Establishing reference intervals for bone turnover markers in healthy postmenopausal women in a nonfasting state.

In order to interpret bone turnover markers (BTMs), we need to establish healthy reference intervals. It is difficult to establish reference intervals for older women because they commonly suffer from diseases or take medications that affect bone turnover. The aims of this study were: (1) to identify diseases and drugs that have a substantial effect on BTMs; (2) to establish reference intervals for premenopausal and postmenopausal women; and (3) to examine the effects of other factors on BTMs in healthy postmenopausal women. We studied women aged 30-39 years (n=258) and women aged 55-79 years (n=2419) from a five-European centre population-based study. We obtained a nonfasting serum and second morning void urine samples at a single baseline visit. BTMs were measured using automated immunoassay analysers. BTMs were higher in patients with vitamin D deficiency and chronic kidney disease. Three or more BTMs were higher in women who were osteoporotic and at least two BTMs were lower in women who were oestrogen replete, taking osteoporosis treatments or having diseases known to affect bone turnover. These were used as exclusion criteria for selecting the populations for the reference intervals. The reference intervals for BTMs were higher in postmenopausal than premenopausal women. Levels of BTMs were not dependent on geographical location and increased with age

A comprehensive fracture prevention strategy in older adults: The European union geriatric medicine society (EUGMS) statement

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) – European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people

Towards a dynamic earthquake risk framework for Switzerland

Scientists from different disciplines at ETH Zurich are developing a dynamic, harmonised, and user-centred earthquake risk framework for Switzerland, relying on a continuously evolving earthquake catalogue generated by the Swiss Seismological Service (SED) using the national seismic networks. This framework uses all available information to assess seismic risk at various stages and facilitates widespread dissemination and communication of the resulting information. Earthquake risk products and services include operational earthquake (loss) forecasting (OE(L)F), earthquake early warning (EEW), ShakeMaps, rapid impact assessment (RIA), structural health monitoring (SHM), and recovery and rebuilding efforts (RRE). Standardisation of products and workflows across various applications is essential for achieving broad adoption, universal recognition, and maximum synergies. In the Swiss dynamic earthquake risk framework, the harmonisation of products into seamless solutions that access the same databases, workflows, and software is a crucial component. A user-centred approach utilising quantitative and qualitative social science tools like online surveys and focus groups is a significant innovation featured in all products and services. Here we report on the key considerations and developments of the framework and its components. This paper may serve as a reference guide for other countries wishing to establish similar services for seismic risk reduction.</p

Imaging of trabecular bone structure in osteoporosis

Osteoporosis is a metabolic bone disorder that is characterized by reduced bone mass and a deterioration of bone structure which results in an increased fracture risk. Since the disease is preventable, diagnostic techniques are of major importance. Standard techniques determine bone mineral density, whereas some of the newer techniques focus on trabecular structure. This article reviews structure analysis techniques in the diagnosis of osteoporosis. Imaging techniques applied to the assessment of trabecular bone structure include conventional radiography, magnification radiography, high-resolution CT (HRCT) and high-resolution MR imaging (HRMRI). The best results were obtained using high-resolution tomographic techniques. The highest spatial resolutions in vivo were achieved using HRMRI. The most common texture analysis techniques that have been used are morphological parameters (analogous to bone histomorphometry). Fractal dimension, co-occurrence matrices, mathematical filter techniques and autocorrelation functions are more complex techniques. Most of the studies evaluating structure analysis show that texture parameters and bone mineral density both predict bone strength and osteoporotic fractures, and that combining both techniques yields the best results in the diagnosis of osteoporosis