Orientador: Roberta Okamoto / Coorientador: Leonardo Perez Faverani / Banca: Idelmo Rangel Garcia Junior / Banca: Clóvis Marzola / Resumo: Objetivos: Avaliar a morfometria e dinâmica óssea periimplantar em ratos submetidos à orquiectomia, tratados com teriparatida. Materiais e Métodos: 18 ratos foram divididos em 3 grupos: SHAM - cirurgia fictícia, ORQ - orquiectomia, e ORQTERI - orquiectomia bilateral, tratados com teriparatida. Cada animal recebeu um implante na metáfise tibial. Aos 14 e 42 dias de pós-operatório, foram administrados os fluorocromos calceína e alizarina, respectivamente. A eutanásia ocorreu ao 60 dias após a instalação dos implantes. As peças foram analisadas na microtomografia computadorizada (microCT) para avaliação dos parâmetros de volume e percentual de volume ósseo (BV, BV/TV), espessura do trabeculado (Tb.Th), número e separação de trabéculas (Tb.N, Tb.Sp) e percentual de porosidade total, (Po-tot). Para microscopia confocal a laser, a mensuração da área dos fluorocromos, da taxa diária de aposição mineral (MAR), da extensão linear de contato osso/implante (ELCOI) e área de osso neoformado (AON), foi realizada no programa Image J. Os dados não paramétricos foram comparados pelo teste Kruskal-Wallis e paramétricos pelo teste ANOVA 1 ou 2 fatores. Como pós-teste, os testes de Holm-Sidak, ou Tukey foram aplicados, com nível de significância a 5%. Resultados: Para os parâmetros BV, BV/TV, Tb.Th, o grupo ORQTERI apresentou os maiores valores em relação aos demais grupos e, para Po-tot, os menores valores foram para o grupo ORQTERI (ORQ: p<0,05 e SHAM: p>0,05). Para Tb.Sp o grupo SHAM apres... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Objectives: To evaluate morphometry and peri-implant bone dynamics in rats submitted to orchiectomy, treated with teriparatide. Materials and Methods: 18 rats were divided into 3 groups: SHAM - fictitious surgery, ORQ - orchiectomy, and ORQTERI - bilateral orchiectomy, treated with teriparatide. Each animal received an implant in the tibial metaphysis. At the 14 and 42 postoperative days, calcein and alizarin were administered, respectively. Euthanasia occurred 60 days after implant installation. The pieces were analyzed by computerized microtomography (microCT) for evaluation of volume and percentage of bone volume (BV, BV/TV), trabecular thickness (Tb.Th), number and separation of trabeculae (Tb.N, Tb.Sp) and percentage of total porosity, (Po-tot). For laser confocal microscopy, the area of the fluorochromes, the mineral apposition rate (MAR), the linear bone implant contact (ELCOI) and the newly formed bone area (AON) were measured in Image J. The nonparametric data were compared by the Kruskal-Wallis test and parametric by the ANOVA 1 or 2 factor test. As a post-test, the Holm-Sidak or Tukey tests were applied, with significance level at 5%. Results: For the parameters BV, BV/TV, Tb.Th, the ORQTERI group presented the highest values in relation to the other groups and, for Po-tot, the lowest values were for the ORQTERI group (ORQ: p <0.05 and SHAM: p> 0.05). For !27 Tb.Sp the SHAM group presented the best result (ORQ: p<0.05 and ORQTERI: p>0.05), and Tb.N, there was no statistically significant difference in the comparison of intragroup results (p>0.05). For MAR and fluorochemical evaluation, ORQTERI showed better peri-implantar bone turnover (ORQ: p <0.05), for ELCOI and AON, the SHAM group presented the highest results (ORQ: p <0.05). Conclusions: Treatment with Teriparatide improves bone dynamics, in addition to increasing the volume and quality of peri-implant bone / Mestre

Made available in DSpace on 2014-06-11T19:29:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-01Bitstream added on 2014-06-13T20:38:33Z : No. of bitstreams: 1 faria_pc_me_sjc.pdf: 6372500 bytes, checksum: 58c08c65f4ab45f619952f283a2337c0 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / De acordo com a Organização Mundial de Saúde (OMS), a osteoporose está atrás apenas das doenças cardiovasculares como um problema de saúde mundial (2007). Atingindo cerca de um terço das mulheres na pósmenopausa tornou-se uma das doenças osteometabólicas mais comuns. A identificação de indivíduos com baixa densidade óssea mineral e alto risco de fraturas é a base de qualquer programa preventivo de osteoporose. Indivíduos de alto risco deveriam ser encaminhados para realização do Dual Energy X ray Absorptiometry (DXA) considerada o exame padrão ouro de avaliação da densidade mineral óssea, no entanto o DXA tem disponibilidade limitada para uso de rotina no rastreamento populacional. Existem métodos qualitativos e quantitativos realizados em radiografias panorâmicas, denominados índices radiomorfométricos que podem ser capazes de identificar mulheres na pós-menopausa com indicação de realização de densitometria óssea. O propósito deste trabalho volta-se para a investigação sobre utilização de radiografias panorâmicas e índices radiomorfométricos como método auxiliar para diagnóstico de osteoporose em mulheres pós-menopáusicas / According to World Health Organization (WHO), osteoporosis is the second only to cardiovascular diseases as a global health problem (2007). Reaching about one third of postmenopausal women. It has become one of the most common bone metabolic diseases. The identification of individuals with low bone mineral density and high fractures risk is the foundation of any preventive osteoporosis program. High risk individuals should be referred for dual X-ray absorptiometry (DXA) considered the gold standard of bone mineral density assessment, however bone densitometry has a limited availability for routine use in population screening. There are qualitative and quantitative methods performed on panoramic radiographs, called radiomorfometricos rates, which may identify postmenopausal women with bone densitometry indication. The purpose of this paper was to evaluate panoramic radiographs and radiomorphometric use as an auxiliary method for osteoporosis diagnosis in postmenopausal women

Orientador: Luiz Cesar de Moraes / Banca: Cristiane Yumi Koga Ito / Banca: Cláudio Freitas / Resumo: De acordo com a Organização Mundial de Saúde (OMS), a osteoporose está atrás apenas das doenças cardiovasculares como um problema de saúde mundial (2007). Atingindo cerca de um terço das mulheres na pósmenopausa tornou-se uma das doenças osteometabólicas mais comuns. A identificação de indivíduos com baixa densidade óssea mineral e alto risco de fraturas é a base de qualquer programa preventivo de osteoporose. Indivíduos de alto risco deveriam ser encaminhados para realização do Dual Energy X ray Absorptiometry (DXA) considerada o exame padrão ouro de avaliação da densidade mineral óssea, no entanto o DXA tem disponibilidade limitada para uso de rotina no rastreamento populacional. Existem métodos qualitativos e quantitativos realizados em radiografias panorâmicas, denominados índices radiomorfométricos que podem ser capazes de identificar mulheres na pós-menopausa com indicação de realização de densitometria óssea. O propósito deste trabalho volta-se para a investigação sobre utilização de radiografias panorâmicas e índices radiomorfométricos como método auxiliar para diagnóstico de osteoporose em mulheres pós-menopáusicas / Abstract: According to World Health Organization (WHO), osteoporosis is the second only to cardiovascular diseases as a global health problem (2007). Reaching about one third of postmenopausal women. It has become one of the most common bone metabolic diseases. The identification of individuals with low bone mineral density and high fractures risk is the foundation of any preventive osteoporosis program. High risk individuals should be referred for dual X-ray absorptiometry (DXA) considered the gold standard of bone mineral density assessment, however bone densitometry has a limited availability for routine use in population screening. There are qualitative and quantitative methods performed on panoramic radiographs, called radiomorfometricos rates, which may identify postmenopausal women with bone densitometry indication. The purpose of this paper was to evaluate panoramic radiographs and radiomorphometric use as an auxiliary method for osteoporosis diagnosis in postmenopausal women / Mestre

Abstract The purpose of the present study was to investigate the value of different markers of collagen metabolism in assessing the disease process and further disease progression in patients with inflammatory arthritis, mainly rheumatoid arthritis (RA). In a series of 59 patients with RA and knee joint effusion, the level of synovial fluid (SF) carboxyterminal telopeptide of type I collagen (ICTP), a marker for type I collagen degradation, was associated with the Larsen's grade of the corresponding joint (p &lt; 0.001). The mean SF concentrations of ICTP and the markers of type I and III collagen synthesis (the aminoterminal propeptides of type I and III procollagens, PINP and PIIINP) were higher than those in serum. In addition, the levels of these markers correlated with each other in both serum and SF (p &lt; 0.001 in both occasions). In a three-year follow-up study of 44 RA patients from the abovementioned series and 11 patients with other chronic arthritides, a high SF ICTP level turned out to reflect accelerated radiological progression in the assessed joint (p &lt; 0.05). Contrary to this, the results on the SF leukocyte level were contradictory. In a population-based cross-sectional series of 90 patients with advanced RA, elevated baseline serum ICTP levels discriminated the patients with a need for total joint replacement surgery from those with milder disease (p = 0.001) in a three-year follow-up.In a study of 52 patients with recent onset RA, the changes in BMD during a two-year follow-up were not associated with the serum level of markers of type I collagen metabolism. In this series, however, the decrease in BMD (measured in the spine and the femoral neck) was smaller than earlier reported. In a three-year follow-up series of 63 patients with early RA, the patients with simultaneously elevated serum ICTP (> 4.6 mg/l) and RF positivity at baseline, had an increased risk for progressive joint disease (an increase in Larsen's score > 20 as assessed from radiographs of hands and feet) with an odds ratio of 9.1 (95% CI 2.5 to 32.9). A risk profile of this kind may be useful in early disease assessment to identify the patients who will need the most active drug therapy.

4 pp. / Calcium is an essential mineral found in great abundance in the body. Ninety-nine percent of all the calcium in the body is found in the bones and teeth. The remaining one percent is in the blood. Calcium plays important roles in nerve conduction, muscle contraction, and blood clotting. If calcium levels in the blood drop below normal, calcium will be taken from bone and put into the blood in order to maintain blood calcium levels. Therefore, it is important to consume enough calcium to maintain adequate blood and bone calcium levels. Revised 2017, Revised 2011, Original 2004

Class of 2013 Abstract / Specific Aims: To determine efficacy of alendronate (ALN) and risedronate (RIS) for treatment of osteoporosis and osteopenia in men. Methods: Literature search was primarily via PubMed. Inclusion criteria were: randomized controlled trials or observational studies assessing treatment of osteoporosis in men, either of primary or secondary etiology. Exclusion criteria were: minority population with baseline osteoporosis, inclusion of women, lack of control group. Primary outcomes were bone mineral density (BMD) of femoral neck (FN) and lumbar spine (LS); secondary outcomes were vertebral or non-vertebral fractures incidence. Data were synthesized using a random effects meta-analysis. Main Results: Eleven ALN and six RIS studies were included; most provided LS and FN data, but trials longer than 1-year were infrequent (ALN 3, RIS 4) as were fracture data (ALN 4, RIS 3). For both FN and LS BMD, both drugs showed significant treatment effects at one and two-years (p<0.001). For FN BMD, 2-year treatment effects were ALN: SDM= 0.638, p<0.001; RIS: SDM= 0.391, p<0.001; heterogeneity was insignificant (p> 0.05). For LS BMD, treatment effects were: 2-year ALN: SDM= 1.206, p<0.001; 1-year RIS: SDM= 0.0.574; p<0.001; heterogeneity was insignificant (p>0.05). For fracture, both drugs showed significant treatment effects at vertebral sites: ALN: OR 0.450, p<0.05; RIS: OR 0.423, p=0.001; heterogeneity was insignificant (p>0.05). RIS also showed a promising effect at non-vertebral sites (p<0.05), however only two studies provided data at this site. Conclusion: Both ALN and RIS are effective to increase BMD and decrease vertebral fracture occurrence in men with osteoporosis or osteopenia.

La mutation F508del dans la protéine CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) est considérée comme un facteur de risque indépendant de maladie osseuse liée à la mucoviscidose. Nous avons évalué la densité minérale osseuse et les paramètres histomorphométriques de la formation osseuse et la masse osseuse chez des souris homozygotes F508del-CFTR (F508del) et contrôle(WT), de la même portée, âgées de 6 semaines (pré-pubères), 10 semaines (pubères) et 14 semaines (jeunes adultes), dans deux sexes. L'architecture osseuse des souris F508del et WT a été évaluée par densitométrie osseuse, micro-CT et l'analyse des paramètres dynamiques de la formation osseuse a été réalisée par double marquage, in vivo. Les niveaux de sérum de l'insuline-like growth factor 1 (IGF-1) et l'ostéocalcine ont également été déterminés. Une diminution de la densité minérale osseuse, de la masse osseuse et une altération de l'architecture osseuse trabéculaire fémorale ont été observées chez les souris F508del par rapport aux témoins à 6, 10 et 14 semaines. Une diminution du taux de formation osseuse dans F508del été mise en évidence, par rapport aux souris témoins, indépendamment de l'âge et du sexe. En outre, nous avons observé un taux sérique d'IGF-1 plus faibles chez la souris F508del par rapport aux souris WT tandis que le taux sérique d'ostéocalcine est normal. Nos résultats démontrent que la mutation F508del-CFTR affecte la masse osseuse trabéculaire en réduisant la formation osseuse.Le N-butyldeoxynojyrimicin (NB-DNJ, le miglustat [Zavesca], les Laboratoires Actelion, Suisse) est un médicament approuvé pour le traitement de la pathologie osseuse de la maladie de Gaucher de type I. Il a été montré que le miglustat normalise le transport des ions sodiques et chlorures dépendant de la protéine CFTR au niveau de la muqueuse nasale des souris F508del. La microarchitecture osseuse de la souris F508del par rapport à son contrôle a été évaluée après l'administration du miglustat à une dose de 120 mg / kg / jour par gavage pendant 28 jours. Les niveaux de sérum IGF-1 et 17β-estradiol (E2) ont également été déterminés. Le traitement, de 4 semaines, avec le miglustat, normalise le volume osseux trabéculaire des vertèbres lombaires de la souris F508del. Cette augmentation du volume osseux est associée à une augmentation du taux de formation osseuse et une augmentation sérique de E2, mais pas au taux sérique d'IGF-1 chez la souris F508del traitées par rapport aux souris non traitées F508del.Nos données montrent clairement que l'administration orale de miglustat normalise la masse osseuse par une augmentation de la formation osseuse chez des souris F508del. Ces résultats appuient fortement le potentiel thérapeutique du miglustat chez les patients atteints de la maladie osseuse associée à la mucoviscidose. / The F508del mutation in the cystic fibrosis transmembrane conductance regulator (Cftr) gene is believed to be an independent risk factor for cystic fibrosis-related bone disease.We evaluated the bone mineral density and histomorphometric parameters of bone formation and bone mass in F508del-CFTR homozygous mice (F508del) and littermate (WT) controls at 6 (prepubertal), 10 (pubertal) and 14 (young adult) weeks of age in two genders. The bone architecture of F508del and WT mice was evaluated by bone densitometry, micro-CT and analysis of dynamic parameters of bone formation. Levels of serum insulin-like growth factor 1 (IGF-1) and osteocalcin were also determined. Reduced bone mineral density, lower femoral bone mass and altered trabecular bone architecture were observed in F508del compared to controls at 6, 10, and 14 weeks of age. A decrease in bone formation rate in F508del was evidenced compared to control mice, independently of age and sex. Additionally, we found lower IGF-1 levels in F508del mice compared to WT mice whereas osteocalcin level was normal. Our findings demonstrate that the F508del mutation in CFTR impacts trabecular bone mass by reducing bone formation.N-butyldeoxynojyrimicin (NB-DNJ, miglustat [Zavesca], Laboratoires Actelion, Suisse) an approved drug for treating bone pathology in type I Gaucher disease, was reported to normalizes sodium and Cftr-dependent chloride transport in nasal mucosa of F508del cystic fibrosis mice. The bone microarchitecture of F508del mice relative to WT littermates was evaluated after an administration of 120 mg/kg/day miglustat by oral gavage for 28 days. Levels of serum IGF-1 and 17β-estradiol (E2) were also determined. Once-day treatments with miglustat, over 4 weeks, normalized trabecular bone volume of the lumbar spine in F508del mice. This increase of bone volume was related to both an increased rate of bone formation and increased serum E2 level but not IGF-1 level in miglustat-treated F508del mice compared to untreated F508del mice.Our data provides clear evidence that oral administration of miglustat normalizes bone mass by increasing bone formation in F508del mice; these findings strongly support the therapeutic potential of miglustat in patients with cystic fibrosis related bone disease.Key words : cystic fibrosis, bone disease, miglustat

The purpose of this study was to describe and evaluate a health education program provided primarily for older women who have or suspect they have osteoporosis. The health education program evaluated is provided by the Ostop Society of British Columbia (Ostop). One of the goals of the study was to provide Ostop with descriptive information about the organization's members, their participation in the organization's education program and their evaluation of the value of the information sources provided by the organization. A second goal was to evaluate the relationships between variables which may explain how Ostop functions as a provider of osteoporosis health education. Bandura's social learning theory was used to provide a theoretical explanation of the Ostop education program, to identify study variables and to generate the research questions. The variables that were expected to be related to the members' level of knowledge about osteoporosis were selected personal characteristics, the amount of participation in Ostop, and members' perceptions about the value of the different sources of information provided by Ostop. The same variables plus members' level of knowledge about osteoporosis were expected to be related to the level of participation in health behaviors believed to help prevent or slow the progression of osteoporosis. The study sample consisted of 120 women members of Ostop, randomly selected from a membership list which contained the names of 261 women members of Ostop. All of the members included on the list lived close enough to Vancouver, British Columbia to attend the lecture series offered by Ostop. The study group is a random sample of Ostop members but may not accurately represent all women with or at risk of developing osteoporosis. Ostop is a special interest group which tends to attract as members well educated women with at least some prior awareness of and concern about the condition. The data were collected by means of a mailed questionnaire which was developed for this study. The content of the questionnaire was based on the recent osteoporosis research literature, and the advice of a variety of content experts. Prior to conducting the study, the researcher pilot tested the questionnaire using nine Ostop members. The descriptive information demonstrated that members are typically post-menopausal women in their sixties and seventies who have osteoporosis and who have an educational attainment of at least graduation from high school. The respondents were well-informed about osteoporosis and were more likely to practice health behaviors related to calcium intake than to perform the recommended amount of exercise. One important finding was that 66% of the respondents reported daily intakes of calcium which exceeded the highest recommended daily intake. This is of concern in light of research findings that excessive calcium intake is associated with the development of kidney stones in some women. Regression analysis of the study variables demonstrated that: 1. the number of Ostop-provided information sources identified by respondents as being useful was positively and significantly (p≦.05) correlated with knowledge level. 2. Both age and menopause status were negatively and significantly (p≦.05) correlated with knowledge level. 3. The only variable which was correlated significantly (p≦.05) with the performance of osteoporosis-related health behavior was knowledge level. This was a weak positive correlation of .234. These results suggest that Ostop’s present educational program may be helping women gain knowledge about osteoporosis and that having knowledge about osteoporosis is one factor which is associated with the practice of recommended health behavior. Social learning theory was used to explain the results and to suggest ways in which Ostop may be able to increase the effectiveness of its educational efforts. Suggestions were also made about other ways to provide osteoporosis health education and about directions for further research. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Osteoporosis is the most common human bone disease and a growing public health problem. Worldwide, 9 million fractures due to osteoporosis occur annually. Fracture is the main burden of the disease and is linked with significant morbidity and mortality. A history of upper extremity fragility fracture is known to contribute to increased risk of subsequent fractures. In this study, we compared the estimated FRAX 10-year probability of major osteoporotic fracture and hip fracture between upper extremity (UE) fracture and non-fracture patients. In addition, we assessed differences in demographics and osteoporosis evaluation between the two groups, and we report the prevalence of lab abnormalities among UE fragility fracture patients evaluated in our fracture liaison service (FLS). A total of 243 patients from Brigham and Women’s Faulkner Hospital were recruited to participate in the study. UE fracture patients were recruited from our FLS, and UE non-fracture patients were recruited from the UE clinic. Overall 10-year probability of major osteoporotic and hip fracture was higher in upper extremity fracture patients than upper extremity non-fracture patients (19.23 versus 9.23, p <0.001 and 4.26 versus 1.54. p < 0.001 respectively). When excluding fragility fracture history, 10-year probability of major osteoporotic fracture and hip fracture were similar between upper extremity fracture and non-fracture patients (10.59 versus 9.23, p = 0.095 and 1.88 versus 1.54, p = 0.215 respectively). The proportion of osteoporosis evaluation via bone mineral density assessment was higher in upper extremity fracture patients compared to upper extremity non-fracture patients (p < 0.001). However, the proportion of upper extremity fracture patients on osteoporosis medication was low and not different than upper extremity non-fracture patients (p < 0.079). Our results highlight history of fragility fracture as an important driver in subsequent fracture risk. UE fracture and non-fracture patients harbor similar fracture clinical risk factors, with the exception of fracture history, and are similarly at risk for future hip fracture and major osteoporotic fracture. Our results suggest close osteoporosis evaluation of older upper extremity non-fracture patients is warranted.

No description available.