scholarly journals Assessment of the use of different risk algorithms for osteoporotic fractures in women in the practice of a family doctor

ScienceRise ◽  
2021 ◽  
pp. 34-39
Author(s):  
Yevheniia Lukianets
Keyword(s):  
Risk Factors ◽  
Family Doctor ◽  
Osteoporotic Fractures ◽  
Social Consequences ◽  
Mineral Density ◽  
Early Menopause ◽  
Significant Difference ◽  
Scope Of Application ◽  
Scientific Results ◽  
Technological Product

Object of research: Women in whom the risk of osteoporotic fractures was assessed using the FRAX, Q-Fracture algorithms, and the risk factors for osteoporosis and their role in the development of osteoporotic fractures were studied. Investigated problem: the use of various algorithms in the practice of a family doctor to assess the 10-year risk of osteoporotic fractures. Main scientific results: A decrease in bone mineral density was found in 51.4 % of the surveyed women, of whom osteopenia was in 48.7 %, osteoporosis in 2.9 % of women. The risk of fractures according to all algorithms was higher in women of the age group 70–79 years: FRAX Total – 8.87±3.2, FRAX Hip – 4.03±3.1, Q fracture total – 12.87±1.5, Q fracture Hip – 7.97±2.7, FRAX Total without BMD – 11.9±5.5, FRAX Hip without BMD – 6.3±4.8. Age correlates negatively with the T score (r=–0.47, p=0.007) and positively with the FRAX Total algorithms without BMD (r=–0.47, p=0.003), FRAX Hip without BMD (r=0.78, p=0.006), Q fracture total (r=0.86, p=0.007), Q fracture Hip (r=0.92, p=0.008), FRAX Hip with BMD (r=0.55, p=0.009). No statistically significant difference was found with FRAX Total with BMD (r=0.21, p=0.345). Risk factors: 14.3 % of women had fractures of various localization; fractures in parents were noted by 37.1 % of respondents; a decrease in height by 3 cm during life occurred in 13.3 %. Early menopause (up to 45 years old) occurred in 11.4 % of women. Physical activity less than 30 minutes a day was noted by 68.6 %. The area of practical use of the research results: the primary level of medical care. Innovative technological product: early identification of risk factors for osteoporosis and calculation of the risk of fractures will reduce the medical and social consequences of complications in osteoporosis. Scope of application of the innovative technological product: in the clinical practice of general practitioners.

scholarly journals Assessment of the Relationship Between Bone Mineral Density and Fracture Risk Factors in the Family Doctor Practice

2021 ◽  
pp. 64-67
Author(s):  
Yevheniia Luk’ianets
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Early Detection ◽  
Bone Mineral ◽  
Family Doctor ◽  
Social Consequences ◽  
Mineral Density ◽  
The Impact ◽  
The Relationship ◽  
Average Body

Osteoporosis is the fourth most common after cardiovascular, cancer and endocrine diseases. According to WHO experts, due to the aging population and the impact of negative environmental factors, the incidence of osteoporosis will increase further. The objective: determining the relationship between ultrasound densitometry data on the heel cyst and the risk of fractures in older women from different regions of the country. Materials and methods. The study was based on a survey of women in major cities of Ukraine – Kyiv, Kharkiv, Odessa. 116 women aged 40 to 79 years were included. The average age of the subjects was 56±9,62 years, the average body weight was 74,5±12,9 kg, height 163,1±5,62 cm, the average body mass index (BMI) was 28±4,90. Normal (BMI) 20–24,9 had 35 women (30,2%), rates of preobesity and clinical obesity were in 81 surveyed women (69,8%). All subjects were divided into 4 groups by age: 40–49 years, 50–59 years, 60–69 years, 70–79 years. Results. Decrease in bone mineral density was found in 59,5% of examined women, of which osteopenia was in 57%, osteoporosis in 2,5% of women, the norm in 40,5% of women. The number of women with low BMD increased with age. Analyzing the risk factors in women after 40 years revealed a high incidence of hypertension 40,5%, the frequency of previous fractures in the anamnesis was 22,% of respondents, fractures of the femur and other fractures in parents noted 33,6% of women, a decrease in growth by 3 cm during life occurred in 13,7%, early menopause (up to 45 years) in 16,3% of women. Physical activity less than 30 minutes a day was noted by 27,5%. The risk of FRAX and Q-fracture fractures is significantly correlated with densitometry. Conclusions. Early detection of osteoporosis risk factors in the practice of a family doctor will help prevent an epidemic of this disease in our country and will prevent negative medical and social consequences. All of the above should be considered for planning preventive measures for osteoporosis and its complications, as well as for subsequent diagnostic steps for early detection of the disease.

Risk Factors for the Development of Osteoporosis and Osteoporotic Fractures Among Older Men

2009 ◽  
Vol 36 (9) ◽  
pp. 1947-1952 ◽  
Author(s):  
MARIA THOMAS-JOHN ◽  
MARY B. CODD ◽  
SIALAJA MANNE ◽  
NELSON B. WATTS ◽  
ANNE-BARBARA MONGEY
Keyword(s):  
Risk Factors ◽  
African American ◽  
Dairy Products ◽  
African American Men ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Older Men ◽  
Current Treatment ◽  
Androgen Deprivation ◽  
Mineral Density

Objective.Osteoporotic fractures are associated with significant morbidity and mortality particularly among older men. However, there is little information regarding risk factors among this population. The aims of our study were to determine risk factors for osteoporosis and fragility fractures and the predictive value of bone mineral density (BMD) measurements for development of fragility fractures in a cohort of elderly Caucasian and African American men.Methods.We evaluated 257 men aged 70 years or older for risk factors for osteoporosis and fragility fractures using a detailed questionnaire and BMD assessment. Exclusion criteria included conditions known to cause osteoporosis such as hypogonadism and chronic steroid use, current treatment with bisphosphonates, bilateral hip arthroplasties, and inability to ambulate independently.Results.Age, weight, weight loss, androgen deprivation treatment, duration of use of dairy products, exercise, and fracture within 10 years prior to study entry were associated with osteoporosis (p ≤ 0.05). Fragility fractures were associated with duration of use of dairy products, androgen deprivation treatment, osteoporosis, and history of fracture within 10 years prior to BMD assessment (p ≤ 0.05). There were some differences in risk factors between the Caucasian and African American populations, suggesting that risk factors may vary between ethnic groups.Conclusion.Although men with osteoporosis had a higher rate of fractures, the majority of fractures occurred in men with T-scores > −2.5 standard deviations below the mean, suggesting that factors other than BMD are also important in determining risk.

scholarly journals Prevalence and incidence of osteoporotic fractures in patients on long-term glucocorticoid treatment for rheumatic diseases: the Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) study

Reumatismo ◽  
2017 ◽  
Vol 69 (1) ◽  
pp. 30 ◽  
Author(s):  
M. Rossini ◽  
O. Viapiana ◽  
M. Vitiello ◽  
N. Malavolta ◽  
G. La Montagna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fractures ◽  
Chronic Treatment ◽  
Randomized Clinical Trials ◽  
Real Life ◽  
Connective Tissue Diseases ◽  
Specific Treatment ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Glucocorticoid Treatment

Osteoporosis and fractures are common and invalidating consequences of chronic glucorticoid (GC) treatment. Reliable information regarding the epidemiology of GC induced osteoporosis (GIOP) comes exclusively from the placebo group of randomized clinical trials while observational studies are generally lacking data on the real prevalence of vertebral fractures, GC dosage and primary diagnosis. The objective of this study was to evaluate the prevalence and incidence of osteoporotic fractures and to identify their major determinants (primary disease, GC dosage, bone mineral density, risk factors, specific treatment for GIOP) in a large cohort of consecutive patients aged >21 years, on chronic treatment with GC (≥5 mg prednisone - PN - equivalent) and attending rheumatology centers located all over Italy. Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) is a national multicenter cross-sectional and longitudinal observational study. 553 patients suffering from Rheumatoid Arthritis (RA), Polymyalgia Rheumatica (PMR) and Connective Tissue Diseases (CTDs) and in chronic treatment with GCs were enrolled. Osteoporotic BMD values (T score <-2.5) were observed in 28%, 38% and 35% of patients with CTDs, PMR or RA at the lumbar spine, and in 18%, 29% and 26% at the femoral neck, respectively. Before GC treatment, prevalent clinical fractures were reported by 12%, 37% and 17% of patients with CTDs, PMR, or RA, respectively. New clinical fragility fractures during GC treatment were reported by 12%, 10% and 23% of CTDs, PMR and RA patients, respectively. Vertebral fractures were the prevailing type of fragility fracture. More than 30% of patients had recurrence of fracture. An average of 80% of patients were in supplementation with calcium and/or vitamin D during treatment with GCs. Respectively, 64%, 80%, and 72% of the CTDs, PMR and RA patients were on pharmacological treatment for GIOP, almost exclusively with bisphosphonates. The GIOTTO study might provide relevant contributions to clinical practice, in particular by highlighting and quantifying in real life the prevalence of GIOP and relative fractures, the frequency of the main risk factors, and the currently sub-optimal prevention. Moreover, these results emphasize the importance of the underlying rheumatic disease on the risk of GIOP associated fractures.

scholarly journals Cutting forces when grinding parts from martensite aging steels with highporous abrasive, borazon and diamond wheels

ScienceRise ◽  
2021 ◽  
pp. 11-16
Author(s):  
Vladimir Lebedev ◽  
Alla Bespalova ◽  
Tatiana Chumachenko ◽  
Yevhen Omelchenko ◽  
Tatiana Nikolaieva
Keyword(s):  
Cutting Force ◽  
Cutting Forces ◽  
Grinding Wheels ◽  
Engineering Technology ◽  
Maraging Steels ◽  
Processing Modes ◽  
Scope Of Application ◽  
Scientific Results ◽  
Highly Porous ◽  
Technological Product

Object of research. The article investigates the cutting forces when grinding martensitic-aging steels with highly porous grinding wheels. The problem to be solved is the regularities of the change in the magnitude of the cutting forces when grinding maraging steels with highly porous CBN wheels. Main scientific results. The studies were performed on martensiticaging steel H8K18M14. As a result of the experiments, it was found that when grinding wheels made of materials such as electrocorundum, CBN (borazon) and diamond, a significant role is played by the values of the cutting force, which increase during processing. During the experiment it was found out: the cutting forces Py and Pz in the width of the allowable modes, which are most often used in circular and flat grinding, can reach the following values: with the structure of the wheel 26 come to values from 2.714N to 30.721 and with the structure of the wheel 40 come to values from 2.49N to 28.185N. Reducing the grain size of the wheel, let’s obtain the effect of increasing the energy costs of the grinding process, by increasing the magnitude of the cutting forces. If to compare the cutting forces that occur when grinding different wheels, it is possible to note the following: in comparison with electrocorundum wheels when using wheels with KNB cutting forces are reduced by 20-25 %, and when grinding with diamond wheels, the effect of cutting forces is reduced by 25 - 30 %. When grinding with highly porous wheels, the cutting force is 15-20 % higher than when grinding with wheels of normal porosity. The area of practical use of research results-grinding technology for maraging steels. Innovative technological product – relationship between processing modes and the magnitude of cutting forces when grinding maraging steels. Scope of application of an innovative technological product-mechanical engineering technology

scholarly journals Clinical Risk Factors for Osteoporotic Fractures in Men With Non-Metastatic Prostate Cancer on Androgen Deprivation Therapy With or Without Anti-Osteoporosis Treatment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A243-A244
Author(s):  
Hajerah Sonnabend ◽  
Vishnu Priya Pulipati ◽  
Sanford Baim ◽  
Todd Beck ◽  
J Alan Simmons ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cancer Therapy ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Clinical Risk Factors ◽  
Mineral Density ◽  
Steroid Use ◽  
Clinical Risk ◽  
Significant Difference

Abstract Introduction: Androgen deprivation therapy (ADT) decreases bone mineral density and increases osteoporotic fracture (OsteoFx) risk. Hypothesis: To assess OsteoFx clinical risk factors (CRF) most predictive of future OsteoFx among men with prostate cancer on ADT. Methods: 4370 electronic medical records were reviewed of adult men with prostate cancer on cancer therapy +/- anti-osteoporosis therapy (Anti-OsteoRx) from 2011–2019. Cancer therapy included ADT (anti-androgens, GnRH agonists & antagonists, orchiectomy) and supplemental cancer therapy (SupplRx) (prostatectomy, brachytherapy, radiation, immunotherapy, and chemotherapy). Anti-OsteoRx included bisphosphonates, denosumab, and parathyroid hormone analogs. Patients with other cancers within 5 years of initial visit, metastasis, and traumatic fractures were excluded. Retrospective analysis was done to determine baseline characteristics, type and duration of ADT, Anti-OsteoRx, SupplRx, and osteoporosis CRF. Results: 615 men on ADT +/- SupplRx +/- Anti-OsteoRx were included in the study. 10.08% had OsteoFx irrespective of SupplRx or Anti-OsteoRx. Comparing the OsteoFx group to the non-fracture group, the following CRF were found to be statistically significant (p <0.05): age at prostate cancer diagnosis (75.10 +/- 11.80 vs 71.59 +/- 9.80 y), diabetes mellitus (DM) (33.9 vs 19%), pre-existing comorbidities affecting bone (PreCo) (41.9 vs 24.8%), steroid use (11.3 vs 4.0%), and anti-convulsant and proton-pump inhibitor (med) use (45.2 vs 26.8%). 9.89% of 374 men on ADT only without (wo) Anti-OsteoRx fractured. Statistically significant CRF for OsteoFx were age (76.86 +/- 10.55 vs 73.02 +/- 10.06 y), DM (40.5 vs 19.6%), PreCo (45.9 vs. 26.4%), and med use (48.6 vs. 25.5%). In the following subgroups there were no statistically significant difference in CRF:•7.64% of 170 men on ADT + SupplRx wo Anti-OsteoRx •19.23% of 52 men on ADT only + Anti-OsteoRx •10.52% of 19 men on ADT + SupplRx + Anti-OsteoRx To increase statistical power, patients on ADT +/- SupplRx were assessed:•Among 71 men on ADT +/- SupplRx + Anti-OsteoRx, there were no statistically significant differences in CRF•Among the 544 men on ADT +/- SupplRx wo Anti-OsteoRx, significant CRF for OsteoFx were age (75.16 + 11.70 vs 71.37 + 9.85 y), DM (38 vs 19.4%), PreCo (38 vs 24.1%), steroid use (12 vs 3.8%), and med use (48 vs 24.3%) Discussion: Men with prostate cancer requiring ADT have a higher incidence of osteoporosis defined by DXA prior to initiating ADT compared to age-matched cohorts (Hussain et al). Our study revealed ADT with CRF is associated with OsteoFx irrespective of SupplRx or Anti-OsteoRx. Limitations include inability to evaluate efficacy of Anti-OsteoRx due to insufficient power. Conclusion: OsteoFx risk assessment utilizing CRF, FRAX, DXA with timely intervention may prevent OsteoFx in these high-risk patients.

scholarly journals Iatrogenic lesions of the skeleton

2017 ◽  
Vol 20 (4) ◽  
pp. 19-25
Author(s):  
Galina A. Melnichenko ◽  
Elizaveta O. Mamedova
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Bone Metabolism ◽  
Negative Impact ◽  
Public Health Problem ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Level Of Evidence ◽  
Important Public Health Problem

Osteoporotic fractures are an important public health problem due to their negative impact on the quality of life and life expectancy, as well as high cost of treatment and rehabilitation. Along with the major risk factors for osteoporotic fractures, such as low bone mineral density (BMD), age, low body weight, frequent falls and previous fractures, an important secondary risk factor, especially among susceptible individuals, is taking certain medications. The difficulty in assessing fracture risk when taking various drugs, as well as the development of appropriate methods of prevention and treatment, is often due to the absence of large randomized trials with a sufficient level of evidence, as well as the heterogeneity of the main risk factors for fractures in studied groups of patients. We focus on the main groups of drugs for which there is evidence of a negative impact on bone metabolism, BMD and fracture risk. In addition to drugs, bone metabolism is also influenced by bariatric surgery, transplantation of solid organs, gonadectomy for various diseases. This article is the RePrint from the original publication in Obesity and Metabolism 2016; 13(2); pp. 41-47. doi: 10.14341/omet2016241-47

scholarly journals Analysis of the clinical risk factors of re-fracture after osteoporotic fracture

2020 ◽  
Author(s):  
Lin Wang ◽  
Guo-Zheng Ding ◽  
Min Yang
Keyword(s):  
Risk Factors ◽  
Osteoporotic Fracture ◽  
Preventive Measures ◽  
Osteoporotic Fractures ◽  
Clinical Situation ◽  
Clinical Risk Factors ◽  
Early Investigation ◽  
Mineral Density ◽  
Clinical Risk ◽  
Research Objects

Abstract Background To investigate the clinical risk factors of patients with osteoporotic fracture and re-fracture. Methods A total of 96 patients with osteoporotic fractures and re-fractures who were treated in the relevant department of our hospital from January 2017 to December 2018 were selected as the research objects. By comparing the basic clinical situation of these two groups Analysis to explore the main risk factors after refracture. Results Through statistical analysis of clinical data, it was found that gender, age, the time from lying down to standing, and the bone mineral density T value were all clinical risk factors for refracture. Women who lie prolonged to stand have a higher risk of re-fracture. Conclusions The risk factors of re-fracture after treatment in elderly patients with osteoporotic fractures are many and complex. Early investigation and targeted preventive measures can be of great significance to reduce the incidence of re-fractures.

The Relationship between Risk Factors for Metabolic Syndrome and Bone Mineral Density in Menopausal Korean Women

2020 ◽  
Author(s):  
Seok-Hee KIM ◽  
Jooyoung KIM
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Bone Mineral ◽  
Korean Women ◽  
Mineral Density ◽  
Significant Difference ◽  
The Relationship

Background: The risk factors of metabolic syndrome (MetS) in menopausal women are potential causes of osteoporosis. However, there is no consensus on this. We aimed to determine the relationship between risk factors of MetS and bone mineral density (BMD) in menopausal Korean women. Methods: We enrolled 205 menopausal Korean women who visited a health promotion center in Seoul in 2015 and divided them into the following two groups according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria with modified waist-circumference criteria: the non-MetS group (Group 1, n=90) and the MetS group (Group 2, n=115). Anthropometric parameters and clinical parameters, including blood pressure, blood lipid profile (cholesterol, triglycerides), and fasting blood sugar levels were recorded for all participants. BMD at the lumbar spine was determined using dual-energy X-ray absorptiometry (DEXA). The relationship between the risk factors of MetS and bone mineral density was analyzed by statistical methods. Results: There was no significant difference in risk factors of MetS between the groups. In correlation tests, waist circumference showed a significant association with body surface area (BSA) (r = -0.242, P < 0.001). Diastolic blood pressure was correlated with BSA (r = 0.186, P < 0.01) and bone mineral content (BMC) (r = 0.161, P < 0.05). However, multiple regression analysis showed no significant relationship between MetS risk factors and BMD. Conclusion: The risk factors of MetS did not affect BMD in menopausal Korean women. Follow-up studies with a larger study population are necessary size to allow the investigation of other research variables.

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