I R Reid

..Trials are underway to assess these possibilities further. At present, there is insufficient evidence to support vitamin D supplementation for improving cardiovascular outcomes...

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..The management of established ONJ lesions is problematic: the greatest success seems to come from vigorous antimicrobial therapy with judicious use of surgical debridement...

..Whether the newer agents can improve on this remains to be seen, though it is possible that anabolic agents which increase bone mass more substantially will be needed to achieve greater reductions in all fracture numbers...

..This is likely to result in the local release at high concentrations of bisphosphonates. Management focuses on prevention, treatment of infection and cessation of bisphosphonates. The role of surgery is unclear...

..There is no consistent evidence, to our knowledge, that calcium supplementation affects bone mineral density (BMD) in men, despite male osteoporosis being a common clinical problem...

..There is no clear evidence from this study that any of these newer markers are superior to total AP in assessing patients with this severity of Paget's disease...

..Calcium supplementation has been suggested to have beneficial effects on serum lipids, blood pressure, and body weight, but these possibilities have not been rigorously assessed in men...

..Although many studies have assessed the effects of estrogen and raloxifene hydrochloride on bone mineral density and serum lipid concentrations, there are few direct comparative data...

..Therefore, caution is appropriate in incorporating these findings into clinical practice, but the balance of evidence suggests that calcium is a cost-effective adjunct to the dietary management of hyperlipidaemia...

..While none of these options is suitable for everyone, the range of available therapies does mean that most patients can find an intervention that is effective and acceptable...

..The role of bisphosphonates in osteogenesis imperfecta was further confirmed, and novel roles in ankylosing spondylitis, myelofibrosis, and hypertrophic pulmonary osteoarthropathy were suggested...

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..However, these effects are small, it is unknown whether they are sustained with long-term use, they have not been shown with intention-to-treat analyses, and the evidence for fracture prevention with calcium monotherapy is inconsistent...

..Obvious abnormalities are apparent with a variety of radiologic modalities, and it is not clear that radiographs are inferior to other approaches. Most authors favor a conservative approach to surgical debridement of the lesions...

..EXPERIMENTAL SUBJECTS: Subjects included 80 women with postmenopausal osteoporosis who had been taking estrogen for at least 1 yr...

..Zoledronic acid, a bisphosphonate administered as a single intravenous infusion, might meet these needs...

..More immediately, the role of weight maintenance in the prevention of osteoporosis is an important public health message that needs to be more widely appreciated...

..beta-blockers increase bone mass in mice, and some observational studies have suggested a beneficial effect of these drugs on bone in humans EXPERIMENTAL SUBJECTS: We studied 41 normal postmenopausal women...

..In addition, those at risk should be looking to other agents with a proven capacity to prevent hip fractures, such as bisphosphonates...

..Epidemiological data suggest that high calcium intakes are associated with decreased body weight and blood pressure. However, there is little evidence from randomized trials that addresses these important issues...

..We studied the association of beta-blocker use with BMD and fractures in the Study of Osteoporotic Fractures. beta-blocker use and BMD are unrelated in this cohort, and associations with fracture risk are inconsistent...

..Until there are definitive randomized, controlled trials of beta-blockers, which include fracture as an endpoint, it is unlikely that the current confusing situation will be resolved...

..Denosumab markedly reduces bone turnover and also reduces fracture numbers. Longer follow-up is necessary to determine how long such low turnover is safe...

..Intravenous aminobisphosphonates often cause an acute-phase response (APR), but the precise components of this, its frequency, and the risk factors for its development have not been systematically studied...

..Patients at high risk of fracture need to take interventions of proven anti-fracture efficacy. Available evidence suggests that this efficacy is not dependent on the co-administration of calcium supplements...

..Gastrointestinal intolerance limits maximal dosing. Although intermittent intravenous treatments have been used, the optimal doses and dosing interval have not been systematically explored...

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..01). Bone markers at 6 months were predictive of response duration. These data demonstrate an unprecedented duration of remission of Paget disease following treatment with zoledronic acid, accompanied by an improved quality of life...

..To assess whether statins have clinically significant effects on bone, we studied the frequency of fractures in a large randomised controlled trial of these agents...

..It is incumbent on all physicians supervising long-term glucocorticoid therapy to ensure that a skeletal assessment is carried out and that osteoporosis prophylaxis is instituted, where appropriate...

..Longer-term data are required to further assess the efficacy of this treatment in chronic stable primary hyperparathyroidism...

..Additional effects of aging and menopause can substantially increase an individual's fracture risk. It is important that physicians assess fracture risk in susceptible patients and initiate treatment when indicated...

..There is a need for an effective bone anabolic factor but those which have been trialled to date have not proceeded because of significant adverse effects...

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..Since food sources have not been associated with adverse cardiovascular effects, they may be preferable. Available evidence suggests that other osteoporosis treatments are still effective without calcium co-administration...

..In the clinic, the key issues are that obesity is protective against osteoporosis, but underweight is a major preventable risk factor for fractures...

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..However, we believe that the central role of sunlight exposure in determining vitamin D status needs to be explicitly reflected in public policy in this area...

..More immediately, the role of weight maintenance in the prevention of osteoporosis is an important public health message that needs to be more widely appreciated...

..These data demonstrate that preptin, which is cosecreted from the pancreatic beta-cell with amylin and insulin, is anabolic to bone and may contribute to the preservation of bone mass observed in hyperinsulinemic states such as obesity...

..Such peptides should be converted to a hydrochloride or biologically equivalent salt before assessment of their biological effects is undertaken...

..Amylin-(1---8) thus has significant anabolic effects in vivo, suggesting that this peptide or analogs of it should be further evaluated as potential therapies for osteoporosis...

..These may contribute to the effects of HRT and menopause on many tissues and disease processes, including the development of osteoporosis...

..Our findings support the suggestion that vitamin D supplementation should become standard practice in this population of women, particularly during winter...

..The improvements in bone density seen in the first 2 years were sustained throughout the extension study. Thiazides provide a further option in the prevention of postmenopausal bone loss...

..identify, appraise, and synthesize data from randomized, controlled trials of vitamin D supplementation in older people...

..Good compliance with HRT long-term is achievable. These findings are relevant to deciding the frequency of bone density measurement, and in advising women regarding prevention and treatment of postmenopausal bone loss...

..With baseline 25OHD > 50 nmol/L, vitamin D supplementation does not reduce PTH levels...

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..We conclude that lactoferrin might have a physiological role in bone growth and healing and a potential therapeutic role as an anabolic factor in osteoporosis...

..It is concluded that adrenomedullin(27-52) acts as an anabolic agent on bone. These findings may be relevant to the normal regulation of bone mass and to the design of agents for the treatment of osteoporosis...

..They were not found in the acid phosphatase-positive staining osteoclasts. These results indicate that cells which have a mitogenic response to LIF are bone-forming rather than bone-resorbing cells...

..However, their effects in mature bone cells and in organ cultures have not been well studied. It is uncertain whether their activities in different experimental models are comparable...

..Uncertainty exists as to the optimal management and monitoring of the skeletal consequences of mild primary hyperparathyroidism (PHPT)...

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..When administered systemically, the direct actions of leptin outweigh its centrally mediated effects on bone, the latter possibly being mediated by leptin's regulation of insulin sensitivity...

..Epidemiological studies suggest that calcium supplementation may decrease the risk of cardiovascular disease...

..Parathyroid hormone (PTH) change at 3 months was associated with change in 25(OH)D but not with baseline levels, and PTH fell even when starting levels of 25(OH)D were >40 nmol/L, consistent with optimal values for 25(OH)D of ?40 nmol/l...

..Thus, these small peptides, or their analogues, are attractive candidates as anabolic therapies for osteoporosis...

..This activity is shared by amylin and CGRP. The much greater potency of calcitonin than amylin and CGRP is consistent with the action of these peptides being mediated by calcitonin receptors...

..Combined, these studies indicate that IL-18 may have an autocrine/paracrine mitogen role for both osteogenic and chondrogenic cells, independent of the production of IFNgamma or GM-CSF...

..001), with marked differences evident even in the youngest group (mean age 23 years). Compared to other racial groups, women of Indian origin preferentially accumulate abdominal fat--a trait that is well established in young adulthood...

..These data suggest that FGF-8 may have a physiological role in bone acting in an autocrine/paracrine manner...

..Therefore, this is an important clinical risk factor that points to the need for bone density measurement, consideration of lifestyle modification, and antiosteoporosis therapies in these women...

..To determine factors possibly associated with reduced bone density in women using the injectable contraceptive depot medroxyprogesterone acetate...

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..Because adiponectin does influence bone mass in vivo, it is likely to be a contributor to the fat-bone relationship...

..To investigate whether calcium supplements increase the risk of cardiovascular events...

..We conclude that atorvastatin (40 mg/day) has no significant effect on bone turnover in man...

..Unexpected hypogonadism in men with Addison's disease is common...

..The aetiology is uncertain, and its management and natural history poorly defined...

..Some patients with PHPT may experience an increase in urinary calcium excretion after vitamin D repletion...

..The calibration varied, suggesting that the calculators should be validated in local cohorts before clinical use...

..We sought to study the relationship between left ventricular (LV) size and body composition in male endurance athletes and age-matched control subjects...

..Annual iv administration of 5 mg zoledronate decreases fracture risk. The optimal dosing interval of 5 mg zoledronate is not known...

..To determine the association, if any, between male-pattern hair loss (baldness) and serum 25-hydroxyvitamin D (25-OHD) levels...

..To explore the effects of seasonal variation on the diagnosis of vitamin D sufficiency and to determine whether age, gender, and ethnicity modify these effects...

..0%, P = 0.029). There were no major adverse events. These data support the view that the likely cause of DMPA-associated bone loss is estrogen deficiency and demonstrate that it can be arrested by estrogen replacement therapy...

..These results are in contrast to those in young or premenopausal women, and they provide no support for an important role for the CASR A986S polymorphism in osteoporosis...

..Our findings are potentially important in refining these peptides for the therapy of osteoporosis...

..These data demonstrate that the antiresorptive effects of a single 5-mg dose of zoledronate are sustained for 3 years; clinical trials to investigate the antifracture efficacy of dosing intervals longer than 1 year are justified...

..The latter result may also be contributed to by alpha-MSH effects elsewhere, such as the adipocyte, pancreatic beta-cell, or central nervous system...

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..To analyze cellular mechanisms of bone erosion in gout...

..Recent studies have reported low bone mineral density (BMD) in HIV-infected patients. Annual iv administration of 4 mg zoledronate has been shown to increase BMD and suppress bone turnover in postmenopausal women...

..Human data on the skeletal effects of thiazolidinediones are currently available only from observational studies...

..It is likely that definitive clinical trial data will not become available to resolve these questions, so careful clinical observation and caution are needed in patients who require treatment over periods of more than 10 years...

..The purpose of this study was to determine the rate of early postmenopausal bone loss in women who had used depot medroxyprogesterone acetate contraception through to menopause...

..We sought to determine whether BMD in HIV-infected men treated with HAART for at least 3 months is different from that in healthy controls, and, if so, what HIV-related factors might explain this finding...

..We hypothesized that these findings might be explained by effects of these variables on vitamin D binding protein (DBP) levels. We set out to determine the relationships between DBP and gender, 25OHD, body weight and body composition...

..This association between fat mass and PTH might contribute to the association between primary hyperparathyroidism and increased body weight...

..The effect of season on vitamin D status is often overlooked in studies of optimal vitamin D concentrations and in clinical practice...

..The cross-sectional studies may have been confounded by the failure to control for low body weight in HIV-infected patients...

..Conclusions: Treatments for osteoporosis with established vertebral and nonvertebral fracture efficacy reduce mortality in older, frailer individuals with osteoporosis who are at high risk of fracture...