Osteoporosis is a disease with great importance in current public health due to the associated risk of fracture; therefore, a rapid and accurate diagnosis becomes increasingly important. Recent literature has described a possible relationship between the changes in the organic phase of bone and the changes in nail keratin measured through Raman spectroscopy, aiming at the development of a standard for measuring bone quality and fracture risk both rapid and accurately. This work evaluated the correlation between the bone mineral density (BMD) scores of women with and without osteoporotic disease with the changes in the Raman spectra of the nail keratin, by assessing the intensity of the peak at 510 cm(-1) (S-S bridge) and the scores of principal component analysis (PCA), correlated with the values of BMD measured at the lumbar and hip. Raman spectra of ex vivo fingernails of 213 women were obtained by means of a dispersive Raman spectrometer (830 nm, 300 mW, in the spectral range between 400 and 1,800 cm(-1)). Peak intensities at ∼510 cm(-1) (assigned to the keratin S-S bridge) were measured, and the scores of first principal component loading vectors were calculated. Results showed no differences in the mean Raman spectra of nails of groups with and without osteoporosis. No correlation was found between the BMD scores and both the intensities of the 510 cm(-1) peak and the scores of the first four principal component vectors. Results suggest that BMD and fracture risk could not be assessed by the nail keratin features.
To evaluate the efficacy of conservative treatment of patients with slipped capital femoral epiphysis (SCFE) and the complications due to the progression of the disease. Methods: 18 patients (26 hips) seen consecutively from December 1996 to August 2006 at the Orthopedics Service of Santa Casa de Misericórdia de São Paulo, who had been referred from other services with a diagnosis of SCFE and were treated without surgery, were retrospectively analyzed. Results: Slip progression occurred in 19 hips (73%). Among the mild cases, eight remained mild, four became moderate and one became severe, according to the Southwick classification. Four out of the six originally moderate cases became severe and the two already severe cases worsened. Conclusion: Although today there is a consensus regarding the indication of surgical treatment for SCFE to prevent progression, some cases with confirmed diagnoses are still being treated conservatively. This is a major error, since it implies increased morbidity of the disease.
Resumo
Objetivo Descrever as características de ressonância magnética (RM) dos ombros de pacientes com lesão medular (LM) e correlacionar esses achados com idade, duração da LM e nível neurológico.
Método A amostra do presente estudo incluiu pacientes maiores de 18 anos com LM torácica, que eram cadeirantes ativos e haviam sido submetidos a uma ressonância magnética do ombro de janeiro de 2004 a dezembro de 2015.
Resultados Foram estudados 41 ombros (37 pacientes), incluindo 27 de pacientes do sexo masculino (65,9%) e 14 de pacientes do sexo feminino (34,1%). Na época da ressonância magnética, a média de idade era de 41,9 anos e a duração média da LM era de 9,4 anos. A análise da relação entre a duração do trauma e a gravidade da lesão do manguito rotador (LMR), bem como entre a idade e a gravidade da lesão do ombro mostrou diferença estatisticamente significativa (p < 0,001), com associação positiva em ambos os casos. Não foi observada diferença estatisticamente significativa (p = 0,095) entre o nível neurológico da LM e da LMR.
Conclusão Neste estudo, pode-se notar um aumento progressivo da gravidade das lesões do ombro com o avanço da idade e uma maior duração da LM. No entanto, o nível da LM não parece interferir com a LMR.
Nível de Evidência Nível IV, série de casos.
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