A concise review of the current knowledge of osteoporosis, aimed at the busy pratitioner who is increasingly involved in the management of osteoporosis and who wants accurate and practical answers to questions that arise in daily clinical practice. All the major aspects are covered including diagnosis, fractures, prevention and treatment. Each chapter has been written by a recognised expert in the field to provide readers with the most up-to-date and authoritative knowledge on each of the topics discussed, making this an invaluable source of reference.

Bone is hard tissue that is in a constant state of flux being built up by bone-forming cells called osteoblasts while also being broken down or resorbed by cells known as osteoclasts. During childhood and adolescence bone formation is dominant; bone length and girth increase with age ending at early adulthood when peak bone mass is attained. Males generally exhibit a longer growth period resulting in bones of greater size and overall strength. In males after the age of 20 bone resorbtion becomes predominant and bone mineral content declines about 4% per decade. Females tend to maintain peak mineral content until menopause at which time it declines about 15% per decade. Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue leading to bone fragility and an increased susceptibility to fractures especially of the hip spine and wrist. Osteoporosis occurs primarily as a result of normal ageing but can arise as a result of impaired development of peak bone mass (e.g. due to delayed puberty or undernutrition) or excessive bone loss during adulthood (e.g. due to estrogen deficiency in women undernutrition or corticosteriod use). Osteoporosis-induced fractures cause a great burden to society. Hip fractures are the most serious as they nearly always result in hospitalization are fatal about 20% of the time and produce permanent disability about half the time. Fracture rates increase rapidly with age and the lifetime risk of fracture in 50 year-old women is about 40% similar to that for coronary heart disease. In 1990 there were 1.7 million hip fractures alone worldwide; with changes in population demographics this figure is expected to rise to 6 million by 2050. To help describe the nature and consequences of osteoporosis as well as strategies for its prevention and management a WHO Scientific Group meeting of international experts was held in Geneva which resulted in this technical report. This monograph describes in detail normal bone development and the causes and risk factors for developing osteoporosis. The burden of osteoporosis is characterized in terms of mortality morbidity and economic costs. Methods for its prevention and treatment are discussed in detail for both pharmacological and non-pharmacological approaches. For each approach the strength of the scientific evidence is listed. The report also provides cost-analysis information for potential interventions and discusses important aspects of developing national policies to deal with osteoporosis. Recommendations are made to the general population care providers health administrators and researchers. Lastly national organizations and support groups are listed by country.

Menopause is a comprehensive resource for the care and treatment of menopausal and postmenopausal women. Explores menopause from a number of different perspectives and familiarizes clinicians with the medical issues associated with menopause, including physiology, symptomatology, risk factors, the medical evaluation, and hormone therapy and other medical treatments. ? Addresses the major symptoms experienced by the menopausal woman like hot flashes, genitourinary difficulties, sexual concerns, mood and memory issues and their management. ? Focuses on disease prevention educating women on cardiovascular disease, preservation of bone density, meeting nutritional needs, and cancer screening. ? Discusses Hormone therapy'its risks and benefits as well as prescribing method.

Leading clinicians and researchers concisely review the significant risk factors, including dyslipidemias, hypertension, diabetes, lack of exercise, obesity, tobacco, and homocysteine, and outline the best preventive strategies available. They also offer an overview of the new paradigms in coronary artery disease pathophysiology, including the nature of the unstable atherosclerotic plaque, new strategies for the modification of plaque constituents, the importance of the endothelium in the maintenance of cardiovascular health, and the emerging roles of oxidative stress, infection, and inflammation. Comprehensive and pathbreaking, Preventive Cardiology: Strategies for the Prevention and Treatment of Coronary Artery Disease provides physicians with the understanding and tools necessary to bring the practice of preventive cardiology to their patients.

Preventive cardiology is a fast moving field that places emphasis on the prevention and treatment of coronary disease. Preventive Cardiology: Insights Into the Prevention and Treatment of Cardiovascular Disease, Second Edition is intended for clinical cardio- gists, internists, primary care providers, and allied health care professionals who wish to extend their knowledge and expertise in the rapidly expanding field of preventive car- ology. It is the mission of this book to provide clinicians with the understanding and tools necessary to implement prevention in their daily practices. Recent changes in the delivery of health care in the United States and abroad, in conjunction with new scientific evidence supporting the role of preventive strategies in the maintenance of cardiovascular health, have focused new attention and efforts on the field of cardiovascular disease prevention. The field of cardiology is thus making a gradual transition from the technology-driven, intervention-oriented perspective of the last several decades to a new, preventive, molecular-based perspective. As fresh evidence amasses that preventive measures produce a considerable decrease in the incidence of both primary and secondary cardiac events and mortality, there is growing, widespread acknowledgment that health care providers from all arenas must initiate preventive str- egies in the management and care of their patients.

An exhaustive report on recommended clinical preventive services that should be provided to patients in the course of routine clinical care, including screening for vascular, neoplastic and infectious diseases, and metabolic, hematologic, ophthalmologic and ontologic, prenatal, and musculoskeletal disorders. Also, mental disorders and substance abuse, counseling, and immunization. The majority of deaths below age 65 are preventable. This Guide results from the most comprehensive evaluation and synthesis of preventive interventions to date.