Long-term unemployment associated with poorer health

Patients with long-term chronic conditions, such as Cushing’s disease or Klinefelter’s syndrome, appear to be at increased risk for long-term unemployment related to their disease.

Researchers compared unemployment rates with re-employment rates for 130 patients (81 women) aged 65 years or younger with Addison’s disease, Cushing’s disease, craniopharyngioma or Klinefelter’s syndrome. The researchers presented the results at the Annual Society for Endocrinology BES 2010 in Manchester, England.

Based on telephone questionnaires, 83 patients (63.8%) were employed at the time of diagnosis. However, 79 patients (60.8%) were later unemployed, related to their long-term chronic condition.

Seventy-seven patients (59.2%) reported being satisfied with their current working status and ability to work. Among those unemployed, nine of 53 patients (40.8%) said they would like to work but did not feel supported.

Although the study was small and did not include all chronic endocrine conditions, the researchers said data show a high rate of unemployment for this patient population.

“Long-term unemployment is a significant problem for people with chronic diseases,” John Wass, MD, professor of endocrinology at Oxford University and consultant endocrinologist at Oxford Radcliffe Hospitals, said in a press release. “More people should consider returning to work following diagnosis, and more doctors need to encourage and support their patients in this. While a return to work may not be suitable for all patients, it can significantly improve their well-being and quality of life.”

Wass J. Poster #116. Presented at: The Annual Society for Endocrinology BES meeting; March 15-18, 2010; Manchester, England.

From http://www.endocrinetoday.com/view.aspx?rid=62296

Osteoporosis

Part of http://medicindo.blogspot.com/2008/07/osteoporosis.html

Risk factors for developing osteoporosis are:

* Ethnicity and particularly the Caucasian subjects. This is due to a lifestyle (diet rich in calcium, protein and low in vitamin (including vitamin D, B12 and K)
* The high age,
* Females,
* Low body mass index,
* Family history of fractures of the hip,
* Deficiencies in calcium and protein
* The excessive consumption of tobacco, alcohol, coffee,
* Vitamin D deficiency (lack of sunshine and consumption of plants),
* Physical inactivity, prolonged detention,
* The deficit to sex hormones,
o early menopause induced or spontaneous,
o castration (both sexes) chemical or surgical
o late puberty,
* Certain hormonal diseases hyperthyroidism, hyperparathyroidie, diabetes insulin, hypercorticism (Cushing's disease, ...), hyperandrogénisme, Klinefelter syndrome, Turner syndrome,
* Certain metabolic diseases haemochromatosis, hypercalciuria isolated idiopathic or family ...
* Inflammatory rheumatism: rheumatoid arthritis, ankylosing spondylitis,
* Other chronic diseases: chronic renal failure, hepatocellular failure, cirrhosis, mastocytosis,
* Certain treatments, especially prolonged corticosteroid, GnRH analogues, anti-aromatases.

At the genetic level, several mutations in the genes LPR5 and LPR6 (low-density lipoprotein receptor) seem to be correlated with a slightly increased risk of osteoporosis.

Signs and symptoms
Osteoporosis usually does not sign. His presence significantly increases the risk of fracture. This risk is inversely correlated with bone mineral density.

Diagnosis
The diagnosis of osteoporosis based on the measurement of bone mineral density by ostéodensitométrie, using the method most often X-rays DEXA. There is talk of osteoporosis if the density is below 2.5 standard deviations from normal. Between -2.5 and -1 standard deviations, it is called osteopenia.

Etiology
The bone is renewed throughout life through a process known as "bone remodeling": this remodeling is not at the same time on all surfaces but bone on tiny homes. In these homes remodeling begins with a phase of bone resorption leading to the formation of a cavity, followed by a phase of bone formation during which the cavity is filled by new bone. This process of remodeling is in deficit, ie it has formed a little less bone than it has been eliminated. This balance deficit explains bone loss associated with age, which will lead to osteoporosis if the bone at the end of growth was insufficient or if the activity remodeling a record high deficit. This balance deficit is enhanced by a deficiency or worse absorption of calcium and vitamin D. In women, the decline in the rate of female sex hormones at menopause is a factor. This explains that, on average, loss of bone density becomes sensitive from 50 years for women and 70 years for men, with significant variations depending on individual genetic predisposition of each diet, physical activity . Osteoporosis is common after a prolonged bed rest. It is also a symptom of evil of space.

Often called the "silent epidemic", osteoporosis exposes them to greater risk of fractures, the main danger, including fractures of the hip, wrist and fractures of the spine.

List of diseases associated with osteoporosis
Osteoporosis may be secondary to a condition which can consider setting up a prevention of this bone loss:

* Lack gonadotrope particularly in the following diseases: Turner syndrome, Klinefelter syndrome, anorexia nervosa, insufficient hypothalamic, hyperprolactinemia.
* Endocrine disorders that can be found in: Cushing's Syndrome, hyperparathyroidism, hyperthyroidism, insulin-dependent diabetes, acromegaly,

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