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1.
Bone Health Following Bariatric Surgery: An Update.
Saad, R, Habli, D, El Sabbagh, R, Chakhtoura, M
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry. 2020;(2):165-181
Abstract
Obesity rates are increasing rapidly, and bariatric surgery is currently the most effective tool for weight loss. Recently, bariatric surgery induced bone loss has gained attention. Such detrimental effect on bone is multifactorial and causes may include nutrient deficiencies, gut and gonadal hormonal changes, mechanical unloading, loss of lean mass, increased bone marrow fat, and increased risk of fall. This review describes the available evidence on bone loss and fracture risk following bariatric surgery and summarizes the guidelines on the topic. Increased bone resorption starts early postsurgery, and bone markers peak at 1-2 yr. Across studies, the drop in areal bone mineral density is inconsistent at the lumbar spine, while a 2%-5% drop at 6 mo and a 6%-10.5% at 9-12 mo are observed at the total hip. Conversely, studies using quantitative CT showed a 6%-7% decrease in volumetric bone mineral density at the lumbar spine at 6-12 mo postsurgery. These studies also report significant bone loss at the radius and tibia, in addition to alteration in bone microarchitecture. Fracture risk increases 2 yr after surgery, more so following malabsorptive procedures. Fractures were reported at axial, weight bearing sites and at appendicular sites. The available evidence is very heterogeneous, and mostly derived from studies on Roux-en-y gastric bypass in premenopausal women. Data on restrictive procedures is scarce. Our findings suggest that the early postoperative phase represents the "golden window" to intervene and promote bone health. More research is needed to determine the effect of different bariatric procedures on bone, to identify optimal interventions to prevent bone loss and to characterize high risk individuals who should be targeted.
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2.
Resorbable bone fixation alloys, forming, and post-fabrication treatments.
Ibrahim, H, Esfahani, SN, Poorganji, B, Dean, D, Elahinia, M
Materials science & engineering. C, Materials for biological applications. 2017;(Pt 1):870-888
Abstract
Metallic alloys have been introduced as biodegradable metals for various biomedical applications over the last decade owing to their gradual corrosion in the body, biocompatibility and superior strength compared to biodegradable polymers. Mg alloys possess advantageous properties that make them the most extensively studied biodegradable metallic material for orthopedic applications such as their low density, modulus of elasticity, close to that of the bone, and resorbability. Early resorption (i.e., <3months) and relatively inadequate strength are the main challenges that hinder the use of Mg alloys for bone fixation applications. The development of resorbable Mg-based bone fixation hardware with superior mechanical and corrosion performance requires a thorough understanding of the physical and mechanical properties of Mg alloys. This paper discusses the characteristics of successful Mg-based skeletal fixation hardware and the possible ways to improve its properties using different methods such as mechanical and heat treatment processes. We also review the most recent work pertaining to Mg alloys and surface coatings. To this end, this paper covers (i) the properties and development of Mg alloys and coatings with an emphasis on the Mg-Zn-Ca-based alloys; (ii) Mg alloys fabrication techniques; and (iii) strategies towards achieving Mg-based, resorbable, skeletal fixation devices.
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3.
Plyometric exercise and bone health in children and adolescents: a systematic review.
Gómez-Bruton, A, Matute-Llorente, Á, González-Agüero, A, Casajús, JA, Vicente-Rodríguez, G
World journal of pediatrics : WJP. 2017;(2):112-121
Abstract
BACKGROUND Many jumping interventions have been performed in children and adolescents in order to improve bone-related variables and thus, ensure a healthy bone development during these periods and later in life. This systematic review aims to summarize and update present knowledge regarding the effects that jumping interventions may have on bone mass, structure and metabolism in order to ascertain the efficacy and durability (duration of the effects caused by the intervention) of the interventions. DATA SOURCES Identification of studies was performed by searching in the database MEDLINE/PubMed and SportDiscus. Additional studies were identified by contacting clinical experts and searching bibliographies and abstracts. Search terms included "bone and bones", "jump*", "weight-bearing", "resistance training" and "school intervention". The search was conducted up to October 2014. Only studies that had performed a specific jumping intervention in under 18-year olds and had measured bone mass were included. Independent extraction of articles was done by 2 authors using predefined data fields. RESULTS A total of 26 studies were included in this review. Twenty-four studies found positive results as subjects included in the intervention groups showed higher bone mineral density, bone mineral content and bone structure improvements than controls. Only two studies found no effects on bone mass after a 10-week and 9-month intervention. Moreover, those studies that evaluated the durability of the effects found that some of the increases in the intervention groups were maintained after several years. CONCLUSIONS Jumping interventions during childhood and adolescence improve bone mineral content, density and structural properties without side effects. These type of interventions should be therefore implemented when possible in order to increase bone mass in early stages of life, which may have a direct preventive effect on bone diseases like osteoporosis later in life.
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4.
Bilateral condylar resorption in down syndrome.
Grippaudo, C, Grippaudo, FR, Marianetti, TM, Cacucci, L, Deli, R, Pelo, S
The Journal of craniofacial surgery. 2014;(6):e580-2
Abstract
Asymptomatic idiopathic condylar resorption is a rare disease of difficult diagnosis and treatment. We review the literature about this rare condition and report a case of a patient, affected by Down syndrome, who underwent a complete untreated bilateral condylar resorption in adolescence and then developed pain on chewing only 20 years later. Despite a precise orthodontic and surgical therapeutic plan, treatment had to be discontinued because of patient lack of compliance. This case is the first of its kind to be reported and emphasizes the need for special attention in patients with disability.
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5.
Effects of tyrosine kinase inhibition on bone metabolism: untargeted consequences of targeted therapies.
Alemán, JO, Farooki, A, Girotra, M
Endocrine-related cancer. 2014;(3):R247-59
Abstract
Tyrosine kinase inhibitors (TKIs) are at the forefront of molecular-targeted therapies for cancer. With the advent of imatinib for the treatment of chronic myelogenous leukemia, a new wave of small-molecule therapeutics redefined the oncologic treatment to become chronically administered medications with tolerable side-effect profiles compared with cytotoxic agents. Effects on bone mineral metabolism were observed during early imatinib treatment, in the form of hypophosphatemia with increased urinary phosphorus excretion. This finding led to detailed investigations of off-target effects responsible for changes in bone cell maturation, activity, and impact on bone mass. Subsequently, another BCR-Abl inhibitor (dasatinib), vascular endothelial growth factor (VEGF) inhibitors (sorafenib and sunitinib) as well as rearranged during transfection (RET) inhibitors (vandetanib and cabozantinib) were developed. Inhibition of bone resorption appears to be a class effect and is likely contributed by TKI effects on the hematopoietic and mesenchymal stem cells. As long-term, prospective, clinical outcomes data accumulate on these targeted therapies, the full extent of off-target side effects on bone health will need to be considered along with the significant benefits of tyrosine kinase inhibition in oncologic treatment.
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6.
Flavonoid intake and bone health.
Weaver, CM, Alekel, DL, Ward, WE, Ronis, MJ
Journal of nutrition in gerontology and geriatrics. 2012;(3):239-53
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Abstract
Flavonoids, found in a wide diversity of plant foods from fruits and vegetables, herbs and spices, essential oils, and beverages, have the most potential of dietary components for promotion of bone health beyond calcium and vitamin D. Recent epidemiological studies show flavonoid consumption to have a stronger association with bone than general fruit and vegetable consumption. Bioactive flavonoids are being assessed for properties beyond their chemical antioxidant capacity, including anti-inflammatory actions. Some have been reported to enhance bone formation and to inhibit bone resorption through their action on cell signaling pathways that influence osteoblast and osteoclast differentiation. Future research is needed to determine which of the flavonoids and their metabolites are most effective and at what dose, as well as the mechanism of modulating cellular events, in order to set priorities for clinical trials.
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7.
Primary hyperparathyroidism: Skeletal and non-skeletal effects, diagnosis and management.
Pyram, R, Mahajan, G, Gliwa, A
Maturitas. 2011;(3):246-55
Abstract
Primary hyperparathyroidism (PHPT) is the third most common endocrinopathy seen today, and is most frequently found in the 6th to 7th decade of life. PHPT can present with various degrees of symptoms, and can affect many organ systems, including the skeletal, renal, central nervous system and cardiovascular system. Despite this, the most common presentation of hyperparathyroidism is "asymptomatic" with the diagnosis being made incidentally with the initial finding of hypercalcemia on routine laboratory studies, leading to further investigation. Surgical versus medical management is usually based on factors such as age and complications related to hyperparathyroidism (i.e. the presence of renal stones, renal insufficiency and bone loss and significant increases in serum calcium). Treatment options include parathyroidectomy, bisphosphonates, calcitonin and calcimimetics. In this review, we discuss primary hyperparathyroidism in detail with a focus on clinical manifestations particularly in the elderly population. We highlight the indications for surgical versus medical management and compare some of the uses of newer therapeutic agents relative to traditional ones.
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8.
Efficacy of ossein-hydroxyapatite complex compared with calcium carbonate to prevent bone loss: a meta-analysis.
Castelo-Branco, C, Ciria-Recasens, M, Cancelo-Hidalgo, MJ, Palacios, S, Haya-Palazuelos, J, Carbonell-Abelló, J, Blanch-Rubió, J, Martínez-Zapata, MJ, Manasanch, J, Pérez-Edo, L
Menopause (New York, N.Y.). 2009;(5):984-91
Abstract
OBJECTIVE There is increasing evidence to suggest that ossein-hydroxyapatite complex (OHC) is more effective than calcium supplements in maintaining bone mass. The aim of this meta-analysis was to determine whether OHC has a different clinical effect on bone mineral density (BMD) compared with calcium carbonate (CC). METHODS A meta-analysis of randomized controlled clinical trials was carried out to evaluate the efficacy of OHC versus CC on trabecular BMD. We identified publications on clinical trials by a search of electronic databases, including MEDLINE (1966-November 2008), EMBASE (1974-November 2008), and the Cochrane Controlled Clinical Trials Register.The primary endpoint was percent change in BMD from baseline. Data were pooled in a random-effects model, and the weighted mean difference was calculated. A sensitivity analysis that excluded trials without full data was performed. RESULTS Of the 18 controlled trials initially identified, 6 were included in the meta-analysis. There was no significant heterogeneity among the included trials. The percent change in BMD significantly favored the OHC group (1.02% [95% CI, 0.63-1.41], P < 0.00001). These results were confirmed in the sensitivity analysis. CONCLUSIONS OHC is significantly more effective in preventing bone loss than CC.
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9.
CT findings of a nasoalveolar cyst.
Yerli, H, Cabbarpur, C, Aydin, E
The British journal of radiology. 2009;(976):e76-8
Abstract
We report the CT findings of a nasoalveolar cyst that developed as a slowly enlarging mass in our patient. CT showed a soft-tissue mass with a smooth margin; a sediment level was apparent. A dense calcified layer with a "milk of calcium" appearance was seen in the inferior portion of the lesion. The maxilla was resorbed by the lesion. Total excision of the mass was performed, and the microscopic findings were consistent with a nasoalveolar cyst.
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10.
Botanicals for age-related diseases: from field to practice.
Weaver, CM, Barnes, S, Wyss, JM, Kim, H, Morré, DM, Morré, DJ, Simon, JE, Lila, MA, Janle, EM, Ferruzzi, MG
The American journal of clinical nutrition. 2008;(2):493S-7S
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Abstract
The Purdue-University of Alabama Botanicals Research Center for Age Related Disease joins novel technologies to study the bioavailability of bioactive polyphenolic constituents and their relation to health. Many diseases that manifest with age relate to oxidative stress and tissue damage. Our goal is to follow the fate of bioactive constituents from a complex mixture to the organ affected by the disease and relate that to a protective mechanism. Equally important is to screen commercially available botanicals for their efficacy and safety. Botanicals and their relation to bone antiresorptive capacity, cognitive function, vascular effects, and cancer are principal themes in our center.