Arquivos Brasileiros de Endocrinologia e Metabologia This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Diagnosis and management of Paget?s disease of bone
Conclusion: We present a scientific statement on Paget’s disease of bone providing the level of evidence and the degree of recommendation regarding causes, clinical presentation as well as surgical and medical treatment. Arq Bras Endocrinol Metab. 2014;58(6):587-99 Objetivo: Conduzir uma atualização das últimas evidências científicas a respeito da apresentação, diagnóstico e manejo clínico da doença de Paget óssea. Materiais e métodos: Este documento foi concebido pelo Departamento de Metabolismo Ósseo da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) a partir daquele oriundo do Programa d...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - September 10, 2014 Category: Endocrinology Source Type: research

Normocalcemic primary hyperparathyroidism: long-term follow-up associated with multiple adenomas
In conclusion, this is an unusual presentation of NPHPT and highlights the long-term complications.Hiperparatiroidismo primário normocalcêmico (NPHPT) caracteriza-se pela elevação do hormônio da paratiroide (PTH), na ausência da elevação dos níveis séricos de cálcio e exclusão de causas secundárias. O caso descrito ilustra o seguimento de uma mulher na pós-menopausa com NPHPT que evoluiu com múltiplos adenomas. Este caso relata uma paciente de 77 anos de idade que tem dor generalizada crônica e osteoporose. O PTH inicial foi elevado com níveis séricos de cálcio, albumina, fósforo e 25OH vitamina D norma...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Modifiable factors of vitamin D status among a Brazilian osteoporotic population attended a public outpatient clinic
Conclusions In this osteoporotic population, vitamin D supplementation of 7,000 IU/week is not enough to reach the desired 25(OH)D concentration (≥ 30 ng/mL). Engagement in physical activity and the month of the year are modifiable factors of the vitamin D status in this population. Objetivos Avaliar a concentração sérica de 25-hidroxivitamina D [25(OH)D] em pacientes osteoporóticos brasileiros e os fatores modificáveis do status de vitamina D nesta população. Sujeitos e métodos Em um estudo transversal, 363 pacientes, residentes na comunidade, que procuravam atendimento médico especializado, foram avaliado...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Surgical treatment of secondary hyperparathyroidism: a systematic review of the literature
O hiperparatireoidismo (HPT) secundário tem prevalência elevada em doentes renais crônicos. Decorre de alterações na homeostase mineral, principalmente do cálcio, que estimulam as glândulas paratireoides, com aumento na secreção de paratormônio (PTH). O estímulo prolongado pode levar à autonomia na função paratireóidea. Inicialmente, o tratamento é clínico, mas a paratireoidectomia (PTx) pode ser necessária. A PTx pode ser total, subtotal e total seguida de autoimplante de tecido paratireóideo. Este trabalho compara as indicações e resultados dessas técnicas na literatura. Foi realizada revisão siste...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Bone disease in primary hyperparathyroidism
Bone disease in severe primary hyperparathyroidism (PHPT) is described classically as osteitis fibrosa cystica (OFC). Bone pain, skeletal deformities and pathological fractures are features of OFC. Bone mineral density is usually extremely low in OFC, but it is reversible after surgical cure. The signs and symptoms of severe bone disease include bone pain, pathologic fractures, proximal muscle weakness with hyperreflexia. Bone involvement is typically characterized as salt-and-pepper appearance in the skull, bone erosions and bone resorption of the phalanges, brown tumors and cysts. In the radiography, diffuse demineraliza...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Bone disease in hypoparathyroidism
Hypoparathyroidism is a rare disorder that may be acquired or inherited. Postsurgical hypoparathyroidism is responsible for the majority of acquired hypoparathyroidism. Bone disease occurs in hypoparathyroidism due to markedly reduced bone remodeling due to the absence or low levels of parathyroid hormone. Chronically reduced bone turnover in patients with hypoparathyroidism typically leads to higher bone mass than in age- and sex-matched controls. Whether this increased bone density reduces fracture risk is less certain, because while increased bone mineralization may be associated with increased brittleness of bone, this...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Ethnic aspects of vitamin D deficiency
Vitamin D deficiency has been linked to bone fragility in children and adults, and to an increased risk of chronic diseases. The main sources of vitamin D are the diet and cutaneous synthesis, the latter being the most important one, since foods are relatively poor in vitamin D. The main factors influencing this endogenous production are the seasons, the time of day, latitude and skin phototype. Due to the contribution of sun exposure in maintaining vitamin D levels, it would be expected that this deficiency would be more prevalent in countries at a high latitude; it has been shown, however, that hypovitaminosis D is commo...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Osteoporosis management in patient with renal function impairment
Aging is associated with decreases in bone quality and in glomerular filtration. Consequently, osteoporosis and chronic kidney disease (CKD) are common comorbid conditions in the elderly, and often coexist. Biochemical abnormalities in the homeostasis of calcium and phosphorus begin early in CKD, leading to an increase in fracture risk and cardiovascular complications since early stages of the disease. The ability of DXA (dual energy X-ray absorptiometry) to diagnose osteoporosis and to predict fractures in this population remains unclear. The management of the disease is also controversial: calcium and vitamin D, although...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Long-term risks of bisphosphonate therapy
The objective this study was to summarize long-term risks associated with bisphosphonate therapy. Search of relevant medical publications for data from clinical trials, trial extensions, observational studies and post-marketing reports. Trial extensions and modifications did not reveal significant long-term safety issues. Observational data suggest at least as many benefits as risks. Post-marketing reports of musculoskeletal pain, osteonecrosis of the jaw and atypical femur fractures have been widely circulated in the lay press. Most focus on long-terms risks has been on osteonecrosis of the jaw and atypical femur fracture...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women
Physical exercise is an important stimulus for osteoporosis prevention and treatment. However, it is not clear yet which modality would be better to stimulate bone metabolism and enhance physical function of postmenopausal women. This review paper aims to summarize and update present knowledge on the effects of different kinds of aquatic and ground physical exercises on bone metabolism and physical function of postmenopausal women. Moderate to intense exercises, performed in a high speed during short intervals of time, in water or on the ground, can be part of a program to prevent and treat postmenopausal osteoporosis. Mec...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Bone markers and osteoporosis therapy
Several factors are involved in determining bone quality including bone density, bone turnover, the extent of trabecular bone connectivity, cortical porosity and geometry. Metabolically active and in a continuous process of remodeling, approximately 20% of bone tissue is renewed annually. Bone turn over markers (BTM) are frequently used in clinical trials and to provide valid information about the effectiveness of osteoporosis treatment, reflecting the state of bone metabolism and its response to treatment, although they are not useful alone to estimate bone loss. In this review the behavior of BTM from different clinical ...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Trabecular bone score: perspectives of an imaging technology coming of age
The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQ...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Bone disease after transplantation: osteoporosis and fractures risk
Organ transplantation is the gold standard therapy for several end-stage diseases. Bone loss is a common complication that occurs in transplant recipients. Osteoporosis and fragility fractures are serious complication, mainly in the first year post transplantation. Many factors contribute to the pathogenesis of bone disease following organ transplantation. This review address the mechanisms of bone loss including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and management of bone loss in the tran...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

HIV infection, bone metabolism, and fractures
With the advent of high active antiretroviral therapy there was a significant improvement on HIV subjects survival. Thus, bone changes related to HIV became an important aspect of these individuals. HIV affects bone remodeling causing bone fragility. In addition, antiretroviral therapy may also negatively affect bone metabolism. Several studies describe an increased incidence of fractures in these patients when compared with controls without the disease. The European Society of AIDS (EACS), and other societies, have included guidance on management of osteoporosis in HIV-infected patients emphasizing the identification of p...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research

Obesity and fractures
Until recently obesity was believed to be protective against fractures. However, a report from a Fracture Liaison Clinic in the UK (2010) reported a surprisingly high proportion of obese postmenopausal women attending the clinic with fractures, and in the GLOW study (2011), a similar prevalence and incidence of fractures in obese and non-obese postmenopausal women was observed. Subsequently, other studies have demonstrated the importance of obesity in the epidemiology of fractures. Obese women are at increased risk of fracture in ankle, leg, humerus, and vertebral column and at lower risk of wrist, hip and pelvis fracture ...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - August 22, 2014 Category: Endocrinology Source Type: research