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Guidelines on Management of Osteoporosis, April 2011 (Updated 04/2012, 06/2013, 09/2013, 04/2014, 09/2014 and 02/2015)
Hertfordshire Guidelines on Management of Osteoporosis, April 2011 (updated 04/2012, 06/2013, 09/2013, 04/2014, 09/2014 and 02/2015) Guidelines on Management of Osteoporosis Introduction These guidelines take into account recommendations from the DH Guidance on Falls and Fractures (Jul 2009), NICE Technology appraisals for Primary and Secondary Prevention (updated January 2011) and interpreted locally, National Osteoporosis Guideline Group (NOGG) and local decisions on choice of drug treatment. The recommendations in the guideline should be used to aid management decisions but do not replace the need for clinical judgement in the care of individual patients in clinical practice. Diagnosis of osteoporosis The diagnosis of osteoporosis relies on the quantitative assessment of bone mineral density (BMD), usually by central dual energy X-ray absorptiometry (DXA). BMD at the femoral neck provides the reference site. It is defined as a value for BMD 2.5 SD or more below the young female adult mean (T-score less than or equal to –2.5 SD). Severe osteoporosis (established osteoporosis) describes osteoporosis in the presence of 1 or more fragility fracture. Diagnostic thresholds differ from intervention thresholds for several reasons. Firstly, the fracture risk varies at different ages, even with the same T-score. Other factors that determine intervention thresholds include the presence of clinical risk factors and the cost and benefits of treatment. Investigation of osteoporosis The range of tests will depend on the severity of the disease, age at presentation and the presence or absence of fractures. The aims of the clinical history, physical examination and clinical tests are to: • Exclude diseases that mimic osteoporosis (e.g. -
Alendronate, Etidronate, Risedronate, Raloxifene, Strontium Ranelate And
Issue date: October 2008 (amended January 2010 and January 2011) Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women (amended) NICE technology appraisal guidance 161 (amended) NICE technology appraisal guidance 161 (amended) Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women (amended) Ordering information You can download the following documents from www.nice.org.uk/guidance/TA161 • The NICE guidance (this document). • A quick reference guide – the recommendations. • ‘Understanding NICE guidance’ – a summary for patients and carers. • Details of all the evidence that was looked at and other background information. For printed copies of the quick reference guide or ‘Understanding NICE guidance’, phone NICE publications on 0845 003 7783 or email [email protected] and quote: • N1725 (quick reference guide) • N1726 (’Understanding NICE guidance’). This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. -
Botanicals in Postmenopausal Osteoporosis
nutrients Review Botanicals in Postmenopausal Osteoporosis Wojciech Słupski, Paulina Jawie ´nand Beata Nowak * Department of Pharmacology, Wroclaw Medical University, ul. J. Mikulicza-Radeckiego 2, 50-345 Wrocław, Poland; [email protected] (W.S.); [email protected] (P.J.) * Correspondence: [email protected]; Tel.: +48-607-924-471 Abstract: Osteoporosis is a systemic bone disease characterized by reduced bone mass and the deterioration of bone microarchitecture leading to bone fragility and an increased risk of fractures. Conventional anti-osteoporotic pharmaceutics are effective in the treatment and prophylaxis of osteoporosis, however they are associated with various side effects that push many women into seeking botanicals as an alternative therapy. Traditional folk medicine is a rich source of bioactive compounds waiting for discovery and investigation that might be used in those patients, and therefore botanicals have recently received increasing attention. The aim of this review of literature is to present the comprehensive information about plant-derived compounds that might be used to maintain bone health in perimenopausal and postmenopausal females. Keywords: osteoporosis; menopause; botanicals; herbs 1. Introduction Women’s health and quality of life is modulated and affected strongly by hormone status. An oestrogen level that changes dramatically throughout life determines the Citation: Słupski, W.; Jawie´n,P.; development of women’s age-associated diseases. Age-associated hormonal imbalance Nowak, B. Botanicals in and oestrogen deficiency are involved in the pathogenesis of various diseases, e.g., obesity, Postmenopausal Osteoporosis. autoimmune disease and osteoporosis. Many female patients look for natural biological Nutrients 2021, 13, 1609. https:// products deeply rooted in folk medicine as an alternative to conventional pharmaceutics doi.org/10.3390/nu13051609 used as the prophylaxis of perimenopausal health disturbances. -
(12) Patent Application Publication (10) Pub. No.: US 2017/0009296A1 Glessner Et Al
US 20170009296A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2017/0009296A1 Glessner et al. (43) Pub. Date: Jan. 12, 2017 (54) ASSOCIATION OF RARE RECURRENT (60) Provisional application No. 61/376.498, filed on Aug. GENETIC VARATIONS TO 24, 2010, provisional application No. 61/466,657, ATTENTION-DEFICIT, HYPERACTIVITY filed on Mar. 23, 2011. DISORDER (ADHD) AND METHODS OF USE THEREOF FOR THE DAGNOSS AND TREATMENT OF THE SAME Publication Classification (71) Applicant: The Children's Hospital of Philadelphia, Philadelphia, PA (US) (51) Int. Cl. CI2O I/68 (2006.01) (72) Inventors: Joseph Glessner, Mullica Hill, NJ A63L/454 (2006.01) (US); Josephine Elia, Penllyn, PA (52) U.S. Cl. (US); Hakon Hakonarson, Malvern, CPC ........... CI2O I/6883 (2013.01); A61 K3I/454 PA (US) (2013.01); C12O 2600/156 (2013.01); C12O (21) Appl. No.: 15/063,482 2600/16 (2013.01) (22) Filed: Mar. 7, 2016 Related U.S. Application Data (57) ABSTRACT (63) Continuation of application No. 13/776,662, filed on Feb. 25, 2013, now abandoned, which is a continu ation-in-part of application No. PCT/US 11/48993, Compositions and methods for the detection and treatment filed on Aug. 24, 2011. of ADHD are provided. Patent Application Publication Jan. 12, 2017. Sheet 1 of 18 US 2017/000929.6 A1 Figure 1A ADHD Cases and Parentsi Siblings O SO Samples8 O 1. 1. 250C 40 gE 520 - Samples 3. Figure 1B Patent Application Publication Jan. 12, 2017. Sheet 2 of 18 US 2017/000929.6 A1 S&s sess'. ; S&s' ' Ny erre 8 Y-8 W - - 8 - - - - 8 - W - 8-8- W - 8 w w W & . -
Nutriceuticals: Over-The-Counter Products and Osteoporosis
serum calcium levels are too low, and adequate calcium is not provided by the diet, calcium is taken from bone. Osteoporosis: Clinical Updates Long- term dietary calcium deficiency is a known risk Osteoporosis Clinical Updates is a publication of the National factor for osteo porosis. The recommended daily cal- Osteoporosis Foundation (NOF). Use and reproduction of this publication for educational purposes is permitted and cium intake from diet and supplements combined is encouraged without permission, with proper citation. This 1000 mg/day for people aged 19 to 50 and 1200 mg/ publication may not be used for commercial gain. NOF is a day for people older than 50. For all ages, the tolerable non-profit, 501(c)(3) educational organization. Suggested upper limit is 2500 mg calcium per day. citation: National Osteoporosis Foundation. Osteoporosis Clinical Updates. Issue Title. Washington, DC; Year. Adequate calcium intake is necessary for attaining peak bone mass in early life (until about age 30) and for Please direct all inquiries to: National Osteoporosis slowing the rate of bone loss in later life.3 Although Foundation 1150 17th Street NW Washington, DC 20037, calcium alone (or with vitamin D) has not been shown USA Phone: 1 (202) 223-2226 to prevent estrogen-related bone loss, multiple stud- Fax: 1 (202) 223-1726 www.nof.org ies have found calcium consumption between 650 mg Statement of Educational Purpose and over 1400 mg/day reduces bone loss and increases Osteoporosis Clinical Updates is published to improve lumbar spine BMD.4-6 osteoporosis patient care by providing clinicians with state-of-the-art information and pragmatic strategies on How to take calcium supplements: prevention, diagnosis, and treatment that they may apply in Take calcium supplements with food. -
(Arc/Arg3.1) in the Nucleus Accumbens Is Critical for the Acqui
Behavioural Brain Research 223 (2011) 182–191 Contents lists available at ScienceDirect Behavioural Brain Research j ournal homepage: www.elsevier.com/locate/bbr Research report Expression of activity-regulated cytoskeleton-associated protein (Arc/Arg3.1) in the nucleus accumbens is critical for the acquisition, expression and reinstatement of morphine-induced conditioned place preference ∗ Xiu-Fang Lv, Ya Xu, Ji-Sheng Han, Cai-Lian Cui Neuroscience Research Institute and Department of Neurobiology, Peking University Health Science Center, Key Laboratory of Neuroscience, the Ministry of Education and Ministry of Public Health, 38 Xueyuan Road, Beijing 100191, PR China a r t i c l e i n f o a b s t r a c t Article history: Activity-regulated cytoskeleton-associated protein (Arc), also known as activity-regulated gene 3.1 Received 27 January 2011 (Arg3.1), is an immediate early gene whose mRNA is selectively targeted to recently activated synaptic Received in revised form 1 April 2011 sites, where it is translated and enriched. This unique feature suggests a role for Arc/Arg3.1 in coupling Accepted 18 April 2011 synaptic activity to protein synthesis, leading to synaptic plasticity. Although the Arc/Arg3.1 gene has been shown to be induced by a variety of abused drugs and its protein has been implicated in diverse Key words: forms of long-term memory, relatively little is known about its role in drug-induced reward memory. In Activity regulated cytoskeleton-associated this study, we investigated the potential role of Arc/Arg3.1 protein expression in reward-related associa- protein/activity-regulated gene (Arc/Arg3.1) tive learning and memory using morphine-induced conditioned place preference (CPP) in rats. -
Strontium Ranelate Cochrane Reviews Does It Affect the Management of Postmenopausal Osteoporosis?
CLINICAL PRACTICE Strontium ranelate Cochrane reviews Does it affect the management of postmenopausal osteoporosis? This series of articles facilitated by the Cochrane Musculoskeletal Group (CMSG) aims to place the findings of recent Tania Winzenberg Cochrane musculoskeletal reviews in a context immediately relevant to general practitioners. This article considers MBBS, FRACGP, whether the availability of strontium ranelate affects the management of postmenopausal osteoporosis. MMedSc(ClinEpi), PhD, is Research Fellow – General Practice, Menzies Research Institute, University of Osteoporosis is a costly condition1,2 and is the fifth the pharmacologically active component of the compound Tasmania. tania.winzenberg@ most common musculoskeletal problem managed in and has been shown to simultaneously decrease bone utas.edu.au general practice at 0.9 per 100 patient encounters.3 resorption and stimulate bone formation both in vitro and in Sandi Powell Secondary prevention of osteoporotic fracture is poorly animal models,6 although the exact mechanisms for these MBBS(Hons), is junior implemented4 despite the availability of efficacious actions are as yet unclear. Research Fellow, Menzies Research Institute, and senior 1 treatments. O’Donnell et al performed a systematic review to assess endocrinology registrar, Royal the efficacy and adverse effects of strontium compared Hobart Hospital, Tasmania Strontium ranelate, a pharmacological treatment for to either placebo or other treatments for postmenopausal Graeme Jones osteoporosis which is relatively new to Australia, has been osteoporosis. The review results are summarised in Table MBBS(Hons), FRACP, MMedSc, available on the Pharmaceutical Benefits Scheme (PBS) 1 and how these results might affect practice are shown MD, FAFPHM, is Head, by authority prescription since April 2007.5 Strontium is in Table 2. -
Synapse Development Organized by Neuronal Activity-Regulated Immediate- Early Genes Seungjoon Kim1, Hyeonho Kim1 and Ji Won Um1
Kim et al. Experimental & Molecular Medicine (2018) 50:11 DOI 10.1038/s12276-018-0025-1 Experimental & Molecular Medicine REVIEW ARTICLE Open Access Synapse development organized by neuronal activity-regulated immediate- early genes Seungjoon Kim1, Hyeonho Kim1 and Ji Won Um1 Abstract Classical studies have shown that neuronal immediate-early genes (IEGs) play important roles in synaptic processes critical for key brain functions. IEGs are transiently activated and rapidly upregulated in discrete neurons in response to a wide variety of cellular stimuli, and they are uniquely involved in various aspects of synapse development. In this review, we summarize recent studies of a subset of neuronal IEGs in regulating synapse formation, transmission, and plasticity. We also discuss how the dysregulation of neuronal IEGs is associated with the onset of various brain disorders and pinpoint key outstanding questions that should be addressed in this field. Introduction experience-dependent synaptic changes and maturation Numerous studies have shown that neural activity plays of neural circuits. an important role in regulating synaptic strength, neuro- More than dozens of neuronal IEGs were identified by fi 1– 12 1234567890():,; 1234567890():,; nal membrane properties, and neural circuit re nement Paul Worley, Elly Nedivi, and colleagues , owing to the 3. In particular, sensory experiences continually influence use of the subtractive hybridization method, in combi- brain development at synaptic, circuit, and organismal nation with various neural stimulation protocols, most levels, as Hubel4 and Wiesel5 elegantly demonstrated in notably seizure paradigms. Among them, cAMP- their work on visual cortex organization during the cri- responsive element-binding protein (CREB) has been tical period5. -
Pharmaco-Economic Study for the Prescribing of Prevention and Treatment of Osteoporosis
Technical Report 2: An analysis of the utilisation and expenditure of medicines dispensed for the prophylaxis and treatment of osteoporosis Technical report to NCAOP/HSE/DOHC By National Centre for Pharmacoeconomics An analysis of the utilisation and expenditure of medicines dispensed for the prophylaxis and treatment of osteoporosis February 2007 National Centre for Pharmacoeconomics Executive Summary 1. The number of prescriptions for the treatment and prophylaxis of osteoporosis has increased from 143,261 to 415,656 on the GMS scheme and from 52,452 to 136,547 on the DP scheme over the time period 2002 to 2005. 2. In 2005 over 60,000 patients received medications for the prophylaxis and treatment of osteoporosis on the GMS scheme with an associated expenditure of €16,093,676. 3. Approximately 80% of all patients who were dispensed drugs for the management of osteoporosis were prescribed either Alendronate (Fosamax once weekly) or Risedronate (Actonel once weekly) respectively. 4. On the DP scheme, over 27,000 patients received medications for the prophylaxis and treatment of osteoporosis in 2005 with an associated expenditure of € 6,028,925. 5. The majority of patients treated with drugs affecting bone structure were over 70 years e.g. 12,224 between 70 and 74yrs and 25,518 over 75yrs. 6. In relation to changes in treatment it was identified from the study that approximately 8% of all patients who are initiated on one treatment for osteoporosis are later switched to another therapy. 7. There was a statistically significant difference between the use of any osteoporosis medication and duration of prednisolone (dose response, chi- square test, p<0.0001). -
Recent Advances in the Pathogenesis and Treatment of Osteoporosis
AGEING Clinical Medicine 2015 Vol 15, No 6: s92–s96 R e c e n t a d v a n c e s i n t h e p a t h o g e n e s i s a n d t r e a t m e n t of osteoporosis Authors: E l i z a b e t h M C u r t i s , A R e b e c c a J M o o n , B E l a i n e M D e n n i s o n , C N i c h o l a s C H a r v e y D a n d C y r u s C o o p e rE Over recent decades, the perception of osteoporosis has and propensity to fracture. Worldwide, there are nearly 9 changed from that of an inevitable consequence of ageing, to million osteoporotic fractures each year, and the US Surgeon that of a well characterised and treatable chronic non-commu- General's report of 2004, consistent with data from the UK, nicable disease, with major impacts on individuals, healthcare suggested that almost one in two women and one in five men systems and societies. Characterisation of its pathophysiol- will experience a fracture in their remaining lifetime from ABSTRACT ogy from the hierarchical structure of bone and the role of its the age of 50 years.1 The cost of osteoporotic fracture in the cell population, development of effective strategies for the UK approaches £3 billion annually and, across the EU, the identifi cation of those most appropriate for treatment, and estimated total economic cost of the approximately 3.5 million an increasing armamentarium of effi cacious pharmacologi- fragility fractures in 2010 was €37 billion. -
Podocin Inactivation in Mature Kidneys Causes Focal Segmental Glomerulosclerosis and Nephrotic Syndrome
BASIC RESEARCH www.jasn.org Podocin Inactivation in Mature Kidneys Causes Focal Segmental Glomerulosclerosis and Nephrotic Syndrome Ge´raldine Mollet,*† Julien Ratelade,*† Olivia Boyer,*†‡ Andrea Onetti Muda,*§ ʈ Ludivine Morisset,*† Tiphaine Aguirre Lavin,*† David Kitzis,*† Margaret J. Dallman, ʈ Laurence Bugeon, Norbert Hubner,¶ Marie-Claire Gubler,*† Corinne Antignac,*†** and Ernie L. Esquivel*† *INSERM, U574, Hoˆpital Necker-Enfants Malades, Paris, France; †Faculte´deMe´ decine Rene´ Descartes, Universite´ Paris Descartes, Paris, France; ‡Pediatric Nephrology Department and **Department of Genetics, Hoˆpital Necker- Enfants Malades, Assistance Publique-Hoˆpitaux de Paris, Paris, France; §Department of Pathology, Campus ʈ Biomedico University, Rome, Italy; Department of Biological Sciences, Imperial College London, London, England; and ¶Max-Delbruck Center for Molecular Medicine, Berlin, Germany ABSTRACT Podocin is a critical component of the glomerular slit diaphragm, and genetic mutations lead to both familial and sporadic forms of steroid-resistant nephrotic syndrome. In mice, constitutive absence of podocin leads to rapidly progressive renal disease characterized by mesangiolysis and/or mesangial sclerosis and nephrotic syndrome. Using established Cre-loxP technology, we inactivated podocin in the adult mouse kidney in a podocyte-specific manner. Progressive loss of podocin in the glomerulus recapitu- lated albuminuria, hypercholesterolemia, hypertension, and renal failure seen in nephrotic syndrome in humans. Lesions of FSGS appeared -
Journal of Trace Elements in Medicine and Biology Strontium Stimulates
Journal of Trace Elements in Medicine and Biology 55 (2019) 15–19 Contents lists available at ScienceDirect Journal of Trace Elements in Medicine and Biology journal homepage: www.elsevier.com/locate/jtemb Technical note Strontium stimulates alkaline phosphatase and bone morphogenetic protein- 4 expression in rat chondrocytes cultured in vitro T Jinfeng Zhanga,b,1, Xiaoyan Zhua,1, Yezi Konga, Yan Huanga, Xukun Danga, Linshan Meia, ⁎ ⁎ Baoyu Zhaoa, Qing Lina,b, , Jianguo Wanga, a College of Veterinary Medicine, Northwest A&F University, Yangling 712100, Shaanxi, China b State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining 810016, Qinghai, China ARTICLE INFO ABSTRACT Keywords: The trace element strontium has a significant impact on cartilage metabolism. However, the direct effects of Strontium strontium on alkaline phosphatase (ALP), a marker of bone growth, and bone morphogenetic protein-4 (BMP-4), Rat chondrocyte which plays a key role in the regulation of bone and cartilage development, are not entirely clear. In order to Expression understand the mechanisms involved in these processes, the chondrocytes were isolated from Wistar rat articular Alkaline phosphatase cartilage by enzymatic digestion and cultured under standard conditions. They were then treated with strontium Bone morphogenetic protein-4 at 0.5, 1.0, 2.0, 5.0, 20.0 and 100.0 μg/mL for 72 h. The mRNA abundance and protein expression levels of ALP and BMP-4 were measured using real-time polymerase chain reaction (real-time PCR) and Western blot analysis. The results showed that the levels of expression of ALP and BMP-4 in chondrocytes increased as the con- centration of strontium increased relative to the control group, and the difference became significant at 1.0 μg/ mL strontium (P < 0.05).