Osteonekroza żuchwy

This review looks at osteonecrosis in the stomatognathic system (mainly the jaws). Osteonecrosis of the jaw (ONJ) is a rare but serious clinical condition. It affects patients treated with bisphosphonates, and also with denosumab, mainly in oncological doses. In osteoporosis, it is a problem of relatively small significance. Article presents a thorough review of this phenomenon, including its definition, pathogenesis, risk factors, prevention and treatment methods, and its incidence rate. (Pol J Endocrinol 2011; 62 (1): 88-92)Praca poglądowa dotyczy osteonekrozy w układzie stomatognatycznym (głównie żuchwy). Osteonekroza żuchwy jest zjawiskiem rzadkim, ale poważnym. Dotyczy pacjentów leczonych bisfosfonianami, ale także denosumabem, głównie w dawkach onkologicznych. W osteoporozie jest to problem o bardzo małym znaczeniu. W pracy przedstawiono: definicję, patogenezę, czynniki ryzyka, sposoby zapobiegania i leczenia oraz częstość występowania tego zjawiska. (Endokrynol Pol 2011; 62 (1): 88-92

Jakość szkieletu i stan funkcjonalny u pacjentów po odległym udarze mózgu

Introduction: Skeletal and functional status can be affected after stroke, mainly due to subjects&#8217; immobilisation. The aim of our study was to assess the functional and bone status in post-stroke patients with hemiplegia. Quantitative ultrasound at hand phalanges and bone mineral density (BMD) in the wrist and the calcaneal bone were compared between the paralysed and the non-paralysed side. The study was performed at the Department of Rehabilitation in Nowa Sol. Material and methods: The study included a group of 71 subjects (29 females and 42 males) who had suffered a stroke. Skeletal status was assessed by densitometry (Pixi, Lunar Corp., USA, forearm, calcaneus) and ultrasound (DBM Sonic 1200, IGEA, Italy, hand phalanges). Functional status was evaluated by the Barthel index. Results: The mean values of forearm BMD and ultrasound measurements were significantly lower in the affected limbs versus the opposite site. The mean Barthel index value was 73 &#177; 21.5. Reduction of the time interval between stroke and standing up positively influenced the difference between wrist BMD in the affected versus the opposite limb, both in the whole group of patients (r = 0.3, p < 0.05) and females (r = 0.41, p < 0.05). Forearm BMD in males in the affected limb correlated with the Barthel index (r = 0.35, p < 0.05). Conclusion: Fracture risk in post-stroke subjects may be increased due to disturbed skeletal and functional status. Reduction of the time interval between stroke and standing up improved wrist densitometric results. (Pol J Endocrinol 2011; 62 (1): 2-7)Wstęp: Unieruchomienie spowodowane udarem mózgu może być przyczyną obniżonej jakości tkanki kostnej i funkcjonalnej sprawności chorego. Celem pracy była ocena stanu kostnego i funkcjonalnego pacjentów z niedowładem połowiczym będącym następstwem udaru. Dokonano obustronnego porównania pomiarów prędkości fali ultradźwiękowej paliczków rąk oraz gęstości mineralnej kości piętowych i przedramion. Badanie przeprowadzono na Oddziale Rehabilitacji Szpitala w Nowej Soli. Materiał i metody: Zbadano 71 osób po przebytym udarze (29 kobiet i 42 mężczyzn). Pomiary densytometryczne aparatem PIXI (Lunar, Stany Zjednoczone) i ultradźwiękowe aparatem DBM Sonic (Igea, Włochy) zestawiono z oceną sprawności za pomocą skali Barthel. Wyniki: Średnie wartości pomiarów ultradźwiękowych i gęstości mineralnej kości (BMD, bone mineral density) przedramion były znamiennie obniżone po stronie porażonej. Wskaźnik Barthel wynosił średnio 73 &#177; 21,5 pkt. Skrócenie czasu pomiędzy wystąpieniem udaru a pionizacją pozytywnie wpływało na różnice między BMD kości przedramion po stronie niedowładnej i przeciwnej w całej grupie (r = 0,3, p < 0,05) i u kobiet (r = 0,41, p < 0,05). Gęstość mineralna kości przedramion po stronie porażonej u mężczyzn korelowała ze wskaźnikiem Barthel (r = 0,35, p < 0,05). Wnioski: Ryzyko złamań wśród pacjentów po udarze może być zwiększone z powodu zaburzeń tkanki kostnej i stanu funkcjonalnego. Skrócenie czasu między udarem a pionizacją poprawiało wartości densytometryczne przedramion. (Endokrynol Pol 2011; 62 (1): 2-7

Martwica żuchwy

The paper concerns osteonecrosis of the jaw (ONJ). It is a rare but serious clinical condition. It can develop in patients treated in oncologic doses with bisphosphonates but also with denosumab. In osteoporosis ONJ seems to be very rare. Definition, pathogenesis, risk factors, prevention and treatment, and the frequency of ONJ are presented. (Pol J Endocrinol 2011; 62 (education supplement III): 4&#8211;9)W pracy przedstawiono informacje na temat martwicy w układzie stomatognatycznym, głównie żuchwy (ONJ). Martwica żuchwy jest zjawiskiem rzadkim, ale poważnym. Dotyczy pacjentów leczonych bisfosfonianami, ale także denosumabem, głównie w dawkach onkologicznych. W osteoporozie jest to problem o bardzo małym znaczeniu. W pracy przedstawiono: definicję, patogenezę, czynniki ryzyka, sposoby zapobiegania i leczenia oraz częstość występowania tego zjawiska. (Endokrynol Pol 2011; 62 (zeszyt edukacyjny III): 4&#8211;9

Osteoporotic fractures

W pracy przedstawiono aktualne dane dotyczące złamań osteoporotycznych (definicje złamań, przyczyny, cechy epidemiologiczne i kliniczne, powikłania, sposoby leczenia) ze szczegółowym opisem najczęstszych złamań osteoporotycznych: końca dalszego kości promieniowej, trzonów kręgowych oraz końca bliższego kości udowej.The paper presents actual data concerning osteoporotic fractures (definitions, causes, epidemiologic and clinical data, consequences, treatment) particulary data about the most common fractures (distal forearm, vertebral and proximal hip fractures)

Upadki u kobiet po menopauzie w wieku ponad 55 lat w epidemiologicznym badaniu RAC-OST-POL

  Introduction: Falls are often noted in elderly women. They may have serious clinical consequences. The aim of the study is the presentation of epidemiological data on falls in postmenopausal women. Material and methods: A total of 978 women in mean age 65.9 ± 7.6 years from the population of Raciborz district were included. In a questionnaire the following data were gathered: falls in last 12 months, place of stay, kind of job, marital status, education, smoking, underlying diseases, and used medications. Results: Falls occurred in 328 women (33.5%). The number of falls correlated positively with increasing age, (r = 0.13, p &lt; 0.0001). The falls rate was not related to weight and height, but weak, significant correlation with body mass index was noted (r = 0.076, p&lt; 0.05). Among 286 women with prior osteoporotic fracture falls were present in 40.9%, which was significantly more than the 30.4% seen in women without fracture (Chi-square test; 10.05; df = 1; p &lt; 0.01). Falls were fewer often among women from the city of Raciborz (29.8%) than in women from the rural population (39.7%). After adjustment for age, rural stay, diabetes type 1, renal failure, rheumatoid arthritis, bronchial asthma, and depression revealed influence on falls occurrence. As was shown by logistic regression, age, rural stay, prior fracture, diabetes type 1, bronchial asthma, and depression increased the risk of fall. The cumulative number of these risk factors correlated with the number of falls (r = 0.22, p &lt; 0.000001). Conclusions: Falls are common among postmenopausal women, and their occurrence is modified by several factors including age, place of stay, and some co-morbidities. (Endokrynol Pol 2016; 67 (2): 185–189)    Wstęp: Upadki są częste u starszych kobiet i mogą powodować wiele poważnych konsekwencji. Celem pracy było przedstawienie występowania upadków w epidemiologicznej próbce kobiet po menopauzie. Materiał i metody: W badaniu brało udział 978 kobiet po menopauzie w średnim wieku 65,87 ± 7,63 lat z powiatu raciborskiego. W kwestionariuszu zebrano dane dotyczące upadków w okresie 12 miesięcy przed badaniem, miejsca zamieszkania, rodzaju pracy, stanu cywilnego, wykształcenia, palenia tytoniu, chorób i stosowanej terapii. Wyniki: Upadki wystąpiły u 328 kobiet (33,54%). Liczba upadków wzrastała z wiekiem (r = 0,13, p &lt; 0,0001). Masa ciała i wzrost nie wpływały na występowanie upadków, a słaby, ale znamienny wpływ wykazywał indeks masy ciała (r = 0,076, p &lt; 0,05). Wśród 286 kobiet z wcześniejszym złamaniem osteoporotycznym upadki zanotowano u 40,9% pacjentek, znamiennie częściej niż u kobiet bez złamań, u których upadki zanotowano u 30,4% (Chi-square test; 10,05; df = 1; p&lt; 0,01). Upadki były rzadsze u kobiet z Raciborza (29,8%) niż kobiet z terenów wiejskich (39,7%). Na częstość występowania upadków, po uwzględnieniu wieku, miało wpływ zamieszkanie na wsi, cukrzyca typu 1, niewydolność nerek, gościec stawowy, astma oskrzelowa i depresja. Za pomocą regresji logistycznej wykazano, że wiek, zamieszkanie na wsi, wcześniejsze złamanie, cukrzyca typu 1, astma oskrzelowa i depresja zwiększały ryzyko upadków. Im większa była liczba tych czynników, tym ryzyko upadków wzrastało (r = 0,22, p &lt; 0,000001). Wnioski: Upadki są powszechne u kobiet po menopauzie, a na ich występowanie wpływ mają wiek, miejsce zamieszkania i niektóre choroby. (Endokrynol Pol 2016; 67 (2): 185–189)

Presence of human papilloma virus in Caucasian women living in the central Europe diagnosed with vulvar intraepithelial neoplasia

Objectives: The role of human papilloma virus (HPV) in the development of cancerous states of female reproductive tracthas been widely debated. However, the information about presence of HPV in the Caucasian women living in the centralEurope diagnosed with vulvar intraepithelial neoplasia (VIN) is missing. So far, no recommendation was made to completeHPV detection in time of vulvar biopsy or after the results of positive VIN are obtained. We aimed to assess the presence ofHPV in women with vulvar intraepithelial neoplasia diagnosed at the Department of Gynecology, Obstetrics and OncologicalGynecology in Bytom, Poland.Material and methods: The retrospective examination of 120 consecutive vulvar biopsies obtained from women withpersistent vulvar itching was done. Only patients with diagnosis of VIN were included in the further analysis. HPV DNAwas detected using HPV Linear Array Genotyping Test including 14 HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56,58, 59, 66, 68).Results: Out of 120 vulvar samples retrieved, 18 women were positive for VIN, including15 usual VIN (uVIN) and three differentiatedtype (dVIN ). 10 samples were eligible for DNA detection. HPV DNA was found in two women with uVIN (HPV16 and 51).Conclusions: It is advisable to recommend HPV genotyping in women with VIN, regardless of their age and histologic type.The incidence of HPV infection in Caucasian women from the central Europe with VIN should be further studied

Functional status as a predictor of the incidence of falls in 10-year follow-up: results from the RAC-OST-POL study

Introduction: The aim of this prospective study was to establish the influence of baseline functional status on the incidence of falls. Material and methods: The study was performed in an epidemiological sample of postmenopausal women from the RAC-OST-POL study. At baseline there were 978 postmenopausal women with a mean age of 65.9 ± 7.6 years, and at the end of 10-year follow-up 640 patients with a mean age of 65.04 ± 6.95 years remained in observation. Functional status was established at baseline using a stand up and go test (SAG) and the Lawton Instrumental Activities of Daily Living (IADL) scale. Afterwards, data on fall incidence were updated annually using phone interviews. Results: In a 10-year period of observation, in 384 (60%) women at least one fall occurred. At baseline, 90% of subjects achieved maximal value in the IADL scale (24 points). Although the difference between mean IADL score in those who fell and did not fall was noticeable (23.50 ± 1.68 vs. 23.65 ± 1.47, respectively), the category of any IADL score below 24 points was significantly more frequent in women with falls (71.9% vs. 28.1%; chi-square 4.2, p &lt; 0.05). The SAG score in the subgroup with falls was (10.75 ± 3.39) and did not differ in comparison to subgroup without falls (10.27 ± 2.72). Conclusion: The baseline result of the IADL scale but not that of the SAG test are related to the incidence of falls in a 10-year prospective observation. Adequate correction of functional status may benefit patients and reduce the fall rate

Low dietary calcium intake does not modify fracture risk but increases fall frequency: the results of GO Study

Introduction: The aim of the study was to verify the thesis that dietary calcium intake influences the risk of osteoporotic fractures established by online available calculators. Material and methods: The study was performed in 521 postmenopausal women aged over 55 years, recruited in one osteoporotic outpatient clinic. Mean age was 67.7 ± 8.6 years. Fracture risk was established using FRAX (major and hip fractures, 10 years), Garvan calculator (any and hip fractures, 5 and 10 years), and the Polish algorithm available at www.fracture-risk.pl (any fractures, 5 years). Bone densitometry at the femoral neck was performed using a DPX device (Lunar, GE, USA) to calculate fracture risk by each of those calculators. Calcium intake was established based on a dietary questionnaire. Results: Mean values of fracture risk for all three calculators and T-score value for DXA measurement at the femoral neck did not correlate with calcium intake. A tendency to insignificantly lower calcium intake was observed in the subgroup with high hip fracture risk by FRAX (≥ 3%) vs. low hip FRAX (&lt; 3%): 744 ± 328 mg/day vs. 765 ± 299 mg/day. The same analysis for FRAX major fracture risk revealed a similar tendency: 700 ± 299 mg/day and 760 ± 311 mg/day in high (≥ 20%) and low (&lt; 20%) fracture-risk groups, respectively. Calcium intake did not influence the results obtained in the other two calculators at all. Calcium intake did not differ between subjects with prior falls and those without falls. However, if the number of falls was taken into account, the women who reported three and more falls had significantly lower calcium intake (621 ± 275 mg/day) than subjects with no falls (767 ± 304 mg/day; p &lt; 0.05) or those with one fall (766 ± 317 mg/day; p &lt; 0.05). Conclusions: Calcium intake does not correlate with fracture risk established by calculators available on-line, but low calcium intake may increase the risk of falls.

The efficacy of pharmacotherapy in postmenopausal osteoporosis: a longitudinal observational study

Introduction: The aim of the study was an assessment of longitudinal changes in fracture probability in postmenopausal women. Material and methods: A group of 226 postmenopausal women at baseline mean age 66.46 ± 7.96 years were studied. There were 21 women without therapy, 102 taking calcium + vitamin D, and 103 women on antiresorptive therapy, in the study group. Data concerning clinical risk factors for osteoporosis and hip BMD were gathered. Fracture probability for major and hip fractures was established using FRAXTM. Results: Mean follow-up time was 2.43 ± 0.59 years. Baseline FRAX value in the whole group for major fracture was 7.1 ± 4.18, and at follow-up it was 7.44 ± 4.04. Respective results for FRAX for hip fracture were 3.17 ± 2.69 and 3.02 ± 2.35. In the whole group the probability for major fractures significantly increased during follow-up (p &lt; 0.05) and for hip fracture did not change. In non-treated patients and patients taking calcium + vitamin D the fracture probability increased significantly. In patients on antiresorptive therapy the fracture probability did not change, which was connected with an improvement in bone status assessed by DXA. Femoral neck T-score in the whole group did not change, in those not treated and taking calcium + vitamin D it decreased significantly (p &lt; 0.05), while in treated women it increased significantly (p &lt; 0.05). In patients with improved bone status the FRAX values for major and hip fractures decreased by 0.44 ± 1.62 and 0.36 ± 1.19, respectively. Conversely, in patients with worsening T-score value the FRAX values increased by 1.33 ± 1.42 and 0.66 ± 1.25, respectively. Conclusion: Antiresorptive therapy stabilises fracture probability in postmenopausal women due to improvement in bone status