EMAS position statement: Bone densitometry screening for osteoporosis

Brincat, Mark; Calleja‐Agius, Jean; Erel, C. Tamer; Gambacciani, Marco; Lambrinoudaki, Ιrene; Moen, Mette Haase; Schenck‐Gustafsson, Karin; Trémollières, Florence; Vujovic, Svetlana; Rees, Margaret; Rozenberg, Serge

doi:10.1016/j.maturitas.2010.09.009

Cited by 14 publications

(14 citation statements)

References 26 publications

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“…Low bone mass is a risk factor for fractures at nearly all skeletal sites [ 4 ]. However, it has been claimed that BMD assessment is not a cost-effective population screening tool and is best applied based on age and other risk factors [ 5 ]. Worldwide the osteoporotic and normal patients are defined according to the “ T -score”, which is the number of standard deviations above or below the mean BMD for normal young adults as follows: normal BMD is defined as a T -score between +2.5 and –1.0 (i.e., the patient's BMD is between 2.5 standard deviations (SDs) above the young adult mean and one SD below the young adult mean); osteopenia (low BMD) is associated with a T -score between –1.0 and –2.5, inclusive; osteoporosis is defined as a T -score lower than –2.5; severe or established osteoporosis defines patients whose T -score is below –2.5 and who also have suffered a fragility fracture.…”

Section: Diagnosismentioning

confidence: 99%

“…The probability of fracture in an individual can be estimated using different models and algorithms that integrate various risk factors for fracture. They include the FRAX ® model developed by the World Health Organization [ 5 ]. FRAX ® estimates the 10-year probability of fracture combining clinical risk factors ( Table II ) with or without BMD (available online at www.sheffield.ac.uk/FRAX/ ).…”

Section: Diagnosismentioning

confidence: 99%

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Featured Editorial Hormone replacement therapy and the prevention of postmenopausal osteoporosis

Gambacciani¹,

Levancini²

2014

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107

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Fracture prevention is one of the public health priorities worldwide. Estrogen deficiency is the major factor in the pathogenesis of postmenopausal osteoporosis, the most common metabolic bone disease. Different effective treatments for osteoporosis are available. Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant, reduction in vertebral and non-vertebral fractures. Tibolone, a selective tissue estrogenic activity regulator (STEAR), is effective in the treatment of vasomotor symptoms, vaginal atrophy and prevention/treatment of osteoporosis with a clinical efficacy similar to that of conventional HRT. Selective estrogen receptor modulators (SERMs) such as raloxifene and bazedoxifene reduce turnover and maintain or increase vertebral and femoral BMD and reduce the risk of osteoporotic fractures. The combination of bazedoxifene and conjugated estrogens, defined as tissue selective estrogen complex (TSEC), is able to reduce climacteric symptoms, reduce bone turnover and preserve BMD. In conclusion, osteoporosis prevention can actually be considered as a major additional benefit in climacteric women who use HRT for treatment of climacteric symptoms. The use of a standard dose of HRT for osteoporosis prevention is based on biology, epidemiology, animal and preclinical data, observational studies and randomized, clinical trials. The antifracture effect of a lower dose HRT or TSEC is supported by the data on BMD and turnover, with compelling scientific evidence.

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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Featured Editorial Hormone replacement therapy and the prevention of postmenopausal osteoporosis

Gambacciani¹,

Levancini²

2014

Self Cite

107

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“…Among women at high risk for fracture, defined as those over 65 years of age and having at least 2 other fracture risk factors, only about one third in USA reported treatment with osteoporosis medication (19). Many guidelines suggest women with age ≥60 or ≥65 years should have osteoporosis screening (3,5,(20)(21)(22)(23). The International Society for Clinical Densitometry recommends DXA (dual-energy X-ray absorptiometry) assessment for all women and men aged ≥65 and ≥70 years, respectively (24).…”

Section: Review Articlementioning

confidence: 99%

Interpretation of osteoporotic vertebral deformity on frontal view radiographs of the chest and abdomen: a pictorial review

Wáng¹,

Du²,

Gong³

et al. 2021

Quant Imaging Med Surg

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Osteoporotic vertebral fracture (OVF) has high prevalence in the elderly population. It affects at least one-fourth of all postmenopausal women and is commonly seen among women approximately one decade after menopause. A vertebral fracture, after minor trauma, is a hallmark of osteoporosis. Many fractures and associated complications, including secondary fractures and mortality, can be prevented by routine osteoporosis screening in older people and timely treatment initiation in at-risk individuals.Depending on the technical condition of the radiographs, a substantial portion of moderate to severe grades OVFs in mid-thoracic and lower thoracic spine as well as lumbar spine can be detected on a frontal view digital radiograph of the chest or abdomen. Radiologists should pay attention to the potential existence of an OVF while reading chest and abdominal radiographs of elderly female subjects. In this pictorial review, we describe our experience in evaluating the normal shaped and deformed vertebrae on chest and abdominal radiographs.

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“…For them (and others), international scientific societies have provided numerous clinical standards and guidelines on treatment of menopausal symptoms, including the International Menopause Society (IMS) [23], EMAS [24][25][26][27], Endocrine Society [19,28], North American Menopause Society (NAMS) [29][30][31][32] and NICE [33]. EMAS has also provided recommendations on the management of menopausal women with comorbidities such as cardiovascular disease [34,35], osteoporosis [36][37][38][39], obesity [40,41], endometriosis [42], lichen sclerosus [43] and epilepsy [44]. Despite the many recommendations available, an electronic survey of UK GPs found that the majority lacked confidence in effectively managing peri-and postmenopausal women [45].…”

Section: Current Healthcare Provision For Menopausal Womenmentioning

confidence: 99%

A model of care for healthy menopause and ageing: EMAS position statement

Stute

Ceaușu

Depypere³

et al. 2016

Maturitas

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Worldwide, the number of menopausal women is increasing. They present with complex medical issues that lie beyond the traditional scope of gynaecologists and general practitioners (GPs). The European Menopause and Andropause Society (EMAS) therefore provides a holistic model of care for healthy menopause (HM). The HM healthcare model's core consists of a lead clinician, specialist nurse(s) and the woman herself, supported by an interdisciplinary network of medical experts and providers of alternative/complementary medicine. As HM specialist teams are scarce in Europe, they are also responsible for structuring and optimizing processes in primary care (general gynaecologists and GPs) and secondary care (HM specialists). Activities for accreditation of the subspecialty Women's Health are encouraged.

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EMAS position statement: Bone densitometry screening for osteoporosis

Cited by 14 publications

References 26 publications

Featured Editorial Hormone replacement therapy and the prevention of postmenopausal osteoporosis

Featured Editorial Hormone replacement therapy and the prevention of postmenopausal osteoporosis

Interpretation of osteoporotic vertebral deformity on frontal view radiographs of the chest and abdomen: a pictorial review

A model of care for healthy menopause and ageing: EMAS position statement

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