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European Journal of Radiology Jul 2004We present a number of commonly encountered pseudolesions. These represent areas of the skeleton that are relatively radiolucent simulating an osteolytic or cystic... (Review)
Review
We present a number of commonly encountered pseudolesions. These represent areas of the skeleton that are relatively radiolucent simulating an osteolytic or cystic lesion. Such areas discussed in this article include the superolateral humeral head, rhomboid fossa of the clavicle, scapular defect, supratrochlear foramen, biceps tendon insertion, vascular channel of the ulna, distal condylar area of the knee, 'bone in bone' disturbance, dorsal defect of the patella, metadiaphyseal area, 'Wards' triangle', inframalleolar fossa of the fibula, and anterior lytic defect of the calcaneus. We provide an overview of commonly encountered pseudolesions, that may lead to false positive diagnosis of an osteolytic or cystic lesion.
Topics: Bone Cysts; Bone and Bones; Diagnosis, Differential; Humans; Osteolysis; Tomography, X-Ray Computed
PubMed: 15186889
DOI: 10.1016/S0720-048X(03)00180-3 -
Issues in Mental Health Nursing Jul 2013Although individual conflict and containment events among acute psychiatric inpatients have been studied in some detail, the relationship of these events to each other...
Although individual conflict and containment events among acute psychiatric inpatients have been studied in some detail, the relationship of these events to each other has not. In particular, little is known about the temporal order of events for individual patients. This study aimed to identify the most common pathways from event to event. A sample of 522 patients was recruited from 84 acute psychiatric wards in 31 hospital locations in London and the surrounding areas during 2009-2010. Data on the order of conflict and containment events were collected for the first two weeks of admission from patients' case notes. Event-to-event transitions were tabulated and depicted diagrammatically. Event types were tested for their most common temporal placing in sequences of events. Most conflict and containment occurs within and between events of the minimal triangle (verbal aggression, de-escalation, and PRN medication), and the majority of these event sequences conclude in no further events; a minority transition to other, more severe, events. Verbal abuse and medication refusal were more likely to start sequences of disturbed behaviour. Training in the prevention and management of violence needs to acknowledge that a gradual escalation of patient behaviour does not always occur. Verbal aggression is a critical initiator of conflict events, and requires more detailed and sustained research on optimal management and prevention strategies. Similar research is required into medication refusal by inpatients.
Topics: Adult; Aggression; Clinical Nursing Research; Conflict, Psychological; Cross-Sectional Studies; Female; Hospitalization; Humans; Injections, Intramuscular; London; Male; Medication Adherence; Mental Disorders; Middle Aged; Negotiating; Psychiatric Department, Hospital; Psychotropic Drugs; Risk Management; State Medicine; Treatment Refusal; Violence
PubMed: 23875553
DOI: 10.3109/01612840.2013.780117 -
Rheumatology International Nov 2012Osteoporosis represents an important cause of morbidity in adult rheumatoid arthritis (RA) patients who exhibit increased fracture risk. It is thought that osteoclast...
Osteoporosis represents an important cause of morbidity in adult rheumatoid arthritis (RA) patients who exhibit increased fracture risk. It is thought that osteoclast and its dysfunction which mediated by many cytokines are the principal pathogenesis of this bone disease, although the mechanisms are still not fully understood. Osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa B ligand (RANKL) have been revealed in the pathogenesis of primary osteoporosis and other metabolic bone diseases. Thus, the aim of this study was to investigate the possible role of the OPG/RANKL system in RA-related bone loss. A total of 64 Chinese patients with RA and 60 healthy control subjects were involved. Serum levels of OPG and RANKL were measured by ELISA. BMD of nondominant forearm, lumbar spine(L(1-4)) and proximal femur, including femoral neck, Wards triangle, greater trochanter were assessed using dual-energy X-ray absorptiometry. RA patients had a higher incidence of osteoporosis (23/64, 35.9%) than that in healthy controls (9/60, 15.0%) (P < 0.0001). They displayed lower BMD values than controls at positions of all detected region. Compared with healthy controls, RA group showed significantly higher serum levels of RANKL (48.4 ± 12.5 vs. 23.0 ± 11.2 pmol/l, P < 0.0001), lower serum levels of OPG (106.2 ± 40.6 vs. 231.6 ± 65.6 pg/ml, P < 0.0001), and OPG/RANKL ratio (2.4 ± 0.7 vs. 7.0 ± 1.1, P < 0.0001). Multiple linear regression analysis revealed that in RA group, plasma rheumatoid factor concentration (β = -0.187, P = 0.031), swollen joint count (β = 0.567, P = 0.029), BMD at forearm (β = 0.324, P = 0.002), femoral Wards triangle (β = 0.370, P < 0.0001), and lumbar spine (β = 0.313, P = 0.003) were the contributors for serum OPG (R ( 2 ) = 0.718, P < 0.0001). Age (β = 0.241, P = 0.042) and BMD at femoral Wards triangle (β = -0.441, P < 0.0001) and lumbar spine (β = -0.320, P = 0.013) were the determinants for serum RANKL (R ( 2 ) = 0.616, P < 0.0001), while swollen joint count (β = 1.029, P = 0.019) and BMD at femoral neck (β = 0.285, P = 0.042) for serum OPG/RANKL ratio (R ( 2 ) = 0.279, P < 0.011). Analysis of logistic regression showed age (P = 0.004, OR = 1.156, 95% CI: 1.047-1.276) and the level of C-reactive protein (P = 0.028, OR = 1.019, CI 95%: 1.002-1.036) in peripheral blood of RA were the risk factors for the occurrence of osteoporosis in RA, while OPG/RANKL ratio (P = 0.007, OR = 0.035, CI 95%: 0.003-0.400) was the unique protective factor. These data suggest that, in Chinese RA patients, an altered modulation of the OPG/RANKL system resulting in increased RANKL and decreased OPG in peripheral blood, could contribute to the bone loss characteristic and the generation of osteoporosis in these patients. Changes of ratio of OPG/RANKL might be a protective mechanism against the accelerated bone loss in RA.
Topics: Adult; Aged; Arthritis, Rheumatoid; Bone Density; Female; Femur; Humans; Lumbar Vertebrae; Male; Middle Aged; Osteoporosis; Osteoprotegerin; RANK Ligand; Radiography
PubMed: 22057136
DOI: 10.1007/s00296-011-2175-5 -
European Journal of Sport Science Oct 2016The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages.
OBJECTIVES
The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages.
METHODS
Sixty five girls aged 8-14 years (10.14 ± 0.1, Tanner stages I-IV) participated in the study. Twenty participants were prepubertal (10 prepubertal control) and 45 peripubertal (15 peripubertal control). All footballers trained two days per week while the control group did not perform regular physical activity outside of school. Body composition was assessed by Dual-energy X-ray absorptiometry. Analysis of covariance was performed to evaluate differences in lean and bone masses.
RESULTS
Significant differences in lower-body extremities lean mass (LLM) between peripubertal groups were found (P < .05). Additionally, prepubertal footballers showed higher values of bone mineral content (BMC) at the femoral neck (P < .05) while peripubertal footballers exhibited enhanced BMC at the whole-body, trochanter and Wards triangle area. Bone mineral density (BMD) was higher in footballers compared to their non-active peers at the femoral neck and intertrochanter (P < .05, respectively) while in the peripubertal footballers higher BMD values were found in almost all of the studied body sites.
CONCLUSION
Female footballers showed higher bone and lean masses compared to control counterparts; these differences are already detectable at prepubertal ages and more consistent after pubertal spurt.
Topics: Adolescent; Athletes; Bone Density; Case-Control Studies; Child; Female; Humans; Soccer
PubMed: 26902531
DOI: 10.1080/17461391.2016.1144794 -
International Journal of Sports Medicine Dec 2007The present study investigated the interaction between Cdx-2 polymorphism and physical activity level over bone mineral density (BMD) variation in Brazilian...
The present study investigated the interaction between Cdx-2 polymorphism and physical activity level over bone mineral density (BMD) variation in Brazilian postmenopausal women. One hundred and ninety women volunteered to participate in the study (66.6 +/- 5.3 years, 64.58 +/- 11.74 kg and 151.94 +/- 6.36 cm). Physical activity level (PAL) was assessed using the international physical activity questionnaire (IPAQ). Lumbar spine (L2 - L4), femoral neck, great trochanter and Wards' triangle bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DXA). The Cdx-2 polymorphism was genotyped by minisequencing, using the SNaPshottrade mark Multiplex System (Applied Biosystems, Foster City, CA, USA). Overall, no significant association was found between Cdx-2 polymorphism and adjusted BMD at any site. However, the results revealed a significant interaction between PAL and Cdx-2 genotype on adjusted femoral neck and Wards' triangle BMD. Active women carrying the Cdx-G/G genotype showed higher adjusted femoral neck and Wards' triangle BMD than inactive women carrying the same genotype, thus suggesting a larger chronic response to physical activity. These results suggest that, in postmenopausal women, the Cdx-2 polymorphism does not influence BMD by itself; however, it seems to affect the BMD response to physical activity since only the Cdx-G/G genotype carriers presented significant differences between active and inactive.
Topics: Absorptiometry, Photon; Aged; Analysis of Variance; Bone Density; Brazil; CDX2 Transcription Factor; Cross-Sectional Studies; Female; Genotype; Homeodomain Proteins; Humans; Middle Aged; Motor Activity; Polymorphism, Genetic; Postmenopause; Surveys and Questionnaires; Trans-Activators
PubMed: 17614034
DOI: 10.1055/s-2007-965130 -
Nutricion Hospitalaria 2013Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important...
INTRODUCTION
Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important confounders when studying bone mass.
AIM
To clarify the effect that Ca and VitD may have on bone mass in adolescent cyclists.
METHODS
Bone mineral content (BMC) and density (BMD) of 39 male adolescents (20 cyclists) were measured. Ca and VitD intake were also registered. Different ANCOVA analyses were performed in order to evaluate the influence of Ca and VitD on BMC and BMD.
RESULTS
Cyclists showed lower values of BMC and BMD than controls at several sites and when adjusting by Ca, Wards triangle BMD appeared also to be lower in cyclists than controls.
CONCLUSION
Nutritional aspects might partially explain differences regarding bone mass in adolescent cyclists and should be taken into account in bone mass analysis as important confounders.
Topics: Absorptiometry, Photon; Adolescent; Analysis of Variance; Bicycling; Bone Density; Bone and Bones; Calcium, Dietary; Humans; Male; Nutritional Status; Vitamin D; Vitamins
PubMed: 23889632
DOI: 10.3305/nh.2013.28.4.6490 -
BMC Pregnancy and Childbirth Sep 2022Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of...
BACKGROUND & OBJECTIVE
Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives' lived experiences of delivering continuous midwife-led intrapartum care.
METHODS
This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected.
RESULTS
"Wanting to lead continuous woman-centered care but being unable to" was identified as an overarching theme. Three other themes "emphasis on the non-interventional care", "midwifery-specific focus" and "barriers and challenges of midwifery care" were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous 'woman'-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a 'triangle of trust' in care.
CONCLUSION
Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran.
Topics: Adult; Delivery, Obstetric; Female; Humans; Iran; Middle Aged; Midwifery; Nurse Midwives; Parturition; Pregnancy; Qualitative Research
PubMed: 36151533
DOI: 10.1186/s12884-022-05040-z -
Annals of Epidemiology Feb 1991Maximum bone mineral density of the femur was measured by dual-photon densitometry in 282 healthy white women, aged 20 to 40 years. Femoral sites included the neck,...
Maximum bone mineral density of the femur was measured by dual-photon densitometry in 282 healthy white women, aged 20 to 40 years. Femoral sites included the neck, Wards triangle, and the trochanter. Quetelet Index was used as a measure of weight adjusted for height, and body composition was measured using four-point bioelectrical impedance and anthropometry. Maximum bone mass is believed to be an important measure if the level established which remain characteristic or predict bone mineral density during the aging process. Body weight was correlated with each measure of femoral bone density, including the femoral neck (r = .42), Wards triangle (r = .34), and the trochanter (r = .44). Weight was more highly correlated with bone mass than with other measures of body composition, including fat-free mass, percent body fat, humeral muscle area, and humeral fat area. We observed that age was negatively associated with bone mass at all three femoral sites, even in subjects within the age range of 20 to 40 years, and the relationship was significant after controlling for Quetelet Index. There was no evidence of a nonlinear relationship that would indicate when maximal femoral bone mass reaches its peak within this age range.
Topics: Adult; Aging; Body Composition; Body Height; Body Weight; Bone Density; Densitometry; Female; Humans
PubMed: 1669505
DOI: 10.1016/1047-2797(91)90003-u -
Maternal & Child Nutrition Apr 2022Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable...
Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable household decision-making, intra-household food allocation and limited paternal support for resources and caregiving. In Igabi local government area of Kaduna State, Nigeria, the Alive & Thrive (A&T) initiative implemented an intervention to improve complementary feeding practices through father engagement. This study describes household gender roles among A&T participants and how they influence maternal and paternal involvement in complementary feeding. We conducted 16 focus group discussions with mothers and fathers of children aged 6-23 months in urban and rural administrative wards and analysed them using qualitative thematic analysis methods. Most mothers and fathers have traditional roles with fathers as 'providers' and 'supervisors' and mothers as 'caregivers'. Traditional normative roles of fathers limit their involvement in 'hands-on' activities, which support feeding and caring for children. Less traditional normative roles, whereby some mothers contributed to the provision of resources and some fathers contributed to caregiving, were also described by some participants and were more salient in the urban wards. In the rural wards, more fathers expressed resistance to fathers playing less traditional roles. Fathers who participated in caregiving tasks reported respect from their children, strong family relationships and had healthy home environments. Our research findings point to the need for more context-specific approaches that address prevalent gender normative roles in complementary feeding in a variety of settings.
Topics: Child; Fathers; Female; Gender Role; Humans; Infant; Infant Nutritional Physiological Phenomena; Male; Mothers; Nigeria
PubMed: 35080111
DOI: 10.1111/mcn.13325 -
Chinese Journal of Integrative Medicine Jun 2005To observe the efficacy and safety of Yigu capsule (YGC), a Chinese herbal compound preparation, in treating postmenopausal osteoporosis (PMO) and to explore its... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
OBJECTIVE
To observe the efficacy and safety of Yigu capsule (YGC), a Chinese herbal compound preparation, in treating postmenopausal osteoporosis (PMO) and to explore its possible mechanism.
METHODS
The clinical study was conducted in a prospective, randomized, double blinded method lasting for 6 months with placebo and positive control. Two hundred and ten PMO patients with confirmed diagnosis were assigned into the YGC group, the calciferol group and the placebo group. Besides being administered element calcium, they were treated with YGC, calciferol capsule and placebo capsule respectively. And such symptoms as newly found fracture and ostealgia, bone mineral density (BMD) of the 2nd-4th lumbar vertebrae (L(2-4)) and upper femur, blood and urinary indexes for bone metabolism, sex hormone level and adverse reaction that occurred in patients were observed.
RESULTS
In the YGC group, the total effective rate was 95.50%, with no new occurrence of fractures, which was significantly better than that in the other two groups (P < 0.05). Moreover, in the YGC group, the increase rate of BMD was 9.83% in L(2-4), 4.09% in femoral neck, 4.60% in Wards triangle, 3.00% in greater trochanter, which was also better than that in the placebo group (P < 0.05, P < 0.01). As compared with the placebo group, levels in the YGC group of urinary oxyproline hydroxyproline/creatinine, urinary calcium/creatinine were significantly lower, serum and bone alkaline phosphatase, osteocalcin, estradiol and estradiol/testosterone were significantly higher, but no difference was shown in the comparison of testosterone level. In the observation period, no abnormality in blood or urine routine, liver or renal function was found. Only mild, transient gastro-intestinal response occurred in individual patients, but it did not affect the treatment.
CONCLUSION
YGC could treat PMO effectively, as it could obviously increase the BMD of lumbar vertebrae and coxafemoral bone, elevate the alleviating rate of ostealgia and incessant motion time, yet causing no newly found compressive fracture of vertebrae, or and any related adverse reaction. YGC could not only promote the formation, but also inhibit the absorption of bone as well as increase the sex hormone level. Therefore, it is a pure Chinese herbal compound preparation worthy of further research and development.
Topics: Administration, Oral; Aged; Amidohydrolases; Bone Density; Bone and Bones; Calcium; Drugs, Chinese Herbal; Female; Fractures, Bone; Gonadal Steroid Hormones; Humans; Hydroxyproline; Incidence; Middle Aged; Osteoporosis, Postmenopausal; Prospective Studies; Treatment Outcome
PubMed: 16150195
DOI: 10.1007/BF02836464