ABSTRACT
BACKGROUND: Bariatric surgery (BS) can lead to bone loss and an increased fracture risk. METHODS: To determine the morphometric vertebral fracture (MVF) prevalence, and its relationship with bone mineral density (BMD), and biomarker's turnover after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), we analyzed post-surgery X-rays of the spine in 80 patients (88% female, 51% RYGB, age 41.2 [6.8] years) from 117 participants' retrospective cohort (1-2 years, >2 and <5 years, and >5 years). We still analyzed body composition and BMD by dual-energy X-ray absorptiometry and bone parameters. RESULTS: MVF prevalence was 17.5% (14/80), with no statistical difference between groups (p = 0.210). RYGB group had a higher prevalence of secondary hyperparathyroidism (SHPT) (PTH ≥ 65 pg/ml; 18.4% vs 7.8%, respectively, p = 0.04), PTH (61.3 vs 49.5 pg/ml, p = 0.001), CTX (0.766 [0.29] ng/ml vs 0.453 [0.30] ng/ml, p = 0.037), and AP (101.3 [62.4] U/L vs 123.9 [60.9] U/L, p = 0.027) than the SG group. Up to 5 years postoperatively, RYGB had a lower total (1.200 [0.087] vs 1.236 [0.100] g/cm2, p = 0.02), femoral neck (1.034 [0.110] vs 1.267 [0.105], p = 0.005), and total femur BMD (1.256 [0.155] vs 1.323 [0.167], p = 0.002) than SG group. We found no statistically significant difference between the MFV (+) and MVF (-) groups regarding age, sex, BMI, surgery time, BMD, or bone and metabolic parameters, including leptin. CONCLUSION: We found a high prevalence of MVF after BS with no differences between RYGB and SG.
Subject(s)
Bariatric Surgery , Gastric Bypass , Obesity, Morbid , Spinal Fractures , Humans , Female , Adult , Male , Bone Density , Spinal Fractures/diagnostic imaging , Spinal Fractures/epidemiology , Spinal Fractures/surgery , Retrospective Studies , Obesity, Morbid/surgery , Prevalence , Gastric Bypass/adverse effects , GastrectomyABSTRACT
Este trabalho apresenta um caso clínico sobre tratamento periodontal em pacientes hemofílicos. Os autores descrevem um caso clínico de um paciente jovem portador de deficiência do fator VIII da coagulação que após controlada, com a inoculação do fatore VIII, pelo hematologista, foi submetido a uma gengivectomia na maxila. O caso evoluiu favoravelmente devido ao controle sistêmico através da reposição do fator VIII. Ficou demonstrado, através deste caso e do que recomenda a literatura, que qualquer paciente portador de deficiência de coagulação pode ser submetido a tratamento periodontal desde que esteja controlado
This report presents a case report about periodontal treatment in haemophilia patient. The author describes the treatment of a young patient with factor VIII disorder that was controlled by the hematologist using the intra-venous factor VIII before a gengivectomy technique. The patient had a satisfactory recovery after the surgery. It is shown, by this case report and the literature, that any patient with congenital coagulation disorders can be submitted to oral surgery if the disorder is controlled
