OBJECTIVE: To assess the direct cost during hospitalization for an osteoporotic hip fracture in Brazilian private health care system, by health plan companies’ perspective. METHODS: We conducted a cross-sectional and retrospective study on costs of medical resources in patients above 50 years with an osteoporotic hip fracture, under hospital treatment, between July 2003 and June 2004. The study sample was collected from electronic claims databases of patients enrolled in Brazilian health plans. RESULTS: There were 129,611 patients with osteoporosis diagnosis. […]

Osteoporosis is a common complication following kidney, heart, liver and lung transplantation. Immununosuppressive regimens to prevent graft rejection after transplantation commonly include glucocorticoids, cyclosporin A and tacrolimus which are detrimental to bone and mineral homeostasis and are superimposed on an already compromised skeleton. Additional factors likely to contribute to post-transplantation osteoporosis pathogenesis are vitamin D insufficiency, secondary hyperparathyroidism and hypogonadism. Measures should be taken to optimize bone health prior transplantation: bone mineral density and spinal X-rays should be performed, and […]

During development, thyroid hormone deficiency results in delayed skeletal maturation and epiphyseal dysgenesis, resulting in reduced growth and skeletal abnormalities. Thyroid hormone also has effects on bones of adults. Thyrotoxicosis is frequently associated with increased bone turnover and decreased bone mass. However, the mechanisms that mediate its effects on bone tissue are poorly understood. Thyroid hormone acts indirectly in the skeleton, by increasing the secretion of growth hormone and insulin-like growth factor-1; or directly, by modulating target genes via specific […]

Despite the incessant dedication of the researchers to the study of osteoporosis, a lot still needs to be elucidated. The deficiency of sexual steroids, mainly of estrogen, is considered the main cause of osteoporosis, although a number of other factors are involved. Hyperthyroidism, for instance, is considered a risk factor for induction or aggravation of osteoporosis and has risen the interest in the study of the effects of T3 and T4 on osseous metabolism. Although hypothyroidism and gonadic dysfunction are […]

Parathyroid glands produce the parathyroid hormone (PTH) that acts on bone and kidneys controlling calcium and phosphorus serum concentration. It has long been known that PTH can act as an anabolic hormone if it is given by small and intermittent doses. Recently, there are data showing that PTH (1-34) increases bone mineral density, increases bone mass, improves trabecular connectivity, and reduces the risk of vertebral, non-vertebral and hip fractures in women with postmenopausal or corticoid-induced osteoporosis and in men with […]

In this study a cross-sectional survey was conducted to evaluate the frequency of osteoporosis according to the site used. Six hundred and ten densitometric exams were analyzed regarding the frequency of osteoporosis/osteopenia according to the bone site. Besides the high correlation of bone density among the different sites analyzed, the frequency of osteoporosis has significantly changed with respect to the bone site examined. Osteoporosis was present in 14% and 18% of the patients when neck or total femur were used […]

Chronic hypercortisolism is the most frequent cause of secondary osteoporosis involving mainly trabecular bone. Approximately 30-35% of the patients with Cushing’s syndrome present with compression fractures of vertebrae, and the risk of femoral neck fracture is increased in 50% in that population. Several mechanisms have been proposed to explain the association between hypercortisolism and osteoporosis, as the direct action of glucocorticoids in parathyroid glands and bone cells, alterations in the production of prostaglandins, citokines, interleukines, growth hormone (GH), insulin like […]

The evolution of the idea of the potential use of parathyroid hormone in the treatment of osteoporosis was a long one. It was also an example of how the concepts in medicine can take a long time to change, and the change is mainly dependant on the availability of adequate diagnostics resources. The acceptance that an hormone, that when present in excess leads to bone disease, can be a therapeutic agent that brings an increase in bone mass, is difficult. […]

Parathyroid hormone (PTH) will be available in a few months for the treatment of osteoporosis. When used as a single daily subcutaneous injection for at least 1 year, it increases bone mass and reduces fracture rate more efficiently than the usual anti-resorptive therapy. Recently published articles show that PTH can act through different intracellular signaling pathways, depending on its concentration, time of exposure and molecular fragments. High concentration and prolonged exposure to amino-terminal PTH fragments stimulate bone resorption. On the […]

Total or partial X chromosome loss, hypergonadotrophic hypogonadism and short stature characterize Turner syndrome (TS). Delayed puberty and hypoestrogenism are the determinant factors of osteoporosis in TS, and the compromise of intrinsic bone defect is yet obscure. The aim of this study was to evaluate the association between bone mineral density (BMD) and chronological and bone age, weight, height, karyotype, associated diseases, bone age and estrogen therapy in TS patients. We performed a transversal study with areal BMD of L2-L4 […]

In physiological circumstances, bone resorption and formation are coupled processes. When, however, one predominates over the other the result is a gain or a loss of bone mass. To study this dynamic process, biochemical bone markers have been developed. Osteocalcin and bone alkaline phosphatase better represent bone formation, while pyridinoline, deoxypyridinoline and collagen type I cross-linking (amino and carboxi-terminal) telopeptides, the bone resorption. In the follow up of osteoporosis treatment, the bone resorption markers are more specific and sensitive than […]