The family Opilioacaridae (Parasitiformes: Opilioacarida) in Mexico, description of two new species, new records, and geographical distribution.

Two new species of Neocarus (Opilioacarida: Opilioacaridae), N. haicolous n. sp. and N. queretanus n. sp., are described from mesophyll and pine-oak forests in the state of Querétaro, central Mexico. One species was described from adults and tritonymphs. Distribution and habitat preferences of all known collections of Opilioacarida are reviewed. In Mexico, they have been collected in all habitats, from semideserts areas to tropical forest and from to sea level in dunes to high temperate and cloud forest.

Influencia de la vitamina D sobre la microestructura y propiedades biomecánicas de pacientes con fractura de cadera / Influence of vitamin D on biomechanical microstructure and properties of patients with hip fracture

Introducción: Valorar niveles séricos de 25-hidroxivitamina D -25(OH)D-, hormonas con influencia sobre el metabolismo óseo (parathormona -PTH- y factor de crecimiento insulínico -IGF-I-), marcadores de remodelado óseo (MRO) (telopéptido carboxilo-terminal del colágeno tipo I -β-CTX- y propéptido aminoterminal del procolágeno tipo I -PINP-), densidad mineral ósea (DMO), microestructura y biomecánica de cuello de fémur, en pacientes con fractura de cadera osteoporótica (OP) vs. pacientes artrósicos (OA). Material y métodos: Estudio observacional transversal de 29 pacientes OP y 14 OA, edad ≥50 años. Cuantificamos niveles séricos hormonales y MRO (inmunoensayo), DMO de cadera (DXA), microestructura (micro-CT) y biomecánica (ensayos de compresión uniaxial, sistema IGFA). Análisis estadístico (SPSS 20.0.) Resultados: Los pacientes OP presentaron niveles inferiores de 25(OH)D (p=0,02) y DMO de cadera (p<0,05), y superiores de PTH (p=0,029) y de β-CTX (p=0,04). Los niveles de 25(OH)D se correlacionaron positivamente con IGF-I (p=0,04) y negativamente con β-CTX (p=0,003). Los valores de PTH se correlacionaron negativamente con DMO de cadera (p=0,0005) y positivamente con la separación trabecular (Tb.Th) (p=0,006). Los pacientes con niveles de 25(OH)D <20 ng/mL presentaron niveles mayores de β-CTX (p=0,006), menores de IGF-I (p=0,007) y Tb.Th (p=0,04). Conclusiones: Los niveles de vitamina D son bajos en población anciana, sobre todo en pacientes con fractura de cadera osteoporótica. Además, en estos pacientes existen niveles elevados de PTH y MRO y descendidos de DMO. Los pacientes cuyos niveles de 25(OH)D son inferiores a 20 ng/mL presentan un remodelado óseo más elevado, con menores niveles de IGF-I y alteraciones de la estructura ósea (Tb.Th) que puedan estar en relación con un mayor riesgo de fracturas (AU)

Introduction: To assess serum levels of 25-hydroxyvitamin D-25 (OH) D-hormones with influence on bone metabolism (parathormone -PTH- and insulin-like growth factor (IGF)-I), bone remodeling markers (BRM) (carboxy-terminal telopeptide of collagen type I-β-CTX- and amino-peptide pro-peptide of procollagen type I -PINP), bone mineral density (BMD), microstructure and biomechanics of the femoral neck, in patients with osteoporotic hip fracture (OH) versus arthritic patients (OA). Material and methods: A cross-sectional observational study of 29 OH and 14 OA, age ≥50 years. We quantified hormonal serum levels and BRM (immunoassay), hip BMD (DXA), microstructure (micro-CT) and biomechanics (uniaxial compression tests, IGFA system). Analysis (SPSS 20.0.) Results: OH patients had lower levels of 25(OH)D (p=0.02) and hip BMD (p<0.05), and higher PTH (p=0.029) and β-CTX (p=0.04). Levels of 25(OH)D correlated positively with IGF-I (p=0.04) and negatively with β-CTX (p=0.003). The PTH values were correlated negatively with hip BMD (p=0.0005) and positively with trabecular thickness (TbTh) (p=0.006). Patients with 25(OH)D <20 ng/mL presented higher levels of β-CTX (p=0.006), lower IGF-I (p=0.007) and TbTh (p=0.04). Conclusions: Vitamin D levels are low in the elderly population, especially in patients with osteoporotic hip fracture. These patients also presented raised levels of PTH and BRM and descended from BMD. Patients whose 25(OH)D levels are below 20 ng/mL present higher bone remodeling, with lower levels of IGF-I and alterations of the bone structure (TbTh) that may be linked to a greater risk of fractures (AU)

Influencia de la obesidad sobre la microarquitectura y las propiedades biomecánicas en pacientes con fractura de cadera / Influence of obesity on microarchitecture and biomechanical properties in patients with hip fracture

Introducción: La obesidad y la osteoporosis (OP) son dos patologías muy prevalentes en nuestra sociedad actual. El efecto de la obesidad sobre la calidad ósea se encuentra en debate en la actualidad. Objetivo: Valorar el efecto del peso corporal sobre la microestructura y las propiedades biomecánicas de hueso trabecular procedente de biopsias de extremidad proximal de fémur de pacientes con fractura de cadera por fragilidad. Material y método: Estudio transversal de 16 pacientes con fractura de cadera. 2 grupos según su IMC: (A) sujetos normopeso y (B) con obesidad. Recogimos biopsias de hueso trabecular de cabeza femoral. Valoramos determinaciones bioquímicas (PTH, 25(OH) vitamina D e IGF-1), marcadores de remodelado óseo (PINP,CTX), masa ósea (DMO cuello y cadera total), microestructura ósea y estudio biomecánico (μCt). El análisis estadístico: t-Student (SPSS 22.0) significación p<0,05. Resultados: Todos los pacientes presentaron DMO de cadera en rango osteoporótico. El grupo de obesos presentó niveles superiores de PTH e inferiores de IGF-1, vitamina D y PINP. No encontramos diferencias en los parámetros relacionados con el metabolismo óseo. El grupo de obesos presentó mejores índices microestructurales alcanzando la significación: mayor volumen óseo (BV/TV: 36,6±12,7 vs. 19,4±11,4%, BS/TV: 5,5±1,1 vs. 3,9±1,3%), mayor número de trabéculas (Tb.N: 1,6±0,4 vs. 1,01±0,4), mayor anchura de trabéculas (Tb.Th: 0,22±0,003 vs. 0,17±0,05) y menor separación trabecular (Tb.Sp: 0,51±0,12 vs. 0,66±0,16). Los parámetros biomecánicos confirman una mayor resistencia del hueso trabecular en pacientes obesos. Conclusión: La obesidad puede ser un factor protector de la calidad ósea en la región femoral y tiene menos efecto sobre la densidad mineral ósea (AU)

Introduction: Obesity and osteoporosis (OP) are two very prevalent diseases in our society today. The effect of obesity on bone quality is currently a subject under discussion. Objective: To assess the effect of body weight on the microstructure and biomechanical properties of trabecular bone biopsies from the proximal end of the femur in patients with hip fracture fragility. Material and methods: Cross-sectional study of 16 patients with hip fracture. The 2 groups are divided according to their BMI: (A) normal weight individuals and (B) those with obesity. We collected biopsies of cancellous bone from the femoral head and assessed biochemical determinations (PTH, 25 (OH) vitamin D and IGF-1), bone remodeling markers (PINP, CTX), bone mass (BMD neck and total hip), bone microstructure and biomechanical study (μCt). Statistical analysis: Student's t test (SPSS 22.0) significance p<0.05. Results: All patients had hip BMD in osteoporotic range. The obese group had higher levels of PTH and lower IGF-1, vitamin D and PINP. We found no differences in the parameters related to bone metabolism. The obese group showed better indices reaching microstructural significance: increased bone volume (BV/TV: 36.6±12.7 vs 19.4±11.4%, BS/TV: 5.5±1.1 vs 3.9±1.3%), higher trabecular number (Tb.N: 1.6±0.4 vs 1,01±0,4), greater trabecular width (Tb.Th: 0.22±0.003 vs 0.17±0.05) and lower trabecular separation (Tb.Sp: 0.51±0.12 vs 0.66±0.16). Biomechanical parameters confirm greater strength of trabecular bone in obese patients. Conclusion: Obesity may be a protective factor of bone quality in the femoral region and has less effect on bone mineral density (AU)

Oblitoma en la cirugía ginecoobstétrica: un problema creciente. Reporte de un caso / Oblitoma in obstetric and gynecologic surgery: a growing problem

Resumen ANTECEDENTES: Los oblitomas, u objetos extraños retenidos en el abdomen posterior a una cirugía, son consecuencia de una iatrogenia que causa morbilidad, dificultad diagnóstica, problemas médico-legales, y complicaciones para las pacientes, el médico y la institución hospitalaria. CASO CLINICO: Paciente de 27 años de edad, con un cuerpo extraño retenido en la cavidad abdominal (bulbo de la cánula de Yankauer), olvidado durante una cesárea de urgencia. El diagnóstico y tratamiento fueron expeditos, con reintervención quirúrgica para extraer el cuerpo extraño, sin complicaciones y con evolución satisfactoria de la paciente. CONCLUSIONES: El estudio actual de los oblitomas u objetos extraños retenidos es un problema creciente, con estadísticas en contra, sobre todo asociadas con elevada frecuencia de cesáreas y alta prevalencia de obesidad materna durante el embarazo, esto debe alertar a los ginecoobstetras a conducirse con más cuidado para evitar este tipo de accidentes.

Abstract BACKGROUND: Oblitomas or retained surgical items (RSI) in the abdominal cavity after surgery are cause of iatrogenic medical problems, that origin high morbidity, difficult diagnosis and medical malpractice claims to may lead complications to patients, physicians included to hospital. CLINICAL CASE: We report an exceptional case, in a 27-year-old women, with a bulb of Yankahuer cannula retained in abdominal cavity, Forgotten during an emergency cesarean section. The diagnosis and management was realized with opportunity, avoiding complications. CONCLUSION: Actually, the study of oblitoma or foreign objects retained that's considered a growing problem, with statistics against it, mainly associated with high frequency of cesarean sections and high prevalence of maternal obesity during pregnancy. In fact, that situation place the gynecologists and obstetricians at a latent risk for this event. It is important to know the predisposing factors for its prevention and to implement institutional programs to reduce complications.

Comparación de un entrenamiento propioceptivo sobre base estable y base inestable / Comparison of a proprioceptive training program on stable base and unstable base

El objetivo de este estudio fue comparar dos programas de entrenamiento propioceptivo sobre base estable (G1) y base inestable (G2). Durante 5 semanas, 18 jugadores de fútbol profesional se sometieron a un programa de entrenamiento propioceptivo, 9 formaron el G1 y 9 G2. Se aplicó el Standard Excursion Balance Test (Test de Estrella) antes y después de la intervención. Los resultados intragrupo mostraron diferencias significativas en las variables ANT.IZDO; ANTLAT.IZDO; POST.D y ANTMED.D (p<0,005) para el G1 y ANT.D; ANT.IZDO; POSTMED.D; POSTMED.IZDO Y MED.D (p< 0,005) para el G2. No se hallaron evidencias significativas entre el entrenamiento en base estable y base inestable para la mejora del equilibrio y la estabilidad (AU)

The aim is to compare two proprioceptive training programs on a stable (G1) and an unstable (G2) base in terms of balance and stability. During a 5 week period, 18 professional football players underwent a proprioceptive training program, 9 in G1 and the other 9 in G2. The Standard Excursion Balance Test was applied before and after the intervention program. Significant intragroup differences were found in the variables LEFT FRONT, ANTEROLATERAL LEFT (ANTLAT.LEFT), BACK RIGHT and ANTEROMEDIAL RIGHT (ANTMED.RIGHT) (p<0,005) for the G1, and FRONT RIGHT, FRONT LEFT, POSTMED.RIGHT, POSTMED.LEFT and MED.RIGHT (p <0,005) for G2. We conclude that there are no significant differences between the unstable base training and training stable base regarding improvement in balance and stability (AU)

Respuesta a valores de referencia de la proteína S100β en población pediátrica / Response to serum S100β protein reference values in a paediatric population

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¿Qué son los microARNs? Posibles biomarcadores y dianas terapéuticas en la enfermedad osteoporótica / What are microRNAs? Potential biomarkers and therapeutic targets in osteoporosis

Los micro-ARN (miRs) son pequeñas moléculas de ARN no codificantes que regulan la expresión génica a nivel post-transcripcional. Generalmente actúan sobre la expresión genética mediante el silenciamiento o degradación de los ARNm, y están implicados en la regulación de varios procesos biológicos, como la diferenciación celular, la proliferación, la apoptosis y en el desarrollo embrionario y tisular. Actualmente son un importante foco de interés para el estudio de diversas enfermedades como el cáncer o la diabetes mellitus tipo 2. A nivel del metabolismo óseo, están surgiendo diversos miRs implicados en su regulación, abriendo un campo de investigación importante para identificar nuevos biomarcadores para el diagnóstico de la enfermedad osteoporótica, de su evolución, así como para diseñar nuevas terapias farmacológicas (AU)

Micro-RNAs (miRs) are small non-coding RNA molecules that regulate gene expression at post-transcriptional level. Generally, they act on gene expression by silencing or degrading mRNAs, and are involved in regulating various biological processes, such as cell differentiation, proliferation, apoptosis and in embryonic and tissue development. They are currently a major focus of interest in the study of various diseases such as cancer or type 2 diabetes mellitus. At level of bone metabolism, various miRs are emerging that are involved in their regulation, opening an important research field to identify new biomarkers for diagnosis of osteoporosis and its development, and to design new drug therapies (AU)

The cyclic-di-GMP diguanylate cyclase CdgA has a role in biofilm formation and exopolysaccharide production in Azospirillum brasilense.

In bacteria, proteins containing GGDEF domains are involved in production of the second messenger c-di-GMP. Here we report that the cdgA gene encoding diguanylate cyclase A (CdgA) is involved in biofilm formation and exopolysaccharide (EPS) production in Azospirillum brasilense Sp7. Biofilm quantification using crystal violet staining revealed that inactivation of cdgA decreased biofilm formation. In addition, confocal laser scanning microscopy analysis of green-fluorescent protein-labeled bacteria showed that, during static growth, the biofilms had differential levels of development: bacteria harboring a cdgA mutation exhibited biofilms with considerably reduced thickness compared with those of the wild-type Sp7 strain. Moreover, DNA-specific staining and treatment with DNase I, and epifluorescence studies demonstrated that extracellular DNA and EPS are components of the biofilm matrix in Azospirillum. After expression and purification of the CdgA protein, diguanylate cyclase activity was detected. The enzymatic activity of CdgA-producing cyclic c-di-GMP was determined using GTP as a substrate and flavin adenine dinucleotide (FAD(+)) and Mg(2)(+) as cofactors. Together, our results revealed that A. brasilense possesses a functional c-di-GMP biosynthesis pathway.

The family Opilioacaridae (Parasitiformes: Opilioacarida) in Mexico, description of two new species and notes on biology and geographical distribution.

Two new species of Opilioacaridae from Mexico are described, Neocarus chactemalensis sp. nov. and N. comalensis sp. nov., and new records for N. texanus Chamberlin & Mulaik and N. veracruzensis Vazquez & Klompen are presented. Relative positions of internal structures of the ovipositor, a highly variable character, are described based on comparisons of invaginated and evaginated ovipositors. A study of records of Opilioacaridae in Mexico shows that the group is distributed across a wide range of ecosystems and elevations, from dry, semi-desert to wet tropical forest, and coastal plains to the altiplano (>2,000 m).

Post-embryonic development in the mite suborder Opilioacarida, with notes on segmental homology in Parasitiformes (Arachnida).

In order to study homology among the major lineages of the mite (super)order Parasitiformes, developmental patterns in Opilioacarida are documented, emphasizing morphology of the earliest, post-embryonic instars. Developmental patterns are summarized for all external body structures, based on examination of material in four different genera. Development includes an egg, a 6-legged prelarva and larva, three 8-legged nymphal instars, and the adults, for the most complete ontogenetic sequence in Parasitiformes. The prelarva and larva appear to be non-feeding. Examination of cuticular structures over ontogeny allows development of an updated model for body segmentation and sensillar distribution patterns in Opilioacarida. This model includes a body made up of a well-developed ocular segment plus at most 17 additional segments. In the larvae and protonymphs each segment may carry up to six pairs of sensilla (setae or lyrifissures) arranged is distinct series (J, Z, S, Sv, Zv, Jv). The post-protonymphal instars add two more series (R and Rv) but no extra segments. This basic model is compatible with sensillar patterns in other Parasitiformes, leading to the hypothesis that all taxa in that (super)order may have the same segmental ground plan. The substantial segmental distortion implied in the model can be explained using a single process involving differential growth in the coxal regions of all appendage-bearing segments.

Brasilacarus cocaris (Acari: Opilioacaridae), a new genus and species from Amazonia, Brazil.

A new genus and species of Opilioacaridae, Brasilacarus cocaris n. gen., n. sp., is described from adult females and males from Manaus, Brazil. Brief descriptions of damaged tritonymphs and deutonymphs are also provided. The new genus appears to be related to Caribeacarus but possess a unique group of additional strongly modified setae on the tibiotarsus. 

Effectiveness of botulinum toxin (type-A) administered by the fixed-site dosing approach versus the muscle area identification.

INTRODUCTION: Botulinum toxin is widely used in glabellar musculature. The authors express the need to individualize the approach by means of muscular identification to improve effectiveness. Despite these guidelines, the fixed-point technique is still used. OBJECTIVE: Comparison of effectiveness of botulinum toxin administration in the glabellar zone by using fixed-site application versus objective-muscle-identification. MATERIALS AND METHODS: Prolective dynamic cohort study. Patients (after previous informed consent) were assessed on their facial expressions, level of satisfaction, re-interventions, adverse effects, dosage, dilution, and number of injections. All patients who experienced either of both techniques of botulinum toxin administration (fixed-site or objective-muscle-identification) were subjected to followup by the following parameters: statistical analysis: student's t Test (inter-group mean comparisons), paired student's t test (intra-group mean comparisons), χ (2) with Fisher exact text. RESULTS: Sixty-two patients were evaluated (31 fixed-site approach, 31 objective-muscle-identification). No patient abandoned the trial during followup. Fixed-site injections required larger doses (16 vs 12 U, p = 0.001), greater volume (0.48 vs. 0.37 ml, p = 0.001), and more application sites (4 vs 2, p = 0.001), compared to the objective-muscle-identification approach. Under the objective-muscle-identification technique, facial expressions were better attenuated (52 vs 65%, p = 0.001), with a higher initial satisfaction level (6 vs 9, p = 0.001) and final satisfaction level (9 vs 9.9, p = 0.001). CONCLUSIONS: Botulinum toxin application is more effective when administered through the objective-muscle-identification approach (less frowning, lower doses, less fixed sites injected, and patients more satisfied at the end). LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

A new genus and two new species of Opilioacaridae (Acari: Parasitiformes) from Amazonia, Brazil with a key to world genera.

Collections of Opilioacaridae made close to 50 years ago in Manaus in the Amazonian Region have allowed the description of a new genus and two new species from Brazil, Amazonacarus setosus n.gen, n.sp. and A. paraensis n.gen, n.sp. These species show a unique combination of characters in the Opilioacaridae: a high number of foliate setae (10) on the palp tarsus with each seta bearing many lobes (6-7), a group of large, serrate setae (26-31) on the palp tibia (this group of setae is much smaller in other species), and 5-7 dorsal setae on idiosomal segment XVIII. Indiacarus and some Opilioacarus show 3-5 setae on segment XVIII, but these genera (and Caribeacarus) have fewer foliate setae on the palp (3-4). Females of Amazonacarus have an ovipositor of the "complex" type, with spiny projections and 2-4 genital setae, while males have two pairs of rounded, large glands.

Sling pulmonar de diagnóstico casual / Pulmonary artery sling as a casual diagnosis

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Smoking habit profile and health-related quality of life.

BACKGROUND: Few studies have investigated the relationship between smoking and health-related quality of life (HRQOL), and the results are not consistent. The aim of this study is to explore the association between smoking and HRQOL. METHOD: Cross-sectional study of 714 Spanish adults (44.7% never smokers and 55.3% smokers) without diagnosis of physical or mental disorder. Each participant provided information about different sociodemographic variables and data on HRQOL. Smokers also reported smoking-related information about smoking-related variables. RESULTS: Nicotine dependence was not associated with the physical dimension of HRQOL, but in the mental component, nicotine dependent smokers showed worse HRQOL than never smokers (p = 0.004) and than non-nicotine dependent smokers (p = 0.014). There were no differences between no-nicotine dependent smokers and never smokers. Smoking status (non smokers vs. smokers), number of cigarettes smoked per day, stage of change, quit attempts in the past year or age of smoking onset were not related to HRQOL. CONCLUSIONS: In subjects without physical or mental diseases, only nicotine dependent smokers showed a significant impairment in the mental component of HRQOL. Therefore, it is important to consider nicotine dependence in the relationship between smoking and HRQOL.

Differences in osteogenic and apoptotic genes between osteoporotic and osteoarthritic patients.

BACKGROUND: Osteoporosis is a metabolic disorder characterized by a reduction in bone mass and deterioration in the microarchitectural structure of the bone, leading to a higher risk for spontaneous and fragility fractures.The main aim was to study the differences between human bone from osteoporotic and osteoarthritic patients about gene expression (osteogenesis and apoptosis), bone mineral density, microstructural and biomechanic parameters. METHODS: We analyzed data from 12 subjects: 6 with osteoporotic hip fracture (OP) and 6 with hip osteoarthritis (OA), as the control group. All subjects underwent medical history, analytical determinations, densitometry, histomorphometric and biochemical study. The expression of 86 genes of osteogenesis and 86 genes of apoptosis was studied in pool of bone samples from patients with OP and OA by PCR array. RESULTS: We observed that most of the genes of apoptosis and osteogenesis show a decrease in gene expression in the osteoporotic group in comparison with the osteoarthritic group. The histomorphometric study shows a lower bone quality in the group of patients with hip fractures compared to the osteoarthritic group. CONCLUSIONS: The bone tissue of osteoporotic fracture patients is more fragile than the bone of OA patients. Our results showed an osteoporotic bone with a lower capacities for differentiation and osteoblastic activity as well as a lower rate of apoptosis than osteoarthritic bone. These results are related with structural and biochemical parameters.

Culture of limbal stem cells on human amniotic membrane.

Limbal stem cells (LSC) have an important role in the maintenance of the corneal surface epithelium, and autologous cultured limbal epithelial cell (HLECs) transplantations have contributed substantially to the treatment of the visually disabling condition known as LSC deficiency. A major challenge is the ability to identify LSC in vitro and in situ, and one of the major controversies in the field relates to reliable LSC markers. This study was carried out to evaluate the culture of a limbal biopsy on human amniotic membrane (HAM): directly on the chorionic side and on intact epithelium, and the expression of the stem cell associated markers: ABCG2, p63. HAM has been extensively used for ocular surface reconstruction and has properties which facilitate the growth of epithelial cells controlling inflammation and scarring.

Illness beliefs about cancer among healthy adults who have and have not lived with cancer patients.

BACKGROUND: Illness representations have been proposed as key determinants for facing health risks and managing disease, and consequently for health outcomes. PURPOSE: This study aims to know and compare non-specialised illness representations of cancer among adults who had not suffered from cancer and who had/had not lived with cancer patients. METHOD: The revised Illness Perception Questionnaire was adapted to assess illness perceptions among healthy people. Cancer representations were explored in a community-based sample of adults of both genders from different educational backgrounds and who had differing experience with cancer, none being a patient. RESULTS: The participants' beliefs about cancer included both biomedical and folk knowledge. Compared to age, sex, and educational level, family experience with cancer (having lived or not with a patient) had the strongest impact on the contents of the representations on cancer. Further, people with a family experience with the disease, compared to those not having a relative diagnosed with cancer, reported significantly more symptoms and stronger emotional impact. CONCLUSIONS: This study allowed us to establish the perceptions on cancer of non-patients with no specialised knowledge. Findings may help in designing and implementing tailored preventive interventions taking into account family experience with the disease, as well as interventions aimed at enhancing family and social care and support given to cancer patients.

Five years experience with a new intraoral maxillary distraction device (RID).

Maxillary distraction osteogenesis is well established for the treatment of severe retromaxilla. We report our experience since 2004 of the treatment of 19 patients using a new intraoral maxillary distraction device. Maxillary advancement was successful in all patients with mean advancement of 9.6mm (range 4-17) measured at a point in lateral cephalograms. The new device limited surgical exposure and the amount of materials implanted, and improved control in every phase of the distraction. It was psychologically accepted by patients and was more comfortable than existing devices.

Alendronate and raloxifene affect the osteoprotegerin/RANKL system in human osteoblast primary cultures from patients with osteoporosis and osteoarthritis.

The osteoprotegerin/RANKL system modulates bone remodelling. Alendronate and raloxifene are anti-resorptive drugs effective in osteoporotic disease. They reduce fracture risk, the activity of bone remodelling and increase bone mineral density. It is not known if they can exert a direct effect in osteoblasts via the osteoprotegerin/RANKL system. Our objective was to assess the effects of alendronate and raloxifene among osteoprotegerin production (ELISA), as well as osteoprotegerin and RANKL expression (RT-PCR), in primary cultures of human osteoblasts (hOB). We compared 17 osteoporotic patients with 16 patients affected by osteoarthritis in basal conditions and after incubation with alendronate (10(-6) M), raloxifene (10(-7) M) or 17-ß estradiol (10(-7) M) for 24 h. The statistical analysis was determined by ANOVA. Osteoprotegerin protein secretion in hOB cultures was higher in patients with osteoporosis than osteoarthritis. Osteoprotegerin secretion levels remained unchanged after each treatment. The osteoporotic group was more sensitive to treatment. Both raloxifene (34%) and estradiol (37%) increased osteoprotegerin mRNA expression, and alendronate (118%) and raloxifene (61%) increased the mRNA expression of RANKL. The RANKL/osteoprotegerin mRNA ratio was higher in osteoporotic than osteoarthritic patients. In the osteoporotic group, the RANKL/osteoprotegerin mRNA ratio was significantly increased after treatment with alendronate (112%) and after treatment with raloxifene (60%). These results indicate a direct action of alendronate and raloxifene on hOB cultures from osteoporotic patients, and the cited drugs are able to modulate the osteoprotegerin/RANKL system.