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 'Current Osteoporosis Reports' source. Fri, 19 Mar 2010 16:06:03 +0100 http://www.medworm.com/index.php?rid=3361211&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh7n787k45582w30q%2F Abstract  Osteoporosis and fractures are under-recognized and undertreated, both in men and women worldwide. Male osteoporosis is not the epidemic problem that female osteoporosis is; however, the National Osteoporosis Foundation estimates that over 14 million American men have osteoporosis or low bone mass, and approximately 25% to 30% of all hip fractures occur in male individuals who incur greater morbidity and mortality than their female counterparts. Until recently, alendronate, risedronate, and teriparatide were the only pharmacologic agents approved by the US Food and Drug Administration for treating male osteoporosis. In December 2008, zoledronic acid was approved for “treatment to increase bone mass in men with osteoporosis.” In 2009, zoledronic acid was also a... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3361211 Thu, 11 Mar 2010 02:24:30 +0100 3361211 http://www.medworm.com/index.php?rid=3329320&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj5118q2572108660%2F Abstract  Several case series and multiple individual case reports suggest that some subtrochanteric and femoral shaft fractures might occur in patients who have been treated with long-term bisphosphonates. Several unique clinical and radiographic features are emerging: prodromal thigh pain prior to the fracture, complete absence of trauma precipitating the fracture, and bilateral fractures in some patients. Radiographic features include presence of stress reaction, transverse or short oblique fractures, and thick femoral cortices. The overall incidence of subtrochanteric and shaft fractures combined is below 30 per 100,000 person-years, so this type of fracture is much less common than proximal femur (hip) fracture. Furthermore, the unique “atypical” fracture type is a... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3329320 Tue, 02 Mar 2010 10:08:05 +0100 3329320 http://www.medworm.com/index.php?rid=3329321&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9440854572p08182%2F Abstract  Teriparatide is a drug currently approved for treating patients with osteoporosis who are at high risk for future fracture. In the treatment of osteoporosis, teriparatide works as an anabolic agent stimulating bone formation throughout the skeleton by principally enhancing osteoblast-derived bone formation relative to osteoclast-derived bone resorption. The net effect is increased bone mass. For patients with a fracture, a similar process of increased bone formation is required transiently at the fracture site for repair. Teriparatide has been investigated in animal models and in patients as a potential agent to enhance fracture repair. In addition, evidence that teriparatide enhances chondrogenesis has generated interest in using the agent for articular cartilage... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3329321 Tue, 02 Mar 2010 10:08:03 +0100 3329321 http://www.medworm.com/index.php?rid=3296646&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9674014257781658%2F Abstract  Can osteoporosis disease management be cost effective? To answer that question, we conducted an extensive review of osteoporosis and fragility fracture prevention literature in peer-reviewed scientific journals and evidence-based guidelines from professional societies and government health organizations. We explored different strategies suggested by the literature to find how programs can be structured to be cost effective and to decrease fracture rates. We focused on ways to cost effectively identify, risk stratify, treat, and then track patients at risk for osteoporosis and fragility fractures. Studies have shown that osteoporosis management can decrease the hip fracture rate by 25% to 50% and be cost effective at the same time. Content Type Journal ArticleD... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3296646 Sat, 20 Feb 2010 06:57:45 +0100 3296646 http://www.medworm.com/index.php?rid=3291654&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu821088017355002%2F Abstract  Osteoporosis due to glucocorticoid-induced osteoporosis (GIOP) for inflammatory disorders continues to be a common problem. Well-distributed guidelines have provided evidence-based recommendations for management, yet many patients have little attention paid to their increased fracture risk. The purpose of this article is to discuss how new treatments for GIOP may improve overall management. Intravenous zoledronic acid (ZA), an antiresorptive agent, and teriparatide (TPT), which stimulates osteoblasts, have received US Food and Drug Administration (FDA) approval for treating GIOP. ZA is appealing because one 15-min infusion covers the patient for a year and potentially will increase the proportion of GIOP patients who are treated. TPT makes physiologic sense becaus... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3291654 Fri, 19 Feb 2010 06:44:44 +0100 3291654 http://www.medworm.com/index.php?rid=3291653&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc368054401034550%2F This article reviews the clinical use and abuse of the two biomarkers most commonly used to assess the effectiveness of therapy in clinical practice: bone mineral density testing and measurement of markers of bone turnover. Content Type Journal ArticleDOI 10.1007/s11914-010-0004-5Authors E. Michael Lewiecki, New Mexico Clinical Research & Osteoporosis Center 300 Oak Street NE Albuquerque NM 87106 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3291653 Fri, 19 Feb 2010 06:44:44 +0100 3291653 http://www.medworm.com/index.php?rid=3289746&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3015288l71616336%2F Abstract  The striking clinical benefits of intermittent parathyroid hormone in osteoporosis have begun a new era of skeletal anabolic agents. Recombinant human parathyroid hormone (rhPTH) (1–34) is the first US Food and Drug Administration–approved anabolic therapy. Its use has been limited by the need for subcutaneous injection. Newer delivery systems include transdermal and oral preparations. Newer anabolic therapies include monoclonal antibody to sclerostin, a potent inhibitor of osteoblastogenesis; and use of bone morphogenetic proteins and parathyroid hormone–related protein PTHrP, a calcium-regulating hormone similar to PTH. Content Type Journal ArticleDOI 10.1007/s11914-010-0005-4Authors Nancy E. Lane, University of California at Davis Medical Center Agi... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3289746 Thu, 18 Feb 2010 06:53:05 +0100 3289746 http://www.medworm.com/index.php?rid=3289748&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2100p71804m7t122%2F This article explains the role of microbial biofilms in BONJ and also discusses associated factors in the disease pathogenesis, which include BP effects on bone remodeling, anti-angiogenesis, matrix necrosis, microcracks, soft tissue toxicity, and inflammation and wound healing. Recent findings suggest a key role for microbial biofilms in the pathogenesis of BONJ; this has important therapeutic implications because biofilm organisms represent a clinical target for prevention and treatment efforts aimed at reducing the significant morbidity and costs associated with this condition. Content Type Journal ArticleDOI 10.1007/s11914-010-0008-1Authors Satish K. S. Kumar, University of Southern California Clinical Dentistry, Orofacial Pain and Oral Medicine Center, Division of Diagnost... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3289748 Thu, 18 Feb 2010 06:53:04 +0100 3289748 http://www.medworm.com/index.php?rid=3289747&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa678n04735856347%2F Content Type Journal ArticleCategory CLINICAL TRIAL REPORTDOI 10.1007/s11914-010-0001-8Authors David S. Silver, Cedars Sinai Medical Center/UCLA School of Medicine and the OMC Clinical Research Center 8641 Wilshire Boulevard, Suite 301 Beverly Hills CA 90211 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3289747 Thu, 18 Feb 2010 06:53:04 +0100 3289747 http://www.medworm.com/index.php?rid=3042263&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl30k38k4wv857t68%2F This article describes the latest data in this exciting area of research, including novel epigenetic and translation work, which should help to elucidate the underlying mechanisms and give rise to potential public health interventions to reduce the burden of osteoporotic fracture in future generations. Content Type Journal ArticleDOI 10.1007/s11914-009-0024-1Authors Chivon WinsloeSusie EarlElaine M. DennisonCyrus CooperNicholas C. Harvey, University of Southampton, School of Medicine, Southampton General Hospital Medical Research Council Epidemiology Resource Centre Southampton SO16 6YD UK Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 4 / December, 2009 (Source: Current Osteoporosis... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3042263 Sun, 29 Nov 2009 09:37:08 +0100 3042263 http://www.medworm.com/index.php?rid=3042262&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvt62n015k318763x%2F Abstract  Recent reports suggest that bone loss begins during late perimenopause at a dramatic rate, even before estrogen levels plummet. During the ensuing 5 years, there is evidence of the beginnings of microarchitectural deterioration, which impacts bone strength and ultimately enhances its propensity to fracture. The diagnosis of osteoporosis based on T-scores alone, or through stratification for a high fracture risk by FRAX, excludes these women who are rapidly losing bone. Because all antiosteoporosis therapies, in particular bisphosphonates, reduce bone loss, we propose aggressive, likely short-term therapy with a goal to reduce bone loss, stabilize bone density, and prevent microarchitectural deterioration. Content Type Journal ArticleDOI 10.1007/s11914-009-0021-4... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3042262 Sun, 29 Nov 2009 09:37:08 +0100 3042262 http://www.medworm.com/index.php?rid=3042265&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3p173x6326132838%2F Abstract  Although calcium and vitamin D have been the primary focus of nutritional prevention of osteoporosis, recent research has clarified the importance of several additional nutrients and food constituents. Further, results of calcium and vitamin D supplementation trials have been inconsistent, suggesting that reliance on this intervention may be inadequate. In addition to dairy, fruit and vegetable intake has emerged as an important modifiable protective factor for bone health. Several nutrients, including magnesium, potassium, vitamin C, vitamin K, several B vitamins, and carotenoids, have been shown to be more important than previously realized. Rather than having a negative effect on bone, protein intake appears to benefit bone status, particularly in older adults.... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3042265 Sun, 29 Nov 2009 09:37:07 +0100 3042265 http://www.medworm.com/index.php?rid=3042264&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbl883u86q08m5523%2F Abstract  Experimental studies indicate that the proinflammatory cytokines interleukin-1, interleukin-6, and tumor necrosis factor-α are important regulators of bone resorption and may play an important role in age- and estrogen deficiency-related bone loss. Although the observation of accelerated bone loss in patients with inflammatory disorders supports this mechanism, the role of cytokines in the etiology of osteoporosis has yet to be determined. Elucidation of this potential relationship could not only provide clinicians with an additional tool to identify patients at risk for osteoporosis, but may also inform the development of cytokine-blocking therapies as potential interventions to curb bone loss. Although some epidemiologic studies suggest increases in proinflamma... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3042264 Sun, 29 Nov 2009 09:37:07 +0100 3042264 http://www.medworm.com/index.php?rid=3042266&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjn200365g6237h6h%2F Abstract  Fractures in older people are important medical problems. Knowledge of risk factors is essential for successful preventive measures, but when fracture sites of diverse etiology are combined, risk factors for any one site are difficult to identify and may be missed entirely. Among older people, incidence rates of hip, proximal humerus, and vertebral fractures increase with age, but not rates of distal forearm and foot fractures. Low bone mineral density is strongly associated with hip, distal forearm, vertebral, and proximal humerus fractures, but not foot fracture. Most fractures of the hip, distal forearm, and proximal humerus result from a fall, whereas smaller proportions of fractures of the foot and vertebrae follow a fall. Frail people are likely to fracture ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3042266 Sun, 29 Nov 2009 09:37:06 +0100 3042266 http://www.medworm.com/index.php?rid=3042267&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2t08288763828050%2F Content Type Journal ArticleDOI 10.1007/s11914-009-0025-0Authors Chin Lee, Northwestern Feinberg School of Medicine and Abbott Laboratories Chicago USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 4 / December, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=3042267 Sun, 29 Nov 2009 09:37:05 +0100 3042267 http://www.medworm.com/index.php?rid=2767703&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fph6142240mg7m3k7%2F Abstract  Intravenous (IV) zoledronic acid, a new once-yearly bisphosphonate therapy, is approved by the US Food and Drug Administration for treatment of postmenopausal osteoporosis, glucocorticoid-induced osteoporosis, and osteoporosis in men. IV zoledronic acid significantly reduced the risk of vertebral, nonvertebral, and hip fractures in postmenopausal women and decreased risk of clinical fracture and clinical vertebral fracture in men and women with hip fracture. Two promising new therapies are in late clinical development. Denosumab is a monoclonal receptor activator of nuclear factor-κB ligand (RANKL) antibody given by subcutaneous injection every 6 months that has been shown to significantly reduce risk of vertebral-, nonvertebral-, and hip fracture in postmenopaus... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767703 Thu, 03 Sep 2009 06:07:53 +0100 2767703 http://www.medworm.com/index.php?rid=2767705&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6838265u44451337%2F This article describes the steps undertaken in the development of FRAX. Content Type Journal ArticleDOI 10.1007/s11914-009-0013-4Authors Eugene V. McCloskey, University of Sheffield, Sorby Wing, Northern General Hospital World Health Organization Collaborating Centre for Metabolic Bone Diseases Herries Road Sheffield S5 7AU UKHelena JohanssonAnders OdenJohn A. Kanis Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / September, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767705 Thu, 03 Sep 2009 06:07:52 +0100 2767705 http://www.medworm.com/index.php?rid=2767704&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fnh86870645g8w145%2F Abstract  Osteoporosis treatments need to combine an unequivocally demonstrated reduction of fractures, at various skeletal sites, long-term safety, and a user-friendly profile that optimizes therapeutic adherence. Strontium ranelate is the first compound to simultaneously decrease bone resorption and stimulate bone formation. Its anti-fracture efficacy at various skeletal sites has been established for as long as 5 years through studies of the highest methodological standards. Increases in bone mineral density observed after 1 year of treatment are predictive of the long-term fracture efficacy, suggesting for the first time in osteoporosis that bone densitometry can be used as a monitoring tool. Due to a positive risk/benefit ratio, strontium ranelate is now considered as ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767704 Thu, 03 Sep 2009 06:07:52 +0100 2767704 http://www.medworm.com/index.php?rid=2767707&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd7236n2606316rg5%2F Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11914-009-0018-zAuthors Piet Geusens, University Hasselt Biomedical Research Institute Hasselt Belgium Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / September, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767707 Thu, 03 Sep 2009 06:07:51 +0100 2767707 http://www.medworm.com/index.php?rid=2767706&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm722704813m82951%2F Abstract  Low bone mineral density and the presence of vertebral fractures are independent predictors for future vertebral and non-vertebral fractures. Combining the conventional measurement of bone mineral density of spine and hips with the morphometry of the thoracal and lumbar vertebrae on lateral images using dual energy x-ray absorptiometry scanners, a technique called vertebral fracture assessment, facilitates detection of vertebral fractures in those patients at older age and with clinical risk factors for osteoporosis. Particularly, the finding of one or more vertebral deformities in patients with osteopenia is clinically important, because this might prompt the start of anti-osteoporotic treatment. Content Type Journal ArticleDOI 10.1007/s11914-009-0017-0Authors ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767706 Thu, 03 Sep 2009 06:07:51 +0100 2767706 http://www.medworm.com/index.php?rid=2767708&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv732673305416qu3%2F Abstract  Current biological markers of bone turnover have proven useful in improving fracture risk assessment and monitoring treatment efficacy in postmenopausal osteoporosis. Recent developments in the field of bone markers include 1) identification of new biochemical markers providing additional information on the complex pathways leading to bone fragility; 2) application of novel technologies such as proteomics for the discovery of novel markers; 3) automation and multiplexing for improving analytical performance and convenience; and 4) refinement of the clinical interpretation of markers. Currently, however, for the management of individual patients, their most established application is to monitor treatment efficacy and possibly to improve fracture risk assessment. Th... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767708 Thu, 03 Sep 2009 06:07:49 +0100 2767708 http://www.medworm.com/index.php?rid=2767709&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc4057821766606g4%2F Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11914-009-0019-yAuthors Chin Lee, 200 Abbott Park Road Department NJ44, Building AP6C-6 Abbott Park IL 60064 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / September, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2767709 Thu, 03 Sep 2009 06:07:48 +0100 2767709 http://www.medworm.com/index.php?rid=2643396&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F285n866631230710%2F This article reviews recent data demonstrating that Wnt pathways are active during fracture repair and that increasing the activities of Wnt pathway components accelerates bone regeneration. Content Type Journal ArticleDOI 10.1007/s11914-009-0012-5Authors Frank J. SecretoLuke H. HoeppnerJennifer J. Westendorf, Mayo Clinic Departments of Orthopedic Surgery and Biochemistry & Molecular Biology 200 First Street SW Rochester MN 55905 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 2 / July, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2643396 Sat, 25 Jul 2009 03:57:11 +0100 2643396 http://www.medworm.com/index.php?rid=2643398&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1p1587h734716856%2F Abstract  Peripheral quantitative computed tomography (pQCT) systems measure bone parameters noninvasively using low radiation doses. This limits image resolution but is practical for the diagnosis and quantitative monitoring of the properties of the peripheral human skeleton. pQCT determines volumetric bone mineral density separately in trabecular and cortical bone. It may combine densitometry determinations with geometric estimates and use strain-stress indexes, and it may be used to analyze muscle variables in some areas, allowing the study of regional fragility. Experimental and clinical ex vivo studies show that pQCT variables correlate with biomechanical predictors of fragility and/or fractures. Since pQCT was approved by the US Food and Drug Administration in 1997, n... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2643398 Sat, 25 Jul 2009 03:57:09 +0100 2643398 http://www.medworm.com/index.php?rid=2643397&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9l513k0485036603%2F Abstract  Cardiovascular calcium deposition is associated with osteoporosis through various potential mechanisms involving molecular regulatory factors at the nanoscale level that govern skeletal bone and cardiovascular tissues. In this article, several possible mechanisms linking cardiovascular calcification and osteoporosis are discussed, including aging, tissue-specific responses to chronic inflammation, flow-limiting atherosclerosis of skeletal end arteries causing ischemic abnormalities in metabolism, shared endogenous regulatory factors that affect the two tissues in a reciprocal manner, and changes in a cysteine protease inhibitor, fetuin. Any or all of these factors and phenomena may contribute to the association. Content Type Journal ArticleDOI 10.1007/s11914-009... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2643397 Sat, 25 Jul 2009 03:57:09 +0100 2643397 http://www.medworm.com/index.php?rid=2643399&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg71577r612263824%2F Abstract  Vitamin D, acting through its active metabolite 1,25(OH)2D3, exerts its influence on many physiologic processes in addition to the regulation of calcium and phosphate homeostasis. These processes include the immune system. Both the adaptive and innate immune systems are affected by 1,25(OH)2D3 and its receptor, and the cells involved express not only the vitamin D receptor but also, in most cases, the enzyme CYP27B1, which produces 1,25(OH)2D3. Both the vitamin D receptor and CYP27B1 can be constitutive or induced by the ligands that activate the immune processes in these cells, providing feedback loops that help regulate the immune response. In general, 1,25(OH)2D3 suppresses most elements of the adaptive immune system while inducing most elements of the innate immu... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2643399 Sat, 25 Jul 2009 03:57:08 +0100 2643399 http://www.medworm.com/index.php?rid=2643401&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpu488318765064h8%2F Abstract  Adult hematopoietic stem cells (HSCs) reside in the bone marrow in stable microenvironments known as the stem cell niche. One key component of the stem cell niche is cells of the osteoblastic lineage. Factors that are known to affect osteoblast activity, such as parathyroid hormone (PTH), have also been shown to affect the HSCs. Treatment of mice with PTH has led to beneficial effects on the HSC pool, which have led to clinical trials of PTH treatment to enhance HSC-based therapies. Content Type Journal ArticleDOI 10.1007/s11914-009-0010-7Authors Narges RashidiGregor B. Adams, University of Southern California Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research at University of Southern California, Keck School of Medicine 1450 Biggy Stre... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2643401 Sat, 25 Jul 2009 03:57:06 +0100 2643401 http://www.medworm.com/index.php?rid=2643400&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpwq81868w9657455%2F Abstract  It has become accepted by virtue of rich anecdotal experience and clinical research that thyrotoxicosis is associated with high-turnover osteoporosis. The bone loss, primarily due to accelerated resorption that is not compensated by a coupled increase in bone formation, has been attributed solely to elevated thyroid hormone levels. Evidence using mice lacking the thyroid hormone receptors α and β establishes a role for thyroid hormones in regulating bone remodeling but does not exclude an independent action of thyroid-stimulating hormone (TSH), levels of which are low in hyperthyroid states, even when thyroid hormones are normal, as after thyroxine supplementation and in subclinical hyperthyroidism. We show that TSH directly suppresses bone remodeling and that T... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2643400 Sat, 25 Jul 2009 03:57:06 +0100 2643400 http://www.medworm.com/index.php?rid=2371860&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0576n58k730111q4%2F This article reviews the connections of homocysteine and B vitamins to measures of bone quality and osteoporotic fracture. Although the literature suggests that these factors may be associated with bone health, most of the epidemiologic studies are observational, limiting conclusions regarding causality. More controlled trials are needed to determine whether treatment with B vitamins would reduce fracture rates among community-dwelling cohorts. Content Type Journal ArticleDOI 10.1007/s11914-007-0026-9Authors Robert R. McLean, Hebrew SeniorLife Institute for Aging Research 1200 Centre Street Boston MA 02131 USAMarian T. Hannan Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 3 / Septe... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371860 Sun, 26 Apr 2009 05:56:15 +0100 2371860 http://www.medworm.com/index.php?rid=2371859&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8v472k3k8l738806%2F This article reviews the roles of the RANKL/RANK/OPG system in bone and other tissues. Content Type Journal ArticleDOI 10.1007/s11914-007-0024-yAuthors Brendan F. Boyce, University of Rochester Medical Center Department of Pathology and Laboratory Medicine 601 Elmwood Avenue Box 626 Rochester NY 14642 USALianping Xing Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 3 / September, 2007 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371859 Sun, 26 Apr 2009 05:56:15 +0100 2371859 http://www.medworm.com/index.php?rid=2371858&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8l6p78pu00087041%2F This article reviews risk factors and mechanisms associated with cancer-related bone loss and metastases as well as strategies for the detection of bone-related complications of cancer and therapies to treat these complications. This article focuses on the more common cancers with adverse skeletal effects: breast cancer, prostate cancer, and multiple myeloma. Content Type Journal ArticleDOI 10.1007/s11914-007-0027-8Authors Sue A. Brown, University of Virginia Department of Medicine P.O. Box 801420 Charlottesville VA 22908 USATheresa A. Guise Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 3 / September, 2007 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371858 Sun, 26 Apr 2009 05:56:15 +0100 2371858 http://www.medworm.com/index.php?rid=2371857&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq553308t29r7rt87%2F Content Type Journal ArticleDOI 10.1007/s11914-007-0022-0 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 3 / September, 2007 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371857 Sun, 26 Apr 2009 05:56:15 +0100 2371857 http://www.medworm.com/index.php?rid=2371856&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F918585t2235162h3%2F Abstract  Osteogenesis imperfecta (OI) is the most common of the inherited connective tissue disorders that primarily affect bone. However, it is a systemic disorder, as evidenced by the occurrence of ocular complications, dentinogenesis imperfecta, hearing loss, joint laxity, restrictive pulmonary disease, and short stature. The OI classification initially included four phenotypes (I–IV) involving COL1A1 and COL1A2 mutations. Three new phenotypes have been added, of which one, type VII, is the result of mutations of the cartilage-associated protein (CRTAP) gene. Investigation of recessive forms of OI particularly reported among South African blacks have revealed mutations involving both the CRTAP gene and the leucine proline-enriched proteoglycan 1 (LEPRE1) gene, each inv... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371856 Sun, 26 Apr 2009 05:56:15 +0100 2371856 http://www.medworm.com/index.php?rid=2371855&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh8j03228v7708230%2F Abstract  As children grow, they accumulate bone mineral, which serves as a “bone bank” for the future. Any condition that interferes with normal bone mineral accrual during childhood has the potential to reduce peak bone mass and subsequently increase future risk for fracture. In contrast to adults, for whom dual-energy x-ray absorptiometry (DXA) has become the standard clinical instrument for assessing bone mineral density and criteria have been developed to define osteopenia and osteoporosis, information for children is still limited. Numerous issues confound the interpretation of DXA-derived bone mineral density measurements in children, and clinicians often find themselves caught between the limitations of these methods and the practical issue of taking care of the... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371855 Sun, 26 Apr 2009 05:56:15 +0100 2371855 http://www.medworm.com/index.php?rid=2371862&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm7346248j38g0846%2F Abstract  Bisphosphonate drugs are the major treatment options for primary and secondary osteoporosis and other demineralizing bone diseases. This class of drugs was presaged over a decade ago when etidronate disodium, the “mother compound” for modern-day bisphosphonates, was first used in the treatment of osteoporosis. The cyclic use of etidronate in therapy, which is known mainly to specialists in the field, is not approved in the United States. The drug does, however, have a worldwide reputation as a relatively inexpensive, efficacious, and highly tolerable treatment for osteoporosis. Many studies still describe its use for primary osteoporosis and some have described use in immobilization bone loss, periprosthetic bone loss, and even glucocorticoid-induced osteoporo... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371862 Sun, 26 Apr 2009 05:56:07 +0100 2371862 http://www.medworm.com/index.php?rid=2371861&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw264j3m6w3525655%2F Abstract  Recent studies have added to the evidence that type 1 and type 2 diabetes are associated with increased risk of hip fracture and other fractures. More frequent falls probably account for some of this increased risk, but reduced bone strength may also play a role. Although type 1 diabetes is associated with lower bone density, those with type 2 diabetes usually have elevated bone density. Yet for both types of diabetes, bone appears to be more fragile for a given density. Diabetes can affect bone through multiple pathways—some with contradictory effects—including obesity, insulin levels, hyperglycemia, and advanced glycation end products in collagen. Treatment with thiazolidinediones may increase fracture risk, at least in older women. Clinicians need to be awa... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371861 Sun, 26 Apr 2009 05:56:07 +0100 2371861 http://www.medworm.com/index.php?rid=2371864&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5068325013g287x3%2F Abstract  Although rarely used to diagnose and manage patients with osteoporosis, bone biopsies are performed to establish bone quality, including degree of mineralization and microarchitecture; to assess bone turnover and bone loss mechanisms; and to analyze treatment effects on bone structure and bone turnover. Bone biopsies are also the only method to diagnose mineralization defect or frank osteomalacia. Due to the availability of antiresorptive agents and anabolic drugs, determining bone turnover and bone-loss mechanisms is critical to appropriate treatment regimen selection. Bone biopsies establish the safety and efficacy of new therapeutic modalities. Further, new techniques such as molecular morphometry (in situ hybridization and immunohistochemistry) and analysis of... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371864 Sun, 26 Apr 2009 05:56:06 +0100 2371864 http://www.medworm.com/index.php?rid=2371863&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F59362j8515531611%2F Abstract  Bone-turnover suppression is central to the therapeutic benefit of many interventions used to prevent osteoporotic fractures. There are theoretical concerns that long-term suppression may have adverse effects on bone strength, although at present no direct evidence exists that this happens. Nevertheless, further research is required to establish the optimal duration of treatment with antiresorptive agents. Content Type Journal ArticleDOI 10.1007/s11914-007-0014-0Authors Juliet Compston, Addenbrooke’s Hospital Department of Medicine Box 157 Cambridge CB2 2QQ UK Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 4 / December, 2007 (Source: Current Osteoporosis Report... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371863 Sun, 26 Apr 2009 05:56:06 +0100 2371863 http://www.medworm.com/index.php?rid=2371866&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl23u22685762532r%2F Abstract  Caloric restriction caused by undernutrition or overexercise is increasingly common and has significant health consequences such as hypothalamic amenorrhea, infertility, attainment of low peak bone mass, and bone loss leading to fracture. In these patients, the pathophysiology of amenorrhea and bone loss is multifactorial, involving hormones that integrate the nutritional state with the hypothalamic-pituitary-ovarian axis, including leptin and possibly ghrelin. The pathophysiology of bone loss includes nutritional deficiencies, possibly estrogen deficiency, and direct and indirect effects of leptin on bone. Identifying patients at risk for low bone mineral density and fracture is important, as is screening with dual energy radiograph absorptiometry. Treatment has ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371866 Sun, 26 Apr 2009 05:56:05 +0100 2371866 http://www.medworm.com/index.php?rid=2371865&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvtp06158g6684345%2F Abstract  Cancers of the breast and prostate are very common in the general population, with breast cancer accounting worldwide for 23% of cancer cases in women and prostate cancer accounting for 12% of cases in men. During the past decade, the survival rates of patients with estrogen-dependent breast cancer and testoster-one-dependent prostate cancer have improved. This improvement has been possible thanks to the introduction of hormone treatments that suppress the synthesis or antagonize the actions of gonadal steroids. However, estrogen and testosterone deficiencies are associated with excessive bone resorption that translates into damage of the bone microarchitecture, loss of bone mineral density, and predisposition to osteoporosis and fractures. Herein, we review the m... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371865 Sun, 26 Apr 2009 05:56:05 +0100 2371865 http://www.medworm.com/index.php?rid=2371868&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F47u566w5363w2246%2F Abstract  Osteoporosis, a major public health problem, is characterized by increased risk for fracture. To reduce the morbidity and excess loss of life associated with this common disease, we need to understand the efficacy of treatment strategies for fracture reduction. The Women’s Health Initiative Clinical Trials have extended our understanding of the effect of hormone therapy and calcium plus vitamin D supplements on risk for hip and total fractures. Although estrogen, with or without progestin, significantly decreases fracture risk at all skeletal sites—almost irrespective of underlying risk for osteoporosis—its risks outweigh its benefits, negating its general use for fracture reduction. For calcium-replete women, calcium plus vitamin D supplementation has a non... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371868 Sun, 26 Apr 2009 05:56:04 +0100 2371868 http://www.medworm.com/index.php?rid=2371867&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc73263m733837wx7%2F Abstract  Osteoporosis, a condition of low bone mass and microarchitectural deterioration, results in fractures with minimal trauma. Secondary osteoporosis is defined as bone loss resulting from either specific clinical disorders or medications. Some medications that can induce osteoporosis are discussed. Specifically, this article reviews the pathogenesis of glucocorticoid-induced bone loss and demonstrates the means to successfully manage the condition with a combination of calcium and vitamin D supplementation and, depending on the severity of the bone loss, bisphosphonates or parathyroid hormone. In addition, the pathphysiology of bone loss from aromatase inhibitors in women, gonadotropin-releasing hormone agonists in men, anticonvulsant medications, and proton pump inh... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371867 Sun, 26 Apr 2009 05:56:04 +0100 2371867 http://www.medworm.com/index.php?rid=2371869&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh4582m466u350176%2F Content Type Journal ArticleDOI 10.1007/s11914-007-0015-z Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 4 / December, 2007 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2371869 Sun, 26 Apr 2009 05:55:59 +0100 2371869 http://www.medworm.com/index.php?rid=2253285&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw62868391h443563%2F This article reviews current information on the epidemiology, pathophysiology, and clinical studies that support using bone-active agents to prevent and treat GIO. Content Type Journal ArticleDOI 10.1007/s11914-009-0005-4Authors Stuart L. Silverman, Cedars-Sinai/UCLA and OMC Clinical Research Center 8641 Wilshire Boulevard, Suite 301 Beverly Hills CA 90211 USANancy E. Lane Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 1 / March, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2253285 Tue, 10 Mar 2009 08:12:16 +0100 2253285 http://www.medworm.com/index.php?rid=2253287&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdxxm083843n65026%2F Abstract  Denosumab (anti-receptor activator of nuclear factorκB ligand [RANKL] antibody) is a novel agent, a fully human monoclonal antibody that inhibits osteoclastic-medicated bone resorption by binding to osteoblast-produced RANKL. By reducing RANKL binding to the osteoclast receptor RANK, bone resorption and turnover decrease. In phase 2 dose-ranging studies, denosumab had a rapid onset and offset effect. Also, in patients who had received 2 years of denosumab and were discontinued for the third year, rechallenge with denosumab during the fourth year demonstrated a return of responsiveness to denosumab that mimicked the initial treatment. Phase 3 pivotal fracture data were recently presented with positive outcome data; denosumab (60 mg subcutaneously every 6 months) s... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2253287 Tue, 10 Mar 2009 08:12:15 +0100 2253287 http://www.medworm.com/index.php?rid=2253289&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl43gq71002936g81%2F Abstract  Doctors who treat patients with osteoporosis are increasingly confronted with the question of how long to continue treatment with bisphosphonates (BPs), which have the unique characteristic of accumulating in the skeleton. Limited available long-term data suggest that such decisions should be made on a case-by-case approach and guided by an individual re-evaluation of clinical fracture risks and bone mineral density, efficacy, and safety issues. In patients who still have a high fracture risk after 5 years of treatment with BPs, continuing treatment could be considered, but stopping BPs could be appropriate in those with a low fracture risk after 5 years of treatment. Switching to recombinant human parathyroid hormone 1–34 or 1–84 is indicated when recurrent i... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2253289 Tue, 10 Mar 2009 08:12:14 +0100 2253289 http://www.medworm.com/index.php?rid=2253293&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu8213633h4726750%2F Abstract  Nutrition is important in promoting bone health and in managing an individual with low bone mass or osteoporosis. In adult women and men, known losses of bone mass and microarchitecture occur, and nutrition can help minimize these losses. In every patient, a healthy diet with adequate protein, fruits, vegetables, calcium, and vitamin D is required to maintain bone health. Recent reports on nutritional remedies for osteoporosis have highlighted the importance of calcium in youth and continued importance in conjunction with vitamin D as the population ages. It is likely that a calcium intake of 1200 mg/d is ideal, and there are some concerns about excessive calcium intakes. However, vitamin D intake needs to be increased in most populations. The ability of soy produ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2253293 Tue, 10 Mar 2009 08:12:13 +0100 2253293 http://www.medworm.com/index.php?rid=2253291&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4428x63266701297%2F Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11914-009-0001-8Authors Stuart L. Silverman Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 7 Journal Issue Volume 7, Number 1 / March, 2009 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2253291 Tue, 10 Mar 2009 08:12:13 +0100 2253291 http://www.medworm.com/index.php?rid=2253295&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa372g6628mk60854%2F Abstract  A significant gap exists between evidence-based advances and real-world clinical practice in the diagnosis and prevention of osteoporosis. The goal of osteoporosis care is to prevent fractures and improve health-related quality of life, and ideally lower mortality. Despite recent advances in osteoporosis detection and treatment options, studies suggest underdiagnosis and undertreatment of osteoporosis, even among those who have already sustained fractures. The challenges in translating knowledge into practice are multifaceted, with efforts directed at the patient, provider, and health care system levels achieving variable success at the population level. Methods to improve quality of care in osteoporosis need to be multipronged, with emphasis on clinical process i... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2253295 Tue, 10 Mar 2009 08:12:10 +0100 2253295 http://www.medworm.com/index.php?rid=2183033&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fwv2kt22132835725%2F Content Type Journal ArticleDOI 10.1007/s11914-007-0001-5 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 2 / June, 2007 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183033 Wed, 11 Feb 2009 07:20:16 +0100 2183033 http://www.medworm.com/index.php?rid=2183032&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6446n58560198h32%2F Abstract  Osteoclasts are cells of monocyte/macrophage origin that degrade bone matrix. Receptor activator of NF-κB ligand (RANKL) induces osteoclast differentiation in the presence of macrophage colony-stimulating factor. RANKL activates the tumor necrosis factor receptor-associated factor 6, c-Fos, and calcium signaling pathways, all of which are indispensable for the induction and activation of nuclear factor of activated T cells (NFAT) c1. NFATc1 is the master transcription factor for osteoclast differentiation, which regulates many osteoclast-specific genes. Multiple immunoglobulin-like receptors associated with immunoreceptor tyrosine-based activation motif (ITAM)-harboring adapters, Fc receptor common γ subunit (FcRγ), and DNAX-activating protein (DAP) 12 mediate ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183032 Wed, 11 Feb 2009 07:20:16 +0100 2183032 http://www.medworm.com/index.php?rid=2183031&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn827238101112q04%2F Abstract  Human genetic studies have firmly established a link between bone mass in humans and gain-of-function or loss-of-function mutations in a Wnt coreceptor, low-density lipoprotein receptor-related protein 5 (LRP5), or in the Wnt antagonist sclerostin, and several molecular genetic studies in mice have consistently confirmed the critical importance of the Wnt signaling pathway in skeletal biology and disease. In what may be a novel paradigm, the ubiquitous nature of LRP5/6 and Wnt signaling is counterbalanced by the bone-restricted and regulated expression of Wnt antagonists such as sclerostin and Dickkopf-1 (Dkk1) in adult tissues, offering new and potentially safe therapeutic means of intervention to stimulate bone formation. Content Type Journal ArticleDOI 10.100... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183031 Wed, 11 Feb 2009 07:20:16 +0100 2183031 http://www.medworm.com/index.php?rid=2183034&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F52g43380007wm22h%2F Abstract  The collagen network in bone provides resistance against fracture and may be susceptible to changes with aging and disease. This review identifies the changes in quality of collagen matrix as contributors to bone fragility. With aging and in diabetes, cross-links accumulate in bone collagen as a result of nonenzymatic glycation and consequently impair matrix properties, increasing bone fragility. Cell-culture and animal studies suggest that the accumulation of cross-links induced by nonenzymatic glycation may be related to a reduction in bone turnover resulting from the altered responses of osteoblasts and osteoclasts to advanced glycation end products. Content Type Journal ArticleDOI 10.1007/s11914-007-0004-2Authors Deepak Vashishth, Rensselaer Polytechnic In... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183034 Wed, 11 Feb 2009 07:20:14 +0100 2183034 http://www.medworm.com/index.php?rid=2183036&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk5055k50p7724382%2F Abstract  Bone strength and stiffness depend strongly on bone mass, but they also depend on the microarchitecture and tissue quality of both cancellous and cortical bone. All these aspects differ between individuals and between anatomic sites. This review discusses ways to characterize the three-dimensional cancellous architecture as well as changes in architecture and bone composition caused by bone remodeling. The methods used range from detailed descriptions of sizes and distances in cancellous bone to coarser texture analysis methods using clinical data. As the resolution of clinical images increases, it may become possible to use knowledge of the relationship between bone microarchitecture and strength to predict fracture risk clinically. Content Type Journal Article... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183036 Wed, 11 Feb 2009 07:20:11 +0100 2183036 http://www.medworm.com/index.php?rid=2183035&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F452x861r74gv6081%2F Abstract  Osteocytes, the most abundant cell type in bone, remain the least characterized. Several theories have been proposed regarding their function, including osteolysis, sensing the strains produced in response to mechanical loading of bones, and producing signals that affect the function of osteoblasts and osteoclasts and hence, bone turnover. This review also discusses the role of osteocyte apoptosis in targeted bone remodeling and proposes that the occurrence of osteocyte apoptosis is consistent with the description of apoptosis as an essential homeostatic mechanism for the healthy maintenance of tissues. Content Type Journal ArticleDOI 10.1007/s11914-007-0007-zAuthors Giolanta KogianniBrendon S. Noble, University of Edinburgh Medical School Musculoskeletal Tissu... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183035 Wed, 11 Feb 2009 07:20:11 +0100 2183035 http://www.medworm.com/index.php?rid=2183037&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F21251208547m4p82%2F This article reviews the factors that govern the strength of an object, how they are used in engineering simulations, and how those properties can be extracted from DXA data. It is important to recognize that that although DXA scanners can be used to measure geometric strength, they were not designed to do so. The current HSA method is fundamentally limited to evaluating bending strength in the plane of the image, so precision is sensitive to consistent femur positioning. The positioning issue and other limitations of the HSA method are discussed, as well as the critical importance of body-size scaling when interpreting bone geometry. Also discussed is how current HSA limitations could be ameliorated in a “next-generation” DXA scanner that is optimized for the purpose. Content... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=2183037 Wed, 11 Feb 2009 07:20:10 +0100 2183037 http://www.medworm.com/index.php?rid=1996734&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F415175346651n1h8%2F Abstract  Paget’s disease of bone is a focal disorder of aging bone. The classic late-onset Paget’s disease is often caused by a P392L mutation in the gene SQSTM1, which disturbs signaling pathways in osteoclasts on cell activation. This prevalent mutation is neither necessary nor sufficient to cause Paget’s disease. Its identification, along with the elucidation of other mutations underlying early-onset Paget’s and Paget’s disease seen in association with inclusion body myopathy and frontotemporal dementia, have redefined our understanding of genetic disorders of bone remodeling by emphasizing the importance of environmental determinants in their pathophysiology. Content Type Journal ArticleDOI 10.1007/s11914-008-0022-8Authors Margaret Seton, Massachusetts Gen... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996734 Thu, 27 Nov 2008 09:16:24 +0100 1996734 http://www.medworm.com/index.php?rid=1996733&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv7t33m2102625075%2F Abstract  Phosphorus is an essential element in skeletal development, bone mineralization, membrane composition, nucleotide structure, and cellular signaling. Phosphate, the principal form in which phosphorus is found in the body, is regulated by the complex interplay of the hormones parathyroid hormone (PTH), calcitriol (1,25[OH]2 vitamin D3), and fibroblast growth factor 23 (FGF23). These collectively govern bone mineralization, absorption of phosphorus by the intestine, and renal tubular reabsorption of phosphate. The skeleton is the major storage pool for phosphate and the principal production site for FGF23, a major phosphate regulatory hormone. Recent advances in understanding the molecular basis of disorders of phosphate metabolism have revealed new phosphate-regulato... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996733 Thu, 27 Nov 2008 09:16:24 +0100 1996733 http://www.medworm.com/index.php?rid=1996737&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3731458212h81m07%2F Abstract  Recent discoveries in humans and mice have revealed that the Wnt (Wingless and Int-1) signaling pathway is responsible for a complex array of functions in maintaining bone homeostasis. The Wnt proteins are key modulators of mesenchymal lineage specification and regulate most aspects of osteoblast physiology and postnatal bone acquisition by controlling the differentiation and activity of osteoblasts and osteoclasts. Initial reports have indicated that activators of Wnt signaling are potent promoters of osteogenesis; however, systemic hyperactivation of the canonical Wnt pathway could potentially accelerate neoplastic transformation and subsequent tumor growth. Alternatively, recent investigations of natural soluble antagonists of Wnt signaling in bone suggest the ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996737 Thu, 27 Nov 2008 09:16:23 +0100 1996737 http://www.medworm.com/index.php?rid=1996736&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb2n1m63011031785%2F Abstract  The finding of low bone mineral density with a T-score of −2.5 or below on dual energy x-ray absorptiometry is usually reported as indicating that the patient has “osteoporosis” according to the World Health Organization classification, and, in postmenopausal women, it is often assumed that this is due to estrogen deficiency. However, up to one third of postmenopausal women have a secondary cause of low density, including osteomalacia. Osteomalacia is defined as a mineralization defect caused by disorders that lead to decreased mineralization of bone. Clues from the history, physical examination, laboratory tests, and radiographs may indicate that the patient suffers from a form of osteomalacia rather than postmenopausal estrogen deficiency alone. Establishin... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996736 Thu, 27 Nov 2008 09:16:23 +0100 1996736 http://www.medworm.com/index.php?rid=1996735&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkv0733m71462uq12%2F Content Type Journal ArticleDOI 10.1007/s11914-008-0021-9 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 4 / December, 2008 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996735 Thu, 27 Nov 2008 09:16:23 +0100 1996735 http://www.medworm.com/index.php?rid=1996738&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft4464883n101rk42%2F Abstract  Falls are common in the elderly, and frequently result in injury and disability. Most falls result from an interaction between individual characteristics that increase an individual’s propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, comorbidities such as osteoarthritis, visual impairment and dementia, psychotropic medications, and certain types of footwear. Fewer studies have focused on acute precipitating factors, but environmental and situational factors are clearly important to fall risk. Approximately 30% of falls result in an injury that requires medical attention, with fractures occurring in approximately 10%. In addition to the risk f... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996738 Thu, 27 Nov 2008 09:16:22 +0100 1996738 http://www.medworm.com/index.php?rid=1996739&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa53244q6l755h13g%2F Abstract  Osteoporosis is one of the most disabling consequences of aging in women. Strategies that permit earlier identification of women at risk for fracture are needed. The Women’s Health Initiative has extended our knowledge of clinical risk factors and biomarkers of fracture risk in postmenopausal women. Based upon 11 clinically available risk factors (age, race/ethnicity, self-reported health, weight, height, physical activity, parental hip fracture, fracture history after age 54, current smoking, corticosteroid use, and history of treated diabetes), an algorithm has been developed to predict 5-year hip fracture risk. Biomarkers including low vitamin D or bioavailable testosterone and/or high cystatin C or sex hormone-binding globulin also predict risk for hip fract... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1996739 Thu, 27 Nov 2008 09:16:20 +0100 1996739 http://www.medworm.com/index.php?rid=1901929&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe60thp6q3024886n%2F Abstract  Osteoporosis is a skeletal disorder that predisposes individuals to increased risk of fracture. However, most osteoporotic fractures occur in women who do not meet criteria for osteoporosis. Hence, bone density, by itself, is a relatively poor predictor of fracture. Age and age-related factors are now recognized as increasingly important in determining fracture risk. Osteoporotic fractures are associated with increased disability and mortality, suggesting that osteoporosis may be a clinical manifestation of an underlying disease process affecting multiple systems. The systems affected, the musculoskeletal system and the central nervous system, are shared in many respects with the frailty syndrome. Vitamin D deficiency is a major contributor to the frailty syndrome... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901929 Tue, 21 Oct 2008 05:44:12 +0100 1901929 http://www.medworm.com/index.php?rid=1901931&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F53365l2rxn750736%2F Abstract  Inhibins A and B are gonadal peptide members of the transforming growth factor-β superfamily that serve as negative feedback regulators of pituitary follicle-stimulating hormone (FSH). Accumulating evidence suggests that bone turnover and bone loss increase in women before menopause and the decrease in serum estradiol levels. Increased FSH levels have been correlated with some of these perimenopausal changes, whereas decreased inhibins strongly correlate with increases in bone formation and resorption across the menopause transition, and predict lumbar bone mass in perimenopausal women, likely resulting from the direct inhibin suppression of osteoblast and osteoclast development. Interestingly, continuous exposure of mice to inhibin A in vivo is anabolic and prot... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901931 Tue, 21 Oct 2008 05:44:10 +0100 1901931 http://www.medworm.com/index.php?rid=1901930&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd352274802558618%2F Content Type Journal ArticleDOI 10.1007/s11914-008-0008-6 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 2 / June, 2008 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901930 Tue, 21 Oct 2008 05:44:10 +0100 1901930 http://www.medworm.com/index.php?rid=1901933&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4689wu55k370018h%2F Abstract   Bone never forms without vascular interactions. Although this is a very simple and obvious statement, the biological, clinical, and pharmacologic implications are incompletely appreciated. The vasculature is not only the conduit for nutrient-metabolite exchange and the rate-limiting “point-of-reference” for Haversian bone formation, but also provides the sustentacular niche for the self-renewing osteoprogenitor. This past year, significant advances have been made in our understanding of the osteogenic-angiogenic interface that are immediately germane to osteoporosis disease biology and fracture management. The critical contributions of the osteoblast oxygen-sensing machinery, paracrine vascular endothelial growth factor and placental growth factor signaling, ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901933 Tue, 21 Oct 2008 05:44:09 +0100 1901933 http://www.medworm.com/index.php?rid=1901932&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fcj31317hk2730507%2F Abstract  Leptin and its actions in bone came to prominence in 2000, with the publication of two landmark articles identifying a novel interaction between energy and bone homeostasis, as well as a novel hypothalamic circuit to the skeleton. However, they also revealed the dichotomous nature of leptin’s effect on the skeleton. Subsequent research has increased understanding of the factors critical to interpretation of the leptin-bone signaling. These include opposing effects in cortical and cancellous bone, central and peripheral effects, involvement of other neural and endocrine factors, and leptin receptor polymorphisms in human populations. It is clear that leptin can markedly influence the regulation of bone mass, and that study of this pathway continues to increase ou... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901932 Tue, 21 Oct 2008 05:44:09 +0100 1901932 http://www.medworm.com/index.php?rid=1901935&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3434243p2079574x%2F Abstract  The classical actions of parathyroid hormone (PTH) are well recognized, but its effects on other target tissues, such as the cardiovascular system, are less appreciated. Several studies have evaluated the effects of PTH in patients with primary hyperparathyroidism in order to understand potential cardiovascular effects in terms of hypertension, cardiovascular mortality, left ventricular function, and endothelial function. We review these studies and evaluate the cellular mechanisms that may affect these outcomes. Content Type Journal ArticleDOI 10.1007/s11914-008-0014-8Authors Lorraine A. Fitzpatrick, Musculoskeletal Diseases, GlaxoSmithKline Research and Development 2301 Renaissance Boulevard, RN0420 King of Prussia PA 19406 USAJohn P. BilezikianShonni J. Silve... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901935 Tue, 21 Oct 2008 05:44:08 +0100 1901935 http://www.medworm.com/index.php?rid=1901934&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbl14874332405212%2F Abstract  Continuous exposure to parathyroid hormone (PTH) is associated with catabolic effects, whereas intermittent exposure to low doses of PTH is associated with anabolic effects. By controlling osteoblast function, PTH increases bone formation on cancellous, endocortical, and periosteal bone surfaces. In general, PTH does not affect the replication of uncommitted osteoblast progenitors but suppresses proliferation of committed osteoprogenitors. Intermittent PTH promotes osteoblast differentiation, in part, by its ability to promote exit from the cell cycle, to activate Wnt signaling in osteoblasts, and to inhibit the Wnt antagonist sclerostin in osteocytes. Insulin-like growth factor-1 is also required for the actions of PTH to increase osteoblast numbers. Intermittent... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1901934 Tue, 21 Oct 2008 05:44:08 +0100 1901934 http://www.medworm.com/index.php?rid=1895550&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe02g88138119j824%2F Abstract  Vertebroplasty and kyphoplasty are minimally invasive vertebral augmentation procedures in which a filler material is percutaneously injected into a vertebral body for the treatment of vertebral fractures associated with osteoporosis, malignant conditions, hemangiomas, and osteonecrosis. In vertebroplasty, the filler is injected directly into the bone, whereas in kyphoplasty, the filler is injected into a cavity created by inflation of a balloon tamp. The goals of treatment include pain relief, fracture stabilization, restoration of vertebral height, and strengthening of the vertebral body to reduce the risk of a future fracture at the same level. When performed by a well-trained physician in appropriately selected patients, vertebral augmentation is usually effec... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1895550 Sat, 18 Oct 2008 11:08:32 +0100 1895550 http://www.medworm.com/index.php?rid=1895549&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx866660222312153%2F This article summarizes the most currently available data relative to nonvertebral and hip fracture risk reduction for the N-containing bisphosphonates alendronate, ibandronate, risedronate, and zoledronic acid, and presents results of an analysis of comparative efficacy of these compounds using the technique of adjusted indirect comparisons. Content Type Journal ArticleDOI 10.1007/s11914-008-0016-6Authors Marc C. Hochberg, University of Maryland School of Medicine 10 South Pine Street, MSTF 8-34 Baltimore MD 21201 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 3 / September, 2008 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1895549 Sat, 18 Oct 2008 11:08:32 +0100 1895549 http://www.medworm.com/index.php?rid=1895548&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx7n0776kx5r31750%2F Abstract  Since the introduction of hormone replacement therapy (HRT) in 1942, the availability of scientific information regarding the physiologic action of estrogen alone and in combination with progesterone has grown substantially. The specific physiology of changes in endogenous estrogen as a causal factor in bone loss that occurs as the result of menopause is now better understood. Accumulating evidence regarding the benefit of estrogen in protecting against bone loss at the time of menopause made it the first choice for prevention and treatment of osteoporosis, until the findings of the Women’s Health Initiative (WHI) were announced in 2002. Fortunately, the availability of multiple alternative agents for prevention and treatment of osteoporosis in menopausal women ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1895548 Sat, 18 Oct 2008 11:08:32 +0100 1895548 http://www.medworm.com/index.php?rid=1895547&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyu455081334jw067%2F Abstract  Low vitamin D status, which is endemic due to inadequate oral intake combined with sun avoidance, contributes to musculoskeletal and other pathologies. Although controversial, it is increasingly recommended that serum 25-hydroxyvitamin D (25[OH]D) concentrations less than 30 ng/mL be considered suboptimal. Clinicians should appreciate that 25(OH)D measurements, like all quantitative laboratory tests, are subject to assay and biologic variability. Additionally, international standardized calibrators do not exist for 25(OH)D measurement. As such, a single 25(OH)D value of “30 ng/mL” may have substantial variability surrounding it, thereby making 25(OH)D levels of approximately 35 to 40 ng/mL a reasonable therapeutic goal to assure vitamin D adequacy. Achieving s... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1895547 Sat, 18 Oct 2008 11:08:32 +0100 1895547 http://www.medworm.com/index.php?rid=1895546&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F82u172031r74145k%2F This article reviews recent research findings of general measures and pharmacologic therapy that are applicable to managing osteoporosis in the elderly. Content Type Journal ArticleDOI 10.1007/s11914-008-0018-4Authors Diane L. Schneider, University of California San Diego, La Jolla CA 92093 USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 3 / September, 2008 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1895546 Sat, 18 Oct 2008 11:08:32 +0100 1895546 http://www.medworm.com/index.php?rid=1895545&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8r382775705764x6%2F Content Type Journal ArticleDOI 10.1007/s11914-008-0015-7 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 3 / September, 2008 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1895545 Sat, 18 Oct 2008 11:08:32 +0100 1895545 http://www.medworm.com/index.php?rid=1720534&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb487778t67032537%2F This article reviews what is known about the factors in men that lead to acquisition, maintenance, and loss of bone, as well as new insights into causes, pathogenesis, and treatment of osteoporosis in men. Content Type Journal ArticleCategory TherapeuticsDOI 10.1007/BF02938619Authors Luigi GennariJohn P. Bilezikian, College of Physicians and Surgeons 630 W. 168th Street 10032 New York NY USA Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 5 Journal Issue Volume 5, Number 1 / March, 2007 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1720534 Tue, 19 Aug 2008 17:21:45 +0100 1720534 http://www.medworm.com/index.php?rid=1720536&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F26267810x0x05tnt%2F Abstract  Osteoporotic fractures result in significant deficits in health-related quality of life (HRQOL). The accumulation of deficits resulting from osteoporosis and fractures is now recognized as a major cause of reduced HRQOL in women after the menopause and in later life. Some of these same postmenopausal women may also have deficits in HRQOL related to vasomotor symptoms during the menopausal transition. Although estrogen therapy has not been shown to improve overall HRQOL in late postmenopausal women in randomized, controlled trials, it may improve menopausal symptoms. In contrast, selective estrogen receptor modulators (SERMs) such as raloxifene may increase vasomotor symptoms. Although estrogen is not indicated for the primary prevention of osteoporosis, estrogen t... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1720536 Tue, 19 Aug 2008 17:21:42 +0100 1720536 http://www.medworm.com/index.php?rid=1720535&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj46xq2771860t405%2F Abstract  Bisphosphonates, which are potent bone resorption inhibitors, currently are the mainstay of treatment for osteoporosis. Antifracture efficacy has been demonstrated for at least three nitrogen-containing bisphosphonates in oral formulations that are designed to be administered in weekly or monthly dosing regimens. Frequent reports of adverse events, primarily related to the upper gastrointestinal tract, and the strict dosing schedule necessary for oral bisphosphonate therapy are considered the major reasons for disappointing adherence to therapy. New intravenous formulations have been developed that allow dosing at very long intervals, thus avoiding the gastrointestinal complications associated with oral bisphosphonates and, it is hoped, improving compliance, parti... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1720535 Tue, 19 Aug 2008 17:21:42 +0100 1720535 http://www.medworm.com/index.php?rid=1720539&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq361377223250h38%2F Abstract  Postmenopausal osteoporosis (PMO) is a progressive disease of bone loss, fractures, or both. The progression of osteoporosis leads to increased mortality and morbidity and impairs quality of life. There are effective treatments that prevent bone loss, increase bone strength, and reduce fracture risk. Improvement in persistence and adherence to therapy leads to better clinical outcomes. The management of PMO is facilitated by measuring surrogate markers of the efficacy of PMO treatments: 1) bone mineral density, 2) bone turnover markers, and 3) assessment of spinal integrity by vertebral fracture assessment by dual-energy x-ray absorptiometry. Appropriate use of markers measures the patient’s baseline fracture risk and monitors response to treatments. Clinicians ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1720539 Tue, 19 Aug 2008 17:21:41 +0100 1720539 http://www.medworm.com/index.php?rid=1720538&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F10068362j6x6g004%2F Abstract  Transplantation is an established therapy for end-stage diseases of the kidney, endocrine pancreas, heart, liver, and lung, and for many hematologic disorders. Improved survival rates have been accompanied by increased recognition of previously neglected longterm complications of transplantation such as fractures and osteoporosis. Pretransplantation bone disease and immunosuppressive therapy result in rapid bone loss and increased fracture rates early after transplantation. Patients should be assessed and pretransplantation bone disease should be treated. Preventive therapy initiated in the immediate posttransplantation period is indicated in patients with osteopenia or osteoporosis, as further bone loss will occur in the first several months after transplantation... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1720538 Tue, 19 Aug 2008 17:21:41 +0100 1720538 http://www.medworm.com/index.php?rid=1720537&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F980q387745055437%2F Abstract  Glucocorticoids continue to be used for many inflammatory diseases, and glucocorticoid-induced osteoporosis (GIOP) remains the most common secondary form of metabolic bone disease. Recent meta-analyses suggest that both active and native vitamin D can help maintain lumbar spine bone mineral density (BMD), particularly in patients receiving lower-dose glucocorticoid therapy. Recent randomized, controlled clinical trials have shown that oral bisphosphonates are superior to vitamin D in maintaining BMD and should be continued for as long as a person receives glucocorticoid treatment. Similar to the oral bisphosphonates, intravenous ibandronate has been shown to preserve BMD and also to significantly reduce vertebral fracture risk. Increasing evidence supports a role ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1720537 Tue, 19 Aug 2008 17:21:41 +0100 1720537 http://www.medworm.com/index.php?rid=1340892&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu3072p7u17q66235%2F Abstract  The fat-soluble vitamin D prohormones, ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3), are essential for the efficient intestinal absorption of calcium and phosphate and the subsequent mineralization of bone. Inadequate vitamin D leads to chronic secondary hyperparathyroidism and osteoporosis. The increasing prevalence of osteoporosis has paralleled a pandemic of vitamin D insufficiency. Based on observational and prospective trials with clinical end points, the standards for vitamin D sufficiency have been recently revised. All patients with osteopenia or osteoporosis should be monitored with a reliable assay to maintain serum 25-hydroxyvitamin D levels more than 32 ng/dL. Patients who are taking bisphosphonates and those with coexisting primary hype... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340892 Sat, 29 Mar 2008 09:11:42 +0100 1340892 http://www.medworm.com/index.php?rid=1340891&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F47146x7l73637432%2F Content Type Journal ArticleDOI 10.1007/s11914-008-0001-0 Journal Current Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal Volume Volume 6 Journal Issue Volume 6, Number 1 / March, 2008 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340891 Sat, 29 Mar 2008 09:11:42 +0100 1340891 http://www.medworm.com/index.php?rid=1340890&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc481127u521p0324%2F Abstract  Osteonecrosis of the jaws associated with bisphosphonate therapy was first identified in 2003 as a condition typified by exposed bone that does not heal after 8 weeks. Other signs and symptoms, such as pain and infection, may or may not be present. There is a strong need for consensus on a case definition for this condition. This condition has occurred primarily among cancer patients treated with the aminobisphosphonates zoledronic acid and pamidronate. The etiology of this condition remains unknown; however, oral disease and trauma appear to be important risk factors. This condition appears to be rare in metabolic bone disease and Paget’s disease, with an estimated prevalence of approximately 1 per 100,000 person-years. Thus, the benefits of bisphosphonate ther... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340890 Sat, 29 Mar 2008 09:11:42 +0100 1340890 http://www.medworm.com/index.php?rid=1340894&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb536p46p448184r5%2F Abstract  Osteoporosis is a preventable disease characterized by loss of bone mineral density, progression to diminished skeletal integrity, extensive bone fragility, and an increased risk of fracture. Morbidity and mortality from osteoporosis are significant, and the public health costs are substantial. Although safe and effective therapy is available, the disease remains underdiagnosed and undertreated. Oral bisphosphonates such as alendronate, risedronate, and ibandronate are the current first-line therapy; however, adherence to treatment is suboptimal, largely because the treatment regimen is difficult to follow. The bisphosphonate zoledronic acid (zoledronate), 5 mg, is administered as an annual 15-minute intravenous infusion for the treatment of postmenopausal osteopo... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340894 Sat, 29 Mar 2008 09:11:41 +0100 1340894 http://www.medworm.com/index.php?rid=1340893&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk004527136223646%2F Abstract  Antiresorptive agents for osteoporosis are a cornerstone of therapy, but anabolic drugs have recently increased our options. By stimulating bone formation, anabolic agents reduce fracture incidence by improving bone qualities in addition to increasing bone mass. The only anabolic agent currently approved for osteoporosis by the US Food and Drug Administration, teriparatide (recombinant human parathyroid hormone [1–34]), has emerged as a major approach to selected patients with osteoporosis. Recombinant human parathyroid hormone (1–84) is also available in Europe. Teriparatide increases bone density and bone turnover, improves microarchitecture, and changes bone size. The incidence of vertebral and nonvertebral fractures is reduced. A current concept in the mec... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340893 Sat, 29 Mar 2008 09:11:41 +0100 1340893 http://www.medworm.com/index.php?rid=1340895&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3165336h16814241%2F Abstract  Teriparatide (recombinant human 1-34 parathyroid hormone) has been registered for the treatment of postmenopausal osteoporosis and osteoporosis in men for more than 5 years, whereas 1-84 parathyroid hormone has just recently been registered in Europe for osteoporosis management. Therefore, more data are available regarding the long-term safety of teriparatide. The issues to be considered are the effects of the registered dose of teriparatide (20 µg/day) on the incidence of hypercalcemia, hypercalciuria, and hyperuricemia, and the US Food and Drug Administration’s “black-box” warning regarding osteogenic sarcoma in the rat model. This review discusses these issues and provides the author’s extensive clinical experience and advice on the use of teriparatide ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340895 Sat, 29 Mar 2008 09:11:40 +0100 1340895 http://www.medworm.com/index.php?rid=1340896&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft555737417636756%2F Abstract  Interpretation of bone mineral density (BMD) results in premenopausal women is particularly challenging, because the relationship between BMD and fracture risk is not the same as for postmenopausal women. Z scores rather than T scores should be used to define “low BMD” in premenopausal women. The finding of low BMD in a premenopausal woman should prompt an evaluation for secondary causes of bone loss. If a secondary cause is found, management should focus on treatment of this condition. In some cases in which the secondary cause cannot be addressed, such as glucocorticoid therapy or cancer chemotherapy, treatment with a bone-active agent to prevent bone loss should be considered. In women with no fractures and no known secondary cause, low BMD may not signify ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=1340896 Sat, 29 Mar 2008 09:11:39 +0100 1340896 http://www.medworm.com/index.php?rid=853243&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu71u23323667g377%2F Abstract  Children with moderate to severe forms of osteogenesis imperfecta (OI) require adequate physiotherapy, rehabilitation and orthopedic surgery. Supportive treatment with bisphosphonates can improve the effects of these nonmedicinal treatment modalities. Benefits of bisphosphonate treatment include decreased pain, lower fracture incidence, and better mobility. Among the various bisphosphonates, intravenous pamidronate has been studied in most detail. However, the optimal treatment regimen and the long-term consequences of pamidronate treatment in children are currently unknown. Given these uncertainties, treatment with bisphosphonates during growth should be reserved for patients who have significant clinical problems, such as vertebral compression fractures or long-... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853243 Sat, 08 Sep 2007 04:34:51 +0100 853243 http://www.medworm.com/index.php?rid=853239&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb27031t863257k06%2F Abstract  Clinical decision rules (CDRs) are designed to help physicians practice better. A number of CDRs to assist in identifying women with low bone mass have been developed since the mid 1990s, including SCORE, OST (OSTA), OSIRIS, SOFSURF, NOF, ABONE, pBW, ORAI, and weight-only-EPIDOS (which we have termed WO-E). This review discusses these CDRs in terms of development and validation cohorts and their sensitivity and specificity. The sensitivities of the available CDRs exceed 80% and specificities are about 50%. After much analysis, it appears that most experts prefer OST for its simplicity and SCORE for its flexibility, but there is no consensus on what risk factors to use in the CDRs and what regions of interest (spine, total hip, femoral neck, or a combination) to te... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853239 Sat, 08 Sep 2007 04:34:51 +0100 853239 http://www.medworm.com/index.php?rid=853232&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj48545w743334765%2F Abstract  In the early 1980s, researchers studying osteoporosis noted that depression was one of the major negative consequences of bone loss and fractures. These researchers believed that osteoporosis and fractures occurred first, causing a reactive depression. Meanwhile, a similar but distinct psychiatry literature noted that osteoporosis or bone loss appeared to be an undesirable consequence of major depression. Here, depression was seen as the causal factor, and osteoporosis was the outcome. The psychiatric perspective is more biological, based on the presence of hypercorticoidism in depressed individuals. Those who believe that osteoporosis leads to depression point out that depression is a consequence of many chronic illnesses. Regardless of the correct causal order, ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853232 Sat, 08 Sep 2007 04:34:51 +0100 853232 http://www.medworm.com/index.php?rid=853231&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft3051626142q782r%2F Abstract  The "holy grail" of inquiry regarding exercise and osteoporosis has been identifying a type of exercise that builds bone. Investigation using animal models has provided many insights into how bone responds to mechanical loading, but translating these findings into an exercise prescription for patients with osteoporosis is difficult. Patients expect bone to respond to exercise in a linear fashion, such as they are accustomed to experiencing with muscles in response to progressive strength training or with the cardiopulmonary system in response to endurance training. If the skeleton accrued greater mass in response to increasing intensity and duration of mechanical strain, our bones would weigh so much that we could not move. A unique requirement of bone is that ada... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853231 Sat, 08 Sep 2007 04:34:51 +0100 853231 http://www.medworm.com/index.php?rid=853229&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F360103237n87u631%2F Abstract  In determining fracture risk, it has become apparent that bone mineral density accounts for only a portion of bone strength, with the remainder being determined by the material and structural properties of the bone tissue. Over the past 15 years, high-resolution MRI has provided a window into the structural nature of bone disease. Cross-sectional studies imaging the trabecular bone in patients with conditions ranging from postmenopausal osteoporosis to organ transplantation to renal osteodystrophy have all demonstrated a correlation of microarchitecture with fracture burden and have done so at a variety of anatomic sites. Recently, the utility of longitudinal studies for monitoring treatment in vivo has been demonstrated. This technique is noninvasive, involving n... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853229 Sat, 08 Sep 2007 04:34:51 +0100 853229 http://www.medworm.com/index.php?rid=853240&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh3240200h03n1873%2F Abstract  A stress fracture represents the inability of the skeleton to withstand repetitive bouts of mechanical loading, which results in structural fatigue and resultant signs and symptoms of localized pain and tenderness. To prevent stress fractures, an appreciation of their risk factors is required. These are typically grouped into extrinsic and intrinsic risk factors. Extrinsic risk factors for stress fractures are those in the environment or external to the individual, including the type of activity and factors involving training, equipment, and the environment. Intrinsic risk factors for stress fractures refer to characteristics within the individual, including skeletal, muscle, joint, and biomechanical factors, as well as physical fitness and gender. This article di... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853240 Sat, 08 Sep 2007 04:34:50 +0100 853240 http://www.medworm.com/index.php?rid=853235&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F26m023q6940u7407%2F Abstract  Osteoporosis in men is an unrecognized but growing problem as the number of men who live to old age increases. The 10-year fracture risk at age 50 quadruples by age 80, and in general the incidence rate of osteoporotic fracture in men is about half that of women. Of note, the mortality and morbidity after hip fracture are much greater in men. There are many men whose osteoporosis is the result of specific causes such as oral glucocorticoid therapy, hypogonadism, or androgen withdrawal therapy for prostate cancer. In addition there are several interesting syndromes of osteoporosis in middle-aged men; these men usually present with vertebral fractures. As knowledge about the prevalence and etiology of osteoporosis in men increases, it will be recognized and treated ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853235 Sat, 08 Sep 2007 04:34:50 +0100 853235 http://www.medworm.com/index.php?rid=853241&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F051468218v577086%2F Abstract  Oral antiresorptive agents play a pivotal role in the management of osteoporosis. This paper discusses the effects and potential future role of newer agents such as ibandronate. Alternative dosing schedules and routes of administration have become available and may improve fracture protection, compliance, and tolerability for the long term treatment of a chronic condition such as osteoporosis. Increasingly these agents are being used to reduce bone loss in other diseases associated with high risk for osteoporosis such as organ transplantation and cystic fibrosis. Such studies may act as prototypes for the extended use of this class of drugs in other chronic inflammatory disease states. The innovative, yet disappointing results from combining an antiresorptive agen... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853241 Sat, 08 Sep 2007 04:34:49 +0100 853241 http://www.medworm.com/index.php?rid=853233&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq248p7272w043r10%2F Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 4 Journal IssueVolume 4, Number 3 / September, 2006 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853233 Sat, 08 Sep 2007 04:34:49 +0100 853233 http://www.medworm.com/index.php?rid=853230&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy661585065r37nk3%2F Abstract  Combination therapy includes the concomitant or sequential use of compounds sharing the same mode of action (eg, two or more inhibitors of bone resorption) or with distinct pathways of activity (eg, an inhibitor of resorption plus an anabolic agent). Combination use of antiresorptive agents may generate concerns, because of the risk of inducing oversuppression of bone turnover. However, if low doses of estrogen, used for the management of climacteric symptoms, are insufficient to normalize bone turnover, the addition of a bisphosphonate to hormone therapy may prove to be useful to achieve this objective. Patients pretreated with inhibitors of resorption, who have not achieved a full therapeutic response, are good candidates for treatment with anabolic agents. The ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853230 Sat, 08 Sep 2007 04:34:49 +0100 853230 http://www.medworm.com/index.php?rid=853226&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp3052v74l0w0v216%2F Abstract  Vertebroplasty and kyphoplasty are minimally invasive procedures aimed at relieving symptoms associated with vertebral compression fractures. They have become accepted, highly effective, safe procedures, and are known for their high patient satisfaction rates. Although they are image-guided percutaneous spine therapies, differences do exist. They have each arisen from different backgrounds and are championed by different subspecialties and each involves slightly different techniques. In addition, a prospective, randomized trial comparing the two techniques has yet to be performed. This lack of objective data allows market forces and opinions to have a large influence on utilization and patient referral. Content TypeJournal Article JournalCurrent Osteoporosi... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853226 Sat, 08 Sep 2007 04:34:49 +0100 853226 http://www.medworm.com/index.php?rid=853242&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw126220855618r51%2F Abstract  In the context of osteoporosis, bone quality (which encompasses trabecular bone and cortical bone architecture), bone mineralization, turnover, and microdamage are all important, as are bone density and total content. Noninvasive assessment of bone quality has recently received considerable attention because bone density alone is not a surrogate for fracture prevalence and occurrence, and does not completely explain the therapeutic efficacy of emerging treatments. This paper focuses on the assessment of trabecular bone architecture, one of the factors that governs bone strength and may be categorized as a contributor to bone quality. The methodologies described include micro-computed tomography, magnetic resonance imaging, and computerized analysis of radiographic ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853242 Sat, 08 Sep 2007 04:34:48 +0100 853242 http://www.medworm.com/index.php?rid=853234&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F675v780g85tj1327%2F Abstract  Despite the importance of vertebral compression fractures, there is much that remains uncertain. There is no “gold standard“ for the definition which has led to epidemiologic and study differences. Height loss is a way to suspect vertebral fractures but it has its own issues. There are multiple radiographic systems for defining vertebral fractures, both prevalent and incident; risk factors for prevalent fractures have already been delineated. Recent studies have elucidated the risk factors for incident vertebral fractures including age, low weight, late menarche, lower bone mineral density, history of vertebral and nonvertebral fractures, smoking, and use of a walking aid. Fan beam densitometers have had improving ability to image the spine, a procedure now kn... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853234 Sat, 08 Sep 2007 04:34:48 +0100 853234 http://www.medworm.com/index.php?rid=853225&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn7515607831l7374%2F Abstract  The discovery and characterization of the RANKL/RANK/ OPG signaling pathway and the identification of its role in the pathogenesis of bone loss have provided the rationale for the development of drugs with the ability to modulate RANK-induced osteoclastogenesis. In vivo studies have identified interfering with the RANKL/RANK interaction as a potential therapeutic target in the management of osteoporosis. Two agents capable of blocking the binding of RANKL to RANK have been so far tested in clinical studies—osteoprotegerin (Fc-OPG fusion molecule) and the RANKL-antibody (AMG 162). Both have been found to have profound inhibitory effects on bone resorption, with AMG 162 appearing to be overall superior to OPG. Data are still very scarce, however, and much remains t... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853225 Sat, 08 Sep 2007 04:34:48 +0100 853225 http://www.medworm.com/index.php?rid=853224&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx284761011224k37%2F Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 3 Journal IssueVolume 3, Number 4 / December, 2005 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853224 Sat, 08 Sep 2007 04:34:48 +0100 853224 http://www.medworm.com/index.php?rid=853238&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl872638781t164w5%2F Abstract  Bisphosphonates are effective inhibitors of bone remodeling. In the clinical setting, these agents prevent bone loss, preserve bone architecture, and improve bone strength. Clinically significant reduction in the risk of spine and nonspine fractures is observed in patients known to be at risk for fracture. When administered appropriately, these drugs are well tolerated and have an excellent safety profile. Potent bisphosphonates are now the preferred treatment option to reduce the fracture risk in men and women with involutional and glucocorticoid-induced osteoporosis. Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 1 Journal IssueVolume 1, Number 3 / December, 2003 (Source... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853238 Sat, 08 Sep 2007 04:34:47 +0100 853238 http://www.medworm.com/index.php?rid=853237&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc65h2jh166402454%2F Abstract  In the United States, the impact regarding the routine fortification of milk and other dairy products has been less than satisfactory in preventing vitamin D depletion in adults. As more individuals are being evaluated and treated for osteoporosis, it has become necessary to exclude vitamin D depletion as a cause, because of the likelihood that differences in vitamin D and calcium nutrition may modify the individual response to therapy. Increased prevalence of subclinical vitamin D depletion among vertebral and hip fracture patients and the beneficial effect of vitamin D therapy and calcium supplementation in preventing such fractures lend credence to this assumption. The prevalence of vitamin D depletion is increasing again, especially among older adults, precise... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853237 Sat, 08 Sep 2007 04:34:47 +0100 853237 http://www.medworm.com/index.php?rid=853236&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdpq325656w888125%2F Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 1 Journal IssueVolume 1, Number 3 / December, 2003 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853236 Sat, 08 Sep 2007 04:34:47 +0100 853236 http://www.medworm.com/index.php?rid=853228&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F580120328gh7701g%2F Abstract  Quantitative ultrasound (QUS) techniques have found widespread clinical use, but their specific role in clinical practice needs further refinement. This review discusses the ability of QUS approaches to predict the risk for prevalent vertebral fractures and the risk for future fractures. QUS approaches perform as well as central dual x-ray absorptiometry devices but with some disadvantages (at least for older QUS approaches) with regard to the predictive power for hip fractures. Technologic diversity of QUS approaches may lead to differences in performance. QUS also has the potential for assessing bone mineral density-independent aspects of bone composition that are relevant for bone strength. For measurements at the calcaneus, it is evident that bone microstructu... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853228 Sat, 08 Sep 2007 04:34:47 +0100 853228 http://www.medworm.com/index.php?rid=853227&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv75m101422v185q1%2F Abstract  Raloxifene, a selective estrogen receptor modulator, is approved for the prevention and treatment of postmenopausal osteoporosis. Prevention studies with raloxifene have demonstrated preservation of bone density and suppression of bone turnover markers in young postmenopausal women. The Multiple Outcomes of Raloxifene Evaluation study was the pivotal treatment trial for raloxifene. It demonstrated significant reduction in the risk for vertebral fractures after 1 and 3 years. Significant reduction of nonvertebral fractures with raloxifene has not yet been demonstrated. In addition to the effects of raloxifene on bone, potentially beneficial effects on the cardiovascular system, breast, and uterus have been described. Most of these nonskeletal effects have been repo... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=853227 Sat, 08 Sep 2007 04:34:47 +0100 853227 http://www.medworm.com/index.php?rid=779059&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh37467q3l20qj716%2F Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 4 Journal IssueVolume 4, Number 3 / September, 1996 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779059 Mon, 11 Jun 2007 05:35:01 +0100 779059 http://www.medworm.com/index.php?rid=779057&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F94527255626jh5k3%2F Abstract  Vitamin D inadequacy is pandemic in adults. Vitamin D deficiency causes osteopenia, precipitates and exacerbates osteoporosis, causes the painful bone disease osteomalacia, and increases muscle weakness, which worsens the risk of falls and fractures. Vitamin D deficiency can be prevented by sensible sun exposure and adequate supplementation. Monitoring serum 25-hydroxyvitamin D is the only way to determine vitamin D status. Recent recommendations suggest that in the absence of sun exposure, adults should ingest 1000 IU of vitamin D3 per day. The ideal healthy blood level of 25-hydroxyvitamin D should be 30 to 60 ng/mL. Vitamin D intoxication occurs when 25-hydroxyvitamin D levels are greater than 150 ng/mL. Three recent reports suggesting that vitamin D and calcium... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779057 Mon, 11 Jun 2007 05:35:00 +0100 779057 http://www.medworm.com/index.php?rid=779055&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F111qkj046011587h%2F Abstract  There is a global need to identify individuals at risk for osteoporotic fracture so that those at high risk can be treated and unnecessary treatment for those at low risk can be avoided. Bone mineral density (BMD) information is not sufficient to identify patients at high risk; approximately half of patients in the community with fractures do not have osteoporosis by the 1994 World Health Organization BMD criteria. Furthermore, BMD information is not easily accessible worldwide. The use of clinical risk factors with or without BMD information will improve our ability to identify patients at high risk for fracture. These risk factors can be integrated to predict a 10-year absolute risk or probability of fracture. Intervention thresholds based on absolute risk will ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779055 Mon, 11 Jun 2007 05:34:59 +0100 779055 http://www.medworm.com/index.php?rid=779060&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq4g4g866252kk861%2F Abstract  A stress fracture represents the inability of the skeleton to withstand repetitive bouts of mechanical loading, which results in structural fatigue and resultant signs and symptoms of localized pain and tenderness. To prevent stress fractures, an appreciation of their risk factors is required. These are typically grouped into extrinsic and intrinsic risk factors. Extrinsic risk factors for stress fractures are those in the environment or external to the individual, including the type of activity and factors involving training, equipment, and the environment. Intrinsic risk factors for stress fractures refer to characteristics within the individual, including skeletal, muscle, joint, and biomechanical factors, as well as physical fitness and gender. This article di... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779060 Mon, 11 Jun 2007 05:34:58 +0100 779060 http://www.medworm.com/index.php?rid=779056&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg844141q83541037%2F Abstract  Osteoporosis in men is an unrecognized but growing problem as the number of men who live to old age increases. The 10-year fracture risk at age 50 quadruples by age 80, and in general the incidence rate of osteoporotic fracture in men is about half that of women. Of note, the mortality and morbidity after hip fracture are much greater in men. There are many men whose osteoporosis is the result of specific causes such as oral glucocorticoid therapy, hypogonadism, or androgen withdrawal therapy for prostate cancer. In addition there are several interesting syndromes of osteoporosis in middle-aged men; these men usually present with vertebral fractures. As knowledge about the prevalence and etiology of osteoporosis in men increases, it will be recognized and treated ... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779056 Mon, 11 Jun 2007 05:34:56 +0100 779056 http://www.medworm.com/index.php?rid=779058&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8vl26861831006t4%2F Abstract  Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is associated with an increased risk of osteoporosis and bone fractures. Initial studies suggested very high rates of osteoporosis in IBD, but more recent studies have suggested that bone mineral density (BMD) is often normal in patients with IBD and typically changes little over time. Nonetheless, IBD is associated with an increased risk of fractures. Doctors managing patients with IBD must consider a variety of risk factors, not just BMD measurements, in assessing fracture risk. Advances have been made in exploring the pathogenesis of osteoporosis in IBD. The evolution of knowledge regarding receptor for activated factor of nuclear factor κB (RANK), its ligand RANKL, and oste... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779058 Mon, 11 Jun 2007 05:34:55 +0100 779058 http://www.medworm.com/index.php?rid=779067&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj5x787puxm364566%2F Abstract  Ibandronate is a potent nitrogen-containing bisphosphonate available as a once-monthly oral formulation for the treatment and prevention of osteoporosis. Preclinical experiments with estrogen-depleted rats, dogs, and monkeys demonstrated the efficacy of daily and intermittent ibandronate dosing. Initial clinical trials explored the optimal dosing regimens for oral administration in humans. The Oral Ibandronate Osteoporosis Vertebral Fracture Trial in North America and Europe (BONE) and Monthly Oral Ibandronate in Ladies (MOBILE) trials demonstrated that long-term daily and intermittent administration of ibandronate was efficacious for increasing bone mineral density, reducing markers of bone turnover, and preventing fractures, while maintaining bone quality. These... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779067 Sun, 03 Jun 2007 07:29:07 +0100 779067 http://www.medworm.com/index.php?rid=779066&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa487137434wtw21t%2F Abstract  One of the major challenges of successful osteoporosis management is poor patient adherence to current therapies. Individuals who are nonadherent have significant consequences of reduced bone mineral density response, reduced bone marker suppression, and increased risk for fracture compared with individuals who are adherent. Although reducing the dosing interval from daily to weekly oral bisphosphonates has improved adherence, adherence with weekly bisphosphonates remains suboptimal. Barriers to adherence include patient health beliefs, inadequate patient education and age. Potential solutions include increased health care provider-patient interaction, and longer times between doses of medications. Content TypeJournal Article JournalCurrent Osteoporosis Rep... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779066 Sun, 03 Jun 2007 07:29:06 +0100 779066 http://www.medworm.com/index.php?rid=779065&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2r1758374233k013%2F Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 4 Journal IssueVolume 4, Number 1 / March, 2006 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779065 Sun, 03 Jun 2007 07:29:06 +0100 779065 http://www.medworm.com/index.php?rid=779061&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr707868905840781%2F Abstract  Paget’s disease of bone is a common skeletal disorder of the elderly that often results in significant morbidity and disability. Although there are a number of oral bisphosphonates currently available for treatment, normalization of biochemical markers of bone turnover with these agents is rarely accomplished due to difficulty with administration, adherence, and possibly resistance to individual bisphosphonates. This paper will focus on zoledronic acid, a potent and easily administered intravenous bisphosphonate that appears to result in a higher percentage of patients with normalization of markers of bone turnover and results in improvements in quality of life in patients with Paget’s disease of bone. Content TypeJournal Article JournalCurrent Osteopor... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779061 Sun, 03 Jun 2007 07:29:05 +0100 779061 http://www.medworm.com/index.php?rid=779063&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh355n25886p616k4%2F Abstract  Osteoporosis and several other bone disorders occur when there is an imbalance between the resorption and formation components of bone remodeling activity. Therapies available for some of these conditions modulate the activity of osteoclasts and/or osteoblasts. The recent discoveries of receptor activator of NF-кB ligand (RANKL), an endogenous activator of osteoclastogenenesis and osteoclast activity and its inhibitor, osteoprotegerin (OPG) as pivotal regulatory factors in the pathogenesis of bone diseases like osteoporosis provide unique targets for therapeutic agents. In laboratory animals and now in humans, administering forms of OPG markedly inhibits osteoclast activity and improves bone strength, documenting that the strategy of inhibiting RANKL activity has... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779063 Sun, 03 Jun 2007 07:29:04 +0100 779063 http://www.medworm.com/index.php?rid=779062&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F90526up67h6hn7t5%2F Abstract  Strontium ranelate is a novel therapy for the treatment of postmenopausal osteoporosis with actions to reduce bone resorption and increase bone formation. In vitro, strontium ranelate has anabolic and antiresorptive activity, increasing collagen and non-collagen protein synthesis, enhancing pre-osteoblast differentiation, inhibiting osteoclast differentiation, and reducing osteoclast function. In animal models, the increase in bone density is closely correlated with increases in biomechanical bone strength. Histomorphometry demonstrates reduced osteoclast surfaces with increased bone formation. Clinical trials in postmenopausal women have demonstrated 3-year fracture efficacy. Reductions in vertebral fracture were seen in patients with and without prevalent verteb... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779062 Sun, 03 Jun 2007 07:29:02 +0100 779062 http://www.medworm.com/index.php?rid=779064&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F114l41150g7g8505%2F Abstract  In this paper, we focus upon the use of anabolic skeletal therapy for the treatment of postmenopausal and other forms of osteoporosis. The only anabolic skeletal agent currently available is a recombinant bioactive fragment of parathyroid hormone, PTH(1-34), known as teriparatide. The full length molecule, human PTH(1-84) is being investigated at this time as are other PTH molecules. Teriparatide improves bone quality by actions on bone turnover, bone density, bone size, and microarchitecture. In postmenopausal women with osteoporosis, teriparatide reduces the incidence for vertebral and nonvertebral fractures. In individuals who have been treated previously with an antiresorptive agent, the subsequent actions of teriparatide on bone density are delayed transiently... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779064 Sun, 03 Jun 2007 07:29:00 +0100 779064 http://www.medworm.com/index.php?rid=779073&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbrvv2543m0014657%2F Abstract  Surrogate markers in clinical medicine provide a useful means to assess therapeutic response to pharmacologic therapy in a wide range of chronic disease states. In the area of osteoporosis, the surrogate markers of change in bone mineral density (BMD) and bone turnover markers (BTM) provide the clinician with a means of assessing the biologic response to osteoporosis-specific pharmacologic agents. Increases in BMD and/or reductions in BTM can independently be correlated to reductions in vertebral and nonvertebral fracture risk. In managing osteoporosis patients, the BTM change at an earlier point of time after initiation of therapy and a change in BTM can provide earlier feed-back to the patient and clinician regarding issues such as compliance and a bone biologic... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779073 Sat, 02 Jun 2007 08:03:04 +0100 779073 http://www.medworm.com/index.php?rid=779071&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3g1t503560021888%2F Abstract  Glucocorticoids induce rapid bone loss and increase the risk for osteoporotic fractures. The mechanisms include a phase of increased bone resorption, probably a result of the increased expression of receptor activator of nuclear factor-κ-B ligand and colony stimulating factor-1, followed-up by a decrease in bone formation. This effect is central to the actions of glucocorticoids in bone and it is secondary to the loss of bone forming cells, caused by an inhibition of cell differentiation and an increase in the apoptosis of mature osteoblasts and osteocytes. Glucocorticoids also inhibit the function of mature osteoblasts and suppress the synthesis of insulin-like growth factor-I, an agent that enhances bone formation. Glucocorticoids alter the growth hormone/insul... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779071 Sat, 02 Jun 2007 08:03:02 +0100 779071 http://www.medworm.com/index.php?rid=779069&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fak737755042h2711%2F Abstract  Clinical practice guidelines (CPGs) are systematically developed statements intended to influence the behavior of health care providers and improve patient care. There are many CPGs with recommendations for selection of patients for bone mineral density testing and pharmacologic treatment of osteoporosis. Health care provider adherence rates for these CPGs are low. The multiplicity of osteoporosis CPGs directed to the same health care providers may play a role in their limited utilization in clinical practice. Similarities, differences, and conflicts in osteoporosis CPGs with wide distribution in the United States were examined. The analysis showed similarities as well as substantial variation in the patient populations addressed, inconsistency of some recommendat... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779069 Sat, 02 Jun 2007 08:02:57 +0100 779069 http://www.medworm.com/index.php?rid=779074&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq0505837482v413g%2F Abstract  The discovery and characterization of the RANKL/RANK/ OPG signaling pathway and the identification of its role in the pathogenesis of bone loss have provided the rationale for the development of drugs with the ability to modulate RANK-induced osteoclastogenesis. In vivo studies have identified interfering with the RANKL/RANK interaction as a potential therapeutic target in the management of osteoporosis. Two agents capable of blocking the binding of RANKL to RANK have been so far tested in clinical studies—osteoprotegerin (Fc-OPG fusion molecule) and the RANKL-antibody (AMG 162). Both have been found to have profound inhibitory effects on bone resorption, with AMG 162 appearing to be overall superior to OPG. Data are still very scarce, however, and much remains t... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779074 Sat, 02 Jun 2007 08:02:47 +0100 779074 http://www.medworm.com/index.php?rid=779070&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8248323144k8m4u8%2F Abstract  Children with moderate to severe forms of osteogenesis imperfecta (OI) require adequate physiotherapy, rehabilitation and orthopedic surgery. Supportive treatment with bisphosphonates can improve the effects of these nonmedicinal treatment modalities. Benefits of bisphosphonate treatment include decreased pain, lower fracture incidence, and better mobility. Among the various bisphosphonates, intravenous pamidronate has been studied in most detail. However, the optimal treatment regimen and the long-term consequences of pamidronate treatment in children are currently unknown. Given these uncertainties, treatment with bisphosphonates during growth should be reserved for patients who have significant clinical problems, such as vertebral compression fractures or long-... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779070 Sat, 02 Jun 2007 08:02:46 +0100 779070 http://www.medworm.com/index.php?rid=779072&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy14581331608h64t%2F Abstract  Clinical decision rules (CDRs) are designed to help physicians practice better. A number of CDRs to assist in identifying women with low bone mass have been developed since the mid 1990s, including SCORE, OST (OSTA), OSIRIS, SOFSURF, NOF, ABONE, pBW, ORAI, and weight-only-EPIDOS (which we have termed WO-E). This review discusses these CDRs in terms of development and validation cohorts and their sensitivity and specificity. The sensitivities of the available CDRs exceed 80% and specificities are about 50%. After much analysis, it appears that most experts prefer OST for its simplicity and SCORE for its flexibility, but there is no consensus on what risk factors to use in the CDRs and what regions of interest (spine, total hip, femoral neck, or a combination) to te... Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779072 Sat, 02 Jun 2007 08:02:42 +0100 779072 http://www.medworm.com/index.php?rid=779068&cid=s_35942_31_f&fid=35942&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fxr47762m1hx83162%2F Content TypeJournal Article JournalCurrent Osteoporosis ReportsOnline ISSN 1544-2241Print ISSN 1544-1873 Journal VolumeVolume 4 Journal IssueVolume 4, Number 4 / December, 1996 (Source: Current Osteoporosis Reports) Current Osteoporosis Reports journals http://www.medworm.com/rss/comments.php?id=779068 Sat, 02 Jun 2007 08:02:32 +0100 779068