Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women.

OBJECTIVE: To evaluate, during the first postoperative year in obese pre-menopausal women, the effects of laparoscopic gastric banding on calcium and vitamin D metabolism, the potential modifications of bone mineral content and bone mineral density, and the risk of development of secondary hyperparathyroidism. SUBJECTS: Thirty-one obese pre-menopausal women aged between 25 and 52 y with a mean body mass index (BMI) of 43.6 kg/m(2), scheduled for gastric banding were included. Patients with renal, hepatic, metabolic and bone disease were excluded. METHODS: Body composition and bone mineral density (BMD) were measured at baseline, 6 and 12 months after gastric banding using dual-energy X-ray absorptiometry. Serum calcium, phosphate, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, bilirubin, urea, creatinine, uric acid, proteins, parathormone, vitamin D(3), IGF-1, IGF-BP3 and telopeptide, as well as urinary telopeptide, were measured at baseline and 1, 3, 6, 9 and 12 months after surgery. RESULTS: After 1 y vitamin D3 remained stable and PTH decreased by 12%, but the difference was not significant. Serum telopeptide C increased significantly by 100% (P<0.001). There was an initial drop of the IGF-BP3 during the first 6 months (P<0.05), but the reduction was no longer significant after 1 y. The BMD of cortical bone (femoral neck) decreased significantly and showed a trend of a positive correlation with the increase of telopeptides (P<0.06). The BMD of trabecular bone, at the lumbar spine, increased proportionally to the reduction of hip circumference and of body fat. CONCLUSION: There is no evidence of secondary hyperparathyroidism 1 y after gastric banding. Nevertheless biochemical bone markers show a negative remodelling balance, characterized by an increase of bone resorption. The serum telopeptide seems to be a reliable parameter, not affected by weight loss, to follow up bone turnover after gastroplasty.

Forms and accumulation of copper and zinc in a sandy typic hapludalf soil after long-term application of pig slurry and deep litter

Successive applications of pig slurry and pig deep litter may lead to an accumulation of copper (Cu) and zinc (Zn) fractions in the soil profile. The objective of this study was to evaluate the Cu and Zn forms and accumulation in a Sandy Typic Hapludalf soil after long-term application of pig slurry and deep litter. In March 2010, eight years after initiating an experiment in Braço do Norte, Santa Catarina (SC), Brazil, on a Sandy Typic Hapludalf soil, soil samples were collected from the 0-2.5, 2.5-5.0, 5-10 and 10-15 cm layers in treatments consisting of no manure application (control) and with applications of pig slurry and deep litter at two levels: the single and double rate of N requirement for maize and black oat succession. The soil was dried, ground in an agate mortar and analyzed for Cu and Zn contents by 0.01 mol L-1 EDTA and chemically fractionated to determine Cu and Zn. The applications of Pig deep litter and slurry at doses equivalent to 90 kg ha-1 N increased the contents of available Cu and Zn in the surface soil layer, if the double of this dose was applied in pig deep litter or double this dose in pig slurry, Cu and Zn migrated to a depth of 15 cm. Copper is accumulated mainly in the organic and residual fractions, and zinc preferentially in the fraction linked to clay minerals, especially in the surface soil layers.

Análise espaço-temporal de componentes do balanço hídrico em um Latossolo

O monitoramento das variáveis que constituem a equação do balanço hídrico do solo em campo cultivado é necessário para avaliar com confiabilidade os períodos de déficits hídricos durante o ciclo das culturas, manejar a irrigação e quantificar perdas de nutrientes por lixiviação. Os componentes da equação do balanço hídrico podem variar no espaço e no tempo, e o estudo da estabilidade temporal da variabilidade espacial desses componentes é essencial para determinar quais são os pontos de observação no campo (locais) para monitorar a água do solo com precisão e esforço amostral reduzido. Assim, os objetivos deste trabalho foram avaliar os componentes do balanço da água (especificamente a variação de armazenamento de água do solo, drenagem interna e evapotranspiração real) de plantas de milho em um Latossolo Vermelho-Amarelo e analisar a variabilidade espacial e temporal, por meio da técnica de estabilidade temporal. O estudo foi realizado em uma área do Campus da ESALQ/USP, município de Piracicaba, Estado de São Paulo, Brasil. O relevo da área experimental, que tem 1.500 m², é plano. Nessa área foram instalados 60 tubos de alumínio para acesso de uma sonda de nêutrons e 120 tensiômetros com manômetro de mercúrio (60 na profundidade de 0,75 m e 60 na profundidade de 0,85 m). Isso permitiu estimar a densidade de fluxo de água do solo na profundidade de 0,80 m por meio da equação de Darcy-Buckingham e o armazenamento de água na camada de 0,0-0,80 m, ao longo do ciclo da cultura. A precipitação pluvial foi medida por meio de um pluviômetro instalado no centro da área experimental, e a evaporação real foi considerada como desconhecida da equação do balanço hídrico. A pesquisa foi realizada dividindo o ciclo de cultivo em 13 períodos (P1 a P13). O uso da estatística descritiva foi feito para evidenciar a variação do comportamento dos dados após a remoção dos pontos discrepantes, que representaram entre 0,0 e 3,9 % dos pontos amostrais por período. O uso da estatística descritiva foi útil por ter apresentado a mudança no comportamento dos dados, após a retirada de valores discrepantes e extremos em alguns períodos. A técnica da estabilidade temporal é viável para avaliação do balanço hídrico no espaço e no tempo. Os coeficientes de correlação de Spearman entre os períodos indicaram estabilidade temporal para a armazenagem da água independentemente do teor de umidade do solo, mas não expressaram confiabilidade para a avaliação da drenagem interna e a evapotranspiração real da cultura. A evapotranspiração oscilou ao longo do ciclo da cultura mantendo-se praticamente constante nos períodos P5 a P9, em que houve maior desenvolvimento vegetativo das plantas.

Ponction biopsie medullaire [Bone marrow aspiration and biopsy]

Le diagnostic final des pathologies impliquant le système hématopoïétique tel que les leucémies, pancytopénies inexpliquées ou autres désordres médullaires, requiert une ponction biopsie de moelle. Cette procédure relativement invasive doit être maîtrisée non seulement par l'hématologue, mais également par l'interniste. Il est crucial d'en connaître les indications et contre-indications et de pouvoir prévenir les complications par une bonne connaissance de celles-ci. Cet article revoit ces différents éléments et apporte les détails pratiques de la procédure ainsi que le matériel nécessaire. The definitive diagnosis of several hematological diseases, as for instance leukaemias, unexplained pancytopenias and other bone marrow disorders, requires a bone marrow aspiration and biopsy. Not only haematologists, but also internists, need to master this rather invasive procedure. The knowledge of indications, contra-indications, potential complications and their prevention of its complications is of utmost importance. This article reviews these topics about bone marrow biopsy, giving some practical advices on this procedure

Pig slurry and nutrient accumulation and dry matter and grain yield in various crops

Pig slurry (PS) represents an important nutrient source for plants and using it as fertilizer makes greater nutrient cycling in the environment possible. The aim of this study was to assess how PS application over a period of years can affect grain yield, dry matter production and nutrient accumulation in commercial grain and cover crops. The experiment was carried out in an experimental area of the Universidade Federal de Santa Maria, in Santa Maria, RS, Brazil, from May 2000 to January 2008. In this period, 19 grain and cover crops were grown with PS application before sowing, at rates of 0, 20, 40 and 80 m³ ha-1. The highest PS rate led to an increase in nutrient availability over the years, notably of P, but also of nutrients that are potentially toxic to plants, especially Cu and Zn. The apparent recovery of nutrients by commercial grain and cover crops decreased with the increasing number of PS applications to the soil. Accumulated dry matter production of the crops and maize grain yield were highest at an annual application rate of 80 m³ ha-1 PS. However, common bean yield increased up to 20 m³ ha-1 PS, showing that the crop to be grown should be considered to define the application rate.

Caracterização das chuvas erosivas em Urussanga, SC, com relação ao padrão de distribuição temporal

O estudo da distribuição temporal de chuvas é realizado com objetivo de caracterizar o padrão de chuva mais frequente. O conhecimento das características físicas das chuvas com relação aos padrões de precipitação permite realizar modelagem matemática de eventos hidrológicos em condições mais próximas às condições reais. O objetivo deste trabalho foi caracterizar as chuvas erosivas em Urussanga, SC, com relação aos padrões hidrológicos de distribuição temporal. Foram usados os pluviogramas da estação meteorológica de Urussanga (latitude 28,31º S, longitude 49,19º W e altitude de 49 m) relativos ao período de outubro de 1980 a março de 2012. As chuvas erosivas foram classificadas em padrões avançado, intermediário e atrasado, se a maior intensidade ocorre no terço de duração inicial, intermediário e final, respectivamente. Foram determinadas as características de altura pluvial, duração da chuva, energia cinética, intensidade máxima em 30 min, erosividade e frequência de chuvas mensais de cada padrão de chuva. Verificou-se a ocorrência de 1.221 chuvas erosivas, das quais 651 com perfil avançado; 416, intermediário; e 154, atrasado. A duração média das chuvas erosivas é de 14,4 h. A média total de intensidade média para as chuvas erosivas foi de 17,4 mm h-1. A maior concentração de chuvas (32,9 %) foi observada no intervalo de duração de 6 a 12 h. Para duração inferior a 18 h, ocorre maior frequência de chuvas do padrão avançado; já para acima de 18 h, as frequências de chuvas do padrão avançado e intermediário são semelhantes.

Early stage primary bone lymphoma - a retrospective, multicenter rare cancer network (rcn) study

Purpose: Primary bone lymphoma (PBL) accounts for less than 1% of all malignant lymphomas, and 4-5% of all extra-nodal lymphomas. In this study, the disease profile, outcome, and prognostic factors were assessed in patients with stage I and II PBL.Patients and Methods: Thirteen Rare Cancer Network (RCN) institutions enrolled 116 consecutive patients with PBL treated between 1987 and 2008 in this study. Inclusion criteria were age > 16 years, stage I and II, minimum 6 months follow-up and a biopsy-proven confirmation of non-Hodgkin's lymphoma (NHL). Eighty-seven patients underwent chemoradiotherapy (CXRT), 15 radiotherapy (RT) without (13) or with (2) surgery, 14 chemotherapy (CXT) without (9) or with (5) surgery. Median RT dose was 40 Gy (range: 4-60). The median number of CXT cycles was 6 (range: 2-8). Median follow-up was 41 months (range: 6-242).Results: The overall response rate at the end of treatment was 91% (CR 74%, PR 17%). Local recurrence or progression was observed in 12 (10%) patients, and systemic recurrence in 17 (15%). Causes of death included disease progression in 21, unrelated in 5, CXT-related toxicity in 1, and second primary cancer in 2 patients. The 5-yr overall survival (OS), lymphoma-specific survival (LSS), and local control (LC) were 76%, 78% and 92%, respectively. In univariate analyses (log-rank test), favorable prognostic factors for OS were age <50 years (P=0.008), international prognostic index (IPI) score ≤1 (P=0.009), high grade histology (P=0.04), CXRT (P=0.05), CXT (P=0,0004), complete response (CR) (P<0.0001), number of CXT cycles ( ≥6 ) (P=0.01), and RT dose > 40 Gy (P=0.005). All above-mentioned parameters were also significant for LSS except for age and number of chemotherapy cycles. For LC, only CR and stage I were favorable factors. In multivariate analysis, IPI score, RT dose, complete response, and chemotherapy were independently influencing the outcome (OS and LSS). Complete response at the end of treatment was the only predicting factor for LC. Six patients developed grade 3 or more toxicities, according to Common Terminology Criteria for Adverse Events (CTCAE) V3.0.Conclusion: This large multicenter study confirms the relatively good prognosis of early stage PBL treated with combined CXRT. Local control was excellent, while systemic failures were rare. An adequate dose of RT (40 Gy or more) and complete CXT regime (≥ 6 cycles) were associated with better outcome.

Effects of pig slurry application on soil physical and chemical properties and glyphosate mobility

Pig slurry applied to soil at different rates may affect soil properties and the mobility of chemical compounds within the soil. The purpose of this study was to evaluate the effects of rates of pig slurry application in agricultural areas on soil physical and chemical properties and on the mobility of glyphosate through the soil profile. The study was carried out in the 12th year of an experiment with pig slurry applied at rates of 0 (control), 50, 100 and 200 m³ ha-1 yr-1 on a Latossolo Vermelho distrófico (Hapludox) soil. In the control, the quantities of P and K removed by harvested grains were replaced in the next crop cycle. Soil physical properties (bulk density, porosity, texture, and saturated hydraulic conductivity) and chemical properties (organic matter, pH, extractable P, and exchangeable K) were measured. Soil solution samples were collected at depths of 20, 40 and 80 cm using suction lysimeters, and glyphosate concentrations were measured over a 60-day period after slurry application. Soil physical and chemical properties were little affected by the pig slurry applications, but soil pH was reduced and P levels increased in the surface layers. In turn, K levels were increased in sub-surface layers. Glyphosate concentrations tended to decrease over time but were not affected by pig slurry application. The concentrations of glyphosate found in different depths show that the pratice of this application in agricultural soils has the potential for contamination of groundwater, especially when the water table is the surface and heavy rains occur immediately after application.

Augmentation of bone defect healing using a new biocomposite scaffold: an in vivo study in sheep.

Previous studies support resorbable biocomposites made of poly(L-lactic acid) (PLA) and beta-tricalcium phosphate (TCP) produced by supercritical gas foaming as a suitable scaffold for tissue engineering. The present study was undertaken to demonstrate the biocompatibility and osteoconductive properties of such a scaffold in a large animal cancellous bone model. The biocomposite (PLA/TCP) was compared with a currently used beta-TCP bone substitute (ChronOS, Dr. Robert Mathys Foundation), representing a positive control, and empty defects, representing a negative control. Ten defects were created in sheep cancellous bone, three in the distal femur and two in the proximal tibia of each hind limb, with diameters of 5 mm and depths of 15 mm. New bone in-growth (osteoconductivity) and biocompatibility were evaluated using microcomputed tomography and histology at 2, 4 and 12 months after surgery. The in vivo study was validated by the positive control (good bone formation with ChronOS) and the negative control (no healing with the empty defect). A major finding of this study was incorporation of the biocomposite in bone after 12 months. Bone in-growth was observed in the biocomposite scaffold, including its central part. Despite initial fibrous tissue formation observed at 2 and 4 months, but not at 12 months, this initial fibrous tissue does not preclude long-term application of the biocomposite, as demonstrated by its osteointegration after 12 months, as well as the absence of chronic or long-term inflammation at this time point.

Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis. Results of a 2-year study.

A Strontium ranelate appears to influence more than alendronate distal tibia bone microstructure as assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), and biomechanically relevant parameters as assessed by micro-finite element analysis (mu FEA), over 2 years, in postmenopausal osteoporotic women.Introduction Bone microstructure changes are a target in osteoporosis treatment to increase bone strength and reduce fracture risk.Methods Using HR-pQCT, we investigated the effects on distal tibia and radius microstructure of strontium ranelate (SrRan; 2 g/day) or alendronate (70 mg/week) for 2 years in postmenopausal osteoporotic women. This exploratory randomized, double-blind trial evaluated HR-pQCT and FEA parameters, areal bone mineral density (BMD), and bone turnover markers.Results In the intention-to-treat population (n = 83, age: 64 +/- 8 years; lumbar T-score: -2.8 +/- 0.8 [DXA]), distal tibia Cortical Thickness (CTh) and Density (DCort), and cancellous BV/TV increased by 6.3%, 1.4%, and 2.5%, respectively (all P < 0.005), with SrRan, but not with alendronate (0.9%, 0.4%, and 0.8%, NS) (P < 0.05 for all above between-group differences). Difference for CTh evaluated with a distance transformation method was close to significance (P = 0.06). The estimated failure load increased with SrRan (+2.1%, P < 0.005), not with alendronate (-0.6%, NS) (between-group difference, P < 0.01). Cortical stress was lower with SrRan (P < 0.05); both treatments decreased trabecular stress. At distal radius, there was no between-group difference other than DCort (P < 0.05). Bone turnover markers decreased with alendronate; bALP increased (+21%) and serum-CTX-I decreased (-1%) after 2 years of SrRan (between-group difference at each time point for both markers, P < 0.0001). Both treatments were well tolerated.Conclusions Within the constraints of HR-pQCT method, and while a possible artefactual contribution of strontium cannot be quantified, SrRan appeared to influence distal tibia bone microstructure and FEA-determined biomechanical parameters more than alendronate. However, the magnitude of the differences is unclear and requires confirmation with another method.

ORGANIC NITROGEN IN A TYPIC HAPLUDOX FERTILIZED WITH PIG SLURRY

The application of pig slurry may have a different effect on nitrogen dynamics in soil compared to mineral fertilization. Thus, the aim of this study was to determine the different forms of organic N in a Latossolo Vermelho distroférrico (Typic Hapludox) and their relationship to N uptake by crops in response to 10 years of annual application of pig slurry and mineral fertilizer. The treatments were application rates of 0, 25, 50, 100, and 200 m3 ha-1 of pig slurry, in addition to mineral fertilizer, organized in a randomized block design with four replications. The N contents were determined in the plant tissue and in the forms of total N and acid hydrolyzed fractions: ammonium-N, hexosamine-N, α-amino-N, amide-N, and unidentified-N. Annual application of pig slurry or mineral fertilizer increased the total-N content in the 0-10 cm depth layer. The main fractions of organic N in the soil were α-amino-N when pig slurry was applied and unidentified-N in the case of mineral fertilizers. Pig slurry increased the N fractions considered as labile: α-amino-N, ammonium-N, and amide-N. The increase in these labile organic N fractions in the soil through pig slurry application allows greater N uptake by the maize and oat crops in a no-tillage system.

A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture.

This case-control study assessed whether the trabecular bone score (TBS), determined from gray-level analysis of DXA images, might be of any diagnostic value, either alone or combined with bone mineral density (BMD), in the assessment of vertebral fracture risk among postmenopausal women with osteopenia. Of 243 postmenopausal Caucasian women, 50-80 years old, with BMD T-scores between -1.0 and -2.5, we identified 81 with osteoporosis-related vertebral fractures and compared them with 162 age-matched controls without fractures. Primary outcomes were BMD and TBS. For BMD, each incremental decrease in BMD was associated with an OR = 1.54 (95% CI = 1.17-2.03), and the AUC was 0.614 (0.550-0.676). For TBS, corresponding values were 2.53 (1.82-3.53) and 0.721 (0.660-0.777). The difference in the AUC for TBS vs. BMD was statistically significant (p = 0.020). The OR for (TBS + BMD) was 2.54 (1.86-3.47) and the AUC 0.732 (0.672-0.787). In conclusion, the TBS warrants a closer look to see whether it may be of clinical usefulness in the determination of fracture risk in postmenopausal osteopenic women.

Effects of Pig Slurry Application and Crops on Phosphorus Content in Soil and the Chemical Species in Solution

The application of pig slurry rates and plant cultivation can modify the soil phosphorus (P) content and distribution of chemical species in solution. The purpose of this study was to evaluate the total P, available P and P in solution, and the distribution of chemical P species in solution, in a soil under longstanding pig slurry applications and crop cultivation. The study was carried out in soil columns with undisturbed structure, collected in an experiment conducted for eight years in the experimental unit of the Universidade Federal de Santa Maria (UFSM), Santa Maria (RS). The soil was an Argissolo Vermelho distrófico arênico (Typic Hapludalf), subjected to applications of 0, 20, 40, and 80 m3 ha-1 pig slurry. Soil samples were collected from the layers 0-5, 5-10, 10-20, 20-30, 30-40, and 40-60 cm, before and after black oat and maize grown in a greenhouse, for the determination of available P, total P and P in the soil solution. In the solution, the concentration of the major cations, anions, dissolved organic carbon (DOC), and pH were determined. The distribution of chemical P species was determined by software Visual Minteq. The 21 pig slurry applications increased the total P content in the soil to a depth of 40 cm, and the P extracted by Mehlich-1 and from the solution to a depth of 30 cm. Successive applications of pig slurry changed the balance between the solid and liquid phases in the surface soil layers, increasing the proportion of the total amount of P present in the soil solution, aside from changing the chemical species in the solution, reducing the percentage complexed with Al and increasing the one complexed with Ca and Mg in the layers 0-5 and 5-10 cm. Black oat and maize cultivation increased pH in the solution, thereby increasing the proportion of HPO42- and reducing H2PO4- species.