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Grand Rounds 05/29/13 @ BID-Needham - Dr. Harold Rosen  

Update on the Diagnosis and Treatment of Osteoporosis
Last Updated: Aug 12, 2014 URL: http://bidmc.libguides.com/Rosen Print Guide RSS Updates
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Speaker: Date: Topic

Harold Rosen, MD

May 29, 2013

Update on the Diagnosis and Treatment of Osteoporosis

      

    Responsibility for Content

    The take-away points and article links were sent by the Medical Library and the CME Committee.

    Diane E. Young, Information Specialist

    dyoung3@bidmc.harvard.edu

        

      Take-Away Points of the Lecture

      1. BMD should be done in women >65, men >70 and sooner in patients with additional risk factors.

      2. VFA should be done in patients with increased risk for vertebral fracture based on age, steroid use, or height loss.

      3. Although there is controversy about how much calcium and vitamin D to give, moderate doses probably gives the patient most of the benefit without any risk.

          

        Links to Articles Cited in the Presentation

        1. Leslie WD et al: Fracture risk assessment without bone density measurement in routine clinical practice. Osteoporos Int 2012 Jan;23(1):75-85. http://link.springer.com.ezp-prod1.hul.harvard.edu/content/pdf/10.1007%2Fs00198-011-1747-2.pdf

        2. Cauley JA et al: Prevalent vertebral fractures in black women and white women. J Bone Miner Res 2008 Sep;23(9):1458-67.  http://onlinelibrary.wiley.com.ezp-prod1.hul.harvard.edu/doi/10.1359/jbmr.080411/pdf

        3. Pasco JA et al: Morphometric vertebral fractures of the lower thoracic and lumbar spine, physical function and quality of life in men. Osteoporos Int 2009 May;20(5):787-92.  http://link.springer.com.ezp-prod1.hul.harvard.edu/content/pdf/10.1007%2Fs00198-008-0744-6.pdf

        4. Gourlay ML: Bone-density testing interval and transition to osteoporosis in older women. N Engl J Med 2012 Jan 19;366(3):225-33.  http://www.nejm.org/doi/pdf/10.1056/NEJMoa1107142

        5. Chapurlat RD et al: Risk of fracture among women who lose bone density during treatment with alendronate. The Fracture Intervention Trial. Osteoporos Int 2005 Jul;16(7):842-8.  http://link.springer.com.ezp-prod1.hul.harvard.edu/content/pdf/10.1007%2Fs00198-004-1770-7.pdf

        6. Chapuy MC et al: Vitamin D3 and calcium to prevent hip fracturres in the elderly women. N Engl J Med 1992 Dec 3;327(23):1637-42.  http://www.nejm.org/doi/pdf/10.1056/NEJM199212033272305

        7. Dawson-Hughes B et al: Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997 Sep 4;337(10):670-6.    http://www.nejm.org/doi/pdf/10.1056/NEJM199709043371003

        8. Melhus H et al: Plasma 25-hydroxyvitamin D levels and fracture risk in a community-based cohort of elderly men in Sweden. J Clin Endocrinol Metab 2010 Jun;95(6):2637-45.  http://jcem.endojournals.org.ezp-prod1.hul.harvard.edu/content/95/6/2637.full.pdf+html

        9. Stolzenberg-Solomon RZ et al: Circulating 25-hydroxyvitamin D and risk of pancreatic cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol 2010 Jul1;172(1):81-93.  http://aje.oxfordjournals.org.ezp-prod1.hul.harvard.edu/content/172/1/81.full.pdf+html

        10. Bolland MJ et al: Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010 Jul 29;341:c3691.  http://www.bmj.com/highwire/filestream/384420/field_highwire_article_pdf/0/bmj.c3691

        11. Lewis JR et al: Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5 year follow-up. J Bone Miner Res 2011 Jan;26(1):35-41.  http://onlinelibrary.wiley.com.ezp-prod1.hul.harvard.edu/doi/10.1002/jbmr.176/pdf

        12. Melamed ML et al: 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 2008 Aug 11;168(15):1629-37.  http://archinte.jamanetwork.com/article.aspx?articleid=770360

        13. Looker AC: Serum 25-hydroxyvitamin D and risk of major osteoporotic fractures in older U.S. adults. J Bone Miner Res 2013 May;28(5):997-1006.  http://onlinelibrary.wiley.com.ezp-prod1.hul.harvard.edu/doi/10.1002/jbmr.1828/pdf

        14. Dawson-Hughes B et al: A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990 Sep 27;323(13):878-83.  http://www.nejm.org/doi/pdf/10.1056/NEJM199009273231305

        15. Bone HG et al: Ten years' experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 2004 Mar 18;350(12):1189-99.  http://www.nejm.org/doi/pdf/10.1056/NEJMoa030897

        16. Woo SB et al: Systematic Review: Bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 2006 May 16;144(10):753-61.  http://annals.org/article.aspx?articleid=723466

         

         

            

          Obtaining the PowerPoint Presentation

          Contact Lauren Oliva at loliva@bidneedham.org

           

              
             

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