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8/14/2019 1-23 Osteoporosis Symposium
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INTRUDUCTIONOSTEOPOROSIS
PREVENTION SOCIETYESTABLISHMENT
Hazem Abdel Azeem
Prof. of Orthopedic Surgery, Cairo University
Cairo April 2005
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As more & more diseases become eradicated
Leading causeof death will
become
Osteoporosis
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Hard Structure should not beleft to fail
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Age-related changes
After age 60, subperiostealarea slowly increases butmedullary cavity enlargesfaster, resulting in netdecrease of corticalthickness and mass
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Underdiagnosed and Undertreated
osteoporosis is commonly notdiagnosed or treated appropriately
Follin SL et al. Pharmacotherapy . 2003;23:190-198 .
large numbers of people withosteoporosis are still not beingdiagnosedare not being treated.
Schnitzer TJ. Diagnosis and Treatment for Osteoporosis:Current Status and Expectations for the New Millennium.Available at: http://www.medscape.com/viewprogram/605.
Women are not aggressively treated for
osteoporosis after hip fractureKiebzak GM et al. Arch Intern Med . 2002;162:2217-2222 .
http://www.medscape.com/viewprogram/605.%20Accessed%20May%2028http://www.medscape.com/viewprogram/605.%20Accessed%20May%20288/14/2019 1-23 Osteoporosis Symposium
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BE AWARE
of The Silent Thief
The Deafening Silent Epidemic
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Over Suspicion
Due to wrong awareness propaganda
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A lifestyle conducive to osteoporosis
Milk intake low
Body image distorted
Exercise non existent
Smoking on the riseSteroid abuse excessive
Health education patchy
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DRUGS RELATED RISKS Smoking
Glucocorticoids and ACTH
Thyroxine
Anticonvulsants
Heparin
Lithium
Cytotoxic
Gonadotrophin-RH agonists
Tamoxifen
Medroxyprogester-one acetate
Aluminium Excess Vitamin D Drugs causing falls Hyperoxia
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MORBIDITY OF OSTEOPOROSIS
Osteoporotic Bone LossOsteoporoticOsteoporotic Bone LossBone Loss
NormalOsteoporosis
Dempster DW, et al. J Bone Min Res . 1986;1:15-21.Reprinted with permission from the American Society for Bone and Mineral Research.
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PAINS
MICROFRACTURES. LONG STANDING
KYPHOSIS. ASSOCIATED
OSTEOMALACIA. OSTEOPOROTIC
FRACTURES. MUSCULAR. FIBROMYOSITIS.
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FRACTURES
FRAGILITYFRACTURES.
MINOR TRAUMA.
COMMON SITES Spine. Proximal end of femur. Distal end of radius. Proximal end of humerus.
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PROGRESSIVE KYPHOSI
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Assessment of osteoporosis (aim)
Diagnosis.
Identification of disorders mimicking osteoporosis. Identification of risk factors.
Methodology for prognosis. Selection of treatment . Baseline for response evaluation.
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Evolution of Diagnostic Facilities for Osteoporosis
X-Ray
Densitometry
Laboratory; New Bone Markers
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Bone Biopsy
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X-Ray Diagnosed Patient
Risk Factors Person
Densitometry diagnosed patient
History of Low-Trauma
(Fragility) Fracture
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Conclusion
Everything about Osteoporosis on the RISE!!
Patient numbers increase as life expectancy rises
Increase risk factors- Early menopause
- Increase smoking
- Increase use of steroids
- Increase sedentary life
Increase in available options for treatment of Osteoporosis
Increase in Research for development of new treatments
Increase in awareness of Osteoporosis
Increase in ways of surgical management (internal fixation,replace tools, bone stimulation)
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Evolution of Medical Treatment Options for Osteoporosis
1986 Calcitonin, HRT
1997 Alendronate, Bisphosphonate daily launch
2001 Risedronate, Bisphosphonate daily launch
2002
Weekly Bisphosphonates launched
Raloxifene, SERM launch WHI study highlights risk of HRT
2003 Parathormone available
And many more to come..
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Evolution of Surgical Treatment Options for Osteoporosis
Leave patient with fracture neck of femur & advise patient to rest
Internal fixation or ways to replace
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High Costs :How Many of Our Patients Have These Facilities?
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Who is picking up the bill inEgypt?
?
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Inaugurated 1999 EOPS
Founders Prof. Samir El Badawi & Prof. Hazem Abdel Azeim
Board Members Prof. Ahmed Rashed, Prof. Omar Hussein, Prof. Ahmed
Mortegy, Prof. Amal El Badawi, Prof. Mohamed Hassan, Mr.
Hatem Sedky, Mrs Nafeesa AbedGeneral Assembly
300 Members
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the correct awareness among the medical & non-medical communitiesresearch work related to osteoporosispublications related to osteoporosisng scientific meetings both National & in conjunction with IOF, PAOS, & Mediterranean Osteoporosis Societywith Pharmaceutical companies & scientific offices interested in the field of Osteoporosis
AIMS
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National Osteoporosis Conferences 2003 PanArab Osteoporosis Society Meeting in
Egypt September 2005 Annual National Osteoporosis
Prevention Society Conference Social events to propagate patient awareness
Activities
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Level of awareness of Osteoporosis Egyptian curve for BMD Steroid Induced Osteoporosis
Discharge Program after fracture Osteoporosis in Males
Research
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New Research Directions
HOW to
PREVENT
DIAGNOSEEARLY
TREAT
PREVENT FRACTURES &SUBSEQUENT SEQUELAE PAIN
& DEFORMITIES
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HOWEVER we are still getting fractures
-Maybe in older age
-Maybe more than once (2ndry fractures)
So we must have
better ways of Management
1. Complete diagnosis (assessment)2. Treatment of fractures
3. Prevention of further fractures
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BoneStrength
BMD
Bone Turnover Bone QualityOsteoporosis is defined as a skeletal disorder characterized by
compromised
bone strength predisposing a person to an increased risk of fracture. NIH Consensus Development Panel, JAMA. 2001;285(6):785-795
Bone Strength Depends on Three Elements
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THANK YOU