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Copy of Untitled Prezi

Osteoporosis
by

tonhi nguyen

on 26 November 2013

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Transcript of Copy of Untitled Prezi

Osteoporosis


Most common type of bone disease
- literal meaning: “porous bone”
- weak and brittle
- increased risk breaking a bone
Fracture
- discontinuity in a bone
- injury of a bone when tissue of bone is broken
How does that happen?
- bone is living tissue constantly being broken down and built up
- bone turnover
- imbalance
WHO definition of osteoporosis:
“Systemic skeletal disorder characterized by low bone mass and by microarchitectural deterioration of bone tissue with subsequent increase in bone fragility and susceptibility to fracture”
INTRODUCTION
Silent Killer
- osteoblasts and osteoclasts
- bone turnover is a balance

After age 30, osteoclast increases while osteoblast activity decreases
Etiology:

Primary and Secondary Osteoporosis
Primary Osteoporosis:
- main cause is age
- hormonal levels in men and women
Secondary Osteoporosis:
- can occur due to several chronic conditions that cause low bone mass
- anorexia, chronic liver disease, alcoholism, nutritional deficiencies, and malabsorption syndromes

- genetics
- ethnicity
- low bone mass density (BMD)
- low body weight
- history of previous fractures
- diet low in calcium
- rheumatoid arthritis
- glucocorticoids

- (0 to -0.99) = normal bone mineral density
- (-1 to -2.49) = lower than normal but not low enough (osteopenia)
- less than -2.5 without fracture = osteoporosis
- less than -2.5 with fracture or history of fracture = severe osteoporosis
Osteoporosis
Nazneen Patel
Aleena Rahat
Tonhi Nguyen
History/Evolution
Prevalence

Diagnosis is based on two methods: Fragility Factor and Bone Mineral Density (BMD) criteria

- Fragility factor is usually diagnosed using dual energy X-ray absorptiometry
- Bone mineral density is represented as either the Z score or the T score
- Z score
- T score
Can affect anybody
- from newborn babies to the elderly
- heredity
- lifestyle you choose
- other leading causes
Attack any bone in body
- mainly affects hips, spine, wrist
T scores
-
Diagnosis
Risk Factors
Awareness and Prevention
- Statistics: 15% to 85% in last few years!
- Less than 15% of those diagnosed receive treatment for prevention
- Education Programs
- Nutrition and Exercise
Best Treatment:
- DEXA (dual energy X-ray absorptiometry)
- suggested by xrays, confirmed by tests
Early and correct diagnosis is key for effective therapy
- →bone formation
→- slowing or stopping the rate of breakdown
Two Ways To Look Into Treatment
- no cure for osteoporosis, however it can be controlled

Depends greatly on where fractures have occurred:
- hip fractures are most dangerous
- once receive treatment, patient can see change
- early diagnosis and detection as well as early treatment = better outcome
- more awareness, more research
Prognosis
Secondary Osteoporosis
Slowing/Stopping
Antiresorptive agents:
- decrease removal of calcium from bones

Hormone Replacement Therapy:
- taken orally or as a skin patch
- therapy for menopausal in women
- Positive effects singularly
- Risks when combined
- Still used but not recommended as much
Alendronate
-

- Stop bone loss, help build bone
- decrease risk of fracture by 50%
- prevention and treatment
- first nonhormonal medication for osteoporosis ever approved by FDA

Side effects:
- long-term use effects are unknown
Calcitonin

- similar to alendronate
- hormone used as injection for many years
- nasal spray as well!


Side effects:
- not as effective
- minimal
- builds bone by 1.5% a year
Bisphosphonates
-

- decrease risk of hip, wrist & spine fracture
- special measures to reduce side effects and increase absorption (orally)

Surgery
- complicated fractures (broken hips)
- spine pain
- Kyphoplasty
PRIMARY GOAL?
Long term Disease
Teriparatide (Forteo)
- promise for severely diagnosed patients
- synthetic version of human hormone
- regulation and promotion
- self-injected
- switched to bisphosphonate after two years

Side Effects
- long term safety not established
- 24 month FDA approved
- the term osteoporosis
- osteoclast and osteoblasts
- the standard definition of osteoporosis was not until 1992
- 1980s, updates on technologies to measure bone density (medical imaging) prompted the medical community’s need and demand for a standard definition
- Construction of the term osteoporosis
Bone Formation
Primary Osteoporosis (aging)
Discrepancy In Literature
- location of diagnosis of osteoporosis
- diagnosing children
References
Picture References
Heffernan, E. J., O'Sullivan, P. J., Alkubaidan, F. O., Heran, M. S., Legiehn, G. M., & Munk, P. L. (2008). The Current Status of Percutaneous Vertebroplasty in Canada. Canadian Association Of Radiologists Journal, 59(2), 77-82.

MacLaughlin, E. J. (2010). Improving osteoporosis screening, risk assessment, diagnosis, and treatment initiation: Role of the health-system pharmacist in closing the gap. American Journal Of Health-System Pharmacy, 67S4-S8. doi:10.2146/ajhp100075

Cawthon, P. M. (2011). Gender Differences in Osteoporosis and Fractures. Clinical Orthopaedics & Related Research, 469(7), 1900-1905. doi:10.1007/s11999-011-1780-7

Wylie, C. W. (2010). Setting a standard for a “silent” disease: defining osteoporosis in the 1980s and 1990s. 41(4), 376-385. Retrieved from http://www.sciencedirect.com/science/article/pii/S1369848610000774

Wickham, R. (2011). Osteoporosis Related to Disease or Therapy in Patients With Cancer. Clinical Journal Of Oncology Nursing, 15(6), E90-E104.

Gass, M. G., & Hughes, B. H. (2006). Preventing osteoporosis-related fractures: An overview. 119(4), Retrieved from http://www.sciencedirect.com/science/article/pii/S0002934305011976

Dhanapal, V., & Reeves, D. (2012). Bone health management in prostate cancer patients receiving androgen deprivation therapy. Journal Of Oncology Pharmacy Practice, 18(1), 84-90. doi:10.1177/1078155211402105

Heffernan, E. J., O'Sullivan, P. J., Alkubaidan, F. O., Heran, M. S., Legiehn, G. M., & Munk, P. L. (2008). The Current Status of Percutaneous

Schuiling, KD., Robinia, K., & Nye, R. (2011). Osteoporosis Update. Journal of Midwifery & Women’s Health. 56(6), 615-627. doi: 10.1111/j.1542-2011.2011.00135.x

Elliott, M. (2011). Taking control of osteoporosis to cut down on risk of fracture. Nursing Older People. 23(3), 30-35.

Bartl, R., & Frisch, B. (2009). Osteoporosis in Men. Osteoporosis. 25, 183-188. doi: 10.1007/978-3-540-79527-8_25

Martini, F. H. M., Timmons, M. J. T., & Tallitsch, R. B. T. (2012). Human Anatomy: Volume 1. San Francisco, CA: Benjamin Cummings

Bartl, R., & Frisch, B. (2009). Osteoporosis in Children. Osteoporosis. 26, 189-198. doi: 10.1007/978-3-540-79527-8_26
http://weheartit.com/entry/6100548
http://stock-clip.com/video-footage/diagnosing/9
http://footage.shutterstock.com/clip-25299-stock-footage-cell-interaction-e-g-signalling-neurons-d-animation.html
Martini, F. H. M., Timmons, M. J. T., & Tallitsch, R. B. T. (2012). Human Anatomy: Volume 1. San Francisco, CA: Benjamin Cummings
http://www.jeffersonhospital.org/diseases-conditions/osteoporosis.aspx?disease=d3fecf7d-29a6-4776-95da-7450d5650bcd
http://www.marieclaire.com/career-money/jobs/pill-for-productivity-focus
http://www.glamour.com/health-fitness/blogs/vitamin-g/2011/12/health-experts-spell-it-out-hc.html
http://www.pachd.com/free-images/food-images-8.html
http://www.islandnaturopathic.com/19p_vitamin-injection-therapies-and-heavy-metal-chelation.htm
http://animalpetdoctor.homestead.com/surgery.html
http://www.marieclaire.com/career-money/jobs/pill-for-productivity-focus
Most common
In Canada:
- ~1.4 million Canadians, for people aged 50 years or older the prevalence is 16% in women and 6.5% in men
- One in 4 Canadian women over 50 will suffer at least one osteoporotic fracture in their lifetime

In United States
- ~10 million Americans, following with a disproportionate effect on women; 80% are women and 20% are men
- One in two women and one in four men older than 50 years of age will experience an osteoporosis-related fracture in their remaining lifetime
Higher fracture risks are more common in women than men
Heredity/Genetics
Current Research
- Osteoporosis Related to Disease or Therapy in Patients With Cancer (Prostate Cancer)
- risk for bone mineral density loss due to the cancer-related therapy known as Androgen-deprivation
- ADT significantly increases the fracture risk in men with prostate cancer
- Thus, Optimization of the prevention and management of osteoporosis in prostate cancer patients receiving ADT can and should be actively incorporated in to daily practice.
"Womans disease?"
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