Keterangan
The prevention and treatment of osteoporosis involve a multifaceted approach aimed at increasing bone density and strength to reduce the risk of fractures. Prevention includes adequate intake of calcium and vitamin D through diet or supplements, regular weight-bearing and muscle-strengthening exercises, lifestyle modifications such as quitting smoking and limiting alcohol consumption, and fall prevention strategies to reduce fracture risk. For treatment, bisphosphonates are commonly prescribed to slow bone loss, while denosumab, selective estrogen receptor modulators (SERMs), and parathyroid hormone analogs like teriparatide may be used to stimulate bone formation. Additionally, hormone replacement therapy (HRT) can be considered in some postmenopausal women, although its use must be carefully weighed against potential risks. Regular bone density tests are recommended to monitor the effectiveness of treatment and adjust as necessary, emphasizing the importance of a tailored approach based on individual risk factors and overall health.
Ringkasan
- The presentation focuses on osteoporosis prevention, treatment, and maintenance, particularly in menopausal women. Identifying women at risk of osteoporotic fractures is the primary goal, enabling appropriate diagnosis, treatment, and follow-up. While gynecologists don't directly treat osteoporosis, they should be aware of at-risk patients for referral to rheumatologists.
- Osteoporosis is a common skeletal disorder affecting postmenopausal women, leading to pain, disability, and reduced life expectancy. Hip fractures are particularly debilitating, often resulting in loss of independence. The presentation emphasized the importance of early detection and management to mitigate the personal and economic burdens associated with the disease.
- Osteoporotic fractures are more prevalent than heart attacks, strokes, and breast cancer. Osteopenia, a silent disease, often progresses to osteoporosis without noticeable symptoms until a fracture occurs. Early diagnosis relies on assessing a patient's history, posture, and gait, as well as utilizing bone mineral density scans.
- Risk factors for osteoporosis include gender, age, body size, family history, and ethnicity. Symptoms may manifest as height loss or changes in posture. Bone mineral density, determined by the thickness of bone, is crucial for diagnosis. Osteoblasts and osteoclasts play vital roles in bone formation and breakdown, respectively.
- High-risk populations include women with late menarche, early menopause, poor nutrition, and a family history of hip fractures. Certain medical conditions, such as inflammatory disorders and low BMI, and medications, including steroids, can also contribute to osteoporosis. Screening involves DEXA scans of the spine, hip, and forearm.
- The FRAX scoring system is used to assess the 10-year fracture risk. US guidelines recommend DEXA scans for women over 65, while UK guidelines follow individual risk assessments. T-scores are used for adults over 50, while Z-scores are for younger individuals. The presentation stresses the importance of calculating FRAX and assessing clinical risk factors.
- Management includes lifestyle changes such as preventing falls, stopping smoking, and reducing alcohol intake. Regular physical activity, calcium and vitamin D supplementation are recommended. Treatment options include anti-resorptive drugs, gentle medications, and anabolic therapy.
- The NICE guidelines recommend second and third-line treatment durations of 24 months. Follow-up treatments are recommended especially in those who had a fracture. HRT for younger postmenopausal women is another consideration.
Contoh Sertifikat
Tentang Pembicara
Dr. Yamini Dhar
Spesialis Obstetri dan Ginekologi, Rumah Sakit AlZahra, UEA
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