scholarly journals Mechanisms of Bone Impairment in Sickle Bone Disease

2021 ◽  
Vol 18 (4) ◽  
pp. 1832
Author(s):  
Paola Giordano ◽  
Flavia Urbano ◽  
Giuseppe Lassandro ◽  
Maria Felicia Faienza
Keyword(s):  
Bone Disease ◽  
Negative Impact ◽  
Genetic Disorder ◽  
Growth Spurt ◽  
Mineral Density ◽  
High Fracture ◽  
High Incidence ◽  
And Biological Markers ◽  
Bone Complications ◽  
Strong Activator

Sickle bone disease (SBD) is a chronic and invalidating complication of Sickle cell disease (SCD), a multisystem autosomal recessive genetic disorder affecting millions of people worldwide. Mechanisms involved in SBD are not completely known, especially in pediatric age. Among the hypothesized pathogenetic mechanisms underlying SBD are bone marrow compensatory hyperplasia and bone ischemic damage, both secondary to vaso-occlusive crisis (VOC), which leads to cell sickling, thus worsening local hypoxia with a negative impact on osteoblast recruitment. Furthermore, the hypoxia is a strong activator of erythropoietin, which in turn stimulates osteoclast precursors and induces bone loss. Hemolysis and iron overload due to a chronic transfusion regimen could also contribute to the onset of bone complications. Vitamin D deficiency, which is frequently seen in SCD subjects, may worsen SBD by increasing the resorptive state that is responsible for low bone mineral density, acute/chronic bone pain, and high fracture risk. An imbalance between osteoblasts and osteoclasts, with a relative decrease of osteoblast recruitment and activity, is a further possible mechanism responsible for the impairment of bone health in SCD. Moreover, delayed pubertal growth spurt and low peak bone mass may explain the high incidence of fracture in SCD adolescents. The aim of this review was to focus on the pathogenesis of SBD, updating the studies on biochemical, instrumental, and biological markers of bone metabolism. We also evaluated the growth development and endocrine complications in subjects affected with SCD.

scholarly journals Impaired Alignment of Bone Matrix Microstructure Associated with Disorganized Osteoblast Arrangement in Malignant Melanoma Metastasis

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 131
Author(s):  
Aira Matsugaki ◽  
Yumi Kimura ◽  
Ryota Watanabe ◽  
Fumihito Nakamura ◽  
Ryo Takehana ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Cell Activation ◽  
Ex Vivo ◽  
Bone Matrix ◽  
Melanoma Metastasis ◽  
Mineral Density ◽  
High Fracture ◽  
Matrix Microstructure ◽  
Metastasis Model

Malignant melanoma favors spreading to bone, resulting in a weakened bone with a high fracture risk. Here, we revealed the disorganized alignment of apatite crystals in the bone matrix associated with the homing of cancer cells by developing an artificially controlled ex vivo melanoma bone metastasis model. The ex vivo metastasis model reflects the progressive melanoma cell activation in vivo, resulting in decreased bone mineral density and expression of MMP1-positive cells. Moreover, less organized intercellular connections were observed in the neighboring osteoblasts in metastasized bone, indicating the abnormal and randomized organization of bone matrix secreted by disconnected osteoblasts. Our study revealed that the deteriorated microstructure associated with disorganized osteoblast arrangement was a determinant of malignant melanoma-related bone dysfunction.

scholarly journals Menstrual and reproductive function repair in patients with polycystic ovary syndrome and obesity by correcting of glucose intolerance

2008 ◽  
Vol 5 (2) ◽  
pp. 38-41 ◽  
Author(s):  
O I Lineva ◽  
M V Glukhova
Keyword(s):  
Reproductive System ◽  
Negative Impact ◽  
Positive Impact ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Endocrine Function ◽  
Anthropometric Parameters ◽  
Ovary Syndrome ◽  
High Incidence ◽  
Total Treatment

The aim of the study was to investigate the effect of sibutramine on metabolic and hormonal parameters in women with PCOS and obesity. Materials and methods. The study included 53 women aged 18 to 35 years (mean age 31,3 ± 1,1 years) with PCOS and obesity. All patients received therapy with sibutramine. The total treatment duration was 6 months. The treatment was evaluated monthly nature of the menstrual cycle, anthropometric parameters (body weight, BMI, ON, ON, ON / OF). The Results. The studies found that after 3 months of treatment with weight loss was 8,1 ± 0,31 kg, after 6 months - 13,1 ± 0,78 kg (p 0,05). Results of the survey of women included in this study strongly support the negative impact of obesity on the functional state of the reproductive system, evidenced by the high incidence of anovulation, rhythm disturbances of menstruation (amenorrhea up to), infertility. Conclusions. The obtained results once again confirm the high efficacy and safety of sibutramine to reduce body mass, suggest correction of metabolic, hormonal disorders and positive impact on women's reproductive health. This allows us to consider the use of sibutramine in women with PCOS and obesity as a way to restore the endocrine function of the reproductive system.

scholarly journals Effect of Antidiabetic Treatment on Bone

2019 ◽  
pp. S107-S120 ◽  
Author(s):  
J. JACKULIAK ◽  
M. KUŽMA ◽  
J. PAYER
Keyword(s):  
Diabetes Mellitus ◽  
Bone Fractures ◽  
Negative Impact ◽  
Osteoporotic Fractures ◽  
Antidiabetic Drugs ◽  
Mineral Density ◽  
Skeletal Health ◽  
Antidiabetic Treatment ◽  
Increased Risk ◽  
Patients With Diabetes

Patients with diabetes mellitus are at an increased risk of bone fractures. Several groups of effective antidiabetic drugs are available, which are very often given in combination. The effects of these medications on bone metabolism and fracture risk must not be neglected. Commonly used antidiabetic drugs might have a positive, neutral or negative impact on skeletal health. Increased risk of fracture has been identified with use of thiazolidinediones, most definitively in women. Also treatment with sulfonylureas can have adverse effects on bone. One consequence of these findings has been greater attention to fracture outcomes in trails of new diabetes medication (incretins and SGLT-2 inhibitors). The effect of insulin on bone is discussed and the risk of fractures in patients using insulin seems to be unrelated to insulin as itself. The aim of the review is to summarize effects of antidiabetic treatment on bone – bone mineral density, fractures and bone turnover markers. The authors also try to recommend a strategy how to treat patients with diabetes mellitus regarding the risk of osteoporotic fractures. In this review the problem of how to treat osteoporosis in patient with diabetes is also discussed.

scholarly journals PREVALENCE OF OSTEOPOROSIS AND HYPOVITAMINOSIS D AT SIRIRAJ METABOLIC BONE DISEASE CLINIC

2017 ◽  
Vol 25 (6) ◽  
pp. 262-265
Author(s):  
AASIS UNNANUNTANA ◽  
POJCHONG CHOTIYARNWONG
Keyword(s):  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Fragility Fractures ◽  
Hypovitaminosis D ◽  
Mineral Density ◽  
Baseline Serum ◽  
Metabolic Bone ◽  
Vitamin D Levels ◽  
History Of ◽  
Prevalence Of Osteoporosis

ABSTRACT Objective: To identify the prevalence of osteoporosis and hypovitaminosis D among patients at the Siriraj Metabolic Bone Disease (MBD) Clinic, and to compare initial vitamin D levels in patients with and without a history of fragility fractures. Methods: Medical records of patients who attended our MBD clinic between 2012 and 2015 were retrospectively reviewed. Patient baseline demographic, clinical, bone mineral density (BMD), and laboratory data were collected and analyzed. Osteoporosis was diagnosed when patients had a BMD T-score <-2.5 or presented with fragility fractures. Results: There were 761 patients included in this study. Of these, 627 patients (82.4%) were diagnosed with osteoporosis and 508 patients (66.8%) had fragility fractures. Baseline serum 25-hydroxyvitamin D (25(OH)D) levels were available in 685 patients. Of these, 391 patients (57.1%) were diagnosed with hypovitaminosis D. When evaluated only in patients with fragility fractures, the average initial 25(OH)D level was 28.2±11.6 ng/mL, and the prevalence of hypovitaminosis D was 57.6%. Conclusion: A high prevalence of osteoporosis and hypovitaminosis D was found among patients at our clinic; two-thirds of patients had a history of fragility fractures, and no difference in initial 25(OH)D levels was seen between patients with and without fragility fractures. Level of Evidence III, Retrospective Study .

scholarly journals Development of Algorithm for Clinical Management of Sickle Cell Bone Disease: Evidence for a Role of Vertebral Fractures in Patient Follow-up

2020 ◽  
Vol 9 (5) ◽  
pp. 1601 ◽  
Author(s):  
Lucia De Franceschi ◽  
Daniele Gabbiani ◽  
Andrea Giusti ◽  
Gianluca Forni ◽  
Filippo Stefanoni ◽  
...  
Keyword(s):  
Bone Density ◽  
Sickle Cell ◽  
Bone Disease ◽  
Vertebral Fractures ◽  
Cell Disease ◽  
High Incidence ◽  
The Mean

Sickle-cell disease (SCD) is a worldwide distributed hemoglobinopathy, characterized by hemolytic anemia associated with vaso-occlusive events. These result in acute and chronic multiorgan damage. Bone is early involved, leading to long-term disability, chronic pain and fractures. Here, we carried out a retrospective study to evaluate sickle bone disease (SBD) in a cohort of adults with SCD. We assessed bone density, metabolism and turnover. We also evaluated the presence of fractures and the correlation between SCD severity and skeletal manifestations. A total of 71 patients with SCD were analyzed. The mean age of population was 39 ± 10 years, 56% of which were females. We found osteoporosis in a range between 7% and 18% with a high incidence of vertebral fractures. LDH and AST were predictive for the severity of vertebral fractures, while bone density was not. Noteworthy, we identified -1.4 Standard Deviations T-score as the cutoff for detecting the presence of fractures in patients with SCD. Collectively our data allowed us to develop an algorithm for the management of SBD, which may be useful in daily clinical practice to early intersect and treat SBD.

scholarly journals The epidemiology of osteoporosis

2020 ◽  
Author(s):  
Michael A Clynes ◽  
Nicholas C Harvey ◽  
Elizabeth M Curtis ◽  
Nicholas R Fuggle ◽  
Elaine M Dennison ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Economic Burden ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Ageing Population ◽  
Mineral Density ◽  
High Fracture ◽  
Osteoporosis Screening ◽  
The Usa ◽  
Receive Treatment

Abstract Introduction With a worldwide ageing population, the importance of the prevention and management of osteoporotic fragility fractures is increasing over time. In this review, we discuss in detail the epidemiology of fragility fractures, how this is shaped by pharmacological interventions and how novel screening programmes can reduce the clinical and economic burden of osteoporotic fractures. Sources of data PubMed and Google Scholar were searched using various combinations of the keywords ‘osteoporosis’, ‘epidemiology’, ‘fracture’, ‘screening’, `FRAX’ and ‘SCOOP’. Areas of agreement The economic burden of osteoporosis-related fracture is significant, costing approximately $17.9 and £4 billion per annum in the USA and UK. Areas of controversy Risk calculators such as the web-based FRAX® algorithm have enabled assessment of an individual’s fracture risk using clinical risk factors, with only partial consideration of bone mineral density (BMD). Growing points As with all new interventions, we await the results of long-term use of osteoporosis screening algorithms and how these can be refined and incorporated into clinical practice. Areas timely for developing research Despite advances in osteoporosis screening, a minority of men and women at high fracture risk worldwide receive treatment. The economic and societal burden caused by osteoporosis is a clear motivation for improving the screening and management of osteoporosis worldwide.

scholarly journals High incidence of cisplatin-induced ototoxicity in paediatric patients in the Western Cape, South Africa

2018 ◽  
Vol 2 ◽  
Author(s):  
Mukovhe Phanguphangu ◽  
Lebogang Ramma
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Negative Impact ◽  
Paediatric Oncology ◽  
Cancer Drug ◽  
Oncology Patients ◽  
Profound Hearing Loss ◽  
Distortion Product ◽  
High Incidence

Background: Fourteen million new cancer cases are reported annually, and up to 10% of those involve children below 15 years. Cisplatin, a commonly used anti-cancer drug for its high success rate, is associated with ototoxicity. Cisplatin-induced ototoxicity is characterised by permanent bilateral severe-to-profound hearing loss. Hearing loss, when occurring during childhood, can impact negatively communication development, scholastic performance and quality of life.Aim: To determine the incidence of cisplatin-induced ototoxicity in paediatric oncology.Setting: A retrospective records review of paediatric oncology patients who underwent cisplatin-based chemotherapy and had ototoxicity monitoring from January 2015 to December 2017 at a children’s hospital.Method: Data collected included demographic, cisplatin treatment and audiometric information. The data were analysed using descriptive and inferential statistics.Results: A total of 49 records meeting the inclusion criteria were reviewed. Ototoxic hearing loss was found in 39 (80%) of the patients whose records were reviewed and the majority (56%) presented with a bilateral moderate-to-severe sensorineural hearing loss. Distortion product otoacoustic emissions were absent in 32 (67%) patients. Cumulative dose (> 200 mg/m2) was associated with higher incidences of ototoxicity (odds ratio [OR]: 1.81; 95% confidence interval [CI]: 0.67–17.34; p = 0.044). Younger patients (< 10 years) had higher odds of developing ototoxicity, but this was not statistically significant (OR: 4.00; 95% CI: 0.82–19.46; p = 0.085).Conclusion: This study found a high incidence of cisplatin-induced ototoxicity in paediatric oncology patients. This is concerning because hearing loss during this age can have long-term negative impact on a child’s development and overall quality of life. Early identification of ototoxicity-induced hearing loss and appropriate intervention are highly recommended in this patient group.

Metabolic and musculoskeletal effects of cystic fibrosis

2015 ◽  
Author(s):  
Uta Hill ◽  
Jane Ashbrook ◽  
Charles Haworth
Keyword(s):  
Quality Of Life ◽  
Bone Mineral Density ◽  
Urinary Incontinence ◽  
Bone Mineral ◽  
Negative Impact ◽  
Fragility Fractures ◽  
Pulmonary Complications ◽  
Mineral Density ◽  
Airway Clearance

This chapter provides a comprehensive update on the prevention, recognition, and treatment of low bone mineral density in people with CF. As life expectancy improves, the extra-pulmonary complications of CF are becoming increasingly important to quality of life. Up to 25 per cent of CF patients have reduced bone mineral density in adulthood, leading to the development of fragility fractures which cause pain, thereby interfering with airway clearance and predisposing to pulmonary infection. Osteoporosis can be a relative contraindication for lung transplantation. Other important musculoskeletal issues including CF arthropathy, growth, and urinary incontinence are covered. CF arthropathy is a non-erosive episodic sero-negative arthritis, often difficult to treat and which may require specialist input. Urinary incontinence is common girls and women with CF and has a negative impact on quality of life and ability to complete therapies. The pathophysiology and management of urinary incontinence are discussed.

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