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Related Concept Videos

Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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Bone Remodeling01:40

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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Osteoclasts in Bone Remodeling01:31

Osteoclasts in Bone Remodeling

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Role of Vitamins in Maintaining Bone Health01:25

Role of Vitamins in Maintaining Bone Health

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The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
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Hormones and Bone Tissue01:17

Hormones and Bone Tissue

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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Challenges in implementing and maintaining osteoporosis therapy.

Ankita Modi1, Shiva Sajjan1, Sampada Gandhi2

  • 1Center for Observational and Real-World Evidence, Merck & Co., Inc., Whitehouse Station, NJ, USA.

International Journal of Women'S Health
|August 26, 2014
PubMed
Summary

Osteoporosis affects millions globally, yet remains underdiagnosed and undertreated. Further research is crucial for effective treatment strategies in challenging patient groups to reduce fracture risk.

Keywords:
adherencechronic kidney diseasefractureglucocorticoid-induced osteoporosis

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Area of Science:

  • Gerontology
  • Orthopedics
  • Pharmacology

Background:

  • Osteoporosis poses a significant global health burden, with high fracture risks in older adults.
  • Prevalence is rising worldwide due to aging populations and urbanization.
  • Despite high prevalence, osteoporosis is frequently underdiagnosed and undertreated.

Purpose of the Study:

  • To highlight the challenges in osteoporosis diagnosis and treatment implementation.
  • To identify specific patient populations requiring further research for optimal osteoporosis therapy.
  • To emphasize the need for improved adherence and persistence with osteoporosis medications.

Main Methods:

  • Literature review and clinical expertise synthesis.
  • Identification of patient subgroups with complex treatment needs.
  • Analysis of factors contributing to poor adherence and persistence.

Main Results:

  • Significant proportions of older men and women are at elevated risk for osteoporotic fracture.
  • Challenging patient groups include the very elderly, men, those with specific comorbidities, and those unresponsive to current therapies.
  • Poor adherence and persistence are common, leading to increased fractures and healthcare costs.

Conclusions:

  • Further studies are essential to guide osteoporosis treatment in men, the very elderly, and patients with comorbidities or treatment resistance.
  • Enhanced patient education and secondary prevention programs can improve adherence.
  • Development of safe, effective, and convenient therapies is needed to address physician and patient preferences.