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Healthcare Professionals Overlook The Relevance Of Fractures – Failing To Diagnose And Treat Underlying Osteoporosis
Crownsville, MD (PRWEB) May 12, 2005
On May 1st, Osteoporosis Awareness Month, the Mid Atlantic Osteoporosis Board sent Back Breaking News (attached) to 10,OOO healthcare providers emphasizing the need to improve fracture treatment. The U.S. Surgeon General estimates roughly 1.5 million people a year suffer a bone fracture related to osteoporosis.
“….physicians who diagnose and treat fractures are not evaluating patients with acute fractures for the presence of osteoporosis and are not prescribing calcium, vitamin D, or specific pharmacological therapy to reduce future fractures,” said Dr. Marc Hochberg of the University of Maryland School of Medicine. His comments were included in an article he co-authored for the Journal of Clinical Endocrinology and Metabolism in August 2003.
The members of the Mid Atlantic Osteoporosis Board are committed to educating physicians and the lay public on how to assess, diagnose and treat osteoporosis. According to Dr. Michael Bolognese, the board’s chairman, “the board is entering its sixth year of existence and the members are more dedicated then ever. Today we see more primary care physicians involved in osteoporosis patient discussions and treatment than we did six years ago. However, fracture patients remain under-diagnosed and under-treated to prevent future fractures.”
A recent analysis of the Pennsylvania (PACE) Medicare drug benefit program from 1994 to 2000 supports this lack of attention to fractures. (American Journal of Medicine, October 2003) Over the 6 year study period 21,000 patients developed either a hip or wrist fracture. Forty nine (49) percent of the 21,000 had a prior fracture.
Over time there was a slight increase in therapeutic intervention after fracture, but by the study end only 1 out of 5 patients were taking an osteoporosis medication in the six months following fracture. According to author Dr. Daniel Solomon, “It appears that many doctors and patients do not recognize that fracture is a key event that should alert us to the presence of osteoporosis, a condition with very effective treatment options.”
To curb the osteoporosis “epidemic,” doctors should order bone density scans for older Americans who suffer bone fractures. The bone mineral density test is a painless scan in which patients lie on a table and are scanned by a machine that measures spine and hip bone density. It takes about five to ten minutes and involves a very small amount of radiation. The National Osteoporosis Foundation provides these clear guidelines for physicians ordering a bone mineral density (BMD) test:
BMD testing should be performed on:
1. All women aged 65 and older regardless of risk factors.
2. Younger postmenopausal women with one or more risk factors (other than being white, postmenopausal, and female).
3. Postmenopausal women who have suffered fractures (to confirm diagnosis and determine disease severity)
Women over 50 years of age who suffer a bone fracture should request that their physicians order a bone mineral density test to determine if they have osteoporosis.
Note to Media: The members of the Mid Atlantic Osteoporosis Board (see complete list below) will be available for media interviews during the month of May. Call 410-923-6591 to schedule an interview. Visit their website to see the entire issue of Back Breaking News and additional information, http://www.midatlanticosteo.org.
About Us: The principal mission of the MAOB is to change this perception by improving the standard of care provided by healthcare professionals throughout the District of Columbia, Delaware, Maryland, Pennsylvania, Virginia and West Virginia; simultaneously enhancing public awareness.
Established in 1999, the MAOB is a non-profit Maryland based 501(C)3 corporation comprised of specialists involved in the diagnosis and treatment of osteoporosis. These clinical experts represent various fields of medicine ranging from rheumatology to obstetrics and gynecology. To date, the MAOB has sponsored and conducted clinical trials, which have gained them both national and international recognition. Their commitment to the medical community is demonstrated through the provision of free Continuing Medical Education activities available in print and lecture format to over 15,000 physicians. In addition, the MAOB has improved public consciousness by developing WomenÂs Osteoporosis Educational Programs, whereupon 1,000s of free bone density heel scans were provided.
Contact Info: Contact: Dr. Michael Bolognese
Phone: 410-923-6591
Alternate Phone Number: 703-725-7390
Email: bolognese.m@midatlanticosteo.org
URL: http://www.midatlanticosteo.org
Additional:
Company: Mid Atlantic Osteoporosis Board
Country: United States
Contact: Dr. Michael Bolognese
Website: http://www.midatlanticosteo.org
Bus E-Mail: bolognese.m@midatlanticosteo.org
Phone: 410-923-6591
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More Osteoporosis Vitamin Press Releases
Spine-health.com Launches Info Hub To Address Osteoporosis And Spine Fractures
Chicago, IL (PRWEB) June 1, 2006 –-
Spine-health.com, the leading online medical journal for patients with back and neck problems, is making available premium quality content that informs and empowers patients and caregivers to take action on behalf of those affected by osteoporosis and spine fractures.
Unique to the Web, Spine-health.com’s new Osteoporosis & Spine Fracture Info Hub teaches patients to identify what a spine fracture feels like, how to get a fracture diagnosed, and what the latest in treatment options are for fracture-related pain and disability. The site is located at http://www.spine-health.com/osteoporosis/index.html and offers visitors peer reviewed, professionally written, unbiased articles; procedure animations; patient-to-patient insights and advice; and other free tools to fight back against thinning bones.
At least 44 million Americans, about 80% women, are impacted by osteoporosis – which can weaken the spine to the point where it can no longer sustain even minor trauma (like sneezing or rolling over in bed), resulting in a painful spine fracture. About 750,000 people suffer osteoporotic spinal fractures each year, which can result in chronic pain, decreased physical function, spinal deformity (e.g. dowager’s hump), social isolation, and even increased mortality rates. Unfortunately, only about one third of the fractures are even diagnosed, as it is often difficult to see this type of fracture on an x-ray and back pain complaints by elderly women are often dismissed as a general part of aging or simple muscle strain. According to research conducted by Spine-health.com, less than 25% of people are aware that the most common outward sign of osteoporosis is in fact a fracture.
Spine-health.com’s Osteoporosis & Spine Fracture Info Hub provides a new way for patients at risk or already suffering from osteoporosis to proactively identify and battle debilitating spine fractures. Visitors to http://www.spine-health.com/osteoporosis/index.html can now access the myriad of highly-regarded Spine-health resources about osteoporotic spine fractures all from a centralized information “hub”, learning about who’s at risk for osteoporosis and spinal fractures; the critical role of diet, exercise, and osteoporosis medications in fracture prevention; and minimally invasive surgical techniques like vertebroplasty and kyphoplasty for treating spine fractures. Visitors can also view interactive animations, access other patient’s experiences with spine fractures, join a message board discussion, or read a doctor’s response to common questions about fractures.
About Spine-health.com:
As the Web’s authoritative resource for patients with back and neck pain, Spine-health.com is already helping millions of people each year learn more about their condition and seek appropriate treatment for their pain. Through the new Osteoporosis & Spine Fracture Info Hub, Spine-health hopes to reach more patients earlier in the disease progression to improve spine fracture diagnosis and pain relief.
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, Vocus PRW Holdings, LLC.
Vocus, PRWeb, and Publicity Wire are trademarks or registered trademarks of Vocus, Inc. or Vocus PRW Holdings, LLC.
Prevent Spinal Fractures: What You Don’t Know about Osteoporosis Can Hurt You
Award-winning SpineUniverse logo
Montclair, NJ (PRWEB) May 20, 2008
Every year, there are close to 550,000 spinal fractures, compared to around 300,000 hip fractures. That’s just the reported number of fractures: because spinal fractures can be painless, some people may not realize that their bones have become so weak that they’ve cracked. Even though spinal fractures caused by osteoporosis are more common than hip fractures, hips get more hype. SpineUniverse, as part of National Osteoporosis Awareness and Prevention Month, will get the word out about spinal fractures. As an authoritative website for back pain, SpineUniverse has expanded their osteoporosis information, working toward helping more people understand the danger of spinal fractures.
For the aging American population, osteoporosis and spinal fractures should be a major concern. Baby Boomer women should be especially vigilant because even the youngest Boomers are now approaching menopause–a time when a woman’s risk of spinal fractures caused by osteoporosis dramatically increases.
“Spinal fractures from osteoporosis are particularly dangerous because they can affect your breathing, your mobility, and even irritate or damage the spinal cord or nerves,” explains Dr. Isador Lieberman, Chairman of the Spine Program at Cleveland Clinic Florida. “Although some fractures can be painless, many do cause intense chronic pain if the bone does not heal or if the nerves are pinched. Multiple spinal fractures can even decrease your lung capacity as your spine curves forward and reduces space for the lungs.”
Osteoporosis-induced spinal fractures come with a cost, of course: it’s estimated that fractures requiring hospitalization cost about $ 10,000 each in just the first year. That’s the cost for hospitals to provide care and follow-up, and with so many spinal fractures a year, costs quickly add up.
Osteoporosis is a disease that specifically affects your bone density–how strong your bones are. It literally means “porous bones”. Even healthy bones have holes in them as part of their intricate honeycomb-like design. But for people with osteoporosis, their bones have bigger holes, making them weaker and more prone to breaking. Osteoporosis is most often seen in older people, but it can occur in younger people as well. Women, especially post-menopausal women, are the most susceptible to developing osteoporosis, but that doesn’t mean that men can’t get it, too. It’s estimated that 80% of the 10 million Americans with osteoporosis are women, which means that 2 million men are living with osteoporosis.
Fortunately, osteoporosis and related spinal fractures are preventable. SpineUniverse.com offers extensive, thorough articles on osteoporosis in the spine. The following links will help patients understand what they can do about osteoporosis:
SpineUniverse Osteoporosis ConditionCenter at http://www.spineuniverse.com/osteoporosis/condition-center/
Learn easy-to-implement prevention tips at http://www.spineuniverse.com/displayarticle.php/article3518.html
Hear what respected spine surgeons have to say about possible treatment options at http://www.spineuniverse.com/displayarticle.php/article1525.html
Read about why it’s important to be screened for osteoporosis at http://www.spineuniverse.com/displayarticle.php/article3516.html
About SpineUniverse
SpineUniverse, the most-visited spine-focused site on the web, provides online and offline resources for both patients and spine professionals. SpineUniverse.com helps patients and their families understand their back or neck problems with clear, straightforward explanations about what causes spinal problems and how they can be treated. SpineUniverse.com/professional features an industry-leading library of patient case studies and education resources. Relying on an 80 member Editorial Board of leading spine experts, SpineUniverse ensures that all information presented is trustworthy and of the highest quality.
For more information, please visit http://www.spineuniverse.com.
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©Copyright 1997-
, Vocus PRW Holdings, LLC.
Vocus, PRWeb, and Publicity Wire are trademarks or registered trademarks of Vocus, Inc. or Vocus PRW Holdings, LLC.
Half of all Americans over 50 at Risk for Fractures from Osteoporosis, New Study Says
Fairfield, NJ (PRWEB) October 21, 2004
According to U.S. Surgeon General Richard H. Carmona, a new report indicates that by 2020, half of all American citizens older than 50 will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken by individuals at risk, doctors, health systems, and policymakers.
Coinciding with the skyrocketing number of cases of osteoporosis has been the marketing of new drugs to treat the condition. Fortical®, a nasal calcitonin treatment from Unigene Laboratories, is expected to be one of the newest players in the osteoporosis therapy race.
In third-party clinical trials, calcitonin demonstrated a 62 percent reduction in the incidence of new vertebral fractures for a subgroup of women over 75 years of age, one of the most significant reductions demonstrated by any current osteoporosis therapy.
In addition, calcitonin is the only therapy for the disease that can reduce the severe bone pain associated with advanced stages of the disease. Currently, calcitonin is available only as an injection or a nasal spray. Because calcitonin is a peptide, it is very difficult to administer this drug orally, as it would be digested before it could exert its therapeutic effect. However, Unigene has developed a technology that in clinical trials has made oral delivery of certain peptides possible and is currently developing an oral formulation of calcitonin.
ÂCalcitonin has a proven, 30-year record of safe human use with virtually no significant side effects and can be taken simultaneously with other medications, said Dr. Warren Levy, president and CEO of Unigene. ÂOnce therapy is initiated with any osteoporosis treatment, it should ideally be taken for life. We believe that an oral formulation of calcitonin could improve compliance to facilitate long-term administration.Â
Another therapeutic option is parathyroid hormone (PTH), which can rebuild bone mass lost due to osteoporosis. PTH has been proven to increase the volume and strength of the honeycomb-like bone infrastructure. This inner framework begins to erode in old age. In third-party studies, PTH injections have been shown to reduce the incidence of fractures by restoring some of the lost bone, although this method of administration is not preferred by most patients. Unigene and GlaxoSmithKline are jointly developing an orally administered PTH treatment.
According to “Bone Health and Osteoporosis: A Report of the Surgeon General”, 10 million Americans over the age of 50 currently have osteoporosis.
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©Copyright 1997-
, Vocus PRW Holdings, LLC.
Vocus, PRWeb, and Publicity Wire are trademarks or registered trademarks of Vocus, Inc. or Vocus PRW Holdings, LLC.
Vertebral compression fractures may occur with major trauma, such as a motorcycle accident, or with something as insignificant as a sneeze, or stepping off of a curb. With a compression fracture, the bone compressed and collapses into itself, similar to squeezing a Styrofoam peanut between your fingers.
How much force it takes to cause a compression fracture, depends on the quality of the bone. Elderly women with osteoporosis have frail, thin bones, which are easily crushed. But even the young strong bone of an 18 year old, will collapse if sufficient force is applied. These fractures may also be caused by metastatic disease, and multiple myeloma, which can weaken the bone to the point that it simply collapses.
A large majority of these fractures are termed wedge fractures, which refers to the shape of the fractured vertebra. The anterior, or front part of the vertebra, is compressed, and the posterior or back portion maintains its height. But in some cases, when sufficient force is applied, the entire vertebra is flattened.
Compression fractures cause the sudden severe pain and disability. The compression fracture itself will generally cause only back pain, focused at the sight of the fracture. Occasionally, when fracture fragments are forced out of place and begin pressing on nerves, there may be buttock and lower extremity pain as well.
Historically, the treatment for these fractures has been bed rest, and pain medication. Depending on how stable the fracture was thought to be, sometimes a brace or body cast would be added. Young people were more likely to survive the period of immobility. In the elderly population, with multiple medical problems, there was a high rate of mortality from the immobilization. People often had complications with pneumonia, blood clots, and loss of muscle. In many cases, even though the fracture would heal, people were never able to return to regular activity.
In 1998 the first kyphoplasty was performed. This new procedure has been shown to restore the height of the vertebra, and quickly stabilize the fracture. There is almost an immediate reduction in pain making it possible to mobilize patients the day after surgery. Braces or body casts are generally not necessary.
This surgery is performed through a tiny 1/2 inch incision. A large needle is threaded precisely into the center of the damaged vertebra, using flouroscopic x-ray guidance. Then a balloon is inserted and inflated in the center of the fracture. This pushes the fracture fragments back out to their original position, re-establishing the dimensions of the vertebra, and correcting any deformity.
When the surgeon is satisfied with the shape and height of the vertebra, the balloon is deflated and withdrawn. The void that is left is then filled with methyl methacrylate, which is the same bone cement that is used to glue prosthetic joint replacements in place. Within minutes this hardens and immediately stabilizes the fracture fragments.
Most people are up the next day. If their pain is not completely resolved, is greatly improved. They are generally able to return to their normal activities within a few weeks.
There are risks with any surgery, but kyphoplasty is minimally invasive and the risks are considered to be very low. It is reported that in up to 10% of cases some methyl methacrylate will extrude outside of the vertebra. In most cases this is harmless and does not cause any problems. The American Academy of Orthopedic Surgeons reports that in 1 case in 10,000 this cement may damage or irritate nerves or the spinal cord. A second surgery may be required to remove the excess cement.
The benefits of this procedure are that it greatly shortens the time of pain and disability that people with compression fractures are forced to endure. Because people are mobilized the day after surgery, it greatly reduces the risk of complications associated with prolonged bed rest.
When comparing the risks and benefits of using kyphoplasty to treat a vertebral compression fracture. The benefits seem to outweigh the risks, and this procedure may be worth considering.
Vertebral compression fractures may occur with major trauma, such as a motorcycle accident, or with something as insignificant as a sneeze, or stepping off of a curb. With a compression fracture, the bone compressed and collapses into itself, similar to squeezing a Styrofoam peanut between your fingers.
How much force it takes to cause a compression fracture, depends on the quality of the bone. Elderly women with osteoporosis have frail, thin bones, which are easily crushed. But even the young strong bone of an 18 year old, will collapse if sufficient force is applied. These fractures may also be caused by metastatic disease, and multiple myeloma, which can weaken the bone to the point that it simply collapses.
A large majority of these fractures are termed wedge fractures, which refers to the shape of the fractured vertebra. The anterior, or front part of the vertebra, is compressed, and the posterior or back portion maintains its height. But in some cases, when sufficient force is applied, the entire vertebra is flattened.
Compression fractures cause the sudden severe pain and disability. The compression fracture itself will generally cause only back pain, focused at the sight of the fracture. Occasionally, when fracture fragments are forced out of place and begin pressing on nerves, there may be buttock and lower extremity pain as well.
Historically, the treatment for these fractures has been bed rest, and pain medication. Depending on how stable the fracture was thought to be, sometimes a brace or body cast would be added. Young people were more likely to survive the period of immobility. In the elderly population, with multiple medical problems, there was a high rate of mortality from the immobilization. People often had complications with pneumonia, blood clots, and loss of muscle. In many cases, even though the fracture would heal, people were never able to return to regular activity.
In 1998 the first kyphoplasty was performed. This new procedure has been shown to restore the height of the vertebra, and quickly stabilize the fracture. There is almost an immediate reduction in pain making it possible to mobilize patients the day after surgery. Braces or body casts are generally not necessary.
This surgery is performed thru a tiny 1/2 inch incision. A large needle is threaded precisely into the center of the damaged vertebra, using flouroscopic x-ray guidance. Then a balloon is inserted and inflated in the center of the fracture. This pushes the fracture fragments back out to their original position, re-establishing the dimensions of the vertebra, and correcting any deformity.
When the surgeon is satisfied with the shape and height of the vertebra, the balloon is deflated and withdrawn. The void that is left is then filled with methyl methacrylate, which is the same bone cement that is used to glue prosthetic joint replacements in place. Within minutes this hardens and immediately stabilizes the fracture fragments.
Most people are up the next day. If their pain is not completely resolved, is greatly improved. They are generally able to return to their normal activities within a few weeks.
There are risks with any surgery, but kyphoplasty is minimally invasive and the risks are considered to be very low. It is reported that in up to 10% of cases some methyl methacrylate will extrude outside of the vertebra. In most cases this is harmless and does not cause any problems. The American Academy of Orthopedic Surgeons reports that in 1 case in 10,000 this cement may damage or irritate nerves or the spinal cord. A second surgery may be required to remove the excess cement.
The benefits of this procedure are that it greatly shortens the time of pain and disability that people with compression fractures are forced to endure. Because people are mobilized the day after surgery, it greatly reduces the risk of complications associated with prolonged bed rest.
When comparing the risks and benefits of using kyphoplasty to treat a vertebral compression fracture. The benefits seem to outweigh the risks, and this procedure may be worth considering.
David Stevens PA-C
Living with Back Pain
Fosamax carries the generic name of alendronate. It belongs to a group of drugs called bisphosphonates. The main function of the drug is to bring about changes in the cycle of bone formation and breakdown in the body. Result is that fractures can be prevented to a great extent because of the bone mass the drug helps to form. Occurrence of hip and spine fractures which may be termed as vertebral compression fractures can especially be avoided.
A number of conditions are treated with Fosamax namely osteoporosis caused in post menopause as well as induced by steroid. The drug also helps to control osteoporosis in men again by increasing bone mass. Another ailment is Paget’s disease of the bone which responds well to Fosamax.
Consumption of this drug involves some caution. One such is to stay upright for at least 30 minutes after taking the drug in order to avoid upsetting your stomach as well as esophagus. You are supposed to take it first thing in the morning with a glass of plain water before any food or drink or any other type of medication. It’s also essential to take supplementary calcium and vitamin D if intake through diet is found to be insufficient. But take care to take these as well as other medications at a different time of the day. A good exercise routine is also essential while on this drug.
Pregnant women and feeding mothers had better inform their doctor about their condition before consuming this drug because to avoid adverse effects. Make sure you keep up all appointments with your doctor as well carry out tests to test your bone mineral density regularly. Another important thing to be remembered is to take this drug only the next morning in case you miss a dose and not any other time on the same day.
Fosamax is a well known drug and at the same time it is widely considered as the best option for most of the strange diseases that you might come along. It is always advised to buy these drugs at CanAmerica Global, as you can save a lot of time and money.
Actonel is a widely prescribed drug for post menopausal osteoporosis found in umpteen women today. It’s also used in treating osteoporosis in men. So popular is the drug that in the US alone, about 50 million prescriptions have been reported to have been filled since its approval by the FDA in 2000. The generic name of the drug is risedronate and it falls in a group called bisphosphonates. Its main function is to reduce bone loss increasing bone mass which can be helpful in preventing fractures. Another condition called Paget’s disease of the bone also responds well to this drug.
Actonel may be prescribed for daily dosing or even once or twice in a month. A once a month dose approved by the FDA after a comparative study with the usual 5mg daily dose has gained popularity in recent years. Studies revealed similar increases in Bone Mineral density (BMD) in both the cases. The drug has to be taken at least 30 minutes before the first food or drink of the day with a plain glass of water. Users are advised not to lie down for the next 30 minutes. Abstain from taking any other medication including calcium, antacids, vitamins etc. during this time frame.
Pregnant women and feeding mothers should discuss with their doctors the possible implications of this drug on the unborn child and feeding infant respectively. People suffering from conditions like kidney diseases, low blood calcium, stomach ulcers etc should also inform their doctor before hand because special tests and care may be required with the administration of this drug.
In case of any severe symptoms like nausea, vomiting, numbness etc which may be indicative of an over dosage, make it a point to drink a full glass of milk and contact your local poison control center or ER right away. Get immediate care in case of serious side effects which though rare may occur in the form of chest pain, acute heartburns, jaw pain, numbness etc.
Actonel is a well known drug and at the same time it is widely considered as the best option for most of the strange diseases that you might come along. It is always advised to buy these drugs at CanAmerica Global , as you can save a lot of time and money.
The U.S. Food and Drug Administration issued a statement stating they did not find a link between thigh fractures and oral bisphosphonates – a type of osteoporosis medication, despite lawsuits alleging otherwise.
After several reports surfaced showing an increased number of atypical subtrochanteric femur fractures in women prescribed oral bisphosphonates, the FDA began investigating the osteoporosis medication. The fractures occurred just below the hip joint in the femur – the largest bone in the human body – an unusual place for a break to occur, which prompted the investigation.
Bisphosphonates are a type of osteoporosis drug used to offset bone loss and prevent bone fractures in menopausal women. The following popular medications are oral bisphosphonates:
*Fosamax – Merck and Co Inc.
*Boniva – Roche Holding AG
*Reclast – Novartis AG
*Actonel – Warner Chilcott
The FDA requested information from the oral bisphosphonates manufacturers in June 2008, however, did not find an increased rick for women using the medications. Despite the clear connection between the two, the FDA is currently working with outside sources to further examine the issue.
Bisphosphonates have a controversial history. In 2008, the drugs were investigated after several reports linked them to an increased risk of cardiovascular complications, although the FDA has since issued a statement stating no overall heart risks exist.
Additionally, Fosamax, a popular bisphosphonate, has been linked osteonecrosis, or bone death of the jaw – a potentially life-threatening side effect. Osteonecrosis occurs when poor blood supply to the bone causes slow death of the bone tissue in the jaw. ONJ side effects include loosening of teeth, exposed bone and mouth swelling.
Merck is facing close to 900 Fosamax lawsuits from patients alleging permanent jaw damage. A federal judge refused to dismiss a Fosamax lawsuit in January 2010 that alleged the drug was responsible for sever jaw damage in an Indiana woman who took the medication for nearly eight years.
The manufacturer, Merck, has repeatedly denied any association between Fosamax and increased fracture risks or ONJ. Ron Rogers, Merck’s spokesman stated that “In clinical studies, Fosamax has not been associated with increased fracture risk at any skeletal site.” Until generic versions became available, Fosamax generated close to $3 billion in sales for the company.
Unless directed otherwise by their doctor, the FDA recommends that patients continue to take their prescribed medication. The FDA has advised healthcare professionals to be aware of the “possible risk” of atypical subtrochanteric femur fractures in patients taking oral bisphosphonates, although further action has not been decided at this time.
Most women unaware of risk for fractures
An international osteoporosis study involving a McMaster University researcher has found that most post-menopausal women at risk for hip and other osteoporosis-related fractures fail to appreciate their actual risk of debilitating bone breaks.
Read more on Ancaster News
Evolving Data about Subtrochanteric Fractures and Bisphosphonates
Osteoporosis, a skeletal disorder characterized by reduced bone strength that predisposes to an increased risk of fracture, affects 10 to 12 million people in the United States. In 2000, there …
Read more on New England Journal of Medicine