1/58. pregnancy-associated osteoporosis with elevated levels of circulating parathyroid hormone-related protein: a report of two cases.Two lactating women who had complained of back pain developed spontaneous vertebral fractures with low bone mineral density (BMD) several months postpartum. The back pain and biochemical abnormalities presented as hypercalcemia and elevated plasma levels of the parathyroid hormone-related protein (PTH-rP) that returned to normal indices with increasing BMD after weaning. The increased circulating PTH-rP might contribute to the pregnancy-associated osteoporosis in women who probably are already osteopenic.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/58. Transient osteoporosis during pregnancy: the perioperative nurse's role.Perioperative nurses are confronted with ever changing demands in their daily practice. Perhaps the greatest challenge, however, is in the care of patients with multi-faceted health problems. These patients require the coordination of many multi-disciplinary team members in attempting to achieve optimum health. This paper will describe the case study of a 28 year old, 26 week primip, who presented to a tertiary care centre with spontaneous bilateral hip fractures of unknown origin. It will further discuss the disease process known as Transient osteoporosis during pregnancy, the surgical approach, and finally, the role of the perioperative nurse in coordinating the patient's perioperative care.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
3/58. Oral contraceptives: therapeutic uses and quality-of-life benefits--case presentations.Numerous studies have shown that oral contraceptives (OC) provide protection against a wide variety of illnesses and conditions, including loss of bone density, ovarian cysts, menstrual cycle irregularities, dysmenorrhea and menorrhagia, ectopic pregnancy, pelvic inflammatory disease, benign breast disease, endometrial cancer, and ovarian cancer. How OC can be used not only for contraception but also to improve health among women throughout their reproductive years is illustrated by four case presentations: an adolescent with menstrual problems; a 25-year-old mulligravida who wishes to delay childbearing; a 35-year-old who has completed her family and requests tubal ligation; and a 45-year-old with perimenopausal symptoms. In view of their numerous health benefits, OC are to reproductive-age women as hormone replacement therapy is to menopausal women.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
4/58. Transient osteoporosis of the hip: presentation of (a)typical cases and a review of the literature.Transient osteoporosis of the hip (TOH) is a rare disorder affecting primarily middle-aged men and women during the last trimester of pregnancy. The disease is characterized by pain in the involved joint with temporary osteopenia apparent on radiology without joint space narrowing or destruction, in the absence of other recognizable causes of synovitis or osteoporosis. Within a few months the pain as well as radiological abnormalities disappear spontaneously with complete resolution. In this paper the literature is reviewed, with particular focus on the topic of the role of magnetic resonance imaging (MRI) in the diagnostic procedure. Two patients with TOH, a father and daughter, are described. Such a familial appearance has not been reported before. Based on HLA-typing, the existence of an HLA-associated genetic predisposition nevertheless seems unlikely.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
5/58. A case of postpregnancy osteoporosis.A puerperant woman, who was previously healthy and had no disease known to affect bone metabolism, experienced lower back pain and lumbar vertebral fractures during lactation. Both bone formation markers and resorption markers were markedly elevated. Bone mineral density of the lumbar spine as measured by dual energy X-ray absorptiometry was extremely low. She stopped lactation through the use of bromocriptine because of the large volume of milk secretion. After treatment with calcitonin injections and the use of a corset, her back pain gradually disappeared. This case appears to be postpregnancy osteoporosis.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
6/58. Transient osteoporosis of hip in pregnancy.Transient osteoporosis in pregnancy is a relatively rare disorder characterized by disabling pain in the hip without prior trauma and by striking radiographic evidence of osteopenia that is limited to the hip. Clinical and radiographic findings regress spontaneously within months after pregnancy and without late sequelae. In this study, we report on a case of a 28-yr-old Caucasian woman who suffered from transient osteoporosis during pregnancy. Nine months later, the patient was asymptomatic and there was resolution of the bone marrow edema pattern seen on the initial magnetic resonance imaging scan of her hip. Follow-up bone densitometry at 1 yr revealed a dramatic increase (12.3%) in bone mineral density of the symptomatic hip. We review the literature and discuss possible mechanisms involved in the pathogenesis of transient osteoporosis in pregnancy.- - - - - - - - - - ranking = 8keywords = pregnancy (Clic here for more details about this article) |
7/58. Transient osteoporosis of the hip during pregnancy.We report the clinical features of and MRI findings in transient osteoporosis of the hip during pregnancy. The study population consisted of 4 patients with a mean age of 33 years. The mean gestational age at onset was 31 weeks (range: 27 to 35 weeks). The main symptoms consisted of a weight-bearing pain in the hip and gait disturbance. The pain occurred suddenly and was of unknown cause and became severe within 2 to 3 weeks. X-ray examinations showed diffuse osteoporosis in the femoral head and neck. Moreover in 3 patients, similar lesions were also found in the lumbar spine or the knee. MRI obtained from 3 patients revealed a mottled low-signal lesion extending from the femoral head and neck on T1-weighted images and a high-signal lesion in the bone marrow suggesting edema on T2-weighted images. Mild elevation of C- reactive protein was shown in 2 patients. Conservative treatments with the limitation of weight bearing and bed rest were performed for all patients, and nonsteroidal anti-inflammatory drugs were given to 3 patients. The hip pain began to decline from 8 to 14 weeks after the onset, and completely disappeared from 14 to 24 weeks. X-ray examinations showed that osteoporotic lesions tended to improve at 10 to 14 weeks, on MRI, a high-signal lesion suggesting bone marrow edema resolved together with relief of the pain. No recurrence was found in any patients at mean follow-up of 70.8 months.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
8/58. osteoporosis with vertebral fractures associated with pregnancy and lactation.Three cases of young women who developed severe vertebral osteoporosis after pregnancy and during lactation are described. These patients shared several features: a low-calcium diet during most of their lives, very-low body weight in two patients, and a positive family history of osteoporosis in two patients. Initial studies disclosed vertebral fractures, severely diminished bone mineral density of the spine (Z score = -3.3 to -4.1), and a less severely affected bone mineral density of the hip (Z score = -1.6 to -2.3). During the prolonged follow-up of these patients, treated with oral biphosphonates, vitamin d, and calcium, an improved clinical response with a marked recovery of spine bone mineral density was observed. Poor general nutrition, low calcium intake, and a positive family history of osteoporosis appear to be strong risk factors for pregnancy- and lactation-associated osteoporosis. Although the mechanism of action is uncertain, calcium, vitamin d, and antiresorptive agents may have been beneficial in the treatment of this severe disorder.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
9/58. Transient bilateral osteoporosis of the hip in pregnancy. A case report and review of the literature.osteoporosis of the hip is a rare complication of pregnancy, the diagnosis of which can only be determined by radiologic means. Differentiation between osteonecrosis and osteoporosis remains problematic in some cases. magnetic resonance imaging was reported as useful for the diagnosis of osteoporosis. Treatment of osteoporosis of the hip in pregnancy should be conservative including physical therapy, restricted weight bearing and analgetic therapy. We report an unusual case of bilateral transient osteoporosis of the hip in pregnancy.- - - - - - - - - - ranking = 7keywords = pregnancy (Clic here for more details about this article) |
10/58. Postpartal sacral fracture without osteoporosis.Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. vitamin d levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. magnetic resonance imaging is the diagnostic investigation of choice.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
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