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JFSF 2017

Original article JFSF, Vol 2, No 1, March 2017, p.1-5
The effect of a new oral anticoagulant (Rivaroxaban) on implants pull-out strength. An experimental study in rats
Artemis G. Kapetanou, Matthaios S. Savvidis, Michel E. Potoupnis, George E. Petsatodis, John M. Kirkos, George A. Kapetanos
Keywords: Anticoagulation, Osseointegration, Oral, Pull-out, Rivaroxaban
Abstract
Objectives: Thromboprophylaxis reduces the risk of surgery related deep venous thrombosis and pulmonary embolism. The classical anticoagulants (heparin and LWMH) were associated with systemic osteoporosis, poor bone healing and materials’ osseointegration. There is a lack of data concerning the effect of the new orally administered anticoagulants on osseointegration. The aim of this study is to investigate the possible effect of rivaroxaban, a direct anti-Xa factor, on osseointegration. Methods: Twenty eight white, male, Wistar rats were divided into two groups: Group A, study group (n=14) and group B, control group (n=14). In all animals under general anesthesia one screw was inserted on the right tibia. For twenty eight days the animals of group A received intraperitoneal rivaroxaban injections 5mgr/kgr every day. The animals of group B received intraperitoneal equal amount of normal saline injections. At the end of the four weeks all animals were sacrificed and their right tibias were excised and underwent the pull-out test. Results: The mean values of pull-out test were 92,10±19,12N for the control group and 95,46±21,02N for the study group. The statistical analysis using t-test showed no significant difference (p=0,665) for the pull-out test. Conclusions: These results indicate that Rivaroxaban hasn’t got any deleterious effect on the osseointegration of implants on rats.
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Case Report Article JFSF, Vol 2, No 1, March 2017, p.6-8
From pruritus to CREST syndrome in a middle aged woman
Nikolaos D. Karakousis, Charis A. Kanakas
Keywords: Cholestasis, CREST Syndrome, Liver, PBC, Scleroderma
Abstract
CREST syndrome, a subtype of scleroderma and Primary Biliary Cholangitis, is an autoimmune disease where the immune system is causing a progressive slow damage to the bile ducts. We report the case of a 67-year-old female patient presenting symptoms indicative of CREST syndrome. During her hospitalization in the internal medicine clinic and after the appropriate imaging and laboratory investigation the diagnosis of CREST syndrome was confirmed, and she was also diagnosed with PBC. This case adds up to a list of literature sources and several case reports which indicate the association of PBC and CREST syndrome, including the accompanied clinical symptoms and musculoskeletal manifestations of the latter.
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Case Report Article JFSF, Vol 2, No 1, March 2017, p.9-11
Vertigo as the first manifestation of paget’s disease: a case report
Konstantinos Boukas, George Bazoukis
Keywords: Paget disease, Vertigo, Bone disease, Neurological complications, Osteitis deformans
Abstract
Paget’s disease of bone is characterized by the dysfunction of the bone architecture due to the extreme increase of the osteoclast and osteoblast activity which results in the production of pathological bone. The particular disease afflicts any skeleton bone. Its sources have not been specified yet. There is evidence for the existence of strong genetic background as well as the effect of environmental factors. The neurological complications are relatively rare and are related to the central and peripheral nervous system (headache, ataxia, vertigo, loss of hearing, smell etc.). In our case, we present a patient with vertigo as the first manifestation of Paget’s disease.
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Mini Review Article JFSF, Vol 2, No 1, March 2017, p.12-15
Frailty and bone health in European men
Aggeliki Giannopoulou
Keywords: Frailty, Aging, Male health, Bone health, Epidemiology
Abstract
Frailty is a geriatric syndrome, which is characterized by the decline of the functions of older people systems, resulting in the exposure of one’s health at risk, disability and mortality. Older people lose their autonomy and independence, quality of life and their psychological state is decreased. Frailty is a syndrome with multiple manifestations and with no single feature being enough in its presentation, many signs and symptoms determinate it, which frame the "frailty clinical phenotype". The rates of frailty are constantly increasing, due to the increase of the aging population in Western countries. In Europe, these percentages are higher in the Mediterranean countries, on the contrary to the Nordic countries. For this reason it is important to prevent the syndrome and its effects, in order to improve the elderly population quality of life. The aim of this study is to review assessment tools for frailty, to flag consequences of this syndrome, to mention the epidemiological data in European community-dwelling population and mainly in European men, to accent the correlation between frailty and bone health and to report the treatment of frailty.
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Mini Review Article JFSF, Vol 2, No 2, June 2017, p.16-20
Headache in patients with Paget’s Disease of Bones
Gerasimos Evangelatos, Alexios Iliopoulos
Keywords: Denosumab, Headache, Paget’s disease of bones, Zolendronic acid
Abstract
Paget’s disease of bone (PDB) is a focal remodeling disorder of unknown origin. Head bones are frequently involved and patients may suffer from deformities and specific symptoms, mainly headache, or neurological deficits, such as deafness. Several pathophysiological entities can give rise to headache in PDB patients. Clinical, laboratory, radiological and scintigraphic findings contribute to distinguish headache related to PDB from other causes of headache. Up to the present, treatment with intravenous zolendronic acid has been reported to improve symptoms of PDB and induce long-standing biochemical and scintigraphic remission. In this review, the main strands of literature about epidemiology, pathophysiology, clinical characteristics and treatment of PDB-related headache are drawn together.
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Review Article JFSF, Vol 2, No 2, June 2017, p.21-27
Diagnosis of osteoporosis in dental patients
Theodora S. Tounta
Keywords: Osteoporosis, Panoramic x-rays, Mandibular cortex, Periodontitis, Tooth loss
Abstract
Osteoporosis is a severe skeletal disease that leads to bone fractures, even disability, if it remains undetected. However, osteoporosis remains frequently unnoticed until a fracture occurs. It is possible for dental practitioners to screen patients at risk of osteoporosis and refer them for an osteoporosis evaluation. Screening can be achieved mainly through dental radiographs and especially panoramic x-rays, where several radiographic indices, such as Mandibular Cortical Width (MCW), Mandibular Cortical Index (MCI), Gonial Index (GI), Antigonial Index (AI), Panoramic Mandibular Index (PMI) and alveolar crest resorption degree (M/M ratio) can be assessed. Furthermore, patients with osteoporosis develop changes in the trabecular bone of their jaws and those alternations can be detected by dentists through periapical and panoramic x-rays. Moreover, periodontitis, which is a major reason for tooth loss, deteriorates when the patient also suffers from osteoporosis. Dentists can thus screen their patients who are possibly unaware of their osteoporosis, and refer them further for dual-energy X-ray absorptiometry (DXA) examination. However, all the above indices are merely indicative of low skeletal bone mineral density and the dentist must always take into account the medical history and clinical risk factors of osteoporosis before further referring to an osteoporosis specialist
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Mini Review Article JFSF, Vol 2, No 2, June 2017, p.28-32
Obesity and its relationship with falls, fracture site and bone mineral density in postmenopausal women
Stella Sotiriadi-Vlachou
Keywords: Obesity, Elderly, BMI, Postmenopausal woman, Fractures
Abstract
Obesity in elder women is a difficult problem for public health, as it is related to increased incidence of all-related injuries and fractures. The kind of fall-related fracture seems to relate to the distribution of body mass. A review of the literature was carried out based on systematic searches of electronic databases (PubMed/ Medline). The results of this mini-review did not support that obesity increases the risk of falls during post-menopause compared to normal weight women. However, there was a relation between obesity and site of fractures.
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Mini Review Article JFSF, Vol 2, No 2, June 2017, p.33-38
Risk of falls in chronic kidney disease
Konstantina Papakonstantinopoulou, Ioannis Sofianos
Keywords: Chronic kidney disease, Accidental falls, End stage renal disease, Hemodialysis
Abstract
Chronic Kidney Disease (CKD) is known to be an important risk factor for accidental, low-energy falls especially among elder individuals. The high incidence of falls is a major cause of morbidity and mortality with a substantial annual cost. Patients suffering from CKD are more prone to fall and develop fractures than the general population. Multiple risk factors have been identified and analyzed in order to explain this fact, such as drug combination, diabetes mellitus, orthostatic hypotension, vitamin D deficiency, sarcopenia and anemia, all very common in CKD. In this mini review of published evidence, we tried to search and present a complete aspect of the problem called ‘Falls in Chronic Kidney Disease’, focusing especially on the risk factors, discussing each one separately and its association with low- energy falls. Concluding, we discuss potential therapies and treatment goals based on the pathophysiology of CKD and accidental falls and propose new fields of investigation.
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Original Article JFSF, Vol 2, No 3, September 2017, p.39-44
Evaluation of commonly used nutritional assessment methods in hip fracture patients
Amalia Tsagari, Evaggelia Papakitsou, Yannis Dionyssiotis, Stavroula Rizou, Antonios Galanos, George P. Lyritis
Keywords: Hip fracture, Malnutrition, Mini Nutritional Assessment, Anthropometry, Biochemical markers
Abstract
Objective: Malnutrition is a common problem in hip fracture patients. The prevalence of malnutrition and available nutritional markers for use for nutritional assessment in this population group was investigated. Methods: This is a case control study including 214 patients with a hip fracture from “KAT” Hospital in Athens, Greece, and 108 controls from three Elderly Open Protection Centers. Main outcome measures were anthropometric [Body Mass Index (BMI), triceps skinfold thickness (TST) and mid-arm muscle circumference (MAMC)] and biochemical parameters (serum albumin and serum cholesterol). Mini Nutritional Assessment (MNA) was used for malnutrition assessment. Results: Based on MNA score only, we found 19.5 % vs. 0.9% malnourished, 54.6% vs. 32.4% at risk and 25.9% vs. 66.7% well-nourished, in hip fracture group and controls, respectively. All anthropometric parameters of malnutrition were significantly lower in the hip fracture patients compared to controls (p value<0.05). Serum albumin and serum-cholesterol levels correlated negatively significantly with s-CRP levels (R2=0.247, p<0.001 and R2=0.06, p<0.001, respectively) in the hip fracture group. Conclusions: Hip fracture patients are often malnourished. MNA application may be helpful in identifying malnourished hip fracture patients. Moreover, serum cholesterol may be a useful marker of malnutrition in hip fracture patients.
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Review Article JFSF, Vol 2, No 3, September 2017, p.45-52
The role of Mediterranean diet and its components on the progress of osteoarthritis
Evaggelia E. Pitaraki
Keywords: Osteoarthritis, Mediterranean diet, Prevention, Olive oil, Components of Mediterranean diet
Abstract
Osteoarthritis is the most common, incurable joint disease. The rapid pace of the disease has adverse consequences in the quality of patient’s life, while affecting healthcare systems. The research interest is focused on cost-effective and without side-effects methods to reduce the symptoms and improve the quality of life. Several dietary factors have been linked to the health of cartilage tissue, inflammatory processes and the progress of osteoarthritis. Mediterranean diet (MD) is a dietary pattern that was adopted by people living around the Mediterranean sea. This term first appeared in 1950, by Ancel Keys. It’s characterized by high consumption of vegetables, unprocessed grains, fruits, legumes, seeds, modest consumption of fish and poultry and olive oil is the principal fat source. Emerged data emphasize the beneficial effects of MD against chronic inflammation, metabolic complications and chronic diseases. There are few studies investigating the effect of MD against osteoarthritis, but apparent evidence is encouraging, this highlights the need for further research of the relationship between MD and osteoarthritis. The purpose
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Mini Review Article JFSF, Vol 2, No 3, September 2017, p.53-57
Falls among hospitalized patients
Konstantina Kafantogia, Panagiota Katsafourou, Antonia Tassiou, Nikoletta Vassou
Keywords: Falls, Hospitalized patients, In-hospital falls, Prevention and positive outcomes
Abstract
This article presents a review of the main causes of falls among hospitalized patients, a global, cost-effective phenomenon with many complications for patients and institutions alike, with the objective of looking into fall prevention. Reviewing articles from various databases we look into data from articles with positive outcomes, published in English. Following an analysis of the main factors of in-hospital falls -intrinsic, extrinsic and exposure to risk-, we present a concise analysis of the existing fall prevention studies, focusing on the most popular risk assessing tools which seem to lead to the best results when used in combination with an integral approach from and proper communication between the patient, the family, the institution and the health-care teams.
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Mini Review Article JFSF, Vol 2, No 3, September 2017, p.58-61
Public Health issues in hospital management of Sarcopenic patients
Vassiliki Marinaki, George I. Lambrou
Keywords: Sarcopenia, Public Health, Management, Public Health Expenditure, Quality of Life
Abstract
Sarcopenia is a combination of a progressive and generalized loss of skeletal muscle mass and muscle strength or physical performance, with high risk of adverse outcomes such as physical disability, poor quality of life and death. It mainly affects older people, aged 60-70 years. The development of sarcopenia is multifactor. The first step towards the management of sarcopenia is the proper and professional diagnosis. According to EWGSOP the diagnosis of sarcopenia depends on the presence of low muscle mass (LMM) plus low muscle strength (LMS) or low physical performance (LPP). Although it is difficult to establish its prevalence, the higher prevalence is observed in hospitalized elderly patients. It has direct and indirect impact on public health, which are difficult to be measured due to numerous negative outcomes of sarcopenia.
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Opinion Article JFSF, Vol 2, No 3, September 2017, p.62-64
Mechanical loading effect to the functional bone adaptation
Alexander D. Kokkinias, Sophianos-Orpheus D. Kokkinias
Keywords: Muscle, Mechanical stimulus, Forces of gravity, Loading, Bone adaptation
Abstract
The loads on skeleton control bone turnover, rates of adapted remodeling and influence growth. Mechanical stimulus detected by osteocytes, is derived from muscle contraction or gravity forces. It is difficult to separate the effect of gravity from muscle contractions at bone mass. A great number of studies show that muscle contractions are present, significant and able to represent the large majority which causes the adaptive bone responses
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