Scoliosis and spine involvement in fibrous dysplasia of bone

Few studies focused on the prevalence of scoliosis and involvement of the spine in patients with fibrous dysplasia (FD) of bone. We examined for FD involvement of the spine and scoliosis in 56 patients affected by FD of bone. Fifty patients were part of a cohort reported in a multicentric study on FD promoted by European Pediatric Orthopedic Society (EPOS) in 1999, and six were new patients. There were 30 females and 26 males (mean age 12.5 years; range 1–42 years). Twenty-three had monostotic FD, 9 polyostotic FD, and 24 McCune-Albright Syndrome (MAS). Scoliosis was observed in 11 cases of polyostotic FD and MAS (33.3%). In seven of the patients with scoliosis (63.3%) spine was involved by FD lesional tissue. FD lesions involved the thoracic or lumbar spine in all patients but one, where cervical spine was also affected. A correlation between scoliosis and either spinal (p < 0.01) or pelvic lesions (p < 0.05) and pelvic obliquity (p < 0.01) was observed. Three of the 11 patients showed familiarity for scoliosis but in 2 of them spine was involved by FD. Scoliosis and spine involvement were never detected in monostotic FD. This study indicates that in FD patients with polyostotic disease (1) the prevalences of FD involvement of the spine and scoliosis are high enough to include spine in the clinico-radiographic survey of these patients, and (2) the involvement of the spine and pelvis by FD lesions and pelvic obliquity are important determinants in the occurrence of scoliosis

Líquido amniótico, atividade física e imersão em água na gestação Amniotic fluid, physical activity and water immersion during pregnancy

O objetivo desta revisão foi avaliar a inter-relação entre volume do líquido amniótico, atividade física e imersão em água na gestação. Utilizando diferentes combinações desses termos, foram consultadas as bases de dados do MedLine e do Scielo, no período de 1980 a 2005 para a identificação de artigos relevantes ao assunto. O líquido amniótico é fundamental no desenvolvimento dos sistemas músculo-esquelético, gastrointestinal e respiratório fetal. Sua avaliação no passado era imprecisa, mas com o advento da ultra-sonografia, tornou-se fácil e não invasiva. Surgiram técnicas para a aferição do seu volume e curvas de normalidade. Mais recentemente, têm-se tentado diversas técnicas para a correção do seu volume, na tentativa de diminuir a morbidade associada. Um método não invasivo muito utilizado no Brasil é a hiperhidratação materna. Outros autores sugerem medidas como a imersão estática ou com atividade física em água, muito na moda nos dias de hoje. Ainda são poucos os estudos relativos à prática da atividade física na água para gestantes e seus benefícios maternos, fetais e perinatais. A presente revisão visa aprofundar os conhecimentos acerca dos exercícios aeróbicos sob imersão de gestantes em água, no que diz respeito ao volume de líquido amniótico e bem-estar fetal durante a gestação.<br>The objective of this paper was to assess the relationship between amniotic liquid volume, physical activity and immersion in water during pregnancy. By using different combinations of these terms MedLine and Scielo databases were consulted in the period of 1980 and 2005 for subject related articles. Amniotic liquid is fundamental for fetal muscle skeletal, gastrointestinal and respiratory systems development. In the past amniotic liquid evaluation was poor but with the introduction of ultrasonography it has become easy and non-invasive. New techniques to measure volume and normality curves emerged. More recently, several new techniques for volume correction have been tried in an attempt to reduce associated morbidity. A non-invasive method intensively used in Brazil is maternal hyper hydration. Other authors suggest water immersion techniques, static or with physical activity, quite in use these days. Nowadays there are yet few studies on physical exercise in the water for pregnant women related to maternal, fetal and perinatal benefits. This paper aims at a more in-depth study of water immersion aerobic exercises for pregnant women in connection with amniotic liquid volume and fetal well being