RESUMEN
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic. It has been proved that LMWH has good efficacy and safety in the prevention of VTE after hip and knee arthroplasty and is a priority anticoagulant. Rivaroxaban can effectively control the occurrence of DVT and the drug is convenient, but it will increase the risk of bleeding and should be used carefully.
Asunto(s)
Artroplastia de Reemplazo de Rodilla/efectos adversos , Aspirina/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Rivaroxabán/uso terapéutico , Trombosis de la Vena/etiología , Anciano , Anticoagulantes/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trombosis de la Vena/prevención & controlRESUMEN
This study aims to investigate the effects of individuals' exposure to rare earth elements (REEs) on bone metabolism. Adopting the inductively coupled plasma mass spectrometry, we measured REEs and eight other elements (Ca, Fe, Cu, Na, K, Zn, Mg, and P) in the hair of 53 miners exposed to REEs from Baiyunebo and 57 healthy farmers as the control group. Furthermore, bone mineral density (BMD) in both groups was assessed by dual-energy X-ray absorptiometry. Analysis of variance showed that the concentrations of La, Ce, Pr, Nd, Tb, Ho, Tm, and Yb in male hair of exposed group were significantly higher compared with the control group, whereas the concentrations of Ca and Fe in exposed group were significantly lower; the results of female hair, except for Ce, Tb, Ho, Tm, and Yb, were consistent with male hair. Student's t test showed that the BMD of exposed males at lumbar vertebrae, femoral neck, greater trochanter, and intertrochanter was significantly lower than that of controls, and exposed females reported lower BMD values at lumbar vertebrae and femoral neck. Multiple linear regression analysis showed that concentrations of differential REEs were inversely related to BMD in males, and concentrations of Ca and Fe were positively related to BMD both in males and females. Our study suggests that long-term environmental and occupational exposure leads to REE accumulation, and a low level of iron and calcium due to the competitive binding of REEs, which together induce bone metabolism disorders, and further reduce BMD.
Asunto(s)
Densidad Ósea , Metales de Tierras Raras , China , Femenino , Cabello/química , Humanos , Masculino , MineríaRESUMEN
To explore the toxic effects of rare earth elements (REEs) accumulated in human body, adopting the inductively coupled plasma mass spectrometry (ICP-MS) method, the present study measured REEs and the contents of eight other elements (Ca, Fe, Cu, Na, K, Zn, Mg, and P) in the hair of eight persons exposed to soil containing REEs for a long time as well as in the control group. In addition, proteomic analysis of serum of the two groups was conducted by isobaric tags for relative and absolute quantitation (iTRAQ) technique. Experimental results show that in the hair of the two groups, 15 REEs and eight other elements were detected, in which the content of La, Ce, Pr, Nd, Tb, Ho, Tm, Yb, and Fe in the exposure group is significantly higher than that of the control group, but the content of Ca in the exposure group is significantly lower than that of the control group; analysis yields out 29 differentially expressed proteins, in which 16 proteins are upregulated and 13 proteins are downregulated. Bioinformatics analysis of differentially expressed proteins demonstrates that they participate in various biological processes and five Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, forming an interaction network. Besides, some differentially expressed proteins may be related to neurovirulence, hepatotoxicity, pathological fibrosis, osteoporosis, and anticoagulation caused by REEs. The present experiment investigated the toxic effects of REEs accumulated in human body at the molecular level, which may lay a foundation for the future research of biological effect, threshold limit values, protection from exposure, and reasonable application of REEs.
Asunto(s)
Proteínas Sanguíneas/metabolismo , Metales de Tierras Raras/toxicidad , Minería , Exposición Profesional/efectos adversos , Proteómica , Adulto , China , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Although Charcot arthropathy, also known as neuropathic arthropathy, of which early diagnosis and treatment is extremely difficult, associated with other cause factor has been widely described, Charcot arthropathy caused by syringomyelia and Chiari malformation complicated with scoliosis has never been described in the literature. CASE PRESENTATION: A 44-year-old male was hospitalized for diagnosis and treatment due to complaining the progressively swelling and limitation of motion in his left shoulder joint for 1 year. The patient has no significant past medical history except for scoliosis 8 years prior to his presentation to our clinic; He denied any constitutional symptoms, trauma, or pain in the upper extremities at this time of presentation. Based on history, physical and auxiliary examination, following diagnoses were made: Charcot arthropathy of the left shoulder, syringomyelia, Chiari malformation and scoliosis. CONCLUSION: Once Charcot arthritis was found, it was mostly in advanced stage and very difficult to treat. So we recommended that if patient suffering from scoliosis visited in clinic, further examination such as magnetic resonance imaging (MRI) and regular follow-up should be carried out, and early-stage of this devastating disease caused by syringomyelia and Chiari malformation may be diagnosed easily.