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Journal of Bone and Mineral Research :... Dec 2023Conditions during gestation, such as maternal smoking, may affect offspring's bone structure. This could increase the offspring's risk of bone fractures during...
Conditions during gestation, such as maternal smoking, may affect offspring's bone structure. This could increase the offspring's risk of bone fractures during childhood. In this study, we aimed to assess the association between prenatal exposure to maternal smoking and childhood bone fracture risk. We used a register-based birth cohort that included all children born in Finland between January 1987 and September 1990. After exclusions, the final study population consisted of 220,699 persons. Using a unique national identification number, we linked the cohort data to the fracture diagnosis in specialty care and covariate data using the Medical Birth Register (MBR), Statistics Finland and Care Register for Health Care (CRHC). The fractures were analyzed in three groups: all fractures, non-high-energy fractures, and high-energy fractures. The analyses were adjusted for sex, parity, child's year of birth, mother's age at childbirth, mother's and father's educational level, and mother's fracture status. We tested the association in three age groups: <1 year, 1-<5 years, and 5-<15 years using Cox and (recurrent fractures) Poisson regression. A total of 18,857 (8.5%) persons had at least one bone fracture diagnosis before the age of 15 years. In the age group 5-<15 years, maternal smoking during pregnancy was associated with higher fracture risk in all of the studied fracture groups: hazard ratio (HR) = 1.12 (95% confidence interval [CI] 1.06-1.17) in all fractures, 1.13 (95% CI 1.07-1.19) in non-high-energy, and 1.15 (95% CI 1.00-1.32) in high-energy fractures. There were no significant associations in other age groups in any of the fracture groups. No statistically significant association between maternal smoking during pregnancy and offspring's risk of recurrent fractures was found. In conclusion, 5- to 15-year-olds whose mothers have smoked during pregnancy have an increased risk of bone fractures treated in specialty care. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Topics: Child; Female; Pregnancy; Humans; Adolescent; Infant; Smoking; Fractures, Bone; Finland; Minerals
PubMed: 37823763
DOI: 10.1002/jbmr.4923 -
Nigerian Journal of Clinical Practice Mar 2022Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients...
BACKGROUND
Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients with head trauma should be evaluated early with a multidisciplinary approach.
AIM
The association between frontal and maxillary bone fractures and concurrent craniocerebral injuries were investigated in patients presenting with head trauma in this study. The data of the patients were analyzed retrospectively.
METHODS AND MATERIAL
Age and gender distributions were evaluated in frontal and maxillary fractures. Concomitant craniocerebral injuries were investigated. Craniocerebral injuries were grouped as pneumocephalus, extra-axial, intra-axial injuries and brain edema. Craniocerebral injuries in frontal and maxillary fractures were compared statistically.
RESULTS
Frontal bone and maxillary bone fractures were detected in 24% and 95% of the patients. Coexistence of pneumocephalus and intra-axial injuries in frontal bone fracture was statistically significant. The association of frontal posterior wall fractures with pneumocephalus and parenchymal contusion was found to be statistically significant. In addition, the association of craniocerebral injuries were evaluated and statistically significant ones were determined.
CONCLUSION
The presence of maxillofacial fractures in patients presenting with head trauma increases mortality and morbidity. Craniocerebral injuries can be life-threatening and delay the treatment of facial fractures. Upper facial bone fractures are significantly more common in craniocerebral injuries.
Topics: Craniocerebral Trauma; Humans; Maxillary Fractures; Retrospective Studies; Skull Fractures
PubMed: 35295058
DOI: 10.4103/njcp.njcp_1582_21 -
Peptides Feb 2018Bone fractures are common comorbidities of type 2 diabetes mellitus (T2DM). Bone fracture incidence seems to develop due to increased risk of falls, poor bone quality... (Review)
Review
Bone fractures are common comorbidities of type 2 diabetes mellitus (T2DM). Bone fracture incidence seems to develop due to increased risk of falls, poor bone quality and/or anti-diabetic medications. Previously, a relation between gut hormones and bone has been suspected. Most recent evidences suggest indeed that two gut hormones, namely glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), may control bone remodeling and quality. The GIP receptor is expressed in bone cells and knockout of either GIP or its receptor induces severe bone quality alterations. Similar alterations are also encountered in GLP-1 receptor knock-out animals associated with abnormal osteoclast resorption. Some GLP-1 receptor agonist (GLP-1RA) have been approved for the treatment of type 2 diabetes mellitus and although clinical trials may not have been designed to investigate bone fracture, first results suggest that GLP-1RA may not exacerbate abnormal bone quality observed in T2DM. The recent design of double and triple gut hormone agonists may also represent a suitable alternative for restoring compromised bone quality observed in T2DM. However, although most of these new molecules demonstrated weight loss action, little is known on their bone safety. The present review summarizes the most recent findings on peptide-based incretin therapy and bone physiology.
Topics: Animals; Bone Remodeling; Comorbidity; Diabetes Mellitus, Type 2; Disease Models, Animal; Fractures, Bone; Gastric Inhibitory Polypeptide; Gastrointestinal Hormones; Glucagon-Like Peptide 1; Glucagon-Like Peptide-1 Receptor; Humans; Incretins; Mice; Mice, Knockout
PubMed: 29412811
DOI: 10.1016/j.peptides.2017.12.008 -
International Journal of Cardiology Dec 2021Only one large series has been reported on fat embolism syndrome (FES), a condition caused by fat globules release into the circulation, primarily as consequence of bone... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Only one large series has been reported on fat embolism syndrome (FES), a condition caused by fat globules release into the circulation, primarily as consequence of bone fracture. Thus, more data on clinical features, therapies, and prognosis are needed.
METHODS AND RESULTS
The study screened 1090 manuscripts in PubMed and Web of Science on cases of FES published from June 2010 to June 2020. The authors identified 124 studies and included in the pooled-analysis 135 patients (>14 years), plus one additional unpublished case managed in Tongji hospital. All had confirmed diagnosis of FES with complete clinical data. The median age at presentation was 39 years, and 82 (61.8%) were men. FES was predominantly associated with bone fractures (78, 57.4%), particularly femur fracture (59, 43.4%). The most common clinical finding at the onset was respiratory abnormalities in 34.6% of all clinical presentations. Therapies included respiratory supportive care in 127 (93.4%) patients, application of corticosteroids in 22 (16.2%) and anticoagulant in 5 (3.7%) cases. Overall mortality was 30.2% (N = 41), and logistic regression analysis showed that corticosteroid therapy was significantly associated with reduced mortality with an OR of 0.143 (95%CI 0.029-0.711), while age ≥ 65 years and non-orthopedic conditions were significantly associated with increased mortality with an OR of 4.816 (95%CI 1.638-14.160) and 4.785 (95%CI 1.019-22.474).
CONCLUSIONS
FES has been associated with a larger mortality rate than previously observed, although publication bias can have led to overestimation of mortality. Finally, a potential protective effect of corticosteroid therapy has been suggested by the current analysis.
Topics: Adrenal Cortex Hormones; Aged; Embolism, Fat; Fractures, Bone; Humans; Male; Prognosis
PubMed: 34743891
DOI: 10.1016/j.ijcard.2021.10.151 -
International Journal of Nanomedicine 2021Postoperative infection and pain management are of great concern to orthopedic surgeons. Although there are several protocols available to deal with these aspects, they...
PURPOSE
Postoperative infection and pain management are of great concern to orthopedic surgeons. Although there are several protocols available to deal with these aspects, they are fraught with complications, such as cartilage damage, cardiovascular and neurological intoxication, and systemic adverse responses. Therefore, it is necessary to develop safe and effective perioperative protocols. In the current study, antimicrobial agents/analgesics/growth factor-embedded biodegradable hybrid fixators (polycaprolactone fixator + poly[lactide-co-glycolide] sheath-core structured nanofibers) for bone fracture repair were designed.
METHODS
The biodegradable hybrid fixators were fabricated using solution-extrusion three-dimensional printing and electrospinning. In vitro, the characteristics of the hybrid fixators were examined. Additionally, the release of the incorporated vancomycin, ceftazidime, lidocaine, and bone morphogenetic protein-2 (BMP-2) was evaluated. The in vivo efficacy including drug-eluting properties, fracture repair, and pain management of the biomolecule-loaded nanofibrous fixators was investigated in rabbit rib-fracture models.
RESULTS
The nanofibrous fixators released vancomycin, ceftazidime, and lidocaine in a sustained manner under both in vitro and in vivo conditions and protected BMP-2 from burst release. The implantation of these hybrid fixators around the fractured rib significantly improved animal activities and bone union, indicating that the inclusion of analgesic in the fixator effectively reduced postsurgical pain and thereby helped in recovery.
CONCLUSION
The novel biomolecule-loaded nanofibrous hybrid fixators resulted in excellent therapeutic outcomes. These fixators may be effective in the repair of rib fractures in clinical settings and may help mitigate surgical complications, such as infection, nonunion, and intolerable postoperative pain.
Topics: Analgesics; Animals; Anti-Infective Agents; Fractures, Bone; Nanofibers; Polylactic Acid-Polyglycolic Acid Copolymer; Rabbits
PubMed: 34408414
DOI: 10.2147/IJN.S325885 -
Calcified Tissue International Oct 2022Previous studies suggest that saturated fat (SFA) intake may negatively impact on bone. However, few human studies on the topic exist. Women and men aged 31-46 years... (Observational Study)
Observational Study
Previous studies suggest that saturated fat (SFA) intake may negatively impact on bone. However, few human studies on the topic exist. Women and men aged 31-46 years from the Cardiovascular Risk in Young Finns study attended the peripheral quantitative computed tomography and ultrasound bone measurements in 2008 (n = 1884-1953, ~ 56% women). In addition, fracture diagnoses in 1980-2018 were searched for the national health care registers and 431 participants had at least one fracture. Food consumption was gathered with the 48-h dietary recall interviews and food frequency questionnaire in 1980-2007. In the present study, radial, tibial, and calcaneal bone traits, and fractures were examined relative to the long-term intake of SFA. No consistent associations were seen between bone outcomes and SFA intake that would have replicated in both women and men. The only evidence for differential distributions was seen in cortical density and cortical-to-total area ratio at the radial shaft, and speed of sound at the calcaneus, which were 0.1-0.4% higher in women in the lowest tertile of SFA intake compared with the highest tertile. In addition, among men, the odds ratio (OR) of fractures was greater in the second (OR 1.86, 95% confidence interval (CI) 1.03-3.33) and third tertile of SFA intake (OR 2.45, 95% CI 1.38-4.36) compared with the lowest tertile, independently of many risk factors of osteoporosis. In this observational study, we found no robust evidence of the associations of dietary long-term SFA intake with bone outcomes. Therefore, additional studies are needed to confirm the association of dietary SFA with bone health in humans.
Topics: Bone Density; Calcaneus; Dietary Fats; Fatty Acids; Female; Finland; Fractures, Bone; Humans; Male; Young Adult
PubMed: 35896727
DOI: 10.1007/s00223-022-01008-5 -
Journal of the Mechanical Behavior of... Mar 2023A dynamic phase-field fracture finite element model is applied to discretized high-resolution three-dimensional computed tomography images of human trabecular bone to...
A dynamic phase-field fracture finite element model is applied to discretized high-resolution three-dimensional computed tomography images of human trabecular bone to analyse rapid bone fracture. The model is contrasted to quasi-static experimental results and a quasi-static phase-field finite element model. The experiment revealed complex stepwise crack evolution with multiple crack fronts, and crack arrests, as the global tensile displacement load was incrementally increased. The quasi-static phase-field fracture model captures the fractures in the experiment reasonably well, and the dynamic model converges towards the quasi-static model when mechanically loaded at low rates. At higher load rates, i.e., at larger impulses, inertia effects significantly contribute to an increased initial global stiffness, higher peak forces and a larger number of cracks spread over a larger volume. Since the fracture process clearly is different at large impulses compared to small impulses, it is concluded that dynamic fracture models are necessary when simulating rapid bone fracture.
Topics: Humans; Porosity; Models, Biological; Finite Element Analysis; Fractures, Bone; Bone and Bones
PubMed: 36638634
DOI: 10.1016/j.jmbbm.2023.105659 -
International Orthopaedics Apr 2012The aim of this paper is to review recent experimental and clinical publications on bone biology with respect to the optimal mechanical environment in the healing... (Review)
Review
The aim of this paper is to review recent experimental and clinical publications on bone biology with respect to the optimal mechanical environment in the healing process of fractures and osteotomies. The basic postulates of bone fracture healing include static bone compression and immobilisation/ fixation for three weeks and intermittent dynamic loading treatment afterwards. The optimal mechanical strain should be in the range of 100-2,000 microstrain, depending on the frequency of the strain application, type of bone and location in the bone, age and hormonal status. Higher frequency of mechanical strain application or larger number of repetition cycles result in increased bone mass at the healing fracture site, but only up to a certain limit, values beyond which no additional benefit is observed. Strain application and transition period from non-load-bearing to full load-bearing can be modified by implants allowing dynamisation of compression and generating strains at the fracture healing site in a controlled manner.
Topics: Adaptation, Physiological; Fracture Fixation; Fracture Healing; Fractures, Bone; Humans; Mechanotransduction, Cellular; Osteocytes; Osteotomy; Stress, Mechanical; Weight-Bearing
PubMed: 22302177
DOI: 10.1007/s00264-012-1487-8 -
International Journal of Molecular... Sep 2023Fractures are the most common large organ trauma in humans. The initial inflammatory response promotes bone healing during the initial post-fracture phase, but chronic... (Review)
Review
Fractures are the most common large organ trauma in humans. The initial inflammatory response promotes bone healing during the initial post-fracture phase, but chronic and persistent inflammation due to infection or other factors does not contribute to the healing process. The precise mechanisms by which immune cells and their cytokines are regulated in bone healing remain unclear. The use of mesenchymal stem cells (MSCs) for cellular therapy of bone injuries is a novel clinical treatment approach. Bone progenitor MSCs not only differentiate into bone, but also interact with the immune system to promote the healing process. We review in vitro and in vivo studies on the role of the immune system and bone marrow MSCs in bone healing and their interactions. A deeper understanding of this paradigm may provide clues to potential therapeutic targets in the healing process, thereby improving the reliability and safety of clinical applications of MSCs to promote bone healing.
Topics: Humans; Osteogenesis; Reproducibility of Results; Bone and Bones; Fractures, Bone; Mesenchymal Stem Cells; Mesenchymal Stem Cell Transplantation; Fracture Healing
PubMed: 37833933
DOI: 10.3390/ijms241914484 -
BioMed Research International 2019Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate... (Review)
Review
Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone and there is a risk of infection. Additionally, problems with bone graft substitutes, including rejection and stimulation of bone formation, have been noted, and the health of the stem cell niche is a major consideration in cell-based therapy. In recent years, researchers have found that exosomes can be used to deliver functional RNA and mediate cell-to-cell communication, suggesting that exosomes may repair bone defects by regulating cells and cytokines involved in bone metabolism. In this review, we highlight the possible relationships between risk factors for nonunion and exosomes. Additionally, we discuss the roles of exosomes in bone metabolism and bone regeneration.
Topics: Bone Regeneration; Bone Substitutes; Bone Transplantation; Cell- and Tissue-Based Therapy; Exosomes; Fractures, Bone; Fractures, Ununited; Humans; Osteogenesis
PubMed: 31467871
DOI: 10.1155/2019/1983131