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René Rizzoli Menopause is the time in a woman’s life when reproductive capacity ends. Ovaries decrease their activity and the production of sex hormones ceases. This period may be associated with a large variety of symptoms affecting the cardiovascular and urogenital systems, as well as skin, hair and bone. Bone capital is accumulated by the end of the second decade and remains more or less constant up to the time of menopause. Sex hormone deficiency leads to accelerated bone turnover, a negative balance and microarchitectural deterioration, which compromises bone strength, thereby increasing bone fragility and, thus, fracture risk. By the age of 80, it is estimated that 50% of trab- ular bone will have been lost. Natural menopause occurs between the ages of 45 and 54 years all over the world. This age does not appear to have changed significantly over the centuries. In contrast, since the middle of the 19th century, life expectancy, particularly in women, has increased considerably, with most women living to the age of 80 years or more in many regions of the world. This means that at the age of 50 years, a woman will live for more than 30 years without bone protection by sex hormones. This r- resents more than one-third of a woman’s life. At the age of 50 years, the lifetime risk to experience a fracture is about 50% (ie, one out of two women will have a fracture during this period).
This book responds to the daily needs of all clinicians treating patients with osteoporosis and provides a key reference guide for any challenges that arise in clinical practice. This book also covers the genetics of the disease, clinical presentation, diagnosis, and current and upcoming treatment recommendations in accordance with the latest international guidelines. Osteoporosis is a disease in which the density and quality of bone are greatly reduced, and as bones become more porous and fragile the risk of fracture increases greatly. It is one of the most common metabolic bone diseases globally with one in three women and one in five men at risk of an osteoporotic fracture, and can result in devastating physical, psychosocial, and economic consequences. However, in spite of this osteoporosis can often be overlooked and undertreated, thus there is a real need to raise awareness of this disease.
This first-ever Surgeon General's Report on bone health and osteoporosis illustrates the large burden that bone disease places on our Nation and its citizens. Like other chronic diseases that disproportionately affect the elderly, the prevalence of bone disease and fractures is projected to increase markedly as the population ages. If these predictions come true, bone disease and fractures will have a tremendous negative impact on the future well-being of Americans. But as this report makes clear, they need not come true: by working together we can change the picture of aging in America. Osteoporosis, fractures, and other chronic diseases no longer should be thought of as an inevitable part of growing old. By focusing on prevention and lifestyle changes, including physical activity and nutrition, as well as early diagnosis and appropriate treatment, Americans can avoid much of the damaging impact of bone disease and other chronic diseases. This Surgeon General's Report brings together for the first time the scientific evidence related to the prevention, assessment, diagnosis, and treatment of bone disease. More importantly, it provides a framework for moving forward. The report will be another effective tool in educating Americans about how they can promote bone health throughout their lives. This first-ever Surgeon General's Report on bone health and osteoporosis provides much needed information on bone health, an often overlooked aspect of physical health. This report follows in the tradition of previous Surgeon Generals' reports by identifying the relevant scientific data, rigorously evaluating and summarizing the evidence, and determining conclusions.
This Atlas provides an up-to-date and comprehensive overview of the historical and current perspectives on osteoarthritis, including the pathophysiology and epidemiology of the disease. Written by leading authors in the field of osteoarthritis, the book discusses classification, etiology and risk factors for osteoarthritis, the disease course and determinants of osteoarthritis progression, clinical features and diagnosis as well as imaging methods to assess joint damage. The Atlas of Osteoarthritis concludes with the latest treatment updates including both nonpharmacological and pharmacological treatments, as well as surgical recommendations for patients with the disease. Osteoarthritis is the most common form of joint disease causing joint pain, stiffness, and physical disability among adults. It is an important issue for both the individual and society with its impact on public health continuing to grow as a result of the aging population, the rising prevalence of obesity, and the lack of definitive treatments to prevent or halt the progress of the disease.
EDITOR-IN-CHIEF: Clifford J. Rosen, M.D., Maine Medical Center Research Institute, Scarborough, Maine SENIOR ASSOCIATE EDITORS: Juliet E. Compston, M.D., FRCP, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom Jane B. Lian, Ph.D., University of Massachusetts Medical School, Worcester, Massachusetts This comprehensive yet concise handbook is an indispensable reference for the many clinicians who see patients with disorders of bone formation, metabolic bone diseases, or disorders of stone formation. It is also a crucial tool for researchers, students, and all other professionals working in the bone field. In a format designed for quick reference, it provides complete information on the symptoms, pathophysiology, diagnosis, and treatment of all common and rare bone and mineral disorders. New in this edition: detailed coverage of osteonecrosis of the jaw, more in-depth coverage of cancer and bone including new approaches to pathogenesis, diagnosis, and treatment; new approaches to anabolic therapy of osteoporosis; the latest research on Vitamin D; expanded coverage of international topics; more on the genetics of bone mass; and newer imaging techniques for the skeleton. In addition, this edition features a free, online-only appendix of medicines used to treat bone disorders and their availability around the world.
Written by a world-recognised expert in the field of osteoporosis, who has published extensively, and is recognized as a key opinion leader. Aimed at primary care physicians, rheumatologists, orthopaedic surgeons, geriatricians, endocrinologists, and nurse specialists who wish to keep up to date in the prevention and management of osteoporosis High quality clinical photos and figures to enhance descriptions and aid diagnosis Written by a well-known author During the menopause, both the quantity and quality of bone decline rapidly, leading to a dramatic increase in the risk of fracture in postmenopausal women. Although many factors are known to be associated with osteoporotic fractures, measures to identify and treat women at risk are underused in clinical practice. Consequently, osteoporosis is frequently not detected until a fracture occurs. Identification of postmenopausal women at high risk of fracture therefore is a priority. The Handbook of Osteoporosis reviews the risk factors, and lifestyle changes that can help prevent osteoporosis and evaluates the pharmacological treatments currently available.
The 4th International Symposium on Women's Health and Menopause, organized by the Giovanni Lorenzini Medical Foundation (Milan, Italy and Houston, Texas) focused on the new strategies to improve the quality of life of post-menopausal women. This volume illustrates the findings of this conference and includes information on the age-related degenerative processes occurring after menopause including cardiovascular disease, cancer, fractures and dementia.
When considering the idea of using machine learning in healthcare, it is a Herculean task to present the entire gamut of information in the field of intelligent systems. It is, therefore the objective of this book to keep the presentation narrow and intensive. This approach is distinct from others in that it presents detailed computer simulations for all models presented with explanations of the program code. It includes unique and distinctive chapters on disease diagnosis, telemedicine, medical imaging, smart health monitoring, social media healthcare, and machine learning for COVID-19. These chapters help develop a clear understanding of the working of an algorithm while strengthening logical thinking. In this environment, answering a single question may require accessing several data sources and calling on sophisticated analysis tools. While data integration is a dynamic research area in the database community, the specific needs of research have led to the development of numerous middleware systems that provide seamless data access in a result-driven environment. Since this book is intended to be useful to a wide audience, students, researchers and scientists from both academia and industry may all benefit from this material. It contains a comprehensive description of issues for healthcare data management and an overview of existing systems, making it appropriate for introductory and instructional purposes. Prerequisites are minimal; the readers are expected to have basic knowledge of machine learning. This book is divided into 22 real-time innovative chapters which provide a variety of application examples in different domains. These chapters illustrate why traditional approaches often fail to meet customers’ needs. The presented approaches provide a comprehensive overview of current technology. Each of these chapters, which are written by the main inventors of the presented systems, specifies requirements and provides a description of both the chosen approach and its implementation. Because of the self-contained nature of these chapters, they may be read in any order. Each of the chapters use various technical terms which involve expertise in machine learning and computer science.
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.
Ultrasound is quickly becoming the technique of choice in the measurement of bone density. Proving cheaper and more portable than previous techniques, and also having the advantage of not using ionizing radiation, it is likely that the use of various ultrasound systems will become increasingly widespread in clinical practice. This book is a comprehensive review of the systems currently available, preceded by a summary of the basic science of ultrasound and concluding with a section on clinical studies, trials and experience in a number of countries. Likely future developments are also discussed, bringing the book completely up to date.