תוצאת חיפוש

יאיר ליאל

בעוד רבים רואים באוסטיאופורוזיס מחלה מיגדרית (gender) של נשים, הצטבר מידע רב על האפידמיולוגיה, הפתופיסיולוגיה והטיפול באוסטיאופורוזיס בגברים. המסקנות העולות מהמחקרים מצביעות על בעיה שהיקפה מצוי במגמת עלייה, אם כי לא בהיקף המדווח בנשים. גורמי הסיכון לשברים בגברים דומים במידה רבה לאלה בנשים. למרות הבדלים בפתופיסיולוגיה של אוסטיאופורוזיס בין המינים, גברים מגיבים לטיפולים נגד אוסטיאופורוזיס בדומה לנשים. על רקע המידע הקיים, מומלץ על החלת צעדי מנע (prevention) בסיסיים (תוספי סידן וויטאמין D, פעילות גופנית) ועל קביעת מדיניות לטיפול בתרופות, על מנת לטפל בגברים המצויים בסיכון גבוה לאוסטיאופורוזיס.

Inflammatory Bowel Disease and Osteoporosis: an Evidence-Based Connection

Eyal Meltzer, Eran Dolev,

Department of Internal Medicine E, Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv, Israel

Inflammatory bowel diseases (IBD) often have chronic or remittent course. Control of symptoms and disease activity often requires the administration of glucocorticoids.

Osteoporosis is a frequent finding in patients with IBD. The evidence-based connection between the two conditions relies on a relatively limited number of cross-sectional and longitudinal studies. The cause of this connection has not been defined completely. Probably, both the chronic inflammation and the steroid therapy contribute to the osteopenia, through an increase in bone resorption without a compensatory increase in bone formation. There is little data regarding the efficacy of therapeutic interventions for the prevention of osteoporosis in patients with IBD. Recently, guidelines for the evaluation and treatment of osteoporosis and IBD have been published. There is need for further research on the relation between these conditions and on the efficacy of current therapy for this unique population.

Pelvic Lytic Lesion and Osteoporosis-Related Fractures

Yaron Weisel, Ehud Rath, Nissim Ohana, Dan Atar

Orthopedic Dept., Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

Insufficiency fractures of the pelvis may be overlooked as a cause of hip or groin pain. These fractures occur in the elderly, usually those with pronounced osteopenia of the pelvis. Predisposing factors include corticosteroids, local irradiation and postmenopausal osteoporosis. These fractures are difficult to detect clinically and plain radiographs and other studies may be misleading, delaying diagnosis and treatment. A 65-year-old woman had left groin and hip pain for 2 months with no history of trauma. Plain radiographs showed lytic lesions in the left pubic rami. Bone scan revealed increased uptake in that region, suggesting metastatic bone disease. Computed tomography and magnetic resonance imaging demonstrated fractures in the left superior and inferior pubic rami, with callus formation with no involvement of soft tissues. Quantitative computed tomography indicated low calcium concentration, below fracture threshold. The diagnosis of insufficiency fractures of the pelvis was confirmed by the favorable clinical and radiographic outcome. It is therefore important to be familiar with the appearance and location of these fractures.

Biological Test for Menopausal Osteoporosis

Benjamin Klein, Nathan Rojansky

Depts. of Experimental Surgery and of Obstetrics and Gynecology, Hadassah- Hebrew University Medical Center, Ein Kerem, Jerusalem

Osteoporosis has become a major public health problem in many western countries in which about 25% of women by the age of 65 will have had osteopenic fractures. The most important contributing factor to this condition is loss of gonadal function. This progressive disease, characterized by reduction in bone mass, may be prevented by estrogen replacement therapy. While there are several methods of diagnosing the disease when already established, there is no method that can identify women at high risk of developing osteoporosis. We have developed a biological test in which the serum of postmenopausal women is added to rat osteoprogenitor cell culture and its influence on proliferation, differentiation and mineralization of bone cells is determined. The serum of 20 menopausal women was examined by the biological test and the results compared to the findings of dual photon absorptiometry. This showed that rapid bone-losers had a significantly lower mineralization index as compared to nonosteopenic women (p<0.0001). The proliferation index (cell count) and alkaline phosphatase activity did not show significant differences between osteopenic and nonosteopenic groups. This preliminary study showed that a test based on serum reacting with a culture of bone cells to induce mineralization may be of value in the diagnosis of osteoporosis.