MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Reviews in Bone and Mineral Metabolism' source. Thu, 09 Feb 2012 09:15:07 +0100 http://www.medworm.com/index.php?rid=5654516&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl45712135663n648%2F Abstract  Older adults with type 2 diabetes have a higher risk of fracture but do not have decrements in bone density. The reasons for greater bone fragility in diabetes are still not clearly understood, but progress has been made in identifying potential contributors. With new imaging techniques, increased cortical porosity has been identified as a possible contributing factor to bone fragility. Cortical porosity may be especially detrimental to bone strength in the presence of higher levels of advanced glycation end products. Initial results have reported higher levels of marrow adiposity in diabetic men, suggesting that diabetes may contribute to marrow stem-cell lineage allocation toward adipocytes rather than osteoblasts. Higher levels of sclerostin have also been obse... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5654516 Fri, 27 Jan 2012 17:55:23 +0100 5654516 http://www.medworm.com/index.php?rid=5642300&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Faxl5776675875744%2F Abstract  Diabetes increases the likelihood of suffering a fracture, and in the case of type 2 diabetes mellitus (T2D), low bone mass does not explain this loss in fracture resistance. Insulin contributes to the accrual of bone mass. As such, the elevated fracture risk among those with type 1 diabetes (T1D) could be due to a deficit in bone structure, especially if the diabetes is poorly controlled. Clinical studies involving computed tomography scans do suggest that low moment of inertia and low cross-sectional area of cortical bone accompany T1D. However, low bone mass does not typically accompany T2D, and fracture resistance arises from all the hierarchical levels comprising the organization of bone’s constituents. One consequence of diabetes, hyperglycemia, causes an ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5642300 Tue, 24 Jan 2012 07:20:55 +0100 5642300 http://www.medworm.com/index.php?rid=5615417&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F01071wv2r3774k36%2F Abstract  Uncarboxylated osteocalcin enhances insulin and adiponectin release and improves glucose tolerance in mice. Data in humans do not unequivocally support a role for osteocalcin in glucose homeostasis. Changes in the amount of uncarboxylated osteocalcin induced by vitamin K or warfarin treatment are not associated with changes in glucose and insulin concentrations. Interventional studies in humans, designed to detect small changes in insulin secretion and action attributable to changes in uncarboxylated osteocalcin, will be required to reliably detect effects of osteocalcin on glucose metabolism and to better understand its interaction with adiposity and adipokines. Content Type Journal ArticleCategory Original PaperPages 1-6DOI 10.1007/s12018-012-9126-xAuthors ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5615417 Tue, 17 Jan 2012 07:10:01 +0100 5615417 http://www.medworm.com/index.php?rid=5602516&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj284w36502u8218w%2F Abstract  Most studies across a variety of geographic locations suggest that vitamin D insufficiency is more common in individuals with type 1 diabetes (T1D) compared to the general population. In type 2 diabetes (T2D), while obesity is commonplace and lower vitamin D levels are present in obese adolescents and adults, the association between vitamin D insufficiency and T2D is less clear. Studies suggest that the relationship between T2D and vitamin D may be concurrently influenced by ethnicity, geography, BMI and age. Nonetheless, diabetic osteopathy is a significant comorbidity of both forms of diabetes and is characterized by micro-architectural changes that decrease bone quality leading to an increased risk for bone fracture in both disorders. The question remains, howe... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5602516 Fri, 13 Jan 2012 16:50:22 +0100 5602516 http://www.medworm.com/index.php?rid=5541525&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw3p2102r3r7j86t5%2F Abstract  In the last decade, osteocyte-produced sclerostin has emerged as a key regulator of bone remodeling. Sclerostin inhibits bone formation and may also stimulate bone resorption. Impaired sclerostin synthesis leads to generalized hyperostosis, particularly of the skull bones, in patients with sclerosteosis and van Buchem disease due to unrestrained bone formation. The synthesis of sclerostin is controlled by systemic and local factors, and aberrant sclerostin synthesis has been reported in several disorders of bone and mineral metabolism. The restricted expression of sclerostin in bone, the excellent quality of bone of patients with sclerosteosis and van Buchem disease and the lack of abnormalities in organs other than the skeleton in these patients have made scleros... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5541525 Wed, 21 Dec 2011 20:06:42 +0100 5541525 http://www.medworm.com/index.php?rid=5491367&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff700821677942716%2F Abstract  Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a complex interplay of risk factors, diseases and outcomes. In the last two decades, there has been a steady drift towards definitions depending ever more closely on laboratory abnormalities, which only represent at best possible risk factors for downstream pathology. In the early years of nephrology, especially when the therapeutic agents we had available to combat CKD–MBD were modest, bone and muscle problems were often advanced, and symptomatic, with bone and muscle pain, fractures and myopathy. This ‘old style’ hyperparathyroidism paradigm has become substantially less common now, and we can forget how symptomatic, and how draining of life-quality, CKD-MBD can be. In this chapter, we explore i... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5491367 Wed, 07 Dec 2011 12:54:26 +0100 5491367 http://www.medworm.com/index.php?rid=5426862&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F41q114088423q2r7%2F Abstract  Chronic kidney disease–mineral and bone disorders (CKD-MBD) is a term introduced by the Kidney Disease: Improving Global Outcomes (KDIGO) work group on mineral and bone disorder as a syndrome of interrelated biochemical, bone, and vascular abnormalities encountered in CKD. Biochemical abnormalities in CKD represent primary indicators for the diagnosis and management of CKD-MBD. This review discusses each abnormality separately, with references to both the Kidney Dialysis Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease and KDIGO Guidelines for Mineral and Bone Disorder. Selected references to the association between biochemical abnormalities and adverse clinical outcomes in CKD population ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5426862 Tue, 15 Nov 2011 06:49:06 +0100 5426862 http://www.medworm.com/index.php?rid=5426863&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ftl2p38425w255235%2F Abstract  Sclerostin, a secreted protein encoded by the SOST gene, has been identified as a key regulator of bone formation by studies in human and mouse genetics. Expression of this protein in osteocytes has been shown to be regulated by mechanical forces, and this has been shown to be critical for the bone formation response to load. Osteocytic expression of sclerostin is also regulated by systemic hormones that are known to influence the skeleton including parathyroid hormone and calcitonin. Circulating levels of sclerostin appear to be influenced by circulating sex steroid levels. Paracrine and autocrine factors expressed by the cells within bone (osteoblasts, osteoclasts and osteocytes), including some members of the family of cytokines that signal through gp130 (oncost... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5426863 Tue, 15 Nov 2011 06:49:04 +0100 5426863 http://www.medworm.com/index.php?rid=5371923&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy702823284r07138%2F Abstract  Changes in mineral metabolism parameters and the skeleton are commonly seen in kidney transplant recipients, especially in the first 6 months post-transplant. They include correction of complications of end-stage kidney disease, such as hypocalcemia, hyperphosphatemia and secondary hyperparathyroidism—although the latter itself may not resolve fully or may develop de novo with time. Hypercalcemia and hypophosphatemia may occur due to imbalance of their respective regulatory hormones or effects of immunosuppressive medications. Bone formation tends to decrease, and although significant loss of bone mineral density is common, the association of these changes with the significantly increased fracture risk is not well established. Therapeutic approaches have in... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5371923 Mon, 31 Oct 2011 17:00:12 +0100 5371923 http://www.medworm.com/index.php?rid=5371924&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp6656845x221223p%2F Abstract  To maintain calcium and phosphate balance despite declining kidney function, adaptations must begin in the earliest stages of chronic kidney disease (CKD). These are generally successful in maintaining calcium and phosphate levels within the normal range through CKD stages 1–4. Although routine biochemistry is not informative about net gain of these minerals, newer markers such as Klotho and fibroblast growth factor 23 may provide clues to these early adjustments and be of prognostic value. Bone cells play a central role in modulating responses to CKD. This review describes that role and highlights the dynamic communication between bone and the kidneys. Content Type Journal ArticleCategory Original PaperPages 1-14DOI 10.1007/s12018-011-9120-8Authors Graham... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5371924 Mon, 31 Oct 2011 17:00:11 +0100 5371924 http://www.medworm.com/index.php?rid=5328950&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx7p7l2317h688n51%2F Abstract  Over the past decade there has been an increasing awareness of the complexity of bone and mineral complications observed in chronic kidney disease (CKD) and recognition that the consequences of these abnormalities affect not only the skeleton, but also the cardiovascular system. These scientific advances led to the naming of a systemic disorder, “Chronic Kidney Disease-Mineral Bone Disorder” (CKD-MBD) defined as abnormalities in mineral-related biochemistries, bone modeling/remodeling and strength, and extraskeletal calcification. CKD-MBD begins early in the course of progressive CKD, at estimated glomerular filtration rates of 60 ml/min or earlier, with progression such that all dialysis patients have one or more components. The older term, renal osteody... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5328950 Fri, 14 Oct 2011 15:44:26 +0100 5328950 http://www.medworm.com/index.php?rid=5309398&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr7511504341479v5%2F Abstract  Considerable advances in the understanding and management of CKD–MBD were made in the last years; however, mortality rates remain extremely high, and the optimal approach for preventing and/or treating the mineral bone disorders in patients with stages 3, 4, and 5 CKD remains frustratingly unclear. In an attempt to minimize the morbidity and mortality associated with abnormal mineral metabolism, several evidence-based clinical practice guidelines were published, including the 2009 KDIGO guideline. But, because of the lack of randomized clinical trials, these guidelines were not able to generate strong statements in an area where there is a great unmet medical need for “guidance.” The current paper is a mini review of the current treatment approach of CKD–M... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5309398 Mon, 10 Oct 2011 15:01:32 +0100 5309398 http://www.medworm.com/index.php?rid=5266744&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0037282582n00443%2F Abstract  Genetics plays an important role in establishing susceptibility to nephrolithiasis, although diet and other environmental factors make major contributions. In a small number of patients, the genetic causes of stones are more clearly established. Four of these hereditary diseases include primary hyperoxaluria, Dent disease, cystinuria, and adenine phosphoribosyltransferase deficiency, which results in 2,8-dihydroxyadenine stones. Patients with these disorders often experience recurring stones from early childhood, requiring frequent hospitalizations and procedures. They are at risk of kidney damage and chronic kidney disease. Because of their rarity, these four disorders are difficult to study and recognize. This in turn slows progress toward effective therapies an... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5266744 Sat, 24 Sep 2011 15:44:32 +0100 5266744 http://www.medworm.com/index.php?rid=5256068&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa6011v5228t47682%2F Content Type Journal ArticleCategory IntroductionPages 1-1DOI 10.1007/s12018-011-9117-3Authors Alan Wasserstein, University of Pennsylvania School of Medicine, Philadelphia, PA, USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5256068 Fri, 23 Sep 2011 15:51:22 +0100 5256068 http://www.medworm.com/index.php?rid=5256069&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw6k177m8j217k160%2F Abstract  Bone lesions, collectively known as renal osteodystrophy (ROD), are a common complication of chronic kidney disease (CKD). Besides osteitis fibrosa and mixed lesions, other bone and mineral disorders such as adynamic bone disease, osteomalacia, osteoporosis, dialysis-related amyloidosis, and calcific uremic arteriolopathy are increasingly recognized in patients with CKD. Although bone lesions usually begin early in the course of CKD and are progressive, symptoms and signs such as bone pain and fractures may not occur until the patient is already on maintenance dialysis. More importantly, these disorders are associated with increased risk of cardiovascular disease and mortality in patients with CKD. The term ROD does not reflect the full spectrum of bone pathology ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5256069 Tue, 20 Sep 2011 15:46:35 +0100 5256069 http://www.medworm.com/index.php?rid=5231155&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa85p5205757t5774%2F Abstract  Chronic kidney disease-mineral bone disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism that has deleterious consequences on skeletal and cardiovascular health. Nowhere is the morbidity of this disorder more telling than in children. During childhood and adolescence, CKD-MBD may result in poor growth and skeletal deformities, while the mineral dysregulation can manifest in cardiovascular disease in early adulthood, a development that places the patients at high risk for severe morbidity and early mortality. Unfortunately, management of CKD-MBD has been less than satisfactory in children despite recent advances and is limited by the lack of evidence-based treatment guidelines. More positive are ongoing research efforts, such as the Chronic Kidn... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5231155 Thu, 15 Sep 2011 05:49:36 +0100 5231155 http://www.medworm.com/index.php?rid=5202064&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh4v5p535131u1351%2F Abstract  Pediatric urolithiasis is more common than previously reported. All children with urolithiasis deserve a thorough evaluation after their initial presentation. With careful assessment, metabolic risk factors may be found in the majority of children, leading to appropriate medical therapy of modifiable risk factors and prevention of further stone formation. Furthermore, early identification of inborn errors of metabolism is important to prevent morbidities associated with these disorders, such as end-stage renal disease. This review discusses the etiologies of pediatric urolithiasis, the metabolic evaluation, and treatment options. Content Type Journal ArticleCategory Original PaperPages 1-11DOI 10.1007/s12018-011-9110-xAuthors Michelle A. Baum, Children’s H... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5202064 Tue, 06 Sep 2011 15:48:26 +0100 5202064 http://www.medworm.com/index.php?rid=5202065&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw8mj7kg0p8284348%2F Abstract  Nephrolithiasis is a prevalent and costly condition with high recurrence rate. A medical evaluation to identify abnormalities responsible for nephrolithiasis and guide subsequent therapy has been advocated to reduce the risk of stone recurrence. The evaluation of kidney stone formers generally comprises an extensive medical history to identify metabolic, environmental, dietary, and/or genetic factors contributing to stone formation. Imaging studies are utilized to evaluate and follow stone burden. Laboratory studies including stone composition analysis and serum and urinary chemistries are commonly obtained to further assess for any underlying systemic disorders, to detect environmental and metabolic processes contributing to stone disease, and to guide initial an... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5202065 Tue, 06 Sep 2011 08:54:36 +0100 5202065 http://www.medworm.com/index.php?rid=5123622&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr74l4g6l63865353%2F Abstract   Renal colic describes the acute, severe, and paroxysmal pain caused by the obstruction, distension, and resultant increase in intraluminal pressure of the urinary tract. The treatment of renal colic is aimed at relief of symptoms, facilitating urinary drainage to preserve renal function and treat infection and ultimately removal or passage of the obstructing stone. The medical management of renal colic is directed at mitigating, through pharmacologic intervention, one or more of the complex processes contributing to the clinical sequelae of obstruction including pain, nausea, vomiting, and irritative voiding symptoms. Numerous medications and combinations of medications have been employed with varying degrees of clinical success. Urgent interventions are typicall... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5123622 Mon, 08 Aug 2011 19:55:16 +0100 5123622 http://www.medworm.com/index.php?rid=5084394&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7068p816634n761u%2F Content Type Journal ArticlePages 1-2DOI 10.1007/s12018-011-9108-4Authors Alan G. Wasserstein, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Founders 1, 3400 Spruce St, Philadelphia, PA 19104, USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5084394 Fri, 29 Jul 2011 16:06:07 +0100 5084394 http://www.medworm.com/index.php?rid=5060833&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk22645k305445728%2F Abstract  Infection and stones can be associated in two ways. Stone disease can occur due to infection by an organism that expresses the urea-splitting enzyme urease (infection stones). Nephrolithiasis can also be complicated by urinary tract infection that in turn was caused by obstruction of the urinary tract by a stone and/or colonization of a pre-existing stone, in both cases by non-urease producing organisms. Although the incidence of infection stones appears to have declined over recent years in the United States, they remain a cause of significant morbidity and mortality. A strong index of suspicion is necessary to identify infection stones before they become large, damage kidneys, or lead to acute morbidity such as urosepsis. Surgery remains the mainstay of therapy ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5060833 Thu, 21 Jul 2011 18:02:03 +0100 5060833 http://www.medworm.com/index.php?rid=5060834&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd483528g4550k4r6%2F Abstract  Uric acid nephrolithiasis is characteristically a manifestation of a systemic metabolic disorder. It has a prevalence of about 10% among all stone formers, the third most common type of kidney stone in the industrialized world. Uric acid stones form primarily due to an unduly acid urine; less deciding factors are hyperuricosuria and a low urine volume. The vast majority of uric acid stone formers have the metabolic syndrome, and not infrequently, clinical gout is present as well. A universal finding is a low baseline urine pH plus insufficient production of urinary ammonium buffer. Persons with gastrointestinal disorders, in particular chronic diarrhea or ostomies, and patients with malignancies with a large tumor mass and high cell turnover comprise a less common... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5060834 Tue, 19 Jul 2011 06:08:12 +0100 5060834 http://www.medworm.com/index.php?rid=5015861&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F413173374p7p8x34%2F Content Type Journal ArticlePages 1-6DOI 10.1007/s12018-011-9107-5Authors Edgar V. Lerma, Section of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine/Associates in Nephrology, SC, Chicago, IL, USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5015861 Sat, 09 Jul 2011 06:17:12 +0100 5015861 http://www.medworm.com/index.php?rid=5015862&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk835861gm82prvg7%2F Abstract  We have reviewed the general mechanisms involved in kidney stone formation, with reference to those composed of calcium oxalate or phosphate, uric acid, and cystine. These processes include nucleation of individual crystals, aggregation or secondary nucleation to produce small intrarenal multicrystalline aggregates, fixation within the kidney, and further aggregation and secondary nucleation to produce the clinical stone. The factors regulating these processes have been discussed as well as the effects of tubular fluid or urine pH and promoters or inhibitors, including urate or uric acid in the case of calcium oxalate stones, citrate, pyrophosphate, phytate, and urinary proteins. We also discuss the potential for macromolecular inhibitors to actually promote stone... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=5015862 Sat, 09 Jul 2011 06:17:10 +0100 5015862 http://www.medworm.com/index.php?rid=4990252&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjq855p78r2418567%2F In this report, we will review the epidemiology and mechanisms of calcium kidney stones formation and outline management aimed at preventing recurrences. Improved awareness and education in both the general population and among health care providers about these modifiable risk factors has the potential to improve general health and decrease morbidity and mortality secondary to renal stone disease. Content Type Journal ArticlePages 1-9DOI 10.1007/s12018-011-9103-9Authors Zachary Z. Brener, Nephrology, Beth Israel Medical Center, Albert Einstein Yeshiva University, New York, NY 10003, USAJames F. Winchester, Division of Nephrology, Beth Israel Medical Center, New York, NY 10003, USAMichael Bergman, Medicine, Rabin Medical Center, Tel-Aviv University, Campus Hasharon, Petah-Tikva, I... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4990252 Wed, 29 Jun 2011 15:51:16 +0100 4990252 http://www.medworm.com/index.php?rid=4973818&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqrn652wm130h1321%2F Content Type Journal ArticlePages 81-82DOI 10.1007/s12018-011-9102-xAuthors Izabela Podgorski, Department of Pharmacology, Wayne State University School of Medicine, 540 E. Canfield, 6304 Scott Hall, Detroit, MI 48201, USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal Volume Volume 9 Journal Issue Volume 9, Number 2 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4973818 Thu, 23 Jun 2011 16:09:29 +0100 4973818 http://www.medworm.com/index.php?rid=4973819&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl683686831p23280%2F Abstract  Cathepsin L is a ubiquitous lysosomal cysteine endopeptidase that is mainly involved in the metabolic turnover of intracellular proteins. However, it is now well established that this enzyme may also be implicated in the regulation of other important biological processes including bone resorption. Therefore, altered expression levels of Cathepsin L may result in disturbances of bone homeostasis and, eventually, in the onset of pathological conditions associated with altered bone turnover. These observations support the concept that Cathepsin L may be regarded as an additional target for the development of novel therapeutic options for the treatment of patients with bone diseases. This review provides insight into the most recent advances in understanding the role ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4973819 Thu, 23 Jun 2011 06:01:07 +0100 4973819 http://www.medworm.com/index.php?rid=4973820&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F46t42155n6507362%2F Abstract  Cysteine cathepsins are lysosomal proteases with housekeeping as well as tissue-specific functions. One of their specialized functions includes the degradation of extracellular matrix proteins and the regulation of the immune response. In recent years, this protease family received increasing attention as drug targets for bone and cartilage-related diseases. Cathepsin K is identified as the major osteoclast protease with a potent and unique collagenase activity. The protease is responsible for the bulk of collagen degradation in bone remodeling and plays a significant role in the regulation of osteoclast activity. Major efforts in the pharmaceutical industry led to the development of highly potent and specific cathepsin K inhibitors for clinical trials in osteopor... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4973820 Thu, 23 Jun 2011 06:01:05 +0100 4973820 http://www.medworm.com/index.php?rid=4966291&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0242335425834732%2F Abstract  The epidemiology and natural history of nephrolithiasis comprise its incidence and prevalence; role of age, gender, and race; risk factors, comorbidities, and course. As such, epidemiology verges into clinical features, pathogenesis, treatment, and prognosis. Although it is well known that associations derived from epidemiological studies do not prove causal relationships, lessons from epidemiology and natural history have been readily applied to pathogenesis and treatment. Conversely, knowledge derived from experiment and interventional trials has furnished models for understanding epidemiological data. Hence, it is not easy to divide epidemiology from other aspects of nephrolithiasis. While my primary emphasis in this review will be on epidemiological studies, I... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4966291 Wed, 22 Jun 2011 15:59:18 +0100 4966291 http://www.medworm.com/index.php?rid=4950466&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5385u103572h5170%2F Abstract  Drug-induced calculi and other rare stone types, such as ammonium acid urate or protein matrix stones, represent only about 2% of all renal calculi. However, the chance to easily reverse stone formation risk by discontinuing the offending drug makes identification of these entities important for clinicians. Additionally, study of these rare stone types contributes to understanding the biochemistry of stone formation. Drug-induced calculi may be classified into two groups based on the mechanism of stone formation. The first group includes drugs that provoke calculi composed of principally the drug and its metabolites. These medications tend to be poorly soluble, highly excreted in urine, and required at high dosages for long durations of therapy. Historically, sulf... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4950466 Fri, 17 Jun 2011 10:55:03 +0100 4950466 http://www.medworm.com/index.php?rid=4950467&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvr4553hn26827174%2F This article reviews different mechanisms for cathepsins in atherosclerosis and abdominal aortic aneurysm that could be targeted by selective cathepsin inhibitors. Content Type Journal ArticlePages 1-10DOI 10.1007/s12018-011-9098-2Authors Sara Sjöberg, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USAGuo-Ping Shi, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4950467 Fri, 17 Jun 2011 10:55:02 +0100 4950467 http://www.medworm.com/index.php?rid=4930335&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1114u7q083126753%2F Abstract  Members of the cysteine protease cathepsin family play an important part in human pathophysiology. Among those, Cathepsin K has a major role in enzymatic bone degradation. Cathepsin K was recently found to be expressed in adipose tissue and increased in obesity. This led to the hypothesis that Cathepsin K and potentially other forms of cathepsin might contribute to obesity and obesity-linked complications. In this context, we identified Cathepsin S gene as one of the most deregulated gene in the adipose tissue of obese subjects, showing a strong correlation with body mass index, while Cathepsin L was also found in high abundance in the adipose tissue of diet-induced and genetically obese mice. Cathepsin K or Cathepsin L deletion in genetically modified mice reduce... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4930335 Fri, 10 Jun 2011 06:38:50 +0100 4930335 http://www.medworm.com/index.php?rid=4918818&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj83522p2q14364mn%2F Abstract  There is now growing evidence that lung cysteine cathepsins take part in several biological processes and pulmonary homeostasis, although their exact functions remain to be clarified. Their production is increased in most tumors and in chronic and acute inflammatory lung disorders such as silicosis, COPD (emphysema, chronic bronchitis), asthma, and bronchopulmonary dysplasia. Cathepsins aggravate the extent and severity of inflammation and contribute to the remodeling and/or degradation of the extracellular matrix and the basement membrane. Cysteine cathepsins and their inhibitors (stefins and cystatins) are both potential markers of the prognosis and diagnosis of cancer. Cathepsin S is a potential marker of asthma, while cathepsin K may be a useful immunohistologi... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4918818 Wed, 08 Jun 2011 15:49:09 +0100 4918818 http://www.medworm.com/index.php?rid=4918819&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0t65468364728657%2F Abstract  Cathepsin S is a lysosomal cysteine protease that has been shown to play a key role in MHC class II antigen presentation. Consequently, it has been extensively evaluated as a therapeutic target in autoimmune diseases, such as rheumatoid arthritis and psoriasis. Additionally, clinical and mechanistic evidence is emerging, revealing its inappropriate expression and secretion in a wide range of disease states including atherosclerosis and tumourigenesis. This review covers the known role and consequences of cathepsin S activity in these pathological disorders, highlighting various studies that have demonstrated its utility as a therapeutic target. This review also examines challenges that exist towards the development of agents that specifically target this protease ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4918819 Tue, 07 Jun 2011 15:52:41 +0100 4918819 http://www.medworm.com/index.php?rid=4918820&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq2275q42w20247m4%2F Abstract  The human genome encodes 11 cysteine cathepsins belonging to the papain-like family of cysteine peptidases that are known predominantly as endo-lysosomal enzymes. However, it is now understood that the functions and activities of cysteine cathepsins are not limited to endo-lysosomal compartments, as they are also active in the peri- and extracellular space. The thyroid gland is an endocrine organ where such intra- and extracellular proteolytic activities are required to solubilize the prohormone thyroglobulin from its luminal, covalently cross-linked storage forms for subsequent processing into smaller protein fragments and thyroid hormone liberation. Cathepsin K has been identified as one of the cysteine cathepsins with a crucial role in thyroglobulin processing.... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4918820 Sat, 04 Jun 2011 05:53:44 +0100 4918820 http://www.medworm.com/index.php?rid=4752075&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh013wjj7282xku42%2F Abstract  Damage to normal, nontumor bone tissue following therapeutic irradiation increases the risk of fracture among cancer patients. For example, women treated for various pelvic tumors have been shown to have a greater than 65% increased incidence of hip fracture by 5 years postradiotherapy. Another practical situation in which exposure to ionizing radiation may negatively impact skeletal integrity is during extended spaceflight missions. There is a limited understanding of how spaceflight-relevant doses and types of radiation can influence astronaut bone health, particularly when combined with the significant effects of mechanical unloading experienced in microgravity. Historically, negative effects on osteoblasts have been studied. Radiation exposure has been sh... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4752075 Thu, 21 Apr 2011 06:14:27 +0100 4752075 http://www.medworm.com/index.php?rid=4744470&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffk547ml340h6312g%2F Abstract  Atraumatic osteonecrosis in adults most commonly presents in the hip. The specific etiology and pathogenesis is often uncertain, and we will review some of the specific theories regarding the development of this disease. The utility of radiographs and magnetic resonance imaging in the diagnosis and staging of osteonecrosis will also be presented. We include a summary of the different non-surgical and surgical treatment options. Early, pre-collapse, disease often has a better prognosis with head-sparing treatment options available such as core decompression and bone grafting. More advanced disease may require total hip or resurfacing arthroplasty. Content Type Journal ArticlePages 1-10DOI 10.1007/s12018-011-9091-9Authors Lynne C. Jones, Good Samaritan Hospita... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4744470 Wed, 20 Apr 2011 06:06:16 +0100 4744470 http://www.medworm.com/index.php?rid=4730727&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh724261353122601%2F Abstract  The optimal treatment for osteonecrosis of the hip is contingent on early and accurate diagnosis. Magnetic resonance imaging (MRI) has become the recommended diagnostic tool for this purpose. In order to optimize the diagnostic accuracy of MRI, consideration for other hip diseases that may cause bone marrow edema must be given. Several studies have demonstrated improvements in scanning protocols, methods for determining lesion size, and approaches for evaluating images. The potential benefits of these advancements will not be fully realized until there is greater uniformity and consensus regarding the approach for assessing and staging osteonecrosis of the hip with MRI. Content Type Journal ArticlePages 1-15DOI 10.1007/s12018-011-9088-4Authors David R. Marke... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4730727 Tue, 12 Apr 2011 21:34:49 +0100 4730727 http://www.medworm.com/index.php?rid=4681614&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F465127243w5141q3%2F This article will expand the concepts associated with the pathophysiology of the osteoclasts, providing up-to-date information on their function and involvement in bone diseases. Content Type Journal ArticlePages 1-27DOI 10.1007/s12018-011-9086-6Authors Barbara Peruzzi, Department of Experimental Medicine, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, ItalyAnna Teti, Department of Experimental Medicine, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4681614 Sat, 02 Apr 2011 05:55:38 +0100 4681614 http://www.medworm.com/index.php?rid=4681615&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk111820874775rn5%2F Content Type Journal ArticlePages 1-1DOI 10.1007/s12018-011-9089-3Authors Matthew R. Allen, Department of Anatomy & Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4681615 Sat, 02 Apr 2011 05:55:37 +0100 4681615 http://www.medworm.com/index.php?rid=4651002&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fax01873p855u3047%2F Abstract  Femoral head osteonecrosis (FHO) is potentially a devastating condition of the hip joint that can affect children and adults. The most serious outcome of this condition is the development of painful progressive osteoarthritis necessitating a total hip replacement at a relatively young age. This review focuses on childhood FHO with a special attention to the conditions that are more commonly seen in the pediatric population: Legg-Calve-Perthes disease, corticosteroid-associated FHO, and sickle cell disease. Content Type Journal ArticlePages 1-11DOI 10.1007/s12018-011-9087-5Authors Harry K. W. Kim, Center of Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USAA. Noelle Larson, University of Minnesota... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4651002 Sun, 27 Mar 2011 05:48:23 +0100 4651002 http://www.medworm.com/index.php?rid=4620515&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy448333432370218%2F Abstract  The beneficial effects of the nitrogen-containing bisphosphonate drugs have been clearly defined, especially for the treatment for osteoporosis, metastatic or primary bone malignancies, and some rare bone diseases. The adverse effects of these drugs on oral hard and soft tissues are significant and recognized with increasing frequency. The clinical, radiographic, and histopathologic features of osteonecrosis of the jaws (ONJ) are well characterized; the effects of bisphosphonates on oral soft tissues are an emerging area of study. This review will provide an overview of ONJ from a clinical perspective and also discuss recent findings related to bisphosphonate-induced soft tissue pathology. Content Type Journal ArticlePages 1-9DOI 10.1007/s12018-011-9083-9Autho... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4620515 Sat, 19 Mar 2011 02:52:50 +0100 4620515 http://www.medworm.com/index.php?rid=4539551&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx016441352274033%2F Content Type Journal ArticlePages 1-2DOI 10.1007/s12018-011-9085-7Authors Jenneke Klein-Nulend, Department of Oral Cell Biology, Academic Centre for Dentistry, Amsterdam-University of Amsterdam and VU University Amsterdam, Research Institute MOVE, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4539551 Fri, 25 Feb 2011 16:59:12 +0100 4539551 http://www.medworm.com/index.php?rid=4510975&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7423675015v08476%2F Abstract  Communication between osteoblasts, osteoclasts, and osteocytes is integral to their ability to build and maintain the skeletal system and respond to physical signals. Various physiological mechanisms, including nerve communication, hormones, and cytokines, play an important role in this process. More recently, the important role of direct, cell–cell communication via gap junctions has been established. In this review, we demonstrate the integral role of gap junctional intercellular communication (GJIC) in skeletal physiology and bone cell mechanosensing. Content Type Journal ArticlePages 1-12DOI 10.1007/s12018-011-9084-8Authors Shane A. J. Lloyd, Division of Musculoskeletal Sciences, Department of Orthopaedics and Rehabilitation, The Pennsylvania State Univ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4510975 Sat, 19 Feb 2011 07:00:11 +0100 4510975 http://www.medworm.com/index.php?rid=4487954&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F66klv83070q82771%2F Abstract  Osteocytes are commonly referred to as the professional mechanosensors in bone tissue. Despite recent advances in the study of how bone tissue adapts to mechanical loading, much remains not understood concerning the cellular mechanisms involved. We have shown that bone cell monolayers in vitro release signaling molecules in response to dynamic stress loading in a rate-dependent manner. Fluid shear stress induces high release of nitric oxide (NO) at high rates, whereas vibration stress promotes high NO release but low prostaglandin E2 (PGE2) release at high rates, indicating the specificity for signaling molecule of the type of stress. Also, we show evidence that bone cells require a stress threshold in order to respond to loading. These observations collectively p... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4487954 Mon, 14 Feb 2011 07:06:19 +0100 4487954 http://www.medworm.com/index.php?rid=4469510&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmx4w5un5772w6714%2F Abstract  Osteoradionecrosis (ORN) is one of the most serious oral complications of head and neck cancer treatment with radiotherapy. There is bone tissue necrosis and failure to heal. The bone becomes devitalized and exposed through the overlying skin or mucosa, without healing for 3 months, without the recurrence of tumor. We review the etiological factors implicated in the ORN and describe the influence of infection, radiation therapy, dental status, and surgery. Finally, we present the currently accepted therapeutics procedures for the management of osteoradionecrosis. Content Type Journal ArticlePages 1-7DOI 10.1007/s12018-011-9081-yAuthors Jose V. Bagan, Valencia University, University General Hospital, Avda/Tres Cruces s/n, 46013 Valencia, SpainCrispian Scu... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4469510 Thu, 10 Feb 2011 06:55:32 +0100 4469510 http://www.medworm.com/index.php?rid=4441453&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F982067u055875846%2F Abstract  The physiological adaptation of humans to harsh extracorporeal conditions such as those endured during space flight missions is incompletely understood and deserves considerably more attention to better comprehend and prepare space flight personnel for these alterations. Notable and well-documented changes include the loss of musculoskeletal homeostasis and impairment of bone remodeling. These deleterious effects promote loss of bone mass and mineral density and could lead to insufficient reparative processes such as fracture healing. Knowing this, the question arises as to whether extended exposure to space flight would promote altered musculoskeletal physiologies that impinge upon the normal reparative response should a fracture occur during, or some time after,... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4441453 Tue, 01 Feb 2011 08:51:08 +0100 4441453 http://www.medworm.com/index.php?rid=4359580&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp0wn7351310n0055%2F Abstract  Healthy bones combine a proper resistance against fracture with a minimum use of material. This property is likely brought about by osteocytes in response to mechanical cues, but it is still unknown how whole bone loads are translated into a signal that can be sensed by the osteocytes. The goal of this chapter is to critically analyze our current knowledge on how bone transduction takes place from the level of mechanical loads placed upon the bone as an organ to activation of a cell. Content Type Journal ArticlePages 1-7DOI 10.1007/s12018-010-9079-xAuthors Astrid D. Bakker, Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam-University of Amsterdam and VU University Amsterdam, Research Institute MOVE, Gustav Mahlerlaan 3004, 1081 LA Amster... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4359580 Sat, 15 Jan 2011 00:56:43 +0100 4359580 http://www.medworm.com/index.php?rid=4270630&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr2gm213l74365n11%2F Abstract  Mechanotransduction is a process in which cells sense applied mechanical stimulus and convert these forces into biochemical responses. This process regulates skeletal homeostasis, organization, and development, although the cellular mechanism that is responsible for mechanotransduction in bone is currently unknown. One candidate mechanosensor is the primary cilium, a single immotile organelle that extends from the surface of bone cells. The inhibition of primary cilia formation or associated components leads to reduced expression of mechanosensitive osteogenic genes, impaired osteoblastic differentiation, and skeletal phenotype irregularities. In this review, we discuss growing evidence supporting primary cilia as mediators of mechanically regulated skeletal homeo... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4270630 Tue, 14 Dec 2010 06:42:01 +0100 4270630 http://www.medworm.com/index.php?rid=4166320&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd6536v1242vw0577%2F Abstract  We introduced the mechanosome hypothesis in 2003 as a heuristic model for investigating mechanotransduction in bone (Pavalko et al., J Cell Biochem, 2003, 88(1):104–112). This model suggested specific approaches for investigating how mechanical information is conveyed from the membrane of the sensor bone cell to the target genes and how this transmitted information from the membrane is converted into changes in transcription. The key concepts underlying the mechanosome hypothesis are that load-induced deformation of bone deforms the sensor cell membrane; embedded in the membrane are the focal adhesion and cadherin–catenin complexes, which in turn are physically connected to the chromatin via a solid-state scaffold. The physical stimulation of the membrane laun... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4166320 Thu, 11 Nov 2010 06:58:39 +0100 4166320 http://www.medworm.com/index.php?rid=4166319&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm12167170046r012%2F Abstract  In a variety of scientific fields, it is helpful to visualize natural phenomena. Newly developed methods of visualization often lead to breakthroughs in scientific fields. Especially, in the bioscience field, it is significant to reveal temporal–spatial responses in cells while visualizing molecular phenomena. Such visualization may provide information to help understand cellular behavior in response to an extracellular stimulus. Although osteocytes are the most abundant cells in bone, it has been difficult to study their biological nature because they are embedded in hard bone tissue. So, the real 3D structure of osteocytes was not clarified until recently. On the other hand, a newly developed technique of visualization was recently introduced into bone cell bi... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4166319 Thu, 11 Nov 2010 06:58:39 +0100 4166319 http://www.medworm.com/index.php?rid=4166321&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvw21457p118m2538%2F Abstract  Osteoporosis is characterized by the reduced mass as well as quality of bone, and increased risk of fragility fracture. Skeletal homeostasis is maintained through the balanced activities of osteoclasts and osteoblasts, and osteoporosis is considered to be a metabolic disorder caused by an imbalance between bone resorption and formation. Whereas osteoclasts and osteoblasts have been the primary targets for elucidating the cell-based mechanisms underlying the pathophysiology of osteoporosis, much less attention has been paid to the role of osteocytes. This review focuses on the physiologic function of osteocytes in the regulation of bone and mineral metabolism, summarizing the findings from human disease and mouse genetics, and then extending the discussion to the p... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=4166321 Thu, 11 Nov 2010 06:58:38 +0100 4166321 http://www.medworm.com/index.php?rid=3493261&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F47020247n6nr6583%2F Content Type Journal ArticleCategory IntroductionDOI 10.1007/s12018-010-9074-2Authors José A. Riancho, Hospital U.M. Valdecilla-IFIMAV-RETICEF, University of Cantabria Department of Internal Medicine Santander Spain Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3493261 Tue, 20 Apr 2010 11:20:47 +0100 3493261 http://www.medworm.com/index.php?rid=3436087&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd727r4483638w3g1%2F Abstract  Osteoporosis is a common disease with a strong genetic component characterized by reduced bone mass and increased risk of fragility fractures. Twin and family studies have shown that bone mineral density (BMD) and other determinants of fracture risk such as ultrasound properties of bone, skeletal geometry, and bone turnover have a significant heritable component. Osteoporotic fractures also have a genetic component but heritability reduces dramatically with increasing age. Many different genetic variants contribute to the regulation of these phenotypes; most are common variants of small effect size, but there is evidence that rare variants of large effect size also contribute in some individuals. Genome wide association studies have recently been successfully empl... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3436087 Fri, 02 Apr 2010 08:52:48 +0100 3436087 http://www.medworm.com/index.php?rid=3381593&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F66005650167247g4%2F Abstract  Epigenetics, the study of changes in gene expression without alteration of the DNA sequence, has emerged as a promising area of research in the field of age-related diseases. Epigenetic processes, mainly DNA methylation and histone acetylation, can influence genotypes as a response to environmental and stochastic factors. The aging process is considered to be an accumulation of molecular errors, which also affect epigenetic mechanisms and could contribute to the appearance of age-related diseases. Based on the role of epigenetics in several age-dependent diseases, in this paper we discuss its possible involvement in age-dependent bone diseases such as osteoporosis and rheumatoid arthritis. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-0... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3381593 Wed, 17 Mar 2010 15:51:42 +0100 3381593 http://www.medworm.com/index.php?rid=3270843&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl620264047h9482q%2F Abstract  Although dual-energy absorptiometry (DXA) has proven its clinical utility, there are many limitations to using areal bone mineral density (aBMD) measured by DXA to predict bone strength and fracture risk. Recent advances in imaging techniques including quantitative computed tomography (QCT) and magnetic resonance imaging (MRI) have led to non-invasive assessment of bone macro-architecture and micro-architecture. Analysis techniques such as finite element (FE) modelling use image data to estimate the ability of a bone to carry load, and provide new insight into treatment effects and fracture risk. QCT and MRI can image clinically relevant sites such as the lumbar spine and proximal femur. High-resolution peripheral QCT (HR-pQCT) offers superior resolution at periph... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3270843 Fri, 12 Feb 2010 07:32:42 +0100 3270843 http://www.medworm.com/index.php?rid=3248395&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F14717263l87374r7%2F Abstract  Diagnosis and therapy of osteoporosis associated with gastrointestinal diseases is a remarkable problem. Osteoporosis is most common in celiac disease, Crohn’s disease, chronic liver disease, and in postgastrectomy patients. Protocols regarding prevention, diagnosis and therapy are based on results gained from patients with osteoporosis in the general population. This review aims to summarize the special aspects and most important clinical data regarding the bone loss associated with gastrointestinal diseases. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-010-9069-zAuthors Pál Miheller, Semmelweis University 2nd Department of Medicine Szentkirályi u. 46 H-1088 Budapest HungaryPéter L. Lakatos, Semmelweis University 1st Department of... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3248395 Fri, 05 Feb 2010 08:09:48 +0100 3248395 http://www.medworm.com/index.php?rid=3248396&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw24p4057j36p25k4%2F Abstract  Osteoporosis is a common disease with strong genetic control. Genetic linkage and association studies are the two most popular methods used to investigate the genetic basis of osteoporosis. Linkage studies have been successfully used to identify quantitative trait loci (QTLs), and association studies have been widely performed to test candidate genes for osteoporosis. In this article, we review the design and interpretation of linkage and association studies on osteoporosis. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-010-9070-6Authors Ting Xu, University of Missouri School of Medicine Kansas City MO 64108 USAYu Cheng, University of Missouri School of Medicine Kansas City MO 64108 USAYan Guo, Xi’an Jiaotong University The Key Laborato... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3248396 Thu, 04 Feb 2010 07:01:25 +0100 3248396 http://www.medworm.com/index.php?rid=3248397&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd1848604n1421317%2F Abstract  Pharmacogenomics and pharmacogenetics are emerging interdisciplinary areas recently defined, respectively as “the investigation of variations of DNA and RNA characteristics as related to drug response”, and the study of “the influence of variations in DNA sequence on drug efficacy and toxicity”. A major challenge of future genetic studies in complex disorders such as osteoporosis is the development of specific genetic tests to identify responders from non-responders as well as to identify patients at higher risk to develop adverse reactions. Even though the knowledge of the genetic determinants of bone fragility and fracture risk has consistently increased over the past decade and despite the parallel development of multiple drugs with antiresorptive or an... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3248397 Thu, 04 Feb 2010 07:01:23 +0100 3248397 http://www.medworm.com/index.php?rid=3162800&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F180j54329815m428%2F Abstract  The genetic susceptibility is clearly important in the complex inheritance of inflammatory bowel disease (IBD). Furthermore, the etiologic basis of the relationship between Crohn’s disease (CD) and ulcerative colitis (UC) is as yet unexplained. The strongest evidence supporting the contribution of inherited factors in the pathogenesis of CD and UC comes from concordance rates in twin pairs. The development of a linkage map of the human genome with informative microsatellite markers has enabled hypothesis-free scanning of the human genome for loci associated with the susceptibility to simple monogenic and polygenic diseases. Many susceptibility loci have been implicated in IBD with varying degrees of replication and statistical support. Genetic research in IBD ha... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3162800 Sat, 09 Jan 2010 08:26:47 +0100 3162800 http://www.medworm.com/index.php?rid=3155429&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn7627wh53742259h%2F Abstract  Current models for the genetics of common diseases suggest that diseases are the result of the sum of variants which on their own produce a small effect on the disease phenotype. Because of this small effect, common disease variants are very difficult to find, even with the application of the powerful new methods for the study of gene variants–disease association. An alternative approach based on the functional changes due to the variants is described here. The focus is set on regulatory variants because they fit best the current models. Regulatory variants filtered by the application of bioinformatic methods are analysed in order to select those best suited for subsequent association studies. No single method can characterize the functional consequences of a va... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=3155429 Wed, 06 Jan 2010 06:55:46 +0100 3155429 http://www.medworm.com/index.php?rid=2991928&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Flun00l1u71272151%2F Abstract  It is now well established that the onset of adult diseases such as heart disease, stroke, type 2 diabetes and hypertension are linked to an adverse uterine growth environment, in particular through maternal nutrition, during development of the individual. The geographical distribution of the incidence rate of heart disease is similar to that of osteoporosis. This may indicate a link between maternal nutrition during pregnancy and the subsequent risk of developing osteoporosis in the offspring. This review summarises what we know to date, from animal models, about maternal nutrition and the subsequent alterations in the offspring’s skeletal structure. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9065-3Authors Stuart A. Lanham, Un... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2991928 Thu, 12 Nov 2009 09:09:05 +0100 2991928 http://www.medworm.com/index.php?rid=2983962&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F42293q401wm86m7m%2F Abstract  Bone mineral density (BMD) can be measured by a variety of techniques at several skeletal sites. Once measured, the manufacturers’ software uses the BMD to calculate a T-score and/or Z-score. Both T-scores and Z-scores are derived by comparison to a reference population on a standard deviation scale. The recommended reference group for the T-score is a young gender-matched population at peak bone mass, while the Z-score should be derived from an age-matched reference population. T-scores and Z-scores are widely quoted in scientific publications on osteoporosis and BMD studies, and are the values used for DXA diagnostic criteria and current clinical guidelines for the management of osteoporosis. Errors in BMD measurement, differences in reference populations, and v... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2983962 Tue, 10 Nov 2009 07:50:37 +0100 2983962 http://www.medworm.com/index.php?rid=2897683&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd8k1680781p41647%2F Abstract  The present osteoimmunology paradigm whereby inflammation in the periosseous tissue is significantly associated with an increase in osteoclasts (OC) frequency, activity and bone destruction (i.e., inflammation-induced osteoclastogenesis and bone loss) has now been fully implemented. We and others have studied the role(s) of dendritic cells (DC) during this process and thereafter proposed that, in addition to innate effector functions and their critical role as antigen-presenting cells (APC) involved in triggering and orchestrating the adaptive immune responses, they could be directly implicated as osteoclast precursors (OCp) during inflammation at the osteo–immune interface [called; DC-derived OC or DDOC]. Further understanding of the role(s) of DC in the inflam... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2897683 Tue, 13 Oct 2009 10:54:00 +0100 2897683 http://www.medworm.com/index.php?rid=2870944&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmj37887p88285318%2F This article will review the effects of vitamin D on innate immune responses with specific emphasis on the autocrine induction of antibacterial responses in macrophages, and the regulation of dendritic cell-mediated antigen presentation. The impact of vitamin D on adaptive immunity will also be reviewed, focusing on the effects of vitamin D on T-cell function, particularly the induction of regulatory T-cells. The review will also explore the impact of vitamin D deficiency on these facets of immune function, as well as the possible benefits of vitamin D supplementation. Finally, the review will also include an appraisal of human diseases such as infection and autoimmune disease that may be substantially influenced by vitamin D-dependent regulation of human immunity. Content Type Jo... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2870944 Tue, 06 Oct 2009 12:57:58 +0100 2870944 http://www.medworm.com/index.php?rid=2811973&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F734k6234t5440101%2F Abstract  Multiple myeloma (MM) is a clonal malignancy of terminally differentiated plasma cells. Myeloma patients often have extensive skeletal complications, including bone pain, osteolytic lesions and pathological fractures, which represent the major cause of morbidity and possible mortality. Osteolysis is due to the uncoupling of bone cell activity, caused by osteoclast activation and osteoblast inhibition. Osteoclast biology is dominantly regulated by the RANK/RANKL/OPG axis. A disruption of RANKL/OPG ratio, due to the prevalence of RANKL and/or inactivation of OPG, has been reported in MM bone disease by different mechanisms involving either malignant plasma cells and/or other cells of immune system. Despite the major involvement of RANKL in MM is well documented, a d... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2811973 Fri, 18 Sep 2009 06:20:45 +0100 2811973 http://www.medworm.com/index.php?rid=2768083&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvn18586574673031%2F Abstract  Recent literature indicates that osteoclast formation in vitro from peripheral blood of patients with diseases associated with bone loss such as rheumatoid arthritis, osteoporosis, periodontitis and bone metastatic cancer may occur spontaneously being independent of addition of osteoclast formation stimulating factors such as macrophage colony forming factor (M-CSF) and receptor activator of NFκB ligand (RANKL). This could provide important clues to our understanding on how osteoclast precursors are primed within the circulation whilst commuting to the site of ultimate osteoclast differentiation. When comparing the various bone-lytic diseases, the common view emerges that accessory cells, such as T- and B-lymphocytes provide osteoclastogenesis stimulating factors... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2768083 Thu, 03 Sep 2009 06:05:14 +0100 2768083 http://www.medworm.com/index.php?rid=2733124&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu82104887j751t4g%2F Abstract  The relation between immune system, estrogen deficiency and postmenopausal bone loss is an intriguing and yet unexplained challenge of the past two decades. Here we summarize the evidences that link estrogen deficiency, T and B cells proliferation and activation, cytokines production, and bone loss with particular regard to humans. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9061-7Authors Patrizia D’Amelio, University of Torino Department of Surgical and Medical Disciplines, Section of Gerontology Corso Bramante 88/90 10126 Torino ItalyGiovanni Carlo Isaia, University of Torino Department of Surgical and Medical Disciplines, Section of Gerontology Corso Bramante 88/90 10126 Torino Italy Journal Clinical Reviews in Bone and M... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2733124 Mon, 24 Aug 2009 17:40:30 +0100 2733124 http://www.medworm.com/index.php?rid=2722632&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F20u761x4582h3642%2F Content Type Journal ArticleCategory IntroductionDOI 10.1007/s12018-009-9060-8Authors Patrizia D’Amelio, University of Torino-Italy Department of Surgical and Medical Disciplines, Section of Gerontology Corso Bramante 88/90 10126 Torino Italy Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2722632 Thu, 20 Aug 2009 09:08:00 +0100 2722632 http://www.medworm.com/index.php?rid=2718736&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3706071452427h85%2F Abstract  Although the best known actions of vitamin D involve its regulation of bone mineral homeostasis, actions critical for a healthy skeleton, vitamin D exerts its influence on many physiologic processes. One of these processes is the immune system. Both the adaptive and innate immune systems are impacted by the active metabolite of vitamin D, 1,25(OH)2D3. In turn, the immune system is now recognized as having a major impact on the skeleton. In this review, I will examine the regulation by 1,25(OH)2D3 of immune function, then examine the evidence for such regulation as potential means of ameliorating the bone loss that accompanies the inflammatory state. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9056-4Authors Daniel D. Bikle, Veterans... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2718736 Wed, 19 Aug 2009 11:16:00 +0100 2718736 http://www.medworm.com/index.php?rid=2592845&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr1535xjn74706309%2F Abstract  Biphosphonate-related osteonecrosis of the jaw (BRONJ) is a devastating side effect of oral bisphosphonates associated with patient morbidity and high financial burden to health services. BRONJ is usually associated with parenteral use of bisphosphonates in oncologic patients, but its incidence among individuals with osteoporosis who take oral bisphosphonates is on the rise. In the absence of definitive treatment for BRONJ, every effort should be made toward its prevention. The patients must be informed about the extremely small but proven risk of oral BRONJ and be recommended to undergo periodic dental evaluation and meticulous oral hygiene. Once BRONJ occurs, long-term antibiotic therapy and superficial curettage may be beneficial. Content Type Journal Article... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2592845 Thu, 09 Jul 2009 13:47:45 +0100 2592845 http://www.medworm.com/index.php?rid=2568111&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F905783226l972770%2F Abstract  Assessment of fracture risk is a key component in the evaluation of skeletal health and a critical step in determining whether to initiate pharmacological therapy to reduce fracture risk. The identification of high risk patients allows clinicians to direct limited healthcare resources to those who are most likely to benefit. Bone mineral density (BMD) and clinical risk factors (CRFs) for fracture predict fracture risk better than BMD or CRFs alone. Dual-energy X-ray absorptiometry (DXA) is a technology for the measurement of BMD to diagnose osteoporosis, assess fracture risk, and monitor the BMD response to therapy. Validated CRFs and femoral neck BMD by DXA, when available, provide the input for the World Health Organization fracture risk assessment tool (FRAX) t... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2568111 Tue, 30 Jun 2009 15:55:21 +0100 2568111 http://www.medworm.com/index.php?rid=2500290&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgpj13346h511m703%2F Abstract  Type 2 diabetes (T2DM) is associated with increased fracture risk and higher bone density (BMD), suggesting that diabetic bone is more fragile for a given density. The changes in bone quality that accompany T2DM are still not fully delineated but potential factors include more rapid bone loss, differences in cortical bone and bone structure, and changes in material properties of bone collagen due to accumulation of advanced glycation endproducts (AGEs). Increased fracture risk appears to be concentrated among patients with longer duration of diabetes while those with recent onset or with impaired glucose tolerance may instead be protected from fracture risk. Characteristics of T2DM have contradictory effects on bone strength and fracture risk. Bone strength is gen... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2500290 Tue, 09 Jun 2009 15:43:19 +0100 2500290 http://www.medworm.com/index.php?rid=2462353&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F971j9w20668061u8%2F In conclusion, bone metabolism is regulated by long-term energy balance, acute effects of feeding and dietary composition, and there are likely to be multiple interactions between these processes. Some of the endocrine mediators of feeding and bone metabolism have potential as therapeutic agents. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9052-8Authors J. S. Walsh, Northern General Hospital NIHR Bone Biomedical Research Unit Herries Road Sheffield S5 7AU UKR. Eastell, Northern General Hospital NIHR Bone Biomedical Research Unit Herries Road Sheffield S5 7AU UK Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2462353 Fri, 05 Jun 2009 09:18:52 +0100 2462353 http://www.medworm.com/index.php?rid=2462354&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk8n7813857n2nu63%2F Abstract  The assessment of bone in children is more difficult than in adults mainly due to the effect of growth and/or puberty. Despite this, there is an increasing body of evidence showing that measurement of different components of bone is of clinical relevance. Fracture incidence peaks during the early teenage years, and dual energy X-ray absorptiometry (DXA) has been shown to predict fractures in children, especially those of the upper limb, in four prospective studies. Case control and cross-sectional studies have also shown similar associations for peripheral quantitative computed tomography (pQCT), heel ultrasound, metacarpal index, and skeletal age deviation. In some cases, these latter results are additive to DXA suggesting a multifaceted approach to bone assessme... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2462354 Thu, 04 Jun 2009 11:08:43 +0100 2462354 http://www.medworm.com/index.php?rid=2454356&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmnvk4705841pt507%2F Abstract  Glucocorticoid (GC)-induced osteoporosis is the main cause of secondary osteoporosis. Fractures, which are often asymptomatic, can occur in as many as 50% of patients receiving chronic GC therapy. GCs have direct and indirect effects on bone cells (osteoblasts, osteocytes, and osteoclasts) with a suppression of bone formation and an increased bone resorption. The management of patients exposed to GCs should include the use of the minimal effective dose of GC, general health measures, and adequate intakes of calcium and vitamin D. Bisphosphonates are nowadays largely used in GC-induced osteoporosis and teriparatide has proved its efficiency as well. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9051-9Authors Béatrice Bouvard, INSERM... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2454356 Tue, 02 Jun 2009 08:15:14 +0100 2454356 http://www.medworm.com/index.php?rid=2445590&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr7hk58546k7568u3%2F Abstract  Animal models have proven valuable for elucidating the effects of body fat on bone metabolism, and this review highlights recent findings relevant for better understanding the relationship between adiposity and bone mass. Genetically obese mice and rats with altered leptin signaling consistently show reduced bone mass, demonstrating that leptin deficiency can contribute directly to osteopenia; however, the effect of leptin on bone is concentration dependent, such that relatively low doses of leptin stimulate bone formation, whereas high concentrations of leptin suppress bone formation and increase bone resorption. The hyperleptinemia associated with obesity and leptin receptor downregulation is therefore likely to have a negative impact on bone modeling and adapta... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2445590 Thu, 28 May 2009 09:26:09 +0100 2445590 http://www.medworm.com/index.php?rid=2445589&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2q74163258kl4051%2F Abstract  There is extensive clinical evidence that fat mass and bone mass are related to one another, and there are many laboratory and animal studies that explore the mechanisms of these relationships. However, there are a number of methodological issues that complicate the interpretation of both types of studies, and these need to be borne in mind as the studies reviewed in this volume are considered. These issues are reviewed in this introduction. Content Type Journal ArticleCategory IntroductionDOI 10.1007/s12018-009-9045-7Authors Ian R. Reid, University of Auckland Faculty of Medical and Health Sciences Private Bag 92019 Auckland New Zealand Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Revi... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2445589 Thu, 28 May 2009 09:26:09 +0100 2445589 http://www.medworm.com/index.php?rid=2435737&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx7v0x24235085808%2F Abstract  Nutritional status is an important determinant of skeletal health. Increased fat mass favorably influences bone mineral density and reduces fracture risk. The mechanisms by which adiposity influences skeletal health include mechanical skeletal loading, the effects of adipocyte and pancreatic β-cell-derived hormones that act on bone, and neuroendocrine outputs from the hypothalamus that respond to peripheral nutritional signals. A growing body of evidence, including the recognition that specific fatty acid receptors are expressed in skeletal tissue, also suggests that fatty acids affect skeletal health. These effects include indirect actions of dietary and circulating fatty acids, mediated by hormonal signals derived from the intestine and pancreas, and direct eff... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2435737 Sun, 24 May 2009 06:00:03 +0100 2435737 http://www.medworm.com/index.php?rid=2435738&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn2klx1014824nu42%2F Abstract  Adipocytes are an essential component of the bone marrow micro-environment. Developmentally, fatty infiltration of the marrow in the appendicular skeleton occurs at the time of peak bone acquisition. Conversely, vertebral marrow fat is most predominant with advancing age. Recent studies suggest that the amount of marrow fat is inversely associated with bone mineral density. It may also be a predictor of subsequent fracture. The molecular cellular and genetic aspects of marrow fat in mouse models and humans are discussed. More studies are needed to understand the relationship of marrow fat to mineral metabolism, energy balance, and skeletal fragility. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9050-xAuthors Masanobu Kawai, Maine M... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2435738 Sun, 24 May 2009 06:00:02 +0100 2435738 http://www.medworm.com/index.php?rid=2431409&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm422455l2u801726%2F Abstract  The adipocyte is an important source of factors that act as circulating regulators of bone metabolism. These include estrogens, and the adipokines, leptin, resistin, adiponectin, and probably others. Leptin acts directly on bone cells, and in some experimental models these effects are modified by its actions on the central nervous system, which impact on appetite, body weight, and insulin sensitivity. While not strictly an adipokine, insulin circulates in increased concentrations in obesity and exerts anabolic effects on bone. Adipokine levels correlate with bone turnover, suggesting that they dynamically influence bone metabolism. In postmenopausal women, they may be among the principal regulators of bone turnover, accounting for their increasing importance as de... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2431409 Thu, 21 May 2009 06:01:15 +0100 2431409 http://www.medworm.com/index.php?rid=2421703&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvk2k2822h1648813%2F Abstract  Bone metabolism can be assessed by measuring bone turnover markers in serum or urine. Bone turnover markers are substances released from bone during bone turnover. They can be skeletal tissue proteins, collagen fragments, peptides, or enzymes released from bone cells. Bone turnover markers are extensively used in research applications but also as tools for the management of skeletal disorders in clinical practice. Osteoporosis-related applications may include assessment of response to, or deciding on osteoporosis therapy; identification of individuals with increased bone loss, and prediction of risk for fragility fractures. Advancements in the development of assays to measure bone markers has made the measurements available also for clinical practice. The possibil... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2421703 Tue, 12 May 2009 05:51:05 +0100 2421703 http://www.medworm.com/index.php?rid=2395626&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq0170r1212290135%2F Content Type Journal ArticleCategory IntroductionDOI 10.1007/s12018-009-9043-9Authors Michael F. Holick, Boston University Medical Center Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory Boston MA USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal Volume Volume 7 Journal Issue Volume 7, Number 2 / June, 2009 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2395626 Sat, 02 May 2009 05:48:39 +0100 2395626 http://www.medworm.com/index.php?rid=2379446&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp5768n02jp95h136%2F Abstract  Africa is heterogeneous in latitude, geography, climate, food availability, religious and cultural practices, and skin pigmentation. It is expected, therefore, that prevalence of vitamin D deficiency varies widely, in line with influences on skin exposure to UVB sunshine. Furthermore, low calcium intakes and heavy burden of infectious disease common in many countries may increase vitamin D utilization and turnover. Studies of plasma 25OHD concentration indicate a spectrum from clinical deficiency to values at the high end of the physiological range; however, data are limited. Representative studies of status in different countries, using comparable analytical techniques, and of relationships between vitamin D status and risk of infectious and chronic diseases rele... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2379446 Tue, 28 Apr 2009 12:57:48 +0100 2379446 http://www.medworm.com/index.php?rid=2358467&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn31377266611243h%2F Abstract  Research over the last two to three decades has slowly demonstrated that Vitamin D, a long neglected and unappreciated hormone, is of profound importance to human health and survival. Vitamin D begins its synthesis in human skin with ultraviolet B radiation (UVB) from the sun. Melanin is a potent UVB blocker, protecting the skin from the high intensity sunlight found on the tropical savannah into which humans evolved, but not impairing the skin’s ability to synthesize generous quantities of vitamin D there. Adaptation to environmental availability of UVB radiation from the sun appears to explain the variation in skin melanin content in indigenous human populations around the world. Evidence shows populations in the United States have mean vitamin D levels that a... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2358467 Tue, 21 Apr 2009 10:49:11 +0100 2358467 http://www.medworm.com/index.php?rid=2358498&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd068026018882524%2F Abstract  This chapter reviews the potential of vitamin D for the prevention of falls and fractures. Evidence from randomized-controlled trials will be reviewed for both endpoints, as well as epidemiologic data that links higher 25-hydroxyvitamin D (25(OH)D) status to better bone and muscle health. The chapter addresses the evidence of fracture and fall prevention by dose of vitamin D, by type of dwelling and treatment duration. All data considered, this chapter summarizes the compelling dual benefit of vitamin D on fracture reduction by its bone and muscle target, a concept that is reviewed at the onset of the chapter. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9037-7Authors Heike Bischoff-Ferrari, University of Zurich Department of Rheuma... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2358498 Tue, 21 Apr 2009 10:49:09 +0100 2358498 http://www.medworm.com/index.php?rid=2358483&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm58n3r3l125w5ul0%2F Abstract  Vitamin D deficiency is now being recognized as one of the most common medical conditions worldwide. The consequences of vitamin D deficiency include poor bone development and health as well as increased risk of many chronic diseases including type I diabetes; rheumatoid arthritis; Crohn’s disease; multiple sclerosis; heart disease; stroke; infectious diseases; as well as increased risk of dying of many deadly cancers including colon, prostate, and breast. The major source of vitamin D for most humans is exposure to sunlight. However, avoidance of sun exposure has resulted in an epidemic of vitamin D deficiency. Once vitamin D is made in the skin or ingested from the diet, it requires activation steps in the liver and kidney to form 25-hydroxyvitamin D [25(OH)D]... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2358483 Tue, 21 Apr 2009 10:49:09 +0100 2358483 http://www.medworm.com/index.php?rid=2358512&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F507l5v608428n61x%2F Abstract  Despite its abundant sunshine the Middle East, a region spanning latitudes from 12°N to 42°N allowing vitamin D synthesis year round, registers some of the lowest levels of vitamin D and the highest rates of hypovitaminosis D worldwide. This major public health problem affects individuals across all life stages including pregnant women, neonates, infants, children and adolescents, adults, and the elderly. Furthermore, while rickets is almost eradicated from developed countries, it is still reported in several countries in the Middle East. These observations can be explained by limited sun exposure due to cultural practices, dark skin color, and very hot climate in several countries in the gulf area, along with prolonged breast feeding without vitamin D supplemen... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2358512 Tue, 21 Apr 2009 10:49:08 +0100 2358512 http://www.medworm.com/index.php?rid=2320367&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff2455802t4766021%2F Abstract  Originally recognized for reducing the risk of rickets, the benefits of vitamin D were extended in the past three decades, to protection against many non-calcemic diseases. The primary source of vitamin D is production by solar ultraviolet B (UVB) irradiance. In this paper, evidence is reviewed that vitamin D reduces the risk of about 17 types of cancer; bacterial infections for diseases such as dental caries, periodontitis, septicemia, and tuberculosis; viral infections such as respiratory infections and Epstein-Barr virus; autoimmune diseases such as asthma and multiple sclerosis; cardiovascular diseases such as coronary heart disease, diabetes, and stroke; and dementia. Several studies have also reported longer life expectancy with higher vitamin D supplement o... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2320367 Wed, 01 Apr 2009 06:03:44 +0100 2320367 http://www.medworm.com/index.php?rid=2320366&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp88803123p4t77m3%2F Abstract  The evolution of our understanding of the biological impact of vitamin D is briefly reviewed, with a focus on the physiology and endocrinology of the vitamin D system. This chapter attempts to bring the molecular discoveries in vitamin D metabolism and mechanisms of action into focus on known physiology and endocrinology. The latest developments on metabolism of vitamin D, the enzymes involved, and the genes responsible are presented. The impact of the molecular discoveries on current views of the importance of vitamin D in public health is also presented. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9040-zAuthors Lori A. Plum, University of Wisconsin-Madison Department of Biochemistry 433 Babcock Drive Madison WI 53706 USAHector F.... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2320366 Wed, 01 Apr 2009 06:03:44 +0100 2320366 http://www.medworm.com/index.php?rid=2320368&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbl1788224m55311n%2F Abstract  Higher levels of the principal circulating form of vitamin D, 25-hydroxyvitamin D (25(OH)D), are associated with substantially lower incidence and death rates from colon, breast, and ovarian cancer, with a linear dose–response gradient. The accumulated evidence from observational studies and a randomized trial reveal that population serum levels of 25(OH)D in the range of 40 to 50 ng/ml will markedly reduce incidence and mortality rates of several cancers including those of the breast, colon, and ovary. There is an immediate clinical need for cancer care providers worldwide to assure that a serum 25(OH)D level >40 ng/ml is achieved as soon as feasible after diagnosis of patients with breast and colon cancer, unless specifically contraindicated by pr... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2320368 Tue, 31 Mar 2009 05:59:11 +0100 2320368 http://www.medworm.com/index.php?rid=2320369&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj718466236877l88%2F Abstract  Vitamin D has been reported to have a variety of non-skeletal actions, including on glucose metabolism. There has been increasing evidence from animal and human studies, to suggest that vitamin D may be important in modifying risk of type 2 diabetes. Vitamin D is thought to have both direct (through activation of the vitamin D receptor) and indirect (via regulation of calcium homeostasis) effects on various mechanisms related to the pathophysiology of type 2 diabetes, including pancreatic beta-cell dysfunction, impaired insulin action, and systemic inflammation. The evidence from human studies comes primarily from cross-sectional and a few prospective observational studies showing an inverse association between vitamin D status and prevalence or incidence of type ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2320369 Fri, 27 Mar 2009 07:01:35 +0100 2320369 http://www.medworm.com/index.php?rid=2293576&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6w574754x3276156%2F Abstract  Genetic mouse models with targeted deletion (“knockout”) of the 25-hydroxyvitamin D-1alpha-hydroxylase gene [1α(OH)ase−/−], as well as with targeted deletion of the VDR gene, when exposed to different dietary regimens, have provided considerable insight into the molecular regulation of skeletal physiology by the 1,25(OH)2D/VDR system. These regimens induced different phenotypic changes and demonstrated that parathyroid gland size and the development of the cartilaginous growth plate were each co-ordinately regulated by calcium and by 1,25(OH)2D, and that parathyroid hormone (PTH) secretion and mineralization of bone reflected ambient calcium (and phosphorus) levels rather than the direct actions of the 1,25(OH)2D/VDR system. In contrast, increased calcium ab... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2293576 Sat, 21 Mar 2009 08:49:22 +0100 2293576 http://www.medworm.com/index.php?rid=2293579&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm2p8j17ql0164271%2F Abstract  This chapter will examine the role of vitamin D in the innate immune system as a mediator of human host defense mechanisms microbial disease, focusing on tuberculosis. The first section will examine tuberculosis and the innate immune response to the intracellular pathogen, Mycobacterium tuberculosis (M. tuberculosis), the causative agent of tuberculosis. This is followed by a discussion of the known associations, genetic and mechanistic, between the vitamin D pathway and tuberculosis susceptibility. Finally, the chapter will conclude with a discussion on the potential for adjuvant treatment of tuberculosis with vitamin D. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9034-xAuthors Philip Liu, UCLA Orthopaedic Hospital Research Cente... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2293579 Sat, 21 Mar 2009 08:49:21 +0100 2293579 http://www.medworm.com/index.php?rid=2293582&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd771065703333580%2F Abstract  This chapter reviews data on the prevalence of vitamin D deficiency, risk factors that predispose children and adolescents to this problem, and current approaches to routine vitamin D supplementation and treatment of vitamin D deficiency. The increasing world-wide prevalence of vitamin D deficiency among otherwise healthy pediatric patients is explored. Risk factors for vitamin D deficiency have been identified and include, among others, northern geographical location, dark skin pigmentation, female gender, lack of supplementation, and diseases associated with malabsorption. While supplementation strategies to prevent vitamin D deficiency have not been standardized for infants, children, and adolescents, previous studies comparing different doses have been tested ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2293582 Sat, 21 Mar 2009 08:49:20 +0100 2293582 http://www.medworm.com/index.php?rid=2293585&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv061623n7rv11844%2F Abstract  Based on clues from epidemiology, it has been proposed that low prenatal vitamin D may be a risk factor for schizophrenia. In order to explore this hypothesis, our group has undertaken an integrated research program linking analytic epidemiology and rodent experiments. There is consistent evidence from rodents that offspring exposed to low developmental vitamin D deficiency have altered brain structure and function as adults. This chapter provides a concise summary of the evidence linking vitamin D to brain development and function. In addition, the epidemiological evidence linking hypovitaminosis D and various neuropsychiatric disorders is outlined. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9031-0Authors Louise Harvey, Queensla... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2293585 Sat, 21 Mar 2009 08:49:18 +0100 2293585 http://www.medworm.com/index.php?rid=2293588&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc849742316723658%2F Abstract  The relation between vitamin D status and cancer risk has been investigated in a number of epidemiologic studies, while data from interventional studies remain scarce. The approaches to estimate vitamin D status have been varied, and include direct measures of circulating 25(OH)vitamin D (25(OH)D) levels, surrogates, or determinants of 25(OH)D, including region of residence, intake, and sun exposure estimates. In terms of cancer sites, the body of evidence is the most extensive for colorectal cancer, for which support comes from studies of 25(OH)D, vitamin D intake, multiple predictors of 25(OH)D, and region of residence in a sunny climate. The evidence for breast cancer is also intriguing, but prospective studies of 25(OH)D are sparse and somewhat conflicting. In... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2293588 Sat, 21 Mar 2009 08:49:15 +0100 2293588 http://www.medworm.com/index.php?rid=2281481&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgr9t0433457pxg89%2F Abstract  Although the kidney was initially thought to be the sole organ responsible for the production of 1,25(OH)2D3 via its enzyme CYP27b1, it is now appreciated that the expression of CYP27b1 in tissues other than the kidney is wide spread. However, the kidney is the major source for circulating 1,25(OH)2D3. Therefore the existence of the capacity for extra renal 1,25(OH)2D3 production begs the question why, and in particular whether the extra renal production of 1,25(OH)2D3 has physiologic importance. In this chapter this question will be discussed. First a compilation of the extra renal sites for CYP27b1 expression is provided. This is followed by a discussion of the regulation of CYP27b1 expression and activity in extra renal tissues, pointing out that such regulation i... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2281481 Wed, 18 Mar 2009 07:00:10 +0100 2281481 http://www.medworm.com/index.php?rid=2281480&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqv604w6t2340r646%2F Abstract  Pregnancy and lactation represent time periods where health status affects two persons instead of one. With the monumental development and growth that occurs in fetal and in early life, optimizing health status is imperative. An important part of health status is achieving and sustaining vitamin D sufficiency with vitamin D’s critical function in bone health, immune function, and cell proliferation. Investigation regarding the short-term and long-term effect of vitamin D status during these times is exponentially growing and, so far, demonstrates important roles for vitamin D in both maternal and infant bone health, glucose tolerance, and immune function. In addition, evidence points to a critical role for vitamin D in sustaining pregnancy and avoiding pregnancy... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2281480 Wed, 18 Mar 2009 07:00:10 +0100 2281480 http://www.medworm.com/index.php?rid=2222956&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy58t322731nlw102%2F The objective of this review is to describe the current evidence regarding the association of unipolar and bipolar depression with BMD and indicators of bone metabolism, and to explore potential mediating and confounding influences of those relationships. The majority of studies of unipolar depression and BMD indicate that depressive symptoms are associated with low BMD. In contrast, evidence regarding the relationship between bipolar depression and BMD is inconsistent. There is limited but suggestive evidence to support an association between affective disorders and some markers of bone turnover. Many medications used to treat affective disorders have effects on physiologic systems that influence bone metabolism, and these conditions are also associated with a range of health behavi... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2222956 Wed, 25 Feb 2009 10:25:54 +0100 2222956 http://www.medworm.com/index.php?rid=2163802&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk5x6817855g92111%2F Abstract  Thyrotoxicosis is associated with a high-turnover osteoporosis, which has been solely attributed to elevated thyroid hormone levels. Mice lacking the thyroid hormone receptors α and β establish a role for thyroid hormones in regulating bone remodeling. We show that TSH, which falls when thyroid hormones rise, directly suppresses bone remodeling, and that TSH receptor null mice have profound bone loss. We suggest that reduced TSH signaling contributes to hyperthyroid osteoporosis and that TSH and its receptor could become valuable drug targets. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-009-9024-zAuthors Li Sun, Mount Sinai School of Medicine The Mount Sinai Bone Program One Gustave L. Levy Place New York 10029 NY USAXuan Liu, Mount ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=2163802 Wed, 04 Feb 2009 14:01:03 +0100 2163802 http://www.medworm.com/index.php?rid=1921178&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F003kp1327121u857%2F Abstract  There is sufficient epidemiological and clinical data demonstrating an association between reduced bone mineral density and idiopathic hypercalciuria (IH). There have been relatively few studies that have addressed the underlying defect in bone remodeling. The limited studies to date suggest that increased bone turnover occurs in some forms of IH such as fasting hypercalciuria or renal calcium leak and explains the bone loss observed in these forms of IH. On the other hand, defective bone formation is the major defect observed in patients with IH resulting from intestinal hyperabsorption of calcium. These alterations in bone remodeling have been ascribed to genetic, metabolic, and nutritional causes. Although there are several therapeutic options available for tre... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1921178 Wed, 29 Oct 2008 06:50:03 +0100 1921178 http://www.medworm.com/index.php?rid=1790465&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx4473xr4174064t3%2F Abstract  The term “osteopetrosis” is applied to a group of disorders characterized by an increased bone density, due to an inadequate bone resorption. A considerable part of our current knowledge on osteoclast biology is based on the study of osteopetrotic animal models. The search for mutations in these animals has unveiled many molecular mechanisms underlying osteoclast differentiation and functioning. It also supplied new candidate genes for the identification of genes involved in the human variants of this disease. All osteopetrotic genes identified so far in humans have their animal counterpart. The reverse is not true. This can partially be explained by the fact that still more than 30% of all patients suffer from osteopetrosis with an unkown molecular defect. Th... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1790465 Fri, 12 Sep 2008 08:10:37 +0100 1790465 http://www.medworm.com/index.php?rid=1729623&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F172l5043pp475456%2F Abstract  Current anti-osteoporotic pharmacological treatments reduce fracture risk in part by altering bone remodeling/modeling. These effects can manifest on any or all of the bone envelopes—periosteal, intracortical, and trabecular/endocortical—each of which has unique effects on the biomechanical properties of bone. The purpose of this review is to provide an overview of how the most common FDA-approved anti-osteoporosis agents [bisphosphonates, estrogen/hormone replacement therapy, selective estrogen receptor modulators (SERMs), and parathyroid hormone (PTH)] affect tissue-level remodeling/modeling on each of the bone surfaces. Iliac crest biopsy data, the only means of assessing surface-specific bone formation in humans, exist for all of these agents although they... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1729623 Fri, 22 Aug 2008 12:46:34 +0100 1729623 http://www.medworm.com/index.php?rid=1723598&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg6r1q483l30r3681%2F Content Type Journal ArticleCategory IntroductionDOI 10.1007/s12018-008-9020-8Authors Daniel D. Bikle, University of California Department of Medicine and Dermatology, Veterans Affairs Medical Center San Francisco CA 94121 USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1723598 Tue, 19 Aug 2008 23:05:32 +0100 1723598 http://www.medworm.com/index.php?rid=1660967&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3783j634465474w4%2F Abstract  This review will highlight evidence from crew members flown on space missions >90 days to suggest that the adaptations of the skeletal system to mechanical unloading may predispose crew members to an accelerated onset of osteoporosis after return to Earth. By definition, osteoporosis is a skeletal disorder—characterized by low bone mineral density (BMD) and structural deterioration—that reduces the ability of bones to resist fracture under the loading of normal daily activities. “Involutional” or age-related osteoporosis is readily recognized as a syndrome afflicting the elderly population because of the insipid and asymptomatic nature of bone loss that does not typically manifest as fractures until after age ∼60. It is not the thesis of this rev... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1660967 Sat, 26 Jul 2008 08:56:54 +0100 1660967 http://www.medworm.com/index.php?rid=1657306&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6161643j56tt7365%2F Abstract  Nongenomic actions of thyroid hormone include several that involve or require calcium. Actions of thyroid hormone at the plasma or intracellular membranes include stimulation of membrane glucose transport and of the Na+/H+ antiporter (exchanger) by mechanisms that require liberation of intracellular calcium and stimulation of the cell membrane and sarcoplasmic reticulum calcium pumps (Ca2+-ATPases). These pumps not only transport Ca2+, but also are regulated by the intracellular calmodulin-Ca2+ complex (plasma membrane/sarcolemma) or calmodulin-dependent protein kinase II phosphorylation of phospholamban (sarcoplasmic reticulum). Intracellular calcium ion concentration may also be subject to regulation by other nongenomic effects of iodothyronines, such as those on ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1657306 Fri, 25 Jul 2008 16:23:48 +0100 1657306 http://www.medworm.com/index.php?rid=1616372&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff6523525w8360245%2F Abstract  Homocystinuria and Marfan syndrome represent distinct genetic conditions that share phenotypically similar skeletal features. An overview of the current understanding of genetic and physiologic contributing to the etiology of these conditions is summarized. The focus of this review is to explore the present understanding of the pathophysiology of Marfan syndrome and homocystinuria relative to the occurrence of osteoporosis in both conditions. Osteoporosis has been reported in association with homocystinuria. However, evidence supporting an association of osteoporosis with Marfan syndrome is equivocal and sources of ambiguity are critically reviewed. Advisability and approaches to bone mineral density monitoring in patients with Marfan syndrome or homocystinuria to... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1616372 Fri, 11 Jul 2008 07:09:38 +0100 1616372 http://www.medworm.com/index.php?rid=1522384&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F90v8v719n02r6h7w%2F This article discusses the tissue-level processes regulating bone health, mechanisms of action of exercise and pharmaceutical agents, and rationale and current evidence for combined exercise and pharmaceutical intervention for optimizing bone health. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-008-9017-3Authors R. K. Fuchs, Indiana University Department of Physical Therapy, School of Health and Rehabilitation Sciences 1140 West Michigan Street, CF-326 Indianapolis IN 46202 USAS. J. Warden, Indiana University Department of Physical Therapy, School of Health and Rehabilitation Sciences 1140 West Michigan Street, CF-326 Indianapolis IN 46202 USA Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Cli... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1522384 Sat, 14 Jun 2008 05:58:44 +0100 1522384 http://www.medworm.com/index.php?rid=1497665&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl36h3r832l674334%2F Abstract  Klotho was originally identified when a random insertional mutation disrupting the mouse gene caused an abnormal phenotype with accelerated aging and shortened lifespan. Klotho appears to play an important role in the renal handling of calcium and phosphate, in part by interacting with the FGF23 signaling system. In general, klotho tends to decrease phosphate retention and 1,25-dihydroxyvitamin D3 synthesis. It directly stimulates calcium reabsorption in the kidney and tends to increases serum calcium, but may have opposite indirect effects related to the changes in vitamin D metabolism. Klotho may also influence the response of the parathyroids to hypocalcemia and may interact with other biological systems, including Wnt, OPG/RANKL, insulin/IGF-I, and sex steroid... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1497665 Wed, 04 Jun 2008 07:28:42 +0100 1497665 http://www.medworm.com/index.php?rid=1482168&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb441246r7175vk82%2F Abstract  The adaptation of the skeleton to changes in mechanical loading depends on the ability of bone cells first to detect then to convert diverse mechanical forces into chemical signals that regulate cell behavior, a process known as mechanotransduction. A network of interactions between the extracellular matrix, integrin receptors that span the cell membrane, and intracellular cytoskeletal and signaling elements participates in mechanotransduction along with other proteins, most notably ion channels. Integrins are a family of heterodimeric proteins with binding specificity for extracellular matrix proteins, and the ability to influence cell behavior via various key effector functions in addition to mechanotransduction, including adhesion, motility, differentiation, pr... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1482168 Fri, 30 May 2008 05:55:26 +0100 1482168 http://www.medworm.com/index.php?rid=1482169&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3385466u27152300%2F Abstract  Estrogen receptors critically regulate a number of steps in the pathways in osteoblasts and osteocytes activated by exposure to dynamic mechanical strain. It is these pathways that are responsible for converting the immediate effects of strain change into a coherent stimulus for (re)modelling. It is this stimulus that controls the (re)modelling responsible for matching bones’ architecture to their customary loading. Less effective processing of this strain-related stimulus will have the same downstream effects as the absence of strain. The (re)modelling consequences are the same as those of disuse; bone loss to a genetically determined minimum. Here we review studies showing involvement of the estrogen receptor in a number of bone cells’ early responses to mec... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1482169 Fri, 30 May 2008 05:55:24 +0100 1482169 http://www.medworm.com/index.php?rid=1478167&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff1350jp883762396%2F Abstract  The mechanical consequences of skeletal microdamage have been clearly documented using various experimental methods, yet recent experiments suggest that physiological levels of microdamage accumulation are not sufficient to compromise the bones’ biomechanical properties. While great advances have been made in our understanding of the biomechanical implications of microdamage, less is known concerning the physiological role of microdamage in bone remodeling. Microdamage has been shown to act as a signal for bone remodeling, likely through a disruption of the osteocyte-canalicular network. Interestingly, age-related increases in microdamage are not accompanied by increases in bone remodeling suggesting that the physiological mechanisms which link microdamage and r... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1478167 Wed, 28 May 2008 06:38:35 +0100 1478167 http://www.medworm.com/index.php?rid=1450384&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy3375176k0800028%2F Abstract  Bone loss during skeletal unloading, whether due to neurotrauma resulting in paralysis or prolonged immobilization due to a variety of medical illnesses, accelerates bone loss. In this review the evidence that skeletal unloading leads to bone loss at least in part due to disrupted IGF signaling, resulting in reduced osteoblast proliferation and differentiation, will be examined. The mechanism underlying this disruption in IGF signaling appears to involve integrins, the expression of which is reduced during skeletal unloading. Integrins play an important, albeit not well defined, role in facilitating signaling not only by IGF but also by other growth factors. However, the interaction between selected integrins such as αVβ3 and β1 and the IGF receptor are of espe... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1450384 Fri, 16 May 2008 06:12:52 +0100 1450384 http://www.medworm.com/index.php?rid=1443113&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh772618785rg534v%2F Abstract  Over the past 40 years, much has been learnt about how mechanical loading affects bone structure. The latest studies suggest that bone cells detect mechanical loads through integrin linkages at focal adhesions. Loading stimulates new bone formation, which is due in part to increased signaling through the Wnt/LRP5 pathway. Skeletal disuse both suppresses periosteal bone formation and increases bone resorption. The latter effect is due mostly to increased RANKL signaling that stimulates new osteoclasts. Increasing the rate or frequency by which loading is applied greatly improves bone tissue mechanosensitivity, possibly due to loading-induced extracellular fluid forces around osteocytes, which serve as mechanosensors. In addition, osteogenesis after mechanical ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1443113 Tue, 13 May 2008 06:09:23 +0100 1443113 http://www.medworm.com/index.php?rid=1443112&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr6k744h315233483%2F Abstract  Significant progress has been made in the field of mechanotransduction in bone cells. The knowledge about the role of osteocytes as the professional mechanosensor cells of bone as well as the lacuno-canalicular porosity as the structure that mediates mechanosensing is increasing. New insights might result in a paradigm for understanding the bone formation response to mechanical loading, and the bone resorption response to disuse. Under physiological loading conditions the strain-derived flow of interstitial fluid through the lacuno-canalicular porosity seems to mechanically activate the osteocytes, which subsequently alter the bone remodeling activity of osteoblasts and/or osteoclasts. Fatigue loading results in local microdamage, disruption of normal flow pattern... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1443112 Tue, 13 May 2008 06:09:23 +0100 1443112 http://www.medworm.com/index.php?rid=1432740&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff6112g37033h23g1%2F Abstract  Fibroblast growth factor 23 (FGF23) is expressed primarily in skeletal tissues including osteoblasts/osteocytes and acts as a hormone regulating phosphate and vitamin D homeostasis. An excess of active FGF23 in the circulation causes multiple anomalies seen in phosphaturic diseases including rickets/osteomalacia, consistent with some but not all of the phenotypic anomalies seen in FGF23 deficient mice. FGF23 is targeted to kidney and negatively regulates activity/expression of the type II sodium-phosphate cotransporter (NPT2) as well as 25-hydroxy vitamin D-1α-hydroxylase in proximal tubular cells. Recently, teeth have been identified as a possible second principle source of FGF23. Further, both the parathyroid and bone also appear to be functional targets of FGF... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1432740 Wed, 07 May 2008 14:53:07 +0100 1432740 http://www.medworm.com/index.php?rid=1082152&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgq10721k507177p7%2F This article reviews the results of recent studies on the efficacy and safety of bisphosphonates for the treatment of postmenopausal osteoporosis. Results of randomized trials using novel dosing regimens of bisphosphonates are discussed. Outcomes include bone mineral density, bone turnover markers fractures adverse events. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-007-9006-yAuthors Ann Cranney, University of Ottawa Department of Medicine, Ottawa Health Research Institute 1053 Carling Ave K1Y 4E9 Ottawa ON CanadaJonathan D. Adachi, St. Joseph’s Healthcare – McMaster University Department of Medicine Hamilton ON Canada Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bon... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1082152 Fri, 07 Dec 2007 16:37:47 +0100 1082152 http://www.medworm.com/index.php?rid=1057451&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff57l542k50r7q074%2F Content Type Journal ArticleCategory IntroductionDOI 10.1007/s12018-007-9007-xAuthors Jonathan D. Adachi, St. Joseph’s Healthcare-McMaster University Department of Medicine 25 Charlton Avenue East, Suite 501 Hamilton ON Canada L8N1Y2 Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=1057451 Tue, 27 Nov 2007 15:39:04 +0100 1057451 http://www.medworm.com/index.php?rid=991981&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn138478q37n460g3%2F Abstract  Renal osteodystrophy includes a broad spectrum of abnormalities in bone and mineral metabolism. This review article discusses related bone disorders, including calcific uremic arteriolopathy, “osteoporosis” and compromised bone strength, and dialysis-related amyloidosis, as well as the contributing roles of glucocorticoids and metabolic acidosis. Bone disorders in the setting of renal transplantation, including osteoporosis, osteonecrosis, and presistent hyperparathyroidism, are also reviewed. Content Type Journal ArticleDOI 10.1007/BF02736670Authors Francis L. Weng, Saint Barnabas Medical Center Renal and Pancreas Transplant Division Livingston NJStanley Goldfarb, Saint Barnabas Medical Center Renal and Pancreas Transplant Division Livingston NJ Jour... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991981 Mon, 29 Oct 2007 14:36:13 +0100 991981 http://www.medworm.com/index.php?rid=991980&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx7v64h68l467w688%2F Content Type Journal ArticleDOI 10.1007/BF02736671 Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal Volume Volume 5 Journal Issue Volume 5, Number 1 / December, 2007 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991980 Mon, 29 Oct 2007 14:36:13 +0100 991980 http://www.medworm.com/index.php?rid=991986&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe12413t00mh8p262%2F Abstract  Chronic Kidney Disease (CKD) is commonly associated with alterations in bone and mineral metabolism (renal osteodystrophy). To date, bone biopsy remains the gold standard for the diagnosis and classification of the various types of renal osteodystrophy, namely: osteitis fibrosa, mixed uremic osteodystrophy, osteomalacia, aplastic and adynamic bone disease. However, due to its invasive nature and the fact that it is quite expensive, there has been a clamor for a search for other tests. Traditionally, the level of parathyroid hormone (PTH) has been considered a surrogate of bone turnover. At this time, the search continues for a specific and sensitive biochemical marker for monitoring bone turnover in CKD., e.g., alkaline phosphatase, osteocalcin, collagen degradati... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991986 Mon, 29 Oct 2007 14:36:12 +0100 991986 http://www.medworm.com/index.php?rid=991985&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F637783080rn376tm%2F Abstract  One of the major complications that arise as a result of chronic kidney disease is that of ‘renal osteodystrophy.’ It is believed to be a multifactorial disorder of altered bone modeling. Bone biopsy occupies a central role in the differentiation of the various kinds of renal osteodystrophy based on histological findings. However, due to its limitations of being a rather invasive and costly procedure, it is performed rather infrequently. Therefore, scientists started to focus on alternative measures of classifying the various types, e.g., the parathyroid hormone (PTH). PTH has been used as an indicator of bone turnover, thereby dividing the diseases into those of high turnover and low turnover. To further our understanding of this particular disease entity, a ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991985 Mon, 29 Oct 2007 14:36:12 +0100 991985 http://www.medworm.com/index.php?rid=991984&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd0w6737071h22532%2F This article discusses the therapeutic approaches focuses for renal osteodystrophy. Content Type Journal ArticleDOI 10.1007/BF02736669Authors Anca Gal-Moscovici, Hebrew University Hadassah Hospital Medical Center Ein Keren, Jeruslaem IsraelStuart M. Sprague, Northwestern University Feinberg School of Medicine Division of Nephrology and Hypertension, Evanston Northwestern Healthcare Evanston ILEdgar V. Lerma, University of Illinois at Chicago College of Medicine/Associates in Nephrology Section of Nephrology Chicago IL Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal Volume Volume 5 Journal Issue Volume 5, Number 1 / December, 2007 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991984 Mon, 29 Oct 2007 14:36:12 +0100 991984 http://www.medworm.com/index.php?rid=991983&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw141811003t86155%2F Content Type Journal ArticleDOI 10.1007/BF02736665Authors Edgar V. Lerma, University of Illinois at Chicago College of Medicine/Associates in Nephrology Section of Nephrology Chicago IL Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal Volume Volume 5 Journal Issue Volume 5, Number 1 / December, 2007 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991983 Mon, 29 Oct 2007 14:36:12 +0100 991983 http://www.medworm.com/index.php?rid=991982&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmku706nk002v6n6j%2F Abstract  Renal osteodystrophy is a common complication of chronic Kidney disease, and abnormalities of bone metabolism are a reflection of broad-based disturbances in the control mechanisms for mineral metabolism. Secondary hyperparathyroidism is a major contributor to the high turnover form of renal osteodystrophy. Detailed investigations over the past several decades have uncovered many of the mechanisms involved in the initiation and maintenance of secondary hyperparathyroidism and it is these mechanisms that provide the basis for therapeutic intervention to control this complication of chronic kidney disease. An additional form of renal osteodystropy is characterized by abnormally low bone turnover, which also is multi-factorial in origin. Again, an understanding of th... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991982 Mon, 29 Oct 2007 14:36:12 +0100 991982 http://www.medworm.com/index.php?rid=991979&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl168q47832015tg7%2F Content Type Journal ArticleDOI 10.1007/BF02736672Authors Edgar V. Lerma, University of Illinois at Chicago College of Medicine/Associates in Nephrology Section of Nephrology Chicago IL Journal Clinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal Volume Volume 5 Journal Issue Volume 5, Number 1 / December, 2007 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=991979 Mon, 29 Oct 2007 14:36:12 +0100 991979 http://www.medworm.com/index.php?rid=974625&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj21656p6wpx74731%2F Abstract  BPs can be grouped into two general classes according to their chemical structure and the molecular mechanism by which they inhibit osteoclast-mediated bone resorption. The simple BPs can be metabolically incorporated into non-hydrolysable analogues of ATP that accumulate intracellularly in osteoclasts, causing osteoclast cell death by apoptosis. By contrast, the more potent N-BPs inhibit FPP synthase, an enzyme in the mevalonate pathway. Inhibition of this enzyme in osteoclasts prevents the biosynthesis of isoprenoid lipids that are required for the prenylation of small GTPase signalling proteins necessary for osteoclast function. Inhibition of FPP synthase in cells other than osteoclasts also appears to account for the adverse effects of N-BPs in vivo (incl... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=974625 Sun, 21 Oct 2007 00:09:41 +0100 974625 http://www.medworm.com/index.php?rid=947441&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh45u448l67510lp0%2F Abstract  Osteogenesis Imperfecta (OI) is a rare heritable condition characterized by bone fragility and reduced bone mass. Most affected individuals carry a mutation that compromises the synthesis and/or the structural organization of type I collagen. Histologically there is a picture of osteoporosis with increased remodeling rate. On that basis, bisphosphonate treatment was introduced, and definite benefits, in terms of pain control, fracture incidence and degree of ambulation, became rapidly evident. Cyclical intravenous pamidronate is now the standard of care for moderate/severe OI in combination with appropriate orthopedic corrections and rehabilitation programs. While it is amply demonstrated that the use of bisphosphonates in OI is effective and safe for the short te... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=947441 Thu, 11 Oct 2007 15:11:16 +0100 947441 http://www.medworm.com/index.php?rid=941932&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5m14429554711584%2F Abstract  Tumor-induced osteolysis is responsible for a considerable morbidity and often dramatically alters patients’ quality of life. Bone destruction is essentially mediated by the osteoclasts, the formation and activity of which are stimulated by tumor secretory products. Bisphosphonates are able to interrupt the vicious circle between metastatic cancer cells and bone cells/bone matrix by inducing osteoclast apoptosis. For breast cancer patients with metastatic disease and radiographic evidence of bone destruction, current guidelines consist in the administration of either pamidronate 90 mg over 2 h or zoledronic acid 4 mg over 15 min every 3–4 weeks. Other bisphosphonates were not considered. Nevertheless, placebo-controlled trials have esta... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=941932 Tue, 09 Oct 2007 15:34:04 +0100 941932 http://www.medworm.com/index.php?rid=941931&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmg73275r83104274%2F Abstract  Paget’s disease of bone is a chronic focal bone remodeling disorder with distinctive geographic occurnece. In the US, 1.8% of people over 60 years of age are affected. At present, 70% of patients are asymptomatic with the most common presenting symptoms being bone pain, osteoarthritis, and bone deformity. Paget’s disease is usually easily diagnosed by an elevated serum alkaline phosphatase level, a bone scan and skeletal radiographs of area that show increased activity on the bone scan. There is no cure for this disorder; however, a class of drugs, the bisphosphoates, can control the elevated bone remodeling rates, improve osteolytic skeletal lesions and attendant bone pain. The most effective bisphosphonates are the nitrogen-containing compounds, which can be... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=941931 Tue, 09 Oct 2007 15:34:04 +0100 941931 http://www.medworm.com/index.php?rid=912074&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc702513425x27142%2F Abstract  Drugs may affect bone turnover and density in many ways. However, the disease for which the drugs are administered may also contribute to bone loss. Infection with human immunodeficiency virus leads to a loss of bone mineral, while treatment with highly active antiretroviral therapy does not seem to contribute to further bone loss. Type 1 diabetes is associated with a decrease in bone mineral, while type 2 diabetes is associated with an increase. The new class of thiazolidinediones (glitazones) has been associated with an increased loss of bone mineral. In breast cancer treatment, tamoxifen is associated with an increased bone mineral, while the newer class of aromatase inhibitors through a decrease in serum oestradiol are associated with an increased loss of bone... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=912074 Thu, 27 Sep 2007 15:43:47 +0100 912074 http://www.medworm.com/index.php?rid=882923&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Far68q43838106585%2F Abstract  Corticosteroid osteoporosis is a common clinical problem with the risk of fracture, highest in postmenopausal women. The first choice for prevention is a potent oral bisphosphonate such as alendronate or risedronate. In patients intolerant of oral bisphosphonates, intravenous bisphosphonates should be used. Prophylactic therapy should be continued whilst patients continue significant doses of corticosteroid therapy. In patients receiving chronic low-dose corticosteroids where the BMD is substantially reduced, other therapies such as PTH should be considered, followed by a bisphosphonate. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s12018-007-9000-4Authors Philip N. Sambrook, University of Sydney, Royal North Shore Hospital Institute of Bone a... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=882923 Fri, 14 Sep 2007 19:31:25 +0100 882923 http://www.medworm.com/index.php?rid=865627&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ftv4401071v352837%2F Abstract  In the setting of renal disease and hyperparathyroidism, a near total parathyroidectomy with cryopreservation is a safe and effective treatment. Even with improved dialysis and medical management, parathyroid surgery remains effective therapy for patients with hyperparathyroidism associated with renal failure. Symptomatic patients particularly need to be identified earlier for parathyroidectomy to prevent progression of bone disease in chronic renal failure. Content Type Journal ArticleDOI 10.1007/s12018-007-0006-8Authors Jyotirmay Sharma, Emory University Department of General Surgery 1365 Clifton Atlanta GA 30322 USACollin J. Weber, Emory University Department of Surgery/Research 101 Woodruff Circle, Suite 5105 Atlanta GA 30322 USA Journal Clinical Revi... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=865627 Tue, 11 Sep 2007 08:12:26 +0100 865627 http://www.medworm.com/index.php?rid=841847&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu622727u75058481%2F Abstract  The field of parathyroid surgery is rich in history. It begins with an obscure publication by a Swedish medical student noting a distinct anatomic entity in the neck adjacent to the thyroid gland; these tiny glands would come to be known as the parathyroid glands. This was followed by the subsequent discovery of their role in calcium metabolism, once the devastating effects of hyperparathyroidism on the bones and kidneys were recognized. The first neck explorations with identification and removal of parathyroid adenomas took place in the early twentieth century. Following the initial parathyroid operations in the United States and Europe, the mid-twentieth century was dominated by extensive investigation into calcium metabolism and the effects of parathyroid hormo... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=841847 Tue, 04 Sep 2007 14:47:24 +0100 841847 http://www.medworm.com/index.php?rid=823644&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2l73m72g732422t2%2F Abstract  Numerous studies have provided evidence of an association between antiepileptic drugs (AEDs) and adverse effects. Manifestations of bone disease in persons treated with AEDs include rickets, osteomalacia, osteoporosis, and fracture. There exists pathological and radiographic evidence of bone disease in persons with epilepsy treated with AEDs. As well, numerous biochemical abnormalities have been described including hypocalcemia, hypophosphatemia, reduced levels of biologically active vitamin D metabolites, hyperparathyroidism, and accelerated bone turnover, as measured by markers of bone formation and bone resorption. The AEDs most commonly reported as affecting bone include inducers of the cytochrome P450 enzyme system (phenytoin, phenobarbital, primidone, carbam... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823644 Sun, 26 Aug 2007 08:32:40 +0100 823644 http://www.medworm.com/index.php?rid=823646&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F97079238p7t84263%2F Abstract  It is relatively well established that thyroid hormone has a clinically significant effect on bone. Although some aspects, such as the bone mineral loss associated with overt thyrotoxicosis have been relatively well described, others remain much less clear. A major focus of this review is on the effects of chronic exogenous thyroid hormone administration on bone physiology. When thyroid hormone dosage is supraphysiologic, an iatrogenic clinical model is produced comparable to endogenous “subclinical hyperthyroidism”. Indeed, literature on bone mineral changes in the latter entity may be analyzed as representative of effects of excessive circulating thyroid hormone. At the molecular level, thyroid hormone receptors as well as thyroid-stimulating hormone (TSH) r... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823646 Sun, 26 Aug 2007 08:32:39 +0100 823646 http://www.medworm.com/index.php?rid=823645&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq870673271546045%2F This article focuses on therapy for breast cancer and other malignancies and the respective contributions of such therapy to bone loss. Content TypeJournal Article JournalClinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal VolumeVolume 2 Journal IssueVolume 2, Number 2 / June, 2004 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823645 Sun, 26 Aug 2007 08:32:39 +0100 823645 http://www.medworm.com/index.php?rid=823643&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1736p28864516481%2F Abstract  Osteoporosis is an important complication of androgen-deprivation therapy (ADT) for prostate cancer. ADT by either bilateral orchiectomies or treatment with a gonadotropin-releasing hormone (GnRH) agonist decreases bone mineral density (BMD) and increases the risk of fracture. Prospective data about treatment or prevention of osteoporosis in men with prostate cancer are limited. Supplemental calcium and vitamin D are recommended. Additional therapy may be warranted for men with osteoporosis or fractures. Intravenous pamidronate prevents bone loss in the hip and spine during ADT. Intravenous zoledronic acid not only prevents bone loss but also increases BMD. Alendronate is approved to treatmen with osteoporosis although the efficacy of alendronate or other oral bis... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823643 Sun, 26 Aug 2007 08:32:39 +0100 823643 http://www.medworm.com/index.php?rid=823641&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr351tm5l35504126%2F Abstract  The anticoagulants heparin and sodium warfarin (4-hydroxycoumarin) are commonly used as antithrombotic agents. However, their long-term use has been linked to a variety of adverse effects on the skeleton, including warfarin-induced embryopathy and osteoporosis. Although both heparin and warfarin have been reported to decrease bone density, the mechanisms responsible for bone loss have not yet been fully elucidated. Recent studies with experimental animals have suggested that these agents act on bone to decrease the rate of bone formation while increasing the rate of bone resorption. In addition, such studies along with a number of clinical trials suggest that the risk of developing osteoporosis may be lower with low-molecular-weight heparins than it is with hepari... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823641 Sun, 26 Aug 2007 08:32:39 +0100 823641 http://www.medworm.com/index.php?rid=823638&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhm814104k1220433%2F This article offers a review of the relevant literature over the past decade on the relationship between bone mineral density (BMD) and selected forms of hormonal contraception, specifically, depot medroxyprogesterone (DMPA) and oral contraceptives (OC) in women younger than 30 yr of age. In summary, findings to date suggest an adverse impact of DMPA and ultra-low-dose (20 μg ethinyl estradiol) OCs on BMD in young women. The effects appear independent of age; however, the acquisition of optimal peak bone mass, particularly in adolescents, may be impeded in young women utilizing these types of hormonal contraception. Several mitigating issues also need to be considered in evaluating prescription of DMPA and OCs in young women. These include the following: (1) likelihood of at least p... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823638 Sun, 26 Aug 2007 08:32:39 +0100 823638 http://www.medworm.com/index.php?rid=823642&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgn8277066g3n9856%2F Abstract  The immunosuppressive agents introduced to enhance the action of glucocorticoids and to prevent organ rejection had a dramatic impact on reducing the incidence of organ rejection, enhancing donor organ, and hence patient survival following transplantation. However, these agents, cyclosporine and tacrolimus, termed calcineurin inhibitors (CIs) also have side effects, including the promotion of rapid and severe bone loss in vivo experimentally as well as clinically. The mechanism at present accounting for this action is unclear, but the role of the T lymphocyte in vivo is essential for the process of bone loss. Other immune-modifying drugs, such as az athioprine, mycophenolate mofetil, and sirolimus, which are used in conjunction with glucocorticoids and the CIs have... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823642 Sun, 26 Aug 2007 08:32:38 +0100 823642 http://www.medworm.com/index.php?rid=823640&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F87081h158p2w8w7u%2F Abstract  Glucocorticoid-induced osteoporosis is the leading cause of medication-induced osteoporosis. The fracture incidence after 1 yr of glucocorticoid therapy has been found to be 17% and observational studies suggest that fractures eventually occurin 30 to 50% of chronic glucocorticoid-treated patients. An increased risk of fracture develops within as quickly as 3 mo, and with doses of prednisone as low as 2.5 mg daily. Despite effective methods of prevention and treatment, only 50% of chronic glucocoriticoid-treated patients undergo any evaluation for osteoporosis and less than one in four receives treatment. This article addresses the various issues the clinician faces in managing patients receiving chronic glucocorticoids. It begins and ends with a case perspective.... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823640 Sun, 26 Aug 2007 08:32:38 +0100 823640 http://www.medworm.com/index.php?rid=823639&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0177k8742x480344%2F Abstract  Bone disorders have emerged in the last 5 yr as additional long-term complications of human immunodeficiency virus (HIV) infection and its treatment. In particular, multiple studies suggest that HIV-infected patients receiving potent antiretroviral therapy have an increased prevalence of both osteopenia and osteoporosis. Studies prior to the era of potent antiretroviral therapy suggest that HIV infection has a modest effect on bone turnover. Treatment of HIV increases bone turnover with a greater effect on bone resorption. The mechanisms for increased bone demineralization in HIV-infected patients are unclear, although there is some evidence that specific drugs may inhibit bone formation in vitro. Small studies suggest that, in general, bone loss is not progressiv... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=823639 Sun, 26 Aug 2007 08:32:37 +0100 823639 http://www.medworm.com/index.php?rid=778953&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv6281675r6523361%2F Conclusion  This introduction to normal calcium provides a basis for an understanding of the investigation of calcium disorders, which now follows. Content TypeJournal Article JournalClinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal VolumeVolume 1 Journal IssueVolume 1, Number 1 / March, 2002 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=778953 Thu, 02 Aug 2007 06:59:50 +0100 778953 http://www.medworm.com/index.php?rid=778950&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl1t14748j8u85426%2F Conclusions  The etiology of hypercalcemia can be clearly defined in the majority of patients by following a simple diagnostic algorithm outlined in Fig. 1. The performance and interpretation of analytical methods, now routinely available within diagnostic laboratories, has improved considerably within the last decade. These developments have improved our ability to diagnose the cause of hypercalcemia with confidence. Consequently, it should be possible to determine whether the hypercalcemia, in an individual patients, is mediated principally by the bowel, kidney, or bone compartment. Armed with this information and with the advent of novel, more selective therapeutic agents, treatment prescriptions in the future may be more appropriately tailored to each individual case. ... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=778950 Thu, 02 Aug 2007 06:59:50 +0100 778950 http://www.medworm.com/index.php?rid=778936&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc2281610k6821261%2F Content TypeJournal Article JournalClinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal VolumeVolume 1 Journal IssueVolume 1, Number 1 / March, 2002 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=778936 Thu, 02 Aug 2007 06:59:50 +0100 778936 http://www.medworm.com/index.php?rid=778954&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F406303r5525w8500%2F Conclusion  In summary, both FBHH and NSHPT represent the phenotypic expression of inactivating mutations of the CaSR in most cases, FBHH usually presenting with mild asymptomatic lifelong hypercalcemia and NSHPT with generally more severe, potentially lethal hypercalcemia, which, in cases of homozygous or compound heterozygous CaSR mutations, carries a high morbidity. Additional molecular studies should elucidate the basis for variations in the phenotypic and biochemical abnormalities observed with both FBHH and NSHPT and identify the disease genes on chromosome 19 that can also cause FBHH in rare cases. Content TypeJournal Article JournalClinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal VolumeVolume 1 Journal Is... Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=778954 Thu, 02 Aug 2007 06:59:49 +0100 778954 http://www.medworm.com/index.php?rid=778951&cid=s_35924_49_f&fid=35924&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu5ql57483l823j01%2F Conclusion  Rehydration and bisphosphonates represent the mainstay of the management of hypercalcemia associated with malignancy with successful achievement of normocalcemia in some 90% of patients. New experimental approaches are currently being tested. and the antiosteoclastic potential of osteoprotegrin appars to be promising. Content TypeJournal Article JournalClinical Reviews in Bone and Mineral MetabolismOnline ISSN 1559-0119Print ISSN 1534-8644 Journal VolumeVolume 1 Journal IssueVolume 1, Number 1 / March, 2002 (Source: Clinical Reviews in Bone and Mineral Metabolism) Clinical Reviews in Bone and Mineral Metabolism journals http://www.medworm.com/rss/comments.php?id=778951 Thu, 02 Aug 2007 06:59:49 +0100 778951