Bones, fractures

Fluorides ia small (1 ppm ia water, 0.1% ia dentifrices) quantities have been shown to provide dramatic reduction ia dental decay. Fluorides also show promise for bone treatment and ia pharmaceuticals (qv) (see also Chemotherapeutics, anticancer Steroids). However, larger quantities of fluorides can lead to dental fluorosis, bone fracture, and even death. The oral LD q for free fluoride ion ia rats appears to be 50 to 100 mg/kg body weight based on LD q values for several fluorides. 

Bone Fractures. A dislocation occurs when sudden pressure or force pulls a bone out of its socket at the joint. This is also known as subluxation. Bone fractures are classified into two categories simple fractures and compound, complex, or open fractures. In the latter the skin is pierced and the flesh and bone are exposed to infection. A bone fracture begins to heal nearly as soon as it occurs. Therefore, it is important for a bone fracture to be set accurately as soon as possible. 

In the beginning of the twentieth century, surgical techniques were developed for the fixation of bone fractures with a plate and screw combination. Sherman-type bone plates were fabricated from the best available alloy at the time, vanadium steel. By the 1920s the use of vanadium steel became questionable because of poor tissue compatibility. At that time however, no other alloy was available with high strength and good corrosion resistant properties. 

Application of vitamin K-antagonistic anticoagulants like warfarin gave no clearcut results concerning bone density or a changed risk for bone fractures. 

An elevated activity of serum acid 3-glycerophosphatase was not specific for carcinoma, as Marshall and Amdor found it in 8% of patients with uncomplicated prostatic hyperplasia, in some patients with bone fractures, carcinoma involving the liver, and other diseases of bone and liver. This activity has also been reported to be elevated in 3 of 12 patients with Gaucher s disease. 

Osteoporosis is a common and often silent disorder associated with significant morbidity and mortality and reduced quality of life. It is associated with increased risk and rates of bone fracture and is responsible for over 1.5 million fractures in the United States annually, resulting in direct health care costs of over 17 billion.1 As the population ages, these numbers are expected to increase. It is estimated that postmenopausal Caucasian women have a 50% lifetime chance of developing an osteoporosis-related fracture.1 Common sites of fracture include the spine, hip, and wrist, although almost all sites can be affected. Only a fraction of patients with osteoporosis receive optimal treatment. 

Anastrozole is a selective nonsteroidal aromatase inhibitor that lowers estrogen levels. The pharmacokinetics of anastrozole demonstrate good absorption, with hepatic metabolism the primary route of elimination and only 10% excreted unchanged by the kidney. The elimination half-life is approximately 50 hours. Anastrozole is used for the adjuvant treatment of postmenopausal women with hormone-positive breast cancer and in breast cancer patients who have had disease progression following tamoxifen. Side effects include hot flashes, arthralgias, osteoporosis/bone fractures, and thrombophlebitis. 

Exemestane is an irreversible aromatase inactivator that binds to the aromatase enzyme to block the production of estrogen from androgens. Exemestane is absorbed rapidly after oral administration, with a terminal half-life of 24 hours. The drug is eliminated primarily by the liver and feces, with less than 1% of the dose excreted unchanged in the urine. Exemestane is indicated for the treatment of advanced breast cancer in postmenopausal women who have had disease progression following tamoxifen therapy. Side effects include hot flashes, fatigue, osteoporosis/bone fractures, and flulike symptoms. 

Letrozole is another selective aromatase that inhibits the conversion of androgens to estrogen. Maximum plasma concentrations occur 1 hour after oral dosing concomitant food has not been shown to have an effect on the extent of absorption of letrazole. The terminal half-life is approximately 2 days. Letrozole is used in the treatment of postmenopausal women with hormone-receptor-positive or unknown advanced breast cancer. Side effects include bone pain, hot flushes, back pain, nausea, arthralgia, osteoporosis/bone fractures, and dyspnea. 

One of the factors that determine the effectiveness of a placebo is the nature of the condition being treated. Conditions that have a strong psychological component - such as pain, anxiety and depression - are particularly prone to placebo influence, whereas conditions like bone fractures, diabetes and infertility are less likely to be affected by placebo treatment. But this does not mean that placebo effects are all in the mind . Placebos affect physiology as well as psychology. 

In individuals who took thyroid hormones, 80% of the weight lost was lean body mass (muscle and bone) rather than excess fat. People taking these extracts experienced muscle weakness and bone breakdown, which led to a condition called osteoporosis, in which bones are weakened and the risk of bone fractures or breaks is increased. Thyroid hormone extracts also made the heart work harder by increasing metabolism, which led to problems such as increased heart rate, palpitations, and irregular heartbeat. These problems were potentially life threatening When the heart beats abnormally (or not at all), it is unable to pump blood and oxygen to the brain and body. Individuals die suddenly from this condition because the brain can only function for a few minutes without oxygen and nutrients. 

Bondline readout, 7 122 Bond number (Bo), 15 687t Bond orientational order, of liquid crystalline materials, 15 85 Bonds, fullerene, 12 233-234 Bond strength, in thermal bonding, 17 510 Bone, 7 273t. See also Bones citric acid in, 6 632t Bone fractures, 3 725 treatment, 3 725... 

It appears from these studies that the postprandial responses of postmenopausal women may differ from those of younger men. In studies in which calciuria has been demonstrated, the detrimental effect of such a condition on bone has been implied. Osteoporosis is defined as a diminution of skeletal mass in which the bone is normally mineralized but the amount of bone tissue is lower than normal. Unfortunately, it is seldom diagnosed unless bone fracture occurs 30% of skeletal mass may have been lost by this time (23). Osteoporosis occurs more frequently in females then males and has been estimated as the cause of 90% of all fractures in people over the age of 60 yr (28). Therefore, differences in the postprandial responses of postmenopausal women, a population at high risk for osteoporosis, and men may help to identify contributing factors to the etiology of bone loss. 

It has long been known that certain individuals are exceedingly susceptible to bone fractures. In some cases fractures may occur during fetal life, in other cases the difficulty may show up during infancy, and in still others it appears in later life. The severest cases die very early, but those with less severe conditions may live to suffer from scores of broken bones during childhood. This condition is... 

Gaucher Glucocerebrosidase Glucocerebroside Type 1 Adult Hepatosplenomegaly Erosion of bones, fractures Pancytopenia or thrombocytopenia Characteristic macrophages (crumpled paper inclusions)... 

In assessing a patient with osteogenesis imperfecta, a history of bone fractures, as well as blue sclerae, are noted. These findings are an example of... 

As we age, the activity of osteoclasts tends to outrun that of osteoblasts, leading to gradual loss of bone and increasing susceptibility to bone fracture. In the elderly, a hip fracture has about the same mortality rate as a heart attack. Crush fractures of vertebrae lead to an abnormal curvature of the spine and an inability to stand up straight. So, exercise and get enough calcium and vitamin D in your diet. 

When diet and exercise have not been adequate to maintain good bone mineral density, the bisphosphonates are frequently prescribed. These molecules are actually incorporated into bone where they inhibit the action of osteoclasts. The biochemical consequence is an improvement in bone mineral density over time and the clinical consequence is a lessened frequency of bone fractures. 

Chronic exposure to high levels of cadmium in food has caused bone disorders including osteoporosis and osteomalacia. Long-term ingestion of water, beans, and rice contaminated with cadmium by a Japanese population was associated with a crippling condition, Itai-Itai disease. The affliction is characterized by pain in the back and joints, osteomalacia, bone fractures, and occasional renal failure, and it most often affected women with multiple risk factors such as multiparity and poor nutrition. ... 

Carbon fiber composites are replacing screws for bone fracture repair and joint replacements. These fiber composites are equally strong and chemically inert. By comparison, the metals they replace are often alloys, which may contain metals that the patient may be allergic to. 

Monitoring Closely monitor patients coinfected with HBV and HIV who discontinue tenofovir with both clinical and laboratory follow-up for at least several months. Monitor patients at risk for, or with a history of, renal dysfunction and patients receiving concomitant nephrotoxic agents for changes in serum creatinine and phosphorus. Consider bone monitoring for HIV infected patients who have a history of pathologic bone fracture or are at substantial risk for osteopenia. 

Spontaneous reports of osteoporosis, osteopenia, bone fractures, and delayed healing of bone fractures have been seen in the isotretinoin population. While causality to isotretinoin has not been established, an effect cannot be ruled out. Physicians should use caution when prescribing isotretinoin to patients with a genetic predisposition for age-related osteoporosis, a history of childhood osteoporosis conditions, osteomalacia, or other disorders of bone metabolism. This would include patients diagnosed with anorexia nervosa and those who are on chronic drug therapy that causes drug-induced osteoporosis/osteomalacia and/or affects vitamin D metabolism, such as systemic corticosteroids and any anticonvulsants. 

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