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2.
Rev. medica electron ; 43(2): 3192-3201, mar.-abr. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251936

ABSTRACT

RESUMEN En los adultos mayores existen múltiples enfermedades que afectan su calidad de vida y el logro de una longevidad satisfactoria. Una de ellas es la osteoporosis, enfermedad de elevada incidencia a nivel mundial, lo cual también se refleja en Cuba. Siendo una afección que conlleva a un alto grado de discapacidad, constituye un problema en el campo de la salud y de magnitud epidémica, más aún cuando la supervivencia de la humanidad tiende al aumento. Con el objetivo de estructurar los referentes teóricos sobre la osteoporosis, que contribuyan a la capacitación de médicos y estudiantes de Medicina como promotores de salud en prevención primaria de esta enfermedad, se realizó el siguiente artículo científico. Los factores que predisponen la aparición de la enfermedad son diversos, algunos modificables. Se señaló la importancia de su prevención, diagnóstico y tratamiento, así como formas de actuar sobre la misma, para modificar estilos de vida en la comunidad (AU).


ABSTRACT There are many diseases affecting life quality and the achievement of a satisfactory longevity in elder people; osteoporosis, a disease of high incidence around the world that also strikes in Cuba, is found among them. It is an affection leading to a high disability level, being a problem in the health field with an epidemic magnitude, even more when the human kind survival tends to increase. The current scientific article was written with the objective of structuring the theoretical referents on osteoporosis contributing to train Medicine doctors and students as health promoters in the primary prevention of this disease. The factors predisposing the disease's appearance are different, some of them modifiable. It is also stated the importance of its prevention, diagnosis and treatment, and also forms and ways of working on it to modify life styles in the community (AU).


Subject(s)
Humans , Male , Female , Aged , Osteoporosis/epidemiology , Aged/physiology , Osteoporosis/complications , Osteoporosis/diagnosis , Osteoporosis/prevention & control , Osteoporosis/therapy , Quality of Life , Disabled Persons/rehabilitation , Life Style
3.
Braz. J. Pharm. Sci. (Online) ; 57: e18976, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345448

ABSTRACT

Phosphodiesterase-5 inhibitors (PDE-5Is) exert positive effects on bone healing and mineralization by activation the nitric oxide/cyclic guanosine monophosphate/protein kinase-G (NO/cGMP/PKG) signaling pathway. In this study, the effects of zaprinast and avanafil, two PDE-5Is, on the NO signaling pathway, estrogen levels, selected bone formation and destruction marker levels, whole-body bone mineral density (WB-BMD), right femur trabecular bone thickness (RF-TBT) and epiphyseal bone width, angiogenesis in the bone-marrow, and selected oxidative stress parameter levels were investigated in rats with ovariectomy-induced osteoporosis. Twenty four adult rats (8 months old) were equally divided into four groups. The first group was the sham operated group. Groups 2, 3 and 4 included ovariectomized rats. At six months after ovariectomy, the 3rd and 4th groups were administered 10 mg/kg zaprinast and avanafil daily as a single dose for 60 days, respectively. Increases in the activity of the NO/cGMP/PKG signalling-pathway, C-terminal collagen peptide levels, angiogenesis in the bone marrow, RF-TBT, epiphyseal bone width and WB-BMD were observed compared to the ovariectomized positive control group (OVX), while the pyridinoline and deoxypyridinoline levels were decreased in the OVX+zaprinast and OVX+avanafil groups (p<0.05). The malondialdehyde, ubiquinone10/ubiquinol10 and 8-hydroxy-2-deoxyguanosine/106deoxyguanosine levels were also increased in the ovariectomized groups compared to the sham group (p<0.05). Based on these results, the levels of bone atrophy and some markers of oxidative stress were increased due to acute estrogen deficiency induced by ovariectomy, but zaprinast and avanafil administration significantly prevented these changes


Subject(s)
Animals , Male , Female , Rats , Protein Kinases , Bone and Bones , Cyclic Nucleotide Phosphodiesterases, Type 5 , Osteoporosis/complications , Atrophy/prevention & control , Ovariectomy/classification , Bone Density/physiology , Single Dose/classification , Oxidative Stress
4.
Actual. osteol ; 16(2): [95]-[103], mayo.-ago. 2020. ilus, graf, tab
Article in English | LILACS | ID: biblio-1129692

ABSTRACT

Introduction. Diabetes is a chronic disease associated with important comorbidities. Type 2 diabetes (T2DM) is associated with a three times increased risk of hip fracture but reports describing potential associations with vertebral fractures (VF) are contradictory. Our objective was to evaluate the factors involved in the prevalent VF in women with and without T2DM. Materials and methods. A cross-sectional design was used and the relationship between morphometric VF and T2DM in adult women was evaluated. The cases were adult women with morphometric VF and the controls were adult women without VF. Thoracic and spinal radiographs in lateral and antero-posterior projections were obtained. Bone mineral density (BMD) values of the lumbar spine (L-BMD) were measured by DXA. Results. A greater number of women with T2DM were found in the VF group (61% vs 31.5%). Non-T2DM women with VF were significantly older and with lower L-BMD than non-T2DM without VF. We observed a negative correlation between age and L-BMD (r=-0.463) in non-T2DM women, but not in the T2DM with FV group. T2DM was a risk factor for prevalent VF with OR of 3.540 (IC95% 1.750-7.160). Conclusion. Our study showed a higher prevalence of T2DM in the VF group. T2DM women with VF were younger and had higher L-BMD than non-T2DM women, L-BMD did not correlate with age and VF were not distributed according to BMD-L and age. (AU)


Introducción. La diabetes es una enfermedad crónica asociada con comorbilidades importantes. La diabetes tipo 2 (DM2) se asocia con un riesgo tres veces mayor de fractura de cadera pero la asociación con fracturas vertebrales (FV) es contradictoria. Nuestro objetivo fue evaluar los factores involucrados en las FV prevalentes en mujeres adultas con y sin DM2. Materiales y métodos. Se realizó un diseño transversal y se evaluó la relación entre FV morfométrica y DM2 en mujeres adultas. Los casos fueron mujeres adultas con FV morfométricas y los controles fueron mujeres adultas sin FV. Se obtuvieron radiografías torácicas y espinales en proyecciones lateral y anteroposterior. Los valores de densidad mineral ósea (DMO) de la columna lumbar (DMO-L) se midieron por DXA. Resultados. Se observó un mayor número de mujeres con DM2 en el grupo de FV (61% frente a 31.5%). Las mujeres sin DM2 con FV eran significativamente mayores y con una DMO-L más baja que las mujeres sin DM2 sin FV. Observamos una correlación negativa entre la edad y la DMO-L (r= -0.463) en mujeres sin DM2 y FV, pero no en DM2 con FV. La DM2 fue un factor de riesgo para FV prevalente con un OR 3.540 (IC95% 1.750-7.160). Conclusión. Nuestro estudio demostró una mayor prevalencia de DM2 en el grupo de FV. Las mujeres con DM2 y FV eran más jóvenes y tenían mayor DMO-L que las mujeres sin DM2, la DMO-L no correlacionó con la edad y las FV no se distribuyeron de acuerdo a la DMO-L y edad. (AU)


Subject(s)
Humans , Female , Adult , Young Adult , Spinal Fractures/microbiology , Diabetes Mellitus, Type 2/complications , Osteoporosis/complications , Vitamin D/blood , Absorptiometry, Photon , Bone Density , Cross-Sectional Studies , Risk Factors , Spinal Fractures/chemically induced , Spinal Fractures/diagnostic imaging , Age Factors , Thiazolidinediones/therapeutic use , PPAR gamma/therapeutic use , Diabetes Mellitus, Type 2/drug therapy , Rosiglitazone/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Pioglitazone/therapeutic use , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use
5.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 332-338, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1132603

ABSTRACT

Abstract Introduction: Age-related hearing impairment is the most common sensory dysfunction in older adults. In osteoporosis, the mass of the ossicles will be decreased, affecting the bone density of the cochlea, and interfering with the sound transmission to the cochlea. Age related hearing loss might be closely related to osteoporosis. Objective: To determine the relationship between age-related hearing impairment and osteoporosis by investigating the relationship between hearing loss and cortical bone density evaluated from femur neck bone mineral density. Methods: We used data from the Korea National Health and Nutrition Examination Survey to examine the associations between osteoporosis and age-related hearing impairment from 2009 to 2011. Total number of participants was 4861 including 2273 men and 2588 women aged 50 years or older. Osteoporosis was defined as a bone mineral density 2.5 standard deviations below according to the World Health Organization diagnostic classification. Age-related hearing impairment was defined as the pure-tone averages of test frequencies 0.5, 1, 2, and 4 kHz at a threshold of 40 dB or higher on the more impaired hearing side. Results: Total femur T-score (p < 0.001), lumbar-spine T-score (p < 0.001) and, femur neck T-score (p < 0.001) were significantly lower in the osteoporosis group compared to the normal group. Thresholds of pure-tone averages were significantly different in normal compared to osteopenia, and osteoporosis groups. In addition, there were significantly higher pure-tone averages thresholds in the osteoporosis group compared to other groups (p < 0.001). After adjusting for all covariates, the odds ratio for hearing loss was significantly increased by 1.7 fold with reduced femur neck bone mineral density (p < 0.01). However, lumbar spine bone mineral density was not statistically associated with hearing loss (p = 0.22). Conclusion: Our results suggest that osteoporosis is significantly associated with a risk of hearing loss. In addition, femur neck bone mineral density was significantly correlated with hearing loss, but lumbar spine bone mineral density was not.


Resumo Introdução: A perda auditiva associada ao envelhecimento é a disfunção sensorial mais comum em idosos. Na osteoporose, a massa dos ossículos diminui e afeta a densidade óssea da cóclea, o que irá interferir na transmissão do som para a mesma. A perda auditiva associada à idade pode estar intimamente relacionada à osteoporose. Objetivo: Determinar a relação entre deficiência auditiva relacionada à idade e osteoporose, investigar a relação entre perda auditiva e densidade óssea cortical avaliada a partir da densidade mineral óssea do colo do fêmur. Método: Utilizamos dados da Korea National Health and Nutrition Examination Survey para examinar as associações entre osteoporose e perda auditiva associada ao envelhecimento de 2009 a 2011. O número total de participantes foi de 4.861, incluiu 2.273 homens e 2.588 mulheres com 50 anos ou mais. A osteoporose foi definida como densidade mineral óssea com 2,5 desvios-padrão abaixo da média, de acordo com a classificação diagnóstica da Organização Mundial da Saúde. A perda auditiva associada ao envelhecimento foi definida como as médias de tom puro das frequências de teste de 0,5, 1, 2 e 4 kHz a um limiar de 40 dB ou superior no lado da audição mais afetado. Resultados: O T-score total do fêmur (p < 0,001), o T-score da coluna lombar (p < 0,001) e o T-score do colo do fêmur (p < 0,001) foram significantemente menores no grupo com osteoporose em comparação ao grupo normal. Os limiares de médias de tom puro foram significantemente diferentes nos grupos normais em comparação com aqueles com osteopenia e osteoporose. Além disso, houve limiares significantemente maiores de médias de tom puro no grupo com osteoporose em comparação com os outros grupos (p < 0,001). Após o ajuste para todas as covariáveis, a odds ratio da perda auditiva mostrou estar significantemente aumentada em 1,7 vez com densidade mineral óssea reduzida no colo do fêmur (p < 0,01). No entanto, a densidade mineral óssea da coluna L não se associou estatisticamente à perda auditiva (p = 0,22). Conclusão: Nossos resultados sugerem que a osteoporose está significantemente associada ao risco de perda auditiva. Além disso, a densidade mineral óssea da coluna lombar não se correlacionou com a perda auditiva, apenas a densidade mineral óssea do colo do fêmur foi significantemente correlacionada.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Osteoporosis/complications , Presbycusis/complications , Aging/physiology , Bone Density/physiology , Osteoporosis/physiopathology , Presbycusis/physiopathology , Cross-Sectional Studies , Risk Factors , Health Surveys , Republic of Korea
6.
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 83-90, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089374

ABSTRACT

Abstract Introduction Subjective benign paroxysmal positional vertigo is a form of benign paroxysmal positional vertigo in which during the diagnostic positional maneuvers patients only present vertigo symptoms with no nystagmus. Objective To study the characteristics of subjects with subjective benign paroxysmal positional vertigo. Methods Prospective multicenter case-control study. All patients presenting with vertigo in the Dix-Hallpike test that presented to the participating hospitals were included. The patients were separated into two groups depending on whether nystagmus was present or not. An Epley Maneuver of the affected side was performed. In the follow-up visit, patients were checked to see if nystagmus and vertigo were present. Both groups of patients were compared to assess the success rate of the Epley maneuver and also to compare the presence of 19 variables. Results 259 patients were recruited, of which 64 belonged to the subjective group. Nystagmus was eliminated in 67.2% of the patients with benign paroxysmal positional vertigo. 89.1% of the patients with subjective benign paroxysmal positional vertigo remained unaffected by nystagmus, thus showing a significant difference (p = 0.001). Osteoporosis and migraine were the variables which reached the closest to the significance level. In those patients who were taking vestibular suppressors, the percentage of subjective benign paroxysmal positional vertigo was not significantly higher. Conclusions Subjective benign paroxysmal positional vertigo should be treated using the Epley maneuver. More studies are needed to establish a relationship between osteoporosis, migraine and subjective benign paroxysmal positional vertigo. The use of vestibular suppressants does not affect the detection of nystagmus.


Resumo Introdução A vertigem posicional paroxística benigna subjetiva é um tipo de vertigem posicional paroxística benigna na qual, durante as manobras posicionais diagnósticas, os pacientes apresentam apenas sintomas vertiginosos sem nistagmo. Objetivo Estudar as características de indivíduos com vertigem posicional paroxística benigna subjetiva. Método Estudo prospectivo multicêntrico de caso-controle. Foram incluídos todos os pacientes com vertigem no teste de Dix-Hallpike, que se apresentaram nos hospitais participantes. Os pacientes foram separados em dois grupos, dependeu da presença ou não do nistagmo. Uma manobra de Epley foi realizada no lado afetado. Na consulta de seguimento, os pacientes foram avaliados para verificar a presença ou não do nistagmo e da vertigem. Ambos os grupos de pacientes foram comparados para avaliar a taxa de sucesso da manobra de Epley e também para comparar a presença de 19 variáveis. Resultados Foram recrutados 259 pacientes, dos quais 64 pertenciam ao grupo subjetivo. O nistagmo foi eliminado em 67,2% dos pacientes com vertigem posicional paroxística benigna. Em 89,1% dos casos, os pacientes com vertigem posicional paroxística benigna subjetiva mantiveram-se não afetados pelo nistagmo, mostraram uma diferença significativa (p = 0,001). Osteoporose e enxaqueca foram as variáveis que atingiram o nível mais próximo ao de significância. Nos pacientes que tomavam supressores vestibulares, a porcentagem de vertigem posicional paroxística benigna subjetiva não foi significativamente maior. Conclusões A vertigem posicional paroxística benigna subjetiva deve ser tratada com a manobra de Epley. Mais estudos são necessários para estabelecer uma relação entre osteoporose, enxaqueca e vertigem posicional paroxística benigna subjetiva. O uso de supressores vestibulares não afeta a detecção do nistagmo.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Osteoporosis/physiopathology , Benign Paroxysmal Positional Vertigo/physiopathology , Migraine Disorders/physiopathology , Osteoporosis/complications , Posture/physiology , Sulpiride/therapeutic use , Betahistine/therapeutic use , Nystagmus, Physiologic/physiology , Case-Control Studies , Prospective Studies , Physical Therapy Modalities , Benign Paroxysmal Positional Vertigo/complications , Benign Paroxysmal Positional Vertigo/drug therapy , Migraine Disorders/complications
7.
Rev. chil. endocrinol. diabetes ; 12(3): 165-169, jul. 2019. graf
Article in Spanish | LILACS | ID: biblio-1006502

ABSTRACT

Existe escasa información respecto al estudio y manejo de la osteoporosis en los pacientes que han sufrido fractura por fragilidad en Chile. Objetivo: Describir la epidemiologia, aproximación diagnóstica y manejo realizado a pacientes hospitalizados por fractura por fragilidad (muñeca, cadera, columna) que ingresaron al Servicio de Traumatología (ST) del Hospital de Antofagasta (HRA). Método: Estudio retrospectivo, se revisó registros de pacientes hospitalizados en ST y se identificó a pacientes que presentaron fractura por fragilidad. Se revisó sus fichas clínicas (período enero 2015-diciembre 2016). Se analizaron factores de riesgos, exámenes realizados, terapias y controles médicos al alta. Resultados: Fueron 971 ingresos y 100 pacientes con fractura por fragilidad. 88% fueron mujeres cuya edad promedio fue 73,1 años. El factor de riesgo más común fue la postmenopausia y antecedente de fractura previa. Las fracturas se distribuyeron en cadera 64%, muñeca 35% y columna 1%. A solo 3 pacientes se le pidió densitometría ósea. En ninguno fue evaluada vitamina D ni PTH. Al 7% se indicó calcio y vitamina D post fractura, a 4% se indicó antiresortivos. En ningún paciente se promovió el consumo de lácteos. Discusión: Las fracturas osteoporóticas en el HRA son inadecuadamente estudiadas para descarte de factores modificables y son farmacológicamente subtratadas, con el riesgo de nueva aparición de fracturas por fragilidad y morbimortalidad asociada. Es importante reforzar en los servicios de traumatología la importancia del manejo médico postfracturas y eventualmente incorporar la participación de otros especialistas en el manejo de estos pacientes durante la hospitalización y al alta.


We have poor information regarding study and management of osteoporosis in patient who have a fragility fracture in Chile. Objetive: Describe epidemiology, diagnostic approach and management performed on patients hospitalized for fragility fracture in Traumatology Service(ST) of the Antofagasta Hospital(HRA). Method: Retrospective study, we reviewed your clinical record (period January 2015-December 2016). Risk factor, laboratory test performed, therapies and medical controls at discharge were analyzed. Resuls: 971 patient admited to ST, 100 were fragility fracture. 88% were women with average age 73,1 years old. The mosts commons risk factors were chronic kidney failure and anticonvulsants treatment. The fractures were 64% of hip, 35% wrist, and 1% column. Only 3 patients have bone densitometry. None had vitamin D or PTH evaluated. Calcium and vitamin D after fracture were indicated at 7%, antiresorptives were indicated at 4%. In none diary consumption were promoted. Discussion: Osteoporotic fractures in HRA are inadequately studied to rule out modifiable factors and they are pharmacologically subtracted, with risk of new fractures an mobility and mortality. Is important remember in the ST importance of the medical management postfracture and the multidisciplinary work.


Subject(s)
Humans , Male , Female , Aged , Frail Elderly , Osteoporotic Fractures/therapy , Osteoporotic Fractures/epidemiology , Osteoporosis/complications , Trauma Centers , Chile/epidemiology , Retrospective Studies , Risk Factors , Osteoporotic Fractures/diagnosis , Hospitalization
8.
Rev. Assoc. Med. Bras. (1992) ; 65(6): 779-785, June 2019. graf
Article in English | LILACS | ID: biblio-1012995

ABSTRACT

SUMMARY OBJECTIVE: To investigate the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar spinal stenosis (LSS) combined with osteoporosis. METHODS: Eighty patients with LSS combined with osteoporosis were divided into a control and PTED group, which received conventional transforaminal lumbar interbody fusion and PTED, respectively. The surgical indications, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores, bone mineral density (BMD), and adverse reactions were observed. RESULTS: Compared with the control group, in the PTED group, the operation time, bleeding loss and hospitalization duration, incision VAS scores at postoperative 12, 24 and 48 h and lumbar and leg pain VAS and lumbar ODI scores on postoperative 6 months were significantly decreased (P < 0.01), and the lumbar JOA score on postoperative 6 months was significantly increased (P < 0.05). There was no significant difference in BMD between two groups (P > 0.05). Compared with the control group, in the PTED group, the total effective rate was significantly higher (P < 0.05), and the incidence of adverse reactions was significantly lower (P < 0.05). CONCLUSIONS: PTED is safe and effective in the treatment of LSS combined with osteoporosis.


RESUMO: OBJETIVO: Investigar a eficácia e segurança da discectomia endoscópica percutânea transforaminal (DEPT) no tratamento da estenose lombar (EL) combinada à osteoporose. MÉTODOS: Oitenta pacientes com EL combinada à osteoporose foram divididos entre um grupo de controle e um grupo de DEPT, que receberam tratamento convencional com fusão intersomática lombar transforaminal e DEPT, respectivamente. As indicações cirúrgicas, a escala analógica visual (VAS) da incisão e de dor lombar e nas pernas, os escores lombares de acordo com a Associação Ortopédica Japonesa (JOA) e o Oswestry Disability Index (ODI), a densidade mineral óssea (DMO) e possíveis reações adversas foram observados. RESULTADOS: Em comparação com o grupo de controle, no grupo de DEPT o tempo de operação, a perda de sangue e duração de internação, os escores VAS da incisão no pós-operatório após 12, 24 e 48 h, o VAS para dor lombar e nas pernas e os escores ODI lombares após 6 meses de pós-operatório foram significativamente menores (P < 0,01); já o escore JOA lombar após 6 meses de pós-operatório foi significativamente maior (P < 0,05). Não houve diferença significativa na densidade mineral óssea entre os dois grupos (P > 0,05). Em comparação com o grupo de controle, o grupo de DEPT teve uma taxa efetiva total significativamente maior (P < 0,05), e a incidência de reações adversas foi significativamente menor (P < 0,05). CONCLUSÕES: A discectomia endoscópica percutânea transforaminal é segura e eficaz no tratamento de EL combinada à osteoporose.


Subject(s)
Humans , Aged , Aged, 80 and over , Osteoporosis/surgery , Spinal Stenosis/surgery , Diskectomy, Percutaneous/methods , Lumbar Vertebrae/surgery , Osteoporosis/complications , Postoperative Care , Spinal Stenosis/complications , Time Factors , Bone Density , Reproducibility of Results , Treatment Outcome , Diskectomy, Percutaneous/standards , Disability Evaluation , Visual Analog Scale , Middle Aged
9.
Rev. med. Rosario ; 85(1): 27-33, ene.-abr. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1052937

ABSTRACT

La vertebroplastia percutánea es una técnica aplicable a pacientes con fractura vertebral con síndrome doloroso importante y que no mejora con un manejo ortopédico y clínico integral. Se incluye una apretada historia del procedimiento, y se revisan sus indicaciones y contraindicaciones, así como las publicaciones que analizan sus ventajas y riesgos (AU)


Percutaneous vertebroplasty is a technique for the treatment of patients with vertebral fracture who have persistent pain even after orthopedic and clinical therapeutic measures. A brief historical note of the procedure is presented, and its indications and contraindications are outlined, along with a literature overview of its advantages and risks (AU)


Subject(s)
Female , Aged , Spinal Fractures/therapy , Vertebroplasty/history , Vertebroplasty/methods , Osteogenesis Imperfecta/complications , Osteoporosis/complications , Vertebroplasty/adverse effects
10.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(1): 33-40, mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1004381

ABSTRACT

RESUMEN Introducción: La osteoporosis afecta a 200 millones de personas en el mundo y corresponde a una enfermedad crónica que afecta más a mujeres que a hombres, con una prevalencia en Chile del 1,7% y 0,2%, respectivamente. Debido al gran porcentaje de pacientes que la padecen, se han llevado a cabo diversos estudios sobre los síntomas secundarios que pueden encontrarse en esta patología. En el último tiempo, se ha investigado la osteoporosis como un factor de riesgo para padecer pérdida auditiva. Objetivo: Comparar los resultados de umbrales auditivos aéreos, timpanometria y reflejos acústicos ipsilaterales entre pacientes con osteoporosis y pacientes sin osteoporosis, menores de 65 años sin otra patología de base. Material y método: Estudio preliminar de tipo observacional de caso y controles con alcance exploratorio. Se analizaron 28 oídos de una muestra conformada por un grupo estudio de 7 participantes con osteoporosis y un grupo control de 7 participantes sin osteoporosis. Se evaluó el sistema tímpano osicular con la timpanometria y el umbral del reflejo acústico estapedial ipsilateral, y el nivel auditivo por frecuencia con la audiometria tonal. Resultados: Se observaron diferencias estadísticamente significativas entre ambos grupos en los umbrales auditivos, con predominancia sensorioneural en el grupo estudio, y en los umbrales del reflejo acústico ipsilateral. Conclusión: La osteoporosis podría ser un factor de riesgo para padecer pérdida auditiva del tipo sensorioneural. Es necesario continuar el estudio para obtener resultados con mayor representatividad.


ABSTRACT Introduction: Osteoporosis affects over 200 million people in the world and corresponds to a chronic disease that affects more women than men, with a prevalence in Chile of 1.7% and 0.2% respectively. Due to the large percentage of patients who suffer it, several studies about the secondary symptoms that can be found in this pathology have been carried out. In the last time, osteoporosis has been investigated as a risk factor for hearing loss. Aim: To compare the results of air auditory thresholds, tympanometry, and ipsilateral acoustic reflexes in patients with osteoporosis versus patients without osteoporosis, under 65 years old without another underlying disease. Material and method: Preliminary study of observational type of case and controls with exploratory scope. We analyzed 28 ears of a sample consisted of a group study of 7 participants with osteoporosis and a control group of 7 participants without osteoporosis. The tympanic oscillating system and auditory level of each participant were evaluated with tympanometry, ipsilateral stapedial acoustic reflex threshold and tonal audiometry. Results: Statistically significant differences were observed between both groups in the auditory thresholds with a sensorineural predominance and in the ipsilateral stapedial acoustic reflex thresholds. Conclusions: The osteoporosis could be a risk factor for suffer hearing loss of sensorineural type. It is necessary to continue the study to obtain results with greater representativeness.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Osteoporosis/complications , Auditory Threshold , Audiometry, Pure-Tone , Chile , Risk Factors
11.
Arch. endocrinol. metab. (Online) ; 62(6): 615-622, Dec. 2018. tab
Article in English | LILACS | ID: biblio-983802

ABSTRACT

ABSTRACT Objective: The objective was to evaluate the association between sarcopenia (EWGSOP) and osteoporosis in older adults. Subjects and methods: This is a cross sectional analysis of a baseline evaluation of the SARCopenia and OSteoporosis in Older Adults with Cardiovascular Diseases Study (SARCOS). Three hundred and thirty-two subjects over 65 years of age were evaluated. Sarcopenia was determined by EWGSOP flowchart and Osteoporosis was established by WHO's criteria. Physical function, comorbidities and medications were evaluated. Results: Women were older (79.8 ± 7.2 years) than men (78.21 ± 6.7 years) (p = 0.042). Osteoporosis occurred in 24.8% of men, and in 42.7% of women (p < 0.001); sarcopenia occurred in 25.5% of men and in 17.7%, of women (p = 0.103). Osteoporosis was diagnosed in 68% of sarcopenic women, however only 20.7% (p = 0.009) of women with osteoporosis had sarcopenia; in older men, 44.7% of individuals with sarcopenia presented osteoporosis and 42.9% (p = 0.013) of men with osteoporosis showed sarcopenia. In an adjusted logistic regression analyses for sarcopenia, osteoporosis presented a statistically significant association with sarcopenia in men [OR: 2.930 (95% CI: 1.044-8.237; p = 0.041)] but not in women [OR: 2.081 (0.787-5.5; p = 0.142)]; in the adjusted logistic regression analyses for osteoporosis, a statistically significant association occurred in men [OR: 2.984 (95% CI: 1.144-7.809; p = 0.025)], but not in women [OR: 2.093 (0.962-3.714; p = 0.137)]. Conclusion: According to sex, there are significant differences in the association between sarcopenia EWGSOP and osteoporosis in outpatient older adults. It is strong and significant in males; in females, despite showing a positive trend, it was not statistically significant.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Osteoporosis/complications , Sarcopenia/complications , Osteoporosis/epidemiology , Outpatients/statistics & numerical data , Body Composition , Brazil/epidemiology , Cardiovascular Diseases/epidemiology , Bone Density , Logistic Models , Sex Factors , Prevalence , Cross-Sectional Studies , Prospective Studies , Risk Factors , Analysis of Variance , Age Factors , Sex Distribution , Hand Strength , Disability Evaluation , Sarcopenia/epidemiology
12.
Rev. Assoc. Med. Bras. (1992) ; 64(5): 420-427, May 2018. tab
Article in English | LILACS | ID: biblio-956467

ABSTRACT

SUMMARY BACKGROUND Hip fractures may be the greatest complication secondary to osteoporotic disorder. The objective of this study was to determine the influence of age distribution in the functionality, comorbidity, complications and surgical features of older adults with hip fractures. METHODS A prospective cohort study was carried out from 2013 to 2014. A sample of 557 adults over 75 years old with osteoporotic hip fractures was recruited from the Orthogeriatric Unit of the León University Hospital (Spain). Age distributions of 75-84, 85-90 and >90 years old were considered. Firstly, sociodemographic data, fracture type and hospital staying days were collected. Secondly, baseline functionality (Barthel index), ambulation, cognitive impairment and comorbidities were described. Thirdly, surgical intervention, urgency, type, American Association of Anesthesiologists (ASA) scores, non-surgical cause, and baseline pharmacologic treatments were determined. Finally, complications and features at hospital discharge were observed. RESULTS The age ranges did not show any statistically-significant differences (P<.05; R2=.000-.005) for gender, fracture type, or number of hospital staying days. Statistically-significant differences (P<.05; R2=.011-.247) between age groups were observed for Barthel index, cognitive impairment, dementia, osteoporosis, Parkinson's disease, aortic stenosis, surgery type, ASA-score, non-surgical cause, benzodiazepines, antidementia, anti-osteoporosis, insulin, pharmacologic treatments, renal function alteration, heart failure, destination and ambulation features. All other measurements did not show statistically-significant differences (P>.05; R2=.000-.010). CONCLUSION Age distributions greater than 75 years old may determine the functionality, comorbidities, surgical features, baseline pharmacologic treatments, complications and features at hospital discharge for older adults who suffer a hip fracture.


RESUMO CONTEXTO As fraturas do quadril podem ser a maior complicação secundária à doença osteoporótica. O objetivo deste estudo foi determinar a influência da distribuição etária na funcionalidade, comorbidade, complicações e características cirúrgicas de idosos com fratura de quadril. MÉTODOS Um estudo prospectivo de coorte foi realizado de 2013-2014. Uma amostra de 557 adultos mais velhos, com mais de 75 anos, com fratura de quadril osteoporótica foi recrutada na Unidade Ortogeriátrica do Hospital Universitário de León (Espanha). As distribuições de idade de 75-84, 85-90 e >90 anos foram consideradas. Em primeiro lugar, foram coletados dados sociodemográficos, tipo de fratura e dias de permanência hospitalar. Em segundo lugar, foram descritas funcionalidades de base (índice Barthel), ambulação, comprometimento cognitivo e comorbidades. Em terceiro lugar, determinaram-se a intervenção cirúrgica, a urgência, o tipo, os resultados da Associação Americana de Anestesiologistas (ASA), a causa não cirúrgica e os tratamentos farmacológicos iniciais. Finalmente, foram observadas complicações e características na alta hospitalar. RESULTADOS As faixas etárias não mostraram diferenças estatisticamente significativas (P <,05; R2 = ,000-,005) para sexo, tipo de fratura ou dias de permanência hospitalar. Foram apresentadas diferenças estatisticamente significativas (P <,05; R2 = ,011-,247) para o índice de Barthel, comprometimento cognitivo, demência, osteoporose, doença de Parkinson, estenose aórtica, tipo de cirurgia, pontuação ASA, causa não cirúrgica, benzodiazepínicos, antidementia, antiosteoporose, insulina, tratamentos farmacológicos, alteração da função renal, insuficiência cardíaca, destino e características de ambulação entre grupos etários. O restante das medidas não apresentou diferença estatisticamente significativa (P> 0,05; R2 = ,000-,010). CONCLUSÃO As distribuições de idade após 75 anos podem determinar a funcionalidade, comorbidades, características cirúrgicas, tratamentos farmacológicos de base, complicações e características na alta hospitalar de adultos mais velhos que sofrem fratura de quadril.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Age Factors , Osteoporotic Fractures/surgery , Osteoporotic Fractures/complications , Osteoporotic Fractures/physiopathology , Osteoporotic Fractures/epidemiology , Hip Fractures/surgery , Hip Fractures/complications , Hip Fractures/physiopathology , Hip Fractures/epidemiology , Osteoporosis/complications , Spain/epidemiology , Comorbidity , Prospective Studies , Risk Factors , Age Distribution
13.
Braz. j. infect. dis ; 21(6): 581-586, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-888924

ABSTRACT

ABSTRACT Introduction: Osteoporosis represents one of the most frequent comorbidity among HIV patients. The current standard method for osteoporosis diagnosis is dual-energy X-ray absorptiometry. Calcaneal quantitative ultrasound can provide information about bone quality. The aims of this study are to compare these two methods and to evaluate their ability to screen for vertebral fracture. Methods: This cross-sectional study was conducted in HIV patients attending the Clinic of Infectious and Tropical Diseases of Brescia during 2014 and who underwent lumbar/femoral dual-energy X-ray absorptiometry, vertebral fracture assessment and calcaneal quantitative ultrasound. The assessment of osteoporosis diagnostic accuracy was performed for calcaneal quantitative ultrasound and for vertebral fracture comparing them with dual-energy X-ray absorptiometry. Results: We enrolled 73 patients and almost 48% of them had osteoporosis with at least one of the method used. Vertebral fracture were present in 27.4%. Among patients with normal bone measurements, we found vertebral fracture in proportion between 10% and 30%. If we used calcaneal quantitative ultrasound method and/or X-ray as screening, the percentages of possible savable dual-energy X-ray absorptiometry ranged from 12% to 89% and misclassification rates ranged from 0 to 24.6%. A combined strategy, calcaneal quantitative ultrasound and X-Ray, identified 67% of patients with low risk of osteoporosis, but 16.4% of patients were misclassified. Conclusions: We observed that patients with osteoporosis determined by calcaneal quantitative ultrasound and/or dual-energy X-ray absorptiometry have higher probability to undergo vertebral fracture, but neither of them can be used for predicting vertebral fracture. Use of calcaneal quantitative ultrasound for screening is a reasonable alternative of dual-energy X-ray absorptiometry since our study confirm that none strategy is clearly superior, but both screen tools must be always completed with X-ray.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Osteoporosis/diagnostic imaging , Calcaneus/diagnostic imaging , Absorptiometry, Photon , HIV Infections/complications , Ultrasonography , Osteoporosis/complications , Bone Density , Cross-Sectional Studies , Predictive Value of Tests , Cohort Studies , Sensitivity and Specificity
14.
Braz. j. otorhinolaryngol. (Impr.) ; 83(6): 646-652, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-889322

ABSTRACT

Abstract Introduction: There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. Objective: We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. Methods: This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than −2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. Results: A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p = 0.04, I 2 = 82%, Pheterogeneity = 0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p = 0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p = 0.02). Conclusion: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.


Abstract Introduction: There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. Objective: We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. Methods: This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than −2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. Results: A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p = 0.04, I 2 = 82%, Pheterogeneity = 0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p = 0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p = 0.02). Conclusion: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.


Subject(s)
Humans , Male , Female , Osteoporosis/complications , Hearing Loss, Mixed Conductive-Sensorineural/etiology , Hearing Loss, Conductive/etiology , Hearing Loss, Sensorineural/etiology , Osteoporosis/etiology , Bone Density/physiology , Sex Factors , Risk Factors , Age Factors , Hearing Loss, Mixed Conductive-Sensorineural/ethnology , Hearing Loss, Conductive/ethnology , Hearing Loss, Sensorineural/ethnology
15.
Acta cir. bras ; 32(9): 767-780, Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-886243

ABSTRACT

Abstract Purpose: To assess the efficacy of allogeneic mesenchymal stem cells and xenogenic platelet rich plasma in the treatment of bone failure of osteoporotic rabbits secondary to estrogenic deprivation and iatrogenic hypercortisolism. Methods: Eight female rabbits underwent ovarian resection and corticoid therapy to induce clinical status of osteoporosis. Four failures were produced in the tibiae, with each failure being treated with hemostatic sponge, allogenic mesenchymal stem cells, xenogenic platelet-rich plasma and the association between both. The animals were divided into two groups, evaluated radiographically and histopathologically at 30 and 60 days post treatment. Results: A radiographically confirmed consolidation of bone failures treated with allogeneic mesenchymal stem cells, associated with the histopathological image of mature and immature bone tissue, without evidence of osteopenia, was compared with the other groups, in which radiolucent failures with osteopenia and fibrosis were still present, denoting the satisfactory effect of the first treatment in detriment to the others. Conclusion: The treatment of bone failures of rabbits with secondary osteoporosis with allogeneic mesenchymal stem cells induced greater bone consolidation with mature and immature bone tissue production (p<0.01), when compared to the other treatments.


Subject(s)
Animals , Female , Rats , Osteoporosis/complications , Tibia/pathology , Bone Regeneration/physiology , Mesenchymal Stem Cell Transplantation , Platelet-Rich Plasma , Tibia/injuries , Time Factors , Transplantation, Heterologous
17.
Rev. chil. endocrinol. diabetes ; 10(3): 85-89, jul. 2017. tab
Article in Spanish | LILACS | ID: biblio-998957

ABSTRACT

It has been shown that there is an association between air pollution and cardiovascular mortality. In bone pathology, studies show that air pollution is associated with a risk of developing osteoporosis and osteoporotic fracture associated with MP2.5 and nitrogen dioxide (NO2 ). The aim of our study was to determine whether or not there is an association between air pollution and osteoporotic disease, associating the incidence of femoral neck fracture in individuals aged 50 years or more and the contamination present in the several cities. Our results showed no statistically significant association between air pollution, evaluated using PM10 and PM2.5 as indicators, and the average annual incidence of osteoporotic hip fracture, comparing the most polluted cities and the less polluted cities of Chile


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Osteoporosis/epidemiology , Environmental Pollution/adverse effects , Femoral Neck Fractures/epidemiology , Osteoporosis/complications , Chile/epidemiology , Incidence , Retrospective Studies , Age and Sex Distribution , Particulate Matter/adverse effects , Femoral Neck Fractures/etiology
18.
Clinics ; 72(5): 289-293, May 2017. tab
Article in English | LILACS | ID: biblio-840079

ABSTRACT

OBJECTIVE: We aimed to analyze the applicability of a fracture risk assessment tool for the prediction of osteoporotic fractures in middle-aged and elderly healthy Chinese adults. METHODS: A standard questionnaire was administered, and bone mineral density was measured in residents visiting the Dongliu Street Community Health Service Center. Paired t-tests were used to compare the FRAX-based probabilities of fractures estimated with and without consideration of bone mineral density. Risk stratification and partial correlation analyses were applied to analyze the associations between FRAX-based probabilities and body mass index or bone mineral density at different sites. RESULTS: A total of 444 subjects were included in this study. Of these subjects, 175 (39.59%) were diagnosed as osteoporotic, and 208 (47.06%) were diagnosed as osteopenic. The Kappa value for the detection of osteoporosis at the L1-L4 lumbar spine and femoral neck was 0.314. The FRAX-based 10-year major osteoporotic fracture probability and hip osteoporotic fracture probability estimated without considering bone mineral density were 4.93% and 1.64%, respectively; when estimated while considering bone mineral density, these probabilities were 4.97% and 1.54%, respectively. A significant positive association was observed between the FRAX-based fracture probabilities estimated with and without consideration of bone mineral density, while significant negative associations between body mass index and the estimated FRAX-based fracture probabilities after adjustment for age and the estimated FRAX-based fracture probabilities and femoral neck bone mineral density were identified. These results remained the same after controlling for lumbar spine bone mineral density. CONCLUSIONS: The Chinese FRAX model could predict osteoporotic fracture risk regardless of whether bone mineral density was considered and was especially appropriate for predicting osteoporotic fractures of the femoral neck.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Osteoporosis/complications , Osteoporosis/physiopathology , Osteoporotic Fractures/etiology , Osteoporotic Fractures/physiopathology , Risk Assessment/methods , Absorptiometry, Photon/methods , Age Factors , Analysis of Variance , Body Mass Index , Bone Density/physiology , China , Femoral Neck Fractures/etiology , Femoral Neck Fractures/physiopathology , Predictive Value of Tests , Reference Values , Reproducibility of Results , Risk Factors , Sex Factors , Urban Population
20.
Motriz (Online) ; 23(3): e101749, 2017. tab
Article in English | LILACS | ID: biblio-894998

ABSTRACT

Aims: To analyze factors associated with osteoporosis among outpatients of the Brazilian National Health System and to identify their association with hospital and labor economic outcomes. Methods: Cross-sectional study carried out in the city of Presidente Prudente / SP. The sample consisted of 542 adults of both sexes and aged ≥ 50 years old. The occurrence of osteoporosis, health-related productivity loss, use of hospital services and level of physical activity were assessed using questionnaires. Statistical analysis was composed of chi-square test, binary logistic regression and Mann-Whitney test. The significance level adopted was p-value <0.05. Results: The prevalence of osteoporosis was 14.4% (95% CI: 11.4% - 17.3%) and it was associated with female sex (p = 0.001), lower economic status (p-value = 0.036) and obesity (p-value = 0.003). Participants with osteoporosis showed a higher incidence of surgery in the last 12 months (OR = 2.13 [1.04 to 4.35]), productivity loss (OR = 1.91 [1.13 to 3.42]) and disability retirement (OR = 2.03 [1.20 to 3.43]). Over the past 12 months, the sum of direct and indirect economic loss was R$ 1,382,630.00. Conclusion: The female sex, lower economic status and obesity were associated with a higher occurrence of osteoporosis, and consequent higher use of hospital services and significant economic losses.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Osteoporosis/complications , Unified Health System , Hospital Services , Occupational Health , Health Care Costs , Efficiency
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