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Osteoporosis: HELP
Articles from Africa
Based on 201 articles published since 2009

These are the 201 published articles about Osteoporosis that originated from Africa during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9
1 Guideline Osteoporosis in thalassemia major: an update and the I-CET 2013 recommendations for surveillance and treatment. 2013

De Sanctis, Vincenzo / Soliman, Ashraf T / Elsedfy, Heba / Yassin, Mohamed / Canatan, Duran / Kilinc, Yurdanur / Sobti, Praveen / Skordis, Nicos / Karimi, Mehran / Raiola, Giuseppe / Galati, Maria Concetta / Bedair, Elsaid / Fiscina, Bernadette / El Kholy, Mohamed / Anonymous2850786. ·Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy. vdesanctis@libero.it · Department of Pediatrics, Division of Endocrinology, Hamad General Hospital Doha, Qatar. · Department of Pediatrics, Ain Shams University, Cairo, Egypt. · Department of Hematology, Alamal Hospital, Hamad Medical Center, Doha, Qatar. · Director of Hemoglobinopathy Diagnosis Center and President of Mediterranean Blood Diseases Foundation, Antalya, Turkey. · Pediatric Hematology and Oncology, Cukurova University, Adana, Turkey. · Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India. · Department of Paediatrics, Division of Pediatric Endocrinology, Makarios Hospital, Nicosia, Cyprus. · Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. · Department of Paediatrics, Pugliese Ciaccio Hospital, Catanzaro, Italy. · Department of Haematology, Thalassaemia and Prenatal Diagnosis Regional Center, Pugliese Ciaccio Hospital, Catanzaro, Italy. · Department of Radiology, Hamad General Hospital, Doha, Qatar. · Department of Pediatrics, NYU School of Medicine, New York, USA. ·Pediatr Endocrinol Rev · Pubmed #24575552.

ABSTRACT: In recent years, the issue of osteopenia/osteoporosis in children, adolescents and young adults with thalassaemia major (TM) has attracted much attention because it is a prominent cause of morbidity despite adequate transfusion and iron chelation therapy. The reported frequency of osteoporosis, even in well treated TM patients varies from 13.6% to 50% with an additional 45% affected by osteopenia. The pathogenesis of TM-induced osteoporosis is multifactorial. Genetic and acquired factors play role in demineralization of bones in thalassemia. Osteoporosis is characterized by low bone mass and disruption of bone architecture, resulting in reduced bone strength and increased risk of fractures. The significant predictors of fracture prevalence include male gender, hypothyroidism, age, lack of spontaneous puberty in females, active hepatitis, heart disease and diabetes. The early identification of osteopenia and osteoporosis is of paramount importance. This is because delayed diagnosis and inadequate treatment have led to severe osteoporosis, skeletal abnormalities, fractures, spinal deformities, nerve compression and growth failure. dequate hormonal replacement, has been posponed, Effective iron chelation adequate hormonal replacement, improvement of hemoglobin levels, calcium and vitamin D administration and physical activity are currently the main measures for the management of the disease. The use of bisphosphonates in TM patients with osteoporosis is increasing and their positive effect in improving bone mineral density is encouraging. The recommendations of the International Network on Growth Disorders and Endocrine Complications in Thalassaemia (I-CET) for diagnosis and management of osteoporosis in TM are also briefly included in this review.

2 Guideline South African recommendations for the management of rheumatoid arthritis: an algorithm for the standard of care in 2013. 2013

Hodkinson, Bridget / Van Duuren, Elsa / Pettipher, Clive / Kalla, Asgar / Anonymous210765. ·Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa. drbridget@gmail.com ·S Afr Med J · Pubmed #23885741.

ABSTRACT: Updated treatment recommendations for the therapy of rheumatoid arthritis (RA) in South Africa advocate early diagnosis, prompt initiation of disease-modifying anti-rheumatic drugs (DMARDs), and an intense treatment strategy where disease activity is assessed with a composite score such as the Simplified Disease Activity Index (SDAI). Frequent assessments and escalation of therapy are necessary until low disease activity (LDA) (SDAI ≤11) or ideally remission (SDAI ≤3.3) is achieved. Synthetic DMARDs may be used as monotherapy or in combination, and can be co-prescribed with low-dose corticosteroids if necessary. Biologic DMARD therapy should be considered for patients who have failed a 6-month trial of at least 3 synthetic DMARDs. All RA patients in SA are at increased risk of tuberculosis (TB), in particular patients using anti-tumour necrosis factor (TNF) biologic therapy. These recommendations provide practical suggestions for the screening and management of TB and other comorbidities, and offer an approach to monitoring of RA patients.

3 Review Bone management in hematologic stem cell transplant recipients. 2018

Kendler, D L / Body, J J / Brandi, M L / Broady, R / Cannata-Andia, J / Cannata-Ortiz, M J / El Maghraoui, A / Guglielmi, G / Hadji, P / Pierroz, D D / de Villiers, T J / Rizzoli, R / Ebeling, P R / Anonymous1981118. ·Department of Medicine, Division of Endocrinology, University of British Columbia, 150 - 943 W. Broadway, Vancouver, V5Z 4E1, Canada. davidkendler@gmail.com. · CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium. · Mineral and Bone Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Department of Medicine, Division of Hematology, University of British Columbia, Vancouver, Canada. · Servicio de Metabolismo Óseo y Mineral, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain. · Haematology Department, IIS Princesa, Hospital de la Princesa, Madrid, Spain. · Rheumatology Department, Military Hospital Mohammed V, Mohammed V-Souissi University, Rabat, Morocco. · Department of Radiology, University of Foggia, Foggia, Italy. · Department of Bone Oncology, Endocrinology and Reproductive Medicine, Nord West Hospital, Frankfurt, Germany. · International Osteoporosis Foundation (IOF), Nyon, Switzerland. · Department of Gynaecology, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, South Africa. · Mediclinic Panorama, Cape Town, South Africa. · Division of Bone Diseases, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland. · Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia. ·Osteoporos Int · Pubmed #30178158.

ABSTRACT: Autologous and allogeneic hematopoietic stem cell transplantation (HSCT) is the treatment of choice for patients with some malignant and non-malignant hematological diseases. Advances in transplantation techniques and supportive care measures have substantially increased the number of long-term HSCT survivors. This has led to an increasing patient population suffering from the late effects of HSCT, of which, bone loss and its consequent fragility fractures lead to substantial morbidity. Altered bone health, with consequent fragility fractures, and chronic graft-versus-host disease (GVHD) are factors affecting long-term quality of life after HSCT. Hypogonadism, HSCT preparative regimens, nutritional factors, and glucocorticoids all contribute to accelerated bone loss and increased fracture risk. Management strategies should include bone mineral density examination, evaluation of clinical risk factors, and general dietary and physical activity measures. Evidence has accumulated permitting recommendations for more attentiveness to evaluation and monitoring of bone health, with appropriate application of osteoporosis pharmacotherapies to patients at increased risk of bone loss and fracture.

4 Review Postmenopausal osteoporosis and breast cancer: The biochemical links and beneficial effects of functional foods. 2018

Muhammad, Aliyu / Mada, Sanusi Bello / Malami, Ibrahim / Forcados, Gilead E / Erukainure, Ochuko L / Sani, Hadiza / Abubakar, Ibrahim Babangida. ·Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810271, Kaduna State, Nigeria. Electronic address: amachida31@gmail.com. · Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810271, Kaduna State, Nigeria. · Department of Pharmacognosy and Ethnopharmacy, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria. · Nutrition and Toxicology Division, Federal Institute of Industrial Research, Oshodi, Lagos, Nigeria. · Department of Medicine, Kaduna State University, Kaduna, Nigeria. · Department of Biochemistry, Kebbi State University of Science and Technology, Aliero, Nigeria. ·Biomed Pharmacother · Pubmed #30114641.

ABSTRACT: Breast cancer as a multifactorial disease has been classified among the major causes of morbidity and mortality in women across the world, with a higher prevalence among post-menopausal women. Osteoporosis, a condition characterized by altered bone mineralization is also commonly found among post-menopausal women. Consequently, post-menopausal women are at risk of morbidity and mortality associated with breast cancer and postmenopausal osteoporosis. This may not be unconnected to the fact that, there may be existent biochemical links between the two mayhems, which might rally round between the cellular and molecular connectivity based on the actions and inactions of RANKL, estrogen, free radicals-induced oxidative stress and metabolic implications of age related obesity among others. Cells and tissues including breast and bone are more prone to oxidative stress with age, and oxidative stress could alter the activity of key proteins and pathways required for protection against breast cancer and osteoporosis. As a result, the potentials of antioxidant rich functional foods in preventing, managing and possibly treating breast cancer and postmenopausal osteoporosis cannot be overemphasised. This review mainly uses ISI, SCOPUS and PubMed indexed journals and books containing various experimental reports vacillating from humans, animals and in vitro studies in relation to breast cancer and postmenopausal osteoporosis, biochemical links and possible beneficial effects of functional foods. One distinct feature of the review is that it categorically intends to provide a critical appraisal on the said available experimental data within the variables of breast cancer and osteoporosis among females vis-à-vis the potentials of functional foods.

5 Review Gonadotropins and Their Analogs: Current and Potential Clinical Applications. 2018

Anderson, Ross C / Newton, Claire L / Anderson, Richard A / Millar, Robert P. ·Centre for Neuroendocrinology, University of Pretoria, Pretoria, South Africa. · Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. · Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. · MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom. · Department of Integrative Biomedical Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. · Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa. ·Endocr Rev · Pubmed #29982442.

ABSTRACT: The gonadotropin receptors LH receptor and FSH receptor play a central role in governing reproductive competency/fertility. Gonadotropin hormone analogs have been used clinically for decades in assisted reproductive therapies and in the treatment of various infertility disorders. Though these treatments are effective, the clinical protocols demand multiple injections, and the hormone preparations can lack uniformity and stability. The past two decades have seen a drive to develop chimeric and modified peptide analogs with more desirable pharmacokinetic profiles, with some displaying clinical efficacy, such as corifollitropin alfa, which is now in clinical use. More recently, low-molecular-weight, orally active molecules with activity at gonadotropin receptors have been developed. Some have excellent characteristics in animals and in human studies but have not reached the market-largely as a result of acquisitions by large pharma. Nonetheless, such molecules have the potential to mitigate risks currently associated with gonadotropin-based fertility treatments, such as ovarian hyperstimulation syndrome and the demands of injection-based therapies. There is also scope for novel use beyond the current remit of gonadotropin analogs in fertility treatments, including application as novel contraceptives; in the treatment of polycystic ovary syndrome; in the restoration of function to inactivating mutations of gonadotropin receptors; in the treatment of ovarian and prostate cancers; and in the prevention of bone loss and weight gain in postmenopausal women. Here we review the properties and clinical application of current gonadotropin preparations and their analogs, as well as the development of novel orally active, small-molecule nonpeptide analogs.

6 Review Therapeutic Potential and Recent Advances of Curcumin in the Treatment of Aging-Associated Diseases. 2018

Sundar Dhilip Kumar, Sathish / Houreld, Nicolette Nadene / Abrahamse, Heidi. ·Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg-2028, South Africa. sathishd@uj.ac.za. · Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg-2028, South Africa. nhoureld@uj.ac.za. · Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg-2028, South Africa. habrahamse@uj.ac.za. ·Molecules · Pubmed #29621160.

ABSTRACT: Curcumin, a low molecular weight, lipophilic, major yellow natural polyphenolic, and the most well-known plant-derived compound, is extracted from the rhizomes of the turmeric (

7 Review Should women be screened for osteoporosis at midlife? 2018

de Villiers, T J. ·a Department of Gynecology, Faculty of Health Sciences , Stellenbosch University , Stellenbosch , South Africa. · b Mediclinic Panorama , Cape Town , South Africa. ·Climacteric · Pubmed #29447485.

ABSTRACT: Osteoporosis and associated fractures are common in women after midlife and will increase as the population ages. Osteoporosis-related fractures cause a significant increase in morbidity and mortality. Osteoporosis decreases the quality of life and productivity of many older women, with an increasing burden on health-care resources. Future risk of fracture can be managed by evidence-based interventions. It is thus appropriate to estimate the future risk of fracture in all women at the age of 50 years or at menopause, whichever occurs first. This can be achieved in a non-invasive fashion by targeted clinical history-taking. The future risk of fracture can be quantified using computerized models that integrate all risk factors, with or without dual-energy X-ray absorptiometry (DXA). Individuals found to be at increased risk of fracture need also to be assessed by DXA and, in the absence of lateral vertebral assessment, also by conventional X-ray imaging. All women should be screened by DXA at the age of 65 years, if not done before that time. At the age of 50, all women should be informed about a bone-friendly lifestyle.

8 Review [Paget's disease of bone: Diagnostic and therapeutic updates]. 2018

Alaya, R / Alaya, Z / Nang, M / Bouajina, E. ·Service de rhumatologie, centre hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France. · Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie. Electronic address: zeineb_a@hotmail.fr. · Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie. ·Rev Med Interne · Pubmed #28690091.

ABSTRACT: Paget's disease of bone is the second most common metabolic bone disease after osteoporosis. Its pathogenesis is not yet clearly understood. Geographic distribution and epidemiological variations suggest a role of genetic and environmental factors in its pathophysiology. The frequency of the Paget's disease of bone increases with age. Its discovery can be fortuitous. Prognosis mainly depends on the occurrence of complications involving bones and joints, neurological, cardiovascular or metabolic systems. Treatment of symptomatic forms currently relies on bisphosphonates that have transformed its prognosis.

9 Review What is the effect of anti-resorptive drugs (ARDs) on the development of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: A systematic review. 2017

Aljohani, Suad / Fliefel, Riham / Ihbe, Jacob / Kühnisch, Jan / Ehrenfeld, Michael / Otto, Sven. ·Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Michael Ehrenfeld), Lindwurmstrasse 2a, 80337, Ludwig-Maximilians-Universität, Munich, Germany; Department of Oral Basic & Clinical Sciences (Head: Prof. Dr. Ali Saad Thafid Al Ghamdi), Al Sulaimaniyah, 21589, King Abdulaziz University, Jeddah, Saudi Arabia. · Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Michael Ehrenfeld), Lindwurmstrasse 2a, 80337, Ludwig-Maximilians-Universität, Munich, Germany; Experimental Surgery and Regenerative Medicine (Head: Prof. Dr. med. Wolfgang Böcker), Nussbaumstrasse 20, 80336, Ludwig-Maximilians-Universität, Munich, Germany; Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Maged Fahmy), Champollion Street, Azarita, Alexandria-University, Alexandria, Egypt. Electronic address: Riham.Fliefel@med.uni-muenchen.de. · Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Michael Ehrenfeld), Lindwurmstrasse 2a, 80337, Ludwig-Maximilians-Universität, Munich, Germany. · Department of Conservative Dentistry and Periodontology (Head: Prof. Dr. Reinhard Hickel), Goethestrasse 70, 80336, Ludwig-Maximilians-Universität, Munich, Germany. ·J Craniomaxillofac Surg · Pubmed #28687467.

ABSTRACT: PURPOSE: To conduct a systematic review of the literature to detect the effect of anti-resorptive drugs (ARDs) and their administration characteristics in the development of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients. METHODS: Systematic search in PubMed, Web of Sciences and Cochrane Library was performed for relevant studies to July 2016. Population variables (age, gender, comorbidities, medications, preceding events, number of patients with MRONJ), ARDs and clinical variables were abstracted independently from these articles. RESULTS: The 44 eligible studies described 680 MRONJ cases in osteoporotic patients. The mean age of MRONJ patients was 69.7 ± 5.2 years. It was more common in females. Mandible was the most common site. Alendronate was the most frequently administered ARD. Oral route of administration was noted in 86.7% of the patients. The mean duration of BPs intake was 50.4 ± 19 months. Extraction was the most frequently preceding event followed by dentoalveolar surgery. Corticosteroids or immunosuppressants were the most common concomitant medications in MRONJ. CONCLUSION: A long duration of ARDs administration seems to be an important risk factor in MRONJ development. Patients under treatment with corticosteroids or immunosuppressants might be at a higher risk even if the BPs duration is less than 4 years.

10 Review Calcium supplementation and cardiovascular risk: A rising concern. 2017

Tankeu, Aurel T / Ndip Agbor, Valirie / Noubiap, Jean Jacques. ·Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon. · Ibal sub-Divisional hospital, Oku, North-west Region, Cameroon. · Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. ·J Clin Hypertens (Greenwich) · Pubmed #28466573.

ABSTRACT: Over the past decade, the number of individuals taking calcium supplementation worldwide has been on the rise, especially with the emergence of new pharmaceutical companies specialized in the marketing of dietary supplements; with calcium supplementation being their main business axis. This is mostly because of the established role of calcium in the prevention and treatment of osteoporosis and, to a lesser extent, its role in the prevention of fractures. Recently, a rising body of evidence on the adverse effect of calcium supplementation on nonskeletal, especially cardiovascular, health has been a cause for concern. In fact, a significant number of studies have reported an association between calcium supplementation and adverse cardiovascular events, even though high dietary calcium intake was shown to have a protective effect. The mechanism by which calcium supplementation could cause a cardiovascular event was still unclear until a recent study published in the Journal of the American Heart Association. Combining this recent finding with available data associating calcium supplementation with cardiovascular mortality and all-cause mortality, we call on the need for an evidence-based approach to calcium supplementation, while stressing on the safety of dietary calcium intake over the former on cardiovascular health.

11 Review The quest for new drugs to prevent osteoporosis-related fractures. 2017

de Villiers, T J. ·a Mediclinic Panorama and Department of Gynecology , University of Stellenbosch , Cape Town , South Africa. ·Climacteric · Pubmed #28286990.

ABSTRACT: There is a need for the development of new drugs to prevent osteoporosis-related fractures. Fractures are projected to increase and the present drugs have modest efficacy, significant side-effects and poor compliance. To illustrate the difficulties in the development of new drugs, the author reviews the fate of several drugs that have failed to gain regulatory approval. These drugs include arzoxifene, lasofoxifene, MK-5442, roncalceret and odanacatib. Romosozumab and abaloparatide are the only new drugs presently in phase-3 development. It is anticipated that ongoing studies of the mechanisms and signaling pathways involved in the regulation of bone remodeling will open up new opportunities for targeted pharmacological interventions to increase bone strength. However, the perfect drug is still a long way off and will face many obstacles before approval.

12 Review The importance of physical activity in osteoporosis. From the molecular pathways to the clinical evidence. 2016

Castrogiovanni, Paola / Trovato, Francesca Maria / Szychlinska, Marta Anna / Nsir, Houda / Imbesi, Rosa / Musumeci, Giuseppe. ·Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy. · Department of Clinical and Experimental Medicine, Internal Medicine Division, School of Medicine, University of Catania, Catania, Italy. · Department of Molecular and Cellular Biology and Plant Physiology, Centre of Biotechnology of Borj Cedreya, University of Carthage, Tunisia. · Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy. g.musumeci@unict.it. ·Histol Histopathol · Pubmed #27311988.

ABSTRACT: Osteoporosis is a very common bone disorder characterized by low bone mass and signs of deterioration, responsible for bone fragility typical in this pathology. The risk factors for the onset of osteoporosis are many and different from each other. Some of them cannot be modified, such as age, hereditary diseases and endocrine diseases. Others are modifiable, so that prevention is an advisable tool to reduce the incidence of osteoporosis. Among preventive tools, physical activity is certainly a valid instrument of prevention, in fact physical activity contributes to a healthy energy balance and increases muscle mass and bone mass. In the present narrative review, we wanted to pay attention to the possible influence of physical activity on the pathophysiological molecular pathways of osteoporosis and to the use of different exercise training in treatment of osteoporosis. From the literature analyzed, in relation to the effects of physical activity on bone metabolism, it is shown that exercise acts on molecular pathways of bone remodeling involving all cellular types of bone tissue. In relation to clinical trials adopted in patients with osteoporosis, it is evident that a multi-component training, including aerobic activity and other types of training (resistance and/or strength exercises), is the best kind of exercise in improving bone mass and bone metabolism in older adults and especially osteopoenic and osteoporotic women. With regard to whole-body-vibration training, it seems to be a valid alternative to current methods due to its greater adaptability to patients. In conclusion, physical activity, whatever the adopted training, always has beneficial effects on patients suffering from osteoporosis, and not only on bone homeostasis but on the whole skeletal muscle system.

13 Review Neurocognitive, Neuroprotective, and Cardiometabolic Effects of Raloxifene: Potential for Improving Therapeutic Outcomes in Schizophrenia. 2016

Khan, Mohammad M. ·Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Zawia, Jamal Abdul Nassre Street, P.O. Box 16418, Az-Zawiyah, Libya. mmkhan0@gmail.com. ·CNS Drugs · Pubmed #27193386.

ABSTRACT: Raloxifene is a selective estrogen receptor modulator that has been approved for treating osteoporosis and breast cancer in high-risk postmenopausal women. However, recent evidence suggests that raloxifene adjunct therapy improves cognition and reduces symptom severity in men and women with schizophrenia. In animal models, raloxifene increases forebrain neurogenesis and enhances working memory and synaptic plasticity. It may consequently repair the neuronal and synaptic connectivity that is disrupted in schizophrenia. It also reduces oxidative stress and neuroinflammation, which are potent etiological factors in the neuropathology of schizophrenia. Furthermore, in postmenopausal women, raloxifene reduces the risks for atherosclerosis, diabetes mellitus, and weight gain, which are serious adverse effects associated with long-term antipsychotic treatment in schizophrenia; therefore, it may improve the safety and efficacy of antipsychotic drugs. In this review, recent insights into the neurocognitive, neuroprotective, and cardiometabolic effects of raloxifene in relation to therapeutic outcomes in schizophrenia are discussed.

14 Review Postmenopausal Breast Cancer, Aromatase Inhibitors, and Bone Health: What the Surgeon Should Know. 2016

Baatjes, K J / Apffelstaedt, J P / Kotze, M J / Conradie, M. ·Department Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, PO Box 19063, Tygerberg, 7505, South Africa. kbaatjes@sun.ac.za. · Department Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, PO Box 19063, Tygerberg, 7505, South Africa. · Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa. · Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa. ·World J Surg · Pubmed #27189076.

ABSTRACT: Breast cancer, as the most common malignancy in women, remains a major public health issue despite countless advances across decades. Endocrine therapy is the cornerstone of treatment of the hormone-sensitive subtype of breast cancer. The use of aromatase inhibitors (AIs) in the postmenopausal women has extended the survival beyond that of Tamoxifen, but harbors a subset of side effects, most notably accelerated bone loss. This, however, does not occur in all women undergoing treatment. It is vital to identify susceptible patients early, to limit such events, employ early treatment thereof, or alter drug therapy. International trials on AIs, predominantly performed in North American and European females, provide little information on what to expect in women in developing countries. Here, surgeons often prescribe and manage endocrine therapy. The prescribing surgeon should be aware of the adverse effect of the endocrine therapy and be able to attend to side effects. This review highlights clinical and biochemical factors associated with decrease in bone mineral density in an, as yet, unidentified subgroup of postmenopausal women. In the era of personalized medical care, appropriate management of bone health by surgeons based on these factors becomes increasingly important.

15 Review Which HIV patients should be screened for osteoporosis: an international perspective. 2016

Alvarez, Elena / Belloso, Waldo H / Boyd, Mark A / Inkaya, Ahmet Ç / Hsieh, Evelyn / Kambugu, Andrew / Kaminski, Greg / Martinez, Esteban / Stellbrink, Hans-Jürgen / Walmsley, Sharon / Brown, Todd T / Mallon, Patrick W G. ·aHIV Molecular Research Group, School of Medicine, University College Dublin, Dublin, Ireland bInfectious Diseases and Clinical Pharmacology Sections, Internal Medicine Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina cThe Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia dSchool of Medicine, Hacettepe University, Ankara, Turkey eDepartment of Infectious Diseases at Peking Union Medical College Hospital, Beijing, China fInfectious Diseases Institute (IDI) HIV outpatient clinic at Mulago Hospital Complex, Makerere University College of Health Sciences, Kampala, Uganda gMoscow Regional AIDS Centre, Moscow, Russia hInfectious Diseases Unit Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain iICH Study Center, Hamburg, Germany jToronto General Research Institute (TGRI), University Health Network (NHN), Toronto General Hospital, Toronto, Canada kDivision of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA lMater Misericordiae University Hospital, Department of Infectious Diseases, Dublin, Ireland. ·Curr Opin HIV AIDS · Pubmed #26895510.

ABSTRACT: PURPOSE OF REVIEW: This review provides international insights into the real-world clinical approach to screening for bone mineral density (BMD) and osteoporosis in people living with HIV (PLWH) using opinions from HIV physicians from key regions around the world. RECENT FINDINGS: Although a significant proportion of PLWH are aged over 50, the relative importance of low BMD to clinical care differs significantly between countries and regions, based on factors such as the population at risk, access to adequate screening resources, and physicians' knowledge. Generally, management of osteoporosis in PLWH follows similar principals as for the general population, with risk factors for fracture combined with measurement of BMD by dual energy X-ray absorptiometry in algorithms such as Fracture Risk Assessment Tool, designed to provide an overall risk estimation. Although in most regions age is considered among the most important factors contributing to low BMD and fractures, considerable country and region-specific factors become apparent, such as malnutrition, inactivity and impact of comorbidities, substance abuse, and increasing use of tenofovir disoproxil fumarate. SUMMARY: These opinions highlight the diversity that still exists in the approach to the long-term management of PLWH and highlight challenges facing development of consensus guidelines that can be effectively implemented worldwide.

16 Review Glucocorticoids and Rheumatoid Arthritis. 2016

Ferreira, Joana Fonseca / Ahmed Mohamed, Alaa Abdelkhalik / Emery, Paul. ·Rheumatology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal. · Rheumatology, Physical medicine and Rehabilitation Department, Assiut University Hospitals, Assiut 71515, Egypt. · Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospital NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK. Electronic address: p.emery@leeds.ac.uk. ·Rheum Dis Clin North Am · Pubmed #26611549.

ABSTRACT: Glucocorticoids (GCs) were discovered in the 1940s and were administered for the first time to patients with rheumatoid arthritis in 1948. However, side effects were subsequently reported. In the last 7 decades, the mechanisms of action for both therapeutic properties and side effects have been elucidated. Mechanisms for minimizing side effects were also developed. GCs are the most frequently used class of drugs in the treatment of rheumatoid arthritis because of their efficacy in relieving symptoms and their low cost. A review of clinical applications, side effects, and drug interactions is presented.

17 Review Efficacy and safety of denosumab for the treatment of osteoporosis: A systematic review. 2015

Diédhiou, Demba / Cuny, Thomas / Sarr, Anna / Norou Diop, Saïd / Klein, Marc / Weryha, Georges. ·Department of Endocrinology, Lorraine University, University Hospital Center of Nancy, Vandœuvre-lès-Nancy, France; Department of Internal Medicine II, Cheikh Anta Diop University, University Hospital Center of Dakar, Dakar, Senegal. · Department of Endocrinology, Lorraine University, University Hospital Center of Nancy, Vandœuvre-lès-Nancy, France. · Department of Internal Medicine II, Cheikh Anta Diop University, University Hospital Center of Dakar, Dakar, Senegal. · Department of Endocrinology, Lorraine University, University Hospital Center of Nancy, Vandœuvre-lès-Nancy, France. Electronic address: g.weryha@chu-nancy.fr. ·Ann Endocrinol (Paris) · Pubmed #26639186.

ABSTRACT: Denosumab is an anti-RANK ligand (RANKL) monoclonal antibody approved for the treatment of postmenopausal osteoporosis and prevention of skeletal metastasis complications. Administered subcutaneously every 6 months, it reduces the risk of vertebral fracture by 70% and of hip fracture by 40%. Its safety profile is acceptable. Denosumab may be used to treat patients with moderate to severe renal insufficiency. It has anti-fracture activity equivalent to that of zoledronic acid, but no residual effect, and no action at all beyond 6 months. In France, denosumab is reimbursed as a second-line treatment after a first attempt with bisphosphonate.

18 Review Co-morbidity index in rheumatoid arthritis: time to think. 2015

El Miedany, Yasser. ·Rheumatology and Rehabilitation, Ain Shams University Egypt, Cairo, Egypt. drelmiedany@rheumatology4u.com. · King's College London, London, UK. drelmiedany@rheumatology4u.com. · 2 Italian Hospital St. Abbassia, Cairo, 11381, Egypt. drelmiedany@rheumatology4u.com. ·Clin Rheumatol · Pubmed #26497664.

ABSTRACT: Rheumatoid arthritis patients are clinically complex, and the interplay of their disease activity together with the other associated conditions may lead to increased morbidity and mortality. The recent advances in the disease management attracted the attention to its associated co-morbidities and highlighted the need for a tool to provide clinicians and potential payers with a clinically powerful measure of the disease burden and prognosis. Predicting outcome or co-morbidity probability has been previously implemented successfully for calculating 10-year fracture probability (FRAX) as well as for predicting 1-year patient mortality using co-morbidity data obtained (Charlson index). Developing a specific rheumatoid arthritis-independent tool able to predict morbidity, mortality, cost and hospitalization would be a step forward on the way to achieve full disease remission. The co-morbidity index should be used both at baseline as well as a continuous variable in analyses. It should be implemented regularly in the clinical assessment as a confounder of outcomes. This article will review the redefined health outcomes in rheumatoid arthritis and the concept of co-morbidity index for patients with inflammatory arthritis. It will also present a proposed co-morbidity index for rheumatoid arthritis patients.

19 Review The role of menopausal hormone therapy in the management of osteoporosis. 2015

de Villiers, T J. ·a Mediclinic Panorama and Department of Gynecology , University Stellenbosch , Cape Town , South Africa. ·Climacteric · Pubmed #26474003.

ABSTRACT: It is now 75 years since Fuller Albright published his observations on the causal relationship between menopausal estrogen deficiency and osteoporosis. He introduced the concept of menopausal hormone therapy (MHT) for the prevention of osteoporosis. Most of his remarkable observations have stood the test of time and scientific scrutiny. Unfortunately, the uptake of MHT for the prevention of osteoporosis and related fractures remains very low. This can be ascribed to several factors. The availability of new drugs, supported by randomized clinical trials, has increased therapeutic options and created the impression that all new drugs are better compared to MHT. Confusion exists as to the benefit/risk profile of menopausal hormone therapy, limitations on the age of initiation of treatment, limitations on the length of treatment, and the need for treatment in the young menopausal woman with low bone density.

20 Review Comprehensive treatment of psoriatic arthritis: managing comorbidities and extraarticular manifestations. 2014

Ogdie, Alexis / Schwartzman, Sergio / Eder, Lihi / Maharaj, Ajesh B / Zisman, Devy / Raychaudhuri, Siba P / Reddy, Soumya M / Husni, Elaine. ·From the University of Pennsylvania, Philadelphia, Pennsylvania; Hospital for Special Surgery, New York, New York, USA; Toronto Western Hospital, Toronto, Ontario, Canada; Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa, and Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Carmel Medical Center, Faculty of Medicine, Technion, Haifa, Israel; Rheumatology, VA Sacramento Medical Center; Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, UC Davis, Davis, California; Division of Rheumatology, New York University School of Medicine, New York, New York; and the Cleveland Clinic, Cleveland, Ohio, USA.A. Ogdie, MD, MSCE, University of Pennsylvania; S. Schwartzman, MD, Hospital for Special Surgery; L. Eder, MD, PhD, Toronto Western Hospital; A.B. Maharaj, MB, BS, HDipIntMed(SA), FCP(SA), Nelson R. Mandela School of Medicine, University of KwaZulu Natal and Academic Medical Center, University of Amsterdam; D. Zisman, MD, Carmel Medical Center, Faculty of Medicine, Technion; S.P. Raychaudhuri, MD, Rheumatology, VA Sacramento Medical Center; Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, UC Davis; S.M. Reddy, MD, Division of Rheumatology, New York University School of Medicine; E. Husni, MD, MPH, Cleveland Clinic. ·J Rheumatol · Pubmed #25362717.

ABSTRACT: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis that can lead to decreased health-related quality of life and permanent joint damage leading to functional decline. In addition to joint and skin manifestations, both psoriasis and PsA are associated with numerous comorbidities and extraarticular/cutaneous manifestations, which may influence the physician's choice of therapy. The objectives of this review are (1) to identify comorbidities in patients with PsA based on the available evidence; (2) to examine the effects of these comorbidities or extraarticular/cutaneous manifestation on the management of patients with PsA as well as the selection of therapy; and (3) to highlight research needs around comorbidities and treatment paradigms. This review is part of a treatment recommendations update initiated by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

21 Review Efficacy and safety of medical therapy for low bone mineral density in patients with inflammatory bowel disease: a meta-analysis and systematic review. 2014

Melek, John / Sakuraba, Atsushi. ·Department of Internal Medicine, Mercy Hospital and Medical Center, Chicago, Illinois; Division of Colorectal Surgery, Department of Surgery, University of Alexandria, Alexandria, Egypt. · Inflammatory Bowel Disease Center, The University of Chicago Medicine, Chicago, Illinois. Electronic address: asakurab@medicine.bsd.uchicago.edu. ·Clin Gastroenterol Hepatol · Pubmed #23981521.

ABSTRACT: BACKGROUND & AIMS: Patients with inflammatory bowel disease (IBD) are at risk for osteoporosis and fracture. However, the efficacy of medical treatments for osteoporosis in increasing bone mineral density (BMD) in patients with IBD has not been well characterized. METHODS: We conducted a meta-analysis and systematic review of controlled trials to evaluate the efficacy and safety of medical therapies used for low BMD in patients with IBD (Crohn's disease, ulcerative colitis, or indeterminate colitis). We searched MEDLINE, EMBASE, Google scholar, the University Hospital Medical Information Network (UMIN) Clinical Trials Registry, and Cochrane Central Register of Controlled Trials for studies that assessed the efficacy of medical treatment for low BMD in patients with IBD. We also manually searched abstracts from scientific meetings and bibliographies of identified articles for additional references. The primary outcome assessed was changes in BMD at the lumbar spine. We also collected data on hip BMD, numbers of new fractures, and adverse effects. Data were pooled by using random-effects models and by mixed-effects analysis for primary aims, when subgroup analysis by individual drug was possible. RESULTS: We analyzed data from 19 randomized controlled studies; 2 used calcium and vitamin D as therapies, 13 used bisphosphonates, 4 used fluoride, 1 used calcitonin, and 1 used low-impact exercise. The pooled effect of bisphosphonates was greater than that of controls in increasing BMD at the lumbar spine (standard difference in means, 0.51; 95% confidence interval, 0.29-0.72) and hip (standard difference in means, 0.26; 95% confidence interval, 0.04-0.49) with comparable tolerability, and the risk of vertebral fractures was reduced. Fluoride increased lumbar spine BMD, but its ability to reduce risk of fracture was unclear. There was no evidence that the other interventions increased BMD. CONCLUSIONS: On the basis of a meta-analysis, bisphosphonate is effective and well tolerated for the treatment of low BMD in patients with IBD and reduces the risk of vertebral fractures. There are insufficient data to support the efficacy of calcium and vitamin D, fluoride, calcitonin, or low-impact exercise. However, the small number of randomized controlled trials limited our meta-analysis.

22 Review Moderate alcohol use and health: a consensus document. 2013

Poli, A / Marangoni, F / Avogaro, A / Barba, G / Bellentani, S / Bucci, M / Cambieri, R / Catapano, A L / Costanzo, S / Cricelli, C / de Gaetano, G / Di Castelnuovo, A / Faggiano, P / Fattirolli, F / Fontana, L / Forlani, G / Frattini, S / Giacco, R / La Vecchia, C / Lazzaretto, L / Loffredo, L / Lucchin, L / Marelli, G / Marrocco, W / Minisola, S / Musicco, M / Novo, S / Nozzoli, C / Pelucchi, C / Perri, L / Pieralli, F / Rizzoni, D / Sterzi, R / Vettor, R / Violi, F / Visioli, F. ·NFI (Nutrition Foundation of Italy), Viale Tunisia 38, 20124 Milan, Italy. poli@nutrition-foundation.it ·Nutr Metab Cardiovasc Dis · Pubmed #23642930.

ABSTRACT: AIMS: The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. DATA SYNTHESIS: In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician. CONCLUSIONS: The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered.

23 Review Targeting RANKL in breast cancer: bone metastasis and beyond. 2013

Azim, Hamdy / Azim, Hatem A. ·Department of Clinical Oncology, Cairo University Hospital, Cairo, Egypt. ·Expert Rev Anticancer Ther · Pubmed #23406560.

ABSTRACT: In breast cancer, RANK ligand (RANKL) appears to play an important role in the process of chemotaxis between circulating tumor cells and the bone microenvironment, which enables RANK-expressing breast cancer cells to migrate into the bone. Mounting clinical evidence has further demonstrated that the anti-RANKL monoclonal antibody; denosumab is the most effective approach in the prevention of skeletal-related events. On the other hand, inhibiting RANKL in preclinical models, not only reduced breast cancer formation but also decreased the development of lung metastases, suggesting RANKL as a novel target for breast cancer chemoprevention. In addition, recent data have pointed to a potential role of RANKL in the biology of breast cancer arising at a young age. Hence, RANKL emerges as a key molecule, not only in the field of breast cancer bone metastasis but also in the biology of breast cancer as a whole.

24 Review Transient osteoporosis of the hip, complete resolution after treatment with alendronate as observed by MRI description of eight cases and review of the literature. 2012

Emad, Yasser / Ragab, Yasser / El-Shaarawy, Nashwa / Rasker, Johannes J. ·Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt. yasseremad68@yahoo.com ·Clin Rheumatol · Pubmed #22933125.

ABSTRACT: Transient osteoporosis of the hip (TOH), also referred to as transient bone marrow edema syndrome, is most common in middle-aged men and often after trivial trauma or sport-related injuries. Diagnosis is usually made by eliminating other possible causes of hip pain. Magnetic resonance imaging (MRI) plays an important role in diagnosis and demonstrates a typical pattern of bone marrow edema (BME) in the form of diffuse low signal on T1-weighted images and high signal on T2 fat-suppressed or short T1 inversion recovery images. No consensus exists about the management of TOH, as it may progress to avascular necrosis. We describe eight cases of TOH treated with alendronate resulting in improvement of pain and function and complete resolution of BME on MRI. The literature is reviewed regarding TOH and the relationship with bone marrow edema syndrome, avascular necrosis of the hip, and regional migratory osteoporosis. To our knowledge, this is the first report describing the improvement of this condition after of alendronate with documented radiological improvement on follow-up MRI.

25 Review The WHI: the effect of hormone replacement therapy on fracture prevention. 2012

de Villiers, T J / Stevenson, J C. ·Mediclinic Panorama and Department of Gynaecology, University Stellenbosch, Cape Town, South Africa. ·Climacteric · Pubmed #22612613.

ABSTRACT: The Women's Health Initiative (WHI) randomized, controlled trial was the first study to prove that hormone replacement therapy (HRT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women, even those at low risk of fracture. The study authors concluded that the bone-friendly aspect of HRT was limited in clinical practice as possible adverse effects outweighed possible benefit. On the strength of these publications, regulatory authorities downgraded the use of HRT for the prevention of fracture to second-line therapy. This article examines the original and subsequent evidence presented by the WHI study and concludes that the restrictions placed on HRT as a bone-specific drug by regulatory bodies have not withstood the test of time and are not supported by the data of the WHI.