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JRPMS 2019

Review Article JRPMS, Vol 3, No 1, March 2019, p.1-4
Hypergravity and its effects on bones and the musculoskeletal system: a narrative review
Chrysoula Argyrou, George I. Lambrou
Keywords: Hypergravity, Microgravity, Space, Bone cells, Musculoskeletal
The entrance of mankind into the Space Age, accomplished by the second half of the 20th century, and the advances in modern physics have completely transformed the way we perceive the role of gravity. The musculoskeletal system is long known to be heavily affected by the gravitational forces, resulting in marked loss in bone mineral density in the setting of microgravity. The meticulous study of the underlying pathophysiologic mechanisms is pivotal in order to identify possible therapeutic targets for the management of the microgravity-induced changes in bone physiology during spaceflight missions, as well as the osteopenia induced changes in the setting of osteoporosis affecting a vast majority of elder individuals. In the present bibliographic narrative review, the importance of mechanisms employed by cells in order to perceive and respond to altered gravity are discussed. Current in vitro and in vivo studies focusing on the effect of hypergravity on the musculoskeletal system are also presented. Overall, the variability in study design of the available published data makes the deduction of safe conclusions rather challenging and uncertain. It is important that future studies address the matter by employing similar research methodology and study design in order to increase the comparability of their results.
Mini Review JRPMS, Vol 3, No 1, March 2019, p.5-8
The effects of radiation therapy in musculoskeletal system of children
Christina K. Lappa
Keywords: Childhood cancer, Radiation therapy, Musculoskeletal, Early and late effects
This review summarizes the literature investigating the radiotherapy related early and late musculoskeletal abnormalities in children, concerning non-malignant conditions and secondary malignancies. We searched the PubMed for English written articles and 10 relevant articles were found published between 1992 and 2015. We found that the late musculoskeletal effects were the more frequent among the survivors of childhood cancer, that they occurred more in children who have been irradiated for cranial or abdominal tumors and they were age and dose related. Further research with larger clinical trials examining the radiation dose, especially in younger children, should be done, to refine radiation dose protocols and also annual screening for high risk survivors should be recommended.
Review Article JRPMS, Vol 3, No 1, March 2019, p.9-16
Dental implants in patients with oral autoimmune diseases
Theodora S. Tounta
Keywords: Oral autoimmune diseases, Dental implants, Lichen planus, Pemphigus, Peri-implantitis
Oral mucosal autoimmune diseases include a variety of disorders, like oral lichen planus (OLP), pemphigus vulgaris (PV), mucous membrane (MMP) and bullous pemphigoid (BP), epidermolysis bullosa acquisita (EBA), systemic lupus erythematosus (SLE) and Sjögren syndrome (SS) and can cause painful erosions, blisters and ulceration at the oral epithelium. Such diseases complicate dental hygiene and can lead to tooth loss. When natural teeth are missing, dental implants can improve quality of life for these patients. Osseointegration is necessary for dental implant success and is not contraindicated for patients with oral mucosal autoimmune diseases. However, the clinical dentist must consider the possible impact of oral autoimmune diseases on the oral epithelium that might affect implant success, also due to the difficulty of everyday oral hygiene, leading to bone absorption around the implant. Moreover, medication approved for the therapy of such diseases, such as corticosteroids, immunosuppressants and non-steroidal anti-inflammatory drugs (NSAIDs) could provoke osseointegration, as it compromises bone quality and affects the patient’s general health. However, the impact of these drugs on implant surgery depends on dose and duration of the drug and usually dental implantation is possible.
Review Article JRPMS, Vol 3, No 1, March 2019, p.17-25
Signaling pathways that overactivate metabolism and drive neoplasia, in rhabdomyosarcoma
Christos P. Tselios, George I. Lambrou
Keywords: Signaling, Pathway, Metabolism, Neoplasia, Rhabdomyosarcoma
The functional status of a cell is expressed in its metabolic activity. Cancer cells differ from normal cells through unlimited cell division, and show a greater need for energy for their rapid growth and duplication. Thus, cancerassociated metabolic alterations, i.e. metabolic over-activation through signaling pathways alterations, have emerged as a cancer hallmark. Rhabdomyosarcoma (RMS) is a myogenic tumor classified as the most frequent soft tissue sarcoma affecting children, adolescents and adults. Signaling pathway alterations present in this cancer can be related to increased metabolic activity and drive neoplasia. In this review first of all, we would like to enlighten cancer and particular RMS metabolism. Further, we aim to summarize several pathways related to oncogenic drivers affecting metabolism of RMS cells in order to simulate them (in other studies) with a system biology approach. The understanding of the common mechanisms that transform physiological cells to malignant may reveal novel therapeutic targets and strategies that may improve the currently poor outcome for patients with RMS.
Mini Review JRPMS, Vol 3, No 1, March 2019, p.26-31
The role of the calcium intake in the development of cardiovascular calcification
Evaggelia E. Pitaraki
Keywords: Calcium intake, Dietary calcium, Supplemental calcium, Cardiovascular calcification, Cardiovascular disease (CVD) risk
Calcium covers a wide range of body functions. Adequate calcium intake is critical for skeletal health. Dietary calcium intake is considered safe, while supplemental calcium raises concerns, regarding cardiovascular health. Calcium can be administered alone or in combination with vitamin D. Supplemental calcium can be provided if people cannot meet their dietary needs or as a prescription in patients receiving medication for osteoporosis. The last ten years, a major research debate has been ongoing, regarding the possible relationship between calcium intake and cardiovascular risk. Possible mechanisms have been investigated, concerning the possible effect of calcium supplementation on cardiovascular calcifications. Further analysis is needed regarding levels of calcium intake that could possibly promote calcifications. It is also significant to evaluate the effect of the duration of supplemental calcium administration and the possible protective effect of concomitant administration of vitamin D supplementation. Until there are clinical studies to address those hypotheses, the current recommendations include that calcium (dietary and supplemental) can be given safely, within normal limits, to all healthy people and patients, possibly excluding those with chronic kidney disease.