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  • 1
    Digitale Medien
    Digitale Medien
    Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report (1994)
    Springer
    Osteoporosis international 4 (1994), S. 368-381 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Bone mineral measurement ; Fractures ; Osteoporosis ; Screening
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The criteria required for an effective screening strategy for osteoporosis are largely met in Caucasian women. The disease is common and readily diagnosed by the measurement of bone mineral with single- or dual-energy absorptiometry. Such measurements have high specificity but lower sensitivity, so that the value of the technique is greater for those identified as being at higher risk. Against this background there is little evidence that osteoporosis can usefully be tackled by a public health policy to influence risk factors such as smoking, exercise and nutrition. This suggests that it is appropriate to consider targetting of treatment with agents affecting bone metabolism to susceptible individuals. Since the main benefits of the use of hormone replacement therapy (HRT) are probably on cardiovascular morbidity, the major role for selective screening is to direct non-HRT interventions. An appropriate time to consider screening and intervention is at the menopause, but screening at later ages is also worthy of consideration. Since the cost of screening is low and that of bone-active drugs is high, the selective use of screening techniques will improve the cost-benefit ratio of intervention.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01622200
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  • 2
    Digitale Medien
    Digitale Medien
    Influence of age and body mass on the effects of vitamin d on hip fracture risk (1995)
    Springer
    Osteoporosis international 5 (1995), S. 450-454 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Body mass index ; Hip fracture ; Sunlight ; Vitamin D
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The role of vitamin D in the prevention of hip fracture is controversial and protective effects appear to be confined to the institutionalized and elderly population. The aim of this study was to assess the interaction of age and body mass index (BMI) on the effects of vitamin D on the risk of hip fracture in the community. We studied 1634 women with low-energy fractures of the hip aged 50 years or older, and 3532 age-matched controls from 14 centres in six Mediterranean countries (the MEDOS study), with a structured retrospective questionnaire. The use of vitamin D supplements was associated with a modest and non-significant decrease in the risk of hip fracture (RR=0.74; 95% confidence interval (CI) 0.53–1.03;p=0.07). The risk reduction was influenced by age and body mass. Women aged above 80 years had a significant decrease in the relative risk of hip fracture (RR=0.63; 95% CI 0.40–0.98) as did women with a BMI below 20 kg/m2 (RR=0.45; 95% CI 0.24–0.84). Elderly women were more likely to have a low BMI but the elderly did not appear to benefit from vitamin D where their BMI was 20 kg/m2 or higher. The findings could not be explained by differences in sun exposure or in physical exercise. We conclude that the use of vitamin D for the prevention of hip fracture might usefully be targeted to the frail and elderly.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01626607
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  • 3
    Digitale Medien
    Digitale Medien
    Risk of Hip Fracture Derived from Relative Risks: An Analysis Applied to the Population of Sweden (2000)
    Springer
    Osteoporosis international 11 (2000), S. 120-127 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Key words:Absolute risk – Hip fracture – Relative risk – Risk factors
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: Bone mineral density measurements are widely used to estimate the relative risk of hip fracture. In addition, many other risk factors have been identified, some of which are known to add to the risk independently of other risk factors, including bone mineral density measurements. In this paper we develop an algorithm that converts relative risks for hip fracture to absolute (15 years and lifetime) risks, modeled on the population of Sweden. Lifetime risks increased as expected with increments in relative risk. Average lifetime risk in women at the age of 50 years was 22.7%, which increased to 64.9% when the relative risk was 6.0. In men the risk increased from 11.1% to 41.3%. The identification of high-risk groups had little effect on the specificity of assessments but increased the sensitivity over a wide range of assumptions. The increment in lifetime risk was relatively stable across all ages, reducing the complexity of computing lifetime risks from relative risk. The derivation of absolute risk from relative risk permits the optimization of selection of individuals or populations either for further risk assessment or for treatment.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/PL00004173
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  • 4
    Digitale Medien
    Digitale Medien
    The incidence of hip fracture in Europe (1993)
    Springer
    Osteoporosis international 3 (1993), S. 10-15 
    Details
    ISSN: 1433-2965
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Fragility fractures are now recognized as a major public health problem. Although the prevalence of all fractures is similar among men and women, the vast majority of osteoporotic fractures occur in elderly women. These comprise vertebral compression fractures, Colles' fracture at the wrist and hip fracture, and to a lesser extent fractures at other sites. The fracture of greatest socioeco-nomic consequence in Europe is hip fracture, which increases exponentially in incidence with age. The reasons for differences in age- and sex-specific incidence relate in part to the lower bone density of women at the time of maturity (peak bone density) and the accelerated bone loss that occurs after the menopause. Women live significantly longer than men, so that the prevalence of osteoporosis amongst elderly women is six-fold that of men. The age-specific incidence of hip fracture is rising in men and women in many countries, and if the current trends in the United Kingdom continue then the number of hip fractures occurring each year will more than double over the next 20 years. There is a marked geographic distribution in the incidence of hip fractures, even in Europe. Indeed the differences in incidence between communities is greater than the differences in incidence between sexes within communities. This suggests that the importance of gonadal insufficiency in women has been overemphasized and that other factors, probably relating to genetic or lifestyle factors affecting peak bone density, account for ecological differences in incidence of hip fracture between communities.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01621853
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  • 5
    Digitale Medien
    Digitale Medien
    Rationale for the use of clodronate in osteoporosis (1993)
    Springer
    Osteoporosis international 3 (1993), S. 23-28 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Clodronate ; Osteoporosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Bisphosphonates are widely used in disorders associated with increased resorption of bone, particularly in Paget's disease of bone and in the hypercalcemia of malignancy. Because of their undoubted efficacy and relatively low toxicity, bisphosphonates are attractive candidates for the management of osteoporosis. Clodronate, one of the many bisphosphonates being tested in osteoporosis, may be given intravenously or by mouth. In contrast to etidronate, even high doses of clodronate do not impair the mineralization of bone, making it suitable for long-term use in osteoporosis. As do all the bisphosphonates tested thus far, clodronate appears to delay the rate of bone loss in osteoporosis. Long-term studies are relatively few, so that its steady-state effects on bone mass are not yet known. Most data suggest clodronate is capable at least of delaying the rate of bone loss, but several pilot studies with this agent suggest that increments of bone mass might be sustainable for several years. Clodronate is likely to decrease the frequency of osteoporotic fractures, but there is no evidence for this at present. Well-controlled, long-term prospective studies are needed.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01623223
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  • 6
    Digitale Medien
    Digitale Medien
    Clinical Assessment of Bone Mass, Quality and Architecture (1999)
    Springer
    Osteoporosis international 9 (1999), S. S24 
    Details
    ISSN: 1433-2965
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/PL00004157
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  • 7
    Digitale Medien
    Digitale Medien
    A precise method for the assessment of tibial ultrasound velocity (1996)
    Springer
    Osteoporosis international 6 (1996), S. 1-7 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Osteoporosis ; Ultrasound velocity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We assessed a method for the measurement of ultrasound velocity in cortical bone of the human tibia using a probe designed to minimize the effects of surrounding soft tissues. Of four different measurement values, the maximum velocity (average of the five highest readings) gave the lowest errors of reproducibility in relation to the population variance (standardized coefficient of variation=1.8%). The maximum velocity varied according to the tibial site measured and for practical reasons the mid-tibial site was chosen for further study. The short-term intra- and inter-observer reproducibilities (coefficients of variation) were 0.35% (n=22) and 0.50% (n=27) respectively. Long-term reproducibility over 4 months in 31 subjects was 0.68%. There was no significant difference in maximum ultrasound velocity between the dominant and non-dominant tibia in 78 women (3764±209 vs 3763±199 m/s). Tibial ultrasound velocity was significantly higher in 73 premenopausal women (3999±102 m/s) than in 129 women referred for assessment of postmenopausal osteoporosis (3780±168 m/s), 26 women with steroid-induced osteoporosis (3790±188 m/s) and 4 women with hyperparathyroidism (3575±261 m/s). In premenopausal women, ultrasound velocity did not correlate significantly with age, height, weight or body mass index. In women with postmenopausal osteoporosis, ultrasound velocity decreased with age after the menopause (r=−0.47,p〈0.0001) and body weight exerted a weaker protective effect. The apparent annual decrease in velocity with age in postmenopausal osteoporosis (8.5 m/s) was comparable to the error of reproducibility. We conclude that the technique for measuring tibial ultrasound velocity is highly reproducible in relation to the distribution of values in the population and is sensitive to age- and osteoporosis-induced changes in bone. Further studies are required to examine its relationship to other indices of skeletal status to determine the biological and clinical relevance of the technique.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01626530
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  • 8
    Digitale Medien
    Digitale Medien
    The possible role of calcitonin deficiency in the development of bone disease due to chronic renal failure (1976)
    Springer
    Calcified tissue international 22 (1976), S. 147-153 
    Details
    ISSN: 1432-0827
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin , Physik
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02064056
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  • 9
    Digitale Medien
    Digitale Medien
    Vitamin D Analogs: From Renal Bone Disease to Osteoporosis (1997)
    Springer
    Calcified tissue international 60 (1997), S. 106 -110 
    Details
    ISSN: 1432-0827
    Schlagwort(e): Key words: Alfacalcidol — Calcitriol — Hemodialysis — Renal failure — Osteoporosis — Renal bone disease.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin , Physik
    Notizen: Abstract.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s002239900196
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  • 10
    Digitale Medien
    Digitale Medien
    Histological measurements in Paget's disease of bone (1976)
    Springer
    Calcified tissue international 22 (1976), S. 295-297 
    Details
    ISSN: 1432-0827
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin , Physik
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02064082
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