Diagnosis And Management Of Osteoporosis

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Diagnosis And Management Of Osteoporosis

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Question:

Discuss About The Diagnosis And Management Of Osteoporosis.

Answer:
Introduction

A seventy-year-old man came to the hospital with osteoporosis disease. He had been receiving treatment/ medical therapy using the drug bisphosphonates. The drug had very harmful side effects such as kidney diseases for quite a while. However, there was no improvement in his body at all. The drug added to him having many other side effects then the doctors decided to use the nuclear magnetic resonance on bone mineral density if this would benefit his disease and have an improvement in his health.
PICO Question:
Inpatient with osteoporosis does treatment with nuclear magnetic resonance help in pain management or the use of exercise program compared to therapy with medical therapy using the bisphosphonates, raloxifene, and osteoporosis in patients with osteoporosis.
Articles:

Krpan, D., Stritzinger, B., LUKENDA, I. L., Overbeck, J., & Kullich, W. (2015). Non-pharmacological treatment of osteoporosis with Nuclear Magnetic Resonance Therapy (NMR-Therapy). Periodicum biologorum, 117(1), 161-165.

Summary and Appraisal of Key Evidence of Krpan et al. (2015) Article
The study was done by Krpan et al. (2015) for a total of 103 patients aged 45 and 99 years with a mean age of 66years who had osteoporosis with a T-score mineral density less than-2.5 were included in the trial. All these patients had been taking the bisphosphonates medicine for almost a year, and there was no improvement. All these patients received osteoporosis treatments with low field nuclear magnetic resonance using a special NMR device. For one hour a day which was to take place for ten consecutive days. After the 12 month treatment, there was an increased improvement for those patients as compared to supplement to medical therapy in patients with osteoporosis.
The bone is very metabolically active and constantly needs repair and to be remodeled to function very well but the osteoporosis diseases have become a threat especially to the old people and are causing many side effects to them. This disease can be prevented and also treated the only problem is that it is underestimated, underdiagnosed and also undertreated. The medical therapy used bisphosphonate as medical therapy had many effects which led to the emergence of the new NMRT system which would lead to an improvement of the treatment (Krpan, Stritzinger, Lukenda, Overbeck & Kullich, 2015).
This method can provoke positive effects on the bone cells and improve the function and movement and also reduce the pain that one was experiencing. This NMRT system uses a technology that will activate the cellular metabolism and regenerative processes and will bring about the pain relief in degenerative rheumatic diseases. To show the effect of this method we use two parameters that are the bone density and the marker for a born turnover. Where the accuracy of bone.
This NMR measurement brought about the improvement of the T-score on the umbra vertebrae hence there was an increase in the bone density and also led to the improvement of the serum level of the born turnover in the 12 months of the treatment and also the bone formation of the parameter osteocalcin increased also. These small changes led to unaltered bone degeneration. Using this NMR device using this electromagnetic fields this could lead to promote osteogenesis, which activates the metabolic processes and regenerates in selecting the cellular tissues.

Summary and Appraisal of Key Evidence of Jeremiah et al. (2015)
The systematic review done by Jeremiah, Unwin, Groenewald and Casino in 2015 them they recommended exercise exerciser physical therapy and vitamin D supplementation to patients whose age are 65 years and above with the osteoporosis disease because they believed it was related by fracture risk but not the BMD risk (Jeremiah, Unwin, Greenawald & Casiano, 2015). This exercise includes weight-bearing resistance and balance training that should be highly recommended. This exercise should be the ones that don’t incorporate a lot of strength and also the balance training that this will decrease the pains. this patients were also discouraged from alcohol drinking and smoking since these will decrease the BMD to all the skeletal sites, also their diets are modified where they should reduce the amount of caffeine they consume and take food rich in proteins this could either be animal or plant protein and also these diet should contain vitamin D, calcium, vegetable and fruits this is likely to optimize bone health
Clinical Bottom Line
The use of NMR was Avery important fact since would increase the bone density as well as reduce the rate of pain in the areas affected this method was the best since using the medical therapy which included the use of bisphosphonates ,reloxifenes, calcitonin, terriparatide and denosumab had a lot of side effects such as the increase rate of breast cancer and causing kidney diseases that will affect the patient despite him treating osteoporosis it leads him to getting other disease that are very vulnerable’ another good advantage of using the NMR system it doesn’t lead to bone loss but increases its density and also the turnover reducing to the pain. Using the aerobic system was also effective but the problem is it would take many years for one to realize the changes hence most patients would give up. We need more information of using these two methods and how will one benefit from them and also the cost of using these two methods
Implications for Practice
This two methods have their own benefits but also their implications, the aerobic method that do not incorporate strength and balance causes high risk to the fracture and also the risk factor of patients falling and mitigation will prevent from the treatment while the NRM systems kneads to proliferations, apoptosis and visibility of human rocytes and osteoblasts due to the continuous use of the excess use of the rays for treatment and they are likely also to resist treatment and also its an expensive way to all the [patient and the risk factors to people below 65 years is very adamant as compared to those above 65.and the old people cannot manage these human therapy by aerobics.

References
Jeremiah, M. P., Unwin, B. K., Greenawald, M. H., & Casiano, V. E. (2015). Diagnosis and management of osteoporosis. Am Fam Physician, 92(4), 261-268.
Krpan, D., Stritzinger, B., Lukenda, I. L., Overbeck, J., & Kullich, W. (2015). Non-pharmacological treatment of osteoporosis with Nuclear Magnetic Resonance Therapy (NMR-Therapy). Periodicum biologorum, 117(1), 161-165.

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