Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.573
Filtrar
1.
BMC Endocr Disord ; 22(1): 78, 2022 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-35346169

RESUMO

BACKGROUND: Comprehensive, real-world osteoporosis care has many facets not explicitly addressed in practice guidelines. We sought to determine the areas of knowledge and practice needs in osteoporosis medicine for the purpose of developing an osteoporosis curriculum for specialist trainees and knowledge translation tools for primary care. METHODS: This was a retrospective review of referral questions received from primary care and specialists to an academic, multi-disciplinary tertiary osteoporosis and metabolic bone clinic. There were 400 referrals in each of 5 years (2015-2019) selected randomly for review. The primary referral question was elucidated and assigned to one of 16 pre-determined referral topics reflecting questions in the care of osteoporosis and metabolic bone patients. The top 7 referral topics by frequency were determined while recording the referral source. RESULTS: The majority of referrals (71%) came from urban primary care. The most common specialists to request care included rheumatology, oncology, gastroenterology and orthopedic surgery (fracture liaison services). Primary care referrals predominantly requested assistance with routine osteoporosis assessments, bisphosphonate holidays, bisphosphonate adverse effects/alternatives, fractures occurring despite therapy and adverse changes on bone densitometry despite treatment. Specialists most often referred patients with complex secondary bone diseases or cancer. The main study limitation was that knowledge needs of referring physicians were inferred from the referral question rather than tested directly. CONCLUSION: By assessing actual community demand for services, this study identified several such topics that may be useful targets to develop high quality knowledge translation tools and curriculum design in programs training specialists in osteoporosis care.


Assuntos
Fraturas Ósseas , Osteoporose , Medicina Comunitária , Humanos , Osteoporose/terapia , Encaminhamento e Consulta , Estudos Retrospectivos
2.
Int J Qual Stud Health Well-being ; 17(1): 2070976, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35491886

RESUMO

INTRODUCTION: Although osteoporosis-exercise recommendations have been established, implementation of the information remains a challenge for people with osteoporosis. This study aimed to understand how participants integrate osteoporosis management advice into their lifestyle and the challenges they might face. METHODS: Integrative descriptive methods were used for this qualitative study. In-depth interviews were conducted with 13 Canadian participants (age range 51-90) that knew they had osteoporosis. Participants were asked to participate in one-on-one interviews; discussing exercise, nutrition and falls prevention for people with osteoporosis. RESULTS: The following themes emerged from this study: understanding fragility fractures and fall risk, knowledge acquisition through personal and vicarious experience over the lifespan, awareness of environmental risks and opportunities, understanding the effect of exercise on the bones and in life, challenges managing exercise expectations, attitude towards non-pharmacological management. CONCLUSION: Participants recognized the benefit of non-pharmacological management for managing osteoporosis, but sometimes found it difficult to integrate into their daily activities due to lack of time or knowledge. Participants weren't always clear on which component of their osteoporosis management should be prioritized.


Assuntos
Osteoporose , Idoso , Idoso de 80 Anos ou mais , Canadá , Exercício Físico , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Osteoporose/terapia , Pesquisa Qualitativa
3.
Ann Intern Med ; 175(4): JC46, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35377720

RESUMO

SOURCE CITATION: Zhang S, Huang X, Zhao X, et al. Effect of exercise on bone mineral density among patients with osteoporosis and osteopenia: a systematic review and network meta-analysis. J Clin Nurs. 2021. [Epub ahead of print]. 34725872.


Assuntos
Doenças Ósseas Metabólicas , Osteoporose , Densidade Óssea , Doenças Ósseas Metabólicas/terapia , Terapia por Exercício , Humanos , Vértebras Lombares , Osteoporose/terapia
4.
J Geriatr Phys Ther ; 45(2): E120-E126, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35384944

RESUMO

BACKGROUND AND PURPOSE: Osteoporosis is a systemic, metabolic bone disease that affects bone quality, increases susceptibility to low-trauma bone fracture, and has downstream effects on falls and fragility fractures. Osteoporosis is a multifactorial disease process that requires management from multiple health care providers including physicians, nurses, and physical therapists. However, the paucity of information regarding comprehensive physical therapist management for patients with osteoporosis indicated the need for an evidence-based document. The purpose of this document was to provide the best available expert guidance for clinicians in the selection of screening tools, essential tests and measures, treatment goals, and interventions for patients with osteoporosis. METHODS: A Delphi process was used. Thirty-one physical therapists with expertise in the care of patients with osteoporosis participated in a series of 3 sequential surveys designed to build and reach agreement on the management of patients with osteoporosis. The desired survey outcomes were to: (1) identify the range of examination and plan of care components considered important to physical therapists' care for patients with osteoporosis, (2) determine which components should be considered essential, and (3) achieve consensus on the final list of essential components and related operational definitions. RESULTS: A clear consensus on the essential components of examination and interventions was achieved. In general, there were 4 to 6 items across each category of history, tests and measures, education/goals, and treatment. CONCLUSIONS: The prioritization of these management items will better support clinicians working with adults who have osteoporosis.


Assuntos
Fraturas Ósseas , Osteoporose , Fisioterapeutas , Consenso , Técnica Delfos , Humanos , Osteoporose/terapia
5.
JMIR Mhealth Uhealth ; 10(4): e32557, 2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35451968

RESUMO

BACKGROUND: Osteoporosis is the fourth most common chronic disease worldwide. The adoption of preventative measures and effective self-management interventions can help improve bone health. Mobile health (mHealth) technologies can play a key role in the care and self-management of patients with osteoporosis. OBJECTIVE: This study presents a systematic review and meta-analysis of the currently available mHealth apps targeting osteoporosis self-management, aiming to determine the current status, gaps, and challenges that future research could address, as well as propose appropriate recommendations. METHODS: A systematic review of all English articles was conducted, in addition to a survey of all apps available in iOS and Android app stores as of May 2021. A comprehensive literature search (2010 to May 2021) of PubMed, Scopus, EBSCO, Web of Science, and IEEE Xplore was conducted. Articles were included if they described apps dedicated to or useful for osteoporosis (targeting self-management, nutrition, physical activity, and risk assessment) delivered on smartphone devices for adults aged ≥18 years. Of the 32 articles, a random effects meta-analysis was performed on 13 (41%) studies of randomized controlled trials, whereas the 19 (59%) remaining studies were only included in the narrative synthesis as they did not provide enough data. RESULTS: In total, 3906 unique articles were identified. Of these 3906 articles, 32 (0.81%) articles met the inclusion criteria and were reviewed in depth. The 32 studies comprised 14,235 participants, of whom, on average, 69.5% (n=9893) were female, with a mean age of 49.8 (SD 17.8) years. The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth-supported interventions resulted in a significant reduction in pain (Hedges g -1.09, 95% CI -1.68 to -0.45) and disability (Hedges g -0.77, 95% CI -1.59 to 0.05). The posttreatment effect of the digital intervention was significant for physical function (Hedges g 2.54, 95% CI -4.08 to 4.08) but nonsignificant for well-being (Hedges g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges g 0.09, 95% CI -0.59 to 0.50), anxiety (Hedges g -0.29, 95% CI -6.11 to 5.53), fatigue (Hedges g -0.34, 95% CI -5.84 to 5.16), calcium (Hedges g -0.05, 95% CI -0.59 to 0.50), vitamin D intake (Hedges g 0.10, 95% CI -4.05 to 4.26), and trabecular score (Hedges g 0.06, 95% CI -1.00 to 1.12). CONCLUSIONS: Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be valuable tools for patients and health professionals. However, most of the apps that are currently available lack clinically validated evidence of their efficacy and focus on a limited number of symptoms. A more holistic and personalized approach within a cocreation design ecosystem is needed. TRIAL REGISTRATION: PROSPERO 2021 CRD42021269399; https://tinyurl.com/2sw454a9.


Assuntos
Aplicativos Móveis , Osteoporose , Autogestão , Adolescente , Adulto , Ecossistema , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/terapia , Smartphone
6.
Med Sci Monit ; 28: e935937, 2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35477700

RESUMO

Exosomes can be derived from mesenchymal stem cells (MSCs) and have recently been used to treat defects in the tendons. They may also have applications in treating osteoporosis. MSC-derived exosomes communicate with mesenchymal and osteogenic cells through endocrine or paracrine mechanisms and contribute factors involved in physiological and pathological orthopedic conditions associated with hypoxia and bone tumors. Also, generalized medical conditions, such as obesity, hyperglycemia, and degenerative diseases, can inhibit the osteogenic effect of MSC-derived exosomes. This review aims to present an update on the roles of MSCs and exosomes derived from MSCs in treating orthopedic diseases, such as osteoporosis, and in the repair of cartilage, tendons, and bone fractures.


Assuntos
Exossomos , Células-Tronco Mesenquimais , Osteoporose , Cartilagem/patologia , Exossomos/patologia , Humanos , Osteogênese , Osteoporose/terapia
7.
BMC Med Educ ; 22(1): 323, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35473636

RESUMO

BACKGROUND: Clinical reasoning is of high importance in clinical practice and thus in medical education research. Regarding the clinical reasoning process, the focus has primarily been on diagnostic reasoning and diagnostic errors, but little research has been done on the subsequent management reasoning process, although the therapeutic decision-making process is at least equally important. The aim of this study was to investigate the frequency of therapeutic decision errors and the cognitive factors leading to these errors in the context of osteoporosis, as it is known to be frequently associated with inadequate treatment decisions in clinical practice worldwide. METHODS: In 2019, 19 medical students and-for comparison-23 physicians worked on ten patient cases with the medical encounter of osteoporosis. A total of 254 cases were processed. The therapeutic decision errors were quantitatively measured, and the participants' cognitive contributions to therapeutic errors and their clinical consequences were qualitatively analysed. RESULTS: In 26% of the cases, all treatment decisions were correct. In the remaining 74% cases, multiple errors occurred; on average, 3 errors occurred per case. These 644 errors were further classified regarding the cognitive contributions to the error. The most common cognitive contributions that led to errors were faulty context generation and interpretation (57% of students, 57% of physicians) and faulty knowledge (38% of students, 35% of physicians). Errors made due to faulty metacognition (5% of students, 8% of physicians) were less common. Consequences of these errors were false therapy (37% of cases), undertreatment (30% of cases) or overtreatment (2.5% of cases). CONCLUSION: The study is the first to show that errors in therapy decisions can be distinguished and classified, similar to the already known classification for errors in diagnostic reasoning. Not only the correct diagnosis, but particularly the correct therapy, is critical for the outcome of a patient.


Assuntos
Osteoporose , Médicos , Estudantes de Medicina , Cognição , Erros de Diagnóstico/psicologia , Humanos , Osteoporose/diagnóstico , Osteoporose/terapia , Médicos/psicologia
8.
Lancet Diabetes Endocrinol ; 10(4): 273-283, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35247315

RESUMO

Osteoporosis in men is a common but often overlooked disorder by clinicians. The criterion for osteoporosis diagnosis in men is similar to that in women-namely, a bone mineral density (BMD) that is 2·5 standard deviations or more below the mean for the young adult population (aged 20-29 years; T-score -2·5 or lower), measured at the hip or lumbar spine. Sex steroids are important for bone health in men and, as in women, oestrogens have a key role. Most men generally have bigger and stronger bones than women and typically have less bone loss during their lifetime. Men typically fracture less often than women, although they have a higher mortality rate after a fracture. Secondary osteoporosis is more common in men than in women. Lifestyle changes, adequate calcium, vitamin D intake, and exercise programmes are recommended for the management of osteoporosis in men. Bisphosphonates, denosumab, and teriparatide have been shown to increase BMD and are used for pharmacological treatment. In this Review, we report an updated overview of osteoporosis in men, describe new treatments and concepts, and discuss persistent controversies in the area.


Assuntos
Conservadores da Densidade Óssea , Osteoporose , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Difosfonatos/uso terapêutico , Feminino , Humanos , Masculino , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/terapia , Teriparatida/uso terapêutico
9.
Health Informatics J ; 28(1): 14604582211066465, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35257612

RESUMO

Osteoporotic fractures are a major and growing public health problem, which is strongly associated with other illnesses and multi-morbidity. Big data analytics has the potential to improve care for osteoporotic fractures and other non-communicable diseases (NCDs), reduces healthcare costs and improves healthcare decision-making for patients with multi-disorders. However, robust and comprehensive utilization of healthcare big data in osteoporosis care practice remains unsatisfactory. In this paper, we present a conceptual design of an intelligent analytics system, namely, the dual X-ray absorptiometry (DXA) health informatics prediction (HIP) system, for healthcare big data research and development. Comprising data source, extraction, transformation, loading, modelling and application, the DXA HIP system was applied in an osteoporosis healthcare context for fracture risk prediction and the investigation of multi-morbidity risk. Data was sourced from four DXA machines located in three healthcare centres in Ireland. The DXA HIP system is novel within the Irish context as it enables the study of fracture-related issues in a larger and more representative Irish population than previous studies. We propose this system is applicable to investigate other NCDs which have the potential to improve the overall quality of patient care and substantially reduce the burden and cost of all NCDs.


Assuntos
Informática Médica , Osteoporose , Fraturas por Osteoporose , Absorciometria de Fóton , Densidade Óssea , Humanos , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Osteoporose/terapia , Fraturas por Osteoporose/epidemiologia
10.
Int J Mol Sci ; 23(5)2022 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-35269841

RESUMO

Age-related chronic diseases are an enormous burden to modern societies worldwide. Among these, osteoporosis, a condition that predisposes individuals to an increased risk of fractures, substantially contributes to increased mortality and health-care costs in elderly. It is now well accepted that advanced chronical age is one of the main risk factors for chronical diseases. Hence, targeting fundamental aging mechanisms such as senescence has become a promising option in the treatment of these diseases. Moreover, for osteoporosis, the main pathophysiological concepts arise from menopause causing estrogen deficiency, and from aging. Here, we focus on recent advances in the understanding of senescence-related mechanisms contributing to age-related bone loss. Furthermore, treatment options for senile osteoporosis targeting senescent cells are reviewed.


Assuntos
Senescência Celular , Osteoporose , Idoso , Envelhecimento/fisiologia , Senescência Celular/fisiologia , Doença Crônica , Feminino , Humanos , Osteoporose/terapia
11.
Dent Med Probl ; 59(1): 75-83, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35254009

RESUMO

BACKGROUND: Osteoporosis is one of the most common yet difficult to treat diseases. It affects millions of people and costs the health care systems billions worldwide. All of the available kinds of pharmacological treatment have multiple side effects, which is why a need for safer treatment options has emerged. OBJECTIVES: This study aimed to assess the bone-healing potential of bone marrow mesenchymal stem cells (BM­MSCs) in jawbone osteoporosis in Wistar albino rats. MATERIAL AND METHODS: Osteoporosis was induced with a daily intraperitoneal injection of 200 µg/100 g dexamethasone for 1 month. The rats were then randomly distributed into 2 groups: the osteoporotic group (left untreated); and the BM­MSCs group (received an intravenous injection of 50 million cultured BM­MSCs). Half of the rats from each group were sacrificed 2 weeks and the other half 6 weeks after the introduction of treatment. Bone regeneration was assessed by means of dual-energy X-ray absorptiometry (DEXA), real-time polymerase chain reaction (RT­PCR), as well as the histopathological and histomorphometric analyses. RESULTS: As for the 1st sacrifice time, there were no significant differences between the osteoporotic and BM­MSCs groups with regard to all parameters except for bone mineral density (BMD), which was significantly higher in the BM­MSCs group. Regarding the 2nd sacrifice time, the DEXA analysis showed a significant increase in BMD in the BM­MSCs group (p < 0.001). The RT­PCR analysis showed a significant decrease in RANKL gene expression (p < 0.001) and a significant increase in OPG gene expression (p < 0.001) in the BM­MSCs group. In addition, the histopathological examination of the BM­MSCs group showed pronounced healing progress in the jawbone microarchitecture. The histomorphometric analysis also revealed that the bone area percentage significantly increased in the BM­MSCs group (p < 0.001). CONCLUSIONS: This study proved that BM­MSCs could be effective in the treatment of osteoporosis.


Assuntos
Células-Tronco Mesenquimais , Osteoporose , Animais , Células Cultivadas , Humanos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Osteoporose/tratamento farmacológico , Osteoporose/terapia , Ratos , Ratos Wistar
12.
Comput Math Methods Med ; 2022: 9619867, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35309846

RESUMO

Objective: To evaluate the influence of sinusoidal vibration (50-Hertz) stimulation on the uterus of osteoporotic rats. Methods: We constructed an osteoporosis rat model by ovariectomy (OVX). 36 3-month-old Sprague Dawley rats were randomly divided into the control group, vibrating group, sham operation group, sham operation vibrating group, OVX group, and OVX vibrating group (n = 6 per group). Rats started to vibrate one week after the operation: one 10 minutes 50-Hertz sinusoidal vibration per day, except for Saturday and Sunday. In the second, 8, and 12 week after vibration stimulation, rats were sacrificed in batches. And then, the uteruses were taken out to measure the wet weight and calculate uterus relative wet weight. Results: Compared with the control group, OVA induced a significant increase in wet weight and relative wet weight in rat uterus. The vibration was to the uterus wet weight and the uterus relative wet weight in ovariectomized rats and at the same time had no significant effect, but the 12-week prolonged vibration can significantly reduce the uterus wet weight and the uterus relative wet weight in ovariectomized rats than 2 weeks. Conclusions: The uterus wet weight and the uterus relative wet weight were increased in the OVA-induced osteoporosis rats. The 50-Hertz sinusoidal vibration had no significant effect on the uterus wet weight and the uterus relative wet weight in the ovariectomized rats at the same time, but 12 weeks of vibration can significantly reduce the uterine wet weight and uterine relative wet weight of ovariectomized rats. And the uterus relative wet weight can be used as a new indicator of stimulating the uterus.


Assuntos
Osteoporose/etiologia , Osteoporose/terapia , Ovariectomia/efeitos adversos , Útero/patologia , Vibração/uso terapêutico , Animais , Biologia Computacional , Modelos Animais de Doenças , Feminino , Tamanho do Órgão , Osteoporose/patologia , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
13.
Arch Osteoporos ; 17(1): 37, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35235056

RESUMO

We conducted a survey during the first pandemic wave of coronavirus disease 2019 (COVID-19) on a large group of osteoporotic patients to evaluate the general conditions of osteoporotic patients and the impact of the pandemic on the management of osteoporosis, finding high compliance to treatments and low COVID-19 lethality. INTRODUCTION: During the first pandemic wave of coronavirus disease 2019 (COVID-19), 209,254 cases were diagnosed in Italy; fatalities were 26,892 and were overwhelmingly older patients. The high prevalence of osteoporosis in this age group suggests a potential relationship between SARS-CoV-2 infection and bone metabolism. METHODS: In a telephone survey conducted from April to May 2020, patients from the Osteoporosis Center, Clinic of Endocrinology and Metabolic Diseases of Umberto I Hospital (Ancona, Italy), were interviewed to evaluate the general clinical conditions of osteoporotic patients, compliance with osteoporosis medications, COVID-19 prevalence, hospitalization rate, COVID-19 mortality, and lethality. RESULTS: Among the 892 patients interviewed, 77.9% were taking osteoporosis treatment and 94.6% vitamin D supplementation as prescribed at the last visit. COVID-19-like symptoms were reported by 5.1%, whereas confirmed cases were 1.2%. A total number of 33 patients had been in hospital and the hospitalization rate of those who had not discontinued vitamin D supplementation was less than 4%. There were eight deaths, two with a concomitant COVID-19 diagnosis. The prevalence of severe osteoporosis was 50% in total COVID-19 patients and 87.5% in deceased COVID-19 patients. The overall COVID-19 mortality was 0.2%; lethality was 20%, lower than the national rate of the same age group. CONCLUSIONS: This large group of osteoporotic patients showed high compliance and lower COVID-19 lethality compared to patients of the same age. Novel approaches such as telemedicine can provide critical support for the remote follow-up of patients with chronic diseases also in the setting of routine care.


Assuntos
COVID-19 , Osteoporose , COVID-19/epidemiologia , Teste para COVID-19 , Humanos , Osteoporose/epidemiologia , Osteoporose/terapia , Pandemias , SARS-CoV-2
14.
Comput Math Methods Med ; 2022: 8332737, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35281947

RESUMO

The goal of this study is to see how cold plasma affects rabbit bone tissue infected with osteoporosis. The search is divided into three categories: control, infected, and treated. The rabbits were subjected to cold plasma for five minutes in a room with a microwave plasma voltage of "175 V" and a gas flow of "2." A histopathological photograph of infected bone cells is obtained to demonstrate the influence of plasma on infected bone cells, as well as the extent of destruction and effect of plasma therapy before and after exposure. The findings of the search show that plasma has a clear impact on Ca and vitamin D levels. In the cold plasma, the levels of osteocalcin and alkali phosphates (ALP) respond as well. Image processing techniques (second-order gray level matrix) with textural elements are employed as an extra proof. The outcome gives good treatment indicators, and the image processing result corresponds to the biological result.


Assuntos
Osteoporose/terapia , Gases em Plasma/uso terapêutico , Animais , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Cálcio/metabolismo , Biologia Computacional , Modelos Animais de Doenças , Feminino , Processamento de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Osteoporose/diagnóstico por imagem , Osteoporose/fisiopatologia , Fósforo/sangue , Coelhos , Vitamina D/metabolismo
15.
Biochem Biophys Res Commun ; 601: 86-92, 2022 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-35231656

RESUMO

RNA interference (RNAi)-based gene therapy that promotes anabolic bone formation is an effective approach for addressing osteoporosis. However, the selection of target gene and tissue-specific delivery systems has hindered the progression of this strategy. In this study, we identified casein kinase-2 interacting protein-1 encoding gene (Ckip-1), a negative regulator of bone formation, as an effective target of small interfering RNAs (siRNAs) for improving bone mass. Moreover, an impressive (DSS)6-Liposome (Lipos) nanoparticle system that could target the bone formation surface was synthesized to enhance the delivery of Ckip-1 siRNA to osteogenic lineage cells. The in vitro results confirmed that the (DSS)6-Lipos system could efficaciously improve the intracellular delivery of Ckip-1 siRNA without obvious cell toxicity. The in vivo application of the delivery system showed specific accumulation of siRNA in osteogenic cells located around the bone formation surface. Bone-related analysis indicated increased bone mass and improved bone microarchitecture in mice with ovariectomy-induced osteoporosis. Moreover, the biomechanical characteristics of the tibia were enhanced significantly, indicating increased resistance to fragile fracture induced by osteoporosis. Thus, (DSS)6-Lipos-Ckip-1 siRNA-based osteoanabolic therapy may be a promising option for the treatment of osteoporosis.


Assuntos
Osteogênese , Osteoporose , Animais , Proteínas de Transporte/metabolismo , Feminino , Lipossomos , Camundongos , Osteogênese/genética , Osteoporose/genética , Osteoporose/metabolismo , Osteoporose/terapia , Interferência de RNA , RNA Interferente Pequeno/genética , Terapêutica com RNAi
16.
Cell Transplant ; 31: 9636897221079745, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35225020

RESUMO

Bone marrow mesenchymal stem cell transplantation (BMSCT) is a potential treatment for osteoporosis, capable of contributing to bone tissue repair. BMSCT has demonstrated osteoinductive effects and the ability to regulate microenvironmental metabolism; however, its role and mechanisms in bone loss due to reduced estrogen levels remain unclear. In this study, the effect of BMSCT on ovariectomy (OVX)-induced osteoporosis in mice was assessed, and liquid chromatography-mass spectrometry (LC-MS) metabolomic studies of bone tissue were conducted to identify potential metabolic molecular markers. The results revealed that BMSCT reduces OVX-induced bone loss in mice while improving the mechanical properties of mouse femurs and increasing the expression of osteogenic markers in peripheral blood. In a metabolomic study, 18 metabolites were screened as potential biomarkers of the anti-osteoporotic effect of BMSCT. These metabolites are mainly involved in arachidonic acid metabolism, taurine and hypotaurine metabolism, and pentose and glucuronate interconversions. Collectively, these results illustrate the correlation between metabolites and the underlying mechanisms of osteoporosis development and are important for understanding the role and mechanisms of exogenous bone marrow mesenchymal stem cells (BMSCs) in osteoporosis management. This study lays the foundation for research on BMSCs as a treatment strategy for osteoporosis.


Assuntos
Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Osteoporose , Animais , Medula Óssea/metabolismo , Diferenciação Celular , Feminino , Humanos , Células-Tronco Mesenquimais/metabolismo , Metabolômica , Camundongos , Osteogênese , Osteoporose/metabolismo , Osteoporose/terapia , Ovariectomia
17.
PLoS One ; 17(2): e0263935, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35196338

RESUMO

OBJECTIVE: To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. DATA SOURCES: Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. METHODS: A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWiM) was used for result synthesis. RESULTS: Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. CONCLUSION: There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.


Assuntos
Terapia por Exercício/métodos , Osteoporose/prevenção & controle , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Ensaios Clínicos como Assunto , Humanos , Osteoporose/etiologia , Osteoporose/terapia
18.
Artigo em Inglês | MEDLINE | ID: mdl-35130160

RESUMO

Little is known about the effect of pulsed electromagnetic fields (PEMFs) as an option for preventing osteoporosis. This study sought to investigate the effectiveness of PEMFs for the management of primary osteoporosis in older adults. We searched databases from the inception to date to target trials examining the effects of PEMFs compared to placebo or sham or other agents for the management of primary osteoporosis for a meta-analysis using random effects model. Eight trials including 411 participants were included. PEMFs was non-inferior to conventional pharmacological agents and exercise respectively in preventing the decline of Bone Mineral Density (BMD) at the lumbar (MD 8.76; CI -9.64 to 27.16 and MD 1.33; CI -2.73 to 5.39) and femur neck (MD 0.04; CI -1.09 to 1.16 and MD 1.50; CI -0.26 to 3.26), and significantly improving balance function measured by Berg Balance Scale (BBS) (MD 0.91; CI 0.32 to 1.49) and Timed Up and Go test (MD -3.61; CI -6.37 to -0.85), directly after intervention. The similar trends were observed in BMD and BBS at 12- and 24-weeks follow-up from baseline. PEMFs had positive effects non-inferior to first-line treatment on BMD and better over placebo on balance function in older adults with primary osteoporosis, but with moderate to very low certainty evidence and short-term follow-ups. There is a need for high-quality randomised controlled trials evaluating PEMFs for the management of primary osteoporosis.


Assuntos
Campos Eletromagnéticos , Osteoporose , Idoso , Densidade Óssea , Humanos , Osteoporose/terapia , Equilíbrio Postural , Estudos de Tempo e Movimento
19.
Zhongguo Zhen Jiu ; 42(2): 145-9, 2022 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-35152577

RESUMO

OBJECTIVE: To observe the effect of electroacupuncture on motor function and muscle state in patients with primary osteoporosis (POP). METHODS: A total of 60 female patients with POP were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case dropped off). On the basis of adjusting lifestyle, caltrate was given orally in the control group, 2 pills a day for 4 weeks. On the basis of the treatment in the control group, electroacupuncture was applied at Zusanli (ST 36), Yanglingquan (GB 34), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), etc. in the observation group, with disperse-dense wave of 2 Hz/10 Hz in frequency, once every other day, 3 times a week for 4 weeks. The time of timed up-and-go test (TUGT) and the value of 10 m maximal walking speed (10 m MWS) before and after treatment were compared in the two groups, and the Young's modulus values of bilateral multifidus muscles in prone position and sitting position before and after treatment were compared by real-time shear wave elastography (SWE) in the two groups. RESULTS: After treatment, the TUGT time was decreased compared before treatment in the observation group (P<0.01), and that in the observation group was shorter than the control group (P<0.01). After treatment, the value of 10 m MWS test was increased compared before treatment in the observation group (P<0.05). After treatment, the Young's modulus values of bilateral multifidus muscles in prone position and sitting position were increased compared before treatment in the observation group (P<0.01); except for the left side in sitting position, the Young's modulus values of multifidus muscles in the observation group were higher than those in the control group (P<0.01, P<0.05). CONCLUSION: On the basis of oral caltrate, electroacupuncture can improve the motor function and muscle state in patients with POP.


Assuntos
Eletroacupuntura , Osteoporose , Pontos de Acupuntura , Feminino , Humanos , Estilo de Vida , Osteoporose/terapia , Músculos Paraespinais
20.
Cells ; 11(4)2022 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-35203401

RESUMO

Osteoporosis is characterized by an alteration of bone microstructure with a decreased bone mineral density, leading to the incidence of fragility fractures. Around 200 million people are affected by osteoporosis, representing a major health burden worldwide. Several factors are involved in the pathogenesis of osteoporosis. Today, altered intestinal homeostasis is being investigated as a potential additional risk factor for reduced bone health and, therefore, as a novel potential therapeutic target. The intestinal microflora influences osteoclasts' activity by regulating the serum levels of IGF-1, while also acting on the intestinal absorption of calcium. It is therefore not surprising that gut dysbiosis impacts bone health. Microbiota alterations affect the OPG/RANKL pathway in osteoclasts, and are correlated with reduced bone strength and quality. In this context, it has been hypothesized that dietary supplements, prebiotics, and probiotics contribute to the intestinal microecological balance that is important for bone health. The aim of the present comprehensive review is to describe the state of the art on the role of dietary supplements and probiotics as therapeutic agents for bone health regulation and osteoporosis, through gut microbiota modulation.


Assuntos
Microbiota , Osteoporose , Probióticos , Densidade Óssea , Suplementos Nutricionais , Humanos , Osteoporose/metabolismo , Osteoporose/terapia , Probióticos/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...