The prevention and treatment of osteoporosis
Article Abstract:
Low bone mass is the most important preventable cause of fractures. These fractures affect 1.5 million Americans yearly with an annual cost to the United States health care system of at least $10 billion. This decrease in bone mass, osteoporosis, is concentrated in the spinal column and at the ends of the long bones, particularly in women. During their lifetimes, women lose about 50% of reticular bone while men lose only 30%. Women lose 30% of cortical bone, and men, 20%. Drugs can either prevent bone mass decrease, as estrogen replacement and calcium supplements after menopause or increase bone formation, as sodium fluoride or parathyroid hormone. Postmenopausal women can prevent osteoporosis by weight bearing exercise to increase lumbar spine density plus estrogen therapy for women under age 75. High dosages of calcium supplements for both men and postmenopausal women are also recommended.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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The threat to medical records research
Article Abstract:
The institutional review board may provide the answer to the increasing conflict between the desire for greater confidentiality surrounding medical records and the risk to important observational studies based on such documents. Legislation has been passed in Minnesota that severely restricts access to health records for research purposes. It can be shown that requiring consent before using medical records in research could result in erroneous results, and severely hamper medical progress. By using a review board to waive these restrictions after determining a valid need and insuring patient welfare, both goals could be achieved simultaneously.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
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Vitamin D-receptor genotypes and bone density
Article Abstract:
Research on large groups of twins may be necessary to determine whether gene variations in the receptor for vitamin D can affect bone density. Vitamin D is involved in calcium and bone metabolism. A 1997 study of Mexican-American children found that children with a specific gene variation had a 2% to 3% higher bone density in the thighbone and an 8% to 10% higher density in the spine. However, of 50 other studies on this topic, only half have confirmed this link. Even those that confirmed the link found the differences in bone density to be small. There are probably many factors that affect bone density.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
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