Early Postmenopausal Fragility Fractures and Elevated IgE: Two Cases Suggesting Hyper-IgE Syndrome and a Novel Adverse Reaction to Romosozumab.

Severe, treatment-refractory or early-onset osteoporosis should prompt evaluation for secondary causes. Hyper-IgE syndrome (HIES) is a rare primary immunodeficiency disorder characterised by markedly elevated serum IgE, recurrent infections and skeletal anomalies, including osteoporosis and increased fracture burden. We present two cases of severe osteoporosis in early postmenopausal women.

Parathyroid hormone receptor agonists in the management of osteoporosis.

Parathyroid hormone (PTH) regulates bone homeostasis. Intermittent exposure to PTH results in bone formation being greater than bone resorption, and this effect has been harnessed through the development of agonists of the PTH and PTH-related protein type 1 receptor (PTH1R) to treat osteoporosis. Teriparatide, an analogue of the first 34 amino acids of PTH, and abaloparatide, which resembles PTH-related protein (PTHrP) in structure, are PTH1R agonists currently in clinical use.

Experiences and outcomes of older adults with obesity transitioning from gym- to home-based resistance training due to COVID-19 lockdowns: a mixed-methods analysis of a RCT.

Background: Supervised gym-based high-intensity resistance and impact training (HiRIT) can enhance physical function and muscle strength, but older adults may face challenges affecting adherence to HiRIT, such limited access to facilities and lack of transportation, necessitating a shift towards unsupervised home-based exercise. The aim of this study was to explore experiences and perspectives of older adults with obesity who were required to transition from supervised gym-based HiRIT to unsupervised home-based resistance training (RT) and aerobic training (AT) during COVID-19 lockdowns. Secondary aims were to compare changes in body composition and physical function after 12 weeks between participants required to transition to home-based exercise ("HOME") and those who were able to continue gym-based exercise ("GYM").

Management of aromatase inhibitor-associated bone loss (AIBL) in women with hormone-sensitive breast cancer: An updated joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS, and SIOG.

Background: Women with hormone-responsive breast cancer who receive adjuvant endocrine treatment with aromatase inhibitors (AI) are known to be at higher fracture risk due to a marked increase in bone resorption. In 2017, several interdisciplinary cancer and bone societies involved in the management of women with AI-associated bone loss (AIBL) published a joint position statement comprising evidence-based recommendations and a practical management algorithm for the assessment of fracture risk and optimal treatment of this patient population.

Patients And Methods: In order to provide updated recommendations that reflect recent advances in the assessment and management of AIBL since publication of the 2017 joint position statement, a systematic literature review was undertaken to identify relevant studies for analysis, including systematic reviews and meta-analyses.

Improvements in Bone Disorganization and Pseudo-Fracture Healing in Hypophosphatasia Following Asfotase Alfa Therapy May Be Detectable by the ALIGNOGRAM Before Changes in Bone Radiography or Scintigraphy.

Hypophosphatasia (HPP) is a rare genetic disorder characterized by bone fragility due to defective bone mineralization resulting in impaired alignment of bone components (bone disorganization). Current challenges in the management of HPP include accurately quantifying bone disease severity, monitoring disease progression, and assessing treatment response, particularly in pseudo-fracture healing. Conventional tools such as bone mineral density (BMD) and architecture assessments do not adequately address these issues as they do not assess bone disorganization, limiting their utility in HPP.

Best practice recommendations for the diagnosis and management of hypoparathyroidism.

Background: Hypoparathyroidism (HypoPT) is characterized by low serum calcium due to insufficient parathyroid hormone (PTH). This manuscript builds upon the 2022 international HypoPT guidelines and three systematic reviews, which have been further informed by updated narrative reviews and expert consensus. This paper presents current best practice consensus recommendations for the diagnosis and management of HypoPT.

Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity - A Phase 2 Trial.

Background: Maridebart cafraglutide (known as MariTide) is a long-acting peptide-antibody conjugate that combines glucagon-like peptide-1 receptor agonism and glucose-dependent insulinotropic polypeptide receptor antagonism and that is intended for the treatment of obesity.

Methods: We conducted a phase 2, double-blind, randomized, placebo-controlled, dose-ranging trial that included 11 groups as two cohorts. Participants with obesity (obesity cohort) were randomly assigned in a 3:3:3:2:2:2:3 ratio to receive maridebart cafraglutide subcutaneously at a dose of 140, 280, or 420 mg every 4 weeks without dose escalation; 420 mg every 8 weeks without dose escalation; 420 mg every 4 weeks with 4-week dose escalation; 420 mg every 4 weeks with 12-week dose escalation; or placebo.

Bone health perspectives among Indigenous people: a qualitative study.

Objectives: To explore perspectives and beliefs on bone health among Indigenous adults in Victoria.

Design: Qualitative focus groups with semi-structured questions. Focus group discussions were analysed for themes and subthemes using an Indigenous research framework based on three concepts: Ways of Knowing, Ways of Being and Ways of Doing.

Asia-Pacific consensus for the management of osteoporosis in men.

Unlabelled: Osteoporosis in men is an underdiagnosed and undertreated condition that leads to significant morbidity and mortality, particularly in the aging population. This consensus report provides tailored guidelines for diagnosing, preventing, and treating male osteoporosis in the Asia-Pacific region by integrating global best practices with regional adaptations.

Purpose: To establish evidence-based, region-specific guidelines for the management of male osteoporosis in the Asia-Pacific region, addressing demographic and lifestyle factors.

The influence of HIV on body composition and its relationship with physical function in mid-life women: a cross-sectional study from Zimbabwe.

Objective: Menopause-related changes in body composition and physical function are unclear in Southern Africa, particularly in the context of a generalized HIV epidemic with high antiretroviral therapy (ART) coverage.

Method: A total of 263 Zimbabwean women (53% women living with HIV [WLH]) aged 40-60 years provided data on menopause, ART use, anthropometry, body composition (appendicular lean mass [ALM], muscle area, fat mass), handgrip strength (HGS) and gait speed. Linear regression determined relationships between body composition and physical function, unadjusted and age-menopause-adjusted, stratified by HIV status.

The Lebanese GRADE-based vitamin D guidelines: a paradigm for the MENA region.

Background: The Middle East and North Africa region are traditionally known as regions with a high prevalence of vitamin D deficiency. However, serum 25-hydroxyvitamin D (25OHD) levels seem to be increasing lately. We developed guidelines on the screening and supplementation of adult Lebanese patients with vitamin D.

Resistance and Impact Training During Weight Loss Improves Physical Function and Body Composition in Older Adults With Obesity.

Background: Weight loss achieved via energy restriction leads to significant losses in muscle and bone mass, potentially increasing risk for sarcopenia and osteoporosis. High-intensity resistance and impact training (HiRIT) might attenuate weight loss-induced musculoskeletal declines. Our objective was to compare changes in physical function and body composition in older adults with obesity undertaking dietary weight loss combined with HiRIT or aerobic training (AT).

Feasibility and effectiveness of a digital voice assistant for improving anti-osteoporosis medication adherence, and osteoporosis knowledge and attitudes, in postmenopausal women with osteoporosis: A 12-month randomised controlled trial.

Unlabelled: Digital voice assistants (DVAs) are feasible for delivering a digital health intervention designed to improve osteoporosis self-management in postmenopausal women with osteoporosis. However, the DVA intervention did not improve anti-osteoporosis drug adherence, nor did it enhance osteoporosis knowledge or attitudes in this population.

Purpose: To determine feasibility and effectiveness of a digital voice assistant (DVA) intervention for improving anti-osteoporosis medication adherence, and osteoporosis knowledge and attitudes, in postmenopausal women with osteoporosis.

First-line treatment of osteoporosis with osteoanabolic therapy: a new opportunity.

Osteoporosis is a national health priority, and over six million Australians over the age of 50 years have poor bone health. Fragility fractures due to osteoporosis are associated with an increased morbidity and mortality risk and a high economic cost to the community. It is a chronic condition requiring long-term management.

Effect of osteoporosis medications on vascular and valvular calcification: a systematic review and meta-analysis.

Objective: Vascular calcification shares many features with skeletal mineralisation and shares an inverse relationship with osteoporosis (skeletal de-mineralisation). However, medications that reduce bone loss (anti-resorptives) have had inconsistent effects on extra-skeletal mineralisation (i.e.

Bone Effects of Anti-Cancer Treatments in 2024.

Considerable progress has been made in the management of cancer patients in the last decade with the arrival of anti-cancer immunotherapies (immune checkpoint inhibitors) and targeted therapies. As a result, a broad spectrum of cancers, not just hormone-sensitive ones, have seen several patients achieve profound and prolonged remissions, or even cures. The management of medium- and long-term side-effects of treatment and quality of life of patients are essential considerations.

The effect of vitamin D supplementation on cancer incidence in the randomised controlled D-Health Trial: Implications for policy and practice.

Meta-analyses suggest that vitamin D supplementation reduces cancer mortality. As mortality is a function of incidence and survival, if use of vitamin D supplements does reduce cancer mortality, it must affect one or both of these parameters. Trials have found little evidence that vitamin D supplementation affects cancer incidence, but results were generally imprecise.

Exploring the Validity of Measures of Health-Related Quality of Life in Older Adults at Increased Risk of Falls and/or Fractures in Exercise Clinical Trials.

Exercise targeting physical function and body composition may mitigate falls and fracture risk among older adults. This study aimed to identify the most valid instrument(s) to assess quality of life (QoL) in this context by comparing the psychometric properties of the EQ-5D-3L, EQ-5D-5L, CDC Healthy Days measure, Modified Falls Efficacy Scale (MFES), and Work Productivity and Activity Impairment Questionnaire. Data from four exercise trials ( = 210, mean age 64.

Outcomes of Robot-Assisted Transbronchial Biopsies of Pulmonary Nodules: A Review.

: Robot-assisted bronchoscopy (RAB) is a novel platform for sampling peripheral pulmonary nodules (PPNs). To further clarify the role robot-assisted platforms have in diagnosing PPNs, we performed a review of the recent literature. : A systematic review was performed in Medline from 2019 to 2024 using the search terms "robotic bronchoscopy", "diagnostic yield", "sensitivity", and "positive predictive value", alone and in combination.

The effect of prednisolone ingestion and acute exercise on lipocalin-2 and its variants in young men: a pilot randomised crossover study.

Lipocalin-2 (LCN2) has three main variants; polyaminated (hLCN2) and non-polyaminated (C87A and R81E). The polyaminated form is proposed to positively influence energy control, whereas the non-polyaminated forms negatively impact energy control in mice. Glucocorticoids negatively affect glucose regulation and exercise has a positive effect.

Trabecular bone deficits predominate in the appendicular skeleton of midlife women living with HIV: findings from a cross-sectional study in Zimbabwe.

HIV-related mortality has fallen due to the scale-up of antiretroviral therapy (ART), so more women living with HIV (WLH) now live to reach menopause. Menopausal estrogen loss causes bone loss, as do HIV and certain ART regimens. However, quantitative bone data from WLH are few in Africa.

Bone imaging modality precision and agreement between DXA, pQCT, and HR-pQCT.

Quantifying precision error for DXA, peripheral QCT (pQCT), and HR-pQCT is crucial for monitoring longitudinal changes in body composition and musculoskeletal outcomes. Agreement and associations between bone variables assessed using pQCT and second-generation HR-pQCT are unclear. This study aimed to determine the precision of, and agreement and associations between, bone variables assessed via DXA, pQCT, and second-generation HR-pQCT.