MRI-based texture analysis of trabecular bone for opportunistic screening of skeletal fragility

2021 ◽  
Author(s):  
Caroline Zaworski ◽  
Jonathan Cheah ◽  
Matthew F Koff ◽  
Ryan Breighner ◽  
Bin Lin ◽  
...  
Keyword(s):  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Texture Analysis ◽  
Fragility Fracture ◽  
Spatial Organization ◽  
Lumbar Vertebrae ◽  
Skeletal Fragility ◽  
Second Moment ◽  
Number Of Patients ◽  
History Of

Abstract Context Many individuals at high risk for osteoporosis and fragility fracture are never screened by traditional methods. Opportunistic use of imaging obtained for other clinical purposes is required to foster identification of these patients. Objective The aim of this pilot study was to evaluate texture features as a measure of bone fragility, by comparing clinically acquired magnetic resonance imaging (MRI) scans from individuals with and without a history of fragility fracture. Methods This study retrospectively investigated 100 subjects who had lumbar spine MRI performed at our institution. Cases (n=50) were postmenopausal women with osteoporosis and a confirmed history of fragility fracture. Controls (n=50) were age and race matched postmenopausal women with no known fracture history. Trabecular bone from the lumbar vertebrae was segmented to create regions of interest within which a gray level co-occurrence matrix was used to quantify the distribution and spatial organization of voxel intensity. Heterogeneity in the trabecular bone texture was assessed by several features, including: contrast (variability), entropy (disorder) and angular second moment (homogeneity). Results Texture analysis revealed that trabecular bone was more heterogeneous in fracture patients. Specifically, fracture patients had greater texture variability (+76% contrast; p=0.005), greater disorder (+10% entropy; p=0.005), and less homogeneity (-50% angular second moment; p=0.005) compared to controls. Conclusions MRI-based textural analysis of trabecular bone discriminated between patients with known osteoporotic fractures and controls. Further investigation is required to validate this promising methodology which could greatly expand the number of patients screened for skeletal fragility.

scholarly journals Premenopausal Trabecular Bone Loss is Associated with a Family History of Fragility Fracture

2016 ◽  
Vol 76 (08) ◽  
pp. 895-901 ◽  
Author(s):  
J. Prior ◽  
C. Hitchcock ◽  
Y. Vigna ◽  
V. Seifert-Klauss
Keyword(s):  
Family History ◽  
Bone Loss ◽  
Trabecular Bone ◽  
Fragility Fracture ◽  
Trabecular Bone Loss ◽  
History Of

scholarly journals Colposcopy in postmenopausal women: a challenging procedure

2020 ◽  
Vol 9 (8) ◽  
pp. 3341
Author(s):  
Arshdeep Kaur ◽  
Gursewak Singh
Keyword(s):  
Postmenopausal Women ◽  
Prospective Observational Study ◽  
Pap Smear ◽  
Total Population ◽  
Cervical Screening ◽  
Indian Women ◽  
Number Of Patients ◽  
Carcinoma Of Cervix ◽  
History Of ◽  
Post Menopausal

Background: Introduction-carcinoma of cervix is the commonest cancer in Indian women. It constitutes 14%of the total population above age of 50 years. Atrophic changes in the genital tract causes problems in Pap smear as well as in the colposcopy.Methods: This is prospective observational study conducted in the department of obstetrics and gynecology of SGRDIMSR, Sri Amritsar, which comprised 30 cases of postmenopausal women referred for colposcopy. Inclusion criteria were complaints of post-menopausal bleeding, abnormal vaginal discharge, post coital bleeding, an abnormal PAP smear, an unhealthy-looking cervix. Women with history of any surgery on the cervix in the past three months or with obvious cervical cancer were excluded.Results: Patient with age group of 44-70 years were included, and maximum number of patients had complaint of post-menopausal bleeding (50%). 9 (30%) patients were positive for malignancy on histopathology, while with 9 (30%) false positive patients on colposcopy. Problems encountered while performing colposcopy includes cervix flushed with vagina, atrophy of introitus, bleeding from the cervix and relaxed vaginal walls. Use of various corrective measures were helpful to overcome the problems of colposcopy.Conclusions: It is an essential part of cervical screening programme, but it has some limitations and pitfalls which can lead to error in the diagnosis.

scholarly journals Demographic Characteristics and Family History of Lumbar Problems in Patients with Lumbar Disc Degenerative Diseases Candidate for Surgery

2020 ◽  
Vol 6 (3) ◽  
pp. 121-132
Author(s):  
Shiva Mashinchi ◽  
◽  
Shahrokh Yousefzadeh-Chabok ◽  
Mesbah Dibavand ◽  
◽  
...  
Keyword(s):  
Family History ◽  
Lumbar Disc ◽  
Occupational Status ◽  
Lumbar Vertebrae ◽  
Demographic Characteristics ◽  
Low Back ◽  
Acute Trauma ◽  
First Degree Relatives ◽  
Number Of Patients ◽  
History Of

Background and Aim: Previous studies have reported the important effect of age, sex, heredity, and occupational status on intervertebral degenerative dick diseases, which are among the most important causes of low back pain. However, their results are not always so conclusive. This study was performed to investigate the demographic characteristics and family history of lumbar problems in patients with lumbar degenerative dick diseases due to causes other than acute trauma. Methods and Materials/Patients: This cross-sectional descriptive study included patients without acute trauma who were candidates for surgery of lumbar degenerative dick diseases from 2017 to 2018 in the only state hospital admitting these patients in Rasht, Iran. The data related to the disease were obtained from the patients' medical records. Their demographic characteristics and family history of lumbar vertebrae diseases in their relatives were collected using a researcher-made questionnaire through face-to-face interview by the researcher. The data were analyzed using SPSS (Version 16). Descriptive statistics and the chi-square test were conducted at a significance level of 0.05. Results: More than half of the patients were in their 4th to 6th decades of life, and the number of men was 1.8 times as women. The frequency of herniated discs was more than that of both spinal canal stenosis and spondylolisthesis, and most people had no history of low back trauma. The duration of disease in 73% of the patients was more than 1 year and the mean duration was about 4.5 years. More than half of the patients reported problems with the lumbar vertebrae in at least 1 of their first-degree relatives. About one-third of the patients reported a history of vertebrae surgery in their first-degree relatives and the maximum number of reported surgeries in 1 family was 5. Most of the patients were low-literate and illiterate, and about one-third of the patients were workers/farmers. More than one-third of them were housewives and the number of patients working in administrative and driving jobs was very low. There was no significant relationship between study variables and the type of degenerative problems of the lumbar vertebrae. Conclusion: These findings showed similarities with previous studies in terms of age groups, occupational status, and a history of family lumbar problems in patients with lumbar degenerative disc diseases.

Frequency of FRAX risk factors in osteopenic postmenopausal women with and without history of fragility fracture

2012 ◽  
Vol 19 (11) ◽  
pp. 1193-1199 ◽  
Author(s):  
Francesc Baró ◽  
Antonio Cano ◽  
Rafael Sánchez Borrego ◽  
Javier Ferrer ◽  
Silvia Pilar González Rodríguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postmenopausal Women ◽  
Fragility Fracture ◽  
History Of

scholarly journals 570. “I don’t know”: The Typical Response When Taking Pneumococcal Immunization Histories in Kidney Transplant Candidates

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S349-S351
Author(s):  
Jahanavi M Ramakrishna ◽  
Tambi Jarmi ◽  
Claudia R Libertin
Keyword(s):  
Infectious Disease ◽  
Kidney Transplant ◽  
Pneumococcal Vaccine ◽  
Patient Population ◽  
Pneumococcal Vaccination ◽  
Prior History ◽  
Vaccine Preventable Diseases ◽  
Number Of Patients ◽  
Order Completion ◽  
History Of

Abstract Background Vaccine-preventable diseases account for significant morbidity and mortality in the kidney transplant (KT) patient population. AST Guidelines support review and documentation of pneumococcal vaccines in KT candidate infectious disease (ID) evaluations. The objective of this study is to determine the number of KT candidates screened for prior pneumococcal immunizations and the frequency of vaccines ordered by providers when indicated at Mayo Clinic Florida’s (MCF) Transplant Center. Methods This study was an institution-based retrospective analysis of all KT candidates evaluated at MCF from December 2, 2019 – January 14, 2020. Data collection was obtained by electronic health record review. Outcomes included known history and documentation rates of prior pneumococcal vaccinations (both Prevnar 13 and Pneumovax 23) by infectious disease (ID) providers, as well as pneumococcal vaccine order frequency during ID pre-transplant evaluation when indicated. Data analysis was done using simple descriptive statistics. Results Sixty-one patients underwent KT evaluation during the study period. Among the 61 patients, 20 (32.8%) and 20 (32.8%) had a known prior history of receiving Prevnar 13 and Pneumovax 23 vaccinations, respectively. Vaccine history was unknown for Prevnar 13 and Pneumovax 23 in 39 (63.9%) patients. Vaccine status was not documented by ID providers in 2 (3.3%) patients. When appropriate, ID providers ordered Prevnar 13 and Pneumovax 23 in 38 (92.7%) and 41 (100%) patients, respectively. Orders included both electronic and written documentation to account for patients planning immunization elsewhere. Of the 38 patients advised to receive the Prevnar 13 vaccine, 17 (41.5%) patients were documented completing immunization. Pneumovax 23 order completion rates were not recorded since the study period only lasted six weeks due to closure by COVID-19. Table 1. Pneumococcal Vaccine History Documentation Rates Obtained by Patient Recall or Records Table 2. Pneumococcal Vaccine Order Rates at Pre-Kidney Transplant Consultations Table 3. Prevnar 13 Order Completion Rate by Documentation Conclusion The data reflect a high number of patients who either do not recall or have documentation of prior pneumococcal vaccination available at time of KT ID evaluation. Providers documented history of pneumococcal vaccinations extremely well, ordering immunizations when necessary. This study highlights lack of portability of immunization histories in a given patient population and opportunity for improved care. Disclosures Claudia R. Libertin, MD, Pfizer, Inc. (Grant/Research Support, Research Grant or Support)

scholarly journals Hemi- and Homozygous Loss-of-Function Mutations in DSG2 (Desmoglein-2) Cause Recessive Arrhythmogenic Cardiomyopathy with an Early Onset

2021 ◽  
Vol 22 (7) ◽  
pp. 3786
Author(s):  
Andreas Brodehl ◽  
Alexey Meshkov ◽  
Roman Myasnikov ◽  
Anna Kiseleva ◽  
Olga Kulikova ◽  
...  
Keyword(s):  
Medical History ◽  
Splice Site Mutation ◽  
Pathogenic Mutation ◽  
Large Deletion ◽  
Loss Of Function ◽  
Arrhythmogenic Cardiomyopathy ◽  
Site Mutation ◽  
Snp Arrays ◽  
Number Of Patients ◽  
History Of

About 50% of patients with arrhythmogenic cardiomyopathy (ACM) carry a pathogenic or likely pathogenic mutation in the desmosomal genes. However, there is a significant number of patients without positive familial anamnesis. Therefore, the molecular reasons for ACM in these patients are frequently unknown and a genetic contribution might be underestimated. Here, we used a next-generation sequencing (NGS) approach and in addition single nucleotide polymor-phism (SNP) arrays for the genetic analysis of two independent index patients without familial medical history. Of note, this genetic strategy revealed a homozygous splice site mutation (DSG2–c.378+1G>T) in the first patient and a nonsense mutation (DSG2–p.L772X) in combination with a large deletion in DSG2 in the second one. In conclusion, a recessive inheritance pattern is likely for both cases, which might contribute to the hidden medical history in both families. This is the first report about these novel loss-of-function mutations in DSG2 that have not been previously identi-fied. Therefore, we suggest performing deep genetic analyses using NGS in combination with SNP arrays also for ACM index patients without obvious familial medical history. In the future, this finding might has relevance for the genetic counseling of similar cases.

scholarly journals P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Family History ◽  
Bone Loss ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Mineral Density ◽  
History Of

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.

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