Osteopenia: Key Aspects to Know

Osteopenia is a condition where bone mineral density (BMD) is lower than normal but not low enough to be classified as osteoporosis. It is a precursor to osteoporosis and indicates that bones are weaker than they should be, making them more susceptible to fractures. 

Osteoporosis Care: 7 Essential Points

Osteoporosis is a medical condition characterized by the weakening of bones, which results in reduced bone density and increased vulnerability to fractures and breaks. This condition often progresses silently, with no noticeable symptoms until a fracture occurs.

Gynecomastia: Causes, Symptoms, and Treatment

Gynecomastia is a medical condition characterized by the development of enlarged breast tissue in males. While not typically harmful, it can cause physical discomfort and emotional distress. Let’s delve into the details of gynecomastia, including its causes, symptoms, and available treatment options.

Novel Drug for Hot Flashes

Menopause is a natural change that occurs in a woman’s life when her ovaries stop producing estrogen and progesterone. Typically, this happens between the ages of 45 and 55. Menopause is generally defined as not having a period for 12 consecutive months. Hot flashes, which affect 80% of women, are one of the most common symptoms of menopause and can significantly disrupt a woman’s life.

Bisphosphonate infusion for osteopenia

A group of 2,000 women with osteopenia receiving either zoledronate infusion or placebo were followed for 6 years. Zoledronate 5 mg or placebo was provided every 1.5 years. At the end of the study, the intravenous bisphosphonate reduced vertebral and nonvertebral fractions significantly by about 55% and 35% respectively.

Findings are of major significance as bisphosphonates in general and zoledronate specifically have been approved only for osteoporosis and not osteopenia. Would this expand indications for zoledronate? Should patients with osteopenia be treated?

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Systolic Blood Pressure and Dementia Risk

About 9,000 adults were randomized to receive tight or less-tight systolic blood pressure control. They were followed for about 5 years for cognition and dementia outcomes.

Although the primary outcome was almost significant, the secondary outcomes were truly significant for improvement of mild cognitive impairment or probable dementia with intensive systolic blood pressure <120 mmHg over those who achieved sBP <140 mmHg.

While further trials are needed to clarify the above findings, there appears to be no harm of lowering the sBP down to <120 mmHg in this study.

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Subclinical hypothyroidism in the elderly

Personalized therapy is crucial in good clinical practice, and in the management of older patients with subclinical hypothyroidism, multiple factors must be considered, including age-dependent TSH cutoffs, thyroid autoimmunity, the burden of comorbidities, and the possible presence of frailty. 

Levothyroxine is the drug of choice for the treatment of hypothyroid older people, but the risk of overtreatment, potential adverse drug reactions, and patient compliance should always be considered and thyroid status periodically reassessed.

JES

Atrial fibrillation in aging adults

This is an important study evaluating the associative factors and natural history of atrial fibrillation. Until age 90, men are at higher risk of developing A.Fib compared to women. Tall women, and overweight and dyslipidemic men are more likely to experience it than their counterparts. Lifetime risk for Atrial fibrillation high, more than 30%. It increases the mortality rate by 3.5 fold in both genders. Subjects were followed for about 13 years.

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