The influence of toxic metals As, Cd, Ni and Pb on nutrients accumulation in Mentha piperita

Medicinal plants are, for a considerable part of the population, an important source of treatment for certain diseases. They contain essential nutrients for the human body such as magnesium, iron , and zinc. The present study shows the influence of the addition of As, Cd, Ni, Pb on mineral nutrients in different organs of Mentha piperita. The experiments were carried out in the laboratory for a period of three months (May-July). Mentha piperita plants were AsCd and AsCdNiPb exposed up to final concentrations corresponding to the soil intervention threshold according to Romanian Order no.756/1997 (25 mg/kg As, 5 mg/kg Cd, 150 mg/kg Ni and 100 mg/ kg Pb). Simultaneously with these experiments, a control experiment (M) was performed. To evaluate the effect of the addition of AsCd and AsCdNiPb on the accumulation and transfer of Ca, Cr, Cu, Mn, Mo, Fe and Zn, the transfer coefficient (TC), the translocation factor (TF), and the enrichment factor (EF) were calculated. A higher concentration of Ca, Cr, Cu, Fe, Mn, Mo, and Zn was observed especially in the mint root in the experiments in which AsCdNiPb was added compared to those in which only AsCd was added. The AsCdNiPb addition did not influence the translocation of micro and macronutrients from the root to the aerial (edible) parts of the plant. In the case of the AsCd, addition, the translocation of zinc from the root to the aerial parts (leaves and stem) of the plant was increased.

Association of Postoperative Neutrophil Lymphocyte Ratio (NLR) and Monocyte Lymphocyte Ratio (MLR) with the Presence of Osteoporosis in Japanese Patients after Hip Fracture Surgery: A Retrospective Cohort Study

Background. The diagnosis of osteoporosis is based on bone mineral density measurements expressed as a percentage of the young adult mean (YAM) in Japan. Osteoporosis is defined as YAM <70%, and intervention is recommended at this cutoff. Because osteoporosis has a strong association with systemic metabolic disorders, we postulated that patients with YAM <70% had higher inflammatory biomarker concentrations owing to the higher systemic stress compared with YAM >70%. Method. We retrospectively reviewed 94 patients with low-trauma hip fractures. Blood examinations were performed on postoperative day (POD) 1 and POD 7. We used neutrophil lymphocyte ratio (NLR) and monocyte lymphocyte ratio (MLR) to evaluate postoperative recovery. After dividing the 94 patients into two groups according to a YAM cutoff of 70%, we compared the differences in NLR and MLR. Results. On POD 1, patients with YAM >70% had a median NLR of 5.7 and a median MLR of 0.66, which were significantly lower than for patients with YAM <70% (8.8 and 0.9, respectively). Similarly, on POD 7, patients with YAM >70% had a median NLR of 2.0 and a median MLR of 0.31, which were significantly lower than for patients with YAM <70% (3.5 and 0.43, respectively). Conclusion. A YAM cutoff of 70% is an appropriate intervention threshold regarding postoperative recovery after hip fracture surgery. Mini-Abstract. Patients with YAM >70% showed lower NLR and MLR on POD 1 and POD 7. A YAM cuffoff of 70% is an appropriate intervention threshold regarding postoperative recovery after hip fracture surgery.

Rotational thromboelastometry and conventional coagulation tests in patients undergoing major cardiac or aortic surgery: a retrospective single-center cohort study

Algorithms for treatment of diffuse bleeding in cardiac surgery are based on intervention thresholds of coagulation tests, such as rotational thromboelastometry (ROTEM) or conventional laboratory tests. The relationship between these two approaches is unclear in patients with increased risk of coagulation abnormalities. We retrospectively analyzed the data of 248 patients undergoing major cardiac and/or aortic surgery. ROTEM and conventional laboratory tests were performed simultaneously after termination of cardiopulmonary bypass and protamine administration to investigate the extrinsic and intrinsic system, and to determine deficiencies in platelets and fibrinogen. We evaluated the association between ROTEM and conventional tests by linear regression analysis and compared the frequency of exceeding established thresholds for clinical intervention. Significant linear associations between ROTEM 10 min after the start of coagulation, and plasma fibrinogen concentration or platelet count (FIBTEM A10, R2 = 0.67, p < 0.001; EXTEM A10, R2 = 0.47, p < 0.001) were obtained. However, the 95% prediction intervals exceeded clinically useful ranges (92–233 mg/dL fibrinogen at the intervention threshold of FIBTEM A10 = 10 mm; 14 × 103–122 × 103/µL platelets at the intervention threshold of EXTEM A10 = 40 mm). The association between EXTEM and INR (R2 = 0.23), and INTEM and aPTT (R2 = 0.095) was poor. The frequency of exceeding intervention thresholds and, consequently, of triggering treatment, varied markedly between ROTEM and conventional tests (p < 0.001 for all comparisons). The predictability of conventional coagulation test results by ROTEM is limited, thus hampering the interchangeability of methods in clinical practice.

FRAX-Based Intervention Thresholds for Osteoporosis Treatment in Ukraine

Objectives. Osteoporosis, in addition to its consequent fracture burden, is a common and costly condition. FRAX® is a well-established, validated, web-based tool which calculates the 10-year probability of fragility fractures. A FRAX model for Ukraine has been available since 2016 but its output has not yet been translated into intervention thresholds for the treatment of osteoporosis in Ukraine; we aimed to address this unmet need in this analysis. Methods. In a referral population sample of 3790 Ukrainian women, 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture separately were calculated using the Ukrainian FRAX model, with and without femoral neck bone mineral density (BMD). We used a similar approach to that first proposed by the UK National Osteoporosis Guideline Group, whereby treatment is indicated if the probability equals or exceeds that of a woman of the same age with a prior fracture. Results. The MOF intervention threshold in females (the age-specific 10-year fracture probability) increased with age from 5.5% at the age of 40 years to 11% at the age of 75 years where it plateaued and then decreased slightly at age 90 (10%). Lower and upper thresholds were also defined to determine the need for BMD, if not already measured; the approach targets BMD measurements to those at or near the intervention threshold. The proportion of the referral populations eligible for treatment, based on prior fracture or similar or greater probability, ranged from 44% to 69% depending on age. The prevalence of the previous fracture rose with age, as did the proportion eligible for treatment. In contrast, the requirement for BMD testing decreased with age. Conclusions. The present study describes the development and application of FRAX-based assessment guidelines in Ukraine. The thresholds can be used in the presence or absence of access to BMD and optimize the use of BMD where access is restricted.

Risk factors for fractures in patients with cerebrovascular disease

Aim. To study the link between various risk factors and an occurrence of osteoporotic fractures (OPF) in women who have had a first ischemic stroke (IS). Materials and methods. The study included 170 women 45 to 80 years of age who have had the first IS and received neurorehabilitation treatment for post-stroke speech disorders in the Center for Speech Pathology and Neurorehabilitation in Moscow in 2011–2013. For all women, the ten-year absolute risk of major OPF and hip fractures (HF) was retrospectively analyzed using the FRAX algorithm, excluding the data on bone mineral density. The risk of OPF was assessed according to the treatment intervention threshold proposed by the Russian Osteoporosis Association in 2012. In January 2021, a telephone survey was conducted to register the fractures that occurred over the past period of time. The SPSS Version 20 was used for statistical analysis of the results. Results. During the study period, fractures with a minimal level of trauma occurred in 34 (20%) women (fractures of fingers, toes, and skull bones were excluded). The absolute risk of OPF and HF in women with a low-traumatic fracture was higher than in patients without it (p<0.001), but did not reach the treatment intervention threshold proposed by the Russian Osteoporosis Association in 2012. Correlation analysis demonstrated the association between the occurrence of low-traumatic fractures in patients who had the first non-cardioembolic IS and the following parameters: age (rd=0.277; p<0.001), weight (rd=-0.368; p<0.001), body mass index (rd=-0.378; p<0.001), total cholesterol concentration (rd=0.189; p=0.014), type 2 diabetes mellitus (f=0.225; p=0.003), HF in parents (f=0.375; p<0.001). Conclusion. The results of this study demonstrate the presence of an association between the occurrence of low-traumatic fractures in patients with prior non-cardioembolic IS and traditional risk factors included in the FRAX algorithm, as well as with type 2 diabetes mellitus.

SAT0479 IMPACT OF TRABECULAR BONE SCORE ON INTERVENTION THRESHOLD FOR BONE SPARING THERAPY IN PATIENTS REFERRED FOR BONE MINERAL DENSITY

Background:Trabecular bone score (TBS) is an index of skeletal quality that has been validated as an independent risk factor for fracture and incorporated into fracture risk assessment (FRAX). TBS provides information on bone microarchitecture not captured from standard bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA). Nonetheless, the clinical implications of using TBS in routine practice are not yet fully understood and warrant further evaluation.Objectives:To determine whether lumbar TBS can have an impact on clinician’s treatment threshold derived from DXA and clinical risk factors: does the addition of TBS to DXA measurements make the clinician more or less likely to recommend bone sparing therapy?Methods:A cross-sectional study at a tertiary metabolic bone centre in the West Midlands region of England. Three expert metabolic bone physicians, two rheumatologists and one elderly care, assessed consecutive patients referred for a DXA scan ± clinic review and provided treatment recommendations with and without TBS. Patients ≥ 18 years old with BMI of 15-37 who were not on bone sparing therapy were considered eligible. TBS was defined according to T-score as normal (T-score ≥ -1), moderate (-1 > T-score ≥ -2.5) or degraded (T-score ≤ -2.5). TBS groups were stratified by BMD T-scores (normal, osteopenia, or osteoporosis) using minimum T-score of total hip, femoral neck, and spine to identify categories in which TBS may be of more clinical use. The main outcome measure was the proportion of change in clinician’s treatment threshold between BMD alone and BMD plus TBS. The difference was assessed for significance using Chi-square test. Additionally, the change in UK National Osteoporosis Guideline Group (NOGG) threshold was also assessed using TBS-adjusted FRAX scores. Correlations between BMD-TBS strata and the change in intervention threshold (yes/no) were carried out using Spearman test.Results:540 patients were analysed. The inclusion of TBS resulted in 8.2% change in clinician’s treatment threshold (p <0.001) shifting the outcome 6.5 % for and 1.7 % against treatment. More than half of the cases in which the clinical decision was changed were for patients with osteopenia and degraded TBS (significant correlation; P <0.001). NOGG intervention threshold was changed in 7.4% of the cases (P<0.001); 6.1% for and 1.3% against treatment. 37.5% of NOGG changed outcome was related to osteopenia with degraded TBS (p<0.001). Kappa agreement between the clinician and NOGG was fair at 0.42 (p<0.001).Conclusion:These results demonstrate that using TBS in routine clinical practice is most likely to impact treatment decision in patients with osteopenia who have compromised bone microarchitecture. Incorporating TBS in routine DXA scans may lead to a net increase in bone protective therapy of approximately 5%. It is unknown whether adopting such an approach universally can reduce future fracture risk, and prospective studies are needed to address this question.References:[1]Hans D et al. J Bone Miner Res. 2011;26(11):2762-9.[2]McCloskey EV et al. Calcif Tissue Int. 2015;96(6):500-9.Table 1.Demographic and baseline characteristics (n = 540)Female470 (87%)Age (years)68.1 ± 11.6Body mass index (BMI)26.2 ± 4.6Femoral neck T-score-1.80 ± 1.04Total hip T-score-1.32 ± 1.07Lumbar spine T-score-1.37 ± 1.42Lumbar spine TBS1.32 ± 0.13Major osteoporotic fractures238 (44%)Spinal fractures81 (15%)FRAX major osteoporotic fracture14.43 ± 9.03FRAX hip fracture4.60 ± 6.20TBS-adjusted FRAX major osteoporotic fracture13.82 ± 8.80TBS-adjusted FRAX hip fracture4.45 ± 5.73Figure 1.Distribution of changed clinical treatment threshold in normal, moderate, and degraded TBS according to BMD T-scoreAcknowledgments:Bone density unit &Rheumatology team, Robert Jones and Agnes Hunt Orthopaedic HospitalDisclosure of Interests:None declared

Effects of Toxic Metals Cd, Ni and Pb on Matricaria Chamomilla L. Growth in a Laboratory Study

The paper presents a comparative bioaccumulation study between the growth of chamomile (Matricaria Chamomilla L.) exposed to toxic metals (Cd, Ni and Pb) and the growth of same plant species unexposed to metals. The soil was contaminated within three independent experiments with Cd, Ni and Pb at the intervention threshold value for sensitive use. Each of the toxic metal was added by watering the seeds, and subsequently the germinated plants. The experiments targeted the effects of soil pollution on the growth of chamomile during three months period. The results showed that in the first month of the study, all three metals accumulated in plants. After the seeds germination and plant growth, high Cd concentration in chamomile plants was detected. Moreover, Ni and Pb were detected in soil in the percentage of 96%. Overall, it was observed that chamomile plants were Cd accumulators at the tested concentrations of 6 mg/kg with no phytotoxic effects. Matricaria Chamomilla L. could be used in phytoremediation of polluted soils, with limitations of use for human consumption, except for the extracts.