133 results on '"Musculoskeletal System drug effects"'
Search Results
2. Extracellular Vesicles in Musculoskeletal Regeneration: Modulating the Therapy of the Future.
- Author
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Abreu H, Canciani E, Raineri D, Cappellano G, Rimondini L, and Chiocchetti A
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- Biocompatible Materials pharmacology, Extracellular Vesicles drug effects, Humans, Mesenchymal Stem Cells cytology, Mesenchymal Stem Cells drug effects, Mesenchymal Stem Cells metabolism, Musculoskeletal System drug effects, Regeneration drug effects, Extracellular Vesicles metabolism, Musculoskeletal Diseases physiopathology, Musculoskeletal Diseases therapy, Musculoskeletal System metabolism, Regeneration physiology
- Abstract
Tissue regeneration is a hot topic in health sciences, particularly because effective therapies promoting the healing of several cell types are lacking, specifically those of the musculoskeletal system. Mesenchymal Stem/Stromal Cells (MSCs) have been identified as crucial players in bone homeostasis, and are considered a promising therapy for diseases such as osteoarthritis (OA) and Rheumatoid Arthritis (RA). However, some known drawbacks limit their use, particularly ethical issues and immunological rejections. Thus, MSCs byproducts, namely Extracellular Vesicles (EVs), are emerging as potential solutions to overcome some of the issues of the original cells. EVs can be modulated by either cellular preconditioning or vesicle engineering, and thus represent a plastic tool to be implemented in regenerative medicine. Further, the use of biomaterials is important to improve EV delivery and indirectly to modulate their content and secretion. This review aims to connect the dots among MSCs, EVs, and biomaterials, in the context of musculoskeletal diseases.
- Published
- 2021
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3. Inhibition of Lipoxygenases Showed No Benefit for the Musculoskeletal System in Estrogen Deficient Rats.
- Author
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Saul D, Hohl FE, Franz MK, Meyer I, Taudien S, Roch PJ, Sehmisch S, and Komrakova M
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- Animals, Bone Diseases, Metabolic enzymology, Bone Diseases, Metabolic etiology, Bone Diseases, Metabolic pathology, Female, Flavanones pharmacology, Hydroxyurea analogs & derivatives, Hydroxyurea pharmacology, Osteoporosis enzymology, Osteoporosis etiology, Osteoporosis pathology, Rats, Rats, Sprague-Dawley, Bone Diseases, Metabolic drug therapy, Estrogens deficiency, Lipoxygenase Inhibitors pharmacology, Lipoxygenases chemistry, Musculoskeletal System drug effects, Osteoporosis drug therapy
- Abstract
Background: In previous studies, we reported the beneficial impact of two lipoxygenase-inhibitors, Baicalein and Zileuton, on osteoporotic bone in a postmenopausal rat model. Whereas subcutaneous Baicalein predominantly improved cortical bone, Zileuton enhanced vertebral and femoral trabecular bone. In this study, we aimed to reveal whether the oral administration of Baicalein caused similar effects on bone and whether a combined administration of Baicalein and Zileuton could act synergistically to ameliorate the formerly reported effects in the musculoskeletal system., Methods: We treated ovariectomized (OVX) female Sprague-Dawley rats either with Baicalein (10mg/kg BW), Zileuton (10mg/kg BW) or a combination of both (each 10mg/kg BW) for 13 weeks and compared with untreated OVX and NON-OVX groups (n=12-16 rats per group). Lumbar vertebral bodies and femora were analyzed. Tibiae were osteotomized, plate-stabilized (at week 8 after OVX) and likewise analyzed by biomechanical, histological, micro-computed tomographical and ashing tests. The skeletal muscle structure was analyzed., Results: Oral administration of Baicalein did not confirm the reported favorable cortical effects in neither vertebra nor femur. Zileuton showed a beneficial effect on trabecular vertebra, while the femur was negatively affected. Callus formation was enhanced by all treatments; however, its density and biomechanical properties were unaltered. Lipoxygenase inhibition did not show a beneficial effect on skeletal muscle. The combination therapy did not ameliorate OVX-induced osteoporosis but induced even more bone loss., Conclusions: The preventive anti-osteoporotic treatments with two lipoxygenase inhibitors applied either alone or in combination showed no benefit for the musculoskeletal system in estrogen deficient rats., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Saul, Hohl, Franz, Meyer, Taudien, Roch, Sehmisch and Komrakova.)
- Published
- 2021
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4. The molecular mechanisms of probiotic strains in improving ageing bone and muscle of d-galactose-induced ageing rats.
- Author
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Hor YY, Ooi CH, Lew LC, Jaafar MH, Lau AS, Lee BK, Azlan A, Choi SB, Azzam G, and Liong MT
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- Aging genetics, Aging metabolism, Animals, Bone Development drug effects, Bone and Bones metabolism, Humans, Interleukin-6 genetics, Interleukin-6 metabolism, Male, Musculoskeletal Development drug effects, Musculoskeletal System metabolism, Oxidative Stress drug effects, Rats, Rats, Sprague-Dawley, Tumor Necrosis Factor-alpha genetics, Tumor Necrosis Factor-alpha metabolism, Aging drug effects, Bone and Bones drug effects, Galactose adverse effects, Limosilactobacillus fermentum physiology, Lactobacillus helveticus physiology, Lacticaseibacillus paracasei physiology, Musculoskeletal System drug effects, Probiotics administration & dosage
- Abstract
Aim: The aim of this study was to evaluate the molecular mechanisms of Lactobacillus strains in improving ageing of the musculoskeletal system., Methods and Results: The anti-ageing mechanism of three probiotics strains Lactobacillus fermentum DR9, Lactobacillus paracasei OFS 0291 and L. helveticus OFS 1515 were evaluated on gastrocnemius muscle and tibia of d-galactose-induced ageing rats. Upon senescence induction, aged rats demonstrated reduced antioxidative genes CAT and SOD expression in both bone and muscle compared to the young rats (P < 0·05). Strain L. fermentum DR9 demonstrated improved expression of SOD in bone and muscle compared to the aged rats (P < 0·05). In the evaluation of myogenesis-related genes, L. paracasei OFS 0291 and L. fermentum DR9 increased the mRNA expression of IGF-1; L. helveticus OFS 1515 and L. fermentum DR9 reduced the expression of MyoD, in contrast to the aged controls (P < 0·05). Protective effects of L. fermentum DR9 on ageing muscle were believed to be contributed by increased AMPK-α2 expression. Among the osteoclastogenesis genes studied, TNF-α expression was highly elevated in tibia of aged rats, while all three probiotics strains ameliorated the expression. Lactobacillus fermentum DR9 also reduced the expression of IL-6 and TRAP in tibia when compared to the aged rats (P < 0·05). All probiotics treatment resulted in declined proinflammatory cytokines IL-1β in muscle and bone., Conclusions: Lactobacillus fermentum DR9 appeared to be the strongest strain in modulation of musculoskeletal health during ageing., Significance and Impact of the Study: The study demonstrated the protective effects of the bacteria on muscle and bone through antioxidative and anti-inflammatory actions. Therefore, L. fermentum DR9 may serve as a promising targeted anti-ageing therapy., (© 2020 The Society for Applied Microbiology.)
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- 2021
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5. Maternal use of sedative drugs and its effects on pregnancy outcomes: a Finnish birth cohort study.
- Author
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Björkstedt SM, Kautiainen H, Tuomi U, Gissler M, Pennanen P, Eriksson JG, and Laine MK
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- Adult, Antidepressive Agents adverse effects, Cohort Studies, Educational Status, Female, Finland, Humans, Mental Disorders drug therapy, Musculoskeletal System drug effects, Nervous System drug effects, Pregnancy, Pregnancy Outcome, Risk Factors, Hypnotics and Sedatives adverse effects
- Abstract
Our aim was to evaluate maternal use of sedative drugs before, during, and after pregnancy and to assess the influence of use of these drugs on pregnancy outcomes. The study cohort (N = 6231) consists of all primiparous women, who lived in the city of Vantaa, Finland, and who delivered a singleton between 2009 and 2015. Data were obtained from Finnish national health registers. Of the women, 3.2% (n = 202) purchased at least once sedative drugs within 90 days before conception, during pregnancy and/or within 90 days after delivery. Sedative drug users were older, less likely to cohabitate, more often smokers, had lower educational attainment and had more mental diseases (for all p < 0.001) compared with non-users. Sedative drug users purchased more often antidepressants and drugs for the alimentary tract, musculoskeletal and nervous system than non-users (for all p < 0.001). No adverse birth or pregnancy outcomes were found in the group using sedative drugs compared with the non-users. Studies in larger cohorts are needed to confirm our study findings.
- Published
- 2021
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6. Non-Musculoskeletal Benefits of Vitamin D beyond the Musculoskeletal System.
- Author
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Zhang S, Miller DD, and Li W
- Subjects
- Animals, Biological Availability, Humans, Models, Biological, Muscle Weakness complications, Vitamin D chemistry, Vitamin D metabolism, Vitamin D Deficiency complications, Vitamin D Deficiency pathology, Musculoskeletal System drug effects, Vitamin D pharmacology
- Abstract
Vitamin D, a fat-soluble prohormone, is endogenously synthesized in response to sunlight or taken from dietary supplements. Since vitamin D receptors are present in most tissues and cells in the body, the mounting understanding of the role of vitamin D in humans indicates that it does not only play an important role in the musculoskeletal system, but has beneficial effects elsewhere as well. This review summarizes the metabolism of vitamin D, the research regarding the possible risk factors leading to vitamin D deficiency, and the relationships between vitamin D deficiency and numerous illnesses, including rickets, osteoporosis and osteomalacia, muscle weakness and falls, autoimmune disorders, infectious diseases, cardiovascular diseases (CVDs), cancers, and neurological disorders. The system-wide effects of vitamin D and the mechanisms of the diseases are also discussed. Although accumulating evidence supports associations of vitamin D deficiency with physical and mental disorders and beneficial effects of vitamin D with health maintenance and disease prevention, there continue to be controversies over the beneficial effects of vitamin D. Thus, more well-designed and statistically powered trials are required to enable the assessment of vitamin D's role in optimizing health and preventing disease.
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- 2021
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7. Tissue selective effects of bazedoxifene on the musculoskeletal system in female mice.
- Author
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Cabelka CA, Baumann CW, Lindsay A, Norton A, Blixt NC, Le G, Warren GL, Mansky KC, Novotny SA, and Lowe DA
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- Animals, Drug Evaluation, Preclinical, Female, Mice, Inbred C57BL, Muscle Contraction drug effects, Ovariectomy, Random Allocation, Tibia drug effects, Mice, Estrogens pharmacology, Indoles pharmacology, Motor Activity drug effects, Musculoskeletal System drug effects, Selective Estrogen Receptor Modulators pharmacology
- Abstract
The actions of selective estrogen receptor modulators are tissue dependent. The primary objective of the current study was to determine the tissue selective effects of bazedoxifene (BZA) on the musculoskeletal system of ovariectomized (OVX) female mice, focusing on the strengths of muscle-bone pairs in the lower hindlimb. Treatment with BZA after ovariectomy (OVX+BZA) did not prevent body or fat mass gains (P < 0.05). In vivo plantarflexor muscle isometric torque was not affected by treatment with BZA (P = 0.522). Soleus muscle peak isometric, concentric and eccentric tetanic force production were greater in OVX+BZA mice compared to OVX+E2 mice (P ≤ 0.048) with no effect on maximal isometric specific force (P = 0.228). Tibia from OVX+BZA mice had greater cortical cross-sectional area and moment of inertia than OVX mice treated with placebo (P < 0.001), but there was no impact of BZA treatment on cortical bone mineral density, cortical thickness, tibial bone ultimate load or stiffness (P ≥ 0.086). Overall, these results indicate that BZA may be an estrogen receptor agonist in skeletal muscle, as it has previously been shown in bone, providing minor benefits to the musculoskeletal system.
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- 2021
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8. The Current Evidence for Marijuana as Medical Treatment.
- Author
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Buck JS, Bloomer AK, Wally MK, Seymour RB, and Hsu JR
- Subjects
- Endocannabinoids adverse effects, Endocannabinoids metabolism, Endocannabinoids pharmacology, Endocannabinoids therapeutic use, Humans, Medical Marijuana adverse effects, Musculoskeletal System drug effects, Pain Management methods, Treatment Outcome, Medical Marijuana therapeutic use
- Published
- 2020
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9. Assessment of the risk of musculoskeletal adverse events associated with fluoroquinolone use in children: A meta-analysis.
- Author
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Wang JG, Cui HR, Hu YS, and Tang HB
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Case-Control Studies, Child, Child, Preschool, Female, Fluoroquinolones therapeutic use, Humans, Infant, Infant, Newborn, Levofloxacin adverse effects, Levofloxacin therapeutic use, Male, Naphthyridines adverse effects, Naphthyridines therapeutic use, Retrospective Studies, Sensitivity and Specificity, Topoisomerase II Inhibitors adverse effects, Topoisomerase II Inhibitors therapeutic use, Anti-Bacterial Agents adverse effects, Bacterial Infections drug therapy, Fluoroquinolones adverse effects, Musculoskeletal System drug effects
- Abstract
Background: The use of fluoroquinolone antibiotics has been restricted in children because of their potential to cause adverse musculoskeletal events. This study was performed to systematically evaluate whether there is a difference between fluoroquinolone and non-fluoroquinolone antibiotics in terms of their associated risk of adverse musculoskeletal events in children., Methods: Cochrane Library, Embase, and PubMed databases were used to retrieve studies related to fluoroquinolone and non-fluoroquinolone-induced musculoskeletal adverse events in children. A meta-analysis was performed using Stata 11., Results: A total of 10 studies were included in the analysis. The combined results showed that there was no statistical difference between fluoroquinolone and non-fluoroquinolone groups in terms of musculoskeletal adverse events in children (risk ratio = 1.145, 95% confidence interval = 0.974 - 1.345, P = .101). Subgroup analysis was performed using a random-effects model. Here, the effects on the trovafloxacin and levofloxacin groups were significantly different from that of the control group. However, musculoskeletal adverse events due to either drug was not reported after long-term follow-up., Conclusions: The results showed that fluoroquinolone and non-fluoroquinolone antibiotics were not different in terms of their ability to cause musculoskeletal adverse events in children. For this reason, fluoroquinolone antibiotics can be used in children as appropriate., Prospero Registration Number: CRD42019133900.
- Published
- 2020
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10. Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency.
- Author
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Sosa Henríquez M and Gómez de Tejada Romero MJ
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- Animals, Calcifediol administration & dosage, Cholecalciferol administration & dosage, Dietary Supplements, Humans, Musculoskeletal System drug effects, Osteoporosis drug therapy, Vitamin D administration & dosage, Vitamin D analogs & derivatives, Vitamin D therapeutic use, Calcifediol therapeutic use, Cholecalciferol therapeutic use, Vitamin D Deficiency drug therapy
- Abstract
Vitamin D deficiency is a global health problem due to its high prevalence and its negative consequences on musculoskeletal and extra-skeletal health. In our comparative review of the two exogenous vitamin D supplementation options most used in our care setting, we found that cholecalciferol has more scientific evidence with positive results than calcifediol in musculoskeletal diseases and that it is the form of vitamin D of choice in the most accepted and internationally recognized clinical guidelines on the management of osteoporosis. Cholecalciferol, unlike calcifediol, guarantees an exact dosage in IU (International Units) of vitamin D and has pharmacokinetic properties that allow either daily or even weekly, fortnightly, or monthly administration in its equivalent doses, which can facilitate adherence to treatment. Regardless of the pattern of administration, cholecalciferol may be more likely to achieve serum levels of 25(OH)D (25-hydroxy-vitamin D) of 30-50 ng/mL, an interval considered optimal for maximum benefit at the lowest risk. In summary, the form of vitamin D of choice for exogenous supplementation should be cholecalciferol, with calcifediol reserved for patients with liver failure or severe intestinal malabsorption syndromes., Competing Interests: The authors declare no conflict of interest.
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- 2020
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11. Bilateral Sub-deltoid Bursitis in a Patient Receiving Infliximab for Crohn's Disease.
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Bellakhal S, Abbes M, Jomni MT, Abdelaali I, Charfi M, and Douggui MH
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- Adalimumab therapeutic use, Adult, Drug-Related Side Effects and Adverse Reactions, Fistula, Humans, Male, Musculoskeletal System drug effects, Myalgia, Treatment Outcome, Bursitis chemically induced, Crohn Disease drug therapy, Infliximab adverse effects, Infliximab therapeutic use
- Abstract
Background: Infiximab has been shown to be effective in inducing and maintaining remission of intestinal bowel diseases. Infiximab has been associated with many adverse events. Articular manifestations are commonly reported, but they are of variable clinical expression and aetiology. Among them, inflammatory bursitis has rarely been described., Objective: Herein a case of inflammatory bursitis in a patient with Crohn's disease after switching to biosimilar infliximab is reported., Case Report: A 41-year-old man with Crohn's disease evolving from 3 years was referred to infliximab therapy at a dose of 5mg/kg because of an aggressive resistant perineal fistula. After 14 infusions of infliximab, the treatment was switched to infliximab biosimilar using the same dose and frequency of administration. Forty-eight hours after the second infusion, he developed an acute onset of muscle pain and stiffness on both of his shoulders. A musculoskeletal ultrasound was performed and revealed a hypoechoic widening of both subacromial bursae. It was more severe on the left side., Discussion: The diagnosis of non-infective sub-acromial bursitis secondary to infliximab infusion was made as the patient's symptoms resolved rapidly without any antibiotics. Infliximab was definitively stopped and adalimumab was introduced., Conclusion: Musculoskeletal side effects of infliximab infusion are uncommonly reported. Among them, bursitis has been reported in only a few cases. Ultrasonography can help early diagnosis of bursitis. The time of occurring of this reaction regarding infliximab infusion, screening of Antibodies to Infliximab (ATI) and clinical outcome after drug discontinuation are the main helpful arguments., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2020
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12. Effects of loratadine, a histamine H 1 receptor antagonist, on the skeletal system of young male rats.
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Folwarczna J, Konarek N, Freier K, Karbowniczek D, Londzin P, and Janas A
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- Animals, Bone and Bones metabolism, Male, Musculoskeletal System metabolism, Rats, Rats, Wistar, Bone and Bones drug effects, Histamine H1 Antagonists pharmacology, Loratadine pharmacology, Musculoskeletal System drug effects
- Abstract
Background: Histamine H
1 receptor antagonists are widely used in the treatment of allergic diseases. H1 receptors are expressed on bone cells and histamine takes part in regulation of bone metabolism. Loratadine is often prescribed to children., Purpose: The aim of the present study was to investigate the effects of loratadine on the skeletal system of young rats., Material and Methods: Loratadine (0.5, 5, and 50 mg/kg p.o. daily) was administered for 4 weeks to male Wistar rats, 6-week-old at the start of the experiment. Bone mass, mass of bone mineral, calcium, and phosphorus content in the bone mineral of the tibia, femur, and L-4 vertebra, histomorphometric parameters of the femur, mechanical properties of the proximal tibial metaphysis, femoral diaphysis and femoral neck, and serum levels of bone turnover markers were examined., Results: Loratadine at 0.5 and 5 mg/kg did not significantly affect the skeletal system of young rats. At 50 mg/kg, loratadine decreased the femoral length, increased content of calcium and phosphorus in the bone mineral of the vertebra, and tended to improve mechanical properties of the tibial metaphysis., Conclusion: High-dose loratadine slightly but significantly affected development of the skeletal system in rapidly growing rats., Competing Interests: The authors report no conflicts of interest in this work., (© 2019 Folwarczna et al.)- Published
- 2019
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13. Bone and body composition response to testosterone therapy vary according to polymorphisms in the CYP19A1 gene.
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Aguirre LE, Colleluori G, Robbins D, Dorin R, Shah VO, Chen R, Jan IZ, Qualls C, Villareal DT, and Armamento-Villareal R
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- Absorptiometry, Photon, Adult, Aged, Body Mass Index, Bone Density drug effects, Bone Remodeling drug effects, Humans, Male, Middle Aged, Musculoskeletal System drug effects, Musculoskeletal System metabolism, Polymorphism, Genetic genetics, Polymorphism, Single Nucleotide genetics, Prospective Studies, Prostate diagnostic imaging, Prostate drug effects, Prostate-Specific Antigen blood, Testosterone adverse effects, Aromatase genetics, Body Composition genetics, Bone and Bones metabolism, Testosterone deficiency, Testosterone therapeutic use
- Abstract
Purpose: To evaluate the influence of single nucleotide polymorphisms (SNPs) of CYP19A1 on the response and susceptibility to side effects from testosterone therapy. This is a prospective, single-arm study of men with low-morning serum testosterone (<10.68 nmol/l) administered testosterone cypionate 200 mg intramuscularly every 2 weeks for 18 months., Methods: We measured areal bone mineral density (aBMD) and body composition by dual energy X-ray absorptiometry, tibial volumetric BMD and geometry by peripheral quantitative computer tomography, bone turnover markers by enzyme-linked immunosorbent assay, testosterone, and estradiol by liquid-chromatography/mass-spectroscopy, genotyping by microarray, CYP19A1 expression by quantitative polymerase chain reaction, hematocrit and prostate-specific antigen (PSA)., Results: We enrolled 105 men (40-74-years-old). SNPs rs1062033 and rs700518 were associated with significant differences in outcomes at 18 months. The GG genotype in rs1062033 had significant increase in whole body aBMD, but had significant decrease in tibial bone size compared to the CG and CC genotypes. Body composition analysis showed that the CC genotype of rs1062033, and the AA genotype of rs700518, had significant increase in total lean and appendicular lean mass compared to CG and GG, and AG and GG, respectively. The GG genotype of rs700518 had significant increase in PSA (GG = 105.8 ± 23.3% vs. AG + AA = 53.4 ± 11.3%, p = 0.046) while hematocrit changes were comparable among genotypes. CYP19A1 expression was highest in GG genotype in both SNPs., Conclusions: For the first time, we demonstrated that CYP19A1 SNPs influence response to testosterone therapy in hypogonadal men, highlighting the importance of genetic profiling in therapeutics even for common clinical conditions.
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- 2019
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14. Meeting report from the 3rd IFMRS/KU Leuven Herbert Fleisch Workshop, Brugge, Belgium, 17-19 March 2019.
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Maes C, Bouillon R, and Martin TJ
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- Belgium, Bone Remodeling drug effects, Bone and Bones pathology, Diphosphonates pharmacology, Humans, Mechanotransduction, Cellular, Microbiota drug effects, Musculoskeletal System drug effects, Neoplasms pathology, Osteoblasts drug effects, Osteoblasts metabolism, Biomedical Research, Musculoskeletal System pathology
- Published
- 2019
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15. Vitamin D and Metabolic Supplementation in Orthopedic Trauma.
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Nino S, Soin SP, and Avilucea FR
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- Adult, Aged, Anabolic Agents adverse effects, Antifibrinolytic Agents therapeutic use, Bone Density Conservation Agents therapeutic use, Calcium administration & dosage, Calcium therapeutic use, Diagnostic Screening Programs standards, Female, Fractures, Ununited physiopathology, Homeostasis physiology, Humans, Male, Middle Aged, Prevalence, Risk Factors, Treatment Outcome, Vitamin D therapeutic use, Vitamin D Deficiency etiology, Vitamin D Deficiency prevention & control, Vitamin K administration & dosage, Vitamin K therapeutic use, Fractures, Ununited etiology, Fractures, Ununited prevention & control, Musculoskeletal System drug effects, Vitamin D administration & dosage, Vitamin D Deficiency epidemiology
- Abstract
Active assessment and management of hypovitaminosis D among orthopedic patients is low-risk and low-cost while retaining significant potential to improve patient care. Vitamin D has an established role in musculoskeletal development and calcium homeostasis, and vitamin D deficiency is pervasive in orthopedic trauma populations. Clinical guidelines for screening and supplementation for hypovitaminosis D are lacking. Literature on the effects of vitamin K on bone health is limited. Anabolic hormone analogues may have a future role in delayed union or nonunion treatment. Vitamin D deficiency and other endocrine abnormalities should be considered in orthopedic trauma patients presenting with fracture nonunion of uncertain cause., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
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16. Diabetes pharmacotherapy and effects on the musculoskeletal system.
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Kalaitzoglou E, Fowlkes JL, Popescu I, and Thrailkill KM
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- Humans, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents pharmacology, Musculoskeletal System drug effects
- Abstract
Persons with type 1 or type 2 diabetes have a significantly higher fracture risk than age-matched persons without diabetes, attributed to disease-specific deficits in the microarchitecture and material properties of bone tissue. Therefore, independent effects of diabetes drugs on skeletal integrity are vitally important. Studies of incretin-based therapies have shown divergent effects of different agents on fracture risk, including detrimental, beneficial, and neutral effects. The sulfonylurea class of drugs, owing to its hypoglycemic potential, is thought to amplify the risk of fall-related fractures, particularly in the elderly. Other agents such as the biguanides may, in fact, be osteo-anabolic. In contrast, despite similarly expected anabolic properties of insulin, data suggests that insulin pharmacotherapy itself, particularly in type 2 diabetes, may be a risk factor for fracture, negatively associated with determinants of bone quality and bone strength. Finally, sodium-dependent glucose co-transporter 2 inhibitors have been associated with an increased risk of atypical fractures in select populations, and possibly with an increase in lower extremity amputation with specific SGLT2I drugs. The role of skeletal muscle, as a potential mediator and determinant of bone quality, is also a relevant area of exploration. Currently, data regarding the impact of glucose lowering medications on diabetes-related muscle atrophy is more limited, although preclinical studies suggest that various hypoglycemic agents may have either aggravating (sulfonylureas, glinides) or repairing (thiazolidinediones, biguanides, incretins) effects on skeletal muscle atrophy, thereby influencing bone quality. Hence, the therapeutic efficacy of each hypoglycemic agent must also be evaluated in light of its impact, alone or in combination, on musculoskeletal health, when determining an individualized treatment approach. Moreover, the effect of newer medications (potentially seeking expanded clinical indication into the pediatric age range) on the growing skeleton is largely unknown. Herein, we review the available literature regarding effects of diabetes pharmacotherapy, by drug class and/or by clinical indication, on the musculoskeletal health of persons with diabetes., (© 2018 John Wiley & Sons, Ltd.)
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- 2019
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17. Nazi Medicine-Part 1: Musculoskeletal Experimentation on Concentration Camp Prisoners During World War II.
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Bagatur E
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- Concentration Camps ethics, Female, History, 20th Century, Humans, Male, Nontherapeutic Human Experimentation ethics, Concentration Camps history, Holocaust history, Musculoskeletal System drug effects, Musculoskeletal System pathology, Musculoskeletal System physiopathology, National Socialism history, Nontherapeutic Human Experimentation history, Orthopedic Procedures history, War Crimes history, World War II
- Published
- 2018
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18. The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review.
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Al-Bashaireh AM, Haddad LG, Weaver M, Kelly DL, Chengguo X, and Yoon S
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- Humans, Musculoskeletal System drug effects, Tobacco Smoking adverse effects
- Abstract
This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system. AMSTAR criteria were followed. A comprehensive search of PubMed, Web of Science, and Science Direct returned 243 articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system. In research on bones, smoking was associated with lower BMD, increased fracture risk, periodontitis, alveolar bone loss, and dental implant failure. In research on joints, smoking was associated with increased joint disease activity, poor functional outcomes, and poor therapeutic response. There was also evidence of adverse effects on muscles, tendons, cartilage, and ligaments. There were few studies on the musculoskeletal health outcomes of secondhand smoke, smoking cessation, or other modes of smoking, such as waterpipes or electronic cigarettes. This review found evidence that suggests tobacco smoking has negative effects on the health outcomes of the musculoskeletal system. There is a need for further research to understand mechanisms of action for the effects of smoking on the musculoskeletal system and to increase awareness of healthcare providers and community members of the adverse effects of smoking on the musculoskeletal system.
- Published
- 2018
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19. 'To treat or not to treat': raising awareness on the effects of graft versus host disease drugs on musculoskeletal system.
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Mohammed J, Akomolafe T, Aljurf M, Savani B, and Hashmi SK
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- Graft vs Host Disease pathology, Humans, Graft vs Host Disease drug therapy, Musculoskeletal System drug effects
- Published
- 2018
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20. Musculoskeletal senescence: a moving target ready to be eliminated.
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Baar MP, Perdiguero E, Muñoz-Cánoves P, and de Keizer PL
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- Age Factors, Animals, Apoptosis drug effects, Bone Remodeling drug effects, Bone and Bones drug effects, Bone and Bones metabolism, Bone and Bones pathology, Bone and Bones physiopathology, Cartilage drug effects, Cartilage metabolism, Cartilage pathology, Cartilage physiopathology, Chondrogenesis drug effects, Drug Design, Humans, Muscle Development drug effects, Muscle, Skeletal drug effects, Muscle, Skeletal metabolism, Muscle, Skeletal pathology, Muscle, Skeletal physiopathology, Musculoskeletal Diseases metabolism, Musculoskeletal Diseases pathology, Musculoskeletal Diseases physiopathology, Musculoskeletal System metabolism, Musculoskeletal System pathology, Musculoskeletal System physiopathology, Signal Transduction drug effects, Cellular Senescence drug effects, Molecular Targeted Therapy methods, Musculoskeletal Diseases drug therapy, Musculoskeletal System drug effects, Regeneration drug effects
- Abstract
Aging is the prime risk factor for the broad-based development of diseases. Frailty is a phenotypical hallmark of aging and is often used to assess whether the predicted benefits of a therapy outweigh the risks for older patients. Senescent cells form as a consequence of unresolved molecular damage and persistently secrete molecules that can impair tissue function. Recent evidence shows senescent cells can chronically interfere with stem cell function and drive aging of the musculoskeletal system. In addition, targeted apoptosis of senescent cells can restore tissue homeostasis in aged animals. Thus, targeting cellular senescence provides new therapeutic opportunities for the intervention of frailty-associated pathologies and could have pleiotropic health benefits., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2018
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21. Editorial overview: Musculoskeletal: New therapeutic targets and delivery systems.
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Dixon SJ and Chidiac P
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- Animals, Dosage Forms, Drug Carriers, Drug Compounding, Humans, Musculoskeletal Diseases genetics, Musculoskeletal Diseases pathology, Musculoskeletal Diseases physiopathology, Musculoskeletal System pathology, Musculoskeletal System physiopathology, Pharmacokinetics, Drug Delivery Systems methods, Genetic Therapy methods, Musculoskeletal Diseases therapy, Musculoskeletal System drug effects, Regeneration drug effects, Regeneration genetics
- Published
- 2018
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22. Application of kartogenin for musculoskeletal regeneration.
- Author
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Im GI
- Subjects
- Animals, Bone and Bones pathology, Humans, Tendons pathology, Wound Healing, Anilides pharmacology, Musculoskeletal System drug effects, Phthalic Acids pharmacology, Regeneration drug effects
- Abstract
Kartogenin (KGN) is a recently characterized small molecule that promotes the selective differentiation of mesenchymal stem cells into chondrocytes, and thus, KGN stimulates cartilage regeneration. KGN also possess chondro-protective effect. Furthermore, because it is a highly stable small molecule, KGN can be stored and transported at room temperature. These obvious superiorities over peptide growth factors make KGN a desirable chondrogenic agent for cartilage regeneration. Since its discovery, KGN has drawn much attention as a new chondrogenic drug for intraarticular (IA) treatment. Although it was originally developed with a focus on OA, it has been used to treat other conditions and to promote disc and bone-tendon junction regeneration. Our group has also developed several formulations for IA delivery of KGN including KGN-conjugated chitosan nano/microparticles, thermo-responsive polymeric nanospheres based on chitosan oligosaccharide conjugated pluronic F127, and hyluronate hydrogels containing polyethylene glycol (PEG/KGN) micelles. This review was undertaken to summarize current research on the action mechanism of KGN and the various formulations described in the literature that induce musculoskeletal regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1141-1148, 2018., (© 2017 Wiley Periodicals, Inc.)
- Published
- 2018
- Full Text
- View/download PDF
23. Application of Calcium Sulfate for Dead Space Management in Soft Tissue: Characterisation of a Novel In Vivo Response.
- Author
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Oliver RA, Lovric V, Christou C, Aiken SS, Cooper JJ, and Walsh WR
- Subjects
- Animals, Bone Substitutes chemistry, Bone Substitutes pharmacology, Male, Materials Testing methods, Microscopy, Electron, Scanning methods, Ossification, Heterotopic drug therapy, Polymethyl Methacrylate, Prostheses and Implants, Rabbits, Rats, Rats, Nude, Calcium Sulfate pharmacology, Musculoskeletal System drug effects
- Abstract
Management of dead space (DS) is a fundamental aspect of surgery. Residual DS following surgery can fill with hematoma and provide an environment for bacterial growth, increasing the incidence of postoperative infection. Materials for managing DS include polymethyl-methacrylate (PMMA), which is nonresorbing and requires removal in a second surgical procedure. The use of calcium sulfate (CS) offers the advantage of being fully absorbed and does not require subsequent surgical removal. As CS has historically been used as a bone void filler, there are some concerns for the risk of heterotopic ossification (HO) when implanted adjacent to soft tissue. This study assessed the osteoinductive potential of CS and identified and characterised residual material present in muscle tissue using histology, energy-dispersive X-ray spectroscopy analysis, and scanning electron microscopy (SEM). CS beads with and without antibiotic were implanted in intramuscular sites in both athymic rats and New Zealand white rabbits. At 28 days after implantation in the rat model, no signs of osteoinduction were observed. In the rabbit model, at 21 days after implantation, almost complete bead absorption and presence of a "halo" of material in the surrounding muscle tissue were confirmed. Our results suggested that the halo of material was a calcium phosphate precipitate, not HO.
- Published
- 2018
- Full Text
- View/download PDF
24. Local Control of Soft Tissue and Bone Sarcomas.
- Author
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Crompton JG, Ogura K, Bernthal NM, Kawai A, and Eilber FC
- Subjects
- Bone Neoplasms surgery, Bone Neoplasms therapy, Chemoradiotherapy, Disease-Free Survival, Humans, Musculoskeletal System drug effects, Musculoskeletal System radiation effects, Musculoskeletal System surgery, Neoplasm Recurrence, Local, Osteosarcoma surgery, Osteosarcoma therapy, Sarcoma surgery, Sarcoma therapy, Soft Tissue Neoplasms surgery, Soft Tissue Neoplasms therapy, Bone Neoplasms pathology, Osteosarcoma pathology, Sarcoma pathology, Soft Tissue Neoplasms pathology
- Abstract
Sarcomas of soft tissue and bone are mesenchymal malignancies that can arise in any anatomic location, most commonly the extremity, retroperitoneum, and trunk. Even for lower grade histologic subtypes, local recurrence can cause significant morbidity and even disease-related death. Although surgery remains the cornerstone of local control, perioperative radiation and systemic therapy are often important adjuvants. This review will summarize the current therapeutic approaches for local control of soft tissue and bone sarcomas.
- Published
- 2018
- Full Text
- View/download PDF
25. Nicotine: Sporting Friend or Foe? A Review of Athlete Use, Performance Consequences and Other Considerations.
- Author
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Mündel T
- Subjects
- Humans, Muscle Strength physiology, Musculoskeletal System drug effects, Nicotine pharmacokinetics, Performance-Enhancing Substances pharmacokinetics, Sports, Athletes, Athletic Performance, Doping in Sports, Muscle Strength drug effects, Nicotine adverse effects, Performance-Enhancing Substances adverse effects
- Abstract
Nicotine use amongst athletes is high and increasing, especially in team sports. This narrative review examines the rationale behind its use and evidence of its effect on physical performance, and considers important factors that should determine future research efforts. To date, ten studies have assessed muscular strength and power, sub- or maximal endurance and high-intensity exercise when nicotine (medication) or smokeless tobacco was used as an intervention. Two studies observed an ergogenic effect, one an ergolytic with the remaining seven reporting no change. These studies have notable limitations and confounding factors that include participant tolerance to nicotine, interindividual responses, the nicotine delivery system used and failure to adhere to rigorous experimental/scientific design. Further research is encouraged to address these limitations and determine the extent to which anti-doping and governing bodies should consider promoting, coordinating and monitoring any effort against nicotine and nicotine-containing substances in sports.
- Published
- 2017
- Full Text
- View/download PDF
26. A Brief Overview of the STP 36th Annual Symposium: Musculoskeletal System.
- Author
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Gropp KE and Boyle MC
- Subjects
- Animals, Congresses as Topic, Fibroblast Growth Factor-23, Humans, Societies, Scientific, Toxicological Phenomena, Musculoskeletal System drug effects, Musculoskeletal System physiopathology, Pathology, Clinical, Toxicology
- Abstract
The title of the 2017 Society of Toxicologic Pathology symposium was "Musculoskeletal System." A brief overview of the General Scientific Symposium is presented herein and describes the topics presented by each speaker. Symposium speakers addressed subjects pertinent to musculoskeletal system toxicologic pathology and drug development ranging from molecular biology of bone homeostasis to regulatory agency requirements and considerations for registration of bone therapeutics. This overview serves to summarize sessions and is intended as a guide to the individual submissions by speakers and symposium contributors.
- Published
- 2017
- Full Text
- View/download PDF
27. Integrating three-dimensional printing and nanotechnology for musculoskeletal regeneration.
- Author
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Nowicki M, Castro NJ, Rao R, Plesniak M, and Zhang LG
- Subjects
- Animals, Bone and Bones drug effects, Bone and Bones pathology, Bone and Bones surgery, Cartilage drug effects, Cartilage pathology, Cartilage surgery, Humans, Musculoskeletal Diseases pathology, Musculoskeletal Diseases surgery, Musculoskeletal System drug effects, Musculoskeletal System pathology, Musculoskeletal System surgery, Nanotechnology instrumentation, Neovascularization, Physiologic, Tissue Engineering instrumentation, Tissue Engineering methods, Biocompatible Materials therapeutic use, Musculoskeletal Diseases therapy, Nanotechnology methods, Printing, Three-Dimensional instrumentation, Regeneration physiology, Tissue Scaffolds
- Abstract
The field of tissue engineering is advancing steadily, partly due to advancements in rapid prototyping technology. Even with increasing focus, successful complex tissue regeneration of vascularized bone, cartilage and the osteochondral interface remains largely illusive. This review examines current three-dimensional printing techniques and their application towards bone, cartilage and osteochondral regeneration. The importance of, and benefit to, nanomaterial integration is also highlighted with recent published examples. Early-stage successes and challenges of recent studies are discussed, with an outlook to future research in the related areas.
- Published
- 2017
- Full Text
- View/download PDF
28. Association of Statin Use With Risk of Back Disorder Diagnoses.
- Author
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Makris UE, Alvarez CA, Wei W, Mortensen EM, and Mansi IA
- Subjects
- Adult, Causality, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Musculoskeletal System drug effects, Protective Factors, Retrospective Studies, Risk Assessment, Risk Factors, United States epidemiology, Back Pain diagnosis, Back Pain epidemiology, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Musculoskeletal Diseases classification, Musculoskeletal Diseases diagnosis, Musculoskeletal Diseases epidemiology
- Published
- 2017
- Full Text
- View/download PDF
29. Episodic replacement of clotting factor concentrates does not prevent bleeding or musculoskeletal damage - the MUSFIH study.
- Author
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Poonnoose P, Carneiro JDA, Cruickshank AL, El Ekiaby M, Perez Bianco RP, Ozelo MC, De Bosch N, Baghaipour M, Tien SL, Chuansumrit A, D'Amico EA, van Zyl A, Sabour A, Candela M, Ricciardi JBS, Ruiz-Sàez A, Ravanbod R, Lam JCL, Jaovisidha S, Kavitha ML, Gibikote S, Shyamkumar N, and Srivastava A
- Subjects
- Adolescent, Child, Female, Humans, Longitudinal Studies, Male, Musculoskeletal System pathology, Young Adult, Blood Coagulation Factors pharmacology, Hemorrhage prevention & control, Musculoskeletal System drug effects
- Abstract
Patients and Methods: A longitudinal study was carried out in 255 children from 10 centres in nine developing countries over 5 years to assess the musculoskeletal outcome of children on episodic factor replacement. Outcome was documented by assessment of the annual joint bleeding rate (AJBR), WFH clinical and Pettersson radiological joint scores as well as the FISH score for activities. Of the 203 patients for whom data was available at the end of 5 years, 164 who had received only episodic treatment are included in this report., Results: The median age at the beginning of the study was 10 years (IQR 7-12). The median clotting factor concentrate (CFC) usage was 662 IU kg
-1 year-1 (IQ range: 280-1437). The median AJBR was 10 (IQ range: 5-17). The median AJBR was higher in the older children with the median being 5 for the 5 year old child, while it was 9 for the 10 year old and 11 for children older than 15. Given the episodic nature of the replacement therapy, those with a higher AJBR used significantly greater annual CFC doses (P < 0.001); The median change in WFH clinical score and Pettersson radiological score over the 5 years was 0.4/year for each, while the FISH deteriorated at a rate of 0.2/year with poor correlation of these changes with CFC dose. WFH and FISH scores were significantly worse in those with an AJBR of >3 per year (P = 0.001). The change in the Pettersson score was significantly more in those with an AJBR of >5 per year (P = 0.020). Significant changes in FISH scores were only noted after 10 years of age., Conclusion: Episodic CFC replacement over a large range of doses does not alter the natural course of bleeding in haemophilia or the musculoskeletal deterioration and should not be recommended as a long term option for treatment. Prophylaxis is the only way to preserve musculoskeletal function in haemophilia., (© 2017 John Wiley & Sons Ltd.)- Published
- 2017
- Full Text
- View/download PDF
30. Oestrogens and ageing from the skeletal perspective.
- Author
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Pazianas M
- Subjects
- Animals, Female, Humans, Oxidative Stress, Aging physiology, Estrogens physiology, Estrogens therapeutic use, Menopause physiology, Musculoskeletal System drug effects, Musculoskeletal System physiopathology, Osteoporosis drug therapy, Osteoporosis physiopathology
- Published
- 2017
- Full Text
- View/download PDF
31. Kinetic factors may trigger lesion development in the patients with psoriatic arthritis.
- Author
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Tönük ŞB, Ramadan B, and Yorgancıoğlu ZR
- Subjects
- Anti-Inflammatory Agents therapeutic use, Arthritis, Psoriatic diagnosis, Arthritis, Psoriatic drug therapy, Arthritis, Psoriatic immunology, Arthritis, Psoriatic physiopathology, Biomechanical Phenomena, Humans, Musculoskeletal System drug effects, Musculoskeletal System immunology, Phenotype, Risk Factors, Stress, Mechanical, Arthritis, Psoriatic etiology, Musculoskeletal System physiopathology
- Published
- 2016
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- View/download PDF
32. Musculoskeletal Health of 40-65 Year Old Males and Females in Kosova and the Impact of N05B, A02B (PPI, H2RA), H02AB and Lifestyle Factors on It.
- Author
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Krasniqi E, Koni M, Tschan H, Krasniqi B, Kabashi A, and Boshnjaku A
- Subjects
- Adult, Aged, Bone Density, Cross-Sectional Studies, Exercise, Female, Hand Strength, Health Status, Humans, Kosovo, Male, Middle Aged, Musculoskeletal System drug effects, Nutritional Status, Life Style, Musculoskeletal Diseases epidemiology
- Abstract
Background: This observational, cross-sectional study investigates the impact of medication usage, physical activity (PA) and nutritional status on musculoskeletal health (MSH) in males and females aged 40-65 in the population of a post conflict, developing country., Methods: Bone Mineral Density (BMD), T-score and Z-score at distal forearm regions (measured by DEXA scan), together with isometric hand grip strength (dynamometer) were evaluated in a total of 162 subjects (53 Males, average age 55.15±7.12 and 109 Females, 54.27±5.1). Additionally, bio-anthropometric assessments, medication usage, PA level and nutritional status were assessed., Results: Significant differences (p<0.05) were found in total subjects Body Mass Index (BMI), PA, BMD, T-score and Hand grip between genders. 42% of total participants met the diagnostic criteria of, out of which 6.8% with T-score below -2, while no cases of Osteoporosis was recorded. N05B Anxiolytics and A02B Drugs for peptic ulcer and gastro-oesophageal reflux disease medication groups consumption turned to have no significant differences (p>0.05) in BMD, T-score, and hand grip in total population, except for A02B where p<0.05 were found in Hand grip, as well as between female consumers and no consumers in all variables. Meanwhile, in total subjects consuming H02AB Glucocorticoids p<0.05 were observed in BMD and T-score, but not on hand grip., Conclusions: This study shows a low risk for MSH problems amongst the studied population in Kosova, while the consumption of H02AB medication group in both genders and A02B in females only for extended periods might effect MSH, therefore appropriate benefit/risk assessment should be made before prescribing these medications, notwithstanding age, gender, PA or nutritional status.
- Published
- 2016
- Full Text
- View/download PDF
33. Pre-Vaccination Care-Seeking in Females Reporting Severe Adverse Reactions to HPV Vaccine. A Registry Based Case-Control Study.
- Author
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Mølbak K, Hansen ND, and Valentiner-Branth P
- Subjects
- Adolescent, Adult, Case-Control Studies, Child, Digestive System drug effects, Digestive System pathology, Female, Humans, Middle Aged, Musculoskeletal System drug effects, Musculoskeletal System pathology, Papillomavirus Infections prevention & control, Papillomavirus Vaccines therapeutic use, Registries, Uterine Cervical Neoplasms prevention & control, Young Adult, Papillomavirus Vaccines adverse effects, Vaccination adverse effects, Vaccination statistics & numerical data
- Abstract
Background: Since 2013 the number of suspected adverse reactions to the quadrivalent human papillomavirus (HPV) vaccine reported to the Danish Medicines Agency (DMA) has increased. Due to the resulting public concerns about vaccine safety, the coverage of HPV vaccinations in the childhood vaccination programme has declined. The aim of the present study was to determine health care-seeking prior to the first HPV vaccination among females who suspected adverse reactions to HPV vaccine., Methods: In this registry-based case-control study, we included as cases vaccinated females with reports to the DMA of suspected severe adverse reactions. We selected controls without reports of adverse reactions from the Danish vaccination registry and matched by year of vaccination, age of vaccination, and municipality, and obtained from the Danish National Patient Registry and The National Health Insurance Service Register the history of health care usage two years prior to the first vaccine. We analysed the data by logistic regression while adjusting for the matching variables., Results: The study included 316 cases who received first HPV vaccine between 2006 and 2014. Age range of cases was 11 to 52 years, with a peak at 12 years, corresponding to the recommended age at vaccination, and another peak at 19 to 28 years, corresponding to a catch-up programme targeting young women. Compared with 163,910 controls, cases had increased care-seeking in the two years before receiving the first HPV vaccine. A multivariable model showed higher use of telephone/email consultations (OR 1.9; 95% CI 1.2-3.2), physiotherapy (OR 2.1; 95% CI 1.6-2.8) and psychologist/psychiatrist (OR 1.9; 95% CI 1.3-2.7). Cases were more likely to have a diagnosis in the ICD-10 chapters of diseases of the digestive system (OR 1.6; 95% CI 1.0-2.4), of the musculoskeletal system (OR 1.6; 95% CI 1.1-2.2), symptoms or signs not classified elsewhere (OR 1.8; 95% CI 1.3-2.5) as well as injuries (OR 1.5; 95% CI 1.2-1.9)., Conclusion: Before receiving the first HPV vaccination, females who suspected adverse reactions has symptoms and a health care-seeking pattern that is different from the matched population. Pre-vaccination morbidity should be taken into account in the evaluation of vaccine safety signals., Competing Interests: We have the following interests: This study was funded in part by IBM Denmark (PhD grant to NDH). NDH is in part employed by IBM Denmark. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.
- Published
- 2016
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- View/download PDF
34. Effect of Vitamin D on Joint Replacement Outcomes.
- Author
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Ginnetti M, El-Othmani MM, Wright E, Tzeng TH, Saleh J, Lane JM, Mihalko WM, and Saleh KJ
- Subjects
- Arthroplasty, Replacement methods, Humans, Musculoskeletal System drug effects, Musculoskeletal System metabolism, Patient Care Planning, Patient Outcome Assessment, Risk Factors, Vitamins pharmacology, Arthroplasty, Replacement adverse effects, Joint Diseases complications, Joint Diseases metabolism, Joint Diseases surgery, Postoperative Complications etiology, Postoperative Complications metabolism, Postoperative Complications prevention & control, Preoperative Care methods, Vitamin D pharmacology, Vitamin D Deficiency complications, Vitamin D Deficiency drug therapy
- Abstract
Vitamin D is a steroid hormone that affects not only bone metabolism and strength but also a variety of musculoskeletal health and surgical outcomes that are relevant to orthopaedic medicine. Risk factors for vitamin D deficiency include sex, age, skin pigmentation, obesity, and preexisting conditions such as nephritic syndrome and malabsorption syndrome. Furthermore, vitamin D deficiency is associated with the development of postoperative complications, such as an increased risk of infection, morbidity, and mortality. The standardization of vitamin D terminology as well as a thorough understanding of the medical considerations associated with vitamin D deficiency can improve preoperative planning and clearance, and, ultimately, patient outcomes and satisfaction.
- Published
- 2016
35. Biomaterials and Fabrication to Optimise Scaffold Properties for Musculoskeletal Tissue Engineering.
- Author
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Wheelton A, Mace J, Khan WS, and Anand S
- Subjects
- Humans, Biocompatible Materials pharmacology, Musculoskeletal System drug effects, Tissue Engineering methods, Tissue Scaffolds chemistry
- Abstract
Tissue engineering has emerged as a promising scientific field potentially yielding in vitro developed tissue to replace degenerative or injured tissues in vivo, thus avoiding the donor site morbidity associated with reconstructive surgery. Integral to the process is the role of scaffolds and the biomaterials used to form them. This review explores the concept of scaffold based tissue engineering and design considerations. The scaffold needs to have certain mechanical and architectural properties, it needs to be biocompatible and biodegradable, and allow combination with bioactive molecules. We also discuss scaffolding techniques, different biomaterial options and fabrication technologies, and future areas of development.
- Published
- 2016
36. Doping with anabolic androgenic steroids (AAS): Adverse effects on non-reproductive organs and functions.
- Author
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Nieschlag E and Vorona E
- Subjects
- Adult, Behavior drug effects, Chemical and Drug Induced Liver Injury, Coronary Thrombosis chemically induced, Depression chemically induced, Female, Heart Diseases chemically induced, Hematopoiesis drug effects, Humans, Male, Middle Aged, Musculoskeletal System drug effects, Psychoses, Substance-Induced, Stroke chemically induced, Thromboembolism chemically induced, Anabolic Agents adverse effects, Androgens adverse effects, Athletes, Doping in Sports
- Abstract
Since the 1970s anabolic androgenic steroids (AAS) have been abused at ever increasing rates in competitive athletics, in recreational sports and in bodybuilding. Exceedingly high doses are often consumed over long periods, in particular by bodybuilders, causing acute or chronic adverse side effects frequently complicated by additional polypharmacy. This review summarizes side effects on non-reproductive organs and functions; effects on male and female reproduction have been recently reviewed in a parallel paper. Among the most striking AAS side effects are increases in haematocrit and coagulation causing thromboembolism, intracardiac thrombosis and stroke as well as other cardiac disturbances including arrhythmias, cardiomyopathies and possibly sudden death. 17α-alkylated AAS are liver toxic leading to cholestasis, peliosis, adenomas and carcinomas. Hyperbilirubinaemia can cause cholemic nephrosis and kidney failure. AAS abuse may induce exaggerated self-confidence, reckless behavior, aggressiveness and psychotic symptoms. AAS withdrawal may be accompanied by depression and suicidal intentions. Since AAS abuse is not or only reluctantly admitted physicians should be aware of the multitude of serious side effects when confronted with unclear symptoms.
- Published
- 2015
- Full Text
- View/download PDF
37. The Role of Vitamin C in Orthopedic Trauma and Bone Health.
- Author
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Hart A, Cota A, Makhdom A, and Harvey EJ
- Subjects
- Dietary Supplements, Humans, Oxidative Stress, Ascorbic Acid pharmacology, Musculoskeletal Diseases prevention & control, Musculoskeletal System drug effects, Musculoskeletal System injuries
- Abstract
Vitamin C is an essential micronutrient with an adult daily recommended intake of 75 mg for women and 90 mg for men. Smokers should consume an additional 35 mg per day because of the increased oxidative stresses from cigarette smoke. Observational data support the hypothesis that high dietary intake and supplementation with vitamin C may reduce the risk of hip fractures in postmenopausal women. Results of 2 high-quality trials support use of vitamin C 500 mg daily for 50 days as prophylaxis against complex regional pain syndrome after wrist fracture treated conservatively and operatively. Observational evidence exists for similar treatment after foot and ankle surgery. The role of vitamin C in preventing osteoarthritis has tremendous potential, though results in animal and human studies are controversial. The heterogeneous results and the lack of prospective trials preclude any recommendation at this time.
- Published
- 2015
38. GH therapy in transition age: state of the art and future perspectives.
- Author
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Cappa M, Caruso M, Saggese G, Salerno MC, and Tonini G
- Subjects
- Adolescent, Body Height drug effects, Body Weight, Bone Density drug effects, Cardiovascular System drug effects, Child, Child, Preschool, Congresses as Topic, Dose-Response Relationship, Drug, Dwarfism physiopathology, Energy Metabolism drug effects, Forecasting, Growth Disorders drug therapy, Growth Disorders prevention & control, Human Growth Hormone administration & dosage, Human Growth Hormone metabolism, Human Growth Hormone pharmacology, Humans, Insulin Resistance, Insulin-Like Growth Factor I analysis, Italy, Lipid Metabolism drug effects, Multicenter Studies as Topic, Musculoskeletal System drug effects, Puberty, Delayed drug therapy, Puberty, Delayed prevention & control, Sex Characteristics, Transition to Adult Care, Young Adult, Dwarfism drug therapy, Hormone Replacement Therapy trends, Human Growth Hormone therapeutic use, Puberty drug effects
- Abstract
Growth hormone (GH) has been recently approved by the Italian Health Authorities for use in transition patients with childhood onset-growth hormone deficiency (CO-GHD). GH in addition to promote linear growth influences several key metabolic processes. In particular, in the transition period, from late adolescent to early adulthood, GH plays an important role in the achievement of a complete somatic development including body composition, muscle mass maturation, full skeletal mineralization and reproductive maturation, as well as in the prevention of metabolic and cardiovascular risk. Therefore, GH replacement should be restarted if a GH stimulation test at the re-evaluation fulfills established criteria. Endocrinologists experienced in the care of GHD adolescent patients held a workshop in Rome, Italy in July 2012 to review in detail the literature data and compare experiences of five Italian endocrinological centers on the negative consequences of interrupting GH treatment and the positive effects of continued GH replacement on intermediary metabolism, heart, muscle, pubertal development, and bone. The aim of the meeting was to delineate the state of the art on GH therapy in transition age and provide suggestions to pediatric and adult endocrinologists for a smooth transition care.
- Published
- 2015
39. No pain, no gain: a fallacy so far.
- Author
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Gradishar WJ
- Subjects
- Anastrozole, Female, Humans, Androstadienes adverse effects, Antineoplastic Agents, Hormonal adverse effects, Aromatase Inhibitors adverse effects, Breast Neoplasms drug therapy, Musculoskeletal System drug effects, Nitriles adverse effects, Triazoles adverse effects, Vasomotor System drug effects
- Published
- 2015
- Full Text
- View/download PDF
40. Treatment-associated musculoskeletal and vasomotor symptoms and relapse-free survival in the NCIC CTG MA.27 adjuvant breast cancer aromatase inhibitor trial.
- Author
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Stearns V, Chapman JA, Ma CX, Ellis MJ, Ingle JN, Pritchard KI, Budd GT, Rabaglio M, Sledge GW, Le Maitre A, Kundapur J, Liedke PE, Shepherd LE, and Goss PE
- Subjects
- Adult, Aged, Anastrozole, Androstadienes administration & dosage, Aromatase Inhibitors administration & dosage, Breast Neoplasms surgery, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Hot Flashes chemically induced, Humans, Kaplan-Meier Estimate, Middle Aged, Nitriles administration & dosage, Triazoles administration & dosage, Androstadienes adverse effects, Antineoplastic Agents, Hormonal adverse effects, Aromatase Inhibitors adverse effects, Breast Neoplasms drug therapy, Musculoskeletal System drug effects, Nitriles adverse effects, Triazoles adverse effects, Vasomotor System drug effects
- Abstract
Purpose: Treatment-emergent symptoms with adjuvant tamoxifen and aromatase inhibitors (AIs) have been associated with superior recurrence-free survival (RFS). We hypothesized that MA.27 anastrozole- or exemestane-treated patients with new or worsening vasomotor and/or joint symptoms would have improved RFS., Patients and Methods: MA.27 randomly assigned 7,576 postmenopausal women with breast cancer to 5 years of anastrozole or exemestane. Patient-reported symptoms were collected using the Common Terminology Criteria for Adverse Events version 3.0 at protocol-specified baseline and 6- and 12-month clinical visits. Symptoms were considered present with either vasomotor and/or joint complaints. Associations between symptoms and baseline patient characteristics were examined with χ(2) and Fisher's exact tests. Subsequent effects of new or worsening symptoms on RFS were examined with landmark analyses and stratified univariable and multivariable Cox models. We examined the effects of 3-month symptoms arising from unplanned clinic visits as a result of severe toxicity., Results: Patients were assessable if eligible for the MA.27 trial, received some trial therapy, and had no disease recurrence at the end of a symptom assessment period; 96% of patients (n = 7,306 patients) were included at 6 months, and 96% (n = 7,246) were included at 12 months. Thirty-four percent of patients had baseline symptoms. For patients without baseline symptoms, 25% and 52% had new symptoms by 6 and 12 months, respectively. Neither treatment-emergent nor baseline symptoms significantly impacted RFS (P > .10) in patients with or without baseline symptoms., Conclusion: In MA.27, anastrozole or exemestane treatment-emergent symptoms were not associated with improved RFS. Women should be supported through treatment and encouraged to remain on their AI regardless of their symptoms., (© 2014 by American Society of Clinical Oncology.)
- Published
- 2015
- Full Text
- View/download PDF
41. Musculoskeletal safety outcomes of patients receiving daptomycin with HMG-CoA reductase inhibitors.
- Author
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Bland CM, Bookstaver PB, Lu ZK, Dunn BL, and Rumley KF
- Subjects
- Aged, Creatine Kinase metabolism, Drug Combinations, Female, Humans, Male, Middle Aged, Muscular Diseases chemically induced, Musculoskeletal System drug effects, Myalgia chemically induced, Retrospective Studies, Anti-Bacterial Agents adverse effects, Daptomycin adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects
- Abstract
Daptomycin, a cyclic lipopeptide antibiotic, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are commonly administered in the inpatient setting and are associated with creatine phosphokinase (CPK) elevations, myalgias, and muscle weakness. Safety data for coadministration of daptomycin with statins are limited. To determine the safety of coadministration of daptomycin with statin therapy, a multicenter, retrospective, observational study was performed at 13 institutions in the Southeastern United States. Forty-nine adult patients receiving statins concurrently with daptomycin were compared with 171 patients receiving daptomycin without statin therapy. Detailed information, including treatment indication and duration, infecting pathogen, baseline and subsequent CPK levels, and presence of myalgias or muscle complaints, was collected. Myalgias were noted in 3/49 (6.1%) patients receiving combination therapy compared with 5/171 (2.9%) of patients receiving daptomycin alone (P = 0.38). CPK elevations of >1,000 U/liter occurred in 5/49 (10.2%) patients receiving combination therapy compared to 9/171 (5.3%) patients receiving daptomycin alone (P = 0.32). Two of five patients experiencing CPK elevations of >1,000 U/liter in the combination group had symptoms of myopathy. Three patients (6.1%) discontinued therapy due to CPK elevations with concurrent myalgias in the combination group versus 6 patients (3.5%) in the daptomycin-alone group (P = 0.42). CPK levels and myalgias reversed upon discontinuation of daptomycin therapy. Overall musculoskeletal toxicity was numerically higher in the combination group but this result was not statistically significant. Further prospective study is warranted in a larger population., (Copyright © 2014, American Society for Microbiology. All Rights Reserved.)
- Published
- 2014
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- View/download PDF
42. [Isotretinoin and exercise: can the two walk together?].
- Author
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Dalal A, Ben-Barak S, Zlotogorski A, and Constantini N
- Subjects
- Acne Vulgaris drug therapy, Creatine Kinase, MM Form blood, Dermatologic Agents administration & dosage, Dermatologic Agents adverse effects, Humans, Musculoskeletal System metabolism, Exercise physiology, Isotretinoin administration & dosage, Isotretinoin adverse effects, Musculoskeletal Pain chemically induced, Musculoskeletal Pain prevention & control, Musculoskeletal System drug effects
- Abstract
Since its introduction in 1982, isotretinoin has revolutionized acne treatment, targeting the underlying mechanism of the disease, with effective and long-lasting results. During the first decade of its marketing, several cases of hyperCKemia and rhabdomyolysis were linked to isotretinon therapy. A special concern was given to the possible triggering of muscle toxicity by vigorous exercise. These potential effects discouraged the prescription of isotretinoin to physically active patients or required them to abstain from exercise during treatment. Common musculoskeletal adverse effects of isotretinoin include muscle or joint pains. HyperCKemia is frequently found in patients receiving treatment for rare cases of rhabdomyolysis. Isotretinoin-associated muscle toxicity is usually detected in asymptomatic patients, even though symptoms can appear without hyperCKemia. A possible synergistic effect of isotretinoin and exercise is plausible, although supported by weak evidence and mediated by an unknown mechanism. There are only two reports of myoglobinuria and no reports of decreased renal function in exercising patient under treatment. In conclusion, we believe that current data should not deter physicians from offering isotretinoin to physically active patients nor require them to abstain from exercise. Physicians must explain to patients the possible side effects of treatment, ask them to refrain from an unusual change in their exercise regimen and advise them to avoid other triggers of rhabdomyolysis. Patients should be aware of possible signs of muscle toxicity and inform their doctors about any relevant symptoms.
- Published
- 2014
43. Musculoskeletal functional outcomes in children with osteogenesis imperfecta: associations with disease severity and pamidronate therapy.
- Author
-
Sousa T, Bompadre V, and White KK
- Subjects
- Absorptiometry, Photon, Adolescent, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Fractures, Spontaneous prevention & control, Humans, Injections, Intravenous, Male, Motor Activity physiology, Musculoskeletal System drug effects, Osteogenesis Imperfecta diagnostic imaging, Pamidronate, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Bone Density Conservation Agents therapeutic use, Bone Remodeling drug effects, Diphosphonates therapeutic use, Osteogenesis Imperfecta drug therapy
- Abstract
Background: Intravenous pamidronate has been used off-label in the treatment of severe osteogenesis imperfecta (OI) for almost 20 years. Previous studies have found correlations between function and bone density in patients with OI, but have not studied the functional outcomes of these patients after bisphosphonate therapy with a validated outcome measure. The goal of this investigation is to describe the functionality and comfort of children with OI. We hypothesize that function is impaired in children with severe OI as measured using the Pediatric Outcomes Data Collection Instrument (PODCI) and that improvements in the function of children with severe OI may be observed in association with intravenous bisphosphonate therapy., Methods: A total of 25 patients with OI were evaluated, of those, 15 received pamidronate therapy. Children with >2 long bone fractures per year were classified as having severe OI and were eligible for pamidronate therapy. Functional evaluation was performed using the PODCI for children who qualified for pamidronate therapy (severe OI) and those who did not qualify for pamidronate therapy (mild OI). PODCI evaluation was also performed after treatment with pamidronate in the group that qualified for pamidronate therapy., Results: There was a statistically significant difference at baseline between patients with "mild" and "severe" OI in the sports/physical functioning scale (P=0.0032). Among the children who received bisphosphonate therapy, PODCI scores in the sports/physical functioning domain were significantly improved after pamidronate therapy (P=0.0364)., Conclusions: This study indicates that children with mild forms of OI can be differentiated from their more severe counterparts by their ability to participate in high-level play activities. Furthermore, patients with "severe" OI show a significant improvement in their ability to participate in high-level play after 1 year of pamidronate., Level of Evidence: Level IV.
- Published
- 2014
- Full Text
- View/download PDF
44. A systematic review of selected musculoskeletal late effects in survivors of childhood cancer.
- Author
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Gawade PL, Hudson MM, Kaste SC, Neglia JP, Wasilewski-Masker K, Constine LS, Robison LL, and Ness KK
- Subjects
- Adult, Bone and Bones radiation effects, Child, Drug-Related Side Effects and Adverse Reactions, Humans, Muscle, Striated radiation effects, Radiotherapy adverse effects, Radiotherapy Dosage, Musculoskeletal System drug effects, Musculoskeletal System radiation effects, Neoplasms therapy, Survivors
- Abstract
Survivors of childhood cancer are at risk for treatment-related musculoskeletal late effects. Early detection and orthopedic intervention can help ameliorate musculoskeletal late effects and prevent subsequent complications. This systematic review summarizes the literature describing associations between cancer, its treatment, and musculoskeletal late effects. We searched PubMed and Web of Science for English language articles published between January 1970 and December 2012. The search was limited to investigations with at least 15 participants and conducted at least 2 years after completion of therapy for childhood, adolescent, or young adult cancer. Some late skeletal effects, including low bone mineral density, osteonecrosis, slipped capital femoral epiphyses, oncogenic rickets, and hormonerelated growth disturbances have been previously reviewed and were excluded, as were outcomes following amputation and limb-salvage procedures. Of 2347 references identified, 30 met inclusion criteria and were retained. An additional 54 studies that met inclusion criteria were found in reference lists of retained studies. Of 84 studies, 60 focused on associations between radiotherapy, six between chemotherapy, and 18 between surgery and musculoskeletal late effects. We found that younger age, higher radiation dosage, and asymmetric or partial bone radiation volume influences the effects of radiation on the musculoskeletal system. Methotrexate and vincristine are associated with long-term muscular strength and flexibility deficits. Laminectomy and chest wall resection are associated with spinal malalignment, and enucleation is associated with orbital deformities among survivors. Radiotherapy, chemotherapy, and surgery are associated with musculoskeletal late effects independently and additively. Associations are additionally influenced by host and treatment characteristics.
- Published
- 2014
- Full Text
- View/download PDF
45. Broth versus solid agar culture of swab samples of cadaveric allograft musculoskeletal tissue.
- Author
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Varettas K
- Subjects
- Allografts microbiology, Bacteria isolation & purification, Culture Media, Humans, Musculoskeletal System microbiology, Agar pharmacology, Allografts drug effects, Cadaver, Musculoskeletal System drug effects
- Abstract
As part of the donor assessment protocol, bioburden assessment must be performed on allograft musculoskeletal tissue samples collected at the time of tissue retrieval. Swab samples of musculoskeletal tissue allografts from cadaveric donors are received at the microbiology department of the South Eastern Area Laboratory Services (Australia) to determine the presence of bacteria and fungi. This study will review the isolation rate of organisms from solid agar and broth culture of swab samples of cadaveric allograft musculoskeletal tissue over a 6-year period, 2006-2011. Swabs were inoculated onto horse blood agar (anaerobic, 35 °C) and chocolate agar (CO2, 35 °C) and then placed into a cooked meat broth (aerobic, 35 °C). A total of 1,912 swabs from 389 donors were received during the study period. 557 (29.1 %) swabs were culture positive with the isolation of 713 organisms, 249 (34.9 %) from solid agar culture and an additional 464 (65.1 %) from broth culture only. This study has shown that the broth culture of cadaveric allograft musculoskeletal swab samples recovered a greater amount of organisms than solid agar culture. Isolates such as Clostridium species and Staphylococcus aureus would not have been isolated from solid agar culture alone. Broth culture is an essential part of the bioburden assessment protocol of swab samples of cadaveric allograft musculoskeletal tissue in this laboratory.
- Published
- 2013
- Full Text
- View/download PDF
46. Biomaterials and scaffolds in bone and musculoskeletal engineering.
- Author
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Kosuge D, Khan WS, Haddad B, and Marsh D
- Subjects
- Animals, Humans, Nanotechnology, Biocompatible Materials pharmacology, Bone and Bones drug effects, Musculoskeletal System drug effects, Tissue Engineering methods, Tissue Scaffolds chemistry
- Abstract
In orthopaedic tissue engineering, scaffolds may be viewed as a substitute for the extra-cellular matrix. Factors that contribute to an ideal scaffold include strength, degradation rate, porosity, surface property and immune response.Scaffolds may be composed of natural or synthetic polymers, each with its advantages and disadvantages. Composite scaffolds are utilised to alleviate the inherent issues with natural polymers whilst maintaining its benefits as well. This article reviews biomaterials and scaffolds in orthopaedic tissue engineering and covers clinical applications of scaffolds with particular emphasis on bone and cartilage tissue engineering.
- Published
- 2013
- Full Text
- View/download PDF
47. Opioid receptors and their ligands in the musculoskeletal system and relevance for pain control.
- Author
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Spetea M
- Subjects
- Animals, Humans, Ligands, Musculoskeletal System metabolism, Musculoskeletal System drug effects, Pain prevention & control, Receptors, Opioid metabolism
- Abstract
Interest in opioid drugs like morphine, as the oldest and most potent pain-killing agents known, has been maintained through the years. One of the most frequent chronic pain sensations people experience is associated with pathological conditions of the musculoskeletal system. Chronic musculoskeletal pain is a major health problem, and an adequate management requires understanding of both peripheral and central components, with more attention drawn to the former. Intense experimental and clinical research activities resulted in important knowledge on the mechanisms and functions of the endogenous opioid system located in the periphery. This review describes the occurrence and distribution of endogenous opioids and their receptors in the musculoskeletal system, and their role in pain control in musculoskeletal disorders, such as rheumatoid arthritis and osteoarthritis. Using different techniques, including immunohistochemistry, electron microscopy or radioimmunoassay, expression of enkephalins, dynorphin, β-endorphin, and endomorphins was demonstrated in musculoskeletal tissues of animals and humans. Localization of opioid peptides was found in synovial membrane, periosteum, bone and bone marrow, loose connective tissue, the paratenon and musculotendinous junction of the achilles tendon. Animal and human studies have also demonstrated expression of µ, δ and κ opioid receptor proteins in musculoskeletal tissues using radioligand binding assays, autoradiography, electrophysiology, immunohistochemistry and Western blotting. Opioid receptor gene expression was reported based on polymerase chain reaction and in situ hybridization techniques. Combining morphological and quantitative approaches, important evidence that the musculoskeletal apparatus is equipped with a peripheral opioid system is provided. Demonstration of the occurrence of an endogenous opioid system in bone and joint tissues represents an essential step for defining novel pharmacological strategies to attain peripheral control of pain in musculoskeletal disorders.
- Published
- 2013
- Full Text
- View/download PDF
48. The effect of oral and parenteral vitamin D supplementation in the elderly: a prospective, double-blinded, randomized, placebo-controlled study.
- Author
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Sakalli H, Arslan D, and Yucel AE
- Subjects
- Administration, Oral, Aged, Biomarkers blood, Chi-Square Distribution, Double-Blind Method, Female, Geriatric Assessment, Humans, Injections, Intramuscular, Male, Musculoskeletal System physiopathology, Pain etiology, Pain prevention & control, Pain Measurement, Predictive Value of Tests, Prospective Studies, Quality of Life, Recovery of Function, Time Factors, Treatment Outcome, Turkey, Vitamin D blood, Vitamin D Deficiency blood, Vitamin D Deficiency complications, Vitamin D Deficiency diagnosis, Vitamin D Deficiency physiopathology, Vitamins blood, Accidental Falls prevention & control, Dietary Supplements, Health Status, Musculoskeletal System drug effects, Vitamin D administration & dosage, Vitamin D Deficiency drug therapy, Vitamins administration & dosage
- Abstract
Hypovitaminosis D in the elderly causes falls and fractures as a result of impaired neuromuscular functions and also may be a reason for nonspecific musculosceletal pain. The aim of this study is to investigate the benefits of a single dose per os or parenterally administrated vitamin D on increasing the quality of life and functional mobility and decreasing the pain in the elderly. The community-dwelling elderly subjects over 65 years age were included in the study. The subjects were given 300.000 IU Vitamin D via per os and parenteral route and assessed after 4 weeks. The serum creatinine, calcium, phosphorous, ALT, ALP, 24-h urine calcium excretion, PTH, and vitamin D levels, as well as VAS (visual analog scale) for pain assessment, functional mobility with TUG (timed up and go test) and quality of life with SF-36 before and after the treatment were evaluated. The serum vitamin D levels were measured by the RIA method. The subjects were divided into four groups each consisting of 30 subjects. The 1st group took i.m. vitamin D, the 2nd group took i.m. placebo, the 3rd group took p.o. vitamin D, and the 4th group took p.o. placebo. The mean age of all the participants was 70.1 ± 4.3 years. There was no difference in the age and gender between the groups (P > 0.05). After treatment, the PTH level of first group was decreased (P = 0.0001) and the vitamin D level increased (P = 0.0001) significantly. In the third group, the PTH level of first group was decreased (P = 0.0001) and the vitamin D level increased (P = 0.004) and the 24-h calcium excretion in urine (P = 0.015) increased significantly. When the pain, the functional mobility, and the quality of life were evaluated, in the first group, the TUG (P = 0.0001) and the VAS (P = 0.0001) decreased significantly, whereas the SF-36 subtitles: physical functioning (P = 0.0001), role physical (0.006), bodily pain (P = 0.0001), general health (P = 0.007), social functioning (P = 0.05), and mental health (P = 0.048) increased significantly. In group two, the VAS (P = 0.001) decreased, the role physical (P = 0.009), and role emotional (P = 0.034) increased significantly; In group three, the TUG (P = 0.0001) and the VAS (P = 0.002) decreased, whereas the physical function (P = 0.0001) and role physical (0.001) increased significantly; In group four, the VAS (P = 0.007) decreased significantly. The megadose vitamin D administration increases quality of life, decreases pain, and improves functional mobility via po or im route in the elderly.
- Published
- 2012
- Full Text
- View/download PDF
49. The role of small molecules in musculoskeletal regeneration.
- Author
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Lo KW, Ashe KM, Kan HM, and Laurencin CT
- Subjects
- Animals, Humans, Musculoskeletal System blood supply, Neovascularization, Physiologic drug effects, Osteoclasts drug effects, Osteoclasts metabolism, Osteogenesis drug effects, Musculoskeletal System drug effects, Regeneration drug effects, Small Molecule Libraries pharmacology
- Abstract
The uses of bone morphogenetic proteins and parathyroid hormone therapeutics are fraught with several fundamental problems, such as cost, protein stability, immunogenicity, contamination and supraphysiological dosage. These downsides may effectively limit their more universal use. Therefore, there is a clear need for alternative forms of biofactors to obviate the drawbacks of protein-based inductive factors for bone repair and regeneration. Our group has studied small molecules with the capacity to regulate osteoblast differentiation and mineralization because their inherent physical properties minimize limitations observed in protein growth factors. For instance, in general, small molecule inducers are usually more stable, highly soluble, nonimmunogenic, more affordable and require lower dosages. Small molecules with the ability to induce osteoblastic differentiation may represent the next generation of bone regenerative medicine. This review describes efforts to develop small molecule-based biofactors for induction, paying specific attention to their novel roles in bone regeneration.
- Published
- 2012
- Full Text
- View/download PDF
50. Commentary Re: Botox Article by Berger & Knoll IPH 19(5):243-244 on "The efficacy of botulinum toxin type A in managing chronic musculoskeletal pain: a systematic review and meta analysis".
- Author
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Zhang T, Adatia A, Zarin W, Moitri M, Vijenthira A, Chu R, Thabane L, and Kean WF
- Subjects
- Humans, Botulinum Toxins, Type A therapeutic use, Musculoskeletal Diseases drug therapy, Musculoskeletal System drug effects, Pain drug therapy
- Published
- 2012
- Full Text
- View/download PDF
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