As the Salvadoran population's life expectancy increases, fractures among the elderly are also increasing. There is a dearth of data available on the incidence and cause of fractures in the elderly within developing countries including El Salvador. Inadequate knowledge about bone health and osteoporosis among the elderly is contributing to health issues in the aging population. The purpose of this study was to investigate incidence, knowledge, causes, and risk factors affecting elderly patients admitted for fractures at Hospital Zacamil in order to develop programs targeted to prevention. Study objectives included: 1) determine incidence, causes, and treatment of elderly fractures including hip fractures, vertebral fractures, and forearm fractures and related post-morbidity and/or mortality; 2) compare patient knowledge, cause, treatment of fractures and related post-morbidity and/or mortality among those aged 45 to 65 years with those over 65 years; 3) determine the level of knowledge and presence of risk factors for fractures and osteoporosis among patients including diet, exercise, and environmental risk factors and compare by gender. The research was approved by IRB prior to data collection. The methodology included a researcher-designed and validated survey administered to an accepting sample of 155 patients presenting with fractures to Hospital Zacamil between January 2008 and May 2008. The data were analyzed with SPSS software. Findings indicate that the incidence of fractures in the study sample and those in developed countries are similar. Knowledge and presence of risk factors are similar by age and gender within the study sample. The primary conclusion was that education is needed to prevent falls and osteoporosis. Recommendations for further research include recognition of culturally-specific factors in prevention education and further study of the methods of addressing prevention in the specified population and the outcomes of the educational intervention. / Ph. D.

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No. of bitstreams: 2 Tese - Sara Rosa de Sousa Andrade - 2016.pdf: 12991516 bytes, checksum: 691ed2fcef4d1a34bf6529be8af8c97a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-04-04 / To determine the accuracy of the phalanx ultrasound and bone quality tracker element in view of osteoporosis, produce a review article covering the various diagnostic methods for osteoporosis; establish diagnostic tests ultrasonometry as bone quality, according to age, set a Bone Quality nomogram (UBPI) view ultrasound and build bone quality normal curve according to age setting the cut off of pathological risk. Methods: A descriptive, analytical study of diagnostic accuracy. Attended the screening 932 women, of these, 125 were selected for agreeing to participate and fit the inclusion and exclusion criteria. They were oriented to addressing the Women's Hospital and Maternity Hospital Iris to achieve the phalanx ultrasound scans and bone densitometry. Results: to evaluate the osteossonografia phalanx in relation to spinal bone densitometry test sensitivity was 80% in Group 1 and 100% for G2, G3 and G4. In relation to the femur test sensitivity was 90% and G1 100% G2, G3 and G4. When analyzing the 50th percentile, there was a significant inverse correlation showing that the higher the age, the greater the loss of bone quality. When the disease risk was calculated the results were, for the age group 30-39 years the average: 0.68 and SD: 0.23; 40-49 years, mean 0.64 and SD: 0.28; 50-59, mean and SD years: 0.54 and 0.37, respectively, and finally, age> 60 years, mean and SD: 0.32 and 0.30. Conclusion: a phalanx of ultrasonometry proved to be a method of good accuracy, as part crawler osteoporosis, regarding the evaluation of bone quality. The sensitivity of the phalanx ultrasound was calculated and comparative test densitometry, effective results were obtained, varying between 80 and 100%. When the nomogram was built, it can be seen the evidence that bone quality has a gradual loss with increasing age, but also the ability of this method to check that early. As for the ultimate goal of building a normal curve to calculate the pathological risk the results were, for the age group 30-39 years the average: 0.68 and SD: 0.23; 40-49 years, mean 0.64 and SD: 0.28; 50-59 years, mean and SD: 0.54 and 0.37, respectively, and finally, age> 60 years, mean and SD: 0.32 and 0.30. / definir a acurácia da ultrassonografia de falange como elemento rastreador da qualidade óssea na perspectiva da osteoporose, produzir um artigo de revisão contemplando os diversos métodos diagnósticos para osteoporose; estabelecer os testes diagnósticos da ultrassonometria como qualidade óssea, conforme a faixa etária, definir um Nomograma de Qualidade Óssea (UBPI), vista a ultrassonografia e construir a curva de normalidade da qualidade óssea conforme a faixa etária estabelecendo o cut off do risco patológico. Métodos: estudo descritivo, analítico, de acurácia diagnóstica. Participaram do rastreamento 932 mulheres, destas, 125 foram selecionadas, por concordarem em participar da pesquisa e se adequarem aos critérios de inclusão e exclusão. Receberam orientações para se dirigirem ao Hospital da Mulher e Maternidade Dona Íris para a realização dos exames de ultrassonografia de falange e de densitometria óssea. Resultados: ao avaliar a osteossonografia de falange, em relação a densitometria óssea de coluna a sensibilidade do teste foi de 80% no G1, e 100% para G2, G3 e G4. Em relação ao fêmur a sensibilidade do teste foi 90% para G1 e de 100% para G2, G3 e G4. Ao se analisar o percentil 50, houve correlação inversa e significativa mostrando que quanto maior a idade, maior a perda da qualidade óssea. Quando o risco patológico foi calculado os resultados encontrados foram, para a faixa etária 30-39 anos a média: 0,68 e DP: 0,23; 40-49 anos, média de 0,64 e DP: 0,28; 50-59, anos média e DP: 0,54 e 0,37, respectivamente, e enfim, idade > 60 anos, média e DP: 0,32 e 0,30. Conclusão: a ultrassonometria de falange mostrou ser um método de boa acurácia, como elemento rastreador da osteoporose, no que tange a avaliação da qualidade óssea. A sensibilidade da ultrassonografia de falange foi calculada e em teste comparativo a densitometria, resultados eficazes foram obtidos, variando entre 80 e 100%. Quando o nomograma, foi construído, pode-se observar a comprovação que a qualidade óssea possui uma perda gradativa conforme o aumento da idade, mas também a capacidade deste método em verificar isso precocemente. Quanto ao objetivo final de construir uma curva de normalidade para calcular o risco patológico os resultados encontrados foram, para a faixa etária 30-39 anos a média: 0,68 e DP: 0,23; 40-49 anos, média de 0,64 e DP: 0,28; 50-59 anos, média e DP: 0,54 e 0,37, respectivamente, e enfim, idade > 60 anos, média e DP: 0,32 e 0,30.

published_or_final_version / abstract / Medicine / Master / Master of Philosophy

published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Orthopaedics and Traumatology / Doctoral / Doctor of Philosophy

published_or_final_version / Biochemistry / Doctoral / Doctor of Philosophy

Menopause is associated with disorders such as osteoporosis and ovarian cancer. It is unclear whether the postmenopausal ovary retains steroidogenic capacity and how it can impact the development of these disorders. The present studies used the VCD-treated follicle-depleted mouse model of menopause to test the hypothesis that residual ovarian tissue retains steroidogenic capacity following ovarian failure and, thus, affects the development of these disorders. Microarray technology was used to evaluate gene expression in residual ovarian tissue of follicle-depleted mice compared to that in ovaries from cycling animals. Among the genes identified were those encoding proteins for synthesis of androgens. Steroidogenic capacity of residual ovarian tissue was further evaluated by determining the expression of genes and proteins involved in ovarian steroidogenesis, and by measuring levels of circulating and rostenedione and gonadotropins. Follicle-depleted ovaries were enriched in mRNAs for androgenic enzymes, receptors involved in the internalization of cholesterol, and luteinizing hormone receptor. Increased circulating levels of FSH and LH and detectable and rostenedione were measured throughout the study. Protein for 3β-hydroxysteroid dehydrogenase, 17α- hydroxylase/17,20-lyase and luteinizing hormone receptor was detected in follicledepleted ovaries by Western blot analysis and localized by immunofluorescence staining. The contribution of retaining residual ovarian tissue to accelerated bone loss following ovarian failure was evaluated by comparing bone mineral density from young and aged VCD-treated mice to that in age-matched ovariectomized (OVX) animals. Retaining residual ovarian tissue resulted in protection against accelerated bone loss in young but not aged VCD-treated mice. Whether residual ovarian tissue is more susceptible to development of ovarian neoplasms compared to ovaries from cycling animals was addressed by combining the VCD-treated mouse with the DMBA model of ovarian carcinogenesis. VCD-treated follicle-depleted mice that received DMBA developed Sertoli-Leydig cell tumors while no tumors were observed in cycling animals. Residual ovarian tissue following ovarian failure appears to have a protective effect against loss of bone integrity, but a detrimental effect on development of ovarian neoplasms. Findings from these studies: provided evidence of a physiological role for residual ovarian tissue following ovarian failure, and furthered the use of the VCD-treated mouse as a relevant model for menopause and associated disorders.

No description available.

Class of 2009 Abstract / OBJECTIVES: To assess a student pharmacist administered osteoporosis education program given to assisted living facility staff members in order to evaluate the impact of the program on the staffs’ knowledge and attitudes about osteoporosis treatment and prevention. METHODS: The study consisted of a pre-test/post-test design to evaluate data obtained through surveys administered at assisted living facilities in the Phoenix, Arizona area. The primary dependent variables were knowledge and confidence levels of the staff in regards to osteoporosis management. The surveys included multiple choice questions that measured knowledge of osteoporosis prevention and treatment, as well as Likert-scale questions to measure confidence levels. Mean scores were calculated and paired t- tests were used to compare scores of pre-test versus post-test answers. RESULTS: Surveys were completed by 5 participants. Sixty percent of the staff members were female and the mean age was 36 years old (SD 9.90). Eighty percent of the sample were certified nurse assistants. The mean pre-test score for the knowledge portion of the survey was 3.6 and the mean post-test score was 4.8 (p=0.18). The mean pre-test score on the participants confidence levels was 11.2 and the mean post-test score was 11.8 (p=0.37). Overall, the participants rated the value of the program a mean of 7.6 out of 8 possible points. CONCLUSIONS: Although not statistically significant, knowledge and confidence levels of osteoporosis management were raised in assisted living facility staff members after a student pharmacist administered presentation on the subject.