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1.
Braz. j. biol ; 83: e248828, 2023. tab
Article in English | LILACS, VETINDEX | ID: biblio-1339354

ABSTRACT

Abstract Serum toxic metals have been implicated in development of many diseases. This study investigated the association between blood levels of lead and cadmium with abnormal bone mineral density (BMD) and incidence of osteoporosis. Sixty Saudi male adults age matching were assigned into two groups: A healthy control group (n = 30) and osteoporosis patients diagnosed according to T-score (n = 30). Serum calcium, vitamin D, osteocalcin, lead, cadmium were measured. Osteoporotic group showed a highly significant elevation of blood lead and cadmium levels compared to the control group (p <0.001). BMD was negatively correlated with serum osteocalcin level compared with control. There was a significant negative correlation between the cadmium and lead levels (r=-0.465 and p-value = 0.01) and calcium (p < 0.004). Our findings suggested that high cadmium and lead were negative correlated to BMD and increased the risk factor for osteoporosis.


Resumo Os metais tóxicos do soro têm sido implicados no desenvolvimento de muitas doenças. Este estudo investigou a associação entre os níveis sanguíneos de chumbo e cádmio com densidade mineral óssea anormal (DMO) e incidência de osteoporose. Sessenta adultos sauditas do sexo masculino com idades iguais foram divididos em dois grupos: um grupo de controle saudável (n = 30) e pacientes com osteoporose diagnosticados de acordo com o T-score (n = 30). Cálcio sérico, vitamina D, osteocalcina, chumbo, cádmio foram medidos. O grupo osteoporótico apresentou elevação altamente significativa dos níveis de chumbo e cádmio no sangue em comparação ao grupo controle (p < 0,001). A DMO foi negativamente correlacionada com o nível de osteocalcina sérica em comparação com o controle. Houve correlação negativa significativa entre os níveis de cádmio e chumbo (r = -0,465 ep = 0,01) e cálcio (p < 0,004). Nossos achados sugeriram que cádmio e chumbo elevados foram correlacionados negativamente à DMO e aumentaram o fator de risco para osteoporose.


Subject(s)
Humans , Male , Adult , Osteoporosis/epidemiology , Lead , Saudi Arabia/epidemiology , Absorptiometry, Photon , Osteocalcin , Incidence
2.
Rev. bras. ortop ; 57(5): 851-855, Sept.-Oct. 2022. graf
Article in English | LILACS | ID: biblio-1407707

ABSTRACT

Abstract Objective The present study aims to describe outcomes from a series of surgically treated patients with atypical femoral fracture due to bisphosphonates use, in addition to correlate the time of previous medication use with fracture consolidation time, and to compare the consolidation time of complete and incomplete fractures. Methods This is an observational, retrospective study with 66 patients diagnosed with atypical femur fractures associated with chronic bisphosphonates use. The patients underwent orthopedic surgical treatment at a referral hospital from January 2018 to March 2020. Results All patients were females, with two bilateral cases. Fracture consolidation occurred in all cases, with an average time of 2.3 months and a follow-up time of 5.8 months. The average time of bisphosphonates use was 7.8 years. There was no correlation between the time of previous bisphosphonates use and the time for fracture consolidation. Consolidation time differed in complete and incomplete fractures. Conclusion Surgical treatment with a long cephalomedullary nail resulted in consolidation in all patients. The consolidation time was longer in complete fractures when compared with incomplete lesions, and there was no correlation between the time of previous bisphosphonates use and the consolidation time . Level of evidenceLevel IV, case series


Resumo Objetivo Descrever os resultados de uma série de pacientes tratados cirurgicamente com diagnóstico de fratura femoral atípica associada ao uso de bisfosfonatos, assim como correlacionar o tempo de uso prévio da medicação com o tempo de consolidação da fratura e comparar o tempo de consolidação das fraturas completas e incompletas. Métodos Trata-se de um estudo observacional e retrospectivo de 66 pacientes com diagnóstico de fratura atípica do fêmur associada ao uso crônico de bisfosfonatos. Os pacientes foram submetidos ao tratamento cirúrgico ortopédico em hospital de referência no período de janeiro de 2018 a março de 2020. Resultados Os pacientes incluídos no estudo eram todos do sexo feminino, com dois casos bilaterais. A consolidação da fratura ocorreu em todos os casos com tempo médio de 2,3 meses e seguimento de 5,8 meses. O tempo médio de uso de bisfosfonatos foi de 7,8 anos. Não houve correlação do tempo de uso prévio de bisfosfonatos com o tempo de consolidação das fraturas. Houve uma diferença do tempo de consolidação entre as fraturas completas e incompletas. Conclusão Houve consolidação após tratamento cirúrgico com haste cefalomedular longa em todos os pacientes do presente estudo, sendo o tempo de consolidação maior nas fraturas completas em relação às incompletas, e não houve correlação entre o tempo de uso prévio de bisfosfonatos e o tempo de consolidação. Nível de evidênciaNível IV, série de casos


Subject(s)
Humans , Female , Osteoporosis/therapy , Diphosphonates/therapeutic use , Femoral Fractures/surgery
3.
Rev. Ciênc. Plur ; 8(3): 29053, out. 2022. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1399479

ABSTRACT

Introdução:O Denosumabeé um fármaco antirreabsortivo indicado para o tratamento de osteoporose e doenças ósseas metastáticas. O seu uso está associado ao desenvolvimento de reações adversas em diferentes órgãos, como a osteonecrose dos maxilares, que é o evento adverso de interesseodontológico. Objetivo:Realizar um levantamento bibliográfico sobre o mecanismo de ação do Denosumabe no tecido ósseo e destacar a importância do cirurgião-dentista na prevenção, no diagnóstico e tratamento da osteonecrose nos maxilares.Metodologia:Trata-se de uma revisão integrativa elaboradaem duas etapas: inicialmente realizou-se uma busca de artigos publicados entre os anos 2010a 2022, sobre a osteonecrose em pacientes que fazem uso do Denosumabe nas plataformas de dados Pubmed, ScieloeBiblioteca Virtual em Saúde. Posteriormente, foi feita uma seleção de partes relevantes para a pesquisa, uma leitura analítica e a organização das informações coletadas pertinentes a cada tópico da pesquisa.Resultados:ODenosumabe inibea ligação da citocina RANKL ao seu receptor RANK, tal mecanismo de ação reduz o processo de reabsorção óssea execessiva. As osteonecroses podem apresentar-se em diferentes níveis de estadiamento e caracterizam-se como área de exposição óssea necrótica na região maxilofacial, permanecendo por mais de oito semanas e sem histórico de radioterapia ou doença metastática evidentes nos maxilares. Alguns fatores predispõem o desenvolvimento das osteonecroses, entre eles: procedimentos odontológicos cirúrgicos. Ainda não existe um protocolo de tratamento definitivo, entretanto, modalidades terapêuticas coadjuvantes são administradas de acordo com a condição clínicado paciente.Conclusões:O exame clínico deve ser minucioso, atentando-se a qualquer alteração na cavidade bucal, às doenças preexistentes e às medicações utilizadas pelo paciente. Em todos os casos deve-se, realizar orientações de higiene oral e adequação do meio bucal previamente ao tratamento oncológico e ao uso de drogas antirreabsortivas (AU).


Introduction:Denosumab is an antiresorptive drug indicated for the treatment of osteoporosis and metastatic bone diseases. Its use is associated with the development of adverse reactions in different organs, such as osteonecrosis of the jaws, which is an adverse event ofdentalinterest.Objective:Conducta bibliographic survey on the mechanism of action of Denosumab in bone tissue and to highlight the importance of the dentist in the prevention, diagnosis and treatment of osteonecrosis in the jaws. Methodology: This is an integrative review carried out in two stages: initially, a search was carried out for articles published between the years 2010to 2022, on osteonecrosis in patients using Denosumab in the data platforms Pubmed, Scieloand Virtual Health Library(BVS). Subsequently, a selection of relevant parts for the research was made, an analytical reading and the organization of the collected information pertinent to each research theme was carried out.Results:TheDenosumab inhibitsthe binding of the RANKL cytokine to its RANK receptor, this mechanism of action reduces the process of excessive bone resorption. Osteonecrosis can present at different staging levels and are characterized as an area of necrotic bone exposure in the maxillofacial region, lasting for more than eight weeks and without a history of radiotherapy or evident metastatic disease in the jaws. Some factors predispose the development of osteonecrosis, including: surgical dental procedures. There is still no definitive treatment protocol, however, supporting therapeutic modalities are administered according to the patient's clinical condition.Conclusions:The clinical examination must be thorough, paying attention to any changes in the oral cavity, pre existing diseases and medications used by the patient. In all cases, guidelines on oral hygiene and adequacy of the oral environment should be carried out prior to oncological treatment and the use of antiresorptive drugs (AU).


Introducción: Denosumab es un fármaco antirresortivo indicado para el tratamiento de la osteoporosis y enfermedades óseas metastásicas. Su usoestá asociado al desarrollo de reacciones adversas en diferentes órganos, comola osteonecrosis de los maxilares, que es un evento adverso de interés odontológico. Objetivo: Realizar un levantamiento bibliográfico sobre el mecanismo de acción de Denosumab en el tejido óseo y resaltar la importancia del odontólogo en la prevención, diagnóstico y tratamiento de la osteonecrosis en los maxilares. Metodología: Esta es una revisión integradora realizada en dos etapas: inicialmente se realizó una búsqueda de artículos publicados entre los años 2010 a 2022, sobre osteonecrosis en pacientes usuarios de Denosumab en las plataformas Pubmed, ScieloyBiblioteca Virtual en Salud(BVS).Posteriormente, se realizó una selección de partes relevantes para la investigación, se realizó una lectura analítica y la organización de la información recolectada relevante para cada tema de investigación. Resultados:Denosumab inhibela unión de la citoquina RANKL a su receptor RANK, este mecanismo de acción reduce el proceso de reabsorción ósea excesiva. La osteonecrosis puede presentarse en diferentes nivelesde estadificación y se caracterizan por un área de exposición ósea necrótica en la región maxilofacial, con una duración mayor a ocho semanas y sin antecedentes de radioterapia o enfermedad metastásica evidente en los maxilares. Algunos factores predisponen al desarrollo de osteonecrosis, entre ellos: procedimientos quirúrgicos dentales. Aún noexiste un protocolo de tratamiento definitivo, sin embargo, se administran modalidades terapéuticas de apoyo de acuerdo a la condición clínica del paciente.Conclusiones: El examen clínico debe ser minucioso, prestando atención a cualquier cambio en la cavidad bucal, enfermedades preexistentes y medicamentos utilizados por el paciente. En todos los casos se deben realizar pautas de higiene bucal y adecuación del medio bucal previo al tratamiento oncológico y al uso de fármacos antirresortivos (AU).


Subject(s)
Osteonecrosis/chemically induced , Osteonecrosis/prevention & control , Osteoporosis/diagnosis , Dentists , Denosumab/drug effects , Maxilla , Surveys and Questionnaires , Disease Prevention
4.
Medicina UPB ; 41(2): 166-170, julio-diciembre 2022. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1392160

ABSTRACT

La osteoporosis es una enfermedad sistémica esquelética, cuyas manifestaciones más comunes son las fracturas vertebrales y de cadera. En relación con el oído, se han realizado algunos estudios controversiales que sugieren el aumento de riesgo de pérdida auditiva en pacientes con osteoporosis, mientras otros indican que no hay relación alguna con esta enfermedad. Se realizó un reporte de caso donde se describen los hallazgos en el oído medio y oído interno, tras la valoración bajo microscopía de luz, en un espécimen de hueso temporal con antecedente de osteoporosis. Se evidencia desmineralización, porosidad y disminución cualitativa del tejido óseo, así como disminución del espacio incudomaleolar.


Osteoporosis is a skeletal systemic disease, commonly known for its affection on hips and spine. In relation to the ear, several controversial studies have documented an increased risk for hearing loss in patients with osteoporosis, while others do not find any association with these disorders. A case report was carried out which describes the findings in the middle ear and inner ear, after evaluation under light microscopy, in a temporary bone specimen with a history of osteoporosis. Demineralization, porosity and qualitative diminished bone tissue are found, as well as a decrease in the incudomallear joint.


A osteoporose é uma doença esquelética sistêmica, cujas manifestações mais comuns são as fraturas vertebrais e de quadril. Em relação ao ouvido, foram realizados alguns estudos controversos que sugerem um risco aumentado de perda auditiva em pacientes com osteoporose, enquanto outros indicam que não há relação com essa doença. Foi feito um relato de caso descrevendo os achados em ouvido médio e ouvido interno, após avaliação sob microscopia de luz, em espécime de osso temporal com histórico de osteoporose. Há evidências de desmineralização, porosidade e diminuição qualitativa do tecido ósseo, bem como diminuição do espaço incudomaleolar.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Osteoporosis , Bone and Bones , Demineralization , Ear, Middle , Hearing Loss , Incus , Ear, Inner
5.
Int. j. morphol ; 40(3): 832-838, jun. 2022. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1385655

ABSTRACT

RESUMEN: El objetivo del presente estudio fue establecer la influencia de diferentes materiales en el proceso de regeneración ósea de alveolos post exodoncia de ratas hembra adultas ovariectomizadas (OVX). Para ello, se utilizaron 40 ratas sprague dawley, divididas en grupo experimental (OVX) (n=20) y grupo control (Sin ovariectomía) (n=20). Todas las ratas del grupo experimental fueron sometidas a ovariectomía bilateral para simular un estado de osteoporosis inducida por déficit de estrógeno. Posterior a 12 semanas post OVX, las ratas de ambos grupos fueron divididas en 4 subgrupos, en los cuales fue extraído el primer molar superior derecho de cada rata. Posteriormente, las terapias realizadas en los alveolos post-exodoncia fueron: A: (N=5) Alveolo no rellenado para ser utilizado como control negativo. B: (N=5) Aplicación de injerto bifásico (HA+BTCP). C: (N=5) Aplicación de PRF. D: Aplicación de una combinación de injerto bifásico + PRF. Luego de tres semanas se realizó la eutanasia de los animales y obtención de las muestras para los análisis respectivos. Todos los animales sobrevivieron al final del estudio sin ninguna complicación postoperatoria. Los resultados cuantitativos del área ósea interradicular del segundo molar superior, mostraron diferencias estadísticamente significativas entre grupo control y grupo OVX. Mientras que no se observaron diferencias en la descripción histológica ni en el análisis cuantitativo de fibras colágenas tipo I y III. Es posible concluir que el modelo de osteoporosis inducida por déficit de estrógeno modificaría también la microarquitectura ósea de la Maxila. No obstante, nuevos estudios son necesarios para continuar con el estudio de biomateriales para regeneración ósea en modelos de osteoporosis inducida.


SUMMARY: The aim of the present study was to establish the influence of different materials on the process of bone regeneration in post-extraction sockets of ovariectomized (OVX) adult female rats. For this, 40 Sprague Dawley rats were used, divided into an experimental group (OVX) (n=20) and a control group (without ovariectomy) (n=20). All rats in the experimental group underwent bilateral ovariectomy to simulate a state of estrogen deficiency osteoporosis. After 12 weeks post OVX, rats from both groups were divided into 4 subgroups, in which the upper right first molar of each rat was extracted. Subsequently, the therapies performed in the post-extraction sockets were A: (N=5) Unfilled alveolus to be used as a negative control. B: (N=5) Biphasic graft application (HA+BTCP). C: (N=5) PRF application. D: Application of a combination of biphasic graft + PRF. After three weeks, the animals were euthanized, and the samples were obtained for the respective analyses. All animals survived to the end of the study without any postoperative complications. The quantitative results of the interradicular bone area of ??the upper second molar showed significant differences between the control group and the OVX group. While no differences were observed in the histological description or in the quantitative analysis of collagen fibers type I and III. It is possible to conclude that the model of osteoporosis induced by estrogen deficiency would modify the bone microarchitecture of the Maxilla. However, new studies are necessary to continue with the study of biomaterials for bone regeneration in models of induced osteoporosis.


Subject(s)
Animals , Female , Rats , Osteoporosis/therapy , Bone Regeneration , Ovariectomy , Bone Transplantation , Tooth Extraction , Biocompatible Materials , Rats, Sprague-Dawley , Disease Models, Animal
6.
Medicina (Ribeirao Preto, Online) ; 55(1)maio 2022. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1410579

ABSTRACT

Introdução: Hipofosfatasia é um distúrbio metabólico que afeta a mineralização óssea e dentária, causada por mutações no gene ALPL, levando à deficiência enzimática da fosfatase alcalina tecido não-específica. A forma adulta caracteriza-se por fraturas atípicas do fêmur, osteomalácia, osteoporose, grave osteoartropatia, condrocalcinose e artralgia. Objetivo: Demonstrar desafios diagnósticos relacionados à hipofosfatasia através do relato de dois casos. Paciente 1: feminino, 59 anos, encaminhada para avaliação clínica devido às fraturas patológicas de difícil consolidação e osteoporose generalizada de causa genética. Relata perda dentária precoce da arcada superior, fraturas na coluna, em ombro esquerdo e no fêmur. Atualmente, queixa-se de dor crônica intensa, com uso de múltiplos medicamentos. Achados clínicos, laboratoriais e radiológicos foram compatíveis com o diagnóstico de hipofosfatasia. Paciente 2: masculino, 31 anos, filho da paciente 1, encaminhado para avaliação clínica por fratura patológica precoce em fêmur esquerdo e osteoporose não esclarecida. Atualmente relata dor e claudicação importante em membro inferior esquerdo, associado à lombalgia crônica. Confirmação do diagnóstico de hipofosfatasia por exames laboratoriais e radiológicos e sequenciamento do gene ALPL, aliados ao diagnóstico da sua genitora. Discussão: Hipofosfatasia é uma doença rara de herança autossômica dominante e recessiva. Pacientes acometidos apresentam fraturas constantes, densidade mineral óssea baixa, cicatrização óssea deficitária. É comum a hipofosfatasia ser diagnosticada erroneamente como osteopenia e/ou osteoporose primária, acarretando prejuízos ao paciente. Ressalta-se a importância da história clínica completa e dos antecedentes familiares a fim de se obter um diagnóstico precoce, garantindo, por sua vez, o adequado acompanhamento e manejo terapêutico (AU)


Introduction: hypophosphatasia is a metabolic disorder affecting bone and tooth mineralization, caused by mutations in the ALPL gene leading to enzymatic deficiency of tissue non-specific alkaline phosphatase. The adult form is characterized by atypical femur fractures, osteomalacia, osteoporosis, severe osteoarthropathy, chondrocalcinosis, and arthralgia. Objective: to demonstrate diagnostic challenges related to hypophosphatasia through the report of two cases. Patient 1: female, 59 years old, referred for clinical evaluation due to pathological fractures of difficult consolidation and generalized osteoporosis of genetic cause. She reports early tooth loss in the upper arch, fractures in the spine, left shoulder and femur. Currently, he complains of severe chronic pain, with use of multiple medications. Clinical, laboratory, and radiological findings were compatible with the diagnosis of hypophosphatasia. Patient 2:male, 31 years old, son of patient 1, referred for clinical evaluation due to an early pathological fracture in the left femur and unclear osteoporosis. He currently reports pain and significant claudication in the left lower limb, associated with chronic low back pain. Confirmation of the diagnosis of hypophasatasia by laboratory and radiological tests and sequencing of the ALPL gene combined with the diagnosis of his mother. Discussion: hypophosphatasia is a rare disease of autosomal dominant and recessive inheritance. Affected patients have constant fractures, low bone mineral density, and impaired bone healing. It is common for hypophosphatasia to be misdiagnosed as osteopenia and/or primary osteoporosis, which can be harmful to the patient. The importance of a complete clinical history and family history is emphasized in order to obtain an early diagnosis, ensuring adequate follow-up and therapeutic management (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteoporosis , Bone Diseases, Metabolic , Alkaline Phosphatase , Chronic Pain , Fractures, Spontaneous , Hypophosphatasia/diagnosis
7.
Rev. bras. ortop ; 57(2): 267-272, Mar.-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1387984

ABSTRACT

Abstract Objective To verify how the combined administration of alendronate (ALN) and vitamin D3 (VD) acts on the bone microarchitecture in rats with glucocorticoid-induced osteoporosis. Methods The experiment used 32 90-day-old female Wistar rats weighing between 300 and 400g. The induction of osteoporosis consisted of intramuscular administration of dexamethasone at a dose of 7.5 mg/kg of body weight once a week for 5 weeks, except for the animals in the control group. The animals were separated into the following groups: G1 (control group without osteoporosis), G2 (control group with osteoporosis without treatment), G3 (group with osteoporosis treated with ALN 0.2 mg/kg), G4 (group with osteoporosis treated with VD 10,000UI/500μL), and G5 (group with osteoporosis treated with ALN þ VD). The right femurs of the rats were fixed in 10% buffered formaldehyde, decalcified, and processed for inclusion in paraffin. Histological sections were stained with hematoxylin-eosin for histomorphometric analysis. Cortical thickness and medullary cavity were measured in cross-sections. Results There was a statistical difference (p< 0.05) between groups G3 and G5 compared with the positive control group (G2), both related to the measurement of cortical thickness and to the total diameter of the bone. In the evaluation of the spinal area, only the G3 group has shown to be statistically different from the G2 group. Conclusion Concomitant treatment with daily ALN and weekly VD is effective in preventing glucocorticoid-induced bone loss. However, there was no difference between the therapy tested and treatment with ALN alone.


Resumo Objetivo Verificar como a administração conjunta de alendronato de sódio (ALN) e vitamina D3 (VD) atua na microarquitetura óssea em ratas com osteoporose induzida por glicocorticoide. Métodos O experimento utilizou 32 ratas da linhagem Wistar, com peso médio de 300 a 400g, com 90 dias de vida. A indução da osteoporose consistiu na administração de dexametasona na dose de 7,5 mg/kg de peso corporal, por via intramuscular, 1 vez por semana durante 5 semanas, à exceção dos animais do grupo controle. Os animais foram distribuídos nos seguintes grupos: G1 (grupo controle sem osteoporose), G2 (grupo controle com osteoporose sem tratamento), G3 (grupo com osteoporose tratado com ALN 0,2 mg/kg), G4 (grupo com osteoporose tratado com VD 10.000UI/500μL) e G5 (grupo com osteoporose tratado com ALN þ VD). Os fêmures direitos das ratas foram fixados em formol a 10% tamponado, descalcificados e processados para inclusão em parafina. Os cortes histológicos foram corados com hematoxilina-eosina para análise histomorfométrica. A espessura cortical e a cavidade medular foram medidas em cortes transversais. Resultados Houve diferença estatística (p< 0,05) entre os grupos G3 e G5 em relação ao grupo controle positivo (G2), tanto em relação à medida da espessura cortical quanto em relação ao diâmetro total do osso. Na avaliação da área medular, apenas o grupo G3 se mostrou estatisticamente diferente do grupo G2. Conclusão O tratamento concomitante com ALN diário e VD semanal é eficaz para prevenir a perda óssea induzida por glicocorticoide. No entanto, não houve diferença entre esta terapia testada e o tratamento apenas com o ALN.


Subject(s)
Animals , Rats , Osteoporosis/prevention & control , Vitamin D/therapeutic use , Alendronate/therapeutic use , Menopause
8.
Acta méd. costarric ; 64(1)mar. 2022.
Article in Spanish | LILACS-Express | LILACS, SaludCR | ID: biblio-1402991

ABSTRACT

Resumen Objetivo: Determinar la prevalencia de la osteoporosis en mujeres costarricenses posmenopáusicas, atendidas en el Hospital San Juan de Dios de la Caja Costarricense del Seguro Social, y relacionar con características clínicas y de estilo de vida. Métodos. Estudio transversal. Se analizó un total de 923 estudios de densitometría ósea de mujeres con edad entre los 45 y 80 años, en etapa posmenopáusica; se registró un valor de T-score obtenido por densitometría ósea para columna lumbar y cadera; se documentó las variables como la edad, el índice de masa corporal, tabaquismo y otros reconocidos factores de riesgo; se estimó la prevalencia y se analizó la relación con los factores. Resultados. A partir de 923 estudios y los factores de riesgo comúnmente asociados con la enfermedad, fueron estadísticamente significativos los siguientes: la edad (p<0,001), la edad en la menarquia (p = 0,001), la cantidad de años transcurridos desde la menopausia (p<0,001) y el antecedente familiar de fractura de cadera (p = 0,01). Otros factores no resultaron significativos. Conclusiones. Para la población estudiada, se demostró una prevalencia de 47% para osteopenia y de 39% para osteoporosis en mujeres posmenopáusicas. No se logró establecer una relación en las variables de estilo de vida, tales como tabaquismo, alcoholismo, actividad física y consumo de lácteos. Se deben realizar otras investigaciones con un mayor control sobre estas variables para conocer su riesgo relacionado con la enfermedad.


Abstract Aim: To determine the prevalence of osteoporosis in postmenopausal Costa Rican women treated at the San Juan de Dios Hospital of the Costa Rican Social Security Fund, and relate it to clinical and lifestyle characteristics. Methods. Transversal study. A total of 923 bone densitometry studies of postmenopausal women aged between 45 and 80 years were analyzed; A T-score value obtained by bone densitometry was recorded for the lumbar spine and hip; variables such as age, bodymass index, smoking, and other recognized risk factors were documented; the prevalence was estimated and the relationship with the factors was analyzed. Results. From 923 studies and risk factors commonly associated with the disease, the following were statistically significant: age (p<0.001), age at menarche (p = 0.001), number of years since menopause (p<0.001) and family history of hip fracture (p = 0.01). Other factors were not significant. Conclusions. For the population studied, a prevalence of 47% for osteopenia and 39% for osteoporosis in postmenopausal women was demonstrated. It was not possible to establish a relationship in lifestyle variables, such as smoking, alcoholism, physical activity and dairy consumption. Other investigations with greater control over these variables should be carried out to know their risk related to the disease.


Subject(s)
Humans , Female , Middle Aged , Aged , Bone Diseases, Metabolic/diagnosis , Osteoporosis, Postmenopausal/diagnosis , Osteoporosis/diagnosis , Costa Rica
10.
Article in Portuguese | LILACS | ID: biblio-1368967

ABSTRACT

RESUMO:Introdução: Hipofosfatasia é um distúrbio metabólico que afeta a mineralização óssea e dentária, causada por mutações no gene ALPL, levando à deficiência enzimática da fosfatase alcalina tecido não-específica. A forma adulta caracteriza-se por fraturas atípicas do fêmur, osteomalácia, osteoporose, grave osteoartropatia, condrocalcinose e artralgia. Objetivo: Demonstrar desafios diagnósticos relacionados à hipofosfatasia através do relato de dois casos. Paciente 1: feminino, 59 anos, encaminhada para avaliação clínica devido às fraturas patológicas de difícil consolidação e osteoporose generalizada de causa genética. Relata perda dentária precoce da arcada superior, fraturas na coluna, em ombro esquerdo e no fêmur. Atualmente, queixa-se de dor crônica intensa, com uso de múltiplos medicamentos. Achados clínicos, laboratoriais e radiológicos foram compatíveis com o diagnóstico de hipofosfatasia. Paciente 2: masculino, 31 anos, filho da paciente 1, encaminhado para avaliação clínica por fratura patológica precoce em fêmur esquerdo e osteoporose não esclarecida. Atualmente relata dor e claudicação importante em membro inferior esquerdo, associado à lombalgia crônica. Confirmação do diagnóstico de hipofosfatasia por exames laboratoriais e radiológicos e sequenciamento do gene ALPL, aliados ao diagnóstico da sua genitora. Discussão: Hipofosfatasia é uma doença rara de herança autossômica dominante e recessiva. Pacientes acometidos apresentam fraturas constantes, densidade mineral óssea baixa, cicatrização óssea deficitária. É comum a hipofosfatasia ser diagnosticada erroneamente como osteopenia e/ou osteoporose primária, acarretando prejuízos ao paciente. Ressalta-se a importância da história clínica completa e dos antecedentes familiares a fim de se obter um diagnóstico precoce, garantindo, por sua vez, o adequado acompanhamento e manejo terapêutico. (AU)


ABSTRACT: Introduction: hypophosphatasia is a metabolic disorder affecting bone and tooth mineralization, caused by mutations in the ALPL gene leading to enzymatic deficiency of tissue non-specific alkaline phosphatase. The adult form is characterized by atypical femur fractures, osteomalacia, osteoporosis, severe osteoarthropathy, chondrocalcinosis, and arthralgia. Objective: to demonstrate diagnostic challenges related to hypophosphatasia through the report of two cases. Patient 1: female, 59 years old, referred for clinical evaluation due to pathological fractures of difficult consolidation and generalized osteoporosis of genetic cause. She reports early tooth loss in the upper arch, fractures in the spine, left shoulder and femur. Currently, he complains of severe chronic pain, with use of multiple medications. Clinical, laboratory, and radiological findings were compatible with the diagnosis of hypophosphatasia. Patient 2:male, 31 years old, son of patient 1, referred for clinical evaluation due to an early pathological fracture in the left femur and unclear osteoporosis. He currently reports pain and significant claudication in the left lower limb, associated with chronic low back pain. Confirmation of the diagnosis of hypophasatasia by laboratory and radiological tests and sequencing of the ALPL gene combined with the diagnosis of his mother. Discussion: hypophosphatasia is a rare disease of autosomal dominant and recessive inheritance. Affected patients have constant fractures, low bone mineral density, and impaired bone healing. It is common for hypophosphatasia to be misdiagnosed as osteopenia and/or primary osteoporosis, which can be harmful to the patient. The importance of a complete clinical history and family history is emphasized in order to obtain an early diagnosis, ensuring adequate follow-up and therapeutic management. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteoporosis , Alkaline Phosphatase , Fractures, Spontaneous , Hypophosphatasia/diagnosis
12.
Braz. dent. sci ; 25(3): 1-8, 2022. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1378405

ABSTRACT

Objective: The aim of this study was to assess the bone density of the mandible in adolescents with cerebral palsy (CP) treated with antiepileptic drugs using one beam computed tomography (CBCT). Methods: The study was carried out with 18 adolescents aged 12­18 years, undergoing routine dental treatment at the dental clinic of APCD-São Caetano do Sul. CBCT scans were of divided into two groups: G1 adolescents with CP using antiepileptic drugs and G2 normoactive adolescents. A single dentomaxillofacial radiologist assessed and evaluated the images using Dental Slice software and Image J. Fisher's exact tests as well as paired and unpaired Student's t-tests were performed. Results: Groups differed significantly with regard in the values of density (p < 0.001), with G1 presenting lower values compare to G2. G1 showed significantly lower density means on the right side, left side, and right/left sides of the mandible edge than G2 (p < 0.001). Conclusion: CP patients using antiepileptic drugs show evidence of bone mineral density loss of the mandible.(AU)


Objetivo: O objetivo deste estudo foi avaliar a densidade ótica óssea da mandíbula em adolescentes com paralisia cerebral (PC) tratados com drogas antiepilépticas por meio de tomográfica computadorizada de feixe cônico (TCFC). Métodos: O estudo foi realizado com 18 adolescentes de 12 a 18 anos, em tratamento odontológico de rotina na clínica odontológica da APCD-São Caetano do Sul. As TCFC foram divididas em dois grupos: G1 adolescentes com PC em uso de antiepilépticos e G2 adolescentes normoativos. Um único radiologista dentomaxilofacial assessou e avaliou as imagens usando usando os softwares Dental Slice e Image J. Os testes exatos de Fisher, bem como os testes t de Student pareados e não pareados foram realizados. Resultados: Os grupos diferiram significativamente quanto aos valores de densidade óptica (p <0,001), com o grupo G1 apresentando valores menores em relação ao G2. O grupo G1 apresentou médias de densidade óptica significativamente menores nos lados direito, esquerdo e direito / esquerdo da borda da mandíbula do que o G2 (p <0,001). Conclusão: Pacientes com PC em uso de drogas antiepilépticas apresentam evidências de perda de densidade óssea da mandíbula (AU)


Subject(s)
Humans , Male , Female , Adolescent , Osteoporosis , Bone Density , Cone-Beam Computed Tomography , Anticonvulsants
13.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1358313

ABSTRACT

Objetivo: avaliar a qualidade de vida segundo as comorbidades mais prevalentes em idosos com HIV. Método: estudo transversal realizado com 241 idosos de ambos os sexos usuários dos serviços de referência para acompanhamento do paciente com HIV. Os dados foram obtidos por meio da entrevista face a face com o preenchimento de um questionário sociodemográfico e clínico além do HIV/AIDS Target-Quality of life. Resultados: as três comorbidades mais prevalentes foram hipertensão, diabetes e osteoporose e dentre todas as comorbidades encontradas, apenas a hipertensão e o diabetes não apresentaram diferença estatisticamente significante com nenhuma das dimensões do HIV/AIDS Target-Quality of life. Conclusão: osteoporose e osteoartrose são as comorbidades que tem impacto em mais dimensões da qualidade de vida


Objective: to assess quality of life according to the most prevalent comorbidities in elderly people with HIV. Method: cross-sectional study carried out with 241 elderly people of both sexes, users of reference services for monitoring HIV patients. The data were obtained through a face-to-face interview by completing a sociodemographic and clinical questionnaire in addition to the HIV / AIDS Target-Quality of life. Results: the three most prevalent comorbidities were hypertension, diabetes and osteoporosis and among all the comorbidities found, only hypertension and diabetes did not show a statistically significant difference with any of the dimensions of HIV / AIDS Target-Quality of life. Conclusion: osteoporosis and osteoarthritis are comorbidities that have an impact on more dimensions of quality of life


Objetivo: evaluar la calidad de vida según las comorbilidades más prevalentes en ancianos con VIH. Método: estudio transversal realizado con 241 ancianos de ambos sexos, usuarios de servicios de referencia para el seguimiento de pacientes con VIH. Los datos se obtuvieron a través de una entrevista presencial mediante la cumplimentación de un cuestionario sociodemográfico y clínico además de la HIV/AIDS Target-Quality of life. Resultados: las tres comorbilidades más prevalentes fueron hipertensión, diabetes y osteoporosis y entre todas las comorbilidades encontradas, solo la hipertensión y la diabetes no mostraron diferencia estadísticamente significativa con ninguna de las dimensiones de HIV/AIDS Target-Quality of life. Conclusión: la osteoporosis y la osteoartritis son comorbilidades que repercuten en más dimensiones de la calidad de vida


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Comorbidity , HIV , Osteoarthritis , Osteoporosis , Cross-Sectional Studies , Acquired Immunodeficiency Syndrome , Diabetes Mellitus , Hypertension
14.
Acta cir. bras ; 37(2): e370207, 2022. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1374069

ABSTRACT

Purpose: To analyze the effect of high-intensity interval training (HIIT) on bone mineral density (BMD) in a model of type 2 diabetes mellitus. Methods: Thirty-two male, adult, 12-week-old rats (Rattus norvegicus), of the Wistar lineage, were used. The animals induced to the experimental model received a high fat diet for 10 days and, after that period, intraperitoneal injection of streptozotocin (40 mg·kg­1), dissolved in 20 mmol·L­1 sodium citrate solution (pH = 4.5). The experimental group of diabetes was formed by the animals that, 48 h after the injection of streptozotocin, had fasting blood glucose > 250 mg·dL­1). The animals were randomly divided into four groups with eight animals each: HIIT experimental diabetes; HIIT control; sedentary experimental diabetes and sedentary control. The animals in the HIIT group performed an aerobic exercise protocol on a treadmill inclined at an angle of 15° to the horizontal, with interspersed intensity. Five weekly sessions, lasting 49 min each, were held for 6 weeks. The analysis of cortical bone density (CBD) and BMD were performed by X-ray images using the In-Vivo Xtreme II/Bruker system. Results: For CBD and BMD, when comparing diabetes and control groups, a significant difference was seen between groups in relation to HIIT (p = 0.007). Animals submitted and not submitted to HIIT in the same group showed a significant difference between groups in relation to diabetes (p < 0.001). Conclusions: The HIIT experimental diabetes group had increased CBD and BMD in comparison with the sedentary experimental diabetes group.


Subject(s)
Animals , Male , Rats , Osteoporosis/etiology , Bone Density , Diabetes Mellitus, Experimental/complications , Diabetes Mellitus, Type 2/complications , High-Intensity Interval Training/veterinary , Rats, Wistar
15.
Article in English | WPRIM | ID: wpr-929152

ABSTRACT

Aging of craniofacial skeleton significantly impairs the repair and regeneration of trauma-induced bony defects, and complicates dental treatment outcomes. Age-related alveolar bone loss could be attributed to decreased progenitor pool through senescence, imbalance in bone metabolism and bone-fat ratio. Mesenchymal stem cells isolated from oral bones (OMSCs) have distinct lineage propensities and characteristics compared to MSCs from long bones, and are more suited for craniofacial regeneration. However, the effect of epigenetic modifications regulating OMSC differentiation and senescence in aging has not yet been investigated. In this study, we found that the histone demethylase KDM4B plays an essential role in regulating the osteogenesis of OMSCs and oral bone aging. Loss of KDM4B in OMSCs leads to inhibition of osteogenesis. Moreover, KDM4B loss promoted adipogenesis and OMSC senescence which further impairs bone-fat balance in the mandible. Together, our data suggest that KDM4B may underpin the molecular mechanisms of OMSC fate determination and alveolar bone homeostasis in skeletal aging, and present as a promising therapeutic target for addressing craniofacial skeletal defects associated with age-related deteriorations.


Subject(s)
Aging , Cell Differentiation , Facial Bones/physiology , Humans , Jumonji Domain-Containing Histone Demethylases/genetics , Mesenchymal Stem Cells/cytology , Osteogenesis , Osteoporosis
16.
Frontiers of Medicine ; (4): 496-506, 2022.
Article in English | WPRIM | ID: wpr-939875

ABSTRACT

The fracture risk of patients with diabetes is higher than those of patients without diabetes due to hyperglycemia, usage of diabetes drugs, changes in insulin levels, and excretion, and this risk begins as early as adolescence. Many factors including demographic data (such as age, height, weight, and gender), medical history (such as smoking, drinking, and menopause), and examination (such as bone mineral density, blood routine, and urine routine) may be related to bone metabolism in patients with diabetes. However, most of the existing methods are qualitative assessments and do not consider the interactions of the physiological factors of humans. In addition, the fracture risk of patients with diabetes and osteoporosis has not been further studied previously. In this paper, a hybrid model combining XGBoost with deep neural network is used to predict the fracture risk of patients with diabetes and osteoporosis, and investigate the effect of patients' physiological factors on fracture risk. A total of 147 raw input features are considered in our model. The presented model is compared with several benchmarks based on various metrics to prove its effectiveness. Moreover, the top 18 influencing factors of fracture risks of patients with diabetes are determined.


Subject(s)
Bone Density , Deep Learning , Diabetes Mellitus/epidemiology , Female , Fractures, Bone/etiology , Humans , Osteoporosis/complications , Risk Factors
17.
Article in English | WPRIM | ID: wpr-939825

ABSTRACT

Mammalian bone is constantly metabolized from the embryonic stage, and the maintenance of bone health depends on the dynamic balance between bone resorption and bone formation, mediated by osteoclasts and osteoblasts. It is widely recognized that circadian clock genes can regulate bone metabolism. In recent years, the regulation of bone metabolism by non-coding RNAs has become a hotspot of research. MicroRNAs can participate in bone catabolism and anabolism by targeting key factors related to bone metabolism, including circadian clock genes. However, research in this field has been conducted only in recent years and the mechanisms involved are not yet well established. Recent studies have focused on how to target circadian clock genes to treat some diseases, such as autoimmune diseases, but few have focused on the co-regulation of circadian clock genes and microRNAs in bone metabolic diseases. Therefore, in this paper we review the progress of research on the co-regulation of bone metabolism by circadian clock genes and microRNAs, aiming to provide new ideas for the prevention and treatment of bone metabolic diseases such as osteoporosis.


Subject(s)
Animals , Circadian Clocks/genetics , Circadian Rhythm/genetics , Mammals/genetics , MicroRNAs/genetics , Osteogenesis/genetics , Osteoporosis/genetics
18.
Chinese Journal of Epidemiology ; (12): 509-516, 2022.
Article in Chinese | WPRIM | ID: wpr-935419

ABSTRACT

Objective: To understand the prevalence of osteoporosis and related factors in postmenopausal women aged ≥40 years in China and provide scientific evidence for osteoporosis prevention and control. Methods: Data of this study were from the 2018 China Osteoporosis Epidemiological Survey, covering 44 counties (districts) in 11 provinces in China. Related variables were collected by questionnaire survey and physical measurement, and the BMD of lumbar spine and proximal femur was measured by dual-energy X-ray absorption method. The prevalence of osteoporosis and its 95%CI in postmenopausal women aged ≥40 years were estimated with complex sampling weights. Results: A total of 5 728 postmenopausal women aged ≥40 years were included in the analysis and the prevalence of osteoporosis was 32.5% (95%CI: 30.3%-34.7%). The prevalence of osteoporosis in postmenopausal women aged 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years were 16.0% (95%CI:4.5%-27.5%), 18.4% (95%CI:15.9%-20.8%), 37.5% (95%CI:34.5%-40.4%), 52.9% (95%CI: 47.5%-58.3%), and 68.0% (95%CI:55.9%-80.1%) respectively. The prevalence of osteoporosis was higher (P<0.001) in those with education level of primary school or below (47.2%, 95%CI: 43.0%-51.3%) and in those with individual annual income less than 10 000 Yuan, (40.3%, 95%CI: 36.9%-43.7%). The prevalence of osteoporosis was 35.1% in rural areas (95%CI: 32.0%-38.1%), which was higher than that in urban areas (P<0.001). The prevalence of osteoporosis in low weight, normal weight, overweight and obese groups were 69.9% (95%CI: 59.0%-80.8%), 42.2% (95%CI: 38.7%-45.7%), 24.2% (95%CI: 21.3%-27.1%) and 14.6% (95%CI: 11.1%-18.0%), respectively. The prevalence of osteoporosis in those with menstrual maintenance years ≤30 years and in those with menopause years ≥11 years were 46.1% (95%CI:40.8%-51.3%) and 48.2% (95%CI:45.0%-51.3%), respectively. Multivariate logistic analysis showed that age ≥60 years, education level of primary school or below, annual household income per capita less than 10 000 Yuan, low body weight, menstrual maintenance years ≤30 years, menopause years ≥11 years were risk factors of osteoporosis in postmenopausal women in China. Conclusions: The prevalence of osteoporosis was high in postmenopausal women aged ≥40 years in China, and there were differences in osteoporosis prevalence among different socioeconomic groups. Effective interventions should be taken for the prevention and control of osteoporosis in key groups in the future.


Subject(s)
Absorptiometry, Photon , Bone Density , China/epidemiology , Female , Humans , Lumbar Vertebrae , Osteoporosis/epidemiology , Osteoporosis, Postmenopausal/etiology , Postmenopause , Prevalence , Risk Factors
19.
Article in English | WPRIM | ID: wpr-922535

ABSTRACT

OBJECTIVE@#In traditional Chinese medicine, the herbal pair, Radix Achyranthis Bidentatae (RAB) and Eucommiae Cortex (EC), is widely used to treat osteoporosis. Herein, we determined whether this herbal pair can be used to ameliorate glucocorticoid (GC)-induced osteoporosis (GIOP) and find its optimal dosage in zebrafish.@*METHODS@#The characteristics of the aqueous extract of RAB and EC were separately characterized using high-performance liquid chromatography. Osteoporosis was induced in 5-day post-fertilization zebrafish larvae by exposing them to 10 μmol/L dexamethasone (Dex) for 96 h. Seven combinations of different ratios of RAB and EC were co-administered. Treatment efficacy was determined by calculating zebrafish vertebral area and sum brightness, via alizarin red staining, and by detecting alkaline phosphatase (ALP) activity. Multiple regression analysis was conducted to test the optimal dosage ratio.@*RESULTS@#According to the Chinese Pharmacopoeia (2015), β-ecdysone (β-Ecd) is a major bioactive marker in RAB extract, while pinoresinol diglucoside (PDG) is the major marker in EC extract. Both of β-Ecd and PDG content values aligned with the Chinese Pharmacopoeia standards. Treatment with 10 μmol/L Dex reduced zebrafish vertebral area, sum brightness, and ALP activity, but RAB and EC attenuated these effects. Combining 50 µg/mL RAB and 50 µg/mL EC was optimal for preventing GIOP in zebrafish. Reverse transcription-quantitative polymerase chain reaction was used to evaluate the mRNA expression of osteogenesis-related genes. A treatment of 10 μmol/L Dex decreased runt-related transcription factor 2 (Runx2), osteogenic protein-1 (OP-1), bone γ-carboxyglutamic acid-containing protein (BGLAP), and β-catenin levels. This effect was counteracted by RAB and EC co-treatment (P < 0.05). Additionally, the effect of using the two herbal extracts together was better than single-herb treatments separately. These results demonstrated that RAB and EC preserve osteoblast function in the presence of GC. The best mass ratio was 1:1.@*CONCLUSION@#RAB and EC herbal pair could ameliorate GC-induced effects in zebrafish, with 1:1 as the optimal dosage ratio.


Subject(s)
Animals , Glucocorticoids , Medicine, Chinese Traditional , Osteogenesis , Osteoporosis/prevention & control , Zebrafish
20.
Article in Chinese | WPRIM | ID: wpr-928267

ABSTRACT

OBJECTIVE@#To explore the mechanism of proteasome inhibitor MG132 in improving osteoporosis.@*METHODS@#Total of 32 female SD rats, weighing 220 to 250 g and 8 weeks old, were selected. They were randomly divided into 4 groups(n=8). Rats of group A and group B were cut off ovaris on both sides to make model of osteoporosis, and then they were given proteasome inhibitors MG132 and dimethyl sufoxide (DMSO) respectively. Group C was a sham group and rats were given MG132. Group D was a normal group and rats were given MG132 too. The rats were killed in batches at 6 and 12 weeks after administration, and the femoral neck tissues were obtained. Relevant data were analyzed, such as pathomorphological observation, micro-CT analysis, detection of 20S proteasome activity in tissues, and expression of Wnt and β-catenin.@*RESULTS@#Morphological observation showed that the trabecular were slightly thinner, reticulated, and occasionally interrupted in group A, while the trabecular were obviously thinner and discontinuous in group B. And the trabecular were intact and arranged reticulated in group C and D. The analysis results of bone mineral density(BMD), bone surface(BS), bone volume/total volume(BV/TV) and trabecular thickness(Tb.Th) showed that group B was worse than other groups in all parameters at different time points(P<0.05), and group A was worse than group C and group D in BS(P<0.05), there was no significant difference in all parameters between group C and group D. RFU value of 20S proteasome in group B was significantly higher than that in other groups(P<0.05). According to the results of Western blot, the gray values of Wnt protein and β-catenin protein in group A were significantly higher than those in other groups (P<0.05).@*CONCLUSION@#MG-132, a ubiquitin proteasome inhibitor, can regulate Wnt/β-catenin signaling pathway by inhibiting the degradation of β-catenin protein, and delaying the occurrence and development of osteoporosis.


Subject(s)
Animals , Bone Density , Female , Leupeptins , Osteoporosis/drug therapy , Proteasome Inhibitors/pharmacology , Rats , Rats, Sprague-Dawley , Wnt Signaling Pathway , beta Catenin/metabolism
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