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Osteoporosis: HELP
Articles from Denver
Based on 195 articles published since 2009

These are the 195 published articles about Osteoporosis that originated from Denver during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Guideline Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters. 2017

Ketteler, Markus / Block, Geoffrey A / Evenepoel, Pieter / Fukagawa, Masafumi / Herzog, Charles A / McCann, Linda / Moe, Sharon M / Shroff, Rukshana / Tonelli, Marcello A / Toussaint, Nigel D / Vervloet, Marc G / Leonard, Mary B. ·Klinikum Coburg, Coburg, Germany. Electronic address: markus.ketteler@klinikum-coburg.de. · Denver Nephrology, Denver, Colorado, USA. · University Hospitals Leuven, Leuven, Belgium. · Tokai University School of Medicine, Isehara, Japan. · Hennepin County Medical Center, Minneapolis, Minnesota, USA. · Eagle, Idaho, USA. · Indiana University School of Medicine, Indianapolis, Indiana, USA; Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA. · Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK. · University of Calgary, Calgary, Canada. · The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia. · VU University Medical Center Amsterdam, Amsterdam, The Netherlands. · Stanford University School of Medicine, Stanford, California, USA. Electronic address: leonard5@stanford.edu. ·Kidney Int · Pubmed #28646995.

ABSTRACT: The KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of CKD-MBD represents a selective update of the prior CKD-MBD Guideline published in 2009. This update, along with the 2009 publication, is intended to assist the practitioner caring for adults and children with chronic kidney disease (CKD), those on chronic dialysis therapy, or individuals with a kidney transplant. This review highlights key aspects of the 2017 CKD-MBD Guideline Update, with an emphasis on the rationale for the changes made to the original guideline document. Topic areas encompassing updated recommendations include diagnosis of bone abnormalities in CKD-mineral and bone disorder (MBD), treatment of CKD-MBD by targeting phosphate lowering and calcium maintenance, treatment of abnormalities in parathyroid hormone in CKD-MBD, treatment of bone abnormalities by antiresorptives and other osteoporosis therapies, and evaluation and treatment of kidney transplant bone disease.

2 Editorial Response to the American College of Physicians Osteoporosis Guideline, 2017 Update. 2017

Caplan, Liron / Hansen, Karen E / Saag, Kenneth G. ·University of Colorado Denver School of Medicine and Denver Veterans Affairs Medical Center, Denver, Colorado. · University of Wisconsin School of Medicine & Public Health, Madison. · University of Alabama at Birmingham. ·Arthritis Rheumatol · Pubmed #28881479.

ABSTRACT: -- No abstract --

3 Editorial Bone Density Testing Is the Best Way to Monitor Osteoporosis Treatment. 2017

Rothman, Micol S / Lewiecki, E Michael / Miller, Paul D. ·University of Colorado School of Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,Aurora, Colo. Electronic address: Micol.Rothman@ucdenver.edu. · New Mexico Clinical Research & Osteoporosis Center,Albuquerque, NM. · Colorado Center for Bone Research,Lakewood, Colo. ·Am J Med · Pubmed #28687261.

ABSTRACT: -- No abstract --

4 Review Proceedings of the 2019 Santa Fe Bone Symposium: New Concepts in the Care of Osteoporosis and Rare Bone Diseases. 2019

Lewiecki, E Michael / Bilezikian, John P / Kagan, Risa / Krakow, Deborah / McClung, Michael R / Miller, Paul D / Rush, Eric T / Shuhart, Christopher R / Watts, Nelson B / Yu, Elaine W. ·New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. Electronic address: mlewiecki@gmail.com. · Columbia University College of Physicians and Surgeons, NYC, NY, USA. · UCSF and Sutter East Bay Medical Foundation, Berkeley, CA, USA. · University of California Los Angeles, Los Angeles, CA, USA. · Oregon Osteoporosis Center, Portland, OR, USA; Mary MacKillop Center for Health Research, Australian Catholic University, Melbourne, VIC, Australia. · University of Colorado Health Sciences Center, Denver, CO, USA. · University of Kansas Medical Center, Kansas City, MO, USA; Children's Mercy Hospital, Kansas City, MO, USA; University of Missouri - Kansas City, Kansas City, MO, USA. · Swedish Medical Center, Seattle, WA, USA. · Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA. · Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. ·J Clin Densitom · Pubmed #31685420.

ABSTRACT: The 20th annual Santa Fe Bone Symposium was held August 9-10, 2019, in Santa Fe, New Mexico, USA. This is an annual meeting devoted to clinical applications of recent advances in skeletal research that impact the care of patients with osteoporosis, metabolic bone diseases, and inherited bone diseases. Participants included practicing and academic physicians, fellows, advanced practice providers, fracture liaison service (FLS) coordinators, clinical researchers, and bone density technologists. The symposium consisted of lectures, case presentations, and panel discussions, with an emphasis on learning through interaction of all attendees. Topics included new approaches in the use of anabolic agents for the treatment osteoporosis, a review of important events in skeletal health over the past year, new and emerging treatments for rare bone diseases, the use of genetic testing for bone diseases in clinical practice, medication-associated causes of osteoporosis, new concepts in the use of estrogen therapy for osteoporosis, new Official Positions of the International Society for Clinical Densitometry, skeletal consequences of bariatric surgery, and update on the progress and potential of Bone Health TeleECHO, a virtual community of practice using videoconferencing technology to link healthcare professionals for advancing the care of osteoporosis worldwide. Sessions on rare bone diseases were developed in collaboration with the Rare Bone Disease Alliance. Symposium premeetings included an FLS workshop by the National Osteoporosis Foundation and others devoted to the use of new therapeutic agents for the care of osteoporosis and related disorders.

5 Review Prophylactic treatment of osteoporosis after SCI: promising research, but not yet indicated. 2019

Anderson, Dustin / Park, Andrew J. ·Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO USA. ·Spinal Cord Ser Cases · Pubmed #31666986.

ABSTRACT: In persons with spinal cord injury (SCI), osteoporosis and associated fragility fractures are a prevalent phenomenon with clinically meaningful morbidity and mortality. Prevention of osteoporosis utilizing both physical modalities and pharmacological therapies is an area of high-clinical importance. In our perspective, the current body of research cannot provide clear guidance on prophylactic interventions to prevent osteoporosis specifically to stratify SCI subjects to their risk for fragility fractures. Without this critical research, clinicians cannot weigh the risk versus benefits of interventions, such as bisphosphonates, which is not a benign treatment. Other treatments such as physical modalities provide little risk and have other therapeutic benefit. This perspective is an argument that the current research does not indicate prophylactic pharmacological intervention to prevent osteoporosis in the SCI population.

6 Review Western Osteoporosis Alliance Clinical Practice Series: Treat-to-Target for Osteoporosis. 2019

Lewiecki, E Michael / Kendler, David L / Davison, K Shawn / Hanley, David A / Harris, Steven T / McClung, Michael R / Miller, Paul D. ·New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM. Electronic address: mlewiecki@gmail.com. · Department of Medicine (Endocrinology), University of British Columbia, Vancouver, Canada. · A Priori Medical Sciences, Inc., Victoria, British Columbia, Canada. · Departments of Medicine, Community Health Sciences, and Oncology, Cumming School of Medicine and McCaig Institute for Bone and Joint Health Cumming School of Medicine, The University of Calgary, Calgary, Alberta, Canada. · University of California, San Francisco, CA. · Oregon Osteoporosis Center and Oregon Health & Science University, Portland, OR; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia. · Colorado Center for Bone Research, Lakewood, CO. ·Am J Med · Pubmed #31152714.

ABSTRACT: Patients often start treatment to reduce fracture risk because of a bone mineral density T-score consistent with osteoporosis (≤ -2.5). Others with a T-score above -2.5 may be treated when there is a history of fragility fracture or when a fracture risk algorithm categorizes them as having a high risk for fracture. It is common to initiate therapy with a generic oral bisphosphonate, unless contraindicated, and continue therapy if the patient is responding as assessed by stability or an increase in bone mineral density. However, some patients may respond well to an oral bisphosphonate, yet remain with an unacceptably high risk for fracture. Recognition of this occurrence has led to the development of an alternative strategy: treat-to-target. This involves identifying a biological marker (treatment target) that represents an acceptable fracture risk and then initiating treatment with an agent likely to reach this target. If the patient is on a path to reaching the target with initial therapy, treatment is continued. If it appears the target will not be reached with initial therapy, treatment is changed to an agent more likely to achieve the goal.

7 Review Proceedings of the 2018 Santa Fe Bone Symposium: Advances in the Management of Osteoporosis. 2019

Lewiecki, E Michael / Bilezikian, John P / Giangregorio, Lora / Greenspan, Susan L / Khosla, Sundeep / Kostenuik, Paul / Krohn, Kelly / McClung, Michael R / Miller, Paul D / Pacifici, Roberto. ·New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. Electronic address: mlewiecki@gmail.com. · Columbia University College of Physicians and Surgeons, NYC, NY, USA. · University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada. · University of Pittsburgh, Pittsburgh, PA, USA. · Mayo Clinic College of Medicine, Rochester, MN, USA. · Phylon Pharma Services, Newbury Park, CA, USA. · The CORE Institute, Phoenix, AZ, USA. · Oregon Osteoporosis Center, Portland, OR, USA; MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia. · University of Colorado Health Sciences Center, Denver, CO, USA. · Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University, Atlanta, GA, USA. ·J Clin Densitom · Pubmed #30366683.

ABSTRACT: The Santa Fe Bone Symposium is an annual meeting devoted to clinical applications of recent advances in skeletal research. The 19th Santa Fe Bone Symposium convened August 3-4, 2018, in Santa Fe, New Mexico, USA. Attendees included physicians of many specialties, fellows in training, advanced practice providers, clinical researchers, and bone density technologists. The format consisted of lectures, case presentations by endocrinology fellows, and panel discussions, with all involving extensive interactive discussions. Topics were diverse, including an evolutionary history of calcium homeostasis, osteoporosis treatment in the very old, optimizing outcomes with orthopedic surgery, microbiome and bone, new strategies for combination and sequential therapy of osteoporosis, exercise as medicine, manifestations of parathyroid hormone excess and deficiency, parathyroid hormone as a therapeutic agent, cell senescence and bone health, and managing patients outside clinical practice guidelines. The National Bone Health Alliance conducted a premeeting on development of fracture liaison services. A workshop was devoted to Bone Health TeleECHO (Bone Health Extension for Community Healthcare Outcomes), a strategy of ongoing medical education for healthcare professions to expand capacity to deliver best practice skeletal healthcare in underserved communities and reduce the osteoporosis treatment gap.

8 Review Imaging Advances in Chronic Obstructive Pulmonary Disease. Insights from the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) Study. 2019

Bhatt, Surya P / Washko, George R / Hoffman, Eric A / Newell, John D / Bodduluri, Sandeep / Diaz, Alejandro A / Galban, Craig J / Silverman, Edwin K / San José Estépar, Raúl / Lynch, David A. ·1 UAB Lung Imaging Core and UAB Lung Health Center, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama. · 2 Division of Pulmonary and Critical Care Medicine. · 3 Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa. · 4 Department of Radiology and Center for Molecular Imaging, University of Michigan, Ann Arbor, Michigan; and. · 5 Channing Division of Network Medicine, and. · 6 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · 7 Department of Radiology, National Jewish Health, Denver, Colorado. ·Am J Respir Crit Care Med · Pubmed #30304637.

ABSTRACT: The Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) study, which began in 2007, is an ongoing multicenter observational cohort study of more than 10,000 current and former smokers. The study is aimed at understanding the etiology, progression, and heterogeneity of chronic obstructive pulmonary disease (COPD). In addition to genetic analysis, the participants have been extensively characterized by clinical questionnaires, spirometry, volumetric inspiratory and expiratory computed tomography, and longitudinal follow-up, including follow-up computed tomography at 5 years after enrollment. The purpose of this state-of-the-art review is to summarize the major advances in our understanding of COPD resulting from the imaging findings in the COPDGene study. Imaging features that are associated with adverse clinical outcomes include early interstitial lung abnormalities, visual presence and pattern of emphysema, the ratio of pulmonary artery to ascending aortic diameter, quantitative evaluation of emphysema, airway wall thickness, and expiratory gas trapping. COPD is characterized by the early involvement of the small conducting airways, and the addition of expiratory scans has enabled measurement of small airway disease. Computational advances have enabled indirect measurement of nonemphysematous gas trapping. These metrics have provided insights into the pathogenesis and prognosis of COPD and have aided early identification of disease. Important quantifiable extrapulmonary findings include coronary artery calcification, cardiac morphology, intrathoracic and extrathoracic fat, and osteoporosis. Current active research includes identification of novel quantitative measures for emphysema and airway disease, evaluation of dose reduction techniques, and use of deep learning for phenotyping COPD.

9 Review Bone health in type 1 diabetes. 2018

Shah, Viral N / Carpenter, R Dana / Ferguson, Virginia L / Schwartz, Ann V. ·Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO. · Department of Mechanical Engineering, University of Colorado Denver. · Department of Mechanical Engineering, University of Colorado Boulder. · Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA. ·Curr Opin Endocrinol Diabetes Obes · Pubmed #29794498.

ABSTRACT: PURPOSE OF REVIEW: This article reviews recent publications on the effect of type 1 diabetes (T1D) on fracture risk, bone mineral density (BMD), bone structure, and bone tissue quality. Possible fracture prevention strategies for patients with T1D have also been reviewed. RECENT FINDINGS: T1D is associated with substantially elevated fracture risk and modestly low BMD at the femoral neck. However, BMD alone does not explain higher observed fracture risk in T1D. T1D also affects bone macro- and microstructure, characterized by thinner cortices and trabecular bone changes such as thinner and more widely spaced trabeculae. Structural bone deficit is pronounced in the presence of microvascular complications. Tissue-level changes, such as accumulation of advanced glycation endproducts, detrimental alterations of the mineral phase because of low bone turnover, and occlusion of vascular channels in bone by mineralized tissue, are implicated in pathophysiology of bone fragility in T1D. There are no guidelines on screening and prevention of osteoporotic fractures in T1D. SUMMARY: More studies are needed to understand the influence of T1D on structural bone quality and tissue material properties. There is a need for a prospective study to evaluate better screening strategies for diagnosis and treatment of osteoporosis in T1D.

10 Review The biology of fracture healing in osteoporosis and in the presence of anti-osteoporotic drugs. 2018

Hak, David J. ·Orthopedic Surgery Denver Health/University of Colorado, 777 Bannock Street MC 0188, Denver, CO 80204 USA. Electronic address: david.hak@dhha.org. ·Injury · Pubmed #29709376.

ABSTRACT: Compromised bone strength in osteoporosis predisposes patients to an increased fracture risk. The management of these fractures is complicated due to the poor bone quality, which may lead to inadequate fixation strength and stability. While a number of studies using osteoporotic animal models have shown a detrimental impact on fracture healing, clinical evidence regarding whether fracture healing is impaired in the presence of osteoporosis is complicated by numerous associated conditions including advancing age. The mechanism of some anti-osteoporotic medications creates concern about a potential detrimental impact on fracture healing, while others appear to enhance fracture healing. The current evidence indicates that the beneficial effects of anti-osteoporosis treatment exceeds any concerns about possible adverse consequences on fracture healing in most circumstances.

11 Review Critical gaps in the medical knowledge base of eating disorders. 2018

Gibson, Dennis / Drabkin, Anne / Krantz, Mori J / Mascolo, Margherita / Rosen, Elissa / Sachs, Katherine / Welles, Christine / Mehler, Philip S. ·ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA. · Division of Cardiology, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA. · ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA. Philip.Mehler@dhha.org. · Eating Recovery Center, Denver, 7351E Lowry Blvd, Denver, CO, 80230, USA. Philip.Mehler@dhha.org. · , Denver, USA. Philip.Mehler@dhha.org. ·Eat Weight Disord · Pubmed #29681012.

ABSTRACT: Eating disorders are unique in that they inherently have much medical comorbidity both as a part of restricting-type eating disorders and those characterized by purging behaviors. Over the last three decades, remarkable progress has been made in the understanding and treatment of the medical complications of eating disorders. Yet, unfortunately, there is much research that is sorely needed to bridge the gap between current medical knowledge and more effective and evidence-based medical treatment knowledge. These gaps exist in many different clinical areas including cardiology, electrolytes, gastrointestinal and bone disease. In this paper, we discuss some of the knowledge gap areas, which if bridged would help develop more effective medical intervention for this population of patients.

12 Review Fshb Knockout Mouse Model, Two Decades Later and Into the Future. 2018

Kumar, T Rajendra. ·Department of Obstetrics and Gynecology, Division of Reproductive Sciences, University of Colorado at Denver, Anschutz Medical Campus, Aurora, Colorado. · Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Colorado at Denver, Anschutz Medical Campus, Aurora, Colorado. ·Endocrinology · Pubmed #29579177.

ABSTRACT: In 1997, nearly 20 years ago, we reported the phenotypes of follicle-stimulating hormone (FSH) β (Fshb) null mice. Since then, these mice have been useful for various physiological and genetic studies in reproductive and skeletal biology. In a 2009 review titled "FSHβ Knockout Mouse Model: A Decade Ago and Into the Future," I summarized the need for and what led to the development of an FSH-deficient mouse model and its applications, including delineation of the emerging extragonadal roles of FSH in bone cells by using this genetic model. These studies opened up exciting avenues of research on osteoporosis and now extend into those on adiposity in postmenopausal women. Here, I summarize the progress made with this mouse model since 2009 with regard to FSH rerouting in vivo, deciphering the role of N-glycosylation on FSHβ, roles of FSH in somatic-germ cell interactions in gonads, and provide a road map that is anticipated to emerge in the near future. Undoubtedly, the next 10 years should be an even more exciting time to explore the fertile area of FSH biology and its implications for basic and clinical reproductive physiology research.

13 Review Novel treatment strategies for chronic kidney disease: insights from the animal kingdom. 2018

Stenvinkel, Peter / Painer, Johanna / Kuro-O, Makoto / Lanaspa, Miguel / Arnold, Walter / Ruf, Thomas / Shiels, Paul G / Johnson, Richard J. ·Divison of Renal Medicine M99, Karolinska University Hospital, Karolinska Institutet, Hälsovägen 13, 14157 Stockholm, Sweden. · Konrad Lorenz Institute of Ethology and Research Institute of Wildlife Ecology, Department of Integrative Biology and Evolution at the University of Veterinary Medicine, Savoyenstreet 1, 1160 Vienna, Austria. · Division of Anti-Aging Medicine, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. · Division of Renal Diseases and Hypertension, 12700 East 19th Avenue, Room 7015 Mail Stop C281, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, USA. · Wolfson Wohl Translational Research Centre, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1QH, UK. ·Nat Rev Nephrol · Pubmed #29332935.

ABSTRACT: Many of the >2 million animal species that inhabit Earth have developed survival mechanisms that aid in the prevention of obesity, kidney disease, starvation, dehydration and vascular ageing; however, some animals remain susceptible to these complications. Domestic and captive wild felids, for example, show susceptibility to chronic kidney disease (CKD), potentially linked to the high protein intake of these animals. By contrast, naked mole rats are a model of longevity and are protected from extreme environmental conditions through mechanisms that provide resistance to oxidative stress. Biomimetic studies suggest that the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) offers protection in extreme environmental conditions and promotes longevity in the animal kingdom. Similarly, during months of fasting, immobilization and anuria, hibernating bears are protected from muscle wasting, azotaemia, thrombotic complications, organ damage and osteoporosis - features that are often associated with CKD. Improved understanding of the susceptibility and protective mechanisms of these animals and others could provide insights into novel strategies to prevent and treat several human diseases, such as CKD and ageing-associated complications. An integrated collaboration between nephrologists and experts from other fields, such as veterinarians, zoologists, biologists, anthropologists and ecologists, could introduce a novel approach for improving human health and help nephrologists to find novel treatment strategies for CKD.

14 Review Can Biomarkers Advance HIV Research and Care in the Antiretroviral Therapy Era? 2018

Justice, Amy C / Erlandson, Kristine M / Hunt, Peter W / Landay, Alan / Miotti, Paolo / Tracy, Russell P. ·VA Connecticut Healthcare System West Haven, Yale University, New Haven, Connecticut. · School of Medicine, Yale University, New Haven, Connecticut. · School of Public Health, Yale University, New Haven, Connecticut. · Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora. · Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora. · Division of Experimental Medicine, Department of Medicine, University of California-San Francisco. · Department of Microbial Pathogens and Immunity, Rush University Medical Center, Chicago, Illinois. · Office of AIDS Research, National Institutes of Health, Bethesda, Maryland. · Department of Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Colchester. · Department of Biochemistry, University of Vermont Larner College of Medicine, Colchester. ·J Infect Dis · Pubmed #29165684.

ABSTRACT: Despite achieving human immunodeficiency virus type 1 (HIV-1) RNA suppression below levels of detection and, for most, improved CD4+ T-cell counts, those aging with HIV experience excess low-level inflammation, hypercoagulability, and immune dysfunction (chronic inflammation), compared with demographically and behaviorally similar uninfected individuals. A host of biomarkers that are linked to chronic inflammation are also associated with HIV-associated non-AIDS-defining events, including cardiovascular disease, many forms of cancer, liver disease, renal disease, neurocognitive decline, and osteoporosis. Furthermore, chronic HIV infection may interact with long-term treatment toxicity and weight gain after ART initiation. These observations suggest that future biomarker-guided discovery and treatment may require attention to multiple biomarkers and, possibly, weighted indices. We are clinical trialists, epidemiologists, pragmatic trialists, and translational scientists. Together, we offer an operational definition of a biomarker and consider how biomarkers might facilitate progress along the translational pathway from therapeutic discovery to intervention trials and clinical management among people aging with or without HIV infection.

15 Review Co-occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. 2018

Capone, George T / Chicoine, Brian / Bulova, Peter / Stephens, Mary / Hart, Sarah / Crissman, Blythe / Videlefsky, Andrea / Myers, Katherine / Roizen, Nancy / Esbensen, Anna / Peterson, Moya / Santoro, Stephanie / Woodward, Jason / Martin, Barry / Smith, David / Anonymous7580926. ·Kennedy Krieger Institute, Down Syndrome Clinic & Research Center, Baltimore, Maryland. · Advocate Adult Down Syndrome Center, Park Ridge, Illinois. · Montefiore Hospital, Adult Down Syndrome Clinic, Pittsburgh, Pennsylvania. · Christiana Care Health System, Adult Down Syndrome Clinic, Wilmington, Delaware. · Duke University Medical Center, Durham, North Carolina. · The Adult Disability Medical Home, Urban Family Practice, Marietta, Georgia. · Rainbow Babies and Children's Hospital, Cleveland, Ohio. · Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Jane and Richard Thomas Center for Down Syndrome, Cincinnati, Ohio. · University of Kansas Medical Center, Adults with Down Syndrome Specialty Clinic, Kansas City, Kansas. · Nationwide Children's Hospital, Columbus, Ohio. · Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado. · Children's Hospital of Wisconsin, Down Syndrome Clinic of Wisconsin, Milwaukee, Wisconsin. ·Am J Med Genet A · Pubmed #29130597.

ABSTRACT: Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. The United States Preventive Service Task Force (USPSTF) has developed criteria for prioritizing conditions of public health importance with the potential for providing screening recommendations to improve clinical care. The quality of existing evidence needed to inform clinical guidelines has not been previously reviewed. Using the National Library of Medicine (NLM) database PubMed, we first identified 18 peer reviewed articles that addressed co-occurring medical conditions in adults with DS. Those conditions discussed in over half of the articles were prioritized for further review. Second, we performed detailed literature searches on these specific conditions. To inform the search strategy and review process a series of key questions were formulated a priori. The quality of available evidence was then graded and knowledge gaps were identified. The number of participating adults and the design of clinical studies varied by condition and were often inadequate for answering all of our key questions. We provide data on thyroid disease, cervical spine disease, hearing impairment, overweight-obesity, sleep apnea, congenital heart disease, and osteopenia-osteoporosis. Minimal evidence demonstrates massive gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The development of evidence-based clinical guidance will require an expanded clinical knowledge-base in order to move forward.

16 Review Basics of bone metabolism and osteoporosis in common pediatric neuromuscular disabilities. 2018

Yaşar, Evren / Adigüzel, Emre / Arslan, Mutluay / Matthews, Dennis J. ·Health Sciences University, Gülhane Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey. · Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey. Electronic address: dremreadiguzel@gmail.com. · Health Sciences University, Gülhane Medical School, Department of Pediatric Neurology, Ankara, Turkey. · Physical Medicine and Rehabilitation, Children's Hospital Colorado, Aurora, CO, USA. ·Eur J Paediatr Neurol · Pubmed #28830650.

ABSTRACT: Bone modeling is a process that starts with fetal life and continues during adolescence. Complex factors such as hormones, nutritional and environmental factors affect this process. In addition to these factors, physical conditioning and medications that have toxic effects on bony tissue should be carefully considered in patient follow-up. Osteoporosis is a significant problem in pediatric population because of ongoing growth and development of skeletal system. Two types of osteoporosis are primary and secondary types and children with neuromuscular disabilities constitute a major group with secondary osteoporosis. Low bone mass in patients with cerebral palsy, spina bifida, and Duchenne muscular dystrophy cause increased bone fragility in even slight traumas. Maximizing peak bone mass and prevention of bone loss are very important to reduce the fracture risk in neuromuscular diseases. This article aims to review the determinants of bone physiology and bone loss in children with cerebral palsy, spina bifida, and Duchenne muscular dystrophy.

17 Review Assessment and clinical management of bone disease in adults with eating disorders: a review. 2017

Drabkin, Anne / Rothman, Micol S / Wassenaar, Elizabeth / Mascolo, Margherita / Mehler, Philip S. ·Denver Health and Hospital Authority, 660 Bannock MC 4000, Denver, CO 80204 USA. · 0000 0001 0369 638X · grid.239638.5 · University of Colorado Hospital, Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045 USA. · 0000 0001 0703 675X · grid.430503.1 · Eating Recovery Center, 7351 E. Lowry Blvd. Suite 200, Denver, CO 80230 USA. ·J Eat Disord · Pubmed #29214023.

ABSTRACT: Aim: To review current medical literature regarding the causes and clinical management options for low bone mineral density (BMD) in adult patients with eating disorders. Background: Low bone mineral density is a common complication of eating disorders with potentially lifelong debilitating consequences. Definitive, rigorous guidelines for screening, prevention and management are lacking. This article intends to provide a review of the literature to date and current options for prevention and treatment. Methods: Current, peer-reviewed literature was reviewed, interpreted and summarized. Conclusion: Any patient with lower than average BMD should weight restore and in premenopausal females, spontaneous menses should resume. Adequate vitamin D and calcium supplementation is important. Weight-bearing exercise should be avoided unless cautiously monitored by a treatment team in the setting of weight restoration. If a patient has a Z-score less than expected for age with a high fracture risk or likelihood of ongoing BMD loss, physiologic transdermal estrogen plus oral progesterone, bisphosphonates (alendronate or risedronate) or teriparatide could be considered. Other agents, such as denosumab and testosterone in men, have not been tested in eating-disordered populations and should only be trialed on an empiric basis if there is a high clinical concern for fractures or worsening bone mineral density. A rigorous peer-based approach to establish guidelines for evaluation and management of low bone mineral density is needed in this neglected subspecialty of eating disorders.

18 Review Managing and maintaining bone mineral density in diabetes patients with pharmacotherapy. 2017

Fixen, Cy W / Fixen, Danielle R. ·a Denver Veterans Affairs Medical Center , Denver , CO , USA. · b Department of Clinical Pharmacy , University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences , Aurora , USA. ·Expert Opin Pharmacother · Pubmed #29172834.

ABSTRACT: INTRODUCTION: The population of patients with osteoporosis and diabetes is increasing as the aging population increases. Loss of bone mineral density occurs in patients with diabetes, but is not always a priority in the practice setting. The aim of this review is to discuss clinical considerations when managing osteoporosis in patients with diabetes. Areas covered: The pathophysiology of decreased bone mineral density in patients with diabetes is discussed. Additionally, diabetic risk factors for fracture, such as hypoglycemia, the National Osteoporosis Foundation recommendations for osteoporosis, and secondary causes of osteoporosis, including disease and medication related causes, are discussed. Furthermore, recommendations for antihyperglycemic agents, thiazolidinediones, canagliflozin, insulin, metformin, and sitagliptin are discussed due to their effects on bone mineral density. Expert opinion: Even though diabetes is an important risk factor for osteoporosis, assessing bone health in diabetic patients is often overlooked. Ensuring adequate prevention and treatment strategies for osteoporosis is vitally important with our diabetic patients as the population ages. T-scores and FRAX scores likely underrepresent a diabetic patients risk for fracture, and this should be taken into consideration in treatment decisions. Future studies are needed to determine optimal pharmacologic treatment of hyperglycemia in this population.

19 Review Injuries to the Female Athlete in 2017: Part I: General Considerations, Concussions, Stress Fractures, and the Female Athlete Triad. 2017

Frank, Rachel M / Romeo, Anthony A / Bush-Joseph, Charles A / Bach, Bernard R. ·1Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado 2Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois. ·JBJS Rev · Pubmed #29028750.

ABSTRACT: -- No abstract --

20 Review Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence. 2017

Maes, Marina L / Fixen, Danielle R / Linnebur, Sunny Anne. ·Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA. · Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, 12850 E. Montview Blvd (C238), Aurora, CO 80045, USA. ·Ther Adv Drug Saf · Pubmed #28861211.

ABSTRACT: Proton-pump inhibitors (PPIs) are a widely prescribed class of medications used to treat acid-related disorders and use has significantly increased over the last few decades. PPIs are often inappropriately prescribed and since they have been on the market, a number of post-marketing studies have been published demonstrating associations between longer duration of PPI therapy and a number of adverse effects that are a concern in older adults. The objective of this review is to discuss the existing literature of potential adverse effects with long-term PPI use in older adults and to summarize the implications in clinical practice. A

21 Review Management of Spinal Conditions in Patients With Parkinson Disease. 2017

Baker, Joseph F / McClelland, Shearwood / Hart, Robert A / Bess, R Shay. ·From the Department of Orthopaedic Surgery, Waikato Hospital, Hamilton, New Zealand (Dr. Baker), NYU Hospital for Joint Diseases, New York, NY (Dr. McClelland), the Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR (Dr. Hart), and the Department of Orthopaedic Surgery, Presbyterian/St. Luke's Medical Center, Denver, CO (Dr. Bess). ·J Am Acad Orthop Surg · Pubmed #28692583.

ABSTRACT: Parkinson disease (PD) is increasingly prevalent in the aging population. Spine disorders in patients with PD may be degenerative in nature or may arise secondary to motor effects related to the parkinsonian disease process. Physicians providing care for patients with PD and spine pathologies must be aware of several factors that affect treatment, including the patterns of spinal deformity, complex drug interactions, and PD-associated osteoporosis. Following spine surgery, complication rates are higher in patients with PD than in those without the disease. Literature on spine surgery in this patient population is limited by small cohort size, the heterogeneous patient population, and variable treatment protocols. However, most studies emphasize the need for preoperative optimization of motor control with appropriate medications and deep brain stimulation, as well as consultation with a movement disorder specialist. Future studies must control for confounding variables, such as the type of surgery and PD severity, to improve understanding of spinal pathology and treatment options in this patient population.

22 Review Bone mineral density at femoral neck and lumbar spine in adults with type 1 diabetes: a meta-analysis and review of the literature. 2017

Shah, V N / Harrall, K K / Shah, C S / Gallo, T L / Joshee, P / Snell-Bergeon, J K / Kohrt, W M. ·Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Mail Stop A 140, Room 1318, Aurora, CO, 80045, USA. viral.shah@ucdenver.edu. · School of Pharmacy and Center for Women' Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. · SJM College of Pharmacy, Chitradurga, Karnataka, India. · Rocky Vista University, Parker, CO, USA. · Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Mail Stop A 140, Room 1318, Aurora, CO, 80045, USA. · Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. ·Osteoporos Int · Pubmed #28580510.

ABSTRACT: We performed a meta-analysis to evaluate the femoral neck and lumbar spine bone mineral density (BMD) in adults with type 1 diabetes (T1D) compared with controls. Adults with T1D have modestly lower BMD at femoral neck and lumbar spine than adults without diabetes. INTRODUCTION: Fracture risk is four to sixfold higher in adults with T1D. Since BMD is one of the major contributors for fracture risk, we performed a meta-analysis to evaluate differences in femoral neck and lumbar spine BMD between adults with T1D and controls. METHODS: MEDLINE, Ovid, and the Cochrane library and abstracts from various scientific meetings were searched. Studies reporting the femoral neck and/or lumbar spine BMD in adults (age > 20 years) with T1D in comparison with people without diabetes were selected. General linear mixed models were used to assess differences in BMD at femoral neck and lumbar spine between subjects with T1D and controls adjusting for age, sex, and dual x-ray absorptiometry (DXA) instruments. RESULTS: Sixteen studies met the inclusion criteria. The femoral neck BMD was modestly lower in adults with T1D compared to controls (-0.055 g/cm CONCLUSION: Femoral neck and lumbar spine BMD were modestly lower in adults with T1D compared to controls. However, this modest reduction in femoral neck and lumbar spine BMD cannot explain much higher observed fracture risk in adults with T1D.

23 Review Western Osteoporosis Alliance Clinical Practice Series: Evaluating the Balance of Benefits and Risks of Long-Term Osteoporosis Therapies. 2017

Hanley, David A / McClung, Michael R / Davison, K Shawn / Dian, Larry / Harris, Steve T / Miller, Paul D / Lewiecki, E Michael / Kendler, David L / Anonymous7240901. ·Departments of Medicine, Oncology, and Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada. Electronic address: dahanley@ucalgary.ca. · Oregon Osteoporosis Center, Portland; Institute of Health and Ageing, Australian Catholic University, Melbourne, Australia. · A Priori Medical Sciences Inc, Victoria, BC, Canada. · Department of Medicine, University of British Columbia, Vancouver, Canada. · Department of Medicine, University of California, San Francisco. · Colorado Center for Bone Research, Lakewood. · New Mexico Clinical Research & Osteoporosis Center, Albuquerque. · Department of Medicine, University of British Columbia, Vancouver. ·Am J Med · Pubmed #28359721.

ABSTRACT: Osteoporosis is a chronic disease that requires life-long strategies to reduce fracture risk. Few trials have investigated the balance of benefits and risk with long-term use of osteoporosis therapies, and fewer still have investigated the consequences of treatment discontinuation. The best available evidence suggests that up to 10 years of treatment with an oral bisphosphonate maintains the degree of fracture risk reduction observed in the 3-year registration trials. With denosumab, 10 years of therapy appears to provide fracture risk reduction similar to or better than that observed in the 3-year registration trial. Available data suggest an increasing but low risk of fractures with atypical features with increasing duration of bisphosphonate therapy. Published data linking duration of therapy to osteonecrosis of the jaw are lacking for bisphosphonates and denosumab. Other side effects associated with denosumab or bisphosphonates do not appear to be related to therapy duration. The antifracture benefits of long-term therapy with bisphosphonates and denosumab in appropriately selected patients outweigh the low risk of serious side effects.

24 Review Physical Activity for Strengthening Fracture Prone Regions of the Proximal Femur. 2017

Fuchs, Robyn K / Kersh, Mariana E / Carballido-Gamio, Julio / Thompson, William R / Keyak, Joyce H / Warden, Stuart J. ·Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA. · Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA. · Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, USA. · Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical Engineering, University of California, Irvine, CA, USA. · Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA. stwarden@iu.edu. ·Curr Osteoporos Rep · Pubmed #28133707.

ABSTRACT: PURPOSE OF REVIEW: Physical activity improves proximal femoral bone health; however, it remains unclear whether changes translate into a reduction in fracture risk. To enhance any fracture-protective effects of physical activity, fracture prone regions within the proximal femur need to be targeted. RECENT FINDINGS: The proximal femur is designed to withstand forces in the weight-bearing direction, but less so forces associated with falls in a sideways direction. Sideways falls heighten femoral neck fracture risk by loading the relatively weak superolateral region of femoral neck. Recent studies exploring regional adaptation of the femoral neck to physical activity have identified heterogeneous adaptation, with adaptation principally occurring within inferomedial weight-bearing regions and little to no adaptation occurring in the superolateral femoral neck. There is a need to develop novel physical activities that better target and strengthen the superolateral femoral neck within the proximal femur. Design of these activities may be guided by subject-specific musculoskeletal modeling and finite-element modeling approaches.

25 Review Vasopressin receptor antagonists: Characteristics and clinical role. 2016

Rondon-Berrios, Helbert / Berl, Tomas. ·Renal-Electrolyte Division, University of Pittsburgh, A915 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: rondonberriosh@upmc.edu. · Division of Nephrology and Hypertension, University of Colorado, Aurora, CO, USA. Electronic address: Tomas.Berl@ucdenver.edu. ·Best Pract Res Clin Endocrinol Metab · Pubmed #27156765.

ABSTRACT: Hyponatremia, the most common electrolyte disorder in hospitalized patients is associated with increased risk of mortality even when mild and apparently asymptomatic. Likewise morbidity manifested as attention deficits, gait disturbances, falls, fractures, and osteoporosis is more prevalent in hyponatremic subjects. Hyponatremia also generates a significant financial burden. Therefore, it is important to explore approaches that effectively and safely treat hyponatremia. Currently available strategies are physiologically sound and affordable but lack evidence from clinical trials and are limited by variable efficacy, slow response, and/or poor compliance. The recent emergence of vasopressin receptor antagonists provides a class of drugs that target the primary pathophysiological mechanism, namely vasopressin mediated impairment of free water excretion. This review summarizes the historical development, pharmacology, clinical trials supporting efficacy and safety, shortcomings, as well as practical suggestions for the use of vasopressin receptor antagonists.