Biomedical subjects

Claude Ribot

Publications and source records attributed to Claude Ribot.

2 recordsLinked to original sources

PubMed2002

[Screening techniques].

WOMEN "AT RISK": Assessment of the risk of osteoporosis in a woman approaching the menopause relies essentially on the evaluation of her bone mass and the study of a certain number of clinical criteria. The principle osteoporosis risk markers are age, past personal and family history of fractures due to bone fragility, low body weight, past history of early menopause and all the affections corresponding classically to "secondary" osteoporosis. OSTEODENSITOMETRY: Densitometric measurement is the corner stone of this assessment, since any decrease of 1 in the standard deviation of bone density corresponds to a two-fold greater risk of fracture. This relationship has led to a new densitometric definition of osteoporosis, based on a decrease of more than 2.5 standard deviations compared with the median value of a young adult (t-score < -2.5). THE INTEREST OF BIOCHEMICAL MARKERS: The interest of bone remodeling biochemical markers has not been clearly defined. Combined with densitometric measurements, they may permit the assessment of the level of bone remodeling and hence estimate bone loss, which is one of the determinant factors of fracture risk.

Absorptiometry, Photon↗

PubMed2002

[Current therapeutic means].

UNLABELLED: VARIOUS THERAPEUTIC POSSIBILITIES: Treatment of osteoporosis has greatly progressed over the past few years and, in parallel with hormone replacement therapy (HRT), new drugs (2nd and 3rd generation bisphosphonates and raloxifen) are now available, not only for primary prevention but also for secondary prevention of fractures. WHAT INDICATIONS?: The anti-fracture efficacy that has been demonstrated in large clinical trials, conducted according to the requirements of modern methodology, only appear patent in women at "high risk" for osteoporosis, i.e., those presenting a t-score < -2.5 and a prevalent fracture (particularly vertebral crushing), situation which is relatively rare at the onset of the menopause. IN PRACTICE: The initiation of such treatment in a women approaching the menopause should only be considered after prior measurement of her bone density, using a validated technique, measurement that is not always officially recognized by our Health Authorities. This problem, together with the varying conditions of prescription and reimbursement, explain some of the problems encountered in the use of these new therapeutics, notably in women at high risk of osteoporosis, who have not yet presented a fracture due to their bone fragility.

Bone Density↗