Atypical femoral fracture, case report and literature review / Fractura atípica del fémur, reporte de caso y revisión de la literatura

Abstract: Introduction: Bisphosphonates have been the gold standard in the management of osteoporosis. Its antiresorptive effect has reduced the incidence of fractures due to bone fragility, as well as its impact on public health. We present the clinical case of a patient in prolonged treatment with bisphosphonates and atypical bilateral femur fracture. Case report: A 65-year-old female who presented a fall from her own height, on treatment with risedronate for seven years, and a history of systemic arterial hypertension and hypercholesterolemia, both with medical treatment. Diagnosed with bilateral atypical femoral fracture, treated with closed reduction internal fixation (CRIF) with intramedullary nailing, application of calcium citrate and teriparatide. Discussion: Multiple studies indicate that the benefit of using bisphosphonates for osteoporosis is higher than the risk of presenting atypical fractures.

Resumen: Introducción: Los bifosfonatos han sido de gran utilidad en el manejo de la osteoporosis. Su efecto antirresortivo ha disminuido la incidencia de fracturas por fragilidad ósea, así como, su impacto en salud pública. Presentamos el caso clínico de una usuaria en tratamiento prolongado con bifosfonatos y fractura atípica de fémur bilateral. Caso clínico: Femenino de 65 años, presenta caía de su plano de sustentación, en tratamiento con risedronato desde hace siete años y antecedente de hipertensión arterial sistémica e hipercolesterolemia, ambas con manejo médico. Diagnosticada con fractura bilateral de fémur, tratada con enclavado centro-medular, citrato de calcio y teriparatida. Discusión: Múltiples estudios refieren que el beneficio del uso de bifosfonatos en la prevención del riesgo de fracturas es mayor, aunque exista la posibilidad de presentar fracturas atípicas.

Toxicity of ethanolic extracts from Lippia origanoides and Gliricidia sepium to Tetranychus cinnabarinus (Boisduval) (Acari: Tetranychidae)

Botanical compounds with insecticidal and acaricidal activities have been used in pest management with different levels of success. Toxicity of ethanolic extracts obtained from wild oregano (Lippia origanoides) and gliricidia (Gliricidia sepium) to Tetranychus cinnabarinus (Boisduval) were evaluated. Mite population was collected from black bean plants growing in Urachiche Municipality, Yaracuy State, Venezuela. Ethanolic extracts of wild oregano and gliricidia leaves were evaluated at different concentrations (5, 10, 15, and 20 percent) using the leaf disk immersion technique. The presence of alkaloids, flavonoids, phenols and tannins, essential oils and saponins was verified in the plant material used in our study. Tetranychus cinnabarinus oviposition decreased at a rate of 43.7 percent or 57 percent when 5 percent oregano or gliricidia extracts were used, respectively. Also, 10 percent oregano or gliricidia extracts caused 42.2 percent or 72.5 percent of mortality to T. cinnabarinus, respectively. Ethanolic extracts showed acaricidal effects on T. cinnabarinus, as evidenced by maximum mortality (96.6 percent and 100 percent caused by wild oregano and gliricidia, respectively) when used at a concentration of 20 percent. Our results showed that gliricidia and wild oregano are promising for the management of T. cinnabarinus, although their field efficacy remains to be evaluated.