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Total parenteral nutrition (TPN) is provided when the gastrointestinal tract is nonfunctional because of an interruption in its continuity (it is blocked, or has a leak – a fistula) or because its absorptive capacity is impaired. [6] It has been used for comatose patients, although enteral feeding is usually preferable, and less prone to ...
Osteoporosis, a skeletal disorder characterized by compromised bone strength and increased risk of fractures, is a major concern in bone health, particularly among older adults. [ 2 ] [ 3 ] Maintaining good bone health involves a combination of adequate calcium and vitamin D intake, regular weight-bearing exercise, and avoiding risk factors ...
Bisphosphonates are used to treat osteoporosis, osteitis deformans (Paget's disease of the bone), bone metastasis (with or without hypercalcemia), multiple myeloma, and other conditions involving fragile, breakable bone. In osteoporosis and Paget's, the most popular first-line bisphosphonate drugs are alendronate and risedronate.
In the early 2000s, a link between bisphosphonate use and impaired bone physiology was noted. [3] [4] The strong inhibition of osteoclast function precipitated by bisphosphonate therapy can lead to inhibition of normal bone turnover, leading to impaired wound healing following trauma (such as dental surgery) or even spontaneous non-healing bone exposure.
Bone densities are often given to patients as a T score or a Z score. A T score tells the patient what their bone mineral density is in comparison to a young adult of the same gender with peak bone mineral density. A normal T score is -1.0 and above, low bone density is between -1.0 and -2.5, and osteoporosis is -2.5 and lower.
To prevent steroid-induced osteoporosis, the steroid dose and duration should be as low and as short as possible. All patients on long term glucocorticoids (≥3 months) should be encouraged to do weightbearing exercise, avoid smoking and excess alcohol and take fall prevention measures. Daily calcium and vitamin d intake should be sufficient.
Senile osteoporosis has been recently recognized as a geriatric syndrome with a particular pathophysiology. There are different classification of osteoporosis: primary, in which bone loss is a result of aging and secondary, in which bone loss occurs from various clinical and lifestyle factors. [1]
The RD(N) negotiates a treatment plan with the patient which may include prescriptions, and follow-up visits often focus on maintenance and monitoring progress. Most RDs work in the treatment and prevention of disease (administering medical nutrition therapy, as part of medical teams), often in hospitals, health-maintenance organizations ...