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Osteoporosis: HELP
Articles from Utah
Based on 61 articles published since 2008

These are the 61 published articles about Osteoporosis that originated from Utah during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Guideline 2014 Female Athlete Triad Coalition consensus statement on treatment and return to play of the female athlete triad: 1st International Conference held in San Francisco, CA, May 2012, and 2nd International Conference held in Indianapolis, IN, May 2013. 2014

De Souza, Mary Jane / Nattiv, Aurelia / Joy, Elizabeth / Misra, Madhusmita / Williams, Nancy I / Mallinson, Rebecca J / Gibbs, Jenna C / Olmsted, Marion / Goolsby, Marci / Matheson, Gordon / Anonymous1640786 / Anonymous1650786 / Anonymous1660786 / Anonymous1670786. ·*Penn State University, Department of Kinesiology, University Park, Pennsylvania; †University of California Los Angeles, Los Angeles, California; ‡Intermountain Healthcare, Salt Lake City, Utah; §Harvard Medical School, Boston, Massachusetts; ¶University of Waterloo, Waterloo, Ontario, Canada; ‖University of Toronto, Toronto, Ontario, Canada; **Hospital for Special Surgery, New York, New York; ††Stanford University, Stanford, California. ·Clin J Sport Med · Pubmed #24569429.

ABSTRACT: The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves 3 components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female athletes often present with 1 or more of the 3 Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhea, and osteoporosis. This consensus statement represents a set of recommendations developed following the first (San Francisco, California) and second (Indianapolis, Indianna) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers, and other health care providers for the screening, diagnosis, and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad Expert Panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance, and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team, and implementation of treatment contracts. This consensus paper has been endorsed by The Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians, and other health care professionals, the American College of Sports Medicine, and the American Medical Society for Sports Medicine.

2 Editorial Preventing fractures in the masters athlete: we can do better. 2018

Powell, Amy P / Borowski, Lauren / Kussman, Andrea / Nattiv, Aurelia. ·Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA. · Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA. · Department of Family Medicine, Division of Sports Medicine, University of California, Los Angeles, California, USA. ·Br J Sports Med · Pubmed #29247022.

ABSTRACT: -- No abstract --

3 Review Locked Plating and Advanced Augmentation Techniques in Osteoporotic Fractures. 2019

DeKeyser, Graham J / Kellam, Patrick J / Haller, Justin M. ·University of Utah, Department of Orthopaedics, Orthopaedic Center, 590 Wakara Way, Salt Lake City, UT 84108, USA. · University of Utah, Department of Orthopaedics, Orthopaedic Center, 590 Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: Justin.haller@hsc.utah.edu. ·Orthop Clin North Am · Pubmed #30850075.

ABSTRACT: "The incidence of osteoporotic fracture is increasing with the aging US population. Because osteoporosis leads to a decrease in bone mineral density with a decrease in both trabecular and cortical bones, osteoporotic fracture presents fixation challenges with standard plate and screw constructs. Locked plating has been developed to create a fixed-angle plate-screw construct that is more resistant to failure in osteoporotic bone. Endosteal replacement, additional plates, and cement augmentation have all been demonstrated to further supplement osteoporotic fracture fixation. Technologies on the horizon to treat osteoporotic fracture include SMV screws, hydroxyapatite-coated implants, and far cortical locking screws."

4 Review Injuries of the adolescent girl athlete: a review of imaging findings. 2019

Shampain, Kimberly / Gaetke-Udager, Kara / Leschied, Jessica R / Meyer, Nathaniel B / Hammer, Matthew R / Denay, Keri L / Yablon, Corrie M. ·Department of Radiology, University of Michigan, 1500 E Medical Center Drive, B1 D502, Ann Arbor, MI, 48109, USA. · Department of Radiology, University of Michigan, 1500 E Medical Center Drive, B1 D502, Ann Arbor, MI, 48109, USA. kgaetke@umich.edu. · Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA. · Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. ·Skeletal Radiol · Pubmed #30123946.

ABSTRACT: With the rising participation of girls in sports at both the recreational and elite levels, there has also been increased awareness of injuries common in this athlete population. Anatomic differences between boys and girls cause girl athletes to be predisposed to certain injuries. Certain behavioral patterns, such as eating disorders, also cause problems specific to girl athletes that may result in injury. Imaging plays a large role in diagnosis and ongoing management, but there has been only scant literature dedicated to the specific topic of imaging in girl athletes. The purpose of this article is to review the imaging findings and recommendations for injuries and other conditions affecting the adolescent girl athlete. This article first provides an overview of the key anatomic differences between boys and girls, including both static and dynamic factors, as well as non-anatomic differences, such as hormonal factors, and discusses how these differences contribute to the injury patterns that are seen more typically in girls. The article then reviews the imaging findings in injuries that are commonly seen in girl athletes. There is also a discussion of the "female athlete triad," which consists of osteoporosis, disordered eating, and amenorrhea, and the role of imaging in this condition.

5 Review Rehmanniae Radix in osteoporosis: A review of traditional Chinese medicinal uses, phytochemistry, pharmacokinetics and pharmacology. 2017

Liu, Chenyue / Ma, Rufeng / Wang, Lili / Zhu, Ruyuan / Liu, Haixia / Guo, Yubo / Zhao, Baosheng / Zhao, Shangang / Tang, Jinfa / Li, Yu / Niu, Jianzhao / Fu, Min / Zhang, Dongwei / Gao, Sihua. ·Chinese Material Medica School, Beijing University of Chinese Medicine, Beijing 100102, China. · Preclinical Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China. · Beijing Research Institute of Chinese Medicine and Pharmacy, Beijing University of Chinese Medicine, Beijing 100029, China. · Touchstone Diabetes Center, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390-8549, USA. · The First Affiliated Hospital of He'nan TCM College, Zhengzhou 45000, China. · The Research Institute of McGill University Health Center, Montreal, Quebec, Canada H4A 3J1. · Diabetes Research Center, Beijing University of Chinese Medicine, Beijing 100029, China. Electronic address: dongwei1006@gmail.com. · Diabetes Research Center, Beijing University of Chinese Medicine, Beijing 100029, China. Electronic address: gaosihua1216@163.com. ·J Ethnopharmacol · Pubmed #28111216.

ABSTRACT: ETHNOPHARMACOLOGICAL RELEVANCE: Emerging clinical usage and pharmacological effects have been achieved in using Rehmanniae Radix either singly or in combination with other herbs to treat skeletal diseases in traditional Chinese medicine (TCM) in the recent years. This study is aimed to provide a comprehensive review about the historical TCM interpretation of the action of Rehmanniae Radix in osteoporosis, its usage in clinical trials and osteoporotic models, its main phytochemical constituents, and its pharmacokinetics. MATERIALS AND METHODS: Several databases included PubMed, China Knowledge Resource Integrated Database, China Science and Technology Journal Database, National Science and Technology Library and the Web of Science Database were consulted to locate the publications pertaining to Rehmanniae Radix. The initial inquiry was conducted for the presence of the following terms combinations in the abstracts: Rehmanniae Radix, Dihuang, phytochemistry, pharmacokinetics, osteoporosis, bone, osteoclast and osteoblast. About 330 research papers and reviews were consulted. RESULTS: In TCM, Rehmanniae Radix exerts the anti-osteoporotic effect via regulating the functions of kidney and liver as well as improving blood circulation. 107 clinical trials are identified that used Rehmanniae Radix in combination with other herbs to treat post-menopausal, senile and secondary osteoporosis. Most of the clinical trials are characterized by high efficacy and no obvious adverse effects. However, the efficacies of these clinical trials are limited because of small patient sample size, short treatment duration and poor clinical design. In addition, TCM herbs under the clinical study are not clear because of a lack of standardization and authentication. The pharmacokinetics data demonstrate that the ingredients of Rehmanniae Radix are widely distributed after administration, and that catalpol and ajugol as well as acetoside are supposed to be the active constituents. More than 140 individual compounds have been currently isolated from this plant and reported to show pleiotropic effects on various diseases. Rehmanniae Radix displays bone protecting features in the osteoporosis models via the delicate balance between osteoclastogenesis and osteoblastogenesis through single herb extracts and its isolated compounds. CONCLUSIONS: The successful inclusion of Rehmanniae Radix in clinical trials and preclinical studies for the management of osteoporosis has attracted rising attentions for identifying potential anti-osteoporotic candidates from this plant and clinical existing TCM formulas, which will further speed up anti-osteoporosis drug discovery processes. Properly designed and well controlled prospective studies are still needed to further demonstrate bone protective actions and safe use of this herb and its ingredients.

6 Review Clinical Inquiries: Does vitamin D without calcium reduce fracture risk? 2016

Daly, Sarah / Allison, Cami / Nashelsky, Joan. ·Utah Valley Family Medicine Residency, Provo, UT, USA. · University of Iowa, Iowa City, IA, USA. ·J Fam Pract · Pubmed #28149982.

ABSTRACT: Supplemental vitamin D without calcium--in doses averaging as much as 800 IU per day--doesn't reduce the risk of hip, vertebral, or nonvertebral fractures in postmenopausal women and older men.

7 Review Primary Care of the Prostate Cancer Survivor. 2016

Noonan, Erika M / Farrell, Timothy W. ·Intermountain Healthcare, Provo, UT, USA. · University of Utah School of Medicine and VA Salt Lake City Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA. ·Am Fam Physician · Pubmed #27175954.

ABSTRACT: This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated. Prostate cancer survivors should be screened regularly for urinary incontinence and sexual dysfunction. Patients with predominant urge incontinence symptoms, which can occur after surgical and radiation treatments, may benefit from an anticholinergic agent. If there is difficulty with bladder emptying, a trial of an alpha blocker may be considered. A phosphodiesterase type 5 inhibitor can effectively treat sexual dysfunction following treatment for prostate cancer. Osteoporosis screening should occur before initiation of androgen deprivation therapy, and patients treated with androgen deprivation therapy should be monitored for anemia, metabolic syndrome, and vasomotor symptoms. Healthy lifestyle choices should be encouraged, including weight management, regular physical activity, proper nutrition, and smoking cessation. Primary care physicians should be vigilant for psychosocial distress, including depression, among prostate cancer survivors, as well as the potential impact of this distress on patients' family members and partners.

8 Review Balancing benefits and risks of glucocorticoids in rheumatic diseases and other inflammatory joint disorders: new insights from emerging data. An expert consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). 2016

Cooper, Cyrus / Bardin, Thomas / Brandi, Maria-Luisa / Cacoub, Patrice / Caminis, John / Civitelli, Roberto / Cutolo, Maurizio / Dere, Willard / Devogelaer, Jean-Pierre / Diez-Perez, Adolfo / Einhorn, Thomas A / Emonts, Patrick / Ethgen, Olivier / Kanis, John A / Kaufman, Jean-Marc / Kvien, Tore K / Lems, Willem F / McCloskey, Eugene / Miossec, Pierre / Reiter, Susanne / Ringe, Johann / Rizzoli, René / Saag, Kenneth / Reginster, Jean-Yves. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. cc@mrc.soton.ac.uk. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. cc@mrc.soton.ac.uk. · Department of Rhumatologie, Hôpital Lariboisière Assistance Publique Hôpitaux de Paris, University Paris VII, Paris, France. · Department of Internal Medicine, University of Florence, Florence, Italy. · Department Hospitalo-Universitaire I2B, INSERM, UMR S 959, CNRS 7211, UPMC University of Paris 06, Paris, France. · Group Hospitalier Pitié-Salpêtrière, Department of Internal Medicine, Paris, France. · UCB Biosciences, 8010 Arco Corporate Drive, Raleigh, NC, USA. · Division of Bone and Mineral Diseases, Washington University, St. Louis, MO, USA. · Research Laboratories and Clinical Academic Division of Rheumatology, University Medical School of Genoa, Genoa, Italy. · Internal Medicine, University of Utah, Salt Lake City, UT, USA. · Rheumatology Department, Saint-Luc University Hospital, Louvain University in Brussels, Brussels, Belgium. · Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital del Mar-IMIM and RETICEF, Barcelona, Spain. · Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA, USA. · Bone and Cartilage Metabolism Unit, Department of Public Health Sciences, University of Liege, Liège, Belgium. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · Centre for Metabolic Bone Diseases, Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK. · Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Department of Rheumatology, VU University Medical Hospital, Amsterdam, The Netherlands. · Immunogenomics and Inflammation Research Unit, Department of Immunology and Rheumatology, University of Lyon 1, Lyon, France. · , Bonn, Germany. · West German Osteoporosis Center (WOC), University of Cologne, Leverkusen, Germany. · Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. · Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham, AL, USA. · Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium. ·Aging Clin Exp Res · Pubmed #26746234.

ABSTRACT: PURPOSE: This consensus review article considers the question of whether glucocorticoid (GC) therapy is still relevant in the treatment of rheumatic diseases, with a particular focus on rheumatoid arthritis (RA), and whether its side effects can be adequately managed. Recent basic and clinical research on the molecular, cellular and clinical effects of GCs have considerably advanced our knowledge in this field. An overview of the subject seems appropriate. METHODS: This review is the result of a multidisciplinary expert working group, organised by European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. The recent literature was surveyed and the salient evidence synthetized. RESULTS: The pathophysiological basis of RA (and other inflammatory rheumatic diseases) now strongly implicates the adaptive immune system in addition to innate mechanisms. The molecular effect of GCs and differential GC sensitivity is better understood, although exploiting this knowledge is still in its infancy. The newer treatment strategies of early and aggressive control of RA have gr eatly improved clinical outcomes, but improvements are still possible. Newer targeted anti-inflammatory drugs have made an important impact, yet they too are associated with numerous side effects. DISCUSSION: Short durations of moderate doses of GCs are generally well tolerated and have a positive benefit/risk ratio. Patients should be assessed for fracture risk and bone preserving agents and be prescribed calcium and vitamin D supplementation. CONCLUSIONS: Within a strategy of a disease modifying approach to inflammatory disease, combination therapy including a GC is effective approach.

9 Review Surgical Management of Spinal Conditions in the Elderly Osteoporotic Spine. 2015

Goldstein, Christina L / Brodke, Darrel S / Choma, Theodore J. ·*University of Missouri, Department of Orthopaedic Surgery, Columbia, Missouri; ‡Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah. ·Neurosurgery · Pubmed #26378363.

ABSTRACT: Osteoporosis, the most common form of metabolic bone disease, leads to alterations in bone structure and density that have been shown to compromise the strength of spinal instrumentation. In addition, osteoporosis may contribute to high rates of fracture and instrumentation failure after long posterior spinal fusions, resulting in proximal junctional kyphosis and recurrent spinal deformity. As increasing numbers of elderly patients present for surgical intervention for degenerative and traumatic spinal pathologies, current and future generations of spine surgeons will increasingly be faced with the challenge of obtaining adequate fixation in osteoporotic bone. The purpose of this review is to familiarize the reader with the impact of osteoporosis on spinal instrumentation, the broad variety of techniques that have been developed for addressing these issues, and the biomechanical and clinical evidence in support of the use of these techniques.

10 Review Internal fixation of osteoporotic fractures. 2015

Rothberg, David L / Lee, Mark A. ·University Orthopaedic Center, University of Utah Hospital and Clinics, 590 Wakara Way, Salt Lake City, UT, 84108, USA. ·Curr Osteoporos Rep · Pubmed #25424965.

ABSTRACT: Osteoporosis leads to bone fragility and increased risk of fracture. Despite advances in diagnosis and treatment, the prevalence continues to rise. Osteoporotic fracture treatment has a unique set of difficulties related to poor bone quality and traditional approaches, and implants may not perform well. Fixation failure and repeat surgery are poorly tolerated and highly undesirable in this patient population. This review illustrates the most recent updates in internal fixation, implant design, and surgical theory regarding treatment of patients with osteoporotic fractures.

11 Review Estimating prevalence of osteoporosis: examples from industrialized countries. 2014

Wade, S W / Strader, C / Fitzpatrick, L A / Anthony, M S / O'Malley, C D. ·Wade Outcomes Research and Consulting, 358 South 700 East, Suite B-432, Salt Lake City, UT, 84102, USA, sallyw@amgen.com. ·Arch Osteoporos · Pubmed #24847682.

ABSTRACT: PURPOSE: Standardized country-specific prevalence estimates are scarce, limiting our ability to anticipate the potential global impact of osteoporosis. This study estimated the prevalence of osteoporosis in several industrialized countries (USA, Canada, five European countries, Australia, and Japan) using the World Health Organization (WHO) bone mineral density (BMD)-based definition of osteoporosis: BMD T-score assessed by dual-energy x-ray absorptiometry ≤-2.5. METHODS: Osteoporosis prevalence was estimated for males and females aged 50 years and above using total hip BMD and then either total hip or spine BMD. We compiled published location-specific data, using the National Health and Nutrition Examination Survey (NHANES) III age and BMD reference groups, and adjusted for differences in disease definitions across sources. Relevant NHANES III ratios (e.g., male to female osteoporosis at the total hip) were applied where data were missing for countries outside the USA. Data were extrapolated from geographically similar countries as needed. Population counts for 2010 were used to estimate the number of individuals with osteoporosis in each country. RESULTS: For females, osteoporosis prevalence ranged from 9 % (UK) to 15 % (France and Germany) based on total hip BMD and from 16 % (USA) to 38 % (Japan) when spine BMD data were included. For males, prevalence ranged from 1 % (UK) to 4 % (Japan) based on total hip BMD and from 3 % (Canada) to 8 % (France, Germany, Italy, and Spain) when spine BMD data were included. CONCLUSIONS: Up to 49 million individuals met the WHO osteoporosis criteria in a number of industrialized countries in North America, Europe, Japan, and Australia.

12 Review Developing siRNA therapies to address osteoporosis. 2013

Wang, Yuwei / Grainger, David W. ·Department of Pharmaceutics & Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT 84112 USA. ·Ther Deliv · Pubmed #24116909.

ABSTRACT: Osteoporosis is a skeletal system pathology characterized by low bone mineral density and tissue structural deterioration. This malady is associated with high fracture risk that severely compromises quality of life. Osteoporosis incidence is becoming more significant with increasing lifespan worldwide. However, current approaches for treating osteoporosis cannot and do not treat the disease in the most ideal manner for diverse reasons. Substantial research has sought both the discovery of new targets and new therapies. In this review, emerging possible RNAi-mediated therapeutic opportunities for osteoporosis are identified and associated challenges discussed. Targeted delivery strategies capable of more reliable and efficient delivery to skeletal tissue are described, as well as possibilities to treat bone-forming cells with siRNA to produce cell-based therapy.

13 Review Geriatric gynecology: promoting health and avoiding harm. 2012

Miller, Karen L / Baraldi, Carole A. ·Department of Obstetrics and Gynecology, University of Utah School of Medicine, and Center on Aging, University of Utah, Salt Lake City, UT, USA. ·Am J Obstet Gynecol · Pubmed #22607665.

ABSTRACT: Age increases vulnerability, commonly accompanied by greater reliance on others and susceptibility to maltreatment. Physiologic processes become less resilient; the potential for harm from medical care increases. Awareness of frailty, functional, social, and potential maltreatment issues enables early referrals to help the patient maintain her independence. Health issues that may impede both gynecologic care and self-sufficiency include sensory deficits, physical disability, and cognitive impairment. Speaking slowly and providing contextual information enhance patient comprehension. Cancer screening depends on life expectancy. Osteoporosis treatment requires managing fall risk. Gynecologic symptoms more likely have multiple contributing factors than one etiology. Incontinence is a particularly complex issue, but invariably includes bladder diary assessment and pelvic floor muscle training. Function and frailty measures best predict perioperative morbidity. Communication with the patient, her family, other providers, and health care organizations is an important frontier in avoiding errors and adverse outcomes.

14 Review Vitamin D in orthopaedics. 2012

Patton, Chad M / Powell, Amy P / Patel, Alpesh A. ·Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA. ·J Am Acad Orthop Surg · Pubmed #22382284.

ABSTRACT: Vitamin D is an important component in musculoskeletal development, maintenance, and function. Adequate levels of vitamin D correlate with greater bone mineral density, lower rates of osteoporotic fractures, and improved neuromuscular function. Debate exists about both adequate levels required and intake requirements needed to prevent deficiency of vitamin D. Epidemiologic data have identified an increasing number of orthopaedic patients at risk for vitamin D deficiency, with potentially widespread consequences for bone healing, risk of fracture, and neuromuscular function.

15 Review RNA therapeutics targeting osteoclast-mediated excessive bone resorption. 2012

Wang, Yuwei / Grainger, David W. ·Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT 84112-5820, USA. luckwangyuwei@gmail.com ·Adv Drug Deliv Rev · Pubmed #21945356.

ABSTRACT: RNA interference (RNAi) is a sequence-specific post-transcriptional gene silencing technique developed with dramatically increasing utility for both scientific and therapeutic purposes. Short interfering RNA (siRNA) is currently exploited to regulate protein expression relevant to many therapeutic applications, and commonly used as a tool for elucidating disease-associated genes. Osteoporosis and their associated osteoporotic fragility fractures in both men and women are rapidly becoming a global healthcare crisis as average life expectancy increases worldwide. New therapeutics are needed for this increasing patient population. This review describes the diversity of molecular targets suitable for RNAi-based gene knock down in osteoclasts to control osteoclast-mediated excessive bone resorption. We identify strategies for developing targeted siRNA delivery and efficient gene silencing, and describe opportunities and challenges of introducing siRNA as a therapeutic approach to hard and connective tissue disorders.

16 Review Surgical treatment of osteoporotic fractures about the knee. 2010

Horwitz, Daniel S / Kubiak, Erik N. ·Orthopedic Trauma, University of Utah Orthopaedic Center, Salt Lake City, Utah. USA. ·Instr Course Lect · Pubmed #20415402.

ABSTRACT: The surgical treatment of fractures about the knee in elderly patients and/or those with osteoporosis remains a problematic and evolving challenge to many orthopaedic surgeons. The fundamental issues of poor bone quality, poor hosts, and associated medical comorbidities makes treating these fractures difficult both in terms of the decision-making process and the chosen surgical technique. It is important to review major treatment challenges and the potential solutions for minimizing complications.

17 Review Clinical risk factors for fracture in postmenopausal osteoporotic women: a review of the recent literature. 2008

LaFleur, Joanne / McAdam-Marx, Carrie / Kirkness, Carmen / Brixner, Diana I. ·Pharmacotherapy Outcomes Research Center, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84108, USA. Joanne.Lafleur@Pharm.Utah.Edu ·Ann Pharmacother · Pubmed #18230704.

ABSTRACT: OBJECTIVE: To review recent literature regarding relationships among age, weight or body mass index (BMI), bone mineral density (BMD), maternal history of fracture, or personal prior history of fracture and fragility fractures in women with postmenopausal osteoporosis (PMO). DATA SOURCES: A MEDLINE database search (1995-June 30, 2007) was conducted to identify literature related to risk factors of interest for PMO-related fractures. STUDY SELECTION AND DATA EXTRACTION: Cohort studies, case-control studies, and meta-analyses that reported fracture outcomes were included if they provided an estimate of relative risk for at least 1 of the 5 selected clinical risk factors (CRFs) and studied women with PMO or stratified risk estimates by age and sex. Of 313 identified studies that evaluated fractures as an endpoint, 245 did not report risk estimates for a CRF of interest and/or did not report data for a PMO population. DATA SYNTHESIS: In the 68 included articles, the risks associated with the evaluated CRFs were high and significant. Prior fracture was a strong predictor of fracture and increased risk up to 18 times. Each standard deviation below the referent mean for BMD was associated with an increased fracture risk of up to 4.0 times; maternal fracture history increased risk 1.3-2.9 times. Age (per 5 year increment) increased risk by 1.2-5.0 times; low weight or BMI inconsistently showed a 0.5-3.0 times greater risk. CONCLUSIONS: Low BMD is widely used as a diagnostic indicator for osteoporosis; however, other CRFs play an important role in determining fracture risk among women with PMO.

18 Article Limited Osteoporosis Screening Effectiveness Due to Low Treatment Rates in a National Sample of Older Men. 2018

Colón-Emeric, Cathleen S / Pieper, Carl F / Van Houtven, Courtney H / Grubber, Janet M / Lyles, Kenneth W / Lafleur, Joanne / Adler, Robert A. ·Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Durham VA Geriatric Research, Education and Clinical Center, Durham, NC. Electronic address: colon001@mc.duke.edu. · Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC. · Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Durham VA Health Services Research and Development Center of Innovation, Durham, NC. · Durham VA Health Services Research and Development Center of Innovation, Durham, NC. · Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC; Durham VA Geriatric Research, Education and Clinical Center, Durham, NC. · University of Utah, Salt Lake City, UT. · Hunter Holmes McGuire VA Medical Center, Richmond, VA; Department of Medicine, Virginia Commonwealth University, Richmond, VA. ·Mayo Clin Proc · Pubmed #30497697.

ABSTRACT: OBJECTIVE: To determine the association between dual-energy x-ray absorptiometry (DXA) testing for osteoporosis and subsequent fractures in US male veterans without a previous fracture. PATIENTS AND METHODS: This is a propensity score-matched observational study using Centers for Medicare and Medicaid Services and Veterans Affairs (VA) data from January 1, 2000, through December 31, 2010, with a mean follow-up time of 4.7 years (range, 0-10 years). Men receiving VA primary care aged 65 to 99 years without a previous fracture (N=2,539,812) were included. Men undergoing DXA testing were propensity score matched with untested controls in a 1:3 ratio, indicating the probability of DXA testing within the next year. Time to first clinical fracture was the primary outcome. Comorbidities, demographic characteristics, medications, DXA results, and osteoporosis treatment were defined using administrative data and natural language processing. A landmark analysis contingent on surviving to 12 months after screening was completed, accounting for competing risk of mortality. RESULTS: During follow-up of 153,311 men tested by DXA and 390,158 controls, 56,083 (10.3%) had sustained a fracture and 111,774 (20.6%) died. Overall, DXA testing was not associated with a decrease in fractures; conclusions are limited by unmeasured confounders and low medication initiation and adherence in those meeting treatment thresholds (12% of follow-up time). In contrast, DXA testing in prespecified subgroups was associated with a lower risk of fracture in comparison to the overall population who underwent DXA testing: androgen deprivation therapy (hazard ratio [HR], 0.77; 95% CI, 0.66-0.89), glucocorticoids (HR, 0.77; 95% CI, 0.72-0.84), age 80 years and older (HR, 0.85; 0.81-0.90), 1 or more VA guideline risk factors (HR, 0.91; 95% CI, 0.87-0.95), and high Fracture Risk Assessment Tool using body mass index score (HR, 0.90; 95% CI, 0.86-0.95). CONCLUSION: Current VA DXA testing practices are ineffective overall; interventions to improve treatment adherence are needed. Targeted DXA testing in higher-risk men was associated with a lower fracture risk.

19 Article Clearance and Return to Play for the Female Athlete Triad: Clinical Guidelines, Clinical Judgment, and Evolving Evidence. 2017

Joy, Elizabeth A / Nattiv, Aurelia. ·1Community Health and Food & Nutrition, Intermountain Healthcare, Salt Lake City, UT; and 2Division of Sports Medicine and Non-Operative Orthopaedics, Departments of Family Medicine and Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Department of Athletics, University of California, Los Angeles, CA. ·Curr Sports Med Rep · Pubmed #29135634.

ABSTRACT: -- No abstract --

20 Article A comparison of electronic and manual fracture risk assessment tools in screening elderly male US veterans at risk for osteoporosis. 2017

Williams, S T / Lawrence, P T / Miller, K L / Crook, J L / LaFleur, J / Cannon, G W / Nelson, R E. ·Salt Lake City VA Medical Center and University of Utah Department of Internal Medicine, Salt Lake City, UT, USA. stwilliams12@outlook.com. · George E. Wahlen VA Medical Center, 500 Foothill Drive, Salt Lake City, UT, 84148, USA. stwilliams12@outlook.com. · Salt Lake City VA Medical Center and Roseman University of Health Sciences, Salt Lake City, UT, USA. · Salt Lake City VA Medical Center and University of Utah Division of Rheumatology, Salt Lake City, UT, USA. · University of Utah Division of Epidemiology and Salt Lake City VA Medical Center, Salt Lake City, UT, USA. · University of Utah Department of Pharmacotherapy and Salt Lake City VA Medical Center, Salt Lake City, UT, USA. ·Osteoporos Int · Pubmed #28756457.

ABSTRACT: This study compares four screening tools in their ability to predict osteoporosis. We found that there was no significant difference between the tools. These results provide support for the use of automated screening tools which work in conjunction with the electronic medical record and help improve screening rates for osteoporosis. INTRODUCTION: The purpose of this study is to compare the performance of four fracture risk assessment tools (FRATs) in identifying osteoporosis by bone mineral density (BMD) T-score: Veterans Affairs Fracture Absolute Risk Assessment Tool (VA-FARA), World Health Organization's Fracture Risk Assessment Tool (FRAX), electronic FRAX (e-FRAX), and Osteoporosis Self-Assessment Screening Tool (OST). METHODS: We performed a cross-sectional analysis of all patients enrolled in the VA Salt Lake City bone health team (BHT) who had completed a DXA scan between February 1, 2012, and February 1, 2013. DXA scan results were obtained by chart abstraction. For calculation of FRAX, osteoporosis risk factors were obtained from a screening questionnaire completed prior to DXA. For VA-FARA and e-FRAX, risk factors were derived from the electronic medical record (EMR). Clinical risk scores were calculated and compared against the gold standard of DXA-based osteoporosis. Sensitivity, specificity, and predictive values were calculated. Receiver operator characteristic (ROC) curves were plotted, and areas under the curve (AUC) were compared. RESULTS: A cohort of 463 patients met eligibility criteria (mean age 80.4 years). One hundred twelve patients (24%) had osteoporosis as defined by DXA T-score ≤-2.5. Sensitivity, specificity, and predictive values were calculated. ROC statistics were compared and did not reach statistical significance difference between FRATs in identifying DXA-based osteoporosis. CONCLUSIONS: Our study suggests that all FRATs tested perform similarly in identifying osteoporosis among elderly, primarily Caucasian, male veterans. If these electronic screening methods perform similarly for fracture outcomes, they could replace manual FRAX and thus improve efficiency in identifying individuals who should be sent for DXA scan.

21 Article RON kinase: A target for treatment of cancer-induced bone destruction and osteoporosis. 2017

Andrade, Kelsi / Fornetti, Jaime / Zhao, Ling / Miller, Scott C / Randall, R Lor / Anderson, Neysi / Waltz, Susan E / McHale, Mark / Welm, Alana L. ·Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA. · Department of Radiology and Imaging Sciences, Division of Radiobiology, University of Utah, Salt Lake City, UT 84112, USA. · Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA. · Department of Cancer and Cell Biology, University of Cincinnati and Cincinnati Veterans Affairs Medical Center, Cincinnati, OH 45267, USA. · Aslan Pharmaceuticals, Singapore 089824, Singapore. · Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA. alana.welm@hci.utah.edu. ·Sci Transl Med · Pubmed #28123075.

ABSTRACT: Bone destruction occurs in aging and numerous diseases, including osteoporosis and cancer. Many cancer patients have bone osteolysis that is refractory to state-of-the-art treatments, which block osteoclast activity with bisphosphonates or by inhibiting the receptor activator of nuclear factor κB ligand (RANKL) pathway. We previously showed that macrophage-stimulating protein (MSP) signaling, which is elevated in about 40% of breast cancers, promotes osteolytic bone metastasis by activation of the MSP signaling pathway in tumor cells or in the bone microenvironment. We show that MSP signals through its receptor, RON tyrosine kinase, expressed on host cells, to activate osteoclasts directly by a previously undescribed pathway that is complementary to RANKL signaling and converges on proto-oncogene, non-receptor tyrosine kinase SRC (SRC). Genetic or pharmacologic inhibition of RON kinase blocked cancer-mediated bone destruction and osteoporosis in several mouse models. Furthermore, the RON kinase inhibitor BMS-777607/ASLAN002 altered markers of bone turnover in a first-in-human clinical cancer study, indicating the inhibitor's potential for normalizing bone loss in patients. These findings uncover a new therapeutic target for pathogenic bone loss and provide a rationale for treatment of bone destruction in various diseases with RON inhibitors.

22 Article The Bone Health Team: A Team-Based Approach to Improving Osteoporosis Care for Primary Care Patients. 2017

Lawrence, Phillip T / Grotzke, Marissa P / Rosenblum, Yanina / Nelson, Richard E / LaFleur, Joanne / Miller, Karla L / Ma, Junjie / Cannon, Grant W. ·1 Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA. · 2 Roseman University of Health Sciences, South Jordan, UT, USA. · 3 University of Utah, Salt Lake City, UT, USA. ·J Prim Care Community Health · Pubmed #28093017.

ABSTRACT: BACKGROUND: Significant improvements in secondary prevention of osteoporotic fractures have been noted with fracture liaison services. However, similar models for the primary prevention of such fractures have not been reported. OBJECTIVE: To determine the impact of a Bone Health Team (BHT) on osteoporosis screening and treatment rates in U.S. veterans in primary care practices. DESIGN: Historical cohort study of a primary care-based intervention of a BHT from February 2013 to February 2015. SETTING: Community-based outpatient clinics of the Salt Lake City Veterans Affairs Health Care System. PARTICIPANTS: Men aged 70 years and older and women aged 65 years and older. INTERVENTION: Enrollment in the BHT. MEASUREMENTS: Rates of dual energy x-ray absorptiometry (DXA) completion, chart diagnosis of osteoporosis or osteopenia, completion of vitamin D measurement, and initiation of fracture reducing medication. RESULTS: Our cohort consisted of 7644 individuals, 975 of whom were exposed to the BHT and 6669 of whom were not. Comparison of patients exposed to the BHT versus non-exposed subjects demonstrated a substantial increase in all outcome measures studied. Hazard ratios (HRs) from multivariable cox proportional hazard models were: measurement of vitamin D, HR = 1.619 ( P < .001); chart diagnosis of osteopenia, HR = 37.00 ( P < .001); chart diagnosis of osteoporosis, HR = 16.38 ( P < .001); osteoporosis medication, HR = 17.03 ( P < .001); and completion of DXA, HR = 139.9 ( P < .001). CONCLUSIONS AND RELEVANCE: The implementation of a dedicated BHT produced significantly increased rates of intermediate osteoporosis outcome measures in US veterans in primary care practices. Additional research describing medication adherence rates and cost-effectiveness is forthcoming.

23 Article Reduced prealbumin is associated with bone mineral density in women with osteoporosis. 2017

Li, Xue-Song / Zhang, Ji-Rong / Zhao, Yi-Lin / Li, Ying / Sun, Yuxiang / Liu, Tiemin / Wang, Rui-Tao. ·Department of Orthopedics, The First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. · International Physical Examination and Healthy Center, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. · Harbin Medical University (Da Qing), Harbin, Heilongjiang, China. · Children's Nutrition Research Center, Huffington Center on Aging, Departments of Pediatrics & Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas. · Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas. · Department of Internal Medicine, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. Electronic address: Ruitaowang@126.com. ·Nutrition · Pubmed #27727007.

ABSTRACT: OBJECTIVES: Poor nutritional status is associated with osteoporosis (OP) in postmenopausal women. Moreover, recent studies documented that prealbumin is the best and most widely used parameter to monitor nutrition intervention and is a sensitive predictor of short-term outcome compared with albumin. Therefore, the aim of this study was to examine the association of prealbumin levels with bone mineral density (BMD) in patients with OP. METHODS: This cross-sectional study recruited 664 women. Prealbumin levels and BMD at femoral neck and lumbar spine were measured. Multiple linear regression analysis was performed to assess the correlation between prealbumin and BMD. RESULTS: Results of this study found that prealbumin levels dropped gradually as BMD decreased. Furthermore, partial correlation analysis revealed that prealbumin was correlated with BMD after adjusting for confounders. Multiple linear regression analysis showed that prealbumin is a significant factor for reduced BMD in women (for BMD at spine L2-4, β = 0.186, P < 0.001; for BMD at femoral neck, β = 0.180, P < 0.001). CONCLUSION: Prealbumin was significantly correlated with BMD after adjusting for traditional cardiovascular risk factors. Further prospective research is warranted to further enhance our understanding of the important role of prealbumin in OP.

24 Article Bone mineral density is associated with left ventricular diastolic function in women. 2016

Wang, Rui-Tao / Li, Xue-Song / Zhang, Ji-Rong / Sun, Yuxiang / Yu, Kai-Jiang / Liu, Tiemin. ·Department of Internal Medicine, Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. · Department of Orthopedics, First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. · Department of Geriatrics, Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. · Children's Nutrition Research Center, Huffington Center on Aging, Departments of Pediatrics & Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas. · Department of Intensive Care, Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. · Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas. ·Clin Cardiol · Pubmed #27716992.

ABSTRACT: BACKGROUND: Low bone mineral density (BMD) and left ventricular (LV) diastolic function are associated with heart failure. However, little is known about the association between BMD and LV diastolic function. HYPOTHESIS: BMD is independently related to LV diastolic function in women. METHODS: We conducted a cross-sectional study of 432 women. Brachial-ankle pulse wave velocity (baPWV) and BMD measurements were performed. LV diastolic function and structure were assessed by echocardiographic examination. RESULTS: BaPWV and the percentage of LV diastolic dysfunction increased with progressive bone loss. Moreover, partial correlation analysis demonstrated that BMD at spine L2-4 and at femoral neck were correlated with baPWV and LV diastolic function parameters after adjusting covariates. Multivariate logistic regression analysis revealed that osteoporosis was independently associated with LV diastolic dysfunction in women. CONCLUSIONS: Osteoporosis is independently associated with LV diastolic dysfunction in women. A prospective study is needed to elucidate the effects of BMD on cardiac function in women.

25 Article Increased bone turnover, osteoporosis, progressive tibial bowing, fractures, and scoliosis in a patient with a final-exon SATB2 frameshift mutation. 2016

Boone, Philip M / Chan, Yiu Man / Hunter, Jill V / Pottkotter, Louis E / Davino, Nelson A / Yang, Yaping / Beuten, Joke / Bacino, Carlos A. ·Department of Molecular and Human Genetics, Baylor College of Medicine. · Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China. · Texas Children's Hospital, Houston, Texas. · Department of Orthopedic Surgery, UT Health Science Center at Houston, Houston, Texas. · Medical Genetics Laboratories, Baylor College of Medicine, Houston, Texas. · Department of Molecular and Human Genetics, Baylor College of Medicine. cbacino@bcm.edu. · Texas Children's Hospital, Houston, Texas. cbacino@bcm.edu. · Medical Genetics Laboratories, Baylor College of Medicine, Houston, Texas. cbacino@bcm.edu. ·Am J Med Genet A · Pubmed #27409069.

ABSTRACT: Haploinsufficiency of SATB2 causes cleft palate, intellectual disability with deficient speech, facial and dental abnormalities, and other variable features known collectively as SATB2-associated syndrome. This phenotype was accompanied by osteoporosis, fractures, and tibial bowing in two previously reported adult patients; each possessed SATB2 mutations either predicted or demonstrated to escape nonsense-mediated decay, suggesting that the additional bone defects result from a dominant negative effect and/or age-dependent penetrance. These hypotheses remain to be confirmed, as do the specific downstream defects causing bone abnormalities. We report a SATB2 mutation (c.2018dupA; p.(H673fs)) in a 15-year-old patient whose SATB2-associated syndrome phenotype is accompanied by osteoporosis, fractures, progressive tibial bowing, and scoliosis. As this homeodomain-disrupting and predicted truncating mutation resides within the final exon of SATB2, escape from nonsense-mediated decay is likely. Thus, we provide further evidence of bone phenotypes beyond those typically associated with SATB2-associated syndrome in individuals with potential dominant-negative SATB2 alleles, as well as evidence for age-dependence of bone features. Elevations in alkaline phosphatase, urinary N-telopeptide/creatinine ratio, and osteocalcin in the patient indicate increased bone turnover. We propose surveillance and treatment with osteoclast inhibitors to prevent fractures and to slow progressive bone deformities. © 2016 Wiley Periodicals, Inc.