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https://www.readbyqxmd.com/read/29218381/effectiveness-of-a-two-step-population-based-osteoporosis-screening-program-using-frax-the-randomized-risk-stratified-osteoporosis-strategy-evaluation-rose-study
#1
K H Rubin, M J Rothmann, T Holmberg, M Høiberg, S Möller, R Barkmann, C C Glüer, A P Hermann, M Bech, J Gram, K Brixen
The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. INTRODUCTION: The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self-administered questionnaire to select women for DXA scan...
December 7, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29207490/is-trabecular-bone-score-valuable-in-bone-microstructure-assessment-after-gastric-bypass-in-women-with-morbid-obesity
#2
Agustina Pia Marengo, Fernando Guerrero Pérez, Luis San Martín, Rosa Monseny, Anna Casajoana, Rocio Valera, Nuria Virgili, Andreu Simó Servat, Albert Prats, Carmen Gómez-Vaquero, Nuria Vilarrasa
INTRODUCTION: The effects of bariatric surgery on skeletal health raise many concerns. Trabecular bone score (TBS) is obtained through the analysis of lumbar spine dual X-ray absorptiometry (DXA) images and allows an indirect assessment of skeletal microarchitecture (MA). The aim of our study was to evaluate the changes in bone mineral density (BMD) and alterations in bone microarchitecture assessed by TBS in morbidly obese women undergoing Roux-en-Y gastric bypass (RYGB), over a three-year follow-up...
December 2, 2017: Nutrients
https://www.readbyqxmd.com/read/29207223/-fragility-fracture-in-the-chronic-kidney-disease-ckd
#3
REVIEW
Maria Fusaro, Andrea Aghi, Maria Cristina Mereu, Andrea Giusti
Fragility fractures (FF) are common in patients with chronic kidney disease (CKD), and they occur at a younger age and with a higher frequency than in the general population, producing significant morbidity, mortality and healthcare costs. The pathogenic mechanisms underlying FF in CKD patients have not been completely understood. Behind CKD-MBD, the uremic toxicity should play a role in their pathogenesis, by affecting bone quality (uremic osteoporosis). There are very few prospective studies investigating risk factors for fragility fractures in CKD patients, and available algorithms for fracture risk prediction (FRAX and DeFRA) have never considered CKD...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29201630/avoidance-of-harm-from-treatment-for-anca-associated-vasculitis
#4
REVIEW
Catherine King, Lorraine Harper
Purpose of review With established immunosuppressant treatment regimens for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV), prognosis has significantly improved. The mainstay of treatment still comprises high-dose corticosteroids and cyclophosphamide for severe forms, although rituximab is being increasingly utilised instead of cyclophosphamide as induction therapy. AAV patients experience an excess of infections, malignancies and cardiovascular events as compared to the general population, which is a combination of the systemic inflammatory process associated with vasculitis and the adverse events from treatment...
2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/29199188/cost-effective-osteoporosis-treatment-thresholds-for-people-living-with-hiv-infection-in-greece
#5
P Makras, N Boubouchairopoulou, I Katsarolis, K Athanasakis
OBJECTIVES: We aimed to specifically define the FRAX-based cost-effective treatment thresholds for osteoporosis among people living with HIV (PLWHIV) in Greece and to compare them with those of the general population. METHODS: A previously described state transition Markov cohort model was used in order to estimate the cost-effective intervention thresholds for osteoporotic therapy among Greek PLWHIV employing the FRAX® tool. The model-derived relative risk at which an incremental cost-effectiveness ratio of 30,000€/QALY gained was observed for treatment versus no intervention was multiplied by the average Greek FRAX-based 10-year probabilities for both major osteoporotic and hip fractures...
December 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
https://www.readbyqxmd.com/read/29177559/spanish-consensus-on-treat-to-target-for-osteoporosis
#6
X Nogués, J M Nolla, E Casado, E Jódar, M Muñoz-Torres, J M Quesada-Gómez, L Canals, M Balcells, L Lizán
To reach a Spanish expert consensus on a treat-to-target strategy in osteoporosis, a Delphi Consensus Study has been developed. Most of the experts (59.8%) were rheumatologist with a mean clinical experience of 21.3 years (SD 8.5). Consensus was achieved for 70% of the items. Therapeutic objectives, patient follow-up scheme, treatment failure criteria, and appropriate treatment choice for use in T2T strategy in Spain have been defined. INTRODUCTION: The paper aims to achieve a Spanish expert consensus on a treat-to-target (T2T) strategy in osteoporosis...
November 24, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29172834/managing-and-maintaining-bone-mineral-density-in-diabetes-patients-with-pharmacotherapy
#7
C Y Fixen, Danielle R Fixen
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...
November 27, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29172781/fracture-risk-assessment-in-postmenopausal-women-with-diabetes-comparison-between-defra-and-frax-tools
#8
Gloria Bonaccorsi, Carmelo Messina, Carlo Cervellati, Elisa Maietti, Matilde Medini, Maurizio Rossini, Leo Massari, Pantaleo Greco
This study aimed to compare the performance of Fracture Risk Assessment Tool (FRAX) with that of Derived FRAX (DeFRA) in estimating fracture risk in a cohort of type-2 diabetes mellitus (T2DM) postmenopausal women. One hundred nineteen T2DM postmenopausal women and 118 consecutive healthy postmenopausal women were enrolled. Fracture risk was assessed with FRAX (adjusted or non- for trabecular bone score, TBS) and DeFRA. Bone mineral density (BMD) and TBS were evaluated by dual-energy X-ray absorptiometry (DXA)...
November 24, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29168548/guidelines-for-the-diagnosis-and-management-of-osteoporosis-in-poland-update-2017
#9
Roman Lorenc, Piotr Głuszko, Edward Franek, Mirosław Jabłoński, Maciej Jaworski, Ewa Kalinka-Warzocha, Elzbieta Karczmarewicz, Tomasz Kostka, Krystyna Księzopolska-Orłowska, Ewa Marcinowska-Suchowierska, Waldemar Misiorowski, Andrzej Więcek
In the rapidly ageing society in Poland, osteoporosis is a growing epidemiological problem, and osteoporosis-related fractures are a cause of chronic disability and considerable increase of death risk. It turns out that 80 to 90% of patients suffering from osteoporosis, including osteoporosis accompanied by fractures, do not receive adequate pharmacotherapy. In this paper, a Guideline Working Group of experts from the Multidisciplinary Osteoporosis Forum update the existing Polish guidelines concerning the diagnosis and management of osteoporosis (last revised in 2013), taking account of the latest literature, availability and reimbursement of drugs, and current health care organisation...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/29151451/fracture-risk-assessment-tool-frax-and-for-the-diagnosis-of-osteoporosis-in-japanese-middle-aged-and-elderly-women-chiba-bone-survey
#10
Rena Oka, Masahiro Ohira, Sawako Suzuki, Tomohiko Yoshida, Hisashi Koide, Tomoaki Tanaka, Ichiro Tatsuno
Osteoporosis not only increases bone fracture risk but also affects survival in postmenopausal women. Although osteoporosis is diagnosed based on low bone mineral density (BMD) determined by dual energy X-ray absorptiometry (DXA), BMD measurement is sometimes difficult because DXA is not widely available in the community. The Fracture Risk Assessment tool (FRAX) can predict 10-year major osteoporotic fracture risk and hip fracture risk with or without femoral neck BMD. The FRAX has not been investigated adequately in community-dwelling Japanese women...
November 18, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/29150162/distribution-of-clinical-risk-factors-for-fracture-in-a-brussels-cohort-of-postmenopausal-women-the-frisbee-study-and-comparison-with-other-major-cohort-studies
#11
S I Cappelle, I Ramon, C Dekelver, S Rozenberg, F Baleanu, R Karmali, M Rubinstein, M Tondeur, M Moreau, M Paesmans, P Bergmann, J-J Body
OBJECTIVES: The estimation of fracture risk using clinical risk factors (CRFs) is of primary concern in osteoporosis management, but only some risk factors have been thoroughly evaluated and incorporated in predictive models. We have launched a large prospective study, the 'Fracture Risk Brussels Epidemiological Enquiry' (FRISBEE), to develop a new predictive model for osteoporotic fractures. The aims of this report are to describe the methodology of the FRISBEE study and to compare the distribution of CRFs in our cohort with those reported in other large studies...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29116417/epidemiology-of-fractures-in-armenia-development-of-a-country-specific-frax-model-and-comparison-to-its-surrogate
#12
O Lesnyak, S Sahakyan, A Zakroyeva, J P Bilezikian, N Hutchings, V Babalyan, R Galstyan, A Lebedev, H Johansson, N C Harvey, E McCloskey, John A Kanis
Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. OBJECTIVE: Armenia has relied on a surrogate FRAX model based on the fracture epidemiology of Romania...
November 7, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29107439/effects-of-exercise-improves-muscle-strength-and-fat-mass-in-patients-with-high-fracture-risk-a-randomized-control-trial
#13
Ding-Cheng Chan, Chirn-Bin Chang, Der-Sheng Han, Cian-Hui Hong, Jawl-Shan Hwang, Keh-Sung Tsai, Rong-Sen Yang
BACKGROUND: The deterioration of the musculoskeletal system imposes significant impact on physical activity. Exercise is an important strategy which minimizes these changes. It is not clear which type of exercise provides better improvement on low physical performance, low muscle mass and low strength of sarcopenia. We aim to develop an integrated care (IC) model and compare its relative efficacy in limb fat free mass, muscle strength, and physical performance with low extremities exercise (LEE) in community dwelling older adults with high risk of fractures (Fracture Risk Assessment Tool (FRAX(®))) ≧3% for hip fracture, ≧20% for major osteoporotic fracture or 1-min osteoporosis risk test (≧1 point) or fall (≧2 falls in previous year)...
October 26, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29092086/total-hip-bone-area-affects-fracture-prediction-with-frax%C3%A2-in-canadian-white-women
#14
William D Leslie, Lisa M Lix, Sumit R Majumdar, Suzanne N Morin, Helena Johansson, Anders Odén, Eugene V McCloskey, John A Kanis
Context: Areal bone mineral density (BMD) measurements are confounded by skeletal size. Hip BMD is an input to the FRAX® tool (Centre for Metabolic Bone Diseases, University of Sheffield, United Kingdom), but it is unknown whether performance is affected by hip area. Objective: To examine whether fracture prediction by FRAX® is affected by hip area. Design and Setting: Cohort study using a population-based BMD registry. Patients: A total of 58,108 white women aged ≥40 years...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29078762/design-of-the-salt-osteoporosis-study-a-randomised-pragmatic-trial-to-study-a-primary-care-screening-and-treatment-program-for-the-prevention-of-fractures-in-women-aged-65%C3%A2-years-or-older
#15
P J M Elders, T Merlijn, K M A Swart, W van Hout, B C van der Zwaard, C Niemeijer, M W Heymans, A A van der Heijden, F Rutters, H E van der Horst, P Lips, J C Netelenbos, N M van Schoor
BACKGROUND: Several drugs have become available for the treatment of osteoporosis. However, screening and treatment of patients with a high fracture risk is currently not recommended in the Netherlands, because the effectiveness of bone sparing drugs has not been demonstrated in the general primary care population. Here we describe the design of the SALT Osteoporosis study, which aims to examine whether the screening and treatment of older, female patients in primary care can reduce fractures, in comparison to usual care...
October 27, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29067485/the-role-of-previous-falls-in-major-osteoporotic-fracture-prediction-in-conjunction-with-frax-in-older-chinese-men-and-women-the-mr-os-and-ms-os-cohort-study-in-hong-kong
#16
Y Su, J Leung, T Kwok
Falls are a major concern in terms of fracture risk. Although awareness rising for the absence of falls in the FRAX algorithm, our study only identified the independent predictive role of previous recurrent falls and their better conjunction use with FRAX for major osteoporotic fracture prediction in older Chinese men. INTRODUCTION: Although the association of falls with fracture has been widely explored, the impact of previous falls is not included in the FRAX algorithm currently. Our aim was to examine the FRAX-independent associations between falls in the previous year and subsequent fracture risk, as well as the conjunctive use of falls and the FRAX score for major osteoporotic fracture (MOF) prediction in older Chinese people...
October 24, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29052793/comparison-of-fracture-risk-assessment-tools-in-older-men-without-prior-hip-or-spine-fracture-the-mros-study
#17
Margaret L Gourlay, Victor S Ritter, Jason P Fine, Robert A Overman, John T Schousboe, Peggy M Cawthon, Eric S Orwoll, Tuan V Nguyen, Nancy E Lane, Steven R Cummings, Deborah M Kado, Jodi A Lapidus, Susan J Diem, Kristine E Ensrud
Femoral neck bone mineral density (BMD), age plus femoral neck BMD T score, and three externally generated fracture risk tools had similar accuracy to identify older men who developed osteoporotic fractures. Risk tools with femoral neck BMD performed better than those without BMD. The externally developed risk tools were poorly calibrated. INTRODUCTION: We compared the performance of fracture risk assessment tools in older men, accounting for competing risks including mortality. METHODS: A comparative ROC curve analysis assessed the ability of the QFracture, FRAX® and Garvan fracture risk tools, and femoral neck bone mineral density (BMD) T score with or without age to identify incident fracture in community-dwelling men aged 65 years or older (N = 4994) without hip or clinical vertebral fracture or antifracture treatment at baseline...
October 20, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29044037/-review-of-epidemiology-of-fractures-in-the-icelandic-heart-association-cohort
#18
Gunnar Sigurdsson, Kristin Siggeirsdottir, Brynjolfur Y Jonsson, Brynjolfur Morgensen, Elías F Gudmundsson, Thor Aspelund, Vilmundur Gudnason
IIn recent years, scientific papers have been published in Osteoporosis International on the epidemiology of fractures in Iceland based on the Icelandic Heart Association cohort. We report the main results with emphasis on the major osteoporotic fractures (MOF), distal forearm, upper arm, clinical vertebral and hip. Those four types of fractures have been reported to cause about 90% of the total burden of all osteoporotic fractures. The incidence of those four fractures in the Icelandic Heart Association cohort have been used as the basis for the international fracture risk calculator "FRAX "in Iceland...
October 2017: Læknablađiđ
https://www.readbyqxmd.com/read/29038836/automated-dxa-based-finite-element-analysis-for-hip-fracture-risk-stratification-a-cross-sectional-study
#19
S Yang, W D Leslie, Y Luo, A L Goertzen, S Ahmed, L M Ward, I Delubac, L M Lix
Fracture risk indices (FRIs) generated from DXA-based finite element analysis were associated with hip fracture independent of FRAX score computed with femoral neck bone mineral density (BMD). Prospective studies are warranted to determine whether FRIs represent an improvement over BMD for predicting incident hip fractures. INTRODUCTION: The study aims to examine the association between prior hip fracture and FRIs derived from automated finite element analysis (FEA) of DXA hip scans. Femoral neck, intertrochanteric, and subtrochanteric FRIs were calculated as the von Mises stress induced by a sideways fall divided by the bone yield stress over the specified region of interest (ROI)...
October 6, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29019717/adding-vfa-to-dxa-identifies-fracture-risk-in-a-way-not-duplicated-by-other-measures
#20
Jay P Ginther, Ann W Ginther, Lisa D Brodersen
OBJECTIVE: Published studies have demonstrated that adding Vertebral Fracture Assessment (VFA) to Dual-energy X-ray Absorptiometry (DXA) identifies more patients with increased fracture risk than DXA alone. But who needs VFA? This study attempts to determine if some test, other than VFA, could duplicate the additional information obtained by performing VFA on ALL first-time patients. This study looked at FRAX, Height Loss, Age, documented back pain, and Non-vertebral Fragility Fractures (FFs)...
October 11, 2017: Endocrine Practice
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