Thursday, 6 October 2011


Doctor Nguyen Van Duc

Thanks to advances in our medicine, our life expectancy is increasing. The elderly, we readily fractures. One important factor that makes it or fracture when bone age is porous.

Porous bones, bone diseases (osteoporosis) or empty, causing bones to become weak, soft, brittle. 20 million people in the United States does carry disease or spongy bone. Many minor disabilities, must look thanks to the care of others. In Vietnam, the image of the disease also went on ca dao:

"She also went light rains
The shrimp tép ones go took her also "

Disease occurring to women more than men.

Recently, many new discoveries brought to understanding more about the disease, undertaken at the same time, the methods to correct diseases, more effective treatment, turn out to help doctors more vehicles to the sick, in the hands of more weapons to fight the disease.

Each shell is composed of bone on the outside, covered a heart inside. Normal bone and heart. Porous bone disease caused by a number of the substance in the bone losing gradually over time, causing bone is no longer featured, as before. This is the phenomenon of loss of the bone (bone loss) over time as we get old.

Life is a process of medium destructive, medium build. Bone is the place to express this philosophy most thoroughly. Throughout his life on three thousand nine thousand of us, always in the bone can progress to break bones, creating new bone. Work break old bones was given to cells that have the name "osteoclast". The work of creating new bone by cells that have the name "osteoblast". Name them the same, the only other letters c and b in the middle (c, b is the compensation structure is bitten by appointment).

Time not the gnawing soul, also gnaw bone gradually. Until about the age of between 30 to 40, bones continue to grow, so we created more bone loss of the bone. Then, to a period balance, bones created by osteoblast cells, "equilibrium with bones taken away by" osteoclast cells ". Throughout the bone being bitten, osteoclast cells was immediately place osteoblast cells to the new bone run inning. Then when the older, more or less, we all take the bones out, due to old bones broke away, song new bones does not create up to such activities in places where the old bones, bone is no longer. Who takes too many bones porous bone, ill will.

In particular, women, after menopause, along with other changes of the body caused by menopause, such as hot or the breaking Dawn (hot flashes), sleeplessness, tribulations, vaginal itch snoring, urinate multiple times, hard, ..., the woman also lost bone quickly. Working holiday by the ovaries, no longer more adequate female estrogen hormones needed for the body. Estrogen effects balance the bones and the bones. Lack of estrogen, cells increased osteoclast activity, biting, create holes in the bone, in front of the eyes of osteoblast cells impotent. Long bone gradually, no longer featured, as before, and the bones become porous hollow, soft, brittle.

Thus, the female hormones estrogen is introspection, guards the door prevents time stealing a woman's bone loss. In the age of 45 to 55, the woman menstruation, sudden degrading quality estrogen in the body, steals time spoiled unwholesome. There is a loss of up to 25% density of the bone (bone density), only within 5-7 years after menopause.
Who is susceptible to the disease or spongy bone?
Many factors led to friendship between him and left him susceptible to bone loss, bone-out goes:
-Age: the higher the age, one more bone loss slowly. If the bone takes much too, will lead to disease or spongy bone.
-Women: in 100 cases of the disease or spongy bone, 80 are women.
-Families with porous bone fractures due to sick people (especially hip fractures in the mother).
-Adults who had fractures, especially in places where the sick or porous bones as the backbone, hip bones, wrist bones.
-Early menopause (before age 45).
-Lifetime rarely used compound calcium and vitamin D.
-Life is less active, less athletic.
-Drinking too much.
-The lean, light weight.

In addition, those who bring intensity thyroid disease (hyperthyroidism) or using steroid foam is also prone to long bones.
Porous bone is a silent disease onset. It quietly in many over the years, until she suddenly fractured bones.

When the spine (spine) have become soft and weak due to the loss of bone fracture, it much too slowly, slowly, at least one. Sometimes just a cough, or bow down closing grandchildren are crying, well enough cause spine fractures a little more. Long days, spine fractures already many times, that we do not know, would be short, as lower going. Many people find their natural populations than before, or why long dress clothes slightly now, no longer just Eclipse period. Finally, one day, they began to see pain, lower back also goes, then goes back uphill. Go light rains or falls.

Falls so to cause fractures in another location, the bones were thin pieces of software available, such as phase-Le. There's only va hands on edge tables, has fractured wrist. Fractures wrist cause hindrance to know how to work every day, even the most casual work. Washerwoman, rice water, dressing, patching, gardening, sewing, grandchildren, …, looks all require a strong wrist bones and dexterity.

There's a hip fracture (hip), although only fell very slightly. Hip fractures led to deadly, live was also suffering. More than half of survivors after hip fracture in the nursing home, or to seek help when travelling.
To disease
Porous bone is silent disease, traced the illness in its early stages is not easy. Recently, with new insights, tracing the disease no longer difficult.

The doctor will suspect you carry disease or spongy bone "osteoporosis" If you or back pain, low back is also smaller, now than before as the burden of time, or you suffer from fractures, especially in places prone to disease or spongy bone (such as the spine, hips, wrist bones). As you can easily put the missing element by porous bones mentioned above.

Etiquette is one thing, but you are really sick porous bones or not, we need to ask the opinion of the measurement characteristics of bone (bone densitometry) because it can be said really did take up how much bone. There are many ways to measure bone density. Measuring machine named "dual energy x-ray absorptometry", short for DXA, we considered how to measure bone density useful.

DXA measurement machine for fast, accurate results, to reporters out radioactive minimal, so no harm is measured. Machine can measure density of any bone in the body, but is often used to measure the spine, hips, the bone porous bone attack or ill. Works quickly, within 5-10 minutes is complete, you must not lie long tired back.

Compared with the treatment of bone density of a normal women before menopause, if the measure shows your bone density between 1 and 2.5 below the normal value of women prior to menopause, your bones are more or less have been lost and know. If your DXA measurements indicate that the value of your bone density is worse, namely under 2.5, you indeed got sick, with prospects of porous bone fracture is very high.

Still a little dispute about the case can be used to measure bone density DXA. "Measuring The Bone Anyone"? Who after menopause should also be measured bone?

-The women 65 and older should be measured density bones. (So, Medicare to women 65 meter bracket special bones every two years.)

Menopause-women under 65 years of age, song before each fracture, or weight, are taking steroid medication (such as Canada levitra), smoking, drinking a lot, rheumatoid arthritis (rheumatoid arthritis), films (x-ray) showed the bone looks thin (osteopenia), or have parents been hip fractures, bone density measurements should also.

-In General, bone density measurement is not required prior to menopause (menopause naturally, or by cutting the ovaries). However, should be thinking of bone density measurement for those who are carrying the disease, or taking the pill causes bone loss, though they are not vulnerable.
Drug treatment
In the bone can progress to break bones, creating new bone. When the more egalitarian, break bones, bones lose too much bone creation, porous bones occur.

In the US, there are four groups of drugs commonly used for porous bone healing: bisphosphonates, calcitonin, estrogen, Evista. All four drugs which have the effect of preventing the break bones.
1. Group drug bisphosphonates:The drug Fosamax, Actonel, Boniva, drink Atelvia, every day, every week or once a month depending on the medication.

The new bone drug bisphosphonates help create, should reduce bone loss, used to cure and prevent spongy bone. It is currently the main drug to cure the disease.
Pills in the morning at the new formula, with a full glass of water, before breakfast, before taking the drugs for at least 30-60 minutes. (Except for the drug Atelvia to drink immediately after breakfast.) Then, should not go lie down, that sit straight, stand or go, to ease down stomach medications. If trapped in the esophagus (food pipe down to the stomach), it may cause sores esophagus puncture bothers. It also does not want us to eat, drink anything within 30-60 minutes after taking it, because food, even coffee and fruit juices, reduces absorption in the intestines. Drinking water shall be.
The drug can cause hot chest, inflammation of the esophagus (esophagitis), abdominal pain, diarrhea, or symptoms of digestive discomfort.

Recently two drug Reclast, Zometa (intravenous infusion once a year for the past 15 minutes). New drugs should be very expensive (over 1,000 Usa-a nose), and if medication long years harmful for the body is not, this is unknown.
2. Drug Evista:
Evista (raloxifene) is used to specify to cure and prevent porous bones for menopausal women. Drugs are very similar with estrogen, but not increase the risk of breast cancer, cardiovascular disease if used long-term like estrogen.

Similar to estrogen, Evista prevent drug substances to break bones. In the women's menopause have not been porous bones, drug Evista helps prevent bone loss in all of the bones of the body. Other than the pills containing estrogen, Evista does not cause breast pain medications, or out doing it again. Within a few months of new medication, Evista may cause mild side the breaking dawn hot (hot flashes). Drugs Evista drink every day.

Compared to other bisphosphonates, Evista medication belonging to inferior.
9. Pills calcitonin:
Calcitonin, has long been drug used to treat bone porous form of injecting muscles and inject under the skin. The pain and inconvenience, should not famous. calcitonin Recently, the pharmacy changed tactics, the nasal sprays for Miacalcin, derives its name. A spray on one side of the nose to nose every day, today, tomorrow the nose left.

Patient use sprays Miacalcin also increases bone density and reduces fractures. However, compared to other drugs, the effects of bisphosphonates in generating additional Miacalcin, bone fractures, new vaccine is not as strong.

Miacalcin nasal sprays to cause little, if any, response is dry, irritating little tip of the province, or occasionally hắt cigar.
4. Estrogen:
Quality estrogen effect and prevent porous bones are very good, however, now no longer used to prevent and cure porous bone as before, because long-term, estrogen may increase the risk of breast cancer, cardiovascular disease.

Drugs containing estrogen in the market very much (Premarin, Estrace, Estratab, Ogen, Menast, Gynodiol, Ortho-Prefest, Activella, femhrt, Prempro, Premphase, ...), now usually only used to treat symptoms of menopause such as hot caused due to breaking dawn, sleeplessness, dry itchy vagina, tribulations, urinate multiple times, hard, ...

Some of the women were not suited to the porous bones of other medicines, all taking estrogen for healing.
The cure for non-drug
Porous bone healing, not only using one of the drugs mentioned above is done, we also need full diet, there is lack of calcium and vitamin D in person, often, stop smoking, and if possible, removing the drug use can cause hollow bones.

Eating every day should be sufficient to the body from malnutrition. Along with diet, every day we need 1200 mg calcium (from calcium source of food or drink from Vienna) and 800 units of vitamin D (International Unit) in addition to the market there are many medium-sized Tablet contains both calcium and vitamin D as Os-Cal with vit D.

The lobby is very important. In women aged, people saw athletes help maintain or increase the density of the bone, reduce the risk of hip fracture. Mobility not only made of bone, the muscle also toughness, strong, what factors prevent falls. The exercise put the weight of the body on the bone, like walking, is fine. Walking at least 3 times a week, at least 30 minutes each time. Should exercise habits, and exercise can we select subjects of interest to be regular and long term, due to the discontinuation of mobilization, the benefits of mobility on the bone will rapidly lose.

Tobacco to the bone, as to many other agencies, causing bones to empty quicker, smokers should quit smoking.

Some medications can cause extra long porous, hollow bones, such as the drug Omeprazole, Canada levitra Nexium, if possible, we should stop. (Various stomach medicines, Nexium Omeprazole in to five other habits than is necessary to drink, go see a doctor, so for, not sad evaluators back to see the sick need medication or not, nor instructions for the patient know side effects can empty the bonesfractures of the drug, if medication for too long.)END=VIETNAMESE TRANSLATE ENGLISH BY BACH LIEN HOA.( TAM THANH ).NAM MO SHAKYAMUNI BUDDHA.( 3 TIMES ).YELLOW FLAG WITH THREE STRIBES WILL FLY BACK TO VIETNAM NOT FAR AWAY AT ALL.

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