No abstract

The latest data support the correlation of atherosclerosis and osteoporosis, indicating the parallel progression of two tissue destruction processes with increased fatal and non-fatal coronary events, as well as higher fracture risk. Vitamin D inadequacy associated with low bone mineral density increases fall and fracture risk, leads to secondary hyperparathyroidism, calcifies coronary arteries and significantly increases cardiovascular disease. Randomized clinical trial evidence related to extraskeletal vitamin D outcomes was limited and generally uninformative. A recent recommendation on vitamin D dietary requirements for bone health is 600 IU/d for ages 1-70 years and 800 IU/d for 71 years and older, corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/ml (50 nmol/l). Further large randomized controlled trials are needed to reassess laboratory ranges for 25-hydroxyvitamin D in both diseases, in order to avoid under- and over-treatment problems, and completely clarify the relationship between atherosclerosis and osteoporosis.

Objective: The aim of this study is to estimate and compare the effects of low-level laser therapy and interferential current therapy in patients with complex regional pain syndrome type I. Material and Methods: Prospective randomized clinical research, including 45 patients with post-traumatic unilateral complex regional pain syndrome type I, treated at the Clinical Center Nis from December 2004 to January 2007. Low-level laser therapy and kinesitherapy were applied in group A (n=20), whereas group B (n=25) was treated with interferential current and kinesitherapy. For assessment of the therapeutic effect, the following parameters were tested: pain intensity was determined by visual analog scale, figure-of-eight measurement was used to determine the circumference of the affected part of the extremity, and range of motion of the affected joint was measured by a standard goniometer. Results: Statistically significant differences were obtained for all tested parameters in both groups, but the difference was greater in group A compared to group B (p<0.05). Conclusion:The results of this study show that both physical procedures are effective in the treatment of complex regional pain syndrome type I, but the efficiency of laser therapy is statistically significantly higher compared to interferential current therapy.

Heterotopic ossification represents one of the most frequent complications following any type of hip arthroplasty. However, disagreement exists regarding the clinical significance of heterotopic ossification after total hip arthroplasty (THA). This study evaluated the effect of different grades of heterotopic ossification on range of hip motion, pain, and the clinical outcome in patients after THA. The study included 198 patients with primary THA because of unilateral hip osteoarthritis, followed for a minimum of 1 year after THA. Diagnosis and classification of heterotopic ossification according to Brooker was achieved on anteroposterior radiograph of the hips 1 year postoperatively. The clinical outcome was assessed at 1-year follow-up with the use of the Harris hip score. Pain was assessed as the pain component of the Harris hip score. Hip range of motion was measured passively in the lying position with a goniometer and recorded in degrees according to the method suggested by the American Academy of Orthopaedic Surgeons 1988. The incidence of heterotopic ossification was 47% and the incidence of severe ossification was 11%. The severe heterotopic ossification significantly reduced clinical outcome, overall range of hip motion and certain components such as flexion, abduction and external rotation, but had no significant effect on pain, while the lower degree of ossification did not significantly influence the clinical outcome, hip motion and pain. This study has shown that only severe heterotopic ossification is of clinical significance.

Male sex, increased comorbidity and age more than 85 years could be considered with lower functional recovery capacity potential after hip fracture, and thus should be individually assessed and continuously monitored. Functional status estimation by BBS could be taken as a sensitive predictive value for the evaluation of functional improvement in these patients.