Uso de risedronato na consolidação e formação do calo na fratura de Colles em mulheres na pós-menopausa - estudo solid / Use of risedronate for consolidation and callus formation in Colles fractures in postmenopausal women: solid study

OBJETIVO: Este estudo multicêntrico, randomizado, aberto, grupo paralelo avaliou a eficácia de Actonel(r) 35 mg mais cálcio/vitamina D versus cálcio/vitamina D isoladamente na preservação da densidade mineral óssea (DMO) em mulheres pós-menopausadas com fratura de Colles. MÉTODOS: Pacientes com fratura de Colles em sete dias foram aleatoriamente designadas para receber Actonel(r) 35 mg semanalmente mais cálcio/vitamina D (Grupo AO [GAO]) ou cálcio/vitamina D (grupo O [GO]) isoladamente. As pacientes foram avaliadas após 90 e 180 dias de tratamento. RESULTADOS: Completaram as avaliações 59 pacientes no GAO e 56 no OG. No fim do estudo, a DMO do rádio no local da fratura mostrou variação negativa no GO (32,8%) que foi discretamente menor no GAO (20,8%), assim como uma perda menor na DMO no GAO comparado com o OG. Houve diferença na proporção de paciente com perda da DMO no fim do estudo nos dois grupos de tratamento em favor do GAO, apesar de não estatisticamente significante. Não houve diferença significativa na identificação radiológica da formação do calo entre os grupos de tratamento. Na maioria das pacientes a identificação radiológica do calo ocorreu depois de 90 dias. CONCLUSÃO: Mulheres pós-menopausadas com fratura de Colles que receberam risedronato sódico, além do cálcio/vitamina D, comparado com cálcio/vitamina D não mostraram diferença significativa na perda da DMO na fratura do antebraço, com tendência de efeito protetor do risedronato na perda da DMO devido à imobilização. O tempo até a consolidação da fratura não foi afetado.

OBJECTIVE: This open, randomized and blinded parallel-group multicenter study evaluated the efficacy of Actonel(r) (35 mg) plus calcium/vitamin D versus calcium/vitamin D alone for preserving bone mineral density (BMD) in postmenopausal women with Colles fractures. METHODS: Patients with a Colles fracture for seven days were randomized to receive either Actonel(r) (35 mg) once a week plus calcium/vitamin D (ACD group) or calcium/vitamin D alone (CD group). The patients were evaluated after 90 and 180 days of treatment. RESULTS: 59 ACD patients and 56 CD patients completed all the evaluations. At the end of the study, the BMD of the radius at the fracture location showed a negative change in the CD group (32.8%). The loss of BMD in the ACD group (20.8%) was slightly less than that in the CD group. There was a difference in the proportions of patients with BMD losses at the end of the study period in the two treatment groups, in favor of the ACD group, although this was not statistically significant. There was no significant difference in radiological identification of callus formation between the treatment groups. In the majority of the patients, the callus could be radiologically identified after 90 days. CONCLUSION: Postmenopausal women with Colles fractures who received risedronate sodium plus calcium/vitamin D did not show any significant difference in BMD loss in forearm fractures, in comparison with those who received calcium/vitamin D alone. Risedronate presented a tendency toward a protective effect regarding BMD loss due to immobilization. The time taken for fracture consolidation to be achieved was unaffected.

Densitometria clínica: posições oficiais 2006 / Clinical densitometry: official positions 2006

Descrevemos as posições oficiais da Sociedade Brasileira de Densitometria Clínica (SBDens) para a realização e o relato do exame de densitometria óssea. Essas posições foram obtidas por consenso em encontro realizado em São Paulo no ano de 2006. A SBDens contou com o apoio de várias sociedades científicas descritas no texto.

We describe the official positions of the Brazilian Society for Clinical Densitometry (SBDens) for the performance and report of the bone mineral density testing. These positions were obtained by consensus in a meeting at São Paulo in 2006. SBDens positions were supported by other scientific societies described in the text.

Plica sinovial de joelho em cadáveres de recém-nascidos: comparação entre Anatomio e Artro-TC / Synovial knee plica in newborn cadaver knee: a comparasion between Anatomy and Arthro-TC

Fifty-two newborn knees were used to verify the validity of the arthro-TC of double contrast for the diagnosis of normal synovial plicas, aiming at classifying and verifying their quantitative incidence and ethnic distribution. The plica synovialis mediopatellaris was identified in brown (60 percent), white (40 percent) and black races (9 percent) in this study. The incidence in black people was quite low as compared to white and brown people. The most commonly found folds were the plica synovialis infrapatellaris (69 percent) followed by the plica synovialis suprapatellaris (44 percent) and plica synovialis mediopatellaris (31 percent). Plicas were not found in 6 percent of the knees. The communication of bursa patellares with the articulation of the knee is present at birth in 85 percent of newborns. Identification of plica synovialis infrapatellaris was difficult because it is covered by abundant fat tissue. Arthro-TC was studied and analyzed by six observers, three radiologists and three orthopedic surgeons. The results showed a medium sensibility of 72 percent and a medium specificity of 60 percent for radiologist versus 89 percent and 61 percent for orthopedist surgeons, respectively.