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Osteopenia treatments

Chandan Vangala, Jenny Pan, Ronald T Cotton, Venkat Ramanathan
The risk of mineral and bone disorders among patients with chronic kidney disease is substantially elevated, owing largely to alterations in calcium, phosphorus, vitamin D, parathyroid hormone, and fibroblast growth factor 23. The interwoven relationship among these minerals and hormones results in maladaptive responses that are differentially affected by the process of kidney transplantation. Interpretation of conventional labs, imaging, and other fracture risk assessment tools are not standardized in the post-transplant setting...
2018: Frontiers in Medicine
Sarah M Zimmerman, Melissa E Heard-Lipsmeyer, Milena Dimori, Jeff D Thostenson, Erin M Mannen, Charles A O'Brien, Roy Morello
Osteogenesis imperfecta (OI) is characterized by osteopenia and bone fragility, and OI patients during growth often exhibit high bone turnover with the net result of low bone mass. Recent evidence shows that osteocytes significantly affect bone remodeling under physiological and pathological conditions through production of osteoclastogenic cytokines. The receptor activator of nuclear factor kappa-B ligand (RANKL) produced by osteocytes for example, is a critical mediator of bone loss caused by ovariectomy, low-calcium diet, unloading and glucocorticoid treatment...
December 2018: Bone Reports
Michael R Goldberg, Liat Nachshon, Tali Sinai, Naama Epstein-Rigbi, Yael Oren, Eli Eisenberg, Yitzhak Katz, Arnon Elizur
BACKGROUND: Earlier studies noted that young adults with IgE-mediated cow's milk allergy (IgE-CMA) have significantly lower bone mineral density (BMD) than age- and gender-matched controls. We sought to identify additional risk factors contributing to the low BMD in IgE-CMA patients. METHODS: Post-pubertal (defined by Tanner stage V) IgE-CMA patients (n=78, 16-30-years-old females; 17.5-30-years-old males) were evaluated prospectively for BMD using a DXA scan, serum values of bone turnover factor, and dietary and lifestyle questionnaires...
August 11, 2018: Pediatric Allergy and Immunology
E N Dudinskaya, O N Tkachyeva, E V Bazaeva, N V Sharashkina, I D Strazhesko, Y V Kotovskaya, V N Larina
OBJECTIVE: To assess the effect of moxonidine on bone metabolism and bone mineral density (BMD) in postmenopausal patients with arterial hypertension (AH) and osteopenia. MATERIALS AND METHODS: A randomized, open, clinical trial included 114 postmenopausal patients with AH. All participants were evaluated bone metabolism), BMD, telomerase activity (TA). Randomization was carried out into 2 groups (moxonidine and bisoprolol therapy) using simple envelopes. After 12 months of therapy, a dynamic examination was performed...
2018: Kardiologiia
Isabel Pavón de Paz, José Antonio Rosado Sierra, Carmen Pérez Blanco, Naiara Modroño Móstoles, Guadalupe Guijarro de Armas, Cristina Navea Aguilera
Osteogenesis imperfecta (OI) is an inherited disorder that causes low mineral density and bone fragility. Previous studies have shown the efficacy of bisphosphonates to increase bone mineral density (BMD). This study assessed changes over time in BMD and biochemical markers of bone metabolism in adult patients with osteogenesis imperfecta treated with intravenous zoledronic acid and the safety of this treatment. PATIENTS AND METHODS: A prospective, observational study in patients with OI, osteoporosis or osteopenia (T score <-2) who were administered zoledronic acid infusions (4mg IV) every 6 months for three years and annually thereafter...
August 1, 2018: Endocrinología, Diabetes y Nutrición
May Min, Boskey Patel, Samuel Han, Lisa Bocelli, Joan Kheder, Aditya Vaze, Wahid Wassef
OBJECTIVES: The purpose of this study was to examine the impact of exocrine pancreatic insufficiency (EPI) on chronic pancreatitis (CP) patients and to identify challenges with its diagnosis and treatment. METHODS: Ninety-one patients with CP diagnosed with endoscopic ultrasound were identified and assessed for symptoms of EPI, fat-soluble vitamin levels, dual-energy x-ray absorptiometry scan T-scores, and treatment with pancreatic enzyme replacement therapy. All patients were also screened with the Malnutrition Universal Screening Test...
August 3, 2018: Pancreas
Hadi Darvishi-Khezri, Mehrnoush Kosaryan, Rosseta Akbarzadeh, Aily Aliasgharian, Mehran Fazli
Introduction: The benefit of annual administration of zoledronic acid in the management of thalassemia-associated osteoporosis is unknown. Aim: The aims of this study were to evaluate the efficacy of treatment with two different dosing regimens of IV zoledronic acid (annually versus every 3 months) for increasing low bone mineral density (BMD) in patients with osteoporosis associated with β-thalassemia as annually and 3-monthly on bone density in patients. Materials and Methods: This retrospective, single-center study analyzed patients' clinical records and bone density measurements...
June 2018: Medical Archives
David A Smith
Falls are common in nursing homes (NHs) and may result in serious injury to the resident as well as legal and regulatory liability for the NH. Some of these falls and injuries might be avoided if attending physicians were involved in risk reduction. I developed a communication tool to solicit from attending physicians specific risks for patients most likely to experience a fall and injury, and to consider strategies to reduce those risks. The communication tool addresses medications, osteopenia, vitamin D deficiency, vision, hearing, gait/balance/peripheral sensation, injury mitigation, altered mental status, restraints, and philosophy of treatment...
August 2018: Journal of the American Medical Directors Association
S-J Lim, I Yeo, P-W Yoon, J J Yoo, K-H Rhyu, S-B Han, W-S Lee, J-H Song, B-W Min, Y-S Park
The incidence of atypical femoral fractures (AFFs) was 2.95% among 6644 hip and femoral fractures. Independent risk factors included the use of bisphosphonates (BPs), osteopenia or osteoporosis, rheumatoid arthritis, increased femoral curvatures, and thicker femoral cortices. Patients with AFFs and BP treatment were more likely to have problematic healing than those with typical femoral fractures (TFFs) and no BP treatment. INTRODUCTION: To determine the incidence and risk factors of atypical femoral fractures (AFFs), we performed a multicenter case-control study...
July 23, 2018: Osteoporosis International
Chris E Forsmark
PURPOSE OF REVIEW: Recent studies have documented that many patients with pancreatic exocrine insufficiency (EPI) are not identified and are not treated with appropriate dosages of pancreatic enzyme replacement therapy. This review will summarize the approach to diagnosis, treatment, and monitoring for treatment effect and complications in patients with exocrine insufficiency. RECENT FINDINGS: While chronic pancreatitis is the most commonly identified cause of EPI, pancreatic cancer and pancreatic surgery are increasingly important...
July 19, 2018: Current Treatment Options in Gastroenterology
Katsuhiko Nakatsukasa, Hiroshi Koyama, Yoshimi Ouchi, Kouichi Sakaguchi, Yoshifumi Fujita, Takayuki Matsuda, Makoto Kato, Eiichi Konishi, Tetsuya Taguchi
Background: The aim of the study was to conduct subgroup analyses of therapeutic effects of 12-month denosumab therapy on the percentage change in bone mineral density (BMD) from baseline in the lumber spine and femoral neck. Materials and methods: We prospectively evaluated the BMD of the lumbar spine and femoral neck of 100 hormone receptor-positive, clinical stage I-IIIA postoperative postmenopausal breast cancer patients, for whom treatment with aromatase inhibitors (AIs) as adjuvant endocrine therapy was scheduled...
2018: Therapeutics and Clinical Risk Management
William D Leslie, Ego Seeman, Suzanne N Morin, Lisa M Lix, Sumit R Majumdar
The diagnostic threshold for osteoporosis, a bone mineral density (BMD) T-score ≤ -2.5, signals an increased risk for fracture. However, most fragility fractures arise among the majority of women with 'osteopenia' or 'normal' BMD. We hypothesized that a BMD T-score of -2.5, even if not intended as a treatment threshold, paradoxically may create disincentive to initiating treatment of women with osteopenia or normal BMD at high risk for fracture. From a population-based BMD registry covering the Province of Manitoba, Canada, we identified 3735 untreated women aged ≥ 50 years undergoing BMD screening in 2006-2015 found to qualify for Osteoporosis Canada guidelines-based treatment...
September 2018: Bone
Talya Miller, David L Suskind
PURPOSE OF REVIEW: Nutritional interventions play a central role in the treatment and management of inflammatory bowel disease (IBD) in children. Although malnutrition is a common presenting sign of IBD, nutritional interventions have focused not only on correction of the malnourished state but also on treatment of the primary disease. RECENT FINDINGS: Exclusive enteral nutrition (EEN) has been the primary therapy utilized in pediatric IBD specifically, Crohn's disease...
July 12, 2018: Current Opinion in Pediatrics
Ji Young Choi, Jim K Lai, Zheng-Mei Xiong, Margaret Ren, Megan C Moorer, Joseph P Stains, Kan Cao
Patients with Hutchinson-Gilford progeria syndrome (HGPS) have low bone mass and an atypical skeletal geometry that manifests in a high risk of fractures. Using both in vitro and in vivo models of HGPS, we demonstrate that defects in the canonical WNT/β-catenin pathway, seemingly at the level of the efficiency of nuclear import of β-catenin, impair osteoblast differentiation and that restoring β-catenin activity rescues osteoblast differentiation and significantly improves bone mass. Specifically, we show that HGPS patient-derived iPSCs display defects in osteoblast differentiation, characterized by a decreased alkaline phosphatase activity and mineralizing capacity...
July 12, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Zhan Shi, Jin Lv, Liu Xiaoyu, Li Wu Zheng, Xue-Wen Yang
Objective: The masticatory muscles are the most important contributor to bite force, and the temporomandibular joint (TMJ) receives direct occlusal loading. The present study aimed to investigate condylar remodeling after masseter muscle atrophy in rats. Methods: Sixty 5-week-old female Sprague-Dawley rats were divided into the following 3 groups: the control group, soft diet (SD) group, and botulinum toxin (BTX) group. The cross-sectional area (CSA) of the masseter muscles was investigated as well as atrogin-1/MuRF-1 expression...
2018: BioMed Research International
Yan-Lin Li, Kin-Hoi Wong, Martin Wai-Ming Law, Benjamin Xin-Hao Fang, Vince Wing-Hang Lau, Vince Varut Vardhanabuti, Victor Kam-Ho Lee, Andrew Kai-Chun Cheng, Wai-Yin Ho, Wendy Wai-Man Lam
This study assessed the possibility of diagnosing and excluding osteoporosis with routine abdominal CT scans in a Chinese population who underwent both DXA and CT for unrelated reasons. Statistical correlation was made between the HU measured of the spine on CT and various parameters on DXA. Diagnostic cutoff points in terms of HU were established for the diagnosis (≤ 136 HU) and exclusion (≥ 175 HU) of osteoporosis on sagittal reformatted images. There was excellent positive and negative predictive value for the DXA-defined diagnostic subgroups and were also comparable with previous studies in Caucasian populations...
July 9, 2018: Archives of Osteoporosis
Dezhi Song, Zhen Cao, Zaibing Liu, Jennifer Tickner, Heng Qiu, Chao Wang, Kai Chen, Ziyi Wang, Shiwu Dong, Jiake Xu
Osteoporosis is a metabolic disease characterized by osteopenia and bone microstructural deterioration. Osteoclasts are the primary effector cells that degrade bone matrix and their abnormal function leads to the development of osteoporosis. Reactive oxygen species (ROS) accumulation during cellular metabolism promotes osteoclast proliferation and differentiation, therefore, playing an important role in osteoporosis. Cistanche deserticola polysaccharide (CDP) possesses antitumor, anti-inflammatory, and antioxidant activity...
July 3, 2018: Journal of Cellular Physiology
Zhenshan Jia, Xiaobei Wang, Xin Wei, Gang Zhao, Kirk W Foster, Fang Qiu, Yangyang Gao, Fang Yuan, Fang Yu, Geoffrey M Thiele, Tatiana K Bronich, James R O'Dell, Dong Wang
Nephritis is one of the major complications of systemic lupus erythematosus. While glucocorticoids (GCs) are frequently used as the first-line treatment for lupus nephritis (LN), long-term GC usage is often complicated by severe adverse effects. To address this challenge, we have developed a polyethylene glycol-based macromolecular prodrug (ZSJ-0228) of dexamethasone, which self-assembles into micelles in aqueous media. When compared to the dose equivalent daily dexamethasone 21-phosphate disodium (Dex) treatment, monthly intravenous administration of ZSJ-0228 for two months significantly improved the survival of lupus-prone NZB/W F1 mice and was much more effective in normalizing proteinuria, with clear histological evidence of nephritis resolution...
July 17, 2018: ACS Nano
Carina Scholtysek, Natacha Ipseiz, Christina Böhm, Brenda Krishnacoumar, Martin Stenzel, Tina Czerwinski, Katrin Palumbo-Zerr, Tobias Rothe, Daniela Weidner, Alexandra Klej, Cornelia Stoll, Jörg Distler, Jan Tuckermann, Martin Herrmann, Ben Fabry, Wolfgang H Goldmann, Georg Schett, Gerhard Krönke
NR4A1 (Nur77 or NGFI-B), an orphan member of the nuclear receptor superfamily, has been identified as a key regulator of the differentiation and function of myeloid, lymphoid, and mesenchymal cells. The detailed role of NR4A1 in bone biology is incompletely understood. Here, we report a role for NR4A1 as novel factor controlling the migration and recruitment of osteoclast precursors during bone remodeling. Myeloid-specific but not osteoblast-specific deletion of NR4A1 resulted in osteopenia due to an increase in the number of bone-lining osteoclasts...
June 27, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Y V Dumanskiy, O V Syniachenko, Ph A Stepko, G S Taktashov, O Y Chernyshova, O Y Stoliarova
In recent years, we have discussed the correlation of malignant tumor process with the development of osteoporosis, which can be exacerbated by ongoing chemotherapy and radiation therapy. The aim of the work was to assess the status of bone metabolism in 32 untreated patients with lung cancer without metastasis. MATERIALS AND METHODS: Patients underwent dual-energy X-ray osteodensitometry of proximal part of femoral bone. Osteopontin (OP), osteocalcin (OC) and alkaline phosphatase (AP) parameters were studied in blood, as well as osteo-associated chemical elements...
June 2018: Experimental Oncology
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