Usefulness of bone densitometry in postmenopausal women with clinically diagnosed vertebral fractures.

Objective: To analyse whether bone mineral density (BMD) assessment is required in postmenopausal women presenting with low trauma vertebral fracture. Methods: Women with vertebral fracture diagnosed over a 10 year period were recruited from our database. The following were excluded: (a) patients with high energy trauma; (b) patients with malignancies; (c) patients with a metabolic bone disease other than osteoporosis. All postmenopausal women were included in whom BMD had been evaluated at both the lumbar spine and femoral neck by dual energy x ray absorptiometry during the six months after the diagnosis. Patients with a potential cause of osteoporosis other than age and menopause were not considered. A total of 215 patients were identified. Results: The mean (SD) age of the patients was 65.9 (6.9) years. BMD at the lumbar spine was 0.725 (0.128) g/cm2 and the T score was ¿2.94 (1.22); BMD at the femoral neck was 0.598 (0.095) g/cm2 and the T score was ¿2.22 (0.89). The BMD of the patients was significantly lower than that of the general population at both the lumbar spine and femoral neck. When the lowest value of the two analysed zones was considered, six patients (3%) showed a normal BMD, 51 (23.5%) osteopenia, and 158 (73.5%) osteoporosis. The prevalence of osteoporosis at the femoral neck increased with age; it was 25% in patients under 60, 35% in patients aged 60¿70, and 60% in patients over 70. Conclusion: These results indicate that bone densitometry is not required in postmenopausal women with clinically diagnosed vertebral fractures if it is performed only to confirm the existence of a low BMD.

Parametric analysis of different compact tension specimens for fracture toughness characterisation in woven composite materials

Estudi elaborat a partir d’una estada a l’ Imperial College London, entre juliol i novembre de 2006. En aquest treball s’ha investigat la geometria més apropiada per a la caracterització de la tenacitat a fractura intralaminar de materials compòsits laminats amb teixit. L’objectiu és assegurar la propagació de l’esquerda sense que la proveta falli abans per cap altre mecanisme de dany per tal de permetre la caracterització experimental de la tenacitat a fractura intralaminar de materials compòsits laminats amb teixit. Amb aquesta fi, s’ha dut a terme l’anàlisi paramètrica de diferents tipus de provetes mitjançant el mètode dels elements finits (FE) combinat amb la virtual crack closure technique (VCCT). Les geometries de les provetes analitzades corresponen a la proveta de l’assaig compact tension (CT) i diferents variacions com la extended compact tension (ECT), la proveta widened compact tension (WCT), tapered compact tension (TCT) i doubly-tapered compact tension (2TCT). Com a resultat d’aquestes anàlisis s’han derivat diferents conclusions per obtenir la geometria de proveta més apropiada per a la caracterització de la tenacitat a fractura intralaminar de materials compòsits laminats amb teixit. A més, també s’han dut a terme una sèrie d’assaigs experimentals per tal de validar els resultats de les anàlisis paramètriques. La concordança trobada entre els resultats numèrics i experimentals és bona tot i la presència d’efectes no previstos durant els assaigs experimentals.

Osteomielitis vertebral hematógena relacionada con la asistencia sanitaria: Características epidemiológicas, clínicas y evolución

Se trata de un estudio retrospectivo de los factores predisponentes, etiología, clínica, diagnóstico y evolución de las osteomielitis vertebrales hematógenas (OVH) relacionadas con la asistencia sanitaria (OVHAS) en pacientes adultos diagnosticados en el Hospital Valle de Hebrón durante el periodo comprendido entre 1987 y 2011, y posterior comparación con las de origen comunitario. Como principales conclusiones, un tercio de las OVH están relacionadas con la asistencia sanitaria, y un tercio se asocian a infección de catéter. Los pacientes con OVHAS tienen más patología subyacente, foco conocido de la infección, y peor evolución en cuanto a mortalidad y recidiva.

Pycnodysostosis. A report of 3 clinical cases

Pycnodysostosis is a rare clinical entity, first described in 1962 by Maroteaux and Lamy. It is a genetic disorder, usually diagnosed at an early age. However, the diagnosis is sometimes late, made as a result of bone fracture, given the severe bone fragility resulting from increased bone density. Oral and maxillofacial manifestations of this disease are very clear. The head is usually large, the nose beaked, the mandibular angle obtuse, and both maxilla and mandible hypoplastic. Dental abnormalities and impaction are observed, as well as alterations in eruption and frequent dental crowding. The differential diagnosis is established with osteopetrosis, cleidocranial dysplasia and idiopathic acro-osteolysis. This article reviews the clinical and radiographic characteristics of pycnodysostosis based on three clinical cases of patients with this disease.

A Quantitative method for the characterization of lytic metastases of the bone from radiographic images

The aim of our study was to assess the diagnostic usefulness of the gray level parameters to distinguish osteolytic lesions using radiological images. Materials and Methods: A retrospective study was carried out. A total of 76 skeletal radiographs of osteolytic metastases and 67 radiographs of multiple myeloma were used. The cases were classified into nonflat (MM1 and OL1) and flat bones (MM2 and OL2). These radiological images were analyzed by using a computerized method. The parameters calculated were mean, standard deviation, and coefficient of variation (MGL, SDGL, and CVGL) based on gray level histogram analysis of a region-of-interest.Diagnostic utility was quantified bymeasurement of parameters on osteolyticmetastases andmultiplemyeloma, yielding quantification of area under the receiver operating characteristic (ROC) curve (AUC). Results: Flat bone groups (MM2 and OL2) showed significant differences in mean values of MGL ( = 0.048) and SDGL ( = 0.003). Their corresponding values of AUC were 0.758 for MGL and 0.883 for SDGL in flat bones. In nonflat bones these gray level parameters do not show diagnostic ability. Conclusion: The gray level parametersMGL and SDGL show a good discriminatory diagnostic ability to distinguish between multiple myeloma and lytic metastases in flat bones.