FTIR microspectroscopic analysis: future perspectives
Bone is a composite material, consisting mainly of mineral and collagen. In normal humans, cortical bone constitutes approximately 80% of the human skeletal mass and trabecular bone approximately 20%. Bone surfaces may be undergoing formation or resorption, or they may be inactive. These processes occur throughout life in both cortical and trabecular bone. Bone remodeling is a surface phenomenon and in humans occurs on periosteal, endosteal, Haversian canal, and trabecular surfaces. The rate of cortical bone remodeling, which may be as high as 50% per year in the mid-shaft of the femur during the first two years of life, eventually declines to a rate of 2%-5% per year in the elderly. Rates of remodeling in trabecular bone are proportionately higher throughout life and may normally be 5-10 times higher than cortical bone remodeling rates in the adult. As is evident, tissue age is variable within the same human.
Osteoporosis & bone strength
Osteoporosis is an increasing public health problem. Currently osteoporosis is estimated to affect 200,000 people per year worldwide, costing the health care system over $ 10 billion per year in the US alone. Historically osteoporosis has been defined as a disease in which there is “too little bone, but what there is, is normal”. Recently, osteoporosis was defined as “a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk”. Despite the major efforts being put into producing new therapies to prevent and reduce the bone loss that leads to osteoporosis, and to limit further loss when osteoporosis is recognized, the factors contributing to the fragility of bone are still being determined.
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Loss of bone mass, measured clinically as change in bone mineral density (BMD), is considered an important risk factor for bone fragility. However, BMD is not the sole predictor of whether an individual will experience a fracture, and there is considerable overlap in BMD between populations that do and do not develop fractures. It has been demonstrated that for a given bone mass an individual’s risk to fracture increases with age. Consistent with these findings, numerous investigators have shown that mechanical variables directly related to fracture risk are either independent or not totally accounted for by bone mass itself. Epidemiological evidence also shows considerable overlap of bone density values between fracture and non-fracture groups suggesting that low bone quantity alone is an insufficient cause of fragility fractures. It is becoming evident then, that in addition to BMD, bone quality should also be considered when assessing bone strength and fracture risk. Bone quality is a broad term encompassing a plethora of factors such as geometry and bone mass distribution, trabecular bone microarchitecture, mi- crodamage, remodeling activity, along with genetics, body size, environmental factors, and changes in bone tissue material (mineral maturity / crystallinity, collagen cross-links) properties.