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1.
Rev. venez. cir. ortop. traumatol ; 53(1): 10-19, jun. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1252872

ABSTRACT

El manejo de pseudoartrosis infectadas, osteomielitis y defectos óseos representa un reto enorme para el cirujano ortopedista. Hace diez años, Masquelet presentó la técnica de inducción de membrana como alternativa al manejo de las complicaciones mencionadas arriba con excelentes tasas de consolidación y erradicación del proceso infeccioso. Estudiamos una de serie de 14 casos, prospectiva, con seguimiento clínico y radiológico mínimo de 2 años (enero 2015-diciembre 2018), donde evaluamos múltiples variables en pacientes a quienes se les realizó el protocolo de Masquelet. Obtuvimos una tasa de consolidación de 85,7% (12/14). Con un tiempo promedio para alcanzarla de 6,1 meses (3-9m). Todos los pacientes que lograron la consolidación se encontraban libres de infección al final del seguimiento. Por su reproducibilidad y alta tasa de consolidación, consideramos la técnica de inducción de membrana, como una excelente opción en el manejo de pseudoartrosis infectadas complejas(AU)


The management of infected nonunions, osteomyelitis, and bone defects represents an enormous challenge for the orthopedic surgeon. Ten years ago, Masquelet presented the membrane induction technique as an alternative to the management of the complications afore mentioned with excellent rates of consolidation and eradication of the infectious process. We prospectively studied a series of 14 cases, with a clinical and radiological follow-up of at least 2 years (january 2015-december 2018). Where we evaluated multiple variables in patients who underwent the Masquelet protocol. We obtained a consolidation rate of 85.7% (12/14). With an average time to reach it of 6.1 months (3-9m). All patients who achieved union were free of infection at the end of follow-up. Due to its reproducibility and high consolidation rate, we consider the membrane induction technique an excellent option in the management of complex infected nonunions(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteomyelitis/complications , Pseudarthrosis/complications , Bone Transplantation , Orthopedic Procedures , Bone Diseases , Traumatology
2.
Rev. inf. cient ; 100(3): e3433, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289634

ABSTRACT

RESUMEN Introducción: Los trabajadores de la salud se enfrentan permanentemente a labores complejas que afectan la región lumbar y miembros inferiores. Objetivo: Identificar la prevalencia de enfermedad osteomioarticular lumbosacras y miembros inferiores en auxiliares de enfermería Método: Se realizó un estudio epidemiológico, descriptivo y transversal en una muestra de 46 auxiliares del Distrito 18D04 de salud de Tungurahua, Ecuador. El instrumento aplicado fue un cuestionario para indagar variables sociodemográficas, antigüedad en el sector, horarios, tipos y tiempo de exposición a las labores habituales. Se utilizó la prueba estadística Chi-cuadrado, la paramétrica de correlación de Pearson y la prueba t de Student. Resultados: El 85 % de los estudiados presentó enfermedades lumbosacras y miembros inferiores durante el tiempo de trabajo, se apreció que el 39 % ha tenido una baja temporal al trabajo entre 1-3 días. Se identificó que la carga de peso es realizada por un 37 % y caminatas prolongadas en un 33 %. El 67 % tenía entre 11 y 40 años de trabajo y el resto menos de 10 años en el sector. El 54 % padeció enfermedades pertenecientes a miembros inferiores y un 46 % a lumbosacras. Conclusiones: El padecimiento de enfermedad osteomioarticular lumbosacras y miembros inferiores está relacionado con la edad y con padecerlas en los últimos doce meses, estas han provocado ausentismo laboral. No se comprobó una relación estadísticamente significativa con el padecimiento de enfermedad osteomioarticular con la antigüedad en el sector, las jornadas de trabajo y las actividades que más desarrollan.


ABSTRACT Introduction: Health care workers are constantly confronted with complex tasks that affect the lumbar region and lower limbs. Objective: To identify the prevalence of lumbosacral and lower limb osteomyoarticular pathologies in nursing assistants. Method: An epidemiological, descriptive and cross-sectional study was carried out in the 18D04 health district of Tungurahua, Ecuador. A total of 46 nursing assistants were selected in this study. We aimed a questionnaire to assess the sociodemographic variables, seniority in the health sector, time schedules, modes and time of exposure to the usual work. Chi-square test, Pearson's parametric correlation test, and the Student's t-test were used. Results: Most nursing assistants, the 85%, were diagnosed with lumbosacral and lower limb pathologies, and 39% took a temporary absence from work between 1-3 days. It was found that 37 % performed the heavy load work and 33% performed prolonged walks. The 67% had between 11 and 40 years of work and the rest had less than 10 years in the health sector. Fifty-four percent suffered from lower limb pathologies and 46% from lumbosacral pathologies. Conclusions: Lumbosacral and lower limb osteomyoarticular pathology is related to age, and their suffering in the last 12 months has led to a level of absenteeism in the workplace. There was no an important relationship, statistically, between osteomyoarticular pathology and seniority in the sector, working hours and the activities most frequently performed.


RESUMO Introdução: Os trabalhadores da saúde enfrentam constantemente tarefas complexas que afetam a região lombar e membros inferiores. Objetivo: Identificar a prevalência de doenças osteomioarticulares lombossacrais e de membros inferiores em auxiliares de enfermagem. Método: Estudo epidemiológico, descritivo e transversal em uma amostra de 46 auxiliares do Distrito Sanitário 18D04 de Tungurahua, Equador. O instrumento aplicado foi um questionário para investigar variáveis sociodemográficas, antiguidade no setor, horário, tipos e tempo de exposição a tarefas normais. Foram utilizados o teste estatístico Qui-quadrado, correlação paramétrica de Pearson e teste t de Student. Resultados: 85% dos estudados apresentaram doenças lombossacrais e de membros inferiores durante o tempo de trabalho, observou-se que 39% tiveram afastamento temporário do trabalho entre 1-3 dias. Identificou-se que a descarga de peso é realizada por 37% e as caminhadas prolongadas por 33%. 67% tinham entre 11 e 40 anos de trabalho e o restante menos de 10 anos no setor. 54% sofreram doenças pertencentes aos membros inferiores e 46% lombossacral. Conclusões: O sofrimento da doença osteomioarticular lombossacral e de membros inferiores está relacionado à idade e com o sofrimento nos últimos doze meses, estes têm causado absenteísmo ao trabalho. Não foi verificada relação estatisticamente significativa entre o sofrimento de doença osteomioarticular e o tempo de permanência no setor, a jornada de trabalho e as atividades que mais desenvolvem.


Subject(s)
Humans , Female , Middle Aged , Bone Diseases/epidemiology , Low Back Pain/epidemiology , Lower Extremity , Joint Diseases/epidemiology , Muscular Diseases/epidemiology , Nursing Assistants , Burnout, Professional , Epidemiology, Descriptive , Cross-Sectional Studies
3.
Arq. bras. med. vet. zootec. (Online) ; 73(1): 179-183, Jan.-Feb. 2021. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1153060

ABSTRACT

The occurrence of hyperostotic bones is common in marine fish, especially in the Carangidae family, despite few records of this condition in fishes from Brazilian waters. The present study describes the occurrence of hyperostosis in Atlantic moonfish (Selene setapinnis) in, Rio de Janeiro State, Brazil. Radiographs of the fish specimens were taken and all of them presented hyperostosis in at least three different regions: cleithrum, pterygiophores and pleural ribs. The observed pattern is different from previously described for other species of the same genus. It is the first record for the species and a valuable contribution to the study of bone diseases in fishes from the Brazilian coast.(AU)


A ocorrência de ossos hipertostóticos é comum em peixes marinhos, especialmente na família Carangidae, apesar de poucos relatos dessa condição em peixes de águas brasileiras. O presente estudo descreve a ocorrência de hiperostose no peixe-galo-sem-penacho (Selene setapinnis) no estado do Rio de Janeiro, Brasil. Radiografias dos espécimes de peixes foram feitas e todos os exemplares apresentaram hiperostoses em pelo menos três regiões diferentes: cleithrum, pterigióforos e costelas pleurais. O padrão observado é diferente do descrito previamente para outras espécies do mesmo gênero. Este é o primeiro relato para a espécie e é uma contribuição valiosa para o estudo de doenças ósseas em peixes da costa brasileira.(AU)


Subject(s)
Animals , Hyperostosis/veterinary , Hyperostosis/diagnostic imaging , Fishes/abnormalities , Bone Diseases/veterinary , Brazil , Radiography/veterinary
4.
Rev. Méd. Paraná ; 79(1): 85-87, 2021.
Article in Portuguese | LILACS | ID: biblio-1282484

ABSTRACT

A osteopoiquilose é uma displasia osteosclerótica rara que mostra uma transmissão autossômica dominante e tem características radiológicas específicas que não apresenta clínica específica; o diagnóstico é feito por achados radiológicos incidentais típicos em pacientes que procuram tratamento para outros problemas médicos. A osteopoiquilose pode ser confundida com metástases osteoblásticas, esclerose tuberosa e mastocitose óssea. Relatamos uma mulher de 37 anos queixando-se de dor e edema no punho há 20 dias. A paciente foi submetida a avaliação com ressonância magnética, apresentando ossos do carpo e regiões epifisárias do rádio e ulna, além de metacarpos e algumas falanges, com diversos focos escleróticos dispersos. Em seguida, para nova avaliação, a paciente realizou radiografias de joelhos, ombros e punhos, confirmando os focos escleróticos encontrados na ressonância magnética, confirmando o diagnóstico de osteopoiquilose


Osteopoikilosis is a rare osteosclerotic dysplasia that shows an autosomal dominant transmission and has characteristic radiological features, there are no specific clinical features; diagnosis is made by incidental typical radiological findings in patients seeking treatment for other medical problems. Osteopoikilosis can be confused with osteoblastic metastases, tuberous sclerosis, and bone mastocytosis. We report a 37-years-old woman, complaining of pain and swelling in the wrist 20 days ago. The patient submitted to MRI for evaluation, showing carpal bones and epiphyseal regions of radius and ulna, as well as metacarpal and some phalanges, presenting several scattered sclerotic foci. After that for further evaluation, the patient was referred for radiographs of the knees, shoulders, and wrists, confirming the sclerotic foci found in MRI, confirming the diagnosis of osteopoikilosis


Subject(s)
Osteopoikilosis , Bone Diseases , Magnetic Resonance Imaging
5.
Rev. Ateneo Argent. Odontol ; 63(2): 13-17, nov. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1150415

ABSTRACT

La acción terapéutica favorable que los antirresortivos (bifosfonatos BPs, denosumab DS) y drogas antiangiogénicas ocasionan en el tejido óseo en aquellos pacientes que presentan como causa etiológica cáncer o discrasias óseas incluyen hipercalcemias malignas o ­si requieren el consumo de dicha droga a baja concentración­ como ser: osteoporosis, osteopenia, enfermedad de Paget, displasia fibrosa, Osteogénesis Imperfecta. (1) La presente actualización pretende relacionar el tratamiento odontológico con prescripción crónica y drogas antirresortivas, para lo cual American Association of Oral and Maxillofacial Surgeons AAOMS: define el concepto de Osteonecrosis Maxilar Asociada a drogas Antirresortivas (MRONJ) como: «Área ósea necrótica expuesta al medio bucal con más de ocho semanas de permanencia, en presencia de tratamiento crónico con bifosfonatos en ausencia de radioterapia en cabeza y cuello¼. La AAOMS estableció los siguientes grupos de acuerdo con sus características clínicas en 4 estadios (0, 1 ,2 y 3) de acuerdo con el aspecto clínico y radiológico de la lesión osteonecrótica. Estadío 0: lesión osteonecrótica sin evidencia de hueso necrótico en pacientes bajo consumo de drogas antirresortivas. Estadío 1: lesión osteonecrótica con signos clínicos y ausencia de sintomatología clínica. Estadío 2: lesión osteonecrótica con signo y sintomatología clínica evidente. Estadío 3: lesión osteonecrótica con signo y sintomatología evidente que compromete a estructuras nobles: fracturas patológicas, anestesia del nervio dentario inferior, comunicación buco-nasal, comunicación buco-sinusal, fístulas cutáneas (2) (AU)


It is known the favourable action which antiresorptive (Bisphosphonates BPs, Denosumab: DS) and Antiangiogenic drugs produce in bone tissue. High concentrations are primarily used as an effective treatment in the management of cancer-related disorders, including hypercalcemia of malignant. Besides, low concentrations are used for other metabolic bone diseases including Osteoporosis, Osteopenia, Paget's Disease, Fibrous Dysplasia, Imperfect Osteogenesis. (1) The update relate relationship between dentistry and chronic treatment with antiresorptive drugs. According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), MRONJ is defined as exposed or necrotic bone in the maxillofacial region that has persisted for more than 8 weeks in association with current or previous BPs or DS therapy and with a lack of head and neck radiotherapy. AAOMS divided the MRONJ into 4 stages (0,1, 2 and 3) according to the clinical and radiological aspect of the osteonecrotic lesion: Stage 0: osteonecrotic lesion without sign-pathognomonic evidence of osteonecrosis. Stage 1: osteonecrotic lesion with clinical signs and absence of clinical symptoms. Stage 2: osteonecrotic lesion with sign and evident clinical symptoms. Stage 3: osteonecrotic lesion with signs and evident symptoms that involve noble structures: pathological fractures, anaesthesia of the lower dental nerve, oral-nasal communication, oral-sinus communication, skin fistulas (2) (AU)


Subject(s)
Humans , Female , Aged , Bone Resorption , Diphosphonates/adverse effects , Bone Density Conservation Agents , Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Diseases , Dental Care for Chronically Ill , Angiogenesis Inhibitors , Denosumab , Mouthwashes/therapeutic use
6.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(3): 262-269, ago. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1340625

ABSTRACT

Resumen Se presenta un caso de un hombre de 31 años con fractura de fémur. Los estudios complementarios mostraron una imagen compatible con lesión quística. El primer estudio por biopsia de dicho quiste informó erróneamente un quiste simple. Se realizó una osteosíntesis con enclavado endomedular. El paciente tuvo una evolución tórpida asociada a imágenes líticas diafisarias y pérdida de la reducción de la fractura. Se retiró el material y se tomaron muestras del canal endomedular, cuyo cultivo reveló Pseudomonas aeruginosa y restos de quistes hidatídicos en la anatomía patológica. En nuestro centro, fue tratado por una seudoartrosis infectada secundaria a un quiste óseo hidatídico complicado. Se le colocó un megaespaciador de cemento con antibiótico y, luego, una prótesis total de fémur como tratamiento definitivo. El compromiso óseo es muy raro y de difícil diagnóstico, y puede llevar a una diseminación severa. Si bien no hay consenso ni tratamiento de elección para los casos graves, el reemplazo femoral total en dos tiempos representa una opción alentadora para conservar el miembro, con resultados satisfactorios a corto y mediano plazo.


Abstract We report the case of a 31-year-old male patient presenting a femoral fracture whose complementary studies revealed an image consistent with a cystic lesion. The first biopsy study of this cyst erroneously reported a simple cyst. Osteosynthesis with intramedullary nailing was performed. The patient had a poor postoperative course associated with diaphyseal osteolytic images and loss of fracture reduction. The material was removed and intramedullary canal specimens were taken, which were positive for Pseudomonas aeruginosa and revealed remains of hydatid cysts through pathologic examination. The patient was referred to our center for the treatment of an infected pseudarthrosis secondary to a complicated hydatid bone cyst. A two-stage procedure was performed. The first stage involved the placement of an antibiotic-impregnated cement mega-spacer and the second stage involved the implantation of a total femur prosthesis as definitive treatment. The bone hydatidosis involves a challenging diagnosis, is very rare, and can cause severe dissemination. While there is no consensus or gold standard treatment for severe cases, two-stage total femoral replacement represents an encouraging option for limb preservation, showing satisfactory short- and medium-term outcomes.


Subject(s)
Pseudarthrosis , Bone Cysts , Bone Diseases , Echinococcosis , Hip Prosthesis
7.
Int. j. morphol ; 38(4): 909-913, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124875

ABSTRACT

Porous titanium alloy scaffold was widely used in treating bone defect caused by traumatic injury and osteomyelitis, which was incapable of self-healing. The implantation of scaffold produced stress shielding thereby forming osteolysis. The objective of this study was to analysis trabecular morphological features of osseointegrated bone. 14 New Zealand rabbits were divided into two groups, surgery group and healthy control group. 7 rabbits in surgery group were selected to perform 3D printed porous titanium alloy scaffold implantation surgery with preload at the defect of femoral condyle for osseointegration. The other 7 rabbits in control group were feed free. After 90 days healing, femoral condyles were extracted to perform micro-CT scanning with hydroxyapatite calibration phantom. Mean bone mineral density (BMD), bone volume fraction (BV/TV), BS/TV (bone surface area ratio), Tb.Th (thickness of trabeculae), Tb.N (number of trabeculae), Tb.Sp (trabecular separation) and DA (degree of anisotropy) were calculated from micro-CT images. The results revealed that osseointegration inside and at the surface of scaffolds worked well from grey values of micro-CT images. After 12 weeks healing, mean bone mineral densities (BMD) in surgery group and healthy control group were calculated as 800±20mg/cm3 and 980±90mg/cm3, respectively. This revealed that the strength of trabeculae in surgery group might lower than that in the healthy group. Trabecular morphological parameters test showed that trabecular morphological parameters at the surface of scaffolds in the surgery group deteriorated significantly. It was found from micro-CT images that ingrowth bone was filled with pores of scaffold. Overall, the effect of osseointegration was promoted through the change of mechanical micro-environment in the scaffold region. Overall, preload could improve osseointegration effect in the long-term after surgery. However, the trabecular morphology in the surgery group was deteriorated, which might bring secondary fracture risk again.


La malla de aleación de titanio poroso se usó ampliamente en el tratamiento de defectos óseos causados por lesiones traumáticas y osteomielitis. El implante de la malla generó una protección contra el estrés, formando así osteolisis. El objetivo de este estudio fue analizar las características morfológicas trabeculares del hueso osteointegrado. Se dividieron 14 conejos (Neozelandeses) en dos grupos, grupo cirugía y grupo control saludable. Se seleccionaron 7 conejos en el grupo de cirugía para realizar una implantación de mallas de aleación de titanio poroso, impresas en 3D con precarga en el defecto del cóndilo femoral para la osteointegración. Los 7 conejos restantes del grupo control se mantuvieron sin alimentación. Después de 90 días de curación, se extrajeron los cóndilos femorales para realizar una exploración por micro-CT con un espectro de calibración de hidroxiapatita. Se calcularon a partir de imágenes de micro-CTDensidad mineral ósea media (DMO), fracción de volumen óseo (BV / TV), BS / TV (relación de área de superficie ósea), Tb.Th (espesor de trabéculas), Tb.N (número de trabéculas), Tb.Sp (trabecular separación) y DA (grado de anisotropía). Los resultados revelaron que la osteointegración dentro y en la superficie de los andamios funcionó bien a partir de los valores grises de las imágenes de micro-CT. Después de 12 semanas de curación, las densidades medias de minerales óseos (DMO) en el grupo cirugía y en el grupo control sano se calcularon como 800 ± 20 mg/cm3 y 980 ± 90 mg/cm3, respectivamente. Esto reveló que la fuerza de las trabéculas en el grupo de cirugía podría ser menor que la del grupo sano. La prueba de parámetros morfológicos trabeculares mostró que en el grupo de cirugía, la superficie de las mallas, se deterioraron significativamente. Se descubrió a partir de imágenes de microCT que el hueso en crecimiento estaba lleno de poros de andamio. En general, el efecto de la osteointegración se promovió mediante el cambio del microambiente mecánico en la región de la malla. En general, la precarga podría mejorar el efecto de osteointegración a largo plazo después de la cirugía. Sin embargo, la morfología trabecular en el grupo de cirugía se deterioró, lo que podría traer un nuevo riesgo de fractura secundaria.


Subject(s)
Animals , Rabbits , Bone Diseases/surgery , Osseointegration/physiology , Tissue Scaffolds/chemistry , Printing, Three-Dimensional , Prostheses and Implants , Titanium/chemistry , Porosity , Alloys , X-Ray Microtomography , Femur/surgery
8.
Rev. argent. radiol ; 84(3): 93-106, ago. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1143921

ABSTRACT

Resumen El objetivo de este artículo es realizar una revisión de las localizaciones, causas y hallazgos radiológicos específicos de los procesos avasculares óseos. Se define como isquemia ósea a las alteraciones ocasionadas por déficit de irrigación, llevando a la destrucción del hueso. Existen diferencias entre necrosis isquémica e infarto óseo, en base al sitio óseo de afectación. La etiología traumática es la más frecuente y suele ser unilateral. Los sitios de presentación más frecuentes son: cabeza femoral y humeral, rodilla y semilunar. La resonancia magnética (RM) es considerada la modalidad de imagen más sensible y específica, tanto para el diagnóstico temprano como estadificación y control. El conocimiento de las causas, características radiológicas y sus diferentes fases evitan el diagnóstico erróneo de otras etiologías, como las primarias o infecciosas, facilitando un correcto algoritmo terapéutico.


Abstract The aim of this article is to review the locations, causes and specific radiological findings of avascular bone processes. Bone ischemia is defined as the alterations caused by irrigation deficit, leading into the bone destruction. However, there are differences between ischemic necrosis and bone infarction, based on the bone site of involvement. The most frequent etiology is traumatic and is usually unilateral. The most frequent sites of presentation are: femoral and humeral head, knee, and lunate. Magnetic resonance imaging (MRI) is considered the most sensitive and specific imaging modality for early diagnosis, staging and control. The knowledge of the causes, radiological findings and their different phases avoid the erroneous diagnosis of other lesions, such as primary or infectious, facilitating a correct therapeutic algorithm.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Bone and Bones/diagnostic imaging , Bone Diseases/etiology , Magnetic Resonance Spectroscopy/methods , Osteonecrosis/diagnostic imaging , Bone Diseases/classification , Bone Diseases/diagnostic imaging , Ischemia/diagnostic imaging
9.
Rev. cient. odontol ; 8(2): e023, mayo-ago. 2020. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1119301

ABSTRACT

Los implantes dentales son un tipo más de tratamiento para la resolución de casos de edentulismo. Desde su inicio, en los años 70, han sido una alternativa creciente para rehabilitar pacientes, sobre todo en casos en los que las rehabilitaciones convencionales no eran posibles. Cada vez de forma más frecuente nos enfrentamos a retratamientos de implantes y casos con atrofias más complejas. En el siguiente caso, mostramos un retratamiento de implantes fracasados unido a una situación de atrofia extrema vertical y horizontal combinada. En casos de atrofia severa maxilar y mandibular, el uso de los implantes cortos puede acortar los tiempos de tratamiento y simplificar las técnicas quirúrgicas sin renunciar a la predictibilidad como en el caso mostrado. (AU)


Dental implants are an alternative treatment for extended the resolution of cases of edentulism. Since its inception in the year 70 have been a growing alternative to rehabilitate patients, especially in cases where conventional rehabilitations were not possible. Every time, in the dental office were more often we re-treatments of implants and cases with more complex atrophies. In the following case we show a re-treatment of failed implants attached to a situation of extreme atrophy combined vertical and horizontal. In cases of severe maxillary and mandibular atrophy, the use of short implants can shorten treatment times and simplify surgical techniques without sacrificing predictability as in the case shown. (AU)


Subject(s)
Humans , Female , Aged , Bone Diseases/therapy , Dental Implants , Retreatment , Peri-Implantitis/therapy
10.
Rev. MED ; 28(1): 21-32, ene.-jun. 2020. tab, graf
Article in English | LILACS | ID: biblio-1143828

ABSTRACT

Abstract: Background: Daily dietary calcium intake below the requirements has been related to low levels of vitamin D (Vit-D) and osteoarticular diseases. Objective: To determine the prevalence of Vit-D deficiency in the general population living in Bogotá, its relationship to dietary calcium intake, and the influence of socio-demographic factors and sunlight exposure. Materials and methods: In a pro-spective cohort of the general population (randomly selected), excluding individuals with conditions affecting calcium absorption or adequate Vit-D action, the prevalence of hypovitaminosis D (95 % ci) and regular consumption of calcium (RCI, mg/day) is measured according to socio-demographic, anthropometric, biochemical, and sunlight exposure variables. A multiple regression model is implemented (no intercept) to predict Vit-D concentration based on the factors described. Results: Ninety-seven patients are included, 61 % of which are women, with a median age of 23 years, a weight of 65 kg (IQR: 55.2-70.5), a height of 165 cm ± 8.9, and BMI of 22.8 kg/m2 (IQR: 21.2-25.2). The RCI was 393.7 mg/day, less than the benchmark for Colombian adults (p < 0.001); serum calcium concentration was 9.7 mg/dL. The mean Vit-D concentration (95 % ci) was 23.7 ng/mL (22.6-24.7); hypovitaminosis D was identified in 87 % of the sample (80.6-94.7 %), 24.7 % were classified as poor (15.6-33.8 %) and 62.9% as insufficient (52.8-73%). Vit-D concentration was predicted in a quadratic function by the interaction between sex, sunlight exposure, and RCI (R2 > 90 %). Conclusion: The suspected high prevalence of Vit-D deficiency is confirmed in the general Colombian adult population as a result of low dietary calcium intake, demographic factors, and sunlight exposure.


Resumen: El consumo diario de calcio en la dieta por debajo de los requerimientos se ha relacionado con bajos niveles de Vitamina D (Vit-D) y con enfermedades osteoarticulares. Objetivo: Determinar la prevalencia de la deficiencia de Vit-D en la población general que vive en Bogotá, su relación con la ingesta de calcio en la dieta y la influencia de factores sociodemográficos y de la exposición a la luz solar. Materiales y métodos: En una cohorte prospectiva seleccionada aleatoriamente de la población general, excluyendo individuos con condiciones que afectaran la absorción de calcio o la acción de la Vit-D, se midió la prevalencia de hipovitaminosis D (IC 95 %) y el consumo habitual de calcio (CHC, mg/día), según variables sociodemográficas, antropométricas, bioquímicas y de exposición solar; se implementó un modelo de regresión múltiple (sin el intercepto) para predecir la concentración de Vit-D en función de los factores descritos. Resultados: Se incluyeron 97 pacientes, edad mediana 23 años, 61 % mujeres; con peso mediano 65 kg (RIC; 55,2-70,5), estatura 165 cm ± 8,9 e IMC 22,8 kg/m2 (RIC; 21,2-25,2). El CHC fue 393,7 mg/día, menor que el recomendado para adultos colombianos (p < 0,001); la concentración de calcio sérico fue 9,7 mg/dL. La concentración media (IC 95 %) de Vit-D fue 23,7 ng/mL (22,6-24,7), se identificó hipovitaminosis D en 87% (80,6-94,7%); 24,7% se clasificaron como deficientes (15,6-33,8 %) y 62,9 % como insuficientes (52,8-73 %). La concentración de Vit-D se logró predecir, en función cuadrática, por la interacción entre el sexo, la exposición solar y el CHC (R2 > 90 %). Conclusiones: Teniendo en cuenta los resultados obtenidos, se confirma la sospecha de alta prevalencia de hipovitaminosis D en población general colombiana adulta, relacionada con un bajo consumo de calcio en la dieta habitual, factores demográficos y de exposición solar.


Resumo: Introdução: O consumo diário de cálcio na dieta abaixo dos requerimentos necessários tem sido relacionado com baixos níveis de vitamina D (Vit-D) e com doenças osteoarticulares. Objetivo: Determinar a prevalência da deficiência de Vit-D na população geral que vive em Bogotá, Colômbia, sua relação com a ingestão de cálcio na dieta, a influência de fatores sociodemográficos e a exposição à luz solar. Materiais e métodos: em uma coorte prospectiva selecionada aleatoriamente da população geral, excluindo indivíduos com condições que afetassem a absorção de cálcio ou a ação de Vit-D, foi medida a prevalência de hipovitaminose D (IC 95 %) e o consumo habitual de cálcio (CHC, mg/dia), segundo variáveis sociodemográficas, antropométricas, bioquímicas e exposição solar; foi implementado um modelo de regressão múltipla (sem o intercepto) para predizer a concentração de Vit-D em função dos fatores descritos. Resultados: Foram incluídos 97 pacientes, com idade média 23 anos, 61 % mulheres; com peso médio de 65 kg (RIC; 55,2-70,5), estatura 165 cm ± 8,9 e IMC 22,8 kg/ m2 (RIC; 21,2-25,2). O CHC foi 393,7 mg/dia, menor do que o recomendado para adultos colombianos (p < 0,001); a concentração sérica de cálcio foi 9,7 mg/dL. A concentração média (IC 95 %) de Vit-D foi 23,7 ng/mL (22,6-24,7), foi identificada hipovitaminose D em 87 % (80,6-94,7 %), foram classificados deficientes 24,7% (15,6-33,8%) e insuficientes 62,9% (52,8-73%). A concentração de Vit-D foi possível predizer, em função quadrática, pela interação entre sexo, exposição solar e CHC (R2 > 90%). Conclusões: A partir dos resultados obtidos, é confirmada a suspeita de alta prevalência de hipovita-minose D em população geral colombiana adulta, relacionada com um baixo consumo de cálcio na dieta habitual, fatores demográficos e exposição solar.


Subject(s)
Humans , Adult , Calcium , Avitaminosis , Bone Diseases , Cholecalciferol
12.
Article in English | WPRIM | ID: wpr-811184

ABSTRACT

BACKGROUND: Rosae Multiflorae fructus (RMF), known to have anti-inflammatory and antioxidant properties, has been used as a traditional remedy for inflammatory diseases such as arthritis in Eastern Asia. However, its effect on osteoclasts, which play a crucial role in resorptive inflammatory bone diseases, is yet to be elucidated.METHODS: The effect of extract of RMF (RMF-E) on receptor activator of nuclear factor-κB ligand (RANKL)-mediated osteoclastogenesis was examined by tartrate-resistant acid phosphatase (TRAP) staining, real-time polymerase chain reaction and western blot analysis. In addition, RANKL-induced Ca2⁺-oscillation was also investigated.RESULTS: RMF-E remarkably inhibited TRAP+-osteoclast and resorptive pit formation in a dose-dependent manner. In addition, the expression of c-Fos and nuclear factor of activated T-cells cytoplasmic, known as pivotal transcription factors for osteoclast formation in vitro and in vivo, and that of the osteoclast differentiation markers such as Acp5, Oscar, CtsK, Atp6v0d2, Tm7sf4, and Nfatc1 were significantly decreased by RMF-E treatment during osteoclastogenesis. The inhibitory effect of RMF-E on RANKL-induced osteoclastogenesis was caused by the suppression of p38 mitogen-activated protein kinase activation, and RANKL-induced Ca2⁺-oscillation removal via inactivation of Bruton's tyrosine kinase (BTK), and subsequently phospholipase C-γ2.CONCLUSIONS: RMF-E negatively regulates osteoclast differentiation and formation. These findings suggest the possibility of RMF-E as a traditional therapeutic agent against osteoclast-related bone disorders such as osteoporosis, rheumatoid arthritis, and periodontitis.


Subject(s)
Acid Phosphatase , Antigens, Differentiation , Arthritis , Arthritis, Rheumatoid , Blotting, Western , Bone Diseases , Calcium Signaling , Cytoplasm , Far East , In Vitro Techniques , Osteoclasts , Osteogenesis , Osteoporosis , Periodontitis , Phospholipases , Protein Kinases , Protein-Tyrosine Kinases , Real-Time Polymerase Chain Reaction , Rosa , T-Lymphocytes , Transcription Factors
13.
Article in Chinese | WPRIM | ID: wpr-828359

ABSTRACT

A total of 1 392 reports on liver injury associated adverse drug reaction(LI-ADR) related to bone diseases were retrospectively analyzed based on national ADR monitoring system [18.75% of the patients used traditional Chinese medicine(TCM) alone and 68.68% used Western medicine alone]. This kind of cases accounted for 2.5% of all drug-related liver injury adverse reactions, ranking top ten of all drug categories. The number of reported cases and the proportion of serious cases showed an increasing trend from 2012 to 2016. The average age of the patients was(54.2±15.8) years old, and there was little difference in overall gender(male-female 1.04∶1). However, the number of female patients with rheumatoid arthritis was significantly higher than that of male patients(male-female 1∶2.6), while the number of male patients with gout was significantly higher than that of female patients(male-female 7.16∶1). The overall prognosis was good, with the recovery and improvement rate of 85.27%. The time from medication to liver injury varied due to different medicines. The median time to liver injury was 27 days in TCM alone group, later than 11 days in Western me-dicine alone group(P<0.05). Drugs for bone diseases have been one of the important categories for clinical drug-induced liver injury, and the number of reported cases on liver injury caused by drugs for bone diseases is increasing, so we should pay close attention to the safe and rational use of them. The LI-ADRs of male and female were different due to their different diseases, and the latency of adverse reactions in TCM group was generally longer than that in Western medicine group. In clinical medication, liver function should be monitored according to different diseases and characteristics of drugs to prevent the risk of liver injury.


Subject(s)
Adult , Aged , Bone Diseases , Drug-Related Side Effects and Adverse Reactions , Drugs, Chinese Herbal , Female , Humans , Male , Medicine, Chinese Traditional , Middle Aged , Retrospective Studies
14.
Rev. Salusvita (Online) ; 39(1): 103-110, 2020.
Article in Portuguese | LILACS | ID: biblio-1119728

ABSTRACT

A patela é o maior osso sesamoide do corpo humano, posicionado longitudinalmente na fáscia do músculo quadríceps, entre os tendões quadríceps e patelar. A patela bipartida dolorosa, também conhecida como "sincrondose dolorosa", é uma causa conhecida de dor no joelho anterior, é um diagnóstico de exclusão. Objetivo: Relatar um caso e revisar a literatura acerca desta lesão incomum. Materiais e Métodos: Revisão do prontuário do paciente no Hospital Luxemburgo, registro fotográfico do método diagnóstico e revisão da literatura. Resultados: Homem de 45 anos com dor no joelho direito há 01 ano, principalmente na região anterior, que piora ao agachar. Ao exame físico apresenta edema com dor a palpação da patela. A radiografia demonstra patela bipartida. A ressonância magnética (RM) do joelho direito demonstra patela bipartida com união fibrosa entre o fragmento bipartido superolateral e a patela, associada a lesões condrais e edema subcondrais, compatível com "sincondrose dolorosa" da patela. Conclusão: Este relato demonstra a dificuldade de diagnosticar está lesão, pois seu o exame físico é inespecífico e a radiografia demonstra apenas a variação da normalidade ­ patela bipartida, sem evidenciar as alterações próprias da doença, caracterizada apenas pela RM.


The patella is the largest sesamoid bone in thehuman body, positioned longitudinally in the quadriceps muscle fascia, between the quadriceps and patellar tendons. The painful bipartite patella, also known as "painful synchondrosis", is a known cause of anterior knee pain, is a diagnosis of exclusion.Objective: Report a case and review the literature about this uncommon lesion. Materials and Methods: We carried out a review of medical records at Hospital Luxemburgo, a photographic record of diagnostic methods, and a review from the literature. Results: 45-year-old man with right knee pain for 1 year, mainly in the anterior region, which worsens when crouching. Physical examination shows edema with pain on palpation of the patella. Right knee radiography demonstrates a bipartite patella. Magnetic resonance imaging (MRI) of the right knee demonstrates a bipartite patella with a fibrous union between the superolateral bipartite fragment and the patella, associated with chondral lesions and subchondral edema, compatible with patella "painful synchondrosis". Conclusion: This report demonstrates the difficulty of diagnosing this lesion, since its physical examination is nonspecific and the radiography shows only the normal variation ­ bipartite patella, without evidencing the disease alterations, characterized only by MRI.


Subject(s)
Humans , Male , Adult , Patella/abnormalities , Patella/diagnostic imaging , Bone Diseases/diagnostic imaging , Pain/drug therapy , Pain/diagnostic imaging , Magnetic Resonance Imaging , Pregabalin/therapeutic use , Analgesics/therapeutic use
15.
Actual. osteol ; 16(3): 188-210, 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1253839

ABSTRACT

Los micro-ARNs (miARNs) son pequeñas moléculas de ARN no codificante (de aproximadamente 15-25 nucleótidos), que regulan la expresión de genes involucrados en numerosas funciones biológicas, a través de la inhibición o degradación de un ARN mensajero diana. La homeostasis ósea se mantiene por el balance entre la formación osteoblástica y la resorción osteoclástica. La sobreexpresión o inhibición de miARNs específicos afecta la proliferación, diferenciación y actividad de osteoblastos, osteocitos y osteoclastos. Estas acciones son llevadas a cabo modulando la expresión de distintos factores transcripcionales y moléculas de señalización de las vías esenciales para la osteoblastogénesis u osteoclastogénesis. Estos efectos modifican el balance entre la formación y la resorción, determinando cambios en la homeostasis ósea. Esta revisión enumera una serie de miARNs que participan en la homeostasis ósea. Profundizando en el conocimiento de los mecanismos por medio de los cuales los miARNs actúan sobre el hueso, podrían revelarse nuevos usos potenciales futuros, entre los que se encuentran su utilidad como nuevos biomarcadores óseos o como agentes terapéuticos para el tratamiento de trastornos metabólicos óseos, pérdida de masa ósea o enfermedades óseas. (AU)


MicroRNAs (miRNAs) are endogenous small noncoding RNA molecules (of approximately 15­25 nucleotides), which regulate the expression of genes controlling numerous biological functions, through the inhibition or degradation of the target messenger RNA. Bone homeostasis is maintained by a balance between osteoblastic bone formation and osteoclastic bone resorption. The overexpression or inhibition of specific miRNAs affects cell proliferation, differentiation and activity of osteoblast, osteocytes and osteoclast. This action is done by modulating the expression of different transcription factors and signaling molecules of the most relevant pathways of osteoblastogenesis or osteoclastogenesis. This effect is able to modify the balance between bone formation and resorption, determining changes in bone homeostasis. The present review is an overview of a series of miRNAs involved in bone homeostasis. An in depth knowledge of the mechanisms by which miRNAs act on bone may reveal potential uses in the future as new bone biomarkers or therapeutic agents for treating metabolic bone disorders, bone loss and bone diseases. (AU)


Subject(s)
Humans , Bone Remodeling , MicroRNAs/therapeutic use , Osteoblasts , Osteoclasts , Osteocytes , Skeleton/metabolism , Bone Diseases/therapy , Bone Resorption/therapy , Biomarkers , MicroRNAs/physiology , Fractures, Bone/prevention & control
16.
Med. interna (Caracas) ; 36(1): 56-59, 2020. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1103079

ABSTRACT

El mieloma múltiple (MM) es un tumor de proliferación clonal de plasmocitos en la médula ósea (MO). Hasta ahora no es curable1,2. Puede presentarse como una enfermedad indolente o con manifestaciones clínicas como insuficiencia renal, anemia y lesiones osteolíticas1. Se presenta el caso de una paciente femenina de 46 años, quien padecía dolor en la región del brazo izquierdo, acompañado por dolores óseos generalizados. Al examen físico se observó en el tercio proximal de la región humeral izquierda y hombro ipsilateral, gran tumoración que deformaba la anatomía local, indurada, inmóvil y dolorosa. Presentaba anemia severa (Hb. 6 g/dL), cuantificación de ß2 Microglobulina 4,23 mg/L (VR 0,80 ­ 3,0 mg/L) y rastreo óseo radiológico con múltiples lesiones líticas. En la muestra de médula ósea se encontró infiltración de 80 % de células plasmáticas mono- clonales kappa. Se le diagnosticó discrasia de células plasmáticas tipo MM monoclonal kappa sintomático, estadio II (ISS), con enfermedad ósea extensa y un gran plasmocitoma humeral izquier- do. Se indicó tratamiento de inducción de la remisión con el esquema VCD (bortezomib, ciclofosfamida y dexametasona). Adicionalmente ácido zoledrónico. Posteriormente se modificó a bortezomib, talidomida y prednisona. Luego del tratamiento antineoplásico, refirió acalmia completa del dolor con mejoría de la movilidad. Este caso clínico se trata de una presentación inusual de MM debido a la edad de la paciente y a la extensa enfermedad ósea. Llamó la atención la ausencia de niveles elevados de la cadena liviana kappa de las inmunoglobulinas libres en suero. Por la edad de la paciente y la ausencia de co-morbilidades significativas, es candidata para trasplante de células progenitoras hematopoyéticas (TCPH)(AU)


Multiple myeloma (MM) is a tumor of clonal proliferation of plasma cells in the bone marrow (BM). Until now it is not curable1,2. It can present as without symptoms or with clinical manifestations such as renal failure, anemia and osteolytic lesions1. We describe the case of a 46-year-old female patient, who complained of pain in her left arm, and, also, by generalized bone pain. On physical examination a large tumor was present in the proximal third of the left humeral region and ipsilateral shoulder, it was hard, painful and immo- bile. She had severe anemia (Hb 6 g / dL), quantification of ß2 Microglobulin 4.23 mg / L (VR 0.80 - 3.0 mg /L) and the radiological bone survey showed multiple lytic lesions. In the bone marrow sample, an infiltration of 80 % kappa monoclonal plasma cells was found. Her diagnosis was MM-type plasma cell dyscrasia, symptomatic kappa, stage II (ISS), with extensive bone disease and a large left humeral plasmacytoma. Remission induction therapy was indicated with the VCD scheme (bortezomib, cyclophosphamide and dexa- methasone). Additionally zoledronic acid was administered. Subsequently, it was modified to bortezomib, thalidomide and prednisone. After antineoplastic treatment, she referred pain relief with improvement of mobility. This clinical case is an unusual presentation of MM due to the age of the patient and extensive bone disease. The absence of high levels of the kappa light chain of free immunoglobulins in serum attracted attention. Due to the age of the patient and the absence of significant comorbidities, she is a candidate for trans- plantation of hematopoietic stem cells(AU)


Subject(s)
Humans , Female , Middle Aged , Bone Neoplasms , Bone Marrow Cells , Multiple Myeloma/pathology , Rheumatology , Bone Diseases
18.
Braz. j. infect. dis ; 23(3): 191-196, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1019553

ABSTRACT

ABSTRACT Backgroud: Daptomycin has been used in bone and joint infections (BJI) and prosthesis joint infections (PJI) considering spectrum of activity and biofilm penetration. However, the current experience is based on case reports, case series, cohorts, and international surveys. The aim of this systematic review was to evaluate studies about daptomycin treatment efficacy in BJI/PJI compared to other antibiotic regimens. Methods: PubMed, LILACS, Scielo and Web of Science databases were searched for articles about daptomycin and treatment of BJI and PJI from inception to March 2018. Inclusion criteria were any published researches that included patients with BJI treated with daptomycin. Diagnosis of BJI was based on clinical, laboratory and radiological findings according to IDSA guidelines. Results: From 5107 articles, 12 articles were included. Only three studies described the outcomes of patients with BJI treated with daptomycin with comparator regimen (vancomycin, teicoplanin and oxacillin). Studies presented large heterogeneity regarding device related infections, surgical procedures, and daptomycin regimens (varied from 4 mg/kg to 10 mg/kg). A total of 299 patients have been included in all studies (184 infections associated with orthopedic disposal and 115 osteomyelitis/septic arthritis). Two hundred and thirty-three patients were treated with daptomycin. The clinical cure rates on device related and non-device related infections (i.e. osteomyelitis) were 70% and 78%, respectively. Compared to all regimens evaluated, daptomycin group outcomes were non-inferior. Conclusion: Although a randomized clinical trial is needed, this systematic review tends to support daptomycin usage for bone and joint infections.


Subject(s)
Humans , Bone Diseases/drug therapy , Prosthesis-Related Infections/drug therapy , Daptomycin/therapeutic use , Joint Diseases/drug therapy , Anti-Bacterial Agents/therapeutic use , Osteomyelitis/drug therapy , Arthritis, Infectious/drug therapy , Joint Prosthesis/adverse effects
19.
Journal of Bone Metabolism ; : 133-143, 2019.
Article in English | WPRIM | ID: wpr-764257

ABSTRACT

Anorexia nervosa (AN) affects 2.9 million people, many of whom experience bone loss and increased fracture risk. In this article, we review data on the underlying pathophysiology of AN-related osteoporosis and possible approaches to disease management. Available research suggests that low body weight and decreased gonadal function are the strongest predictors of bone loss and fractures in patients with AN. Additionally, other metabolic disturbances have been linked to bone loss, including growth hormone resistance, low leptin concentrations, and hypercortisolemia, but those correlations are less consistent and lack evidence of causality. In terms of treatment of AN-related bone disease, weight gain has the most robust impact on bone mineral density (BMD). Restoration of gonadal function seems to augment this effect and may independently improve BMD. Bisphosphonates, insulin-like growth factor 1 supplementation, and teriparatide may also be reasonable considerations, however need long-term efficacy and safety data.


Subject(s)
Anorexia Nervosa , Anorexia , Body Weight , Bone Density , Bone Diseases , Diphosphonates , Disease Management , Feeding and Eating Disorders , Gonads , Growth Hormone , Humans , Leptin , Osteoporosis , Teriparatide , Weight Gain
20.
Journal of Bone Metabolism ; : 113-121, 2019.
Article in English | WPRIM | ID: wpr-764243

ABSTRACT

BACKGROUND: Osteoporosis is a geriatric disease with diminished bone density. The increase in the number of patients and medical expenses due to a global aging society are recognized as problems. Bone loss is the most common symptom of bone disease, not only osteoporosis but Paget's disease, rheumatoid arthritis, multiple myeloma, and other diseases. The main cause of this symptoms is excessive increase in the number and activity of osteoclasts. Osteoclasts are multinucleated giant cells that can resorb bone. They are differentiated and activation from monocytes/macrophages in the presence of macrophage colony-stimulating factor and receptor activator of nuclear factor-κB ligand (RANKL). METHODS: The effect of extract of Flavoparmelia sp. (EFV), a genus of lichenized fungi within the Parmeliaceae, on the differentiation of bone marrow-derived macrophages (BMMs) into osteoclasts was examined by phenotype assay and the cell cytotoxicity was evaluated by cell counting kit-8. The osteoclast differentiation-related genes and proteins were investigated by real-time polymerase chain reaction and immunoblotting. The functional activity of osteoclast in response to EFV treatment was evaluated by an Osteo Assay plate. RESULTS: In this study, we found that EFV, a genus of lichenized fungi within the Parmeliaceae, inhibited osteoclast formation. And we investigated its inhibitory mechanism. EFV reduced RANKL-mediated osteoclast formation and activation by inhibiting expression of nuclear factor of activated T cells 1, a key factor of osteoclastogenesis. CONCLUSIONS: Taken together, our results show that EFV is a promising candidate for health functional foods or therapeutic agents that can help treat bone diseases such as osteoporosis.


Subject(s)
Aging , Arthritis, Rheumatoid , Bone Density , Bone Diseases , Cell Count , Functional Food , Fungi , Giant Cells , Humans , Immunoblotting , Lichens , Macrophage Colony-Stimulating Factor , Macrophages , Multiple Myeloma , NFATC Transcription Factors , Osteoclasts , Osteoporosis , Parmeliaceae , Phenotype , Real-Time Polymerase Chain Reaction , T-Lymphocytes
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