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Osteoporosis: HELP
Articles from Kentucky
Based on 76 articles published since 2009
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These are the 76 published articles about Osteoporosis that originated from Kentucky during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline ACR Appropriateness Criteria 2018

Anonymous2771124 / Shah, Lubdha M / Jennings, Jack W / Kirsch, Claudia F E / Hohenwalter, Eric J / Beaman, Francesca D / Cassidy, R Carter / Johnson, Michele M / Kendi, A Tuba / Lo, Simon Shek-Man / Reitman, Charles / Sahgal, Arjun / Scheidt, Matthew J / Schramm, Kristofer / Wessell, Daniel E / Kransdorf, Mark J / Lorenz, Jonathan M / Bykowski, Julie. ·University of Utah, Salt Lake City, Utah. Electronic address: lubdha.shah@hsc.utah.edu. · Research Author, Washington University, Saint Louis, Missouri. · Panel Chair (Neurological), Northwell Health, Zucker Hofstra School of Medicine at Northwell, Manhasset, New York. · Panel Chair (Interventional), Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin. · Panel Chair (Musculoskeletal), University of Kentucky, Lexington, Kentucky. · UK Healthcare Spine and Total Joint Service, Lexington, Kentucky; American Academy of Orthopaedic Surgeons. · University of Texas Medical School, Houston, Texas; neurosurgical consultant. · Mayo Clinic, Rochester, Minnesota. · University of Washington School of Medicine, Seattle, Washington. · Medical University of South Carolina, Charleston, South Carolina; North American Spine Society. · Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. · Central Illinois Radiological Associates, University of Illinois College of Medicine, Peoria, Illinois. · Stony Brook University School of Medicine, Stony Brook, New York. · Mayo Clinic, Jacksonville, Florida. · Specialty Chair (Musculoskeletal), Mayo Clinic, Phoenix, Arizona. · Specialty Chair (Interventional), University of Chicago Hospital, Chicago, Illinois. · Specialty Chair (Neurological), UC San Diego Health, San Diego, California. ·J Am Coll Radiol · Pubmed #30392604.

ABSTRACT: Vertebral compression fractures (VCFs) have various causes, including osteoporosis, neoplasms, and acute trauma. As painful VCFs may contribute to general physical deconditioning, management of painful VCFs has the potential for improving quality of life and preventing superimposed medical complications. Various imaging modalities can be used to evaluate a VCF to help determine the etiology and guide intervention. The first-line treatment of painful VCFs has been nonoperative or conservative management as most VCFs show gradual improvement in pain over 2 to 12 weeks, with variable return of function. There is evidence that vertebral augmentation (VA) is associated with better pain relief and improved functional outcomes compared to conservative therapy for osteoporotic VCFs. A multidisciplinary approach is necessary for the management of painful pathologic VCFs, with management strategies including medications to affect bone turnover, radiation therapy, and interventions such as VA and percutaneous thermal ablation to alleviate symptoms. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

2 Guideline ACR Appropriateness Criteria 2017

Anonymous3730905 / Ward, Robert J / Roberts, Catherine C / Bencardino, Jenny T / Arnold, Erin / Baccei, Steven J / Cassidy, R Carter / Chang, Eric Y / Fox, Michael G / Greenspan, Bennett S / Gyftopoulos, Soterios / Hochman, Mary G / Mintz, Douglas N / Newman, Joel S / Reitman, Charles / Rosenberg, Zehava S / Shah, Nehal A / Small, Kirstin M / Weissman, Barbara N. ·Principal Author, Tufts Medical Center, Boston, Massachusetts. Electronic address: robwardmd@gmail.com. · Panel Chair, Mayo Clinic, Phoenix, Arizona. · Panel Vice-Chair, New York University School of Medicine, New York, New York. · Illinois Bone and Joint Institute, Morton Grove, Illinois; American College of Rheumatology. · UMass Memorial Medical Center, Worcester, Massachusetts. · UK Healthcare Spine and Total Joint Service, Lexington, Kentucky; American Academy of Orthopaedic Surgeons. · VA San Diego Healthcare System, San Diego, California. · University of Virginia Health System, Charlottesville, Virginia. · Medical College of Georgia at Augusta University, Augusta, Georgia. · New York University Medical Center, New York, New York. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · Hospital for Special Surgery, New York, New York. · New England Baptist Hospital, Boston, Massachusetts. · Medical University of South Carolina, Charleston, South Carolina; North American Spine Society. · Hospital for Joint Diseases, New York, New York. · Brigham and Women's Hospital, Boston, Massachusetts. · Specialty Chair, Brigham and Women's Hospital, Boston, Massachusetts. ·J Am Coll Radiol · Pubmed #28473075.

ABSTRACT: Osteoporosis is a considerable public health risk, with 50% of women and 20% of men >50 years of age experiencing fracture, with mortality rates of 20% within the first year. Dual x-ray absorptiometry (DXA) is the primary diagnostic modality by which to screen women >65 years of age and men >70 years of age for osteoporosis. In postmenopausal women <65 years of age with additional risk factors for fracture, DXA is recommended. Some patients with bone mineral density above the threshold for treatment may qualify for treatment on the basis of vertebral body fractures detected through a vertebral fracture assessment scan, a lateral spine equivalent generated from a commercial DXA machine. Quantitative CT is useful in patients with advanced degenerative bony changes in their spines. New technologies such as trabecular bone score represent an emerging role for qualitative assessment of bone in clinical practice. It is critical that both radiologists and referring providers consider osteoporosis in their patients, thereby reducing substantial morbidity, mortality, and cost to the health care system. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

3 Editorial Gender dysphoria and transgender medicine in the year 2018. 2018

Koch, Christian A / Tangpricha, Vin. ·Medicover GmbH Germany, Berlin / Hannover, Germany. Christian.koch65@gmail.com. · Carl von Ossietzky University of Oldenburg, Oldenburg, Germany. Christian.koch65@gmail.com. · Technical University of Dresden, Dresden, Germany. Christian.koch65@gmail.com. · University of Louisville, Louisville, KY, USA. Christian.koch65@gmail.com. · Division of Endocrinology, Metabolism and Lipids at Emory University School of Medicine and the Atlanta VA Medical Center, Atlanta, GA, USA. ·Rev Endocr Metab Disord · Pubmed #30382492.

ABSTRACT:

4 Editorial Strengthening the bones in primary biliary cirrhosis. 2013

Angulo, Paul. ·Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, KY. ·Hepatology · Pubmed #23959535.

ABSTRACT: -- No abstract --

5 Review Advanced Glycation End Products (AGEs), Receptor for AGEs, Diabetes, and Bone: Review of the Literature. 2019

Asadipooya, Kamyar / Uy, Edilfavia Mae. ·Division of Endocrinology and Molecular Medicine, Department of Medicine, University of Kentucky, Lexington, Kentucky. ·J Endocr Soc · Pubmed #31528827.

ABSTRACT: Diabetes compromises bone cell metabolism and function, resulting in increased risk of fragility fracture. Advanced glycation end products (AGEs) interact with the receptor for AGEs (RAGE) and can make a meaningful contribution to bone cell metabolism and/or alter function. Searches in PubMed using the key words "advanced glycation end-product," "RAGE," "sRAGE," "bone," and "diabetes" were made to explain some of the clinical outcomes of diabetes in bone metabolism through the AGE-RAGE signaling pathway. All published clinical studies were included in tables. The AGE-RAGE signaling pathway participates in diabetic complications, including diabetic osteopathy. Some clinical results in diabetic patients, such as reduced bone density, suppressed bone turnover markers, and bone quality impairment, could be potentially due to AGE-RAGE signaling consequences. However, the AGE-RAGE signaling pathway has some helpful roles in the bone, including an increase in osteogenic function. Soluble RAGE (sRAGE), as a ligand decoy, may increase in either conditions of RAGE production or destruction, and then it cannot always reflect the AGE-RAGE signaling. Recombinant sRAGE can block the AGE-RAGE signaling pathway but is associated with some limitations, such as accessibility to AGEs, an increase in other RAGE ligands, and a long half-life (24 hours), which is associated with losing the beneficial effect of AGE/RAGE. As a result, sRAGE is not a helpful marker to assess activity of the RAGE signaling pathway. The recombinant sRAGE cannot be translated into clinical practice due to its limitations.

6 Review Diabetes pharmacotherapy and effects on the musculoskeletal system. 2019

Kalaitzoglou, Evangelia / Fowlkes, John L / Popescu, Iuliana / Thrailkill, Kathryn M. ·University of Kentucky Barnstable Brown Diabetes Center Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, USA. ·Diabetes Metab Res Rev · Pubmed #30467957.

ABSTRACT: Persons with type 1 or type 2 diabetes have a significantly higher fracture risk than age-matched persons without diabetes, attributed to disease-specific deficits in the microarchitecture and material properties of bone tissue. Therefore, independent effects of diabetes drugs on skeletal integrity are vitally important. Studies of incretin-based therapies have shown divergent effects of different agents on fracture risk, including detrimental, beneficial, and neutral effects. The sulfonylurea class of drugs, owing to its hypoglycemic potential, is thought to amplify the risk of fall-related fractures, particularly in the elderly. Other agents such as the biguanides may, in fact, be osteo-anabolic. In contrast, despite similarly expected anabolic properties of insulin, data suggests that insulin pharmacotherapy itself, particularly in type 2 diabetes, may be a risk factor for fracture, negatively associated with determinants of bone quality and bone strength. Finally, sodium-dependent glucose co-transporter 2 inhibitors have been associated with an increased risk of atypical fractures in select populations, and possibly with an increase in lower extremity amputation with specific SGLT2I drugs. The role of skeletal muscle, as a potential mediator and determinant of bone quality, is also a relevant area of exploration. Currently, data regarding the impact of glucose lowering medications on diabetes-related muscle atrophy is more limited, although preclinical studies suggest that various hypoglycemic agents may have either aggravating (sulfonylureas, glinides) or repairing (thiazolidinediones, biguanides, incretins) effects on skeletal muscle atrophy, thereby influencing bone quality. Hence, the therapeutic efficacy of each hypoglycemic agent must also be evaluated in light of its impact, alone or in combination, on musculoskeletal health, when determining an individualized treatment approach. Moreover, the effect of newer medications (potentially seeking expanded clinical indication into the pediatric age range) on the growing skeleton is largely unknown. Herein, we review the available literature regarding effects of diabetes pharmacotherapy, by drug class and/or by clinical indication, on the musculoskeletal health of persons with diabetes.

7 Review Female Athlete Triad. 2018

Daily, Jennifer P / Stumbo, Jessica R. ·KentuckyOne Health, University of Louisville, Louisville, KY, USA; Department of Family and Geriatric Medicine, Centers for Primary Care, University of Louisville, 215 Central Avenue, Suite 205, Louisville, KY 40208, USA. ·Prim Care · Pubmed #30401345.

ABSTRACT: The female athlete triad is a condition seen in physically active female athletes, consisting of low energy availability, menstrual dysfunction, and low bone mineral density. The condition should be viewed as a metabolic injury. It can have an impact on female athletes at any age or level. Activities at highest risk are those emphasizing leanness, aesthetics, and endurance. The cornerstone of treatment is improving mismatched energy balance. A multidisciplinary team, including health care providers, dieticians, and mental health professionals, is vital in caring for female athlete triad patients. Increased awareness and education are needed for medical as well as athletic communities.

8 Review Exosomes: mediators of bone diseases, protection, and therapeutics potential. 2018

Behera, Jyotirmaya / Tyagi, Neetu. ·Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA. ·Oncoscience · Pubmed #30035185.

ABSTRACT: Bone remodeling is a continuous lifelong process in the repair of micro-damage to bone architecture and replacement of aging tissue in bone. A failure to such process leads to pathological destructive bone diseases such as osteoporosis, rheumatoid arthritis, and osteoarthritis. However, this active process is regulated by; osteoclasts, which are involved in the bone resorption process; osteoblasts, with involvement in the bone formation process and bone-derived endothelial cells, which promote angiogenesis. In the bone micro-environment, these cellular interactions are mediated by a complex interplay between cell types via direct interaction of cell secreted growth factors, such as cytokines. Recently, the discovery of exosomes (∼ 40-100 nm in size), has attracted more attention in the field of the bone remodeling process. Exosomes and microvesicles are derived from different types of bone cells such as mesenchymal stem cells, osteoblasts, osteoclasts and their precursors. They are also recognized to play pivotal roles in bone remodeling processes including osteogenesis, osteoclastogenesis, and angiogenesis. In this review, we especially emphasize the origin and biogenesis of exosomes and bone cell derived exosomes in the regulatory process of bone remodeling. Moreover, this review article also focuses on exosomal secreted proteins and microRNAs and their involvement in the regulation of bone remodeling.

9 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.

10 Review Social cognitive or learning theory use to improve self-efficacy in musculoskeletal rehabilitation: A systematic review and meta-analysis. 2018

Ghazi, Cameron / Nyland, John / Whaley, Rumeal / Rogers, Thomas / Wera, Jeff / Henzman, Cameron. ·a Department of Orthopaedic Surgery , University of Louisville , Louisville , KY , USA. · b Athletic Training Program, Kosair Charities College of Health and Natural Sciences , Spalding University , Louisville , KY , USA. ·Physiother Theory Pract · Pubmed #29308969.

ABSTRACT: OBJECTIVE: To review the rehabilitation research methodological quality and intervention effectiveness of studies that used social cognitive or learning theory principles to improve self-efficacy in patients with orthopedic or musculoskeletal conditions. DESIGN: A systematic literature review and meta-analysis of peer reviewed studies published in English was performed using the OVID and SPORTDiscus databases. Initial search terms were "social cognitive theory" or "social learning theory" combined with "rehabilitation". RESULTS: From the 25 total studies that contributed to this review, 23 contributed patient outcome information and 20 contributed to effect size determination. Of 1947 total study participants, most (n = 1537, 78.9%) were women. Participants were primarily late middle-age (64.8 ± 17 years). Studies included participants with hip or knee osteoarthritis (OA) or who were post-hip or knee arthroplasty (11/25, 44%), post-femur or tibia fracture (6/25, 24%), adults in assisted living or inpatient rehabilitation facilities (2/25, 8%), independent community dwelling older adults (2/25, 8%), college-age recreational athletes post-sports injury (2/25, 8%), older women with osteoporosis risk (1/25, 4%) or middle-aged adults post-traumatic hand injury (1/25, 4%). For the 20 studies that contributed to effect size determination, a large overall mean effect size (Cohen's d = 0.98, 95% CI 0.42-1.86) was observed. CONCLUSIONS: Studies that used social cognitive or learning theory principles to improve self-efficacy in patients with orthopedic or musculoskeletal conditions generally displayed moderate to large effect sizes supporting this intervention. Sound research methodological quality and low risk of intervention-related injury or other adverse events were also generally observed. Findings suggest that these interventions may also benefit individuals with conditions that have not progressed to end-stage salvage surgery such as younger, more athletically active individuals for knee OA prevention.

11 Review Female athlete triad. 2017

Loveless, Meredith B. ·Departments Ob/Gyn and Pediatrics, Norton Children's Hospital Louisville, Clinical Faculty University of Louisville, Louisville, Kentucky, USA. ·Curr Opin Obstet Gynecol · Pubmed #28737524.

ABSTRACT: PURPOSE OF REVIEW: The obstetrician/gynecologist (ob/gyn) may be the first provider to have the opportunity to recognize and diagnose female athlete triad. This review will help the ob/gyn to understand the female athlete triad and what is new on this topic, how to screen and diagnose the condition and the ob/gyn's role in treatment. RECENT FINDINGS: Female athlete triad, also known as relative energy deficiency in sports, involves an interrelationship among energy availability, menstrual function and low bone density. When these components are not balanced, the health of the athlete is at risk. By using menstrual cycle as a vital sign, a careful medical history may alert you to this condition. The mainstay of treatment is achieving optimal energy balance and resumption of menses. This may involve dietary invention by increasing caloric intake or activity modification by limiting or restricting participation in sports. A multidisciplinary team, including the ob/gyn, athlete, coach, parents, sport nutritionist and sometimes psychiatrist/psychologist, is optimal for management. Medication may supplement but not replace treating the underlying condition. SUMMARY: The female athlete triad is an important disorder to identify, as early diagnosis and intervention may prevent long-term consequences, some of which may not be reversible if not diagnosed and treated.

12 Review Cross-talk of MicroRNA and hydrogen sulfide: A novel therapeutic approach for bone diseases. 2017

Zhai, Yuankun / Tyagi, Suresh C / Tyagi, Neetu. ·Department of Physiology, School of Medicine, University of Louisville, Louisville, KY 40202, USA. · Department of Physiology, School of Medicine, University of Louisville, Louisville, KY 40202, USA. Electronic address: n0tyag01@louisville.edu. ·Biomed Pharmacother · Pubmed #28618652.

ABSTRACT: Bone homeostasis requires a balance between the bone formation of osteoblasts and bone resorption of osteoclasts to maintain ideal bone mass and bone quality. An imbalance in bone remodeling processes results in bone metabolic disorders such as osteoporosis. Hydrogen sulfide (H

13 Review Homocysteine as a Pathological Biomarker for Bone Disease. 2017

Behera, Jyotirmaya / Bala, Jyoti / Nuru, Mohammed / Tyagi, Suresh C / Tyagi, Neetu. ·Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky. ·J Cell Physiol · Pubmed #27859269.

ABSTRACT: In the last few decades, perturbation in methyl-group and homocysteine (Hcy) balance have emerged as independent risk factors in a number of pathological conditions including neurodegenerative disease, cardiovascular dysfunction, cancer development, autoimmune disease, and kidney disease. Recent studies report Hcy to be a newly recognized risk factor for osteoporosis. Elevated Hcy levels are known to modulate osteoclastgenesis by causing detrimental effects on bone via oxidative stress induced metalloproteinase-mediated extracellular matrix degradation and decrease in bone blood flow. Evidence from previous studies also suggests that the decreased chondrocytes mediated bone mineralization in chick limb-bud mesenchymal cells and during the gestational period of ossification in rat model. However, Hcy imbalance and its role in bone loss, regression in vascular invasion, and osteoporosis, are not clearly understood. More investigations are required to explore the complex interplay between Hcy imbalance and onset of bone disease progression. This article reviews the current body of knowledge on regulation of Hcy mediated oxidative stress and its role in bone remodeling, vascular blood flow and progression of bone disease. J. Cell. Physiol. 232: 2704-2709, 2017. © 2016 Wiley Periodicals, Inc.

14 Review Effects of Type 1 Diabetes on Osteoblasts, Osteocytes, and Osteoclasts. 2016

Kalaitzoglou, Evangelia / Popescu, Iuliana / Bunn, R Clay / Fowlkes, John L / Thrailkill, Kathryn M. ·UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA. evangelia.kalaitzoglou@uky.edu. · Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, 40536, USA. evangelia.kalaitzoglou@uky.edu. · UK Barnstable Brown Diabetes Center, University of Kentucky College of Medicine, 830 S. Limestone St., Lexington, KY, 40536, USA. · Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY, 40536, USA. ·Curr Osteoporos Rep · Pubmed #27704393.

ABSTRACT: PURPOSE OF REVIEW: To describe the effects of type 1 diabetes on bone cells. RECENT FINDINGS: Type 1 diabetes (T1D) is associated with low bone mineral density, increased risk of fractures, and poor fracture healing. Its effects on the skeleton were primarily attributed to impaired bone formation, but recent data suggests that bone remodeling and resorption are also compromised. The hyperglycemic and inflammatory environment associated with T1D impacts osteoblasts, osteocytes, and osteoclasts. The mechanisms involved are complex; insulinopenia, pro-inflammatory cytokine production, and alterations in gene expression are a few of the contributing factors leading to poor osteoblast activity and survival and, therefore, poor bone formation. In addition, the observed sclerostin level increase accompanied by decreased osteocyte number and enhanced osteoclast activity in T1D results in uncoupling of bone remodeling. T1D negatively impacts osteoblasts and osteocytes, whereas its effects on osteoclasts are not well characterized, although the limited studies available indicate increased osteoclast activity, favoring bone resorption.

15 Review Advances in Controlled Drug Delivery for Treatment of Osteoporosis. 2016

Asafo-Adjei, T A / Chen, A J / Najarzadeh, A / Puleo, D A. ·Department of Biomedical Engineering, University of Kentucky, 522A Robotics and Manufacturing Building, Lexington, KY, 40506-0108, USA. · Department of Biomedical Engineering, University of Kentucky, 522A Robotics and Manufacturing Building, Lexington, KY, 40506-0108, USA. puleo@uky.edu. ·Curr Osteoporos Rep · Pubmed #27502334.

ABSTRACT: Osteoporosis, which is characterized by resorption of bone exceeding formation, remains a significant human health concern, and the impact of this condition will only increase with the "graying" of the worldwide population. This review focuses on current and emerging approaches for delivering therapeutic agents to restore bone remodeling homeostasis. Well-known antiresorptive and anabolic agents, such as estrogen, estrogen analogs, bisphosphonates, calcitonin, and parathyroid hormone, along with newer modulators and antibodies, are primarily administered orally, intravenously, or subcutaneously. Although these treatments can be effective, continuing problems include patient noncompliance and adverse systemic or remote-site effects. Controlled drug delivery via polymeric, targeted, and active release systems extends drug half-life by shielding against premature degradation and improves bioavailability while also providing prolonged, sustained, or intermittent release at therapeutic doses to more effectively treat osteoporosis and associated fracture risk.

16 Review Hormonal and nonhormonal treatment of vasomotor symptoms. 2015

Krause, Miriam S / Nakajima, Steven T. ·Fertility and Endocrine Associates, 4121 Dutchman's Lane, Suite 414, Louisville, KY 40207, USA. Electronic address: ms.krause@yahoo.de. · Stanford Fertility and Reproductive Medicine Center, 900 Welch Road, Suite 20, Palo Alto, CA 94304, USA. ·Obstet Gynecol Clin North Am · Pubmed #25681847.

ABSTRACT: This article focuses on the cause, pathophysiology, differential diagnosis of, and treatment options for vasomotor symptoms. In addition, it summarizes important points for health care providers caring for perimenopausal and postmenopausal women with regard to health maintenance, osteoporosis, cardiovascular disease, and vaginal atrophy. Treatment options for hot flashes with variable effectiveness include systemic hormone therapy (estrogen/progestogen), nonhormonal pharmacologic therapies (selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors, clonidine, gabapentin), and nonpharmacologic therapy options (behavioral changes, acupuncture). Risks and benefits as well as contraindications for hormone therapy are further discussed.

17 Review Defining COPD-Related Comorbidities, 2004-2014. 2014

Martinez, Carlos H / Mannino, David M / Divo, Miguel J. ·Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor. · Departments of Preventive Medicine and Environmental Health, University of Kentucky,College of Medicine and College of Public Health, Lexington. · Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. ·Chronic Obstr Pulm Dis · Pubmed #28848811.

ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a disease of aging in combination with genetic, environmental, and behavioral risk factors. Aging and many of these risk factors are shared with other diseases, and, as a result, it is not surprising that patients with COPD often have coexistent diseases. This review of COPD comorbidities uses a framework in which coexistent diseases are considered important comorbidities if they are more frequent, have more severe consequences, influence the progression and outcomes of COPD, or are clustered together into proposed phenotypes, supplemented by a framework in which certain comorbidities are expected to share specific pathogenic mechanisms. This review explores classic COPD comorbidities such as cardiovascular disease, cachexia and sleep apnea, but also looks at more recently described comorbidities, such as gastroesophageal reflux, osteoporosis and depression/anxiety.

18 Review Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes. 2014

Aryal, Shambhu / Diaz-Guzman, Enrique / Mannino, David M. ·Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC, USA. · Division of Pulmonary, Allergy and Critical Care, University of Alabama, Birmingham, AL, USA. · Department of Preventive Medicine and Environmental Health, University of Kentucky, Lexington, KY, USA. ·Int J Chron Obstruct Pulmon Dis · Pubmed #25342899.

ABSTRACT: Chronic obstructive pulmonary disease (COPD), one of the most common chronic diseases and a leading cause of death, has historically been considered a disease of men. However, there has been a rapid increase in the prevalence, morbidity, and mortality of COPD in women over the last two decades. This has largely been attributed to historical increases in tobacco consumption among women. But the influence of sex on COPD is complex and involves several other factors, including differential susceptibility to the effects of tobacco, anatomic, hormonal, and behavioral differences, and differential response to therapy. Interestingly, nonsmokers with COPD are more likely to be women. In addition, women with COPD are more likely to have a chronic bronchitis phenotype, suffer from less cardiovascular comorbidity, have more concomitant depression and osteoporosis, and have a better outcome with acute exacerbations. Women historically have had lower mortality with COPD, but this is changing as well. There are also differences in how men and women respond to different therapies. Despite the changing face of COPD, care providers continue to harbor a sex bias, leading to underdiagnosis and delayed diagnosis of COPD in women. In this review, we present the current knowledge on the influence of sex on COPD risk factors, epidemiology, diagnosis, comorbidities, treatment, and outcomes, and how this knowledge may be applied to improve clinical practices and advance research.

19 Review The role of homocysteine in bone remodeling. 2013

Vacek, Thomas P / Kalani, Anuradha / Voor, Michael J / Tyagi, Suresh C / Tyagi, Neetu. ·Department of Physiology and Biophysics, University of Louisville School of Medicine Louisville, Louisville, KY 40202, USA. ·Clin Chem Lab Med · Pubmed #23449525.

ABSTRACT: Bone remodeling is a very complex process. Homocysteine (Hcy) is known to modulate this process via several known mechanisms such as increase in osteoclast activity, decrease in osteoblast activity and direct action of Hcy on bone matrix. Evidence from previous studies further support a detrimental effect on bone via decrease in bone blood flow and an increase in matrix metalloproteinases (MMPs) that degrade extracellular bone matrix. Hcy binds directly to extracellular matrix and reduces bone strength. There are several bone markers that can be used as parameters to determine how high levels of plasma Hcy (hyperhomocysteinemia, HHcy) affect bone such as: hydroxyproline, N-terminal collagen 1 telopeptides. Mitochondrion serves an important role in generating reactive oxygen species (ROS). Mitochondrial abnormalities have been identified during HHcy. The mechanism of Hcy-induced bone remodeling via the mitochondrial pathway is largely unknown. Therefore, we propose a mitochondrial mechanism by which Hcy can contribute to alter bone properties. This may occur both through generations of ROS that activate MMPs and could be extruded into matrix to degrade bone matrix. However, there are contrasting reports on whether Hcy affects bone density, with some reports in favour and others not. Earlier studies also found an alteration in bone biomechanical properties with deficiencies of vitamin B12, folate and HHcy conditions. Moreover, existing data opens speculation that folate and vitamin therapy act not only via Hcy-dependent pathways but also via Hcy-independent pathways. However, more studies are needed to clarify the mechanistic role of Hcy during bone diseases.

20 Review Bisphosphonates: focus on inflammation and bone loss. 2012

Iannitti, Tommaso / Rosini, Stefano / Lodi, Daniele / Frediani, Bruno / Rottigni, Valentina / Palmieri, Beniamino. ·Department of Physiology, School of Medicine, University of Kentucky Medical Center, Lexington, 40536-0298, USA. tommaso.iannitti@gmail.com ·Am J Ther · Pubmed #22549638.

ABSTRACT: Bisphosphonates are pharmacological compounds that have been used for the prevention and treatment of several pathological conditions including osteoporosis, primary hyperparathyroidism, osteogenesis imperfecta, and other conditions characterized by bone fragility. Many studies have been performed to date to analyze their effects on inflammation and bone remodelling and related pathologies. The aim of this review is, starting from a background on inflammatory processes and bone remodelling, to give an update on the use of bisphosphonates, outlining the possible side effects and proposing new trends for the future. Starting from a brief introduction on inflammation and bone remodelling, we collect and analyze studies involving the use of bisphosphonates for treatment of inflammatory conditions and pathologies characterized by bone loss. Selected articles, including reviews, published between 1976 and 2011, were chosen from Pubmed/Medline on the basis of their content. Bisphosphonates exert a selective activity on inflammation and bone remodelling and related pathologies, which are characterized by an excess in bone resorption. They improve not only skeletal defects, but also general symptoms. Bisphosphonates have found clinical application preventing and treating osteoporosis, osteitis deformans (Paget's disease of bone), bone metastasis (with or without hypercalcaemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, and other conditions that feature bone fragility. Further clinical studies involving larger cohorts are needed to optimize the dosage and length of therapy for each of these agents in each clinical field in order to be able to maximize their properties concerning modulation of inflammation and bone remodelling. In the near future, although "old" bisphosphonates will reach the end of their patent life, "new" bisphosphonates will be designed to specifically target a pathological condition.

21 Review Interactions between antiepileptics and second-generation antipsychotics. 2012

de Leon, Jose / Santoro, Vincenza / D'Arrigo, Concetta / Spina, Edoardo. ·University of Kentucky Mental Health Research Center at Eastern State Hospital, 627 West Fourth St., Lexington, KY 40508, USA. jdeleon@uky.edu ·Expert Opin Drug Metab Toxicol · Pubmed #22332980.

ABSTRACT: INTRODUCTION: Pharmacokinetic and pharmacodynamic drug interactions (DIs) can occur between antiepileptics (AEDs) and second-generation antipsychotics (SGAPs). Some AED and SGAP pharmacodynamic mechanisms are poorly understood. AED-SGAP combinations are used for treating comorbid illnesses or increasing efficacy, particularly in bipolar disorder. AREAS COVERED: This article provides a comprehensive review of the interactions between antiepileptics and second-generation antipsychotics. The authors cover pharmacokinetic AED-SGAP DI studies, the newest drug pharmacokinetics in addition to the limited pharmacodynamic DI studies. EXPERT OPINION: Dosing correction factors and measuring SGAP levels can help to compensate for the inductive properties of carbamazepine, phenytoin, phenobarbital and primidone. Further studies are needed to establish the clinical relevance of combining: i) AED strong inducers with amisulpride, asenapine, iloperidone, lurasidone and paliperidone; ii) valproate with aripiprazole, asenapine, clozapine and olanzapine; iii) high doses of oxcarbazepine (≥ 1500 mg/day) or topiramate (≥ 400 mg/day) with aripiprazole, lurasidone, quetiapine, risperidone, asenapine and olanzapine. Two pharmacodynamic DIs are beneficial: i) valproate-SGAP combinations may have additive effects in bipolar disorder, ii) combining topiramate or zonisamide with SGAPs may decrease weight gain. Three pharmacodynamic DIs contributing to decreased safety are common: sedation, weight gain and swallowing disturbances. A few AED-SGAP combinations may increase risk for osteoporosis or nausea. Three potentially lethal but rare pharmacodynamic DIs include pancreatitis, agranulocytosis/leukopenia and heat stroke. The authors believe that collaboration is needed from drug agencies and pharmaceutical companies, the clinicians using these combinations, researchers with expertise in meta-analyses, grant agencies, pharmacoepidemiologists and DI pharmacologists for future progression in this field.

22 Review Osseous deficits after anterior cruciate ligament injury and reconstruction: a systematic literature review with suggestions to improve osseous homeostasis. 2010

Nyland, John / Fisher, Brent / Brand, Emily / Krupp, Ryan / Caborn, David N M. ·Department of Orthopaedic Surgery, University of Louisville, Kentucky 40202, USA. john.nyland@louisville.edu ·Arthroscopy · Pubmed #20810081.

ABSTRACT: PURPOSE: This systematic review was performed to improve our understanding of the current evidence regarding the influence of anterior cruciate ligament (ACL) injury and reconstruction on involved lower extremity apparent bone mineral density, bone content, or bone area mass (bone integrity). METHODS: Two independent reviewers performed a Medline search from 1966 to January 2010 using the terms "anterior cruciate ligament" or "ACL" combined with "wound" or "injury" and "bone density" or "osteoporosis." Study inclusion criteria were English-language human studies. Reference sections of selected studies were also reviewed. RESULTS: Ten studies were identified that met our inclusion criteria. Eight studies performed ACL reconstruction with bone-patellar tendon-bone autografts and interference screw fixation. One study performed ACL reconstruction by use of Achilles tendon allografts with interference screw and staple fixation. Two ACL injury studies either did not involve ACL reconstruction or attempted primary repair with sutures. All studies reported varying levels of decreased bone mineral density, bone content, or bone area mass (bone integrity) at the involved lower extremity after ACL injury that did not return to premorbid levels even with ACL reconstruction and rehabilitation. Sites of reduced bone integrity included the proximal and distal femur, proximal tibia, patella, and calcaneus. Bone loss was increased with limited weight bearing and prolonged disuse or immobilization; however, significant improvements were not observed with accelerated rehabilitation. Some studies reported relations between Lysholm, Tegner, International Knee Documentation Committee survey, or function scores and bone integrity, whereas others reported no or poor relations. CONCLUSIONS: Involved lower extremity bone integrity is decreased after ACL injury. Current evidence suggests that premorbid bone integrity is not re-established after ACL reconstruction even when accelerated rehabilitation is performed. Recommendations to improve osseous homeostasis and bone health after ACL injury and reconstruction are provided.

23 Article Can we predict failure of percutaneous fixation of femoral neck fractures? 2019

Kane, Christina / Jo, Jacob / Siegel, Jodi / Matuszewski, Paul E / Swart, Eric. ·University of Massachusetts, Department of Orthopaedic Surgery, Worcester, MA, United States. · University of Kentucky School of Medicine, Department of Orthopaedic Surgery and Sports Medicine, Lexington, KY, United States. ·Injury · Pubmed #31679832.

ABSTRACT: PURPOSE: This study evaluated a series of geriatric femoral neck fracture treated with closed reduction percutaneous pinning (CRPP) at a single level-1 trauma center to determine if there are any simple, reliable, radiographic characteristics that can be used to predict increased risk of post-operative failure in nondisplaced and valgus impacted fracture patterns. METHODS: We conducted a retrospective cohort study of all patients with femoral neck fractures (AO/OTA 31B) who underwent CRPP over a 12-year period at a single Level 1 trauma center. Failure was defined as radiographic failure within the first year after the index operation requiring revision surgery. Common patterns identified on initial review were the presence of a visible medial transcervical line (MTL) felt to indicate a tension-sided failure, a straight inferior calcar (SIC) indicating severe valgus impaction, and quality of intra-operative screw positioning. X-rays of patients were then reviewed for these characteristics in a blinded manner by three different trauma-fellowship trained orthopedic surgeons. Inter-rater reliability was calculated using Fleiss' Kappa Coefficient. Comparisons of failure rates between groups were made using a Fisher's Exact test. RESULTS: 139 patients who underwent CRPP for a femoral neck fracture and follow-up for at least 90 days were identified and reviewed. There were a total of 19 failures (13.6%) within one year. The patients with a varus fracture had a failure rate of 9/24 (37.5%). Of the valgus/nondisplaced fractures, MTL was identified in 42/115 (36%) patients. Inter-rater agreement was high for the presence of an MTL (84%, Kappa 0.69). Patients with an MTL had a fourfold increase in risk of failure (7/42=17% with an MTL vs. 3/73=4% without, p  0.03). The presence of a SIC and quality of screw placement were not predictive of failure. CONCLUSION: Varus femoral neck fractures fixed with CRPP have a high rate of failure (37.5%). Nondisplaced or valgus impacted fractures with the presence of a visible medial transcervical line on pre-operative radiographic imaging resulted in a fourfold increase in the risk of failure after CRPP. Identification of the MTL will help treating surgeons better council patients when making pre-operative decisions between arthroplasty and CRPP.

24 Article The RNA demethylase FTO is required for maintenance of bone mass and functions to protect osteoblasts from genotoxic damage. 2019

Zhang, Qian / Riddle, Ryan C / Yang, Qian / Rosen, Clifford R / Guttridge, Denis C / Dirckx, Naomi / Faugere, Marie-Claude / Farber, Charles R / Clemens, Thomas L. ·Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD 21287. · Baltimore Veterans Administration Medical Center, Baltimore, MD 21201. · Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME 04074. · Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425. · Department of Medicine, University of Kentucky, Lexington, KY 40506. · Center for Public Health Genomics, University of Virginia, Charlottesville, VA 22908. · Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD 21287; tclemen5@jhmi.edu. ·Proc Natl Acad Sci U S A · Pubmed #31434789.

ABSTRACT: The fat mass and obesity-associated gene (

25 Article Improvement in viability and mineralization of osteoporotic bone marrow mesenchymal stem cell through combined application of photobiomodulation therapy and oxytocin. 2019

Fallahnezhad, Somaye / Jajarmi, Vahid / Shahnavaz, Sarira / Amini, Abdullah / Ghoreishi, Seyed Kamran / Kazemi, Mahsa / Chien, Sufan / Bayat, Mohammad. ·Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. · Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. · Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. · Department of Statistics, University of Qom, Qom, Iran. · Price Institute of Surgical Research, University of Louisville, and Noveratech LLC of Louisville, Louisville, KY, USA. · Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. bayat_m@yahoo.com. · Price Institute of Surgical Research, University of Louisville, and Noveratech LLC of Louisville, Louisville, KY, USA. bayat_m@yahoo.com. ·Lasers Med Sci · Pubmed #31399862.

ABSTRACT: The probable positive effects of photobiomodulation therapy (PBMT) and oxytocin (OT) treatments together or alone were evaluated on cell viability along with the changes in the gene expression of Osteocalcin (OC), Osteoprotegerin (OPG), and Runt-related transcription factor 2 (Runx2) levels of sham (healthy)-Bone marrow mesenchymal stem cell(BMMSC) and ovariectomy-induced osteoporosis (OVX)-BMMSC. BMMSC was harvested from healthy and OVX rats and was cultured in osteogenic induction medium (OIM). There were five groups of BMMSCs: (1) sham -BMMSCs; (2) control -OVX-BMMSCs; (3) OT-treated-OVX-BMMSCs; (4) PBMT-treated-OVX-BMMSCs, and (5) OT + PBMT-OVX-BMMSCs. In all 5 groups, BMMSC viability and proliferation as well as gene expression of OC, OPG, and RUNX2 were evaluated. PBMT and PBMT + OT treatments showed a promising effect on the increased viability of OVX-BMMSC (ANOVA test; LSD test, p = 0.01, p = 0.002). The results of gene expression analysis revealed that the sham- BMMSCs responded optimally to OT treatment. It was also found that OVX-BMMSCs responded optimally to PBMT + OT and PBMT treatments at early and middle stages of osteogenic induction process. Nevertheless, they responded optimally to PBMT + OT and OT especially at the late stage of osteogenic induction process. PBMT and PBMT + OT treatments significantly increased viability of OVX-BMMSC in OIM in vitro. Both PBMT and PBMT + OT treatments could promote mineralization of OVX-BMMSC in the culture medium at early and middle stages of osteogenic induction process. Both OT and PBMT + OT treatments could promote mineralization of OVX-BMMSC in vitro at late stages of osteogenic induction process.

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