Knowledge, Attitude and Practices of Osteoporosis Risk Factors among Jazan University Students, 2019

Osteoporosis is one of the non-communicable diseases that closely links to lifestyle and nutrition. This is a cross-sectional descriptive epidemiologic study, carried out on 440 Jazan university students (males& females). They are chosen by a stratified multistage cluster sampling technique to assess their knowledge, attitude, and practices (KAP) about osteoporosis risk factors. The data are collected using a validated semi structured Arabic questionnaires. The findings revealed that almost all survey participants agreed with the definition of osteoporosis, which is the decrease of bone density, with only 8.7% disagreeing. Furthermore, 80.0 percent of survey participants classified osteoporosis as a cause of bone fracture. The findings suggest that the study participants' good attitudes toward risk factor prevention of osteoporosis are linked to the daily consumption of an acceptable amount of milk. Another positive attitude toward osteoporosis prevention stemmed from a reduction in the amount of energy drinks consumed, which has been identified as an osteoporosis risk factor. The study recommends that university students of all grades participate in health education programs about osteoporosis risk factors and preventive treatment.

Characteristics of healthy German children and adolescents across tertiles of calcaneal stiffness index

Aim Identifying risk factors for low bone stiffness index (SI) might be one crucial strategy for osteoporosis prevention. Purpose was to characterize healthy schoolchildren across tertiles of SI. Subject and methods In 248 girls (13.4 ± 1.9 years, BMI: 20.2 ± 4.8 kg/m2) and 231 boys (13.6 ± 1.7 years, BMI: 19.3 ± 3.3 kg/m2), the following parameters were assessed: calcaneal SI (quantitative ultrasound), body composition (bioelectrical impedance analysis), Bone Healthy Eating Index (BoneHEI; food frequency questionnaire), and physical activity level (PAL; activity questionnaire). Participants were classified according to age- and sex-specific SI tertiles (low, medium, and high). Between-group comparisons were achieved by Kruskal–Wallis-H-tests (α = 0.05). Results Girls with low SI had significantly lower body mass (49.2 ± 16.7 vs 54.8 ± 12.2 kg; p < 0.01), BMI (19.6 ± 5.4 vs 21.3 ± 3.9 kg/m2; p < 0.0001), fat-free mass (36.3 ± 8.3 vs 39.5 ± 6.0 kg; p < 0.01), and fat mass (23.7 ± 9.1 vs 26.8 ± 7.2%; p < 0.05) compared to those with high SI. In boys, significant differences between low and high SI were obtained for PAL (1.49 ± 0.12 vs 1.56 ± 0.14; p < 0.01). BoneHEI was not significantly different between tertiles in both sexes. Conclusion Girls with low body mass and boys with low PAL have a higher risk for low SI. Schoolchildren should strive for normal body mass and perform regular physical activity.

An Exploration of Current Primary Care Practice Regarding Osteoporosis Assessment Following a Low Trauma Wrist Fracture in people aged 50 years and above in Wellington, New Zealand: A Quantitative Survey

<p>Osteoporosis remains a major health issue worldwide. The impact of the condition and the fractures that can occur, can have significant debilitating impact and also incur substantial financial costs to healthcare systems. The burden of osteoporosis and the rate of osteoporotic fractures in New Zealand is comparable to other countries such as Australia, the United States and Europe. There is global literature evidence dating back as far as 1960, indicating that a fracture sustained after a simple trip or fall can be an indicator of osteoporosis. There is a need to ensure that fracture patients with a potential osteoporosis diagnosis, receive follow up care for assessment to treat any underlying bone health issue to prevent future fragility fractures, particularly, hip fractures. Due to limited formal literature sources describing the associated New Zealand context, the aim of this research work was to explore current practice for osteoporosis assessment following a fragility wrist fracture in the general practitioner (GP) primary health care setting in Wellington, New Zealand. A quantitative cross-sectional descriptive survey of Wellington GPs was undertaken for this purpose. The reporting of study results were guided by the recommendations detailed within the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement on reporting observational studies (Vandenbroucke et al., 2014). 35 out of 297 GPs from 60 practices in the Wellington region responded to the survey. When describing the local context in Wellington, New Zealand, study results showed that almost three quarters of Wellington GP survey respondents follow up patients who have sustained a potential fragility wrist fracture. The discharge summary was also shown to be a vital part of the communication process between the tertiary and primary health care sectors, acting as a prompt to the GP for further investigation. The single biggest barrier inhibiting processes to enable timely osteoporosis treatment as perceived by GP survey respondents, was lack of public funding, in particular to support availability of diagnostic Dual Energy X-ray Absorptiometry (DEXA) scanning. Other barriers were identified by the GP survey respondents, such as anti-osteoporosis medication side effects, patient compliance to treatment plans and a lack of time within the scheduled consultation to screen patients for osteoporosis. The main educational resources that a large percentage of GP survey respondents independently accessed on a regular basis, were those that were readily available. These included GP guidelines published by “Osteoporosis New Zealand” and possibly other, and online resources such as “Health Pathways” (a best-practice, condition-specific guideline and information resource for primary health care practitioners - https://3d.healthpathways.org.nz). The results also highlighted that most GP survey respondents preferred to take the lead role in the care for patients needing to undergo osteoporosis investigation and treatment. In addition, the GP survey respondents demonstrated a high level of knowledge regarding osteoporosis risk factors. In summary, this study has identified features of practice with regards to osteoporosis assessment following a fragility wrist fracture in the Wellington region. In addition, this study has also enabled identification of specific areas that could be better supported and resourced to assist GP’s in the prevention of secondary fragility fractures. These include highly visible public health campaigns to raise public awareness of osteoporosis and education to GP’s regarding the available screening tools. A significant finding was also that the GP respondents in this study indicated they considered that an important part of their role was responsibility for osteoporosis prevention and treatment. The study results also highlight that despite funding issues, GP survey respondents view osteoporosis prevention and treatment as best placed in the care of the primary health care sector. This is the first New Zealand study that has identified and described the local context around current practice for fragility wrist fracture care within the Wellington GP community, establishing important reference points which can be used to support further development and research.</p>

An Exploration of Current Primary Care Practice Regarding Osteoporosis Assessment Following a Low Trauma Wrist Fracture in people aged 50 years and above in Wellington, New Zealand: A Quantitative Survey

<p>Osteoporosis remains a major health issue worldwide. The impact of the condition and the fractures that can occur, can have significant debilitating impact and also incur substantial financial costs to healthcare systems. The burden of osteoporosis and the rate of osteoporotic fractures in New Zealand is comparable to other countries such as Australia, the United States and Europe. There is global literature evidence dating back as far as 1960, indicating that a fracture sustained after a simple trip or fall can be an indicator of osteoporosis. There is a need to ensure that fracture patients with a potential osteoporosis diagnosis, receive follow up care for assessment to treat any underlying bone health issue to prevent future fragility fractures, particularly, hip fractures. Due to limited formal literature sources describing the associated New Zealand context, the aim of this research work was to explore current practice for osteoporosis assessment following a fragility wrist fracture in the general practitioner (GP) primary health care setting in Wellington, New Zealand. A quantitative cross-sectional descriptive survey of Wellington GPs was undertaken for this purpose. The reporting of study results were guided by the recommendations detailed within the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement on reporting observational studies (Vandenbroucke et al., 2014). 35 out of 297 GPs from 60 practices in the Wellington region responded to the survey. When describing the local context in Wellington, New Zealand, study results showed that almost three quarters of Wellington GP survey respondents follow up patients who have sustained a potential fragility wrist fracture. The discharge summary was also shown to be a vital part of the communication process between the tertiary and primary health care sectors, acting as a prompt to the GP for further investigation. The single biggest barrier inhibiting processes to enable timely osteoporosis treatment as perceived by GP survey respondents, was lack of public funding, in particular to support availability of diagnostic Dual Energy X-ray Absorptiometry (DEXA) scanning. Other barriers were identified by the GP survey respondents, such as anti-osteoporosis medication side effects, patient compliance to treatment plans and a lack of time within the scheduled consultation to screen patients for osteoporosis. The main educational resources that a large percentage of GP survey respondents independently accessed on a regular basis, were those that were readily available. These included GP guidelines published by “Osteoporosis New Zealand” and possibly other, and online resources such as “Health Pathways” (a best-practice, condition-specific guideline and information resource for primary health care practitioners - https://3d.healthpathways.org.nz). The results also highlighted that most GP survey respondents preferred to take the lead role in the care for patients needing to undergo osteoporosis investigation and treatment. In addition, the GP survey respondents demonstrated a high level of knowledge regarding osteoporosis risk factors. In summary, this study has identified features of practice with regards to osteoporosis assessment following a fragility wrist fracture in the Wellington region. In addition, this study has also enabled identification of specific areas that could be better supported and resourced to assist GP’s in the prevention of secondary fragility fractures. These include highly visible public health campaigns to raise public awareness of osteoporosis and education to GP’s regarding the available screening tools. A significant finding was also that the GP respondents in this study indicated they considered that an important part of their role was responsibility for osteoporosis prevention and treatment. The study results also highlight that despite funding issues, GP survey respondents view osteoporosis prevention and treatment as best placed in the care of the primary health care sector. This is the first New Zealand study that has identified and described the local context around current practice for fragility wrist fracture care within the Wellington GP community, establishing important reference points which can be used to support further development and research.</p>

Does Folic Acid Protect Patients with Inflammatory Bowel Disease from Complications?

Folic acid, referred to as vitamin B9, is a water-soluble substance, which participates in the synthesis of nucleic acids, amino acids, and proteins. Similarly to B12 and B6, vitamin B9 is involved in the metabolism of homocysteine, which is associated with the MTHFR gene. The human body is not able to synthesize folic acid; thus, it must be supplemented with diet. The most common consequence of folic acid deficiency is anemia; however, some studies have also demonstrated the correlation between low bone mineral density, hyperhomocysteinemia, and folic acid deficiency. Patients with inflammatory bowel disease (IBD) frequently suffer from malabsorption and avoid certain products, such as fresh fruits and vegetables, which constitute the main sources of vitamin B9. Additionally, the use of sulfasalazine by patients may result in folic acid deficiency. Therefore, IBD patients present a higher risk of folic acid deficiency and require particular supervision with regard to anemia and osteoporosis prevention, which are common consequences of IBD.

Stem Cell Induction and Plant Regeneration Are Affected By Medium Components in Maca (Lepidium Meyenii Walp)

Selection, propagation and conservation of important genotypes are important in medicinal-industrial plants. Nowadays, using tissue culture and regeneration techniques of medicinal plants under in vitro conditions has been able to proliferate medicinal plants widely, which is much higher than traditional methods of vegetative propagation. Maca (Lepidium meyenii), is an industrial plant whose root is the usable part. Maca has valuable medicinal effects such as sexual enhancement and reproductive power, infertility treatment, improved sperm count and quality, anti-stress, osteoporosis prevention and more. This study was conducted to induce callus and regeneration of Maca. First, MS medium supplemented with different concentrations of Kinetin, NAA and 2,4-D (0.5, 1 and 2 μM respectively) and control were compared for callus induction from root and leaves. After 38 days of incubation, the first callus appeared, after 50 days of callus induction and after 79 days regeneration occurred. The callus induction experiment was performed for the study of the effect of three explants (leaf, stem and root) and seven hormone levels. The regeneration experiment was carried out by studying the effect of three explants (leaf, stem and root) on eight levels of the hormone. The results of data analysis on callus induction showed that the effects of explants, hormones and their interactions on callus induction percentage were highly significant but not significant on callus growth rate. The results of regression analysis showed that explants, hormones and their interactions had no significant effect on regeneration percentage.

Vitamin D Supplementation in Sarcoidosis: A Double-Edged Sword

Sarcoidosis is complicated by disordered vitamin D and calcium metabolism, which has important implications on disease activity and bone health. Although the majority of the patients with sarcoidosis are typically deficient in 25-hydroxyvitamin D, repletion of vitamin D is controversial in light of the hypercalcemia risk. Presently, there are no clear guidelines regarding vitamin D supplementation as a part of osteoporosis prevention in patients with vitamin D deficiency and sarcoidosis. We report a patient with sarcoidosis who presented with severe hypercalcemia following vitamin D supplementation and review the debated role of vitamin D supplementation in vitamin D-deficient sarcoid patients.

Resveratrol facilitates bone marrow mesenchymal stem cells (BMSCs) differentiation to prevent osteoporosis via restraining of secreted frizzled-related protein 1 expression

Secreted frizzled-related protein 1 (SFRP1) is associated with cell differentiation, and its expression can be modulated by resveratrol. However, their impacts on bone marrow mesenchymal stem cells (BMSCs)-induced osteogenesis and ovariectomy-triggered bone loss remain unclear. Therefore, we in this study aimed to dissect the regulation of resveratrol on SFRP1, along with its sequential effects on differentiation and osteoporosis prevention of BMSCs. The SFRP1 expression in the ovariectomized (OVX) mice-originated bone tissues, BMSCs and bone marrow-derived macrophages (BMMs), during their differentiation towards osteoblasts and chondrocytes, was quantified by qRT-PCR and Western-blot. SFRP1-siRNA was applied for studying its influence on osteogenesis of BMSCs. Additionally, we evaluated the impacts of resveratrol on OVX mice and SFRP1 expression. SFRP1 was significantly up-regulated in the OVX mice-derived bone tissues and BMSCs, but gradually decreased during osteogenesis. Its expression was not significantly changed in BMSCs during their differentiation towards osteoclasts or in BMMs. The knockout of SFRP1 significantly improved mineralization potentiality, alkaline phosphatase activity and expression of several osteoblast-specific genes. Moreover, the bone loss was ameliorated in OVX mice treated with resveratrol, whose therapeutic effects were achieved by facilitating the expression of osteogenesis-associated genes while suppressing the SFRP1 expression. We also observed that the SFRP1 exerted a negative effect on osteogenesis of BMSCs and estrogen deficiency-induced osteoporosis, enabling itself to be an indicator of osteogenesis and also a molecular target for PMOP treatment. Resveratrol is a suppressor of SFRP1that can be applied as an active ingredient for treating PMOP.

Osteoporosis Preventive Behavior Among Female Healthcare Students in Da Nang, Vietnam

Background: Osteoporosis prevention at young ages is crucial to diminish the risk of the disease and its complication in later years of life. Having good osteoporosis knowledge and positive health belief may lead to better preventive behavior which then contributes to build and maintain bone health throughout life. Objective: To investigate knowledge, health belief, and behavior of osteoporosis prevention among female healthcare students. Methods: The descriptive cross-sectional study was conducted in a public medical university in Da Nang of Vietnam. Four hundred participants were selected by applying the multistage sampling technique. Data were collected from May 2020 to June 2020 through the questionnaire that consists of 4 parts including the demographic data form, the osteoporosis knowledge assessment tool, the osteoporosis health belief scale, and the exercise and calcium behaviors scale. Data were analyzed using descriptive statistics and Pearson correlation test. Results: Participants had poor osteoporosis knowledge (mean [SD], 37.8 [16.0]; range, 0 - 75) and low preventive behavior (mean [SD], 5.7 [3.5]; range, 0 - 25). Osteoporosis health belief was found at a moderate level with a mean (SD) of 126.7 (12.9) (range, 84 - 187). There were positive significant correlations between knowledge and health belief, knowledge and behavior of osteoporosis prevention (P < .05). Conclusions: Osteoporosis preventive behavior of female healthcare students was low. Osteoporosis education programs should be developed for female healthcare students to improve their knowledge and health belief that would then lead to their better preventive behavior.

Analysis of the molecular mechanisms by flavonoids with potential use for osteoporosis prevention or therapy

Background: Osteoporosis is the most common skeletal disorder worldwide. Flavonoids have the potential to alleviate bone alterations in osteoporotic patients with the advantage of being safer and less expensive than the conventional therapies. Objective: The main objective is to analyze the molecular mechanisms triggered in bone by different subclasses of flavonoids. In addition, this review provides an up-to-date overview on the cellular and molecular aspects of osteoporotic bones versus healthy bones, and a brief description of some epidemiological studies indicating that flavonoids could be useful for osteoporosis treatment. Methods: The PubMed database was searched in the range of years 2001- 2021 using the keywords osteoporosis, flavonoids, and their subclasses such as flavones, flavonols, flavanols, isoflavones, flavanones and anthocyanins, focusing the data on the molecular mechanisms triggered in bone. Results: Although flavonoids comprise many compounds that differ in structure, their effects on bone loss in postmenopausal women or in ovariectomized-induced osteoporotic animals are quite similar. Most of them increase bone mineral density and bone strength, which occur through enhancement of osteoblastogenesis and osteoclast apoptosis, decrease in osteoclastogenesis as well as increase in neovascularization on the site of the osteoporotic fracture. Conclusion: Several molecules of signaling pathways are involved in the effect of flavonoids on osteoporotic bone. Whether all flavonoids have a common mechanism or they act as ligands of estrogen receptors remain to be established. More clinical trials are necessary to know better their safety, efficacy, delivery and bioavailability in humans, as well as comparative studies with conventional therapies.