Alexandra Papaioannou

..It has been found to significantly reduce vertebral fractures by 65%, and nonvertebral fragility fractures by 53% in treatment-naive postmenopausal women who have previously suffered a vertebral fracture...

..This study examined the measurement equivalence (ME) of the 36-item Medical Outcomes Study Short Form Survey (SF-36), a widely-used measure of HRQOL, by sex and race in a population-based Canadian sample...

..The purpose of this study was to elicit surgical preferences of patients at risk of sustaining hip fracture using a novel decision board...

..The purpose was to estimate the relative efficacy of reduction of fractures in post-menopausal women, and to assess robustness of the results...

..Cystic fibrosis is the most common fatal autosomal recessive genetic disease in the Caucasian population. Osteoporosis is increasingly being recognised as an important complication in people with cystic fibrosis...

..Thus, the purpose of this pilot study is to estimate reference values of medial joint space width and cartilage morphometry in healthy individuals of all ages using standard radiography and peripheral magnetic resonance imaging...

..However, the extent to which patients who fracture are assessed and treated for osteoporosis is not clear...

..We report the safety findings from a 3-year phase 3 study (NCT00205777) of bazedoxifene, a novel selective estrogen receptor modulator under development for the prevention and treatment of postmenopausal osteoporosis...

..Although the tool has several strengths, certain limitations exist which may not allow generalizability to a Canadian setting. Thus, we tested the STRATIFY tool with some modification and re-weighting of items in Canadian hospitals...

..In conclusion, similar proportions of women did not respond to raloxifene or alendronate therapy, as measured by changes in lumbar spine or femoral neck BMD, when precision error was taken into account...

..These trials included two large vertebral fracture studies that used time-to-event methods to evaluate the effects of treatment on fracture risk, thereby allowing both the occurrence and the timing of fractures to be considered...

..Today we have therapies with proven efficacy for the prevention of vertebral fractures and bone loss. Consequently recognition of glucocorticoid-induced osteoporosis is extremely important given the availability of effective therapy...

..Sub optimal levels of compliance and persistence with bisphosphonates are potentially compromising the reduction of post menopausal osteoporotic (PMO) fracture risk...

..The choice of clinical efficacy data is an important consideration in health economic models evaluating osteoporosis therapies...

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..In patients with recent hip fracture who received zoledronic acid therapy, the incidence of new subtrochanteric fractures was too small to draw any meaningful conclusions...

..At month 24 and end of the study visit, ZOL significantly improved patients' overall health state compared to placebo as assessed by the EQ-5D VAS...

..Educational efforts are needed for health care professionals to increase the credibility of assessing health status in clinical practice...

..06; 95% CI: -0.11, -0.00) for women, and rib fractures (-0.06; 95% CI: -0.12, -0.00) for men. In conclusion, this study demonstrates a negative association between osteoporotic fractures and quality of life in both women and men...

..Given our current knowledge and the evidence that is outlined in this review, it is hoped that patients who require therapy with corticosteroids for more than 3 months will be offered appropriate preventative treatment...

..We demonstrated that several modifiable factors influence HRQL in patients with vertebral fractures, and physicians should be aware of these and other markers of reduced HRQL to enhance patient care...

..In this study, we examined longitudinal change in bone mineral density (BMD) and the prevalence of vertebral fractures in adult CF patients, without lung-transplant, attending a Canadian specialty clinic...

..9%, 97.0%; 68 of 73) were not aware of it. Thus, the minimum NNS by BMD testing to detect one previously undiagnosed case of osteoporosis in Canada is: 6 women aged >or=65 yr, 13 men aged >or=65 yr, and 10 men aged >or=70 yr...

..However, appropriate therapy utilization of the disease remains suboptimal. Thus, the objective of the study was to change physicians' therapy administration behavior in accordance with the Osteoporosis Canada 2002 guidelines...

..Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality...

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..To summarize the current knowledge regarding the various determinants of bone strength...

..The primary aim of our study was to examine whether large loading doses in addition to daily vitamin D offered any advantage over a simple daily low-dose vitamin D regimen for increasing vitamin D levels...

..A procedure for creating a simplified version of fracture risk assessment tool (FRAX®) is described. Calibration, fracture prediction, and concordance were compared with the full FRAX tool using two large, complementary Canadian datasets...

..We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system...

..A multicenter, randomized, controlled trial was conducted to assess the efficacy, tolerability, and safety of therapy with oral alendronate (FOSAMAX; Merck; Whitehouse Station, NJ) in adults with CF and low bone mass...

..Furthermore, various anthropometric measures, disease conditions, and medications are associated with a new fracture. Identifying postmenopausal women at risk is important given that fracture prevention therapies are now available...

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..The objective of our study was to quantify changes in AE rates and BMD scores, as well as associated alendronate discontinuation among patients before and after switch from brand to generic alendronate...

..The study objective was to compare trabecular bone microarchitecture of postmenopausal women with type 2 DM and women without type 2 DM...

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..To evaluate factors associated with whether patients associate their fracture with future fracture risk...

..As few premonitory symptoms for fracture exist, it is of critical importance that physicians effectively and efficiently identify individuals at increased fracture risk...

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..Elderly nursing home residents are at increased risk of hip fracture; however, the efficacy of fracture prevention strategies in this population is unclear...

..Thus, there is little evidence to support the use of hip protectors outside the nursing home setting. The potential benefit of hip protectors in reducing hip fractures in nursing home residents requires further confirmation...

..In conclusion, alendronate users were more likely to discontinue therapy than etidronate users over the follow-up period. Potential barriers to long-term patient adherence to osteoporosis therapies need to be evaluated...

..A secondary question assessed was the nurse's and PSW's attitudes and beliefs regarding the role and benefits of vitamin D for LTC patients...

..To determine whether patients with osteoporosis treated with teriparatide experienced improvement in HRQL and pain symptoms after several months of therapy...

..The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures...

..Our objective was to systematically review the anti-fracture efficacy of alendronate in men with low bone mass or with a history of prevalent fracture(s) and incorporate prior knowledge of alendronate efficacy in women in the analysis...

..To determine if there are differences between men and women referred for treatment of osteoporosis in Canada...

..13, 0.62, p = 0.002). In conclusion, early fracture on bisphosphonate therapy is most strongly predicted by a previous history of fracture and early bone loss is most strongly predicted by the potency of the prescribed bisphosphonate...

..To determine the prevalence of osteoporosis in osteoarthritic patients undergoing total hip or total knee arthroplasty...

..The objective of this study was to estimate the prevalence of low glomerular filtration rate (GFR) in a large sample of elderly adults living in long-term care facilities, and to compare two commonly used methods for estimating GFR...

..Results showed that serum 25-hydroxyvitamin D levels <75 nmol/L were common. Given Canada's high latitude, attention should be given to strategies for enhancing vitamin D status in the population...

..Once-weekly dosing options with alendronate and risedronate are effective and reduce serious adverse drug effects, and therefore, are welcome additions to our therapeutic armamentarium...

..In summary, the T-score difference between the lumbar spine and femoral neck is an independent risk factor for major osteoporotic fractures that is independent of the FRAX probability calculated with femoral neck BMD...

..We found that approximately half of these women were not being treated, indicating a significant care gap in osteoporosis treatment...

..The education of both clinicians and policy makers regarding these new insights may translate to enhanced individual practices and an improved overall health care system to optimize the environment for managing osteoporosis...

..Future studies are needed regarding strategies to increase adherence to osteoporosis medications...

..The aim of this study was to compare two year changes in trabecular bone microarchitecture in women with and without type 2 diabetes...

..Male osteoporosis has a substantial economic burden on the Canadian society...

..Our objective was to examine the effect of daily SSRI use on the risk of incident clinical fragility fracture...

..To determine the level of exposure to hip protectors and barriers to their use in nursing homes...

..The current paper supplements that guideline and provides a review and synthesis of the current literature on the diagnosis and management of osteoporosis in men...

..The secondary goal was to examine the incidence of MSK disorders and assess the frequency with which new diagnoses not previously documented in patients' charts were identified...

..We conclude that 10 mg of oral daily alendronate is significantly associated with increase in BMD at the lumbar spine and hip in men over 2-3 yr and that these changes are similar to those previously observed in postmenopausal women...

..To summarize the current knowledge regarding the impact of the most common antifracture medications on the various determinants of bone strength...

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..Hip fractures are a public health concern because they are associated with significant morbidity, excess mortality, and the majority of the costs directly attributable to osteoporosis...

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..This paper reviews a number of these studies regarding the economic benefits of treating osteoporosis with bisphosphonates and considers for whom prevention and/or treatment is most warranted...

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..Osteoporosis and fragility fractures in men account for substantial health care expenditures and decreased quality of life...

..These findings may facilitate the development of innovative approaches to pain management in LTC settings...

..Our purpose was to determine the added value of VFA and its impact on the Canadian fracture risk classification using data from a Dutch academic cohort...

..During the years following menopause, estrogen levels decline leading to accelerated bone loss and an increased risk of osteoporosis and osteoporosis-related fractures...

..PROBLEM ADDRESSED Family physicians are not adequately following the 2002 Osteoporosis Canada guidelines for providing optimal care to patients with osteoporosis...

..There is evidence from randomized controlled trials that pharmacologic therapy can reduce the risk of future fractures by 40% to 50%. Vertebroplasty may be effective in the control of pain and in obtaining stability of the spine...

..Each of these bisphosphonates have been shown to have comparable safety with placebo up to 3 to 4 years, with the most rigourous trials carried out for alendronate and risedronate. Long-term comparative studies are awaited...

..The Panel recommends treating PDB with bisphosphonates that have demonstrated superior efficacy and remission rates...

..Raloxifene can be recommended for the prevention of vertebral fractures in women with osteopenia/osteoporosis who are not at high risk of non-vertebral fractures and who do not have a past history of venous thromboembolism...

..However, a decrease in renal function, albeit rare, remains a significant complication of zoledronic acid; therefore, regular renal monitoring is recommended...

..This study suggests that the improvements in fracture risk resulting from HRT are explained by a reversal of net endocortical resorption of bone...

..Information collected by HR-QOL instruments may provide new insight as to how to improve quality of life for patients with fractures and how to properly allocate healthcare spending...

..Teriparatide (recombinant human parathyroid hormone 1-34) shows promise as a future anabolic agent for the prevention and treatment of patients with corticosteroid-induced osteoporosis...

..In men, risedronate either maintains or increases bone mineral density. In placebo controlled trials it has been shown to be safe and effective in preventing fractures...

..To use the model to examine the consistency of the time course of CK concentration changes...

..2-24.3). Thus, estimation of in vivo trabecular bone porosity by measuring the average diameter of the pQCT-imaged marrow spaces in the ultradistal radius identifies individuals with low bone mass most at risk for osteoporotic fracture...

..Such norms are important to establish, because the effect of any intervention may be confounded by changes due to the natural progression of HRQOL over time...

..Our decision aid shows promise in preparing women for counseling about osteoporosis therapies. Long-term adherence to chosen therapy and quality of life will be evaluated in a randomized controlled trial...

..1 mm anteriorly, -0.3 mm at the mid-location, and +0.2 mm posteriorly. The benefit of exercise in preserving vertebral morphometry in patients with osteoporosis deserves further investigation...

..Longitudinal monitoring of healthy men should be performed to confirm these cross-sectional results...

..69, 0.76, and 0.83 for TUG, BERG, and CBMS, respectively). SFM-SF provides reliable measures of functional movements in community-dwelling individuals at risk for osteoporotic fracture...

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..Over the past 10 years, we have a greater understanding of the epidemiology, pathophysiology, prevention and treatment of glucocorticoid induced osteoporosis. This article reviews these recent findings and selective practice guidelines...

..The decreased vertebral fracture risk in yr 4 alone was not different from that observed in the first 3 yr...

..Raloxifene hydrochloride therapy reduces the risk for vertebral fractures at 3 years, but the effects on clinical vertebral fractures in the first year are not known...

..We sought to estimate the average rate of change in bone mineral density as a function of age among Canadians aged 25-85, stratified by sex and use of antiresorptive agents...