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Osteoporosis: HELP
Articles from Miscellaneous institutions in Ottawa
Based on 6 articles published since 2010

These are the 6 published articles about Osteoporosis that originated from Miscellaneous institutions in Ottawa during 2010-2020.
+ Citations + Abstracts
1 Review Utility of trabecular bone score in the evaluation of osteoporosis. 2017

Martineau, Patrick / Silva, Barbara C / Leslie, William D. ·aUniversity of Ottawa, Ottawa, Ontario, Canada bUNI-BH, Santa Casa Hospital, Belo Horizonte, Brazil cUniversity of Manitoba, Winnipeg, Manitoba, Canada. ·Curr Opin Endocrinol Diabetes Obes · Pubmed #28857846.

ABSTRACT: PURPOSE OF REVIEW: Trabecular bone score (TBS) is a lumbar spine dual-energy absorptiometry texture index which provides information on skeletal quality partially independent of bone mineral density (BMD). A body of work has emerged demonstrating the relationship between TBS and fracture risk, with lower TBS values associated with increased risk for osteoporotic fracture in postmenopausal women and older men. TBS is derived from standard DXA images; however, the information provided by TBS is complementary to that provided by BMD. In this article, we review the current state of TBS and its evolving role in the assessment and management of osteoporosis, with particular emphasis on the literature of the previous year. RECENT FINDINGS: TBS-adjusted The Fracture Risk Assessment tool (FRAX) probabilities enhance fracture risk prediction compared with conventional FRAX predictions. TBS has been found to better categorize fracture risk and assists in FRAX-based treatment decisions, particularly for patients close to an intervention threshold. However, change in lumbar spine TBS while undergoing antiresorptive treatment is not a useful indicator of antifracture effect. SUMMARY: Lumbar spine TBS is a recently developed image-based software technique for skeletal assessment, complementary to conventional BMD, which has been shown to be clinically useful as a fracture risk prediction tool.

2 Article The health and economic burden of osteoporotic fractures in Singapore and the potential impact of increasing treatment rates through more pharmacological options. 2019

Chandran, Manju / Lau, Tang Ching / Gagnon-Arpin, Isabelle / Dobrescu, Alexandru / Li, Wenshan / Leung, Man Yee Mallory / Patil, Narendra / Zhao, Zhongyun. ·Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, 20 College Road, ACADEMIA, Singapore, 169856, Singapore. manju.chandran@singhealth.com.sg. · Department of Medicine (Rheumatology), National University Hospital, NUHS Tower Block, level 10, 1 E Kent Ridge Road, Singapore, 119228, Singapore. · Conference Board of Canada, 255 Smyth Road, Ottawa, Ontario, K1H 8M7, Canada. · Amgen Asia Holding Ltd., Suite 408-12, 4/F, One Island East, 18 Westlands Road, Quarry Bay, Hong Kong. ·Arch Osteoporos · Pubmed #31773442.

ABSTRACT: PURPOSE: This study aims to estimate the health and economic burden of osteoporosis in Singapore from 2017 to 2035, and to quantify the impact of increasing the treatment rate of osteoporosis. METHODS: Population forecast data of women and men aged 50 and above in Singapore from 2017 to 2035 was used along with prevalence rates of osteoporosis to project the osteoporosis population over time. The population projections by sex and age group were used along with osteoporotic fracture incidence rates by fracture type (hip, vertebral, other), and average direct and indirect costs per case to forecast the number of fractures, the total direct health care costs, and the total indirect costs due to fractures in Singapore. Data on treatment rates and effects were used to model the health and economic impact of increasing treatment rate of osteoporosis, using different hypothetical levels. RESULTS: Between 2017 and 2035, the incidence of osteoporotic fractures is projected to increase from 15,267 to 24,104 (a 57.9% increase) F 10,717 to 17,225 (a 60.7% increase) and M 4550 to 6878 (a 51.2% increase). The total economic burden (including direct costs and indirect costs to society) associated with these fractures is estimated at S$183.5 million in 2017 and is forecasted to grow to S$289.6 million by 2035. However, increasing the treatment rate for osteoporosis could avert up to 29,096 fractures over the forecast period (2017-2035), generating cumulative total cost savings of up to S$330.6 million. CONCLUSION: Efforts to improve the detection, diagnosis, and treatment of osteoporosis are necessary to reduce the growing clinical, economic, and societal burden of fractures in Singapore.

3 Article The Impact of Inflammatory Bowel Disease in Canada 2018: Extra-intestinal Diseases in IBD. 2019

Bernstein, Charles N / Benchimol, Eric I / Bitton, Alain / Murthy, Sanjay K / Nguyen, Geoffrey C / Lee, Kate / Cooke-Lauder, Jane / Kaplan, Gilaad G. ·Canadian Gastro-Intestinal Epidemiology Consortium, Ottawa, Ontario, Canada. · University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada. · Children's Hospital of Eastern Ontario IBD Centre, Department of Pediatrics and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. · McGill University Health Centre (MUHC) IBD Centre, McGill University, Montreal, Quebec, Canada. · Ottawa Hospital Research Institute, Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. · Mount Sinai Hospital Centre for IBD, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. · Crohn's and Colitis Canada, Toronto, ON Ontario Canada. · Bataleur Enterprises Inc. · Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. ·J Can Assoc Gastroenterol · Pubmed #31294387.

ABSTRACT: The burden of extra-intestinal disease is high in patients with IBD, some of whom respond to or are prevented by treating the bowel inflammation, whereas others require specific treatment because they are independent of the underlying bowel inflammation. Among the most common extra-intestinal manifestations are other chronic immune-mediated diseases such as erythema nodosum, ankylosing spondylitis and primary sclerosing cholangitis. Patients with IBD are at higher risk of complications in other organ systems such as osteoporosis, venous thromboembolism and cardiovascular disease. In addition, patients with IBD have a higher risk of cancer, including colon cancer. Mental health comorbidity is important and common in IBD though not always recognized and managed. Consequently, patients and care providers need to be vigilant in the surveillance of extra-intestinal manifestations and complications of IBD. Highlights: The burden of extra-intestinal disease is high in patients with IBD.Immune-mediated inflammatory diseases (IMIDs) commonly coexist with patients with IBD and the activity of IMIDs can be either dependent or independent of bowel inflammation.Patients with IBD can be diagnosed with coexisting diseases that affect every organ, including bones, blood, heart, liver, and others.Patients with IBD are at increased risk of cancer, including colon cancer, caused by their bowel inflammation, cholangiocarcinoma due to primary sclerosing cholangitis, and rarely lymphoma related to immunosuppressive medications.The best way to prevent or reduce the burden of many of the extra-intestinal disease is to treat the inflammation of IBD, however some extra-intestinal inflammatory diseases run courses that are independent of the intestinal disease activity. Key Summary Points: Patients with IBD are often burdened with extra-intestinal manifestations, some of which respond to or are prevented by treating the bowel inflammation whereas others require specific treatment because they are independent of the underlying bowel inflammation.Other immune-mediated inflammatory diseases (IMIDs) can coexist with IBD.Some IMIDs run an independent course from the bowel inflammation of IBD, such as ankylosing spondylitis, iritis, and primary sclerosing cholangitis.Immune-mediated inflammatory diseases that often have courses that match the bowel inflammation of IBD include erythema nodosum and peripheral arthritis.Immune-mediated inflammatory diseases such as multiple sclerosis and psoriasis have been associated with IBD. However, these conditions may also emerge as complications of therapy for IBD.Patients with IBD are at risk for venous thromboembolic disease, which occurs at a rate of one per 200 person-years.Venous thromboembolic disease can be reduced by treating patients admitted to hospital with an IBD diagnosis with venous thromboembolism prophylaxis.Arterial vascular disease is also increased in IBD patients, including both coronary artery disease and cerebrovascular disease.Osteoporosis is more prevalent in IBD patients and translates to a 40% increased risk of fracture. While corticosteroids increase the risk of osteoporosis, patients with IBD can also develop metabolic bone disease independent of corticosteroid use.Persons with IBD are more likely to be infected with Gaps in Knowledge and Future Directions: Patients with IBD are often burdened with extra-intestinal disease. Future research should determine the collective frequency and added costs of living with extra-intestinal disease.Immune-mediated inflammatory diseases are commonly codiagnosed with IBD. Future research should focus on the pathogenesis connecting coexisting IMIDs with IBD.Care pathways that support the investigation and mitigation of extra-intestinal disease are needed. For example, when and how ambulatory patients with IBD should receive prophylaxis against venous thromboembolic disease is unknown.With an aging IBD population, the burden of extra-intestinal disease should be studied in the context of comorbidities of advancing age.Increasing mental health screening and access to mental health care should be a goal of IBD management.

4 Article Screening for osteoporosis: A systematic assessment of the quality and content of clinical practice guidelines, using the AGREE II instrument and the IOM Standards for Trustworthy Guidelines. 2018

Hayawi, Lamia M / Graham, Ian D / Tugwell, Peter / Yousef Abdelrazeq, Said. ·Pallium Canada, Ottawa, ON, Canada. · Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada. · School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. · Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. · School of Nursing, Queen's University, Kingston, ON, Canada. · Centre for Global Health, University of Ottawa, Ottawa, ON, Canada. ·PLoS One · Pubmed #30521556.

ABSTRACT: BACKGROUND: Numerous clinical practice guidelines (CPGs) are published to guide management of osteoporosis. Little is known about their quality or how recommendations have changed over time. OBJECTIVE: To systematically assess the quality and content of the guidelines on screening for osteoporosis, using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool, and the Institute of Medicine (IOM) standards for trustworthy guidelines. METHODS: We conducted a systematic search for osteoporosis CPGs published between 2002-2016, using multiple databases and guideline websites. Two reviewers appraised the quality of eligible CPGs using the AGREE II. High quality CPGs were considered if they scored ≥ 60 in four or more domains including the domain for rigor of development. Non-parametric tests were used to test for the change of quality over time. One reviewer assessed the guidelines with IOM standards. We summarized the different evidence grading systems and extracted and compared the recommendations. RESULTS: A total of 33 CPGs were identified. The mean scores for AGREE II differed by domain (range: 42% to 71%). CPGs scored higher on domains for clarity of presentation, scope and purpose, and rigor of development. CPGs scored lower on domains for stakeholder involvement, editorial independence and applicability. Assessment of CPGs by IOM standards showed that CPGs scored better on standards for systematic review, establishing evidence foundation and rating strength of recommendation, articulation of recommendation, and establishing transparency. While scored lower on standards for updating, external review, and the development group composition. There was no difference in AGREE II and IOM defined guidelines' quality before and after the introduction of the two tools (P values >0.05). The IOM identified four more guidelines as high quality compared to the AGREE II. Examining these additional guidelines indicated that the two tools may give conflicting results especially for the rigor of development domain. Recommendations in certain areas showed substantial differences between guidelines. CONCLUSION: Osteoporosis screening CPGs are of variable quality, and their recommendations often differ. Guideline quality as measured by AGREE II and IOM standards has not improved overtime. Guideline developers should work together to improve the quality and consistency of recommendations to improve the likelihood that their guidelines will be used in practice.

5 Article Bone Morbidity and Recovery in Children With Acute Lymphoblastic Leukemia: Results of a Six-Year Prospective Cohort Study. 2018

Ward, Leanne M / Ma, Jinhui / Lang, Bianca / Ho, Josephine / Alos, Nathalie / Matzinger, Mary Ann / Shenouda, Nazih / Lentle, Brian / Jaremko, Jacob L / Wilson, Beverly / Stephure, David / Stein, Robert / Sbrocchi, Anne Marie / Rodd, Celia / Lewis, Victor / Israels, Sara / Grant, Ronald M / Fernandez, Conrad V / Dix, David B / Cummings, Elizabeth A / Couch, Robert / Cairney, Elizabeth / Barr, Ronald / Abish, Sharon / Atkinson, Stephanie A / Hay, John / Rauch, Frank / Moher, David / Siminoski, Kerry / Halton, Jacqueline / Anonymous6540947. ·Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada. · Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. · Department of Pediatrics, Dalhousie University, Halifax, NS, Canada. · Department of Pediatrics, University of Calgary, Calgary, AB, Canada. · Département de Pédiatrie, Université de Montréal, Montréal, QC, Canada. · Department of Medical Imaging, University of Ottawa, Ottawa, ON, Canada. · Department of Radiology, University of British Columbia, Vancouver, BC, Canada. · Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada. · Department of Pediatrics, University of Alberta, Edmonton, AB, Canada. · Department of Pediatrics, University of Western Ontario, London, ON, Canada. · Department of Pediatrics, McGill University, Montreal, QC, Canada. · Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada. · Department of Pediatics, University of Toronto, Toronto, ON, Canada. · Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada. · Department of Pediatrics, McMaster University, Hamilton, ON, Canada. · Department of Health Sciences, Brock University, St, Catharines, ON, Canada. · Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. · Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta, Edmonton, AB, Canada. · Canadian Pediatric Bone Health Working Group, Ottawa, ON, Canada. ·J Bone Miner Res · Pubmed #29786884.

ABSTRACT: Osteoporotic fractures are a significant cause of morbidity in acute lymphoblastic leukemia (ALL). Our objective was to determine the incidence and predictors of fractures and recovery from osteoporosis in pediatric ALL over 6 years following glucocorticoid initiation. Vertebral fractures (VF) and vertebral body reshaping were assessed on annual spine radiographs, low-trauma non-VF were recorded at regular intervals and spine bone mineral density (BMD) was captured every 6 months for 4 years and then annually. A total of 186 children with ALL were enrolled (median age 5.3 years; range, 1.3 to 17.0 years). The cumulative fracture incidence was 32.5% for VF and 23.0% for non-VF; 39.0% of children with VF were asymptomatic. No fractures occurred in the sixth year and 71.3% of incident fractures occurred in the first 2 years. Baseline VF, cumulative glucocorticoid dose, and baseline lumbar spine (LS) BMD Z-score predicted both VF and non-VF. Vertebral body reshaping following VF was incomplete or absent in 22.7% of children. Those with residual vertebral deformity following VF were older compared to those without (median age 8.0 years at baseline [interquartile range {IQR}, 5.5 to 9.4] versus 4.8 years [IQR, 3.6 to 6.2], p = 0.04) and had more severe vertebral collapse (median maximum spinal deformity index 3.5 [IQR, 1.0 to 8.0] versus 0.5 [IQR, 0.0 to 1.0], p = 0.01). VF and low LS BMD Z-score at baseline as well as glucocorticoid exposure predicted incident VF and non-VF. Nearly 25% of children had persistent vertebral deformity following VF, more frequent in older children, and in those with more severe collapse. These results suggest the need for trials addressing interventions in the first 2 years of chemotherapy, targeting older children and children with more severe vertebral collapse, because these children are at greatest risk for incident VF and subsequent residual vertebral deformity. © 2018 American Society for Bone and Mineral Research.

6 Article Bone health: osteoporosis, calcium and vitamin D. 2011

Garriguet, Didier. ·Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6. didier.garriguet@statcan.gc.ca ·Health Rep · Pubmed #22106784.

ABSTRACT: BACKGROUND: Osteoporosis is a bone disease that predisposes to fractures. Sufficient intake of calcium and vitamin D is recommended for prevention and treatment. DATA AND METHODS: Based on 28,406 respondents aged 50 or older to the 2009 Canadian Community Health Survey (CCHS)--Healthy Aging, the population who reported being diagnosed with osteoporosis is profiled. Analysis of calcium and vitamin D intake is based on 10,879 respondents aged 50 or older to the 2004 CCHS--Nutrition. Frequencies, averages and cross-tabulations were produced to estimate the prevalence of diagnosed osteoporosis, dietary intake of calcium and vitamin D, the use of supplements, and total calcium and vitamin D intake. Associations between a diagnosis of osteoporosis and socio-economic, dietary and lifestyle factors were examined with multiple logistic regression. RESULTS: In 2009, 19.2% of women and 3.4% of men aged 50 or older reported having been diagnosed with osteoporosis; the 2004 rates were similar. Age, sex and household income were associated with the probability of reporting osteoporosis. In 2004, based on dietary and supplement intake, 45% to 69% of the population aged 50 or older had inadequate intake of calcium, and 54% to 66% had inadequate intake of vitamin D. INTERPRETATION: A large percentage of people aged 50 or older, particularly women, have osteoporosis. The prevalence of inadequate intake of calcium and vitamin D is relatively high.