RESUMO
Aim: To evaluate pain, flexibility and hydroxyproline (HP) urinary levels in patients with nonspecific low back pain submitted to Global Postural Re-education (GPR) and stretching. Materials & methods: 39 individuals who reported low back pain were randomly assigned to a group submitted to GPR (GPRG) or stretching exercises (SG) for 8 weeks. Pain and flexibility were assessed using the Borg CR10 scale and goniometry, respectively. Results: The GPR group showed a significant reduction in the HP levels and significant improvements in flexibility after the intervention when compared with SG. Both groups presented a significant reduction in HP and pain after the intervention. Conclusion: Both interventions were effective in the treatment of low back pain. However, the GPR method presented better responses than stretching.
Assuntos
Técnicas de Exercício e de Movimento/métodos , Hidroxiprolina/urina , Dor Lombar , Exercícios de Alongamento Muscular/fisiologia , Avaliação de Resultados em Cuidados de Saúde , Manejo da Dor/métodos , Postura/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto , Feminino , Humanos , Dor Lombar/fisiopatologia , Dor Lombar/reabilitação , Dor Lombar/urina , Masculino , Pessoa de Meia-Idade , Medição da Dor , Educação de Pacientes como Assunto/métodosRESUMO
The aim of this study was to compare the effect of concentric with eccentric muscle actions on the resulting level of damage to connective tissues by urinary concentration of hydroxyproline. Twenty-one male volunteers were divided into control group (CG), experimental concentric group (ECG), and experimental eccentric group (EEG). The measures of hydroxyproline were performed at three times: pretest, fourth week, and posttest. Biceps curl and chest press exercises also were performed with three sets of 10 repetitions two times per week for both experimental groups. Analysis of variance (ANOVA) showed a significant difference between pretest of the CG and pretest of the ECG (p = 0.002), and between pretest and posttest for the EEG (p = 0.029). Therefore, this study concluded that the level of damage to the connective tissue is greater when exercises involving eccentric muscle actions are performed. The continuity of training, however might reduce this damage.
Assuntos
Tecido Conjuntivo/lesões , Exercício Físico/fisiologia , Hidroxiprolina/urina , Músculo Esquelético/fisiologia , Análise de Variância , Humanos , Masculino , Adulto JovemRESUMO
Objetivo: Comparar os efeitos da neuroestimulação elétrica transcutânea (TENS) e cinesiologia aplicada, assim como esta isolada, na excreção urinária em indivíduos com a síndrome do impacto do ombro (SIO). Métodos: Participaram do estudo dois grupos de 35 indivíduos cada, sendo 30 mulheres e 40 homens, com idade entre 45 e 60 anos. O grupo controle realizou a cinesiologia aplicada e o grupo experimental realizou o tratamento TENS associado à cinesiologia aplicada. Para a mensuração da hidroxiprolina na urina foi utilizado o protocolo de colorimetria. A coleta urinária foi feita na 1ª, 5ª e 10ª sessão. O tratamento foi realizado em 10 sessões de 55 minutos. O tratamento estatístico utilizado foi feito através da análise de variância One Way (ANOVA). Resultado: Não houve melhora significativa como indicado por F = 0,662, p > 0,05. Conclusão: Os resultados mostraram não haver interação significativa entre os tipos de tratamento com a excreção urinária de hidroxiprolina. Contudo, os resultados obtidos das variáveis mostraram uma forte tendência à melhora, apresentando um resultado mais efetivo no grupo que utilizou somente a cinesiologia aplicada até a quinta sessão e, posteriormente, com uma tendência mais efetiva no grupo que utilizou a cinesiologia aplicada + TENS. O estudo mostrou, também, um resultado mais eficiente do grupo que utilizou apenas a cinesiologia aplicada como tratamento.
Objective: To compare the transcutaneous electrical nerve stimulator (TENS) effects associated to the kinesiology applied, and only the kinesiology applied on the hydroxiproline (HP) excretion on individuals with shoulder pain, during 10 physical therapy sessions with duration of 55 minutes each session for both treatments. Methods: The individuals were divided into two groups of 35 people each, being 30 women and 40 men; aged between 40 and 65 years old. The control group underwent only applied kinesiology and the experimental group applied kinesiology associated to TENS. It was used the colorimetric protocol to measure urinary excretion of HP. Three samples of each variable were carried out on the first, fifth and tenth sessions. The ANOVA test with repeated measures to analyze the HP was used for the statistics. Results: There were no significance as indicated by F = 0.662, p > 0.05. Conclusion: We concluded that the study showed a strong benefit tendency for both groups due to HP decrease levels. As a better result before the 5th session for the group applied kinesiology and after the 5th - 10th session of treatment, for the applied kinesiology + TENS group, although there was no significance based on the statistics. And, also, it showed a better result for the group who practiced only applied kinesiology
Assuntos
Colorimetria , Cinesiologia Aplicada/instrumentação , Cinesiologia Aplicada/métodos , Cinesiologia Aplicada , Hidroxiprolina/análise , Hidroxiprolina/efeitos adversos , Hidroxiprolina/urinaRESUMO
Chronic idiopathic hyperphosphatasia (CIH), or juvenile Paget disease, is a rare disorder characterized by increased bone turnover and progressive enlargement of bones. We report a girl, 6 1/2 years old, with a history of three fractures, short stature, delayed eruption of teeth, and poor hair growth. She had a waddling gait, bone deformities, kyphoscoliosis, hyperlordosis, genu valgum and curvature of her limbs. She also had progressive hearing loss but other cranial nerves were unaffected. Laboratory studies indicated high bone turnover: serum alkaline phosphatase: 4047 IU/l (normal value: 150-550), urinary hydroxyproline: 1205 mg/g creatinine (n.v.: 60-160), and urinary CrossLaps: 4360 microg/mmol creatinine (n.v.: 450-2100). Radiographs demonstrated generalized skeletal involvement with osteoectasia (expansion) of long bones, diffuse sclerosis, cotton wool appearance of the skull, absence of mastoid pneumatization, and crushed dorsal and lumbar vertebrae. Iliac crest biopsy was compatible with CIH. Cyclical intravenous pamidronate (1 mg/kg/day during 3 h, 3 consecutive days at 2- to 3-month intervals) was administered during 2 years with oral calcium 500 mg and vitamin D 1000 IU/day. Oral pamidronate was added after 11 months of i.v. therapy. Treatment-induced remarkable clinical and radiographic improvement with normalization of bone markers of osteoblastic and osteoclastic activity, including bone alkaline phosphatase, urinary hydroxyproline, and urinary CrossLaps.
Assuntos
Remodelação Óssea/efeitos dos fármacos , Difosfonatos/uso terapêutico , Osteíte Deformante/tratamento farmacológico , Administração Oral , Fosfatase Alcalina/sangue , Biomarcadores/sangue , Biomarcadores/urina , Osso e Ossos/metabolismo , Criança , Difosfonatos/administração & dosagem , Esquema de Medicação , Feminino , Humanos , Hidroxiprolina/urina , Injeções Intravenosas , PamidronatoRESUMO
Bisphosphonates are now in the vanguard of osteoporosis treatment. Frequently, gastro-oesophageal symptoms are associated with these drugs. The objective of this study was to compare side effects and bone turnover markers in postmenopausal women who had received alendronate daily or weekly in tablets with or without enteric coating. We conducted a randomised, double-blind, 3-month trial. The trial involved 75 volunteers, aged 45-58 with moderate to severe osteopenia (T-score lower than -2 SD) assessed by quantitative ultrasound. Women were assigned randomly to receive: (a) alendronate 10mg/day: (b) alendronate 70 mg once a week: or (c) enteric alendronate 70 mg per week. We recorded side effects, C-telopeptide, osteocalcin and urine hydroxyproline at the start of the study and at 3 months. After 3 months, pyrosis (heartburn) was noted by seven women in group A (28%), three in group B (12%) and two in group C (8%); nausea: by one woman in group B; and headache by one patient in each group. C-telopeptide (A: 40.7%; B: 34.1% and C: 38.5%); hydroxyproline (A: 31.1%;B: 25.3% and C: 31.5%) and osteocalcin (A: 27.0%; B: 25.4% and C: 25.1%) decreased similarly in the three groups. Weekly intake of alendronate, whether conventional or enteric-coated; is associated with less heartburn and nausea. Enteric alendronate has a similar action to the conventional tablets on biochemical markers.
Assuntos
Alendronato/administração & dosagem , Densidade Óssea/efeitos dos fármacos , Osteoporose Pós-Menopausa/prevenção & controle , Administração Oral , Adulto , Alendronato/efeitos adversos , Colágeno Tipo I , Esquema de Medicação , Feminino , Azia , Humanos , Hidroxiprolina/urina , Incidência , Pessoa de Meia-Idade , Náusea , Osteocalcina/urina , Osteoporose Pós-Menopausa/patologia , Fragmentos de Peptídeos/sangue , Peptídeos , Pró-Colágeno/sangue , Índice de Gravidade de Doença , Comprimidos com Revestimento Entérico , Resultado do TratamentoRESUMO
Se evaluó el recambio óseo en distintas situaciones fisiológicas y patológicas que alteran el metabolismo óseo. A tal fin se analizó la utilidad de un marcador bioquímico de formación como la fosfatasa alcalina ósea (FAO) y uno de resorción ósea, como la fracción carboxilo terminal del telopéptido del colágeno tipo I (CTX). En la población adulta normal los hombres y mujeres premenopáusicas no presentaron diferencias significativas. Contrariamente, las mujeres posmenopáusicas tuvieron niveles de FAO y CTX significativamente mayores que éstos dos grupos (p<0,01). Entre el segundo y tercer trimestre de embarazo ambos marcadores aumentaron significativamente (FAO: p<0,009 y CTX: p<0,0003). Mientras la FAO no varió en posmenopáusicas ante el tratamiento hormonal de reemplazo (THR), el CTX disminuyó significativamente (p<0,001). Mujeres posmenopáusicas osteopénicas y osteoporóticas presentaron niveles de CTX y FAO significativamente menores luego de THR o tratamiento con bifosfonatos respecto de las no tratadas (FAO: p<0,05 y 0,03 y CTX: p<0,02 y 0,0001 respectivamente). Pacientes con insuficiencia renal en hemodiálisis presentaron niveles séricos de FAO y CTX significativamente mayores que los controles sanos por edad y sexo (p<0,05). Pacientes hipertiroideos, pagéticos o con patología ósea secundaria a enfermedad celíaca disminuyeron los niveles de FAO y CTX en forma significativa (p<0,05) luego del tratamiento específico. Como se esperaba, el marcador de resorción respondió más rápidamente a cambios en el remodelamiento óseo. Si le sumamos la alta especificidad y sensibilidad del CTX, se sugiere que éste marcador sería de utilidad en todas aquellas patologías en que se sospeche alteración o se quiera determinar el grado del remodelamiento óseo
Assuntos
Humanos , Masculino , Feminino , Adulto , Gravidez , Pessoa de Meia-Idade , Fosfatase Alcalina , Osso e Ossos/fisiologia , Cálcio , Colágeno , Reabsorção Óssea , Remodelação Óssea/fisiologia , Fosfatase Alcalina/sangue , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/metabolismo , Doenças Ósseas Metabólicas , Colágeno/urina , Colágeno/sangue , Doença Celíaca/complicações , Doença Celíaca/metabolismo , Fosfatase Ácida , Hidroxiprolina , Hidroxiprolina/urina , Hipertireoidismo , Biomarcadores/sangue , Osteocalcina/sangue , Osteomalacia , Osteoporose Pós-Menopausa , Hormônio Paratireóideo/sangue , Hormônio Paratireóideo/urina , Pós-Menopausa , Remodelação Óssea , Insuficiência Renal CrônicaRESUMO
Se evaluó el recambio óseo en distintas situaciones fisiológicas y patológicas que alteran el metabolismo óseo. A tal fin se analizó la utilidad de un marcador bioquímico de formación como la fosfatasa alcalina ósea (FAO) y uno de resorción ósea, como la fracción carboxilo terminal del telopéptido del colágeno tipo I (CTX). En la población adulta normal los hombres y mujeres premenopáusicas no presentaron diferencias significativas. Contrariamente, las mujeres posmenopáusicas tuvieron niveles de FAO y CTX significativamente mayores que éstos dos grupos (p<0,01). Entre el segundo y tercer trimestre de embarazo ambos marcadores aumentaron significativamente (FAO: p<0,009 y CTX: p<0,0003). Mientras la FAO no varió en posmenopáusicas ante el tratamiento hormonal de reemplazo (THR), el CTX disminuyó significativamente (p<0,001). Mujeres posmenopáusicas osteopénicas y osteoporóticas presentaron niveles de CTX y FAO significativamente menores luego de THR o tratamiento con bifosfonatos respecto de las no tratadas (FAO: p<0,05 y 0,03 y CTX: p<0,02 y 0,0001 respectivamente). Pacientes con insuficiencia renal en hemodiálisis presentaron niveles séricos de FAO y CTX significativamente mayores que los controles sanos por edad y sexo (p<0,05). Pacientes hipertiroideos, pagéticos o con patología ósea secundaria a enfermedad celíaca disminuyeron los niveles de FAO y CTX en forma significativa (p<0,05) luego del tratamiento específico. Como se esperaba, el marcador de resorción respondió más rápidamente a cambios en el remodelamiento óseo. Si le sumamos la alta especificidad y sensibilidad del CTX, se sugiere que éste marcador sería de utilidad en todas aquellas patologías en que se sospeche alteración o se quiera determinar el grado del remodelamiento óseo (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Gravidez , Pessoa de Meia-Idade , Idoso , Estudo Comparativo , Reabsorção Óssea , Remodelação Óssea/fisiologia , Fosfatase Alcalina/diagnóstico , Colágeno/diagnóstico , Cálcio/diagnóstico , Osso e Ossos/fisiologia , Insuficiência Renal Crônica , Hipertireoidismo , Pós-Menopausa , Osteoporose Pós-Menopausa , Doenças Ósseas Metabólicas , Fosfatase Alcalina/sangue , Hormônio Paratireóideo/sangue , Hormônio Paratireóideo/urina , Osteocalcina/sangue , Osteomalacia , Remodelação Óssea/efeitos dos fármacos , Biomarcadores/sangue , Fosfatase Ácida/diagnóstico , Colágeno/sangue , Colágeno/urina , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/metabolismo , Hidroxiprolina/urina , Hidroxiprolina/diagnóstico , Doença Celíaca/metabolismo , Doença Celíaca/complicaçõesRESUMO
BACKGROUND: Calcitonin is specially indicated for the treatment of osteoporosis in women that cannot receive estrogen replacement therapy or that have a high bone turnover rate. AIM: To study the effects of low intranasal calcitonin doses on bone remodeling in postmenopausal women with a high bone turnover. PATIENTS AND METHODS: Forty one healthy women aged 56 +/- 6 years old, with a mean lapse after menopause of 7.6 +/- 6.5 years and with a high bone turnover rate, evidenced by an urinary hydroxyproline (mg/dl)/creatinine (g/dl) ratio of 52.4 +/- 7.2, were studied. They were randomly assigned to receive 100 or 50 U/calcitonin thrice a week during 3 months or to a control group that received placebo. All received 500 mg/day calcium carbonate. Urinary hydroxyproline/creatinine ratio was measured a 0, 15, 30, 60 and 90 days. Plasma bone fraction of alkanine phosphatases was measured at 0, 30 and 90 days. RESULTS: Initial urinary hydroxyproline/creatinine ratio and plasma bone fraction of alkanine phosphatases were similar in all study groups and there was no change in these parameters during the study period. CONCLUSIONS: Intranasal calcitonin in doses of 100 U thrice a week or less, does not modify accelerated bone turnover in postmenopausal women.
Assuntos
Remodelação Óssea/efeitos dos fármacos , Calcitonina/administração & dosagem , Osteoporose Pós-Menopausa/tratamento farmacológico , Fosfatase Alcalina/sangue , Análise de Variância , Calcitonina/uso terapêutico , Creatinina/urina , Método Duplo-Cego , Feminino , Humanos , Hidroxiprolina/urina , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/urina , Estudos Prospectivos , Fatores de TempoRESUMO
OBJECTIVE: To study the biochemical markers of bone turnover in children with juvenile chronic arthritis (JCA) and to compare these parameters with those in healthy children in order to evaluate the relationships between age, disease activity and biochemical variables. METHODS: Sixty-two children with JCA and 157 healthy children were studied. Serum samples were analyzed for their concentrations of minerals, osteocalcin (OC) and bone-specific alkaline phosphatase (BAP). Urine samples were examined to monitor the excretion of hydroxyproline (HYP) and deoxypyridinoline crosslinks (DPD). RESULTS: OC, BAP, HYP/Cr, DPD/Cr values were decreased in healthy girls more than 12 years of age and in healthy boys more than 14 years of age compared to younger children from the same population. Lower levels of OC and BAP were observed in younger children with JCA (girls < or = 12 yrs.; boys < or = 14 yrs.) compared to healthy children of the same age. Older girls with JCA (> or = 13 yrs.) were found to have increased HYP/Cr and DPD/Cr values compared to older healthy children. CONCLUSION: These results indicate that abnormalities of bone metabolism occur in an age-related fashion in JCA. This was demonstrated by a reduction in the markers of bone formation in younger JCA patients. Moreover, in older girls the markers of bone resorption were found to be elevated. Taken together, these findings suggest that bone formation is reduced from early childhood to mid-puberty, while resorption levels increase in children with JCA after this time.
Assuntos
Artrite Juvenil/sangue , Artrite Juvenil/urina , Biomarcadores/análise , Remodelação Óssea , Absorciometria de Fóton , Adolescente , Fosfatase Alcalina/sangue , Aminoácidos/urina , Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Juvenil/tratamento farmacológico , Densidade Óssea/fisiologia , Criança , Pré-Escolar , Feminino , Glucocorticoides/uso terapêutico , Humanos , Hidroxiprolina/urina , Masculino , Minerais/sangue , Osteocalcina/sangueRESUMO
From 1960 to 1990, one hundred twenty eight (128) subjects with primary hyperparathyroidism were operated in the University Hospital. The medical records were reviewed. Serum and urine chemistries were done by conventional methods, serum PTH was done by RIA's (N-, C-, and midregion) and intact by IRMA and 1,25 dihydroxycholecalciferol by a non equilibrium receptor assay from calf thymus and preceded by double Sep-Pak chromatography. The distal third of the radius (nondominant arm) was used to evaluate radial bone density (RBD), using single photon absorptiometry (Norland) and the lumbar bone density (LBD) was measured by dual energy X Ray absorptiometry (DEXA). The RBD was done in 41 females and 15 males and the LBD in 12 females and 4 males. The series comprised 95 females, age range from 15 to 79 years, and 33 males, age range from 14 to 69 years. Prominent clinical features included nephrolithiasis in 72 subjects (56 per cent), osteitis fibrosa cystica in 2, isolated familial hyperparathyroidism in 4 subjects in one family, 7 subjects with MEN-1 in 3 families, and 4 subjects with MEN-2 in one family. Only 7 subjects were asymptomatic. Serum calcium was elevated in all, serum alkaline phosphatase was elevated in 24 per cent and urinary hydroxiproline was increased in 48 per cent. Serum phosphorus was low in 92 per cent. PTH assay was either elevated or inappropriately normal for the serum calcium in all patients tested. Serum 1,25 D was elevated in 57 per cent. The PTH level was positively correlated with the serum calcium (r = 0.70), but had no significant correlation with the serum phosphorus and the 1,25 D. The RBD expressed as the standard deviation from that of the mean for age and sex matched controls was > or = 2 SD below the mean in 39 per cent of females and in 40 per cent of males. In contrast to the RBD none of the subjects tested had a LBD > or = 2 SD below the age and sex adjusted mean. 103 subjects had adenomas, 20 primary hyperplasia, 2 carcinomas and in 3 surgical exploration was unsuccessful. As to the outcome of Surgery, 117 (93 per cent) were cured. Thus, in this series, successful surgery for primary hyperparathyroidism is the rule. Primary hyperparathroidism is rarely asymptomatic and appendicular bone disease and nephrolithiasis are commonly seen.