Ídolos-espátulas del País Vasco: fabricación, cronología y paralelos

[ES] La industria ósea postpaleolítica, por lo general, pocas veces ha merecido la atención que se le ha concedido a la fabricada durante el Paleolítico Superior. No obstante una de dichas excepciones serán los denominados ídolos-espátulas con decoración acanalada en su mitad proximal, trabajados sobre tibias de "Capra/Ovis" y procedentes por lo que hasta ahora conocemos de contextos sepulcrales megalíticos. En su morfología deben de señalarse el extremo activo romo, al modo de otras espátulas tan comunes en contextos neolíticos, y el extremo proximal decorado con profundos acanalamientos que conforman motivos geométricos más o menos complejos (espiral, zig-zag, etc.) en unos casos y en menos alguna figura antropomorfa femenina. Los primeros hallazgos se realizaron en la provincia de Álava durante la década de los sesenta, destacando entre ellos los procedentes del sepulcro de corredor de San Martín (Laguardia), a los que se sucedieron otros como los de Kurtzebide, Los Llanos, etc. en el mismo territorio y los importantes conjuntos hallados en distintas provincias de la Meseta Norte y en La Rioja. Todos ellos debido al tipo de contexto del que proceden y las características de los ídolos-espátula ritual dan cierto grado de homogeneidad ideológico o religioso a todo el territorio. No obstante, fuera de este territorio y muy alejados desde el punto de vista geográfico existen otros ejemplares (Tell Halula -Siria-, Sesklo, Agios Petras -Grecia-) que muestran gran similitud tipológica aunque no un nexo de unión entre ambas zonas. Por otra parte, hay que subrayar la notable mayor antigüedad del foco oriental y que el contexto del que proceden no es funerario como en el caso de los ejemplares occidentales.

Função mitocondrial cardíaca de camundongos filhotes e adultos submetidos à hiperalimentação durante a lactação

Estudos demostram que a hiperalimentação no período pós-natal causa obesidade, alterações cardiometabólicas e resistência à insulina em longo prazo. O objetivo do estudo foi investigar as consequências da hiperalimentação na lactação nos corações de camundongos filhotes e adultos ao longo do desenvolvimento. Para induzir a hiperalimentação na lactação, o tamanho da ninhada foi reduzida a 3 filhotes machos no terceiro dia, grupo hiperalimentado (GH). O grupo controle (GC) permaneceu com 9 filhotes da lactação ao desmame. Avaliamos a massa corporal, gordura epididimária e retroperitoneal, morfologia hepática e cardíaca, ultraestrutura dos cardiomiócitos, peso do PVE/CT, glicemia de jejum, triglicerídeos, colesterol total, insulina plasmática e HOMA-IR. Analisamos o consumo de oxigênio das fibras cardíacas através da respirometria de alta resolução, atividade enzimática da PDH, CS e LDH no coração e glicogênio hepático. Biologia molecular, através das proteínas: IRβ, IRS1, pIRS1, PTP1B, PI3K, Akt, pAkt, GLUT1, GLUT4, AMPKα, pAMPKα, HKII, CPT1, UCP2, FABPm, CD36, PGC-1α, PPARα, 4HNE, complexos da CTE (I, II, III, IV e V), α-tubulina, GP91 e VADC. Diferenças entre os grupos analisadas por Two-Way ANOVA, com significância p<0,05. O GH apresentou aumento da massa corporal, gordura epididimária, retroperitoneal e colesterol total em todas as idades; glicemia de jejum, insulina, índice de HOMA-IR e triglicerídeos aos 21 e 90 dias. Aumento do índice de Lee aos 60 e 90 dias. GH apresentou diminuição: do IRβ e GLUT4 aos 21 e 60 dias; aumento do IRβ aos 90 dias; aumento do IRS1, PTP1B, aos 21 e 90 dias e da AKT, pAMPK/AMPK e GLUT1 aos 21 dias; diminuição da pIRS1/IRS1, PI3K, pAKT/AKT aos 21 e 90 dias; diminuição da HKII aos 21 dias e aumento aos 60 e 90 dias; aumento da PDH aos 90 dias; aumento da LDH aos 21 dias e redução aos 60 dias; aumento da CS aos 21 dias e diminuição aos 60 e 90 dias; aumento da oxidação de carboidratos aos 21 dias e redução aos 90 dias; diminuição na oxidação de ácidos graxos aos 60 e 90 dias. Adicionalmente, aumento do desacoplamento mitocondrial entre a fosforilação oxidativa e a síntese de ATP aos 60 e 90 dias. Diminuição da CPT1 e aumento da UCP2 aos 21 e 90 dias. Diminuição da PGC-1α aos 60 e 90 dias; da FABPm e CD36 em todas idades. Aumento da 4HNE aos 21 e diminuição aos 90 dias. Diminuição na expressão do mRNA para CPT1 aos 21, 60 dias. Diminuição na expressão do mRNA para PPARα e aumento na expressão do mRNA para UCP2 aos 21 dias; diminuição na expressão do mRNA para UCP2 ao 60 dias. Alterações morfológicas cardíacas e hepáticas, assim como na ultraestrutura dos cardiomiócitos, em todas as idades, maior conteúdo de glicogênio hepático aos 21 e 90 dias. Concluímos que a hiperalimentação na lactação levou à obesidade, com aumento da oxidação de glicose, alterações no metabolismo energético associadas à diminuição da sensibilidade à insulina, redução da capacidade oxidativa mitocondrial, levando ao desacoplamento e alteração da morfologia e ultraestrutura dos cardiomiócitos do desmame até a idade adulta.

Alterações estruturais cardíaca e aórticana menopausa cirúrgica associada à hipertensão renovascular em ratos

A menopausa e a hipertensão podem alterar o remodelamento cardiovascular, porém pouco se sabe sobre sua associação no remodelamento ventricular esquerdo e na aorta. As ratas foram separadas em quatro grupos com seis animais cada: grupo Sham, OVX (ratas ooforectomizadas), 2K1C (ratas com dois rins, um clipe), e grupo 2K1C+OVX com período experimental de 11 semanas. O ventrículo esquerdo (VE) e a aorta torácica foram removidos e analisados (microscopia de luz, imuno-histoquímica e estereologia). A citologia vaginal mostrou que os animais dos grupos Sham e 2K1C ciclaram normalmente, entretanto, os animais dos grupos OVX e OVK+2K1C permaneceram na fase do diestro ou proestro. Comparado ao grupo Sham, a pressão arterial aumentou 12% no grupo OVX e 35% maior nos grupos 2K1C e OVX+2K1C. A relação massa do VE/comprimento da tíbia e a área seccional média de cardiomiócitos aumentaram em todos os grupos com exceção do grupo Sham. A vascularização intramiocárdica foi reduzida cerca de 30% em relação ao grupo Sham, não havendo diferença significativa entre os grupos OVX, 2K1C e OVX+2K1C. O tecido conjuntivo cardíaco teve um aumento superior a 45% nos grupos 2K1C e OVX+2K1C comparados ao grupo Sham, sem diferença entre o os animais do grupo Sham e OVX. O número de núcleos de cardiomiócitos do VE foi gradualmente menor nos grupos OVX, 2K1C e OVX+2K1C, sem diferença entre os dois últimos grupos. Imuno-histoquímica positiva para receptor AT1 da Ang II nas células musculares lisas da túnica média da aorta foi observado em todos os grupos. Estes resultados indicam que a ooforectomia e a hipertensão renovascular agem aumentando a pressão arterial independentemente, com conseqüente remodelamento cardíaco adverso, com estímulo maior da hipertensão renovascular que da menopausa induzida cirurgicamente.

Alterações estruturais cardíaca e aórtica na menopausa cirúrgica associada à hipertensão renovascular em ratos

A menopausa e a hipertensão podem alterar o remodelamento cardiovascular, porém pouco se sabe sobre sua associação no remodelamento ventricular esquerdo e na aorta. As ratas foram separadas em quatro grupos com seis animais cada: grupo Sham, OVX (ratas ooforectomizadas), 2K1C (ratas com dois rins, um clipe), e grupo 2K1C+OVX com período experimental de 11 semanas. O ventrículo esquerdo (VE) e a aorta torácica foram removidos e analisados (microscopia de luz, imuno-histoquímica e estereologia). A citologia vaginal mostrou que os animais dos grupos Sham e 2K1C ciclaram normalmente, entretanto, os animais dos grupos OVX e OVK+2K1C permaneceram na fase do diestro ou proestro. Comparado ao grupo Sham, a pressão arterial aumentou 12% no grupo OVX e 35% maior nos grupos 2K1C e OVX+2K1C. A relação massa do VE/comprimento da tíbia e a área seccional média de cardiomiócitos aumentaram em todos os grupos com exceção do grupo Sham. A vascularização intramiocárdica foi reduzida cerca de 30% em relação ao grupo Sham, não havendo diferença significativa entre os grupos OVX, 2K1C e OVX+2K1C. O tecido conjuntivo cardíaco teve um aumento superior a 45% nos grupos 2K1C e OVX+2K1C comparados ao grupo Sham, sem diferença entre o os animais do grupo Sham e OVX. O número de núcleos de cardiomiócitos do VE foi gradualmente menor nos grupos OVX, 2K1C e OVX+2K1C, sem diferença entre os dois últimos grupos. Imuno-histoquímica positiva para receptor AT1 da Ang II nas células musculares lisas da túnica média da aorta foi observado em todos os grupos. Estes resultados indicam que a ooforectomia e a hipertensão renovascular agem aumentando a pressão arterial independentemente, com conseqüente remodelamento cardíaco adverso, com estímulo maior da hipertensão renovascular que da menopausa induzida cirurgicamente.

SCALING OF LIMB PROPORTIONS AND LIMB BONE DIAMETERS IN 3 SPECIES OF CHINESE SNUB-NOSED LANGURS (GENUS RHINOPITHECUS)

In this study, aspects of the structural mechanics of the upper and lower limbs of the three Chinese species of Rhinopithecus were examined. Linear regression and reduced major axis (RMA) analyses of natural log-transformed data were used to examine the dimensions of limb bones and other relationships to body size and locomotion. The results of this study suggest that: (1) the allometry exponents of the lengths of long limbs deviate from isometry, being moderately negative, while the shaft diameters (both sagittal and transverse) show significantly positive allometry; (2) the sagittal diameters of the tibia and ulna show extremely significantly positive allometry - the relative enlargement of the sagittal, as opposed to transverse, diameters of these bones suggests that the distal segments of the fore- and hindlimbs of Rhinopithecus experience high bending stresses during locomotion; (3) observations of Rhinopithecus species in the field indicate that all species engage in energetic leaping during arboreal locomotion. The limbs experience rapid and dramatic decelerations upon completion of a leap. We suggest that these occasional decelerations produce high bending stresses in the distal limb segments and so account for the hypertrophy of the sagittal diameters of the ulna and tibia.

Multi-scale permeability of murine bone measured by nanoindentation

The determination of lacunar-canalicular permeability is essential to understand the mechano-transduction mechanism of bone. Murine models are widely used to investigate skeletal growth and regulation, but the value of lacunar-canalicular permeability is still unclear. To address this question, a poroelastic analysis based on nanoindentation data was used to calculate the lacunar-canalicular permeability of wild type C57BL/6 mice of 12 months. Cross-sections of three tibiae were indented using spherical fluid cell indenter tips of two sizes. Results suggest that the value of lacunar-canalicular intrinsic permeability of B6 female murine tibia is in the order of 10 -24 m2. The distribution of the values of intrinsic permeability suggests that with larger contact sizes, nanoindentation alone is capable of capturing the multi-scale permeability of bone. Multi-scale permeability of bone measured by nanoindentation will lead to a better understanding of the role of fluid flow in mechano-transduction. © 2013 American Society of Civil Engineers.

Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty.

BACKGROUND: The majority of total ankle arthroplasty (TAA) systems use extramedullary alignment guides for tibial component placement. However, at least 1 system offers intramedullary referencing. In total knee arthroplasty, studies suggest that tibial component placement is more accurate with intramedullary referencing. The purpose of this study was to compare the accuracy of extramedullary referencing with intramedullary referencing for tibial component placement in total ankle arthroplasty. METHODS: The coronal and sagittal tibial component alignment was evaluated on the postoperative weight-bearing anteroposterior (AP) and lateral radiographs of 236 consecutive fixed-bearing TAAs. Radiographs were measured blindly by 2 investigators. The postoperative alignment of the prosthesis was compared with the surgeon's intended alignment in both planes. The accuracy of tibial component alignment was compared between the extramedullary and intramedullary referencing techniques using unpaired t tests. Interrater and intrarater reliabilities were assessed with intraclass correlation coefficients (ICCs). RESULTS: Eighty-three tibial components placed with an extramedullary referencing technique were compared with 153 implants placed with an intramedullary referencing technique. The accuracy of the extramedullary referencing was within a mean of 1.5 ± 1.4 degrees and 4.1 ± 2.9 degrees in the coronal and sagittal planes, respectively. The accuracy of intramedullary referencing was within a mean of 1.4 ± 1.1 degrees and 2.5 ± 1.8 degrees in the coronal and sagittal planes, respectively. There was a significant difference (P < .001) between the 2 techniques with respect to the sagittal plane alignment. Interrater ICCs for coronal and sagittal alignment were high (0.81 and 0.94, respectively). Intrarater ICCs for coronal and sagittal alignment were high for both investigators. CONCLUSIONS: Initial sagittal plane tibial component alignment was notably more accurate when intramedullary referencing was used. Further studies are needed to determine the effect of this difference on clinical outcomes and long-term survivability of the implants. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

First record of minimum Irish hare (Lepus timidus hibernicus Bell 1837) longevity in the wild.

Average longevity of the mountain hare (Lepus timidus L., 1758) has been estimated at nine years in the wild (Macdonald D. and Barrett, P. 1993 Mammals of Britain and Europe. Harper Collins Publishers, London) with a maximum recorded age of 18 years for one marked animal (Angerbjörn, A. and Flux, J. E. C. 1995 Lepus timidus. Mammalian Species 495: 1–11). However, the longevity of the Irish hare (L. t. hibernicus Bell 1837) is entirely unknown. A total of 14 Irish hares was trapped and tagged at Belfast International Airport, Co. Antrim from February to April 2005. The sex, age (juvenile or adult) and weight of each animal were recorded. Adults were taken as those individuals >8-10 months old defined by the fusing of the notch between the apophysis and diaphysis of the tibia and humerus (Flux, J. E. C. 1970 Journal of Zoology 161: 75-123). Individual identification was made by a system of colourcoded ear tags (Roxan iD Ltd. Selkirk, Scotland) being inserted in the centre of the pinna of each ear. Each ear tag (6 × 34 mm) and puncture site was disinfected with 70 per cent ethanol prior to insertion. An adult male, #001/002 ‘Blue/Blue’, was tagged on 3 March 2005 weighing 3.8 kg and was sighted during a return site visit on 4 April 2007. An adult female, #026/003 ‘Green/Yellow’, was tagged on 15 April 2005 weighing 4.0 kg and was sighted during return visits on 25 March 2010 and 19 October 2010. The latest possible date of birth for both individuals was spring/summer 2004. Consequently, they were at least 3 years and 6.5 years old, respectively. This is the first record of minimum Irish hare longevity in the wild. These observations suggest that ear tagging does not compromise animal welfare and is an effective means of long-term monitoring. Future research may utilize capture-mark-recapture methods.

The effect of osteogenic growth factors on bone growth into a ceramic filled defect around an implant

Currently available synthetic bone substitutes perform poorly compared to autograft. It is hoped that by adding osteogenic growth factors to the materials, new bone formation could be increased and the clinical outcome improved. In this study, IGF-1, bFGF and TGFbeta1, alone and in combination, were absorbed onto a carrier of P-tricalcium phosphate (PTCP) and implanted into a defect around a hydroxyapatite-coated, stainless steel implant in the proximal tibia of rat in a model of revision arthroplasty. Animals were sacrificed at 6 and 26 weeks for routine histology and histomorphometry and mechanical push out tests. The results show that only bFGF had a significant effect on ceramic resorption. The groups that received bFGF and bFGF in combination with TGFbeta1 had smaller and fewer betaTCP particles remaining in the defect at 6 and 26 weeks. No growth factor combination significantly enhanced new bone formation or the mechanical strength of the implant. These results indicate that, of the growth factors tested, only bFGF had any beneficial effect on the host response to the implant, perhaps by delaying osteoblast differentiation and thereby prolonging osteoclast access to the ceramic. (C) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

Controlo postural na sequência de movimento de sentado para de pé em crianças com alterações do desenvolvimento neuromotor

A Sequência de Movimento de Sentado para de Pé (SMSP) é um marco importante na independência funcional da criança, sendo a sua qualidade afetada em casos de alteração do controlo postural do tronco. É por isso motivo de especial foco neste estudo, como elemento avaliativo e interventivo. Este estudo tem como objetivo a análise da modificação de componentes motores relacionados com o controlo postural, durante a SMSP, em 5 crianças com alterações neuromotoras, face à aplicação de um programa de intervenção baseado no Tratamento de Neuro Desenvolvimento (TND). Foi para tal utilizada a análise cinemática da SMSP - nomeadamente as variáveis “variação do deslocamento dos segmentos cabeça e tronco” e “variação do ângulo perna-pé” entre o momento inicial e o seat-off – complementada com a aplicação do Teste de Medida da Função Motora 88 (TMFM-88) e a Classificação Internacional da Funcionalidade Incapacidade e Saúde-Versão Crianças e Jovens (CIF-CJ), bem como a avaliação de componentes de movimento com recurso a registo de imagem. A análise cinemática demonstrou uma diminuição do deslocamento dos segmentos cabeça e tronco na maioria dos casos, bem como uma maior mobilidade da tíbia sobre pé. Verificou-se um aumento do score final do TMFM-88, em todos os casos. A CIF-CJ não evidenciou alterações entre o início e o término do período de intervenção. O registo de imagem demonstrou alterações positivas visíveis no alinhamento de segmentos, nível de atividade, controlo postural, e recurso a estratégias compensatórias no conjunto postural sentado e na SMSP. Após o período de intervenção as crianças deste estudo evidenciaram modificações positivas nas variáveis em estudo, nomeadamente 1) diminuição do deslocamento dos segmentos cabeça e tronco na fase inicial da SMSP, 2) aumento da variação do ângulo perna-pé na fase inicial da SMSP, 3) aumento do score total da TMFM-88, 4) alteração positiva dos componentes de movimento alinhamento de segmentos e nível de atividade e 5) redução do recurso a estratégias compensatórias de movimento na SMSP. Estas modificações sugerem um controlo postural mais eficiente.

Efeitos imediatos da mobilização com movimento da rotação medial da tibio-femural m movimento da rot e movimento, em ind com flexão do joelho, na dor e na amplitude de movimento, em indivíduos com síndrome s da mobilização com dor e na amplitude de patelo-femural

Introdução: O síndrome patelo-femural é uma das disfunções músculo-esqueléticas mais comuns ao nível do joelho. É de etiologia multifatorial, sendo a rotação lateral da tíbia um dos fatores contribuintes, sendo que pode potenciar alterações da biomecânica da articulação patelo-femural por aumentar as forças de reação sobre a articulação. Brian Mulligan sugere que a técnica para a correção da rotação lateral da tíbia pode ser benéfica no alívio da dor e no aumento da amplitude de flexão do joelho, em pacientes com síndrome patelo-femural, apesar da evidência acerca da efetividade desta técnica ser ainda escassa. Objetivo: Avaliar os efeitos da técnica de mobilização com movimento de rotação medial da tíbio-femural com flexão do joelho, ao nível da intensidade da dor e da amplitude de movimento de flexão do joelho, durante o agachamento, em indivíduos com síndrome patelo-femural. Métodos: Estudo experimental, com uma amostra constituída por 20 estudantes universitários, do género feminino, com síndrome patelo-femural e dor ao agachamento bilateral. Estes foram distribuídos aleatoriamente por dois grupos: experimental (intervenção com técnica de mobilização com movimento) e placebo (intervenção placebo). Foram avaliadas a amplitude de flexão do joelho com um goniómetro eletrónico (Biometrics®) e a intensidade de dor com a Escala Visual Analógica, durante o agachamento bilateral, antes e imediatamente após as respetivas intervenções. O nível de significância foi de 0,05. Resultados: A realização da Análise da Covariância revelou que, relativamente à intensidade da dor, foi possível constatar que existiram diferenças significativas entre os dois grupos (p<0,001). Entre a avaliação inicial e a final, o grupo experimental diminuiu mais 2,1cm na Escala Visual Analógica do que o grupo placebo. Em relação à avaliação da amplitude articular, foi possível constatar que, existiram diferenças significativas, entre os dois grupos (p=0,004). Entre a avaliação inicial e a final, o grupo experimental teve mais 8,6º de aumento na amplitude articular do que o grupo placebo. Conclusão: Para indivíduos com síndrome patelo-femural, a técnica de mobilização com movimento para correção da rotação lateral da tíbia, parece ser benéfica no alívio da dor e no ganho de amplitude de flexão do joelho, analisando o movimento de agachamento bilateral.

Iron Overload in a Murine Model of Hereditary Hemochromatosis Is Associated with Accelerated Progression of Osteoarthritis Under Mechanical Stress

OBJECTIVE: Hereditary hemochromatosis (HH) is a disease caused by mutations in the Hfe gene characterised by systemic iron overload and associated with an increased prevalence of osteoarthritis (OA) but the role of iron overload in the development of OA is still undefined. To further understand the molecular mechanisms involved we have used a murine model of HH and studied the progression of experimental OA under mechanical stress. DESIGN: OA was surgically induced in the knee joints of 10-week-old C57BL6 (wild-type) mice and Hfe-KO mice. OA progression was assessed using histology, micro CT, gene expression and immunohistochemistry at 8 weeks after surgery. RESULTS: Hfe-KO mice showed a systemic iron overload and an increased iron accumulation in the knee synovial membrane following surgery. The histological OA score was significantly higher in the Hfe-KO mice at 8 weeks after surgery. Micro CT study of the proximal tibia revealed increased subchondral bone volume and increased trabecular thickness. Gene expression and immunohistochemical analysis showed a significant increase in the expression of matrix metallopeptidase 3 (MMP-3) in the joints of Hfe-KO mice compared with control mice at 8 weeks after surgery. CONCLUSIONS: HH was associated with an accelerated development of OA in mice. Our findings suggest that synovial iron overload has a definite role in the progression of HH-related OA

Flexible Multibody Simulation Approach in the Dynamic Analysis of Bone Strains Activity

The objective of this study is to show that bone strains due to dynamic mechanical loading during physical activity can be analysed using the flexible multibody simulation approach. Strains within the bone tissue play a major role in bone (re)modeling. Based on previous studies, it has been shown that dynamic loading seems to be more important for bone (re)modeling than static loading. The finite element method has been used previously to assess bone strains. However, the finite element method may be limited to static analysis of bone strains due to the expensive computation required for dynamic analysis, especially for a biomechanical system consisting of several bodies. Further, in vivo implementation of strain gauges on the surfaces of bone has been used previously in order to quantify the mechanical loading environment of the skeleton. However, in vivo strain measurement requires invasive methodology, which is challenging and limited to certain regions of superficial bones only, such as the anterior surface of the tibia. In this study, an alternative numerical approach to analyzing in vivo strains, based on the flexible multibody simulation approach, is proposed. In order to investigate the reliability of the proposed approach, three 3-dimensional musculoskeletal models where the right tibia is assumed to be flexible, are used as demonstration examples. The models are employed in a forward dynamics simulation in order to predict the tibial strains during walking on a level exercise. The flexible tibial model is developed using the actual geometry of the subject’s tibia, which is obtained from 3 dimensional reconstruction of Magnetic Resonance Images. Inverse dynamics simulation based on motion capture data obtained from walking at a constant velocity is used to calculate the desired contraction trajectory for each muscle. In the forward dynamics simulation, a proportional derivative servo controller is used to calculate each muscle force required to reproduce the motion, based on the desired muscle contraction trajectory obtained from the inverse dynamics simulation. Experimental measurements are used to verify the models and check the accuracy of the models in replicating the realistic mechanical loading environment measured from the walking test. The predicted strain results by the models show consistency with literature-based in vivo strain measurements. In conclusion, the non-invasive flexible multibody simulation approach may be used as a surrogate for experimental bone strain measurement, and thus be of use in detailed strain estimation of bones in different applications. Consequently, the information obtained from the present approach might be useful in clinical applications, including optimizing implant design and devising exercises to prevent bone fragility, accelerate fracture healing and reduce osteoporotic bone loss.

吳醫彚講Wu yi hui jiang.Collection de traités des médecins de Wu.

Contient : I, livre 1禱告藥王誓疏Dao gao yue wang shi su.Prière au dieu de la médecine ; II, livre 1溫證論治Wen zheng lun zhi.Du traitement en cas de diagnostic par le tiède ; III, livre 1人身一小天地論Ren shen yi xiao tian di lun.Traité des analogies entre le corps humain (microcosme) et l'univers ; IV, livre 1書方宜人共識說Shu fang yi ren gong shi shuo.Traité sur l'exécution des ordonnances ; V, livre 2日講雜記Ri jiang za ji.Notes sur des leçons quotidiennes ; VI, livre 2金匱上工治未病一節辯Jin gui shang gong zhi wei bing yi jie bian.Discussion d'un point du Jin gui yao lüe lun ; VII, livre 3石芝醫話Shi zhi yi hua.Notes médicales de Shi zhi ; VIII, livre 3管見芻言Guan jian chu yan.Vues étroites et paroles humbles ; IX, livre 3核骨踝脛腨辨He gu hua xing shan bian.Discussion relative à la cheville, au tibia, au mollet ; X, livre 3爛喉丹痧論Lan hou dan sha (?) lun.Traité des inflammations et ulcérations de la gorge.Zang fu shou sheng bian.Discussion du contenu des organes internes.Bian zi rong zhi wei.Pour distinguer le faux zi rong, etc ; XI, livre 3大豆黃卷辯Da dou huang juan bian.Discussion au sujet du médicament da dou huang juan.Wen yi zhui yan.Notes sur les maladies épidémiques ; XII, livre 3合論丹溪景岳相火大意He lun dan qi jing yue xiang he da yi.Sur le sens de l'expression xiang he, d'après Dan qi et Jing yue ; XIII, livre 4人身一小天地亦有南北兩極論Ren shen yi xiao tian di yi you nan bei liang ji lun.Le corps humain, étant un microcosme, a un pôle nord et un pôle sud.Ming men mo zhen bian.De l'examen de la veine du rein droit ; XIV, livre 4治肝補脾論Zhi gan bu pi lun.Traitement du foie et de la rate ; XV, livre 4四維相代陽氣乃竭解Si wei xiang dai yang qi nai jie jie.Explication de la phrase : par la succession des quatre wei, le souffle mâle s'épuise ; XVI, livre 4辯素問濁氣歸心之訛Bian su wen zhuo qi gui xin zhi wo.Discussion de l'assertion erronée du Su wen que le souffle trouble revient au cœur ; XVII, livre 4祖氣論Zu qi lun.Sur l'influence productrice du ciel et de la terre ; XVIII, livre 5痘毒藏脾經說Dou du cang pi jing shuo.Le virus de la petite vérole est contenu dans la rate.Dou chu tong shi lun.Sur l'apparition simultanée de la petite vérole.Dou you tai yin zhuan shu yang ming lun.La petite vérole, du principe femelle, évolue vers le principe mâle ; XIX, livre 5擬張令韶傷寒直解辨證歌Yi zhang ling shao shang han zhi jie bian zheng ge.Sur le diagnostic de la fièvre typhoïde ; XX, livre 6三皇藥王考San huang yue wang kao.Sur la divinité de la médecine ; XXI, livre 6脈訣正訛Mo jue zheng wo.Correction au Mo jue ; XXII, livre 6趨庭雜記Qu ting za ji.Notes d'après Qu ting ; XXIII, livre 6辨醫書音義Bian yi shu yin yi.Discussion sur le son et le sens de termes employés dans les livres de médecine.Xia yue ji zhi shuo.Traité sur l'oranger épineux qui doit être évité pendant l'été ; XXIV, livre 6喜傷心恐勝喜解Xi shang xin kong sheng xi jie.Traité sur les maladies provenant de l'excès ou du défaut du souffle vital ; XXV, livre 6百合病贅言Bai he bing zhui yan.Notes sur la maladie appelée bai he ; XXVI, livre 7辨脾胃升降Bian pi wei sheng jiang.Discussion sur un traitement de la rate et de l'estomac ; XXVII, livre 7氣有餘便是火解Qi you yu bian shi he jie.Explication de la phrase : s'il y a excès d'esprit, c'est l'influence du feu.Dong yuan jing yue lun xiang he bian.Discussion des opinions de Zhang Jing yue et de Li Gao sur l'examen du principe feu ; XXVIII, livre 7幼科似驚非驚辨You ke si jing fei jing bian.Discussion sur une affection qui ressemble à la maladie dite jing (trouble, effroi) ; XXIX, livre 7司馬運氣贅言Si tian yun qi zhui yan.Notes sur les influences exercées par les principes célestes.Zhou shen jing luo zong jue.Traité du système des vaisseaux ; XXX, livre 8木鬱達之論Mu yu da zhi lun.Traité relatif à une phrase du Nei jing ; XXXI, livre 8保護元陽說Bao hu yuan yang shuo.Traité sur la protection du principe mâle ; XXXII, livre 8讀傷寒論附記Du shang han lun fu ji.Notes à propos du traité de la fièvre typhoïde ; XXXIII, livre 8論白痘Lun bai phei.Dissertation sur la maladie appelée pei blanche (ulcères laissant des croûtes ou cicatrices blanches) ; XXXIV, livre 8爛喉痧論Lan hou sha (?) lun.Traité des inflammations et ulcérations de la gorge ; XXXV, livre 8爛喉丹痧治宜論Lan hou dan sha (?) zhi yi lun.Sur le traitement des inflammations et ulcérations de la gorge ; XXXVI, livre 8痧疹今昔不同治法亦異說Sha (?) zhen jin xi bu tong zhi fa yi yi shuo.La maladie appelée sha (?) n'étant pas la même aujourd'hui qu'autrefois, le traitement aussi doit différer ; XXXVII, livre 8攝生雜話Sha sheng za hua.Notes pour régler la vie ; XXXVIII, livre 9四大家辯Si da jia bian.Discussion à propos de quatre personnages célèbres ; XXXIX, livre 9攷正古方權量說Kao zheng gu fang quan liang shuo.Traité sur la correction des poids des anciennes formules ; XL, livre 9生氣通天論病因章句辯Sheng qi tong tian lun bing yin zhang ju bian.Discussion de quatre paragraphes de l'ouvrage de Dan qi intitulé : Ge zhi yu lun ; XLI, livre 10虛勞論Xu lao lun.Traité de la maladie appelée xu lao (consomption ?) ; XLII, livre 10讀先祖保陰煎謹記Du xian zu bao yin jian jin ji.Notes sur la formule Bao yin jian, composée par son aïeul ; XLIII, livre 10六味地黃丸方解Liu wei di huang huan fang jie.Explication de la formule des pilules dites à six ingrédients et à base jaune ; XLIV, livre 10司天運氣徵驗Si tian yun qi zheng yan.Preuves des influences exercées par les principes célestes ; XLV, livre 11三焦說San jiao shuo.Traité des trois jiao

Effects of dietary restraint and oral contraceptives on bone strength and bone turnover in young women

ABSTRACT Introduction The purpose of this study was to assess specific osteoporosis-related health behaviours and physiological outcomes including daily calcium intake, physical activity levels, bone strength, as assessed by quantitative ultrasound, and bone turnover among women between the ages of 18 and 25. Respective differences on relevant study variables, based on dietary restraint and oral contraceptive use were also examined. Methods One hundred women (20.6 ± 0.2 years of age) volunteered to participate in the study. Informed written consent was obtained by all subjects prior to participation. The study and all related procedures were approved by the Brock University Research Ethics Board. Body mass, height, relative body fat, as well as chest, waist and hip circumferences were measured using standard procedures. The 10-item restrained eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ) was used to assess dietary restraint (van Strien et al., 1986). Daily calcium intake was assessed by the Rapid Assessment Method (RAM) (Hertzler & Frary 1994). Weekly physical activity was documented by the 4-item Godin Leisure-Time Exercise Questionnaire (Godin & Shephard 1985). Bone strength was determined from the speed of sound (SOS) as measured by QUS (Sunlight 7000S). SOS measurements (m/s) were taken of the dominant and non-dominant sides of the distal one third of the radius and the mid-shaft of the tibia. Resting blood samples were collected from all subjects between 9am and 12pm, in order to evaluate the impact of lifestyle factors on biochemical markers of bone turnover. Blood was collected during the early follicular phase of the menstrual cycle (approximately days 1-5) for all subjects. Samples were centrifliged and the serum or plasma was aliquoted into separate tubes and stored at -80°C until analysis. The bone formation markers measured were Osteocalcin (OC), bone specific alkaline phosphatase (BAP) and 25-OH vitamin D. The bone resorption markers measured were the carboxy (CTx) and amino (NTx) terminal telopeptides of type-I collagen crosslinks. All markers were assessed by ELISA. Subjects were divided into high (HDR) and low dietary restrainers (LDR) based on the median DEBQ score, and also into users (BC) and non-users (nBC) of oral contraceptives. A series of multiple one way ANOVA's were then conducted to identify differences between each set of groups for all relevant variables. A two-way ANOVA analysis was used to explore significant interactions between dietary restraint and use of oral contraceptives while a univariate follow-up analysis was also performed when appropriate. Pearson Product Moment Correlations were used to determine relationships among study variables. Results HDR had significantly higher BMI, %BF and circumference measures but lower daily calcium intake than LDR. There were no significant differences in physical activity levels between HDR and LDR. No significant differences were found between BC and nBC in body composition, calcium intake and physical activity. HDR had significantly lower tibial SOS scores than LDR in both the dominant and non-dominant sites. The post-hoc analysis showed that within the non-birth control group, the HDR had significantly lower tibial SOS scores of bone strength when compared to the LDR but Aere were no significant differences found between the two dietary restraint groups for those currently on birth control. HDR had significantly lower levels of OC than LDR and the BC group had lower levels of BAP than the nBC group. Consistently, the follow-up analysis revealed that within those not on birth control, subjects who were classified as HDR had significantly (f*<0.05) lower levels of OC when compared with LDR but no significant differences were observed in bone turnover between the two dietary restraint groups for those currently on birth control. Physical activity was not correlated with SOS scores and bone turnover markers possibly due to the low physical activity variability in this group of women. Conclusion This is the first study to examine the effects of dietary restraint on bone strength and turnover among this population of women. The most important finding of this study was that bone strength and turnover are negatively influenced by dietary restraint independent of relative body fat. In general, the results of the present thesis suggest that dietary restraint, oral contraceptive use, as well as low daily calcium intake and low physical activity levels were widespread behaviours among this population of college-aged women. The young women who were using dietary restraint as a strategy to lose weight, and thus were in the HDR group, despite their higher relative body fat and weight, had lower scores of bone strength and lower levels of markers of bone turnover compared to the low dietary restrainers. Additionally, bone turnover seemed to be negatively affected by oral contraceptives, while bone strength, as assessed by QUS, seemed unaffected by their use in this population of young women. Physical activity (weekly energy expenditure), on the other hand, was not associated with either bone strength or bone tiimover possibly due to the low variability of this variable in this population of young Canadian women.