osteoporosis

    PubMed Central

    Chan, Christopher KY; Mason, Alice; Cooper, Cyrus; Dennison, Elaine

    2016-01-01

    Introduction Osteoporosis is a significant public health issue affecting over half of women aged over 50. With an aging population its importance is set to increase further over time. Prevention of fragility fractures avoids significant mortality and morbidity as well as saving significant direct and indirect costs to the economy. In this review, we discuss existing treatments to contextualise the treatment landscape, and demonstrate how our understanding of bone pathophysiology has led to novel therapies – in the form of combinations and altered durations of existing treatments, as well as newer drug therapies. Sources of data Pubmed and Embase were searched for randomised controlled trials of new therapies for osteoporosis. These searches were supplemented with material presented in abstract form at international meetings Areas of agreement New drugs that appear promising in the treatment of osteoporosis include the cathepsin K inhibitor, monoclonal antibodies against sclerostin, and parathyroid hormone related peptide. Areas of controversy Separate to the development of novel drug therapies is the issue of how best to use agents that are currently available to us; specifically which agent to choose, alone or in combination; duration of therapy; how best to identify patients at highest risk of fracture, and to ensure the highest possible adherence to medication. Many of these issues have been addressed in other excellent review papers, and will not be considered in detail here. Growing points As with all new treatments, we await results of long term use, and experience in ‘real life’ patient populations Areas timely for developing research As alluded to above, data are urgently required regarding the optimal duration of therapy; use of combination therapy; ordering of therapies for best therapeutic effect. As stratified medicine becomes more strongly considered in all areas of therapy, its merits in osteoporosis as in other musculoskeletal conditions, is

  3. Epidemiology, etiology, and diagnosis of osteoporosis.

    PubMed

    Lane, Nancy E

    2006-02-01

    Osteoporosis, a major public health problem, is becoming increasingly prevalent with the aging of the world population. Osteoporosis is a skeletal disorder characterized by compromised bone strength, which predisposes the individual to an increased risk of fractures of the hip, spine, and other skeletal sites. The clinical consequences and economic burden of this disease call for measures to assess individuals who are at high risk to allow for appropriate intervention. Many risk factors are associated with osteoporotic fracture, including low peak bone mass, hormonal factors, the use of certain drugs (eg, glucocorticoids), cigarette smoking, low physical activity, low intake of calcium and vitamin D, race, small body size, and a personal or a family history of fracture. All of these factors should be taken into account when assessing the risk of fracture and determining whether further treatment is required. Because osteoporotic fracture risk is higher in older women than in older men, all postmenopausal women should be evaluated for signs of osteoporosis during routine physical examinations. Radiologic laboratory assessments of bone mineral density generally should be reserved for patients at highest risk, including all women over the age of 65, younger postmenopausal women with risk factors, and all postmenopausal women with a history of fractures. The evaluation of biochemical markers of bone turnover has been useful in clinical research. However, the predictive factor of these measurements is not defined clearly, and these findings should not be used as a replacement for bone density testing. Together, clinical assessment of osteoporotic risk factors and objective measures of bone mineral density can help to identify patients who will benefit from intervention and, thus, can potentially reduce the morbidity and mortality associated with osteoporosis-associated fractures in this population.

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

    MedlinePlus

    ... on. Feature: Osteoporosis Osteoporosis: Symptoms, Diagnosis, Treatment and Prevention Past Issues / Winter 2011 Table of Contents Osteoporosis ... exercise plan A healthy lifestyle Medications, if needed Prevention Nutrition A diet rich in calcium and vitamin ...

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

    MedlinePlus

    ... With Inflammatory Bowel Disease Need to Know About Osteoporosis Publication available in: PDF (87 KB) Related Resources ... Management Strategies Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  6. BMD and Serum Intact Osteocalcin in Postmenopausal Osteoporosis Women.

    PubMed

    Jagtap, Vanita R; Ganu, Jayashri V; Nagane, Nitin S

    2011-01-01

    India seems to have the highest prevalence of osteoporosis. With growing awareness of osteoporosis and its impact on life span especially in India, special attention is being paid to early detection, management and treatment of postmenopausal osteoporosis in women. Measurement of BMD and osteocalcin are of value in estimating bone turnover rates. The aim of this study is (1) to measure the specific, sensitive bone formation marker such as osteocalcin and BMD in postmenopausal osteoporosis women and postmenopausal non-osteoporosis women; (2) the follow up study to evaluate the impact of specific antiresorptive therapy (alendronate + calcium + vitamin D) regimen in postmenopausal osteoporosis by assaying osteocalcin and BMD. Sixty clinically diagnosed postmenopausal osteoporosis patients and 60 normal subjects (postmenopausal non-osteoporosis women) were recruited as control. Mean bone mineral density T score and Z score was significantly decreased (P < 0.001) in postmenopausal osteoporosis patients as compared to controls. Highly significant increase in the mean score of BMD-T score and Z score from baseline to post therapy of 3 months was observed in postmenopausal osteoporosis women. Serum osteocalcin levels were significantly increased (P < 0.001) as compared to control group. Serum osteocalcin levels were decreased significantly (P < 0.001) from baseline to post therapy of 3 months in postmenopausal osteoporosis women. BMD is the best quantifiable predictor of osteoporotic fracture and osteocalcin is specific, sensitive, promising, currently used marker for better prognosis of osteoporosis and for monitoring responses to antiresorptive therapy.

  7. A model of health education and management for osteoporosis prevention

    PubMed Central

    Wang, Liang; Xu, Xiaowen; Zhang, Yan; Hao, Hongxia; Chen, Liying; Su, Tianjiao; Zhang, Yan; Ma, Weifeng; Xie, Yuanyuan; Wang, Tiantian; Yang, Fan; He, Li; Wang, Wenjiao; Fu, Xuemei; Ma, Yuanzheng

    2016-01-01

    Osteoporosis, a chronic disease with no therapeutic cure, affects a growing number of people as the aging population in China rapidly increases. Therefore, developing an evidence-based model of health education and management for osteoporosis prevention is required. In the present study, an osteoporosis club was established, which is a novel model of health education and management for osteoporosis prevention. A unified management of membership was used based on a digitized database. A total of 436 patients with osteoporosis were randomly assigned to the osteoporosis club group or the self-management control group. For the osteoporosis club group, multiple activities of health education were performed, including monthly systematic health education lectures, exercise programs and communication parties once a year. For the control group, the participants took charge of their own musculoskeletal health. All data of the participants were collected and evaluated prior to and following intervention. In the pre-intervention assessment, no significant difference was identified in the health education between the two groups. Through the four-year intervention, the osteoporosis knowledge, health beliefs, living behavior, medication compliance, quality of life and bone mineral density of the osteoporosis club group were improved significantly compared with the control group (P<0.001), while the pain degree of the osteoporosis club group was relieved significantly more compared with the control group (P<0.001). The results in the present study suggest that setting up an osteoporosis club is an evidence-based model of health education and management for osteoporosis prevention in China. PMID:28105113

  8. Why Do Only Some Women Develop Post-Menopausal Osteoporosis?

    DTIC Science & Technology

    2015-05-01

    AWARD NUMBER: W81XWH-13-1-0307 TITLE: Why Do Only Some Women Develop Post- Menopausal Osteoporosis ? PRINCIPAL INVESTIGATOR: Marc D...Only Some Women Develop Post-Menopausal Osteoporosis ? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-13-1-0307 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...proposed project addresses a novel and potentially important mechanism of osteoporosis which may determine which women suffer the disease. Confirmation

  9. Osteoporosis in children: pediatric and pediatric rheumatology perspective: a review

    PubMed Central

    Uziel, Yosef; Zifman, Eyal; Hashkes, Philip J

    2009-01-01

    It is increasingly recognized that osteoporosis affects children as well as adults both as a primary problem and as secondary to various diseases, medications, and lifestyle issues. In this review, we emphasize the correct diagnosis of osteoporosis in children as opposed to adults, etiology, and pharmaceutical and non-pharmaceutical treatments. We especially focus on rheumatologic conditions associated with osteoporosis and management issues. PMID:19835571

  10. The RAdial Velocity Experiment (RAVE): Third Data Release

    NASA Astrophysics Data System (ADS)

    Siebert, A.; Williams, M. E. K.; Siviero, A.; Reid, W.; Boeche, C.; Steinmetz, M.; Fulbright, J.; Munari, U.; Zwitter, T.; Watson, F. G.; Wyse, R. F. G.; de Jong, R. S.; Enke, H.; Anguiano, B.; Burton, D.; Cass, C. J. P.; Fiegert, K.; Hartley, M.; Ritter, A.; Russel, K. S.; Stupar, M.; Bienaymé, O.; Freeman, K. C.; Gilmore, G.; Grebel, E. K.; Helmi, A.; Navarro, J. F.; Binney, J.; Bland-Hawthorn, J.; Campbell, R.; Famaey, B.; Gerhard, O.; Gibson, B. K.; Matijevič, G.; Parker, Q. A.; Seabroke, G. M.; Sharma, S.; Smith, M. C.; Wylie-de Boer, E.

    2011-06-01

    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.

  11. 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.

  12. 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

  13. Pathogenesis of osteoporosis: concepts, conflicts, and prospects

    PubMed Central

    Raisz, Lawrence G.

    2005-01-01

    Osteoporosis is a disorder in which loss of bone strength leads to fragility fractures. This review examines the fundamental pathogenetic mechanisms underlying this disorder, which include: (a) failure to achieve a skeleton of optimal strength during growth and development; (b) excessive bone resorption resulting in loss of bone mass and disruption of architecture; and (c) failure to replace lost bone due to defects in bone formation. Estrogen deficiency is known to play a critical role in the development of osteoporosis, while calcium and vitamin D deficiencies and secondary hyperparathyroidism also contribute. There are multiple mechanisms underlying the regulation of bone remodeling, and these involve not only the osteoblastic and osteoclastic cell lineages but also other marrow cells, in addition to the interaction of systemic hormones, local cytokines, growth factors, and transcription factors. Polymorphisms of a large number of genes have been associated with differences in bone mass and fragility. It is now possible to diagnose osteoporosis, assess fracture risk, and reduce that risk with antiresorptive or other available therapies. However, new and more effective approaches are likely to emerge from a better understanding of the regulators of bone cell function. PMID:16322775

  14. 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.

  15. 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. Copyright © 2012 Elsevier GmbH. All rights reserved.

  16. Thiol/disulfide homeostasis in postmenopausal osteoporosis.

    PubMed

    Korkmaz, V; Kurdoglu, Z; Alisik, M; Turgut, E; Sezgın, O O; Korkmaz, H; Ergun, Y; Erel, O

    2017-04-01

    To evaluate the impact of postmenopausal osteoporosis on thiol/disulfide homeostasis. A total of 75 participants were divided into two groups: Group 1 (n = 40) was composed of healthy postmenopausal women, and group 2 (n = 35) was composed of women with postmenopausal osteoporosis. Clinical findings and thiol/disulfide homeostasis were compared between the two groups. The disulfide/native thiol ratio was 8.6% ± 3.6 in group 1 and 12.7% ± 8.4 in group 2 (p = 0.04). The disulfide/native thiol percent ratio was significantly higher in group 2 after adjustment for the years since menopause and age (p < 0.05). The native thiol/total thiol percent ratio was 85.6% ± 4.8 in group 1 and 73.8% ± 24.9 in group 2 (p = 0.01). The native thiol/total thiol percent ratio was significantly lower in group 2 after adjustment for the years since menopause and age (p < 0.05). Thiol/disulfide homeostasis shifted to the disulfide side independent of age and years since menopause in postmenopausal osteoporosis.

  17. [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. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. [Lifestyle management approaches in postmenopausal osteoporosis].

    PubMed

    Ohta, Hiroaki

    2004-11-01

    Of the lifestyle management approaches to postmenopausal osteoporosis recommended, encouraging walking appears to be more relevant than ensuring appropriate nutritional intake in preventing bone loss. The focus of the current lecture is therefore on encouraging exercise, as it is not hard to imagine the physical impact of exercise on bone mineral density. As has long been pointed out, in fact, the initial management of postmenopausal osteoporosis consists in subjecting the bone to a continual physical stress, including exercise. In this regard, aerobic exercise including walking has been widely recommended;however, there is no clear evidence showing aerobic exercise to be superior to other kinds of exercise, while several studies reported on the benefit of combining aerobic exercise with pharmacological treatments in postmenopausal women, including our own series. Physical exercise programs or guidelines aimed at the prophylaxis of postmenopausal osteoporosis that draw on research evidence supporting the benefit of encouraging physical exercise need yet to be put in place as a matter of urgency.

  19. Canadian Consensus Conference on Osteoporosis, 2006 Update

    PubMed Central

    Brown, Jacques P.; Fortier, Michel

    2016-01-01

    Objective To provide guidelines for the health care provider on the diagnosis and clinical management of postmenopausal osteoporosis. Outcomes Strategies for identifying and evaluating high-risk individuals, the use of bone mineral density (BMD) and bone turnover markers in assessing diagnosis and response to management, and recommendations regarding nutrition, physical activity, and the selection of pharmacologic therapy to prevent and manage osteoporosis. Evidence MEDLINE and the Cochrane database were searched for articles in English on subjects related to osteoporosis diagnosis, prevention, and management from March 2001 to April 2005. The authors critically reviewed the evidence and developed the recommendations according to the Journal of Obstetrics and Gynaecology Canada’s methodology and consensus development process. Values The quality of evidence is rated using the criteria described in the report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this report. Sponsors The development of this consensus guideline was supported by unrestricted educational grants from Berlex Canada Inc., Lilly Canada, Merck Frosst, Novartis, Novogen, Novo Nordisk, Proctor and Gamble, Schering Canada, and Wyeth Canada. PMID:16626523

  20. [Prevention of osteoporosis and its economic aspects].

    PubMed

    Blachier, C

    1999-01-01

    Osteoporosis is a skeletal disease which deteriorates bone tissue and lowers its density. Bone fragility induces fractures of the hip, vertebrae and distal radius. These fractures occur mainly to women after their menopause due to important postmenopausal changes in bone metabolism. Osteoporosis and related fractures are a major public health issue, as the upcoming population aging will sharply increase their incidence. For the time being prevention of osteoporosis is at a crossroads in France. One way would be to treat the entire postmenopause female population with hormone substitution to avoid the incidence to one third among them: the cost would be very high and, for the time being, the risk/benefit ratio is not well known (we do not know the risks of a treatment lasting 20 or 25 years). The other way would be to implement only reliable diagnostic programs without generalized hormone treatment: such an option might lead to a sharp increase of the disease incidence, causing a high cost both in social and financial terms.

  1. [Diagnosis and treatment of postmenopausal osteoporosis and osteoporosis in men. German Guidelines Update 2006].

    PubMed

    Kurth, A A; Pfeilschifter, J

    2007-07-01

    The treatment of osteoporosis and prevention of osteoporotic fractures consists of both non-drug and drug therapy. Components of non-drug therapy include the improvement of muscle strength and coordination, treatment of modifiable causes of falls, a diet rich in calcium and sufficient in calories, an adequate supply of Vitamin D and an individual assessment of drugs known to increase falls or osteoporosis. The updated DVO diagnostic and treatment guidelines for osteoporosis recommends a 30% 10-year probability for vertebral and hip fractures as an intervention threshold for drug treatment. Using epidemiological fracture data from central Europe, the guidelines provides an assessment of absolute 10-year fracture risk based on a combination of age, gender, prevalent fragility fractures, spine and total hip dual-energy x-ray absorptiometry (DXA) measurements and several other clinical risk factors.

  2. Type 1 diabetes and osteoporosis: A review of literature

    PubMed Central

    Dhaon, Pooja; Shah, Viral N.

    2014-01-01

    With better care and intensive insulin therapy, microvascular complications have reduced and longevity has increased in patients with type 1 diabetes (T1DM). Therefore, there is a need to change the focus from microvascular complications to cardiovascular disease and osteoporosis. Though number of studies from other parts of the world show that patients with T1DM are at increased risk of osteoporosis and fractures, there is a paucity of data from India. A number of factors and mechanisms affecting bone health in patients with T1DM have been proposed. The main defect in genesis of osteoporosis is osteoblastic function, rather than osteoclastic overfunction. Assessment of bone mineral density by dual X-ray absorptiometry and other risk factors for osteoporosis, as a part of diagnostic procedure can help to design tailored treatment plans. A physically active healthy lifestyle, prevention of diabetic complications and adequate calcium and vitamin D supplementation are the mainstay for prevention of osteoporosis. Treatment of osteoporosis is not evidence based but it is proposed to be similar to osteoporosis associated with other conditions. Bisphosphonates are the mainstay for treatment of osteoporosis in patients with T1DM. However, more studies are needed to make definitive guidelines on prevention and treatment of osteoporosis in patients with T1DM. PMID:24741510

  3. 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.

  4. Osteoporosis and bone health in patients with lung disease.

    PubMed

    Bolster, Marcy B

    2010-09-01

    Osteoporosis is a common systemic disease whose presentation crosses many specialties in medicine. Low bone mass, (osteopenia) and osteoporosis increases a patient's risk of suffering from a fracture, and fragility fractures are known to have a significant effect on morbidity and mortality, with up to a 1-year 20% mortality risk. Early detection of osteoporosis is essential to reduce a patient's risk of fracture. Several diseases are associated with an increased risk of osteoporosis because of the medications used to treat these diseases, including but not limited to the prescribing of glucocorticoids. It is important to recognize which patients warrant therapy for bone health and to implement medical management as appropriate.

  5. Similarities in Acquired Factors Related to Postmenopausal Osteoporosis and Sarcopenia

    PubMed Central

    Sirola, Joonas; Kröger, Heikki

    2011-01-01

    Postmenopausal population is at increased risk of musculoskeletal impairments. Sarcopenia and osteoporosis are associated with significant morbidity and social and health-care costs. These two conditions are uniquely linked with similarities in pathophysiology and diagnostic methods. Uniform diagnostic criteria for sarcopenia are still evolving. Postmenopausal sarcopenia and osteoporosis share many environmental risk- and preventive factors. Moreover, geriatric frailty syndrome may result from interaction of osteoporosis and sarcopenia and may lead to increased mortality. The present paper reviews the factors in evolution of postmenopausal sarcopenia and osteoporosis. PMID:21904688

  6. Osteoporosis in Rett syndrome: a case study presenting a novel management intervention for severe osteoporosis.

    PubMed

    Lotan, M; Reves-Siesel, R; Eliav-Shalev, R S; Merrick, J

    2013-12-01

    The present article describes a successful novel therapeutic intervention with Aredia with one child with Rett syndrome, after suffering from six pathological fractures within less than 3 years due to severe osteoporosis. Since the initiation of the treatment (3 years ago), the child has not suffered any fractures. Patients with chronic diseases and those with disabilities or on anticonvulsant medications are at risk for low bone density and possibly for the resultant pathologic fractures that define osteoporosis in children. Individuals with Rett syndrome (RS) have been shown to have low bone mineral density (or osteopenia) at a young age. If osteoporosis occurs in a girl with RS, it can inflict pain and seriously impair the child's mobility and quality of life. The present article describes a case study of a child with RS (showing an average of 1.75 fractures annually for the 4 years preceding the treatment) before and after a treatment with Aredia. Patient received 30 mg/day for 3 days on a once every 3-month cycle. There was a 45 % improvement in bone mass density (BMD) values from pre-post-intervention. The child had no fractures in the 3 years posttreatment. This finding is significant (p < 0.03). The BMD Z-scores of the child showed severe osteoporosis (Z-score of -3.8) at pre-intervention and are elevated to osteopenia levels (Z-score of -1.3) at post-intervention measurements. All measurements suggest that the treatment successfully reversed the osteoporotic process and prevented further fractures. This change caused great relief to the child and her family and an improvement in their quality of life. The findings support the ability (in one case) to reverse the progression of osteoporosis in individuals with Rett syndrome showing severe osteoporosis with multiple fractures.

  7. Nigella Sativa reverses osteoporosis in ovariectomized rats.

    PubMed

    Seif, Ansam Aly

    2014-01-14

    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. 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. 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 in OVX-NS rats. Nigella

  8. 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

  9. 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

  10. Clinical Significance and Pathogenesis of Osteoporosis*

    PubMed Central

    Nordin, B. E. C.

    1971-01-01

    The development of osteoporosis with advancing age in man is a widespread if not a universal phenomenon. The average loss between youth and old age amounts to about 15% of the skeleton but involves a much larger proportion of trabecular than of cortical bone. The principal clinical manifestation of osteoporosis is fracture, and three osteoporotic fracture syndromes can be defined: the lower forearm fracture, which predominantly affects women between the ages of 50 and 65; the fracture of the proximal femur, which affects both sexes over the age of 70; and the relatively rare vertebral crush fracture syndrome, which may present at any age but is most common in elderly women. The lower forearm fracture rate is inversely related to the mean normal lower forearm x-ray “density” of the wrist, which falls by about 30% in the 15 years following the menopause. This process, which is associated with corresponding trabecular bone loss elsewhere in the skeleton, is associated with a corresponding rise in the fasting urinary calcium excretion. Some degree of negative calcium balance, and consequent bone resorption, probably occurs in everyone during the later part of the night because calcium absorption is completed within about three to five hours of a meal. In postmenopausal women, however, the sensitivity of the bone to parathyroid hormone appears to be increased, and their nocturnal negative calcium balance therefore comes to exceed the positive balance which can be achieved during the waking hours. Femoral neck fractures in old people reflect the further progression of osteoporosis with advancing age since the fracture rate is inversely correlated with the mean thickness of the metacarpal cortex in the normal population. This progressive osteoporosis is associated with and could well result from a steady decline in calcium absorption which is at least partially attributable to vitamin-D deficiency and reversible on vitamin-D treatment. The vertebral crush fracture

  11. Osteoporosis management in post-menopausal women.

    PubMed

    Christenson, E S; Jiang, X; Kagan, R; Schnatz, P

    2012-06-01

    Osteoporosis is most prevalent in women over the age of 50 as the hormonal influence of estrogen on bone health dissipates with the onset of menopause. The progressive changes in bone structure, quality and density lead to pathological fractures and an increase in morbidity and mortality among menopausal women. This review will examine the 2010 North American Menopause Society (NAMS) position statement and other recent publications to summarize the data and combinations of therapies used to treat women 50 years or older with osteoporosis. To review the latest research and guidelines for osteoporosis management we performed a PubMed search using the parameters Linked to free full text, Humans, Female, Review, English, Middle Age (45-64 years and 45+ years), Age 65+ years, and published in the last five years. Articles were sorted by relevance and hand searching of these articles was done to further increase the yield. While a perfect treatment has yet to be discovered to completely cure this progressive disease, many breakthroughs have been made in order to prevent fractures and improve quality of life. Calcium and vitamin D supplementation are recommended for patients undergoing pharmacological treatment, however, trials looking at their effectiveness have mixed findings. Bisphosphonates are considered the first line therapy in the treatment of osteoporosis and reduce vertebral fractures by 40% to 70% and non-vertebral fractures by 20% to 35%. Calcitonin showed promise during early trials in 2000 with a 33% reduction in fractures but these results have not been replicated and this therapy is now relegated to a second line treatment. Teriparatide is recommended for patients with severe osteoporosis and has been shown to reduce vertebral fractures 65% and non-vertebral fractures 53%. Selective estrogen receptor modulators (SERMs) are another useful therapy resulting in a 55% reduction in vertebral fractures without any documented advantage when looking at non

  12. Icariin combined with snailase shows improved intestinal hydrolysis and absorption in osteoporosis rats.

    PubMed

    Liu, Congyan; Gao, Xia; Liu, Yuping; Huang, Mengmeng; Qu, Ding; Chen, Yan

    2017-08-11

    Icariin has a significant anti-osteoporotic activity, but its clinical application is limited due to a poor oral bioavailability especially under pathological conditions like osteoporosis. Based on the intestinal absorption and metabolism characteristics of icariin in the osteoporosis rats, a kind of simple enteric capsules containing icariin and snailase was designed to overcome this issue in this study. Snailase was secleted as the most efficient exogenous hydrolase of icariin and the related hydrolysis reaction parameters were optimized in the artificial intestinal liquid. Moreover, the hydrolysates of icariin were proved more effective in promoting the rat calvarial osteoblast proliferation than icariin by the MTT assay. Therefore, snailase and icariin were packed into the enteric-coated capsules at an appropriate mass ratio of 1:1 to prepare the icariin loaded enteric-coated capsules (IECs), and then the in vitro release and in vivo pharmacokinetic behavior of IECs was evaluated. Icariin was almost completely hydrolyzed within 4h and approximately 89% of the total flavonoid had been released from IECs at 0.75h in the release medium, which met the requirement of the Chinese Pharmacopoeia on enteric preparations and the Weibull function model. The pharmacokinetic data showed IECs could significantly improved the integrated oral bioavailability of icariin by 50% compared to the IP (icariin without the snailase) in the ovariectomized rats, but no obvious difference was observed in the sham rats. The aforementioned results suggested that such a strategy of icariin combined with the snailase held a great potential in promoting the intestinal hydrolysis and absorption of icariin in the osteoporosis status, providing new research ideas for the active ingredients of traditional Chinese medicine with similar properties. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. [Secondary osteoporosis UPDATE. Bone loss due to bed rest and human space flight study].

    PubMed

    Ohshima, Hiroshi

    2010-05-01

    Bone loss and renal stone are significant medical concerns for bed rest subjects and space flight astronauts. Bone mineral loss occurs as secondary osteoporosis due to the unloading of weight bearing bones during bed rest and space flight. Increased bone resorption and bone metabolic uncoupling promote bone loss through the release of calcium from unloaded weight bearing bones. The rate of bone mineral loss during bed rest and space flight is about 1-2 percent per month, and recovery requires a period three or four times longer. To prevent bone loss caused by bed rest and space flight, a prophylactic countermeasure program based on scientific evidence should be developed.

  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

    2012-05-16

    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.

  16. 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…

  17. 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.…

  18. 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…

  19. 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…

  20. 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…

  1. [High prevalence of osteoporosis in asymptomatic postmenopausal Mapuche women].

    PubMed

    Ponce, Lucía; Larenas, Gladys; Riedemann, Pablo

    2002-12-01

    Genetic and environmental factors are responsible for variations in the frequency of osteoporosis. Prevalence of osteoporosis in Mapuche women (native Chileans) is unknown. To assess the prevalence and risk factors for osteoporosis in Mapuche women. A random sample of 95 asymptomatic postmenopausal Mapuche females, stratified by age, was studied. Women with diseases or medications that could interfere with calcium metabolism were excluded. Spine and femoral neck bone mass density was determined using a Lunar DPX Alpha densitometer. Seventeen percent of women had normal bone mineral density in both spine and femoral neck. In the spine, 25.3% had a normal bone mineral density, 17.9% had osteopenia and 56.8% had osteoporosis. In the femoral neck, 34.7% had a normal bone mineral density, 57.9% had osteopenia, and 7.4% had osteoporosis. There was a positive correlation between bone mineral density and body mass index. Women with more than one hour per day of physical activity, had a significantly lower proportion of osteopenia or osteoporosis. No association between bone mineral density and parity or calcium intake, was observed. There is a high prevalence of osteopenia and osteoporosis among Mapuche women. Osteoporosis was associated with low body mass index.

  2. The importance of physical function to people with osteoporosis.

    PubMed

    Kerr, C; Bottomley, C; Shingler, S; Giangregorio, L; de Freitas, H M; Patel, C; Randall, S; Gold, D T

    2017-03-06

    There is increasing need to understand patient outcomes in osteoporosis. This article discusses that fracture in osteoporosis can lead to a cycle of impairment, driven by complex psychosocial factors, having a profound impact on physical function/activity which accumulates over time. More information is required on how treatments impact physical function.

  3. Therapeutic potential and outlook of alternative medicine for osteoporosis.

    PubMed

    Wang, Tao; Liu, Qian; Tjhioe, William; Zhao, Jinmin; Lu, Aiping; Zhang, Ge; Tan, Renxiang; Zhou, Mengyu; Xu, Jiake; Feng, Haotian

    2017-03-21

    Osteoporosis, a bone disease resulting in loss of bone density and microstructure quality, is often associated with fragility fractures, and the latter imposes a great burden on the patient and society. Although there are several different treatments available for osteoporosis such as hormone replacement therapy, bisphosphonates, Denosumab, and parathyroid hormone some concern has been raised regarding the inherent side effects of their long term use. It would be of great relevance to search for alternative natural compounds, which could complementarily overcome the limitations of the currently available therapy. Herein, we review current literature on natural compounds that might have therapeutic values for osteoporosis. Search terms included bone resorption, bone density, osteoporosis, postmenopausal, osteoporosis or bone density conservation agents, and any of the terms related to traditional, herbal, natural therapy, natural health, diet, or phytoestrogens. All the compounds and herbs included in the review are naturally bioactive or are used in folk herbal medicine and have been reported to be capable of attenuating osteopenia or osteoporosis in vivo or in vitro, through various mechanisms - estrogen-like activity, antioxidant and anti-inflammatory properties, or by modulating the key signaling pathways in the pathogenesis of osteoporosis. Through our assessment of the therapeutic potential and outlook of alternative medicine, we aim to provide an appealing perspective for the consideration of the application of a complementary anti-osteoporotic treatment option and prevention strategy for osteoporosis or osteolytic bone disorders.

  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. 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…

  6. Osteoporosis with vertebral fractures associated with pregnancy: two case reports.

    PubMed

    Raffaetà, Gloria; Mazzantini, Maurizio; Menconi, Agnese; Bottai, Vanna; Falossi, Francesca; Celauro, Ilenia; Guido, Giulio

    2014-05-01

    Pregnancy and lactation-associated osteoporosis (PAO) is a rare condition characterized by the occurrence of fragility fractures, most commonly vertebral, in late pregnancy or the early postpartum period. The prevalence, etiology and pathogenesis of this osteoporosis are unknown, although there are several hypotheses attempting to explain the etiopathogenesis of pregnancy associated osteoporosis. In this paper we present two cases of young women who developed severe PAO with vertebral fractures: a 42-year-old woman with a family history of osteoporosis, and a 21-year-old woman affected with myasthenia gravis. The case 1 presented fragility fracture of D12, L2, and L3. She did not have any disease causing osteoporosis. However, she had a positive familial history for osteoporosis and during pregnancy (12th week) she had a detached placenta, so bed rest was prescribed for two months. The case 2 presented multiple vertebral fracture. She was affected by myasthenia gravis, which was diagnosed two years before pregnancy, and treated with corticosteroid. In summary, pregnancy and lactation-induced osteoporosis, although it is a rare disorder, should be kept in mind when pregnant women or women in postpartum period develop persistent back pain and it is important to monitor the patients with risk factors or secondary causes of osteoporosis.

  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. 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

  9. Rabbiteye blueberry prevents osteoporosis in ovariectomized rats.

    PubMed

    Li, Tao; Wu, Shou-Mian; Xu, Zhi-Yuan; Ou-Yang, Sheng

    2014-08-08

    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. 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. 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. 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.

  10. 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

  11. [Treatment of osteoporosis: current aspects and perspectives].

    PubMed

    Body, J J

    1994-01-01

    The risk of osteoporotic fractures is currently easily assessed by densitometry. The entities "osteopenia" and "osteoporosis" are less and less separated and, along the same line, it becomes somewhat arbitrary to separate "prevention" and "treatment" of osteoporosis when low bone mass has been diagnosed. An adequate calcium intake is most important in childhood and adolescence, pregnancy and lactation, and in the older population which, moreover, often suffers from vitamin D deficiency leading to cortical bone loss. Supplements of calcium and vitamin D to institutionalized elderly people could reduce by more than one third the risk of hip fractures. Estrogen replacement therapy remains the best means to prevent postmenopausal bone loss; too few women are treated but replacement therapy must be given for at least 7 years to keep a significant residual effect in the old age. Calcitonin has a proved analgesic effect for painful crush fractures and its long term administration can prevent postmenopausal trabecular bone loss. Nasal calcitonin considerably improves treatment tolerance and compliance but its price remains prohibitive. Etidronate is the only oral bisphosphonate available in Belgium. It can increase bone mass but its therapeutic index is too narrow and its antifracture efficacy has not been satisfactorily demonstrated. Pamidronate is a second generation bisphosphonate which has a much better therapeutic index but its usefulness is limited by the absence of an oral formulation. The introduction of third generation compounds will improve the therapeutic approach of osteoporosis if adequate therapeutic schemes are used. Much progress is also awaited concerning stimulators of osteoblastic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Awareness of osteoporosis in postmenopausal Indian women: An evaluation of Osteoporosis Health Belief Scale

    PubMed Central

    Gopinathan, Nirmal Raj; Sen, Ramesh Kumar; Behera, Prateek; Aggarwal, Sameer; Khandelwal, Niranjan; Sen, Mitali

    2016-01-01

    Context: The level of awareness about osteoporosis in postmenopausal women who are the common sufferers. Aims: This study aims to evaluate the level of awareness in postmenopausal women using the Osteoporosis Health Belief Scale (OHBS). Settings and Design: Osteoporosis has emerged as a common health problem in geriatric population. A proactive role needs to be played for preventing its consequences. Before initiating any preventive measures, an evaluation of awareness level of the target population is necessary. The questionnaire-based study design was used for this study. Subjects and Methods: A questionnaire (OHBS)-based study in 100 postmenopausal women in Chandigarh was conducted. The bone mineral density (BMD) was measured in each case by dual energy X-ray absorptiometry. Height, weight, and body mass index (BMI) of the participants were noted. Statistical Analysis Used: Statistical analysis was conducted to evaluate any correlation between the various components of the OHBS and the BMD. Results: No statistically significant difference was noted in the seven component parameters of OHBS among the normal, osteopenic, and osteoporotic women suggesting that the health belief regarding susceptibility is not much different between the three groups of the study population. A statistically significant difference between the mean BMI of normal and osteoporotic population was noted. Conclusions: The results show that there is a great deficit in the awareness level of postmenopausal Indian women regarding osteoporosis. Most of the women were unaware of the condition and the means to prevent it. The study emphasizes that health care professionals have lot of ground to cover to decrease the incidence of osteoporosis and its associated health problem. PMID:28096642

  13. [Age and osteoporosis. Effects of aging on osteoporosis, the diagnostics and therapy].

    PubMed

    Jakob, F; Seefried, L; Schwab, M

    2014-07-01

    Osteoporosis is an age-associated disease, which is influenced by genetic, epigenetic and environmental factors. This article examines the evidence for specific aspects in osteoporosis diagnosis and management in higher age groups. The study was based on extraction of data from literature databases and from the guidelines of the "Dachverband Osteologie" (DVO, Governing Body for Osteology). Age is a high risk factor for osteoporosis. Vitamin D insufficiency and reduced calcium absorption are common in the elderly. Loss of bone and muscle develop in a vicious circle of immobilization caused by underlying diseases. In addition deficits in cognition and coordination promote falls and fragility fractures. Clinical risk assessment including geriatric test batteries is recommended in all women > 70 and men > 80 years of age. Specific medication is indicated if the 10-year fracture risk exceeds 30 %, where in women > 75 and in men > 85 years of age bone density measurement can be relinquished. There is good evidence for the efficacy of antiosteoporotic medication even for the elderly. Prevention of falls requires multimodal management to enhance muscle power and coordination. It is essential to improve underlying cardiovascular, pulmonary and neurological diseases while critically evaluating the necessity of medication that boosts the risk of falls and fractures. There is good evidence for age and disease-adapted exercise programs such as Tai-Chi. Treating osteoporosis reduces the fracture risk, improves the quality of life, maintains independence and decreases mortality. Treating osteoporosis in the elderly is strongly recommended. Multimodal management and medication according to guidelines can be very successful, given that interdisciplinary and geriatric concepts consider the specific needs of the elderly population.

  14. [Ibandronate in the treatment of postmenopausal osteoporosis].

    PubMed

    Lakatos, Péter

    2008-10-01

    Postmenopausal osteoporosis affects 7-10% of the population of developed countries. During the past decade, a number of new therapeutical modalities have been made available. Among these, bisphosphonates mean the mainstay of medical treatment. Ibandronate belongs to the amino-bisphosphonate group of these drugs. Amino-bisphosphonates act via the mevalonate metabolic pathway, thus, inhibiting protein prenylation. Several clinical studies have shown a significant reduction in the fracture risk of osteoporotic patients treated with ibandronate. This compound can be administered orally once a month or intravenously once in every 3 months. Longer dosing intervals stimulate patient compliance, and consequently increase efficacy and cost effectiveness.

  15. 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.

  16. [[Antiresorptive agents in the treatment of osteoporosis].

    PubMed

    Novak, Srdan

    2014-01-01

    The aim of drug treatment of osteoporosis is the balance between activity of osteoblasts and osteoclasts with aug- mentation of mineral bone density and decrease of fracture risk. Antiresorptive agents depress osteoclasts and diminish resorption of bone. They include bisphosphonates, selective estrogen receptor modulators (SERMs), denosumab, while hormone replacement therapy and calcitonin are mostly abandoned. By binding to hydroxyapatite crystals of bone surface bisphosphonates inhibit the resorption of bone and prevent vertebral and non-vertebral fractures. Denosumab is a monoclonal antibody which by hindering interaction between RANKL and RANK inhibits osteoclastogenesis and diminishes bone resorption in cortical and trabecular bones, thus significantly lessening fracture risk.

  17. Postmenopausal osteoporosis: fracture risk and prevention.

    PubMed

    Kaunitz, Andrew M; McClung, Michael R; Feldman, Robert G; Wysocki, Susan

    2009-11-01

    In the estrogen-regulated RANK ligand (RANKL)/RANK/osteoprotegerin (OPG) pathway, estrogen deficiency favors osteoclast maturation, leading to increased bone resorption compared with bone formation. Treatment of low bone mineral density (BMD) should be based on fracture risk, assessed using the WHO Fracture Risk Algorithm (FRAX(R)). Criteria for treatment are 10-year overall fracture risk ≥ 20% or 10-year hip fracture risk ≥ 3%. Vitamin D supplementation at levels higher than those traditionally recommended may be appropriate for healthy menopausal women. Multiple strategies are needed to effectively manage osteoporosis in postmenopausal women.

  18. Diagnostic procedures for osteoporosis in the elderly.

    PubMed

    Delmas, P D

    1995-01-01

    Several recent studies show that bone loss continues in the elderly, and that various regimens are still effective in the elderly to stop bone loss. Thus, diagnostic procedures for osteoporosis should be considered in elderly women, i.e. measurement of bone mass by dual energy X-ray absorptiometry of the hip, spine or forearm that have been shown to predict the subsequent risk of fractures. The rate of bone turnover, and therefore of bone loss, is quite variable from patient to patient and can be assessed with improved sensitivity and specificity with the new markers that are specific for bone formation and bone resorption.

  19. [Epidemiology of respiratory diseases and osteoporosis.

    PubMed

    Fujiwara, Saeko

    A large scale of epidemiological studies demonstrated that osteoporosis risk was about 1.5 times higher and fracture risk was 1.2-1.8 times higher among COPD patients. In COPD, risk factors for fracture have been reported to be severity of the COPD and use of bronchodilator in addition to ordinal risk factors for the fracture such as age, previous fracture, smoking, usage of glucocorticoid and others. There were inconsistent results of the relationship between sleep apnea and low bone mass. The relationship was found between sleep apnea and fall and non-spin fracture risk.

  20. Antipsychotic drugs, menstrual regularity and osteoporosis risk.

    PubMed

    Zhang-Wong, J H; Seeman, M V

    2002-11-01

    This report summarizes the preliminary results of a study in progress, a survey of 200 women with schizophrenia in long-term treatment with antipsychotic medication. In the context of providing clinical service to these women (Seeman, 1997; Seeman and Cohen, 1998), we have begun to investigate the possibility of an association among related factors: type of antipsychotic drug use, the presence of amenorrhea, hyperprolactinemia and risk for osteoporosis (Biller et al., 1992; Grinspoon et al., 1999; Halbreich and Palter, 1996; More et al., 2001; Peuskens, 1997; Sowers et al., 1995).

  1. Combined Pharmacologic Therapy in Postmenopausal Osteoporosis.

    PubMed

    Shen, Yang; Gray, Dona L; Martinez, Dorothy S

    2017-03-01

    Antiresorptive agents for treating postmenopausal osteoporosis include selective estrogen receptor modulator (SERM), bisphosphonates and denoumab. Teriparatide is the only Food and Drug Administration-approved anabolic agent. Synergistic effects of combining teriparatide with an antiresorptive agent have been proposed and studied. This article reviews the trial designs and the outcomes of combination therapies. Results of the combination therapy for teriparatide and bisphosphonates were mixed; while small increases of bone density were observed in the combination therapy of teriparatide and estrogen/SERM and that of teriparatide and denosumab. Those clinical studies were limited by small sample sizes and lack of fracture outcomes.

  2. [Selective serotonin reuptake inhibitors (SSRI) and osteoporosis].

    PubMed

    Fétique-Will, Anne-Catherine; Chevalley, Thierry; Rizzoli, René

    2011-06-15

    Selective serotonin reuptake inhibitors (SSRI) represent the first-line treatment of depression. Several studies demonstrate that use of therapeutical doses of SSRI is associated with a decreased bone mineral density (BMD) and an increased risk of fracture. Mechanisms of action of SSRI on bone tissue are not totally clarified. These treatments would be associated with an increased risk of falls and would also have a direct effect on bone metabolism. Regarding proofs existing of the implication of SSRI on osteoporosis, while waiting for larger-scale prospective studies, it appears reasonable that practitioners assess bone loss within risk groups of patients treated with SSRI.

  3. Osteoporosis in diabetes mellitus: Possible cellular and molecular mechanisms.

    PubMed

    Wongdee, Kannikar; Charoenphandhu, Narattaphol

    2011-03-15

    Osteoporosis, a global age-related health problem in both male and female elderly, insidiously deteriorates the microstructure of bone, particularly at trabecular sites, such as vertebrae, ribs and hips, culminating in fragility fractures, pain and disability. Although osteoporosis is normally associated with senescence and estrogen deficiency, diabetes mellitus (DM), especially type 1 DM, also contributes to and/or aggravates bone loss in osteoporotic patients. This topic highlight article focuses on DM-induced osteoporosis and DM/osteoporosis comorbidity, covering alterations in bone metabolism as well as factors regulating bone growth under diabetic conditions including, insulin, insulin-like growth factor-1 and angiogenesis. Cellular and molecular mechanisms of DM-related bone loss are also discussed. This information provides a foundation for the better understanding of diabetic complications and for development of early screening and prevention of osteoporosis in diabetic patients.

  4. [Osteoporosis- more than a bone disease (author's transl)].

    PubMed

    Krokowski, E; Fricke, M

    1975-05-02

    Neither the bone-matrix theory of osteoporosis established by Albright in the 1940's nor the lack-of-calcium theory of the 1960's especially represented by Nordin, due to experimental tests and clinical results could be maintained. Here a new theory of osteoporosis is introduced, explaining osteoporosis not to be primarily a disfunction of calcium- or bone metabolism, but as a part-symptom of disfunction of the whole sustentaculum -bones, marrow, nucleus pulposus and musculation. Osteoporosis is predisposed by amyothenia respectively in activity and is initiated by reduced blood circulation of the sustentaculum. Certain relevant conclusions for prophylaxis and therapy of osteoporosis can be deduced without neglecting already the presently only effective therapy using sodium fluoride.

  5. Safety of pharmacotherapy of osteoporosis in cardiology patients.

    PubMed

    Zapolski, Tomasz; Wysokiński, Andrzej

    2010-01-01

    The commonest medical conditions following menopause are osteoporosis and atherosclerotic disease. This review considers the safety of pharmacotherapy of osteoporosis in cardiology patients. Drugs used for osteoporosis treatment may have adverse effects on the cardiovascular system. This article has detailed analysed of current drug classes, such as the bisphosphonates and strontium ranelate, as well as reviewed of the controversy surrounding hormone replacement therapy (HRT) and the selective estrogen receptor modulators (SERMs). Additionally, we discuss the adverse effects on the heart of calcium and drugs influencing calcium metabolism such as vitamin D, parathormone and calcitonin. We look at the interference between osteoporosis treatment and the drugs used for atherosclerosis. Moreover, the side effects on bones of cardiology drugs are analysed. Lastly, the possible advantages of selected drugs used for cardiovascular diseases in terms of osteoporosis prevention are evaluated.

  6. [Risk of osteoporosis in women in 4 different occupational groups].

    PubMed

    Rásky, E; Stronegger, W J; Freidl, W

    1996-01-01

    Primary osteoporosis is common, with significant sociomedical consequences. This paper studies the prevalence of risk factors and risk behavior for osteoporosis in women of four different occupational groups: housewives, blue collar workers, white collar workers/civil servants and farmers. We analyzed risk factors and risk behavior associated with osteoporosis in the scientific literature. The sample comprises 9,939 women. The data set is based on a health survey conducted in 79 selected rural communities of Styria (Austria) between 1989 and 1993. Sociodemographic data, lifestyle, health complaints, chronic conditions and utilization of preventive and treatment services were surveyed by means of standardized personal interviews. The results show that the women of the four occupational groups were subjected to very different stresses. White collar workers/civil servants had the lowest risk with regard to osteoporosis. Our results suggest that efficient intervention programs to prevent osteoporosis need to specifically focus on the different social life styles of women.

  7. Strontium signaling: molecular mechanisms and therapeutic implications in osteoporosis.

    PubMed

    Saidak, Zuzana; Marie, Pierre J

    2012-11-01

    Osteoporosis is an important age-related bone disease characterized by increased bone turnover with insufficient bone formation relative to bone resorption. According to the current understanding of this disorder, anti-resorptive and anabolic drugs have been developed for therapeutic intervention. Another therapeutic approach consists of dissociating bone resorption and formation. Preclinical and clinical studies provided evidence that strontium (in the form of ranelate) induces beneficial effects on bone mass and resistance in animal models of bone loss and in osteoporotic patients. These effects are mediated in part by the pharmacological actions of strontium on bone metabolism, by reducing bone resorption and maintaining or increasing bone formation. Current pharmacological studies showed that strontium activates multiple signaling pathways in bone cells to achieve its pharmacological actions. Notably, activation of the calcium-sensing receptor by strontium in osteoclasts or osteoblasts leads to activation of phospholipase Cβ, inositol 1,4,5-triphosphate, release of intracellular Ca²⁺, and activation of MAPK ERK1/2 and Wnt/NFATc signaling. Strontium-mediated activation of these pathways results in the modulation of key molecules such as RANKL and OPG that control bone resorption, and to the regulation of genes promoting osteoblastic cell replication, differentiation and survival. This review focuses on the more recent knowledge of strontium signaling in bone cells and describes how the resulting pharmacological actions on bone metabolism have important therapeutic implications in the treatment of age-related bone loss and possibly other disorders.

  8. 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.

  9. Rainbow's stars

    NASA Astrophysics Data System (ADS)

    Garattini, Remo; Mandanici, Gianluca

    2017-01-01

    In recent years, a growing interest in the equilibrium of compact astrophysical objects like white dwarf and neutron stars has been manifested. In particular, various modifications due to Planck-scale energy effects have been considered. In this paper we analyze the modification induced by gravity's rainbow on the equilibrium configurations described by the Tolman-Oppenheimer-Volkoff (TOV) equation. Our purpose is to explore the possibility that the rainbow Planck-scale deformation of space-time could support the existence of different compact stars.

  10. Pharmacological treatment of osteoporosis in the oldest old

    PubMed Central

    Vandenbroucke, A; Luyten, FP; Flamaing, J; Gielen, E

    2017-01-01

    The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70–75 years. However, in the last years, subgroup analyses of these landmark trials have been published investigating the efficacy and safety of osteoporosis treatment in the very elderly. Based on this evidence, this narrative review discusses the pharmacological management of osteoporosis in the oldest old (≥80 years). Because of the high prevalence of calcium and/or vitamin D deficiency in old age, these supplements are essential in the management of osteoporosis in the elderly people. Adding antiresorptive or anabolic treatments or combinations, thereof, reduces the risk of vertebral fractures even more, at least in the elderly with documented osteoporosis. The reduction of hip fracture risk by antiresorptive treatments is less convincing, which may be explained by insufficient statistical power in some subanalyses and/or a higher impact of nonskeletal risk factors in the occurrence of hip fractures. Compared with younger individuals, a larger absolute risk reduction is observed in the elderly because of the higher baseline fracture risk. Therefore, the elderly will benefit more of treatment. In addition, current osteoporosis therapies also appear to be safe in the elderly. Although more research is required to further clarify the effect of osteoporosis drugs in the elderly, especially with respect to hip fractures, there is currently sufficient evidence to initiate appropriate treatment in the

  11. District nurses' perceptions of osteoporosis management: a qualitative study.

    PubMed

    Claesson, A; Toth-Pal, E; Piispanen, P; Salminen, H

    2015-07-01

    Underdiagnosis of osteoporosis is common. This study investigated Swedish district nurses' perceptions of osteoporosis management. They perceived the condition as having low priority, and the consequences of this perception were insufficient awareness of the condition and perceptions of bone-specific medication as unsafe. They perceived, though, competency when working with fall prevention. Undertreatment of patients with osteoporosis is common. Sweden's medical care strategy dictates prioritisation of various conditions; while guidelines exist, osteoporosis is not prioritised. The aim of this study was to investigate district nurses' perceptions of osteoporosis management within Sweden's primary health care system. Four semi-structured focus group interviews were conducted with 13 female district nurses. The interviews were analysed using thematic analysis. The overall theme was perceiving osteoporosis management as ambiguous. The themes were perceiving barriers and perceiving opportunities. These subthemes were linked to perceiving barriers: (i) insufficient procedures, lack of time and not aware of the condition; (ii) insufficient knowledge about diagnosis and about fracture risk assessment tools; (iii) low priority condition and unclear responsibility for osteoporosis management; and (iv) bone-specific medication was sometimes perceived to be unsafe. These subthemes were linked to perceiving opportunities: (i) professional competency when discussing fall prevention in home visit programs, (ii) willingness to learn more about osteoporosis management, (iii) collaboration with other professionals and (iv) willingness to identify individuals at high risk of fracture. Osteoporosis was reported, by the district nurses, to be a low-priority condition with consequences being unawareness of the condition, insufficient knowledge about bone-specific medications, fracture risk assessment tools and procedures. These may be some of the explanations for the undertreatment of

  12. Osteoporosis in children and adolescents: etiology and management.

    PubMed

    Baroncelli, Giampiero Igli; Bertelloni, Silvano; Sodini, Federica; Saggese, Giuseppe

    2005-01-01

    Bone mass increases progressively during childhood, but mainly during adolescence when approximately 40% of total bone mass is accumulated. Peak bone mass is reached in late adolescence, and is a well recognised risk factor for osteoporosis later in life. Thus, increasing peak bone mass can prevent osteoporosis. The critical interpretation of bone mass measurements is a crucial factor for the diagnosis of osteopenia/osteoporosis in children and adolescents. To date, there are insufficient data to formally define osteopenia/osteoporosis in this patient group, and the guidelines used for adult patients are not applicable. In males and females aged <20 years the terminology 'low bone density for chronologic age' may be used if the Z-score is less than -2. For children and adolescents, this terminology is more appropriate than osteopenia/osteoporosis. Moreover, the T-score should not be used in children and adolescents. Many disorders, by various mechanisms, may affect the acquisition of bone mass during childhood and adolescence. Indeed, the number of disorders that have been identified as affecting bone mass in this age group is increasing as a consequence of the wide use of bone mass measurements. The increased survival of children and adolescents with chronic diseases or malignancies, as well as the use of some treatment regimens has resulted in an increase in the incidence of reduced bone mass in this age group. Experience in treating the various disorders associated with osteoporosis in childhood is limited at present. The first approach to osteoporosis management in children and adolescents should be aimed at treating the underlying disease. The use of bisphosphonates in children and adolescents with osteoporosis is increasing and their positive effect in improving bone mineral density is encouraging. Osteoporosis prevention is a key factor and it should begin in childhood. Pediatricians should have a fundamental role in the prevention of osteoporosis

  13. A review on the performance of osteoporosis self-assessment tool for Asians in determining osteoporosis and fracture risk.

    PubMed

    Chin, Kok-Yong

    2017-09-01

    The prevalence of osteoporosis in Asian countries is growing. An effective screening method will enable patients at risk for osteoporosis to receive early diagnosis and treatment, and avoid overcrowding the limited dual-energy x-ray absorptiometry (DXA) machines available in Asian countries. Many simple osteoporosis screening algorithms have been developed but they are not validated for use in Asian populations. osteoporosis self-assessment tools for Asians (OSTA), established using a multinational Asian cohort, is the first screening algorithm that caters for the Asian populations. It considers only body weight and age in the algorithm. It shows consistently high performance and sensitivity in identifying postmenopausal women at risk for osteoporosis in many Asian countries. Its usage has been expanded for identifying osteoporosis in men, as well as determining fracture risk for both sexes. However, the performance of OSTA is influenced by age, sex, ethnicity and site of BMD measurement to define osteoporosis. Its usage is also limited in individuals without apparent risk factors. These limitations should be noted by physicians considering the use of OSTA in clinical setting. As a conclusion, OSTA is a cost-effective measure for osteoporosis screening in primary healthcare setting.

  14. US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50-64 years.

    PubMed

    Bansal, S; Pecina, J L; Merry, S P; Kennel, K A; Maxson, J; Quigg, S; Thacher, T D

    2015-04-01

    The US Preventative Services Task Force (USPSTF) recommends consideration for screening for osteoporosis in women under age 65 who have an estimated 10-year major osteoporotic fracture risk of 9.3 % or higher. We found that this threshold for osteoporosis screening in women ages 50-64 years old has a low sensitivity to detect osteoporosis. The US Preventative Services Task Force (USPSTF) recommends consideration of dual-energy X-ray absorptiometry (DXA) in women under ages 50-64 with a major osteoporotic fracture (MOF) risk of 9.3 % or higher, as estimated by the fracture risk assessment tool (FRAX) tool. We assessed the performance of the 9.3 % MOF risk threshold for detecting osteoporosis and evaluated whether DXA indication appeared appropriate, based on USPSTF criteria and other risk factors, at our institution. We performed a retrospective record review of women ages 50-64.5 years old to determine clinical factors and FRAX scores of women undergoing a DXA at our institution over a 6-month period after the USPSTF recommendations were released and evaluated the sensitivity and specificity of the 9.3 % MOF threshold to detect densitometric osteoporosis. Additionally, using the USPSTF criteria and several additional risk factors, we evaluated the extent of potentially inappropriate DXA use in women ages 50 to 64 years in a large primary care practice in an academic medical center. The analysis included 465 DXA tests. The overall sensitivity and specificity of a FRAX-calculated MOF risk ≥9.3 % was 37 and 74 %, respectively, for the detection of osteoporosis. The receiver operator characteristic curve (ROC) demonstrated an area under the curve of 0.58. Lowering the FRAX risk threshold to 5.5 % would increase the sensitivity of detecting osteoporosis in our population from 37 to 80 % while reducing the specificity from 74 to 27 %. Out of 465 DXAs, 371 (79.8 %) were classified as appropriately ordered per our pre-specified criteria. Of the 120 women with

  15. 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

  16. Assessment of osteoporosis in family medicine obtained by ultrasound densitometry.

    PubMed

    Alibasic, Esad; Ramic, Enisa; Batic Mujanovic, Olivera; Avdibasic, Enes; Husic, Damir; Alic, Alma

    2013-12-01

    Osteoporosis is a disease characterized by a decrease in bone mineral density, making bones become less rigid, and therefore susceptible to fractures, either spontaneously or with force, which is lower than otherwise needed for healthy bones fractured. Nearly 10% of the world population and 30% of women after menopause, suffer from osteoporosis. Clinical assessment of osteoporosis in family medicine is key to prevention, early detection and treatment of osteoporosis. To investigate the possibility of early detection and diagnosis of osteoporosis by analyzing the risk factors for osteoporosis and to compare the results with the parameters obtained by ultrasound densitometry of calcaneus, and determine the relationship of calcaneus densitometry with DXA findings, as the gold standard for the diagnosis of osteoporosis. The study included all patients of Family Medicine Kalesija Team 1, aged 50 years and over, a total of 711 patients, of whom 425 were women and 286 men. In all patients we assessed the existence of the following risk factors for osteoporosis: Constitutional: gender, age, weight, constitution, menarche and menopause, loss of height and stooped posture; Living habits: smoking, alcohol consumption, coffee, physical activity, and medications: long-term use corticosteroids, anticonvulsants, antacids, thyroid hormones. Comorbidity: history of fractures, hyperthyroidism, COPD, Chussing's disease, diabetes. In the group of high-risk patients determined by the clinical assessment, quantitative ultrasound densitometry screening was carried out. Monitoring parameters derived with densitometry: the value of T-score, BUA (Broadband Ultrasound Attenuation), SOS (Speed of Sound), QUI (Quantitative Ultrasound Index). To confirm the diagnosis of osteoporosis, in all patients with positive findings using ultrasound densitometry (T score lower than 2.5), another densitometry was performed by standard DXA method. The incidence of osteoporosis was 96% in women and 4% in men

  17. Assessment of Osteoporosis in Family Medicine Obtained by Ultrasound Densitometry

    PubMed Central

    Alibasic, Esad; Ramic, Enisa; Batic Mujanovic, Olivera; Avdibasic, Enes; Husic, Damir; Alic, Alma

    2013-01-01

    Introduction: Osteoporosis is a disease characterized by a decrease in bone mineral density, making bones become less rigid, and therefore susceptible to fractures, either spontaneously or with force, which is lower than otherwise needed for healthy bones fractured. Nearly 10% of the world population and 30% of women after menopause, suffer from osteoporosis. Clinical assessment of osteoporosis in family medicine is key to prevention, early detection and treatment of osteoporosis. Objective: To investigate the possibility of early detection and diagnosis of osteoporosis by analyzing the risk factors for osteoporosis and to compare the results with the parameters obtained by ultrasound densitometry of calcaneus, and determine the relationship of calcaneus densitometry with DXA findings, as the gold standard for the diagnosis of osteoporosis. Patients and methods: The study included all patients of Family Medicine Kalesija Team 1, aged 50 years and over, a total of 711 patients, of whom 425 were women and 286 men. In all patients we assessed the existence of the following risk factors for osteoporosis: Constitutional: gender, age, weight, constitution, menarche and menopause, loss of height and stooped posture; Living habits: smoking, alcohol consumption, coffee, physical activity, and medications: long-term use corticosteroids, anticonvulsants, antacids, thyroid hormones. Comorbidity: history of fractures, hyperthyroidism, COPD, Chussing’s disease, diabetes. In the group of high-risk patients determined by the clinical assessment, quantitative ultrasound densitometry screening was carried out. Monitoring parameters derived with densitometry: the value of T-score, BUA (Broadband Ultrasound Attenuation), SOS (Speed of Sound), QUI (Quantitative Ultrasound Index). To confirm the diagnosis of osteoporosis, in all patients with positive findings using ultrasound densitometry (T score lower than 2.5), another densitometry was performed by standard DXA method. Results

  18. Morning Star

    NASA Image and Video Library

    2013-03-04

    Dawn on Saturn is greeted across the vastness of interplanetary space by the morning star, Venus, in this image from NASA Cassini spacecraft. Venus appears just off the edge of the planet directly above the white streak of Saturn G ring.

  19. Osteoporosis Imaging in the Geriatric Patient

    PubMed Central

    Heilmeier, Ursula; Youm, Jiwon; Torabi, Soheyla; Link, Thomas M.

    2016-01-01

    Given the expected rapid growth of the geriatric world population (=individuals aged >65 years) to 1.3 billion by 2050, age-related diseases such as osteoporosis and its sequelae, osteoporotic fractures, are on the rise. Areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) is the current gold standard to diagnose osteoporosis, to assess osteoporotic fracture risk, and to monitor treatment-induced BMD changes. However, most fragility fractures occur in patients with normal or osteopenic aBMD, indicating that factors beyond BMD impact bone strength. Recent developments in DXA technology such as TBS, VFA, and hip geometry analysis are now available to assess some of these non-BMD parameters from the DXA image. This review will discuss the use of DXA and DXA-assisted technologies and their respective advantages and disadvantages. Special attention is given to if and how each method is indicated in the geriatric population, and the latest ISCD 2015 guidelines have been incorporated. PMID:27482472

  20. 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".

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

    PubMed

    Kruger, Marlena C; Wolber, Frances M

    2016-06-17

    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.

  2. 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.

  3. Risk factors for osteoporosis and associated fractures.

    PubMed Central

    Kelsey, J L

    1989-01-01

    Established risk factors for osteoporosis and associated fractures are increasing age, female sex, white race, removal of the ovaries at an early age, prolonged immobility, and prolonged use of corticosteroids. Obesity and use of estrogen replacement therapy are protective. Factors that probably or possibly increase risk in postmenopausal white women include a low calcium intake, cigarette smoking, and, at least for hip fractures, use of long half-life psychotrophic drugs and heavy alcohol consumption. Factors probably or possibly associated with a decreased risk include ingestion of vitamin D and its metabolites, fluoride levels of 2 ppm or more in drinking water, moderate physical activity, pregnancies and breast feeding, use of thiazide diuretics, and progestogens. Some evidence suggests that calcium intake and physical activity at young ages may be important determinants of peak bone mass. Few studies have been undertaken in males and blacks, although at least some risk factors in males may be similar to those in females. Preventive efforts may be aimed at increasing peak bone mass at young ages, preventing bone loss in postmenopausal women, and preventing fractures and their adverse consequences in older people with osteoporosis. PMID:2517695

  4. Ultrasound-tagged light assessment of osteoporosis

    NASA Astrophysics Data System (ADS)

    Lev, Aner; Rubanov, Evgeni; Sfez, Bruno; Shany, Shraga; Foldes, Joseph

    2005-04-01

    There have been several attempts to detect bone structural changes using optical techniques. H.G. Eberle et al. have used ultrafast optical techniques on the finger in trans-illumination and have shown an excellent correlation between their measurements of the scattering coefficient and bone mineral density obtained using dual X-ray absorption (DXA) imaging. Encouraged by these results, we have developed a system based on the combination of cw laser light and low-frequency ultrasound to probe the bone structure. The physical principle of this system is the detection of laser light diffusing in the bone tissue modulated ("tagged") by a low-frequency ultrasound pulse, which allows a local measurement of the attenuation coefficient. The basic assumption of the technique is that the main factor of attenuation changes in the bone of elderly patients is a scattering change due to osteoporosis, and therefore attenuation measurements directly reflect the scattering properties of the bone. We present a preliminary series of clinical experiments showing that this technique allows determining the bone scattering modification inside the trabecular bone. In this series of clinical experiments, the scattering coefficient determined using the optical technique is compared with the bone mineral density obtained using dual X-ray absorption in a group of 9 patients. A correlation of 0.84 (p=0.05) was found, showing the potential of this technique for the assessment of osteoporosis.

  5. Detection of osteoporosis by morphological granulometries

    NASA Astrophysics Data System (ADS)

    Dougherty, Edward R.; Chen, Yidong; Totterman, Saara; Hornak, Joseph P.

    1992-06-01

    Local morphological granulometries are generated by opening an image successively by an increasing family of structuring elements and, at each pixel, keeping an image area count in a fixed-size window about the pixel. After normalization there is at each pixel a probability density, called a `local pattern spectrum,' and the moments of this density are used to classify the pixel according to surrounding texture. The method having been developed for binary images, the present paper applies a gray-scale version of the methodology to detect osteoporosis in magnetic resonance (MR) images of the wrist. Maximum-likelihood classification is used to apply the local-pattern-spectra moment information. Owing to the presence of a continuous intertwined network of bone fibers called trabeculae, when imaged by an MR imaging system a normal region of bone tissue possesses a coarse, grainy texture resulting in characteristic granulometric features. Osteoporosis is a metabolic bone disease typified by a gradual loss of trabecular bone, and this loss is revealed by significant changes in the granulometric features, thereby leading to detection.

  6. 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.

  7. 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.

  8. The Utility of Biomarkers in Osteoporosis Management.

    PubMed

    Garnero, Patrick

    2017-03-07

    The measurement of bone turnover markers is useful for the clinical investigation of patients with osteoporosis. Among the available biochemical markers, the measurements of serum procollagen type I N-terminal propeptide (PINP) and the crosslinked C-terminal telopeptide (serum CTX) have been recommended as reference markers of bone formation and bone resorption, respectively. The important sources of preanalytical and analytical variability have been identified for both markers, and precise measurement can now be obtained. Reference interval data for PINP and CTX have been generated across different geographical locations, which allows optimum clinical interpretation. However, conventional protein-based markers have some limitations, including a lack of specificity for bone tissue, and their inability to reflect osteocyte activity or periosteal metabolism. Thus, novel markers such as periostin, sclerostin and, sphingosine 1-phosphate have been developed to address some of these shortcomings. Recent studies suggest that the measurements of circulating microRNAs, a new class of marker, may represent early biological markers in osteoporosis. Bone markers have been shown to be a useful adjunct to bone mineral density for identifying postmenopausal women at high risk for fracture. Because levels of bone markers respond rapidly to both anabolic and anticatabolic drugs, they are very useful for investigating the mechanism of action of new therapies and, potentially, for predicting their efficacy to reduce fracture risk.

  9. Antiresorptive therapies for osteoporosis: a clinical overview.

    PubMed

    Chen, Jian Sheng; Sambrook, Philip N

    2011-09-06

    Antiresorptive therapies are used to increase bone strength in individuals with osteoporosis and include five principal classes of agents: bisphosphonates, estrogens, selective estrogen receptor modulators (SERMs), calcitonin and monoclonal antibodies such as denosumab. However, no head-to-head studies have compared different antiresorptive agents using fracture as an end point. Bisphosphonates, which have proven antifracture efficacy and a good safety profile, are the most widely used first-line antiresorptive therapy and are recommended for patients with osteoporosis, a prior fragility fracture or osteopenia, as well as individuals with a high risk of fracture. Denosumab, which also has good antifracture efficacy, is another possible first-line therapy, although long-term safety data are lacking. However, no single antiresorptive therapy is currently appropriate for all patients or clearly superior to other therapies. Antiresorptive agents such as estrogens, SERMs (in postmenopausal women) and calcitonin are considered to be second-line agents that are appropriate in special circumstances. Clinicians should determine the most appropriate pharmacological therapy after a careful assessment of the risk:benefit profiles of these drugs in each patient. In addition, patients should receive a detailed explanation of the treatment goals, so that the therapeutic benefit can be maximized through good compliance and persistence.

  10. 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

  11. Calcium bioavailability and its relation to osteoporosis.

    PubMed

    Weaver, C M

    1992-06-01

    The balance of data suggests that calcium intake has a positive influence on bone mass in premenopausal women and has a preventive effect on the rate of bone loss in postmenopausal women. Even small advantages in bone mass provide great reductions in fracture rates. However, the majority of studies have tested the relationship of calcium intake and bone mass using calcium supplements. Few intervention studies have manipulated calcium intake through foods. Calcium is only useful to the skeleton once it is absorbed. Therefore, the bioavailability of dietary calcium becomes important in the prevention and treatment of osteoporosis. Isotopic tracer techniques have only recently been employed in the labeling of foods with calcium isotopes for evaluation of calcium absorption. Milk calcium is usually the referent food which is typically absorbed at 20-40% depending on the calcium status of the subject. The absorptive efficiency of most vegetable sources is as good or better than for dairy foods, unless they have high concentrations of oxalic acid (spinach, for example) or phytic acid (wheat bran cereal, for example). Few vegetable sources are concentrated sources of calcium. Therefore, it would be difficult to obtain adequate intakes of calcium to protect against osteoporosis without liberal use of dairy products in the diet. Alternately, calcium supplements provide concentrated amounts of absorbable calcium, but they do not provide other nutrients necessary for skeletal growth and maintenance.

  12. Fibromyalgia: a risk factor for osteoporosis.

    PubMed

    Swezey, R L; Adams, J

    1999-12-01

    To investigate associations of bone mineral density (BMD) and osteoporosis in patients with fibromyalgia (FM) and healthy controls. Twenty-four women meeting the American College of Rheumatology criteria for FM (23 Caucasians, one Asian) were each compared to 2 age (+/-3 years) and ethnically matched controls by bone densitometry of the femoral neck and lumbar spine. The patients' ages were 33 to 60 years. No patient or control used steroids or other bone demineralizing agents. Simple T tests were used to compare hip and lumbar spine BMD of FM cases to controls by 3 decades (31-40, 41-50, 51-60 years). The patients with FM in all 3 decades had a lower mean BMD of the spine (p<0.05). The femoral neck BMD were also lower, but reached significance (p<0.05) only in the 51-60 age group. FM in this pilot study was frequently associated with osteoporosis. Early detection and implementation of appropriate nutritional supplementation (calcium/vitamin D), resistive and weight bearing exercise, and specific bone mineral enhancing pharmacological therapy may be indicated in pre, peri, and postmenopausal subjects.

  13. A reappraisal of generic bisphosphonates in osteoporosis.

    PubMed

    Kanis, J A; Reginster, J-Y; Kaufman, J-M; Ringe, J-D; Adachi, J D; Hiligsmann, M; Rizzoli, R; Cooper, C

    2012-01-01

    The competitive price of generic bisphosphonates has had a marked effect on practice guidelines, but an increasing body of evidence suggests that they have more limited effectiveness than generally assumed. The purpose of this study is to review the impact of generic bisphosphonates on effectiveness in the treatment of osteoporosis. This study is a literature review. A substantial body of evidence indicates that many generic formulations of alendronate are more poorly tolerated than the proprietary preparations which results in significantly poorer adherence and thus effectiveness. Poorer effectiveness may result from faster disintegration times of many generics that increase the likelihood of adherence of particulate matter to the oesophageal mucosa. Unfortunately, market authorisation, based on the bioequivalence of generics with a proprietary formulation, does not take into account the potential concerns about safety. The poor adherence of many generic products has implications for guideline development, cost-effectiveness and impact of treatment on the burden of disease. The impact of generic bisphosphonates requires formal testing to re-evaluate their role in the management of osteoporosis.

  14. Osteoporosis in patients with a low-energy fracture: 3 years of screening in an osteoporosis outpatient clinic.

    PubMed

    Woltman, Kristel; den Hoed, Pieter T

    2010-07-01

    The prevalence of osteoporosis in the Netherlands is 52 per 1,000 men and 166 per 1,000 women (age >55 years). Previous results of an osteoporosis screening program showed that 55%, 41%, and 37.1% had osteoporosis. This study aims to evaluate the incidence of osteoporosis after low-energy fractures and to describe the care program for osteoporosis screening. The second endpoint was to investigate the incidence of risk factors in the whole study population and a subgroup analysis from the three major groups with osteoporotic fractures. All female and male patients older than 50 years with a low-energy fracture were included for the osteoporosis screening program. Patients with a fracture of the vertebrae were also included if the age was less than 50 years. All patients underwent a bone mineral density measurement by means of dual-energy X-ray film absorptiometry. All obtained data were registered by a nurse specialist in osteoporosis, in a computerized database. The incidence of osteoporosis in patients with low-energy fractures is high, 46.4%. At the time of fracture presentation, there were 33.2% of the patients with a low body weight (<67 kg), almost all osteoporotic patients (96%) had a low-energy fracture occurred after their 50th year. In patients diagnosed with osteoporosis, the hip fracture is the most common fracture site (34%), followed by the humerus (20.1%). In conclusion, a screening program for osteoporosis is necessary and should be a tool in the armamentarium of every traumatology department.

  15. 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

  16. Prevention and treatment of postmenopausal osteoporosis.

    PubMed

    Tella, Sri Harsha; Gallagher, J Christopher

    2014-07-01

    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. At the same time other drugs were being developed for bone that belong to the bisphosphonate group and the first generation of compounds showed moderate potency on bone resorption. The second and third generation compounds were much more potent and in a series of large trials were shown to reduce fractures. For the last 15 years the treatment of osteoporosis belonged to the bisphosphonate compounds, most of which reduce fracture rates by 50 percent. With the exception of gastrointestinal irritation the drugs are well tolerated and highly effective. The sophistication of the delivery systems now allow treatment that can be given daily, weekly, monthly and annually either orally or intravenously. Bone remodeling is a dynamic process that repairs microfractures and replaces old bone with new bone. In the last 10 years there has been a remarkable understanding of bone biology so that new therapies can be specifically designed on a biological basis. The realization that RANKL was the final cytokine involved in the resorption process and that marrow cells produced a natural antagonist called Osteoprotegerin (OPG) quickly led to two

  17. A review on current osteoporosis research: with special focus on disuse bone loss.

    PubMed

    Lau, Roy Yuen-Chi; Guo, Xia

    2011-01-01

    Osteoporosis is a multifactorial skeletal disorder characterized by decreased bone mass and deteriorated microarchitecture that lead to increased risk of fracture. The disuse osteoporosis refers to bone mass decrements under conditions of decreased mechanical loading, including decreased ground force reaction, muscular contraction, and microgravity-related bone loss in astronauts after space flights. Although there are many effective treatments available for primary osteoporosis, there is a lack of effective treatments for disuse osteoporosis. This is because that the aetiology, pathophysiology, and resultant pathology of disuse osteoporosis differ from those of primary osteoporosis. The objective of this paper is to examine the unique pathology and underlying pathophysiology of disuse osteoporosis.

  18. A Review on Current Osteoporosis Research: With Special Focus on Disuse Bone Loss

    PubMed Central

    Lau, Roy Yuen-chi; Guo, Xia

    2011-01-01

    Osteoporosis is a multifactorial skeletal disorder characterized by decreased bone mass and deteriorated microarchitecture that lead to increased risk of fracture. The disuse osteoporosis refers to bone mass decrements under conditions of decreased mechanical loading, including decreased ground force reaction, muscular contraction, and microgravity-related bone loss in astronauts after space flights. Although there are many effective treatments available for primary osteoporosis, there is a lack of effective treatments for disuse osteoporosis. This is because that the aetiology, pathophysiology, and resultant pathology of disuse osteoporosis differ from those of primary osteoporosis. The objective of this paper is to examine the unique pathology and underlying pathophysiology of disuse osteoporosis. PMID:21876833

  19. 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

  20. [Prevalence of osteopenia and osteoporosis in postmenopausal women].

    PubMed

    Reyes Balaguer, J; Moreno Olmos, J

    2005-04-30

    To know the osteoponia and osteoporosis prevalence in postmenopausal women determined with broadband ultrasonic attenuation (BUA). Descriptives cross-sectional study of prevalence. Salvador Allende Health Center. Valencia, Spain. A total of 115 postmenopausal women aged 49 at 85 years old was studied, initiated in September to December 2003. Iatrogenic menopause or women with calcium, vitamin D, estrogen replacement therapy, estrogen receptor modulators, and biphosphonates therapy were considered criteria for exclusion. We measured bone mineral density with BUA at right calcaneus. We analyzed the age, height, and weight, the result of BUA, tobacco and diuretics consumption and years of amenorrhea. . The prevalence of osteoporosis was 50.4%. Other 29.6% had osteopenia. Of the postmenopausal women with osteoporosis, 27.6% were 70 to 75 years old. The 82.8% of postmenopausal women with osteoporosis were younger than 75 years old. The 66.7% postmenopausal women with body mass index lesser than 25 had osteoporosis. The osteoporosis prevalence in our patients was greater than other studies (30%). Emphasis may be placed on screening osteoporosis with BUA in primary health care. We suggested that educational community programs should start at an earlier age to identify factors that contribute to maintaining bone mineral density among postmenopausal women.

  1. UK clinical guideline for the prevention and treatment of osteoporosis.

    PubMed

    Compston, J; Cooper, A; Cooper, C; Gittoes, N; Gregson, C; Harvey, N; Hope, S; Kanis, J A; McCloskey, E V; Poole, K E S; Reid, D M; Selby, P; Thompson, F; Thurston, A; Vine, N

    2017-12-01

    In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over. Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment, lifestyle measures and pharmacological interventions, duration and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, osteoporosis in men, postfracture care and intervention thresholds. The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management.

  2. Whole-body vibration exercise in postmenopausal osteoporosis.

    PubMed

    Weber-Rajek, Magdalena; Mieszkowski, Jan; Niespodziński, Bartłomiej; Ciechanowska, Katarzyna

    2015-03-01

    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'.

  3. 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

  4. 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

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

    PubMed

    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.

  6. Functional relevance for associations between osteoporosis and genetic variants

    PubMed Central

    Tan, Li-Jun; Wang, Peng; Chen, Xiang-Ding; Zhu, Li-Hua; Zeng, Qin; Hu, Yuan; Deng, Hong-Wen

    2017-01-01

    Osteoporosis is characterized by increased bone loss and deterioration of bone microarchitecture, which will lead to reduced bone strength and increased risk of fragility fractures. Previous studies have identified many genetic loci associated with osteoporosis, but functional mechanisms underlying the associations have rarely been explored. In order to explore the potential molecular functional mechanisms underlying the associations for osteoporosis, we performed integrative analyses by using the publically available datasets and resources. We searched 128 identified osteoporosis associated SNPs (P<10−6), and 8 SNPs exert cis-regulation effects on 11 eQTL target genes. Among the 8 SNPs, 2 SNPs (RPL31 rs2278729 and LRP5 rs3736228) were confirmed to impact the expression of 3 genes (RPL31, CPT1A and MTL5) that were differentially expressed between human subjects of high BMD group and low BMD group. All of the functional evidence suggested the important functional mechanisms underlying the associations of the 2 SNPs (rs2278729 and rs3736228) and 3 genes (RPL31, CPT1A and MTL5) with osteoporosis. This study may provide novel insights into the functional mechanisms underlying the osteoporosis associated genetic variants, which will help us to comprehend the potential mechanisms underlying the genetic association for osteoporosis. PMID:28369098

  7. Assessment of postmenopausal women and significant risk factors for osteoporosis.

    PubMed

    Schnatz, Peter F; Marakovits, Kimberly A; O'Sullivan, David M

    2010-09-01

    The assessment of osteoporosis risk factors can help guide early intervention. The objective of this study was to analyze numerous potential risk factors to see which were associated with postmenopausal osteoporosis. Women aged 49 or greater presenting for dual-energy x-ray absorptiometry bone scans were recruited from radiology sites in the Hartford, Connecticut, area between January 2007 and March 2009, inclusive. Information was collected regarding primary and secondary risk factors for osteoporosis development, as well as family history and history of pregnancy and breast-feeding. Survey results were subsequently correlated with each woman's dual-energy x-ray absorptiometry scan results. In a sample of 619 women, history of fracture (odds ratio [OR], 12.49), weight less than 127 pounds (OR, 3.50), and use of anticoagulants (OR, 5.40) increased the chance of developing osteoporosis. In contrast, multiparity (OR, 0.45) and history of breast-feeding (OR, 0.38) decreased the development of osteoporosis in postmenopausal women. In women aged 49 to 54, breast-feeding was significantly protective, while low body mass index was most indicative of osteoporosis in women ages 55 to 64. Both previous fracture and low body mass index were associated with osteoporosis in women over age 64. The current results are consistent with other studies suggesting that previous fracture, low body weight, and use of anticoagulants increase the risk of osteoporosis. Our results also suggest that a history of pregnancy and breast-feeding protects against the development of postmenopausal osteoporosis, especially in women aged 49 to 54.

  8. Osteoporosis screening for men: are family physicians following the guidelines?

    PubMed

    Cheng, Natalie; Green, Michael E

    2008-08-01

    To determine rates of screening for osteoporosis among men older than 65 years and to find out whether family physicians are following the recommendations of the Osteoporosis Society of Canada's 2002 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada. Chart audit. The Family Medicine Centre at Hotel Dieu Hospital in Kingston, Ont. All male patients at the Family Medicine Centre older than 65 years for a total of 565 patients associated with 20 different physicians' practices. Rates of screening with bone mineral density (BMD) scans for osteoporosis, results of BMD testing, and associations between results of BMD testing and age. Of the 565 patients reviewed, 108 (19.1% of the study population) had received BMD testing. Rates of screening ranged from 0% to 38% in the 20 practices. Among 105 patients tested (reports for 3 patients were not retrievable), 15 (14.3%) were found to have osteoporosis, 43 (41.0%) to have osteopenia, and 47 (44.8%) to have normal BMD results. No significant association was found between BMD results and age. Screening rates were higher among men older than 75 years than among men aged 65 to 75 and peaked among those 85 to 89 years old. On average, only about 20% of male patients older than 65 years had been screened for osteoporosis, so most of these men were not being screened by BMD testing as recommended in the guidelines. Considering the relatively high rates of osteoporosis and osteopenia found in this study and the known morbidity and mortality associated with osteoporotic fractures in this population, higher rates of BMD screening and more widespread treatment of osteoporosis could prevent many fractures among these patients. Family physicians need to become more aware of the risk factors indicating screening, and barriers to screening and treatment of osteoporosis in men need to be identified and addressed.

  9. Identification of candidate genes in osteoporosis by integrated microarray analysis.

    PubMed

    Li, J J; Wang, B Q; Fei, Q; Yang, Y; Li, D

    2016-12-01

    In order to screen the altered gene expression profile in peripheral blood mononuclear cells of patients with osteoporosis, we performed an integrated analysis of the online microarray studies of osteoporosis. We searched the Gene Expression Omnibus (GEO) database for microarray studies of peripheral blood mononuclear cells in patients with osteoporosis. Subsequently, we integrated gene expression data sets from multiple microarray studies to obtain differentially expressed genes (DEGs) between patients with osteoporosis and normal controls. Gene function analysis was performed to uncover the functions of identified DEGs. A total of three microarray studies were selected for integrated analysis. In all, 1125 genes were found to be significantly differentially expressed between osteoporosis patients and normal controls, with 373 upregulated and 752 downregulated genes. Positive regulation of the cellular amino metabolic process (gene ontology (GO): 0033240, false discovery rate (FDR) = 1.00E + 00) was significantly enriched under the GO category for biological processes, while for molecular functions, flavin adenine dinucleotide binding (GO: 0050660, FDR = 3.66E-01) and androgen receptor binding (GO: 0050681, FDR = 6.35E-01) were significantly enriched. DEGs were enriched in many osteoporosis-related signalling pathways, including those of mitogen-activated protein kinase (MAPK) and calcium. Protein-protein interaction (PPI) network analysis showed that the significant hub proteins contained ubiquitin specific peptidase 9, X-linked (Degree = 99), ubiquitin specific peptidase 19 (Degree = 57) and ubiquitin conjugating enzyme E2 B (Degree = 57). Analysis of gene function of identified differentially expressed genes may expand our understanding of fundamental mechanisms leading to osteoporosis. Moreover, significantly enriched pathways, such as MAPK and calcium, may involve in osteoporosis through osteoblastic differentiation and bone formation.Cite this article: J. J

  10. Men’s knowledge about osteoporosis and its risk factors

    PubMed Central

    Żołnierczuk-Kieliszek, Dorota; Kulik, Teresa; Dziedzic, Małgorzata A.; Barańska, Agnieszka; Kryk, Aneta

    2016-01-01

    Introduction Until recently osteoporosis was seen mainly as a woman’s problem. However, in the last ten years there has been rising awareness in society that osteoporosis constitutes an inseparable element of getting old for men as well. The aim of the research was to evaluate men’s knowledge about osteoporosis and its risk factors contributing to the development of the disease. Material and methods The study included 205 men aged 20-60. The examined men were patients of selected healthcare centres in Lublin Voivodeship. The study was conducted between September 2014 and April 2015. The research was performed by means of the survey method, using a poll technique. Purposive sampling and an original questionnaire were used. Gathered material was subjected to descriptive and statistical analysis. The Mann-Whitney U test and Kruskal-Wallis test were applied. The statistical significance level was set at α = 0.05. IBM SPSS Statistics software was used to perform the statistical analysis. Results The respondents’ level of knowledge about osteoporosis and its risk factors can be estimated as average. The polled men showed better knowledge on osteoporosis risk factors (M = 59.78) than general osteoporosis knowledge (M = 53.71). Significant differences were found between the respondents’ education and their general osteoporosis knowledge as well as between the respondents’ living conditions and their knowledge about osteoporosis risk factors. Conclusions Because of the insufficient level of knowledge about osteoporosis and its risk factors in the male population it is advisable to launch prevention programmes aimed at men focusing on this issue. PMID:27980526

  11. Gamma-ray bursts generated from phase transition of neutron stars to quark stars

    NASA Astrophysics Data System (ADS)

    Shu, Xiao-Yu; Huang, Yong-Feng; Zong, Hong-Shi

    2017-02-01

    The evolution of compact stars is believed to be able to produce various violent phenomena in our universe. In this paper, we discuss the possibility that gamma-ray bursts (GRBs) might result from the phase transition of a neutron star to a quark star and calculate the energy released from the conversion. In our study, we utilize the relativistic mean field (RMF) theory to describe the hadronic phase of neutron stars, while an improved quasi-particle model is adopted to describe the quark phase of quark stars. With quark matter equation-of-state (EOS) more reliable than models used before, it is found that the energy released is of the order of 1052 erg, which confirms the validity of the phase transition model.

  12. 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.

  13. Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

    PubMed Central

    Edmonds, Stephanie W; Solimeo, Samantha L; Nguyen, Vu-Thuy; Wright, Nicole C; Roblin, Douglas W; Saag, Kenneth G; Cram, Peter

    2017-01-01

    Context Patient education materials can provide important information related to osteoporosis prevention and treatment. However, available osteoporosis education materials fail to follow best-practice guidelines for patient education. Objective To develop an educational brochure on bone health for adults aged 50 years and older using mixed-method, semistructured interviews. Design This project consisted of 3 phases. In Phase 1, we developed written content that included information about osteoporosis. Additionally, we designed 2 graphic-rich brochures, Brochure A (photographs) and Brochure B (illustrations). In Phase 2, interviewers presented the text-only document and both brochure designs to 53 participants from an academic Medical Center in the Midwest and an outpatient clinic in the Southeastern region of the US. Interviewers used open- and closed-ended questions to elicit opinions regarding the brochures. In Phase 3, using feedback from Phase 2, we revised the brochure and presented it to 11 participants at a third site in the Southeastern US. Main Outcome Measures Participants’ comprehension of brochure text and acceptability of brochure design. Results We enrolled 64 participants. Most were women, white, and college-educated, with an average age of 66.1 years. Participants were able to restate the basic content of the brochure and preferred Brochure A’s use of photographs. Conclusions Using feedback from older adults, we developed and refined a brochure for communicating bone health information to older adults at risk of osteoporosis and fragility fractures. The methods outlined in this article may serve to guide others in developing health educational brochures for chronic medical conditions. PMID:28080957

  14. Bilateral transient osteoporosis of the talus in pregnancy.

    PubMed

    Daniel, R S; Farrar, E K; Norton, H R; Nussbaum, A I

    2009-11-01

    We present the case of bilateral transient osteoporosis of the talus in pregnancy, which is rarely reported in the medical literature, confirmed by pre- and postpartum MRI.A gravid 33-year-old white female G4P2A1 with bilateral transient osteoporosis of the talus confirmed by magnetic resonance imaging (MRI) is presented. She was conservatively managed and had clinical resolution several weeks postpartum. A follow-up MRI confirmed improvement in bilateral talus consistent with the natural course of transient osteoporosis.

  15. Quality of life of women with osteoporosis - review of literature.

    PubMed

    Baczyk, Grazyna

    2009-01-01

    Osteoporosis is a systemic skeletal disease characterized by low bone mass and architectural derangements leading to an increased fracture risk. Evaluation of the quality of life of patients with osteoporosis concerns the physical, emotional, social and pain QoL domains. Quality of life can be measured to compare the effect of different treatments of osteoporosis. The assessment of quality of life is also useful in epidemiological studies to estimate the burden of disease and to evaluate the effectiveness of different treatments. The principal goals of health care for these patients are to maintain independence and preserve good quality of life.

  16. [Oral osteoporosis: a review and its dental implications].

    PubMed

    Inagaki, Koji; Kurosu, Yasunari; Sakano, Masahiro; Yamamoto, Genta; Kikuchi, Takeshi; Noguchi, Toshihide; Yano, Hiroyasu; Izawa, Hiroyuki; Hachiya, Yudo

    2007-02-01

    In post-menopausal osteoporosis, lack of estrogen will affect the remodeling of the bone tissue in such a way that, in most patients with periodontitis, the amount of bone resorbed exceeds that being formed, resulting in net bone loss. Osteoporosis can be treated by a variety of methods, the hormone replacement therapy (HRT), the selective estrogen receptor modulators (SERM) and the bisphosphonates. The HRT or bisphosphonates treatments improve the clinical outcome of periodontal disease and may be an adjunctive treatment to preserve periodontal bone mass. This paper reviews the current evidence on the mechanism of periodontal breakdown after menopause and the benefit to oral health by treatments for osteoporosis.

  17. Current approach to fracture prevention in postmenopausal osteoporosis.

    PubMed

    Kaplan, B; Hirsch, M

    2004-01-01

    The prevention and management of osteoporosis are becoming increasingly prominent concerns as the number of postmenopausal women reaching old age continues to grow. Often the first sign of osteoporosis is a fractured bone. It is important that women with low bone density be identified as early as possible and measures taken to reverse the process. These include proper diet and exercise, supplements of calcium and vitamin D, and in cases with proven osteoporosis, antiresorptive or anabolic agents to improve bone strength. Women should also be cautioned to avoid falling as much as possible.

  18. Osteoporosis knowledge among female school students in Jordan.

    PubMed

    Abushaikha, L; Omran, S; Barrouq, L

    2009-01-01

    Although osteoporosis is a preventable disease affecting millions of people, public awareness remains low. This study used a pretest-posttest quasi-experimental design to explore osteoporosis knowledge among adolescent female students in Jordan. A questionnaire was administered to 148 students recruited from a secondary school in the city of Irbid before and after a series of health education sessions based on the health belief model. A significant increase in overall scores for osteoporosis knowledge was seen (mean score pretest = 24.1 and posttest = 29.8, P < 0.001). Further research geared toward the follow-up of attained knowledge and behavioural change over time is greatly needed.

  19. [Vitamin D intake and the prevention of osteoporosis].

    PubMed

    Nakamura, Kazutoshi

    2005-08-01

    The incidence of osteoporosis in Japan is increasing. Osteoporotic fractures have been causes of "bedridden" status among the elderly in recent years, and vitamin D has the potential to decrease the incidence of these health problems of osteoporosis. This article tried to clarify the preventive effect of increased vitamin D intake on osteoporosis in Japan. Vitamin D intake of 700-800 IU/day together with sufficient calcium intake is recommended to prevent fractures in the elderly, and vitamin D intake of 400 IU/day is recommended to prevent bone loss in adult women. The author also discusses the importance of increasing vitamin D intake in public health in Japan.

  20. Star clusters

    NASA Astrophysics Data System (ADS)

    Labhardt, Lukas; Binggeli, Bruno

    Star clusters are at the heart of astronomy, being key objects for our understanding of stellar evolution and galactic structure. Observations with the Hubble Space Telescope and other modern equipment have revealed fascinating new facts about these galactic building blocks. This book provides two comprehensive and up-to-date, pedagogically designed reviews on star clusters by two well-known experts in the field. Bruce Carney presents our current knowledge of the relative and absolute ages of globular clusters and the chemical history of our Galaxy. Bill Harris addresses globular clusters in external galaxies and their use as tracers of galaxy formation and cosmic distance indicators. The book is written for graduate students as well as professionals in astronomy and astrophysics.