The document discusses cost-effective treatment of osteoporosis using the US adapted WHO Fracture Risk Algorithm (FRAX). It describes how FRAX calculates absolute fracture risk based on clinical risk factors with or without bone mineral density (BMD) measurements. The National Osteoporosis Foundation guidelines recommend treatment based on cost-effective thresholds of fracture probability calculated by FRAX.
Elizabeth Curtis's presentation from Osteoporosis 2016: Variation in UK fracture incidence by age, sex, geography, ethnicity, socioeconomic status, and time: results from the UK CPRD:
Find out more at: https://nos.org.uk/conference
Elizabeth Curtis's presentation from Osteoporosis 2016: Variation in UK fracture incidence by age, sex, geography, ethnicity, socioeconomic status, and time: results from the UK CPRD:
Find out more at: https://nos.org.uk/conference
Dr Steve Cummings presentation from Osteoporosis 2016: Patients receiving bisphosphonates should not take holidays from treatment.
Find out more at: https://nos.org.uk/conference
Sanni Ali's presentation from Osteoporosis 2016: Antidiabetic medication use and the risk of fracture amongst type 2 diabetic patients: a nested case-control study
Find out more at: https://nos.org.uk/conference
Bone health of postpartum women: Unexpected high prevalence of a health probl...Premier Publishers
The aim was to see the effect of pregnancy on Bone Mineral Density (BMD) and bone turnover markers (BTMs) in the immediate postpartum period and 12 months thereafter. Eighty women delivered at KAUH (May 2009-Oct 2010) had BMD, bone profile, 25-OH vitamin D and (BTMs). Inclusion criteria: Singleton pregnancy without medical or pregnancy complications. Exclusion criteria: multiple pregnancies, history of diabetes thyroid or bone disease, and use of any medication that affect calcium metabolism. Biochemical tests were repeated for 27 women after one year. Statistical analysis was done using SPSS 16. Eighty women had BMD before discharge. Sixty four women (80%) had low BMD; sixteen of these (25%) had osteoporosis. Although bone profiles were normal, Vitamin D levels were moderately or severely deficient in 35.37% of women. After adjustment for BMI and age there was no correlation between BMD and other variables. Multiple linear regressions showed that BMI was the predictor for BMD (P=0.0014). There was no significant difference between postpartum bone BTMs and bone profiles, and those after twelve months.
Osteoporosis/ osteopenia is a significant health problem in this group of women. Further studies are needed to look into predisposing factors.
Vicki Harber
LA GIOVANE ATLETA
Il ciclo mestruale, punto di riferimento per un sviluppo sano della giovane atleta
Nel processo di sviluppo delle giovani atlete è necessario che siano integrati il monitoraggio continuo del menarca e il controllo del loro stato mestruale. Promuovere lo sviluppo di una giovane atleta e supervisionarne l’allenamento è impegnativo e complesso. Se dispongono di una conoscenza maggiore della funzione mestruale le giovani atlete e le loro famiglie hanno strumenti migliori per rispondere alle esigenze dell’allenamento e delle gare. Lo stato mestruale rappresenta un indicatore globale della salute e del benessere che fornisce informazioni che riguardano l’energia, il rischio di lesioni scheletriche e muscolari, l’apporto alimentare, il profilo metabolico e ormonale, il recupero e altri elementi, importanti per la prestazione. Inoltre, con l’uso crescente dei contraccettivi orali da parte delle giovani atlete che non hanno raggiunto la loro maturità scheletrica, allenatori, allenatrici e genitori debbono essere informati dei risultati recenti che riguardano la salute delle ossa.
Presented by Linus Lay, Pharm.D. Candidate from the University of Rhode Island Class of 2022.
This presentation is on behalf of the Hackettstown Medical Center Pharmacy at Hackettstown, New Jersey as part of Continuing Education.
The Osteoporosis Overview goes over a brief introduction to osteoporosis and current/updated treatment guidelines based on global usage, drug effectiveness, and American association of clinical endocrinologists.
View MyCred Portfolio: https://mycred.com/p/2929377185
Tenslotte zal Prof. Dr. Joop van den Bergh het fractuurrisico bij patiënten met DM type 1 en 2 bespreken: hoe relevant is het verhoogde fractuurrisico bij jonge patiënten met DM type 1? Zijn adipeuze patiënten met DM type 2 beschermd tegen osteoporose? Welke determinanten spelen een rol bij het fractuurrisico bij DM type 2?
Osteoporosis is a poorly recognized entity in India, especially among the non-endocrine physicians. Talk given to chest physicians focusing on glucocorticoid induced osteoporosis
Dr Steve Cummings presentation from Osteoporosis 2016: Patients receiving bisphosphonates should not take holidays from treatment.
Find out more at: https://nos.org.uk/conference
Sanni Ali's presentation from Osteoporosis 2016: Antidiabetic medication use and the risk of fracture amongst type 2 diabetic patients: a nested case-control study
Find out more at: https://nos.org.uk/conference
Bone health of postpartum women: Unexpected high prevalence of a health probl...Premier Publishers
The aim was to see the effect of pregnancy on Bone Mineral Density (BMD) and bone turnover markers (BTMs) in the immediate postpartum period and 12 months thereafter. Eighty women delivered at KAUH (May 2009-Oct 2010) had BMD, bone profile, 25-OH vitamin D and (BTMs). Inclusion criteria: Singleton pregnancy without medical or pregnancy complications. Exclusion criteria: multiple pregnancies, history of diabetes thyroid or bone disease, and use of any medication that affect calcium metabolism. Biochemical tests were repeated for 27 women after one year. Statistical analysis was done using SPSS 16. Eighty women had BMD before discharge. Sixty four women (80%) had low BMD; sixteen of these (25%) had osteoporosis. Although bone profiles were normal, Vitamin D levels were moderately or severely deficient in 35.37% of women. After adjustment for BMI and age there was no correlation between BMD and other variables. Multiple linear regressions showed that BMI was the predictor for BMD (P=0.0014). There was no significant difference between postpartum bone BTMs and bone profiles, and those after twelve months.
Osteoporosis/ osteopenia is a significant health problem in this group of women. Further studies are needed to look into predisposing factors.
Vicki Harber
LA GIOVANE ATLETA
Il ciclo mestruale, punto di riferimento per un sviluppo sano della giovane atleta
Nel processo di sviluppo delle giovani atlete è necessario che siano integrati il monitoraggio continuo del menarca e il controllo del loro stato mestruale. Promuovere lo sviluppo di una giovane atleta e supervisionarne l’allenamento è impegnativo e complesso. Se dispongono di una conoscenza maggiore della funzione mestruale le giovani atlete e le loro famiglie hanno strumenti migliori per rispondere alle esigenze dell’allenamento e delle gare. Lo stato mestruale rappresenta un indicatore globale della salute e del benessere che fornisce informazioni che riguardano l’energia, il rischio di lesioni scheletriche e muscolari, l’apporto alimentare, il profilo metabolico e ormonale, il recupero e altri elementi, importanti per la prestazione. Inoltre, con l’uso crescente dei contraccettivi orali da parte delle giovani atlete che non hanno raggiunto la loro maturità scheletrica, allenatori, allenatrici e genitori debbono essere informati dei risultati recenti che riguardano la salute delle ossa.
Presented by Linus Lay, Pharm.D. Candidate from the University of Rhode Island Class of 2022.
This presentation is on behalf of the Hackettstown Medical Center Pharmacy at Hackettstown, New Jersey as part of Continuing Education.
The Osteoporosis Overview goes over a brief introduction to osteoporosis and current/updated treatment guidelines based on global usage, drug effectiveness, and American association of clinical endocrinologists.
View MyCred Portfolio: https://mycred.com/p/2929377185
Tenslotte zal Prof. Dr. Joop van den Bergh het fractuurrisico bij patiënten met DM type 1 en 2 bespreken: hoe relevant is het verhoogde fractuurrisico bij jonge patiënten met DM type 1? Zijn adipeuze patiënten met DM type 2 beschermd tegen osteoporose? Welke determinanten spelen een rol bij het fractuurrisico bij DM type 2?
Osteoporosis is a poorly recognized entity in India, especially among the non-endocrine physicians. Talk given to chest physicians focusing on glucocorticoid induced osteoporosis
Osteoporosis is a progressive systemic skeletal disease characterized by low bone mass and microarchitecture deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk.
Frequency of Osteoporotic Fractures, Parameters of Bone Mineral Density and T...CrimsonPublishersOPROJ
Frequency of Osteoporotic Fractures, Parameters of Bone Mineral Density and Trabecular Bone Score in Postmenopausal Women by Grygorieva N* in Orthopedic Research Online Journal
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
1. Cost Effective Treatment of Osteoporosis Utilizing the US Adapted WHO Fracture Risk Algorithm Sanford Baim MD, FACR, CCD Colorado Center for Bone Research Lakewood, Colorado
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3. WHO Bone Density Criteria: A Diagnostic Threshold Diagnostic criteria* Classification T is above or equal to -1 Normal T is between -1 and -2.5 Osteopenia (low bone mass) T -2.5 or lower Osteoporosis T -2.5 or lower + fragility fracture Severe established osteoporosis * T-score is the number of standard deviations above or below the average peak bone density in young adults
4. Treatment Guidelines Prior to 2008 Based on BMD and CRFs T-score thresholds Treat Do not Treat BMD + CRFs NOF NOF Risk Factors AACE Risk Factors NAMS Risk Factors ACOG Risk Factors ALL Fragility Fracture (with or without low BMD) -2.5 -2.0 -1.5
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7. BMD and Relative Risk Bone Density (T-score) Relative Risk for Fracture Marshall, BMJ, 1996
8. Gradients of Risk in Women for a 1 SD Decrease in BMD Below Age-adjusted mean Site of Measurement Distal radius Hip Lumbar spine Forearm Fracture 1.7 1.4 1.5 Hip Fracture 1.8 2.6 1.6 Vertebral Fracture 1.7 1.8 2.3 All Fractures 1.4 1.6 1.5 Marshall, BMJ, 1996
16. Age as an Independent Risk Factor for Fracture Adapted from Kanis , OI , 2001 Probability of clinical osteoporotic fractures in Swedish women Gradient of risk Ten Year Fracture Probability (%) Age 80 70 60 50
17. Prior Fracture as an Independent Risk Factor for Fracture Klotzbuecher , JBMR , 2000 RR Incident Fracture Prevalent Fracture Wrist Vertebra Hip Wrist 3.3 1.7 1.9 Vertebra 1.4 4.4 2.3 Hip NA 2.5 2.3
18. Combined Effect of BMD and Clinical Risk Factors on Fracture Risk Rate of hip fracture (per 1000 woman-yr) Calcaneal bone density No. of risk factors Cummings, N EJM, 1995 27.3 14.7 9.4 0 5 10 15 20 25 30 Lowest third Middle third Highest third 0-2 3-4 >4
49. NOF Clinician’s Guide To Prevention and Treatment of Osteoporosis Development Committee Bess Dawson-Hughes (Chair), NOF Robert Lindsay (Co-chair), NOF Sundeep Khosla, NOF L. Joseph Melton III, NOF Anna N.A. Tosteson, NOF Murray Favus, ASBMR Sanford Baim, ISCD Interspecialty Medical Council Reviewers Laura Tosi, AAOS Kenneth W. Lysles, AGS Martin Grabois, AAP Helena W. Rodbard, AMA Richard W. Kruse, AAP Marc F. Swiontkowski, AOA Partricia Graham, AAPMR Kendrin Van Steenwyk, AOA Donald Berman, AACE Shonni Silverberg, ASBMR William C. Andrews, ACOG E. Michael Lewiecki, ISCD Michael Gloth III, ACP John L. Melvin, ISPRM Ronald Bernard Staron, ACR Wendi El-Amin, NMA Lenore Buckley, ACRheum Carolyn Becker, TES
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59. Impact of Duration in Fracture-Loss in Quality of Life on 10-year Hip Fracture Which Treatment Becomes Cost-effective Tosteson, OI , 2008
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62. 10-year Fracture Risk 50 Year Old White Female with BMI 24 5.2% 0.4% 9.4% 2.5% 2.5% 9.2% 16% 2.6% 10% 4.3% 17% 4.5% 28% 8.3%
63. 2003 NOF Physician Guide Treatment Recommendations Core data from Kanis, OI , 2001 McClung, Bone , 2005
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