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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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Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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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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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.
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Changes in Testing and Treatment Methods in Osteoporosis Care.

Takashi Nagai1,2, Koji Ishikawa2, Koki Tsuchiya2

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Physicians increasingly use bone density scans and blood tests for osteoporosis diagnosis. Treatment trends shifted towards medications that rapidly increase bone mineral density, improving fracture prevention in bedridden patients.

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Area of Science:

  • Orthopedics
  • Endocrinology
  • Geriatrics

Background:

  • Osteoporosis treatment is vital for fracture prevention, especially in vulnerable bedridden populations.
  • Understanding physician diagnostic and treatment trends is key to optimizing patient care.

Purpose of the Study:

  • To investigate the 5-year trend in osteoporosis diagnostic and treatment preferences among physicians.
  • To assess changes in the utilization of bone mineral density measurements and bone metabolic markers.
  • To identify shifts in the prescription patterns of osteoporosis pharmacotherapies.

Main Methods:

  • A comparative questionnaire survey of hypothetical clinical cases administered in 2015 and 2020.
  • Targeting physicians in local clinics and hospitals, with a focus on orthopaedic surgeons (n=74).
  • Analysis of responses regarding diagnostic tests and therapeutic agent choices.

Main Results:

  • Significant increase in physician preference for bone mineral density measurements (lumbar spine and hip).
  • Marked rise in the use of bone metabolic markers (NTX, P1NP, TRACP-5b) due to convenience and reliability.
  • Shift in pharmacotherapy from bisphosphonates towards parathyroid hormone and romosozumab for rapid bone density enhancement.

Conclusions:

  • Physician adoption of bone density testing and metabolic markers for osteoporosis diagnosis has grown.
  • There is a clear trend towards early use of potent anabolic agents to rapidly improve bone mineral density.
  • These shifts indicate an evolving approach to osteoporosis management, aiming for earlier and more effective fracture risk reduction.