Cirurgia de fraturas ósseas na osteoporose: Fraturas da coluna vertebral

As fraturas que ocorrem no osso osteoporótico são por definição estrita fraturas patológicas. Podem estar relacionadas com quedas da própria altura ou de traumatismos de baixa energia cinética e envolvem habitualmente a anca, o punho, a coluna vertebral e o ombro. As fraturas osteoporóticas a que se associa a sarcopenia, representam um sério problema de saúde pública em todo o mundo, com uma proporção epidémica e um impacto devastador na morbilidade e mortalidade dos pacientes, assim como nos custos socioeconómicos. Apesar dos avanços registados na prevenção e no tratamento farmacológico da osteoporose bem como no tratamento cirúrgico das fraturas ósseas, continuam a ser desenvolvidos novos biomateriais metálicos e substitutos sintéticos do osso com a intenção de se conseguir alcançar melhores resultados clínicos. Dentro deste contexto incluem-se os cimentos hidráulicos, os parafusos expansivos, os parafusos dinâmicos, as malhas metálicas de titânio, as placas bloqueadas, entre outros, em conjugação com técnicas minimamente invasivas e com diferentes estratégias cirúrgicas. O objetivo central deste trabalho assenta nas modalidades cirúrgicas mais usadas para o tratamento das fraturas em osso osteoporótico, com especial destaque para as fraturas da coluna vertebral.

Diferencia en la evolución de pacientes con diagnóstico de problemas de columna vertebral tratados con crioterapia y baños de parafina, complementados con otras modalidades terapéuticas del sector académico y administrativo de la Facultad Multidisciplinaria Oriental Universidad de El Salvador, período de julio a septiembre de 2010.

La columna vertebral es la estructura más importante del sistema esquelético, encargada de dar equilibrio y sostén al cuerpo humano, en ella se insertan los músculos de la espalda, por lo que cualquier alteración da origen a diversas afecciones entre las cuales están, cervicalgia, dorsalgia y lumbalgia. Las alteraciones de la columna vertebral pueden aparecer de forma brusca o progresiva, la mayoría de estos problemas se manifiestan por, dolor, inflamación y espasmos musculares, producido especialmente por el Stress laboral en ciertas actividades de la vida diaria que en algunos casos puede manifestarse de tal forma que llegan a ser incapacitantes.

Embolisation of Vertebral Artery Damaged Following Cervical Disc Removal

Introduction: The incidence of vertebral artery (VA) injury during cervical spine surgery is rare. Even though tamponade is effective in many cases, early consultation of an endovascular team is recommended if bleeding cannot be controlled. We report a case of emergent endovascular embolisation of left VA due to iatrogenic injury during anterior cervical disc removal and fusion. Case: A 47-year-old woman was admitted to our emergency department with serious arterial bleeding from the neck only hours after undergoing anterior cervical disc removal and fusion surgery. She was intubated and mechanically ventilated, however hemorrhage could not be successfully controlled by packing with surgical hemostatic agents. Cranial computed tomography, computed tomography of the cervical spine and CT angiography confirmed the suspected diagnosis of injury to the VA. Emergent endovascular embolisation successfully stopped the bleeding. Occlusion of the vessel was achieved by vascular plugging. The patient was discharged from our hospital 14 days after the intervention, receiving a revision surgery of the cervical spine on the day of embolisation. At the date of discharge she presented without any focal neurological deficit. Conclusion: Pre-operative radiographic imaging of the cervical spine should be used routinely to identify anatomic abnormalities of the vertebral arteries. Endovascular embolisation appears to be effective in treating acute iatrogenic dissection of the vertebral arteries.

On the rotation of co-orbital bodies in eccentric orbits

We investigate the resonant rotation of co-orbital bodies in eccentric and planar orbits. We develop a simple analytical model to study the impact of the eccentricity and orbital perturbations on the spin dynamics. This model is relevant in the entire domain of horseshoe and tadpole orbit, for moderate eccentricities. We show that there are three different families of spin-orbit resonances, one depending on the eccentricity, one depending on the orbital libration frequency, and another depending on the pericenter's dynamics. We can estimate the width and the location of the different resonant islands in the phase space, predicting which are the more likely to capture the spin of the rotating body. In some regions of the phase space the resonant islands may overlap, giving rise to chaotic rotation.

Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance

International audience

Rotation of Vibrio fischeri Flagella Produces Outer Membrane Vesicles That Induce Host Development

Using the squid-vibrio association, we aimed to characterize the mechanism through which Vibrio fischeri cells signal morphogenesis of the symbiotic light-emitting organ. The symbiont releases two cell envelope molecules, peptidoglycan (PG) and lipopolysaccharide (LPS) that, within 12 h of light organ colonization, act in synergy to trigger normal tissue development. Recent work has shown that outer membrane vesicles (OMVs) produced by V. fischeri are sufficient to induce PG-dependent morphogenesis; however, the mechanism(s) of OMV release by these bacteria has not been described. Like several genera of both beneficial and pathogenic bacteria, V. fischeri cells elaborate polar flagella that are enclosed by an extension of the outer membrane, whose function remains unclear. Here, we present evidence that along with the well-recognized phenomenon of blebbing from the cell's surface, rotation of this sheathed flagellum also results in the release of OMVs. In addition, we demonstrate that most of the development-inducing LPS is associated with these OMVs and that the presence of the outer membrane protein OmpU but not the LPS O antigen on these OMVs is important in triggering normal host development. These results also present insights into a possible new mechanism of LPS release by pathogens with sheathed flagella. IMPORTANCE Determining the function(s) of sheathed flagella in bacteria has been challenging, because no known mutation results only in the loss of this outer membrane-derived casing. Nevertheless, the presence of a sheathed flagellum in such host-associated genera as Vibrio, Helicobacter, and Brucella has led to several proposed functions, including physical protection of the flagella and masking of their immunogenic flagellins. Using the squid-vibrio light organ symbiosis, we demonstrate another role, that of V. fischeri cells require rotating flagella to induce apoptotic cell death within surface epithelium, which is a normal step in the organ's development. Further, we present evidence that this rotation releases apoptosis-triggering lipopolysaccharide in the form of outer membrane vesicles. Such release may also occur by pathogens but with different outcomes for the host.

Relación cráneo cervical en pacientes clase I, II, y III esqueletal entre 9 y 18 años de edad, mediante radiografías cefálicas laterales de un centro radiológico de la ciudad de cuenca.

El objetivo de este estudio fue determinar la relación cráneo cervical en pacientes clases I, II y III esqueletal entre 9 y 18 años de edad, mediante radiografías cefálicas laterales de un centro radiológico de la ciudad de Cuenca, utilizando el análisis cráneo cervical propuesto por Rocabado. Materiales y métodos: Fueron analizadas 161 radiografías cefálicas laterales digitales, de ambos sexos, con edad promedio de 12.3 años (DE± 2.4). Se incluyeron radiografías de individuos con dentición mixta y permanente, sin tratamiento ortodóncico y en donde se observe hasta la sexta vértebra cervical. Fueron excluidas las radiografías de pacientes con mordida abierta, traumatismos maxilofaciales y radiografías de mala calidad. Las telerradiografías fueron analizadas mediante el programa cefalométrico Nemoceph NX, donde se determinó el patrón esqueletal mediante los ángulos SNA, SNB, ANB y APDI. La evaluación de la postura cervical, se realizó mediante el análisis cráneo cervical propuesto por Rocabado. Se obtuvo el índice de concordancia (ICC=0.94). Mediante estadística descriptiva se analizaron las relaciones entre variables usando la prueba de Chi cuadrado y T de Student. Resultados: Se encontró mayor rotación posterior de cráneo en clase I y II esqueletal, encontrándose diferencias estadísticamente significativas respecto al ángulo cráneo vertebral entre hombres y mujeres en individuos clase II esqueletal. Las mujeres presentaron mayor rotación posterior de cráneo a diferencia de los hombres. (p=0.004). En clase III se encontró una relación normal. El espacio suboccipital en las tres clases esqueletales se presento con normalidad. No se encontró diferencia significativa respecto a la edad. Conclusiones: La relación cráneo cervical se presenta con una tendencia a la rotación posterior de cráneo, influida fuertemente por el sexo del individuo. El espacio suboccipital es normal en clase I y II esqueletal y con tendencia al aumento en clase III.

Space density distribution of galaxies in the absolute magnitude - rotation velocity plane: a volume-complete Tully-Fisher relation from CALIFA stellar kinematics

We measured the distribution in absolute magnitude - circular velocity space for a well-defined sample of 199 rotating galaxies of the Calar Alto Legacy Integral Field Area Survey (CALIFA) using their stellar kinematics. Our aim in this analysis is to avoid subjective selection criteria and to take volume and large-scale structure factors into account. Using stellar velocity fields instead of gas emission line kinematics allows including rapidly rotating early-type galaxies. Our initial sample contains 277 galaxies with available stellar velocity fields and growth curve r-band photometry. After rejecting 51 velocity fields that could not be modelled because of the low number of bins, foreground contamination, or significant interaction, we performed Markov chain Monte Carlo modelling of the velocity fields, from which we obtained the rotation curve and kinematic parameters and their realistic uncertainties. We performed an extinction correction and calculated the circular velocity v_circ accounting for the pressure support of a given galaxy. The resulting galaxy distribution on the M-r - v(circ) plane was then modelled as a mixture of two distinct populations, allowing robust and reproducible rejection of outliers, a significant fraction of which are slow rotators. The selection effects are understood well enough that we were able to correct for the incompleteness of the sample. The 199 galaxies were weighted by volume and large-scale structure factors, which enabled us to fit a volume-corrected Tully-Fisher relation (TFR). More importantly, we also provide the volume-corrected distribution of galaxies in the M_r - v_circ plane, which can be compared with cosmological simulations. The joint distribution of the luminosity and circular velocity space densities, representative over the range of -20 > M_r > -22 mag, can place more stringent constraints on the galaxy formation and evolution scenarios than linear TFR fit parameters or the luminosity function alone.

The Effects of Visual Discriminability and Rotation Angle on 30-Month-Olds’ Search Performance in Spatial Rotation Tasks

Tracking objects that are hidden and then moved is a crucial ability related to object permanence, which develops across several stages in early childhood. In spatial rotation tasks, children observe a target object that is hidden in one of two or more containers before the containers are rotated around a fixed axis. Usually, 30-month-olds fail to find the hidden object after it was rotated by 180°. We examined whether visual discriminability of the containers improves 30-month-olds’ success in this task and whether children perform better after 90° than after 180° rotations. Two potential hiding containers with same or different colors were placed on a board that was rotated by 90° or 180° in a within-subjects design. Children (N D 29) performed above chance level in all four conditions. Their overall success in finding the object did not improve by differently colored containers. However, different colors prevented children from showing an inhibition bias in 90° rotations, that is, choosing the empty container more often when it was located close to them than when it was farther away: This bias emerged in the same colors condition but not in the different colors condition. Results are discussed in view of particular challenges that might facilitate or deteriorate spatial rotation tasks for young children.

Age and growth of the bigeye thresher shark, Alopias superciliosus, from the pelagic longline fisheries in the tropical northeastern Atlantic Ocean, determined by vertebral band counts

The bigeye thresher, Alopias supercilious, is commonly caught as bycatch in pelagic longline fisheries targeting swordfish. Little information is yet available on the biology of this species, however. As part of an ongoing study, observers sent aboard fishing vessels have been collecting set of information that includes samples of vertebrae, with the aim of investigating age and growth of A. supercilious. A total of 117 specimens were sampled between September 2008 and October 2009 in the tropical northeastern Atlantic, with specimens ranging from 101 to 242 cm fork length (FL) (176 to 407 cm total length). The A. supercilious vertebrae were generally difficult to read, mainly because they were poorly calcified, which is typical of Lamniformes sharks. Preliminary trials were carried out to determine the most efficient band enhancement technique for this species, in which crystal violet section staining was found to be the best methodology. Estimated ages in this sample ranged from 2 to 22 years for females and 1 to 17 years for males. A version of the von Bertalanffy growth model (VBGF) re-parameterised to estimate L(0), and a modified VBGF using a fixed L(0) were fitted to the data. The Akaike information criterion (AIC) was used to compare these models. The VBGF produced the best results, with the following parameters: L(inf) = 293 cm FL, k = 0.06 y(-1) and L(0) = 111 cm FL for females; L(inf) = 206 cm FL, k = 0.18 y(-1) and L(0) = 93 cm FL for males. The estimated growth coefficients confirm that A. supercilious is a slow-growing species, highlighting its vulnerability to fishing pressure. It is therefore urgent to carry out more biological research to inform fishery managers more adequately and address conservation issues.

Age and growth of the smooth hammerhead shark, Sphyrna zygaena, in the Eastern Equatorial Atlantic Ocean, using vertebral sections

The smooth hammerhead shark Sphyrna zygaena (Sphyrnidae) is regularly caught as bycatch in pelagic longline fisheries, but is one of the least studied of all pelagic sharks. Recently, ICCAT (International Commission for the Conservation of Atlantic Tunas) issued recommendations underlining the need for more studies on the life history parameters of this and other pelagic shark species. To this end, the age and growth of S. zygaena were studied in the Eastern Equatorial Atlantic Ocean, in an area where growth parameters were not yet available for this species. Data from 139 specimens, caught between June and September 2009, ranging in size from 136 to 233 cm fork length (FL), were analysed. Preliminary trials were carried out to assess the most efficient growth band enhancement technique. These indicated that sectioning the vertebrae into 500 μm sections followed by staining with crystal violet produced the best results. Growth models were fitted using the traditional von Bertalanffy growth equation and a modification of this equation using a known size at birth. Growth models were compared using the Akaike information criterion (AIC). The von Bertalanffy growth equation seemed to be the most adequate model to describe growth in this species, with resulting growth parameters of L inf = 272 cm FL, k = 0.06 year for males and L inf = 285 cm FL, k = 0.07 year for females. In the first four years of life, S. zygaena grows 25 cm per year on average, but its growth slows down in later life. Future stock assessment models should incorporate these age and growth parameters for species management and conservation.

Congenital thoracic vertebral malformations in brachycephalic “screw-tailed” dog breeds: Validation of a human classification scheme and a method of Cobb angle measurement in the assessment of vertebral column deformity

Congenital vertebral malformations are common in brachycephalic “screw-tailed” dog breeds such as French bulldogs, English bulldogs, Boston terriers, and Pugs. Those vertebral malformations disrupt the normal vertebral column anatomy and biomechanics, potentially leading to deformity of the vertebral column and subsequent neurological dysfunction. The initial aim of this work was to study and determine whether the congenital vertebral malformations identified in those breeds could be translated in a radiographic classification scheme used in humans to give an improved classification, with clear and well-defined terminology, with the expectation that this would facilitate future study and clinical management in the veterinary field. Therefore, two observers who were blinded to the neurologic status of the dogs classified each vertebral malformation based on the human classification scheme of McMaster and were able to translate them successfully into a new classification scheme for veterinary use. The following aim was to assess the nature and the impact of vertebral column deformity engendered by those congenital vertebral malformations in the target breeds. As no gold standard exists in veterinary medicine for the calculation of the degree of deformity, it was elected to adapt the human equivalent, termed the Cobb angle, as a potential standard reference tool for use in veterinary practice. For the validation of the Cobb angle measurement method, a computerised semi-automatic technique was used and assessed by multiple independent observers. They observed not only that Kyphosis was the most common vertebral column deformity but also that patients with such deformity were found to be more likely to suffer from neurological deficits, more especially if their Cobb angle was above 35 degrees.

Annual crop rotation of tropical pastures with no-till soil as affectedby lime surface application.

Soil acidity and low natural fertility are the main limiting factors for grain production in tropical regionssuch as the Brazilian Cerrado. The application of lime to the surface of no-till soil can improve plant nutrition, dry matter production, crop yields and revenue. The present study, conducted at the Lageado Experimental Farm in Botucatu, State of São Paulo, Brazil, is part of an ongoing research project initi-ated in 2002 to evaluate the long-term effects of the surface application of lime on the soil?s chemical attributes, nutrition and kernel/grain yield of peanut (Arachis hypogaea), white oat (Avena sativa L.) and maize (Zea mays L.) inter cropped with palisade grass (Urochloa brizantha cv. Marandu), as well as the forage dry matter yield of palisade grass in winter/spring, its crude protein concentration, estimated meat production, and revenue in a tropical region with a dry winter during four growing seasons. The experiment was designed in randomized blocks with four replications. The treatments consisted of four rates of lime application (0, 1000, 2000 and 4000 kg ha−1), performed in November 2004. The surface application of limestone to the studied tropical no-till soil was efficient in reducing soil acidity from the surface down to a depth of 0.60 m and resulted in greater availability of P and K at the soil surface. Ca and Mg availability in the soil also increased with the lime application rate, up to a depth of 0.60 m. Nutrient absorption was enhanced with liming, especially regarding the nutrient uptake of K, Ca and Mg by plants.Significant increases in the yield components and kernel/grain yields of peanut, white oat and maize were obtained through the surface application of limestone. The lime rates estimated to achieve the maximum grain yield, especially in white oat and maize, were very close to the rates necessary to increase the base saturation of a soil sample collected at a depth of 0?0.20 m to 70%, indicating that the surface liming of 2000 kg ha−1is effective for the studied tropical no-till soil. This lime rate also increases the forage dry matter yield, crude protein concentration and estimated meat production during winter/spring in the maize-palisade grass inter cropping, provides the highest total and mean net profit during the four growing seasons, and can improve the long-term sustainability of tropical agriculture in the Brazilian Cerrado.

Soil N²O emissions from long-term agroecosystems: interactive effects of rainfall seasonality and crop rotation in the Brazilian cerrado.

2016