Objective: To explore the association between fat intake, serum lipids and the risk of osteoporotic fractures in the elderly. Design: A hospital-based case-control study. Setting: The study was conducted at a tertiary centre and referral hospital for the province of Jaén (Spain). Subjects: Cases (n ¼ 167) were patients aged 65 years or more with a low-energy fracture selected from the population attended at the hospital. Controls (patients without antecedents of any fracture) were 1:1 matched to cases by sex and age (n ¼ 167). Methods: Diet was assessed by a semiquantitative food frequency questionnaire. Serum total cholesterol and high-density lipoprotein (HDL) cholesterol were also measured. Results: Participants in the two upper quartiles of polyunsaturated fat (PUFA) intake showed an increased risk of fracture, with statistically significant differences with respect to the first quartile in the adjusted model (odds ratio (OR) ¼ 3.59; 95% confidence interval (CI) ¼ 1.06-12.1 and OR ¼ 5.88; 95% CI ¼ 1.38-25.02); P ¼ 0.01 for the trend test). A higher ratio of monounsaturated fat (MUFA) to PUFA was associated with a reduced risk of fracture (OR ¼ 0.20; 95% CI ¼ 0.07-0.60 for the fourth quartile; P ¼ 0.002 for the trend test). The intake of omega-6 fatty acids was associated with an elevated risk of fracture (OR ¼ 3.41; 95% CI ¼ 1.05-11.15 for the fourth quartile; P ¼ 0.01 for the trend test). HDL-cholesterol levels were inversely associated with the risk of fracture (test for trend P ¼ 0.03 across quartiles). Conclusions: PUFA intake was associated with an increased risk of osteoporotic fractures in the elderly, whereas a high ratio of MUFA:PUFA was associated with decreased risk.
To investigate the effect of 25-OH-vitamin D supplements (calcidiol) on fracture healing in the elderly, an experimental model with 15 18-month-old female Wistar rats was designed. An experimental fracture in the middle third of both femora of each rat was made. Then the rats were randomly assigned to two groups: one group was subcutaneously treated with 25-OH-vitamin D during all healing processes, and the other group (the control group) was not. After 5 weeks of healing, the animals were killed and both femora were extracted. Blood samples were collected before fracture and at death to determine the levels of 25-OH-vitamin D. All bones that were extracted were subjected to a torsion test to assess healing; a significantly greater maximum shear force before failure was supported in the treated group (p < 0.01). Moreover, a positive correlation (p < 0.01; r=0.55) was found between blood levels of 25-OH-vitamin D at death and the mechanical strength of the callus. Thus, the administration of 25-OH-vitamin D after the experimental fracture significantly improved the mechanical strength of the fractured bone. If similar results are found in the human, then treatment with 25-OH-vitamin D after the occurrence of a fracture would be a good way to improve fracture healing in the elderly.
We demonstrate for the first time that extracts obtained from chondrocytes of osteoarthritic knees promote chondrogenic differentiation of autologous IFPSCs. Moreover, combination of transdifferentiated IFPSCs with biodegradable PLGA 3D scaffolds can serve as an efficient system for the maintenance and maturation of cartilage tissue. These findings suggest its usefulness to repair articular surface in OA.
The analgesic effect of morphine and bupivacaine is different depending on the type of arthroscopic surgery. Intraarticular bupivacaine is effective in surgeries with a low inflammatory response. For surgeries with a higher inflammatory response, morphine has a better analgesic effect. Postoperative intraarticular analgesic therapy should be indicated according to the performed arthroscopic procedure.
Premedication with clonidine reduced bleeding in middle ear microsurgery, attenuated hyperdynamic response to tracheal intubation, and reduced isoflurane, fentanyl, and urapidil requirements for controlled hypotension.
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