Abstract 256: The Differences in Predictors of Osteoporosis between Genders Using Warfarin

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Aseel Hadi Abdulameer Alhashimi ◽  
Hadeer Akram Abdulrazzaq Al-Ani ◽  
Iman Nazar Talib Al-Ani ◽  
Syed Azhar Syed Sulaiman ◽  
Hanan Hussein Hussein
Keyword(s):  
Bone Fragility ◽  
World Health ◽  
Mineral Density ◽  
T Score ◽  
Significant Difference ◽  
Postmenopausal Status ◽  
Chronic Progressive Disease ◽  
One Year ◽  
Definition Of ◽  
Health Organization

Background: Osteoporosis, chronic, progressive disease of multifactorial etiology, is systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with consequent increase in bone fragility. It is most common metabolic bone disease in sexes, races, and ages, therefore, screening at-risk population is essential. Warfarin increases the risk of osteoporosis because of its acting as vitamin K antagonist which is essential as co- factor in bone formation. Objectives: is to determine which gender and race (Malay, Chinese, and Indian) are more affected by the risk of osteoporotic condition and as osteopenia and osteoporosis dependent on definition of World Health Organization which based on bone mineral density (BMD) for each standard deviation (SD) reduction in BMD the relative risk of osteoporosis is increase 1.5-3 times. Methods: quantitative ultrasound machine is used to measure the T-score (BMD) for 270 subjects were divided in two groups; first group involved males and the second involved females. The subjects were also categorised based on using of warfarin more than one year of therapy and compared which factures influence on reduction of BMD. Results: There were 149 females showed significant difference of mean T-score of them when divided in two groups, the first group females less or equal to50 year’s old, non-using warfarin, premenopausal status, females had no history of fracture. Second group included females more than 50 years old, using warfarin more than one year, postmenopausal status, and had history with fractures. While no significant difference for males based on warfarin use. Results showed, Chinese females had more risk of osteoporosis (osteopinia, osteoporosis), than females non-using warfarin (odds ratio [OR] =2.4, 95% CI: 1.04- 5.75). Finally 25% changing of T-score for females was explained by interactions of risk factors; first using of warfarin more than 1 year and races and the second for using of warfarin more than one year and patients aged more than 50 years old. Conclusion: Chinese females with age more than 50 years old are more susceptible for the lower levels of BMD when they used warfarin therapy more than one year.

Understanding Bone Conditions

2012 ◽  
Author(s):  
Anne Sutcliffe ◽  
Cameron Swift
Keyword(s):  
Hip Fracture ◽  
Wide Spectrum ◽  
Bone Fragility ◽  
World Health ◽  
Nursing Management ◽  
Skeletal Disease ◽  
Secondary Care Setting ◽  
Definition Of ◽  
Health Organization ◽  
The Uk

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with bone conditions in an evidence-based and person-centred way. Bone conditions (a major category of musculoskeletal conditions) cover a wide spectrum of diseases, some of which may be considered mild and self-limiting, while others may have a significant impact upon the individual’s quality of life and ability to function. It is estimated that up to 30% of all GP consultations are about musculoskeletal complaints; many are age-associated, and population ageing will continue to increase this demand (Oliver, 2009). The chapter will focus on osteoporosis, hip fracture (perhaps the most serious and costly consequence of osteoporosis or osteopaenia), Paget’s disease, and osteoarthritis, respectively. The chapter will provide a broad overview of these common conditions, enabling a proactive approach to patient care within a multidisciplinary context, whether in the primary or secondary care setting. The nursing management of the symptoms and common health problems associated with bone conditions can be found in several Part 2 chapters, and these are highlighted throughout the chapter. Osteoporosis has been defined as:...A progressive systemic skeletal disease characterised by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. (WHO, 1994)…The World Health Organization (WHO) has recommended a clinical definition of osteoporosis based on a bone mineral density (BMD) measurement of the spine or hip, expressed in standard deviation (SD) units called T scores. Using this definition, an individual is classified as having osteoporosis if his or her T score is ≤–2.5 SD at the spine or hip (WHO, 1994). It is estimated that osteoporosis occurs in approximately 3 million people in the UK, resulting in more than 230,000 fractures per annum, the most frequent being hip, vertebral body, and forearm fractures. In total, 75,000 hip fractures occur annually (British Orthopaedic Association, 2007), with the average age of incidence being 84 and 83 in men and women, respectively (National Hip Fracture Database, 2010).

scholarly journals Food intolerances and associated symptoms in patients undergoing Fobi-Capella technique without gastric ring

2015 ◽  
Vol 28 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Marcella de Arruda MOREIRA ◽  
Patrícia Ramos Maciel ESPÍNOLA ◽  
Camila Wanderley de AZEVEDO ◽  
Cinthia Karla Rodrigues do Monte GUEDES
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Food Intolerance ◽  
World Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
One Year ◽  
Health Organization ◽  
Nutritional Monitoring ◽  
Height Data

BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period.

scholarly journals Seminiferous Tubules and Spermatogenesis

2021 ◽  
Author(s):  
Amor Houda ◽  
Shelko Nyaz ◽  
Bakry Mohamed Sobhy ◽  
Almandouh Hussein Bosilah ◽  
Micu Romeo ◽  
...  
Keyword(s):  
Seminiferous Tubule ◽  
Chromosomal Abnormalities ◽  
Genetic Material ◽  
World Health ◽  
Genetic Abnormalities ◽  
The World ◽  
American Society ◽  
One Year ◽  
Definition Of ◽  
Health Organization

One of the major concerns of the world health community is the infertility. The definition of infertility according to the World Health Organization (WHO) and the American Society for Reproductive Medicine (ASRM) is the inability of a healthy couple to achieve a conception after one year of regular, unprotected intercourse. Fertility complications affect seven percent of the male. The causes of infertility were divided to non-obstructive and obstructive. But, in almost 75% of male infertility cases are idiopathic with predominance of the genetic abnormalities. Numerical or structural chromosomal abnormalities are considered as genetic abnormalities that occur during the meiotic division in spermatogenesis. These abnormalities get transferred to the Offspring, which affects the normal and even the artificial conception. In the human reproduction, sperm cells are considered as a delivery vehicle for the male genetic material packed in chromosomes, which are composed of nearly 2-meter Deoxyribonucleic acid (DNA) molecule and their packaging proteins. This chapter points to grant a summarized description of individual components of the male reproductive system: the seminiferous tubule and spermatogenesis. Here, we describe step by step the structure of the testis seminiferous tubule and what occurs inside these tubules like cell communication and germ cell development from spermatogonia until spermatozoon. This book chapter is very useful for the biologists and physicians working in Assisted reproduction field to understand the physiology and pathology of spermatogenesis.

scholarly journals Osteoporosis: Current Concepts

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 122-127 ◽  
Author(s):  
Ibrahim Akkawi ◽  
Hassan Zmerly
Keyword(s):  
Fracture Risk ◽  
Osteoporosis Treatment ◽  
Bone Fragility ◽  
Pharmacological Therapy ◽  
Bone Architecture ◽  
World Health ◽  
Mineral Density ◽  
Diagnosis Of Osteoporosis ◽  
Average Value ◽  
Health Organization

AbstractOsteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measurement of BMD of the hip and spine using dual energy X-ray absorptiometry. According to the World Health Organization criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviation or more below the average value for young healthy women. Bone turnover biomarker detection may be useful in monitoring osteoporosis treatment and assessing fracture risk but not for diagnosis of osteoporosis. Management of osteoporosis consists of nonpharmacological interventions, which are recommended for all subjects, and pharmacological therapy in all postmenopausal women who have had an osteoporotic fracture or have BMD values consistent with osteoporosis.

P0893BONE EFFECTS AND SAFETY OF ONE YEAR DENOSUMAB THERAPY IN A COHORT OF RENAL TRANSPLANTED PATIENTS: AN OBSERVATIONAL MONOCENTRIC STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Carlo Maria Alfieri ◽  
Valentina Binda ◽  
Maria Teresa Gandolfo ◽  
Donata Cresseri ◽  
Maria Rosaria Campise ◽  
...  
Keyword(s):  
Mineral Metabolism ◽  
Graft Loss ◽  
Lumbar Bone Mineral Density ◽  
Bisphosphonate Therapy ◽  
Primary Role ◽  
Mineral Density ◽  
T Score ◽  
Significant Difference ◽  
One Year ◽  
Tract Infections

Abstract Background and aims Bone and mineral metabolism (MM) disorders are relevant problems in renal transplanted patients (RTxp). In our observational monocentric study, we evaluated the effects on femoral and lumbar bone mineral density (BMD) and on MM parameters, and the safety of one year-treatment with Denosumab (DB) in a cohort of RTxp. Method We recorded data about 32 RTxp treated with DB in our Center in the last year. RTxp were evaluated for BMD and T-score (Ts) before the start (T0) and after 12 months (T12) of treatment. Osteopenia was defined, at femoral (F-OPN) and lumbar (L-OPN) sites as Ts:-1>Ts>-2.5 whereas osteoporosis, in the same sites (F-OPS and L-OPS) as Ts<-2.5. X ray evaluation for spontaneous vertebral fractures (sVF) was made at T0 and, in 25 RTxp repeated at T12. MM and renal function parameters (serum creatinine, sCr and daily urinary protein excretion, ProtU) were recorded at T0 and after 1,3,6, and 12 months of therapy. The clinical indications for DB therapy, in the presence of Ca>9.0 mg/dL were the finding at T0 of: 1) F-OPS and/or V-OPS; 2) sVF. During the year of treatment, hypocalcemic (HpCa=Ca<8.0 mg/dL) episodes, infections, graft rejections and loss and RTxp survival were monitored. Results The cohort was composed mainly by females (n=21). The time of RTx was 144[59-232]mths. Steroid therapy was prescribed in 30 RTxp (93%), 22(68%) and in 2 (6%) RTxp were taking 25OHD and 1-25OH. Three RTxp (9%) were receiving Ca supplements. Bisphosphonate therapy was reported in 15 RTxp (46%) in the year before DB start. At T0, 25(78%) and 7 (22%) RTxp had F-OPS and F-OPN. Twenty-three (71%) and 6 (20%) RTxp had L-OPS and L-OPN. In 3 RTxp normal lumbar T-score was found. sVF were present in 17 RTxp (53%). Ca and P were 9.6±0.6 mg/dL and 3.1±0.6 mg/dL whereas PTH, ALP and 25OHD were 64±32 pg/mL, 80±37 U/L and 28±16 mg/dL. SCr and Prot-U were 1,32±0,4 mg/dL and 0,23±0,16 g/24h. At T12, F-Ts increased significantly (T0: -3.0[-3.5/-2.5] vs T12:-2.8[-3.5/-2.4) as like as V-Ts (T0: -3.0[-3.7/-1.9] vs T12:-2.8[-3.0/-1.6) both p<0.0001. A significant increase was found also in BMD: F-BMD +2.4%[-1.1%/+13%] (p<0.0001), V-BMD +2.6%[-3.4%/+12%] (p=0.009). The prevalence of F-OPS reduced from 78% to 73% (p<0.0001) and 4 RTxp ameliorated their Ts category. Prevalence of V-OPS reduced to 53% at T12 from 71% (p<0.001), and 4 RTxp ameliorated their Ts category. In 2 RTxp were found novel sVF. During the treatment no significant modifications of Ca were found, with only a slight but significant difference between T0 and T12 (T12 Ca: 9.22±1.17, p=0.01). PTH and ALP were significantly higher at T3, T6 and T12 respect T0. No differences in 25OH, sCr and ProtU were found. During the year of treatment, in 3 RTxp 25OHD supplementation was started. No one required novel Ca supplementation. DB therapy wasn’t associated to HpCa episodes. Four RTxp had infections during the time of treatment (mean time of DB treatment:114 days). They had positive pathologic anamnesis for urinary tract infections (UTI). Two of them had symptomatic UTI and 2 required hospitalization for sepsis. No biopsy proven graft rejections were observed during the time of treatment and no graft loss or RTxp death were reported. Conclusions The preliminary results presented in our study, limited by the monocentric, not randomized design and by the smallness of the cohort, reported a good bone efficacy of DB in RTxp, especially at lumbar level. The therapy was characterized by a good general safety. Future longer and randomized studies, involving more RTxp might elucidate the possible primary role of DB in the treatment of bone disorders in RTxp.

scholarly journals Basal serum follicle-stimulating hormone and anti-mullerian hormone are the predictors of poor ovarian response among fertile and infertile women below the age of 40 years 

2021 ◽  
Author(s):  
Haroon Latif Khan ◽  
Shahzad Bhatti ◽  
Imrana ◽  
Humera ◽  
Samina Shuail
Keyword(s):  
Ovarian Response ◽  
Unprotected Sex ◽  
Reproductive Age ◽  
World Health ◽  
Unprotected Sexual Intercourse ◽  
Progressive Decline ◽  
Male And Female ◽  
One Year ◽  
Definition Of ◽  
Health Organization

Abstract Infertility is defined as the inability to conceive despite having frequent, unprotected sex for at least one year. The failure to have children affects men and women across the globe. Infertility can lead to distress and depression [1]. The clinical definition of infertility used by the World Health Organization (WHO) is "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse" [2], while the WHO's epidemiologic definition is "women of reproductive age at risk of becoming pregnant who report unsuccessfully trying for a pregnancy for more than two years" [3]. Clinical definitions are designed for early detection and treatment of infertility [2]–[4]. A progressive decline in fecundity occurs in both males and females with advancing age. Generally, male factors contribute to one-third of infertility cases, the other one-third occurs due to female reproductive deficiencies, while in remaining cases, both male and female causes equally contribute towards infertility. In some cases, infertility is iatrogenic in nature as both male and female profile comes out to be normal and termed as unexplained infertility.

scholarly journals Evaluating the Performance of the WHO International Reference Standard for Osteoporosis Diagnosis in Postmenopausal Women of Varied Polygenic Score and Race

2020 ◽  
Vol 9 (2) ◽  
pp. 499 ◽  
Author(s):  
Qing Wu ◽  
Xiangxue Xiao ◽  
Yingke Xu
Keyword(s):  
African American ◽  
African American Women ◽  
Postmenopausal Women ◽  
World Health ◽  
Nucleotide Polymorphisms ◽  
Mineral Density ◽  
Genetic Profiling ◽  
Polygenic Score ◽  
T Score ◽  
Health Organization

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African American women (POR: 0.52, 95% CI: 0.30–0.83) and in women with low PGS (predicted/observed ratio [POR]: 0.43, 95% CI: 0.28–0.64). Compared to Caucasian women, African American, African Indian, and Hispanic women respectively had a 59%, 41%, and 55% lower hazard of MOF after the T-score was adjusted for. The results were similar when used for any fractures. Conclusions: Our study suggested the BMD T-score performance varies significantly by race in postmenopausal women.

Preventing Premature Weaning: Management Options for Common Lactation Conditions, Including OMT

2020 ◽  
pp. 20-25
Author(s):  
Denise Sackett ◽  
Tala Dajani ◽  
David Shoup ◽  
Uzoma Ikonne
Keyword(s):  
Postpartum Depression ◽  
Family Physician ◽  
Treatment Options ◽  
World Health ◽  
Management Options ◽  
Pharmacological Management ◽  
Control And Prevention ◽  
Lactational Mastitis ◽  
One Year ◽  
Health Organization

The benefits of breastfeeding are well established. The World Health Organization and the Centers for Disease Control and Prevention recommend that mothers breastfeed infants for at least one year, but most children are not breastfed that long because of many factors. Breastfeeding mothers face many challenges to continued breastfeeding, including medical conditions that arise during this period, such as postpartum depression and lactational mastitis. Because of a perceived lack of consistent guidance on medication safety, it can be difficult for the family physician to treat these conditions while encouraging mothers to continue breastfeeding. The purpose of the current review is to summarize and clarify treatment options for the osteopathic family physician treating lactating mothers. We specifically focus on the pharmacological management of contraception, postpartum depression, and lactational mastitis.

Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
National Level ◽  
Health Indicators ◽  
Western Pacific ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

Household and Population-Level Behavioural Changes Due to COVID-19 Pandemic: A Smart Thermostat Based Comparative Data Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Kirti Sundar Sahu ◽  
Arlene Oetomo ◽  
Niloofar Jalali ◽  
Plinio P. Morita
Keyword(s):  
Data Analysis ◽  
Population Level ◽  
World Health ◽  
Motion Sensors ◽  
Household Level ◽  
Work From Home ◽  
Significant Difference ◽  
Health Organization ◽  
Smart Thermostat ◽  
The Impact

The World Health Organization declared the coronavirus outbreak as a pandemic on March 11, 2020. To inhibit the spread of COVID-19, governments around the globe, including Canada, have implemented physical distancing and lockdown measures, including a work-from-home policy. Canada in 2020 has developed a 24-Hour Movement Guideline for all ages laying guidance on the ideal amount of physical activity, sedentary behaviour, and sleep (PASS) for an individual in a day. The purpose of this study was to investigate changes on the household and population-level in lifestyle behaviours (PASS) and time spent indoors at the household level, following the implementation of physical distancing protocols and stay-at-home guidelines. For this study, we used 2019 and 2020 data from ecobee, a Canadian smart Wi-Fi thermostat company, through the Donate Your Data (DYD) program. Using motion sensors data, we quantified the amount of sleep by using the absence of movement, and similarly, increased sensor activation to show a longer duration of household occupancy. The key findings of this study were; during the COVID-19 pandemic, overall household-level activity increased significantly compared to pre-pandemic times, there was no significant difference between household-level behaviours between weekdays and weekends during the pandemic, average sleep duration has not changed, but the pattern of sleep behaviour significantly changed, specifically, bedtime and wake up time delayed, indoor time spent has been increased and outdoor time significantly reduced. Our data analysis shows the feasibility of using big data to monitor the impact of the COVID-19 pandemic on the household and population-level behaviours and patterns of change.

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