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Osteoporosis
- 2. Módulo: Biología del envejecimiento Tema: Osteoporosis Expositor: Dr. German Silva Dórame Fecha: 07 de Agosto de 2010
- 4. Definición de Osteoporosis Osteoporosis Normal
- 8. Epidemiología: ETNICIDAD Hisel T, Bryles B. Formulary 2003; 38:223-43. Hazzard W. Principles of Geriatric Medicine andGerontology. 4 a edición. Mc Graw Hill; 1999: pp 1057-0. RAZA Masa Osea Frecuencia de Fracturas Africana +++ --+ Asiática --+ -++ Blanca nl +++ Hispanas nl --+
- 9. Anatomía: Volumen Óseo Composición: Mineralización Matríz Orgánica Arquitectura: Tamaño, Forma y Estructura Interna Hueso cortical Hueso trabecular
- 10. Estructura Interna : Hueso trabecular Hueso trabecular y cortical
- 11. Estructura Interna : Hueso cortical
- 12. Fisiopatología: Koopman W. Arthritis and Allied Conditions. Text BooK of Rheumathology. 13th edition vol 1. Williams & Wilkins. Pp 98-111 .
- 13. Fisiopatología: Heaney R. Osteoporosis. Endocrinology and Metabolism Clinics 1998; 27:255-265. Alteración Resistencia ósea Fx trabécula Callo trabécula Curación microfx Microestructura trabecular perforaciones Cavidades profundas Resorción
- 15. Fisiopatología Caídas Arquitectura y geometría Hormonas Nutrición Ejercicio Estilo de Vida Masa ósea Fortaleza ósea Fortaleza del Material óseo Reflejos posturales Fractura Golpes Heaney R. Osteoporosis. Endocrinology and Metabolism Clinics 1998; 27:255-265.
- 27. Densitometría y osteoporosis Masa osea máxima **Osteoporosis severa = -2.5 + Fractura
- 28. Grados de Osteoporosis Normal Osteoporosis Moderada Osteoporosis severa
- 33. Tratamiento de osteoporosis posmenopáusica Prevención Tratamiento Alendronato (Fosamax) Si Si Residronato (Actonel) Si Si Calcitonina (Miocalcin) No Si HT Si No Raloxifeno (Evista) Si Si PTH (Forteo) No Si
- 41. Estudio MORE – 3 anos (n=1627) % de mujeres con al menos un evento Fractura vertebral Cardio- vascular (total) Cáncer de mama Coronariopatia Cerebro- vascular Fractura de cadera Adaptado de Silverman. Endocrine Society. 2002:145
- 42. Resumen de efectos no esqueléticos de HRT y Raloxifeno HRT Raloxifeno Cáncer de mama ↑ ↓ VTE ↑ ↑ Sx Vasomotor ↓ ↑ Cáncer endometrial ↔ ↔ Sx vaginal ↓ ↔ Sangrado vaginal ↑ ↔ Sx urinario ↑↓ ↔ Cognición ↔ ↔
- 47. NUEVOS TRATAMIENTOS: Osteoporosis agents. Drugwatch.Formulary 2003; 38:115.
Hinweis der Redaktion
- Tipos de fracturas- incidencia Mortalidad al final H vs M mas grueso menos fragil ARTICULO NUEVO
- Aumento de pth secundaria a la reabsorción … En neoformación… diferente Estrogenos predominan en neoformacion
- once
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- In 1994 the World Health Organization (WHO) Working Group established some guidelines by BMD testing called the T score, or the number of standard deviations that the bone density is above or below the average for the young reference population database in our bone density machines. The classification is: T scores of 0 to -1 are normal; -1 to -2.5, osteopenia; and -2.5 or lower, osteoporosis. The categories of osteopenia and osteoporosis were established because fracture risk is not a threshold. It's a gradient risk. There are people in the osteopenic category who, particularly if they have additional risk factors, may fracture. It's important to recognize that those in the osteopenic group are also at risk for fracture even though the highest risk may be seen in the patients with osteoporosis.
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- Objetivo de tx effectiveness, safety, and perhaps peace of mind for clinicians and their patients. Based upon the National Osteoporosis Foundation (NOF) guidelines, earlier pharmacologic intervention is indicated in patients with spine or hip fractures as well as in patients without fractures and with T scores that indicate higher risk
- como introduccion are familiar with the positive effects that estrogen is known to have on bone, but can you bring us up to date on the role of estrogen in osteoporosis prevention and treatment? Let's take the data and weigh the benefits of estrogen in osteoporosis against the risk of estrogen use in women. WHI : This was the largest prospective randomized trial to obtain fracture data. Strictly speaking, the fracture data applied to the estrogen and progestin arm of the study, because that's the only arm that has been stopped and has had the data analyzed. The estrogen-alone arm, and the calcium/vitamin D arm are still ongoing. What we've learned from these 16,000 women who were on the estrogen/progestin arm is that these hormones reduce the rate of hip fractures. In fact, these hormones reduce all osteoporotic fractures and even the total number of fractures. That's very good news. Unfortunately, it may be good news a little too late because at the same time the risks of hormone therapy were defined as well; and it may be that these risks will limit the amount of opportunities that we have for using this therapy for osteoporosis. Trh ideal iniciar 2 años antes de menop Si matriz, conjugados… se permite solo 5 años