ITEMS IN AFP WITH MESH TERM:
Calcium Supplementation in Postmenopausal Women - Cochrane for Clinicians
Predicting Hip Fracture Risk in Older Women - Point-of-Care Guides
NOF Urges Bone Density Tests for Certain Postmenopausal Women and All Women Over Age 65 - Special Medical Reports
Prevention of Osteoporosis and Fractures - Article
ABSTRACT: Osteoporosis and low bone density are associated with a risk of fracture as a result of even minimally traumatic events. The estimated lifetime risk of osteoporotic fracture is as high as 50 percent, especially in white and Asian women. The use of caffeine, tobacco and steroids is associated with a decrease in bone density. Cognitive impairment, vision problems and postural instability increase the risk of falling and sustaining a fracture. Medications such as long-acting sedative hypnotics, anticonvulsants and tricyclic antidepressants also increase this risk. Combinations of clinical and radiographic findings can predict fracture risk more effectively than bone densitometry, but often only after the first fracture has occurred. The addition of dietary calcium and/or vitamin D is clearly both cost-effective and significant in reducing the likelihood of fractures. Bisphosphonates reduce fracture risk but at a cost that may be prohibitive for some patients. Estrogen and estrogen-receptor modulators have not been well studied in randomized trials evaluating the reduction of fractures, but they are known to increase bone density. Pharmacologic therapy and the reduction of sensory and environmental hazards can prevent osteoporotic fractures in some patients.
ABSTRACT: Osteoporosis affects more than 28 million Americans. With the advent of accessible and affordable diagnostic studies, awareness and recognition of this disease by patients and clinicians are growing. Osteoporotic fractures of the spine and hip are costly and associated with significant morbidity and mortality. Over the past decade, a surge of new antiosteoporotic drugs have been labeled or are awaiting labeling by the U.S. Food and Drug Administration. One class of agents used to treat osteoporosis is the bisphosphonates, which inhibit bone resorption, cause an increase in bone mineral density and reduce the risk of future fractures caused by aging, estrogen deficiency and corticosteroid use. Overall, bisphosphonates have been shown to have a strong safety and tolerability profile.
Screening for Osteoporosis - Putting Prevention into Practice
Screening for Osteoporosis: Recommendation Statement - U.S. Preventive Services Task Force
Update on Subclinical Hyperthyroidism - Article
ABSTRACT: Subclinical hyperthyroidism is defined by low or undetectable serum thyroid-stimulating hormone levels, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (as in Graves disease or toxic nodular goiter), administration of thyroid hormone for treatment of malignant thyroid disease, or unintentional excessive thyroid hormone therapy. The rate of progression to overt hyperthyroidism is higher in persons who have suppressed thyroid-stimulating hormone levels compared with those who have low but detectable levels. Subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation in older adults, and with decreased bone mineral density in postmenopausal women; however, the effectiveness of treatment in preventing these conditions is unknown. There is lesser-quality evidence suggesting an association between subclinical hyperthyroidism and other cardiovascular effects, including increased heart rate and left ventricular mass, and increased bone turnover markers. Possible associations between subclinical hyperthyroidism and quality of life parameters, cognition, and increased mortality rates are controversial. Prospective randomized con- trolled trials are needed to address the effects of early treatment on potential morbidities to help determine whether screening should be recommended in the asymptomatic general population.