MO567PILOT STUDY OF BONE RESISTANCE MEASURED IN VIVO BY IMPACT MICROINDENTATION IN KIDNEY TRANSPLANTATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Maria Jesus Lloret ◽  
Cristina Canal ◽  
Silvana Di Gregorio ◽  
Carmen Facundo Molas ◽  
Ana Vila Santandreu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Trabecular Bone Score ◽  
Individual Risk ◽  
Control Group ◽  
Material Strength ◽  
Bone Material Strength ◽  
History Of ◽  
The Individual ◽  
Impact Microindentation

Abstract Background and Aims Impact microindentation (IMI) is a new technique that measures bone material strength (BMS). Results are expressed as a BMS index (BMSi) which represents the ratio between the IMI distance [penetration of the needle-probe in patient’s bone (mid-shaft tibia)] versus a reference material (polimethylmethacrylate). Method Observational, prospective, single-center study. Baseline IMI (Osteoprobe®, Active Life Scientific, USA) and bone densitometry (iDXA, Lunar Health Care GE) were performed and data collected in the peritransplantation period of kidney transplant (KT) patients from May 2019 to May 2020, following our current clinical bone and transplant protocols. Based on the individual risk of fracture and current Spanish Society of Rheumathology/Nephrology guidelines, antirresorptive treatment (bisphosphonates or denosumab) was added on top of calcium and vitamin D supplements. We hereby present preliminary results of the control IMI performed 6 months after KT. Results Baseline IMI was performed in 45 patients, 62% men, 56±14 y/o, and a BMI of 24.9±3.5 kg/m2, reasonably controlled for classical serum bone mineral parameters. 70% were on dialysis prior to KT, 20% were diabetic, and 33.3% of women suffered from early menopause. 15.9% had a history of previous fragility fracture, 13% had a parent history of hip fracture, and 14% fell more than twice during the last year. Mean baseline FRAX® (https://www.sheffield.ac.uk/FRAX/tool.aspx?lang=sp) for a major osteoporotic fracture and hip were 4.3% and 2.3%, respectively. Baseline lumbar, femoral neck, hip and ultradistal radius DXA T-score were respectively -0.9, -1.7, -1.5, -2.0 SD. Mean BMSi was 78.5±7.6. Osteopenic/osteoporotic patients had a significantly lower BMSi than those who were not (76.3 vs 83; r = 0.37; p = 0.012). A statistically significant positive correlation was observed between BMSi and the trabecular bone score [(TBS), r = 0.346 ; p = 0.036). On a visual-analogic scale of pain, puncture was rated on average 1.1±1.6 over 10 (82% 0-2). 37.2% of patients began bisphosphonates (alendronic acid) and 9.3% denosumab. Control IMI was performed at 6 months in 24 patients, with a mean BMSi of 76.9±10.5. Mean difference between baseline and 6 months BMSi in this subgroup was 1.18±11.5. The group of patients treated with antiresorptives showed on average an increase in BMSi at 6 months, compared with a decrease in the control group (+5.2 vs -5.3; p = 0.054). Conclusion IMI is a technique with excellent tolerance that may offer complementary information on bone quality in the global assessment of bone resistance. IMI may allow the detection of EARLY changes in bone resistance in corticosteroid-treated KT patients with/without antiresorptives added to prophylactic treatment with calcium and vitamin D.

scholarly journals Bone material strength index as measured by impact microindentation in vivo is altered in patients with primary hyperparathyroidism

Bone Reports ◽  
2020 ◽  
Vol 13 ◽  
pp. 100630
Author(s):  
Manuela Schoeb ◽  
Elizabeth M. Winter ◽  
Abbey Schepers ◽  
Marieke Snel ◽  
Natasha M. Appelman-Dijkstra
Keyword(s):  
Primary Hyperparathyroidism ◽  
Material Strength ◽  
Strength Index ◽  
Bone Material ◽  
Bone Material Strength ◽  
Impact Microindentation

BONE REMODELING MARKERS AS PREDICTORS OF BONE METABOLIC CHANGES IN MALES WITH DIABETIC OSTEOPATHY

2020 ◽  
Vol 58 (3) ◽  
pp. 290-293
Author(s):  
S. S. Safarova ◽  
S. S. Safarova
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Remodeling ◽  
Control Group ◽  
Mineral Density ◽  
Amino Terminal ◽  
Bone Remodeling Markers ◽  
History Of ◽  
Male Patients

Diabetic osteopathy is one of the little studied complications of diabetes mellitus (DM), which leads to common lowtrauma fractures and, as a consequence, disability and death. The level of insulin is connected with bone functional and morphological changes followed by decreased bone mineral density (BMD) in the early stages of diabetic osteopathy. Objective: to study bone morphofunctional properties in males with type 1 and 2 DM (T1DM and T2DM). Subjects and methods. Examinations were made in 41 male patients with T1DM and 52 male patients with T2DM without a history of fractures. Their age varied from 40 to 70 years (mean age, 55.8±0.7 years and 58.4±0.9 years, respectively). A control group consisted of 34 patients (mean age, 55.9±0.9 years) without a history of DM. Patients with other endocrine disorders, end-stage complications, or chronic liver and kidney diseases were excluded from the investigation. BMD was determined by dual-energy X-ray absorptiometry (DXA). Serum bone remodeling markers (procollagen type 1 amino-terminal propeptide and C-terminal telopeptide), as well as 25(OH)D, parathyrin, insulin, glycated hemoglobin (HbA1c), and electrolytes (Ca2+, P+) were evaluated. Results and discussion. An association of BMD with renal function, HbA1c, and body mass index was observed in patients with T2DM. In the T1MD group, BMD was closely related to insulin deficiency and was significantly lower than that in the control group. In patients with vitamin D deficiency, BMD was significantly lower than in those with normal vitamin D levels (p<0.05). The patients with T1DM displayed both a decrease in BMD (p<0.05) and a pronounced change in the levels of bone markers (p<0.05). Those with T2DM had impaired bone remodeling processes, which was determined by the level of these markers (p<0.05) and observed in the presence of normal BMD due to the complex pathophysiology of the underlying disease. Conclusion. Vitamin D deficiency, insufficient and decreased insulin sensitivity, hyperglycemia, and overweight are important causes of osteopathy in patients with DM. The markers of bone remodeling may become promising indicators for diagnosing osteopathy, but additional studies are needed to elaborate recommendations for their use in routine practice in order to predict and prevent this complication of DM.

scholarly journals SAT-395 Correlations Between Biochemical Parameters and Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHP) Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lívia Marcela Santos ◽  
Monique Nakayama Ohe ◽  
Sthefanie Giovanna Pallone ◽  
Ilda Sizue Kunii ◽  
Renata Elen Costa Silva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Trabecular Bone ◽  
Vitamin D Deficiency ◽  
Negative Correlation ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
Control Group ◽  
Total Calcium ◽  
Mineral Density ◽  
Positive Correlation

Abstract Background: Vitamin D deficiency is common among PHP patients. While data are limited, some studies suggest that vitamin D deficiency may exacerbates skeletal disease in PHP. TBS is a software-based method for assessment of trabecular bone structure of the spine, based on analysis of pixels obtained in dual energy x-ray absorptiometry (DXA) images. The aim of this study was to evaluate TBS, vitamin D status, clinical and laboratorial measurements in a PHP group of patients in a search for a more accurate bone fragility test for risk assessment in this group of patients. Methods: From June/2017 to January/2019, patients who met the criteria for PHP diagnosis were included in this study. Control group was composed by age and sex-matched healthy individuals. Overall, 64 PHP and 63 controls were enrolled. Bone mineral density (BMD) measured by DXA (Hologic QDR 4500) at the lumbar spine, total hip, femoral neck, and TBS values (InSight™) were determined in both groups. Total and ionized calcium, PTH, 25-hydroxyvitamin D (25(OH)D), creatinine, alkaline phosphatase, P1NP and CTX were measured. None were in use of Vitamin D supplementation. Results: As expected, PHP patients had lower BMD values than controls in all sites (p&lt;0.0001). TBS measurements were also reduced in PHP patients compared to controls (1233 vs 1280, p=0.0444). TBS values were inversely correlated with total calcium (CaT) and phosphorus measurements were positively correlated in the PHP patients. 25(OH)D measurements didn’t differ between groups (PHP 22.5 vs. controls 19.8 ng/mL, p=0.1699). There was a positive correlation between 25(OH)D and TBS in both PHP and controls (r= 0,3088, p= 0,0138 and r= 0,3708, p= 0,003 respectively). Considering individuals with vitamin D deficiency (25(OH)D levels &lt;=20 ng/mL), a negative correlation between TBS and CaT measurements among PHP patients (r= -0,4391, p=0,0172) was observeed, while in controls there was a positive correlation between TBS and 25(OH)D (r= 0,3504, p= 0,0362). Conclusion: Serum total calcium presents negative correlation and phosphorus a positive one with TBS in PHP patients. We also found a correlation between TBS and 25(OH)D, both in PHP and in controls. 25(OH)D &lt;=20 ng/mL is an independent risk factor determining degraded TBS among PHP patients and controls.

Predictors of deep venous thrombosis in patients admitted to rehabilitation clinics after major orthopaedic surgery

VASA ◽  
2013 ◽  
Vol 42 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Jan Beyer-Westendorf ◽  
Vitalie Bogorad ◽  
Ingeborg Tautenhahn ◽  
Sandra Marten ◽  
Sebastian M. Schellong
Keyword(s):  
Orthopaedic Surgery ◽  
Standard Of Care ◽  
Female Gender ◽  
Individual Risk ◽  
Hip Fracture Surgery ◽  
Vein Thrombosis ◽  
Compression Ultrasound ◽  
History Of ◽  
Major Orthopaedic Surgery ◽  
The Individual

Background: Venous thromboembolism (VTE) is a frequent complication of major orthopaedic surgery; prolonged prophylaxis with anticoagulants is standard of care. However, late manifestation of VTE is common and little is known about the predictors of late deep vein thrombosis (DVT) and the distribution of proximal and distal DVT and isolated calf muscle vein thrombosis (MVT). Patients and methods: 482 patients admitted to a rehabilitation clinic (RC) after total hip or knee replacement (THR; TKR) or hip fracture surgery (HFS) underwent complete compression ultrasound (CCUS) screening for VTE within 72 hours after admission into RC. Predictors of VTE were evaluated. Results: DVT was prevalent in 74 events (14.7 %), consisting of 13 (2.7 %) proximal DVT, 17 (3.5 %) distal DVT and 41 (8.5 %) MVT, respectively. Multivariate analyses established history of VTE (OR for proximal DVT 7.0; 95 %-CI 1.9 - 25.9; OR for any DVT 3.9; 95 %-CI 1.7 - 8.9), female gender (OR 3.3; 95 %-CI 1.0 - 10.6), coronary artery disease (OR 3.8; 95 %-CI 1.1 - 12.9) and cancer (OR 8.0; 95 %-CI 1.8 - 35.5) as independent VTE predictors for proximal DVT. For MVT, age (OR 2.4; 95 %-CI 1.2 - 5.0) and a history of musculo-skeletal disease (OR 2.6; 95 %-CI 1.1 - 5.8) or autoimmune disease (OR 3.9; 95 %-CI 1.0 - 15.4) were found to be independent predictors. Conclusions: This study confirms well-known predictors of VTE and high rates of postoperative VTE despite optimal thromboprophylaxis. In addition, independent risk factors for proximal DVT and MVT were identified. The data support the concept or continuing thromboprophylaxis during rehabilitation after major orthopaedic surgery because a considerable percentage of patients had asymptomatic DVT at RC on admission. However, significant differences in the individual risk profile and the distribution pattern of DVT and MVT exist, which could be used for a more individualized thromboprophylaxis strategy.

Does the Vitamin D Deficiency Have Any Role in Severity or Prolongation of Seizure? A Pilot Study in Iran

2020 ◽  
Vol 16 (5) ◽  
pp. 781-787
Author(s):  
Mohammad Vafaee-Shahi ◽  
Reza S. Badv ◽  
Alinaghi Kazemi ◽  
Samileh Noorbakhsh ◽  
Koorosh Kamali ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Normal Level ◽  
Significant Relationship ◽  
Positive Family History ◽  
Final Analysis ◽  
Idiopathic Epilepsy ◽  
Control Group ◽  
Vitamin D Levels ◽  
History Of

Background: Based on previous studies, vitamin D deficiency could lead to nerve stimulation. The purpose of the present study was to determine frequency and duration of seizures in children with idiopathic epilepsy in two groups; normal level of vitamin D versus decreased level of vitamin D. Methods: This pilot, comparative study was carried out in Zanjan University of Medical Sciences on total 40 children aging between 2 to 12 years old (23 male and 17 female) with the diagnosis of idiopathic epilepsy. All patients were receiving anti-epileptic drugs. The initial questionnaire was completed by each parent. Total 40 epileptic cases were examined in close follow-ups every three months, during total 9 months. Meanwhile, the frequency and duration of each seizure were recorded in questionnaire at every three-month period. Vitamin D blood samples were analyzed at the beginning of the study and after 9 months following the study. Serum levels of Vitamin D were analyzed by ELISA method (Elecsys2010, RocheCo, Germany; STAR FAX; 2100), simultaneously, Vitamin D level <30 ng/ml (nanogram per milliliter) was defined as Vitamin D deficiency. Cases were divided into two groups based on Vitamin D level. The frequency and duration of convulsions were compared in patients with normal level of vitamin D versus children with decreased level of vitamin D. Data were analyzed by Chi-square and t-test methods. Results: In all 40 patients, vitamin D level less than 30 ng/ml was detected in 32% (13 patients) at the beginning of study and 35% (14 patients) in 9 months later (13 patients were common between the two groups). There was no significant relationship between the frequency of seizures, the duration of seizures and vitamin D levels in patients. The relationship between positive family history of epilepsy and the number of seizures was reported significant. The frequency of vitamin D deficiency was higher in female cases in final evaluation. Conclusion: In the present study, a considerable correlation was detected between the frequency of seizures and positive history of seizure in the family. The frequency of vitamin D deficiency was higher in female cases in final analysis. No significant relationship was detected between the number of seizures, the mean duration of seizures and serum level of Vitamin D in children who received anticonvulsant drugs. However, vitamin D deficiency in patients was not overlooked in order to prevent known complications. We recommend a randomized clinical trial in the future with an adequate sample size. Moreover, a non-epileptic control group in study would be useful.

АЛЛЕРГИЯ К ЛИМОНУ: ОПИСАНИЕ СЛУЧАЯ ОРАЛЬНОГО АЛЛЕРГИЧЕСКОГО СИНДРОМА В СОЧЕТАНИИ С АЛЛЕРГИЧЕСКИМ СРЕДНИМ ОТИТОМ И ЛАБИРИНТИТОМ У БОЛЬНОЙ С ПОЛИСЕНСИБИЛИЗАЦИЕЙ И МНОЖЕСТВЕННЫМИ ПРОЯВЛЕНИЯМИ АЛЛЕРГИИ

2019 ◽  
pp. 25-32
Author(s):  
O.S. Prilutskiy ◽  
Yu.A. Lyhina
Keyword(s):  
Drug Allergy ◽  
Allergic Rhinoconjunctivitis ◽  
Oral Allergy Syndrome ◽  
Plant Origin ◽  
Pollen Allergens ◽  
History Of ◽  
Skin Prick Tests ◽  
The Individual

Оральный аллергический синдром представляет собой IgEопосредованную аллергическую реакцию на продукты питания растительного происхождения у лиц с сенсибилизацией к различным пыльцевым аллергенам. Впервые описан клинический случай орального аллергического синдрома при употреблении в пищу лимона у женщины 25 лет. Кроме того, в анамнезе у больной зарегистрированы сезонный аллергический риноконъюнктивит, бронхиальная астма, контактный аллергический дерматит, проявления лекарственной аллергии в виде крапивницы, диареи и др. Установлена сенсибилизация ко многим группам аллергенов и наличие явлений аллергического среднего отита и вызванного аллергенами лабиринтита. Установлена целесообразность аллергенспецифической диагностики с использованием различных методов (лабораторных и прик, прикприктестов) для назначения индивидуальной диеты и гипоаллергенного режима.Oral allergic syndrome is an IgEmediated allergic reaction to foods of plant origin in persons with sensitization to various pollen allergens. A clinical case of oral allergy syndrome caused by consumption of lemon in a 25yearold woman with sensitization to many groups of allergens and presence of allergic otitis media and allergyinduced labyrinthitis is presented. The patient had a history of seasonal allergic rhinoconjunctivitis, bronchial asthma, contact allergic dermatitis, urticaria as a manifestation of drug allergy. In vivo (skin prick tests, prickprick tests) and in vitro allergen specific diagnostics allowed to work out the individual diet and a hypoallergenic regime in this case.

Temporal complexity in clinical manifestations of lung disease

2011 ◽  
Vol 110 (6) ◽  
pp. 1723-1731 ◽  
Author(s):  
Urs Frey ◽  
Geoffrey Maksym ◽  
Béla Suki
Keyword(s):  
Lung Function ◽  
Statistical Physics ◽  
Clinical Manifestations ◽  
Individual Risk ◽  
Fluctuation Analysis ◽  
Temporal Complexity ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
Insight Into

In this review, we summarize results of recent research on the temporal variability of lung function, symptoms, and inflammatory biomarkers. Specifically, we demonstrate how fluctuation analysis borrowed from statistical physics can be used to gain insight into neurorespiratory control and complex chronic dynamic diseases such as asthma viewed as a system of interacting components (e.g., inflammatory, immunological, and mechanical). Fluctuation analysis tools are based on quantifying the distribution and the short- and long-term temporal history of tidal breathing and lung function parameters to assess neurorespiratory control and monitor chronic disease. The latter includes the assessment of severity and disease control, the impact of treatment and environmental triggers, the temporal characterization of disease phenotypes, and the individual risk of exacerbation. While in many cases specific mechanistic insight into the fluctuations still awaits further research, appropriate analyses of the fluctuations already impact on clinical science and practice.

scholarly journals Vitamin D moderates the interaction between 5-HTTLPR and childhood abuse in depressive disorders

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sarah Bonk ◽  
Johannes Hertel ◽  
Helena U. Zacharias ◽  
Jan Terock ◽  
Deborah Janowitz ◽  
...  
Keyword(s):  
Vitamin D ◽  
Childhood Abuse ◽  
Depressive Disorders ◽  
Tryptophan Hydroxylase ◽  
Serum Vitamin ◽  
Individual Risk ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Tph2 Gene ◽  
The Individual

AbstractA complex interplay between genetic and environmental factors determines the individual risk of depressive disorders. Vitamin D has been shown to stimulate the expression of the tryptophan hydroxylase 2 (TPH2) gene, which is the rate-limiting enzyme for serotonin production in the brain. Therefore, we investigate the hypothesis that serum vitamin D levels moderate the interaction between the serotonin transporter promotor gene polymorphism (5-HTTLPR) and childhood abuse in depressive disorders. Two independent samples from the Study of Health in Pomerania (SHIP-LEGEND: n = 1 997; SHIP-TREND-0: n = 2 939) were used. Depressive disorders were assessed using questionnaires (BDI-II, PHQ-9) and interview procedures (DSM-IV). Besides serum vitamin D levels (25(OH)D), a functional polymorphism (rs4588) of the vitamin D-binding protein is used as a proxy for 25(OH)D. S-allele carriers with childhood abuse and low 25(OH)D levels have a higher mean BDI-II score (13.25) than those with a higher 25(OH)D level (9.56), which was not observed in abused LL-carriers. This significant three-way interaction was replicated in individuals with lifetime major depressive disorders when using the rs4588 instead of 25(OH)D (p = 0.0076 in the combined sample). We conclude that vitamin D relevantly moderates the interaction between childhood abuse and the serotonergic system, thereby impacting vulnerability to depressive disorders.

Comparative assessment of the level of physical activity and physical fitness IIn patients treated for sciatica versus healthy individuals

2020 ◽  
Vol 1 (3) ◽  
pp. 27-38
Author(s):  
Grzegorz MAŃKO ◽  
Anna STROKOWSKA ◽  
Magda PIENIĄŻEK ◽  
Marcin ZIELIŃSKI ◽  
Robert DZIURA ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Fitness ◽  
Healthy People ◽  
Individual Risk ◽  
Control Group ◽  
Degree Of Disability ◽  
Disability Questionnaire ◽  
The Individual ◽  
Individual Risk Factors ◽  
Age Range

Introduction: Sciatica (Ischias) is a set of symptoms associated with the compression of L4, L5 and S1 spinal nerves, forming the sciatic nerve, the largest peripheral human nerve. Pain can radiate to the buttock, lateral surface of the hip, calf and foot. The individual risk factors for sciatica include height, body mass, muscle strength, and physical condition. I n d i v i d u a l f a c t o r s a l s o i n c l u d e pregnancies and births. The aim of this study was to assess and compare the level of physical activity and physical fitness of people treated for sciatica and compare the results with the results of tests carried out among healthy people, not treated for sciatica or other diseases of the lower spine. Material and methods: The study was conducted among 60 people, both sexes, aged 50-69. The I n t e r n a t i o n a l P h y s i c a l A c t i v i t y Questionnaire IPAQ and the Oswestry Disability Questionnaire were used for the assessment. In the research group there were 30 people diagnosed with sciatica, treated for this disease or other diseases of the lumbar spine. The control group consisted of 30 healthy people in the same age range. Results and conclusion: On the basis of the conducted research, there were significant differences between the degree of disability of healthy people and patients, which confirmed that sciatica is a disease significantly affecting physical fitness during everyday activities.

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