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Polisel EEC, Beck WR, Scariot PPM, Pejon TMM, Gobatto CA, Manchado-Gobatto FB. Effects of high-intensity interval training in more or less active mice on biomechanical, biophysical and biochemical bone parameters. Sci Rep 2021; 11:6414. [PMID: 33742012 PMCID: PMC7979708 DOI: 10.1038/s41598-021-85585-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/27/2021] [Indexed: 02/07/2023] Open
Abstract
High-intensity interval training (HIIT) is of scientific interest due its role in improving physical fitness, but the effects of HIIT on bone health need be carefully explored. Further, it is necessary to know whether HIIT effects on bone health are dependent on the physical activity levels. This may be experimentally tested since we have built a large cage (LC) that allows animals to move freely, promoting an increase of spontaneous physical activity (SPA) in comparison to a small cage (SC). Thus, we examined the effects of HIIT on biophysical, biomechanical and biochemical parameters of bone tissue of C57BL/6J mice living in cages of two different sizes: small (SC) or large (LC) cages with 1320 cm2 and 4800 cm2 floor space, respectively. Male mice were subdivided into two groups within each housing type: Control (C) and Trained (T). At the end of the interventions, all mice were euthanized to extract the femur bone for biophysical, biomechanical and biochemical analyses. Based a significant interaction from two-way ANOVA, trained mice kept in large cage (but not for trained mice housed in SC) exhibited a reduction of tenacity and displacement at failure in bone. This suggests that long-term HIIT program, in addition with a more active lifestyle correlates with exerts negative effects on the bone of healthy mice. A caution must also be raised about the excessive adoption of physical training, at least regarding bone tissue. On the other hand, increased calcium was found in femur of mice housed in LC. In line with this, LC-C mice were more active (i.e. SPA) than other groups. This implies that an active lifestyle without long-term high intensity physical training seems to play a role in promoting benefits to bone tissue. Our data provides new insights for treatment of osteo-health related disorders.
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Affiliation(s)
- Emanuel E. C. Polisel
- grid.411087.b0000 0001 0723 2494Laboratory of Applied Sport Physiology, School of Applied Sciences, University of Campinas, Pedro Zaccaria Street, 1.300, Jardim Santa Luíza, Limeira, SP 13484-350 Brazil
| | - Wladimir R. Beck
- grid.411247.50000 0001 2163 588XLaboratory of Endocrine Physiology and Physical Exercise, Department of Physiological Sciences, Federal University of São Carlos, São Carlos, SP Brazil
| | - Pedro P. M. Scariot
- grid.411087.b0000 0001 0723 2494Laboratory of Applied Sport Physiology, School of Applied Sciences, University of Campinas, Pedro Zaccaria Street, 1.300, Jardim Santa Luíza, Limeira, SP 13484-350 Brazil
| | - Taciane M. M. Pejon
- grid.411247.50000 0001 2163 588XLaboratory of Endocrine Physiology and Physical Exercise, Department of Physiological Sciences, Federal University of São Carlos, São Carlos, SP Brazil
| | - Claudio A. Gobatto
- grid.411087.b0000 0001 0723 2494Laboratory of Applied Sport Physiology, School of Applied Sciences, University of Campinas, Pedro Zaccaria Street, 1.300, Jardim Santa Luíza, Limeira, SP 13484-350 Brazil
| | - Fúlvia B. Manchado-Gobatto
- grid.411087.b0000 0001 0723 2494Laboratory of Applied Sport Physiology, School of Applied Sciences, University of Campinas, Pedro Zaccaria Street, 1.300, Jardim Santa Luíza, Limeira, SP 13484-350 Brazil
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Value-Added Opportunistic CT: Insights Into Osteoporosis and Sarcopenia. AJR Am J Roentgenol 2020; 215:582-594. [DOI: 10.2214/ajr.20.22874] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Cancellous allogenic and autologous bone grafting ensure comparable tunnel filling results in two-staged revision ACL surgery. Arch Orthop Trauma Surg 2020; 140:1211-1219. [PMID: 32239328 PMCID: PMC7429541 DOI: 10.1007/s00402-020-03421-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Patients with recurrent instability after anterior cruciate ligament (ACL) reconstruction often present with enlarged or misplaced tunnels and bone grafting is required prior to the actual revision reconstruction. Autologous bone grafting features limited quantity and donor site morbidity. These problems may be eliminated utilizing cancellous bone allografts, but their efficiency and reliability have not been investigated systematically. The aim of the present study was to compare tunnel filling rates attained by utilizing either allogenic or autologous cancellous bone grafts. MATERIALS AND METHODS A total of 103 consecutive patients were enrolled retrospectively. All patients suffered from recurrent instability and underwent either allogenic or autologous cancellous bone grafting. Computed tomography (CT) was carried out before and after the bone grafting procedure. Based on preoperative CT scans, positioning and maximum diameter of the femoral and tibial tunnels were determined. Tunnel filling rates were calculated as a ratio of pre- and postoperative tunnel volumes. Primary outcome was the tibial tunnel filling rate. Femoral filling rates and density of the grafted bone were assessed secondarily. RESULTS Preoperative CT scans revealed no significant differences between the two groups regarding distribution of misplacement and widening of the femoral or tibial tunnel. Postoperative CT scans were conducted after an interval of 5.2 months. Tunnel filling rates of 74.5% (± 14.3) femoral and 85.3% (± 10.3) tibial were achieved in the allogenic compared to 74.3% (± 15.9) femoral and 84.9% (± 9.4) tibial in the autologous group. With p values of 0.85 at the femur and 0.83 at the tibia, there were no significant differences between the groups. The density of the grafted bone revealed significantly higher values in the allogenic group. CONCLUSIONS Utilizing cancellous bone allografts in two-staged revision ACL surgery provides for sufficient and reproducible filling of enlarged or misplaced tunnels. The filling rates are comparable to those achieved with autologous bone grafting. Advantages of allografts are the unrestricted quantity and the absence of any harvesting procedure.
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Prall WC, Kusmenkov T, Fürmetz J, Haasters F, Mayr HO, Böcker W, Grote S. Outcomes of revision anterior cruciate ligament reconstruction secondary to reamer-irrigator-aspirator harvested bone grafting. Injury 2019; 50:467-475. [PMID: 30580931 DOI: 10.1016/j.injury.2018.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/29/2018] [Accepted: 12/16/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions. MATERIAL AND METHODS A total of 15 consecutive patients were prospectively enrolled in this case series. CT scans were analysed before and after autologous RIA harvested bone grafting. Tunnel volumes and filling rates were calculated based on manual segmentation of axial CT scans. Revision ACL reconstruction was carried out after a mean interval of 6.2 months (±3.7) and positioning of the revision tunnels was assessed by plane radiographs. The mean follow-up was 19.8 months (±8.4) for objective evaluation and 37.1 months (±15.4) for patient reported outcomes. The clinical outcome was assessed by the quantification of the anterior tibial translation, the IKDC objective score, the Tegner activity scale and the Lysholm score. RESULTS Initial CT scans revealed mean tunnel volumes of 3.8cm3 (±2.7) femoral and 6.1cm3 (±2.4) tibial. Filling rates of 76.1% (±12.4) femoral and 87.4% (±5.9) tibial were achieved. Postoperative radiographs revealed significantly improved tunnel positioning with anatomical placement in all but one case at the femur and in all cases at the tibia. At follow up, patients showed significantly improved anterior tibial translations with residual side-to-side differences of 1.7 mm (±0.8) and significantly improved IKDC objective scores. Furthermore, significantly higher values were achieved on the Tegner activity scale (5.3 ± 1.4 vs. 2.8 ± 0.5) and the Lysholm score (85.4 ± 7.9 vs. 62.5 ± 10.5) compared to the preoperative status. CONCLUSION Autologous RIA harvested bone grafting ensures sufficient bone stock consolidation allowing for anatomical tunnel placement of the subsequently conducted revision ACL reconstruction. The two-staged procedure reliably restores stability and provides satisfying subjective and objective outcomes. Thus, RIA harvested bone grafting is an eligible alternative to autologous iliac crest or allogenic bone grafting.
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Affiliation(s)
- W C Prall
- FIFA Medical Center of Excellence, Division of Knee, Hip and Shoulder Surgery, Schoen Clinic Munich Harlaching, Academic Teaching Hospital of the Paracelsus Medical University (PMU), Strubergasse 21, 5020 Salzburg, Austria; Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, Ludwig-Maximilians-University (LMU), Nussbaumstr. 20, 80336 Munich, Germany.
| | - T Kusmenkov
- Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, Ludwig-Maximilians-University (LMU), Nussbaumstr. 20, 80336 Munich, Germany
| | - J Fürmetz
- Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, Ludwig-Maximilians-University (LMU), Nussbaumstr. 20, 80336 Munich, Germany
| | - F Haasters
- FIFA Medical Center of Excellence, Division of Knee, Hip and Shoulder Surgery, Schoen Clinic Munich Harlaching, Academic Teaching Hospital of the Paracelsus Medical University (PMU), Strubergasse 21, 5020 Salzburg, Austria; Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, Ludwig-Maximilians-University (LMU), Nussbaumstr. 20, 80336 Munich, Germany
| | - H O Mayr
- FIFA Medical Center of Excellence, Division of Knee, Hip and Shoulder Surgery, Schoen Clinic Munich Harlaching, Academic Teaching Hospital of the Paracelsus Medical University (PMU), Strubergasse 21, 5020 Salzburg, Austria; Department of Orthopaedics and Trauma Surgery, Freiburg University Hospital, Albert-Ludwigs-University, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - W Böcker
- Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, Ludwig-Maximilians-University (LMU), Nussbaumstr. 20, 80336 Munich, Germany
| | - S Grote
- Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, Ludwig-Maximilians-University (LMU), Nussbaumstr. 20, 80336 Munich, Germany; Department of Orthopaedics and Trauma Surgery, Brothers of Mercy, Hospital St. Elisabeth Straubing, St.-Elisabeth-Straße 23, 94315 Straubing, Germany
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Nunes PV, Suemoto CK, Leite REP, Ferretti-Rebustini REDL, Pasqualucci CA, Nitrini R, Farfel JM, de Oliveira KC, Grinberg LT, da Costa NR, Nascimento CF, Salmasi F, Kim HK, Young LT, Jacob-Filho W, Lafer B. Factors associated with brain volume in major depression in older adults without dementia: results from a large autopsy study. Int J Geriatr Psychiatry 2018; 33:14-20. [PMID: 28055136 DOI: 10.1002/gps.4649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/25/2016] [Accepted: 11/29/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We examined brain volume and atrophy in individuals with major depressive disorder (MDD) without dementia that were referred to a large autopsy service. We also examined potential risk factors for brain atrophy, including demographics and clinical variables. METHODS In this study, 1373 participants (787 male) aged 50 years or older who died from natural causes were included. Participants with no reliable informant, with cognitive impairment or dementia, with a medical history of severe chronic disease, or with prolonged agonal state were excluded. Presence of MDD at least once in their lifetime was defined according to the Structured Clinical Interview for DSM. Brain volume was measured immediately after removal from the skull. RESULTS Mean age at death was 68.6 ± 11.6, and MDD was present in 185 (14%) individuals. Smaller brain volume was associated with older age (p < 0.001), lower education (years; p < 0.001), hypertension (p = 0.001), diabetes (p = 0.006), and female gender (p < 0.001). In the multivariate analysis adjusted for sociodemographics and cardiovascular risk factors, smaller brain volume was not associated with major depression (β = -0.86, 95% CI = -26.50 to 24.77, p = 0.95). CONCLUSIONS In this large autopsy study of older adults, MDD was not associated with smaller brain volumes. Regardless of the presence of MDD, in this sample of older adults without dementia, we found that smaller brain volumes were associated with risk factors for brain neurodegeneration such as older age, diabetes, hypertension, and lower education. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lea Tenenholz Grinberg
- University of São Paulo Medical School, Sao Paulo, Brazil.,Memory and Aging Center University of California, San Francisco, CA, USA
| | | | | | - Faraz Salmasi
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Helena Kyunghee Kim
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Lionel Trevor Young
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Beny Lafer
- University of São Paulo Medical School, Sao Paulo, Brazil
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Gausden EB, Nwachukwu BU, Schreiber JJ, Lorich DG, Lane JM. Opportunistic Use of CT Imaging for Osteoporosis Screening and Bone Density Assessment: A Qualitative Systematic Review. J Bone Joint Surg Am 2017; 99:1580-1590. [PMID: 28926388 DOI: 10.2106/jbjs.16.00749] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to determine the clinical opportunities for the use of computed tomography (CT) imaging for inferring bone quality and to critically analyze the correlation between dual x-ray absorptiometry (DXA) and diagnostic CT as reported in the literature. METHODS A systematic review of the MEDLINE database was performed in February 2016 using the PubMed interface. The inclusion criteria were English language, studies performed using living human subjects, studies pertaining to orthopaedics, use of conventional diagnostic CT scans, studies that measured cancellous bone, and studies that reported Hounsfield unit (HU) measurements directly rather than a computed bone mineral density. RESULTS Thirty-seven studies that reported on a total of 9,109 patients were included. Of these, 10 studies correlated HU measurements of trabecular bone with DXA-based bone assessment. Reported correlation coefficients ranged between 0.399 and 0.891, and 5 of the studies reported appropriate threshold HU levels for diagnosing osteoporosis or osteopenia. CONCLUSIONS Direct HU measurement from diagnostic CT scans has the potential to be used opportunistically for osteoporosis screening, but in its current state it is not ready for clinical implementation. There is a lack of exchangeability among different machines that limits its broad applicability. Future research efforts should focus on identifying thresholds at specific anatomic regions in high-risk patients in order to have the greatest impact on patients. However, using diagnostic CT to infer region-specific osteoporosis could be extraordinarily valuable to orthopaedic surgeons and primary care physicians, and merits further research.
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Affiliation(s)
- Elizabeth B Gausden
- 1Hospital for Special Surgery, New York, NY 2Raleigh Orthopaedic Clinic, Raleigh, North Carolina 3New York Presbyterian Hospital, New York, NY
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Computed tomography value and tunnel enlargement of round and rounded rectangular femoral bone tunnel for anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 2016; 136:1587-1594. [PMID: 27498102 DOI: 10.1007/s00402-016-2541-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION We developed a novel technique for anatomical single-bundle anterior cruciate ligament (ACL) reconstruction: creation of a rounded rectangular femoral bone tunnel. The purpose of this study was to compare the computed tomography (CT) value and tunnel enlargement ratio of the femoral bone tunnel with those of round tunnel ACL reconstruction. MATERIALS AND METHODS We included 39 knees that underwent round tunnel ACL reconstruction and 42 that underwent rounded rectangular ACL reconstruction. To evaluate the CT value, we compared the CT images approximately 1 week after surgery. Making a parallel slice toward the opening of bone tunnels to a depth of 3 mm, we evaluated the CT value of eight directions in the bone tunnel wall. To evaluate tunnel enlargement, we compared CT images approximately 1 week after surgery with images taken 3 months after surgery. Using a parallel slice toward the opening of the bone tunnel, we measured the bone tunnel area and calculated the tunnel enlargement ratio. The level of significance was P < 0.05, and the t test was used for statistical analyses. RESULTS The CT value was significantly increased for the rounded rectangular tunnel in comparison with the round tunnel in almost all directions (P < 0.05). The rounded rectangular tunnel area enlargement ratio was significantly lower (round, 110 ± 38 %; rounded rectangular, 73 ± 37 %; P = 0.001). CONCLUSION The rounded rectangular tunnel could have a compression effect on the cancellous bone and reduce enlargement of the bone tunnel.
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Measurement of regional trabecular bone attenuation of the knee following anterior cruciate ligament rupture. Arch Orthop Trauma Surg 2016; 136:1453-7. [PMID: 27481367 DOI: 10.1007/s00402-016-2534-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The purpose of this study was to determine regional trabecular bone attenuation changes of the knee using computed tomography after anterior cruciate ligament rupture. MATERIALS AND METHODS Thirty one patients'-computed tomography images of the injured knees were used to measure trabecular bone attenuation in seven predetermined regions. RESULTS Trabecular bone attenuation at four of seven regions (anteromedial area of the proximal tibia, anterolateral area of the proximal tibia, posteromedial area of the proximal tibia, and posterocentral area of the proximal tibia) was negatively correlated with the duration after injury. Independent negative correlation between the duration after injury and the density in anteromedial area of the proximal tibia was detected. CONCLUSIONS After anterior cruciate ligament injury, trabecular bone attenuation of the knee decreases by time in certain regions of proximal tibia. Anteromedial region is the most significantly effected of all, which it is the anterior cruciate ligament fixation area.
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Ferretti-Rebustini REDL, Jacob-Filho W, Suemoto CK, Farfel JM, Leite REP, Grinberg LT, Pasqualucci CA, Nitrini R. Factors associated with morphometric brain changes in cognitively normal aging. Dement Neuropsychol 2015; 9:103-109. [PMID: 29213951 PMCID: PMC5619348 DOI: 10.1590/1980-57642015dn92000004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/04/2015] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE Cognitive impairment is associated with reductions in brain weight and volume. The factors related to morphometric brain changes in cognitively normal aging remain unknown. We aimed to identify which clinical factors are associated with morphometric brain changes in cognitively normal aging. METHODS A cross-sectional study of 414 subjects, ≥50 years old submitted to clinical assessment and brain autopsy, after informed consent, was carried out at the São Paulo Autopsy Service, Brazil. Data on cognitive and functional evaluations were collected through structured interview applied to the next-of-kin. Brain weight (g) and volume (mL) measurements were obtained and adjusted for head circumference (cm). Associations between brain weight/volume and related factors were obtained through univariate and multivariate analysis. RESULTS Participants were predominantly male (60.4%), Caucasian (69%), with mean age of 67.1 ± 10.9 years. Mean brain weight was 1219.2 ± 140.9 g, and mean brain volume was 1217.1 ± 152.3 mL. Head circumference was independently associated with low brain weight (p<0.001) and volume (p<0.001). Total and adjusted brain weight and volume decreased in some conditions. Female gender (p<0.001), hypertension (p<0.009), coronary artery disease (p<0.013) and walking assistance (p<0.011) were associated with lower adjusted brain weight while schooling was associated with higher adjusted brain weight (p<0.003). Female gender (p<0.001), age (p<0.001) and hypertension (p<0.011) were associated with low adjusted brain volume. CONCLUSION Morphometric brain changes occur despite the absence of cognitive impairment and were predominantly associated with age, female gender, mobility impairment and cardiovascular conditions. Schooling may be a protective factor.
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Affiliation(s)
- Renata Eloah de Lucena Ferretti-Rebustini
- BSN, RN, CNS, Ph.D, Medical-Surgical Nursing Department.
University of São Paulo School of Nursing. São Paulo SP, Brazil;
Physiopathology on Aging Lab/ SGHC - LIM 22. University of São Paulo School
of Medicine. São Paulo SP, Brazil
| | - Wilson Jacob-Filho
- MD, Ph.D, Physiopathology on Aging Lab/SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP, Brazil.
Division of Geriatrics of the Clinicas Hospital. University of São Paulo
School of Medicine. São Paulo SP, Brazil
| | - Claudia Kimie Suemoto
- MD, Ph.D, Physiopathology on Aging Lab/SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP, Brazil.
Division of Geriatrics of the Clinicas Hospital. University of São Paulo
School of Medicine. São Paulo SP, Brazil
| | - José Marcelo Farfel
- MD, Ph.D, Physiopathology on Aging Lab/SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP, Brazil.
Division of Geriatrics of the Clinicas Hospital. University of São Paulo
School of Medicine. São Paulo SP, Brazil
| | - Renata Elaine Paraiso Leite
- BSc, Ph.D, Physiopathology on Aging Lab/ SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP,
Brazil
| | - Lea Tenenholz Grinberg
- MD, Ph.D, Physiopathology on Aging Lab/ SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP, Brazil;
Department of Pathology. University of São Paulo School of Medicine.
São Paulo SP, Brazil
| | - Carlos Augusto Pasqualucci
- MD, Ph.D, Physiopathology on Aging Lab/ SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP, Brazil;
Department of Pathology. University of São Paulo School of Medicine.
São Paulo SP, Brazil
| | - Ricardo Nitrini
- MD, Ph.D, Physiopathology on Aging Lab/ SGHC - LIM 22.
University of São Paulo School of Medicine. São Paulo SP, Brazil.
Department of Neurology. University of São Paulo School of Medicine
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Chen X, Feng H, Zhang H, Song G. Measurement of bone mineral density in anterior cruciate ligament-injured patients by computed tomography scan. Arthroscopy 2013; 29:193. [PMID: 23369474 DOI: 10.1016/j.arthro.2012.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 11/29/2012] [Indexed: 02/02/2023]
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