Navegando por Palavras-chave "Fractures, bone"
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- ItemAcesso aberto (Open Access)Collaborative multicenter trials in Latin America: challenges and opportunities in orthopedic and trauma surgery(Associacao Paulista Medicina, 2013-01-01) Moraes, Vinicius Ynoe de [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; Faloppa, Flavio [UNIFESP]; Bhandari, Mohit; Universidade Federal de São Paulo (UNIFESP); McMaster UnivCONTEXT and OBJECTIVE: Orthopedic research agendas should be considered from a worldwide perspective. Efforts should be planned as the means for obtaining evidence that is valid for health promotion with global outreach.DESIGN and SETTING: Exploratory study conducted at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil, and McMaster University, Hamilton, Canada.METHODS: We identified and analyzed collaborative and multicenter research in Latin America, taking into account American and Canadian efforts as the reference points. We explored aspects of the data available from official sources and used data from traffic accidents as a model for discussing collaborative research in these countries.RESULTS: the evaluation showed that the proportion of collaborative and multicenter studies in our setting is small. A brief analysis showed that the death rate due to traffic accidents is very high. Thus, it seems clear to us that initiatives involving collaborative studies are important for defining and better understanding the patterns of injuries resulting from orthopedic trauma and the forms of treatment. Orthopedic research may be an important tool for bringing together orthopedic surgeons, researchers and medical societies for joint action.CONCLUSIONS: We have indicated some practical guidelines for initiatives in collaborative research and have proposed some solutions with a summarized plan of action for conducting evidence-based research involving orthopedic trauma.
- ItemSomente MetadadadosOsteoporosis after solid organ transplantation(Edizioni Minerva Medica, 2012-09-01) Kulak, Carolina Aguiar Moreira; Borba, Victoria Zeghbi Cochenski|Kulak Junior, Jaime; Custodio, Melani Ribeiro [UNIFESP]; Univ Fed Parana; Universidade Federal de São Paulo (UNIFESP)Osteoporosis and high risk of fractures have emerged as frequent and devastating complications of organ solid transplantation process. Bone loss after organ transplant is related to adverse effects of immunosuppressive drugs on bone remodeling and bone quality. Many factors contribute to the pathogenesis of osteoporosis in transplanted patients. This review address the mechanisms of bone loss that occurs both in the early and late post-transplant periods including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver and cardiac transplantation. Therapy for bone loss and prevention of fragility fracture in the transplant recipient will also be discussed.
- ItemAcesso aberto (Open Access)Teriparatide (recombinant human parathyroid hormone 1-34) in postmenopausal women with osteoporosis: systematic review(Associacao Paulista Medicina, 2008-09-04) Trevisani, Virginia Fernandes Moça [UNIFESP]; Riera, Rachel; Imoto, Aline Mizusaki; Saconato, Humberto; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Fed Rio Grande do Norte; Brazilian Cochrane Ctr; APMCONTEXT AND OBJECTIVE: Osteoporosis is defined as a disease characterized by low bone mass and deterioration of the bone tissue microarchitecture. Teriparatide stimulates the formation and action of osteoblasts, which are responsible for bone formation, thus promoting bone tissue increase. The aim was to assess the effectiveness and safety of teriparatide for treating postmenopausal osteoporosis.METHODS: A systematic review was conducted using the Cochrane Collaboration methodology.RESULTS: 1) Teriparatide 20 mu g or 40 mu g versus placebo: there was a benefit from teriparatide, considering the following outcomes: reduction in the number of new vertebral and non-vertebral fractures, and increased whole-body, lumbar and femoral bone mineral density. 2) Teriparatide 40 mu g versus alendronate 10 mg/day for 14 months: there was no statistical difference regarding the incidence of new vertebral or non-vertebral fractures, although in the group that received teriparatide there was greater bone mineral density increase in the whole body, lumbar column and femur. 3) Estrogen plus teriparatide 25 mu g versus estrogen: there was a benefit, considering the following outcomes: reduction in the number of new vertebral fractures, and increased whole-body, lumbar and femoral bone mineral density after three years.CONCLUSIONS: When teriparatide is intermittently administered in low doses, it reduces the incidence of vertebral fractures (67%) and non-vertebral fractures (38%) and increases bone mineral density in the lumbar column and femur. There is a need for studies with longer observation in order to allow conclusions regarding the safety and duration of the therapeutic effects.
- ItemAcesso aberto (Open Access)Vitamin D and its relation to bone mineral density in postmenopause women(Sociedade Brasileira de Ortopedia e Traumatologia, 2013-06-01) Labronici, Pedro José [UNIFESP]; Blunck, Saulo Santos; Lana, Flavius Ribeiro; Esteves, Bruno Bandeira; Franco, José Sergio; Fukuyama, Junji Miller; Pires, Robinson Esteves Santos; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Teresa Clinical Head of the Orthopedics and Traumatology Service of Prof. Dr. Donato D'Ângelo; Hospital Santa Teresa Clinical Head of the Orthopedics and Traumatology Service of Prof. Dr. Donato D'ngelo; UFRJ Department of the Medical School; Hospital Geral Vila Penteado; Universidade Federal de Minas Gerais Department of the Locomotor System; Hospital Felício RochoOBJECTIVE:Compare the level of vitamin D with the bone mineral density (BMD) in postmenopausal women, with or without fractures.METHODS:250 women with mean age of 71.1 were evaluated. The serum levels of vitamin D considered sufficient were ≥ 30 ng/mL, insufficient between 20 and 30 ng/mL and deficient < 20 ng/mL. The bone mineral density was measured and considered osteopenia when T value total of lumbar spine or hip was between -1 and -2.5 and osteoporosis < 2.5. The patients with fractures accounted for 25.2%.RESULTS:There was no significant difference in the vitamin D (ng/mL) levels among the age groups (p = 0.25), the levels of fractures (p = 0.79) and the levels of BMD (p = 0.76).CONCLUSION:82% of the patients presented deficient and insufficient blood levels of vitamin D. Ours results showed any significant correlation between vitamin D levels and bone mineral density after adjusting for age.