W D Leslie

..It is hypothesized that the opposing effects of overweight/obesity and diabetes-related complications contribute to the observed biphasic fracture risk, though causality cannot be proven from this observational study...

..First Nations peoples were eight times less likely to receive post-fracture care compared to non-First Nations peoples, representing a clinically significant ethnic difference in post-fracture care...

..Conclusions: Lumbar spine TBS predicts osteoporotic fractures in those with diabetes, and captures a larger portion of the diabetes-associated fracture risk than BMD...

..A modified Kaplan-Meier method is easy to implement and provides an alternative approach to existing methods for competing mortality risk adjustment...

..Differences in bone mineral density (BMD) as assessed with dual-energy x-ray absorptiometry are observed between geographic and ethnic groups, with important implications in clinical practice...

..The need for improved methods for identification of fracture in older adults with T2D is an important priority for osteoporosis research. © 2012 American Society for Bone and Mineral Research...

..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...

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..The objectives of this study are to determine the efficacy of a home-based walking exercise program in promoting bone health, physical function and quality of life in men with prostate cancer receiving ADT...

..Although FRAX should not be used to assess the reduction in fracture risk in individuals on treatment, it may still have value for guiding the need for continued treatment or treatment withdrawal..

..There is contradictory information on whether the rate of bone mineral density (BMD) loss is an independent risk factor for osteoporotic fractures and whether this should be included in fracture prediction systems...

..The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined...

..Postfracture care is suboptimal, and strategies to address this major gap in care are necessary. We investigated whether notifications sent by mail to physicians and patients would lead to improved postfracture care...

..Use of a weighted mean between the lumbar spine and femoral neck T-scores was found to provide an arithmetically equivalent result to a previously described offset adjustment...

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..For individuals falling in a moderate risk range, there is incremental value in using BMD in the probability calculation as this appropriately reclassifies risk in over one third of the individuals...

..7 years of observation. Hip axis length (HAL) and strength index (SI) made a small but statistically significant contribution to hip fracture prediction that was independent of age and hip bone density...

..We found a very high prevalence of BMD in the osteoporotic range and a significant correlation between lower BMD and prior fragility fractures...

..Since collection of population-based hip fracture data is considerably easier than collection of non-hip fracture data, this study supports the current emphasis on using hip fractures as the preferred site for FRAX model calibration...

..3-16.4] per 1000 person-years) or major CS use (11.2 [95% CI, 4.1-18.2] per 1000 person-years). This simplified fracture risk assessment system provides an assessment of fracture risk that is consistent with observed fracture rates...

..This prospective study was undertaken to clarify the role of body mass and composition as a determinant of bone mineral density (BMD) in recently diagnosed inflammatory bowel disease (IBD)...

..Absolute 10-year fracture risk is the preferred method for fracture risk assessment. The validity of applying published fracture rates from one population to another population is uncertain...

..Incident fracture rates correlate equally well with BMD across all bone area quartiles when adjusted for age...

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..Absolute fracture risk reporting was well received and was strongly preferred to traditional T-score-based reporting. Non-specialist physicians were particularly supportive of risk-based bone mineral density (BMD) reporting...

..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...

..First Nations women had a preferential increase in trunk fat and this may contribute to high reported rates of diabetes, metabolic syndrome, and cardiovascular events...

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..Approaches that consider the error in the LSC estimate may provide more robust determinations of BMD change even when the precision study sample size is limited...

..Bone density measurement with dual-energy x-ray absorptiometry is widely used for fracture risk assessment. Discordance between measurement sites is common, but it is unclear how this affects fracture prediction...

..The profile reversed after age 65 yr, with a greater proportion considered high risk in the 10-yr fracture risk system compared to the densitometric system...

..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...

..Further research is needed to see whether these measures can in turn predict the metabolic complications associated with overweight and obesity...

..These results highlight the importance of FRAX(®) model calibration, and speak to the importance of using high-quality fracture epidemiology in constructing FRAX(®) tools...

..Strategies to enhance risk stratification in this group should be developed through international collaborations...

..We found that there are large incremental health care costs associated with incident fractures in Canada. Identifying COI from HCR use offers a cost baseline for measuring the effects of evidence-based guidelines implementation...

..This paper reviews recently updated CPGs from the following countries: Australia, Belgium, Canada, Germany, the United Kingdom, and the United States...

..This FRAX tool was used to examine possible thresholds for therapeutic intervention in Canada in two large complementary cohorts of women and men...

..We examined trends in fracture rates over 20 years in the Province of Manitoba, Canada. Hip fractures, major low-trauma fractures, and high-trauma fractures declined significantly from 1986 to 2006...

..Several national organizations recommend that fracture risk assessment and osteoporotic treatment be based on estimated absolute 10-year fracture risk rather than bone mineral density (BMD) alone...

..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 describe a simple procedure for using lumbar spine BMD to enhance fracture risk assessment under the FRAX system...

..The improvement in fracture risk prediction is small but supports clinical interest in a system that integrates LS in fracture risk assessment...

..In conclusion, a Canadian FRAX tool calibrated on national hip fracture data generates fracture risk predictions that generally are consistent with observed fracture rates across a wide range of risk categories...

..This may facilitate implementation of a population-based osteoporosis surveillance program, providing information that could help to inform and guide screening, prevention, and treatment resources...

..Abdominal obesity is a major risk factor for diabetes. Dual-energy x-ray absorptiometry (DXA) of the lumbar spine provides an index of abdominal fat...

..Use of the US fracture risk assessment tool (FRAX) would be inappropriate for Canada as it would overestimate fracture risk in Canadian women and older men...

..Despite evidence of greater referral bias in men resulting in a higher rate of clinical risk factors, the performance of the prediction algorithm was not affected...

..It has not been established that published gradients of fracture risk from study populations can be directly applied to clinical populations...

..We sought to determine the overall and site-specific fracture rates of First Nations people compared with non-First Nations people...

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..This analysis focusses on geographic area of residence, income level, and diabetes mellitus as possible explanatory variables since they have been implicated in the fracture rates observed in other populations...

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..The purpose of this study is to describe the scintigraphic pattern of de Quervain tenosynovitis, a common inflammatory condition of the thumb tendon sheaths related to repetitive use...

..In conclusion, the Manitoba bone density database has great potential as a resource for clinical and health policy research because it is population based with a high level of completeness and accuracy...

..We sought to determine whether lung uptake of technetium-99m (99mTc)-based myocardial perfusion tracers predicts cardiac events...

..The impact of changes in reference data need to be carefully evaluated by users and manufacturers before widespread clinical dissemination...

..Categorization of change based upon absolute change in BMD is strongly preferred in the routine clinical setting...

..Canadian Aboriginal women are at increased risk of fracture compared with the general population...

..The International Society of Clinical Densitometry (ISCD) recommends that each center determine precision error using repeat measurements in 30 subjects (or an equivalent method providing 30 degrees of freedom)...

..Aboriginal Canadians have higher fractures rates than non-Aboriginals. This analysis examined the interaction of ethnicity with diabetes mellitus, disease comorbidity and substance abuse as possible explanatory variables...

..Race/ethnicity is often a proxy for other disease-related risk factors. Understanding fundamental risk factors goes beyond the language of race/ethnicity...

..In summary, we believe that the total hip site has been undervalued for monitoring purposes and might actually be the preferred site in older individuals with a high prevalence of lumbar spine artifact...

..Our objective was to assess the degree of concordance between the visual and automated diagnostic assessments of 99mTc sestamibi SPECT...

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..The doses measured were significantly lower than previously predicted for the adult and infant phantom. Our measurements suggest that patient contact restrictions could be made less stringent than those currently in widespread use...

..Dual-tracer subtraction parathyroid imaging is superior to double-phase sestamibi-only imaging. The washout data may provide additional information in some cases, however, and an approach that combines both techniques may be optimal...

..In conclusion, we have shown that a multidimensional approach to hip fracture risk stratification is feasible, and greatly modifies risk stratification based on BMD alone...

..A simpler "1-cm(2) rule" for the lumbar spine also predicted significantly worse spine precision (p<0.005). In conclusion, differences in bone area are sources of short-term bone density measurement error...

..Greater number of osteoporotic sites correlates with lower T scores at each index site. This largely explains the positive association between number of osteoporotic sites and fracture risk...

..Volumetric measures of lumbar spine density can be obtained with high precision. Because of poor reproducibility in the femoral neck, the total hip region may be preferable for measuring volumetric bone density in the proximal femur...

..The availability of age-specific risk factor prevalence rates in this population may allow for more accurate fracture risk modeling...

..We report our experience with this model of bone density service delivery, which is unique in North America, and confront the challenge of balancing accessibility, clear guidelines, and fiscal responsibility...

..All methods of vertebral exclusion led to a small improvement in fracture prediction. Computer algorithms performed at least as well as physicians...

..Weight and body mass index are associated with low bone mineral density and fractures in older women. This retrospective cohort study confirms a similar relationship in women aged 40 to 59 years...

..High BMD is an infrequent finding. In this retrospective cohort study of women 50 years and older, we documented a strong association between high BMD and high BMI...

..In conclusion, PTH is a better predictor of BMD than 25(OH)D in this population of Aboriginal and White women...

..Despite the potential for children with IBD to develop osteoporosis, their BMD as adults is generally normal...

..Bone mineral density (BMD) is usually normal at the time of inflammatory bowel disease (IBD) diagnosis. The purpose of this study was to evaluate the role of vitamin D metabolism in recently diagnosed IBD...

..Our hypothesis was that there would be a positive association between SES and BMD utilization (i.e. higher utilization rates in higher income women), resulting in disparities that disadvantage lower SES or lower income women...

..quot; T-scores are preferred and the WHO classification is applicable for postmenopausal women and men age 50 and older. These Official Positions, rationale and evidence are discussed in the following report...

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..The mechanism by which PPI use promotes the development of hip fracture is uncharacterized. Therefore, we sought to determine whether PPI use is associated with osteoporosis or accelerated bone mineral density (BMD) loss...

..We sought to compare the relationship between body composition, insulin resistance, and inflammatory adipokines in Aboriginal Canadian women, who are at high risk of vascular disease, with white women...

..The aim was to construct and validate algorithms for osteoporosis case ascertainment from administrative databases and to estimate the population prevalence of osteoporosis for these algorithms...

..The use of proton pump inhibitors has been associated with an increased risk of hip fracture. We sought to further explore the relation between duration of exposure to proton pump inhibitors and osteoporosis-related fractures...

..However, this does not seem to influence BMD. Calcium and vitamin D intake is not a predictor of bone status in premenopausal women with IBD...

..We seek to explore if, in the Canadian system of public, universal health care access, pediatric appendicitis rupture rates are an indicator of health disparities...

..Wrist fractures are the most prevalent type of fracture occurring in postmenopausal women. We sought to contrast the probability of recurrent osteoporotic fractures after a primary wrist fracture with other important primary fracture sites...

..A population-based case-control study was undertaken to determine whether tamoxifen use is associated with osteoporotic fractures in routine clinical practice...

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..Survival analysis did not demonstrate any difference in the time to outcome between the fixed and adjusted dose methods. The use of a fixed dose method simplifies the approach to treatment with potential cost savings...

..Radioactive iodine (as Na131I) has been used in the diagnosis and treatment of thyroid disease for more than 60 years, but the various treatment centres in Canada have different practice patterns...

..We propose that an individual's absolute fracture risk category should be the basis for deciding on treatment and frequency of BMD monitoring...

..Serological testing with tissue transglutaminase (TTG) and immunoglobulin A endomysial (EMA) antibodies is highly specific for celiac disease, while antigliadin antibody (AGA) testing is less specific...

..We sought to confirm the higher fracture risk of men with prostate cancer on ADT in the Canadian population...

..This report will summarize current concepts regarding gastrointestinal diseases (primarily IBD, coeliac disease and postgastrectomy states) and low bone mass and fracture...

..Consistent risk factors were: age, smoking, low weight, physical/functional limitations, and previous fracture. Data specific to men has clinical and policy implications...