1/5. Type I osteogenesis imperfecta: diagnostic difficulties.A 65-year-old woman presented with vertebral fractures of the lumbar spine and a history of pathological fractures following minor trauma, which had occurred before the onset of menopause. Her past medical history was significant for intermittent low back pain since childhood, which was attributed to thoracolumbar scoliosis. A diagnosis of unclassifiable osteoporosis was made until invasive diagnostic procedures suggested a mild form of type I osteogenesis imperfecta (OI). In unclear or atypical perimenopausal osteoporosis and diagnosis of OI should be considered.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
2/5. A case of sternal insufficiency fracture.We report a case of insufficiency fracture of the sternum in a 70-year-old female patient with a review of the literature. She complained of sudden onset chest pain and aggravating dyspnea. She has been managed with corticosteroid due to chronic obstructive pulmonary disease for 15 years. diagnosis of sternal insufficiency fracture presented with thoracic kyphosis was made on the basis of absence of trauma history, radiologic findings of lateral chest radiograph, bone scintigraphy and chest computed tomography. Thoracic kyphosis and osteoporosis secondary to menopause, corticosteroid therapy and limited mobility due to chronic obstructive pulmonary disease were considered as predisposing factors of the sternal insufficiency fracture in this patient.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
3/5. osteoporosis--diagnosis, treatment and management.BACKGROUND: osteoporosis is common, asymptomatic and usually undetected until a fracture occurs. Fracture, particularly hip fracture, can be associated with significant mortality, morbidity and loss of independence. OBJECTIVE: This article presents a practical case based approach to identify and manage osteoporosis. DISCUSSION: The major risk factors for osteoporosis in men and women are known, and case finding by dual X-ray absorptiometry and treatment with effective medications are subsidized by the commonwealth government. At the menopause, symptomatic women considering oestrogen replacement should assess their individual risk of osteoporosis, cardiovascular events and breast cancer. Men also develop osteoporosis and this should be on the health agenda along with cardiovascular disease, prostate and colon cancer, and diabetes. Treatment should include supplemental calcium and occasionally vitamin d. There is strong evidence for the benefits of bisphosphonates, the selective oestrogen receptor modulators and oestrogen replacement.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
4/5. Prevention of osteoporosis: the calcium controversy.The continuing scientific controversy regarding the use of calcium supplements for the prevention of osteoporosis during menopause presents a challenge to the nurse practitioner. There is little doubt that estrogen prevents bone loss following menopause, but there is a growing doubt among many researchers whether calcium supplementation beyond 800 mg/per day produces any benefit at all in preventing postmenopausal osteoporosis. Yet, the medical consensus in this country continues to recommend 1500 mg of calcium per day for menopausal women. The practitioner's clinical questions relate to the effectiveness, cost, and compliance of calcium prescription. An alternate recommendation and protocol are presented here.- - - - - - - - - - ranking = 2keywords = menopause (Clic here for more details about this article) |
5/5. hormone replacement therapy in chronic active hepatitis; a case report.There is an increased incidence of osteoporosis in patients with chronic liver disease. Because patients with chronic active hepatitis (CAH) usually require corticosteroids for their liver disease prevention and treatment of bone loss presents a difficult problem. This case report describes a 41 year old female patient with CAH who had a high rate of bone loss. After an early menopause with noticeable menopausal symptoms, she was given transdermal oestrogen replacement therapy. The menopausal symptoms resolved completely, and there was no deterioration in her liver function tests or corticosteroid requirement. In addition, follow up quantitative bone mineral measurements over two years have shown improvement. This case shows the value of measurements of bone density, and oestrogen replacement therapy in CAH, even in the presence of continued corticosteroids.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |