复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)谢瑞满 - 骨质疏松症 Osteoporosis

Chapter 28 Osteoporosis Presentation: 2005 谢瑞满 Rui-man xie,Ph.D,MD Professor of Neurology Gerontology ZhongShan Hospital, Fudan University rmxie@zshospital.netxieruiman@yahoo.com
Chapter 28 Osteoporosis Presentation: 2005 谢瑞满 Rui-man Xie,Ph.D., M.D. Professor of Neurology & Gerontology ZhongShan Hospital, Fudan University rmxie@zshospital.net, xieruiman@yahoo.com

Obiective 1 Definition, types and mechanism of osteoporosis 2 Diagnosis, prevention and treatment of osteoporosis 3 Etiology and epidemiology of osteoporosis times-45 minutes×2
Objective 1、Definition、types and mechanism of osteoporosis 2、 Diagnosis、prevention and treatment of osteoporosis 3 、Etiology and Epidemiology of osteoporosis times – 45 minutes×2

Overview Definition: Osteoporosis is a bone disease in which the amount of bone is decreased and the structural integrity of trabecular bone is impaired. Cortical bone becomes more porous and thinner This makes the bone weaker and more lkely to fracture
Overview Definition : Osteoporosis is a bone disease in which the amount of bone is decreased and the structural integrity of trabecular bone is impaired. Cortical bone becomes more porous and thinner. This makes the bone weaker and more likely to fracture

豢 fiqures
figures

aSsociated changes in body shape and vertebra ( deleted 6 pictures) norma 50vrs above 55yrs above kyphosis 75yrs S
Associated changes in body shape and vertebra (deleted 6 pictures) norma l 50yrs above 55yrs above 75yrs kyphosi s

Patients with risk factors or conditions that cause osteoporosis Postmenopausal woman with family history of hip fractures or kyphosis + Medications: corticosteroids, dilantin, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, thyroid, heparin, cyclosporin, depot- medroxy progesterone acetate Hereditary skeletal diseases: osteogenesis imperfecta, rickets, hypophos phatasia Endocrine and metabolic: hypogonadism, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, Gaucher's disease Marrow diseases: myeloma, mastocytosis, thalassemia Others: Anorexia, Malabsorption cystic fibrosis, renal insufficiency, Hypercalciuria, Hepatic disease, Depression, Spinal cord injury, Systemic Lupus, Weight below healthy range, Cigarette smoking
Patients with risk factors or conditions that cause osteoporosis Postmenopausal woman with family history of hip fractures or kyphosis Medications: corticosteroids, dilantin, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, thyroid, heparin, cyclosporin, depotmedroxyprogesterone acetate Hereditary skeletal diseases: osteogenesis imperfecta, rickets, hypophosphatasia Endocrine and metabolic: hypogonadism, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, Gaucher's disease Marrow diseases: myeloma, mastocytosis, thalassemia Others: Anorexia, Malabsorption, Cystic fibrosis, Renal insufficiency, Hypercalciuria, Hepatic disease, Depression, Spinal cord injury, Systemic Lupus, Weight below healthy range, Cigarette smoking

epic idemiology The population of older men and women has been increasing, and therefore the number of people with osteoporosis is increasing + In the USA, about 21%of postmenopausal women have osteoporosis (low bone density), and about 16% have had a fractur n women older than 80, about 40 have re. experienced a fracture of the hip, vertebra, arm, or pelvis. * Women have more osteoporotic fractures than men. Age is one of the most important risks in all groups w The decreased physical activity may be playing a role in increased hip fractures
Epidemiology The population of older men and women has been increasing, and therefore the number of people with osteoporosis is increasing. In the USA, about 21% of postmenopausal women have osteoporosis (low bone density), and about 16% have had a fracture. In women older than 80, about 40% have experienced a fracture of the hip, vertebra, arm, or pelvis. Women have more osteoporotic fractures than men. Age is one of the most important risks in all groups. The decreased physical activity may be playing a role in increased hip fractures

Mechanism Bone physiology a The bone is continuously remodelling, and the bone surface moves in and out. The Basic Multicellular Unit (BMU)is a wandering team of cells that dissolves an area of the bone surface and then fills it with new bone. the sequence is Origination, Osteoclast recruitment, Resorption, Osteoblast recruitment osteoid formation mineralization mineral maturation. Quiescence w Bone strength(Quality): In addition to bone porosity, the bone strength is determined by the trabecular microstructure Perforations of individual trabecula occur when resorption cavities are too deep. This, too, is seen with estrogen deficiency. The remaining trabecula are not as well connected and are mechanically weaker
Mechanism : Bone physiology The bone is continuously remodelling, and the bone surface moves in and out. The Basic Multicellular Unit (BMU) is a wandering team of cells that dissolves an area of the bone surface and then fills it with new bone. The sequence is Origination, Osteoclast recruitment, Resorption, Osteoblast recruitment, Osteoid formation, Mineralization, Mineral maturation, Quiescence. Bone strength (Quality): In addition to bone porosity, the bone strength is determined by the trabecular microstructure. Perforations of individual trabecula occur when resorption cavities are too deep. This, too, is seen with estrogen deficiency. The remaining trabecula are not as well connected and are mechanically weaker

Mechanism Bone physiology a Microfracture healing is another aspect of bone strength that is not measured by bone density. Trabeculae inside the bone may fracture and microcalluses are formed that resemble the calluses seen on xrays of long bones after a macro-fracture. Osteoporotic bone is more susceptible to e these fractures because the individual trabeculae do not have as many reinforcing connections. The calluses may represent a method of repairing the bone and even connecting some of the trabecula. Bone which has lost the ability to form these calluses will be weaker The age of the bone mineral crystals may also play a role in the strength of bone. This is an area that needs further research. Studies suggest that older bone is more brittle and that one purpose of bone remodelling is to remove the old bone and replace it with newer, more elastic bone
Mechanism : Bone physiology Microfracture healing is another aspect of bone strength that is not measured by bone density. Trabeculae inside the bone may fracture and microcalluses are formed that resemble the calluses seen on xrays of long bones after a "macro-fracture". Osteoporotic bone is more susceptible to these fractures because the individual trabeculae do not have as many reinforcing connections. The calluses may represent a method of repairing the bone and even connecting some of the trabecula. Bone which has lost the ability to form these calluses will be weaker. The age of the bone mineral crystals may also play a role in the strength of bone. This is an area that needs further research. Studies suggest that older bone is more brittle, and that one purpose of bone remodelling is to remove the old bone and replace it with newer, more elastic bone

T Clinical manifestation and types w Secondary osteoporosis: Mndocrine and metabolic: hypogonadism hyperparathyroidism, hyperthyroidism, Cushing syndrome acidosis Gaucher's disease Marrow diseases: myeloma, mastocytosis, thalassemia Medications: corticosteroids, dilantin, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, thyroid, heparin, cyclosporin, depot-medroxyprogesterone acetate Malabsorption, Hepatic disease, others Hereditary skeletal diseases osteogenesis imperfecta, rickets, hypophosphatasia; 秦 Primary osteoporosis
Clinical manifestation and types Secondary osteoporosis: Mndocrine and metabolic: hypogonadism, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, Gaucher's disease; Marrow diseases: myeloma, mastocytosis, thalassemia; Medications: corticosteroids, dilantin, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, thyroid, heparin, cyclosporin, depot-medroxyprogesterone acetate; Malabsorption、Hepatic disease, others; Hereditary skeletal diseases: osteogenesis imperfecta, rickets, hypophosphatasia; Primary osteoporosis
按次数下载不扣除下载券;
注册用户24小时内重复下载只扣除一次;
顺序:VIP每日次数-->可用次数-->下载券;
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)谢毅-白血病 Leukemia.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)谢彦辉-贫血概述 ANEMIA.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)蔡映云-慢支肺气肿 COPD.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)范维琥-心力衰竭 Heart failure.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)胡必杰-肺炎 Respiratory Diseases Pneumonia.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)胡仁明-糖尿病 Diabetes Mellitus.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)白春学-呼吸衰竭 Respiratory Failure.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)王吉耀-内科学绪论 INTRODUCTION TO INTERNAL MEDICINE.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)王吉耀 - 肝硬化 Hepatic Cirrhosis.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)沈锡中-炎症性肠病(Inflammatory bowel disease,IBD).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)李益明-甲状腺功能减退 Hypothyroidism.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)李勇-高血压诊断和治疗(从JNC-7和2003 ESC/EHC指南到临床实践).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)施海明-心肌疾病.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)於强-血管炎病的诊断与治疗 Vasculitides.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)於强 - Systemic Lupus Erythematosus(SLE).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)徐建民-特发性血小板减少性紫癜 DISORDERS OF HEMOSTASIS.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)徐建民-出血性疾病 DISORDERS OF HEMOSTASIS.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)徐三荣-急性胰腺炎 ACUTE PANCREATITIS.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)张顺财 - 黄疸鉴别 Differencial Diagnosis of Jaundice.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)张新-支气管肺癌.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)谢瑞满 - 骨质疏松症(Osteoporosis, OP).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)邹和健-风湿——血清阴性脊柱关节病(Serum RF negative spondylarthropathy).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)邹和建-理化因素所致疾病.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)邹善华 - 淋巴瘤 Lymphoma.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)邹善华-再生障碍性贫血 Aplastic Anemia(AA).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)邹善华-缺铁性贫血 Iron-Deficiency Anemia.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)陆福明-尿毒症 Chronic Renal Insufficiency.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)陈勤奋-溶血性贫血 Hemolytic Anemia.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)陈小东-支气管哮喘 bronchial asthma.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)顾勇-急性肾衰 Acute Renal Failure.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)顾勇-水电解介酸碱平衡 Disorders of Fluid and eletrolyte Metabolism.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)顾勇-肾脏总论 General Concepts of Renal Disease.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)高鑫-内分泌系统疾病总论 Introduction to Endocrinology and Metabolic Diseases.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)黄培志 - 危重医学 Critical Care Medicine.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)黄培志-心肺复苏 Cardiopulmonary Resuscitation.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(练习题)内分泌和代谢系统.doc
- 复旦大学附属中山医院:《内科学》课程教学资源(练习题)呼吸系统.doc
- 复旦大学附属中山医院:《内科学》课程教学资源(练习题)心血管系统疾病.doc
- 复旦大学附属中山医院:《内科学》课程教学资源(练习题)泌尿系统疾病.doc
- 复旦大学附属中山医院:《内科学》课程教学资源(练习题)消化系统疾病.doc