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1.
Biomed Eng Online ; 21(1): 3, 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35012556

RESUMO

BACKGROUND: Demographic change is leading to an increase in the number of osteoporotic patients, so a rethink is required in implantology in order to be able to guarantee adequate anchoring stability in the bone. The functional modification of conventional standard screw implants using superelastic, structured Ti6Al4V anchoring elements promises great potential for increasing anchoring stability. METHODS: For this purpose, conventional screw implants were mechanically machined and extended so that structured-superelastic-positionable-Ti6Al4V anchoring elements could be used. The novel implants were investigated with three tests. The setup of the anchoring elements was investigated in CT studies in an artificial bone. In a subsequent simplified handling test, the handling of the functional samples was evaluated under surgical conditions. The anchorage stability compared to standard screw implants was investigated in a final pullout test according to ASTM F543-the international for the standard specification and test methods for metallic medical bone screws. RESULTS: The functionalization of conventional screw implants with structured superelastic Ti6Al4V anchoring elements is technically realizable. It was demonstrated that the anchoring elements can be set up in the artificial bone without any problems. The anchorage mechanism is easy to handle under operating conditions. The first simplified handling test showed that at the current point of the investigations, the anchoring elements have no negative influence on the surgical procedure (especially under the focus of screw implantation). Compared to conventional standard screws, more mechanical work is required to remove the functional patterns completely from the bone. CONCLUSION: In summary, it was shown that conventional standard screw implants can be functionalized with Ti6Al4V-structured NiTi anchoring elements and the new type of screws are suitable for orthopedic and neurosurgical use. A first biomechanical test showed that the anchoring stability could be increased by the anchoring elements.


Assuntos
Parafusos Ósseos , Osso e Ossos , Ligas , Fenômenos Biomecânicos , Humanos , Teste de Materiais
2.
J Sci Food Agric ; 102(2): 597-606, 2022 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-34148242

RESUMO

BACKGROUND: With the development of intensive farming, long-term exposure of pigs to poor light conditions is not conducive to the production of vitamin D3 , and vitamin D3 deficiency could affect absorption and metabolism of calcium (Ca) and phosphorus (P). 25-Hydroxyvitamin D3 (25OHD3 ) has higher bioactivity than regular vitamin D3 . This study investigated the effects of 25OHD3 on performance, serum parameters, fecal microbiota, and metabolites in weaned piglets fed with low Ca-P diet. RESULTS: It was found that a low Ca-P diet supplemented with 50 µg/kg 25OHD3 (NC + 25-D) improved (P < 0.05) average daily gain (ADG) in phase 2 and in the overall period of the experiment, and increased (P < 0.05) the immunoglobulin G (IgG), immunoglobulin A (IgA), catalase (CAT), bone-specific alkaline phosphatase (BALP), and osteocalcin (OC) serum content on day 28 compared with a low Ca-P diet (NC), but no differences were observed between a normal Ca-P diet (PC) and the NC + 25-D diet. Compared with NC, the abundance of Firmicutes was higher (P < 0.05) in PC and NC + 25-D. NC + 25-D decreased (P < 0.05) the abundance of Streptococcaceae compared with PC and NC, and increased (P < 0.05) the abundance of Lachnospiraceae compared with NC. Serum 25OHD3 was negatively correlated with the abundance of fecal Streptococcaceae (P < 0.05), and positively correlated with the abundance of fecal Lachnospiraceae (P < 0.05). CONCLUSION: Supplementation of 25OHD3 in a low Ca-P diet improved serum immunity, bone biochemical parameters, and fecal microbiota such as decreased Streptococcaceae abundance and increased Lachnospiraceae abundance, which could subsequently promote growth of piglets. The effects were similar to that of a normal Ca-P diet. © 2021 Society of Chemical Industry.


Assuntos
Calcifediol/metabolismo , Fezes/microbiologia , Microbioma Gastrointestinal , Suínos/crescimento & desenvolvimento , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Desenvolvimento Ósseo , Osso e Ossos/metabolismo , Cálcio/análise , Cálcio/metabolismo , Suplementos Nutricionais/análise , Feminino , Masculino , Fósforo/análise , Fósforo/metabolismo , Suínos/sangue , Suínos/metabolismo , Suínos/microbiologia , Desmame
3.
Clin Nucl Med ; 47(1): 43-55, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34874348

RESUMO

ABSTRACT: The introduction of total body (TB) PET/CT instruments over the past 2 years has initiated a new and exciting era in medical imaging. These instruments have substantially higher sensitivity (up to 68 times) than conventional modalities and therefore allow imaging the entire body over a short period. However, we need to further refine the imaging protocols of this instrument for different indications. Total body PET will allow accurate assessment of the extent of disease, particularly, including the entire axial and appendicular skeleton. Furthermore, delayed imaging with this instrument may enhance the sensitivity of PET for some types of cancer. Also, this modality may improve the detection of venous thrombosis, a common complication of cancer and chemotherapy, in the extremities and help prevent pulmonary embolism. Total body PET allows assessment of atherosclerotic plaques throughout the body as a systematic disease. Similarly, patients with widespread musculoskeletal disorders including both oncologic and nononcologic entities, such as degenerative joint disease, rheumatoid arthritis, and osteoporosis, may benefit from the use of TB-PET. Finally, quantitative global disease assessment provided by this approach will be superior to conventional measurements, which do not reflect overall disease activity. In conclusion, TB-PET imaging may have a revolutionary impact on day-to-day practice of medicine and may become the leading imaging modality in the future.


Assuntos
Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Osso e Ossos , Humanos , Neoplasias/diagnóstico por imagem , Tomografia por Emissão de Pósitrons
4.
Endocrinology ; 163(1)2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34669927

RESUMO

Thyroid hormones (TH) are essential for skeletal development and adult bone homeostasis. Their bioavailability is determined by specific transporter proteins at the cell surface. The TH-specific transporter monocarboxylate transporter 8 (MCT8) was recently reported as a regulator of bone mass in mice. Given that high systemic triiodothyronine (T3) levels in Mct8 knockout (KO) mice are still able to cause trabecular bone loss, alternative TH transporters must substitute for MCT8 function in bone. In this study, we analyzed the skeletal phenotypes of male Oatp1c1 KO and Mct10 KO mice, which are euthyroid, and male Mct8/Oatp1c1 and Mct8/Mct10 double KO mice, which have elevated circulating T3 levels, to unravel the role of TH transport in bone. MicroCT analysis showed no significant trabecular bone changes in Oatp1c1 KO mice at 4 weeks and 16 weeks of age compared with wild-type littermate controls, whereas 16-week-old Mct8/Oatp1c1 double KO animals displayed trabecular bone loss. At 12 weeks, Mct10 KO mice, but not Mct8/Mct10 double KO mice, had decreased trabecular femoral bone volume with reduced osteoblast numbers. By contrast, lack of Mct10 in 24-week-old mice led to trabecular bone gain at the femur with increased osteoblast numbers and decreased osteoclast numbers whereas Mct8/Mct10 double KO did not alter bone mass. Neither Mct10 nor Mct8/Mct10 deletion affected vertebral bone structures at both ages. In vitro, osteoblast differentiation and activity were impaired by Mct10 and Mct8/Mct10-deficiency. These data demonstrate that MCT10, but not OATP1C1, is a site- and age-dependent regulator of bone mass and turnover in male mice.


Assuntos
Sistemas de Transporte de Aminoácidos Neutros/metabolismo , Osso e Ossos/metabolismo , Animais , Transporte Biológico , Fenômenos Biomecânicos , Osso Esponjoso/metabolismo , Diferenciação Celular , Fêmur/fisiologia , Homeostase , Masculino , Camundongos , Camundongos Knockout , Proteínas de Transporte de Cátions Orgânicos/metabolismo , Osteoblastos/citologia , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osteócitos/citologia , Fenótipo , Simportadores/metabolismo , Glândula Tireoide/metabolismo , Hormônios Tireóideos/metabolismo , Tri-Iodotironina/metabolismo , Microtomografia por Raio-X
5.
Proc Inst Mech Eng H ; 236(1): 103-120, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34617494

RESUMO

Bone cutting plays an important role in spine surgical operations. The power devices with high speed employing in bone cutting usually leads to high cutting temperature of the bone tissue. This high temperature control is important in improving cutting surface quality and optimizing the cutting parameters. In this paper, the bone-cutting model was appropriately simplified for finite element (FE) based modeling of 2D orthogonal cutting to discuss the change law of cutting temperature of cortical bones for cervical vertebra, and to study the orthogonal cutting mechanism of the anisotropic cortical bone, a 3D FE simulation model had been also established in which longitudinal, vertical, and transversal cutting types were accomplished to investigate the effect of osteons orientation. Secondly, this response surface method was used to regress the simulation results, and establishes the prediction model of maximum temperature on cutting depth, cutting speed, and feed speed. Then, the Sobol method was used to analyze the sensitivity of the milling temperature prediction mathematical model parameters, in order to clarify and quantitatively analyze the influence of input milling parameters on the output milling temperature. Finally, the cutting temperatures obtained with the simulations were compared with the corresponding experimental results obtained from the bone milling tests. This study verifies the influence of key variables and the cutting parameters on thermo mechanical behavior of the bone cutting. The obtained cutting temperature distribution for the bone surfaces could be employed to establish a theoretical foundation for research on thermal damage control of bone tissues.


Assuntos
Procedimentos Ortopédicos , Osso e Ossos/cirurgia , Osso Cortical/cirurgia , Temperatura Alta , Temperatura
6.
Life Sci ; 289: 120233, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34921865

RESUMO

Tributyltin (TBT), an endocrine disruptor is used globally in agribusiness and industries as biocides, heat stabilizers, and in chemical catalysis. It is known for its deleterious effects on bone by negatively impacting the functions of osteoblasts, osteoclasts and mesenchymal stem cells. However, the impact of TBT on the metabolomics profile in bone is not yet studied. Here, we demonstrate alterations in chemical metabolomics profiles measured by solid state 1H nuclear magnetic resonance (1H NMR) spectroscopy in zebrafish bone following tributyltin (TBT) treatment. TBT of 0, 100, 200, 300, 400 and 500 µg/L were exposed to zebrafish. From this, zebrafish bone has subjected for further metabolomics profiling. Samples were measured via one-dimensional (1D) solvent -suppressed and T2- filtered methods with in vivo zebrafish metabolites. A dose dependent alteration in the metabolomics profile was observed and results indicated a disturbed aminoacid metabolism, TCA cycle, and glycolysis. We found a significant alteration in the levels of glutamate, glutamine, glutathione, trimethylamine N-oxide (TMAO), and other metabolites. This investigation hints us the deleterious effects of TBT on zebrafish bone enabling a comprehensive understanding of metabolomics profile and is expected to play a crucial role in understanding the deleterious effects of various endocrine disruptor on bone.


Assuntos
Osso e Ossos/metabolismo , Disruptores Endócrinos/toxicidade , Metabolômica , Ressonância Magnética Nuclear Biomolecular , Compostos de Trialquitina/toxicidade , Peixe-Zebra/metabolismo , Aminoácidos/metabolismo , Animais , Ciclo do Ácido Cítrico/efeitos dos fármacos , Glicólise/efeitos dos fármacos
7.
J Mech Behav Biomed Mater ; 125: 104815, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34678618

RESUMO

Bone is a biological tissue with unique mechanical properties, owing to a complex hierarchical structure ranging from the nanoscale up to the macroscale. To better understand bone mechanics, investigation of mechanical properties of all structural elements at every hierarchical level and how they interact is necessary. Testing of bone structures at the lower microscale, e.g. bone lamellae, has been least performed and remains a challenge. Focused ion beam (FIB) milling is an attractive technique for machining microscopic samples from bone material and performing mechanical testing at the microscale using atomic force microscopy (AFM) and nanoindentation setups. So far, reported studies at this length scale have been performed on bone samples of animal origin, mostly in a dehydrated state, except for one study. Here we present an AFM-based microbeam bending method for performing bending measurements in both dehydrated and rehydrated conditions at the microscale. Single lamella bone microbeams of four human donors, aged 65-94 yrs, were machined via FIB and tested both in air and fully submerged in Hank's Balanced Salt Solution (HBSS) to investigate the effect of (de)hydration and to a certain extent, of age, on bone mechanics. Bending moduli were found to reduce up to 5 times after 2 h of rehydration and no trend of change in bending moduli with respect to age could be observed. Mechanical behavior changed from almost purely elastic to viscoelastic upon rehydration and a trend of lower dissipated energy in samples from older donors could be observed in the rehydrated state. These results confirm directly the importance of water for the mechanical properties of bone tissue at the microscale. Moreover, the trend of lowered capability of energy dissipation in older donors may contribute to a decrease of fracture toughness and thus an increase in bone fragility with age.


Assuntos
Osso e Ossos , Fêmur , Idoso , Osso Cortical , Humanos
8.
J Mech Behav Biomed Mater ; 125: 104889, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34736022

RESUMO

The whole bone geometry, microstructure, and mechanical properties of mature human bone are widely reported; however, immature bone (0-18 years) has not been similarly robustly characterized. There is an interest in analyzing and predicting the mechanical loading conditions associated with long bone diaphyseal fractures attributed to trauma in children. Thus, understanding the mechanical properties of immature bone in a temporal reference frame is an essential first step to understand diaphyseal fractures of pediatric long bones. The purpose of this systematic review was to ask, what is the state of knowledge regarding the 1) evolution of whole bone geometry and microstructure of immature pediatric bone as a function of maturation and 2) cortical bone density and experimental quasi-static mechanical properties at the tissue level in the diaphyseal region of immature pediatric long bones? The systematic search yielded 36 studies of the whole bone geometry, microstructure, and mechanical properties of immature pediatric long bones. The elastic modulus, yield stress, and ultimate stress were shown to generally increase with maturation, whereas the yield strain was approximately invariant; however, the specific year-to-year progression of these properties could not be characterized from the limited studies available. The results of this systematic search indicate there is a dearth of knowledge associated with the biomechanics of cortical bone from immature pediatric long bones; it also provides a basis for computational studies of immature human long bones. Additional biomechanical studies of immature human bone are necessary to develop a robust catalogue, which can be used in broad applications to understand fracture mechanics, bone pathologies, and athletic injury in the pediatric setting.


Assuntos
Osso e Ossos , Osso Cortical , Fenômenos Biomecânicos , Biofísica , Criança , Diáfises , Humanos
9.
Eur J Radiol ; 146: 110081, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34911006

RESUMO

PURPOSE: 18F-NaF PET is valuable for detecting bone metabolism through osteoblastic activity in the assessment of bone disease. Hawkins, Patlak, and standardised uptake value (SUV) are the most common quantitative measurements used to evaluate bone metabolism. This systematic review evaluates the correlation between quantitative positron emission tomography (PET) methods and to compare their precision. METHODS: A systematic search in Medline, PubMed, SCOPUS, and Web of Science was undertaken to find relevant papers published from 2000. All studies with human adults undergoing 18F-NaF PET, PET/CT, or PET/MRI were included except for subjects diagnosed with non-diffuse metabolic bone disease or malignancy. Quality Assessment Tool for Studies of Diverse Designs (QATSDD) was used to assess risk of bias. A qualitative review and meta-analysis using Hedges random-effect model was used producing summary size effects of the correlation between methods in healthy and unhealthy bone sites and assessing study heterogeneity. RESULTS: 228 healthy and unhealthy participants were included across 12 studies resulted from the systematic search. One-third of studies had a moderate quality percentage while the rest had relatively high quality. The pooled correlation coefficient in meta-analysis showed a high correlation of more than 0.88 (0.71-1.05. 95 %CI) between SUV and Hawkins and more than 0.96 (0.88-1.03. 95 %CI) between Patlak and Hawkins within all subgroups, suggesting all methods yield similar results in healthy and unhealthy bone sites. SUV has the lowest precision error followed by Patlak while Hawkins method showed the highest precision error. CONCLUSION: Patlak is the best within research and SUV is better within clinical practice.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Adulto , Osso e Ossos/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Cinética , Imageamento por Ressonância Magnética , Compostos Radiofarmacêuticos
10.
J Pediatr Orthop B ; 31(1): 7-11, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32991375

RESUMO

The purpose of this study was to investigate whether an elbow arthrogram after closed reduction and percutaneous fixation of lateral condyle fractures results in a change in surgical management. This is a retrospective review of lateral condyle fractures managed with closed reduction and percutaneous fixation followed by an elbow arthrogram at our institution between 2008 and 2019. Chart and radiographic review was performed and operative notes were reviewed to determine rates of subsequent intervention after arthrogram. Descriptive statistics were used to summarize the data. This study included 47 patients. The majority of patients were male (34 patients, 72%), and the mean age at time of injury was 5.5 ± 2.6 years. The mean radiographic displacement was 2.6 mm (range 0.8-6.9 mm). All fractures were managed by fellowship-trained pediatric orthopaedic surgeons with an average of 10.5 years of experience (range 0-32 years). Fractures were stabilized with percutaneous pins in 44 patients (94%) and percutaneous screws in three patients (6%). No patients had subsequent changes in management after an elbow arthrogram. There were no complications related to performance of the arthrogram. Closed reduction and percutaneous fixation is often indicated for mildly displaced lateral condyle fractures. Articular reduction after percutaneous fixation is commonly assessed using an elbow arthrogram; however, it did not change surgical management in any case reviewed over the 10-year study period. While there seems to be little risk of performing an arthrogram, the clinical utility should be further evaluated.


Assuntos
Articulação do Cotovelo , Fraturas do Úmero , Osso e Ossos , Gestão de Mudança , Criança , Cotovelo , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Feminino , Fixação Interna de Fraturas , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Masculino , Estudos Retrospectivos , Resultado do Tratamento
11.
Methods Mol Biol ; 2373: 283-296, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34520019

RESUMO

This protocol describes a comprehensive practical guide for the biofabrication of 3D in vitro models of vascularized and mineralized bone Minitissues. These models give the possibility to study the contribution of physical and biochemical parameters on bone vascularization, as well as the osteoblast/osteoclast mediated matrix remodeling. Based on the specific pathophysiological processes to be investigated, the 3D bone Minitissues allow to select the most suitable cell composition, by coculturing up to four cell types, and to customize the material properties of the hydrogel matrix. Considering their versatility, these 3D bone Minitissues could be relevant for the recapitulation of bone pathologies such as bone tumors and metastases and could be and used as screening platforms to test antimetastatic drugs.


Assuntos
Osso e Ossos , Técnicas de Cocultura , Hidrogéis , Osteoblastos , Osteoclastos
13.
BMJ Case Rep ; 14(12)2021 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-34969788

RESUMO

Vitamin D-resistant rickets shows the resistance to vitamin D (Vit-D) therapy, which traditionally works well in cases with deficiency rickets. The signs start appearing as early as in the first month of life and are characterised by the defective mineralisation at the ends of cartilage and bones despite having normal Vit-D levels in the serum. This case report highlights the dental and maxillofacial manifestations in a 3-year-old girl diagnosed with pseudo-Vit-D deficiency rickets. The report also highlights the variations in the dental manifestations of the condition reported in the literature.


Assuntos
Raquitismo Hipofosfatêmico Familiar , Raquitismo , Deficiência de Vitamina D , Osso e Ossos , Criança , Pré-Escolar , Raquitismo Hipofosfatêmico Familiar/complicações , Feminino , Humanos , Raquitismo/diagnóstico , Raquitismo/etiologia , Vitamina D , Vitaminas
14.
Pain Res Manag ; 2021: 5565747, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34900071

RESUMO

Objective: To characterize the closed-mouth temporomandibular joint (TMJ) disc-condyle relationship in a population of individuals who sought hospital services for temporomandibular disorders (TMD). Methods: Two hundred and twenty-four TMJ magnetic resonance images (MRIs) of 112 patients were assessed in all spatial planes to classify disc position with respect to the condyle in a closed-mouth position. Results: Disc displacement (DD) was present in 62.1% and superior disc position in 29.9% of the patients. Position could not be determined in 8% of the cases. Among DD, pure anteriorized position was the most common condition (34.4%), with different combined translational and rotational displacements in all the other joints (27.7%). Conclusion: There is a wide biological variability in disc position in closed mouth among patients seeking for TMD advice. Getting deeper into the correlation with clinical symptoms is recommended to refine the potential relevance of any diagnostic and management strategies based on the imaging evaluation of TMJ disc position.


Assuntos
Luxações Articulares , Transtornos da Articulação Temporomandibular , Osso e Ossos , Humanos , Imageamento por Ressonância Magnética , Boca , Disco da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem
15.
Wiad Lek ; 74(10 pt 1): 2384-2391, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34896992

RESUMO

OBJECTIVE: The aim: To evaluate osteocalcin and PINP levels in men suffering from AS and to compare them with structural and functional state of bone tissue and clinical course of illness. PATIENTS AND METHODS: Materials and methods: The study included 82 patients suffering from AS with an average age of 40,9±0,9 years. Osteocalcin level was determined in 82 patients, and PINP level was determined in 79 patients. Control group included 22 apparently healthy persons. Disease activity was assessed through CRP level, ASDAS and BASDAI scores, while functional ability was assessed through the BASFI score. Osteocalcin and PINP levels were determined by immunoenzymatic method for the purpose of evaluating the metabolic state of bone tissue. RESULTS: Results: Average osteocalcin and PINP levels were not significantly different in patients suffering from AS and patients in the control group and did not show any significant correlation with ASDAS, BASDAI, BASFI and CRP scores. In patients with spinal ankylosis, average osteocalcin values (14,3 ng\ml) and PINP (747,2 pg\ml) were higher compared to patients with single syndesmophytes (11,0 ng\ml; 711,8 pg\ml) and patients without syndesmophytes (10,4 ng\ml; 537,7 pg\ml respectively). CONCLUSION: Conclusions: Osteocalcin and PINP levels are not related to age, disease duration, BMI, glucocorticoids load and inflammatory process activity, however, they are closely related to the presence of bone growths.


Assuntos
Pró-Colágeno , Espondilite Anquilosante , Atividades Cotidianas , Osso e Ossos , Humanos , Recém-Nascido , Osteocalcina
16.
Int J Comput Dent ; 24(4): 363-374, 2021 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-34931772

RESUMO

AIM: The present clinical trial aimed to preliminarily assess whether navigation could help to position impacted supernumerary teeth (STs) and reduce surgical trauma. MATERIALS AND METHODS: Subjects with an impacted supernumerary tooth (ST) in the premaxillary area were enrolled in the study and randomly distributed into a navigation group and a control group. In the navigation group, STs were positioned and extracted under real-time optic navigation. In the control group, STs were extracted depending on the surgeon's experience. Subjects were followed up for 12 to 24 weeks postsurgery. Operating time, futile bony trauma, and the positioning precision of the STs were the major outcomes assessed. Multivariate correlation analysis was performed. RESULTS: In 24 subjects, 32 STs were removed and no severe complications occurred in either group. The proportion of ST exposure at the planned access point was 100% in the navigation group and 68.75% in the control group (χ² = 5.926, P = 0.015). Futile length, futile width, and the distance between the point where the ST was initially exposed and the bony point planned for accessing it were related to both navigation/control grouping and bone thickness in the access side. For challenging STs with bone thickness of > 0.5 mm in the access side (N = 22), the futile length in the navigation group (0.0 [0.0, 4.0] mm) was significantly smaller than that in the control group (3.0 [0.0, 8.0] mm, P = 0.028). Similarly, the futile width in the navigation group (0.0 [0.0, 2.0] mm) was significantly smaller than that in the control group (2.0 [0.0, 4.0] mm, P = 0.018). CONCLUSIONS: Navigation helped to position impacted STs precisely and reduced surgical bony trauma to some extent, especially in challenging cases in which the bone in the access side was thicker than 0.5 mm.


Assuntos
Dente Impactado , Dente Supranumerário , Osso e Ossos , Humanos , Extração Dentária , Dente Supranumerário/cirurgia
17.
Minerva Obstet Gynecol ; 73(6): 678-696, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34905875

RESUMO

INTRODUCTION: Short-term and long-term steroid contraceptive systems are widely employed in adolescents and premenopausal women; they could induce variation in bone metabolism, but whether these changes increase the overall fracture risk is not yet clear. EVIDENCE ACQUISITION: A systematic search of scientific publications about "hormonal contraceptives" and "bone metabolism" in reproductive age women was conducted. EVIDENCE SYNTHESIS: In adolescent girl, combined oral contraceptives could have a deleterious effect on bone health when their onset is within three years after menarche and when they contain ethinyl estradiol at the dose of 20 mcg. In perimenopausal women, steroid contraceptives seem not influence bone health nor increase osteoporotic fractures risk in menopause. The oral progestogens intake is not related to negative effects on skeletal health. Depot medroxyprogesterone acetate (DMPA) induce a prolonged hypoestrogenism with secondary detrimental effect on healthy bone; the higher bone loss was observed at the DMPA dose of 150 mg intramuscular such as after long-term DMPA-users. Progestin-based implants and intrauterine devices have not negative effect on bone health. CONCLUSIONS: Since sex-steroid drugs induce variations in hormonal circulating concentrations, they may negatively affect bone metabolism. Contraceptive choice should be tailored evaluating any possible effect on bone health. Clinicians should always perform a precontraceptive counselling to identify any coexisting condition that may affect bone health. Further randomized studies are needed to confirm these results.


Assuntos
Densidade Óssea , Acetato de Medroxiprogesterona , Adolescente , Osso e Ossos , Feminino , Contracepção Hormonal , Humanos , Acetato de Medroxiprogesterona/efeitos adversos , Progestinas/efeitos adversos
18.
Minerva Obstet Gynecol ; 73(6): 704-713, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34905876

RESUMO

Osteoporosis is a common disease, with fragility fractures representing its dreaded complications. The role of calcium and vitamin D supplementation needs to be addressed in the context of a heavy health burden, with a massive impact on individuals, healthcare systems, and societies as a whole. Calcium and vitamin D are often discussed together as interventions for promoting bone health. Still, it is essential to remember that they are quite distinct entities that play different roles in mineral metabolism. Insufficient calcium intake and vitamin D deficiency are common and widespread. Furthermore, a strong association between vitamin D deficiency and extra-skeletal outcomes has emerged over the last decades. When dietary intake is insufficient, with little room for improvement, several supplementation strategies have proved to be effective and safe. Adequate calcium intake and vitamin D serum levels should be pursued efficiently in the general population, and deficiency should be considered unacceptable in subsets particularly at risk. The aim of this narrative review was to present an overview of calcium and vitamin D intake and their supplementation.


Assuntos
Suplementos Nutricionais , Deficiência de Vitamina D , Osso e Ossos , Cálcio na Dieta , Humanos , Vitamina D , Deficiência de Vitamina D/tratamento farmacológico
19.
Semin Musculoskelet Radiol ; 25(6): 711-724, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34937112

RESUMO

Imaging-guided needle biopsy of musculoskeletal lesions is a high-yield and low-risk procedure that can be used for definitive characterization of indeterminate bone and soft tissue lesions. Familiarity with the preprocedural, technical, and postprocedural steps is vital for the appropriate management of these cases. Biopsy request triage requires an awareness of definitively benign conditions and other tumor mimics. A complete clinical, laboratory, and imaging work-up is essential for procedural planning and determining pathologic concordance. Consultation with an orthopaedic oncologist is a requisite step to ensure maximizing biopsy yield and to avoid interference with any future limb-sparing surgical intervention. Knowledge of the equipment, pertinent medications, and appropriate biopsy technique can minimize the risk of periprocedural complications. Finally, the radiologist may be required to discuss the concordance of histopathology with preprocedure imaging, perform repeat image-guided biopsy, and carefully interpret sarcoma surveillance imaging examinations.


Assuntos
Neoplasias Ósseas , Neoplasias de Tecidos Moles , Biópsia , Biópsia por Agulha , Neoplasias Ósseas/diagnóstico por imagem , Osso e Ossos , Humanos , Biópsia Guiada por Imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem
20.
Rev Med Suisse ; 17(763): 2194-2200, 2021 Dec 15.
Artigo em Francês | MEDLINE | ID: mdl-34910406

RESUMO

Chronic osteomyelitis is an inflammatory process of the bone caused by an infectious agent. This condition leads to altered bone vascularization and thus to bone destruction and formation of necrotic bone fragments (sequestrum). The treatment of chronic osteomyelitis is primarily based on surgical management, which includes debridement of the sequestrum and sampling of bone tissue for microbiological analysis in order to initiate a targeted antibiotic therapy. A multidisciplinary approach is essential, involving expertise in orthopedic surgery, musculoskeletal imaging and nuclear medicine, infectious diseases, as well as plastic or vascular surgery for complex cases with soft tissue and/or vascular defects.


Assuntos
Osteomielite , Adulto , Antibacterianos/uso terapêutico , Osso e Ossos , Doença Crônica , Desbridamento , Humanos , Osteomielite/tratamento farmacológico , Osteomielite/terapia
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