Bone Structural Deterioration Research Articles

Modern approach to bone comorbidity in prolactinoma.

Prolactinomas account for more than half of pituitary adenomas, and besides their clinical impact on fertility and gonadal function, they lead to detrimental effects on bone. Patients with prolactinoma are prone to deterioration of bone structure caused not only by prolactin (PRL) induced hypogonadism but also by its direct actions on bone cells and calcium metabolism. However, clinical studies have shown inconsistent evidence regarding whether PRL could have a deleterious effect independently from gonadal insufficiency on skeletal integrity. Seminal studies from our group reported an increased prevalence of vertebral fractures (VFs) in both female and male patients with prolactinoma. Treatment of prolactinoma with dopamine agonists can restore gonadal function and improve bone mineral density. Since the presence of VFs may be related to more aggressive disease, bone comorbidities in prolactinoma should be managed by a multidisciplinary team in line with the recent concept of 'pituitary tumors centers of excellence'. The review aims to evaluate the mechanism of PRL actions on bone, as well as to provide practical indications for a modern approach to the management of skeletal complications of patients with prolactin-secreting adenoma considering different clinical characteristics and outcomes.

Bone Disease in Primary Hyperparathyroidism-Changes Occurring in Bone Metabolism and New Potential Treatment Strategies.

Primary hyperparathyroidism (PHPT) is a common endocrinopathy, predominantly caused by a single parathyroid adenoma that is responsible for the excessive secretion of parathyroid hormone (PTH)-the hallmark of disease. Excess of this hormone causes remarkable changes in bone metabolism, including an increased level of bone remodeling with a predominance of bone resorption. Those changes lead to deterioration of bone structure and density, especially in cortical bone. The main treatment for PHPT is surgical removal of the adenoma, which normalizes PTH levels and terminates the progression of bone disease and leads to its regeneration. However, because not all the patients are suitable candidates for surgery, alternative therapies are needed. Current non-surgical treatments targeting bone disease secondary to PHPT include bisphosphonates and denosumab. Those antiresorptives prevent further bone loss, but they lack the ability to regenerate already degraded bone. There is ongoing research to find targeted drugs capable of halting resorption alongside stimulating bone formation. This review presents the advancements in understanding the molecular mechanisms responsible for bone disease in PHPT and assesses the efficacy of new potential therapeutic approaches (e.g., allosteric inhibitors of the PTH receptor, V-ATPase, or cathepsin inhibitors) aimed at mitigating bone loss and enhancing bone regeneration in affected patients.

Analysis of Prescribing Patterns of Drugs Used in Osteoarthritis in Tertiary Care Center

Background: Osteoarthritis (O.A.) is a common degenerative lesion of the articular cartilage that corresponds to hypertrophy deterioration of bone structure is osteoarthritis. The treatment is mainly focused on the management of pain. Methods: An Observational study was conducted among 163 patients visiting Orthopedics Out Patient Department at GMC Hospital. The duration of study was for 6 months from Jan 2024-Jun 2024. The analysis of collected data was done by SPSS version Software. Descriptive Statistics tools like frequency, Percentage were used to express the findings. Results: We found that female was (68.7%) in comparison to male (31.3%). Oral route (79%) was most commonly preferred route of drugs administration than topical route (21%). Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) (41.78%), Vitamins and minerals (22.5%), Antiulcers (19.5%), Symptomatic Slow-acting Drugs in Osteoarthritis (SYSODA) (6.82%), Muscle Relaxants (5.02%) and Others (4.07%) were Prescribed groups of drugs. Diclofenac (19.52%) was most commonly prescribed Non-Steroidal Anti-Inflammatory Drugs followed by Aceclofenac (11.37%). Average no. of drugs prescribed was 5.12, % of drugs Prescribed from National List of Essential Medicine (NLEM) was 79.88%, % of drugs prescribed by generic name was 0% and Average dispensing time was 225.13 sec. Conclusion: Osteoarthritis (O.A) was mostly common in female than male. Lumbar was most commonly affected site of Osteoarthritis. Non-Steroidal Anti-Inflammatory Drugs was most commonly prescribed groups of drugs. Keywords: Osteoarthritis, Prescribing Pattern, Non-Steroidal Anti-Inflammatory Drugs, Diclofenac, Symptomatic Slow-acting Drugs in Osteoarthritis.

Physical activity in the prevention and treatment of osteoporosis: From biomarkers to quality of life

Introduction and Objective: Osteoporosis is a common skeletal disease typified by diminished bone density and deterioration of bone structure. It represents a significant risk factor for fractures, particularly in postmenopausal women. This study evaluates the role of physical activity and bone biomarkers in the prevention and treatment of osteoporosis. Review and Methods: A review of the literature was conducted with the objective of analysing the impact of weight-bearing exercise and resistance training on bone health and the use of biomarkers in diagnosing and monitoring osteoporosis. Moreover, the potential impact of dietary interventions and supplementation was examined. Abbreviated Description of the State of Knowledge: It is of the utmost importance to engage in regular physical activity, particularly weight-bearing exercises, in order to prevent and treat osteoporosis. It has been demonstrated to enhance bone density and moderate the likelihood of fracture. Biomarkers such as osteocalcin and alkaline phosphatase are of significant value in the assessment of bone health. Summary: The combination of physical activity, a balanced diet and appropriate supplementation is fundamental to the prevention and effective management of osteoporosis. This approach confers substantial benefits with respect to bone health and quality of life. Keywords: Osteoporosis; Physical activity; Bone health; Skeletal System

Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review.

Osteoporosis is a common systemic bone disorder in the elderly, characterized by low bone mineral density and deterioration of bone structure. Apical periodontitis is an inflammatory response to the microbial infection of root canals, typically characterized by apical bone destruction surrounding the tooth's apex. This systematic review aimed to determine if osteoporosis affects the prevalence of apical periodontitis in adults. PRISMA guidelines have been followed. It included randomized clinical trials, cross-sectional, cohort, and case-control studies, and excluded non-relevant investigations and various secondary sources. A comprehensive search was performed in PubMed, Scopus, and Web of Science, until 13 March 2024. The Newcastle-Ottawa Scale was used to assess the quality of the three selected studies: two cross-sectional studies and one case-control study. One investigation only included post-menopausal women recruited at a dental university clinic, the other integrated data from the total hospital patients' population, and the third selected patients referred to the university dental clinic from the university hospital. The findings varied: one study noted a marginal association between low bone mineral density and apical periodontitis, another found a significant association, and the third, with the lowest risk of bias, reported no link. The main limitations were the scarcity of eligible studies and their overall quality. The review was registered in the PROSPERO database (CRD42024523705), applied strict inclusion criteria and thorough searches by experienced and independent reviewers. There is no strong evidence that adult individuals with osteoporosis have a higher probability of developing apical periodontitis. However, clinicians should remain cautious of osteoporosis's potential impact on apical periodontitis development.

Mitigating aging and doxorubicin induced bone loss in mature mice via mechanobiology based treatments

Aging leads to a reduced anabolic response to mechanical stimuli and a loss of bone mass and structural integrity. Chemotherapy agents such as doxorubicin exacerbate the degeneration of aging skeleton and further subject older cancer patients to a higher fracture risk. To alleviate this clinical problem, we proposed and tested a novel mechanobiology-based therapy. Building upon prior findings that i) Yoda1, the Piezo1 agonist, promoted bone growth in young adult mice and suppressed bone resorption markers in aged mice, and ii) moderate tibial loading protected bone from breast cancer-induced osteolysis, we hypothesized that combined Yoda1 and moderate loading would improve the structural integrity of adult and aged skeletons in vivo and protect bones from deterioration after chemotherapy. We first examined the effects of 4-week Yoda1 (dose 5 mg/kg, 5 times/week) and moderate tibial loading (4.5 N peak load, 4 Hz, 300 cycles for 5 days/week), individually and combined, on mature mice (∼50 weeks of age). Combined Yoda1 and loading was found to mitigate age-associated cortical and trabecular bone loss better than individual interventions. As expected, the non-treated controls experienced an average drop of cortical polar moment of inertia (Ct.pMOI) by −4.3 % over four weeks and the bone deterioration occurred in the majority (64 %) of the samples. Relative to no treatment, loading alone, Yoda1 alone, and combined Yoda1 and loading increased Ct.pMOI by +7.3 %, +9.5 %, +12.0 % and increased the % of samples with positive Ct.pMOI changes by +32 %, +26 %, and +43 %, respectively, suggesting an additive protection of aging-related bone loss for the combined therapy. We further tested if the treatment efficacy was preserved in mature mice following two weeks (six injections) of doxorubicin at the dose of 2.5 or 5 mg/kg. As expected, doxorubicin increased osteocyte apoptosis, altered bone remodeling, and impaired bone structure. However, the effects induced by DOX were too severe to be rescued by Yoda1 and loading, alone or combined, although loading and Yoda1 individually, or combined, increased the number of mice showing positive responsiveness by 0 %, +15 %, and +29 % relative to no intervention after doxorubicin exposure. Overall, this study supported the potentials and challenges of the Yoda1-based strategy in mitigating the detrimental skeletal effects caused by aging and doxorubicin.

Exploring the Role of Hormones and Cytokines in Osteoporosis Development.

The disease of osteoporosis is characterized by impaired bone structure and an increased risk of fractures. There is a significant impact of cytokines and hormones on bone homeostasis and the diagnosis of osteoporosis. As defined by the World Health Organization (WHO), osteoporosis is defined as having a bone mineral density (BMD) that is 2.5 standard deviations (SD) or more below the average for young and healthy women (T score < -2.5 SD). Cytokines and hormones, particularly in the remodeling of bone between osteoclasts and osteoblasts, control the differentiation and activation of bone cells through cytokine networks and signaling pathways like the nuclear factor kappa-B ligand (RANKL)/the receptor of RANKL (RANK)/osteoprotegerin (OPG) axis, while estrogen, parathyroid hormones, testosterone, and calcitonin influence bone density and play significant roles in the treatment of osteoporosis. This review aims to examine the roles of cytokines and hormones in the pathophysiology of osteoporosis, evaluating current diagnostic methods, and highlighting new technologies that could help for early detection and treatment of osteoporosis.

Impressive clinical improvement and disappearance of neuropathic pain in an adult patient with hypophosphatasia treated with asfotase alfa

Hypophosphatasia (HPP) is a rare disorder, resulting from loss-of-function variants of the ALPL gene encoding non-tissue specific alkaline phosphatase (TNSALP). Presentation varies largely, with increased severity usually occurring with earlier disease onset. Here we describe the clinical improvement of a 57-year-old woman with childhood onset HPP, after initiating treatment with asfotase alfa (Strensiq®). This was started because of the rapid and progressive radiological deterioration of bone structure after placement of nails in both upper legs for spontaneous atypical femur fracture (AFF) - like fractures. Initiation of treatment, not only resulted in stabilization of bone structure on X-rays, but within a few weeks there was a dramatic reduction of burning pain sensations in the lower legs, attributed in retrospect to neuropathic pain, and also almost complete disappearance of headaches. Additionally, unhealed metatarsal fractures finally healed after almost 10 years. Drug efficacy was further evaluated through -quality of life questionnaires and multiple tests conducted by the physiotherapist, and showed clear improvements. Within 3 months after starting asfotase alfa, the patient was able to carry out her daily tasks indoors without relying on a walker and even started electric bike rides for 20 km/day. In conclusion, treatment with asfotase alfa, halted rapid radiological bone deterioration after bilateral intramedullary femoral pen placement and strongly increased quality of life, marked by rapid disappearance of neuropathic pain, reduction in headaches and musculoskeletal pains, and enhanced muscle strength and mobility. The quick and almost complete disappearance of neuropathic pain and headache suggests a relation with disturbed levels of metabolites in HPP.

Bone Microarchitecture and Volumetric Mineral Density Assessed by HR-pQCT in Patients with 21- and 17α-Hydroxylase Deficiency.

Due to disturbances in hormones and long-term glucocorticoid replacement therapy (GRT), congenital adrenocortical hyperplasia (CAH) patients are at risk of impaired bone structure and metabolism. This cross-sectional, case-control study aims to investigate for the first time bone microarchitecture features in 21-hydroxylase deficiency (21OHD; N = 38) and 17α-hydroxylase deficiency (17OHD; N = 16) patients using high-resolution peripheral quantitative computed tomography (HR-pQCT) by matching the same sex and similar age [21OHD vs. control: 29.5 (24.0-34.3) vs. 29.6 (25.9-35.2) years; 17OHD vs. controls: 29.0 (21.5-35.0) vs. 29.7 (24.6-35.3) years] with healthy controls (1:3). All patients underwent HR-pQCT scans of the nondominant radius and tibia, and had received GRT. Compared with corresponding controls, 17OHD cases had higher height (P < 0.001), weight (P = 0.013) and similar body mass index (BMI), while 21OHD had lower height (P < 0.001), similar weight and higher BMI (P < 0.001). 17OHD and 21OHD patients demonstrated various significant bone differences in most HR-pQCT indices, suggesting abnormalities in bone microarchitectures from healthy people. Further correlation analyses revealed that some characteristics, such as height and hormones, may contribute to the bone differences in HR-pQCT indices between two diseases. However, treatment dosage and time were not correlated, indicating that the current glucocorticoid doses may be within safety limits for bone impairment. Overall, our study for the first time revealed changes of bone microarchitecture in CAH patients and their potential relations with clinical characteristics. Further longitudinal researches are required to confirm these findings.

Dual X-ray absorptiometry-derived bone status indexes and videocapsule intestinal aspects in celiac disease.

Celiac disease is a risk factor for osteopenia and osteoporosis. Our aim was to evaluate the possible correlation between villous atrophy extension and dual-energy X-ray absorptiometry (DXA)-derived parameters of bone status. We have retrospectively analyzed data of 47 celiac patients (36 women, 52 ± 14 years of age) who underwent video capsule endoscopy and DXA scans within 1 year of interval from 2006 to 2019. Quantitative, qualitative and geometric DXA parameters were collected only from the most recent DXA measurements. . Patients were divided into three categories; the first included those with no lesions at video capsule endoscopy (23 patients), the second those with typical lesions (mucosal atrophy, mosaicism and scalloping) in less than one-third of the small bowel (SB) (16 patients) and the third those with typical lesions in more than one-third of the SB (7 patients). In the third group, bone mineral density seemed to be lower in both the lumbar spine and the hip ( P = 0.026 and P = 0.011, respectively). The deterioration of bone structure in patients with severe and extended SB atrophy was statistically significant ( P = 0.032). Furthermore, bone density, structure and geometry did not correlate with the duration of the gluten-free diet. Notably, autoimmune comorbidities did not affect DXA results. Neither endoscopic nor histological atrophy itself can explain the deterioration of bone mineralization and structure, whereas atrophy extension appeared to be responsible for bone impairment.

Bone-targeting cell membrane-engineered CaCO3-based nanoparticles restore local bone homeostasis for microenvironment-responsive osteoporosis treatment

Osteoporosis is a common bone disease characterized by the systemic disruption of hone homeostasis, where the imbalance between bone resorption and formation causes deterioration of bone structure and bone mass loss. Targeted restoration of bone hemostasis has thus become a promising strategy for osteoporosis treatment. For this purpose, we report a bone-targeted nanoformulation based on CaCO3 nanomaterials, which could be activated in the acidic osteoporotic microenvironment and cooperatively regulate the activity of osteoclasts and osteoblasts to reverse bone deterioration. Herein, a clinical antiosteoporosis drug β-estradiol (E2) is first biomineralized using CaCO3 to form physiologically stable nanocores. Meanwhile, azido groups are introduced onto MC3T3-E1 cells through incubation with AC4ManNAz. The azido-tagged MC3T3-E1 cell membranes are extracted for the camouflaging of the CaCO3@E2 nanocores to enhance their in vivo stability and availability, while also enabling the surface modification of bone-targeting dibenzocyclooctyne-tagged alendronate moieties via copper-free click reaction. After the selective deposition into acidic osteoporotic bone tissues, the CaCO3@E2 cores would be spontaneously degraded to release E2 and Ca2+ ions, which would systematically inhibit the activity of osteoclasts while promoting osteoblast-mediated new bone formation, eventually ameliorating the osteoporosis symptoms. This study offers an effective approach for osteoporosis treatment in the clinics.

Effects of antiresorptive agents on body composition: a case-control retrospective study.

Osteoporosis is the most represented metabolic bone disease and is characterized by the reduction of bone mineral density (BMD), exposing patients to high fracture risk and disability. Bisphosphonates (BPs) are the main compounds exploited in treatment of osteoporosis and significantly reduce fracture risk. Sarcopenia is the pathological reduction of muscle masses and strength, and many studies highlighted its co-existence in patients with impaired bone mass. Indeed, the pathological reduction of lean tissue has been linked to a higher risk of falls and, consequently, fractures and disability. Moreover, the pathological reduction of lean tissue seems to share many pathological mechanisms with impaired bone strength and structure; thus, in this context, we decided to conduct a retrospective case-control study aimed at evaluating the effects of BPs on lean mass and body composition. We enrolled postmenopausal women from our metabolic bone diseases outpatient clinic who underwent at least two consecutive dual-energy X-ray absorptiometry (DXA) examinations concomitantly to the beginning of an antiresorptive agent. The body composition of patients and controls was compared by fat masses, lean masses and android-to-gynoid ratio (A/G ratio). A total of 64 female subjects were considered for the study: 41 starting a BPs and 23 without treatment were used as control. The fat masses and lean masses appeared to be unaffected by BPs. Conversely, A/G ratio was lower in BPs group after 18 months of therapy compared to baseline (p < 0.05). From the stratification based on the single BP we failed to highlight any significant difference between the tested variables. Bisphosphonates treatment did not modify lean tissues, however a significant reduction of A/G ratio in BP group was documented. Thus the BPs seems to act on patients body composition and extra-skeletal tissues but larger prospective studies are needed to evaluate whether these modifications have clinical relevance.

Prediction of osteoporosis in men and women through orthopantomograph

Osteoporosis is a systemic disease characterized by low bone mineral density, deterioration of bone structure and increased bone fragility most commonly seen in females of old age as a result of lack of estrogen. The mandibular cortical index, observed on panoramic radiograph, is useful for the screening of osteoporosis. The aim of the study is to study and analyze thickness of mandibular cortical bone on orthopantomography as a representative for the preliminary diagnosis of osteoporosis. The study was conducted on 100 subjects orthopantomographs which included both males and females of all ages. Patients with prior systemic diseases were not included. There were 50% males and 50% females in the age group of 21-90 with 43% in group 1 patients with all teeth, 57% in group 2 patients with few or no teeth. Group 1 had 60.5% males and 39.5% females, Group 2 had 42.1% males and 57.9% females. C1 had 43%, C2 42% and C3 15%. C1 had 52% males, 42% females, C2 had 48% males, 36% females, C3 had 30% females, 0% males. There is relevant relation between age, gender and osteoporosis. With increased age there is decreased oral health seen in both males and females of middle aged. Due to decreased levels of estrogen in females they are more likely to develop osteoporosis. Use of radio morphometric indices on OPG can predict osteoporosis. There are high chances of osteoporosis in females than males.

RF06 | PSAT147 Impairments in volumetric bone mineral density, bone microarchitecture, and estimated strength in women with atypical anorexia nervosa

Abstract While anorexia nervosa is associated with impaired skeletal integrity, less is known about the skeletal effects of atypical anorexia nervosa, in which psychological criteria for anorexia nervosa are met, but affected individuals are not low weight. Mean bone mineral density (BMD) is higher in atypical anorexia nervosa than in low-weight anorexia nervosa but lower than in healthy controls. However, it is unknown whether bone microarchitecture and strength are affected. We hypothesized that bone microarchitecture and estimated strength would be impaired in women with atypical anorexia nervosa. This was a cross-sectional study of women ages 21-46 years (n=55): n=28 with atypical anorexia nervosa (body mass index (BMI) &amp;gt;18.5 kg/m2), n=27 healthy, normal weight, eumenorrheic controls. Exclusion criteria included use of oral contraceptives. Areal BMD (aBMD) was assessed by DXA. Volumetric BMD (vBMD), microarchitecture, and failure load (a bone strength estimate) at the distal tibia and radius were assessed by high-resolution peripheral quantitative CT. Median(IQR) BMI was lower [19.4(18.6,20.2) vs 22.2(21.5,23.0), p&amp;lt;0.0001] and median serum 25OH vitamin D level was higher [31(24,39) vs 22(17,25), p=0.0001] in atypical anorexia nervosa than healthy controls. In the atypical anorexia nervosa group, 89% had a history of low weight, 21% had a history of overweight/obesity, 31% had current amenorrhea, and 88% had a history of amenorrhea; median duration of anorexia nervosa was 11(5,14) years. Median lateral spine, total hip, femoral neck, and total radius aBMD Z-scores were lower in atypical anorexia nervosa than healthy controls [lateral spine: -1.1(-2.0,-0.1) vs -0.4(-0.7,0.4), total hip: -0.8(-1.3,0.2) vs 0.2(-0.4,0.7), femoral neck: -0.9(-1.4,0.1) vs -0.1(-0.9,0.6), radius: -0.2(-0.9,0.3) vs 0.1(-0.4,0.6); p≤0.04 for all]. At the tibia, median total, cortical, and trabecular vBMD; cortical thickness; trabecular bone volume fraction; and failure load were lower in atypical anorexia nervosa than healthy controls (p&amp;lt;0.05). At the radius, median trabecular number was lower and trabecular separation was higher in atypical anorexia nervosa than healthy controls (p≤0.04), but there was no difference in failure load between the groups. After controlling for baseline BMI, differences at the radius but not tibia remained significant. At the tibia and radius, median total vBMD, cortical vBMD, and cortical thickness were lower in atypical anorexia nervosa subjects with amenorrhea compared to healthy controls and to atypical anorexia nervosa subjects with eumenorrhea (p≤0.04). Conclusions We demonstrate that, despite normal weight, women with atypical anorexia nervosa have impaired vBMD, microarchitecture, and estimated strength compared to healthy controls, with differences more pronounced at the weight-bearing tibia vs non-weight-bearing radius. Individuals with amenorrhea had additional impairments in the non-weight-bearing radius, suggesting an effect of systemic estrogen deficiency. Our data suggest that current normal weight is not protective against impaired bone structure and strength in atypical anorexia nervosa. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m., Saturday, June 11, 2022 1:30 p.m. - 1:35 p.m.

Rapidly destructive osteoarthritis of the spine: lessons learned from the first reported case

BackgroundRapidly Destructive Osteoarthritis (RDOA) has been described for the hip and shoulder joints and is characterized by a quickly developing bone edema followed by extensive remodeling and joint destruction. Confronted with a similarly evolving case of endplate edema and destruction of the disk space, we offer the first described case of spinal RDOA and illustrate the challenges it presented, along with the strategies we put in place to overcome them.Case presentationWe present a case of spinal RDOA that, also due to the delay in the diagnoses, underwent multiple revisions for implant failure with consequent coronal and sagittal imbalance. A 37-years-old, otherwise healthy female presented with atraumatic low back pain: after initial conservative treatment, subsequent imaging showed rapidly progressive endplate erosion and a scoliotic deformity. After surgical treatment, the patient underwent numerous revisions for pseudoarthrosis, coronal and sagittal imbalance and junctional failure despite initially showing a correct alignement after each surgery. As a mechanic overload from insufficient correction of the alignement of the spine was ruled out, we believe that the multiple complications were caused by an impairment in the bone structure and thus, reviewing old imaging, diagnosed the patient with spinal RDOA. In case of spinal RDOA, particular care should be placed in the choice of extent and type of instrumentation in order to prevent re-intervention.ConclusionSpinal RDOA is characterized by a quickly developing edema of the vertebral endplates followed by a destruction of the disk space within months from the first diagnosis. The disease progresses in the involved segment and to the adjacent disks despite surgical therapy. The surgical planning should take the impaired bone structure account and the use of large interbody cages or 4-rod constructs should be considered to obtain a stable construct.

Diagnosis and Treatment of Osteoporosis, an Update Bibliographic Review

Introduction: Osteoporosis is a chronic, progressive skeletal disease characterized by low bone mineral density and deterioration of bone structure. There are multiple risk factors, both modifiable and non-modifiable. The main complication is fractures, which is why it must be diagnosed early and in a timely manner. Material and methods: Fourteen articles and one book on the diagnosis and treatment of osteoporosis were chosen in order to compare the best plan to follow in these patients in the different bibliographies reviewed. Discussion: The gold standard for diagnosing osteoporosis is the measurement of bone density with the dual energy X-ray absorptiometry device, using the T-score. The use of different biomarkers is useful both for early diagnosis and for monitoring the reaction to treatment, but it is necessary to take into account that the main objective is to prevent the disease and to improve the quality of life of the patients. On the other hand, the main and early treatment consists of physical activity adapted to each patient, diet rich in calcium, magnesium and vitamins that promote bone health, the pharmacological part of the treatment has different areas that depends on the situation of each patient, considering gender such as estrogens and progestogens in postmenopausal women, tolerance to drugs such as Denosumab, and in general, bisphosphonate is used as the first line of treatment due to the increase in bone mineral density that it produces, helping to prevent fractures and improving the quality of life of each patient. Conclusion: Osteoporosis is one of the diseases that can prevent the realization of basic activities, for this disease there are different methods of diagnosis and treatment, the main objective is to detect risk factors and make an early diagnosis to avoid complications that entails, relying on tools such as the FRAX calculator and the use of biomarkers, all this to reach the conclusion of the investigation, to use the different options and tools to provide appropriate treatment, this publication being an update on the options that are available today to treat this condition.

The mechanosensitive lncRNA Neat1 promotes osteoblast function through paraspeckle-dependent Smurf1 mRNA retention

Mechanical stimulation plays an important role in bone remodeling. Exercise-induced mechanical loading enhances bone strength, whereas mechanical unloading leads to bone loss. Increasing evidence has demonstrated that long noncoding RNAs (lncRNAs) play key roles in diverse biological, physiological and pathological contexts. However, the roles of lncRNAs in mechanotransduction and their relationships with bone formation remain unknown. In this study, we screened mechanosensing lncRNAs in osteoblasts and identified Neat1, the most clearly decreased lncRNA under simulated microgravity. Of note, not only Neat1 expression but also the specific paraspeckle structure formed by Neat1 was sensitive to different mechanical stimulations, which were closely associated with osteoblast function. Paraspeckles exhibited small punctate aggregates under simulated microgravity and elongated prolate or larger irregular structures under mechanical loading. Neat1 knockout mice displayed disrupted bone formation, impaired bone structure and strength, and reduced bone mass. Neat1 deficiency in osteoblasts reduced the response of osteoblasts to mechanical stimulation. In vivo, Neat1 knockout in mice weakened the bone phenotypes in response to mechanical loading and hindlimb unloading stimulation. Mechanistically, paraspeckles promoted nuclear retention of E3 ubiquitin ligase Smurf1 mRNA and downregulation of their translation, thus inhibiting ubiquitination-mediated degradation of the osteoblast master transcription factor Runx2, a Smurf1 target. Our study revealed that Neat1 plays an essential role in osteoblast function under mechanical stimulation, which provides a paradigm for the function of the lncRNA-assembled structure in response to mechanical stimulation and offers a therapeutic strategy for long-term spaceflight- or bedrest-induced bone loss and age-related osteoporosis.

Osteoporosis risk group: Screening for osteoporosis in dental clinics using panoramic radiographs.

Osteoporosis is a specific condition which is characterized by low bone mineral density (BMD) and deterioration of bone structure resulting in an increased susceptibility to fractures. It contributes to a great deal of morbidity and mortality, and is a large burden to the healthcare system, especially in the case of the elderly population. In the last four decades, a plethora of studies have reported characteristic oral radiographic findings in the early stages of osteoporosis, suggesting the possible use of oral radiographic signs for the early detection of the condition. Digital orthopantomographs (OPGs) are usually taken for the screening of dental patients during routine dental evaluations. These radiographs and the characteristic changes seen on them may have a significant role in the screening for initial osteoporotic changes. A number of precise radiomorphometric indices of the mandible have also been developed to allow quantification of the mandibular bone mass for identification of the initial signs of osteoporosis. The present review focuses on the possible role of panoramic radiographs in the initial screening for osteoporosis in dental clinics in high-risk groups.

Osteoporotic changes in bone and cartilaginous tissue in women with ovarian hypofunction

Annotation. Osteoporosis is the most common disease of the musculoskeletal system, which ranks 4th in the world as a cause of disability and mortality among non-communicable diseases. This is a polyetiological systemic disease of bone tissue, characterized by a decrease in bone mass and deterioration of bone structure and increased fragility. This problem has not only a medical aspect, but also important socio-economic significance in all countries of the world due to the high cost of treatment of such patients and high disability. The aim of the work is to study and analyze the scientific literature and give a generalized description of etiological factors, pathogenesis, primary and secondary methods of prevention of osteoporosis in women with ovarian hypofunction in the pre- and menopausal periods. An analysis of recent research and publications on the problem of osteoporosis and changes in the skeletal system. The main risk factors, etiology and pathogenesis of osteoporosis in the pre- and menopausal period of a woman's life are determined, the main methods of prevention of osteoporosis are described. The most common form of primary osteoporosis is postmenopausal osteoporosis, the trigger of which is hypogonadal states, estrogen deficiency, which causes a sharp acceleration of bone loss. I guarantee healthy bone tissue and prevention of osteopenia and osteoporosis are: accumulation of bone mass in the first 30 years, mechanical stress contributes to the restructuring and remodeling of bone tissue throughout life, timely and early compensation of hypogonadal conditions, improvement of blood flow, improvement of blood flow stability of mineral metabolism and hormonal background. Not all women with hypogonadal condition develop osteoporosis, so studying the use of methods to prevent osteopenia and strengthen bone tissue from a young age is the basis of quality life of modern women at any time in her life in the XXI century, so it needs further study.

Application of deep learning neural network in predicting bone mineral density from plain X-ray radiography.

Osteoporosis is defined as a systemic disease of the bone characterized by a decrease in bone strength and deterioration of bone structure at the microscopic level, leading to bone fragility and increased risk of fracture. Bone mineral density (BMD) is the preferred method for the diagnosis of osteoporosis, and dual-energy x-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. Conventional radiography is more suited for the screening of osteoporosis rather than diagnosis, and osteoporosis can be detected on radiographs by experienced physicians only. This study explored the possibility of predicting BMD relative to DXA using patient radiographs. A deep learning algorithm of convolutional neural network (CNN) was used for the purpose. The method includes image segmentation, CNN learning, and a convolution-based regression model (DeepDXA) that links the isolated images of the femur bone to predict BMD value. Data were obtained in a single medical center from 2006 to 2018, with a total amount of 3472 pairs of pelvis X-ray and DXA examination within 1year. The proposed workflow successfully predicted BMD values of the femur bone with the correlation coefficient (R) of 0.85 (P < 0.001) and the accuracy of 0.88 for prediction osteoporosis, a finding that could be reliably ready for further clinical use. When suspicious osteoporosis is seen on plain films using the deep learning method we developed, further referral to DXA for the definite diagnosis of osteoporosis is indicated.