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1

Kalchenko, A. V., B. A. Babalyan, O. M. Khvysyuk, T. S. Gurbanova, D. V. Cherepov, and S. M. Maznyakov. "Fractures of the proximal femur in patients with concomitant diseases." Problems of Uninterrupted Medical Training and Science 2017, no. 1 (April 2017): 49–53. http://dx.doi.org/10.31071/promedosvity2017.01.049.

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Gafarov, Kh Z., I. F. Akhtyamov, M. V. Maleev, and A. I. Blokha. "Analysis of the variations of the fixation of proximal part of the femur in the treatment of hip joint diseases in children using the apparatus." Kazan medical journal 74, no. 2 (April 15, 1993): 83–87. http://dx.doi.org/10.17816/kazmj64627.

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On the basis of a numerical experiment using the mathematical apparatus of finite element method on the computer IBM PC by means of program package Microcomputeraided design of structures modified for design of structures, applied in traumatology and orthopedics, a new method of the apparatus fixation if proximal part of the femur is developed. The arranging of Elizarovs apparatus suggested provides the needle rod fixation of the femur. The method is used in the treatment of 84 patients with hip joint diseases, positive results are obtained in 96,4% of the cases. The efficacy of the method allows recommending it for the treatment of patients with congenital dislocations of the femur, aseptic necrosis of the head of the femur and coxa-vara in specialized hospitals.
3

Levadnyi, Ievgen, Jan Awrejcewicz, Yan Zhang, and Yaodong Gu. "Comparison of femur strain under different loading scenarios: Experimental testing." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 235, no. 1 (August 18, 2020): 17–27. http://dx.doi.org/10.1177/0954411920951033.

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Bone fracture, formation and adaptation are related to mechanical strains in bone. Assessing bone stiffness and strain distribution under different loading conditions may help predict diseases and improve surgical results by determining the best conditions for long-term functioning of bone-implant systems. In this study, an experimentally wide range of loading conditions (56) was used to cover the directional range spanned by the hip joint force. Loads for different stance configurations were applied to composite femurs and assessed in a material testing machine. The experimental analysis provides a better understanding of the influence of the bone inclination angle in the frontal and sagittal planes on strain distribution and stiffness. The results show that the surface strain magnitude and stiffness vary significantly under different loading conditions. For the axial compression, maximal bending is observed at the mid-shaft, and bone stiffness is also maximal. The increased inclination leads to decreased stiffness and increased magnitude of maximum strain at the distal end of the femur. For comparative analysis of results, a three-dimensional, finite element model of the femur was used. To validate the finite element model, strain gauges and digital image correlation system were employed. During validation of the model, regression analysis indicated robust agreement between the measured and predicted strains, with high correlation coefficient and low root-mean-square error of the estimate. The results of stiffnesses obtained from multi-loading conditions experiments were qualitatively compared with results obtained from a finite element analysis of the validated model of femur with the same multi-loading conditions. When the obtained numerical results are qualitatively compared with experimental ones, similarities can be noted. The developed finite element model of femur may be used as a promising tool to estimate proximal femur strength and identify the best conditions for long-term functioning of the bone-implant system in future study.
4

Kim, Hui Taek, Byung Guk Park, and Chong Il Yoo. "Valgus-Flexion Osteotomy of the Proximal Femur in Childhood Hip Diseases." Journal of the Korean Orthopaedic Association 37, no. 2 (2002): 233. http://dx.doi.org/10.4055/jkoa.2002.37.2.233.

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5

Adusumilli, Gautam, Joshua D. Kaggie, Simona D’Amore, Timothy M. Cox, Patrick Deegan, James W. MacKay, and Scott McDonald. "Improving the quantitative classification of Erlenmeyer flask deformities." Skeletal Radiology 50, no. 2 (July 30, 2020): 361–69. http://dx.doi.org/10.1007/s00256-020-03561-2.

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AbstractThe Erlenmeyer flask deformity is a common skeletal modeling deformity, but current classification systems are binary and may restrict its utility as a predictor of associated skeletal conditions. A quantifiable 3-point system of severity classification could improve its predictive potential in disease. Ratios were derived from volumes of regions of interests drawn in 50 Gaucher’s disease patients. ROIs were drawn from the distal physis to 2 cm proximal, 2 cm to 4 cm, and 4 cm to 6 cm. Width was also measured at each of these boundaries. Two readers rated these 100 femurs using a 3-point scale of severity classification. Weighted kappa indicated reliability and one-way analysis of variance characterized ratio differences across the severity scale. Accuracy analyses allowed determination of clinical cutoffs for each ratio. Pearson’s correlations assessed the associations of volume and width with a shape-based concavity metric of the femur. The volume ratio incorporating the metaphyseal region from 0 to 2 cm and the diametaphyseal region at 4–6 cm was most accurate at distinguishing femurs on the 3-point scale. Receiver operating characteristic curves for this ratio indicated areas of 0.95 to distinguish normal and mild femurs and 0.93 to distinguish mild and severe femurs. Volume was moderately associated with the degree of femur concavity. The proposed volume ratio method is an objective, proficient method at distinguishing severities of the Erlenmeyer flask deformity with the potential for automation. This may have application across diseases associated with the deformity and deficient osteoclast-mediated modeling of growing bone.
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Kim, Young Jae, Seung Ro Lee, Ja-Young Choi, and Kwang Gi Kim. "Using Convolutional Neural Network with Taguchi Parametric Optimization for Knee Segmentation from X-Ray Images." BioMed Research International 2021 (August 23, 2021): 1–7. http://dx.doi.org/10.1155/2021/5521009.

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Loss of knee cartilage can cause intense pain at the knee epiphysis and this is one of the most common diseases worldwide. To diagnose this condition, the distance between the femur and tibia is calculated based on X-ray images. Accurate segmentation of the femur and tibia is required to assist in the calculation process. Several studies have investigated the use of automatic knee segmentation to assist in the calculation process, but the results are of limited value owing to the complexity of the knee. To address this problem, this study exploits deep learning for robust segmentation not affected by the environment. In addition, the Taguchi method is applied to optimize the deep learning results. Deep learning architecture, optimizer, and learning rate are considered for the Taguchi table to check the impact and interaction of the results. When the Dilated-Resnet architecture is used with the Adam optimizer and a learning rate of 0.001, dice coefficients of 0.964 and 0.942 are obtained for the femur and tibia for knee segmentation. The implemented procedure and the results of this investigation may be beneficial to help in determining the correct margins for the femur and tibia and can be the basis for developing an automatic diagnosis algorithm for orthopedic diseases.
7

Li, Guoan, Ramprasad Papannagari, Kyung Wook Nha, Louis E. DeFrate, Thomas J. Gill, and Harry E. Rubash. "The Coupled Motion of the Femur and Patella During In Vivo Weightbearing Knee Flexion." Journal of Biomechanical Engineering 129, no. 6 (April 19, 2007): 937–43. http://dx.doi.org/10.1115/1.2803267.

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The movement of the knee joint consists of a coupled motion between the tibiofemoral and patellofemoral articulations. This study measured the six degrees-of-freedom kinematics of the tibia, femur, and patella using dual-orthogonal fluoroscopy and magnetic resonance imaging. Ten normal knees from ten living subjects were investigated during weightbearing flexion from full extension to maximum flexion. The femoral and the patellar motions were measured relative to the tibia. The femur externally rotated by 12.9deg and the patella tilted laterally by 16.3deg during the full range of knee flexion. Knee flexion was strongly correlated with patellar flexion (R2=0.91), posterior femoral translation was strongly correlated to the posterior patellar translation (R2=0.87), and internal-external rotation of the femur was correlated to patellar tilt (R2=0.73) and medial-lateral patellar translation (R2=0.63). These data quantitatively indicate a kinematic coupling between the tibia, femur, and patella, and provide base line information on normal knee joint kinematics throughout the full range of weightbearing flexion. The data also suggest that the kinematic coupling of tibia, femur, and patella should be considered when investigating patellar pathologies and when developing surgical techniques to treat knee joint diseases.
8

Landines Jiménez, Katherin, Nayive Nieves Pimiento, and Carlos Augusto Toledo Bueno. "Simulation of forces applied to the human femur: Analysis of finite elements." Revista vínculos 16, no. 1 (June 30, 2019): 73–81. http://dx.doi.org/10.14483/2322939x.15575.

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This document analyzes the efforts made to the human femur through a simulation of finite elements in Solidworks, in order to carry out the design of the femur in this study, the average height of the population of Malaysia were used, which is similar to that of the average Colombian population (Table 1.) and for the tests, a material with the same mechanical characteristics was simulated in the program of the human cortical bone, permitting a more approximate visualization of stresses and deformations to which the femur is exposed in the usual state and thus, identify the critical areas in which the probability of fracture or wear is greater, the results of this analysis do not apply For women in a state of pregnancy or people with osteoarthritic diseases. This analysis is important to identify which are the areas that present greater deterioration, considering that the bones lose their property of self-recovery over the years increasing the probability of presenting a fracture, having this information clear the prosthetic studies and medical treatments focused on the femur can be deepened. In this analysis, it can be identified that the male femur has greater resistance to tension and deformation than the female femur and how the femoral head is the most critical area of both the female and male fêmur.
9

Schultz, Kyle A., Benjamin A. Westcott, Kimberly R. Barber, and Todd A. Sandrock. "Elevated 1-Year Mortality Rate in Males Sustaining Low-Energy Proximal Femur Fractures and Subgroup Analysis Utilizing Age-Adjusted Charlson Comorbidity Index." Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145931989864. http://dx.doi.org/10.1177/2151459319898644.

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Introduction: Low-energy proximal femur fractures are common in the aging population and the ability to identify patients at increased mortality risk provides surgeons information to improve informed decision-making with patients and families. We evaluated for gender differences in 1-year mortality after sustaining low-energy proximal femur fractures with subgroup analysis to identify the impact of fracture location, age, and comorbidities on mortality. Materials and Methods: Patients ≥40 years of age sustaining a low-energy proximal femur fracture identified at our institution between January 1, 2014, and December 31, 2017. International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes were used to identify comorbidities for calculation of the age-adjusted Charlson comorbidity index (ACCI). The county clerk database was searched to identify mortality within 1 year of injury. One-year mortality rates were calculated and multiple comparisons were made between genders controlling for age, fracture location, and/or ACCI. Results: Women presented with low-energy proximal femur fractures at a rate of almost 3:1 to men at our institution ( P = .001). Men demonstrated a significantly increased ACCI at presentation (5.35 ± 2.55 vs 4.86 ± 1.77, P = .03). Men had an increased 1-year mortality rate for all (31.3% vs 21.5%, P = .004) and intertrochanteric (IT) fractures (36.2% vs 22.9%, P = .008). Controlling for ACCI, gender, and fracture location, men demonstrated increased mortality rate with IT fractures ( P = .002) and trended toward but did not reach significance with femoral neck fractures ( P = .07). Discussion: Men presenting with low-energy femur fractures are at an increased mortality risk compared to women. On average, men present with an overall worse health status as identified by ACCI, which could predispose these patients not only to fractures themselves but also impair their ability to recover from injury. Conclusion: Men are at an increased 1-year mortality risk after sustaining proximal femur fractures.
10

De Faria, Paula Cristina, Maria Fernanda Lima Villaça-Carvalho, Sérgio Lúcio Pereira de Castro Lopes, Mari Eli Leonelli De Moraes, and Luiz Roberto Coutinho Manhães Júnior. "Radiographic signs of bone mineral density in panoramic radiographs from pre and postmenopausal patients." Brazilian Dental Science 20, no. 1 (March 21, 2017): 56. http://dx.doi.org/10.14295/bds.2017.v20i1.1276.

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<p><strong>Objective:</strong> The aim of this study was to evaluate the potential of panoramic radiographs (PR) and their radiomorphometric indices as an auxiliary method for the diagnosis of osteoporosis. <strong>Material and</strong> <strong>Methods:</strong> Twenty five women were selected, who had been prescribed PR for different purposes. The PR were analysed according to the MCI, which evaluates the mandibular cortex below the mental foramen, and then divided into two groups: normal and bone mineral loss. Bone densitometry scans were obtained (DXA) from the lumbar spine and neck of the femur/whole femur, which were used as the gold standard for comparison against the MCI. Kappa test (p&lt;0.05) was used to determine the association between the MCI and bone densitometry readings. <strong>Results:</strong> Regarding the DXA, 7 patients were normal at the lumbar spine or femur, 24 subjects showed osteopenia at the lumbar spine or femur and 9 subjects had osteoporosis at the lumbar spine or femur. Regarding the association between DXA and MCI, 18 subjects showed some degree of bone loss at the spine detected by both DXA and the Klemetti index. <strong>Conclusions:</strong> PR may be useful to assess the risk of such diseases being present.</p>
11

Maduakonam, Dim Edwin, Lam Ying Lee, Ho Wai Yip Kenneth, Yau Ching Hin Raymond, and WH Shek Tony. "Tuberculous osteomyelitis of the proximal femur masquerading as bone secondary: A case report." Journal of Orthopaedics, Trauma and Rehabilitation 27, no. 1 (March 24, 2020): 72–76. http://dx.doi.org/10.1177/2210491720907492.

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Tuberculosis is a mycobacterial infection, but it can mimic many diseases including diseases of the musculoskeletal system. The need to consider it as a differential diagnosis of musculoskeletal tumours and tumour-like conditions cannot be overemphasized. The opinions of some, that tuberculosis is a disease of the undeveloped world, can no longer be sustained especially in the presence of immunodeficiency disorders, including HIV/AIDS, which have a worldwide prevalence. Traditionally, literature evidence shows that tuberculosis can mimic quite a number of diseases, including cancers. This has been found to be true, even in some technologically advanced countries. We present a case of hepatocellular cancer patient incidentally found to have concomitant hepatic tuberculosis who complained of bone lesion, with clinico-radiologic features of metastasis, but which turned out to be a tuberculous infection of the bone.
12

Kalman, Süleyman, Onur Sakallıoğlu, and Ahmet Altunbaş. "Brucellae osteoarthritis on the Head of the Femur." Journal of Tropical Pediatrics 51, no. 4 (August 1, 2005): 250–51. http://dx.doi.org/10.1093/tropej/fmh090.

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13

Averkieva, J., T. Raskina, M. Letaeva, O. Malyshenko, and I. Grigoreva. "AB0888 REASONS FOR LETHALITY IN ELDERLY AND SENIOR AGE PATIENTS WITH OSTEOPOROTIC FRACTURES OF FEMUR." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1748.2–1748. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5405.

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Objectives:to identify the causes of mortality in middle-aged and elderly patients during the first year after they had a low-energy hip fracture.Methods:the causes of lethality were examined of the patients with a non-traumatic femur fracture. 432 patients with osteoporotic hip fractures were under observation: 328 women and 104 men. The mean age of women was 75, 4 (70; 82) years, the mean age of men was 71,5 (65; 80) years.Results:after 12 months, mortality rate was 137 cases (total mortality - 31.8%). Most of the deaths were due to cardiovascular system diseases. The total number of fatal cases was 93 (67.8%): for men - 22 (66.0%) cases, for women - 71 (68.3%) (p = 0.65). Diseases of the respiratory system caused death in 23 (16.8%) patients: in men - 5 (15.1%) cases and in women - 18 (17.3%) (p = 0.31). Mortality from oncological diseases was 15 (10.9%) cases: in men - 3 (9.09%) cases and in women - 12 (11.5%) (p = 0.45). Diseases of the digestive system, as the cause of death, were detected in 5 (3.6%) men and women (2 (6.06%) and 3 (2.9%) cases, respectively (p = 0.1)).Conclusion:the most of the deceased men and women had cardiovascular and respiratory diseases. The gender differences in mortality rates were not found.Disclosure of Interests:None declared
14

Mironov, S. P., A. V. Balberkin, A. K. Morozov, Z. G. Natsvlishvili, A. F. Kolondaev, G. I. Khokhrikov, A. L. Baranetskiy, and Yu V. Buklemishev. "Arterial Embolization in Patients with Tumors and Tumor-Like Diseases of Loco-Motor System." N.N. Priorov Journal of Traumatology and Orthopedics 11, no. 3 (September 15, 2004): 40. http://dx.doi.org/10.17816/vto200411340.

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Reendovascular occlusion of pathologic vessels responsible for the blood supply of highly vascu­larized tumors of the femur, large pelvic bones, spine and tumor-like foci was used in 20 patients. High efficacy of the method was demonstrated. Marked reduction of the pathologic blood flow resulted in the decreased blood loss during organ saving operations for malignant tumors. Improvement of bone tissue structure in aneurismal cyst and pelvic bones hemangioma was accompanied by manifest positive clinical dynamics. At palliative treatment of patients with inoperable and metastatic tumors rapid and significant reduction of pain syndrome was noted.
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Shrivastava, Bhavana, Rupali Mehta, Prabhakaran K., and L. K. Jain. "A study of femoral bicondylar angle in Udaipur, India zone." International Journal of Research in Medical Sciences 8, no. 2 (January 27, 2020): 417. http://dx.doi.org/10.18203/2320-6012.ijrms20200219.

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Background: Human body consists of 206 bones; among which femur. The thigh bone is considered as the biggest and strongest bone of the body. The bone contains a femoral bicondylar angle which helps in maintaining the balance and certain movements of the body. Those movements are essential to stand upright and erect; therefore, helps in balancing the posture of the body. Bicondylar angle shows various gestures and characteristics essential for describing the necessary ailments of the human skeleton. Thus, the present study is designed with an aim to measure and compare the bicondylar angle of femur both in males and females in Udaipur, Rajasthan, India zone.Methods: Totally, 96 bones were studied- 48 males and 48 females’ bones in 2 years duration. The study was carried out in the Department of Anatomy of Geetanjali Medical College and Hospital and R.N.T. Medical College. The bicondylar angle was measured with a suitable apparatus comprising of compass, Digital Vernier Calliper, scale and protector (Figure 1) along with osteometric board. Bicondylar angle of male and female bone was calculated using SPSS software.Results: The study shows that the bicondylar angle of left femur was greater than right femur in both the genders, but their side differences was statistically insignificant (p>0.05).Conclusions: Hence, the bicondylar angle of female is larger than in comparison to males and these results can put emphasis/light on the orthopaedic clinicians and surgeons to know the etiology of osteometric diseases.
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Kara, M. E., and F. Sevil. "The effects of ovariectomy on bone mineral density, geometrical, and biomechanical characteristics in the rabbit femur." Veterinary and Comparative Orthopaedics and Traumatology 23, no. 01 (2010): 31–36. http://dx.doi.org/10.3415/vcot-08-09-0085.

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SummaryThe aim of the study was to evaluate the bone mineral density, as well as the biomechanic and morphometric changes in the femur of ovariectomised rabbits.Twenty-four six-month-old New Zealand rabbits were randomly divided into an ovariectomy (n = 12) and a sham (n = 12) group. Six rabbits in each group were euthanatized at eight and 16 weeks after surgery, and the femora were resected. The morphometric data were obtained from tomographic images. Periosteal and endosteal diameters and cortical thickness were measured. Total cross-sectional, cortical and medullary areas were also measured. The bone mineral content, the bone area and the bone mineral density were measured from the proximal, distal and mid-shaft of the femur as well as the total femur by dual energy X-ray absorptiometry. Employing the three-point bending method, the ultimate force, stiffness and work-to-failure were measured. The mechanical data were normalised to obtain intrinsic biomechanical properties such as ultimate stress, elastic modulus, and toughness, all of which are independent of size and shape.The results indicated that the femur was both larger and weaker 16 weeks after surgery in the ovariectomised group. Results also suggest that the rabbit might be a useful animal model for investigation of diseases related to oestrogen loss such as human postmenopausal osteoporosis. However, additional studies with advanced techniques at several time points via in vivo animal studies, and precision and predictability analyses should be designed to standardise the rabbit as a model for osteoporosis.
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Narloch, Jerzy, and Wojciech M. Glinkowski. "Osteoarthritis Changes Hip Geometry and Biomechanics Regardless of Bone Mineral Density—A Quantitative Computed Tomography Study." Journal of Clinical Medicine 8, no. 5 (May 12, 2019): 669. http://dx.doi.org/10.3390/jcm8050669.

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We aimed to compare proximal femur geometry and biomechanics in postmenopausal women with osteoarthritis (OA) and/or osteoporosis (OP), using quantitative computed tomography (QCT). A retrospective analysis of QCT scans of the proximal femur of 175 postmenopausal women was performed. Morphometric and densitometric data of the proximal femur were used to evaluate its biomechanics. We found, 21 had a normal bone mineral density (BMD), 72 had osteopenia, and 81 were diagnosed with OP. Radiographic findings of hip OA were seen in 43.8%, 52.8%, and 39.5% of the normal BMD, osteopenic, and OP groups, respectively (p < 0.05). OA was significantly correlated with total hip volume (r = 0.21), intertrochanteric cortical volume (r = 0.25), and trochanteric trabecular volume (r = 0.20). In each densitometric group, significant differences in hip geometry and BMD were found between the OA and non-OA subgroups. Hip OA and OP often coexist. In postmenopausal women, these diseases coexist in 40% of cases. Both OA and OP affect hip geometry and biomechanics. OA does so regardless of densitometric status. Changes are mostly reflected in the cortical bone. OA leads to significant changes in buckling ratio (BR) in both OP and non-OP women.
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Iwakura, T., A. Sakurai, and S. Sawamura. "Involvement of lifestyle-related diseases in the development of fragility fracture of the proximal femur." Osteoporosis and Sarcopenia 3, no. 3 (September 2017): S7—S8. http://dx.doi.org/10.1016/j.afos.2017.08.014.

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Negi, Ravikanta, Robin Kaushik, Simrandeep Singh, and Rajpal Singh Punia. "Mucor as a cause of surgical site infection." Tropical Doctor 50, no. 3 (April 29, 2020): 249–51. http://dx.doi.org/10.1177/0049475520921284.

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Dobrovolskaya, O. V., N. V. Dyomin, A. V. Smirnov, I. A. Shornikova, and N. V. Toroptsova. "Bone mineral density in women of reproductive age with rheumatic diseases." Medical alphabet 2, no. 37 (January 20, 2020): 7–11. http://dx.doi.org/10.33667/2078-5631-2019-2-37(412)-7-11.

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The article is devoted to the study of bone mineral density (BMD) in women of reproductive age suffering from rheumatic diseases (RD). A survey was conducted of 134 women — 94 patients with RD (rheumatoid arthritis, systemic scleroderma and psoriatic arthritis) and 40 people without RD. Reduced BMD was detected significantly more often in the group of patients with RE compared with the healthy control (25 and 8 %, respectively; p = 0.0213). Patients with RD showed a direct association of BMD values in all measurement areas with height, weight, body mass index, serum vitamin D concentration, and the reverse — with a cumulative dose of glucocorticoids; For MPC of the proximal femur, an additional relationship was revealed with the duration of RD. Thus, a quarter of women with RD in reproductive age need to be monitored, and in the presence of fractures, treatment of osteoporosis.
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Ibrahim Rasul, Mohammed, and Shwan Kader Media. "Evaluation of Bone Density in Ankylosing Spondylitis Patient on Biologic Agents in Erbil City Case Control Study." Diyala Journal of Medicine 20, no. 2 (June 25, 2021): 82–93. http://dx.doi.org/10.26505/djm.20025851206.

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Background: Ankylosing spondylitis is a chronic autoimmune inflammatory disease, mostly affect young men. Reduced bone density is the most common complication in ankylosing spondylitis, since reduced bone density occurs in most of the patients. Assessment of bone density in the early stages of the disease by using X- ray absorptiometry is essential. Objective: To determine and evaluate the bone mineral density of ankylosing spondylitis patients compared healthy to control group. Patients and Methods: This is a cross-sectional case control study of 50 patients with ankylosing spondylitis according to the Modified New York criteria and 50 healthy control group. The data were collected including socio demographic information of all patients (age, gender, medical history); systemic diseases type of biology treatment, using supplements, duration of ankylosing spondylitis, regular exercise, and smoking. The body mass index was calculated. Bone mineral density of the lumbar spine (L1-L4), and the left femoral neck were measured by using a dual energy x-ray absorptiometry. Statistical analysis was done by using a statistical package for social sciences (SPSS) version 22; Fisher’s exact, and Student’s t tests were used to compare two means. A p value of ≤ 0.05 was considered statistically significant. Results: The prevalence of osteoporosis and osteopenia among patients group according to T-spine score were 12% and 42% respectively, compared with 0% and 26% respectively among the control group (p= 0.002) which was statistically significant. According to the T-left femur none patients group and the control group had osteoporosis, but 46% of the cases had osteopenia, compared with 8% of the controls which was statistically significant. There was a significant but non-consistent association between the disease duration and the osteoporosis, and osteopenia in spine and femur. The prevalence of osteopenia and osteoporosis in the spine and femur were highest among those with low body mass index. Conclusion: Osteoporosis and osteopenia are common among patients with ankylosing spondylitis. In the early stage of disease osteoporosis can occur. The osteoporosis of the spine is more common than in the femur. Osteoporosis related to the duration of the diseases and body mass of the patient.
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Asachuk, S. S., O. S. Yakovleva, A. F. Martsinkevich, and Е. A. Karpenkа. "The Effect of Three-Month Atorvastatin and α-Calcidol Administration on Some Bone Tissue Morphometric Parameters." Traumatology and Orthopedics of Russia 27, no. 2 (July 13, 2021): 65–74. http://dx.doi.org/10.21823/2311-2905-2021-27-2-65-74.

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Background.Osteoporosis is the fourth most common disease after cardiovascular diseases, cancer, and diabetes. All these diseases have common pathogenetic mechanisms associated with impaired cholesterol metabolism. In recent decades, the use of the key enzyme of cholesterol synthesis inhibitors — statins, which can stimulate osteogenesis, has become widespread. However, statins affect the production of the vitamin D active form by reducing the production of testosterone and thus reducing the activity of 1α-hydroxylase. The combined use of statins and α-calcidol (α-C) for the osteoporosis prevention seems promising. The aim of the study was to evaluate the effect of long-term atorvastatin (ATV) and α-C administration on morphometric growth parameters and bone vascularization in the experiment.Materials and Methods. The experiment was conducted for three months on 120 laboratory male rats, which were injected daily intragastrically with ATV and α-C. After 90 days of the experiment, the animals were decapitated under ether anesthesia. For the study, the right femur and jawbone were taken from the animals. The rat bone sections were impregnated with silver, decalcified, and the histosections were stained according to van Gieson. The distribution of the studied features was evaluated according to the Shapiro-Wilk test. The differences were considered statistically significant at p<0.05.Results.It was found that ATV, both separately and together with α-C, increased the size of the newly formed bone in the endoostal and periosteal zones of the femur by 64.8; 40.4 and 15.8; 29.1%, respectively. The combined use of ATV and α-C had a positive effect on the growth of blood vessels in the femur (+23.4%). ATV increased the size of the newly formed bone from the periodontal and vestibular surfaces of the lower jaw by 18.3 and 29.5%, respectively. α-C potentiated the effect of ATV on the size of the newly formed bone tissue in the periodontal and vestibular growth zones of the mandibular bone by 10.1 and 15.0%, respectively. As for the number of vessels in the jawbone tissue, thanks to ATV, it increased by 17.2%, α-C had no effect.Conclusion. ATV increases the thickness of the newly formed bone layer in the growth areas of the femur and jawbone and increases the number of vessels in the jawbone. α-calcidol increases the number of vessels in the bone tissue of the femur and potentiates the effect of ATV on the jawbone growth zones. The combined use of ATV and α-C shows that they positively complement each other.
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Toroptsova, N., O. Dobrovolskaya, O. Nikitinskaya, N. Demin, A. Smirnov, and L. Shornikova. "AB0915 BONE MINERAL DENSITY AND FRACTURE FREQUENCY IN PREMENOPAUSAL WOMEN WITH RHEUMATIC DISEASES." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1759.2–1759. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2740.

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Background:The onset of the disease in young and middle age is typical for rheumatic diseases (RDS), but most studies on osteoporosis were conducted in patients (pts) older than 50 years, which included postmenopausal women.Objectives:To assess bone mineral density (BMD), fracture frequency and the factors associated with low BMD in premenopausal women with RDs.Methods:160 women (median age, 36 [29; 43] years): 120 pts with RDs (43 rheumatoid arthritis (RA), 53 systemic sclerosis (SSc) and 24 psoriatic arthritis (PsA)) and 40 age-matched healthy controls were enrolled in the study. We performed a dual-energy X-ray absorptiometry (DXA, Hologic Discovery A, USA) to measure BMD in lumbar spine, femoral neck and total hip. BMD decreasing grade was evaluated by the Z-score <-2SD. All pts were interviewed using a unified questionnaire including assessment of daily dietary calcium intake. Serum vitamin D, C-reactive protein and erythrocyte sedimentation rate (ESR) measurements were done.Results:25% pts with RDs and only 8% healthy controls have low BMD (p=0.02). RA, SSc and PsA pts had low BMD in 37%, 21% and 13%, respectively, that was more often than in healthy women (p=0.004, p=0.046 and p= 0.081, respectively). 9,3% RA pts and 7,5% SSc pts had low energy fractures. BMD of RDs pts in all areas of measurement demonstrated a direct correlation with height, weight, body mass index, and serum vitamin D concentration and an inverse correlation with the cumulative dose of glucocorticoids. Also, proximal femur BMD inversely correlated with RDs duration. BMD of femoral neck and total hip inversely correlated with C-reactive protein level in SSc pts. In RA women we found a direct correlation between lumbar spine and femur neck BMD and ESR.Conclusion:25% of premenopausal women with RDs had reduced BMD and needed monitoring and osteoporosis prevention, while 9.3% pts with RA and 7.5% women with SSc needed anti-osteoporotic treatment.Disclosure of Interests:None declared
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Ponnuswami, Abiram, Cordelia Babitha S., Krishnakanth Muralidhar, and Murugan Sundaram. "The dreaded osteonecrosis of femur following chronic steroid therapy: a case series from a dermatologist’s eye." International Journal of Research in Dermatology 6, no. 2 (February 24, 2020): 264. http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20200609.

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<p>Corticosteroids, undoubtedly, is the saving grace of many patients ailing from a variety of inflammatory and autoimmune dermatoses. But it is not free of side effects, some being crippling enough to subject the patient to huge amounts of morbidity. Here we report a series of cases – Vesiculobullous diseases and Lupus Erythematosus - with prolonged oral steroid therapy that lead to osteopenia and osteonecrosis of the femur.</p>
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ODIERE, M. R., K. G. KOSKI, H. A. WEILER, and M. E. SCOTT. "Concurrent nematode infection and pregnancy induce physiological responses that impair linear growth in the murine foetus." Parasitology 137, no. 6 (December 23, 2009): 991–1002. http://dx.doi.org/10.1017/s0031182009991764.

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SUMMARYThis study examined concurrent stresses of nematode infection and pregnancy using pregnant and non-pregnant CD1 mice infected 3 times with 0, 50 or 100 Heligmosomoides bakeri larvae. Physiological, energetic, immunological and skeletal responses were measured in maternal and foetal compartments. Resting metabolic rate (RMR) was elevated by pregnancy, but not by the trickle infection. Energy demands during pregnancy were met through increased food intake and fat utilization whereas mice lowered their body temperature during infection. Both infection and pregnancy increased visceral organ mass and both altered regional bone area and mineralization. During pregnancy, lumbar mineralization was lower but femur area and mineralization were higher. On the other hand, infection lowered maternal femur bone area and this was associated with higher IFN-γ in maternal serum of heavily infected pregnant mice. Infection also reduced foetal crown-rump length which was associated with higher amniotic fluid IL-1β.
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Toussirot, E., R. Winzenrieth, M. Desmarets, D. Wendling, F. Aubin, and G. Dumoulin. "AB0570 BONE MINERAL DENSITY, TRABECULAR BONE SCORE AND PROXIMAL FEMUR 3D-DXA ANALYSIS IN PSORIATIC DISEASES." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1322. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1242.

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Background:current data regarding areal bone mineral density (aBMD) in patients with psoriasis (PsO) or psoriatic arthritis (PsA) are conflicting. Results on Trabecular Bone Score (TBS) in these patients are lacking. 3D-analysis of cortical and trabecular bone from hip DXA is a new method for non-invasive bone structure assessment, providing separate assessment of the cortical layer and trabecular macrostructure.Objectives:Case-control study (NCT02849795)Methods:52 PsO and 52 PsA cases (CASPAR criteria) were each paired to a control subject matched for age, sex and body mass index (BMI). aBMD measurements at (L2-4) lumbar spine (LS), femoral neck (FN) and total hip (TH) were performed using DXA, Lunar GE. TBS was calculated from antero-posterior L2-L4 BMD image using TBS iNsight V1.8 (Med-Imaps, Pessac, France). 3D-SHAPER software (version 2.10, Galgo Medical S.L, Barcelona, Spain) was used to derive a 3D analysis from the hip DXA scans.Results:LS and TH aBMD measurements did not differ between patients with PsO or PsA and their respective controls (Table 1). Left FN BMD was higher in patients with PsO compared to controls (p = 0.028), a difference not observed on the right FN. TBS was similar in PsA patients and their controls while decreased values were observed in PsO patients (p = 0.04). In 3D analysis, none of the parameters differed between patients with PsA and their controls. For patients with PsO, no difference was found with the controls for 3D-DXA parameters from the right FN, while total hip cortical surface BMD (sBMD) of the left FN was higher in PsO compared to their controls (p = 0.037). Similarly, cortical thickness (Cth) of the intertrochanteric and shaft regions of the left FN was also higher in PsO (p = 0.032 and p = 0.033). Finally, analysis by region (neck, intertrochanteric and shaft) showed higher values for cortical sBMD from each region of the left FN in the patients with PsO (all p <0.05).Conclusion:Our results showed comparable aBMD, TBS and 3D proximal femur parameters in patients with PsA and controls. This supports that PsA population is not at increased risk of osteoporosis. In patients with PsO, while LS bone microarchitecture seems impaired, FN displayed better cortical parameters than the controls. Although these results seem marginal, they support the fact that patients with PsO are not at high risk for osteoporosis and hip fracture.Table 1.PsA: psoriatic arthritis; PsO: psoriasis; M: male; F: female; BMI: body mass index; PASI: psoriasis area severity index; CPDAI: composite psoriatic disease activity index; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; aBMD: areal bone mineral density; LS: lumbar spine; FN: femoral neck; TH: total hip; TBS: trabecular bone score; sBMD: surface bone mineral density; Cth: cortical thickness; quantitative data are mean ± standard deviation; * and ***: paired t test comparing patients with psoriatic arthritis or psoriasis alone to their respective controls; * p < 0.05; *** p < 0.001).PsAPsA controlsPsOPsO controlsN52525252Age (years)52.5 ± 11.752.8 ±11.150.5 ± 12.850.7 ± 12.8Sex (M/F)25/2725/2738/1436/16Menopausal women18 (67%)16 (59%)5 (36%)8 (50%)BMI (Kg/m2)27.4 ± 5.927.7 ± 6.428.4 ± 5.828.2 ± 6.1PASI2.4 ± 4.18.4 ± 4.9CPDAI7.4 ± 3.3ESR (mm/h)19.8 ± 16.6 ***6.9 ± 5.810.7 ± 8.8 ***6.4 ± 6.4CRP (mg/L)10.5 ± 11.7 ***3.9 ± 4.86.0 ± 9.04.7 ± 5.5LS (L2-4) aBMD (g/cm2)1.27 ± 0.491.20 ± 0.201.25 ± 0.211.20 ± 0.18FN aBMD (g/cm2) right0.96 ± 0.120.94 ± 0.140.98 ± 0.150.98 ± 0.15 left0.96 ± 0.160.93 ± 0.121.0 ± 0.14 *0.97 ± 0.13TH aBMD (g/cm2)1.01 ± 0.161.00 ± 0.151.11 ± 0.221.06 ± 0.21L2-L4 TBS1.32 ± 0.111.32 ± 0.151.23 ± 0.15 *1.30 ± 0.16Cortical sBMD (left FN) (mg/cm2)169.7 ± 32.8163.1 ± 29.7182.0 ± 31.0 *173.5 ± 30.3Cth intertrochanteric (left FN) (mm)1.91 ± 0.201.94 ± 0.182.03 ± 0.23 *1.97 ± 0.19Cth shaft (left FN) (mm)2.98 ± 0.313.01 ± 0.283.19 ± 0.36 *3.09 ± 0.29Cortical sBMD (left FN) (mg/cm2)neck135.27 ± 26.9129.67 ± 21.9140.29 ± 24.2 *134.6 ± 22.5intertrochanteric162.32 ± 31.1155.34 ± 29.3171.39 ± 29.1 *163.1 ± 28.9shaft cort269.20 ± 49.0257.12 ± 47.3286.2 ± 47.5 *272.7 ± 45.2Disclosure of Interests:ERIC TOUSSIROT: None declared., Renaud Winzenrieth Employee of: GALGO MEDICAL, maxime DESMARETS: None declared., Daniel Wendling: None declared., Francois AUBIN: None declared., Gilles DUMOULIN: None declared.
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Ferndndez-Guerrero, Manuel L., José Azofra, Pilar Macarrón, and Carlos Barros. "Osteomyelitis of the femur complicating Serratia marcesens bacteraemia arising from an infected intravascular catheter." Journal of Infection 16, no. 1 (January 1988): 109–10. http://dx.doi.org/10.1016/s0163-4453(88)96337-2.

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Fonseca, R. L., A. R. Lobo-Jr, and M. I. S. Santana. "Measurements of femoral angles, femur length, and hip width in cat radiographs." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 69, no. 6 (November 2017): 1513–20. http://dx.doi.org/10.1590/1678-4162-9583.

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ABSTRACT Femoral angle, femur length, and hip width were measured in radiographs of 92 intact domestic cats, males and females of mixed breed from the Center for Zoonosis Control of the Federal District. The animals showed no trauma, orthopedic diseases or angular deformities and had closed physeal lines. Accordingly, we measured aLPFA (anatomical lateral proximal femoral angle, aLDFA (anatomical lateral distal femoral angle), mLPFA (mechanical lateral proximal femoral angle), mLDFA (mechanical lateral distal femoral angle), IA (femoral inclination angle), FL (femur length) and HW (hip width) using ventrodorsal radiographs, with both hindlimbs in a single exposure to an X-ray beam centered on the hip. The mean values of the variables were: mLPFA: 82.5±3.62°; aLPFA: 80.1±4.29°; mLDFA: 96.1±3.51° (males) and 97.3±2.05° (females); aLDFA: 94,3±3.43°; IA: 136.6±3.86°; FL: 12.9±0.55cm (males) and 13.4±0.66cm (females); and HW: 3.1cm±0.23 (males) and 3.5±0.26cm (females). These values will serve as a reference for the diagnosis of angular deformities and as support for planning corrective osteotomies in domestic cats.
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Straková, Eva, Pavel Suchý, Ivan Herzig, Ladislav Steinhauser, Vlasta Šerman, and Nora Mas. "Amino Acid Profile of Protein from Pelvic Limb Long Bones of Broiler Chickens." Acta Veterinaria Brno 78, no. 4 (2009): 571–77. http://dx.doi.org/10.2754/avb200978040571.

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The objective of the study was to determine the amino acid profile in protein from long bones of the pelvic limb (femur, tibiotarsus) in ROSS 308 hybrid broiler chickens, and to examine whether it is sex-dependent.The study material was obtained from 120 Ross 308 broiler chickens (60 males and 60 females) at the end of the fattening (40 days of age). The average weight of birds was 2 694 ± 32.6 g for cockerels and 2 345 ± 23.9 g for pullets. The study birds did not show any clinical signs of leg diseases. The long bones of the right pelvic limbs (femur and tibiotarsus) were collected after bird slaughter and after removal of soft tissues, they were used for laboratory analyses. The crude protein content and the amino acid (AA) composition were determined and the obtained values were recalculated to 100% dry matter. The chemical score (CS) and the essential amino acid index (EAAI) were calculated for each AA. As a standard, the hen egg ovalbumin was used. The crude protein content in 100% dry matter shows that the content of crude protein was significantly higher (P ⪬ 0.01) in the femur (405.3 ± 17.21 g/kg) compared to the tibiotarsus (393.5 ± 12.68 g/kg). The same trends were found with regard to sex. Both males and females had significantly (P ⪬ 0.01) higher crude protein content in the femur (406.6 ± 19.34 g/kg and 404.1 ± 15.09 g/kg, respectively) than in the tibiotarsus (395.0 ± 12.16 g/kg and 392.1 ± 13.21 g/kg, respectively). Both bones showed the highest contents of Gly, Glu and Pro, and the lowest contents of Met, Tyr and His. The same trends were found with regard to chicken sex. Collagenous protein has lower contents of most AA in comparison to the standard protein - ovalbumin; especially contents of Ser, Val, Met, Ileu and Phe are substantially lower. On the other hand, collagenous protein had higher contents of Gly, Pro, His and Arg. The collagenous protein EAAI for the femur and the tibiotarsus was 59.0% and 57.4%, respectively. The knowledge of amino acid composition in protein from long bones of the pelvic limb in broiler chickens is important because it can help us understand the origin of bone disorders.
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Oh, Hyeong-Seok, Chan Shik Shim, Jin-Sung Kim, and Sang-Ho Lee. "Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases." Journal of Korean Neurosurgical Society 53, no. 1 (2013): 6. http://dx.doi.org/10.3340/jkns.2013.53.1.6.

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Panayiotakopoulos, G. D., N. V. Sipsas, A. Kontos, E. Patsouris, P. Korkolopoulou, K. Revenas, E. Dounis, and T. Kordossis. "Eosinophilic Granuloma of the Femur in an HIV-1-Positive Patient." AIDS Patient Care and STDs 16, no. 3 (March 2002): 103–6. http://dx.doi.org/10.1089/108729102317330436.

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Hilliquin, S., V. Zhukouskaya, O. Fogel, C. Chaussain, C. Miceli Richard, and C. Bardet. "POS0046 MICRO-CT ANALYSIS OF SACROILIAC JOINT AS A NEW TOOL FOR STUDYING TRABECULAR BONE AND OSTEO-ARTICULAR LESIONS IN MURINE MODELS." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 228.1–228. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3881.

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Background:Skeletal disorders affect the skeleton in different ways with some bones being very impaired while others less severely. In translational studies using murine models of human disorders, the bone phenotype is mainly evaluated at distal femur or proximal tibia. The sacroiliac joint (SIJ), which connects the spine to the pelvis, is involved in the balanced transfer of mechanical energy from the lumbar spine to the lower extremities. Its role in biomechanical stress makes it of particular interest in various bone diseases. For instance, patients with X-linked hypophosphatemia (XLH), who mainly display osteomalacia, are frequently affected with early osteoarthritis of the SIJ. Interestingly, we recently showed that the Hyp mouse, a murine model of XLH that greatly mimics the human disorder, displayed early and severe osteoarticular alterations of the SIJ [1].Objectives:Here, using the Hyp mouse as a model, we show that the SIJ constitutes a highly reliable joint to investigate in murine models of skeletal disorders.Methods:SIJ and distal femur were evaluated in 3-month-old Hyp mice compared to wild-type (WT) mice (n=10 per group). using high-resolution microCT. Measurements of trabecular and cortical bone parameters at sacral and iliac sides and trabecular bone parameters at distal femur were performed with the CTanalyzer software.Results:Hyp mice displayed a significant reduction in parameters of trabecular bone at distal femur, compared to WT mice (Figure 1A). Similarly, a reduction in trabecular bone was shown in Hyp SIJ compared to WT at sacral side (Figure 1B). There was a significant positive correlation between trabecular bone parameters of distal femur and sacral side of SIJ in Hyp mice (e.g. bone volume to total volume [BV/TV]: r = 0,763 p: 0,01). Bone parameters such as sacral BV/TV were higher in comparison to femoral parameters (Figure 1C). No difference was observed on trabecular bone parameters at iliac side of Hyp and WT mice. However, regarding the cortical bone of SIJ, significant alterations were noticed especially at iliac side of SIJ in Hyp mice compared to WT mice. An increase in open cortical porosity, and a decrease in cortical area fraction, as well as in average cortical thickness at iliac side of SIJ in Hyp mice were suggestive of osteo-articular lesions, characteristic for XLH.Conclusion:Trabecular bone parameters at the SIJ, in comparison to the femur, appear to be a relevant alternative to evaluate bone alterations in Hyp mice. Our study suggests that the SIJ represents a valuable tool to investigate both bone and local osteo-articular alterations for murine models of skeletal disorders.Figure 1.A) Bone to total volume ratio in the trabecular bone of distal femur, expressed in percent. B) Bone to total volume ratio in the trabecular bone of sacral slope of the SIJ, expressed in percent. C) Bone to total volume ratio in the trabecular bone of distal femur and sacral slope of the SIJ of Hyp mice, expressed in percent. *: p < 0,05; **: p < 0,01; ***: p< 0,001; ****: p< 0,0001.References:[1]Cauliez, Zhukouskaya et al. Impact of Early Conventional Treatment on Adult Bone and Joints in a Murine Model of X-Linked Hypophosphatemia. Front Cell Dev Biol.:doi: 10.3389/fcell.2020.591417Disclosure of Interests:None declared.
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Keuroghlian, Armand, Ana Dilza Viana Barroso, Gary Kirikian, Olga Bezouglaia, Yin Tintut, Sotirios Tetradis, Peter Moy, Flavia Pirih, and Tara Aghaloo. "The Effects of Hyperlipidemia on Implant Osseointegration in the Mouse Femur." Journal of Oral Implantology 41, no. 2 (April 1, 2015): e7-e11. http://dx.doi.org/10.1563/aaid-joi-d-13-00105.

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A high-fat (HF) diet inducing hyperlipidemia has been associated with the pathophysiology of major diseases, such as atherosclerosis and osteoporosis. A HF diet has significant adverse effects on bone, including lower bone density, volume, and strength. Statins, drugs that lower serum cholesterol levels have beneficial effects on bone metabolism. Since the host's bone quantity, quality, and healing potential play a crucial role in osseointegration of dental implants, we hypothesized that hyperlipidemia may negatively affect implant osseointegration. In the present study, we evaluated the effects of hyperlipidemia on implant osseointegration in mice. Atherosclerosis susceptible C57BL/6J male mice were randomly placed on a control chow or a HF diet. After 12 weeks on the diet, each mouse received a titanium implant in the proximal metaphysis of the femur. The animals were humanely killed at 4 or 8 weeks after the implant surgery. Results showed that the mice fed a HF diet had significantly increased implant loss as well as decreased formation and strength of bone-to-implant interface. These results support the hypothesis that a HF diet can significantly compromise osseointegration, causing poor outcome in dental implant therapy.
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Pesic, Goran, Jovana Jeremic, Isidora Stojic, Aleksandra Vranic, Marija Cankovic, Tamara Nikolic, Nevena Jeremic, et al. "Redox Status in Patients with Femoral Neck Fractures." Serbian Journal of Experimental and Clinical Research 17, no. 3 (September 1, 2016): 199–206. http://dx.doi.org/10.1515/sjecr-2015-0061.

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Abstract The femur transfers the body weight from the pelvic bone to the shinbone. Femur fractures are a significant cause of morbidity and mortality among the group of locomotor apparatus injuries, especially in the elderly population. Considering that oxidative stress occurs as a result of increased production of free radicals that damage cell function and cause numerous pathological conditions and diseases, the aim of this study was to investigate oxidative stress parameters in older patients with femoral neck fractures. This clinical study included 70 patients, of which 35 had femoral neck fractures (26 males and 9 females), while the other half of the patients formed the matched control group. Markers of oxidative stress (NO2−, TBARS, H2O2 and O2-) and anti-oxidative enzymes (SOD, CAT, and GSH) were measured. Results showed that the levels of O2- increased, while levels of NO2-, H2O2 and all the antioxidative enzymes decreased in patients with femoral neck fractures. These findings indicate that fractures cause oxidative stress, probably because of the reduced activity of osteoblasts and the increased activity of osteoclasts.
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Siwach, Ramchander, Roop Singh, Virender Kumar Kadian, Zile Singh, Mantu Jain, Harnam Madan, and Sunita Singh. "Extensive hydatidosis of the femur and pelvis with pathological fracture: A case report." International Journal of Infectious Diseases 13, no. 6 (November 2009): e480-e482. http://dx.doi.org/10.1016/j.ijid.2008.12.017.

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Bhat, Towseef Ahmad, Zameer Ali, Amara Gulzar, and Furqaan Mirza. "Cementless bipolar hemiarthroplasty for displaced fracture neck of femur with modular hydroxyapatite coated stem in elderly with cardiopulmonary co-morbidities." International Journal of Research in Medical Sciences 5, no. 5 (April 26, 2017): 1862. http://dx.doi.org/10.18203/2320-6012.ijrms20171807.

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Background: Bipolar hemiarthroplasty is one of the common procedures done for fracture neck of femur in elderly. Debate about Cemented or cementless is still on. Cementing increases perioperative mortality by causing significant hemodynamic changes or embolization. Patients with cardiopulmonary complications are at higher risk of cementing complications. We report our series of 31 cases of fracture neck of femur with cardiopulmonary diseases operated over 2 years with modular cementless bipolar hemiarthroplasty.Methods: 31 elderly patients with cardiopulmonary co-morbidities (age=75 to 97 years) with displaced femoral neck fractures were operated between January 2011 to December 2013. Cementless bipolar hemiarthroplasty using hydroxyapatite coated stem was done by single surgeon using same implant in all the patients through anterolateral approach. Clinical and radiological follow-up was done with mean follow up of 54 months (36-72 months).Results: Total 31 cases with cardiopulmonary comorbidities were operated. The average follow up was 54 months. No intraoperative mortality was seen. 3 patients had splitting of femur during canal preparation. 1 patient died due to cardiac arrest in the post-operative period. 1 patient had surgical site infection. 3 patients had hemodynamic abnormalities and 1 patient had significant limb length discripency (1.5 cm). 2 patients died in the follow up because of comorbidities. 27 patients reached to pre-injury status with average harris hip score of 86 at final follow up.Conclusions: Cementless bipolar hemiarthroplasty with hydroxyapatite coated stem is a good option for femoral neck fractures in elderly patients with cardiopulmonary complications without risking the harmful effects of cementing.
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Esposito, L., V. Minutolo, P. Gargiulo, H. Jonsson, M. K. Gislason, and M. Fraldi. "Towards an App to Estimate Patient-Specific Perioperative Femur Fracture Risk." Applied Sciences 10, no. 18 (September 14, 2020): 6409. http://dx.doi.org/10.3390/app10186409.

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Total Hip Arthroplasty has been one of the most successful surgical procedure in terms of patient outcomes and satisfaction. However, due to increase in life expectancy and the related incidence of age-dependent bone diseases, a growing number of cases of intra-operative fractures lead to revision surgery with high rates of morbidity and mortality. Surgeons choose the type of the implant, either cemented or cementless prosthesis, on the basis of the age, the quality of the bone and the general medical conditions of the patients. Generally, no quantitative measures are available to assess the intra-operative fracture risk. Consequently, the decision-making process is mainly based on surgical operators’ expertise and qualitative information obtained from imaging. Motivated by this scenario, we here propose a mechanical-supported strategy to assist surgeons in their decisions, by giving intelligible maps of the risk fracture which take into account the interplay between the actual mechanical strength distribution inside the bone tissue and its response to the forces exerted by the implant. In the presented study, we produce charts and patient-specific synthetic “traffic-light” indicators of fracture risk, by making use of ad hoc analytical solutions to predict the stress levels in the bone by means of Computed Tomography-based mechanical and geometrical parameters of the patient. We felt that if implemented in a friendly software or proposed as an app, the strategy could constitute a practical tool to help the medical decision-making process, in particular with respect to the choice of adopting cemented or cementless implant.
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Fröschen, Frank S., H. P. Fischer, G. T. Hischebeth, I. Reiter-Owona, T. M. Randau, S. Gravius, and N. Gravius. "Osseous hydatidosis of the proximal femur: a rare diagnosis in revision total hip arthroplasty." Infection 47, no. 2 (August 20, 2018): 301–5. http://dx.doi.org/10.1007/s15010-018-1193-6.

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Greig, J., C. Edwards, M. Wallis, J. Cox, R. Cunningham, and J. Keenan. "P4.28 Prevalence of MRSA Colonization in Individuals Admitted with Suspected Fractured Neck of Femur." Journal of Hospital Infection 64 (January 2006): S27. http://dx.doi.org/10.1016/s0195-6701(06)60089-3.

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Khan, O. A., V. C. Weston, and B. E. Scammell. "Methicillin-resistant Staphylococcus aureus incidence and outcome in patients with neck of femur fractures." Journal of Hospital Infection 51, no. 3 (July 2002): 185–88. http://dx.doi.org/10.1053/jhin.2002.1257.

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Greig, J., C. Edwards, M. Wallis, P. Jenks, R. Cunningham, and J. Keenan. "Carriage of meticillin-resistant Staphylococcus aureus among patients admitted with fractured neck of femur." Journal of Hospital Infection 66, no. 2 (June 2007): 187–89. http://dx.doi.org/10.1016/j.jhin.2007.03.016.

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Manniën, Judith, Susan van den Hof, Jan Muilwijk, Peterhans J. van den Broek, Birgit van Benthem, and Jan C. Wille. "Trends in the Incidence of Surgical Site Infection in The Netherlands." Infection Control & Hospital Epidemiology 29, no. 12 (December 2008): 1132–38. http://dx.doi.org/10.1086/592094.

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Objective.To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands.Setting.Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty.Methods.Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance.Results.The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90–0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88–1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83–1.02]).Conclusions.Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.
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Hurbanova, T. S. "MEDICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF PROXIMAL FEMUR FRACTURES IN CITY OF KHARKIV AND KHARKIV REGION POPULATION." International Medical Journal, no. 2 (July 15, 2020): 81–88. http://dx.doi.org/10.37436/2308-5274-2020-2-16.

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Regional clinical and epidemiological characteristics of the patients with the proximal femur fractures have been determined. To perform the research, the following tasks were solved: to establish the prevalence of fractures of the proximal femur depending on age and sex characteristics, place of residence, lesion, features of admission to the clinic, mechanisms of referral, timing of admission, concomitant pathology and comorbid burden, functional level, type of fracture and treatment tactics. The regional epidemiological characteristics of patients with these fractures were retrospectively studied using the date of seven medical institutions of the city of Kharkiv during 2011−2016. The predominance of women with a total average age of all the patients of 70.36±0.20 years and the one of the contingent of the patients aged 71−80 years and older 80 years and older were found. There was a significant prevalence of urban dwellers among the patients. The predominance of patients admitted to trauma departments by ambulance crews was determined. It was stated that the vast majority of respondents received medical care in the first 6 hours after injury. A significant proportion of comorbidly burdened patients with a predominance of the patients with one or two concomitant diseases was identified. Almost identical injuries of both the right and left extremities with a significant predominance of closed fractures and those of type 31A1 and 31B1 according to the classification of the Society for the Study of Osteosynthesis. A certain decrease in functional status was determined according to the classification of the American Society of Anesthesiologists. Conservative treatment was used more often than surgical treatment. Key words: proximal femur fractures, clinical and epidemiological characteristics, concomitant pathology, comorbid burden, age−sexual characteristics, functional status.
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Mizutani, Kento, Kana Isono, Yoshiaki Matsushima, Karin Okada, Ai Umaoka, Shohei Iida, Koji Habe, Kohei Hagimori, Hidetoshi Yamazaki, and Keiichi Yamanaka. "Inflammatory Skin-Derived Cytokines Accelerate Osteoporosis in Mice with Persistent Skin Inflammation." International Journal of Molecular Sciences 21, no. 10 (May 20, 2020): 3620. http://dx.doi.org/10.3390/ijms21103620.

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Secondary osteoporosis can also be caused by chronic inflammatory skin disease as well as rheumatoid arthritis or inflammatory bowel disease. However, the exact role of osteoporosis in inflammatory skin conditions has not been elucidated. Using a mouse model of dermatitis, we investigated the pathophysiology of osteoporosis in inflammatory skin conditions and the therapeutic impact of osteoporosis medication on inflammatory skin disease. We employed model mice of spontaneous skin inflammation, specifically overexpressing human caspase-1 in the epidermis. Bone density and the expression of various mRNAs in the femur were examined by micro CT and RT-PCR. The effects of minodronate and anti-RANKL antibody on bone structure, histology, and femur blood flow were studied. The mouse model of skin inflammation showed a marked decrease in bone density compared to wild-type littermates with abnormalities in both bone resorption and formation. Minodronate improved bone density by decreasing osteoclasts, but anti-RANKL antibody did not improve. In the dermatitis model, the blood flow in the bone marrow was decreased, and minodronate restored this parameter. A model of persistent dermatitis exhibited marked osteoporosis, but the impact of chronic dermatitis on osteoporosis has not been thoroughly investigated. We should explore the pathogenesis of osteoporosis in skin inflammatory diseases.
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Kozhevnikov, O. V., S. E. Kralina, L. N. Furtseva, I. A. Bogdanova, and N. M. Savost’yanova. "Biochemical Changes in Tissues and Synovial Fluid of Hip Joint in Congenital and Degenerative-Dystrophic Diseases in Children and Adolescents." N.N. Priorov Journal of Traumatology and Orthopedics 23, no. 3 (September 15, 2016): 33–40. http://dx.doi.org/10.17816/vto201623333-40.

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Results of biochemical analysis of hip tissues (femoral head cartilage, proximal femur bone tissue, scarry tissue from hip cavity) and synovial fluid in 72 children and adolescents (aged 1 - 18 years) with congenital and pathologic hip dislocation, Legg-Calve-Perthes disease, femoral head aseptic necrosis and early coxarthrosis are presented. In tissue samples the content of hydroxyproline, hexuronic acids and hexoses was determined. In synovial fluid the content of hyaluronic acid, total protein and protein fractions, albumin, glucose and alkaline phosphatase activity was analyzed. It was detected that in congenital and acquired hip pathology the articular cartilage showed increased content of hydroxyproline, disorders of glycosaminoglycan metabolism and shift in glycoprotein metabolism indicative of destructive changes of basic cartilaginous tissue substance. Changes of synovial fluid chemical composition confirmed the disturbance of synovium permeability and were closely related to the clinical picture of metabolic-dystrophic changes in the joint.
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Kozhevnikov, O. V., S. E. Kralina, L. N. Furtseva, I. A. Bogdanova, and N. M. Savost’Yanova. "Biochemical Changes in Tissues and Synovial Fluid of Hip Joint in Congenital and Degenerative-Dystrophic Diseases in Children and Adolescents." Vestnik travmatologii i ortopedii imeni N.N. Priorova, no. 3 (September 30, 2016): 33–40. http://dx.doi.org/10.32414/0869-8678-2016-3-33-40.

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Results of biochemical analysis of hip tissues (femoral head cartilage, proximal femur bone tissue, scarry tissue from hip cavity) and synovial fluid in 72 children and adolescents (aged 1 - 18 years) with congenital and pathologic hip dislocation, Legg-Calve-Perthes disease, femoral head aseptic necrosis and early coxarthrosis are presented. In tissue samples the content of hydroxyproline, hexuronic acids and hexoses was determined. In synovial fluid the content of hyaluronic acid, total protein and protein fractions, albumin, glucose and alkaline phosphatase activity was analyzed. It was detected that in congenital and acquired hip pathology the articular cartilage showed increased content of hydroxyproline, disorders of glycosaminoglycan metabolism and shift in glycoprotein metabolism indicative of destructive changes of basic cartilaginous tissue substance. Changes of synovial fluid chemical composition confirmed the disturbance of synovium permeability and were closely related to the clinical picture of metabolic-dystrophic changes in the joint.
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Kader Media, Shwan. "Evaluation of Bone Densitometry in Rheumatoid Arthritis Case Control Study." Diyala Journal of Medicine 20, no. 1 (April 17, 2021): 50–60. http://dx.doi.org/10.26505/djm.20015731019.

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Background: Rheumatoid arthritis is a systemic autoimmune inflammatory disease that causes joint deformity, including erosion of bone, and narrowing of the joint space. Osteoporosis is more prevalent among rheumatoid arthritis patients than in the general population. Objective: To determine changes in the bone mineral density in rheumatoid arthritis patients and to evaluate factors were associated with bone mineral density. Patients and Methods: In this study, 70 cases with rheumatoid arthritis were included and 70 healthy subjects on the other hand as a control group. The data were collected including socio-demographic information of all patients’age, gender, medical histories included systemic diseases, types of biological agents, use of supplements, duration of the disease, smoking, and regular exercise. Bone mineral density was evaluated by using bone densitometry in two areas including Lumber 1 to lumber 4 and neck of the left femur. Statistical analyses were performed by using Statistical Package for Social Sciences (SPSS) version 22; Fisher’s exact test and Chi-square test Student’s t-test of two independent samples was used to comparing two means. A p-value of ≤ 0.05 was considered statistically significant. Results: In the rheumatoid arthritis group according to T-spine scores the prevalence of osteoporosis was 22.9%, osteopenia was 42.9% and normal bone mineral density was 34.4% compared with the control group 4.3%,42.9%,52.9% successively which were statistically significant difference between the two groups (p = 0.003). According to femur neck T-scores in the rheumatoid arthritis group, 17.1% had osteoporosis, 34.3% had osteopenia and 48.6% had normal bone mineral density compared with the control group 2.9%,24.3%,72.9 respectively which were statistically significant difference between the two groups (p = 0.003). lumber spine was the commonest site affected by osteoporosis (16 cases,22.9 %)and the second most common site was the femur neck (12 cases ,6.6%). The cases of 50 years and older were most commonly affected by osteoporosis (p-value = 0.0001). No significant association was detected between bone mineral density (as assessed with spine T-scores and femur T-scores) with gender, duration of the disease, BMI, exercise, supplement, systemic disease, and diabetes. Conclusion: Osteoporosis and osteopenia were considered as common complications in rheumatoid arthritis, the age of the patient also considered as a risk factor for reduced bone mineral density. Keywords: Rheumatoid Arthritis; Bone Mineral Density; Osteoporosis; Osteopenia
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Antunes, Pontes, Monte, Barbosa, and Ferreira. "Optical Properties on Bone Analysis: An Approach to Biomaterials." Proceedings 27, no. 1 (September 27, 2019): 36. http://dx.doi.org/10.3390/proceedings2019027036.

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The objective of the present study was to investigate the influence of demineralization solution on the optical properties of chicken femoral samples. Biomaterials based on bone have gained importance in clinical applications due to their properties as better osseointegration and biocompatibility. Biomateriais (bone substitute) are essentials to auxiliary in treatment of diseases related to bones such as bone density disorder, low bone mineral mass and the deterioration of bone tissue. Our data shows that integrating sphere technique permits to determinate significant difference in optical properties between healthy and demineralized samples. In this work, the optical properties of bone samples from chicken femur have been measured over the wavelength range 700–1000 nm.
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Zhukov, N. V., and L. L. Kazakova. "The transformation of aneurysmal bone cyst into telangiectatic osteosarcoma: the development of a second tumour or a wrong initial diagnosis?" Pediatric Hematology/Oncology and Immunopathology 19, no. 4 (December 22, 2020): 150–57. http://dx.doi.org/10.24287/1726-1708-2020-19-4-150-157.

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Aneurysmal bone cyst (ABC) and telangiectatic osteosarcoma (TOS) share a lot of similarities in terms of the initial clinical presentation, the radiological semiotics and even the morphological pattern, however, they are completely different nosological entities requiring absolutely different treatment approaches. This article reports a clinical case of TOS of the femur which developed 1.5 years after the treatment of ABC of the same location and presents an analysis of literature on the differential diagnosis of these diseases, the modern concept of the pathogenesis of ABC and the possibility of the transformation of ABC into TOS. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.
50

Khramov, A. E., M. A. Makarov, S. A. Makarov, V. N. Amirdzhanova, A. V. Rybnikov, V. P. Pavlov, and A. A. Askerov. "Intraoperative periprosthetic fractures during total hip arthroplasty in patients with rheumatic diseases." Rheumatology Science and Practice 56, no. 6 (January 22, 2019): 791–96. http://dx.doi.org/10.14412/1995-4484-2018-791-796.

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Surgical treatment in patients with rheumatic diseases (RDs) is associated with the higher risk of complications due to the presence of the inflammatory process, to long-term therapy with glucocorticoids, disease-modifying antirheumatic drugs, and biologic agents (BA), to decreased physical activity, and the severity of functional disorders, and to obvious osteoporosis. All this increases the risk of intraoperative complications, including periprosthetic fractures.Objective: to comparatively analyze intraoperative periprosthetic fractures of the greater trochanter, acetabulum, and proximal femur during total hip arthroplasty (THA) in patients with RDs.Subjects and methods. From 1998 till 2017, a total of 1569 THA were performed in patients with RA, including 464 patients with rheumatoid arthritis (RA), 396 with juvenile rheumatoid arthritis (JRA) and systemic lupus erythematosus (SLE), and 709 with osteoarthritis (OA).Results and discussion. Periprosthetic fractures after THA were diagnosed in a total of 68 (4.33%) patients, including 23 (4.96%) patients with RA, 27 (6.82%) with JRA and SLE, and 18 (2.54%) with OA; 42 (61.8%) patients with periprosthetic fractures underwent osteosynthesis. Statistical analysis of the findings revealed significantly higher rates of complications in patients with RA and JRA with SLE (p < 0.005).Conclusion. The findings confirm that the risk of periprosthetic fractures is higher in patients with inflammatory diseases, including RA, JRA, and SLE. These patients require a special approach that involves medical correction of impaired bone metabolism and proper individual selection of endoprosthetic components, by taking into account the anatomical features of female patients and delicate bone handling during surgery.

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