This document discusses prevention of osteoporosis in early menopause. It begins with definitions of early menopause including bilateral oophorectomy and premature ovarian failure. It then discusses the effects of estrogen deficiency on bone loss and how early menopause can negatively impact bone mineral density. The document notes that early menopause is associated with increased risk of fractures compared to natural menopause. Finally, it discusses approaches for preventing osteoporosis in women experiencing early menopause.
This document describes a new technique called repeated Muscle Vibration (rMV) that uses low-amplitude mechanical vibration applied to individual muscles to induce potentiation of the neuromotor networks that control joint stability. Studies show rMV improves strength, power, stability and fatigue resistance in healthy, injured and elderly populations. It allows direct intervention on neuromotor control networks for the first time, opening new possibilities for prevention and rehabilitation.
Oklahoma CyberKnife treats several different types of malignant and benign tumors in the brain, spine, lung, liver, pancreas, prostate, kidney and eye. Lung tumors, brain tumors and prostate cancer are some of the center’s most frequently treated diseases. Oklahoma CyberKnife also has specialized expertise in the treatment of trigeminal neuralgia, a neuropathic disorder that causes intense pain in the face, forehead and jaw.
Back pain is common in adolescents, with incidence higher in girls than boys. Associations exist with heavy school bags, lack of lockers, and family history. Red flags include younger age, persistent or worsening pain, fever, and neurological symptoms. MRI is most valuable for imaging. Rehabilitation and back education are the mainstay of treatment.
Osteoporosis is a global health problem characterized by low bone mass and deterioration of bone tissue, leading to increased bone fragility and fracture risk. It affects over 150 million people worldwide, including over 10 million in the US and an estimated 61 million in India. The number of those affected is expected to rise significantly with aging populations. Key risk factors for osteoporosis include increasing age, menopause, low body weight, smoking, and lack of exercise. Diagnosis involves tests such as dual-energy x-ray absorptiometry to measure bone mineral density.
The document discusses osteoporosis, including its definition, epidemiology, classification, etiology, risk factors, pathology, clinical manifestations, diagnosis, prevention, and treatment. Specifically, it defines osteoporosis as a condition characterized by fragile bones with low bone density and increased risk of fractures. It also notes that over 200 million people worldwide suffer from the disease, with aging populations experiencing a major increase in postmenopausal osteoporosis. Prevention focuses on lifestyle modifications like adequate nutrition, exercise, and fall prevention.
Breastfeeding provides numerous health benefits to both mother and baby. It provides a balanced source of nutrition tailored to the infant's needs through various components in breastmilk including proteins, fats, carbohydrates, vitamins, minerals and antibodies. The composition of breastmilk changes over time from colostrum in the first few days to mature milk which is produced from 10 days after delivery. Breastfeeding is advantageous as it provides protection against infections, anemia, allergies and other conditions in infants. Proper positioning and attachment during breastfeeding is important to maximize its benefits.
Metastatic bone disease: An old dogma and a new insightMohamed Abdulla
Metastatic bone disease is a challenging condition that places a heavy burden on patients. New insights into the cellular and molecular mechanisms have led to improved treatments. Cancer cells interact with the bone microenvironment through factors like RANKL, RANK, and osteoprotegerin, inducing a "vicious cycle" of bone destruction. Emerging therapies target these interactions by inhibiting RANKL with drugs like denosumab. Radiopharmaceuticals like radium-223 also show promise by targeting areas of new bone growth in metastases. While radiation remains important for pain relief, combination therapies offer the potential for improved outcomes in metastatic bone disease.
This document describes a new technique called repeated Muscle Vibration (rMV) that uses low-amplitude mechanical vibration applied to individual muscles to induce potentiation of the neuromotor networks that control joint stability. Studies show rMV improves strength, power, stability and fatigue resistance in healthy, injured and elderly populations. It allows direct intervention on neuromotor control networks for the first time, opening new possibilities for prevention and rehabilitation.
Oklahoma CyberKnife treats several different types of malignant and benign tumors in the brain, spine, lung, liver, pancreas, prostate, kidney and eye. Lung tumors, brain tumors and prostate cancer are some of the center’s most frequently treated diseases. Oklahoma CyberKnife also has specialized expertise in the treatment of trigeminal neuralgia, a neuropathic disorder that causes intense pain in the face, forehead and jaw.
Back pain is common in adolescents, with incidence higher in girls than boys. Associations exist with heavy school bags, lack of lockers, and family history. Red flags include younger age, persistent or worsening pain, fever, and neurological symptoms. MRI is most valuable for imaging. Rehabilitation and back education are the mainstay of treatment.
Osteoporosis is a global health problem characterized by low bone mass and deterioration of bone tissue, leading to increased bone fragility and fracture risk. It affects over 150 million people worldwide, including over 10 million in the US and an estimated 61 million in India. The number of those affected is expected to rise significantly with aging populations. Key risk factors for osteoporosis include increasing age, menopause, low body weight, smoking, and lack of exercise. Diagnosis involves tests such as dual-energy x-ray absorptiometry to measure bone mineral density.
The document discusses osteoporosis, including its definition, epidemiology, classification, etiology, risk factors, pathology, clinical manifestations, diagnosis, prevention, and treatment. Specifically, it defines osteoporosis as a condition characterized by fragile bones with low bone density and increased risk of fractures. It also notes that over 200 million people worldwide suffer from the disease, with aging populations experiencing a major increase in postmenopausal osteoporosis. Prevention focuses on lifestyle modifications like adequate nutrition, exercise, and fall prevention.
Breastfeeding provides numerous health benefits to both mother and baby. It provides a balanced source of nutrition tailored to the infant's needs through various components in breastmilk including proteins, fats, carbohydrates, vitamins, minerals and antibodies. The composition of breastmilk changes over time from colostrum in the first few days to mature milk which is produced from 10 days after delivery. Breastfeeding is advantageous as it provides protection against infections, anemia, allergies and other conditions in infants. Proper positioning and attachment during breastfeeding is important to maximize its benefits.
Metastatic bone disease: An old dogma and a new insightMohamed Abdulla
Metastatic bone disease is a challenging condition that places a heavy burden on patients. New insights into the cellular and molecular mechanisms have led to improved treatments. Cancer cells interact with the bone microenvironment through factors like RANKL, RANK, and osteoprotegerin, inducing a "vicious cycle" of bone destruction. Emerging therapies target these interactions by inhibiting RANKL with drugs like denosumab. Radiopharmaceuticals like radium-223 also show promise by targeting areas of new bone growth in metastases. While radiation remains important for pain relief, combination therapies offer the potential for improved outcomes in metastatic bone disease.
Prof. Muhammad Aslam from the Department of ObGyn at LGH Lahore discusses osteoporosis and its prevention through nutrition. Osteoporosis causes millions of fractures annually worldwide and leads to disability and death for many elderly. Key nutrients like calcium, vitamin D, and vitamin K play important roles in bone health and fracture prevention. Maintaining sufficient intake of these nutrients through diet and supplements can help attain peak bone mass and protect against osteoporosis and fractures later in life.
This document provides information on breastfeeding basics including breast anatomy, milk production, positioning and latching, common issues, and benefits. It describes the lobes, ducts, areola, and hormones involved in lactation. Milk composition changes from colostrum to mature milk. Optimal positioning supports the baby's mouth on the breast and lower jaw. Common issues like engorgement, plugged ducts, and mastitis are explained with treatment plans. The document emphasizes the nutritional, developmental and health benefits of breastfeeding for both mother and baby.
This document discusses the benefits of breastfeeding for babies, mothers, and families. It outlines the scientific evidence that exclusive breastfeeding for the first six months can reduce infant mortality by 13-15%. The document then describes advantages of breastfeeding such as reduced infections for babies and decreased cancer risk for mothers. It provides guidance on proper breastfeeding techniques and addressing common issues like engorgement, sore nipples, and lactation.
breast feeding problems can be easily tackled by obstetricians provided they make conscious efforts to look into the problem,they can create awareness among the paramedical people who are under their direct control
Osteoporosis poses a significant disease burden, with over 2 million fractures occurring annually in the United States due to low bone density or previous fractures. Bisphosphonates are the mainstay treatment for osteoporosis, approved in the 1990s, but there is ongoing research into their potential links to rare adverse events like osteonecrosis of the jaw or atypical femoral fractures. While more data is still needed, the overall benefits of bisphosphonates in reducing fracture risk are considered to outweigh the potential risks for most osteoporosis patients. Treatment duration should be individualized based on fracture history and risk level.
Osteoporosis is a disease where bones become brittle and weak, increasing the risk of fractures. It occurs when the body loses more bone than it forms, reducing bone density. Common symptoms include back pain, loss of height, and fractures of the spine, wrists and hips. Risk factors include age, gender, family history, smoking, excessive alcohol, low calcium intake, and medical conditions or medications that reduce bone density. Diagnosis involves tests like DXA scans to measure bone mineral density. Treatment focuses on lifestyle changes, medications, and fall prevention to reduce fractures and complications.
La osteoporosis es una enfermedad ósea caracterizada por la disminución de la masa ósea y deterioro de la microarquitectura del tejido óseo, lo que aumenta la fragilidad del hueso y el riesgo de fracturas. Se diagnostica mediante densitometría ósea que mide valores por debajo de -2.5 DE. Los principales tratamientos incluyen suplementos de calcio y vitamina D, ejercicio, terapia hormonal en mujeres y fármacos antirresortivos como bifosfonatos.
Osteoporosis is a disease where bones become brittle and weak, increasing the risk of fractures. It is caused by low bone density due to lack of calcium and other minerals in bones. Symptoms include back pain and loss of height. Risk factors include age, gender, family history, and medications like corticosteroids. It is diagnosed through tests like DXA scans and treated through lifestyle changes, medications, and hormone therapy.
The document discusses osteoporosis management and improving patient outcomes. It outlines learning objectives around signs and symptoms of osteoporosis, risk factors by race, and guideline-recommended prevention and treatment strategies. It also emphasizes the importance of improving patient adherence to pharmacotherapies and other osteoporosis management methods. Key challenges discussed include clinicians not equating all fractures with osteoporosis and difficulties identifying at-risk patients above the osteoporosis diagnostic threshold.
Via Christi Women's Connection April presentation on osteoporosis prevention and treatment by Dr. Rami Mortada, University of Kansas School of Medicine-Wichita.
This document discusses updates in the diagnosis and treatment of osteoporosis. It defines osteoporosis as a disease characterized by low bone mass and deterioration of bone structure. Osteoporosis increases the risk of fractures, with vertebral fractures being the most common. It can lead to pain, disability, and increased mortality. An estimated 8 million women and 2.5 million men in the US have osteoporosis, and these numbers are expected to increase by 40% by 2020. Osteoporosis poses a significant economic burden and reduces quality of life. Advances have been made in assessing fracture risk levels based on 10-year probability in addition to bone mineral density scores. Treatment involves lifestyle changes and medications
Osteoporosis is a silent epidemic that causes bones to become weak and brittle, increasing the risk of fractures. It is caused by a combination of genetic and lifestyle factors that lead to a loss of bone mass as people age. While osteoporosis has no symptoms, it can be diagnosed through bone mineral density tests and is a major public health problem due to its link to fractures, especially of the hip, back, and wrist, which can reduce mobility and quality of life. Prevention focuses on adequate calcium, vitamin D, exercise and avoiding risk factors like smoking to build strong bones early in life and maintain bone mass with age.
This document provides information on osteoporosis, including its definition, classification, epidemiology, clinical features, investigations used for diagnosis, and management. Osteoporosis is defined as a reduction in bone density leading to an increased risk of fractures. It is classified based on whether it is primary/secondary and type. Diagnosis involves tests like DEXA scans, biomarkers, and imaging. Management includes lifestyle modifications, calcium/vitamin D supplementation, and medications like bisphosphonates, teriparatide, and denosumab that reduce resorption or stimulate bone formation.
Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
This document discusses the diagnosis and assessment of osteoporosis. It defines osteoporosis as a systemic skeletal disease characterized by low bone mass and deterioration of bone tissue, leading to bone fragility and susceptibility to fractures. It describes who is at risk and the different types of osteoporosis. Physical exams and various imaging techniques can be used to diagnose osteoporosis such as dual-energy x-ray absorptiometry (DXA) scans, quantitative ultrasound, CT scans, and plain radiography. Factors like BMD T-scores, clinical risk factors, and markers of bone turnover help assess fracture risk in patients.
Musculoskeletal tumors can originate from a multistep accumulation of mutations leading to unregulated cell proliferation. Osteosarcoma is the most common type of bone tumor, arising from osteoblasts. It is diagnosed through radiography, cytology, and histopathology. Grading is based on features like pleomorphism and mitoses. Treatment involves surgery with chemotherapy. Variants include osteoblastic, chondroblastic, telangiectatic and fibroblastic subtypes. Multilobular tumor of bone is a slow growing but potentially malignant tumor appearing as islands of bone or cartilage surrounded by spindle cells. Chondrosarcoma arises from cartilage and osteochondroma involves cartilage capped bone protrusions.
Integrating TBS Into Your Clinical Practice.pdfssuser4eaa71
Today’s current technology for diagnosing osteoporosis only measures bone density, which is only half of the World Health Organization's definition of osteoporosis. The full definition includes bone mineral density (BMD) and microarchitecture - trabecular bone score (TBS).
Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. It increases bone fragility and risk of fracture. While not a natural part of aging, risk is higher for post-menopausal women over 65 and all races and sexes can be affected. Bone density testing is recommended for women over 65, men over 70, and younger adults with clinical risk factors to diagnose osteoporosis. Dual energy x-ray absorptiometry (DEXA) is the gold standard test which measures bone mineral density at the hip and spine.
- Mastocytosis is a heterogeneous group of disorders involving infiltration of mast cells in tissues. The prevalence of indolent systemic mastocytosis is estimated to be at least 13.0 cases per 100,000 people aged 15 and older.
- A study of 221 patients with indolent systemic mastocytosis found that 41% reported lifetime fragility fractures, with many fractures occurring before mastocytosis diagnosis. Fracture risk assessment tools had poor accuracy in predicting fracture risk in these patients.
- A multivariate analysis identified male gender, elevated bone resorption, low hip bone mineral density, absence of urticaria pigmentosa rash, and alcohol use as independent risk factors associated with fragility fractures after mastocytosis diagnosis.
The document discusses osteoporosis and questions whether it should be considered a disease. It summarizes the WHO conference that defined osteoporosis and established T-scores. It raises concerns about the definition and how DEXA scans are used to diagnose based on measurements that may not be accurate or applicable to all groups. Risk factors are highlighted and questions are raised about whether they apply to all populations equally.
Prof. Muhammad Aslam from the Department of ObGyn at LGH Lahore discusses osteoporosis and its prevention through nutrition. Osteoporosis causes millions of fractures annually worldwide and leads to disability and death for many elderly. Key nutrients like calcium, vitamin D, and vitamin K play important roles in bone health and fracture prevention. Maintaining sufficient intake of these nutrients through diet and supplements can help attain peak bone mass and protect against osteoporosis and fractures later in life.
This document provides information on breastfeeding basics including breast anatomy, milk production, positioning and latching, common issues, and benefits. It describes the lobes, ducts, areola, and hormones involved in lactation. Milk composition changes from colostrum to mature milk. Optimal positioning supports the baby's mouth on the breast and lower jaw. Common issues like engorgement, plugged ducts, and mastitis are explained with treatment plans. The document emphasizes the nutritional, developmental and health benefits of breastfeeding for both mother and baby.
This document discusses the benefits of breastfeeding for babies, mothers, and families. It outlines the scientific evidence that exclusive breastfeeding for the first six months can reduce infant mortality by 13-15%. The document then describes advantages of breastfeeding such as reduced infections for babies and decreased cancer risk for mothers. It provides guidance on proper breastfeeding techniques and addressing common issues like engorgement, sore nipples, and lactation.
breast feeding problems can be easily tackled by obstetricians provided they make conscious efforts to look into the problem,they can create awareness among the paramedical people who are under their direct control
Osteoporosis poses a significant disease burden, with over 2 million fractures occurring annually in the United States due to low bone density or previous fractures. Bisphosphonates are the mainstay treatment for osteoporosis, approved in the 1990s, but there is ongoing research into their potential links to rare adverse events like osteonecrosis of the jaw or atypical femoral fractures. While more data is still needed, the overall benefits of bisphosphonates in reducing fracture risk are considered to outweigh the potential risks for most osteoporosis patients. Treatment duration should be individualized based on fracture history and risk level.
Osteoporosis is a disease where bones become brittle and weak, increasing the risk of fractures. It occurs when the body loses more bone than it forms, reducing bone density. Common symptoms include back pain, loss of height, and fractures of the spine, wrists and hips. Risk factors include age, gender, family history, smoking, excessive alcohol, low calcium intake, and medical conditions or medications that reduce bone density. Diagnosis involves tests like DXA scans to measure bone mineral density. Treatment focuses on lifestyle changes, medications, and fall prevention to reduce fractures and complications.
La osteoporosis es una enfermedad ósea caracterizada por la disminución de la masa ósea y deterioro de la microarquitectura del tejido óseo, lo que aumenta la fragilidad del hueso y el riesgo de fracturas. Se diagnostica mediante densitometría ósea que mide valores por debajo de -2.5 DE. Los principales tratamientos incluyen suplementos de calcio y vitamina D, ejercicio, terapia hormonal en mujeres y fármacos antirresortivos como bifosfonatos.
Osteoporosis is a disease where bones become brittle and weak, increasing the risk of fractures. It is caused by low bone density due to lack of calcium and other minerals in bones. Symptoms include back pain and loss of height. Risk factors include age, gender, family history, and medications like corticosteroids. It is diagnosed through tests like DXA scans and treated through lifestyle changes, medications, and hormone therapy.
The document discusses osteoporosis management and improving patient outcomes. It outlines learning objectives around signs and symptoms of osteoporosis, risk factors by race, and guideline-recommended prevention and treatment strategies. It also emphasizes the importance of improving patient adherence to pharmacotherapies and other osteoporosis management methods. Key challenges discussed include clinicians not equating all fractures with osteoporosis and difficulties identifying at-risk patients above the osteoporosis diagnostic threshold.
Via Christi Women's Connection April presentation on osteoporosis prevention and treatment by Dr. Rami Mortada, University of Kansas School of Medicine-Wichita.
This document discusses updates in the diagnosis and treatment of osteoporosis. It defines osteoporosis as a disease characterized by low bone mass and deterioration of bone structure. Osteoporosis increases the risk of fractures, with vertebral fractures being the most common. It can lead to pain, disability, and increased mortality. An estimated 8 million women and 2.5 million men in the US have osteoporosis, and these numbers are expected to increase by 40% by 2020. Osteoporosis poses a significant economic burden and reduces quality of life. Advances have been made in assessing fracture risk levels based on 10-year probability in addition to bone mineral density scores. Treatment involves lifestyle changes and medications
Osteoporosis is a silent epidemic that causes bones to become weak and brittle, increasing the risk of fractures. It is caused by a combination of genetic and lifestyle factors that lead to a loss of bone mass as people age. While osteoporosis has no symptoms, it can be diagnosed through bone mineral density tests and is a major public health problem due to its link to fractures, especially of the hip, back, and wrist, which can reduce mobility and quality of life. Prevention focuses on adequate calcium, vitamin D, exercise and avoiding risk factors like smoking to build strong bones early in life and maintain bone mass with age.
This document provides information on osteoporosis, including its definition, classification, epidemiology, clinical features, investigations used for diagnosis, and management. Osteoporosis is defined as a reduction in bone density leading to an increased risk of fractures. It is classified based on whether it is primary/secondary and type. Diagnosis involves tests like DEXA scans, biomarkers, and imaging. Management includes lifestyle modifications, calcium/vitamin D supplementation, and medications like bisphosphonates, teriparatide, and denosumab that reduce resorption or stimulate bone formation.
Slideshow is from the University of Michigan Medical School's M2 Musculoskeletal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Muscu
This document discusses the diagnosis and assessment of osteoporosis. It defines osteoporosis as a systemic skeletal disease characterized by low bone mass and deterioration of bone tissue, leading to bone fragility and susceptibility to fractures. It describes who is at risk and the different types of osteoporosis. Physical exams and various imaging techniques can be used to diagnose osteoporosis such as dual-energy x-ray absorptiometry (DXA) scans, quantitative ultrasound, CT scans, and plain radiography. Factors like BMD T-scores, clinical risk factors, and markers of bone turnover help assess fracture risk in patients.
Musculoskeletal tumors can originate from a multistep accumulation of mutations leading to unregulated cell proliferation. Osteosarcoma is the most common type of bone tumor, arising from osteoblasts. It is diagnosed through radiography, cytology, and histopathology. Grading is based on features like pleomorphism and mitoses. Treatment involves surgery with chemotherapy. Variants include osteoblastic, chondroblastic, telangiectatic and fibroblastic subtypes. Multilobular tumor of bone is a slow growing but potentially malignant tumor appearing as islands of bone or cartilage surrounded by spindle cells. Chondrosarcoma arises from cartilage and osteochondroma involves cartilage capped bone protrusions.
Integrating TBS Into Your Clinical Practice.pdfssuser4eaa71
Today’s current technology for diagnosing osteoporosis only measures bone density, which is only half of the World Health Organization's definition of osteoporosis. The full definition includes bone mineral density (BMD) and microarchitecture - trabecular bone score (TBS).
Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. It increases bone fragility and risk of fracture. While not a natural part of aging, risk is higher for post-menopausal women over 65 and all races and sexes can be affected. Bone density testing is recommended for women over 65, men over 70, and younger adults with clinical risk factors to diagnose osteoporosis. Dual energy x-ray absorptiometry (DEXA) is the gold standard test which measures bone mineral density at the hip and spine.
- Mastocytosis is a heterogeneous group of disorders involving infiltration of mast cells in tissues. The prevalence of indolent systemic mastocytosis is estimated to be at least 13.0 cases per 100,000 people aged 15 and older.
- A study of 221 patients with indolent systemic mastocytosis found that 41% reported lifetime fragility fractures, with many fractures occurring before mastocytosis diagnosis. Fracture risk assessment tools had poor accuracy in predicting fracture risk in these patients.
- A multivariate analysis identified male gender, elevated bone resorption, low hip bone mineral density, absence of urticaria pigmentosa rash, and alcohol use as independent risk factors associated with fragility fractures after mastocytosis diagnosis.
The document discusses osteoporosis and questions whether it should be considered a disease. It summarizes the WHO conference that defined osteoporosis and established T-scores. It raises concerns about the definition and how DEXA scans are used to diagnose based on measurements that may not be accurate or applicable to all groups. Risk factors are highlighted and questions are raised about whether they apply to all populations equally.
Este documento presenta el programa de actividades del Instituto de Formación Cofares para el primer semestre de 2010. Incluye un programa de dirección de oficinas de farmacia impartido por el IESE, talleres sobre indicación farmacéutica, sesiones sobre los efectos de la radiación solar, y un simposio sobre técnicas de comunicación. También presenta un programa sobre embarazo y primeros años de vida, y las XIII Jornadas Profesionales sobre medicamentos para el autocuidado. Las actividades se llevarán a cabo en varias ciudades
El documento proporciona información sobre la vacuna contra el virus del papiloma humano (VPH). Explica que existen vacunas tetravalentes y bivalentes que previenen diferentes cepas de VPH y cáncer de cuello uterino. Recomienda vacunar a mujeres hasta los 26 años e integrarla en el calendario de vacunación obligatorio entre los 11 y 14 años. Detalla que la vacunación consta de 3 dosis en un período máximo de un año y previene en un 70% el cáncer de cuello uterino. Finalmente, enfat
El documento proporciona información sobre la vacuna contra el virus del papiloma humano (VPH). Explica que existen vacunas tetravalentes y bivalentes que previenen diferentes cepas de VPH asociadas con cáncer cervical y otras lesiones. Recomienda vacunar a mujeres hasta los 26 años e integrarla en el calendario escolar entre los 11 y 14 años. Detalla que la vacunación consta de 3 dosis en un período máximo de un año y puede prevenir el 70% de los casos de cáncer cervical. Finalmente, enfatiza la importancia de
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tests for analysis of different pharmaceutical.pptx
Prevention of Osteoporosis in early menopause
1. Prevention of osteoporosis in
early menopause
Dr. Santiago Palacios
Antonio Acuña, 9
28009 Madrid
Phone: +34 91 578 05 17
E-mail: ipalacios@institutopalacios.com
3. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
4. EARLY MENOPAUSE
Bilateral oophorectomy
Bilateral oophorectomy Premature ovarian failure
Premature ovarian failure
Acute hypoestrogenism
Acute hypoestrogenism The transition is
The transition is
and hypoandrogenism
and hypoandrogenism similar to natural
similar to natural
menopause
menopause
ET may be higher
ET may be higher
5. BILATERAL OOPHORECTOMY
Ovarian, endometrial or fallopian tube
cancers
Severe endometriosis
Bilateral tubo-ovarian abscess
Familial breast-ovarian cancer syndrome
Severe premenstrual syndrome
6. Surgical Menopause in USA
• Chen WY Manson JE 2006 JNCI
• “Premature Ovarian Failure in Cancer Survivors:
New Insights, Looming Concerns”
• 598 000 hysterectomies 1994-1999 in women below
40 (1/3 with BSO) i.e. 100 000 pa!
• ie. Every year in US 33 000 left menopausal and 66
000 left with increased risk of POF.
7. PREMATURE OVARIAN FAILURE
Is the development of amenorrhea with
Is the development of amenorrhea with
concomitant sex hormone deficiency and
concomitant sex hormone deficiency and
elevated serum gonadotropin levels before
elevated serum gonadotropin levels before
age of 40 years?
age of 40 years?
8. Clinical Definitions
• Abnormal Menses: a history of at least 3
consecutive months of oligomenorrhea or
abnormal uterine bleeding.
• Evidence of Reduced Fecundity: the development
of fewer than 5 follicles (>15 mm) after
appropriate gonadotropin stimulation (300 IU/day)
or no pregnancy after one year of unprotected
intercourse.
• Elevated FSH: above the normal limit (95% CI)
for the early follicular phase (days 2 to 5) as
defined by the assay employed.
9. PREMATURE OVARIAN FAILURE
STUDY OF WOMEN ACROSS THE NATION (SWAN)
CAUCASIAN 1.0%
AFRICAN – AMERICAN 1.4%
LATIN 1.4%
CHINESE 0.5%
JAPANESE 0.1%
~ 70.000 women in Spain who have experienced premature ovarian failure
Coulam CB et al. Obstet Gynecol. 1986 Apr;67(4):604-6
10.
11. Aetiology of POF
50%
45% 42% 43%
40%
35%
% of patients
30%
25%
20%
15% 13%
10%
5% 2%
0%
Idiopathic Cancer Benign Genetic
12. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
13. Influence of Estrogens on the development of
physiologic bone geometry and bone architecture
menopause
peak bone mass
„norma
1,2 - l“
Bone Mass (g/m2)
1,1 -
1,0 -
0,9 - mean
SD
0,8 -
fracture
threshold
menarche
0 I I I I I I I I
0 10 20 30 40 50 60 70 80
Age
14. Influence of Estrogens on Bone Remodeling Sequence
Estrogen Estrogen
Neg Neg
Neg . Neg
.
. .
Neg
.
15. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
16. Influence of age on Spine-BMD
menopause
peak bone mass
„normal“
1,2 -
Bone Mass (g/m2)
1,1 -
1,0 -
0,9 - mean
SD
0,8 -
fracture
threshold
0 I I I I I I I I
0 10 20 30 40 50 60 70 80
Age
17. Age-adjusted RR for Spine and Hip-Fracture
in Relation to endogenous Serum E2-Levels
1,00
Hip-Fracture Spine-Fracture
1.0 1.0
0,75 Independent of BMD
Relative Risk
0,50 0.5 0.5
0.4 0.4
0.3 0.3
0,25
0,00
<5 5-6 7-9 >9
Endogenous Serum Estradiol Level [pg/ml]
Cummings et al. (1998); NEJM Vol 339 No 11, 733-740
18. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
19. Effect of estrogen deficiency on BMD in
premenopausal women
1,2-
Peak bone mass
Lumber Spine BMD (g/m2)
1,1-
1,0-
0,9-
SD Mean
0,8-
Increased bone loss
fracture threshold
0
0 10 20 30 40 50 60 70 80
Age
Hadji et al. Frauenarzt 46, 10: 890-897 (2005)
20. T – SCORES vs Z-SCORES
The Z-score compares bone
mass density with that of
someone of similar age, sex,
weight and ethnic/racial origin.
So a Z-score of -0.5 indicates
a bone density one-half of a
standard deviation less than
the norm.
21. PREMATURE OVARIAN FAILURE
Peak bone mass reaches
its maximum between ages
20 to 29 years
Up to 60% of adult total
bone mineral is acquired
during adolescence
There are no normative tables
for women <25 years
is WHO criteria appropriate
for diagnosis of
osteopaenia/osteoporosis (A) Normal bone
in POF ? (B) Osteoporotic bone
22. Current T scores are invalid diagnostic markers of bone density in young
POF patients
POF patients require their own group specific baseline BMD values
The rising incidence of premature ovarian failure in an increasingly younger
age group warrants re-evaluation of our diagnostic criteria to facilitate
management of reduced bone mass in this vulnerable patient group.
ALTERNATIVES:
Quantitative computed tomography (QCT)
- evaluate bone in 3 dimensions, ‘gold standard’, primarily for research
Quantitative ultrasound
- no radiation exposure, inexpensive, lack adequate normative databases
Magnetic resonance imaging
- radiation-free, evaluate bone geometry AND quality, lack normative databases
23. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
24. EARLY MENOPAUSE AS PREDICTOR OF
FRACTURES
AUTHOR % INCREASED
Gardsel et al. 1991 50
Mallmin et al. 1994 100 (Colles fractures)
Vega et al. 1994 300 (hip fractures)
Tuppurainen et al. 1995 300
Van Der Voort et al. 2003 40
Van Der Klift et al 2004 247 (vertebral fractures)
25. OOPHORECTOMY AS PREDICTOR OF
FRACTURE
(1) Women younger than
Fracture %
age 45 years
Oophorectomy 39
Histerectomy (non oop.) 24
Natural menopause 21
(2) Oophorectomy after Equal than natural
menopause menopause
(1) Johansson C et al. Maturitas 1993;17:39-50
(2) Antoniucci DM et al. J Bone Miner Res 2005;20:741-47
26. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
27. PROPHYLACTIC OOPHORECTOMY
Routine prophylactic oophorectomy concumitantly with hysterectomy
Routine prophylactic oophorectomy concumitantly with hysterectomy
The familiar cancer syndromes
The familiar cancer syndromes >40 years old
>40 years old
After chilbearing
After chilbearing •Prevention of ovarian cancer
•Prevention of ovarian cancer
1.000 cases prevented
1.000 cases prevented
300.000 oophorectomies performed
300.000 oophorectomies performed
•Reoperations for ovarian pathology
•Reoperations for ovarian pathology
4-5 % of women who have had aa
4-5 % of women who have had
previous hysterectomy
previous hysterectomy
Piver MS et al. Cancer. 1993 May 1;71(9):2751-5.
Christ JE, Lotze EC. Obstet Gynecol. 1975 Nov;46(5):551-6.
28. Principles of Hormone Replacement in early
menopause
Estrogen replacement is first line treatment
1)Pre pubertal : To induce development of secondary
sexual characteristics
2)To relieve the immediate sequelae of menopause i.e.
symptom relief and quality of life
3)To prevent the long term sequelae of the menopause
4)To create an environment conducive to the successful
replacement of donated embryos
29. Early menopause
Therapeutic Options
• Route / Type HRT
• Choice of oestrogen route of administration must be made
on individual basis
• No controlled studies regarding the ideal hormone
replacement strategy for women with premature
ovarian failure
In principle, non oral E2 / progesterone preparations
can be better monitored but what is ideal E2 level?
30. HRT preparations in Early
menopause
• Progestogenic opposition if uterus present
– Even after radiotherapy
• Aim for minimum effective oral dose or local
opposition with Mirena / Crinone / Cyclogest
• ?Aim for natural progesterone replacement
31. Timing of HRT Usage
• Management
– Liaise with gynae oncologists / medical oncologists /
haematologists re time to start
– Immediately if curative procedure (after hist diagn)
– Delay (1 year disease free interval) if oestrogen
sensitive tumour e.g. endometrial carcinoma
– Treat at least until average age of menopause
– HRT “holidays” to test ovarian function
32. Hormonal Replacement Therapy
• Hormonal therapy would seem warranted for women – to
eliminate symptoms and prevent bone loss; data from the WHI
do not apply.
• Abundant data indicate that E/P in any form does not prevent
ovulation and pregnancy – for unclear reasons. Thus, barrier
contraception may be warranted.
• Young women without ovarian function may require more
estrogen than older women to alleviate symptoms of estrogen
deficiency.
• There are virtually no data regarding the safety and efficacy of
E/P in women with POF.
33. Premature Ovarian Failure
Therapeutic Options
• Combined oral contraceptive pill
– “Use of ethinylestradiol has been driven by
practicalities rather than science”
» Conway et al (1996)
33 West London
17th Nov 2005 Menopause & PMS
Centre
34. Premature Ovarian Failure
Therapeutic Options
• Combined Pill v HRT
– 0.625mg v 30mcg EE in 17 adult women with Turner’s
Syndrome
– 6 month cross over study :Hormones, Lipids, Bone
Turnover etc
– FSH most suppressed by EE, BUT HRT was superior at
minimising hyperinsulinaemia & bone turnover
Guttman et al Clin Endocrinol 2001 West London Menopause & PMS Centre
35. Questions for Gynecologists, ACOG 2003-5: Would
you give a woman with idiopathic POF hormone
therapy (HT)?
• Yes – 94%
• No – 6%
36. Questions for Gynecologists, ACOG 2003-5: What
form of HT would you administer to women with
POF?
• Combination oral contraceptives 60%
• Continuous combined HT 16%
• Sequential HT 22%
• No therapy 1%
37. Questions for Gynecologists, ACOG 2003-5: How long
should a woman with POF be treated?
• Until the expected age of menopause 67%
• For the remainder of her life 11%
• For 1 to 5 years 11%
• Uncertain 11%
38. Questions for Gynecologists, ACOG 2003-5: Is a
woman with POF at increased risk of side effects from
estrogen?
• Yes 25%
• No 38%
• Uncertain 37%
39. Additional Treatment in POF
• Addition of exogenous androgen?
• Recommendations to prevent osteoporosis are
warranted:
– Calcium 1200-1500 mg/day
– Daily weight bearing exercise
– Daily vitamin D
40. Fertility Options in women at risk of POF
• Surgery
– Ovarian transposition
– Ovarian Tissue Cryopreservation
• Transplantation – e.g. (Donnez 2004, Chaim Sheba Medical
Centre Israel 2005, Oktay 2006)
• IVF
– Own Embryo Cryopreservation
– Own Oocyte Cryopreservation (1st pregnancy 2001)
41. • CONCEPT
• EFFECT OF ESTROGEN DEFICIENCY ON
BONE LOSS
• BONE LOSS AFTER NATURAL
MENOPAUSE
• EFFECT OF EARLY MENOPAUSE ON BMD
• EARLY MENOPAUSE AND FRACTURES
• PREVENTION
• CONCLUSIONS
42. FUTURE RESEARCH IN WOMEN UNDERGOING
PREMATURE MENOPAUSE
1. Is premature menopause a deficiency disease
requiring physiologic replacement?
2. Should be treated with exogenous E with or without
progestin?
3. What form of HT is most appropiate?
4. For how long should HT be administrated?
5. How safe is HT in women with premature versus
natural menopause?
Hendrix SL. Am J Med. 2005 Dec 19;118(12 Suppl 2):131-5.
43. Future Objectives:
• Need to merge data over the long term to look at
quality of life / fertility outcomes / osteoporosis / CV
disease
• POF patients should therefore remain under long term
follow up