Made available in DSpace on 2014-12-17T14:13:57Z (GMT). No. of bitstreams: 1 MariaSMM_DISSERT.pdf: 2097672 bytes, checksum: a8d12b585bf2f2d8634db421fbda96fc (MD5) Previous issue date: 2011-07-14 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Embora a Transi??o Menopausal e a menopausa sejam eventos biol?gicos normais, podem ser acompanhadas de agravos que aumentam o risco de morbidade e mortalidade com destaque para os sintomas agudos da S?ndrome Climat?rica(SC). O tratamento visa o controle destes sintomas para evitar as consequ?ncias tardias da defici?ncia estrog?nica, sempre considerando a seguran?a e a tolerabilidade ao f?rmaco empregado e os fatores de risco para complica??es futuras. Objetivo: Avaliar a efic?cia, o perfil de seguran?a e tolerabilidade do uso da tibolona na transi??o menopausal. Material e m?todos: Estudo randomizado, duplo-cego, controlado com placebo, envolvendo 65 mulheres saud?veis com idade m?dia de 48,5(?3.5) anos. Crit?rios de Inclus?o: a) idade entre 40 e 55 anos; b) ?tero sem anormalidades avaliado por ultrassonografia transvaginal e com espessura endometrial&#8804;10 mm; c) irregularidade menstrual nos ?ltimos 6 meses e amenorreia inferior a 12 meses; d) n?veis s?ricos de Horm?nio Fol?culo Estimulante(FSH)>30mIU/ml; e) SC avaliada pelo ?ndice Menopausal de Blatt e Kupperman (IMK) com escore de pontos>14; f) ?ndice de Massa Corporal<30Kg/m2; g) mamografia com BI-RADS igual a 1 e 2; e ) valores de bioqu?mica sangu?nea, p?s jejum de 12 horas, dentro dos limites de normalidade. Crit?rios de exclus?o: a) fumo; b) uso nos 90 dias que antecederam a entrada no estudo de qualquer medica??o hormonal, psicotr?pica ou que interfiram com metabolismo glic?dico e lip?dico; c) qualquer doen?a neopl?sica anterior ou atual; d) hipertens?o arterial(press?o sist?lica&#8805;160 mmHg e diast?lica&#8805;105 mmHg); e) doen?as hep?ticas e renais; f)desordens cerebrovasculares, tireoideanas, cardiovasculares e 1-xiv tromboemb?licas; g) doen?as mentais; e h) diabetes mellitus. Trinta participantes foram escolhidas pelo m?todo rand?mico para o Grupo Tibolona (GT) que recebeu 2,5 mg/dia de tibolona por via oral durante 12 semanas cont?nuas; as demais 35 foram inclu?das no Grupo Placebo (GP) que recebeu 1 c?psula/lactose/dia, por igual per?odo. Medidas utilizadas: A efic?cia da tibolona foi avaliada pelo IMK e a Escala Climat?rica de Greene (GSC). Na avalia??o da seguran?a e tolerabilidade utilizou-se par?metros bioqu?micos (perfil lip?dico, glicemia e fun??o hep?tica), medida da espessura endometrial, o registro di?rio de queixas relacionadas com o tratamento e a evolu??o de medidas antropom?tricas {?ndice de Massa Corporal(IMC), Circunfer?ncia da Cintura(CC) e Raz?o cintura/quadril(RCQ)}.Resultados: Cinquenta e sete participantes (87,7%) conclu?ram o estudo. Ao final de 12 semanas, ao se comparar os dois grupos, em rela??o aos valores basais, observa-se: no GT uma diminui??o significativa nos sintomas climat?ricos: IMK (35,5 + 6,7 vs. 11,3 + 6,5) e GSC (31,9?4.6 vs. 19,8 + 10,5) p<0,001; melhora do perfil lip?dico com redu??o do Triglicer?deos (152,2 + 53,0 vs. 105,2 + 26,8)p<0,001, colesterol total (220,7 + 38,5 vs. 193,3 + 37,9) p=0,001 e LDL colesterol (144,7 + 36,9 vs. 129,0 + 43,6)p=0,03; redu??o em 25,7% na rela??o Triglicerideos/HDL-c, fator preditor de resist?ncia insul?nica e de risco para doen?a arterial coronariana. No mesmo grupo, observou-se redu??o de 21% na espessura endometrial em rela??o ao valor basal (8.1 ? 2.6 vs 6.4 ? 1.9; p<0,05), compat?vel com atrofia; n?o houve altera??es nos marcadores hep?ticos e nem relatos de efeitos colaterais que levassem a interrup??o do tratamento. Conclus?es: A tibolona mostrou-se eficaz para reduzir a sintomatologia climat?rica de mulheres na transi??o menopausal, com boa tolerabilidade e melhora no perfil lip?dico. A 1-xv atrofia endometrial sugere prov?vel seguran?a para o seu uso como agente terap?utico da transi??o menopausal.

Estrogen therapy (ET) is most effective to reduce menopausal symptoms and prevent other disorders associated with estrogen deficiency. However, Women's Health Initiative studies found that hormone therapy (HT) containing estrogen plus progestogen, but not estrogen-alone increases breast cancer (BC) risk. To prevent the increase in BC risk and yet relieve menopausal symptoms, a novel HT with 17β-estradiol (E2) for symptom relief, progesterone (P4) for uterine protection and melatonin (Mel) for both BC and uterine protection was designed. Inclusion of Mel was postulated to offer uterine protection with lower P4 dose and protect against BC. The goal of this study was to assess the efficacy of E2, P4 and Mel Therapy (EPMT) on mammary cancer (MC) and uterine protection in MMTV-Neu mouse model that mimics HER2 BC. Starting at 2 months age, female mice received Mel in drinking water at night to supplement endogenous Mel surge; while E2 and P4 Therapy (EPT) was provided continuously in diet until 14 months with weekly MC onset and growth monitoring. Normal mammary, uterus and mammary tumors harvested by month 14 were analyzed for potential mechanisms. The results from this study revealed that EPMT delayed tumor onset leading to a decrease in MC incidence. In addition, mice in the EPMT group had no increase in relative uterine weight as opposite to an increase of this parameter in EPT group versus control. The percent tumor-bearing mice with gross metastatic lung lesions were reduced in Mel, EPT and EPMT groups. Mel receptor, estrogen receptor (ER) and progesterone receptor (PR) expression revealed that all tissues examined have Mel receptors. However, ER and PR expression varied. In normal mammary tissue, both ERα and PR were detected by immunohistochemistry. However, no ERα and PR were detected in mammary tumors of same mice. In uterus, mice given Mel or EPMT had significant decreases in PR expression but no change in ERα expression compared to control suggesting that Mel-mediated inhibition of ER binding to estrogen response elements may be involved in the down regulation of uterine PRs. Overall, this study reveal that EPMT prevents mammary cancer and may protect against uterotrophy. / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences; / Pharmacology / PhD; / Dissertation;

A interrelação de fatores como o avanço da idade, aliado às condições sócio-econômicas e à vulnerabilidade social, refletem na proeminência de doenças crônicas como a osteoporose e a doença periodontal. Tendo em vista que a perda óssea é a principal consequência para ambas as doenças, a osteoporose e a doença periodontal podem estar relacionadas. Considerando o limitado número de estudos longitudinais sobre a associação entre osteoporose e doença periodontal, o objetivo do nosso estudo foi avaliar, através de parâmetros clínicos periodontais, o efeito da osteoporose sobre os resultados do tratamento periodontal não-cirúrgico em mulheres na pós-menopausa, acompanhadas por um ano. Delineou-se um ensaio clínico controlado, duplo cego, para avaliar trinta e cinco mulheres selecionadas divididas em dois grupos: o grupo OST, composto por dezoito mulheres com diagnóstico de periodontite e osteoporose e o grupo controle (CTRL), composto por dezessete mulheres diagnosticadas para periodontite, porém, sistemicamente saudáveis. O efeito do tratamento periodontal não cirúrgico foi avaliado por meio das mensurações dos parâmetros clínicos como índice de placa bacteriana, sangramento à sondagem, profundidade de sondagem e nível clínico de inserção após o tratamento, nos períodos de três e doze meses. Assumindo-se como resultado principal a diferença no nível clínico de inserção, aos doze meses após o tratamento periodontal, utilizou-se o teste student t para amostras pareadas na análise intra-grupo e, para a comparação entre os grupos, o teste t para amostras independentes. Observou-se que o tratamento periodontal foi efetivo e ambos os grupos mostraram melhora em todos os parâmetros estudados após tratamento periodontal, quando comparado aos valores iniciais (p<0,05), houve ganho de inserção clínica para ambos os grupos, aos doze meses de avaliação, não havendo, porém, diferença estatisticamente significante entre os grupos (p>0,05). Não pudemos observar, dentro das limitações deste estudo, a interferência da osteoporose sobre as alteraçôes dos parâmetros clínicos periodontais após um ano de avaliação dos resultados do tratamento não cirúrgico da peridontite em mulheres na pós-menopausa. / To date no studies have evaluated the effect of osteoporosis on non-surgical periodontitis treatment. The aim of the present study was to evaluate the effect of osteoporosis on non-surgical periodontal therapy in post-menopausal women with chronic periodontitis. 35 women diagnosed with slight to moderate periodontitis were divided in two groups: osteoporotic (OST, n=18) and non-osteoporotic (CTRL, n=17) women. The effect of non-surgical periodontal treatment was assessed by measuring the changes in plaque (PI) and bleeding on probing (BOP) scores, probing depth (PD) and clinical attachment level (CAL) during one year. Only sites with baseline PD 4mm were used for statistical analysis. The periodontal therapy resulted in significant improvements for both groups. At the end of twelve months, the mean PI, BOP, PD and CAL for the OST group were 27.2 ±17.7, 2.6 ±3.0, 2.5 ±0.7, 3.6 ±1.3, respectively, versus 30.2 ±17.0, 8.4 ±10.6, 3.2 ±1.2, 4.3 ±1.5, respectively, for the control group. Using an individual-based analysis and Student t test for unpaired and paired observations (significance of differences between and within groups, respectively), women in CTRL group showed enhanced in BOP and PD scores (p<0.05) over a period of 12 months compared with those in OST group but no significant difference was found between the groups for PD and CAL difference changes (p>0,05). Within the limits of the present study, it can be concluded that osteoporosis did not influence the result of non-surgical periodontal therapy in slight to moderate periodontitis, the effect of osteoporosis condition on changes in clinical parameters could not be observed after one year post non-susrgical periodontal treatment.

A interrelação de fatores como o avanço da idade, aliado às condições sócio-econômicas e à vulnerabilidade social, refletem na proeminência de doenças crônicas como a osteoporose e a doença periodontal. Tendo em vista que a perda óssea é a principal consequência para ambas as doenças, a osteoporose e a doença periodontal podem estar relacionadas. Considerando o limitado número de estudos longitudinais sobre a associação entre osteoporose e doença periodontal, o objetivo do nosso estudo foi avaliar, através de parâmetros clínicos periodontais, o efeito da osteoporose sobre os resultados do tratamento periodontal não-cirúrgico em mulheres na pós-menopausa, acompanhadas por um ano. Delineou-se um ensaio clínico controlado, duplo cego, para avaliar trinta e cinco mulheres selecionadas divididas em dois grupos: o grupo OST, composto por dezoito mulheres com diagnóstico de periodontite e osteoporose e o grupo controle (CTRL), composto por dezessete mulheres diagnosticadas para periodontite, porém, sistemicamente saudáveis. O efeito do tratamento periodontal não cirúrgico foi avaliado por meio das mensurações dos parâmetros clínicos como índice de placa bacteriana, sangramento à sondagem, profundidade de sondagem e nível clínico de inserção após o tratamento, nos períodos de três e doze meses. Assumindo-se como resultado principal a diferença no nível clínico de inserção, aos doze meses após o tratamento periodontal, utilizou-se o teste student t para amostras pareadas na análise intra-grupo e, para a comparação entre os grupos, o teste t para amostras independentes. Observou-se que o tratamento periodontal foi efetivo e ambos os grupos mostraram melhora em todos os parâmetros estudados após tratamento periodontal, quando comparado aos valores iniciais (p<0,05), houve ganho de inserção clínica para ambos os grupos, aos doze meses de avaliação, não havendo, porém, diferença estatisticamente significante entre os grupos (p>0,05). Não pudemos observar, dentro das limitações deste estudo, a interferência da osteoporose sobre as alteraçôes dos parâmetros clínicos periodontais após um ano de avaliação dos resultados do tratamento não cirúrgico da peridontite em mulheres na pós-menopausa. / To date no studies have evaluated the effect of osteoporosis on non-surgical periodontitis treatment. The aim of the present study was to evaluate the effect of osteoporosis on non-surgical periodontal therapy in post-menopausal women with chronic periodontitis. 35 women diagnosed with slight to moderate periodontitis were divided in two groups: osteoporotic (OST, n=18) and non-osteoporotic (CTRL, n=17) women. The effect of non-surgical periodontal treatment was assessed by measuring the changes in plaque (PI) and bleeding on probing (BOP) scores, probing depth (PD) and clinical attachment level (CAL) during one year. Only sites with baseline PD 4mm were used for statistical analysis. The periodontal therapy resulted in significant improvements for both groups. At the end of twelve months, the mean PI, BOP, PD and CAL for the OST group were 27.2 ±17.7, 2.6 ±3.0, 2.5 ±0.7, 3.6 ±1.3, respectively, versus 30.2 ±17.0, 8.4 ±10.6, 3.2 ±1.2, 4.3 ±1.5, respectively, for the control group. Using an individual-based analysis and Student t test for unpaired and paired observations (significance of differences between and within groups, respectively), women in CTRL group showed enhanced in BOP and PD scores (p<0.05) over a period of 12 months compared with those in OST group but no significant difference was found between the groups for PD and CAL difference changes (p>0,05). Within the limits of the present study, it can be concluded that osteoporosis did not influence the result of non-surgical periodontal therapy in slight to moderate periodontitis, the effect of osteoporosis condition on changes in clinical parameters could not be observed after one year post non-susrgical periodontal treatment.

Made available in DSpace on 2016-08-19T18:16:00Z (GMT). No. of bitstreams: 1 LIVIA ALMEIDA BARROS BERTULUCCI.pdf: 244668 bytes, checksum: bb16875972e4c9c85c8f8386bcac47f9 (MD5) Previous issue date: 2010-07-30 / FUNDAÇÃO DE AMPARO À PESQUISA E AO DESENVOLVIMENTO CIENTIFICO E TECNOLÓGICO DO MARANHÃO / The Osteoporosis, defined as an age disorder, characterized for the decrease of bone mass and increase of breakings susceptibility, is the most common metabolicbone illness, affecting at least 30% of all postmenopausal women. The aim of this study was to make a quantitative periodontal condition analysis through a casecontrol study of post menopausal women and its relation with osteoporosis. The sample consisted of 99 postmenopausal women, divided in to three groups according with the avaliation of the mass bone: normal bone (G1 with N=45), osteopenia (G2 with N=31) and osteoporosis (G3 with N=23). There applied the indexes of clinical attachment level (CAL), gingival on pob (BOP), plaque index (PI) and probing depth (PD) for all participants. The periodontal condition data were submitted to the BioEstat 2.0 software using parametrical tests as analysis of variance (ANOVA) and Bonferroni test, using the significance level of 5%. The results shown that the women in postmenopausal with osteoporosis had presented high average in CAL (2,61 ± 0,43mm), as well as PD (2,80 ± 0,64 mm), BOP (72,8 ± 25,9 mm) and PI (72,9 ± 24,2 mm). After the accomplishment of the statistical treatment, it was observed that there was significant difference for the periodontal situation mainly between G1 and G3 and G2 and G3 groups, and still presented higher percentage of presence of the periodontitis, the osteoporosis women group. It was concluded that the periodontal conditions of the interviewed and analyzed postmenopausal women had revealed the relation between periodontitis and osteoporosis. / A osteoporose, definida como uma desordem relacionada com a idade, caracterizada pelo decréscimo de massa óssea e aumento da suscetibilidade para fraturas, é a mais comum doença ósseo-metabólica, afetando pelo menos 30% de todas as mulheres na pós-menopausa. Esta pesquisa teve por objetivo analisar quantitativamente, por meio de estudo caso-controle, a condição periodontal das mulheres na pós-menopausa e sua relação com a osteoporose. Foram incluídas 99 mulheres na pós-menopausa, nas quais foram divididas em três grupos conforme a avaliação da densidade mineral óssea: osso normal (G1 com N=45), osteopenia (G2 com N=31) e osteoporose (G3 com N=23). Foram aplicados os índices de nível de inserção clínica (NIC), de sangramento gengival (ISG), de placa (IP) e profundidade de sondagem (PS) para todas as participantes, sendo um estudo do tipo cego. Os dados condição periodontal foram submetidos ao programa BioEstat 2.0 por meio de testes paramétricos Análise de Variância (ANOVA) e teste de Bonferroni, empregando-se o nível de significância de 5%. Os resultados mostraram que as mulheres na pós-menopausa com osteoporose apresentaram maior média do NIC (2,61 ± 0,43 mm), assim como PS (2,80 ± 0,64 mm), ISG (72,8 ± 25,9 mm) e IP (72,9 ± 24,2mm). Após a realização do tratamento estatístico, observou-se que houve diferença significativa para a condição periodontal principalmente entre os grupos G1 e G3 e G2 e G3, e ainda apresentando maior percentual de presença da doença periodontal o grupo de mulheres com osteoporose. Concluiu-se que as condições periodontais das mulheres pós-menopausadas entrevistadas e analisadas evidenciaram a relação entre periodontite e osteoporose.

Osteoporosis (OP) is a disease characterized by low bone mass and structural breakdown of the skeleton. The disease may be prevented through weight-bearing, moderate to vigorous physical activity (MVPA), which is important for peri- and postmenopausal women who are at great risk for OP. However, most women do not participate in activity according to guidelines, which can negatively impact bone health. A better understanding of multidimensional factors that influence MVPA may help inform physical activity interventions aiming for OP prevention. The purpose of this study was to utilize social cognitive theory (SCT) to understand the associations between social cognitive factors and MVPA among peri- and postmenopausal women. Eighty-seven peri- and postmenopausal women (aged 43 to 65) completed this study. Participants completed demographic, health, calcium, and SCT questionnaires. SCT variables assessed included task self-efficacy (SET) and barrier self-efficacy (SEB), perceived social support from friends (SSFR) and family (SSFA), and perceived access to facilities (ACF) and home equipment (ACH). Participants wore an NL-1000 pedometer for one week to assess total steps per day and minutes spent in MVPA. Past year MVPA, past week leisure MVPA, and past week occupational/ transport MVPA were assessed with the Modifiable Activity Questionnaire. Stepwise regression analysis was used to identify the direct relationships between cognitive variables and each of the physical activity outcome measures. Moderation-mediation analysis was conducted to determine if significant interaction effects or confounding effects existed between social cognitive variables and each physical activity variable. Age, income, BMI, and highest level of education were controlled for in all analyses. Results showed significant relationships between social cognitive factors and each physical activity outcome, supporting the use of such variables for understanding physical activity behavior in peri- and postmenopausal women. For steps per day and MVPA minutes per day, 32% and 26% of the variance in activity was explained. For past year MVPA, past week leisure MVPA, and occupational/ transport MVPA, 39%, 26%, and 27% of the variance in activity was explained, respectively. The combination of variables entering the models was different for each physical activity outcome, but overall, SEB consistently emerged as the most prominent factor. Moderation analyses revealed a three way interaction effect between SEB, SSFR, and ACF for steps per day, and two-way interaction effects between SEB and SSFR for past year MVPA and past week leisure MVPA. Mediation analysis indicated SSFA confounded the relationship between SEB and past year MVPA. Results of this study indicate social cognitive factors are directly and indirectly associated with total and MVPA in peri- and postmenopausal women. These relationships should be considered when aiming to develop physical activity intervention programs for prevention of OP in peri- and postmenopausal populations.

Estrogen therapy (ET) is most effective to reduce menopausal symptoms and prevent other disorders associated with estrogen deficiency. However, Women's Health Initiative studies found that hormone therapy (HT) containing estrogen plus progestogen, but not estrogen-alone increases breast cancer (BC) risk. To prevent the increase in BC risk and yet relieve menopausal symptoms, a novel HT with 17&#946;-estradiol (E2) for symptom relief, progesterone (P4) for uterine protection and melatonin (Mel) for both BC and uterine protection was designed. Inclusion of Mel was postulated to offer uterine protection with lower P4 dose and protect against BC. The goal of this study was to assess the efficacy of E2, P4 and Mel Therapy (EPMT) on mammary cancer (MC) and uterine protection in MMTV-Neu mouse model that mimics HER2 BC. Starting at 2 months age, female mice received Mel in drinking water at night to supplement endogenous Mel surge; while E2 and P4 Therapy (EPT) was provided continuously in diet until 14 months with weekly MC onset and growth monitoring. Normal mammary, uterus and mammary tumors harvested by month 14 were analyzed for potential mechanisms. The results from this study revealed that EPMT delayed tumor onset leading to a decrease in MC incidence. In addition, mice in the EPMT group had no increase in relative uterine weight as opposite to an increase of this parameter in EPT group versus control. The percent tumor-bearing mice with gross metastatic lung lesions were reduced in Mel, EPT and EPMT groups. Mel receptor, estrogen receptor (ER) and progesterone receptor (PR) expression revealed that all tissues examined have Mel receptors. However, ER and PR expression varied. In normal mammary tissue, both ER&#945; and PR were detected by immunohistochemistry. However, no ER&#945; and PR were detected in mammary tumors of same mice. In uterus, mice given Mel or EPMT had significant decreases in PR expression but no change in ER&#945; expression compared to control suggesting that Mel-mediated inhibition of ER binding to estrogen response elements may be involved in the down regulation of uterine PRs. Overall, this study reveal that EPMT prevents mammary cancer and may protect against uterotrophy. / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences; / Pharmacology / PhD; / Dissertation;

No description available.

Women with an inherited BRCA mutation are at significantly increased risk for breast and ovarian cancer, often diagnosed at an earlier age than sporadic cancers. Prophylactic surgery, with bilateral mastectomy and/or bilateral prophylactic salpingo-oophorectomy, represents an option for risk reduction. The purpose of this study was to explore quality of life, sexual functioning, menopausal symptoms, psychological well-being and satisfaction with risk management decisions for BRCA-positive women ages 21 to 50 (M = 38.4 years), without a personal history of cancer. A web-based, cross-sectional study design was utilized to compare women opting for any prophylactic surgery (n = 160) with those without a history of prophylactic surgery (n = 71). Quality of life (per the Quality of Life Index, Self-Anchoring Striving Scale and Body Image Quality of Life measures) and Psychological General Well-Being Index scores were essentially the same across the entire study sample. While controlling for age, prophylactic surgery (PS) predicted more severe symptoms of sexual dysfunction as measured by the Female Sexual Functioning Index (total score, Desire, Arousal, Lubrication and Satisfaction domains). Similarly, PS predicted menopausal symptoms and sleep difficulties. Women who had not undergone any prophylactic surgery had higher levels of Stigma and lower levels of Mastery, as measured by the BRCA Self-Concept scale. Prophylactic surgery also predicted higher levels of Satisfaction with Decision for hereditary cancer risk management. Findings from this exploratory study provide insight into the quality of life, sexual functioning and psychological well-being for unaffected, BRCA-positive women. Additional research is needed to examine sexual functioning prospectively, to further investigate the potential sequelae of risk-reducing surgery.

THE INFLUENCE OF PHYSIOTHERAPY ON THE MANAGEMENT OF OSTEOPOROSIS DURING THE POST-MENOPAUSAL PERIOD SUMMARY Keywords: osteoporosis, bone mineral density, post-menopausal period. Osteoporosis is a very dangerous disease, because there appears a great possibility of bone fractures. Fractures of spinal vertebrae cause acute, sometimes even unbearable pains, limit daily activities. Osteoporosis is also a very expensive disease, because money is needed not only for the management of a fracture but also for nursing, psychological and social rehabilitation (Appleby, 1999). Post-menopausal period is very dangerous for the development of osteoporosis, because hormone balance is discomfited. For a half of women symptoms of osteoporosis manifest at the age of 45 – 75; for one out of three of such women osteoporosis has already developed, and those who are 75 and over, nine out of ten, have critically thin bones (Ojeda, 1996). The aim of this research was to evaluate the influence of physical training, which loads down lumbar spinal part, on the management of osteoporosis during the post-menopausal period. To achieve the aim the following tasks were set: 1. To evaluate bone mineral density of the investigative before after physiotherapy. 2. To evaluate the pain sense of the investigative before and after physiotherapy. Seven women of post-menopausal period, who have osteoporosis, have been examined. They were divided into two groups: those who have accomplished a full physiotherapy... [to full text]