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The study was aimed to evaluate the potential of Consciousness Energy Healing based vitamin D3 and DMEM medium on bone health. The test items, were divided into two parts. One part of each sample received the Consciousness Energy Healing Treatment by Gary Richard Gerber and those samples were labeled as the Biofield Energy Treated (BT) samples, while the other parts of each sample were denoted as the untreated test items (UT). ALP, collagen, and bone mineralization activities were performed to assess bone health in human bone osteosarcoma cells (MG-63). The cell viability assay (MTT) data showed that the test samples were found as safe in all the tested concentrations. The level of ALP was significantly increased by 74.54% and 98.26% in the UT-DMEM + BT-Test item and BT-DMEM + UT-Test item groups, respectively at 10 µg/mL compared to the UT-DMEM + UT-Test item group. Further, the ALP level was significantly elevated by 111.17% in the BT-DMEM + BT-Test item group at 100 µg/mL compared to the UT-DMEM + UT-Test item group. Collagen was significantly increased by 147.46%, 59.67%, and 35.36% in the UT-DMEM + BT-Test item group at 1, 10, and 50 µg/mL, respectively compared to the untreated group. Moreover, the level of collagen was significantly increased by 89.88%, 86.42%, and 82.08% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 50 µg/mL with respect to the untreated group. Further, the collagen level was significantly increased by 365.76%, 80.10%, and 76.09% in the BT-DMEM + BT-Test item group at 0.1, 10, and 50 µg/mL compared to the untreated group. Besides, the percent of bone mineralization was distinctly increased by 59.30%, 30.69%, and 177.7% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 50 µg/mL compared to the untreated group. The percent of bone mineralization was distinctly increased by 29.44%, and 45.51% in the BT-DMEM + UT-Test item and BT-DMEM + BT-Test item groups, respectively at 100 µg/mL compared to the untreated group. Overall, the Biofield Energy Treated vitamin D3 was remarkably improved the bone health parameters and help to combat vitamin D3 deficiency and fight against various bone related problems including low bone density, osteoporosis, osteogenesis imperfecta, Paget’s disease of bone, rickets, osteomalacia, bone and joint pain, bone fractures, deformed bones, osteoma, chondrodystrophia fetalis, autoimmune and inflammatory diseases, stress management and prevention, and anti-aging by improving overall health. https://www.trivedieffect.com/the-science/biotech/publication/healers-science/nutraceuticals/in-vitro-study-on-human-bone-osteosarcoma-cells-mg-63-role-of-biofield-energy-treated-vitamin-d3/ http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=244&doi=10.11648/j.bmb.20180301.14, Gary Richard Gerber, Mahendra Kumar Trivedi, Alice Branton, Dahryn Trivedi, Gopal Nayak, Sambhu Charan Mondal, Snehasis Jana. In vitro Study on Human Bone Osteosarcoma Cells (MG-63): Role of Biofield Energy Treated Vitamin D3. Biochemistry and Molecular Biology. Vol. 3, No. 1, 2018, pp. 36-44. doi: 10.11648/j.bmb.20180301.14

The study was aimed to evaluate the potential of Consciousness Energy Healing based vitamin D3 and DMEM medium on bone health. The test items, were divided into two parts. One part of each sample received the Consciousness Energy Healing Treatment by Aileen Carol Lee and those samples were labeled as the Biofield Energy Treated (BT) samples, while the other parts of each sample were denoted as the untreated test items (UT). ALP, collagen, and bone mineralization activities were performed to assess bone health in human bone osteosarcoma cells (MG-63). The cell viability assay (MTT) data showed that the test samples were found as safe in the tested concentrations. The level of ALP was significantly increased by 251.16%, 103.75%, and 119.55% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item, respectively at 50 µg/mL, while 123.37% increased in the BT-DMEM + UT-Test item at 0.1 µg/mL compared to the UT-DMEM + UT-Test item group. Further, the ALP level was significantly elevated by 194.1%, 72.34%, and 65.31% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 100 µg/mL compared to the UT-DMEM + UT-Test item group. Collagen was significantly increased by 83.02%, 145.67%, and 191.41% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 0.1 µg/mL compared to the untreated group. Further, the collagen level was significantly increased by 50.29% and 52.48% in the BT-DMEM + UT-Test item and BT-DMEM + BT-Test item, respectively at 50 µg/mL compared to the untreated group. Additionally, the percent of bone mineralization was distinctly increased by 64.46% and 94.16% in the UT-DMEM + BT-Test item and BT-DMEM + UT-Test item groups, respectively at 100 µg/mL compared to the untreated group. The percent of bone mineralization was distinctly increased by 26.59% and 28.33% in the BT-DMEM + UT-Test item group at 10 and 50 µg/mL, respectively compared to the UT-DMEM + UT-Test item group. Overall, the Biofield Energy Treated vitamin D3 was remarkably improved the bone health parameters and it could be a powerful alternative nutraceutical supplement to combat vitamin D3 deficiency and fight against various bone related problems including low bone density, osteoporosis, osteogenesis imperfecta, rickets, osteomalacia, bone and joint pain, bone fractures, deformed bones, osteoma, chondrodystrophia fetalis, autoimmune and inflammatory diseases, stress management and prevention, and anti-aging by improving overall health. https://www.trivedieffect.com/the-science/biotech/publication/healers-science/nutraceuticals/the-potential-benefits-of-biofield-energy-treated-vitamin-d3-on-bone-mineralization-in-human-bone-osteosarcoma-cells/ http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=153&doi=10.11648/j.ijnfs.20180701.15, Aileen Carol Lee, Mahendra Kumar Trivedi, Alice Branton, Dahryn Trivedi, Gopal Nayak, Sambhu Charan Mondal, Snehasis Jana. The Potential Benefits of Biofield Energy Treated Vitamin D3 on Bone Mineralization in Human Bone Osteosarcoma Cells (MG-63). International Journal of Nutrition and Food Sciences. Vol. 7, No. 1, 2018, pp. 30-38. doi: 10.11648/j.ijnfs.20180701.15

The study objective was to investigate the effect of Consciousness Energy Healing-based vitamin D3 and DMEM medium on bone health. The test items (vitamin D3 and DMEM), were divided into two parts. One part of each sample was received the Biofield Energy Treatment by Debra Jane Schnitzer and those samples were denoted as the Biofield Energy Treated (BT) samples, while the other parts of each sample were referred as the untreated test items (UT). Parameters such as ALP, collagen, and bone mineralization were performed to evaluate the bone strength in human bone osteosarcoma cells (MG-63). The test samples were found as safe in the tested concentrations by MTT cell viability assay. ALP was significantly increased by 27.75%, 28.21%, and 60% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 50 µg/mL compared to the UT-DMEM + UT-Test item group. Moreover, the ALP level was significantly raised by 11.17% and 74.57% in the UT-DMEM + BT-Test item and BT-DMEM + BT-Test item groups, respectively at 100 µg/mL compared to the UT-DMEM + UT-Test item group. Collagen was significantly increased by 54.53% and 115.01% in the UT-DMEM + BT-Test item and BT-DMEM + UT-Test item groups, respectively at 0.1 µg/mL compared to the untreated group. Further, the collagen level was significantly increased by 131.87% (at 1 µg/mL) and 179.77% (at 10 µg/mL) in the UT-DMEM + BT-Test item group compared to the untreated group. Apart from this, the percent of bone mineralization was distinctly increased by 75.94%, 125.79%, and 117.38% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 10 µg/mL compared to the untreated group. Additionally, the percentage of bone mineralization was significantly increased by 46.08%, 173.22%, and 171.17% in the UT-DMEM + BT-Test item, BT-DMEM + UT-Test item, and BT-DMEM + BT-Test item groups, respectively at 50 µg/mL compared to the untreated group. Altogether, the Biofield Energy Treated vitamin D3 was significantly improved the bone health parameters and it could be an alternative approach for nutraceutical supplement to combat vitamin D3 deficiency and able to fight against various bone-related disorders including rickets, low bone density, osteomalacia, bone and joint pain, bone fractures, osteoporosis, osteoma, osteogenesis imperfecta, Paget’s disease, deformed bones, chondrodystrophia fetalis, stress management and prevention, autoimmune and inflammatory diseases, and anti-aging by improving overall health. https://www.trivedieffect.com/the-science/biotech/publication/healers-science/nutraceuticals/improved-structural-and-functional-integrity-of-bone-health-parameters-after-treatment-with-consciousness-energy-treated-vitamin-d3/ http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=378&doi=10.11648/j.jfmhc.20170304.13, Debra Jane Schnitzer, Mahendra Kumar Trivedi, Alice Branton, Dahryn Trivedi, Gopal Nayak, Sambhu Charan Mondal, Snehasis Jana. Improved Structural and Functional Integrity of Bone Health Parameters After Treatment with Consciousness Energy Treated Vitamin D3. Journal of Family Medicine and Health Care. Vol. 3, No. 4, 2017, pp. 79-87. doi: 10.11648/j.jfmhc.20170304.13

The most common cause of fractures in the elderly is falling, usually from standing height, and falling is the leading cause of hospitalisation due to accidental injury, with significant risk of death in the following year due to complications [1]. Low bone density due to osteoporosis or osteopenia means that falls easily result in fractures, even when the fall dynamics are relatively mild, as discussed in Chap. 1. These are often referred to as ‘fragility’, ‘osteoporotic’ or ‘minimal trauma’ fractures and most commonly occur in those over the age of 50 years [2], the same population at risk of osteoporosis.

Osteoporosis is a term that means “porous bones.” It is a skeletal disease affecting both women and men. Osteoporosis is a condition in which bones have lost minerals especially calcium, making them weaker, more brittle, and susceptible to fractures. Any bone in the body can be affected by osteoporosis, but the most common places where fractures occur are the back (spine), hips, and wrists.

Bone stress injuries (BSI) are a common overuse injury in active individuals. The injury is particularly common in athletes participating in land-based sports including running. The cause of BSI is often multifactorial from a combination of biological, biomechanical, and anatomical risk factors. Initial management includes off-loading the affected bone to eliminate pain and facilitate healing, addressing risk factors, and ensuring adequate nutrition, followed by gradual loading program and physical therapy. Injury prevention strategies include addressing deficits in running mechanics, optimizing nutrition and sleep, and early sports participation in sports that optimize bone health, including ball sports.

Objectives Analyses of bone cross-sectional geometry are frequently used by anthropologists and paleontologists to infer the loading histories of past populations. To address some underlying assumptions, we investigated the relative roles of genetics and exercise on bone cross-sectional geometry and bending mechanics in three mouse strains: high bone density (C3H/He), low bone density (C57BL/6), and a high-runner strain homozygous for the Myh4Minimsc allele (MM). Methods and Materials Weanlings of each strain were divided into exercise (wheel) or control (sedentary) treatment groups for a 7-week experimental period. Morphometrics of the femoral mid-diaphysis and mechanical testing were used to assess both theoretical and ex vivo bending mechanics. Results Across all measured morphological and bending traits, we found relatively small effects of exercise treatment compared to larger and more frequent interstrain differences. In the exercised group, total distance run over the experimental period was not a predictor of any morphological or bending traits. Cross-sectional geometry did not accurately predict bone response to loading. Discussion Results from this experimental model do not support hypothesized associations among extreme exercise, cross-sectional geometry, and bending mechanics. Our results suggest that analysis of cross-sectional geometry alone is insufficient to predict loading response, and questions the common assumption that cross-sectional geometry differences are indicative of differential loading history.

Cortical screws in the lumbar spine are an alternative to traditional pedicle screw fixation. The starting point is on the dorsal pars and the trajectory is up and out toward the lateral junction of the pedicle with the vertebral body. It allows for a smaller incision and less lateral dissection when compared with pedicle screw placement. Biomechanical studies have shown that cortical screws are equivalent to pedicle screws, and there is limited evidence of improved fixation with this technique in the setting of low bone density. Clinical studies demonstrate equivalent clinical and radiographic results between cortical screw and pedicle screws when used in conjunction with posterior interbody support. The indications, contraindications, surgical technique, special considerations, and literature surrounding the use of lumbar cortical screws are reviewed.

Purpose of reviewThe scope of this review was to review the newest developments in the context of the existing knowledge on premenopausal bone fragility. Fragility fractures are common in postmenopausal women and men and diagnostic criteria for osteoporosis have been agreed and multiple pharmacological treatments have been developed over the last 25 years. In premenopausal women, fragility fractures and very low bone mass are uncommon and osteoporosis in premenopausal women has therefore attracted much less interest.Recent findingsRecent studies have highlighted that lifestyle and dietary habits affect premenopausal bone mass. Bone mass may be improved by sufficient intake of calcium and vitamin D together with increased physical activity in premenopausal women with idiopathic osteoporosis. If pharmacological treatment is needed, teriparatide has been demonstrated to efficiently increase bone mass; however, no fracture studies and no comparative studies against antiresorptive therapies have been conducted. Pregnancy affects bone turnover and mass significantly, but pregnancy-associated osteoporosis is a rare and heterogeneous condition.SummaryThe diagnosis of osteoporosis should only be considered in premenopausal women with existing fragility fractures, diseases or treatments known to cause bone loss or fractures. Secondary causes of osteoporosis should be corrected or treated if possible. The women should be recommended sufficient intake of calcium and vitamin and physical activity. In women with recurrent fractures or secondary causes that cannot be eliminated, for example glucocorticoid or cancer treatment, pharmacological intervention with bisphosphonates or teriparatide (not in the case of cancer) may be considered.

This guideline updates the 2008 American College of Physicians (ACP) recommendations on treatment of low bone density and osteoporosis to prevent fractures in men and women. This guideline is endorsed by the American Academy of Family Physicians.The ACP Clinical Guidelines Committee based these recommendations on a systematic review of randomized controlled trials; systematic reviews; large observational studies (for adverse events); and case reports (for rare events) that were published between 2 January 2005 and 3 June 2011. The review was updated to July 2016 by using a machine-learning method, and a limited update to October 2016 was done. Clinical outcomes evaluated were fractures and adverse events. This guideline focuses on the comparative benefits and risks of short- and long-term pharmacologic treatments for low bone density, including pharmaceutical prescriptions, calcium, vitamin D, and estrogen. Evidence was graded according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.The target audience for this guideline includes all clinicians. The target patient population includes men and women with low bone density and osteoporosis.ACP recommends that clinicians offer pharmacologic treatment with alendronate, risedronate, zoledronic acid, or denosumab to reduce the risk for hip and vertebral fractures in women who have known osteoporosis. (Grade: strong recommendation; high-quality evidence).ACP recommends that clinicians treat osteoporotic women with pharmacologic therapy for 5 years. (Grade: weak recommendation; low-quality evidence).ACP recommends that clinicians offer pharmacologic treatment with bisphosphonates to reduce the risk for vertebral fracture in men who have clinically recognized osteoporosis. (Grade: weak recommendation; low-quality evidence).ACP recommends against bone density monitoring during the 5-year pharmacologic treatment period for osteoporosis in women. (Grade: weak recommendation; low-quality evidence).ACP recommends against using menopausal estrogen therapy or menopausal estrogen plus progestogen therapy or raloxifene for the treatment of osteoporosis in women. (Grade: strong recommendation; moderate-quality evidence).ACP recommends that clinicians should make the decision whether to treat osteopenic women 65 years of age or older who are at a high risk for fracture based on a discussion of patient preferences, fracture risk profile, and benefits, harms, and costs of medications. (Grade: weak recommendation; low-quality evidence).

Periods of skeletal growth, especially during adolescence, are critical to acquiring maximal peak bone mass to reduce risk of osteoporosis later in life. Linear growth exceeds bone consolidation, creating a vulnerable period of low bone density that increases risk of fracture. Following dietary recommendations for dairy products or equivalent sources of calcium is prudent for meeting bone nutrient requirements. Vitamin D status of most adolescents is adequate for calcium utilization.

Each year millions of patients improve their quality of life through surgical procedures that involve implants or implantable medical devices. Medical implants are devices or tissues that are placed inside or on the surface of the body. Many implants are prosthetics, intended to replace or restore the function of traumatized or degenerated tissues and organs. Other implants deliver medication, monitor body functions, or provide support to organs and tissues [1]. Currently, implants are being used in many different parts of the body for various applications such as orthopedics, pacemakers, cardiovascular stents, and catheters [2]. Concurrent with the increased life span in today’s world, the number of age-related diseases has also increased. For example, the global orthopedic implant market was valued at USD 4.3 billion in 2015 and is expected to reach USD 6.2 billion by 2024, according to a new report by Grand View Research, Inc. The constantly rising geriatric population is primarily driving the growth of the market since people aged above 65 years are at a high risk of developing degenerative disc disease, low bone density, and osteoarthritis [3].This chapter will cover some of the more significane advancements that have been made in medical devices to improve their function, in particular, how the next generation of implants are decreasing implant infection.

The ISCD 2007 Pediatric Official Positions define osteoporosis in children on the basis of fracture history and low bone density, adjusted as appropriate for age, gender, and body size. The task force on fracture prediction and osteoporosis definition has reviewed these positions and suggests modifications with respect to vertebral fracture and the definition of a significant fracture history and draws attention to the need to consider degree of trauma as a factor that may modify fracture risk prediction.

CP is the most prevalent childhood condition associated with low bone mass. Bone density is decreased in children with CP who sustain fragility fractures that impair function and quality of life. Predicting accurately who is at risk for fracture, preventing or reversing low bone mass and maximizing bone accrual during critical stages of growth are essential to minimizing future lifelong risks of fractures. This review article addresses the diagnosis of low bone mass, the anatomy of bone, risk factors for low bone density and for the prevention and treatment for low bone mass for children with CP.

Background and objectives Previous studies have demonstrated lower bone density in patients with kidney stones, but no longitudinal studies have evaluated kidney stone risk in individuals with low bone density. Small studies with short follow-up reported reduced 24-hour urine calcium excretion with bisphosphonate use. We examined history of low bone density and bisphosphonate use and the risk of incident kidney stone as well as the association with 24-hour calcium excretion. Design, setting, participants, & measurements We conducted a prospective analysis of 96,092 women in the Nurses’ Health Study II. We used Cox proportional hazards models to adjust for age, body mass index, thiazide use, fluid intake, supplemental calcium use, and dietary factors. We also conducted a cross-sectional analysis of 2294 participants using multivariable linear regression to compare 24-hour urinary calcium excretion between participants with and without a history of low bone density, and among 458 participants with low bone density, with and without bisphosphonate use. Results We identified 2564 incident stones during 1,179,860 person-years of follow-up. The multivariable adjusted relative risk for an incident kidney stone for participants with history of low bone density compared with participants without was 1.39 (95% confidence interval [95% CI], 1.20 to 1.62). Among participants with low bone density, the multivariable adjusted relative risk for an incident kidney stone for bisphosphonate users was 0.68 (95% CI, 0.48 to 0.98). In the cross-sectional analysis of 24-hour urine calcium excretion, the multivariable adjusted mean difference in 24-hour calcium was 10 mg/d (95% CI, 1 to 19) higher for participants with history of low bone density. However, among participants with history of low bone density, there was no association between bisphosphonate use and 24-hour calcium with multivariable adjusted mean difference in 24-hour calcium of −2 mg/d (95% CI, −25 to 20). Conclusions Low bone density is an independent risk factor for incident kidney stone and is associated with higher 24-hour urine calcium excretion. Among participants with low bone density, bisphosphonate use was associated with lower risk of incident kidney stone but was not independently associated with 24-hour urine calcium excretion.

Objectives: The purpose of this study was to determine alveolar bone density in patients with chronic periodontitis and aggressive periodontitis through panoramic radiography . Material and Methods: The method used in this study was descriptive. This study was conducted on populations that met all criteria. The sampling method used was purposive sampling technique, so that 31 panoramic radiographs were diagnosed with chronic periodontitis and 7 panoramic radiographs were diagnosed with aggressive periodontitis. Results: The study showed that bone density in chronic periodontitis had an average of bony trabeculae 28.6% and marrow spaces 71.4% while bone density in aggressive periodontitis had an average bony trabeculae 20.2% and marrow spaces 79.8% Conclusion: Based on the results of the study it can be concluded that bone density in patients with chronic periodontitis and aggressive periodontitis has a low bone density value. The average bone density in patients with chronic periodontitis and aggressive periodontitis has different values, where the bone density in chronic periodontitis is greater than aggressive periodontitis.

Osteoporosis is a skeletal disorder characterized by reduced bone strength that increases the risk for fracture. Approximately 10 million men and women in the United States have osteoporosis, and more than 2 million osteoporosis-related fractures occur annually. In 2016, the American Association of Clinical Endocrinologists issued the "Clinical Practice Guideline for the Diagnosis and Treatment of Postmenopausal Osteoporosis," and in 2017, the American College of Physicians issued the guideline "Treatment of Low Bone Density or Osteoporosis to Prevent Fracture in Men and Women." Both guidelines agree that patients diagnosed with osteoporosis should be treated with an antiresorptive agent, such as alendronate, that has been shown to reduce hip and vertebral fractures. However, there is no consensus on how long patients with osteoporosis should be treated and whether bone density should be monitored during and after the treatment period. In this Beyond the Guidelines, 2 experts discuss management of osteoporosis in general and for a specific patient, the role of bone density monitoring during and after a 5-year course of alendronate, and treatment recommendations for a patient whose bone density decreases during or after a 5-year course of alendronate.

It is now 75 years since Fuller Albright published his observations on the causal relationship between menopausal estrogen deficiency and osteoporosis. He introduced the concept of menopausal hormone therapy (MHT) for the prevention of osteoporosis. Most of his remarkable observations have stood the test of time and scientific scrutiny. Unfortunately, the uptake of MHT for the prevention of osteoporosis and related fractures remains very low. This can be ascribed to several factors. The availability of new drugs, supported by randomized clinical trials, has increased therapeutic options and created the impression that all new drugs are better compared to MHT. Confusion exists as to the benefit/risk profile of menopausal hormone therapy, limitations on the age of initiation of treatment, limitations on the length of treatment, and the need for treatment in the young menopausal woman with low bone density.

Various methods of using skeletal anchorage for the intrusion of overerupted maxillary molars have been reported; however, it is difficult to intrude the overerupted upper second molars because of the low bone density in the region of the tuberosity. This article illustrates a new treatment method using partial fixed edgewise appliances and miniscrews to intrude the overerupted upper second molars. The miniscrews were applied to reinforce the anchorage of the upper first molar. The intrusive force was generated by the Ni-Ti wire. The clinical results showed a significant intrusion effect without root resorption or periodontal problems. This report demonstrates that the combination of partial conventional fixed appliances with miniscrews is a simple and effective treatment option to intrude overerupted upper second molars, especially in situations where miniscrews cannot be inserted directly next to the second molar.

BACKGROUND Coronary artery calcification (CAC) and low bone density are coexisting deleterious conditions commonly shared by chronic kidney disease (CKD) patients. In the present study, we aimed to investigate whether the progression of CAC was associated with overtime reduction in bone density in non-dialyzed CKD patients. METHODS This is a prospective study of 24 months including 72 non-dialyzed CKD patients Stages 2 - 4 (age 57.6 ± 10.3 years, 62% male, 22% diabetics). CAC and vertebral bone density (VBD) were measured by computed tomography. RESULTS At baseline, 46% of the patients had CAC (calcified group) and calcification was not identified in 54% of the patients (non-calcified group). The calcified group was older, predominantly male, and had lower VBD in comparison to non-calcified group. CAC progression was observed only in the calcified group (91% of the patients increased calcium score). The multiple regression analysis revealed loss of VBD as the independent determinant of CAC progression in these patients. CONCLUSIONS CAC progression was associated with loss of VBD in non-dialyzed CKD patients.

Objective: Previous studies have suggested that depression might be associated with low bone mineral density (BMD) in women with depression. The aim of this study was to investigate the association between the BMD of women with major depressive disorder and correlated factors. Method: This prospective cross-sectional study explored the association between bone density and major depressive disorder in women. One hundred women diagnosed with major depressive disorder were enrolled. The diagnoses were made by board-certificated psychiatrists using the Mini International Neuropsychiatric Interview (MINI). The Beck Depression Inventory (BDI) was administered. The bone density of the hip was measured with dual X-ray densitometry (DEXA) using a Hologic Delphi QDR-2000 densitometer. Results: We found age, family history of osteoporosis, consumption of coffee, and consumption of tea to be associated with low BMD in single-variate analysis. Depression was also related to BMD, in that the worse the depression, the lower the BMD. Multi-variate analysis by linear regression revealed an equation of BMD = 0.91 − 0.004 × (severity of depression) + 0.07 × (tea consumption) − 0.06 × (family history of osteoporosis) − 0.04 × age. Conclusion: These results suggest that depression is associated with lower BMD, and the associated factors should be considered in depressive women. The findings of this research may be useful for improving the care of women with major depressive disorder in terms of developing appropriate and effective care plans.

Comparative analysis of the prevalence of risk factors for osteoporosis among men showed that the risk of osteopo-rosis increases with age. Lack of sufficient physical activity leads to loss of bone mineral density, and smoking is a signifi-cant risk factor. Relationship between alcohol abuse and low bone density is evident, and the lack of calcium intake from food results in bone loss. A family and patient’s own histo-ry of fractures, reduction in height, frequent consumption of caffeine-containing drinks, and low weight lead to a decrease in bone mineral density.

To review the effects of obesity surgery on oral health and to present a case report of the periodontal condition of an obese woman who underwent bariatric surgery. A search of studies related to bariatric surgery and oral health was made in PubMed. For case report, BMI, salivary flow, and periodontal condition were evaluated during three different periods. The oral health problems found were dental wear, periodontal diseases, xerostomia, and dental caries. The patient who was evaluated before bariatric surgery and was followed up for 2 years, lost 40.4 kg, presented normal blood glucose levels and controlled hypertension without medication. Salivary flow remained of equal value in the first year, there was an increase in mean probing depth and there existed low bone density in these sites. Patients who have undergone bariatric surgery need to be closely monitored after surgery to prevent the development of oral complications, especially periodontal conditions.

This Hospital Pharmacy feature is extracted from Off-Label Drug Pacts, a quarterly publication available from Wolters Kluwer Health. Off-Label Drug Pacts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to jgeneral@kumc.edu .

Osteoporosis is being increasingly recognized in pediatric practice as a consequence of several factors. These include the increasing complexity of chronic conditions and the associated treatments managed by pediatricians. In addition, the improved care provided to children with chronic illness has led to many of them living long enough to develop osteoporosis. Many children with cerebral palsy have diminished bone mineral density and the application of capacitively coupled electrical fields and low intensity pulsed ultrasound aim to improve the formation of bone cells and so may be helpful in the management of such cases. In this study, capacitively coupled electrical fields and low intensity pulsed ultrasound was conducted to investigate its effect on bone mineral density in spastic diaplegic cerebral palsy. Twenty spastic hemiparetic children were the sample of this work. There were divided randomly into two equal groups. Bone mineral densities were measured before and after six months of the application of the treatment program. Group A (control) received the physiotherapy program, while group B (study) received capacitively coupled electrical fields and low intensity pulsed ultrasound in addition to the same treatment program given to group A. Significant improvement were observed in all measuring variables when comparing the posttreatment results in both groups in favor of group B. Conclusion: Capacitively coupled electrical fields and low intensity pulsed ultrasound therapy may be considered as one of the most helpful methods of physiotherapy in management of low bone density in spastic hemiparetic cerebral palsied children.Keywords: Cerebral palsy; Hemi-paresis; Osteoporosis; Capacitively coupled electrical fields; Low intensity pulsed ultrasound

Physical activity can play a vital role in the treatment and prevention of many of the long-term effects of childhood cancer and cancer therapy. Specifically, physical activity may attenuate the long-term risk for adverse cardiovascular effects, low bone density, obesity, and poor quality-of-life measures. Physicians caring for long-term survivors of cancer should be prepared to evaluate the survivor's risk for long-term effects and provide accurate advice regarding the prescription of physical activity for the management and prevention of these problems. Knowing when physical activity prescription can help mitigate the late effects of childhood cancer and cancer therapy, and the barriers to physical activity for survivors, will help physicians provide quality care to childhood cancer survivors.

Background: The aim of this study was to verify socioeconomic differences, nutrition, body balance and quality of life (QoL) in postmenopausal women with low bone mineral density (BMD) in two Amazonian communities. Methods: A total of 42 female volunteers participated in the study. The volunteers were separated into two groups: Villa ( n = 20; 53 ± 5.5 years) and City ( n = 22; 56 ± 7.9 years). The following evaluation instruments were used: dual energy X-ray absorptiometry (DXA); a socioeconomic questionnaire; a QoL questionnaire; a dietary habits questionnaire; and a balance test. Parametric and nonparametric tests were used. Results: The data showed significant differences in socioeconomic level (Δ%=+15.9%, p = 0.000), lumbar spine L2-L4 (Δ% = +0.10%, p = 0.007), balance (Δ% = +4.3%, p = 0.03) and some important aspects of nutrition, such as the consumption of milk (Δ%=+34%, p = 0.01) and alcohol (+14.8%, p = 0.0001). These significant differences also contributed to the total QoL score (Δ%=+76.2%, p = 0.000) and the majority of the QoL-related functions. Conclusion: This study verified that socioeconomic level, nutritional status, physical activity levels and QoL can influence the BMD of postmenopausal women. The study suggests new strategies for official health organizations to use in order to prevent and treat osteoporosis. In addition, this study can provide an orientation to physical activity, nutrition and medical professionals.

To investigate the vitamin D sufficiency status and the relationships among serum 25-hydroxyvitamin D [25(OH)D] levels, intact parathyroid hormone (iPTH) levels, and bone mineral density (BMD) in patients attending an osteoporosis clinic in Singapore.In total, 193 adults with or without prevalent fragility fractures and with low BMD at the femoral neck, total hip, or lumbar spine underwent assessment. Multivariate regression models were used to investigate the relationships among serum 25(OH)D, iPTH, and BMD.The mean values (standard deviation) for age of the patients and serum 25(OH)D level were 61 (14) years and 26.05 (7.97) ng/mL, respectively. In 72% of patients, serum 25(OH)D levels were below 30 ng/mL. There was no association between 25(OH)D levels and BMD at the femoral neck, total hip, or lumbar spine (P = .568, .461, and .312, respectively). Serum iPTH levels were negatively associated with BMD at the total hip (P = .035) and the lumbar spine (P = .019). At levels30 ng/mL, 25(OH)D was negatively associated with iPTH (P = .036).Among this Southeast Asian population of patients with low BMD, no direct relationship between serum 25(OH)D levels and BMD was observed. A negative correlation existed, however, between iPTH and 25(OH)D at serum 25(OH)D concentrations30 ng/mL, and serum iPTH levels showed a significant negative association with BMD at the total hip and lumbar spine. These significant negative associations between iPTH levels and BMD at the total hip and lumbar spine underscore the critical role of this hormone in bone metabolism and health.

Aims: Osteogenesis imperfecta (OI) is a rare inherited disorder causing low bone density and increased fragility. Bisphosphonates (BP) are a treatment of choice for OI. Few studies have investigated the long-term effects of BP in OI patients. Thus, aim of our study was to follow up adults affected by OI to evaluate changes in metabolic, clinical situation and safety of long-term neridronic acid therapy, BP authorized for OI treatment. Study design: Longitudinal observational study. Place and duration of the Study: Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition. Year: 2004 - October 2010. Methodology: 68 patients underwent clinical examination, laboratory endocrine/ metabolic, pro-inflammatory cytokines screening, ECG at baseline and every 3 months and bone mineral density evaluation, by DEXA, once a year. Results: Skeletal evaluation showed a significant increase of BMD through follow up. Patients were evaluated for metabolic and cardiovascular risk factors, which were unmodified by long-term therapy. Conclusion: Long-term neridronic acid treatment increases bone density, does not alter metabolic parameters indicating that this therapy can be considered safe and a valid therapeutic option for OI patients.

The latest data support the correlation of atherosclerosis and osteoporosis, indicating the parallel progression of two tissue destruction processes with increased fatal and non-fatal coronary events, as well as higher fracture risk. Vitamin D inadequacy associated with low bone mineral density increases fall and fracture risk, leads to secondary hyperparathyroidism, calcifies coronary arteries and significantly increases cardiovascular disease. Randomized clinical trial evidence related to extraskeletal vitamin D outcomes was limited and generally uninformative. A recent recommendation on vitamin D dietary requirements for bone health is 600 IU/d for ages 1-70 years and 800 IU/d for 71 years and older, corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/ml (50 nmol/l). Further large randomized controlled trials are needed to reassess laboratory ranges for 25-hydroxyvitamin D in both diseases, in order to avoid under- and over-treatment problems, and completely clarify the relationship between atherosclerosis and osteoporosis.

Physical activity during growth induces skeletal adaptations that increase bone strength; however, it remains unclear whether these benefits persist into middle age.We sought to determine if bone loading during adolescence (ages 13-18 years) or young adulthood (ages 19-29 years) in men is associated with greater bone mineral density (BMD) and reduced risk of low bone density in adulthood. We also sought to determine if participation in high-impact activities (ie, those that produce a ground reaction force [GRF]4 times the individual's body weight] during adolescence and/or young adulthood has a lasting positive effect on adult BMD.Eighty-six, apparently healthy, physically active men (aged 30-60 years) participated in this cross-sectional study. Bone loading during adolescence, young adulthood, and adulthood were calculated based on GRFs of the reported physical activities. Whole body, lumbar spine, total hip, and femoral neck BMD were assessed using dual-energy x-ray absorptiometry (DXA). Multiple linear regression was used to examine relationships between BMD and bone loading, including body weight and/or age as covariates; logistic regression was used to predict low bone density for age. Participants were grouped based on participation in high-impact activity (never [n = 42], adolescence only [n = 19], or both adolescence and young adulthood [n=23]), and BMDs were compared.Bone loading during young adulthood, but not adolescence, was a significant positive predictor of adult BMD, with the full models explaining 33.4%, 31.7%, 44.6%, and 50.6% of the variance in whole body, lumbar spine, total hip, and femoral neck BMD, respectively. Ten participants (11.6%) had low bone density for age based on z scores of the hip or spine. Body weight and lean body mass, but not bone loading, were associated with reduced risk of low bone density for age. Individuals who participated in high-impact activity during both adolescence and young adulthood had greater BMD at all measured sites compared with those participated only during adolescence.The results of the study support a lifelong exercise prescription for bone health to preserve the skeletal benefits of activity derived from activity during adolescence and young adulthood.

Low bone mass is highly prevalent among patients receiving endosseous implants. In turn, the implantation prognosis in low-density skeletal sites is poor. However, little is known about the mechanostructural determinants of implant anchorage. Using metabolic manipulations that lead to low bone density and to its rescue, we show here that anchorage is critically dependent on the peri-implant bone (PIB). Titanium implants were inserted horizontally into the proximal tibial metaphysis of adult rats 6 weeks after orchiectomy (ORX) or sham ORX. Systemic intermittent administration of human parathyroid hormone (1-34) [iahPTH(1-34)] or vehicle commenced immediately thereafter for 6 weeks. The bone-implant apparatus was then subjected to image-guided failure assessment, which assesses biomechanical properties and microstructural deformation concomitantly. Anchorage failure occurred mainly in PIB trabeculae, 0.5 to 1.0 mm away from the implant. Mechanically, the anchorage performed poorly in ORX-induced low-density bone, attributable mainly to decreased trabecular number. iahPTH(1-34) rescued the PIB density and implant mechanical function by augmenting trabecular thickness (Tb.Th). However, implant biomechanical properties in low-density bone were relatively insensitive to implant surface treatment that affected only the osseointegration (%bone-implant contact). These results support a model wherein anchorage failure involves buckling of the weakest trabecular struts followed by sequential failure of the stronger trabeculae. Treatment with iahPTH(1-34) induced thicker struts, which were able to delay and even prevent failure of individual elements, thus implicating trabecular thickness as a prime target for enhancing implant anchorage by systemic bone anabolic therapy.

To investigate if intravenous pamidronate improves bone density in a cohort of patients with chronic neurological conditions and low bone density, in whom fractures and bone pain are impacting on care.Fourteen participants (M:F = 7:7, average age 12.4 years) were enrolled in a prospective uncontrolled study in which pamidronate was infused every 6-8 weeks over a 2 year period, the average dose received was 12.5 mg kg(-1).Bone mineral density z-score improved at all sites measured over the 2 years; whole body -4.84 to -3.14 (p = 0.01), lumbar spine -2.92 to -1.1 (p = 0.02) and femoral neck -4.6 to -3.58 (p = 0.04). Of the eight patients with pain at baseline, seven reported decreased pain after 12 months of pamidronate. Of the 11 patients who answered the general wellbeing part of the questionnaire, eight patients reported an improvement in general wellbeing and three reported no change. There was a downward trend in the average annualized fracture rate from 0.42 to 0.14 fractures per year (p = 0.09).Pamidronate improves bone density and reduces pain in children and adolescents with chronic neurological conditions.