Abdominal aortic calcification, cardiac troponin I and atherosclerotic vascular disease mortality in older women

ObjectiveExamine if two inexpensive measures of atherosclerotic vascular diseases (ASVD), abdominal aortic calcification (AAC) and high-sensitivity cardiac troponin I (hs-cTnI) provide complementary information for 10-year ASVD mortality and all-cause mortality risk in older women.Methods908 community-dwelling women without prevalent ASVD (≥75 years) were followed-up between 2003 and 2013. AAC and plasma hs-cTnI measures were obtained in 2003. AAC was assessed on lateral spine images using a semiquantitative method (AAC24). Linked health records were used for mortality outcomes.ResultsMean±SD age was 79.9±2.6 years. 276 (30.4%) women died during follow-up, including 138 (15.2%) ASVD-related deaths. AAC24 and hs-cTnI were independently associated with ASVD and all-cause mortality (p<0.001). The cohort was dichotomised into four groups: (1) low AAC24 (AAC24: 0 or 1) and <median hs-cTnI (n=163, referent), (2) moderate-extensive AAC24 (AAC24:>1) and <median hs-cTnI (n=280), (3) low AAC24 and ≥median hs-cTnI (n=148) and (4) moderate-extensive AAC24 and ≥median hs-cTnI (n=317). Compared with the referent group, a stepwise increase in relative hazard (HR (95% CI)) for ASVD mortality was seen at 2.39 (1.05 to 5.46), 3.18 (1.35 to 7.79) and 5.38 (2.44 to 11.85), respectively. A similar associations were observed for all-cause mortality, at 1.58 (0.99–2.52), 2.38 (1.46–3.89) and 3.02 (1.93–4.72), respectively (all p<0.05).ConclusionHigher AAC and elevated hs-cTnI were associated with higher risk of ASVD mortality and all-cause mortality, independent of each other. Stratifying by moderate to extensive AAC and elevated hs-cTnI identified women at very high risk. Further studies investigating whether combining factors may improve risk prediction are needed.Trial registration numberACTRN12617000640303.

Prediction of Vertebral Fractures by Trabecular Bone Score in Patients With Ankylosing Spondylitis

Ankylosing spondylarthritis (AS) is associated falsely increased lumbar spine bone mineral density (BMD). New tool for discrimination of subjects at fracture risk is needed. Vertebral fracture (VF) prediction of routine methods for osteoporosis assessment, BMD and trabecular bone score (TBS), in patients with AS. Cross-sectional study of all AS patients regularly followed at the rheumatology outpatient clinics of two centers. All subjects undergone BMD measurement at lumbar spine (LS), total hip (TH) and femoral neck (FN) using Hologic® Horizon device. TBS at L1-4 in all subjects by TBS InSight® software were assessed. Vertebral fracture assessment (VFA) was performed using the lateral spine imaging IVA™ and graded using Genant semi-quantitative approach. 119 AS subjects (90 males/29 females), mean age 47.6 years were included in the study. In 20 patients 34 VFs were detected, from whom 7 patients had multiple fractures. Subjects with VF were older and had lower FN BMD, TBS in comparison to non-VF subjects. No differences in LS BMD, FN BMD or BASDAI between groups were observed. Among patients with VF only 3 had T-score less than -2.5 but 7 has TBS less than 1.23 which means highly degraded microarchitecture. AS patients with VF have lower TBS and FN BMD in comparison to non-VF subjects. In addition, TBS was able to detect 20 % more VFs than BMD. Therefore, TBS seems promising in VF discrimination among patients with AS.

Idiopathic scoliosis. Mechanisms of development

Objective: One of the most complicated problems of Orthopaedics is the treatment of scoliosis. More than 90% of cases are attributable to Idiopathic deformation, the cause of which is unknown. We investigated the cause of pathogenesis of this disorder. Methods: At our institution more than 6900 patients aged 1-89 years have undergone inpatient and outpatient treatment in connection with spinal pain syndrome and different neurological disorders associated with idiopathic scoliosis. This study was undertaken between February 1996 and February 2010. All patients had a clinical, radiography and laboratory examinations. Results: The 29.6% of patients were aged 31-50 years old. 60% were men and 40% were women. While examining patients with scoliosis deformation, we noted symptoms of body asymmetry i.e. different volumes of the right and left halves of face body and limbs. These features were typical for all patients irrespective of sex, age, and ethnic origin. 83,2% of patients had underdevelopment of the left part of the body, and only 16,8% of the right side. Analysis of published work in anatomy, physiology, neurophysiology, vertebrology, done simultaneously with analysis of the clinical material, allowed us to make some conclusions. Conclusions: First asymmetrical structure of the human body is based on laws of nature and is linked with difference of sizes of brain’s hemispheres, particularly of the right and left gyrus centralis anterior which controls the muscle’s function and our movements. Second asymmetrical tension of Erector spinae muscles, leads to inclination of the pelvis on a side of weak muscles; thus initiating development of the lateral spine curves. Since such a situation is typical for all people, this deformation is known as functional scoliosis. Third, further development of the bodies of vertebrae, their arches, processes, intervertebral discs, ligaments, and other anatomical elements in position of the deviation leads to one sided underdevelopment of these structures. As a result the areas of instability appear in each segment of spine ( neck, chest, lumbar and sacral areas ). Fourth, the muscles in a growing body misbalance and on the ground of rotating movement, start rotatory dislocation of vertebrae in zones of instability in all parts of the spine. As a result torsion of the deformed wedge-shaped vertebrae leads to formation of the structural scoliosis. The rotation of the vertebrae, described above, does not depend on sex, age and ethnic origin of the patient and has a character of the natural development. Thus from our point of view, the term idiopathic scoliosis, must be changed to spinal muscle asymmetrical deformation of a reflex origin. Understanding of this rotation allowed us to establish an effective non-surgical method of treatment of scoliosis and spinal pain syndrome in patients of all ages.

The Association Between Sagittal Plane Alignment and Disc Space Narrowing of Lumbar Spine in Farmers

Objective To investigate whether lumbar lordosis (LL) and lumbar segmental lordosis (LSL) are related to sex, age, low back pain (LBP), and lumbar disc space narrowing (DSN).Methods A total of 569 farmers were recruited. In lateral spine radiograph, LL (L1–L5) and LSL (L1, L2, L3, L4, and L5) were measured using Cobb’s method. The differences in LSL values (ΔLSL) according to the presence or absence of a DSN were calculated as LSLDSN – LSLnoDSN for each DSN level.Results In male, the lateral spine radiograph showed significantly greater L4-LSL and L5-LSL and smaller L1-LSL and L2-LSL compared to female. LLs in the 50–59 and ≥60 years age groups were significantly smaller compared to those in the <50 years age group. In subjects with LBP, LL and L4-LSL were significantly smaller than in those without. The ΔLSLs at the disc level with DSN showed the greatest decrease: L1-ΔLSL (Δ-3.99°), L2-ΔLSL (Δ-3.31°), L3-ΔLSL (Δ-2.87°), L4-ΔLSL (Δ-3.31°), and L5-ΔLSL (Δ-4.44°) in L1/2, L2/3, L3/4, L4/5, and L5/S1 DSN, respectively. Conversely, distant ΔLSLs were inversely increased: L1-LSL (Δ0.75°) with L4/5 DSN and L2-LSL (Δ0.94°) with L5/S1 DSN.Conclusion Sagittal plane alignment was significantly associated with sex, age, LBP, and DSN. LSLs around the levels of DSN were decreased, and there was compensational increase of LSL distant to the DSN to maintain the overall LL.

Greater Dietary Inflammatory Potential Is Associated With Higher Likelihood of Abdominal Aortic Calcification

Aims: We aimed to assess the association between dietary inflammation index (DII) and abdominal aortic calcification (AAC) in US adults aged ≥40 years.Methods: Data were obtained from the 2013–2014 National Health and Nutrition Examination Survey (NHANES). Participants who were &lt;40 years old and missing the data of DII and AAC were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. AAC score was quantified by assessing lateral spine images and severe AAC was defined as AAC score &gt;6. Weighted multivariable regression analysis and subgroup analysis were preformed to estimate the independent relationship between DII with AAC score and severe AAC.Results: A total of 2,897 participants were included with the mean DII of −0.17 ± 2.80 and the mean AAC score of 1.462 ± 3.290. The prevalence of severe AAC was 7.68% overall, and participants in higher DII quartile tended to have higher rates of severe AAC (Quartile 1: 5.03%, Quartile 2: 7.44%, Quartile 3: 8.38%, Quartile 4: 10.46%, p = 0.0016). A positive association between DII and AAC score was observed (β = 0.055, 95% CI: 0.010, 0.101, p = 0.01649), and higher DII was associated with an increased risk of severe AAC (OR = 1.067, 95% CI: 1.004, 1.134, p = 0.03746). Subgroup analysis indicated that this positive association between DII and AAC was similar in population with differences in gender, age, BMI, hypertension status, and diabetes status and could be appropriate for different population settings.Conclusion: Higher pro-inflammatory diet was associated with higher AAC score and increased risk of severe AAC. Anti-inflammatory dietary management maybe beneficial to reduce the risk of AAC.

Description of three new species of Bradyidius (Copepoda: Calanoida), the new aetideids from the deep Pacific Ocean, with notes on the genera Bradyidius and Aetideopsis

Three new aetideid species, Bradyidius abyssalis sp. nov., Bradyidius parabyssalis sp. nov., and B. kurilokamchaticus sp. nov. are described from female specimens collected near the seafloor in the abyss of the Pacific and Atlantic Oceans. Specimens of Bradyidius parabyssalis sp. nov. were obtained in both the Atlantic and Pacific Oceans (Argentine Basin, area of the Meteor Seamount and the Kurile-Kamchatka Trench). Bradyidius abyssalis sp. nov. was found only in the Atlantic Ocean, (Brazil and Guinea Basins and area of the Meteor Seamount) and Bradyidius kurilokamchaticus sp. nov. was recorded from the Kurile-Kamchatka Trench of the Pacific Ocean. Three new herein described Bradyidius species constitute the first documented records of the genus from the abyss of the World Ocean. In addition, three Bradyidius species from the Weddell Sea, the Atlantic Ocean and the Kurile-Kamchatka Trench, are briefly described without biological names due to their bad condition. Bradyidius parabyssalis sp. nov. and B. abyssalis sp. nov. are distinguished from all known congeners by the presence of 3 setae at the basis of the mandible and morphological details of the prosome posterior corners and P1. They show close resemblance to each other but differ in body size, rostrum structure, P4 coxa armament and length of the setae of the antennule ancestral segment I and the mandible basis. Bradyidius kurilokamchaticus sp. nov. shares with B. curtus Markhaseva, 1993, B. pacificus (Brodsky, 1950) and B. arnoldi Fleminger, 1957 a rostrum with non-divergent or parallel points, but differs from these species in the size, the well developed lateral spine on exopod segment 1, in the number of setae at the antenna exopod segment 1 and some morphological details of the prosome posterior corners. Characters that define the genus Bradyidius Giesbrecht, 1897 from Aetideopsis Sars, 1903, i.e. the shape of lateral spines of P1exopod segments 1 and 2; the endopod of P2 segmentation and the setation of the antennule ancestral segments XII, XV and XVII are discussed.

Vertebral fractures occur despite control of acromegaly and are predicted by cortical volumetric bone mineral density

Introduction Recent studies suggest that cortical bone could also play a role in vertebral fracture (VF) development in acromegaly. Objective Evaluate the occurrence of the VF and their relationship to DXA-derived bone parameters. Patients and methods A single-center two year prospective study of acromegaly patients was conducted. Each subject had L1-4 spine, femoral neck and total hip (TH) aBMD measured using DXA, and TBS measurement performed. 3D Shaper™ was used to assess proximal femur trabecular and cortical volumetric (v)BMD, cortical surface (s)BMD and cortical thickness (Cth). VF assessment was performed using the lateral spine imaging IVA™ mode with a Hologic Horizon® densitometer using semi-quantitative approach. Study outcomes were assessed at two time points –baseline and month 24. Results Seventy acromegaly patients (34 M/36F; average 55.1 years) were studied, including 26 with active disease. In 13 patients, nine of whom with controlled disease, VF was observed. A decrease of TBS, sBMD, neck trabecular vBMD, TH and neck cortical vBMD in VF in comparison to non-VF subjects was observed (p&lt;0.05). Multivariate analysis of fracture prediction showed TH cortical vBMD as best fracture prediction parameter with AUC 0.774. TBS was negatively associated with fasting plasma glucose (FPG) and HBA1c at each time point during the follow-up. Conclusions From the total number of 13 VF subjects, 9 of whom occurred in controlled disease group. The most sensitive and specific predictor of incident VF was TH cortical vBMD, suggesting that cortical bone is involved in fracture development.

Automated Vertebral Segmentation and Measurement of Vertebral Compression Ratio Based on Deep Learning in X-Ray Images

Vertebral compression fracture is a deformity of vertebral bodies found on lateral spine images. To diagnose vertebral compression fracture, accurate measurement of vertebral compression ratio is required. Therefore, rapid and accurate segmentation of vertebra is important for measuring the vertebral compression ratio. In this study, we used 339 data of lateral thoracic and lumbar vertebra images for training and testing a deep learning model for segmentation. The result of segmentation by the model was compared with the manual measurement, which is performed by a specialist. As a result, the average sensitivity of the dataset was 0.937, specificity was 0.995, accuracy was 0.992, and dice similarity coefficient was 0.929, area under the curve of receiver operating characteristic curve was 0.987, and the precision recall curve was 0.916. The result of correlation analysis shows no statistical difference between the manually measured vertebral compression ratio and the vertebral compression ratio using the data segmented by the model in which the correlation coefficient was 0.929. In addition, the Bland–Altman plot shows good equivalence in which VCR values are in the area within average ± 1.96. In conclusion, vertebra segmentation based on deep learning is expected to be helpful for the measurement of vertebral compression ratio.