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Osteoporosis: HELP
Articles from Ireland
Based on 109 articles published since 2008
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These are the 109 published articles about Osteoporosis that originated from Ireland during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Guideline Best Practices for Dual-Energy X-ray Absorptiometry Measurement and Reporting: International Society for Clinical Densitometry Guidance. 2016

Lewiecki, E Michael / Binkley, Neil / Morgan, Sarah L / Shuhart, Christopher R / Camargos, Bruno Muzzi / Carey, John J / Gordon, Catherine M / Jankowski, Lawrence G / Lee, Joon-Kiong / Leslie, William D / Anonymous7130862. ·New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. Electronic address: mlewiecki@gmail.com. · Osteoporosis Clinical Center and Research Program, University of Wisconsin, Madison, WI, USA. · Division of Clinical Immunology and Rheumatology, Department of Medicine, UAB Osteoporosis Prevention and Treatment Clinic, University of Alabama at Birmingham, Birmingham, AL, USA. · Swedish Medical Group, Seattle, WA, USA. · Rede Mater Dei de Saúde - Densimater, Belo Horizonte, Brazil. · Galway University Hospitals, National University of Ireland, Galway, Ireland. · Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. · Illinois Bone and Joint Institute, LLC., Morton Grove, IL, USA. · JK Lee Orthopaedics & Traumatology, Petaling Jaya, Malaysia. · University of Manitoba, Winnipeg, Manitoba, Canada. ·J Clin Densitom · Pubmed #27020004.

ABSTRACT: Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.

2 Editorial Editorial: Working towards an understanding of bone disease in HIV. 2016

Brown, Todd T / Mallon, Patrick W G. ·aDivision of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA bHIV Molecular Research Group, School of Medicine, University College Dublin, Dublin, Ireland. ·Curr Opin HIV AIDS · Pubmed #27045192.

ABSTRACT: -- No abstract --

3 Review Dielectric properties of bones for the monitoring of osteoporosis. 2019

Amin, Bilal / Elahi, Muhammad Adnan / Shahzad, Atif / Porter, Emily / McDermott, Barry / O'Halloran, Martin. ·Department of Electrical and Electronic Engineering, National University of Ireland Galway, Galway, Ireland. b.amin2@nuigalway.ie. · Translational Medical Device Lab, Lambe Institute for Translational Research & HRB Clinical Research Facility, University Hospital Galway, Galway, Ireland. b.amin2@nuigalway.ie. · Department of Electrical and Electronic Engineering, National University of Ireland Galway, Galway, Ireland. · Translational Medical Device Lab, Lambe Institute for Translational Research & HRB Clinical Research Facility, University Hospital Galway, Galway, Ireland. · School of Medicine, National University of Ireland Galway, Galway, Ireland. ·Med Biol Eng Comput · Pubmed #30159660.

ABSTRACT: Osteoporosis is one of the most common diseases that leads to bone fractures. Dual-energy X-ray absorptiometry is currently employed to measure the bone mineral density and to diagnose osteoporosis. Alternatively, the dielectric properties of bones are found to be influenced by bone mineral density; hence, dielectric properties of bones may potentially be used to diagnose osteoporosis. Microwave tomographic imaging is currently in development to potentially measure in vivo dielectric properties of bone. Therefore, the foci of this work are to summarize all available dielectric data of bone in the microwave frequency range and to analyze the confounders that may have resulted in variations in reported data. This study also compares the relationship between the dielectric properties and bone quality reported across different studies. The review suggests that variations exist in the dielectric properties of bone and the relationship between bone volume fraction and dielectric properties is in agreement across all studies. Conversely, the evidence of a relationship between bone mineral density and dielectric properties is inconsistent across the studies. This summary of dielectric data of bone along with a comparison of the relationship between the dielectric properties and bone quality will accelerate the development of microwave tomographic imaging devices for the monitoring of osteoporosis. Graphical abstract ᅟ.

4 Review Current imaging techniques in osteoporosis. 2018

Carey, John J / Buehring, Bjoern. ·1007, Clinical Sciences Institute, National University of Ireland Galway, and Department of Rheumatic Diseases, Galway University Hospitals, Galway, Ireland. · Rheumazentrum Ruhrgebiet, Herne, Germany. bjoern.buehring@elisabethgruppe.de. ·Clin Exp Rheumatol · Pubmed #30296993.

ABSTRACT: Osteoporosis is a global pandemic affecting children, men and women of all ages and ethnicities. Millions of people suffer fragility fractures each year around the world as a result of this bone disease, which can have devastating consequences for them, including permanent disability and death. Many fractures are preventable by identifying people at high risk for fracture and falls, and diagnosing those who already have osteoporosis, before they fracture. Rheumatologists commonly encounter people with fragile bones, either as an isolated entity, or a co-morbidity to their underlying rheumatic illness or treatment. Imaging in osteoporosis can be used to make a diagnosis, while measurements of bone and body tissues, most commonly bone mineral density, can be used to identify those at risk and monitor them following treatment. Modern densitometry scanners may have multiple new features including measures of hip geometry, trabecular bone score, finite element analysis, fat and muscle mass, and may have additional imaging features including vertebral fracture assessment and atypical femoral fracture screening. When used correctly, these tools provide invaluable information for the assessment of the effectiveness of interventions in clinical studies, and patient management in clinical practice. In this article we review osteoporosis imaging techniques, with an emphasis on dual-energy x-ray absorptiometry, and how to apply and interpret them in modern rheumatology practice.

5 Review Sex-based Differences in Common Sports Injuries. 2018

Carter, Cordelia W / Ireland, Mary Lloyd / Johnson, Anthony E / Levine, William N / Martin, Scott / Bedi, Asheesh / Matzkin, Elizabeth G. ·From the Department of Orthopaedic Surgery, Yale University, New Haven, CT (Dr. Carter), the Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY (Dr. Ireland), the Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX (Dr. Johnson), the Department of Orthopaedic Surgery, Columbia University, New York, NY (Dr. Levine), the Department of Orthopaedic Surgery, the Brigham & Women's Hospital, Boston, MA (Dr. Martin), the Department of Orthopaedic Surgery, the University of Michigan, Ann Arbor, MI (Dr. Bedi), and the Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA (Dr. Matzkin). ·J Am Acad Orthop Surg · Pubmed #29847420.

ABSTRACT: The patient's sex plays an important role in mediating the risk for, and experience of, disease. Injuries of the musculoskeletal system are no exception to this phenomenon. Increasing evidence shows that the incidence, clinical presentation, and treatment outcomes for male and female patients with common sports injuries may vary widely. Stress fracture, which is associated with the female athlete triad, is a sports injury with known sex-based differences. Other common sports-related injuries may also have distinct sex-based differences. Understanding these differences is important to optimize each patient's musculoskeletal care.

6 Review The Fascinating Paradox of Osteoporosis in Axial Spondyloarthropathy. 2017

Fitzgerald, Gillian E / O'Shea, Finbar D. ·From the Department of Rheumatology, St. James's Hospital, Dublin, Ireland. GiFitzgerald@stjames.ie. · G.E. Fitzgerald, MB, BCh, BAO, MRCPI, Rheumatology Specialist, Registrar, Department of Rheumatology, St. James's Hospital; F.D. O'Shea, MB, BCh, BAO, MRCPI, Consultant Rheumatologist and General Physician, Department of Rheumatology, St. James's Hospital. GiFitzgerald@stjames.ie. · From the Department of Rheumatology, St. James's Hospital, Dublin, Ireland. · G.E. Fitzgerald, MB, BCh, BAO, MRCPI, Rheumatology Specialist, Registrar, Department of Rheumatology, St. James's Hospital; F.D. O'Shea, MB, BCh, BAO, MRCPI, Consultant Rheumatologist and General Physician, Department of Rheumatology, St. James's Hospital. ·J Rheumatol · Pubmed #28966207.

ABSTRACT: Low bone mineral density (BMD) is a recognized feature of axial spondyloarthropathy (axSpA). However, the osteoproliferation inherent in axSpA can make traditional dual-energy x-ray absorptiometry assessment inaccurate, particularly in structurally advanced disease. As a result, much about osteoporosis in axSpA is unknown. There is a wide variation in prevalence figures for low BMD in the literature. There is also no consensus regarding risk factors for developing low BMD in axSpA. It is accepted that there is an excess of vertebral fractures in patients with axSpA, but the role of low BMD in contributing to this risk is virtually unknown. This article provides a comprehensive review of the current knowledge regarding low BMD in axSpA. It highlights our current BMD measurement techniques along with their potential pitfalls, and discusses the significance of BMD in vertebral fractures. It also identifies gaps in our knowledge and makes recommendations for future research.

7 Review Osteoporosis, obesity, and sarcopenia on abdominal CT: a review of epidemiology, diagnostic criteria, and management strategies for the reporting radiologist. 2017

Murray, Timothy É / Williams, David / Lee, Michael J. ·Department of Radiology, Beaumont Hospital, Dublin, Ireland. timothymurray@rcsi.ie. · Department of Geriatric and Stroke Medicine, Beaumont Hospital, Dublin, Ireland. · Department of Radiology, Beaumont Hospital, Dublin, Ireland. ·Abdom Radiol (NY) · Pubmed #28386693.

ABSTRACT: Abdominal computed tomography (CT) is a widely performed examination, with many indications. Assessment of bone, fat, and muscle on abdominal CT can be performed in a quantitative manner. Published studies have developed diagnostic cutoffs for osteoporosis, obesity, and sarcopenia, which are summarized with pictorial examples. The epidemiological and prognostic significance of these disease states are outlined. Further diagnostic steps and treatment strategies are outlined to inform both the managing clinician and reporting radiologist. This article summarizes an unglamorous yet information-rich field, which is ripe for assessment in the dawning era of personalized medicine, and one in which the radiologist is well placed to add value to patient care.

8 Review Mitigating Nutrition and Health Deficiencies in Older Adults: A Role for Food Innovation? 2017

Baugreet, Sephora / Hamill, Ruth M / Kerry, Joseph P / McCarthy, Sinéad N. ·Food Quality and Sensory Science Dept., Teagasc Food Research Centre, Ashtown, Dublin, 15, Ireland. · Dept. of Food and Nutritional Sciences, Univ. College Cork, Cork, Ireland. · Dept. of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, 15, Ireland. ·J Food Sci · Pubmed #28267864.

ABSTRACT: The aim of this review is to describe the factors contributing to diminished food intake, resulting in nutritional deficiencies and associated health conditions in older adults and proposes food innovation strategies to mitigate these. Research has provided convincing evidence of a link between healthy eating patterns and healthy aging. There is a need to target new food product development (NPD) with functional health benefits specifically designed to address the particular food-related needs of older consumers. When developing foods for older adults, consideration should be given to the increased requirements for specific macro- and micronutrients, especially protein, calcium, vitamin D, and vitamin B. Changes in chemosensory acuity, chewing difficulties, and reduced or poor swallowing ability should also be considered. To compensate for the diminished appetite and reduced intake, foods should be energy dense, nutritionally adequate, and, most importantly, palatable, when targeting this cohort. This paper describes the potential of new food product development to facilitate dietary modification and address health deficiencies in older adults.

9 Review Ageism in Studies on the Management of Osteoporosis. 2017

McGarvey, Caoimhe / Coughlan, Tara / O'Neill, Desmond. ·Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Dublin, Ireland. ·J Am Geriatr Soc · Pubmed #28263366.

ABSTRACT: OBJECTIVES: To review the literature to assess whether the fact that osteoporosis is chiefly considered a disease of the older population was reflected in research in the area of the management of osteoporosis and to determine the extent of ageism in studies on the management of osteoporosis. DESIGN: Review. SETTING: All randomized control trials on the management of osteoporosis entered in the Cochrane Library Database that reported mean age were included. Exclusion criteria were also examined. Of 284 randomized control trials identified, 102 were eligible for inclusion. PARTICIPANTS: Older adult trail participants. MEASUREMENTS: Mean age of participants and exclusion criteria used were analyzed. RESULTS: The mean age of all participants was 64.0, despite the fact that the average age at hip fracture is 83 for women and 84 for men. Overall, the mean age of those presenting with hip fractures is 84.8. Twenty-four (23%) of the 102 trials used older age as an exclusion factor. Other exclusion factors were long time since menopause, impaired cardiac or pulmonary function, dependent in ambulation, any severe comorbidity, dementia or any cognitive impairment, recent history of peptic ulcer disease or erosive gastric disease, uncontrolled hypertension, and psychiatric illness. CONCLUSION: These data show a distinct difference between the mean age of participants in studies of the management of osteoporosis and the mean age of those presenting with hip fractures. Given that osteoporosis is the leading cause of hip fractures, this finding could have a significant effect on future studies in this area. It would follow that future research should include a cohort of an age that is more reflective of those most likely to experience the adverse effects of osteoporosis.

10 Review Lower Bone Mineral Density at the Hip and Lumbar Spine in People with Psychosis Versus Controls: a Comprehensive Review and Skeletal Site-Specific Meta-analysis. 2016

Gomez, Lucia / Stubbs, Brendon / Shirazi, Ayala / Vancampfort, Davy / Gaughran, Fiona / Lally, John. ·Kings College London School of Medical Education, Strand, London, WC2R 2LS, UK. · Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, UK. brendon.stubbs@kcl.ac.uk. · Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK. brendon.stubbs@kcl.ac.uk. · Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium. · University Psychiatric Centre KU Leuven, KU Leuven-University of Leuven, Leuven-Kortenberg, Belgium. · Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. · National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, BR3 3BX, UK. · Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland. ·Curr Osteoporos Rep · Pubmed #27696144.

ABSTRACT: It remains unclear if differences in bone mineral density (BMD) exist at different skeletal sites between people with schizophrenia and age- and sex-matched healthy controls (HCs). Major databases were searched from inception until February 2016 for studies measuring BMD using dual-energy X-ray absorptiometry (DXA) at any skeletal site in individuals with schizophrenia. Ten studies investigating 827 people with schizophrenia (55.4 % female, 33.8 ± 9.7 years) and 1379 HCs (58.7 % female, 34.7 ± 9.1 years) were included. People with schizophrenia had significantly reduced BMD at the lumbar spine (standardised mean difference adjusted for publication bias (SMD) = -0.950 (95 % CI = -1.23 to -0.66, fail-safe number = 825) and hip (SMD = -0.534, 95 % CI = -0.876 to -0.192, fail-safe number = 186). A higher proportion of hyperprolactinaemia (β = -0.0102, p < 0.0001) and smokers (β = -0.0099, p = 0.02) moderated a larger reduced BMD at the lumbar spine. Further research is required to investigate if low bone mass and fractures can be prevented in people with schizophrenia.

11 Review Bone mechanical properties and changes with osteoporosis. 2016

Osterhoff, Georg / Morgan, Elise F / Shefelbine, Sandra J / Karim, Lamya / McNamara, Laoise M / Augat, Peter. ·Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. · Department of Mechanical Engineering, Boston University, Boston, MA02215, USA. · Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA02115, USA. · Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Department of Orthopedic Surgery, Harvard Medical School, Boston, MA02215, USA. · Centre for Biomechanics Research (BMEC), Department of Biomedical Engineering, NUI Galway, Galway, Republic of Ireland; National Centre for Biomedical Engineering Science (NCBES), NUI Galway, Galway, Republic of Ireland. · Institute of Biomechanics, Trauma Center Murnau, Murnau, Germany; Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: biomechanik@bgu-murnau.de. ·Injury · Pubmed #27338221.

ABSTRACT: This review will define the role of collagen and within-bone heterogeneity and elaborate the importance of trabecular and cortical architecture with regard to their effect on the mechanical strength of bone. For each of these factors, the changes seen with osteoporosis and ageing will be described and how they can compromise strength and eventually lead to bone fragility.

12 Review Protecting bone in long-term HIV positive patients receiving antiretrovirals. 2016

McGinty, Tara / Mallon, Patrick. ·a School of Medicine , University College Dublin , Dublin , Ireland. ·Expert Rev Anti Infect Ther · Pubmed #27189695.

ABSTRACT: INTRODUCTION: As the population of people living with HIV ages, the increase in non-AIDs morbidities is expected to increase in parallel. Maintaining bone health in those with HIV will be an important area of focus for the HIV clinician to prevent the morbidity and mortality associated with fragility fractures, the principal clinical sequela of low bone mineral density (BMD). Rates of fractures and prevalence of low bone mineral density, a risk factor for future fragility fractures, are already increased in the HIV positive population. AREAS COVERED: This review examines the strategies to maintain bone health in those living with HIV from screening through to managing those with established low BMD or fracture, including the role for choice of or modification of antiretroviral therapy to maintain bone health. Expert commentary: The increasing complexity of managing bone health in the age of succesful antiretroviral therapy and an aging patient population as well as future perspectives which may help achieve the long term aim of minimising the impact of low BMD in those with HIV are discussed and explored.

13 Review Does systemic inflammation and immune activation contribute to fracture risk in HIV? 2016

McGinty, Tara / Mirmonsef, Paria / Mallon, Patrick W G / Landay, Alan L. ·aHIV Molecular Research Group, School of Medicine, University College Dublin bDepartment of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland cDepartment of Immunology/Microbiology, Rush University Medical Center, Chicago, Illinois, USA *Tara McGinty and Paria Mirmonsef have contributed equally to the writing of this article. ·Curr Opin HIV AIDS · Pubmed #27008474.

ABSTRACT: PURPOSE OF REVIEW: There is increasing evidence pointing toward an important role of heightened immune activation and inflammation in people living with HIV contributing to the development of non-AIDS comorbidities. This review aims to explore low bone mineral density (BMD) in HIV with a focus on the underlying mechanisms and relationships between the immune and skeletal systems. RECENT FINDINGS: Baseline immune activation and inflammation negatively impact BMD at antiretroviral therapy (ART) initiation. B- and T-cell alterations in HIV lead to an imbalance in the osteoblastic osteoprotegerin (OPG) and osteoclastic receptor activator of NF-κB ligand (RANKL) cytokines which favours osteoclastogenesis and bone resorption. These findings suggest an important role for immune-mediated mechanisms in the pathogenesis of low BMD in HIV. SUMMARY: Bone homeostasis is in part regulated by cells of the immune system through complex interactions with the RANK/RANKL/OPG axis. Disturbances in the normal functioning of T, B cells, and monocytes in HIV and the resulting proinflammatory state may contribute to dysregulation of this finely controlled balance leading to increased bone loss. Pre-ART levels of immune activation and inflammation have a consistently negative effect on BMD and further suggest the immunocentric basis of bone loss in HIV alongside supporting the benefits of earlier ART initiation. Further longitudinal studies will help determine the effect this will have on fracture risk in people living with HIV.

14 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.

15 Review Aging with HIV: osteoporosis and fractures. 2014

Mallon, Patrick W G. ·aHIV Molecular Research Group, School of Medicine and Medical Science University College Dublin bDepartment of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland. ·Curr Opin HIV AIDS · Pubmed #24871090.

ABSTRACT: PURPOSE OF REVIEW: Osteoporosis remains an important focus of contemporary research in HIV, with co-morbidities and mortality from non-AIDS illnesses now a major barrier to normal lifespan in many populations living with HIV. This review outlines the major recent advances in our understanding of osteoporosis and fractures in those living with HIV and identifies remaining gaps in our knowledge of this complex but increasingly important aspect of aging research in HIV. RECENT FINDINGS: Low bone mineral density (BMD), osteoporosis and fractures are all more common in those living with HIV, with recent data pointing for the first time to causal links between low BMD and fractures in those with HIV. The natural history and pathogenesis of osteoporosis in HIV and the epidemiology of fractures in this vulnerable population differ considerably from the general population, with both disease-related and treatment-related factors both contributing to its development through alterations in bone turnover and defects in bone architecture. SUMMARY: Only through a greater understanding of the pathogenesis can appropriate screening and preventive measures be taken in people living with HIV to preserve bone health as they age.

16 Review High prevalence of osteoporosis in patients with chronic pancreatitis: a systematic review and meta-analysis. 2014

Duggan, Sinead N / Smyth, Niamh D / Murphy, Anne / Macnaughton, David / O'Keefe, Stephen J D / Conlon, Kevin C. ·Centre for Pancreatico-Biliary Diseases, Professorial Surgical Unit, Trinity College Dublin, Tallaght Hospital, Dublin, Ireland. Electronic address: siduggan@tcd.ie. · Department of Nutrition & Dietetics, Tallaght Hospital, Dublin, Ireland. · Tallaght Hospital Library, Tallaght Hospital, Dublin, Ireland. · Hamilton Library, Trinity College Dublin, Dublin, Ireland. · Small Intestinal Rehabilitation & Transplant Center, Clinical Nutrition Service, Pittsburgh University Hospital, Pittsburgh, Pennsylvania. · Centre for Pancreatico-Biliary Diseases, Professorial Surgical Unit, Trinity College Dublin, Tallaght Hospital, Dublin, Ireland. ·Clin Gastroenterol Hepatol · Pubmed #23856359.

ABSTRACT: BACKGROUND & AIMS: Patients with chronic pancreatitis may be at high risk for osteoporosis and osteopenia. We performed a systematic review and meta-analysis to determine the prevalence of osteoporosis and osteopenia in patients with chronic pancreatitis. METHODS: Articles were identified from MEDLINE, EMBASE, and SCOPUS databases (through October 2012) and a manual search of the literature. The primary outcome measure was bone density, measured by dual-energy X-ray absorptiometry (T-score or Z-score). When available, data on the prevalence of osteopenia, bone mineral density, and bone mineral content also were recorded. RESULTS: Ten studies including 513 patients were eligible for inclusion. Based on a random-effects model, the pooled prevalence rate for osteoporosis among patients with chronic pancreatitis was 23.4% (95% confidence interval, 16.6-32.0). The pooled prevalence for osteopenia was 39.8% (95% confidence interval, 29.1-51.6). The pooled prevalence rate for either osteoporosis or osteopenia was 65% (95% confidence interval, 54.7-74.0). CONCLUSIONS: Based on meta-analysis, almost 1 of 4 patients with chronic pancreatitis have osteoporosis, and almost two-thirds of patients have either osteoporosis or osteopenia. Osteoporosis and osteopenia are underappreciated sources of morbidity in patients with chronic pancreatitis. Bone health management guidelines are urgently required in patients with chronic pancreatitis.

17 Review The risk of bisphosphonate-related osteonecrosis of the jaw in children. A case report and literature review. 2013

Ngan, Kwok-Kit / Bowe, John / Goodger, Nicolas. ·Dental Services, Kent Community Health NHS Trust. · Mid Western Regional Hopsital, Limerick, Ireland. · East Kent Hospitals University NHS Foundation Trust, UK. ·Dent Update · Pubmed #24386765.

ABSTRACT: CLINICAL RELEVANCE: Dental clinicians need to be aware of the potential risk of BRONJ in paediatric patients who have had intravenous bisphosphonate therapy. It is important that these patients are identified and managed appropriately.

18 Review Osteoporosis and bone health in HIV. 2012

Powderly, William G. ·School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland. bill.powderly@ucd.ie ·Curr HIV/AIDS Rep · Pubmed #22581359.

ABSTRACT: Patients with HIV can develop several complications that involve bone including low bone mineral density and osteoporosis, osteonecrosis, and rarely osteomalacia. Low bone mineral density leading to osteoporosis is the most common bone pathology. This may result from HIV infection (directly or indirectly), antiretroviral toxicity, or as a consequence of other co-morbidities. The clinical relevance of osteoporosis in HIV infection has been uncertain; however, fragility fractures are increasingly reported in HIV-infected patients. Further research is required to understand the pathogenesis of osteoporosis in HIV-infected patients and determine effective management; however, initiation of antiretroviral therapy seems to accelerate (in the short-term) bone demineralization. Tenofovir may be associated with a greater degree of short-term loss of bone density than other antiviral agents and the potential long-term bone dysfunction is unclear. As the HIV-infected population ages, screening for low bone mineral density will become increasingly important.

19 Review Review article: the effects of antitumour necrosis factor-α on bone metabolism in inflammatory bowel disease. 2011

Veerappan, S G / O'Morain, C A / Daly, J S / Ryan, B M. ·Department of Gastroenterology, Adelaide & Meath Hospital, Tallaght, Dublin, Ireland. sveerappan@rcsi.ie ·Aliment Pharmacol Ther · Pubmed #21521250.

ABSTRACT: BACKGROUND: Patients with inflammatory bowel disease (IBD) are at increased risk of osteoporosis. A number of studies have emerged in recent years indicating that tumour necrosis factor (TNF) blockade appears to have a beneficial effect on bone mineral density (BMD) in IBD patients. AIMS: To provide a review of the available data regarding the effect of the currently licensed anti-TNF-α therapies on bone metabolism and BMD in IBD patients. METHODS: A Medline search was performed using the search terms 'infliximab', 'bone metabolism', 'IBD', 'BMD', 'bone markers', 'adalimumab', 'bone disease', 'Crohn's disease' and 'ulcerative colitis'. RESULTS: Infliximab has a beneficial effect on bone turnover markers in Crohn's disease (CD) patients in the short term. The longest study to date comprising 24 CD patients showed an overall improvement in two bone formation markers - b-alkaline phosphatase (P = 0.022) and osteocalcin (P = 0.008) at 4 months post-treatment. Moreover, the largest study to date comprising 71 CD patients showed significant improvement in sCTx, a bone resorption marker (P = 0.04) at week-8 post-treatment. There is little data looking at the effect of anti-TNF-α therapy on bone metabolism in ulcerative colitis. Moreover, the long-term effects of anti-TNF-α therapy on bone structure and fracture risk in IBD patients are currently not known. The effect of cessation of anti-TNF-α therapy on bone metabolism is also unknown. CONCLUSION: Properly controlled long-term trials are needed to fully evaluate the impact of TNF blockade on bone mineral density.

20 Review Treatments for osteoporosis in people with a disability. 2011

Smith, Eimear M. ·Department of Rehabilitation Medicine (Spinal Cord Systems of Care), National Rehabilitation Hospital, Rochestown Ave, Dún Laoghaire, Co. Dublin, Ireland. eimear.smith@nrh.ie ·PM R · Pubmed #21333953.

ABSTRACT: The morbidity from osteoporotic fractures for people with a disability is considerable because of the increased risk of medical complications, loss of independence and mobility, and prolonged hospitalization. The frequency with which low bone mineral density occurs in people with a disability is now well recognized, and professionals have a greater awareness of the need to investigate bone mineral density levels with a view to preventing fragility fractures. After patients with osteoporosis are identified, the challenge is to treat them appropriately. This article reviews the physical and pharmacologic measures that have been researched in the prevention and treatment of low bone mineral density in people with a disability.

21 Review Current and future treatment options in osteoporosis. 2011

Brewer, Linda / Williams, David / Moore, Alan. ·General and Geriatric Medicine, Beaumont Hospital, Dublin, Ireland. lindabrewer@physicians.ie. · General and Geriatric Medicine, Beaumont Hospital, Dublin, Ireland. · Geriatric Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland. ·Eur J Clin Pharmacol · Pubmed #21327420.

ABSTRACT: PURPOSE: The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population. METHODS: When prescribing for older patients the effectiveness profile of drugs needs to be balanced against their tolerability in individual patients. RESULTS: Currently we have good anti-fracture data to support the use of many available anti-resorptive and anabolic drugs including bisphosphonates, strontium ranelate and recombinant human parathyroid hormone. We also have evidence to demonstrate the importance of calcium and vitamin D repletion in these patients. However, in recent years our understanding of normal bone physiology and the mechanisms underlying the development of osteoporosis has significantly advanced and this has led to the development of new therapies. Novel agents, particularly denosumab, but also inhibitors of cathepsin K and anabolic agents that act on Wnt signalling, will increase the therapeutic options for clinicians in the coming years. CONCLUSION: This review discusses the evidence supporting the use of currently available treatment options for osteoporosis and potential future advances in drug therapy. Particular consideration should be given when prescribing for certain older patients who have issues with compliance or tolerance and also in those with co-morbidities or levels of frailty that may restrict the choice of therapy. Understanding the evidence for the benefit and possible harm of osteoporosis treatments is critical to appropriate management of this patient population.

22 Review Vitamin D insufficiency: a common and treatable problem in the Irish population. 2011

O'Malley, G / Mulkerrin, E. ·Department of Medicine for the Elderly, University Hospital, Galway, Ireland. gmnimhaille@yahoo.co.uk ·Ir J Med Sci · Pubmed #20694838.

ABSTRACT: INTRODUCTION: Vitamin D insufficiency is an extremely common condition particularly in the older Irish population. This is a consequence of Ireland's geographical position and climate. A recent study showed more than 75% of a cohort of older Irish females had vitamin D insufficiency. OBJECTIVES: We outline the definition of vitamin D insufficiency and deficiency, its sources and metabolism as well as the clinical consequences of deficiency. We explore the current guidelines and discuss the pitfalls in the management of vitamin D replacement and in particular address recent Irish data on the feasibility and efficacy of intramuscular treatment. CONCLUSION: Vitamin D is important for calcium homeostasis and bone metabolism and reduced levels lead to osteomalacia, exacerbate osteoporosis and increase the risk of falls. Evidence is emerging that vitamin D has a role beyond musculoskeletal health and may impact on the cardiovascular and autoimmune systems, as well as the risk of malignancy.

23 Review Systemic diseases and the elderly. 2010

McCreary, Christine / Ni Riordáin, Richeal. ·Oral Medicine Unit, Cork University Dental School and Hospital, Wilton, Cork, Ireland. ·Dent Update · Pubmed #21179930.

ABSTRACT: CLINICAL RELEVANCE: The systemic diseases can impact upon oral care or can have oral manifestations. Many of the pharmacological interventions prescribed for chronic conditions can have multiple and diverse adverse effects on the oral environment.

24 Review Epidemiology of osteoporosis-related fractures in France: a literature review. 2010

Curran, Desmond / Maravic, Milka / Kiefer, Philippe / Tochon, Valérie / Fardellone, Patrice. ·Omega Research, 189, Shanliss Road, Santry, Dublin 9, Ireland. desmondcurran@eircom.net ·Joint Bone Spine · Pubmed #20378383.

ABSTRACT: OBJECTIVES: To evaluate the health implications and economic burden on society of osteoporotic fractures as a major source of morbidity and mortality in the ageing population. METHODS: We have summarised the findings of a literature review of French studies published between 1960 and 2009, characterised the epidemiology of osteoporosis and osteoporotic fractures, and predicted future trends. RESULTS: Published data for France supported the observation that osteoporosis is under-diagnosed in many countries. The incidence of fracture increased exponentially with age, alongside a concurrent decrease in bone mineral density, a risk factor for fracture. Combined with a projected rise in the French elderly population, this poses a significant burden for the future. The incidence of fracture was high in the osteopenic population; consequently, fragility fractures may be underestimated if reports focus on osteoporotic women only. As in many other countries, French data revealed that women have a higher incidence of osteoporotic fractures than men, although mortality from hip fracture was higher in men. DISCUSSION: Due to ageing of the population, an increase in the number of people suffering from fractures is predicted over the next few decades unless preventative action is taken, highlighting the need for improved diagnosis and screening in postmenopausal women.

25 Review Perspective on post-menopausal osteoporosis: establishing an interdisciplinary understanding of the sequence of events from the molecular level to whole bone fractures. 2010

McNamara, L M. ·Department of Mechanical and Biomedical Engineering, National University of Ireland Galway, Galway, Ireland. laoise.mcnamara@nuigalway.ie ·J R Soc Interface · Pubmed #19846441.

ABSTRACT: Current drug treatments for post-menopausal osteoporosis cannot eliminate bone fractures, possibly because the mechanisms responsible for bone loss are not fully understood. Although research within various disciplines has significantly advanced the state of knowledge, fundamental findings are not widely understood between different disciplines. For that reason, this paper presents noteworthy experimental findings from discrete disciplines focusing on post-menopausal osteoporosis. These studies have established that, in addition to bone loss, significant changes in bone micro-architecture, tissue composition and micro-damage occur. Cellular processes and molecular signalling pathways governing pathological bone resorption have been identified to a certain extent. Ongoing studies endeavour to determine how such changes are initiated at the onset of oestrogen deficiency. It emerges that, because of the discrete nature of previous research studies, the sequence of events that lead to bone fracture is not fully understood. In this paper, two sequences of multi-scale changes are proposed and the experimental challenges that need to be overcome to fully define this sequence are outlined. Future studies must comprehensively characterize the time sequence of molecular-, cellular- and tissue-level changes to attain a coherent understanding of the events that ultimately lead to bone fracture and inform the future development of treatments for post-menopausal osteoporosis.

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