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Osteoporosis: HELP
Articles by Jay R. Shapiro
Based on 5 articles published since 2010
(Why 5 articles?)
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Between 2010 and 2020, J. Shapiro wrote the following 5 articles about Osteoporosis.
 
+ Citations + Abstracts
1 Review Hypophosphatasia in Adults: Clinical Assessment and Treatment Considerations. 2017

Shapiro, Jay R / Lewiecki, E Michael. ·Uniformed Services University of the Health Sciences, Bethesda, MD, USA. · New Mexico Clinical Research and Osteoporosis Center, Albuquerque, NM, USA. ·J Bone Miner Res · Pubmed #28731215.

ABSTRACT: Hypophosphatasia (HPP) is a rare inherited disorder of bone affecting approximately 500 to 600 known individuals in the United States. HPP is the result of mutations involving the gene for tissue nonspecific alkaline phosphatase. Five clinical types of HPP are recognized. The clinical presentation of HPP varies from devastating prenatal intrauterine disease to mild manifestations in adulthood. In adults, main clinical involvement includes early loss of primary or secondary teeth, osteoporosis, bone pain, chondrocalcinosis, and fractures. Treatment for HPP is limited. Asfotase alfa is a subcutaneously administered synthetic human alkaline phosphatase that is approved for treatment of patients, including adults, with perinatal/infantile- and juvenile-onset HPP. However, guidelines for the treatment of adults with HPP are not available. This discussion addresses diagnostic and treatment considerations for adults with HPP. © 2017 American Society for Bone and Mineral Research.

2 Article Resistive exercise in astronauts on prolonged spaceflights provides partial protection against spaceflight-induced bone loss. 2019

Sibonga, J / Matsumoto, T / Jones, J / Shapiro, J / Lang, T / Shackelford, L / Smith, S M / Young, M / Keyak, J / Kohri, K / Ohshima, H / Spector, E / LeBlanc, A. ·Human Health & Performance Directorate, NASA Johnson Space Center, 2101 NASA Parkway, Houston, TX 77058, USA. Electronic address: jean.sibonga-1@nasa.gov. · Fujii Memorial Institute of Medical Sciences, University of Tokushima, Tokushima 770-8503, Japan. Electronic address: toshio.matsumoto@tokushima-u.ac.jp. · Center for Space Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Electronic address: jajones@bcm.edu. · Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. Electronic address: jayrshapiro@gmail.com. · Department of Radiology, University of California, San Francisco, CA 94143, USA. Electronic address: thomas.lang@ucsf.edu. · Human Health & Performance Directorate, NASA Johnson Space Center, 2101 NASA Parkway, Houston, TX 77058, USA. Electronic address: linda.c.shackelford@nasa.gov. · Human Health & Performance Directorate, NASA Johnson Space Center, 2101 NASA Parkway, Houston, TX 77058, USA. Electronic address: scott.m.smith@nasa.gov. · Human Health & Performance Directorate, NASA Johnson Space Center, 2101 NASA Parkway, Houston, TX 77058, USA. Electronic address: millennia.young@nasa.gov. · Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA. Electronic address: jhkeyak@uci.edu. · Department of Nephrology, Nagoya City University, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Electronic address: kohri@med.nagoya-cu.ac.jp. · Japan Aerospace Exploration Agency, Tsukuba Space Center, 2-1-1 Sengen, Tsukuba-Shi, Ibaraki 305-8505, Japan. Electronic address: ohshima.hiroshi2@jaxa.jp. · KBRwyle, 2400 NASA Parkway, Houston, TX 77058, USA. Electronic address: elisabeth.r.spector@nasa.gov. · Center for Space Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Electronic address: adleblanc2@gmail.com. ·Bone · Pubmed #31400472.

ABSTRACT: Bone loss in astronauts during spaceflight may be a risk factor for osteoporosis, fractures and renal stone formation. We previously reported that the bisphosphonate alendronate, combined with exercise that included an Advanced Resistive Exercise Device (ARED), can prevent or attenuate group mean declines in areal bone mineral density (aBMD) measured soon after ~ 6-month spaceflights aboard the International Space Station (ISS). It is unclear however if the beneficial effects on postflight aBMD were due to individual or combined effects of alendronate and ARED. Hence, 10 additional ISS astronauts were recruited who used the ARED (ARED group) without drug administration using similar measurements in the previous study, i.e., densitometry, biochemical assays and analysis of finite element (FE) models. In addition densitometry data (DXA and QCT only) were compared to published data from crewmembers (n = 14-18) flown prior to in-flight access to the ARED (Pre-ARED). Group mean changes from preflight (± SD %) were used to evaluate effects of countermeasures as sequentially modified on the ISS (i.e., Pre-ARED vs. ARED; ARED vs. Bis+ARED). Spaceflight durations were not significantly different between groups. Postflight bone density measurements were significantly reduced from preflight in the Pre-ARED group. As previously reported, combined Bis+ARED prevented declines in all DXA and QCT hip densitometry and in estimates of FE hip strengths; increased the aBMD of lumbar spine; and prevented elevations in urinary markers for bone resorption during spaceflight. ARED without alendronate partially attenuated declines in bone mass but did not suppress biomarkers for bone resorption or prevent trabecular bone loss. Resistive exercise in the ARED group did not prevent declines in hip trabecular vBMD, but prevented reductions in cortical vBMD of the femoral neck, in FE estimate of hip strength for non-linear stance (NLS) and in aBMD of the femoral neck. We conclude that a bisphosphonate, when combined with resistive exercise, enhances the preservation of bone mass because of the added suppression of bone resorption in trabecular bone compartment not evident with ARED alone.

3 Article Opportunistic screening for bone disease using abdominal CT scans obtained for other reasons in newly diagnosed IBD patients. 2018

Rebello, D / Anjelly, D / Grand, D J / Machan, J T / Beland, M D / Furman, M S / Shapiro, J / LeLeiko, N / Sands, B E / Mallette, M / Bright, R / Moniz, H / Merrick, M / Shah, S A. ·Alpert Medical School, Brown University, Providence, RI, USA. Dionne.rebello@lifespan.org. · Department of Internal Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA. Dionne.rebello@lifespan.org. · Alpert Medical School, Brown University, Providence, RI, USA. · Division of Gastroenterology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA. · Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA. · Department of Biostatistics and Research, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA. · Hasbro Children's Hospital, Providence, RI, USA. · The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Division of Gastroenterology, Rhode Island Hospital, Providence, RI, USA. · Crohn's & Colitis Foundation, New York, NY, USA. · The Miriam Hospital, Providence, RI, USA. ·Osteoporos Int · Pubmed #29520605.

ABSTRACT: Bone disease is prevalent among patients with inflammatory bowel disease (IBD), though bone density screening remains underutilized. We used CT scans performed for other indications in IBD patients to identify and monitor osteopenia using CT attenuation values at the lumbar spine. Significant rates of bone disease were detected which would have otherwise gone undiagnosed. INTRODUCTION: Osteoporosis affects about 14-42% of patients with IBD. Though screening is recommended in IBD patients with risk factors, it remains underutilized. In patients with newly diagnosed IBD, we used CT scans performed for other indications to identify and monitor progression of osteopenia. METHODS: Using the Ocean State Crohn's and Colitis Area Registry, we identified adult patients with one or more abdominal CT scans. Each patient had two age- and gender-matched controls. Radiologists measured attenuation through trabecular bone in the L1 vertebral body recorded in Hounsfield units (HU). Generalized estimating equations were used to measure how HU varied as a function of gender, type of IBD, and age. RESULTS: One hundred five IBD patients were included, and 72.4% were classified as "normal" bone mineral density (BMD) and 27.6% as potentially osteopenic: 8.6% with ulcerative colitis and 19.0% with Crohn's disease. We found a decrease in bone density over time (p < 0.001) and that BMD decreases more in Crohn's disease than in ulcerative colitis (p < 0.004). Sixty patients had two CT scans, and mean loss of 9.3 HU was noted. There was a non-significant decrease in BMD over time in patients exposed to > 31 days of steroids and BMD was stable with < 30 days of steroid exposure (p < 0.09). CONCLUSION: Using CT scans obtained for other indications, we found low rates of osteopenia and osteoporosis that may otherwise have gone undiagnosed. Refinement of opportunistic screening may have advantages in terms of cost-savings and earlier detection of bone loss.

4 Article Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence. 2016

Jefferson, Amanda / Leonard, Helen / Siafarikas, Aris / Woodhead, Helen / Fyfe, Sue / Ward, Leanne M / Munns, Craig / Motil, Kathleen / Tarquinio, Daniel / Shapiro, Jay R / Brismar, Torkel / Ben-Zeev, Bruria / Bisgaard, Anne-Marie / Coppola, Giangennaro / Ellaway, Carolyn / Freilinger, Michael / Geerts, Suzanne / Humphreys, Peter / Jones, Mary / Lane, Jane / Larsson, Gunilla / Lotan, Meir / Percy, Alan / Pineda, Mercedes / Skinner, Steven / Syhler, Birgit / Thompson, Sue / Weiss, Batia / Witt Engerström, Ingegerd / Downs, Jenny. ·School of Biomedical Sciences, Curtin Health Innovation Research Institute-Biosciences, Curtin University, Perth, Western Australia, Australia. · Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, West Perth, Western Australia, Australia. · Department of Endocrinology and Diabetes, Princess Margaret Children's Hospital, West Perth, Western Australia, Australia. · Department of Paediatric Endocrinology, Sydney Children's Hospital, Randwick, New South Wales, Australia. · Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia. · Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada. · Division of Endocrinology and Metabolism, Children's Hospital of Eastern Ontario, Ottawa, Canada. · Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. · Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States of America. · Section of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital, Houston, Texas, United States of America. · Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, United States of America. · Bone and Osteogenesis Imperfecta Department, Kennedy Krieger Institute, Baltimore, Maryland, United States of America. · Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Solna, Stockholm, Sweden. · Pediatric Neurology Unit, Edmond & Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel. · Center for Rett Syndrome, Copenhagen, Denmark. · Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark. · Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, University of Salerno, Salerno, Italy. · Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. · Disciplines of Paediatrics and Child Health and Genetic Medicine, University of Sydney, Sydney, New South Wales, Australia. · Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. · Civitan International Research Centre, University of Alabama at Birmingham, Birmingham, Alabama, United States of America. · Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. · Katie's Clinic for Rett Syndrome and Related Disorders, UCSF Benioff Children's Hospital, Oakland, California, United States of America. · Swedish National Rett Centre, Frösön, Sweden. · Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Frösön, Sweden. · Department of Physiotherapy, Ariel University, Ariel, Israel. · Department of Pediatrics and Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America. · Fundació Hospital Sant Joan de Déu, Barcelona, Spain. · Centre for Biomedical Research on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain. · Greenwood Genetic Center, Greenwood, South Carolina, United States of America. · Genetic Metabolic Disorders Service, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. · Division of Pediatric Gastroenterology and Nutrition, Edmond & Lily Safra Children's Hospital, Tel Hashomer, Israel. · Chaim Sheba Medical Center, Tel Hashomer, Israel. · Neuropediatrics, Swedish National Rett Center, Frösön, Sweden. · School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia. ·PLoS One · Pubmed #26849438.

ABSTRACT: OBJECTIVES: We developed clinical guidelines for the management of bone health in Rett syndrome through evidence review and the consensus of an expert panel of clinicians. METHODS: An initial guidelines draft was created which included statements based upon literature review and 11 open-ended questions where literature was lacking. The international expert panel reviewed the draft online using a 2-stage Delphi process to reach consensus agreement. Items describe the clinical assessment of bone health, bone mineral density assessment and technique, and pharmacological and non-pharmacological interventions. RESULTS: Agreement was reached on 39 statements which were formulated from 41 statements and 11 questions. When assessing bone health in Rett syndrome a comprehensive assessment of fracture history, mutation type, prescribed medication, pubertal development, mobility level, dietary intake and biochemical bone markers is recommended. A baseline densitometry assessment should be performed with accommodations made for size, with the frequency of surveillance determined according to individual risk. Lateral spine x-rays are also suggested. Increasing physical activity and initiating calcium and vitamin D supplementation when low are the first approaches to optimizing bone health in Rett syndrome. If individuals with Rett syndrome meet the ISCD criterion for osteoporosis in children, the use of bisphosphonates is recommended. CONCLUSION: A clinically significant history of fracture in combination with low bone densitometry findings is necessary for a diagnosis of osteoporosis. These evidence and consensus-based guidelines have the potential to improve bone health in those with Rett syndrome, reduce the frequency of fractures, and stimulate further research that aims to ameliorate the impacts of this serious comorbidity.

5 Article Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight. 2013

Leblanc, A / Matsumoto, T / Jones, J / Shapiro, J / Lang, T / Shackelford, L / Smith, S M / Evans, H / Spector, E / Ploutz-Snyder, R / Sibonga, J / Keyak, J / Nakamura, T / Kohri, K / Ohshima, H. ·Universities Space Research Association, 3600 Bay Area Blvd, Houston, TX 77058, USA. leblanc@dsls.usra.edu ·Osteoporos Int · Pubmed #23334732.

ABSTRACT: INTRODUCTION: This investigation was an international collaboration between NASA and the JAXA space agencies to investigate the potential value of antiresorptive agents to mitigate the well-established bone changes associated with long-duration spaceflight. METHODS: We report the results from seven International Space Station (ISS) astronauts who spent a mean of 5.5 months on the ISS and who took an oral dose of 70 mg of alendronate weekly starting 3 weeks before flight and continuing throughout the mission. All crewmembers had available for exercise a treadmill, cycle ergometer, and a resistance exercise device. Our assessment included densitometry of multiple bone regions using X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and assays of biomarkers of bone metabolism. RESULTS: In addition to pre- and post-flight measurements, we compared our results to 18 astronauts who flew ISS missions and who exercised using an early model resistance exercise device, called the interim resistance exercise device, and to 11 ISS astronauts who exercised using the newer advanced resistance exercise device (ARED). Our findings indicate that the ARED provided significant attenuation of bone loss compared with the older device although post-flight decreases in the femur neck and hip remained. The combination of the ARED and bisphosphonate attenuated the expected decline in essentially all indices of altered bone physiology during spaceflight including: DXA-determined losses in bone mineral density of the spine, hip, and pelvis, QCT-determined compartmental losses in trabecular and cortical bone mass in the hip, calculated measures of fall and stance computed bone strength of the hip, elevated levels of bone resorption markers, and urinary excretion of calcium. CONCLUSIONS: The combination of exercise plus an antiresoptive drug may be useful for protecting bone health during long-duration spaceflight.