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Bone Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
All of us want to remain active and agile as we age. Preserving our mobility requires addressing bone health. We want to emphasize the value of bone health through the lens of maintaining bone strength and bone density rather than focusing only on bone loss. Of course, osteopenia and osteoporosis are serious concerns for many postmenopausal women. Of the estimated 10 million Americans with osteoporosis, about 80% are women, and one in four women in the United States older than 65 has osteoporosis.1–2 Osteoporosis causes bones to become porous and brittle—a condition that we can’t see or feel. Without any obvious symptoms, often the first indication of osteoporosis is a bone fracture. For this reason, osteoporosis has been called “the silent epidemic.”
Principles of Intraoperative Management of Early-Onset Scoliosis
Published in Alaaeldin (Alaa) Azmi Ahmad, Aakash Agarwal, Early-Onset Scoliosis, 2021
Ashok N. Johari, Rashid Anjum, Vrushali Ponde
Osteopenia is another important factor that has a bearing on intraoperative events and should be assessed by dual-energy x-ray absorptiometry (DEXA) scan. Osteopenia can be reversed by giving bisphosphonates, or it can point to some underlying metabolic conditions and evaluation thereof. Preoperative administration of bisphosphonates or inclusion of additional vertebrae in the anchor region is recommended in cases of osteopenia.
Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
In the application of physical activity, exercise, and rehabilitation, metastatic bone lesions are a commonly encountered and expected issue that must be carefully addressed and understood. In addition to primary bone cancers and metastatic disease, osteoporosis and osteopenia also pose a risk of pathologic fracture. Depending on the therapist’s practice setting, there may be a dearth of information beyond a passing mention of osteoporosis, osteopenia, or metastatic disease. As physician team members are often focused on saving their patient’s life and optimizing medical and emotional quality of life, the same level of information to establish bony stability may not be available as compared to the interest clinicians who administer physical activity. In these cases where there is a concern for bone stability, advocacy for the patient, and facilitating a diagnostic workup is important to comprehensively manage the individual’s physical activity status. If a fall or injury occurred in a high-risk pathologic fracture scenario, it can substantially worsen the remaining quality of life. Conversely, if the pathologic fracture risk is small and the therapist resorts to excessively conservative treatments, their patient may not be able to enjoy an optimal quality of life as their physical status was unnecessarily restricted.
Risk factors of osteoporosis and osteopenia in postmenopausal women based on the L2–L4 BMD T score of the lumbar spine: a study in Iran
Published in Gynecological Endocrinology, 2023
Ladan Younesi Asl, Maryam Kashanian, Zahra Najmi, Ali Mahdavi, Zeinab SafarpourLima
In the univariate logistic regression analysis (Tables 4 and 5), age, BMI, dairy use, calcium-D supplement intake, regular exercise, and parity were significant predictors of osteopenia (p < .05). A one-year increase in age was accompanied by an 8% increased chance of osteopenia. Considering the BMI of less than 25 as the reference group, the chance of osteopenia decreased by about 60% when BMI increased from 30 (OR = 0.39; 95% CI: 0.26–0.59, p = .009). The chance of osteopenia in the women with low dairy consumption was about 1.5 times higher than in the women with medium–high dairy consumption. Women who did not take calcium-D supplements were around 1.5 times more likely to develop osteopenia. Similarly, a lack of regular exercise increases the chance of osteopenia (OR = 1.41, 95% CI: 1.09–1.81). The women with a parity of ≥6 were 2.1 times more likely to develop osteopenia than women with a parity of 0 to 2. (95% CI: 1.39–3.16, p < .001). In multivariate regression analysis, age and BMI were the only significant predictors of osteopenia (p < .001) (Tables 4 and 5).
A brown tumor secondary to hyperparathyroidism in the maxilla, skull, scapula, and femora
Published in Baylor University Medical Center Proceedings, 2021
Alison Psaila, Luca Conti, Alexander P. Azzopardi, David V. Coppini
A 35-year-old woman presented to the dentist with an enlarging left mandibular mass. The mass was noticed over a 3-week period and was not painful. Initial radiological evaluation of the mass raised suspicion of a BT or giant cell tumor (Figure 1). She also complained of occasional abdominal discomfort and constipation and suffered from right knee pain. She had a 12-month-old daughter whom she breastfed for 6 months after birth. Serum calcium was 3.49 mmol/L; phosphate, 0.60 mmol/L; and parathyroid hormone, 918 pg/mL (Table 1). A bone mineral density scan showed osteopenia and osteoporosis in the spine (T score −2.4) and femoral neck (T score −2.5). An ultrasound of the abdomen did not show nephrolithiasis. Biopsy of the left posterior mandible lesion disclosed a central giant cell lesion, favoring BT of hyperparathyroidism (Figure 2). A neck ultrasound showed a homogenously hypoechoic solid mass inferior to the lower pole of the left thyroid lobe, measuring 4.6 × 2.3 × 1.5 cm. These findings correlated with the abnormally high tracer uptake seen posterior to the left thyroid lobe on a sestamibi parathyroid scan. A whole-body bone scintigram showed multiple abnormal foci of increased tracer uptake, namely in the right maxilla and left mandible, bilateral lower third of the femora, and right frontal region of the skull (Figure 3a).
Aromatase inhibitors for the treatment of endometriosis: a systematic review about efficacy, safety and early clinical development
Published in Expert Opinion on Investigational Drugs, 2020
Simone Garzon, Antonio Simone Laganà, Fabio Barra, Jvan Casarin, Antonella Cromi, Ricciarda Raffaelli, Stefano Uccella, Massimo Franchi, Fabio Ghezzi, Simone Ferrero
The majority of populations included in these studies consisted of premenopausal women with symptoms refractory and persistent or signs of endometriosis after at least one previous line of therapy; usually, AIs were started after a minimum of three months from previous treatment suspension. All studies excluded women with osteopenia or osteoporosis. Diagnosis of endometriosis was surgically done at laparoscopy for all patients included in 9 trials [88,89,91,94,96,99–102]; histologic confirmation both from surgery or biopsy was obtained in 3 studies [90,92,97]; ultrasound was only adopted in 3 trials [93,95,98]. Details of study design, therapeutic regimes, length of follow-up, and main findings of studies included in this systematic review are reported in Table 1.