Por qué los huesos frágiles no es solo un problema de las mujeres

Ronald Klein rode his bike to his neighborhood in North Wales, Pennsylvania, in 2006, intending to put on a cuneta. “Pero iba demasiado lento; no tenía suficiente impulsiono,” he recorded.

When transporting the bicycle, extend your arm to cushion the body. There was no serious accident, but “no possibility of raising the weapon”.

In the emergency room, x-rays show that the body was fractured, requiring surgery and the man. Klein, who is a dentist, worked three weeks later, using a cane. After a month and a lot of physiotherapy, they feel good.

But I thought of the misfortune that had caused the fall. “It is assumed that a 52-year-old person does not break up with the woman and the man,” he said. During a subsequent visit to his traumatologist, he said, “Quizás should do a bone densitometry on me.”

As I said, the study found that she had developed osteoporosis, a progressive disease that worsens edibility, weakens human beings and can cause serious fractures. Klein immediately began pharmaceutical treatment and has continued to do so for 70 years.

Osteoporosis is much more common in women, so doctors have recommended universal detection for 65 years, because a man who is not a medical professional cannot consider a densitometry. The trauma doctor didn’t mention the possibility.

But about a year out of five 50-year-old men will suffer a fracture caused by osteoporosis, and among adults, about a portion of body fractures occur in men.

And when it presents itself, “men have prognostic people,” confirmed Dr. Cathleen Colon-Emeric, a geriatrician at Durham Veterans Affairs and Duke University, and lead author of a recent study on treating osteoporosis in veterans. varones.

“Men cannot recover as well as women,” he said, with higher rates of mortality (between 25% and 30% over the course of a year), disability and hospitalization. “A 50-year-old man is more likely to die due to complications from a larger osteoporotic fracture due to prostate cancer,” he added.

(Who considers himself “mayor”? Fracturas de muñeca, cadera, femur, humero, pelvis o vertebra).

In his studio of 3,000 veterans ages 65 to 85, conducted at the North Carolina and Virginia Department of Veterans Affairs Health Center, only the 2 percent assigned to the control group had any sort of human densitometry.

“Magnificently low,” said Douglas Bauer, a clinical epidemiologist and osteoporosis researcher at the University of California, San Francisco, who published a companion commentary in JAMA Internal Medicine. “Pésimo. Yes, in the Department of Asuntos de Veteranos, donde lo financia el gobierno”. But the creation of a health service, supervised by an enfermera who records the indications, sends frequent recordings of citations and explains the results, produces drastic changes in the intervention group, which presents at least one risk factor for the condition.

49% of them agreed to an ultrasound. The majority of the examinees had osteoporosis or a previous condition, called osteopenia. When this matches, most have started taking medications to preserve or rebuild your colors.

“We are happy that as long as we agree to do the trial and we have disputes to start the treatment,” Colon-Emeric asserted.

For 18 months, the density of the organism increased slightly in the intervention group, which led to an improvement in their pharmaceutical treatments, compared to osteoporosis patients of other sexes in real-world conditions.

The study does not extend long enough to determine whether density increases or fractures decrease, but investigators are planning a secondary analysis to follow up.

The results helped to reestablish a major concern in terms of data: the transcendentals and even the mortals which can be fractures, and the availability of effective drugs to slow or restore the loss of health, which means that men can do tests to detect osteoporosis, like women? Of who he is, what men and what people?

These problems were less significant when life expectancy was shorter, Bauer explained. Men have larger, fatter shades, and they have devastating osteoporosis five to four years later than women. “Hasta hace poco, these men morían de enfermedades cardíacas y por fumar” before osteoporosis can be perjudiciable, affirmed.

“Now men generally live into their 70s and 80s because they suffer fractures,” he said. As a result, he has also accumulated other chronic illnesses that affect his ability to recover.

With osteoporosis testing and treatment, “a man can see greater clarity in mortality and, most importantly, in his quality of life,” Bauer said.

Without an embargo, both patients and doctors must now consider osteoporosis as a disease specific to women. “There’s also an idea of ​​Superman,” said Eric Orwoll, an endocrinologist and osteoporosis researcher at Oregon Healt & Science University.

“A los hombres les gusta creer que son indestructible, por lo que no se presta a la factura la importance que ce esta a los,” he added.

One patient, for example, resisted for years the demands of his wife, a nurse, who was “visiting someone” to have his sword visibly shrouded.

Bob Grossman, 74, a retired Portland public school teacher, decided to correct his posture and at the same time told himself that he had to do it. “Thought: ‘No cause for osteoporosis, be a man,'” said. Pero era.

Another obstacle to detection testing: “Clinical practice guidelines are very diverse,” said Dr. Colon-Emeric.

Professional associations such as the Endemic Society and the American Society for Ocean and Mineral Research recommend that men over 50 with a risk factor, and all men over 70, be screened.

Without an embargo, the Colegio Americano de Médicos and the Grupo de Trabajo de Servicios Preventivos de Estados Unidos considered the evidence for male detection tests to be “insufficient”.

Clinical studies have found that osteoporosis medications increase skin density in men, as they do in women, but most men’s study studios have small problems or have not had enough follow-up to demonstrate whether fractures are also reduced.

The task force’s position means that Medicare and many private insurance plans generally do not provide screening tests for men who have not suffered a fracture, but they also must pay attention to men diagnosed with osteoporosis.

“Things that have been established for decades,” Orwoll said.

Therefore, a wide variety of patients may need their doctors for densitometry, also available at a cost of between $100 and $300. Rather, because osteoporosis is often asintomatic, men (and women who also receive tests and treatments) are unaware that their humans have deteriorated until they are fractured.

“If you have a fracture after age 50, you need to have a bone densitometry; that’s one of the key indicators,” Orwoll said.

Other risk factors: causes, familiar history of heart fractures, and a long list of other conditions, such as rheumatoid arthritis, hyperthyroidism, and Parkinson’s disease. Smoking and excessive alcohol consumption also increase the chances of preventing osteoporosis.

“Different medications also affect bone density,” Colon-Emeric explained, particularly steroids and prostate cancer medications. When an ultrasound reveals osteoporosis, depending on your severity, doctors may give oral medications like Fosamax or Actonel, intravenous formulas like Reclast, automatic daily injections of Forteo or Tymlos, or twice-yearly injections of Prolia.

Lifestyle changes, such as exercising, taking calcium and vitamin D supplements, smoking and drinking in moderation, help, but are not enough to retain or restore water loss, Colon-Emeric confirmed.

Although the guidelines are not universally recommended, at least today the feeling that all 70-year-old men occur somewhere during detection tests, because the probabilities of disability after a body fracture are very high (two-thirds of people). Mayors cannot recover their previous mobility, (indicated) and the drugs that treat them are effective and, at the same time, economical.

Without embargo, informing patients and health professionals that osteoporosis is also dangerous for men by taking “a torturous step,” Orwoll said.

Klein attended a seminar to teach patients how to use the drug Forteo. “He was the one man,” he said.

The New Old Age is produced in collaboration with The New York Times.