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  • 1
    Keywords: RISK ; MEN ; body mass index ; EPIC study ; POSTMENOPAUSAL WOMEN ; physical activity ; fat distribution ; elderly ; metabolic syndrome ; anthropometry ; body height ; OLDER-ADULTS ; BODY-MASS-INDEX ; BONE-MINERAL DENSITY ; HIP FRACTURE ; OSTEOPOROTIC FRACTURES ; SELF-REPORT ; Waist-to-hip ratio
    Abstract: Introduction: Hip fractures constitute a major and growing public health problem amongst the elderly worldwide. We examined the association of anthropometry and physical activity with hip fracture incidence in a cohort of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition (EPIC) study. Materials and methods: The study population consisted of 27 982 volunteers (10 553 men and 17 429 women) aged 60 years and above from five European countries. Information on anthropometry, physical activity, medical history and other characteristics was collected at baseline. During a median follow-up of 8 years, 261 incident hip fractures (203 women and 58 men) were recorded. Data were analysed through Cox proportional hazard regression with adjustment for potential confounders. Results: A higher body mass index (BMI) was associated with lower hip fracture risk (hazard ratio (HR) per increasing sex-specific-quintile: 0.85, 95% confidence interval (95% CI): 0.77-0.94). Body height was associated with increased hip fracture risk (HR per 5 cm: 1.13, 95% CI: 1.01-1.25). Waist-to-hip ratio was not related to hip fracture risk. Increasing levels of leisure-time physical activity were related to lower risk (HR per increasing tertile: 0.84, 95% CI: 0.70-0.99, p for trend: 0.039). Conclusions: In a prospective cohort study of elderly Europeans, we found evidence that high body stature increased and high BMI decreased the incidence of hip fractures. After adjustment for BMI, waist-to-hip ratio was not associated with hip fracture risk. Leisure-time physical activity appears to play a beneficial role in the prevention of hip fractures.
    Type of Publication: Journal article published
    PubMed ID: 20863492
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  • 2
    Keywords: EXPRESSION ; SURVIVAL ; ENDOTHELIAL GROWTH-FACTOR ; THERAPY ; TISSUE ; ALPHA ; ISCHEMIA-REPERFUSION INJURY ; ISCHEMIA/REPERFUSION INJURY ; RAT MODEL ; MUSCLE FLAPS ; NITRIC-OXIDE DONOR ; Shock wave treatment ; Skin flap
    Abstract: Advances in the treatment of ischemia-reperfusion injury have created an opportunity for plastic surgeons to apply these treatments to flaps and implanted tissues. Using an extended inferior epigastric artery skin flap as a flap ischemia-reperfusion injury (IRI) model, we examined the capability of extracorporeal shock wave treatment (ESWT) to protect tissue against IRI in a rat flap model. Twenty-four rats were used and randomly divided into three groups (n = 8 for each group). Group I was the sham group and did not undergo ischemic insult; rather, the flap was raised and immediately sutured back (non-ischemic control group). Group II (ischemia control) and Group III (ESWT) underwent 3 h of ischemic insult. During reperfusion Group III was treated with ESWT and Group II was left untreated. Histological evaluation was made to investigate treatment induced tissue alterations. Survival areas were assessed at 5 d postoperatively. Skin flap survival and perfusion improved significantly in the ischemic animals following ESWT (p 〈 0.001, respectively). The tissue protecting effect of ESWT resulted in flap survival areas and perfusion data equal to non-ischemic, sham operated flaps. In line with the observation of better flap perfusion, tissue from ESWT-treated animals (Group III) revealed a significantly increased frequency of CD31-positive vessels compared to both the ischemic (Group II; p = 0.003) and the non-ischemic, sham operated control (Group I; p 〈 0.005) and an enhanced expression of pro-angiogenic genes. This was accompanied by a mild suppression of pro-inflammatory genes. Our study suggests that ESWT improves flap survival in IRI by promoting angiogenesis and inhibiting tissue inflammation. The study identifies ESWT as a low-cost and easy to use technique for surgical techniques that aim at reducing ischemia-reperfusion-induced tissue injury
    Type of Publication: Journal article published
    PubMed ID: 22186230
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  • 3
    Keywords: POSITRON-EMISSION-TOMOGRAPHY ; RECONSTRUCTION ; OSTEOBLAST-LIKE CELLS ; CEMENT ; OSTEOCLAST ; BONE-GRAFT SUBSTITUTES ; STRONTIUM RANELATE ; CALCIUM-CARBONATE ; F-18-FLUORIDE ; HISTOMORPHOMETRY
    Abstract: The aim of the current study was to measure and compare the effect of calcium phosphate cement (CPC) and CPC enriched with strontium (SrCPC) for the healing of osteoporotic bone defects in the rat femur using F-18-Sodium Fluoride dPET-CT. Methods: Osteoporosis was induced by ovariectomy and a calcium restricted diet. After three months, rats were operated to create a 4 mm defect in the distal metaphyseal femur with internal fixation. 7 Rats have been treated either with CPC (Group 2) or with SrCPC (Group 3) for bone replacement and defect healing. Furthermore, a control group of 7 rats without any biomaterial (Group 1) was used for reference. 18 weeks after osteoporosis induction and 6 weeks following femoral surgery, dPET-CT studies scan were performed with 18F-Sodium Fluoride. SUVs and a 2-tissue compartmental learning-machine model (K1-k4, VB, influx) were used for quantitative analysis. Results: VB, reflecting the fractional blood volume and k3, reflecting the formation of fluoroapatite were the most sensitive parameters for the characterisation of healing process and revealed the best differentiation for the control group and the CPC group (Group 2) as well as for the CPC with strontium carbonate group (Group 3) (p 〈 0.05). VB was decreased by the order of Group1, Group 2 and Group3, while k3 was increased by the same order. Therefore, the data direct to a decreased fractional blood volume and increased fixation of fluoride in rats with these biomaterials. Conclusion: We found PET scanning using F-18-Sodium Fluoride to be a sensitive and useful method for evaluation of bone healing after replacement with CPC or SrCPC.
    Type of Publication: Journal article published
    PubMed ID: 24332163
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  • 4
    Keywords: EXPOSURE ; radiation ; TIME ; PATIENT ; REDUCTION ; DIFFERENCE ; fluoroscopy-based surgical navigation,virtual fluoroscopy,distal locking,intramedullary nailing,expo ; ORTHOPEDIC SURGEON ; RADIATION-EXPOSURE
    Abstract: A prospective controlled clinical study was performed to compare fluoroscopic guidance with fluoroscopy-based surgical navigation for distal Locking of intramedullary implants. Forty-two patients with fractures of the tower extremity treated by intramedullary nailing were divided in two groups: distal locking either with fluoroscopic guidance (group I) or with surgical navigation (group II). The average fluoroscopic time to insert one interlocking screw with fluoroscopic guidance was 108 s compared with 7.3 s in the navigation group. The average procedure time to insert one interlocking screw in group I was 13.7 min compared with 17.9 min in group II. The drill bit failed to pass through the interlocking hole in one patient from group II. There was no significant difference in the technical reliability between both groups. Fluoroscopic times to achieve equivalent precision are reduced with fluoroscopy-based surgical navigation compared with fluoroscopic guidance. Fluoroscopy-based surgical navigation is recommended for intraoperative guidance in situations where reduction of exposure to radiation is considered advantageous over the increase of procedure time. (C) 2003 Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 15135275
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  • 5
    Keywords: DISEASE ; metastases ; MUSCLE ; DCE-MRI ; MARROW ; LONGITUDINAL IN-VIVO ; FRACTURES ; VCT
    Abstract: Angiogenesis is pivotal for bone metabolism and bone defect healing. Yet the role of vascularization in osteoporosis and osteoporotic bone repair mechanisms is unclear. Here we investigated effects of osteoporotic phenotype on vascularization during bone defect healing in a rodent osteotomy model using volumetric computed tomography (VCT), dynamic contrast-enhanced VCT (DCE-VCT), dynamic contrast-enhanced MRI (DCE-MRI) and histology. In 16 rats, 8 with physiological bone status (SHAM) and 8 with osteoporotic bone status induced by ovariectomy (OVX) in combination with a vitamin D- and low calcium diet, wedge-shaped defects were created at the left distal femur and stabilized internally by T-shaped miniplate. MRI and VCT were performed in all animals 6 weeks after this procedure. By VCT, relative bone density in the defect was evaluated. Using DCE-VCT and DCE-MRI, parameters associated with regional blood volume were calculated in the bone defect, vicinity of the defect, surrounding muscles and bone marrow: Amplitude A and exchange rate constant Kep (DCE-MRI, respectively) as well as peak enhancement PE and area under the curve AUC (DCE-VCT, respectively). In animals of osteoporotic phenotype, bone density within the osseous defect was significantly reduced as compared to SHAM rats. Vascularization parameters determined by DCE-MRI and DCE-VCT in the defect were significantly elevated compared to the adjacent tissues for both SHAM and OVX groups. However, comparing SHAM and OVX rats, no statistically different values were found by DCE-MRI and DCE-VCT concerning any determined vascularization parameter within the bone defect. Furthermore, parameters of vascularization were increased for OVX as compared to SHAM rats within the bone marrow although significant difference was only found for A. In a rat osteotomy model we showed that at the reparative healing stage, osteoporotic phenotype did influence osteogenic but not angiogenic response within bone defect as imaged by DCE-MRI and DCE-VCT. This study provides insight into the relationship between angiogenesis and osteogenesis during osteoporosis-related compromised bone healing.
    Type of Publication: Journal article published
    PubMed ID: 23522092
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