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The role of bone histomorphometry in the management of postmenopausal osteoporosis
Başlık:
The role of bone histomorphometry in the management of postmenopausal osteoporosis
Yazar:
Rehman, Mirza Tariq Anisu, author.
ISBN:
9780355977929
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (288 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 76-08C.
Özet:
Post-menopausal osteoporosis is a common disease which affects a large proportion of British women in middle and late life. The pathogenesis of this condition is believed to be a complex interaction of various genetic, environmental, systemic and local factors that in a susceptible individual promotes bone loss in excess of formation leading ultimately to excessive bone fragility and fractures with minimal trauma. The precise cellular mechanisms that lead to the development of osteoporosis are not fully understood. However, it is likely that these vary with time in an individual, as well as varying between individuals. This may partly explain why, although, there has been a good deal of progress in the management of osteoporosis over the last ten years, the current treatment of established osteoporosis remains unpredictably variable. The purpose of this thesis, is to explore the hypothesis that variation in the cellular mechanisms at the bone level accounts for the variable and often unsatisfactory response to treatment in osteoporosis. To this end, the cellular patterns of age-related bone loss in the normal population of the North West of England and the cellular and microstructural changes in women with postmenopausal osteoporosis have been studied. I have observed some differences in the cellular mechanism of age-related bone loss, particularly in normal postmenopausal women, in this population compared with reported data from normal individuals elsewhere in the UK and other parts of the world. More importantly, I have been able to recognise five distinct histomorphometric groups based on current cellular abnormalities in a clinically matched cohort of women with PMO. The clinical usefulness of the two most commonest histomorphometric groups, is being evaluated in postmenopausal osteoporosis and secondary osteoporosis due to various underlying causes, in two separate clinical studies. The initial results of clinical studies, particularly the effect of three different forms of treatment on bone mineral density as measured by single energy quantitative computed tomography and dual x-ray absorptiometry, suggest that the patients in each histomorphometric group respond to a particular treatment regime in a very similar fashion which is different from that in other group and the response of patients in each groups may also vary with different treatment regimes. This is a novel observation and represent a rational basis for the management of osteoporosis. These data indicate that an important evolving role for histomorphometry may be to determine an appropriate therapy for each individual based on the patterns of cellular dysfunctions. From the results of these studies, I conclude, histomorphometry is a useful investigation for both confirming the diagnosis of osteoporosis and also contributing to the clinical management of osteoporosis.
Notlar:
School code: 1543
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(683828.1) | 683828-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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