Ostéoporose fracturaire révélatrice du syndrome de Cushing. Deux observations. Revue de la littérature
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Based on X-ray pictures, the authors evaluate the state of osteoporosis by means of bone indexes after implantation of a total prosthesis of the hip joint. They correlate the state of osteoporosis found in the patients with the clinical condition. After 5 years following implantation of TP they found a minimal progression of osteoporosis without restriction of the function of TP of the coxa. Up to ten years after implantation the progression of osteoporosis is apparent, while the functional state of the TP is adequate. After 10 years there is further progression of osteoporosis with restricted function of the TP of the coxa. The cause of progression of osteoporosis is most probably the reaction of the bone tissue to the implant, the type of osteoporosis, reduced burdening when the coxa is insufficient, osteoporosis due to inactivity or osteoporosis as a systemic disease - senile osteoporosis. The investigation indicates some answers to the urgent problems in this sphere: service life of the implanted prosthesis, optimal age for implantation, reaction of the bone to the implant, antiosteoporotic regime, possibly pharmacological treatment of osteoporosis. Key words: osteoporosis, total prosthesis, bone indexes.
Senile osteoporosis
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Secondary causes of osteoporosis are very common, particularly in premenopausal women and in men with osteoporosis, while also being the cause of accelerated bone loss in postmenopausal and age-related osteoporosis. "Secondary causes of osteoporosis" represent the collection of heterogeneous underlying diseases and medications that may contribute to bone loss and increase bone fragility through a number of different mechanisms independently of age or estrogen deficiency. This chapter focuses on systemic inflammatory diseases other than rheumatic diseases, systemic mastocytosis, and endocrine disorders as underlying contributory mechanism for bone loss and/or increased bone fragility in patients with osteoporosis. The ubiquitous nature of "secondary osteoporosis" suggests that diverse medical disciplines need to better interact to meet some of the challenges presented by osteoporosis as a chronic comorbidity of specific disease entities. Screening for secondary causes of osteoporosis should represent an intrinsic part of the optimal management of any patient with osteoporosis.
Bone disease
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Osteoporosis is known to increase in prevalence with age. With aging of population in the recent years, the number of male osteoporosis patients is increasing. Osteoporosis can progress without symptoms. Diagnosis and treatment of osteoporosis are often delayed especially in men, because the concept of male osteoporosis has not been fully penetrated. Even after fragile fracture caused by osteoporosis, it is frequent that an appropriate treatment for osteoporosis has not been provided in men. Furthermore, it has been reported that about half of male osteoporosis patients have secondary causes. In management of osteoporosis patients, we have to pay attention to background diseases and life style of the patients.
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[Objective] To analyze the related factors consequences of stroke in patients with osteoporosis.[Methods] 500 patients with stroke sequelae were divided into patients with osteoporosis(284 cases) and non-osteoporosis group(216 cases).We compared with the gender,degree of hemiplegia,hypertension or diabetes and osteoporosis of the two groups.[Results] There were more women in the osteoporosis group than the non-osteoporosis group.The more severe hemiplegia had the higher incidence of osteoporosis;People complicated with hypertension or diabetes were more prone to osteoporosis.[Conclusion] The incidence of consequences of osteoporosis in stroke has association with the sex,limb movement disorder,hypertension and diabetes.
Stroke
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Osteoporosis has become a major health and economic issue in our fast-growing elderly population (1–3). After attaining peak bone mass between the ages of 20 and 30, both men and women start losing bone at a rate of about 0.5–1% per year (4). In the United States alone, nearly $14 billion is spent each year for treatment of complications of osteoporosis (5). As life expectancy increases, there will be an increase in the financial burden on society. It is estimated that by the year 2050, the cost of osteoporosis-related treatments will increase to $131 billion (6). Osteoporosis is characterized by decreased bone mineral density resulting in susceptibility to fractures with minor to moderate trauma. Osteoporosis has been divided into two types (7). Type I osteoporosis, also designated postmenopausal osteoporosis, is the result of estrogen deficiency, whereas type II osteoporosis occurs in the entire aging population of both men and women.
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Objective: Osteoporosis has become a threat to patients’ health. The search for reliable biomarkers for the diagnosis of osteoporosis is of important clinical significance. microRNAs are involved in the regulation of various physiological and pathological processes. The current study aimed to investigate the potential diagnostic value of microRNA143b for early osteoporosis.
Patients and Methods: This study included 156 osteoporosis patients (69 mild osteoporosis and 87 severe osteoporosis) who were treated. Sixty-nine healthy volunteers were used as controls. Patients were given alendronate hydroxyethyl (5 mg/d) for 2 w. Normal Bone Mineral Density (BMD) is considered effective treatment. The microRNA143b level in blood cells was determined by quantitative Real-Time PCR (qRT-PCR) before and after the treatment. The association between microRNA143b level and osteoporosis was analysed by Pearson’s correlation test.
Results: The microRNA143b level in osteoporosis patients was significantly higher compared with healthy controls (P=0.0017). The post-treatment microRNA143b expression in osteoporosis patients was significantly reduced to a level close to that in control group (P=0.45). Moreover, microRNA143b level in severe osteoporosis was significantly higher compared with mild osteoporosis (P=0.0072). The microRNA143b level in blood cells was positively correlated with the severity of osteoporosis (r=0.91, P=0.011).
Conclusion: MicroRNA143b expression is closely associated with the severity of osteoporosis, and might be a specific biomarker for the disease.
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1. Present and Future of Osteoporosis: Epidemiology 2. Bone Remodeling and Mechanisms of Bone Loss in Osteoporosis 3. Contributions of Bone Mass Measurements by Densitometry in the Definition and Diagnosis of Osteoporosis 4. Ultrasonic Evaluation of Osteoporosis 5. Clinical Usefulness of Markers of Bone Remodelling in Osteoporosis 6. Distal Forearm and Humerus Fractures: Events that Reveal Osteoporosis 7. Oestrogens and Anti-Oestrogens for the Prevention and Treatment of Osteoporosis 8. Bisphosphonates for the Treatment of Osteoporosis 9. Stimulators of Bone Formation for the Treatment of Osteoporosis 10. Other Agents for the Treatment of Osteoporosis 11. Non-Pharmacological Prevention of Osteoporosis: Nutrition and Exercise 12. Practical Management of the Patient with Osteoporotic Vertebral Fracture 13. Pathophysiology and Prevention of Hip Fractures in Elderly People 14. Advances in the Study of Osteoporosis in Men 15. Glucocorticoid-Induced Osteoporosis and Other Forms of Secondary Osteoporosis 16. Quality of Life in Osteoporo sis 17. Preclinical Evaluation of New Therapeutic Agents for Osteoporosis
Densitometry
Bone remodeling
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