Vitamin A is associated with the inflammatory marker CRP in cystic fibrosis

We have observed that vitamin A levels, deficient in patients with severe disease, returned to normal post lungtransplant independent of oral supplementation or pancreatic sufficiency. We hypothesised that vitamin A is associated with disease severity and the inflammatory marker C-related peptide (CRP). Data from RCH paediatric and TPCH adult CF clinic subjects (ns138 CF, 138 control, aged 5–56 yr), who had participated in a study of bone mineral density (BMD) in which vitamins A, E, D, and CRP, height, weight and lung function had been measured was used. Groups were compared using t- or Wilcoxon-tests, and predictors of vitamin A examined usingmultiple regression. Vitamin A was lower in CF subjects (1.23"0.5 vs. 1.80"0.6 mmolyl, P-0.0001), increasingwith age in paediatric subjects but to a lesser extent in the CF group (Ps0.0007). CRP was correlated with age (rs0.6, P-0.0001). FEV1% predicted (FEV) (57.93"23.0 vs. 70.63"21.8, Ps0.0014), weight z-score (WTZ) (y0.76"0.9 vs. y0.12"1.0, Ps0.0002), lumbar spine BMD z-score (y1.08"1.3 vs. y0.50"1.2, Ps0.009) were lower, and CRP higher (median 7.0, IQR 2–4 vs. median 1.0, IQR 1–3 mgy l, P-0.0001) in vitamin A insufficient CF subjects (61 insufficient vs. 71 sufficient). In all subjects, control status (P-0.0001), WTZ (Ps0.02), vitamin E (Ps 0.0003), CRP (Ps0.001), 1,25 dihydroxy vitamin D (1,25 vit. D) (Ps0.0007), and child, adolescent or adult grouping (all P-0.0001) were predictive of vitamin A. In the CF group, CRP (Ps0.01), Vitamin E (P-0.0001) and 1.25 vit. D (Ps 0.006), but not FEV, were predictive. The normal increase in vitamin A with age was not observed in CF subjects, who had lower levels at any age. This failure of normal increase in vitamin A had a consistent association with increasingCRP , supportingthe hypothesis that increased inflammation may result in increased vitamin A consumption.

Energy and calcium stores are preserved in girls and young women with CF, independent of disease severity: An explanation for the 'gender gap'?

Bioenergetics differ between males and females of many species. Human females apportion a substantial proportion of energy resources towards gynoid fat storage, to support the energetic burden of reproduction. Similarly, axial calcium accrual is favoured in females compared with males. Nutritional status is a prognostic indicator in cystic fibrosis (CF), but girls and young women are at greater risk of death despite equivalent nutritional status to males. The aim of this study was to compare fat (energy) and calcium stores (bone density) in males and females with CF over a spectrum of disease severity. Methods: Fat as % body weight (fat%) and lumbar spine (LS) and total body (TB) bone mineral density (BMD) were measured using dual absorption X-ray photometry in 127(59M) control and 101(54M) CF subjects, aged 9–25 years. An equation for predicted age at death had been determined using survival data and history of pulmonary function for the whole clinic, based on a trivariate normal model using maximum likelihood methods (1). For the CF group, a disease severity index (predicted age at death) was calculated from the derived equations according to each subjects history of pulmonary function, current age, and gender. Disease severity was classified according to percentile of predicted age at death (‘mild’ ≥75th, ‘moderate’ 25th–75th, ‘severe’ ≤25th percentile). Wt for age z-score was calculated. Serum testosterone and oestrogen were measured in males and females respectively. Fat% and LSBMD were compared between the groups using ANOVA. Results: There was an interaction between disease severity and gender: increasing disease severity was associated with greater deficits in TB (p=0.01), LSBMD (p

Possible contraindications and adverse reactions associated with the use of ocular nutritional supplements

The role of oxidation in the development of age-related eye disease has prompted interest in the use of nutritional supplementation for prevention of onset and progression. Our aim is to highlight possible contraindications and adverse reactions of isolated or high dose ocular nutritional supplements. Web of Science and PubMed database searches were carried out, followed by a manual search of the bibliographies of retrieved articles. Vitamin A should be avoided in women who may become pregnant, in those with liver disease, and in people who drink heavily. Relationships have been found between vitamin A and reduced bone mineral density, and beta-carotene and increased risk of lung cancer in smoking males. Vitamin E and Ginkgo biloba have anticoagulant and anti-platelet effects respectively, and high doses are contraindicated in those being treated for vascular disorders. Those patients with contraindications or who are considered at risk of adverse reactions should be advised to seek specialist dietary advice via their medical practitioner. © 2005 The College of Optometrists.

Transducer diffraction theory and development of an ultrasonic tomogram

The work described in this thesis is the development of an ultrasonic tomogram to provide outlines of cross-sections of the ulna in vivo. This instrument, used in conjunction with X-ray densitometry previously developed in this department, would provide actual bone mineral density to a high resolution. It was hoped that the accuracy of the plot obtained from the tomogram would exceed that of existing ultrasonic techniques by about five times. Repeat measurements with these instruments to follow bone mineral changes would involve very low X-ray doses. A theoretical study has been made of acoustic diffraction, using a geometrical transform applicable to the integration of three different Green's functions, for axisymmetric systems. This has involved the derivation of one of these in a form amenable to computation. It is considered that this function fits the boundary conditions occurring in medical ultrasonography more closely than those used previously. A three dimensional plot of the pressure field using this function has been made for a ring transducer, in addition to that for disc transducers using all three functions. It has been shown how the theory may be extended to investigate the nature and magnitude of the particle velocity, at any point in the field, for the three functions mentioned. From this study. a concept of diffraction fronts has been developed, which has made it possible to determine energy flow also in a diffracting system. Intensity has been displayed in a manner similar to that used for pressure. Plots have been made of diffraction fronts and energy flow direction lines.

Angiotensin receptor I stimulates osteoprogenitor proliferation through TGFβ-mediated signaling

Clinical studies of large human populations and pharmacological interventions in rodent models have recently suggested that anti-hypertensive drugs that target angiotensin II (Ang II) activity may also improve loss of bone mineral density. Here we identified in a genetic screen the Ang II type I receptor (AT1R) as a potential determinant of osteogenic differentiation and, implicitly, bone formation. Silencing of AT1R expression by RNA interference severely impaired the maturation of a multipotent mesenchymal cell line (W20-17) along the osteoblastic lineage. The same effect was also observed after the addition of the AT1R antagonist losartan but not the AT2R inhibitor PD123,319. Additional cell culture assays traced the time of greatest losartan action to the early stages of W20-17 differentiation, namely during cell proliferation. Indeed, addition of Ang II increased proliferation of differentiating W20-17 and primary mesenchymal stem cells and this stimulation was reversed by losartan treatment. Cells treated with losartan also displayed an appreciable decrease of activated (phosphorylated)-Smad2/3 proteins. Moreover, Ang II treatment elevated endogenous transforming growth factor β (TGFβ) expression considerably and in an AT1R-dependent manner. Finally, exogenous TGFβ was able to restore high proliferative activity to W20-17 cells that were treated with both Ang II and losartan. Collectively, these results suggest a novel mechanism of Ang II action in bone metabolism that is mediated by TGFβ and targets proliferation of osteoblast progenitors.

Desenvolvimento de protótipo de aplicativo móvel em Android® para o controle e acompanhamento nutricional da saúde óssea em mulheres menopáusicas

Following a drop in estrogen in the period of menopause some women begin to lose bone mass more than 1% per year reaching the end of five years with loss greater than 25%. In this regard, factors such as older age, low calcium intake and premature menopause favor the onset of osteoporosis. Preventive methods such as nutritional counseling to a proper diet and the support of technology through applications that assess dietary intake are essential. Thus, this study aimed to develop an application for Android® platform focused on the evaluation of nutritional and organic conditions involved in bone health and risks for developing osteoporosis in postmenopausal women. To achieve this goal we proceeded to a study of 72 women aged 46-79 years, from the physical exercise for bone health of the Laboratory for Research in Biochemistry and Densitometry the Federal Technological University of Paraná program. Data were collected in the second half of 2014 through tests Bone Densitometry and Body Composition, Blood Tests, Anthropometric data and Nutrition Assessment. The study included women with a current diagnosis of osteopenia or osteoporosis primary, aged more than 45 years postmenopausal. For the assessment of bone mineral density and body composition used the device Absorptiometry Dual Energy X-ray (DXA) brand Hologic Discovery TM Model A. For anthropometric assessment was included to body mass, height, abdominal circumference, Waist circumference and hip circumference. The instrument for assessing food consumption was used Recall 24 hours a day (24HR). The estimated intake of energy and nutrients was carried from the tabulation of the food eaten in the Software Diet Pro 4®. In a sub sample of 30 women with osteopenia / osteoporosis serum calcium and alkaline phosphatase tests were performed. The results demonstrated a group of women (n = 30) average calcium intake of 570mg / day (± 340). The analysis showed a mean serum calcium within the normal range (10,20mg / dl ± 0.32) and average values and slightly increased alkaline phosphatase (105.40 U / L ± 23.70). Furthermore, there was a significant correlation between the consumption of protein and the optimal daily intake of calcium (0.375 p-value 0.05). Based on these findings, we developed an application early stage in Android® platform operating system Google®, being called OsteoNutri. We chose to use Java Eclipse® where it was executed Android® version of the project; choice of application icons and setting the visual editor for building the application layouts. The DroidDraw® was used for development of the three application GUIs. For practical tests we used a cell compatible with the version that was created (4.4 or higher). The prototype was developed in conjunction with the Group and Instrumentation Applications Development (GDAI) of the Federal Technological University of Paraná. So this application can be considered an important tool in dietary control, allowing closer control consumption of calcium and dietary proteins.

Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance

International audience

Effects of a rhythmic and choreographic program in obese and overweight participants

Introduction: Currently there is a growing trend in the prevalence of overweight and obesity. This increased prevalence trend leads to an increase in the costs of health care. Objective: The aim of the present study was to analyze the effects on physical fitness and bone mineral density through an intervention program of physical activity based on rhythmic and choreographic activities in an overweight and obese population. Method: An 8-month physical activity based on rhythmic and choreographic activities was conducted in overweight and obese people. Thirty-four participants aged 50.43 ± 10.57 with a body mass index (BMI) 38.37 ± 4.82 took part in the physical activity program. This study assesses the effects of fitness, percentage of body fat and bone mineral density (BMD). Results: After an 8-month physical activity intervention program based on rhythmic and choreographic activities, significant differences were found in: percentage of body fat (p = 0.004), aerobic capacity (p = 0.023), flexibility of the lower limbs (flexibility in the right leg p = 0.029 and left leg p = 0.002), balance (p < 0.001), strength in lower limbs (p = 0..003) and strength in upper limbs (p < 0.001). Besides that, significant differences were found in parameters related with BMD such as T-Score (p = 0.025) and Z-Score (p = 0.012), Bone Quality Index (BQI) (p = 0.026) and an increase in Broadband Ultrasound Attenuation (BUA) although not a statistically significant one (p = 0.939). Conclusions: These findings suggest that a physical activity program based on rhythmic and choreographic activities can act as a preventive method of mobility and fragility, as well as preventing bone loss.

Comparação de diferentes tipos de exercício na composição corporal e força em jovens desportistas do sexo feminino

O estudo pretende comparar o efeito de diferentes tipos de exercício físico na composição corporal e força em jovens desportistas do sexo feminino. A amostra foi constituída por vinte e seis desportistas femininas com idades compreendidas entre os 16 e 21 anos. Previamente ao início do estudo foram sujeitas ao 1º momento de avaliação, e após vinte e quatro semanas realizaram o segundo e ultimo momento de avaliação. Os parâmetros avaliados foram a composição corporal através da técnica de absorciometria radiológica de dupla energia; a força isocinética, nomeadamente os momentos de força (peak-torques) e rácios nos músculos extensores e flexores do joelho; a potência muscular nos membros inferiores através dos saltos verticais Squat jump e Countermovement jump. Posteriormente foram separadas em quatro grupos, grupo natação e exercício vibratório (NAT EV; n= 6), grupo natação (NAT; n=6), grupo futsal (FUTS; n= 6) e o grupo de controlo (CONT; n= 8). O grupo (NAT/EV), participou num programa de exercício vibratório (EV), três sessões por semana complementar ao treino de natação. O grupo de (NAT) cumpriu o plano de treino correspondente à disciplina, o grupo de (FUTS) cumpriu o treino referente à respetiva modalidade, o grupo controlo (CONT) realizou somente os exercícios físicos inerentes às aulas de educação física na escola. Resultados: Nas comparações inter grupos, verificou-se no grupo FUTS um aumento de 0,1 (g/m2) ± 0,0 nos valores da DMO-PE, quando comparado com o grupo de CONT, nas comparações intra grupo o grupo de NAT EV registou um acréscimo de 0,1 (g/m2) ± 0,1 nos valores da DMO-TC. Em conclusão, os resultados obtidos sugerem que a modalidade de FUTS promoveu mais alterações na composição corporal, nomeadamente na DMO-PE, no entanto dados conseguidos pelo grupo de NAT EV sugerem que o exercício vibratório poderá influenciar positivamente o incremento da DMO; ABSTRACT: The objective of this study was to compare the effect of different types of exercise on body composition and strength in young female athletes. The sample consisted of twenty-six female athletes aged between 16 and 21. Before the study there was a 1st evaluation point, after twenty-four weeks there was the 2nd and final evaluation. We evaluated body composition through x-ray absorptiometry technique of dual energy, isokinetic strength, including the peak-torques and ratios in the extensor and flexor muscles of the knee; the muscle power in the lower limbs was evaluatated through the vertical jumps Squat jump and countermovement jump. During the study they were separated into four groups, swimming exercise group and vibration (NAT EV; n = 6), swimming group (NAT; n= 6), footsal group (FUTS; n= 6) and control group (CONT; n= 8). The NAT/EV group, participated in a vibrating exercise program (EV), complementary to swimming training, with three sessions per week. The NAT group fulfilled the corresponding swimming workout plan, FUTS group fulfilled the training related to futsal, the CONT group only performed the usual exercises in physical education classes at school. Results: In intergroup comparisons, there was an increase in FUTS group of 0.1 (g / m2) ± 0.0 in the values of MBD-PE, when compared with the CONT group comparisons in intra-group group NAT EV increased by 0.1 (g / m2) ± 0.1 in BMD-TC values. In conclusion, the results suggest that FUTS group promoted more changes in body composition, particularly in BMD-PE, but data obtained by NAT EV group suggest that vibration exercise can positively influence the increase in BMD.

Modelação matemática para identificar o valor de T-Score

A osteoporose é uma patologia esquelética sistémica, caracterizada pela diminuição da massa óssea, provocando uma diminuição da resistência do osso e, consequentemente um aumento do risco de fraturas no indivíduo. Neste estudo pretende-se prever o valor que permite determinar se um paciente tem ou não osteoporose, denominado de T-Score. Normalmente este valor é obtido através de um exame de densitometria óssea, a absorciometria de raios-X de dupla energia (DEXA). Além disso, pretendeu-se converter os valores de T-Score e a densidade mineral óssea (DMO) (ou bone mineral density - BMD) para os vários equipamentos existentes para este exame. Para finalizar, criou-se um documento PDF com as previsões e as conversões alcançadas.

Body composition by dual X-ray absorptiometry in Mexican schoolchildren with or without obesity

Objective: Apply dual X-ray absorptiometry (DXA) to determine the amount of fat mass, lean mass, and bone mineral density in Mexican schoolchildren with and without obesity. Material and methods: We performed an observational, analytical, comparative, cross-sectional study of 80 Mexican schoolchildren who attended the Nutrition Clinic of the Pediatric Medical Center in Monterrey, Mexico during the period of January to April 2005. Body mass index (BMI) was determined to classify the participants according to the growth charts of the Centers for Disease Control and Prevention. Two groups of 40 children each (with and without obesity) were formed and DXA was carried out on each individual. Cronbach’s Alpha was used to determine instrument reliability and the Kolmogorov-Smirnov test was used to test the normality of numerical variables. Means were compared using Student´s t test. Results: Statistically signiicant differences were found in fat mass (p≤0.001) and lean mass (p≤0.001), but not in bone mineral content (p=0.051) between both groups. Conclusions: Differences exist in fat mass and lean mass in both groups, but not in bone mineral content between both groups. A signiicant positive correlation was found between fat mass, determined by DXA, and BMI in schoolchildren with and without obesity

Protective effect of Rhizoma drynariae extract on osteoporosis in ovariectomized rat model

Purpose: To investigate the therapeutic effect of Rhizoma drynariae extract (RDE) on ovariectomyinduced osteoporosis in rats. Methods: Female Sprague-Dawley rats were randomly assigned to a sham-operated group (control) and five ovariectomy (OVX) subgroups: OVX with vehicle (OVX), OVX with 17ß-estradiol (E2, 25 μg/kg/day), and OVX with RDE doses (40, 80, and 160 mg/kg/day). Daily oral administration of E2 or RDE started 4 weeks after OVX and lasted for 16 weeks. The bone mineral density (BMD) of the L4 vertebrae and right femurs was estimated. The length of each femur was measured with a micrometer gauge, and the center of the diaphysis determined. Three representatives L4 vertebrae were selected to evaluate the trabecular microarchitecture. Serum alkaline phosphatase (ALP), urinary calcium (U-Ca), urinary phosphorus (U-P), urinary creatinine (Cr) and osteocalcin (OC) levels were measured. Results: The study showed that high-dose of RDE significantly inhibited the bone mineral density (BMD) reduction of L4 vertebrae (0.20 ± 0.02 g/cm3, p < 0.05) and femurs (0.18 ± 0.02 g/cm3, p < 0.05) caused by OVX and prevented the deterioration of trabecular microarchitecture (p < 0.05), which were accompanied by a significant decrease in skeletal remodeling (p < 0.05) as evidenced by the lower levels of bone turnover markers. High-dose of RDE improved morphometric parameters, namely, Tb-N (3.8 ± 0.2 mm, p < 0.05), Tb-Th (0.083 ± 0.011 mm, p < 0.05) and Tb-Sp (0.19 ± 0.01 mm, p < 0.05) in L4 vertebrae significantly. The present study indicates that the administration of RDE at higher doses over a 16-week period can prevent OVX-induced osteoporosis in rats without hyperplastic effects on the uterus. Conclusion: Thus, RDE is a potential natural alternative for postmenopausal osteoporosis treatment in elderly women.

Anti-osteoporosis activity of Astragalus membranaceus Bunge extract in experimental rats

Purpose: To investigate the anti-osteoporosis effect of Astragalus membranaceus (Fisch.) Bunge. extract (AMBE) in experimental rats. Method: Female Sprague-Dawley rats were randomly divided into six groups: control group, ovariectomy (OVX) with vehicle group, OVX with 17β-estradiol (E2, 25 μg/kg/day) group, and OVX with AMBE doses (60, 120 and 240 mg/kg/day) groups. Daily oral administration of AMBE or E2 was started 4 weeks after OVX and lasted for 16 weeks. The bone mineral density (BMD) of L4 vertebrae and right femurs was evaluated. The length of each femur was measured with a micrometer, and the center of diaphysis was determined. Three representative L4 vertebrae were selected to evaluate trabecular microarchitecture. Serum alkaline phosphatase (ALP), urinary calcium (U-Ca), urinary phosphorus (UP), urinary creatinine (Cr) and osteocalcin (OC) levels were measured. Results: AMBE dose-dependently inhibited the bone mineral density (BMD) reduction of L4 vertebrae (0.27 ± 0.03 g/cm2, p < 0.05) and femurs (0.23 ± 0.03 g/cm2, p < 0.05) caused by OVX and prevented the deterioration of trabecular microarchitecture (p < 0.05), which were accompanied by a significant decrease in skeletal remodeling (p < 0.05) as evidenced by the lower levels of bone turnover markers. A higher dosage of AMBE treatment (240 mg/kg/day) increased U-Ca/Cr (0.27 ± 0.03 mmol/mmol), ALP (137.23 ± 16.72 U/L), U-P/Cr (4.18 ± 0.27 mmol/mmol) and OC (8.47 ± 0.26 mmol/L) levels (both p < 0.05). Conclusion: The findings of this study indicate that AMBE prevents OVX-induced osteoporosis in rats.

Anti-osteoporosis effect of Cistanche deserticola Ma extract in ovariectomized rats

Purpose: To investigate the therapeutic effects of Cistanche deserticola Ma. extract (CDME) on ovariectomy-induced osteoporosis in rats. Methods: Female Sprague-Dawley rats were randomly assigned to a control group and five ovariectomy (OVX) subgroups, that is, OVX with vehicle (OVX), OVX with 17ß-estradiol (E2, 25 μg/kg/day), and OVX with CDME doses (40, 80, or 160 mg/kg/day). Daily oral administration of E2 or CDME started 4 weeks after OVX and lasted for 16 weeks. Bone mineral density (BMD) of L4 vertebrae and right femur of rats was estimated, The length of each femur was measured, and biochemical analysis of serum and urine specimens were performed. Results: CDME dose-dependently inhibited the reduction in BMD of L4 vertebrae (0.23 ± 0.02 g/cm3, p < 0.05) and femurs (0.20 ± 0.03 g/cm3, p < 0.05) caused by OVX and prevented the deterioration of trabecular microarchitecture (p < 0.05), which were accompanied by a significant decrease in skeletal remodeling (p < 0.05) as evidenced by the lower levels of bone turnover markers. Conclusion: This study indicates that CDME prevents OVX-induced osteoporosis in rats, and could be used for treating osteoporosis in elderly women.

Cordectomía por sustracción pedicular en la columna dorsal y lumbar en fracturas traumáticas: experiencia en el hospital universitario mayor Mederi y revisión sistemática de la literatura

Objetivo: Presentar la experiencia con la técnica de corpectomia por sustracción pedicular en fracturas traumática a nivel de la columna dorsal y Lumbar en el Hospital Universitario Mayor en Bogotá y hacer una revisión sistemática de la literatura de esta técnica quirúrgica. Material y métodos: Se realizó un análisis retrospectivo de las historias clínicas de pacientes que consultaron al servicio de neurocirugía entre los años 2013 y 2015 con fracturas traumáticas a nivel de la columna dorsal y lumbosacra. Se realizó un análisis de déficit neurológico pre y posoperatorio por medio de la Clasificación neurológica estándar de lesión medular (ASIA), al igual que tiempos de cirugía, sangrado intraoperatorio y complicaciones. A su vez se realiza una revisión sistemática de la literatura sobre esta técnica quirúrgica. Resultados: El total de pacientes que se sometieron a cirugía fue de 32, de los cuales el tiempo quirúrgico promedio fue de 396 min, se obtuvo un ASIA prequirúrgico B: 50% C: 47% y E: 3%. El ASIA post operatorio fue de B: 9% C: 47% D: 38% E: 6%. Se obtuvo una mejoría del déficit neurológico en el 75% los pacientes intervenidos. El promedio de sangrado fue de 1,223 cc. Se tuvieron 4 complicaciones, 2 hematomas en lecho quirúrgico que requirió re intervención y dos fistulas de líquido cefalorraquídeo las cuales se manejaron con vendaje compresivo y reposo absoluto. Conclusiones: La corpectomia por sustracción pedicular requiere de un adecuado entrenamiento y un grupo multidisciplinario dentro de los que se incluye neuroanestesiologo, a su vez de neurocirujanos entrenados en columna. Este abordaje presenta grandes beneficios como disminución de tiempos quirúrgicos, disminución de sangrado intraoperatorio y disminución de morbilidad entre otras.