by Physicians Weekly | Jun 22, 2012
This week, the Endocrine Society issued guidelines on managing osteoporosis in men. Published in the June 1, 2012 issue of Journal of Clinical Endocrinology & Metabolism, the guidelines recommend the following: Men at increased risk for osteoporosis should be tested by measurement of bone mineral density (BMD). Men at high risk for osteoporosis should be screened with dual-energy x-ray absorptiometry (DXA). This includes those aged 70 and older and younger men with risk factors. Risk factors for osteoporosis in younger men (aged 50-69) include: – History of fracture after age 50 – low body weight – Diseases such as delayed puberty, hypogonadism, hyperparathyroidism, hyperthyroidism, or COPD – Drugs such as glucocorticoids or GnRH agonists – Life choices such as alcohol abuse or smoking Measure forearm DXA (1/3 or 33% radius) when spine or hip BMD cannot be interpreted and for men with hyperparathyroidism or receiving androgen-deprivation therapy for prostate cancer. FRAX, Garvan, or other fracture risk calculators can improve the assessment of fracture risk and the selection of patients for treatment. Men with low levels of vitamin D (less than 30 ng/mL) should take vitamin D supplements. Those with or at risk for osteoporosis should consume 1,000 to 1,200 mg of calcium every day, ideally from dietary sources. Men aged 50 and older with prior spine or hip fracture, low bone mineral density, or other clinical risk factors (eg, those receiving long-term glucocorticoid therapy in pharmacological doses) should receive drug therapy. Those receiving treatment should have their bone mineral density assessed by DXA at the spine and hip every 1 to 2 years. Pharmacological therapy is recommended for all...
by Physicians Weekly | Apr 3, 2012
An American investigation suggests that osteoporosis would likely develop in less than 10% of postmenopausal women aged 67 or older during rescreening intervals of about 15 years for those with normal bone density or mild osteopenia. Osteoporosis would likely develop in less than 10% of such women during rescreening intervals of 5 years for those with moderate osteopenia and 1 year for women with advanced osteopenia. Abstract: New England Journal of Medicine, January 19,...
by Physicians Weekly | Nov 16, 2010
The Society of Interventional Radiology held its 2010 annual meeting from March 13 to 18 in Tampa, Florida. The features below highlight some of the news emerging from the meeting. For more information on these items and other research that was presented, go to www.sirmeeting.org. » Preventing Strokes During Carotid Artery Stenting » Abnormal ABI Indicative of Cardiovascular Events » Vertebroplasty Relieves Pain for Osteoporotic VCFs Preventing Strokes During Carotid Artery Stenting The Particulars:Until recently, most carotid artery stenting procedures have been performed with filters in order to remove debris. The FDA has cleared a proximal cerebral protection device (Mo.Ma, Invatec) for use during carotid artery stenting. It suspends blood flow and prevents debris from traveling to the brain. Data Breakdown:Investigators evaluated the safety and effectiveness of the proximal cerebral protection device in 262 patients with carotid artery disease considered high risk. The 30-day major adverse cardiac and cerebrovascular events rate was 2.7%, a finding below the performance goal of 13% set before the start of the study. The major stroke rate was 0.9% through to the end of the trial; the death rate was also 0.9%. Take Home Pearls: Use of a proximal cerebral protection device may be able to prevent strokes during carotid stenting procedures. Results add to the body of data to support stenting as an alternative to surgery. Abnormal ABI Indicative of Cardiovascular Events [back to top] The Particulars:The ankle-brachial index (ABI) test is a noninvasive blood pressure reading in the ankle used to screen for peripheral artery disease (PAD). The ABI may provide another way to identify cardiovascular risks in older patients not considered...
