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MSU EPI 390 - A Continuation of Osteoporosis
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EPI 390 Lecture 8Outline of Last Lecture I. Epidemiological MeasuresII. Sample Stratification Contingency TablesIII. Continuation of the Chili Pepper Case StudyIV. Relaying Information in your StudyV. Introduction to OsteoporosisOutline of Current Lecture I. Metadata analysis and Retrospective studiesII. Osteoporosis vs. OsteoarthritisIII. Ethics of PharmacologyIV. Osseointegration Current LectureI. Metadata analysis and Retrospective studiesa. Metadata analysis: your research team doesn’t necessarily do the researchi. Data is taken from preexisting databases and is re-analyzed according to the hypothesis at hand.b. Retrospective Review:i. Participants are classified based on disease and then you go back and findan exposureii. You cannot assess true incidence/risk in this way; Instead you focus on the odds (the # of individuals with the characteristic of interest relative tothe # of those without it)iii. Look back over data that has already been gathered, and reinterpret it to find new information/correlationsII. Osteoporosis vs. Osteoarthritisa. Working Definition of Osteoporosis - a skeletal disease characterized by low bonemass and micro-architectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture”.b. WHO diagnostic criteria (for osteoporosis) – the 1994 definition defines cases of osteoporosis based on Bone Mineral Density (BMD) and previous fracturei. This definition doesn’t factor in micro-architectural changes that may weaken the bone independent of BMD measures.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.ii. Have started to look at treatment more holistically by including risk factors that are independent of BMD (i.e. age and sex)iii. The criteria for a case being classified as osteoporosis is a BMD > 2.5 standard deviations below the young adult mean valuec. Osteopenia vs. Osteoporosis – Osteoporosis, according to WHO, is a BMD of > 2.5SD below the young adult average. Osteopenia is a BMD between 1 and 2.5 SD below the young adult mean (BMD is still low, but not to so severe a degree as osteoporosis)d. Osteoarthritis vs. Osteoporosis – Osteoarthritis is joint damage due to cartilage inthe joints wearing down and disintegrating.i. This allows the bones to rub against each other and break apart, causing pain to the individual.III. Heath and economic impact of Osteoporosisa. It’s estimated that 10 million Americans over 50 years old have Osteoporosis with2 million fragility fractures annually; another 34 million are at riski. It’s estimated that by 2025 there will be 3 million fractures a year and care will cost about $24 billion/yearb. Fractures result in a loss of independence for the affected individual, increased morbidity and increased mortality.IV. Increased Morbidity and Mortality in Certain Individuals/Groupsa. Hydroxyapatite is a form of calcium apatite that makes up 70% of bones. Some individuals/groups (based on ethnicity, age, gender, etc.) are more prone to depleting the reservoirs of this mineral – i.e. menopausal women – and thus are more prone to fragility fracturesV. Ethics of Pharmacology – pharmacology should provide the best help to an individual. Not all supplements or medications given by the pharmacy are helpful, though.a. i.e. giving calcium supplements to someone who can no longer add bone minerals to their reservoir; the treatment is no help.b. Can pharmacists say a drug therapy can fix Osteoporosis, or that they can improve bones better than they originally were?VI. Osseointegration – This is a treatment for the fragility factures and disintegration of bones resulting from osteoporosis.a. The procedure involves connecting the remaining bone to an artificial implant that is better at bearing the weight of the individual, thus reducing the risk of (further)


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MSU EPI 390 - A Continuation of Osteoporosis

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