Osteoporosis and Skeletal Fractures

Osteoporosis affects millions of individuals worldwide, rendering them susceptible to fragility fractures of the spine, hip, and wrist and leading to significant morbidity, mortality, and economic cost. Given the substantial impact of osteoporosis on both patients and the medical community, it is imperative that physicians improve awareness and knowledge of osteoporosis in the setting of low-energy fractures. In this review, we provide information on effective means of preventing fragility fractures and introduce clinicians to issues pertinent to the patient who suffers an osteoporotic fracture. Prevention of fragility fractures centers around adequate mineral nutrition, including daily calcium and vitamin D supplementation, as well as prescription antiresorptive medications such as bisphosphonates or teriparatide therapy in severe cases, both of which have been shown to decrease future fracture risk. Balance and strength training also play important roles in the management of the osteoporotic patient, particularly following a low-energy fracture, and external hip protectors may be useful for certain patients. Kyphoplasty and vertebroplasty are two minimally invasive techniques that show great promise in the treatment of vertebral compression fractures, although questions regarding long-term biomechanical effects still exist. Traditionally, osteoporosis has been underdiagnosed and undertreated following a low-energy fracture in an elderly patient. Although treatment rates may be improving through public health initiatives, the majority of patients with osteoporosis remain inadequately treated. Perioperative intervention programs that focus on patient education about osteoporosis and treatment options lead to significant increases in intervention and treatment. Reducing the risk of skeletal fractures in patients susceptible to osteoporosis involves improved physician education on the risk factors and management of osteoporosis, as well as informing patients on the significance of dual-energy X-ray absorptiometry testing and medical treatment so that they may serve as their own healthcare advocates in this often-undertreated disease

A decade of the Super Dual Auroral Radar Network (SuperDARN): scientific achievements, new techniques and future directions

The Super Dual Auroral Radar Network (SuperDARN) has been operating as an international co-operative organisation for over 10 years. The network has now grown so that the fields of view of its 18 radars cover the majority of the northern and southern hemisphere polar ionospheres. SuperDARN has been successful in addressing a wide range of scientific questions concerning processes in the magnetosphere, ionosphere, thermosphere, and mesosphere, as well as general plasma physics questions. We commence this paper with a historical introduction to SuperDARN. Following this, we review the science performed by SuperDARN over the last 10 years covering the areas of ionospheric convection, field-aligned currents, magnetic reconnection, substorms, MHD waves, the neutral atmosphere, and E-region ionospheric irregularities. In addition, we provides an up-to-date description of the current network, as well as the analysis techniques available for use with the data from the radars. We conclude the paper with a discussion of the future of SuperDARN, its expansion, and new science opportunities