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Osteoporosis: HELP
Articles from Los Angeles
Based on 195 articles published since 2008
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These are the 195 published articles about Osteoporosis that originated from Los Angeles during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Guideline Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. 2018

Anonymous2470953 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Kemper, Alex R / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Phipps, Maureen G / Pignone, Michael / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health and Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · Brown University, Providence, Rhode Island. · Department of Medicine, Dell Medical School, University of Texas, Austin. · University of Texas, Austin. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #29946735.

ABSTRACT: Importance: By 2020, approximately 12.3 million individuals in the United States older than 50 years are expected to have osteoporosis. Osteoporotic fractures, particularly hip fractures, are associated with limitations in ambulation, chronic pain and disability, loss of independence, and decreased quality of life, and 21% to 30% of patients who experience a hip fracture die within 1 year. The prevalence of primary osteoporosis (ie, osteoporosis without underlying disease) increases with age and differs by race/ethnicity. With the aging of the US population, the potential preventable burden is likely to increase in future years. Objective: To update the 2011 US Preventive Services Task Force (USPSTF) recommendation on screening for osteoporosis. Evidence Review: The USPSTF reviewed the evidence on screening for and treatment of osteoporotic fractures in men and women, as well as risk assessment tools, screening intervals, and efficacy of screening and treatment in subgroups. The screening population was postmenopausal women and older men with no known previous osteoporotic fractures and no known comorbid conditions or medication use associated with secondary osteoporosis. Findings: The USPSTF found convincing evidence that bone measurement tests are accurate for detecting osteoporosis and predicting osteoporotic fractures in women and men. The USPSTF found adequate evidence that clinical risk assessment tools are moderately accurate in identifying risk of osteoporosis and osteoporotic fractures. The USPSTF found convincing evidence that drug therapies reduce subsequent fracture rates in postmenopausal women. The USPSTF found that the evidence is inadequate to assess the effectiveness of drug therapies in reducing subsequent fracture rates in men without previous fractures. Conclusions and Recommendation: The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older. (B recommendation) The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men. (I statement).

2 Guideline 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. 2017

Buckley, Lenore / Guyatt, Gordon / Fink, Howard A / Cannon, Michael / Grossman, Jennifer / Hansen, Karen E / Humphrey, Mary Beth / Lane, Nancy E / Magrey, Marina / Miller, Marc / Morrison, Lake / Rao, Madhumathi / Robinson, Angela Byun / Saha, Sumona / Wolver, Susan / Bannuru, Raveendhara R / Vaysbrot, Elizaveta / Osani, Mikala / Turgunbaev, Marat / Miller, Amy S / McAlindon, Timothy. ·Yale University, New Haven, Connecticut. · McMaster University, Hamilton, Ontario, Canada. · Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, Minnesota. · Arthritis Consultants of Tidewater, Virginia Beach, Virginia. · University of California, Los Angeles. · University of Wisconsin, Madison. · Oklahoma University Health Sciences Center, Oklahoma City. · University of California Davis, Sacramento. · Case Western Reserve University, MetroHealth System, Cleveland, Ohio. · Rheumatology Associates, Portland, Maine. · Duke University Medical Center, Durham, North Carolina. · Tufts Medical Center, Boston, Massachusetts. · Rainbow Babies and Children's Hospital, Cleveland, Ohio. · Virginia Commonwealth University, Richmond. · American College of Rheumatology, Atlanta, Georgia. ·Arthritis Rheumatol · Pubmed #28585373.

ABSTRACT: OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users. RESULTS: Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions. Clinicians and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

3 Guideline ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease. 2017

Farraye, Francis A / Melmed, Gil Y / Lichtenstein, Gary R / Kane, Sunanda V. ·Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA. · Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA. · Division of Gastroenterology, Hospital of the University of Pennsylvania, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. ·Am J Gastroenterol · Pubmed #28071656.

ABSTRACT: Recent data suggest that inflammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identification, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identification of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary.

4 Guideline American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. 2016

Runowicz, Carolyn D / Leach, Corinne R / Henry, N Lynn / Henry, Karen S / Mackey, Heather T / Cowens-Alvarado, Rebecca L / Cannady, Rachel S / Pratt-Chapman, Mandi L / Edge, Stephen B / Jacobs, Linda A / Hurria, Arti / Marks, Lawrence B / LaMonte, Samuel J / Warner, Ellen / Lyman, Gary H / Ganz, Patricia A. ·Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University · Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL · Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA · N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI · Heather T. Mackey, Oncology Nursing Society, Pittsburgh · Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA · Mandi L. Pratt-Chapman, The George Washington University Cancer Institute, Washington, DC · Stephen B. Edge, Baptist Cancer Center, Memphis, TN · Arti Hurria, City of Hope, Duarte · Patricia A. Ganz, Schools of Medicine and Public Health, University of California, Los Angeles, CA · Lawrence B. Marks, University of North Carolina, Chapel Hill, NC · Ellen Warner, University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada · and Gary H. Lyman, Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA doi: 10.3322/caac.21319. Available online at cacancerjournal.com. ·J Clin Oncol · Pubmed #26644543.

ABSTRACT: The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for Clinicians and Journal of Clinical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Cancer Society or the American Society of Clinical Oncology.

5 Guideline American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. 2014

Ruggiero, Salvatore L / Dodson, Thomas B / Fantasia, John / Goodday, Reginald / Aghaloo, Tara / Mehrotra, Bhoomi / O'Ryan, Felice / Anonymous6470806. ·Clinical Professor, Division of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, New York Center for Orthognathic and Maxillofacial Surgery, Lake Success, NY. Electronic address: sruggie@optonline.net. · Professor and Chair, Associate Dean for Hospital Affairs, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA. · Chief, Division of Oral Pathology, Department of Dental Medicine, Hofstra North Shore-LIJ School of Medicine , New Hyde Park, NY. · Professor, Department of Oral and Maxillofacial Sciences, Dalhousie University, Halifax, NS, Canada. · Associate Professor, Oral and Maxillofacial Surgery, Assistant Dean for Clinical Research, UCLA School of Dentistry, Los Angeles, CA. · Director, Cancer Institute at St Francis Hospital, Roslyn, NY. · Director, Division of Maxillofacial Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA. ·J Oral Maxillofac Surg · Pubmed #25234529.

ABSTRACT: Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaw (MRONJ) were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007 and 2009. The position papers were developed by a special committee appointed by the board and composed of clinicians with extensive experience in caring for these patients and basic science researchers. The knowledge base and experience in addressing MRONJ has expanded, necessitating modifications and refinements to the previous position paper. This special committee met in September 2013 to appraise the current literature and revise the guidelines as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis, staging, and management strategies and highlights current research status. The AAOMS considers it vitally important that this information be disseminated to other relevant health care professionals and organizations.

6 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.

7 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 --

8 Editorial Improving Our Understanding of Health Issues in Older Women Veterans. 2016

Bastian, Lori A / Hayes, Patricia M / Haskell, Sally G / Atkins, David / Reiber, Gayle E / LaCroix, Andrea Z / Yano, Elizabeth M. ·Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, Veterans Affairs (VA) Connecticut Healthcare System, West Haven. Department of Medicine, University of Connecticut Health Center, Farmington. lori.bastian@va.gov. · Women's Health Services, Veterans Health Administration, Washington, District of Columbia. · Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, Veterans Affairs (VA) Connecticut Healthcare System, West Haven. Women's Health Services, Veterans Health Administration, Washington, District of Columbia. Department of Medicine, Yale University, New Haven. · Department of Veterans Affairs, Health Services Research and Development Service, Washington, District of Columbia. · Health Services Research and Development, VA Puget Sound Health Care System, Seattle, Washington. Department of Health Services and Department of Epidemiology, University of Washington School of Public Health, Seattle. · Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego. · VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California. Department of Health Policy and Management, University of California Los Angeles Fielding School of Public Health, Los Angeles. ·Gerontologist · Pubmed #26768383.

ABSTRACT: -- No abstract --

9 Editorial Bisphosphonate drug holidays: we reap what we sow. 2016

Silverman, S L / Adachi, J D / Dennison, E / Anonymous1891055. ·David Geffen School of Medicine, University of California, Los Angeles; Division of Rheumatology, Cedars-Sinai Medical Center; and OMC Clinical Research Center, 8641 Wilshire Blvd, suite 301, Beverly Hills, CA, 90211, USA. stuarts@bhillsra.com. · St Joseph's Healthcare, McMaster University, Hamilton, ON, Canada. · MRC Life course Epidemiology Unit Southampton University and Victoria University of Wellington, Wellington, New Zealand. ·Osteoporos Int · Pubmed #26667246.

ABSTRACT: -- No abstract --

10 Review Tai chi for treating osteopenia and primary osteoporosis: a meta-analysis and trial sequential analysis. 2019

Zhang, Yili / Chai, Yan / Pan, Xiaojie / Shen, Hao / Wei, Xu / Xie, Yanming. ·Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China, datamining5288@163.com. · School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China. · Department of Epidemiology, University of California, Los Angeles, CA, USA. · Department of Human Nutrition and Health, Wageningen University and Health, Wageningen, The Netherlands. · Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China, weixu.007@163.com. ·Clin Interv Aging · Pubmed #30655662.

ABSTRACT: Purpose: The aim of this meta-analysis was to evaluate the efficacy of Tai chi (TC) as an adjuvant treatment for osteopenia and primary osteoporosis. Methods: We went through eight databases to identify relevant randomized controlled trials that compared TC with a control group. The primary outcome was osteoporosis-related fractures (fracture incidence). Meta-analyses and trial sequential analyses (TSA) were conducted using RevMan 5.3 and TSA 0.9. Results: Fifteen randomized controlled trials involving a total of 857 patients were included in the analyses. No trials reported primary outcome; however, bone mineral density (BMD) values differed significantly in subgroup 1 (TC vs no treatment; weighted mean difference [WMD] =0.05 g/cm Conclusion: Although there is no study monitoring fracture incidence, TC may be beneficial for patients in improving BMD values, level of bone gla protein, and relieving osteoporotic pain. However, due to the low methodological quality, current evidence for treating osteopenia and primary osteoporosis through TC is insufficient.

11 Review Bone Health During the Menopause Transition and Beyond. 2018

Karlamangla, Arun S / Burnett-Bowie, Sherri-Ann M / Crandall, Carolyn J. ·Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue #2339, Los Angeles, CA 90095, USA. Electronic address: AKarlamangla@mednet.ucla.edu. · Endocrinology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. · Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, 1st floor, Los Angeles, CA 90024, USA. ·Obstet Gynecol Clin North Am · Pubmed #30401551.

ABSTRACT: The menopause transition is a critical period for bone health, with rapid losses in bone mass and strength occurring in a 3-year window bracketing the date of the final menstrual period. Declines in bone mass are accompanied by deleterious changes in bone macrostructure and microarchitecture, which may be captured by changes in composite strength indices and indices of trabecular thickness and connectivity. The onset of the rapid bone loss phase is preceded by changes in sex steroid hormones and increases in markers of bone resorption, measurements of which may be clinically useful in predicting the onset of the rapid loss phase and in identifying the women who will lose the most bone strength over the menopause transition.

12 Review Bisphosphonate and Teriparatide Use in Thoracolumbar Spinal Fusion: A Systematic Review and Meta-analysis of Comparative Studies. 2018

Buerba, Rafael A / Sharma, Akshay / Ziino, Chason / Arzeno, Alexander / Ajiboye, Remi M. ·UCLA Medical Center, Los Angeles, CA. · Case Western Reserve School of Medicine, Cleveland, OH. · Stanford Medical Center, Redwood City, CA. ·Spine (Phila Pa 1976) · Pubmed #29462070.

ABSTRACT: STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To compare the efficacy of the use of either bisphosphonates or teriparatide on radiographic and functional outcomes of patients that had thoracolumbar spinal fusion. SUMMARY OF BACKGROUND DATA: Controversy exists as to whether bisphosphonates interfere with successful spinal arthrodesis. An alternative osteoporosis medication is teriparatide, a synthetic parathyroid hormone that has an anabolic effect on osteoblast function. To date, there is limited comparative data on the influence of bisphosphonates or teriparatide on spinal fusion. METHODS: A systematic search of medical reference databases was conducted for comparative studies on bisphosphonate or teriparatide use after thoracolumbar spinal fusion. Meta-analysis was performed using the random-effects model for heterogeneity. Radiographic outcomes assessed include fusion rates, risk of screw loosening, cage subsidence, and vertebral fracture. RESULTS: No statistically significant differences were noted between bisphosphonates and control groups regarding fusion rate and risk of screw loosening (fusion: odds ratio [OR] = 2.2, 95% confidence interval [CI]: 0.87-5.56, P = 0.09; loosening: OR = 0.45, 95% CI: 0.14-1.48, P = 0.19). Teriparatide use was associated with higher fusion rates than bisphosphonates (OR = 2.3, 95% CI: 1.55-3.42, P < 0.0001). However, no statistically significant difference was noted between teriparatide and bisphosphonates regarding risk of screw loosening (OR = 0.37, 95% CI: 0.12-1.18, P = 0.09). Lastly, bisphosphonate use was associated with decreased odds of cage subsidence and vertebral fractures compared to controls (subsidence: OR = 0.29, 95% CI 0.11-0.75, P = 0.01; fracture: OR = 0.18, 95% CI 0.07-0.48, P = 0.0007). CONCLUSION: Bisphosphonates do not appear to impair successful spinal fusion compared to controls although teriparatide use is associated with higher fusion rates than bisphosphonates. In addition, bisphosphonate use is associated with decreased odds of cage subsidence and vertebral fractures compared to controls that had spinal fusion. LEVEL OF EVIDENCE: 3.

13 Review Osteoporosis. 2017

Ensrud, Kristine E / Crandall, Carolyn J. ·From the University of Minnesota and Veterans Affairs Health Care System, Minneapolis, Minnesota; and the University of California, Los Angeles, California. ·Ann Intern Med · Pubmed #28761958.

ABSTRACT: Osteoporosis is a common systemic skeletal disorder resulting in bone fragility and increased fracture risk. However, management of osteoporosis and fracture prevention strategies are often not addressed by primary care clinicians, even in older patients with recent fractures. Evidence-based screening strategies will improve identification of patients who are most likely to benefit from drug treatment to prevent fracture. In addition, careful consideration of when pharmacotherapy should be started and choice of medication and duration of treatment will maximize the benefits of fracture prevention while minimizing potential harms of long-term drug exposure.

14 Review Hypothalamic Amenorrhea and the Long-Term Health Consequences. 2017

Shufelt, Chrisandra L / Torbati, Tina / Dutra, Erika. ·Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California. ·Semin Reprod Med · Pubmed #28658709.

ABSTRACT: -- No abstract --

15 Review 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. 2017

Buckley, Lenore / Guyatt, Gordon / Fink, Howard A / Cannon, Michael / Grossman, Jennifer / Hansen, Karen E / Humphrey, Mary Beth / Lane, Nancy E / Magrey, Marina / Miller, Marc / Morrison, Lake / Rao, Madhumathi / Byun Robinson, Angela / Saha, Sumona / Wolver, Susan / Bannuru, Raveendhara R / Vaysbrot, Elizaveta / Osani, Mikala / Turgunbaev, Marat / Miller, Amy S / McAlindon, Timothy. ·Yale University, New Haven, Connecticut. · McMaster University, Hamilton, Ontario, Canada. · Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, Minnesota. · Arthritis Consultants of Tidewater, Virginia Beach, Virginia. · University of California, Los Angeles. · University of Wisconsin, Madison. · Oklahoma University Health Sciences Center, Oklahoma City. · University of California Davis, Sacramento. · Case Western Reserve University, MetroHealth System, Cleveland, Ohio. · Rheumatology Associates, Portland, Maine. · Duke University Medical Center, Durham, North Carolina. · Tufts Medical Center, Boston, Massachusetts. · Rainbow Babies and Children's Hospital, Cleveland, Ohio. · Virginia Commonwealth University, Richmond. · American College of Rheumatology, Atlanta, Georgia. ·Arthritis Care Res (Hoboken) · Pubmed #28585410.

ABSTRACT: OBJECTIVE: To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP). METHODS: We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users. RESULTS: Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions. Clinicians and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

16 Review Combined Pharmacologic Therapy in Postmenopausal Osteoporosis. 2017

Shen, Yang / Gray, Dona L / Martinez, Dorothy S. ·Endocrinology Clinic, Huntington Health Physicians, 10 Congress Street, Suite 408, Pasadena, CA 91105, USA. · Endocrinology Clinic, Indiana University Health Arnett, 2600 Ferry Street, Lafayette, IN 47904, USA. · Divisions of Endocrinology, Diabetes and Metabolism, David Geffen School of Medicine, University of California, Los Angeles, 200 UCLA Medical Plaza, Suite 530, Los Angeles, CA 90095, USA. Electronic address: dmartinez@mednet.ucla.edu. ·Endocrinol Metab Clin North Am · Pubmed #28131133.

ABSTRACT: Antiresorptive agents for treating postmenopausal osteoporosis include selective estrogen receptor modulator (SERM), bisphosphonates and denoumab. Teriparatide is the only Food and Drug Administration-approved anabolic agent. Synergistic effects of combining teriparatide with an antiresorptive agent have been proposed and studied. This article reviews the trial designs and the outcomes of combination therapies. Results of the combination therapy for teriparatide and bisphosphonates were mixed; while small increases of bone density were observed in the combination therapy of teriparatide and estrogen/SERM and that of teriparatide and denosumab. Those clinical studies were limited by small sample sizes and lack of fracture outcomes.

17 Review Case-Based Review of Osteonecrosis of the Jaw (ONJ) and Application of the International Recommendations for Management From the International Task Force on ONJ. 2017

Khan, Aliya A / Morrison, Archie / Kendler, David L / Rizzoli, Rene / Hanley, David A / Felsenberg, Dieter / McCauley, Laurie K / O'Ryan, Felice / Reid, Ian R / Ruggiero, Salvatore L / Taguchi, Akira / Tetradis, Sotirios / Watts, Nelson B / Brandi, Maria Luisa / Peters, Edmund / Guise, Teresa / Eastell, Richard / Cheung, Angela M / Morin, Suzanne N / Masri, Basel / Cooper, Cyrus / Morgan, Sarah L / Obermayer-Pietsch, Barbara / Langdahl, Bente L / Dabagh, Rana Al / Davison, K Shawn / Sándor, George K / Josse, Robert G / Bhandari, Mohit / El Rabbany, Mohamed / Pierroz, Dominique D / Sulimani, Riad / Saunders, Deborah P / Brown, Jacques P / Compston, Juliet / Anonymous3310890. ·Department of Medicine, Divisions of Endocrinology and Metabolism and Geriatrics, McMaster University, Hamilton, ON, Canada. Electronic address: Aliya@mcmaster.ca. · Division of Oral and Maxillofacial Surgery, Dalhousie University, Halifax, NS, Canada. · Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada. · Division of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland. · Departments of Medicine, Community Health Sciences and Oncology, University of Calgary, Calgary, AB, Canada. · Centre of Muscle & Bone Research, Charité-University Medicine Berlin, Campus Benjamin Franklin, Free University & Humboldt University Berlin, Berlin, Germany. · Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA. · Division of Maxillofacial Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA. · Department of Medicine, University of Auckland, Auckland, New Zealand. · Division of Oral and Maxillofacial Surgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA; Stony Brook School of Dental Medicine, Stony Brook, NY, USA; New York Center for Orthognathic and Maxillofacial Surgery, New York, NY, USA. · Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shojiri, Japan. · Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA. · Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA. · Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. · Department of Medicine, Division of Endocrinology at Indiana University, Indianapolis, IN, USA. · Department of Human Metabolism, University of Sheffield, Sheffield, UK. · Department of Medicine, University of Toronto, Toronto, ON, Canada; Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada; Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. · Department of Medicine, McGill University, Montreal, QC, Canada. · Jordan Osteoporosis Center, Jordan Hospital & Medical Center, Amman, Jordan. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham Osteoporosis Prevention and Treatment Clinic, Birmingham, AL, USA. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University Graz, Graz, Austria. · Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. · Faculty of Dentistry, University of Toronto, Toronto, Canada. · Department of Education, University of Victoria,Victoria, BC, Canada. · Department of Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland. · Division of Endocrinology and Metabolism, University of Toronto, Toronto, ON, Canada. · Division of Orthopaedic Surgery, Department of Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. · Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. · International Osteoporosis Foundation (IOF), Nyon, Switzerland. · College of Medicine, King Saud University, Riyadh, Saudi Arabia. · Department of Dental Oncology, Northeast Cancer Centre/Health Science North, Sudbury, ON, Canada. · Rheumatology Division, CHU de Québec Research Centre, Laval University, Quebec City, QC, Canada. · Department of Medicine, Cambridge Biomedical Campus, Cambridge, UK. ·J Clin Densitom · Pubmed #27956123.

ABSTRACT: Osteonecrosis of the jaw (ONJ) has been associated with antiresorptive therapy in both oncology and osteoporosis patients. This debilitating condition is very rare and advances in diagnosis and management may now effectively reduce the risk of its development and offer valuable treatment options for affected patients. This paper provides a case-based review of ONJ and application of the International Task Force on ONJ (referred to as the "Task Force") recommendations for the diagnosis and management of ONJ. The Task Force was supported by 14 international societies and achieved consensus from representatives of these multidisciplinary societies on key issues pertaining to the diagnosis and management of ONJ. The frequency of ONJ in oncology patients receiving oncology doses of bisphosphonate (BP) or denosumab is estimated at 1%-15%, and the frequency in the osteoporosis patient population receiving much lower doses of BP or denosumab is estimated at 0.001%-0.01%. Although the diagnosis of ONJ is primarily clinical, imaging may be helpful in confirming the diagnosis and staging. In those with multiple risk factors for ONJ for whom major invasive oral surgery is being planned, interruption of BP or denosumab therapy (in cancer patients) is advised, if possible, before surgery, until the surgical site heals. Major oral surgery in this context could include multiple extractions if surgical extractions are required, not simple forceps extractions. ONJ development may be reduced by optimizing oral hygiene and postoperatively using topical and systemic antibiotics as appropriate. Periodontal disease should be managed before starting oncology doses of BP or denosumab. Local debridement may be successful in disease unresponsive to conservative therapy. Successful surgical intervention has been reported in those with stage 3 disease; less severe disease is best managed conservatively. Teriparatide may be helpful in healing ONJ lesions and may be considered in osteoporosis patients at a high fracture risk in the absence of contraindications. Resumption of BP or denosumab therapy following healing of ONJ lesions is recommended, and there have not been reports of subsequent local recurrence.

18 Review Periprosthetic femoral bone loss in total hip arthroplasty: systematic analysis of the effect of stem design. 2017

Knutsen, Ashleen R / Lau, Nicole / Longjohn, Donald B / Ebramzadeh, Edward / Sangiorgio, Sophia N. ·J. Vernon Luck, Sr., M.D. Orthopaedic Research Center Orthopaedic Institute for Children, Los Angeles, California - USA. · University of California, Los Angeles, California - USA. · University of Southern California, Los Angeles, California - USA. ·Hip Int · Pubmed #27515762.

ABSTRACT: INTRODUCTION: Periprosthetic bone loss may lead to major complications in total hip arthroplasty (THA), including loosening, migration, and even fracture. This study analysed the influence of femoral implant designs on periprosthetic bone mineral density (BMD) after THA. METHODS: The results of all previous published studies reporting periprosthetic femoral BMD following THA were compiled. Using these results, we compared percent changes in bone loss as a function of: femoral stem fixation, material, and geometry. RESULTS: The greatest bone loss was in the calcar region (Gruen Zone 7). Overall, cemented stems had more bone loss distally than noncemented stems, while noncemented stems had more proximal bone loss than cemented stems. Within noncemented stems, cobalt-chromium (CoCr) stems had nearly double the proximal bone loss compared to titanium (Ti) alloy stems. Finally, within noncemented titanium alloy group, straight stems had less bone loss than anatomical, tapered, and press-fit designs. DISCUSSION: The findings from the present study quantified percent changes in periprosthetic BMD as a function of fixation method, alloy, and stem design. While no one stem type was identified as ideal, we now have a clearer understanding of the influence of stem design on load transfer to the surrounding bone.

19 Review Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. 2016

Lobo, Roger A / Pickar, James H / Stevenson, John C / Mack, Wendy J / Hodis, Howard N. ·Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA. Electronic address: ral35@columbia.edu. · Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA. · National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK. · Atherosclerosis Research Unit, Departments of Medicine and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90022, USA. ·Atherosclerosis · Pubmed #27745704.

ABSTRACT: In the late 1980s, several observational studies and meta-analyses suggested that hormone replacement therapy (HRT) was beneficial for prevention of osteoporosis, coronary heart disease, dementia and decreased all-cause mortality. In 1992, the American College of Physicians recommended HRT for prevention of coronary disease. In the late 1990s and early 2000s, several randomized trials in older women suggested coronary harm and that the risks, including breast cancer, outweighed any benefit. HRT stopped being prescribed at that time, even for women who had severe symptoms of menopause. Subsequently, reanalyzes of the randomized trial data, using age stratification, as well as newer studies, and meta-analyses have been consistent in showing that younger women, 50-59 years or within 10 years of menopause, have decreased coronary disease and all-cause mortality; and did not have the perceived risks including breast cancer. These newer findings are consistent with the older observational data. It has also been reported that many women who abruptly stopped HRT had more risks, including more osteoporotic fractures. The current data confirm a "timing" hypothesis for benefits and risks of HRT, showing that younger have many benefits and few risks, particularly if therapy is predominantly focused on the estrogen component. We discuss these findings and put into perspective the potential risks of treatment, and suggest that we may have come full circle regarding the use of HRT. In so doing we propose that HRT should be considered as part of a general prevention strategy for women at the onset of menopause.

20 Review Detecting and Managing Adverse Effects of Antipsychotic Medications: Current State of Play. 2016

Ames, Donna / Carr-Lopez, Sian M / Gutierrez, Mary A / Pierre, Joseph M / Rosen, Jennifer A / Shakib, Susan / Yudofsky, Lynn M. ·Department of Psychiatry, Psychosocial Rehabilitation and Recovery Center, West Los Angeles Veterans Affairs Medical Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. Electronic address: Donna.ames@va.gov. · Pharmacy Service, Veterans Affairs Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA; Department of Pharmacy Practice, University of the Pacific, 3601 Pacific Avenue, Stockton, CA 95211, USA. · Chapman University School of Pharmacy, 9401 Jeronimo Road, Irvine, CA 92618, USA. · Schizophrenia Treatment Unit, West Los Angeles VA Medical Center, Los Angeles, CA 90073, USA; Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. · Department of Pharmacy, Veterans Affairs Northern California Healthcare System, 150 Muir Road, Martinez, CA 94553, USA; University of the Pacific School of Pharmacy, 3601 Pacific Avenue, Stockton, CA 95211, USA; University of Southern California School of Pharmacy, 1985 Zonal Avenue, Los Angeles, CA 90089, USA. · Thomas J. Long School of Pharmacy & Health Sciences, University of the Pacific 3601 Pacific Avenue, Stockton, CA 95211, USA; Department of Pharmacy, Veterans Affairs Long Beach Healthcare System, 5901 East 7th Street, Long Beach, CA 90822, USA. · Semel Institute for Neuroscience & Human Behavior, UCLA, 760 Westwood Plaza, Suite C8-193, Los Angeles, CA 90024, USA. ·Psychiatr Clin North Am · Pubmed #27216904.

ABSTRACT: Antipsychotics are some of the most frequently prescribed medications not only for psychotic disorders and symptoms but also for a wide range of on-label and off-label indications. Because second-generation antipsychotics have largely replaced first-generation antipsychotics as first-line options due to their substantially decreased risk of extrapyramidal side effects, attention has shifted to other clinically concerning adverse events associated with antipsychotic therapy. The focus of this article is to update the nonextrapyramidal side effects associated with second-generation antipsychotics. Issues surrounding diagnosis and monitoring as well as clinical management are addressed.

21 Review The Hybrid Mouse Diversity Panel: a resource for systems genetics analyses of metabolic and cardiovascular traits. 2016

Lusis, Aldons J / Seldin, Marcus M / Allayee, Hooman / Bennett, Brian J / Civelek, Mete / Davis, Richard C / Eskin, Eleazar / Farber, Charles R / Hui, Simon / Mehrabian, Margarete / Norheim, Frode / Pan, Calvin / Parks, Brian / Rau, Christoph D / Smith, Desmond J / Vallim, Thomas / Wang, Yibin / Wang, Jessica. ·Departments of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA Microbiology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA Human Genetics, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA jlusis@mednet.ucla.edu. · Departments of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA. · Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA. · Department of Genetics, University of North Carolina, Chapel Hill, NC. · Departments of Biomedical Engineering University of Virginia, Charlottesville, VA. · Departments of Computer Science, University of California-Los Angeles, Los Angeles, CA. · Public Health Sciences, University of Virginia, Charlottesville, VA. · Human Genetics, University of California-Los Angeles, Los Angeles, CA. · Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI. · Anesthesiology, University of California-Los Angeles, Los Angeles, CA. · Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA. ·J Lipid Res · Pubmed #27099397.

ABSTRACT: The Hybrid Mouse Diversity Panel (HMDP) is a collection of approximately 100 well-characterized inbred strains of mice that can be used to analyze the genetic and environmental factors underlying complex traits. While not nearly as powerful for mapping genetic loci contributing to the traits as human genome-wide association studies, it has some important advantages. First, environmental factors can be controlled. Second, relevant tissues are accessible for global molecular phenotyping. Finally, because inbred strains are renewable, results from separate studies can be integrated. Thus far, the HMDP has been studied for traits relevant to obesity, diabetes, atherosclerosis, osteoporosis, heart failure, immune regulation, fatty liver disease, and host-gut microbiota interactions. High-throughput technologies have been used to examine the genomes, epigenomes, transcriptomes, proteomes, metabolomes, and microbiomes of the mice under various environmental conditions. All of the published data are available and can be readily used to formulate hypotheses about genes, pathways and interactions.

22 Review Health Considerations in Female Runners. 2016

Kim, Brian Y / Nattiv, Aurelia. ·Division of Sports Medicine and Non-Operative Orthopaedics, Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Intercollegiate Athletics, UCLA, Los Angeles, CA, USA. Electronic address: bykim@mednet.ucla.edu. · Division of Sports Medicine and Non-Operative Orthopaedics, Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Intercollegiate Athletics, UCLA, Los Angeles, CA, USA; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. ·Phys Med Rehabil Clin N Am · Pubmed #26616182.

ABSTRACT: Female participation in running is at a historical high. Special consideration should be given to this population, in whom suboptimal nutritional intake, menstrual irregularity, and bone stress injury are common. Immature athletes should garner particular attention. Advances in the understanding of the Triad and Triad-related conditions have largely informed the approach to the health of this population. Clinicians should be well versed in the identification of Triad-related risk factors. A multidisciplinary team may be necessary for the optimal treatment of at-risk runners. Nonpharmacologic strategies to increase energy availability in athletes should be used as first-line treatment.

23 Review Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property. 2016

Mao, Song Shou / Li, Dong / Luo, Yanting / Syed, Younus Saleem / Budoff, Matthew J. ·Los Angeles Biomedical Research Institute at Harbor-UCLA, 1124 West Carson Street, Torrance, CA 90502. Electronic address: smao@labiomed.org. · Los Angeles Biomedical Research Institute at Harbor-UCLA, 1124 West Carson Street, Torrance, CA 90502. Electronic address: dli@labiomed.org. · Los Angeles Biomedical Research Institute at Harbor-UCLA, 1124 West Carson Street, Torrance, CA 90502. Electronic address: yluo@labiomed.org. · Los Angeles Biomedical Research Institute at Harbor-UCLA, 1124 West Carson Street, Torrance, CA 90502. Electronic address: ysyed@labiomed.org. · Los Angeles Biomedical Research Institute at Harbor-UCLA, 1124 West Carson Street, Torrance, CA 90502. Electronic address: mbudoff@labiomed.org. ·Clin Imaging · Pubmed #26602163.

ABSTRACT: Osteoporosis is a common metabolic bone disease, causing increased skeletal fragility characterized by a low bone mass and trabecular microarchitectural deterioration. Assessment of the bone mineral density (BMD) is the primary determinant of skeletal fragility. Computed tomography (CT)-based trabecular microarchitectural and mechanical assessments are important methods to evaluate the skeletal strength. In this review, we focus the feasibility of QCT BMD measurement using a calibration phantom or phantomless. The application of QCT could extend the bone mineral density assessment to all patients who underwent a heart, lung, whole-body, and as well as all routine clinical implications of CT scan.

24 Review Effect of osteoporosis medications on fracture healing. 2016

Hegde, V / Jo, J E / Andreopoulou, P / Lane, J M. ·Department of Orthopaedic Surgery, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 755, Los Angeles, CA, 90095, USA. · Weill Cornell Medical College, 445 E 69th St, New York, NY, 10021, USA. jonathan.e.jo@gmail.com. · Department of Orthopaedic Surgery, Hospital for Special Surgery, 475 East 72nd Street, Ground Floor, New York, NY, 10021, USA. jonathan.e.jo@gmail.com. · , 2900 Main St. Apt 332, Bridgeport, CT, 06606, USA. jonathan.e.jo@gmail.com. · Department of Endocrinology, Hospital for Special Surgery, 519 East 72nd St, Suite 202, New York, NY, 10021, USA. · Department of Orthopaedic Surgery, Hospital for Special Surgery, 475 East 72nd Street, Ground Floor, New York, NY, 10021, USA. ·Osteoporos Int · Pubmed #26419471.

ABSTRACT: Antiosteoporotic medications are often used to concurrently treat a patient's fragility fractures and underlying osteoporosis. This review evaluates the existing literature from animal and clinical models to determine these drugs' effects on fracture healing. The data suggest that these medications may enhance bone healing, yet more thorough prospective studies are warranted. Pharmacologic agents that influence bone remodeling are an essential component of osteoporosis management. Because many patients are first diagnosed with osteoporosis when presenting with a fragility fracture, it is critical to understand how osteoporotic medications influence fracture healing. Vitamin D and its analogs are essential for the mineralization of the callus and may also play a role in callus formation and remodeling that enhances biomechanical strength. In animal models, antiresorptive medications, including bisphosphonates, denosumab, calcitonin, estrogen, and raloxifene, do not impede endochondral fracture healing but may delay repair due to impaired remodeling. Although bisphosphonates and denosumab delay callus remodeling, they increase callus volume and result in unaltered biomechanical properties. Calcitonin increases cartilage formation and callus maturation, resulting in improved biomechanical properties. Parathyroid hormone, an anabolic agent, has demonstrated promise in animal models, resulting in accelerated healing with increased callus volume and density, more rapid remodeling to mature bone, and improved biomechanical properties. Clinical data with parathyroid hormone have demonstrated enhanced healing in distal radius and pelvic fractures as well as postoperatively following spine surgery. Strontium ranelate, which may have both antiresorptive and anabolic properties, affects fracture healing differently in normal and osteoporotic bone. While there is no effect in normal bone, in osteoporotic bone, strontium ranelate increases callus bone formation, maturity, and mineralization; forms greater and denser trabeculae; and improves biomechanical properties. Further clinical studies with these medications are needed to fully understand their effects on fracture healing in order to simultaneously treat fragility fractures and underlying osteoporosis.

25 Review Surgical Menopause. 2015

Rodriguez, Maria / Shoupe, Donna. ·Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 2622 South Tower, Los Angeles, CA 90048, USA. · Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, USA. Electronic address: donna.shoupe@med.usc.edu. ·Endocrinol Metab Clin North Am · Pubmed #26316241.

ABSTRACT: In addition to the common symptoms that occur after natural menopause, special considerations apply to women who have had their ovaries removed, particularly when oophorectomy occurs before age 45 years. Women with premenopausal oophorectomy have more severe and prolonged menopausal symptoms. Their risks of adverse mood, heart disease, excessive bone resorption, sexual dysfunction, and cognitive disorders are increased compared with the general population. Retention of the ovaries carries a survival benefit for women at low risk of ovarian malignancy. Women facing oophorectomy should understand the balance of risks and benefits in order to make an informed decision.

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