scholarly journals SYMPOSIUM PRESS RELEASE “KEY FACTORS OF SUCCESSIN THE TREATMENT OF OSTEOPOROSIS. TREATMENT TO THE GOAL. ’’held at the VIII All-Russian Congress of Osteoporosis in Kazan, September 10, 2016

2016 ◽  
Vol 19 (3) ◽  
pp. 41-45
Author(s):  
Keyword(s):  
Metabolic Diseases ◽  
Systemic Disease ◽  
Osteoporosis Treatment ◽  
Fracture Prevention ◽  
Satellite Symposium ◽  
Low Bone Mass ◽  
Key Factors ◽  
Treatment Of Osteoporosis ◽  
Antiresorptive Agents ◽  
Increased Risk

Osteoporosis - is a systemic disease characterized by low bone mass, microarchitectural violation of its structure that leads to an increased risk of fractures. Currently, the method of finding the optimal therapy for osteoporosisis given special attention. In Kazan, September 9, 2016 in the framework of the Russian Congress on Osteoporosis, osteoarthritis and other metabolic diseases of the skeleton was heldAmgen satellite symposium. The event included reports of Russian and foreign experts, dedicated to practical issues of the treatment of osteoporosis and fracture prevention with the particular emphaseson the benefits of using modern antiresorptive agents.

scholarly journals The use of PTH in the treatment of osteoporosis

2010 ◽  
Vol 54 (2) ◽  
pp. 213-219 ◽  
Author(s):  
Victória Z. Cochenski Borba ◽  
Nádila Cecyn Pietszkowski Mañas
Keyword(s):  
Parathyroid Hormone ◽  
Bone Density ◽  
Adverse Effects ◽  
Combination Therapy ◽  
Biochemical Markers ◽  
Osteoporosis Treatment ◽  
Antiresorptive Therapy ◽  
Treatment Of Osteoporosis ◽  
Antiresorptive Agents ◽  
Anabolic Treatment

Anabolic drugs have recently widened therapeutic options in osteoporosis treatment, as they influence processes associated with bone formation to a greater extent and earlier than bone reabsortion. They positively affect a number of skeletal properties besides bone density, as intermittent administration of parathyroid hormone (PTH) results in an increase in the number and activity of osteoblasts leading to an increase in bone mass and improvement in skeletal architecture at both the trabecular and cortical bone. Human recombinant parathyroid hormone (hrPTH 1-84) and human recombinant PTH peptide 1-34 (teriparatide) belong to this group. The objective of this paper is to review PTH actions, benefits and adverse effects, action on biochemical markers, combination therapy with antiresorptive agents, impact of antiresorptive therapy prior to anabolic treatment, sequential treatment, and effect on glucocorticoid-induced osteoporosis.

scholarly journals Nutrition as prevention and treatment of osteoporosis

2009 ◽  
pp. S7-S11 ◽  
Author(s):  
M Stránský ◽  
L Ryšavá
Keyword(s):  
Bone Mass ◽  
Randomized Trials ◽  
Bone Structure ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Systemic Disease ◽  
Treatment Of Osteoporosis ◽  
Number Of Factors ◽  
Increased Risk ◽  
Endocrine Factors

Osteoporosis is a systemic disease of the skeleton, characterized by reduction of bone mass and concurrent deterioration of bone structure. Consequently, bones are more fragile, and there is increased risk of fractures. The potential for acquisition of maximum bone mass is influenced by a number of factors. Among those are heredity, sex, nutrition, endocrine factors, mechanical influences and some risk factors. The best documented nutrient for metabolism of bone is calcium. Major role in the pathogenesis of osteoporosis have some micro and macro nutrients, prebiotics, alcohol, alternative diets, starvation and anorexia. Meta analysis of 29 randomized trials showed that supplementation with calcium and vitamin D3 reduces risk of bone fractures by 24 % and significantly reduces loss of bone mass. Osteoporosis has multi factor etiology. Osteoporosis is one of diseases which are influenced by nutrition and life style. It is preventable by means of adequate nutrition and sufficient physical activity.

scholarly journals AB1363-HPR EVALUATION OF SELECTION CRITERIA OF CLINICIANS IN THE TREATMENT OF OSTEOPOROSIS, OSTREQ RESEARCH IN TURKEY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1968.1-1969
Author(s):  
E. G. Kahraman ◽  
S. Akar ◽  
B. Ö. Pamuk
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Health System ◽  
Metabolic Diseases ◽  
Treatment Options ◽  
Osteoporosis Treatment ◽  
World Population ◽  
Internal Reliability ◽  
Treatment Of Osteoporosis ◽  
Significant Difference

Background:Osteoporosis is a disease with increasing prevalence in the aging and growing world population and its insidious progression and lack of findings without fracture cause certain difficulties in the diagnosis and treatment of this disease. There are many medical and paramedical treatment options for osteoporosis, and clinicians make these treatment decisions with many factors in mind.Objectives:We wanted to evaluate the importance of these factors for clinicians through a questionnaire. This 17-question questionnaire aimed to investigate the factors that clinicians consider in the planning of osteoporosis treatment and the effect of these factors on treatment planning. We made the Turkish version of the OSTEQ questionnaire in this study which factors clinicians in planning treatment for osteoporosis in Turkey we aimed to investigate that take into consideration.Methods:OSTREQ questionnaire developed by Makraz et al. are used in this research. In this survey, which consists of 8 sections (health care system, patients’ preferences regarding regimen’s administration, usage, cost, severity of disease, treatment efficacy, safety profile and pharmaceutical industry) and 17 questions, the participants were asked to evaluate their answers with 5 different scales: Absolutely Preventive, Partially Preventive, Neither Preventive or Encouraging, Partially Encouraging, Absolutely Encouraging.Clinicians of Rheumatology, Physical Therapy and Rehabilitation, Endocrinology and Metabolic Diseases participated in our study. The questionnaires were filled in by e-mail or by inviting the participants to the our university or by going to the clinics where the clinicians were working.Results:In our study 37 (21.8%) were endocrinology, 49 (28.8%) were rheumatology and 84 (49.4%) were physical therapy and rehabilitation specialists. The overall Cronbach alpha coefficient of the questionnaire was found to be 0.855. No material was found to significantly increase the internal reliability coefficient if deleted. As a result of t-test in 27% lower and upper groups to measure the discriminative power of the items, it was seen that all items made a significant difference in the lower and upper groups, which were formed according to the total score of 27 people. Confirmatory factor analysis and internal reliability results did not require removal of the substance, so the substance was not removed. When the responses of the specialist physicians participating in our study to the osteoporosis preference criteria questionnaire were examined according to their specialty, no statistically significant difference was found between specialty branches but only significant difference was found in health system and cost subscale according to branches (p = 0.013). Post-hoc test (LSD) was used to find out the group that made a significant difference in health system and cost sub-factor. higher scores (p = 0.034).Conclusion:We developed and validated a general osteoporosis treatment questionnaire that could provide assessment of the criteria that physicians take into consideration when they decide to implement a regimen for osteoporosis. This tool could assist health care systems and pharmaceutical companies understand which parameters drive physicians’ choices regarding the treatment of osteoporosis.References:[1]P. Makras, A. Galanos, S. Rizou, A. D. Anastasilakis, and G. P. Lyritis, “Development and validation of an osteoporosis treatment questionnaire (OSTREQ) evaluating physicians’ criteria in the choice of treatment,”Hormones, vol. 15, no. 3, pp. 413–422, Jul. 2016.[2]S. Tuzunet al., “Incidence of hip fracture and prevalence of osteoporosis in Turkey: The FRACTURK study,”Osteoporos. Int., vol. 23, no. 3, pp. 949–955, Mar. 2012.Disclosure of Interests:None declared

Osteoporosis treatment and the older patient

2011 ◽  
Vol 21 (3) ◽  
pp. 233-245
Author(s):  
Roger H Jay ◽  
Sarah L Marrinan
Keyword(s):  
Older People ◽  
Population Group ◽  
Osteoporosis Treatment ◽  
Fracture Prevention ◽  
Assessment Tools ◽  
Mineral Density ◽  
Older Patient ◽  
Treatment Of Osteoporosis ◽  
Risk Assessment Tools ◽  
Proven Benefit

SummaryOsteoporosis is a common, chronic condition. Fracture risk assessment tools are increasingly being used to identify those patients who may benefit from treatment, but in older patients clinical judgement is still essential in deciding whom to treat. The treatment of osteoporosis in older people has seen several important developments in recent years. Whilst bisphosphonates are the mainstay of treatment, several newer medications have proven benefit in terms of increases in bone mineral density and fracture prevention. Additionally, some of the newer therapies have characteristics that particularly lend themselves to use in an older population group. This article focuses upon treatment of osteoporosis in older people with an emphasis on newer drug and therapeutic options.

scholarly journals Osteoporosis Treatment with Anti-Sclerostin Antibodies—Mechanisms of Action and Clinical Application

2021 ◽  
Vol 10 (4) ◽  
pp. 787
Author(s):  
Martina Rauner ◽  
Hanna Taipaleenmäki ◽  
Elena Tsourdi ◽  
Elizabeth M. Winter
Keyword(s):  
Bone Mass ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Fracture Prevention ◽  
Bone Architecture ◽  
High Fracture ◽  
Treatment Regimens ◽  
Increased Risk ◽  
Bone Mass Accrual

Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risk of fragility fractures and significant long-term disability. Although both anti-resorptive treatments and osteoanabolic drugs, such as parathyroid hormone analogues, are effective in fracture prevention, limitations exist due to lack of compliance or contraindications to these drugs. Thus, there is a need for novel potent therapies, especially for patients at high fracture risk. Romosozumab is a monoclonal antibody against sclerostin with a dual mode of action. It enhances bone formation and simultaneously suppresses bone resorption, resulting in a large anabolic window. In this opinion-based narrative review, we highlight the role of sclerostin as a critical regulator of bone mass and present human diseases of sclerostin deficiency as well as preclinical models of genetically modified sclerostin expression, which led to the development of anti-sclerostin antibodies. We review clinical studies of romosozumab in terms of bone mass accrual and anti-fracture activity in the setting of postmenopausal and male osteoporosis, present sequential treatment regimens, and discuss its safety profile and possible limitations in its use. Moreover, an outlook comprising future translational applications of anti-sclerostin antibodies in diseases other than osteoporosis is given, highlighting the clinical significance and future scopes of Wnt signaling in these settings.

Covid-19 In Man: A Very Dangerous Affair.

2021 ◽  
Vol 21 ◽  
Author(s):  
Giuseppe Lisco ◽  
Vito A. Giagulli ◽  
Giovanni De Pergola ◽  
Anna De Tullio ◽  
Edoardo Guastamacchia ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Metabolic Diseases ◽  
Systemic Disease ◽  
Public Health Issue ◽  
Immune System Dysfunction ◽  
Data Support ◽  
Systemic Spread ◽  
The Impact

Background: The novel pandemic of Coronavirus disease 2019 (COVID-19) has becoming a public health issue since March 2020 considering that more than 30 million people were found to be infected worldwide. Particularly, recent evidences suggested that men may be considered as at higher risk of poor prognosis or death once the infection occurred and concerns surfaced in regard of the risk of a possible testicular injury due to SARS-CoV-2 infection. Results: Several data support the existence of a bivalent role of testosterone (T) in driving poor prognosis in patients with COVID-19. On one hand, this is attributable to the fact that T may facilitate SARS-CoV-2 entry in human cells by means of an enhanced expression of transmembrane serine-protease 2 (TMPRSS2) and angiotensin-converting enzyme 2 (ACE2). At the same time, younger man with normal testicular function compared to women of similar age are prone to develop a blunted immune response against SARS-CoV-2, being exposed to less viral clearance and more viral shedding and systemic spread of the disease. Conversely, low levels of serum T observed in hypogonadal men predispose them to a greater background systemic inflammation, cardiovascular and metabolic diseases, and immune system dysfunction, hence driving harmful consequences once SARS-CoV-2 infection occurred. Finally, SARS-CoV-2, as a systemic disease, may also affect testicles with possible concerns for current and future testicular efficiency. Preliminary data suggested that SARS-CoV-2 genome is not normally found in gonads and gametes, therefore sex transmission could be excluded as a possible way to spread the COVID-19. Conclusion: Most data support a role of T as a bivalent risk factor for poor prognosis (high/normal in younger; lower in elderly) in COVID-19. However, the impact of medical treatment aimed to modify T homeostasis for improving the prognosis of affected patients is unknown in this clinical setting. In addition, testicular damage may be a harmful consequence of the infection even in case it occurred asymptomatically but no long-term evidences are currently available to confirm and quantify this phenomenon. Different authors excluded the presence of SARS-CoV-2 in sperm and oocytes, thus limiting worries about both a potential sexual and gamete-to-embryos transmission of COVID-19. Despite these evidence, long-term and well-designed studies are needed to clarify these issues.

scholarly journals Combination therapy of anabolic and nonbisphosphonates antiresorptive agents for the treatment of osteoporosis

Medicine ◽  
2017 ◽  
Vol 96 (52) ◽  
pp. e9534 ◽  
Author(s):  
Shenghan Lou ◽  
Lifan Wang ◽  
Yiwen Wang ◽  
Yunduo Jiang ◽  
Jingwei Liu ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Treatment Of Osteoporosis ◽  
Antiresorptive Agents

scholarly journals Timing of Bisphosphonate Initiation After Fracture: What Does the Data Really Say?

2020 ◽  
Vol 11 ◽  
pp. 215145932098036
Author(s):  
David W. Barton ◽  
C. Taylor Smith ◽  
Amit S. Piple ◽  
Sterling A. Moskal ◽  
Jonathan J. Carmouche
Keyword(s):  
Fracture Healing ◽  
Clinical Studies ◽  
Osteoporosis Treatment ◽  
The Body ◽  
Non Union ◽  
Increased Risk ◽  
Level I ◽  
Timing Of Initiation ◽  
The Impact ◽  
Published Research

Introduction: Osteoporosis is often not clinically recognized until after a fracture occurs. Individuals who have 1 fracture are at increased risk of future fractures. Prompt initiation of osteoporosis treatment following fracture is critical to reducing the rate of future fractures. Antiresorptives are the most widely used class of medications for the prevention and treatment of osteoporosis. Many providers are hesitant to initiate antiresorptives in the acute post-fracture period. Concerns include interference with bone remodeling necessary for successful fracture healing, which would cause increased rates of non-union, malunion, and refracture. While such concerns should not extend to anabolic medications, physicians may also hesitate to initiate anabolic osteoporosis therapies due to high cost and/or lack of familiarity. This article aims to briefly review the available data and present a digestible narrative summary to familiarize practicing orthopaedic surgeons with the essential details of the published research on this topic. Results: The results of 20 clinical studies and key pre-clinical studies related to the effect of anti-resorptive medications for osteoporosis on fracture healing are summarized in the body of this narrative review. Discussion & Conclusions: While few level I studies have examined the impact of timing of initiation of osteoporosis medications in the acute post-fracture period, the few that have been published do not support these concerns. Specifically, data from level I clinical trials indicate that initiating bisphosphonates as early as 2 weeks post-fracture does not increase rates of non-union or malunion. By reviewing the available data, we hope to give clinicians the confidence to initiate osteoporosis treatment promptly post-fracture.

scholarly journals The use of an in-vitro batch fermentation (human colon) model for investigating mechanisms of TMA production from choline, l-carnitine and related precursors by the human gut microbiota

2021 ◽  
Author(s):  
Priscilla Day-Walsh ◽  
Emad Shehata ◽  
Shikha Saha ◽  
George M. Savva ◽  
Barbora Nemeckova ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Metabolic Diseases ◽  
Human Colon ◽  
Human Studies ◽  
Bacterial Strains ◽  
Increased Risk ◽  
Carnitine Metabolism ◽  
Registration Number ◽  
Vitro Model

Abstract Purpose Plasma trimethylamine-N-oxide (TMAO) levels have been shown to correlate with increased risk of metabolic diseases including cardiovascular diseases. TMAO exposure predominantly occurs as a consequence of gut microbiota-dependent trimethylamine (TMA) production from dietary substrates including choline, carnitine and betaine, which is then converted to TMAO in the liver. Reducing microbial TMA production is likely to be the most effective and sustainable approach to overcoming TMAO burden in humans. Current models for studying microbial TMA production have numerous weaknesses including the cost and length of human studies, differences in TMA(O) metabolism in animal models and the risk of failing to replicate multi-enzyme/multi-strain pathways when using isolated bacterial strains. The purpose of this research was to investigate TMA production from dietary precursors in an in-vitro model of the human colon. Methods TMA production from choline, l-carnitine, betaine and γ-butyrobetaine was studied over 24–48 h using an in-vitro human colon model with metabolite quantification performed using LC–MS. Results Choline was metabolised via the direct choline TMA-lyase route but not the indirect choline–betaine-TMA route, conversion of l-carnitine to TMA was slower than that of choline and involves the formation of the intermediate γ-BB, whereas the Rieske-type monooxygenase/reductase pathway for l-carnitine metabolism to TMA was negligible. The rate of TMA production from precursors was choline > carnitine > betaine > γ-BB. 3,3-Dimethyl-1-butanol (DMB) had no effect on the conversion of choline to TMA. Conclusion The metabolic routes for microbial TMA production in the colon model are consistent with observations from human studies. Thus, this model is suitable for studying gut microbiota metabolism of TMA and for screening potential therapeutic targets that aim to attenuate TMA production by the gut microbiota. Trial registration number NCT02653001 (http://www.clinicaltrials.gov), registered 12 Jan 2016.

Mechanisms involved in developmental programming of hypertension and renal diseases. Gender differences

2014 ◽  
Vol 18 (2) ◽  
Author(s):  
Analia Lorena Tomat ◽  
Francisco Javier Salazar
Keyword(s):  
Metabolic Diseases ◽  
Current Knowledge ◽  
Adult Life ◽  
Developmental Programming ◽  
Renal Diseases ◽  
Future Studies ◽  
Functional Changes ◽  
Regulatory Systems ◽  
Increased Risk ◽  
Renal Changes

AbstractA substantial body of epidemiological and experimental evidence suggests that a poor fetal and neonatal environment may “program” susceptibility in the offspring to later development of cardiovascular, renal and metabolic diseases.This review focuses on current knowledge from the available literature regarding the mechanisms linking an adverse developmental environment with an increased risk for cardiovascular, renal and metabolic diseases in adult life. Moreover, this review highlights important sex-dependent differences in the adaptation to developmental insults.Developmental programming of several diseases is secondary to changes in different mechanisms inducing important alterations in the normal development of several organs that lead to significant changes in birth weight. The different diseases occurring as a consequence of an adverse environment during development are secondary to morphological and functional cardiovascular and renal changes, to epigenetic changes and to an activation of several hormonal and regulatory systems, such as angiotensin II, sympathetic activity, nitric oxide, COX2-derived metabolites, oxidative stress and inflammation. The important sex-dependent differences in the developmental programming of diseases seem to be partly secondary to the effects of sex hormones. Recent studies have shown that the progression of these diseases is accelerated during aging in both sexes.The cardiovascular, renal and metabolic diseases during adult life that occur as a consequence of several insults during fetal and postnatal periods are secondary to multiple structural and functional changes. Future studies are needed in order to prevent the origin and reduce the incidence and consequences of developmental programmed diseases.

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