3,083 research outputs found

    Osteoporosis in young adults: pathophysiology, diagnosis, and management

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    Postmenopausal osteoporosis is mainly caused by increased bone remodeling resulting from estrogen deficiency. Indications for treatment are based on low areal bone mineral density (aBMD, T-score ≤ −2.5), typical fragility fractures (spine or hip), and more recently, an elevated 10-year fracture probability (by FRAX®). In contrast, there is no clear definition of osteoporosis nor intervention thresholds in younger individuals. Low aBMD in a young adult may reflect a physiologically low peak bone mass, such as in lean but otherwise healthy persons, whereas fractures commonly occur with high-impact trauma, i.e., without bone fragility. Furthermore, low aBMD associated with vitamin D deficiency may be highly prevalent in some regions of the world. Nevertheless, true osteoporosis in the young can occur, which we define as a T-score below −2.5 at spine or hip in association with a chronic disease known to affect bone metabolism. In the absence of secondary causes, the presence of fragility fractures, such as in vertebrae, may point towards genetic or idiopathic osteoporosis. In turn, treatment of the underlying condition may improve bone mass as well. In rare cases, a bone-specific treatment may be indicated, although evidence is scarce for a true benefit on fracture risk. The International Osteoporosis Foundation (IOF) convened a working group to review pathophysiology, diagnosis, and management of osteoporosis in the young, excluding children and adolescents, and provide a screening strategy including laboratory exams for a systematic approach of this conditio

    Non-linear power spectra of dark and luminous matter in halo model of structure formation

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    The late stages of large-scale structure evolution are treated semi-analytically within the framework of modified halo model. We suggest simple yet accurate approximation for relating the non-linear amplitude to linear one for spherical density perturbation. For halo concentration parameter, cc, a new computation technique is proposed, which eliminates the need of interim evaluation of the zcolz_{col}. Validity of the technique is proved for Λ\LambdaCDM and Λ\LambdaWDM cosmologies. Also, the parameters for Sheth-Tormen mass function are estimated. The modified and extended halo model is applied for determination of non-linear power spectrum of dark matter, as well as for galaxy power spectrum estimation. The semi-analytical techniques for dark matter power spectrum are verified by comparison with data from numerical simulations. Also, the predictions for the galaxy power spectra are confronted with 'observed' data from PSCz and SDSS galaxy catalogs, good accordance is found.Comment: 18 pages, 8 figures; major changes from the previous version; accepted for publivation in Phys. Rev.

    From first‐trimester screening to risk stratification of evolving pre‐eclampsia in second and third trimesters of pregnancy: comprehensive approach

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    Preeclampsia and associated hypertensive disorders of pregnancy represent a leading cause of global maternal and neonatal morbidity and mortality. Identification of women at high risk for developing preterm-preeclampsia and prophylaxis with low-dose aspirin has the potential to significantly reduce the rate of preterm-preeclampsia. In addition, risk assessment and monitoring of women in the second and third trimester of pregnancy, to aid in early detection of evolving disease, timely referral to specialist care, and active monitoring of women with confirmed or suspected preeclampsia is essential for improving maternal and neonatal outcomes. The angiogenesis-related biomarkers sFlt-1 and PlGF have been shown to have clinical value to aid in the prediction, diagnosis, and risk stratification of preeclampsia when used either alone or in combination with other risk factors. However, currently there is no consensus on the optimum strategy to link first trimester screening for preterm-preeclampsia with appropriate second and third trimester risk assessment strategies. This opinion paper will outline the current evidence for first trimester preeclampsia screening and prevention, as well as the evidence for various risk stratification approaches for detection of evolving preeclampsia through the second and third trimesters of pregnancy, and proposes a potential model integrating these tools. This article is protected by copyright. All rights reserved
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