DISORDERS OF THE INTESTINAL FLORA AND IT IS EFFECT ON SKELETAL SYSTEM DISEASES.

The intestinal microflora plays an important role in the proper functioning of human. It is complex, diverse and dynamic ecosystem that constantly strives to maintain homeostasis throughout the body. The process of acquiring intestinal microflora begins immediately after human birth. Elementary factors that determine the modification of the composition of the microflora are age, sex, diet, lifestyle. Determinate individual composition of the microflora. Microorganisms inhabiting the intestine perform various functions, from metabolic, immune to trophic. Early changes in the intestinal microflora are reflected in the state of human health. Recently, many studies have been carried out confirming the hypothesis that the bacterial flora of the gastrointestinal tract affects the normal metabolism of bone tissue, and disorders in its composition can lead to the appearance of bumps in the processes of physiological remodeling of bone tissue and contribute to the formation of many inflammations. Microorganisms that rot in the digestive tract regulate bone metabolism through three mechanisms: the impact on the immune system, the hormonal system and the impact on the absorption of minerals. Disorders in the microflora of the digestive tract can lead to the development of inflammatory bowel diseases, and as a consequence to the accelerated development of osteoporosis or arthrosis of the joints. The aim: To collect available publications confirming the impact of microflora on the skeletal system.

TOTAL SHOULDER ARTHROPLASTY, AN OVERVIEW, INDICATINS AND PROSTHETIC OPTIONS.

Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indicationsfor this procedure have recently expanded tremendously. However, the most common are glenohumeral osteoarthritis, inflammatory shoulder arthropathies, rotator cuff-tear arthropathy, complex fractures of the proximal humerus and osteonecrosis of a humeral head. There is range of the procedures, such as resurfacing of humeral head, anatomictotal shoulder arthroplasty, hemiarthroplasty and reverse shoulder arthroplasty. All of them could significantly improve patients quality of life. The outcomes of the shoulder arthroplasty are very satisfying in terms of pain relief and considerable improvements in shoulder function as well as in motion. However, this procedure is not so popular as knee or hip arthroplasties. The reasons for this phenomenon are not clear. The complication rate is considerably low. The most common are periprosthetic fractures, infections, implant loosening and instability. The reasonable solution is a conversion to reverse total shoulder arthroplasty. The survivorship of the prosthesis is up to 12 years, which is acceptable by patients. Long term result are still not clear. Surgeons performing SA opt for deltopectoral approach which provides good exposure of the joint also for revisions. The aim: To summarize knowledge about SA based on current literature.

[Sarcopenia - unnoticed problem of aging society].

In the elderly, there is a reduction of the efficiency in many organs, including muscles. The weight, strength and power reduction of elderly muscles is defined as sarcopenia. The pathophysiology of sarcopenia is multifactorial, it can be influenced by intrinsic and extrinsic factors such as reduced caloric intake, denervation of muscle fibers - in the course of various neurodegenerative diseases, intracellular oxidative stress, hormonal disorders and others. The European Working Group on sarcopenia in the elderly published diagnostic criteria for sarcopenia in 2010, which should increase the recognition of this disease and speed up the treatment process. The best-confirmed methods of treatment of sarcopenia are nutritional hyperalimentation and resistance training. Pharmacological agents, i.e. selective androgen receptor modulators, and myostatin inhibitors are not sufficiently tested to be approved, by the FDA as a treatment regimen of sarcopenia.