Volume 2, Issue 1, March 2017

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.

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.

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.

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.