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1.
Orthop Clin North Am ; 51(3): 345-360, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32498953

RESUMO

Lower extremity deformities in children rely on osteotomies for correction. Percutaneous osteotomies offer a method for cutting bone that is advantageous for soft tissue healing. These low-energy osteotomies preserve the blood supply to bone, which maximizes the ability of bone to heal. Some of these techniques are technically demanding and should be performed first with an experienced operator. The key to maintaining safety in these osteotomies is to remain in a subperiosteal location. The categories of percutaneous osteotomy include multiple drill hole osteotomy, corticotomy, and Gigli saw osteotomy. This article discusses the advantages and indications for each type of osteotomy.


Assuntos
Osso e Ossos/anormalidades , Osso e Ossos/cirurgia , Anormalidades Musculoesqueléticas/cirurgia , Osteotomia/métodos , Criança , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(3): 324-329, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32573143

RESUMO

Lysophosphatidic acid (LPA) is a small phospholipid that is present in all eukaryotic tissues and blood plasma. As an extracellular signaling molecule, LPA mediates many cellular functions by binding to six known G protein-coupled receptors and activating their downstream signaling pathways. These functions indicate that LPA may play important roles in many biological processes that include organismal development, wound healing, and carcinogenesis. Recently, many studies have found that LPA has various biological effects in different kinds of bone cells. These findings suggest that LPA is a potent regulator of bone development and remodeling and holds promising application potential in bone tissue engineering. Here, we review the recent progress on the biological regulatory function of LPA in bone tissue cells.


Assuntos
Fenômenos Biológicos , Receptores de Ácidos Lisofosfatídicos , Osso e Ossos , Lisofosfolipídeos
3.
Artigo em Inglês | MEDLINE | ID: mdl-32559043

RESUMO

Piezoelectric surgery utilizes ultrasonic vibrations to cut bone more precisely and less traumatically than conventional methods. The regional acceleratory phenomenon following bone injury has a demineralization phase followed by a remineralization phase. Part I of this study on rats assessed the biologic modifications following bone injuries with the piezoelectric knife at 10-Hz and 30-Hz modulation frequencies. Part II focuses on piezoelectric surgery-regulated osteoblast activity and changes occurring in the bone during the regeneration phase. The results indicate that at 30 Hz, the remineralization process starts at day 14 and continues until day 70, with osteoblast progenitor cells observed in the periodontal ligament around acellular new bone as early as day 14. These findings emphasize the potential for regeneration in the late postoperative phase and the possible use of the piezoelectric knife as an adjunct for guided bone regeneration, site development, or site preparation for dental implants.


Assuntos
Implantes Dentários , Ultrassom , Animais , Regeneração Óssea , Osso e Ossos , Osteoblastos , Ratos
5.
DNA Cell Biol ; 39(6): 926-937, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32352840

RESUMO

Increasing evidence has announced the emerging roles of long noncoding RNAs (lncRNAs) in modulating bone homeostasis due to their potential regulating effects on bone-related cells' proliferation, migration, differentiation and apoptosis. Thus, lncRNAs have been considered as a promising gene tool to facilitate the bone regeneration process and then to predict and cure bone-related diseases such as osteosarcoma, osteoporosis, and osteoarthritis. In this review, we first enumerated several kinds of dysregulated lncRNAs and concisely summarized their regulating role in bone formation as well as resorption process. The related mechanisms were also discussed, respectively. Then, the positive or negative behavior of these lncRNAs in bone-related diseases was elucidated. This review provides an in-depth sight about the lncRNA's clinical values and limitations, which is conducive to explore new gene targets and further establish new therapeutic strategies for bone-related disease.


Assuntos
Doenças Ósseas/genética , Osso e Ossos/metabolismo , Homeostase/genética , RNA Longo não Codificante/genética , Animais , Humanos
6.
Cell Prolif ; 53(5): e12810, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32472648

RESUMO

OBJECTIVES: Gli1+ cells have received extensive attention in tissue homeostasis and injury mobilization. The aim of this study was to investigate whether Gli1+ cells respond to force and contribute to bone remodelling. MATERIALS AND METHODS: We established orthodontic tooth movement (OTM) model to assess the bone response for mechanical force. The transgenic mice were utilized to label and inhibit Gli1+ cells, respectively. Additionally, mice that conditional ablate Yes-associated protein (Yap) in Gli1+ cells were applied in the present study. The tooth movement and bone remodelling were analysed. RESULTS: We first found Gli1+ cells expressed in periodontal ligament (PDL). They were proliferated and differentiated into osteoblastic cells under tensile force. Next, both pharmacological and genetic Gli1 inhibition models were utilized to confirm that inhibition of Gli1+ cells led to arrest of bone remodelling. Furthermore, immunofluorescence staining identified classical mechanotransduction factor Yap expressed in Gli1+ cells and decreased after suppression of Gli1+ cells. Additionally, conditional ablation of Yap gene in Gli1+ cells inhibited the bone remodelling as well, suggesting Gli1+ cells are force-responsive cells. CONCLUSIONS: Our findings highlighted that Gli1+ cells in PDL directly respond to orthodontic force and further mediate bone remodelling, thus providing novel functional evidence in the mechanism of bone remodelling and first uncovering the mechanical responsive property of Gli1+ cells.


Assuntos
Remodelação Óssea/fisiologia , Osso e Ossos/metabolismo , Osso e Ossos/fisiologia , Proteína GLI1 em Dedos de Zinco/metabolismo , Animais , Diferenciação Celular/fisiologia , Mecanotransdução Celular/fisiologia , Camundongos , Camundongos Transgênicos , Osteoclastos/metabolismo , Osteoclastos/fisiologia , Ligamento Periodontal/metabolismo , Ligamento Periodontal/fisiologia , Estresse Mecânico , Técnicas de Movimentação Dentária/métodos
7.
BMC Med Genet ; 21(1): 64, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228492

RESUMO

BACKGROUND: The calcium-selective channel TRPV6 (transient receptor potential cation channel subfamily V member 6) is crucial for maternal-fetal calcium transport across the placenta. TRPV6 mutations have recently been associated with an antenatally severe under-mineralising skeletal dysplasia accompanied by postnatal biochemical abnormalities. This is the first post-mortem report in a patient with TRPV6 skeletal dysplasia. CASE PRESENTATION: The female infant had severe antenatal and postnatal skeletal abnormalities by 20 weeks gestation and was ventilator-dependent from birth. These skeletal abnormalities were apparent at an earlier gestational age than in previous reported cases and a more severe clinical course ensued. Biochemical and skeletal abnormalities, including bone density, improved postnatally but cardiac arrest at 4 months of age led to withdrawal of intensive care. Compound heterozygous TRPV6 variants (c.1978G > C p.(Gly660Arg) and c.1528C > T p.(Arg510Ter)) were identified on exome sequencing. Post-mortem identified skeletal abnormalities but no specific abnormalities in other organ systems. No placental pathology was found, multi-organ histological features reflected prolonged intensive care only. Post-mortem macroscopic examination indicated reduced thoracic size and short, pale and pliable ribs. Histological examination identified reduced number of trabeculae in the diaphyses (away from the growth plates), whereas metaphyses showed adequate mineralisation and normal number of trabeculae, but with slightly enlarged reactive chondrocytes, indicating post-natal skeletal growth recovery. Post-mortem radiological findings demonstrated improved bone density, improved rib width, healed fractures, although ribs were still shorter than normal. Long bones (especially humerus and femur) had improved from initial poorly defined metaphyses and reduced bone density to sharply defined metaphyses, prominent growth restart lines in distal diaphyses and bone-in-bone appearance along diaphyses. CONCLUSIONS: This case provide bone histological confirmation that human skeletal development is compromised in the presence of TRPV6 pathogenic variants. Post-mortem findings were consistent with abnormal in utero skeletal mineralisation due to severe calcium deficit from compromised placental calcium transfer, followed by subsequent phenotypic improvement with adequate postnatal calcium availability. Significant skeletal recovery occurs in the early weeks of postnatal life in TRPV6 skeletal dysplasia.


Assuntos
Desenvolvimento Ósseo , Osso e Ossos/patologia , Canais de Cálcio/genética , Desenvolvimento Infantil/fisiologia , Osteocondrodisplasias/genética , Osteocondrodisplasias/patologia , Canais de Cátion TRPV/genética , Autopsia , Desenvolvimento Ósseo/genética , Osso e Ossos/anormalidades , Calcificação Fisiológica/genética , Cálcio/metabolismo , Canais de Cálcio/análise , Análise Mutacional de DNA , Feminino , Humanos , Lactente , Osteocondrodisplasias/reabilitação , Parto/fisiologia , Canais de Cátion TRPV/análise
8.
Medicine (Baltimore) ; 99(15): e19508, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282701

RESUMO

INTRODUCTION: Gastrointestinal perforation due to foreign body intake is rare and often secondary to unintentional intake; hence, a misdiagnosis is likely. Herein, we report a case of perforation of the ileum due to fish bone. CASE PRESENTATION: A 57-year-old woman presented with right lower abdominal pain. She did not provide any information about having a history of swallowing foreign bodies. Surgery for uterine fibroids and subtotal gastrectomy was performed 6 years ago. DIAGNOSIS: Laboratory tests and imaging examination showed normal results. During laparotomy, a fish bone was found at the end of the ileum. Two senior radiologists re-evaluated the computed tomography scan, and confirmed the presence of the suspected foreign body. INTERVENTIONS: Partial intestinal resection and manual ileum end anastomosis were performed. OUTCOMES: The patient recovered well after surgery and recalled that she had eaten fish the night before experiencing abdominal pain. CONCLUSION: An accurate diagnosis of complications due to fish bone intake, often secondary to the unintentional intake, is quite challenging. Detailed history-taking about the patient's diet and eating habits is therefore important. Clinical manifestations are mainly determined by the location of perforation, which typically occurs at the junction of the ileum and rectal sigmoid colon. Imaging examination and surgery are often used for definite diagnosis.


Assuntos
Perfuração Intestinal/etiologia , Alimentos Marinhos/efeitos adversos , Osso e Ossos , Feminino , Humanos , Perfuração Intestinal/cirurgia , Pessoa de Meia-Idade
9.
Adv Exp Med Biol ; 1230: 1-14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285361

RESUMO

Bone is a complex and highly dynamic tissue, which has been worldwide studied, from fundamental biology to tissue engineering fields. Even so, current in vitro models do not truly replicate the native bone tissue environment. For so, new and improved in vitro tissue models are necessary to obtain more reliable data, not only in a development point of view, but also to fasten the translation of new drugs into the clinics. In this reasoning, tissue-engineering strategies were applied to develop mimetic and three-dimensional (3D) microenvironments, which were associated with microfluidic devices for the development of more complex and realistic systems. Such devices mimic blood vessels that are present in the native tissue, thus enabling the study of complex biological mechanism as such as bone angiogenesis. More recently, 3D printing has been pursued to produce more intricate microfluidic devices and engineered tissues in a single step. The ability to print spatially controlled structures composed of different biomaterials, growth factors and cells caught the attention of scientists for the development of more efficient in vitro models. Additionally, it allows obtaining microfluidic devices and/or engineered tissues with the desired architecture within a small amount of time and with reduced costs. Recently, the use of high-resolution scanning boosted the production of patient-specific implants. Despite the difficulties associated with 3D printed structures that still need to be overcome, it has been proven to be a valuable tool to accomplish a new generation of 3D bioprinted bone-on-a-chip platforms.


Assuntos
Bioimpressão , Osso e Ossos , Dispositivos Lab-On-A-Chip , Modelos Biológicos , Impressão Tridimensional , Humanos , Técnicas In Vitro , Engenharia Tecidual
11.
Gene ; 749: 144703, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32339623

RESUMO

The repair of segmental bone defects and bone fractures is a clinical challenge involving high risk and postsurgical morbidity. Bone injury and partial bone tumor resection via traditional bone grafting result in high complications. Growth factors have been proposed as alternatives to promote bone repair and formation and circumvent these limitations. In this study, we classified different lengths of mechano growth factor (MGF) E peptides in different species and analyzed their effects on MC3T3-E1 cell proliferation, cell cycle, alkaline phosphatase (ALP) activity, differentiation-related factor expression, and cell mineralization. A rabbit bone injury model was constructed, and the repair function of MGF E peptide was verified by injecting the candidate MGF E peptide. We analyzed 52 different MGF-E peptides and classified them into the following four categories: T-MGF-25E, M-MGF-25E, T-MGF-19E, and M-MGF-19E. These peptides were synthesized for further study. T-MGF-19E peptide obviously promoted cell proliferation by regulating cell cycle after MGF E peptide treatment at 72 h. T-MGF-25E and T-MGF-19E peptide significantly promoted the differentiation of osteoblasts on day 14, and M-MGF-25E peptide promoted cell differentiation on day 7. T-MGF-19E, T-MGF-25E, and M-MGF-19E significantly promoted osteoblast mineralization, with T-MGF19E showing the most significant effect. These results implied that T-MGF19E peptide could remarkably promote MC3T3-E1 cell proliferation, differentiation, and mineralization. The rabbit bone defect model showed that the low-dose T-MGF-19E peptide significantly promoted bone injury healing, suggesting its promoting effect on the healing of bone injury.


Assuntos
Osso e Ossos/efeitos dos fármacos , Calcificação Fisiológica/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Fator de Crescimento Insulin-Like I/farmacologia , Osteogênese/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Fosfatase Alcalina/metabolismo , Animais , Osso e Ossos/fisiologia , Ciclo Celular/efeitos dos fármacos , Linhagem Celular , Expressão Gênica/efeitos dos fármacos , Humanos , Camundongos , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteogênese/genética
12.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(2): 193-197, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32314894

RESUMO

Exosomes are 40-100 nm vesicles that are released into the extracellular environment upon the fusion of multivesicular bodies with the plasma membrane. The biologically cargoes transported by exosomes are diverse. Exosomes are important carriers of signal transmission and interaction between cells. Exosomes are believed to play an important role in tissue repair and bone regeneration. Studies have evaluated that exosomes secreted by cells play an increasingly significant roles in bone tissue engineering and have multiple functions, including regulating immunity, promoting cell proliferation and differentiation, enhancing bone regeneration and angiogenesis. The review analyzes the characteristics and biological properties of different cell-derived exosomes in the bone environment, summarizes their research progress in bone repair, and discusses the challenges and future directions for their application in bone tissue engineering.


Assuntos
Regeneração Óssea , Exossomos , Engenharia Tecidual , Osso e Ossos , Diferenciação Celular
13.
Rev Med Suisse ; 16(691): 778-783, 2020 Apr 22.
Artigo em Francês | MEDLINE | ID: mdl-32320153

RESUMO

Vitamin D plays a critical role in bone health in adolescence. Is screening and treatment of vitamin D deficiency therefore necessary at this age? Inspired by a clinical case, we try to answer this question by presenting a summary of worldwide recommendations for vitamin D in adolescents.


Assuntos
Guias de Prática Clínica como Assunto , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/terapia , Vitamina D/metabolismo , Adolescente , Osso e Ossos/metabolismo , Humanos , Deficiência de Vitamina D/metabolismo
14.
Adv Exp Med Biol ; 1236: 157-188, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32304073

RESUMO

Skeletal defects, such as cleft palate, scoliosis, and shortening of the limb bones are common in the human population. Animal models have been essential for characterizing the molecular and cellular mechanisms that underlie these and other skeletal disorders. This chapter will explore the cellular origins of the vertebrate skeleton and introduce a selection of animal models for human disorders of the skull and facial bones, spinal column, and limbs. The common genetic pathways that build the skeleton of various vertebrate species and how these similarities facilitate the study of human developmental processes in laboratory animals will be a focus of discussion. This chapter will also highlight how current genome editing technologies can be applied to model various perturbations of human chromatin structure in laboratory animals.


Assuntos
Osso e Ossos/anormalidades , Modelos Animais de Doenças , Animais , Fissura Palatina , Ossos Faciais/anormalidades , Humanos , Crânio/anormalidades , Coluna Vertebral/anormalidades
15.
Zhongguo Gu Shang ; 33(3): 224-9, 2020 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-32233248

RESUMO

OBJECTIVE: To compare effects of low frequency pulsed electromagnetic fields on bone quality in growing rats between 1 h and 1.5 h. METHODS: Thirty male SPF SD rats aged 4 weeks selected, which with the average body weight (115.8± 1.5) g, were divided into three groups according to random number table, 10 rats in each group. Control groups put rats into electromagnetic field device with 1.5 h every day, the other two groups put rats in electromagnetic field for 1 h and 1.5 h with a 50 Hz 0.6 mT intensity pulsed. The body weight of rats was weighed every 2 weeks and detected bone mineral density. Rats were sacrificed after 6 weeks to measure bone mineral density and biomechanical value of the right femur and lumbar vertebrae. Serum osteocalcin (OC) and tartrate-resistant acid phosphatase 5b (TRACP 5b) concentrations were determined by ELISA methods. After the magenta-picric acid staining, the micro tissue structure of the right tibia was observed, and the parameters of trabecular bone were analyzed by IPP 6.0 software. RESULTS: There were no statistical difference in body weight and organ coefficient among each groups at different times. Bone mineral density results showed that the body thickness of the 1.5 h group was significantly increased compared with control group at 6 weeks, and bone mineral density of femoral and vertebra in 1.5 h group were higher than that of in 1 h group. The results of three point femoral bending and vertebral compression test showed that the maximum load value of femur and vertebrae in 1.5 h group increased significantly compared with control group, and the maximum femoral load value in 1.5 h group was significantly higher than that of 1 h group, while there was no difference in elastic modulus values among each groups. Results of serum biochemical indicators showed that level of OC in 1.5 h group was significantly increased compared with control group, and significantly higher than that of 1 h group, while no significant difference in TRACP 5b values among each groups. Bone histomorphometry analysis results showed that there was no statistical difference in trabecular thickness, number and resolution between 1 h group and control group, trabecular bone thickness and number in 1.5 h group were increased, and trabecular bone resolution was decreased; The thickness and number of trabecular bone in 1.5 h group were also significantly increased compared with 1 h group, and the degree of resolution was reduced, and had significant difference between two groups. CONCLUSION: Intervention of 50 Hz 0.6 mT low frequency pulsed electromagnetic field for 1.5 h could effectively increase peak bone mineral density and bone microstructure in young rats, enhance biomechanical properties of bone, promote concentration of bone formation markers in rat blood. The results indicating that pulsed electromagnetic field could be used as a good way to prevent and treat osteoporosis.


Assuntos
Densidade Óssea , Campos Eletromagnéticos , Animais , Osso e Ossos , Fêmur , Ovariectomia , Ratos , Ratos Sprague-Dawley
16.
Life Sci ; 253: 117636, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32251631

RESUMO

BMAL1 is a core component of the circadian clock loop, which directs the sophisticated circadian expression of clock-controlled genes. Skeletal Bone development is a complex biological process involving intramembranous ossification, endochondral ossification and bone remodeling, as well as specific cells, such as mesenchymal cells, osteoblasts, osteoclasts, chondrocytes, etc. Growing evidences suggest that BMAL1 is indispensable for hard tissue development, including bone, cartilage and teeth. Loss of BMAL1 in animals can inhibit bone and cartilage development, and result in abnormal bone mass. In mesenchymal cells, BMAL1 defect inhibits osteoblastic and chondrocytic differentiation. Inactivation of BMAL1 also can promote the differentiation and formation of osteoclasts and increase bone resorption. Specifically, preclinical data demonstrate that the abnormity of BMAL1 expression is associated with skeletal disorders such as skeletal mandibular hypoplasia, osteoarthritis, osteoporosis, etc. In this review, we systemically describe the impact of BMAL1 in skeletal development and homeostasis, and devote to searching new therapy strategies for bone disorders.


Assuntos
Fatores de Transcrição ARNTL/metabolismo , Desenvolvimento Ósseo/efeitos dos fármacos , Fatores de Transcrição ARNTL/genética , Animais , Densidade Óssea/efeitos dos fármacos , Reabsorção Óssea/metabolismo , Osso e Ossos/metabolismo , Cartilagem/metabolismo , Diferenciação Celular , Condrócitos/metabolismo , Condrogênese/efeitos dos fármacos , Relógios Circadianos/genética , Regulação da Expressão Gênica , Humanos , Células-Tronco Mesenquimais/metabolismo , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osteogênese , Dente/metabolismo
17.
Life Sci ; 253: 117660, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32294474

RESUMO

AIMS: Osteoporosis has been known to generally result from an imbalance between bone formation and resorption. Osteogenesis is the process of differentiation of mesenchymal stem cells (MSCs) into osteoblasts. Sirtuin6 (SIRT6) has been reported to mediate osteogenic differentiation (OD) in rat bone MSCs (rBMSCs). The present study aimed to assess the influence of microRNA miR-186 on the proliferation and OD potential of rBMSCs. MAIN METHODS: OD was performed and evaluated through Alizarin red S staining, alkaline phosphatase (ALP) activity, and specific marker expression. KEY FINDINGS: miR-186 downregulation was observed during OD. rBMSCs with miR-186 overexpression were generated via transfection. Compared with vehicle negative controls, miR-186 upregulation significantly repressed rBMSCs' OD, as evidenced by a reduced ALP activity and decreased mRNA levels of osteogenic markers [osteocalcin, Runx2, BSP, and ALP]. Furthermore, bioinformatic prediction and dual-luciferase reporter assay demonstrated that miR-186 targeted SIRT6 3'-UTR for silencing. SIRT6 overexpression reversed the inhibitory effect of miR-186 on the OD of rBMSCs. Additionally, further examination showed that the activation of nuclear factor-kappa B (NFκB) pathway was involved in the miR-186/SIRT6 signal axis, and phorbol 12-myristate 13-acetate, a NFκB activator, also inhibited the OD of rBMSCs. SIGNIFICANCE: The present study results may demonstrate a novel mechanism of rBMSCs OD via miR-186-SIRT6 interaction.


Assuntos
MicroRNAs/metabolismo , Osteoblastos/metabolismo , Osteogênese/genética , Sirtuínas/genética , Fosfatase Alcalina/metabolismo , Animais , Sequência de Bases , Regeneração Óssea/genética , Osso e Ossos/citologia , Osso e Ossos/metabolismo , Diferenciação Celular/genética , Proliferação de Células/genética , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Regulação da Expressão Gênica , Lentivirus/genética , Células-Tronco Mesenquimais/citologia , NF-kappa B/metabolismo , Osteocalcina/metabolismo , RNA Mensageiro/metabolismo , Ratos , Transdução de Sinais , Sirtuínas/metabolismo , Transfecção
18.
J Biol Regul Homeost Agents ; 34(1 Suppl. 2): 19-24, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32270664

RESUMO

Biophysical therapy can be performed using inductive, capacitive, mechanic or implanted devices. The mechanism of action of physical stimuli is at a membrane level where the activation of calcium channels determines the enhancement of cell proliferation and the production of growth factors. Biophysical therapy should be performed using devices and modalities described in the literature. The biophysical stimulation of osteogenesis is effective in the enhancement of the biology of fracture healing in presence of a correct orthopedic treatment in terms of good alignment and stabilization at the fracture site. The choice of which method must be used depends on the segment of bone that has to be treated, the type of fracture and if it is possible to apply the device on the skin. The presence of internal or external fixation devices is not a contraindication.


Assuntos
Consolidação da Fratura , Fraturas Ósseas/terapia , Osteogênese , Osso e Ossos , Fixadores Externos , Humanos
19.
Z Gerontol Geriatr ; 53(3): 263-272, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32130502

RESUMO

Multiple myeloma is an age-associated disease. In aged and multimorbid patients the diagnosis could be delayed due to the diversity of symptoms of this disease. Key diagnostic steps are the detection of an M protein as a surrogate of clonal plasma cell proliferation and evaluation of the CRAB criteria (hypercalcemia, renal insufficiency, anemia, bone lesions). The individual prognosis and vulnerability to treatment complications can be assessed by use of validated scores. Following the introduction of many new drugs, vulnerable aged patients with multiple myeloma can also be very effectively treated with modern (partially chemotherapy-free) combination treatment and additional supportive care. Successful management of aged and multimorbid patients with multiple myeloma is not the sole task of the treating hemato-oncologist but also mostly requires the inclusion of general practitioners and geriatricians.


Assuntos
Clínicos Gerais , Geriatras , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/terapia , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Anemia/epidemiologia , Anemia/patologia , Osso e Ossos/patologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Avaliação Geriátrica , Humanos , Hipercalcemia/epidemiologia , Hipercalcemia/patologia , Masculino , Terapia de Alvo Molecular , Morbidade , Mieloma Múltiplo/epidemiologia , Insuficiência Renal/epidemiologia , Insuficiência Renal/patologia
20.
Nature ; 579(7800): 549-554, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32214248

RESUMO

The evolution of fishes to tetrapods (four-limbed vertebrates) was one of the most important transformations in vertebrate evolution. Hypotheses of tetrapod origins rely heavily on the anatomy of a few tetrapod-like fish fossils from the Middle and Late Devonian period (393-359 million years ago)1. These taxa-known as elpistostegalians-include Panderichthys2, Elpistostege3,4 and Tiktaalik1,5, none of which has yet revealed the complete skeletal anatomy of the pectoral fin. Here we report a 1.57-metre-long articulated specimen of Elpistostege watsoni from the Upper Devonian period of Canada, which represents-to our knowledge-the most complete elpistostegalian yet found. High-energy computed tomography reveals that the skeleton of the pectoral fin has four proximodistal rows of radials (two of which include branched carpals) as well as two distal rows that are organized as digits and putative digits. Despite this skeletal pattern (which represents the most tetrapod-like arrangement of bones found in a pectoral fin to date), the fin retains lepidotrichia (fin rays) distal to the radials. We suggest that the vertebrate hand arose primarily from a skeletal pattern buried within the fairly typical aquatic pectoral fin of elpistostegalians. Elpistostege is potentially the sister taxon of all other tetrapods, and its appendages further blur the line between fish and land vertebrates.


Assuntos
Evolução Biológica , Osso e Ossos/anatomia & histologia , Extremidades/anatomia & histologia , Fósseis , Vertebrados/anatomia & histologia , Nadadeiras de Animais/anatomia & histologia , Animais , Teorema de Bayes , Canadá , Peixes/anatomia & histologia , Filogenia
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