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  1. Article ; Online: Evaluating Patients for Secondary Causes of Osteoporosis.

    Lewiecki, E Michael

    Current osteoporosis reports

    2022  Volume 20, Issue 1, Page(s) 1–12

    Abstract: ... Many patients with osteoporosis have contributing factors (e.g., vitamin D deficiency, high fall risk ...

    Abstract Purpose of review: This review provides suggestions for the evaluation of patients with osteoporosis in order to assure that the diagnosis is correct, to identify potentially correctable conditions contributing to skeletal fragility and fracture risk, and to assist in individualizing management decisions.
    Recent findings: Some patients who appear to have osteoporosis have another skeletal disease, such as osteomalacia, that requires further evaluation and treatment that is different than for osteoporosis. Many patients with osteoporosis have contributing factors (e.g., vitamin D deficiency, high fall risk) that should be addressed before and after starting treatment to assure that treatment is effective and safe. Evaluation includes a focused medical history, skeletal-related physical examination, assessment of falls risk, appropriate laboratory tests, and rarely transiliac double-tetracycline labeled bone biopsy. Evaluation of patients with osteoporosis before starting treatment is essential for optimizing clinical outcomes.
    MeSH term(s) Bone Density ; Bone and Bones ; Fractures, Bone/complications ; Humans ; Osteomalacia/complications ; Osteoporosis/drug therapy ; Vitamin D Deficiency/complications
    Language English
    Publishing date 2022-01-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2186581-4
    ISSN 1544-2241 ; 1544-1873
    ISSN (online) 1544-2241
    ISSN 1544-1873
    DOI 10.1007/s11914-022-00717-y
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  2. Article ; Online: Assessment of Skeletal Strength: Bone Density Testing and Beyond.

    Lewiecki, E Michael

    Endocrinology and metabolism clinics of North America

    2021  Volume 50, Issue 2, Page(s) 299–317

    Abstract: A bone fractures when a force applied to it exceeds its strength. Assessment of bone strength is an important component in determining the risk of fracture and guiding treatment decisions. Dual-energy X-ray absorptiometry is used to diagnosis ... ...

    Abstract A bone fractures when a force applied to it exceeds its strength. Assessment of bone strength is an important component in determining the risk of fracture and guiding treatment decisions. Dual-energy X-ray absorptiometry is used to diagnosis osteoporosis, estimate fracture risk, and monitor changes in bone density. Fracture risk algorithms provide enhanced fracture risk predictability. Advanced technologies with computed tomography (CT) and MRI can measure parameters of bone microarchitecture. Mathematical modeling using CT data can evaluate the behavior of bone structures in response to external loading. Microindentation techniques directly measure the strength of outer bone cortex.
    MeSH term(s) Absorptiometry, Photon/methods ; Bone Density/physiology ; Bone and Bones/diagnostic imaging ; Fractures, Bone/diagnostic imaging ; Humans ; Osteoporosis/diagnostic imaging ; Risk Assessment
    Language English
    Publishing date 2021-04-28
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 92116-6
    ISSN 1558-4410 ; 0889-8529
    ISSN (online) 1558-4410
    ISSN 0889-8529
    DOI 10.1016/j.ecl.2021.03.008
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  3. Article ; Online: Operationalizing Treat-to-Target for Osteoporosis.

    Lewiecki, E Michael

    Endocrinology and metabolism (Seoul, Korea)

    2021  Volume 36, Issue 2, Page(s) 270–278

    Abstract: Treat-to-target (TTT) for osteoporosis is a concept for individualizing patient treatment decisions that focuses on achieving an acceptable level of fracture risk rather than response to treatment alone. While a response to treatment is essential in ... ...

    Abstract Treat-to-target (TTT) for osteoporosis is a concept for individualizing patient treatment decisions that focuses on achieving an acceptable level of fracture risk rather than response to treatment alone. While a response to treatment is essential in order to achieve an acceptable level of risk, it is not necessarily sufficient. Some patients have a good response to treatment yet remain at high level of fracture risk. Since there is no way to directly measure bone strength in patients treated for osteoporosis, a surrogate measurement must be used. Bone mineral density (BMD) is commonly used to select patients for treatment and has emerged as the most useful surrogate for assessing reduction of fracture risk after treatment is started. Recent large meta-regression studies have shown a robust correlation between larger increases in BMD with treatment and greater reductions in fracture risk. Application of TTT for osteoporosis involves assessing fracture risk before starting treatment and initiating treatment with an agent that is most likely to reduce fracture risk to an acceptable level, represented by a target BMD T-score, over a reasonable period of time. This review offers suggestions for implementing TTT for osteoporosis in clinical practice and managing patients who fail or succeed in reaching the target. More study is needed to fully validate the use of TTT for osteoporosis for initiating and modifying treatments to reduce fracture risk.
    MeSH term(s) Bone Density ; Fractures, Bone ; Humans ; Osteoporosis/drug therapy
    Language English
    Publishing date 2021-03-24
    Publishing country Korea (South)
    Document type Journal Article ; Review
    ZDB-ID 2802452-7
    ISSN 2093-5978 ; 2093-5978
    ISSN (online) 2093-5978
    ISSN 2093-5978
    DOI 10.3803/EnM.2021.970
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  4. Article: Bone Health ECHO Case Report: Fractures and Hypercalcemia in a Patient with Stage 5 Chronic Kidney Disease.

    Lewiecki, E Michael / Erickson, Dale G / Gildersleeve, Roger W

    Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry

    2024  Volume 27, Issue 2, Page(s) 101478

    Abstract: Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual community of practice with the aim of enhancing global capacity to deliver best practice skeletal healthcare. The prototype program, established at the University of New Mexico, ... ...

    Abstract Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual community of practice with the aim of enhancing global capacity to deliver best practice skeletal healthcare. The prototype program, established at the University of New Mexico, has been meeting online weekly since 2015, focusing on presentation and discussion of patient cases. These discussions commonly cover issues that are relevant to a broad range of patients, thereby serving as a force multiplier to improve the care of many patients. This is a case report from Bone Health ECHO about a patient with stage 5 chronic kidney disease, hypercalcemia, and low bone density, and the discussion that followed.
    MeSH term(s) Humans ; Hypercalcemia/etiology ; Middle Aged ; Renal Insufficiency, Chronic/complications ; Female ; Bone Density ; Male ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy
    Language English
    Publishing date 2024-02-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2040951-5
    ISSN 1094-6950
    ISSN 1094-6950
    DOI 10.1016/j.jocd.2024.101478
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  5. Article: Romosozumab, clinical trials, and real-world care of patients with osteoporosis.

    Lewiecki, E Michael

    Annals of translational medicine

    2020  Volume 8, Issue 15, Page(s) 974

    Language English
    Publishing date 2020-09-02
    Publishing country China
    Document type Editorial ; Comment
    ZDB-ID 2893931-1
    ISSN 2305-5847 ; 2305-5839
    ISSN (online) 2305-5847
    ISSN 2305-5839
    DOI 10.21037/atm.2020.03.196
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  6. Article ; Online: Vitamin D and COVID-19: Is something better than nothing?

    Lewiecki, E Michael

    Osteoporosis and sarcopenia

    2020  Volume 6, Issue 3, Page(s) 95–96

    Abstract: There is no abstract. ...

    Abstract There is no abstract.
    Keywords covid19
    Language English
    Publishing date 2020-09-03
    Publishing country Netherlands
    Document type Editorial
    ISSN 2405-5263
    ISSN (online) 2405-5263
    DOI 10.1016/j.afos.2020.08.005
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  7. Article: Pulse-echo Ultrasound Identifies Caucasian and Hispanic Women at Risk for Osteoporosis.

    Lewiecki, E Michael

    Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry

    2020  Volume 24, Issue 2, Page(s) 175–182

    Abstract: Background: Pulse-echo ultrasonography (PEUS) is a novel ultrasound method that measures the thickness of cortical bone at peripheral skeletal sites with a handheld device connected to a personal computer using proprietary software. Previous studies ... ...

    Abstract Background: Pulse-echo ultrasonography (PEUS) is a novel ultrasound method that measures the thickness of cortical bone at peripheral skeletal sites with a handheld device connected to a personal computer using proprietary software. Previous studies have shown a significant correlation between density index (DI), a PEUS-derived parameter, and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry at the hip. DI thresholds that discriminate patients likely to have osteoporosis with 90% sensitivity and 90% specificity have been established in a population of Caucasian women in Finland and validated in a study of predominately Caucasian women in the state of Minnesota in the USA. The DI thresholds have not previously been evaluated in non-Caucasian populations.
    Methodology: This study aimed to determine whether previously established DI thresholds in Caucasian women require adjustment in Hispanic women. PEUS measurements at the proximal tibia and dual-energy X-ray absorptiometry BMD at the hip were evaluated in Caucasian and Hispanic women at a single investigative site in Albuquerque, New Mexico, USA. DI was calculated for each patient and compared with BMD. The performance of DI threshold values for these populations was compared.
    Results: The study enrolled 293 postmenopausal women (153 Caucasian, 140 Hispanic) with and without osteoporosis. The sensitivity and specificity for DI thresholds to distinguish women with total hip or femoral neck T-score ≤ -2.5 or > -2.5 was similar in Caucasians (sensitivity 80%, specificity 86%) and Hispanics (sensitivity 80%, specificity 91%).
    Conclusions: The findings of this study confirm the utility of previously established DI thresholds to identify women who are likely or unlikely to have osteoporosis and suggest that the same thresholds can be used for postmenopausal Caucasian and Hispanic women.
    MeSH term(s) Absorptiometry, Photon ; Bone Density ; Female ; Femur Neck/diagnostic imaging ; Hispanic Americans ; Humans ; Osteoporosis/diagnostic imaging ; Osteoporosis, Postmenopausal/diagnostic imaging ; Sensitivity and Specificity ; Ultrasonography
    Language English
    Publishing date 2020-05-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2040951-5
    ISSN 1094-6950
    ISSN 1094-6950
    DOI 10.1016/j.jocd.2020.04.002
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  8. Article ; Online: Correction to: Osteoporosis: Treat-to-Target.

    Lewiecki, E Michael

    Current osteoporosis reports

    2019  Volume 17, Issue 6, Page(s) 581

    Abstract: The author Edward Michael Lewiecki is listed incorrectly in indexing sources as "Michael Lewiecki E." ...

    Abstract The author Edward Michael Lewiecki is listed incorrectly in indexing sources as "Michael Lewiecki E."
    Language English
    Publishing date 2019-08-14
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 2186581-4
    ISSN 1544-2241 ; 1544-1873
    ISSN (online) 1544-2241
    ISSN 1544-1873
    DOI 10.1007/s11914-019-00530-0
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  9. Article ; Online: Fractures While Walking Leashed Dogs.

    Lewiecki, E Michael

    JAMA surgery

    2019  Volume 154, Issue 11, Page(s) 1078

    MeSH term(s) Animals ; Dogs ; Fractures, Bone ; United States ; Walking
    Language English
    Publishing date 2019-08-26
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2019.2652
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  10. Article ; Online: The current role of telehealth in the management of patients with osteoporosis.

    Lewiecki, E Michael / Bouchonville, Matthew F

    Expert review of endocrinology & metabolism

    2022  Volume 17, Issue 3, Page(s) 245–254

    Abstract: Introduction: Telehealth is the use of electronic technologies for communication, storage, and analysis of health-related information. Telemedicine is a form of telehealth that involves remote patient care. This is a review and update of the use of ... ...

    Abstract Introduction: Telehealth is the use of electronic technologies for communication, storage, and analysis of health-related information. Telemedicine is a form of telehealth that involves remote patient care. This is a review and update of the use of these modalities as they apply to the education of healthcare professionals who provide care for patients with osteoporosis and the delivery of their care.
    Areas covered: This review focuses on technology-enabled collaborative learning and its prototype model, Project ECHO (Extension for Community Healthcare Outcomes). Bone Health TeleECHO and similar programs apply the ECHO model of learning to mentor healthcare professionals on implementation of best practice care for patients with osteoporosis and other skeletal diseases. Telemedicine, which has seen widespread uptake during the COVID-19 pandemic, is an alternative to in-person visits for patients with osteoporosis as well as for those with other conditions.
    Expert opinion: Remote education of healthcare professionals and the remote delivery of patient care provides opportunities, as well as challenges, for achieving the goal of reducing the global burden of osteoporotic fractures.
    MeSH term(s) COVID-19 ; Humans ; Osteoporosis/therapy ; Pandemics ; Telemedicine
    Language English
    Publishing date 2022-05-22
    Publishing country England
    Document type Journal Article ; Review
    ISSN 1744-8417
    ISSN (online) 1744-8417
    DOI 10.1080/17446651.2022.2078304
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