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Osteoporosis

Surgeon General (Smith 2000) 

Risks of Developing Osteoporosis in Women and Men

Fractures, a common consequence of osteoporosis, and often the first indication of the disease, rank as osteoporosis' most adverse consequence. It of causes severe pain and debilitation, especially in the elderly who fall and fracture their hip, and it can lead to death from complications during the planned recovery period. Some 20% of hip fracture patients die within a year (Leibson et al. 2002).

The 1.5 million osteoporotic fractures in the United States each year lead to more than half a million hospitalizations, over 800,000 emergency room encounters, more than 2,600,000 physician office visits, and the placement of nearly 180,000 individuals into nursing homes. Hip fractures are by far the most devastating type of fracture, accounting for about 300,000 hospitalizations each year (Surgeon General 2004).

The accompanying table from the Surgeon General's 2004 report (Surgeon General 2004) indicates that at age 50 years white women carry a lifetime risk of hip, spine or forearm fracture amounting to nearly 40%, and men about 13%.

Surgeon General Report on Bone Health and Osteoporosis in 2004 (Surgeon General 2004).

The gender difference relates in part to the faster waning of sex steroid hormones in women as they age, menopause predating the more gradual andropause. Male and female sex hormones act on bone in a positive way, not surprisingly since successful reproduction depends in many ways on healthy bones in the parents.

References Cited

Listed here in alphabetical order by last name of first author as cited with publication date in the text.

• Leibson CL, Tosteson AN, Gabriel SE, Ransom JE, Melton LJ. (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr. Soc. 50(10):1644-50. PMID 12366617.

• Abstract: OBJECTIVES: To compare persons with and without hip fracture for subsequent mortality and change in disability and nursing home (NH) use. DESIGN: Population-based historical cohort study. SETTING: Olmsted County, Minnesota. PARTICIPANTS: All residents who experienced a first hip fracture between January 1, 1989, and December 31, 1993, and, for each case, a resident of the same sex and similar age who had not experienced a hip fracture and was seen by a local care provider. MEASUREMENTS: Data on disability (Rankin score), comorbidity (Charlson Index), and NH residency before baseline (fracture date for cases and registration date for controls) were obtained by review of complete community-based medical records. The records were then reviewed from baseline through December 31, 1994, for Rankin disability at 1 month and 1 year, all NH admissions and discharges, and date of death for those who died. RESULTS: There were 312 cases and 312 controls (81% female, mean age +/- standard deviation = 81 +/- 12 years). Before baseline, cases had higher comorbidity (45% vs 30% had Charlson Index >/= 1, P <.001) and disability (mean Rankin score = 2.5 +/- 1.1 vs 2.2 +/- 1.1, P <.001) and were more likely to be in a NH (28% vs 18%, P <.001) than controls. One year after baseline, estimated mortality was 20% (95% confidence interval (CI) = 16-24) for cases vs 11% (95% CI = 8-15) for controls, 51% of cases versus 16% of controls had a level of disability one or more units worse than before baseline (P <.001), and the cumulative incidence of first NH admission was 64% (95% CI = 58-71) for cases versus 7% (95% CI = 4-11) for controls. The risk of NH admission for cases relative to controls diminished over time, but remained elevated 5 years after the event (risk ratio = 20.0 at 3 months and 2.1 at 5 years), but, in persons admitted to a nursing home, cases were two times more likely than controls to be discharged alive within a year (P <.001). CONCLUSIONS: Hip fracture is an important contributor to disability and NH use, but the potential savings from hip fracture prophylaxis may be overestimated by studies that fail to consider differential risk, mortality, and long-term follow-up.

• Cummings SR, Melton LJ. (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761-7 PMID 12049882.

• Abstract: Bone mass declines and the risk of fractures increases as people age, especially as women pass through the menopause. Hip fractures, the most serious outcome of osteoporosis, are becoming more frequent than before because the world's population is ageing and because the frequency of hip fractures is increasing by 1-3% per year in most areas of the world. Rates of hip fracture vary more widely from region to region than does the prevalence of vertebral fractures. Low bone density and previous fractures are risk factors for almost all types of fracture, but each type of fracture also has its own unique risk factors. Prevention of fractures with drugs could potentially be as expensive as medical treatment of fractures. Therefore, epidemiological research should be done and used to identify individuals at high-risk of disabling fractures, thereby allowing careful allocation of expensive treatments to individuals most in need.

• Surgeon General Report. (2004) Bone Health and Osteoporosis

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Scientists

For biographies of scientists.

Template:Infobox Scientist

Table from OO

DATE EVENTS PERTINENT TO THE LIFE, WORK AND TIMES OF J.B.S. HALDANE 1837-1901 The Victorian Age: Reign of Victoria, Queen of England and Ireland 1859 Charles Darwin publishes On the Origin of Species, or the Preservation of Favoured Races in the Struggle for Survival. 1866 Gregor Mendel ... 1892 J.B.S. Born, November 5, John Burdon Sanderson Haldane, Oxford, England ~1894 J.B.S. states: "I suppose my scientific career began at the age of about two, when I used to play on the floor of his laboratory and watch him playing a complicated game called "experiments"-the rules I did not understand, but he clearly enjoyed it."  1896 Birth of J.B.S.'s sister, Naomi; later becomes Lady Mitichison 1900 Rediscovery of Gregor Mendel’s Laws of Heredity by Carl Correns, Erik von Tschermak, and Hugo de Vries; those works later to occupy JBS in attempting to synthesize Mendel's Laws and Darwin's theory of evolution. ~1900-1906 J.B.S. states: "At the age of eight or so I was allowed to take down numbers which I called out when reading the burette of a gas-analysis apparatus and later to calculate from these numbers the amounts of various gases in a sample. After this I was promoted to making up simple mixtures for his use and, still later, to cleaning apparatus."  ~1901 At age 8 years, J.B.S. accompanies his father to attend a lecture by the British experimental geneticist, Arthur Dukinfield Darbishire (1879–1915), reportedly on Mendel’s laws of inheritance, but possibly also on an opposing view of heredity, given Darbishire’s years of work attempting to reconcile the two views, the biometric and Mendelian views.  ~1904+ J.B.S. states: "After I was twelve, he [J.B.S.'s father] discussed with me all his research before publication, and sometimes tried out a lecture course on me before delivering it to students."  1912 J.B.S. at age 19 or 20, publishes his first scientific paper, on human respiratory physiology, co-authored with his father J.S. Haldane and his father’s collaborator, C.G. Douglas.

TIMETABLE OF EVENTS PERTINENT TO THE LIFE, WORK AND TIMES OF J. B. S. HALDANE (referred in this chronology as J.B.S.)

Year(s) Event 1837-1901 The Victorian Age: Reign of Victoria, Queen of England and Ireland. 1892 John Burdon Sanderson Haldane (J. B. S. Haldane) born, month-day, Oxford, England ~1894 J.B.S. states: “I suppose my scientific career began at the age of about two, when I used to play on the floor of his laboratory and watch him playing a complicated game called "experiments"-the rules I did not understand, but he clearly enjoyed it.” 1896 Sister Naomi born; later known as Lady Mitchison 1900 Rediscovery of Gregor Mendel’s Laws of Heredity by Carl Correns, Erik von Tschermak, and Hugo de Vries ~1900-1906 J.B.S. states: “At the age of eight or so I was allowed to take down numbers which I called out when reading the burette of a gas-analysis apparatus and later to calculate from these numbers the amounts of various gases in a sample. After this I was promoted to making up . simple mixtures for his use and, still later, to cleaning apparatus.” ~1901 At age 8 years, J.B.S. accompanies his father to attend a lecture by the British experimental geneticist, Arthur Dukinfield Darbishire (1879–1915), reportedly on Mendel’s laws of inheritance, but possibly also on an opposing view of heredity, given Darbishire’s years of work attempting to reconcile the two views, the biometric and Mendelian views. ~1904+ J.B.S. states: “After I was twelve, he discussed with me all his research before publication, and sometimes tried out a lecture course on me before delivering it to students.” .” 1912 J.B.S.’s first scientific paper published, on human respiratory physiology, co-authored with his father J.S. Haldane and his father’s collaborator, C.G. Douglas. Year(s) Event 1837-1901 The Victorian Age: Reign of Victoria, Queen of England and Ireland. 1892 John Burdon Sanderson Haldane born, month-day, Oxford, England 1896 Sister Naomi born; later known as Lady Mitchison 1900 Rediscovery of Gregor Mendel’s Laws of Heredity by…. new table Shell # Subshell Number No. of Orbitals Orbital Type Orbital Label 1 0 1 1s s 2 0 1 1 3 2s 2p s px, py, p 3 0 1 2 1 3 5 3s 3p 3d s px, py, p dxy, dxy, dyz, dx2-y2, dz2 4 0 1 2 3 1 3 5 7 4s 4p 4d 4f s px, py, p dxy, dxy, dyz, dx2-y2, dz2 See f orbitals here table Shell # Subshell Number No. of Orbitals Orbital Designation 1 0 1 1s 2 0 1 1 3 2s 2p 3 0 1 2 1 3 5 3s 3p 3d 4 0 1 2 3 1 3 5 7 4s 4p 4d 4f References Citations and Notes