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Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
The FDA has approved hip protector garments for the prevention of hip fractures in elderly people with known osteoporosis. Brand names available include Hipsaver and Safehip. These can be helpful for selected patients who are in the nursing-home environment, although the real extent of protection against hip fractures that is gained with use of hip protectors is controversial.
Additionally, for those elderly people who use canes for walking, etc., it is essential that the rubber tips of the canes are regularly checked for any signs of wear. When this rubber wears through it presents a serious risk of causing the cane (and, therefore, the person) to slip, which can result in serious bodily
Controversy
Currently, it is not clear as to how long patients with osteoporosis being treated with bisphosphonates should continue the bisphosphonate treatment. Many doctors are interrupting treatment for a "drug holiday" off of the drug as it may not be necessary after five to seven years. Guidelines for duration of treatment of osteoporosis with bisphosphonates are being developed.
REFERENCES:
Gehlbach, S.H., R.T. Burge, E. Puleo, J. Klar.
Osteoporosis International. 14.1 Jan. 2003: 53-60.
Harris, W.H., and R.P. Heaney.
New England Journal of Medicine. 280.6 Feb. 6, 1969: 303-11.
JAMA. 285.6 Feb. 14, 2001: 785-95.
Lindsay, R., S.L. Silverman, C. Cooper, D.A. Hanley, I. Barton, S.B. Broy, A. Licata,
L. Benhamou, P. Geusens, K. Flowers, H. Stracke, E. Seeman. JAMA. 285.3
Jan. 17, 2001: 320-3.
Marottoli,
R.A., L.F. Berkman, L. Leo-Summers, L.M. Cooney Jr. American Journal of Public
Health. 84.11 Nov. 1994: 1807-12.
National Institutes of Health, Department of Health & Human Services, National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Osteoporosis
Foundation. Ray, N.F., J.K. Chan, M. Thamer, L.J. Melton. Journal of Bone Mineral
Research. 12.1 Jan. 1997: 24-35.
Previous contributing author: Carolyn Janet Crandall, MD, MS, FACP
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