Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
Part IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 e most frequent and most devastating diseases. Fragility fractures (minimal trauma fractures) belong to the most important morbidity and mortality causes in the elderly. Usually they occur as a result of a fall from standing height. In women, the incidence of vertebral fractures starts to rise steep Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 ly in the first years after menopause, whereas the incidence of hip fractures rises sharply around the age of 70. Globally, during the year 2000. therEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
e were an estimated 9 million new fragility fractures, of which 1.6 million were at the hip, 1.7 million at the wrist. 0.7 million at the humerus and Part IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 ical fragility fractures occur in those below age 65 years [2. 3]. In the UK. this amounts to more than 100.000 fractures per year in women aged 50-65 years, over 9000 of which are hip fractures ([2. 3]: www.uk2u.net). Nonetheless the importance of osteoporosis is still largely underestimated by lay Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 -people and by doctors. Prevention of osteoporotic fractures should be one of the major goals of menopause specialists.14.1.1Definition of OsteoporosiEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
sOsteoporosis leads to weakness of the skeleton and increased risk of fracture. The World Health Organization (WHO) has defined osteoporosis as a systPart IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 y and susceptibility to fracture.M. BirkhaeuserProfessor emeritus for Gynaecological Endocrinology and Reproductive Medicine.University of Bern. Bern. SwitzerlandPostal correspondence/address: Gartenstrasse 67. CH-4052. Basel. Switzerland e-mail: martin.birkhaeuser@balcab.ch© International Society o Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 f Gynecological Endocrinology 2018165M. Birkhaeuser. A.R. Genazzani (eds.). PreMenopause, Menopause and Beyond. isr.cAm/Ih inn7/n7fi ỉM166M. BirkhaeusEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
er14.1.2EpidemiologyIn developed countries, lifetime risk for a normal woman aged 50 years to suffer an osteoporotic fracture at any place is 52.3% [IPart IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 is close to the probability of coronary heart disease. In a woman at the menopause, the remaining lifetime probability after a major fracture is less favourable than the one after breast cancer.14.1.2.1Vertebral FracturesVertebral fractures remain most of the time ignored, even if they cause pain. L Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 ess than 10%' result in hospitalisation [9. 10]. They may cause acute pain, loss of function and loss of quality of life but may also occur without seEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
rious symptoms. They occur typically in the mid-thoracic or thoracolumbar regions of the spine [9]. In Europe, the prevalence defined by radiological Part IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 in women [11], increasing markedly with age. Vertebral fractures often recur. New fractures are most likely in nearby vertebrae. The consequent disability increases with the number of fractures.14.1.2.2Distal Forearm (Wrist) FracturesIn Europe, the annual incidences of distal forearm fractures in f Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 emale were 7.3 per 1000 person-years in 2002 [12]. Wrist fractures are most likely to occur in women over 65 years old. There is an increase in age adEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
justed between 45 and 60 years of age. Then the trend stabilises or slightly increases. Functional recovery of distal radial fractures is usually goodPart IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 approximately 1.7 million [13]. They are more common in northern than in southern countries. This might be due to a different duration, intensity and efficiency of sunlight in stimulating vitamin D production in the skin. The sex ratio of hip fractures F/M is 4/5.90% of the hip fractures occur in pe Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 ople over 50 years old [ 14]. Hip fracture is associated with serious disability and excess mortality. Women who have sustained a hip fracture have aEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
10-20% higher mortality than would be expected for their age [15]. Recovery is slow and rehabilitation is often incomplete, with many patients permanePart IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 t restricted to women at risk. It is of utmost importance that general preventive measures are undertaken even without diagnostic investigations to reduce the incidence of osteoporosis and of fragility fractures.14 Healthy Bones After Menopause: What Has to Be Done?167Primary prevention of osteoporo Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 sis includes all measures preventing the occurrence of osteoporosis. Primary prevention starts in adolescence. Its target is to obtain an optimal peakEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
bone mass in adolescence and young adulthood, to slow down the physiological decrease of bone mineral density (BMD) after menopause up to the advancePart IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 ation in already osteoporotic women. In contrast to primary prevention, secondary prevention usually demands a complete investigation before preventive measures can be started. Often a specific treatment has to be initiated being beyond the scope of the field of postmenopausal osteoporosis.General p Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 revention ensuring a normal bone metabolism includes [I6-I8J:14.2.1Supplementation with Vitamin D•50-70% of adults living in developed countries arc uEbook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2
ndersupplicd with vitamin D [19]. In elderly patients suffering from an acute hip fracture, more than 50% display a severe vitamin D deficiency (25-hyPart IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of the Ebook Pre-menopause, menopause and beyond (Volume 5: Frontiers in gynecological endocrinology) - Part 2 1 (30 ng/ml) [20].Part IVBone and Cardiovascular ImpactHealthy Bones After Menopause: What Has to Be Done?14Martin Birkhaeuser14.1IntroductionOsteoporosis is one of theGọi ngay
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