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Cooper, C O, 430440
No full textThis record was harvested from a previous catalogue system and will be withdrawn in 2025. Information in this record may be superseded or incomplete. Visit this record in UMA's new catalogue at: https://archives.library.unimelb.edu.au/nodes/view/378650Surname: COOPER
Given Name(s) or Initials: C O
Military Service Number or Last Known Location: 430440
Missing, Wounded and Prisoner of War Enquiry Card Index Number: 57073192463
Item: [2016.0049.10944] "Cooper, C O, 430440
Epidemiology of osteoporotic fracture: looking to the future
No full textThis paper reviews the recent literature on candidate genes, anthropometric and environmental factors, and the evolving area of intrauterine fetal programming with regard to the development of osteoporosis.<br/
Osteoporosis: disease severity and consequent fracture management
No full textOsteoporosis is a systemic skeletal disease responsible for the high incidence of fractures in older subjects, particularly in postmenopausal women. The increasing prevalence with population ageing and prolonged life expectancy raises the rates of associated morbidity, loss of independence, and mortality. BMD and previous fracture history are two main risk factors associated with osteoporosis such that the presence of prior fractures can predict future fractures. Strontium ranelate is an agent developed for the management of postmenopausal osteoporosis, demonstrated to reduce vertebral, nonvertebral, major nonvertebral, and hip fractures. It has been demonstrated to be effective for a broad spectrum of patients, including women with osteopenia, osteoporosis, and severe diseas
Bone supplement: proceedings of ECTS/IBMS Geneva 2005-06-20
No full textOsteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. At the age of 50 years, the remaining lifetime risk of at least one fracture of the hip, vertebral body, or distal forearm approaches 50% among the white female population and 20% among the white male population. The most frequent site of fracture is the thoracolumbar spine with prevalence rates of radiographic vertebral fracture estimated at around 25% among white women aged 50 years and over and 12% among white men of similar age. Vertebral fractures are the most common complication of osteoporosis and are associated with significant morbidity and frequently do not come to clinical attention, since, first, only one third of these fractures are associated with clinical signs, and, second, there is a high rate of failure in identifying vertebral fractures on X-rays [1] P.D. Delmas, L. Van de Langerijt and N.B. Watts, Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT Study, J. Bone Miner. Res. 20 (2005), pp. 557–563. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (46)[1]. Hip fractures are less frequent but are also associated with lasting disability, decreased quality of life, and a significant increase in morbidity.Fracture incidence depends on two factors: bone strength and trauma [2]. During the first three decades of life, fractures typically arise from high-energy trauma, such as road traffic accidents. Above the age of 64 years, around 90% of fractures result from a fall from standing height or less.Osteoporosis and related fractures are a major health problem in the elderly population. Moreover, osteoporosis is associated with an ever-increasing financial burden on countries. There is a body of evidence showing a lack of awareness about osteoporosis and its treatment options among patients and physicians. Faced with this situation, the European Union has drawn up a plan of action for the prevention of osteoporotic fractures in the European Community. It is aimed at highlighting the key steps required to reduce the social and economic burden of osteoporosis [3].Reduced bone strength is therefore an important, modifiable, determinant of fracture risk in the elderly. Bone mineral density (BMD) is a major determinant of bone strength. However, bone strength is determined by other aspects of bone structure including size, geometry, microarchitecture, and turnover. The two major causes of involutional bone loss are secondary hyperparathyroidism and reduced physical activity. In addition, estrogen deficiency predisposes to bone loss among women. Other important causes of bone loss include thinness, cigarette smoking, heavy alcohol consumption, drugs, and diseases that secondarily predispose to osteoporosis, and a family history of fracture. The use of these clinical risk factors, together with BMD measurement, as part of algorithms for the primary and secondary prevention of osteoporotic fracture is currently the subject of scrutiny by policy makers worldwide. A recent initiative proposes that effective targeting of pharmacological agents to prevent fracture might be made on the basis of algorithms using these risk predictors, to ascertain the 10-year absolute risk of fracture in an individual. The precise choice of intervention can then be determined by the cost-effectiveness of various agents in patients with the estimated absolute fracture probability.Over the past 15 years, large double-blind, placebo-controlled trials have been performed in postmenopausal women with osteoporosis, with incident vertebral and nonvertebral fracture as a primary end point. These trials have confirmed that several agents are able to markedly reduce (by 30% to 50%) the risk of vertebral fracture. These include the bisphosphonates (etidronate, alendronate, risedronate), postmenopausal hormone replacement therapy, selective estrogen receptor modulators (raloxifene), and teriparatide. These studies also demonstrated that some agents are able to reduce the risk of hip and vertebral fractures (alendronate, risedronate). Strontium ranelate is a new antiosteoporotic agent that has recently received approval in the European Union for the treatment of postmenopausal osteoporosis to reduce the risk of vertebral and hip fractures [4]. It is the first such agent that appears to simultaneously increase bone formation and decrease bone resorption. Results from a phase 3 clinical trial, carried out in postmenopausal women with prevalent vertebral fractures, showed that strontium ranelate significantly reduces the risk of new vertebral and new clinical vertebral fractures after 1 year and over 3 years [5]. Results from a second large-scale phase 3 clinical trial, have shown that, over 3 years, strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women, as well as the risk of hip fracture in osteoporotic patients aged 74 years or more [6]. In addition, this study also showed that strontium ranelate decreases the risk of vertebral fracture in patients without prevalent vertebral fracture over 3 years. In both these trials, BMD was significantly increased at the lumbar spine, femoral neck, and total hip. Strontium ranelate is well tolerated, particularly at the upper gastrointestinal level. Strontium ranelate will be useful in the first-line treatment of postmenopausal osteoporosis as well as in those intolerant to oral bisphosphonate therapy, those with a previous history of upper gastrointestinal disease, and the elderly
Beyond daily dosing: clinical experience
No full textOsteoporosis has had a significant public health impact, with many sufferers experiencing fractures. Such fractures lead to increased disability, mortality and reduced quality of life, all of which raise healthcare costs. Oral bisphosphonates are associated with significant antifracture efficacy and have therefore become the mainstay of treatment for postmenopausal osteoporosis. Poor therapeutic adherence with daily bisphosphonates has been improved by the introduction of weekly regimens, although adherence levels remain suboptimal. Bisphosphonate regimens with dosing intervals beyond a week have therefore been developed to address this issue. Oral ibandronate, a potent nitrogen-containing bisphosphonate, has been studied using daily and intermittent regimens (between-dose interval >2 months). The initial phase II 2-year study confirmed the feasibility of the intermittent regimen, providing increases in lumbar spine bone mineral density (BMD) superior to placebo (P < 0.01) and equivalent to the daily regimen (5.64% vs. 5.54%, respectively). BONE (Oral iBandronate Osteoporosis vertebral fracture trial in North America and Europe), a large phase III 3-year study was subsequently initiated, including 2946 women with postmenopausal osteoporosis and testing both a daily as well as an intermittent regimen with a dose-free interval of more than 2 months. Significant vertebral antifracture efficacy (the primary study endpoint) was demonstrated with daily (2.5 mg) and intermittent (20 mg every other day for 12 doses every 3 months) ibandronate in comparison with placebo (P </= 0.0006). As a result of the study not being designed and powered to show an effect on non-vertebral fractures and the overall population being at low risk for osteoporotic fractures, differences in the incidence of non-vertebral fractures were similar between groups (8.2-9.1%) However, a post hoc analysis in a subgroup of patients with a femoral neck BMD T-score < -3.0 showed that daily ibandronate significantly reduced the risk of non-vertebral fractures (P = 0.012). Both regimens were associated with significant increases in lumbar spine and proximal femur BMD and normalization of bone turnover. As determined by adverse event incidence and laboratory evaluation, the safety profile for both ibandronate regimens was similar to that observed for placebo. The BONE study therefore confirmed that daily or intermittent ibandronate is an effective and well-tolerated treatment for postmenopausal women. Being the first study to demonstrate antifracture efficacy with an intermittent regimen, it provided 'proof of concept' for beyond weekly dosing with ibandronate and prompted further development of a more convenient once-monthly regimen
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