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Elderly women with osteoporotic fracture: from clinical and biochemical assessments, bone density studies to bisphosphonate treatment.

Or Pui Ching. / Thesis submitted in: December 1999. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 174-201). / Abstracts in English and Chinese. / acknowledgement --- p.i / abstract (english version) --- p.ii / abstract (chinese version) --- p.vii / table of contents --- p.xi / abbreviations --- p.xvi / list of tables --- p.xviii / list of figures --- p.xxii / Chapter chapter 1. --- introduction --- p.1 / Chapter chapter 2. --- literature review --- p.3 / Chapter 2.1. --- Bone structure --- p.3 / Chapter 2.1.1. --- Composition --- p.3 / Chapter 2.1.2. --- Cortical and Trabecular bone --- p.3 / Chapter 2.2. --- Bone Remodeling --- p.4 / Chapter 2.3. --- Bone Mass --- p.5 / Chapter 2.3.1. --- Peak Bone Mass --- p.5 / Chapter 2.3.1.1. --- Racial and Genetic Factors --- p.5 / Chapter 2.3.1.2. --- Gonadal Factors --- p.6 / Chapter 2.3.1.3. --- Nutrition Factors --- p.6 / Chapter 2.3.1.4. --- Exercise and Physical Activity --- p.7 / Chapter 2.3.2. --- Bone Loss --- p.7 / Chapter 2.3.2.1. --- Determinants of Osteoporotic Bone Loss --- p.7 / Chapter 2.3.2.2. --- Estrogen Deficiency --- p.8 / Chapter 2.3.2.3. --- Dietary Calcium deficiency and Vitamin D deficiency --- p.8 / Chapter 2.3.2.4. --- Physical Activity --- p.9 / Chapter 2.3.2.5. --- Alcoholism and Smoking --- p.9 / Chapter 2.3.2.6. --- Disease-specific Osteoporosis --- p.9 / Chapter 2.3.2.7. --- Drug-induced Osteoporosis --- p.10 / Chapter 2.3.3. --- Bone Mass and Fracture Risk --- p.11 / Chapter 2.4. --- Clinical Presentation of Osteoporosis --- p.12 / Chapter 2.4.1. --- Vertebral Fractures --- p.12 / Chapter 2.4.1.1. --- Radiological Aspects of Vertebral Fracture --- p.13 / Chapter 2.4.1.1.1. --- Changes in Trabecular Pattern --- p.13 / Chapter 2.4.1.1.2. --- Changes in Shape of the Vertebral bodies --- p.13 / Chapter 2.4.1.1.3. --- Changes of Intervertebral Discs --- p.14 / Chapter 2.4.1.2. --- Back Pain --- p.15 / Chapter 2.4.2. --- Hip Fractures --- p.15 / Chapter 2.4.3. --- Quality of Life --- p.16 / Chapter 2.5. --- Treatment of Established Osteoporosis --- p.18 / Chapter 2.5.1. --- Pain Relief --- p.18 / Chapter 2.5.2. --- Drug Therapy --- p.19 / Chapter 2.5.2.1. --- Calcium Supplement --- p.19 / Chapter 2.5.2.2. --- Vitamin D --- p.20 / Chapter 2.5.2.3. --- Estrogen --- p.21 / Chapter 2.5.2.4. --- Fluorides --- p.22 / Chapter 2.5.2.5. --- Calcitonin --- p.23 / Chapter 2.5.2.6. --- Bisphosphonates --- p.24 / Chapter 2.5.2.6.1. --- Physicochemical effects --- p.27 / Chapter 2.5.2.6.2. --- Mechanisms --- p.27 / Chapter 2.5.2.6.3. --- Therapeutic Use --- p.27 / Chapter 2.5.2.6.4. --- Side effects --- p.29 / Chapter 2.5.2.6.5. --- Alendronate --- p.30 / Chapter 2.5.2.7. --- Summary of drug treatment --- p.33 / Chapter 2.6. --- Diagnostic Methods of Osteoporosis --- p.40 / Chapter 2.6.1. --- Biochemical Markers of Bone Metabolism in Osteoporosis --- p.40 / Chapter 2.6.1.1. --- Bone Formation Markers --- p.41 / Chapter 2.6.1.1.1. --- Bone-specific Alkaline Phosphatase (bALP) --- p.41 / Chapter 2.6.1.2. --- Bone Resorption Markers --- p.42 / Chapter 2.6.1.2.1. --- Deoxypyridinoline (Dpd) --- p.43 / Chapter 2.6.2. --- Bone Densitometry --- p.45 / Chapter 2.6.2.1. --- Dual Energy X-ray Absorptiometry (DEXA) --- p.45 / Chapter 2.6.2.2. --- Peripheral Quatitative Computed Tomography (pQCT) --- p.47 / Chapter 2.6.2.3. --- Quantitative Ultrasound (QUS) --- p.48 / Chapter 2.6.3. --- Summary of Diagnostic Methods --- p.49 / Chapter chapter 3. --- methodology --- p.50 / Chapter 3.1. --- Study on Vertebral Structures --- p.51 / Chapter 3.1.1. --- Procedures --- p.51 / Chapter 3.1.2. --- Data analysis --- p.53 / Chapter 3.2. --- Alendronate Treatment --- p.54 / Chapter 3.2.1. --- Subject Selection --- p.54 / Chapter 3.2.2. --- Study design and drug administration --- p.55 / Chapter 3.2.3. --- Bone Densitometry --- p.56 / Chapter 3.2.3.1. --- Dual Energy X-ray absorptiometry --- p.56 / Chapter 3.2.3.2. --- Peripheral Quantitative Computed Tomography (pQCT) --- p.58 / Chapter 3.2.4. --- Biochemical Markers --- p.63 / Chapter 3.2.4.1. --- Bone formation marker --- p.63 / Chapter 3.2.4.2. --- Bone resorption marker --- p.64 / Chapter 3.2.5. --- Quality of Life --- p.65 / Chapter 3.2.6. --- New fracture assessment --- p.66 / Chapter 3.2.7. --- Statistical analysis --- p.67 / Chapter 3.3. --- Proximal femur fracture study --- p.68 / Chapter 3.3.1. --- Subject and study design --- p.69 / Chapter 3.3.2. --- Statistical analysis --- p.70 / Chapter chapter 4. --- results of study on vertebral structures --- p.71 / Chapter 4.1. --- Results of morphological change of vertebral bodes in osteoporotic patients --- p.71 / Chapter 4.2. --- Morphological changes of intervertebral discs --- p.71 / Chapter 4.3. --- Correlation between morphological changes of vertebrae and bulging ratio --- p.72 / Chapter chapter 5. --- results of alendronate study --- p.76 / Chapter 5.1. --- Baseline measurement --- p.76 / Chapter 5.1.1. --- Demographic characteristics --- p.76 / Chapter 5.1.2. --- Reasons for admission --- p.77 / Chapter 5.1.3. --- Social support --- p.77 / Chapter 5.1.4. --- Number of vertebral fracture(s) --- p.78 / Chapter 5.1.5. --- BMD measurement (Baseline) --- p.79 / Chapter 5.1.5.1. --- BMD of Lumbar spine and Hip (measured by DEXA) --- p.79 / Chapter 5.1.5.2. --- BMD of distal tibia and radius measured by pQCT --- p.80 / Chapter 5.1.6. --- Biochemical Markers (Bone formation and resorption) --- p.86 / Chapter 5.2. --- After treatment --- p.88 / Chapter 5.2.1. --- Bone mineral density measurement (measured by DEXA) --- p.90 / Chapter 5.2.1.1. --- Lumbar spine --- p.90 / Chapter 5.2.1.2. --- Femoral Neck --- p.93 / Chapter 5.2.1.3. --- Trochanter --- p.95 / Chapter 5.2.1.4. --- Ward's Triangle --- p.98 / Chapter 5.2.1.5. --- Summary --- p.101 / Chapter 5.2.2. --- Bone Mineral Density measured by pQCT --- p.103 / Chapter 5.2.2.1. --- Distal Radius (Program 1) --- p.103 / Chapter 5.2.2.1.1. --- BMD change of D50 --- p.103 / Chapter 5.2.2.1.2. --- BMD changes of D100 --- p.106 / Chapter 5.2.2.1.3. --- BMD change of P100 --- p.108 / Chapter 5.2.2.2. --- Distal Radius (Program 2) --- p.111 / Chapter 5.2.2.2.1. --- BMD change of pure trabecular bone --- p.112 / Chapter 5.2.2.2.2. --- BMD changes of pure cortical bone --- p.114 / Chapter 5.2.2.3. --- Distal Tibia (Program 1) --- p.118 / Chapter 5.2.2.3.1. --- BMD changes of D50 --- p.118 / Chapter 5.2.2.3.2. --- BMD changes of D100 --- p.121 / Chapter 5.2.2.3.3. --- BMD changes of P100 --- p.124 / Chapter 5.2.2.4. --- Distal Tibia (Program 2) --- p.128 / Chapter 5.2.2.4.1. --- BMD changes of pure trabecular bone --- p.128 / Chapter 5.2.2.4.2. --- BMD changes of pure cortical bone --- p.131 / Chapter 5.2.3. --- Bone turnover --- p.135 / Chapter 5.2.3.1. --- Bone Resorption Marker (urinary Deoxypyridinoline) --- p.135 / Chapter 5.2.3.2. --- Bone Formation Marker (Bone Specific Alkaline Phosphatase) --- p.137 / Chapter 5.2.4. --- Quality of Life (QOL) --- p.139 / Chapter 5.2.5. --- Oswestry Disability Index (ODI) --- p.139 / Chapter 5.2.6. --- Pain --- p.141 / Chapter 5.2.6.1. --- Pain frequency --- p.141 / Chapter 5.2.6.2. --- Night Pain --- p.142 / Chapter 5.2.6.3. --- Administration of pain relief drugs --- p.143 / Chapter 5.2.7. --- Activity of daily living --- p.144 / Chapter 5.2.8. --- Prevention of new vertebral fracture(s) --- p.146 / Chapter 5.2.9. --- Safety and Tolerability --- p.147 / Chapter chapter 6. --- results on proximal femoral fractures study --- p.149 / Chapter 6.1. --- Epidemiological study on proximal femoral fractures --- p.149 / Chapter 6.2. --- The role of ultrasound equipment in the assessment osteoporosis in patients with proximal femoral fractures --- p.154 / Chapter 6.3. --- Summary --- p.155 / Chapter chapter 7. --- discussion --- p.156 / Chapter 7.1. --- The study on vertebral structures --- p.156 / Chapter 7.1.1. --- Changes in Shape of Vertebral Bodies --- p.156 / Chapter 7.1.2. --- Changes of Interevertbral Discs --- p.157 / Chapter 7.2. --- Alendronate treatment on Chinese elderly women with Osteoporotic vertebral fracture --- p.158 / Chapter 7.2.1. --- The Effect of Alendronate on BMD of Lumbar Spine --- p.159 / Chapter 7.2.2. --- The Effects of Alendronate on BMD of Proximal Femur --- p.159 / Chapter 7.2.3. --- The Effects of Alendronate on the BMD of Trabecular and Cortical Bone in the Distal Radius and Distal Tibia --- p.160 / Chapter 7.2.4. --- The Effects of Calcium Supplementation in the study --- p.162 / Chapter 7.2.5. --- The Effect of alendronate on Biochemical Turnover --- p.162 / Chapter 7.2.6. --- The Efficacy of Alendronate on Prevention of New Fractures --- p.163 / Chapter 7.2.7. --- The Effect of Alendronate on Quality of Life --- p.164 / Chapter 7.2.8. --- Adverse Effects of Alendronate --- p.165 / Chapter 7.3. --- Proximal Femur Fracture Study --- p.165 / Chapter chapter 8. --- conclusion --- p.168 / bibliography --- p.174 / epilogue --- p.202 / appendix --- p.xxv

Identiferoai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_323013
Date January 2000
ContributorsOr, Pui Ching., Chinese University of Hong Kong Graduate School. Division of Surgical Sciences.
Source SetsThe Chinese University of Hong Kong
LanguageEnglish, Chinese
Detected LanguageEnglish
TypeText, bibliography
Formatprint, xxi, 213, [7] leaves : ill. ; 30 cm.
CoverageHong Kong, Hong Kong, Hong Kong
RightsUse of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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