Caracterización de la asociación aterosclerosis-osteoporosis en hombres y mujeres: estudio en fallecidos / Caracterization of the aterosclerosis-osteoporosis asociation in men and women: patient death study

Objetivos: Caracterizar la asociación entre las lesiones ateroscleróticas de las arterias coronarias con la osteoporosis de la columna lumbar y de fémur proximal en hombres y mujeres. Métodos: Se estudiaron 79 necropsias, realizando densitometría postmorten de columna lumbar y fémur proximal, clasificando los niveles de densidad mineral ósea (DMO) según T score en: normal, osteopenia y osteoporosis; seguido del examen patomorfológico y morfométrico de las tres coronarias epicárdicas principales aplicando el sistema aterométrico, clasificando las lesiones ateroscleróticas como: estría adiposa, placa fibrosa y placa grave. Resultados: La asociación aterosclerosis-osteoporosis mostró características especiales para cada sexo, con predominio significativo de osteoporosis en hombres y de osteopenia en mujeres. Tras remover el efecto del tabaquismo, las diferencias entre los géneros se modificaron, observándose que los fumadores, de ambos sexos, presentaron una DMO y una asociación aterosclerosis-osteoporosis similares. Conclusiones: La interferencia ejercida por sexo sobre la asociación aterosclerosis-osteoporosis resultó despreciable

Objective: characterize the association between coronary atherosclerotic lesions and osteoporosis of lumbar spine and hip in men and women. Methods: We study 79 necropsies, doing lumbar spine and hip bone densitometry, classifying bone mineral density (BMD) by T score in: normal, osteopenia and osteoporosis. Then we carry out morphological and morphometric characterization of the three principal coronary arteries using the atherometric system, classifying atherosclerotic lesions like: fatty streak, fibrous plaques and severe plaques. Results: The atherosclerosis-osteoporosis association show special characteristics for each sex, with significantly predominance of osteoporosis in men and osteopenia in women. After smoking adjustment, the differences between sexes were modified, finding similar BMD and atherosclerosis-osteoporosis association between smoker patients of both sexes. Conclusions: The sex interference about atherosclerosis-osteoporosis association resulting contemptible

Retrograde Intramedullary Nailing for Distal Femur Fractures with Osteoporosis: An Appraisal: To the Editor

No abstract available.

Retrograde Intramedullary Nailing for Distal Femur Fracture with Osteoporosis

BACKGROUND: The incidence of distal femur fracture in the elderly has been increasing recently, and commonly occurs with osteoporosis. Retrograde intramedullary nailing has been considered a good surgical option for distal femur fracture. The purpose of the present study was to present our surgical results with retrograde intramedullary nailing for distal femur fractures with osteoporosis. METHODS: Thirteen patients diagnosed with extra-articular distal femur fracture and osteoporosis and managed with retrograde intramedullary nailing were retrospectively reviewed. Cement augmentation was used in four patients, shape memory alloy was used in eight patients and both were used in one patient. All patients were followed up for more than 2 years. Radiologic alignments. were scored and Tegner and the Lysholm activity score was used for a functional assessment. RESULTS: The average time to clinical union was 13 weeks (range, 10 to 15 weeks). In 12 of our cases, the total alignment scores were excellent. At the last follow-up, the mean range of motion was 116degrees (range, 110degrees to 125degrees). The average functional score at postoperative 1 year was 2.6 (range, 1 to 5). CONCLUSIONS: Retrograde intramedullary nailing is a good surgical option for distal femur fracture with osteoporosis. Cement augmentation and shape memory alloy can also be used for added mechanical stability. This surgical technique is very useful for distal femur fracture with osteoporosis as it promotes fracture healing and early rehabilitation.

Estado actual del manejo médico de la fracturas del fémur proximal por osteoporosis: revisión de la bibliografía / Current status of medical management of proximal femur fracture due to osteoporosis: a review of the literature

Las fracturas del fémur proximal, secundarias a caída de su altura, pacientes posmenopáusicas con osteoporosis, es un acontecimiento de fecuencia relativa. El médico tratante debe estar preparado para los eventos tanto pre como postoperatorio que suelen ocurrir. Se propone la creación de un Grupo de Atención Geriátrica (GAG) que enfoque los problemas médicos de este grupo de pacientes y sobre todo que tenga conocimiento de la osteoporosis, su dignóstico y tratamiento médico, para prevenir una nueva fracturas. Una vez que egresa del hospital se debe indicar una densitometría doble foton (DXA) e iniciar el tratamiento para la osteoporosis dos semanas luego del egreso y hasta el momento el ácido zoledronico es el único que ha demostrado que disminuye el riesgo de mortalidad y nueva fracturas.

A fracture of the proximal femur secondary to drop height in postmenopausal women with osteoporosis is a relative frequency of occurrence. The treating physician must be prepared for both pre-and postoperative events that do occur. It proposes the establishment of a Gerietric Care Group (GAG) that approach the medical problems of this group of patients and especially with knowledge of osteoporosis, its diagnosis and medical treatment to prevent a new fracture. Once discharged from the hospital should indicate two-photon densitometry (DXA) and initiate treatment for osteoporosis two weeks after graduation and until zoledronic acid is the only one that has been shown to decrease the risk of mortality and new fracture.

Role of phytoestrogens in preventing menopausal osteoporosis

Osteoporosis is gradual declining of bone mass with aging, leading to increased bone fragility and fractures. The incidence of osteoporosis is increasing worldwide especially in Asian countries. Fractures of hip and spine are known to be the most important complication of the condition, resulting in 20% annual mortality and 50% serious morbidity. Menopause is one of the most common risk factors of osteoporosis. After menopause, sex hormone decline causes increased bone remodeling and negative bone balance, leading to accelerated bone loss and micro-architectural defects which brings about increased bone fragility. Estrogen-like compounds like [isoflavones] present in plants especially soy may reduce bone loss in postmenopausal women as they are similar in structure to estrogens. This review study was conducted to survey articles regarding the role of phytoestrogens in preventing menopausal osteoporosis. Published articles from 1990 to 2005 were searched by using Medline and selected with appropriate key words. The mechanism by which phytoestrogens reduce bone mass declining lies in their weak estrogenic properties and their effects on estrogen receptors, so that they can act as human estrogens in a prolonged period. According to research and hypotheses existing about the effects of phytoestrogens on postmenopausal osteoporosis suppression, intake of 90 milligram [30-40 gr soy protein contains 90 mg isoflavones] or more isoflavones per day for at least 12 weeks can positively influence on the reduction of bone resorption markers and the improvement of bone formation markers in postmenopausal women. Considering the accelerated bone mass reduction in menopause, it is necessary to provide other replacements for estrogen which can prevent bone loss. Therefore, because of positive effects of soy protein on bone turnover markers, intake of it in daily diet specially at menopausal women is recommended