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At least 55 records · Page 3Linked to original sources
PubMed2005

Microcracks in cortical bone: how do they affect bone biology?

Microcrack accumulation in cortical bone has been implicated in skeletal fragility and stress fractures. These cracks have also been shown to affect the mechanical and material properties of cortical bone. Their growth has been linked to osteocyte apoptosis and the initiation of the remodeling process, which also has a role in their repair. Clinically, osteoporosis is diagnosed using dual energy x-ray absorptiometry. However, evidence now indicates that bone mass alone is insufficient to satisfactorily explain the skeletal fragility of osteoporosis and consideration needs to be given to bone quality in the diagnosis and treatment of the disease. Bone quality includes parameters such as trabecular and cortical microarchitecture, morphology, bone turnover, degree of mineralization of the bone matrix, and significantly, the amount of microdamage present in the bone. Current clinical treatments concentrate on the inhibition of osteoclast activity to maintain bone mass in osteoporotic patients. However, these cells have a major role in removing existing microcracks from the bone matrix, and hence the use of bone resorption- inhibiting drugs may lead to insufficient bone repair and therefore an increase in microdamage accumulation and loss of bone quality.

Animals↗
PubMed2006

Patients with hip fracture: what can be improved?

Hip fracture is costly from both personal and public health perspectives. Major advances in understanding the risk factors for osteoporotic fracture and in developing strategies to reduce risk have occurred in recent years. Effective interventions to reduce hip fracture risk include vitamin D and calcium supplementation, antiresorptive agents such as bisphosphonates and possibly estrogen and the anabolic agent teriparatide, fall prevention strategies, and use of hip protectors. Current clinical practice regarding hip fracture prevention, however, leaves much to be desired. Primary care physicians seeing high-risk patients must identify and manage this risk. Radiologists, orthopedic surgeons, and rehabilitation medicine physicians who diagnose and treat patients for fracture-a major risk factor for subsequent fracture-must refer patients for additional assessment and treatment to reduce risk. Appropriate risk factor assessment and use of current intervention strategies should markedly reduce the numbers of new fractures.

Bone Density Conservation Agents↗
PubMed2006

Drug injury in the upper gastrointestinal tract: effects of alendronate.

Osteoporosis is a disease characterized by an increase in bone resorption and a decline in bone density, which leads to increased susceptibility to bone fractures. Long-term therapy is needed to increase bone mineral density and maintain bone strength. Safe and well-tolerated medical therapies are required for long-term maintenance. Alendronate, an oral bisphosphonate, has been used for treatment of osteoporosis since the mid 1990s; however, recent studies have suggested alendronate can have significant gastrointestinal side effects. Most data suggest that the risk of these effects is low and not significantly higher than with placebo but there are limited reports that suggest otherwise, in both clinical trials and animal studies. Alendronate continues to remain an important mainstay of osteoporosis therapy.

Alendronate↗
PubMedDate not supplied

Osteoporosis in men.

The subject of osteoporosis in men is gaining international attention because it has become a significant public health issue. Women have been the focus of osteoporosis research for decades, and the majority of published data related only to women until recently. There is now significant research available supporting the importance of prevention and treatment of osteoporosis in men. This article addresses the spectrum of assessment, prevention, and treatment of this problem.

Adult↗
PubMed2004

Prevention of glucocorticoid-induced osteoporosis.

Patients taking low-dose glucocorticoids for 3 months or more are at risk for rapid bone loss. The loss may be as high as 15% in the first 3 to 6 months of treatment, and can lead to osteoporotic fractures, with an increase in morbidity and mortality. This article discusses an evidence-based approach to the prevention of glucocorticoid-induced osteoporosis.

Alendronate↗
PubMed2006

Chemical makeup of microdamaged bone differs from undamaged bone.

Microdamage naturally occurs in bone tissue as a result of cyclic loading placed on the body from normal daily activities. While it is usually repaired through the bone turnover process, accumulation of microdamage may result in reduced bone quality and increased fracture risk. It is unclear whether certain areas of bone are more susceptible to microdamage than others due to compositional differences. This study examines whether areas of microdamaged bone are chemically different than undamaged areas of bone. Bone samples (L3 vertebrae) were harvested from 15 dogs. Samples were stained with basic fuchsin, embedded in poly-methylmethacrylate, and cut into 5-microm-thick sections. Fuchsin staining was used to identify regions of microdamage, and synchrotron infrared microspectroscopic imaging was used to determine the local bone composition. Results showed that microdamaged areas of bone were chemically different than the surrounding undamaged areas. Specifically, the mineral stoichiometry was altered in microdamaged bone, where the carbonate/protein ratio and carbonate/phosphate ratio were significantly lower in areas of microdamage, and the acid phosphate content was higher. No differences were observed in tissue mineralization (phosphate/protein ratio) or crystallinity between the microdamaged and undamaged bone, indicating that the microdamaged regions of bone were not over-mineralized. The collagen cross-linking structure was also significantly different in microdamaged areas of bone, consistent with ruptured cross-links and reduced fracture resistance. All differences in composition had well-defined boundaries in the microcrack region, strongly suggesting that they occurred after microcrack formation. Even so, because microdamage results in an altered bone composition, an accumulation of microdamage might result in a long-term reduction in bone quality.

Alendronate↗
PubMed2002

Prevention and treatment of osteoporosis.

Osteoporosis develops in older adults when the normal processes of bone formation and resorption become uncoupled or unbalanced, resulting in bone loss. Fractures are the result of decreased bone mass and strength and, in the case of wrist and hip fractures, usually involve a fall. Osteoporosis prevention and treatment programs should then focus on strategies that minimize bone resorption and maximize bone formation as well as on strategies that reduce falls. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. A number of pharmacologic options are now available to health care providers. This article focuses on US Food and Drug Administration-approved medications for osteoporosis and emphasizes the importance of using these agents as part of a comprehensive program that includes nonpharmacologic measures, complete diagnostic evaluation, and adequate follow-up with bone mineral density measurement.

Aged↗