Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13

Osteoporosis Related Publications

13 Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

Abstract:

This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: Osteoporosis, Knowledge, Practices, awareness

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12 Trabecular Bone Radiograph Characterization Using Fractal, Multifractal Analysis and SVM Classifier

Authors: I. Slim, H. Akkari, A. Ben Abdallah, I. Bhouri, M. Hedi Bedoui

Abstract:

Osteoporosis is a common disease characterized by low bone mass and deterioration of micro-architectural bone tissue, which provokes an increased risk of fracture. This work treats the texture characterization of trabecular bone radiographs. The aim was to analyze according to clinical research a group of 174 subjects: 87 osteoporotic patients (OP) with various bone fracture types and 87 control cases (CC). To characterize osteoporosis, Fractal and MultiFractal (MF) methods were applied to images for features (attributes) extraction. In order to improve the results, a new method of MF spectrum based on the q-stucture function calculation was proposed and a combination of Fractal and MF attributes was used. The Support Vector Machines (SVM) was applied as a classifier to distinguish between OP patients and CC subjects. The features fusion (fractal and MF) allowed a good discrimination between the two groups with an accuracy rate of 96.22%.

Keywords: Osteoporosis, SVM, fractal, micro-architecture analysis, multifractal

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11 Bone Mineral Density and Quality, Body Composition of Women in the Postmenopausal Period

Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

Abstract:

In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: Osteoporosis, lean mass, fat mass, bone tissue mineral density, bone quality, postmenopausal osteoporosis

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10 Alteration of Bone Strength in Osteoporosis of Mouse Femora: Computational Study Based on Micro CT Images

Authors: Changsoo Chon, Sangkuy Han, Donghyun Seo, Jihyung Park, Bokku Kang, Hansung Kim, Keyoungjin Chun, Cheolwoong Ko

Abstract:

The purpose of the study is to develop a finite element model based on 3D bone structural images of Micro-CT and to analyze the stress distribution for the osteoporosis mouse femora. In this study, results of finite element analysis show that the early osteoporosis of mouse model decreased a bone density in trabecular region; however, the bone density in cortical region increased.

Keywords: Osteoporosis, Finite Element Analysis, micro-CT, bone strength

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9 Screening Post-Menopausal Women for Osteoporosis by Complex Impedance Measurements of the Dominant Arm

Authors: Fırat Matur, Yekta Ülgen

Abstract:

Cole-Cole parameters of 40 post-menopausal women are compared with their DEXA bone mineral density measurements. Impedance characteristics of four extremities are compared; left and right extremities are statistically same, but lower extremities are statistically different than upper ones due to their different fat content. The correlation of Cole-Cole impedance parameters to bone mineral density (BMD) is observed to be higher for dominant arm. With the post-menopausal population, ANOVA tests of the dominant arm characteristic frequency, as a predictor for DEXA classified osteopenic and osteoporic population around lumbar spine, is statistically very significant. When used for total lumbar spine osteoporosis diagnosis, the area under the Receiver Operating Curve of the characteristic frequency is 0.830, suggesting that the Cole-Cole plot characteristic frequency could be a useful diagnostic parameter when integrated into standard screening methods for osteoporosis. Moreover, the characteristic frequency can be directly measured by monitoring frequency driven angular behavior of the dominant arm without performing any complex calculation.

Keywords: Osteoporosis, bone mineral density, characteristic frequency, receiver operating curve, Bio-impedance spectroscopy

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8 Trabecular Texture Analysis Using Fractal Metrics for Bone Fragility Assessment

Authors: Khaled Harrar, Rachid Jennane

Abstract:

The purpose of this study is the discrimination of 28 postmenopausal with osteoporotic femoral fractures from an agematched control group of 28 women using texture analysis based on fractals. Two pre-processing approaches are applied on radiographic images; these techniques are compared to highlight the choice of the pre-processing method. Furthermore, the values of the fractal dimension are compared to those of the fractal signature in terms of the classification of the two populations. In a second analysis, the BMD measure at proximal femur was compared to the fractal analysis, the latter, which is a non-invasive technique, allowed a better discrimination; the results confirm that the fractal analysis of texture on calcaneus radiographs is able to discriminate osteoporotic patients with femoral fracture from controls. This discrimination was efficient compared to that obtained by BMD alone. It was also present in comparing subgroups with overlapping values of BMD.

Keywords: Osteoporosis, fractal dimension, bone mineral density, fractal signature

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7 Evaluation of the Laser and Partial Vibration Stimulation on Osteoporosis

Authors: Ji Hyung Park, Dong-Hyun Seo, Young-Jin Jung, Han Sung Kim

Abstract:

The aim of this study is to evaluate the effects of the laser and partial vibration stimulation on the mice tibia with morphological characteristics. Twenty female C57BL/6 mice (12 weeks old) were used for the experiment. The study was carried out on four groups of animals each consisting of five mice. Four groups of mice were ovariectomized. Animals were scanned at 0 and 2 weeks after ovariectomy by using micro computed tomography to estimate morphological characteristics of tibial trabecular bone. Morphological analysis showed that structural parameters of multi-stimuli group appear significantly better phase in BV/TV, BS/BV, Tb.Th, Tb.N, Tb.Sp, and Tb.pf than single stimulation groups. However, single stimulation groups didn’t show significant effect on tibia with Sham group. This study suggests that multi-stimuli may restrain the change as the degenerate phase on osteoporosis in the mice tibia.

Keywords: Osteoporosis, laser, mice, partial vibration, in vivo micro-CT

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6 How the Decrease of Collagen or Mineral Affect the Fracture in the Turkey Long Bones

Authors: P. Vosynek, T. Návrat, M. Peč, J. Pořízka, P. Diviš

Abstract:

Bone properties and response behavior after static or dynamic activation (loading) are still interesting topics in many fields of the science especially in the biomechanical problems such as bone loss of astronauts in space, osteoporosis, bone remodeling after fracture or remodeling after surgery (endoprosthesis and implants) and in osteointegration. This contribution deals with the relation between physiological, demineralized and deproteinized state of the turkey long bone – tibia. Three methods for comparison were used: 1) densitometry, 2) three point bending and 3) frequency analysis. The main goal of this work was to describe the decrease of the protein (collagen) or mineral of the bone with relation to the fracture in three point bending. The comparison is linked to the problem of different bone mechanical behavior in physiological and osteoporotic state.

Keywords: Osteoporosis, bone properties, long bone, response behavior

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5 Analysis of OPG Gene Polymorphism T245G (rs3134069) in Slovak Postmenopausal Women

Authors: I. Boroňová, J. Bernasovská, J. Kľoc, Z. Tomková, E. Petrejčíková, S. Mačeková, J. Poráčová, M. M. Blaščáková

Abstract:

Osteoporosis is a common multifactorial disease with a strong genetic component characterized by reduced bone mass and increased risk of fractures. Genetic factors play an important role in the pathogenesis of osteoporosis. The aim of our study was to identify the genotype and allele distribution of T245G polymorphism in OPG gene in Slovak postmenopausal women. A total of 200 unrelated Slovak postmenopausal women with diagnosed osteoporosis and 200 normal controls were genotyped for T245G (rs3134069) polymorphism of OPG gene. Genotyping was performed using the Custom Taqman®SNP Genotyping assays. Genotypes and alleles frequencies showed no significant differences (p=0.5551; p=0.6022). The results of the present study confirm the importance of T245G polymorphism in OPG gene in the pathogenesis of osteoporosis.

Keywords: Osteoporosis, real-time PCR, OPG gene, T245G polymorphism

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4 TNFRSF11B Gene Polymorphisms A163G and G11811C in Prediction of Osteoporosis Risk

Authors: Boroňová I., Bernasovská J., Kľoc J., Tomková Z., Petrejčíková E., Gabriková D., Mačeková S.

Abstract:

Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ2) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ2=0.270, p=0.605; χ2=0.250, p=0.616; G1181C: χ2= 1.730, p=0.188; χ2=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.

Keywords: Osteoporosis, real-time PCR method, SNP polymorphisms

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3 Finite Element Prediction and Experimental Verification of the Failure Pattern of Proximal Femur using Quantitative Computed Tomography Images

Authors: Majid Mirzaei, Saeid Samiezadeh , Abbas Khodadadi, Mohammad R. Ghazavi

Abstract:

This paper presents a novel method for prediction of the mechanical behavior of proximal femur using the general framework of the quantitative computed tomography (QCT)-based finite element Analysis (FEA). A systematic imaging and modeling procedure was developed for reliable correspondence between the QCT-based FEA and the in-vitro mechanical testing. A speciallydesigned holding frame was used to define and maintain a unique geometrical reference system during the analysis and testing. The QCT images were directly converted into voxel-based 3D finite element models for linear and nonlinear analyses. The equivalent plastic strain and the strain energy density measures were used to identify the critical elements and predict the failure patterns. The samples were destructively tested using a specially-designed gripping fixture (with five degrees of freedom) mounted within a universal mechanical testing machine. Very good agreements were found between the experimental and the predicted failure patterns and the associated load levels.

Keywords: Osteoporosis, Bone, Noninvasive methods, Failure Analysis

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2 Influence of Calcium Intake Level to Osteoporptic Vertebral bone and Degenerated Disc in Biomechanical Study

Authors: Dae Gon Woo, Ji Hyung Park, Chi Hoon Kim, Tae Woo Lee, Beob Yi Lee, Han Sung Kim

Abstract:

The aim of the present study is to analyze the generation of osteoporotic vertebral bone induced by lack of calcium during growth period and analyze its effects for disc degeneration, based on biomechanical and histomorphometrical study. Mechanical and histomorphological characteristics of lumbar vertebral bones and discs of rats with calcium free diet (CFD) were detected and tracked by using high resolution in-vivo micro-computed tomography (in-vivo micro-CT), finite element (FE) and histological analysis. Twenty female Sprague-Dawley rats (6 weeks old, approximate weight 170g) were randomly divided into two groups (CFD group: 10, NOR group: 10). The CFD group was maintained on a refmed calcium-controlled semisynthetic diet without added calcium, to induce osteoporosis. All lumbar (L 1-L6) were scanned by using in vivo micro-CT with 35i.un resolution at 0, 4, 8 weeks to track the effects of CFD on the generation of osteoporosis. The fmdings of the present study indicated that calcium insufficiency was the main factor in the generation of osteoporosis and it induced lumbar vertebral disc degeneration. This study is a valuable experiment to firstly evaluate osteoporotic vertebral bone and disc degeneration induced by lack of calcium during growth period from a biomechanical and histomorphometrical point of view.

Keywords: Osteoporosis, Finite Element Analysis, Histology, Disc Degeneration, in-vivo micro-CT, Calcium free diet

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1 An Intelligent Fuzzy-Neural Diagnostic System for Osteoporosis Risk Assessment

Authors: Chin-Ming Hong, Chin-Teng Lin, Chao-Yen Huang, Yi-Ming Lin

Abstract:

In this article, we propose an Intelligent Medical Diagnostic System (IMDS) accessible through common web-based interface, to on-line perform initial screening for osteoporosis. The fundamental approaches which construct the proposed system are mainly based on the fuzzy-neural theory, which can exhibit superiority over other conventional technologies in many fields. In diagnosis process, users simply answer a series of directed questions to the system, and then they will immediately receive a list of results which represents the risk degrees of osteoporosis. According to clinical testing results, it is shown that the proposed system can provide the general public or even health care providers with a convenient, reliable, inexpensive approach to osteoporosis risk assessment.

Keywords: Osteoporosis, web interface, BMD, IMDS, fuzzy-neural theory

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