Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.566
Filtrar
1.
Int J Cancer ; 146(5): 1324-1332, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31523804

RESUMO

Modern cancer therapy has led to a growing number of pediatric and young adult cancer survivors, who are prone to increased morbidities caused by the late effects of therapy. The aim of our study was to investigate pediatric and young adult cancer survivors' morbidity due to renal and bone metabolism diseases and especially to study bone metabolism in cancer survivors with renal disease. Patients were identified from the Finnish Cancer Registry, and the cohort consisted of 13,860, 5-year survivors of cancer diagnosed below the age of 35 years. Healthy siblings were used as the comparison cohort. Information on the main outcomes was linked from the national Care Register for Health Care. Hazard ratios (HRs) comparing cancer survivors to siblings were calculated for various outcomes. The patient cohort was separated into two age groups, pediatric (0-19 years) and young adults (20-34 years). Significantly elevated HRs (p < 0.0001) in survivors were observed in both age groups for scoliosis (HR 1.6, 95% confidence interval [CI] 1.3-2.0), osteoporosis (HR 5.2, 95% CI 2.4-11.4), osteonecrosis (HR 12.7, 95% CI 5.4-29.7), nephritis (HR 1.9, 95% CI 1.5-2.2) and kidney failure (HR 3.6, 95% CI 2.4-5.3) for all. For cancer survivors with a renal outcome, the risk for developing any outcome of bone metabolism was increased (HR 2.3, 95% CI 1.4-3.6). These results show that pediatric and young adult cancer survivors have an elevated risk for long-term, adverse outcomes related to renal function and bone metabolism. These results suggest follow-up care for young cancer patients.


Assuntos
Doenças Ósseas Metabólicas/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Nefropatias/epidemiologia , Neoplasias/terapia , Adolescente , Antineoplásicos/efeitos adversos , Doenças Ósseas Metabólicas/etiologia , Criança , Pré-Escolar , Feminino , Finlândia/epidemiologia , Seguimentos , Nível de Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Nefropatias/etiologia , Masculino , Neoplasias/complicações , Neoplasias/mortalidade , Modelos de Riscos Proporcionais , Radioterapia/efeitos adversos , Sistema de Registros/estatística & dados numéricos , Fatores de Risco , Irmãos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Adulto Jovem
2.
BMJ Case Rep ; 12(10)2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31604721

RESUMO

A 39-year-old man was admitted to our hospital with the diagnosis of thyroid storm due to Graves' disease. Near-total thyroidectomy was performed after 1 month's pharmacological treatment, and he presented with tetany next morning. Serum corrected calcium value was 5.7 mg/dL. Procollagen type 1 N-terminal propeptide increased considerably, while tartrate-resistant acid phosphatase 5b decreased. These changes indicated that bone formation exceeded bone resorption in reverse after thyroidectomy. Calcium gluconate was administered intravenously for 14 days, before the patient was discharged. Oral administration of calcium and active forms of vitamin D was continued for 4 months. Rapid skeletal uptake of calcium from blood caused severe and persistent hypocalcaemia, which is called hungry bone syndrome. When patients with Graves' disease have severe thyrotoxicosis, high serum alkaline phosphatase levels and low bone mineral densities, they are at high risk for hungry bone syndrome after thyroidectomy, and should be educated for the symptoms of hypocalcaemia.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Doença de Graves/complicações , Hipocalcemia/etiologia , Tireoidectomia/efeitos adversos , Tireotoxicose/complicações , Adulto , Doenças Ósseas Metabólicas/tratamento farmacológico , Cálcio/uso terapêutico , Doença de Graves/cirurgia , Humanos , Hipocalcemia/tratamento farmacológico , Masculino , Tireotoxicose/cirurgia , Vitamina D/uso terapêutico
3.
Medicine (Baltimore) ; 98(39): e17280, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574843

RESUMO

BACKGROUND: This study will aim to evaluate the diagnostic accuracy of digital X-ray radiogrammetry (DXR) on hand bone loss (HBL) for rheumatoid arthritis (RA). METHODS: In this study, we will search the literature from PubMed, EMBASE, Cochrane Library, PsycINFO, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and WANFANG from the inception to June 1, 2019 without language restrictions. All case-controlled studies on assessing diagnostic accuracy of DXR on HBL for diagnosis of RA will be included. Quality Assessment of Diagnostic Accuracy Studies tool will be used for eligible studies. We will apply RevMan V.5.3 software and Stata V.12.0 software for statistical analysis. RESULTS: We will evaluate diagnostic accuracy of DXR on HBL in patients with RA by assessing the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. CONCLUSION: This study will detect the diagnostic accuracy of DXR evaluation on HBL in patients with RA. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019139489.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Doenças Ósseas Metabólicas/diagnóstico por imagem , Densitometria/estatística & dados numéricos , Intensificação de Imagem Radiográfica/métodos , Radiografia/estatística & dados numéricos , Artrite Reumatoide/complicações , Doenças Ósseas Metabólicas/etiologia , Estudos de Casos e Controles , Densitometria/métodos , Progressão da Doença , Feminino , Ossos da Mão/diagnóstico por imagem , Humanos , Masculino , Radiografia/métodos , Projetos de Pesquisa , Índice de Gravidade de Doença , Revisões Sistemáticas como Assunto
4.
Evid. actual. práct. ambul ; 22(2): e001112, sept. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1046678

RESUMO

La osteopenia, una disminución de la densidad mineral ósea de menor severidad que la osteoporosis, definida por valores de T-score entre -1,0 y -2,5 en la densitometría ósea , podría asociarse con un mayor riesgo de fracturas. Motivado por el pedido de una paciente con osteopenia que solicita a su médico algún medicamento que le ayude a disminuir su riesgo de fracturas, el autor se pregunta si los bifosfonatos podrían ser beneficiosos para las pacientes con este factor de riesgo. Luego de realizar una búsqueda bibliográfica y seleccionar la evidencia más reciente y de mejor calidad, se concluye que estos fármacos podrían ser útiles para prevenir fracturas en mujeres mayores de 65 años con elevado riesgo de fractura,independientemente del resultado de la densitometría. (AU)


Osteopenia, a minor decrease in bone mineral density, defined by T-score values between -1.0 and -2.5 in a bone densitometry, is associated with an increased risk of fractures. Moved by the request of a patient with osteopenia who asks her doctor for any medication that may help her reduce his risk of fractures, the author wonders if bisphosphonates could be beneficial for patients with this condition. After conducting a bibliographic search and selecting the most recent and best quality evidence, he concluded that these drugs could be useful to prevent fractures in women older than 65 years with ahigh risk of fracture, regardless of densitometry results. (AU)


Assuntos
Humanos , Feminino , Idoso , Osteoporose/tratamento farmacológico , Doenças Ósseas Metabólicas/tratamento farmacológico , Difosfonatos/uso terapêutico , Fraturas por Osteoporose/prevenção & controle , Osteoporose/etiologia , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/diagnóstico por imagem , Fatores de Risco , Fraturas por Osteoporose/fisiopatologia , Fraturas por Osteoporose/tratamento farmacológico
5.
Pediatr Blood Cancer ; 66(10): e27927, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31309708

RESUMO

BACKGROUND: In childhood cancer survivors, low bone mineral density (BMD) is a bone-related consequence. Efficacy of denosumab, an effective therapy for adult patients with osteoporosis, remains unclear in children. This study aimed to investigate denosumab therapy efficacy for low BMD in childhood cancer survivors. PROCEDURE: Between January 2014 and January 2018, we monitored lumbar BMD of children with cancer using dual-energy X-ray absorptiometry after completing chemotherapy with a 6-month interval. For patients with low BMD, defined as height-adjusted Z-scores of BMD < -1.5 in this study, calcium carbonate and vitamin D supplements were initially administered. When low BMD continued for at least 6 months, denosumab therapy was introduced. Calcium and vitamin D supplementation were continued in patients on denosumab. We investigated BMD change and adverse effects during denosumab therapy. RESULTS: During the study period, 20 patients received denosumab treatment. Mean height-adjusted Z-score of BMD before denosumab treatment was -2.68 but increased to -2, -1.96, and -1.33 at 0.5, 1, and 1.5 years after denosumab treatment, respectively (P = .012). In addition, hypocalcemia occurred in 40% (8/20) of patients; three patients had hypocalcemic symptoms with numbness in all four limbs. All hypocalcemic patients, except one patient who died due to relapsed leukemia, recovered well after continuous calcium supplementation. CONCLUSIONS: Denosumab is an effective treatment for low BMD in childhood cancer survivors. However, the complication of hypocalcemia might develop posttreatment.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Doenças Ósseas Metabólicas/tratamento farmacológico , Denosumab/uso terapêutico , Neoplasias/complicações , Adolescente , Doenças Ósseas Metabólicas/etiologia , Sobreviventes de Câncer , Criança , Pré-Escolar , Feminino , Humanos , Hipocalcemia/induzido quimicamente , Masculino , Adulto Jovem
6.
J Craniofac Surg ; 30(7): e688-e691, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31306387

RESUMO

AIM: Cutaneous bone formation is an uncommon lesion of the skin. It may be primary or secondary. Secondary lesions are mostly associated with melanocytic nevi. Although many different theories have been proposed to explain the etiology, extraskeletal bone formation is complex and poorly understood phenomenon.Here the authors report a series of melanocytic nevi with cutaneous bone formation and the authors described morphologic and clinicopathologic features such as age, sex, location, focus number and size of the lesion. MATERIAL AND METHOD: Through a single center, this retrospective study presents total number of 20 patients with melanocytic nevus with or without osseous metaplasia. Histologic and clinicopathologic features such as age, sex, location, focus, and size of lesion were compared. RESULTS: Lesions were identified in 10 female patients. All of the cases were seen in the head and neck region such as face, forehead, eyebrow, lip, and neck and most of them were solitary. The nevi were usually associated with the single focus of ossification. Most of patients (50%) had acne symptoms and treatment anamnesis. Granulomatous dermal inflammation was seen in 2 patients. There was no difference in nevus morphology and the size of the nevi between the osteonevi and the other types of nevi. CONCLUSION: In conclusion, this study revealed that although it is rare it has distinctive features such as female patients, face location, and acne anamnesis. Therefore it may be speculated that the osteogenic factors may be involved with inflammatory-induced metaplastic ossification and tend to be related female sex.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Nevo Pigmentado/complicações , Ossificação Heterotópica/etiologia , Dermatopatias Genéticas/etiologia , Neoplasias Cutâneas/complicações , Adulto , Feminino , Humanos , Metaplasia , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Cutâneas/patologia
7.
Dis Markers ; 2019: 9698367, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354894

RESUMO

Recurring nature of idiopathic nephrotic syndrome (INS) and steroid dependence imply a long-term treatment with glucocorticosteroids (GCSs), which increases the risk of bone metabolism disorders. The search for new markers of that process is essential. The aims of this study were to assess the concentrations of sclerostin (Scl) and fibroblast growth factor-23 (FGF-23) in the plasma of children with INS and compare Scl and FGF-23 to existing markers of bone metabolism, mainly parathyroid hormone (PTH). The study involved 70 children, 50 with INS and 20 healthy children. Patients with INS were divided into 4 groups depending on the number of relapses and applied therapy. Significantly higher concentrations of FGF-23 and Scl were found in all patient groups with INS compared to the control group, and increase in the concentrations of examined parameters depending on the number of NS relapses was showed. In patients from the group with numerous relapses, higher concentrations of FGF-23 and Scl in the relapse phase than those in the remission phase were found. We observed positive correlation in these proteins with parathyroid hormone. Positive correlation of FGF-23 and Scl in the examined group was noted. Children having relapsing INS treated with steroids have higher levels of Scl and FGF-23 that can indicate the bone metabolism disorders. The significance of these observations requires further research.


Assuntos
Corticosteroides/efeitos adversos , Doenças Ósseas Metabólicas/sangue , Proteínas Morfogenéticas Ósseas/sangue , Fatores de Crescimento de Fibroblastos/sangue , Síndrome Nefrótica/tratamento farmacológico , Corticosteroides/uso terapêutico , Biomarcadores/sangue , Doenças Ósseas Metabólicas/etiologia , Criança , Feminino , Marcadores Genéticos , Humanos , Masculino , Síndrome Nefrótica/complicações
8.
Cancer Radiother ; 23(5): 408-415, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31331841

RESUMO

PURPOSE: Radiotherapy is a treatment method performed using ionizing radiation on cancer patients either alone or with surgery and/or chemotherapy. Although modern radiotherapy techniques provide a significant advantage in protecting healthy tissues, it is inevitable that normal tissues are also located in the areas targeted by radiations. In this study, we aimed to examine the bone mineral density changes in bone structures commonly included in the irradiated area such as, L5 vertebra, sacrum, and femur heads, in patients who have received pelvic radiotherapy; and the relationship between these changes with radiation dose. MATERIAL AND METHODS: Patients included in the study had been previously diagnosed with rectal cancer, which were operated or not. Preoperative or postoperative pelvic radiotherapy was planned for all patients. In terms of convenience when comparing with future scans, all densitometry and CT scans were performed with the same devices. Fifteen patients were included in the study. In order to determine the dose of radiation each identified area had taken after radiotherapy, the sacrum, L5 vertebra, bilateral femoral heads, and L1 regions were contoured in the CT scans in which treatment planning was done. Sagittal cross-sectional images were taken advantage of while these regions were being contoured. RESULTS: Bone mineral density was evaluated with CT and dual-energy X-ray absorptiometry before and after the treatment. The regions that have theoretically been exposed to irradiation, such as L5, sacrum, left to right femur were found to have significant difference in terms of bone density. According to CT evaluation, there was a significant decrease in bone intensity of L5, sacrum, left and right femurs. Dual-energy X-ray absorptiometry assessment revealed that the whole of the left femoral head, left femur neck and Ward's region were significantly affected by radiotherapy. However, there was no significant difference in the sacrum and L5 vertebra before and after radiotherapy. CONCLUSION: More accurate results could be achieved if the same study was conducted on a larger patient population, with a longer follow-up period. When the reduction in bone density is at maximum or a cure is likely in a long-term period, bone mineral density could be determined by measurements performed at regular intervals.


Assuntos
Densidade Óssea , Cabeça do Fêmur/efeitos da radiação , Vértebras Lombares/efeitos da radiação , Órgãos em Risco/efeitos da radiação , Radioterapia Conformacional/efeitos adversos , Neoplasias Retais/radioterapia , Sacro/efeitos da radiação , Absorciometria de Fóton , Adulto , Idoso , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/etiologia , Terapia Combinada , Estudos Transversais , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/patologia , Seguimentos , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Masculino , Órgãos em Risco/diagnóstico por imagem , Órgãos em Risco/patologia , Neoplasias Retais/cirurgia , Sacro/diagnóstico por imagem , Sacro/patologia , Tomografia Computadorizada por Raios X
9.
Int J Mol Sci ; 20(12)2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31207955

RESUMO

It is well established that smoking has detrimental effects on bone integrity and is a preventable risk factor for metabolic bone disorders. Following orthopedic surgeries, smokers frequently show delayed fracture healing associated with many complications, which results in prolonged hospital stays. One crucial factor responsible for fracture repair is the recruitment and differentiation of mesenchymal stem cells (MSCs) at early stages, a mechanism mediated by transforming growth factor ß (TGF-ß). Although it is known that smokers frequently have decreased TGF-ß levels, little is known about the actual signaling occurring in these patients. We investigated the effect of cigarette smoke on TGF-ß signaling in MSCs to evaluate which step in the pathway is affected by cigarette smoke extract (CSE). Single-cell-derived human mesenchymal stem cell line (SCP-1 cells) were treated with CSE concentrations associated with smoking up to 20 cigarettes a day. TGF-ß signaling was analyzed using an adenovirus-based reporter assay system. Primary cilia structure and downstream TGF-ß signaling modulators (Smad2, Smad3, and Smad4) were analyzed by Western blot and immunofluorescence staining. CSE exposure significantly reduced TGF-ß signaling. Intriguingly, we observed that protein levels of phospho-Smad2/3 (active forms) as well as nuclear translocation of the phospho-Smad3/4 complex decreased after CSE exposure, phenomena that affected signal propagation. CSE exposure reduced the activation of TGF-ß modulators under constitutive activation of TGF-ß receptor type I (ALK5), evidencing that CSE affects signaling downstream of the ALK5 receptor but not the binding of the cytokine to the receptor itself. CSE-mediated TGF-ß signaling impaired MSC migration, proliferation, and differentiation and ultimately affected endochondral ossification. Thus, we conclude that CSE-mediated disruption of TGF-ß signaling in MSCs is partially responsible for delayed fracture healing in smokers.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Células-Tronco Mesenquimais/efeitos dos fármacos , Transdução de Sinais , Poluição por Fumaça de Tabaco/efeitos adversos , Fator de Crescimento Transformador beta/metabolismo , Diferenciação Celular , Linhagem Celular , Movimento Celular , Proliferação de Células , Cílios/efeitos dos fármacos , Cílios/metabolismo , Humanos , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Receptor do Fator de Crescimento Transformador beta Tipo I/metabolismo , Proteínas Smad/metabolismo
10.
Pathol Int ; 69(5): 249-259, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31219232

RESUMO

CD109 is a glycosylphosphatidylinositol-anchored glycoprotein and a member of the α2 -macroglobulin/C3,C4,C5 family of thioester-containing proteins first identified as being expressed on blood cells, including activated T cells and platelets, and a subset of CD34 + bone marrow cells containing megakaryocyte progenitors. Although CD109 carries the biallelic platelet-specific alloantigen Gov, the physiological functions or roles of CD109 in human disease remain largely unknown. It was recently demonstrated that CD109 is expressed in many malignant tumors, including various squamous cell carcinomas and adenocarcinomas, and plays a role as a multifunctional coreceptor. CD109 reportedly associates with transforming growth factor (TGF)-ß receptors and negatively regulates TGF-ß signaling in keratinocytes. Additionally, CD109 is potentially related to signal transducer and activator of transcription-3 signaling and aberrant cell proliferation. In this review, we describe recent evidence of CD109-specific significance in malignant tumors shown in mouse models and human tissues. Furthermore, we discuss the physiological functions of CD109 in vitro and in vivo, including results of phenotype analyses of CD109-deficient mice exhibiting epidermal hyperplasia and osteopenia.


Assuntos
Antígenos CD/metabolismo , Carcinogênese/metabolismo , Proteínas Ligadas por GPI/metabolismo , Proteínas de Neoplasias/metabolismo , Neoplasias , Adenocarcinoma/etiologia , Adenocarcinoma/metabolismo , Animais , Antígenos CD/genética , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/metabolismo , Carcinogênese/imunologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/metabolismo , Linhagem Celular , Proteínas Ligadas por GPI/genética , Homeostase , Humanos , Hiperplasia/etiologia , Hiperplasia/metabolismo , Camundongos , Proteínas de Neoplasias/genética , Neoplasias/etiologia , Neoplasias/imunologia , Neoplasias/metabolismo , Fator de Transcrição STAT3/metabolismo , Fatores de Crescimento Transformadores/metabolismo
11.
Arch Oral Biol ; 103: 40-46, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31128441

RESUMO

OBJECTIVE: To identify an uncommon genetic cause of tooth agenesis (TA) by utilizing whole exome sequencing (WES) and targeted Sanger sequencing in a cohort of 120 patients with isolated TA. DESIGN: One deleterious mutation in the gene encoding bone morphogenetic protein 4 (BMP4) was identified in 6 unrelated patients with TA by WES. After that, the coding exons of BMP4 were examined in 114 TA patients using Sanger sequencing. Dual-energy X-ray absorptiometry (DEXA) was used to measure the bone mineral density of patients who carried a BMP4 mutation. Finally, preliminary functional studies of two BMP4 mutants were performed. RESULTS: We detected 3 novel missense mutations (c.58 G > A: p.Gly20Ser, c.326 G > T: p.Arg109Leu and c.614 T > C: p.Val205Ala) and 1 reported mutation in the BMP4 gene among 120 TA probands. The previously reported BMP4 mutation (c.751C > T: p.His251Tyr) was associated with urethra and eye anomalies. By extending the pedigrees, we determined that the tooth phenotypes had an autosomal dominant inheritance pattern, as individuals carrying a BMP4 mutation exhibit different types of dental anomalies. Interestingly, we observed that patients harboring a BMP4 mutation manifested early onset osteopenia or osteoporosis. Further in vitro functional assays demonstrated that two BMP4 mutants resulted in a decreased activation of Smad signaling. Therefore, a loss-of-function in BMP4 may contribute to the clinical phenotypes seen in this study. CONCLUSIONS: We identified 4 mutations in the BMP4 gene in 120 TA patients. To our knowledge, this is the first study to describe human skeletal diseases associated with BMP4 mutations.


Assuntos
Anodontia/genética , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/genética , Proteína Morfogenética Óssea 4/genética , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Linhagem , Dente
12.
Int J Mol Sci ; 20(10)2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31137669

RESUMO

Almost all patients with chronic liver diseases (CLD) show altered bone metabolism. Depending on the etiology, this manifests in a severe osteoporosis in up to 75% of the affected patients. Due to high prevalence, the generic term hepatic osteodystrophy (HOD) evolved, describing altered bone metabolism, decreased bone mineral density, and deterioration of bone structure in patients with CLD. Once developed, HOD is difficult to treat and increases the risk of fragility fractures. Existing fractures affect the quality of life and, more importantly, long-term prognosis of these patients, which presents with increased mortality. Thus, special care is required to support the healing process. However, for early diagnosis (reduce fracture risk) and development of adequate treatment strategies (support healing of existing fractures), it is essential to understand the underlying mechanisms that link disturbed liver function with this bone phenotype. In the present review, we summarize proposed molecular mechanisms favoring the development of HOD and compromising the healing of associated fractures, including alterations in vitamin D metabolism and action, disbalances in transforming growth factor beta (TGF-ß) and bone morphogenetic protein (BMP) signaling with histone deacetylases (HDACs) as secondary regulators, as well as alterations in the receptor activator of nuclear factor kappa B ligand (RANKL)-osteoprotegerin (OPG) system mediated by sclerostin. Based on these mechanisms, we give an overview on the limitations of early diagnosis of HOD with established serum markers.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Hepatopatias/complicações , Animais , Doenças Ósseas Metabólicas/metabolismo , Proteínas Morfogenéticas Ósseas/metabolismo , Cálcio/metabolismo , Humanos , Hepatopatias/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Vitamina D/metabolismo
13.
PLoS One ; 14(5): e0216428, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31050690

RESUMO

INTRODUCTION: Sandblasting is one of the oldest implant surface modifications to enhance osseointegration. Regarding its superiority over machined surface controversies still exist. Our objective was to compare implant failures (IF) and marginal bone level (MBL) changes between sandblasted and machined dental implants by a meta-analysis utilizing the available data. The PROSPERO registration number of the meta-analysis is CRD42018084190. METHODS: The systematic search was performed in Cochrane, Embase and Pubmed. Inclusion criteria included participants with neither systemic diseases, nor excessive alcohol consumption, nor heavy smoking. We calculated pooled Risk Ratio (RRs) with confidence intervals of 95% (CIs) for dichotomous outcomes (implant failure) and weighted mean difference (WMD) CIs of 95% for continuous outcomes (marginal bone level change). We applied the random effect model with DerSimonian-Laird estimation. I2 and chi2 tests were used to quantify statistical heterogeneity and gain probability-values, respectively. RESULTS: Literature search revealed 130 records without duplicates. Out of these, seven studies met the inclusion criteria and all were included in data synthesis, involving 362 sand-blasted and 360 machined implants. The results indicate that there is an 80% (RR = 0.2 95% CI:0.06-0.67; I2 = 0.0% p = 0.986) lower among sandblasted compared to machined implants after one year of use and 74% (RR = 0.26 95% CI:0.09-0.74; I2 = 0.0% p = 0.968) five years of use, respectively. In contrast, there is no significant difference in MBL (WMD:-0.10mm, 95% CI:-0.20, 0.01; p>0.05; I2 = 0.0%, p = 0.560 and WMD:-0.01mm, 95% CI:-0.12, 0.09; p>0.05; I2 = 26.2%, p = 0.258) between the two implant surfaces after one and five years of use. CONCLUSIONS: This meta-analysis reveals that sandblasting is superior over machined surface in implant failure but not in marginal bone level in healthy subjects. It also points out the need for further randomized clinical trials with large sample size for objective determination of the clinical benefits of certain implant surface modifications.


Assuntos
Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Falha de Restauração Dentária , Osseointegração , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/metabolismo , Doenças Ósseas Metabólicas/patologia , Humanos
14.
Molecules ; 24(10)2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31096652

RESUMO

Diabetic Osteoporosis (DOP) is a common metabolic bone disease, characterized by decreased bone mineral density (BMD) and destruction of bone microstructure. It has been reported that icariin is beneficial for estrogen deficiency-induced osteoporosis, and alcohol-induced osteoporosis; whether icariin has protective effects on diabetes-induced osteoporosis has not been reported. In this study, a rat model of diabetic osteoporosis was established by streptozotocin injection, the bone protective effects and potential mechanism of icariin on diabetes-induced bone loss was observed. Thirty 8-week-old female Sprague Dawley rats were divided into control group (vehicle treatment), T1DM (diabetic) group and T1DM-icariin (ICA) group (diabetic rats treated with icariin), 10 rats in each group. The bone histomorphometry parameters, bone mineral density (BMD), serum bone turnover markers, and bone marrow adipogenesis were analyzed after 8 weeks of icariin administration. The results showed consumption of icariin at a doses of 100 mg kg-1 decreased blood glucose, and increased the BMD of diabetic rats. Icariin effectively decreased serum bone turnover marker levels, including CTX-1, ALP, TRACP 5b, osteocalcin, and PINP. Meanwhile, the bone histomorphometry parameters, the number of osteoclasts per bone perimeter were turned to be normal level, and the icariin treatment suppressed bone marrow adipogenesis. The runt-related transcription factor 2 (RUNX 2), as well as the osteoprotegerin (OPG)/receptor activator of nuclear factor-κ B ligand (RANKL) ratio in serum and bone tissues were increased significantly after icariin treatment in diabetic rats. All of the above indicate that oral administration of icariin can prevent diabetic osteoporosis; the effect is mainly related to its ability to reduce blood glucose, inhibit bone turnover and bone marrow adipogenesis, as well as up-regulate bone RUNX 2, and OPG expression.


Assuntos
Remodelação Óssea/efeitos dos fármacos , Flavonoides/farmacologia , Hipoglicemiantes/farmacologia , Substâncias Protetoras/farmacologia , Adipócitos/metabolismo , Animais , Biomarcadores , Glicemia/efeitos dos fármacos , Densidade Óssea/efeitos dos fármacos , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/metabolismo , Doenças Ósseas Metabólicas/prevenção & controle , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/metabolismo , Osso e Ossos/patologia , Subunidade alfa 1 de Fator de Ligação ao Core/sangue , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Diabetes Mellitus Experimental , Feminino , Flavonoides/química , Expressão Gênica , Hipoglicemiantes/química , Imuno-Histoquímica , Substâncias Protetoras/química , Ligante RANK/sangue , Ligante RANK/genética , Ratos
15.
Adv Clin Exp Med ; 28(7): 955-960, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30929318

RESUMO

BACKGROUND: A common feature in the etiology of inflammatory bowel disease (IBD) and osteoporosis is a complex genetic background. Moreover, it has been shown that some of the susceptibility loci overlap for both diseases. One of the genes that may be involved in the pathogenesis of IBD as well as decreased bone mass is the vitamin D receptor (VDR) gene. OBJECTIVES: The aim of this study was to investigate the association of the TaqI polymorphism (rs731236, c.1056T >C) in the VDR gene with serum vitamin D concentration and bone mineral density (BMD) in patients with IBD. MATERIAL AND METHODS: A total of 172 IBD patients (85 with Crohn's disease (CD) and 87 with ulcerative colitis (UC)) and 39 healthy controls were enrolled in the study. Polymorphism was determined with polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Bone mineral density was measured at the lumbar spine (L2-L4) and the femoral neck (FN) using dual-energy x-ray absorptiometry (DEXA). Serum concentrations of 25-hydroxyvitamin D were determined using electrochemiluminescence binding assay (ECLIA). RESULTS: Our studies revealed that serum vitamin D concentration in IBD patients was not lowered in comparison with healthy controls. Patients with CD presented more advanced osteopenia and osteoporosis. Individuals with UC carrying the TaqI tt genotype of VDR gene showed significantly higher FN BMD than carriers of TT and Tt genotypes (p = 0.02). Moreover, tt genotype was present with higher frequency in UC patients than in controls and CD patients (23% vs 7.7% and 16.5%, respectively). CONCLUSIONS: The tt genotype may have a protective effect on BMD in UC patients.


Assuntos
Densidade Óssea/genética , Doenças Ósseas Metabólicas/etiologia , Colo do Fêmur/diagnóstico por imagem , Doenças Inflamatórias Intestinais/complicações , Vértebras Lombares/diagnóstico por imagem , Receptores de Calcitriol/genética , Vitamina D/sangue , Absorciometria de Fóton , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/diagnóstico por imagem , Estudos de Casos e Controles , Colite Ulcerativa/sangue , Colite Ulcerativa/complicações , Colite Ulcerativa/genética , Doença de Crohn/sangue , Doença de Crohn/complicações , Doença de Crohn/genética , Feminino , Humanos , Doenças Inflamatórias Intestinais/sangue , Doenças Inflamatórias Intestinais/genética , Reação em Cadeia da Polimerase , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Vitamina D/genética
16.
Eur Arch Otorhinolaryngol ; 276(6): 1561-1571, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31030242

RESUMO

BACKGROUND: The association between bone mineral density (BMD) and benign paroxysmal positional vertigo (BPPV) has been investigated by multiple studies, but the conclusions are controversial. This meta-analysis was conducted to evaluate whether the bone mineral density is associated with BPPV. METHODS: The relevant studies were identified by searching PubMed, EMBASE, Cochrane Library, ScienceDirect, Web of Science database up to June 2018. Statas14.0 software was used for meta-analysis. We used the pooled odds ratio (OR) and 95% confidence interval (CI) to assess the incidence of osteoporosis and osteopenia in patients with BPPV and controls (free of BPPV disease). The standardized mean difference (SMD) and 95% confidence interval (CI) were used to assess the T score in BPPV patients and controls. This meta-analysis has been registered at International Prospective Register of Systematic Reviews (PROSPERO) (number CRD42018082271). RESULTS: A total of 11 studies were eligible for meta-analysis, including 1982 subjects. When compared with the controls, the total incidence of osteoporosis and osteopenia was significantly higher in BPPV patients (OR 3.27, 95% CI 2.66-4.03, p < 0.0001). Further analysis was conducted by separate discussion about the incidence of osteoporosis and osteopenia in BPPV patients, the result of which shows that both the incidence of osteoporosis (OR 3.48, 95% CI 1.86-6.51, p < 0.0001) and the incidence of osteopenia (OR 1.75, 95% CI 1.01-3.04, p < 0.0001) were higher in BPPV patients than that in controls. There was an significant reduction in T scores of BPPV patients (SMD - 0.82, 95% CI -1.18 to - 0.46, p < 0.0001). Publication bias for each analysis was evaluated by Egger's test and Begg's indicating that no publication bias existed. Sensitivity analysis was conducted for each analysis demonstrating that the results were robust. CONCLUSIONS: Our meta-analysis provided stronger evidence that patients with BPPV were associated with a lower T score and a higher risk of osteoporosis and osteopenia. The results demonstrated that lower bone mineral density may be a risk factor for BPPV. However, large-scare, multicenter clinical studies need to be carried out to explore the precise risk of osteoporosis and osteopenia in patients with BPPV in future.


Assuntos
Vertigem Posicional Paroxística Benigna/complicações , Densidade Óssea , Doenças Ósseas Metabólicas/etiologia , Vertigem Posicional Paroxística Benigna/fisiopatologia , Doenças Ósseas Metabólicas/epidemiologia , Humanos , Incidência , Razão de Chances , Osteoporose/epidemiologia , Osteoporose/etiologia , Fatores de Risco
18.
J Orthop Res ; 37(4): 942-947, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30835896

RESUMO

Expression of CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) is induced during endoplasmic reticulum (ER) stress, which is related to apoptosis in several cell types. CHOP null mice have been exhibited to decrease bone formation. However, a study of transgenic mice overexpressing CHOP in the bone microenvironment showed that CHOP overexpression impairs the osteoblastic function leading to osteopenia. The regulatory role of CHOP in bone formation is controversial and still remains to be clarified. Here, we investigated the alterations in bone microstructure of CHOP knockout (Chop-/- ) mice and tested the gender difference of CHOP deficiency in susceptibility to osteopenia. Adult female and male mice (WT) and Chop-/- mice were used. The microcomputed tomography (µCT) analysis in trabecular bone and cortical bone of tibia was determined. Trabecular bone volume fraction (BV/TV), trabecular number, and bone mineral density (BMD) in tibia are markedly decreased in both male and female Chop-/- mice compared to the control WT mice. Unexpectedly, the BMD and BV/TV in trabecular bone of tibia in female Chop-/- mice were significantly lower than in male Chop-/- mice. The similar results could also be observed in the cortical bone of tibia in Chop-/- mice. This gender difference was also observed in the decreased capacity of osteoblast differentiation of bone marrow cells isolated from Chop-/- mice. These results indicated that ER stress-related CHOP signaling might play an important role in the bone formation in a mouse model, especially in females. There is the gender difference of CHOP deficiency in susceptibility to osteopenia. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Caracteres Sexuais , Fator de Transcrição CHOP/fisiologia , Animais , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Feminino , Masculino , Camundongos Knockout , Microtomografia por Raio-X
19.
Cancer Nurs ; 42(2): 164-172, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30802224

RESUMO

BACKGROUND: Cancer treatment-induced bone loss is an important long-term effect among breast cancer survivors. Little is known, however, about the pattern of bone loss and the factors associated with it. OBJECTIVE: The aim of this study was to examine annual bone health changes and factors associated with bone loss for 3 years after diagnosis among women with breast cancer. METHODS: Ninety-nine newly diagnosed women with breast cancer (mean age, 51.1 years) were enrolled in a prospective longitudinal study. Bone mineral density (BMD) was measured with dual-energy x-ray absorptiometry at baseline and yearly for 3 years. RESULTS: During the 3-year follow-up, the proportion of women who had osteopenia or osteoporosis increased from 33.3% to 62.5%. The BMD of the participants significantly decreased 6.8% in the lumbar spine, 4.6% in the femur neck, and 3.5% in the total hip, with bone loss the greatest in the first year. In multiple linear regression analysis, chemotherapy was significantly associated with bone loss at all sites, and premenopausal status at diagnosis was significantly related to bone loss at the lumbar spine. We found no significant relationship between health behavior status and BMD change at any site. CONCLUSION: Women newly diagnosed with breast cancer can lose up to 6.8% of BMD during a 3-year follow-up. Chemotherapy and premenopausal status are important risk factors for bone loss. IMPLICATIONS FOR PRACTICE: Identification of premenopausal women at diagnosis and monitoring BMD before and after chemotherapy are key for promoting bone health in women with breast cancer.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Neoplasias da Mama/complicações , Osteoporose Pós-Menopausa/etiologia , Absorciometria de Fóton , Adulto , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/prevenção & controle , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/fisiopatologia , Feminino , Humanos , Estudos Longitudinais , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/prevenção & controle , Pré-Menopausa , Estudos Prospectivos
20.
Am J Pathol ; 189(4): 753-761, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30664862

RESUMO

Glucocorticoid-induced secondary osteoporosis is the most predictable side effect of this anti-inflammatory. One of the main mechanisms by which glucocorticoids achieve such deleterious outcome in bone is by antagonizing Wnt/ß-catenin signaling. Sclerostin, encoded by Sost gene, is the main negative regulator of the proformative and antiresorptive role of the Wnt signaling pathway in the skeleton. It was hypothesized that the partial inactivation of sclerostin function by genetic manipulation will rescue the osteopenia induced by high endogenous glucocorticoid levels. Sost-deficient mice were crossed with an established mouse model of excess glucocorticoids, and the effects on bone mass and structure were evaluated. Sost haploinsufficiency did not rescue the low bone mass induced by high glucocorticoids. Intriguingly, the critical manifestation of Sost deficiency combined with glucocorticoid excess was sporadic, sudden, unprovoked, and nonconvulsive death. Detailed histopathologic analysis in a wide range of tissues identified peracute hemopericardium and cardiac tamponade to be the cause. These preclinical studies reveal outcomes with direct relevance to ongoing clinical trials that explore the use of antisclerostin antibodies as a treatment for osteoporosis. They particularly highlight a potential for increased cardiovascular risk and may inform improved stratification of patients who might otherwise benefit from antisclerostin antibody treatment.


Assuntos
Densidade Óssea/efeitos dos fármacos , Doenças Ósseas Metabólicas/etiologia , Tamponamento Cardíaco/etiologia , Glucocorticoides/toxicidade , Haploinsuficiência , Peptídeos e Proteínas de Sinalização Intercelular/fisiologia , Animais , Doenças Ósseas Metabólicas/metabolismo , Doenças Ósseas Metabólicas/patologia , Tamponamento Cardíaco/metabolismo , Tamponamento Cardíaco/patologia , Modelos Animais de Doenças , Feminino , Marcadores Genéticos , Masculino , Camundongos , Camundongos Endogâmicos C3H , Camundongos Endogâmicos C57BL , Camundongos Knockout , Via de Sinalização Wnt
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA