Decreased Bone Density Research Articles

Hubungan Pengetahuan Dan Dukungan Keluarga Dalam Pencegahan Osteoporosis Pada Pra Lansia Di Wilayah Kerja Puskesmas Tanjung Agung Kabupaten Rejang Lebong Tahun 2023

Aging is a process of decreasing the ability of tissues to repair themselves or replace themselves, maintain normal structure and function slowly, so that they can withstand injury (including infection) and can repair the damage suffered. When aging occurs the bone density process decreases, the decrease in bone density is called osteoporosis (Darmojo, 2015). Knowing the Relationship between Knowledge and Family Support in Preventing Osteoporosis in Pre-Elderly in the Working Area of the Tanjung Agung Health Center, Rejang Lebong Regency in 2023. This type of research is analytical research using this type of research is analytical research using a cross-sectional design (Hidayat, 2012). The population of this study were families who had pre elderly aged 45-59 at the Tanjung Agung Health Center in 2022 totaling 100 people. the number of samples in this study were 50 respondents. The results of this study indicate that almost half of the respondents 23 (46%) had insufficient knowledge about the prevention of osteoporosis, most of the respondents 39 (78%) had supportive family support, Most of the respondents 39 (78%) had supportive family support, more than half of the respondents 29 (58%) had moderate osteoporosis prevention, there was a significant relationship between family knowledge and prevention of osteoporosis in the pre-elderly, there was a significant relationship between family support and prevention of osteoporosis in the pre-elderly at Pukesmas Tanjung Agung Rejang Lebong Regency in 2023. The results of this study are recommended to the health center to provide more frequent counseling to families regarding the prevention of osteoporosis in the pre-elderly.

Fallo ovárico prematuro en supervivientes a un tumor sólido: puntos clave de manejo

IntroductionPrimary ovarian insufficiency (POI) carries significant morbidity, causing infertility, sexual disfunction, decreased bone density, cardiovascular risk, emotional distress and early mortality. ObjectiveTo know the incidence and current management of POI in childhood/adolescent solid tumour survivors. Material and methodsWe conducted a multicentre observational study. It included female patients aged 12 to 18 years with a diagnosis of solid tumour and meeting clinical or biochemical criteria for POI. The risk was estimated based on the criteria of the Pediatric Initiative Network of the Oncofertility Consortium. ResultsWe found an incidence of 1.5 (30 cases of POI): The median age at the time of the event was 14 years (standard deviation, 2.09). The solid tumours associated most frequently with POI were Ewing sarcoma and brain and germ cell tumours. Eighty-three percent of patients did not undergo fertility preservation. Sixty-three percent reported not having undergone menarche at the time of ovarian failure. Ninety-seven percent were at high risk of gonadal toxicity, yet 47% were not monitored before the diagnosis. The median time elapsed to the occurrence of the event was 43.5 months after diagnosis and 29.5 months after completing treatment. The Kaplan-Meier curves showed that approximately 30% of POI cases developed within 2 years of diagnosis and that women at Tanner stage 1 developed insufficiency later than women at Tanner stage 5. ConclusionsThere is room for improvement in the followup of women at risk of POI in Spain. The tools currently available facilitate risk assessment at the time of treatment planning and allow the implementation of monitoring, education, early diagnosis, fertility preservation, and replacement therapy as needed. All of this would achieve significant improvement in health outcomes.

The Influence of Slice Thickness, Sharpness, and Contrast Adjustments on Inferior Alveolar Canal Segmentation on Cone-Beam Computed Tomography Scans: A Retrospective Study.

This retrospective study aims to investigate the impact of cone-beam computed tomography (CBCT) viewing parameters such as contrast, slice thickness, and sharpness on the identification of the inferior alveolar nerve (IAC). A total of 25 CBCT scans, resulting in 50 IACs, were assessed by two investigators using a three-score system (good, average, and poor) on cross-sectional images. Slice thicknesses of 0.25 mm, 0.5 mm, and 1 mm were tested, along with varying sharpness (0, 6, 8, and 10) and contrast (0, 400, 800, and 1200) settings. The results were statistically analyzed to determine the optimal slice thickness for improved visibility of IAC, followed by evaluating the influence of sharpness and contrast using the optimal thickness. The identified parameters were then validated by performing semi-automated segmentation of the IACs and structure overlapping to evaluate the mean distance. Inter-rater and intra-rater reliability were assessed using Kappa statistics, and inferential statistics used Pearson's Chi-square test. Inter-rater and intra-rater reliability for all parameters were significant, ranging from 69% to 83%. A slice thickness of 0.25 mm showed consistently "good" visibility (80%). Sharpness values of zero and contrast values of 1200 also demonstrated high frequencies of "good" visibility. Overlap analysis resulted in an average mean distance of 0.295 mm and a standard deviation of 0.307 mm across all patients' sides. The study revealed that a slice thickness of 0.25 mm, zero sharpness value, and higher contrast value of 1200 improved the visibility and accuracy of IAC segmentation in CBCT scans. The individual patient's characteristics, such as anatomical variations, decreased bone density, and absence of canal walls cortication, should be considered when using these parameters.

Bone-targeted engineered bacterial extracellular vesicles delivering miRNA to treat osteoporosis

Osteoporosis (OP), characterized by decreased bone density and destruction of bone microstructure, is a common systemic bone disease in the elderly. Conventional therapies suffer from poor targeting and long-term toxicity. Engineered bacterial extracellular vesicles (BEVs) containing bioactive molecules show great potential as alternative OP therapies. Here, we developed a delivery system based on BEVs secreted probiotic Lactobacillus rhamnosus GG (LGG). Bone-targeting peptides were anchored on the LGG-EVs membranes, which endowed LGG-EVs the ability to deliver intrinsic miRNA to bone microenvironment. Bone-targeted LGG-EVs (BT-LGG-EVs) exhibited great bone targeting capability without significant toxicity. BT-LGG-EVs not only promoted osteogenic differentiation and mineralization but also inhibited the formation of osteoclasts. Furthermore, BT-LGG-EVs were demonstrated to be able to attenuate the OVX-induced osteoporotic phenotypes. Our study demonstrated that BT-LGG-EVs hold great promise for use as an innovative, safe, and effective solution for the treatment of OP.

Micheliolide prevents estrogen deficiency-induced bone loss via inhibiting osteoclast bone resorption.

Osteoporosis is one of the major health problems characterized by decreased bone density and increased risk of fractures. Nowadays, the treating strategies against osteoporosis are efficient, but still have some drawbacks. Micheliolide, a guaianolide sesquiterpene lactone isolated from Michelia compressa and Michelia champac, has been reported to have anti-inflammatory effects. Here, our data suggest that Micheliolide could protect mice from ovariectomy induced bone loss. According to the Micro-CT scan and histomorphometry quantification data, Micheliolide treatment inhibits excessive osteoclast bone resorption without affecting bone formation in estrogen deficiency mice. Consistently, our data suggest that Micheliolide could inhibit osteoclastogenesis in vitro. Additionally, we confirmed that Micheliolide inhibits osteoclasts formation via inhibiting P38 MAPK signaling pathway, and P79350 (a P38 agonist) could rescue this effect. In summary, our data suggest that Micheliolide could ameliorate estrogen deficiency-induced bone loss via attenuating osteoclastogenesis. Hence, Micheliolide could be used as a novel anti-resorptive agent against osteoporosis.

Relationship between parameters of subclinical atherosclerosis and osteoporosis and their prognostic significance: data from the prospective studies

We analyzed modern publications on the relationship between cardiovascular diseases (CVDs) and osteoporosis and, in particular, their preclinical manifestations. Most of the papers on this issue are observational, cross-sectional, or study associations of preclinical markers with disease risk or outcomes. However, the results of these studies do not always coincide and are contradictory. Therefore, it is not possible to define cause-effect relationship between vascular changes and decreased bone mass, as well as persistence of its relationship. Due to the difficulties in management of prospective studies, in the last decade only a few studies have appeared with long-term follow-up of patients without symptoms with subsequent assessment of preclinical manifestations. A strong relationship has been demonstrated between intima-media thickness, plaque presence, coronary artery calcification and low bone density of the spine and proximal femur, as well as between vascular stiffness (pulse wave velocity) and proximal femur bone density. The data obtained indicate combined disorders of vascular wall morphology and bone tissue, not only in postmenopausal women, but also in elderly men, and can be used to justify indications for screening for decreased bone density in patients with CVD. At the same time, larger-scale prospective studies to explore associations between markers of preclinical manifestations of CVD and decreased bone mass, including in the Russian population, are required.

THU425 Brief, Low-impact, High-intensity Osteogenic Loading Training Utilizing Proprietary Osteostrong Devices With Once-A-Week, 10 Minute Treatments Improves Bone Mineral Density In Women With Osteoporosis Of The Lumbar Spine

Abstract Disclosure: N. Papadopoulou-Marketou: None. A. Papageorgiou: None. G. Vavetsis: None. T. Panagiotis: None. G.P. Chrousos: None. Introduction: Osteoporosis is a chronic condition characterized by a decrease in bone density and deterioration of microarchitecture. It has been associated with a high bone-fracture risk, an increased mortality, and vast health-care costs. Pharmaceutical treatment along with resistance exercise are usually prescribed. “Osteostrong” is a type of bone strengthening that uses brief (12 min), weekly, low-impact, high-intensity osteogenic loading. Aim: to investigate the therapeutic impact of Osteostrong in people with osteoporosis. Methods: In total, 140 postmenopausal women with osteoporosis of the lumbar spine, followed at the Unit on Clinical and Translational Research in Endocrinology, University of Athens, Athens, Greece, were enrolled. They were divided into 2 groups. Group A (GA) included 70 women who were treated with Osteostrong (mean age: 57,7 y, 95% CI 54, 9-60,6 y); Group B (GB) included 70 women who had no exercise intervention (mean age 59,2 y, 95% CI 55,6-61,9 y). All the participants had a complete physical examination, an assessment for exclusion of secondary osteoporosis, bone markers CTX1 and PINP, and a DXA examination [Horizon W (S/N 300472M], twice, at the time of inclusion in the trial, at 9 and 12 months after onset of intervention. Preliminary data at 9 months are shown. Statistical analysis, Medcalc version 20.2. Results: Paired Student t-test (chi-squared) of Bone Mass Density (BMD) and T-score before (1) and after intervention (2) in GA and GB showed: BMD lumbar spine (L1-L4) and T-score L1-L4: GA1 (mean:0.815), GA2 (mean:0.833) (p<0.0007) and GA1 (mean: −2.27), GA2 (mean: −1.93) (p<0.0001)/ GB1 (mean: 0.852), GB2 (mean: 0.851) (p=0.93) and GB1 (mean: −1.98), GB2 (mean: −1.80) (p=0.054), respectively. Trabecular bone score (TBS) and T-score TBS: GA1 (mean: 1.217), GA2 (mean: 1.238), (p=0.036) and GA1 (mean: −2.76), GA2 (mean: −2.52), (p=0.045)/ GB1 (mean:1.22), GB2 (mean: 1.204) (p=0.14) and GB1 (mean: −2.75), GB2 (mean: −2.85), (p= 0.560), respectively. The CTX1 and PINP values were within normal reference range at 9 months. Discussion: The study showed a statistically significant improvement of BMD in the lumbar spine and TBS in people with osteoporosis treated with Osteostrong. The Osteostrong method may have a synergistic effect with anti-osteoporotic medication, significantly reducing bone fracture risk. Conservative therapeutic interventions are important challenges to minimize the osteoporosis-related poor quality of life and mortality. Presentation: Thursday, June 15, 2023

Utilization of Low-Magnitude High-Frequency Vibration (LMHFV) as an Aid in Treating Peri-Implantitis: Case Presentations.

Peri-implantitis is an inflammatory process initiating in the soft tissue and then progressing to the hard tissue surrounding dental implants leading to loss of osseous support and potential loss of the implant if not identified early in the process. This process initiates in the soft tissue, which become inflamed spreading to the underlying bone leading to decreases in bone density with subsequent crestal resorption and thread exposure. In the absence of treatment of the peri-implantitis, the bone loss at the osseous implant interface progresses with inflammatory mediated decrease in the bone density that moves apically, eventually leading to mobility of the implant and its failure. Low-magnitude high-frequency vibration (LMHFV) has been shown to improve bone density, stimulate osteoblastic activity, and arrest progression of peri-implantitis with improvement of the bone or graft around the affected implant with or without surgery as part of the treatment. Two cases are presented using LMHFV to augment treatment.

Relationship between serum uric acid levels and osteoporosis.

Osteoporosis (OP) is a systemic bone disease in which bone density and quality decrease and bone fragility increases due to a variety of causes, making it prone to fractures. The development of OP is closely related to oxidative stress. Uric acid (UA) is the end product of purine metabolism in the human body. Extracellular UA has antioxidant properties and is thought to have a protective effect on bone metabolism. However, the process of UA degradation can lead to intracellular oxidative stress, which together with UA-induced inflammatory factors, leads to increased bone destruction. In addition, UA can inhibit vitamin D production, resulting in secondary hyperparathyroidism and further exacerbating UA-associated bone loss. This review summarizes the relationship between serum UA levels and bone mineral density, bone turnover markers, and so on, in the hope of providing new insights into the pathogenesis and treatment of OP.

Cerium doped TiO2 coating with superior antibacterial property and biocompatibility prepared by micro-arc oxidation

Peri-implantitis is a highly prevalent disease caused by bacterial plaque that results in inflammation. The disease starts from the soft tissue and gradually spreads to the hard tissue around the implant. If left untreated, it can lead to decreased bone density and loss of the implant. Therefore, it is crucial to improve the antibacterial and biological activity of implants to achieve dual functions. In this study, we prepared a Ce-doped TiO2 coating on the surface of pure titanium by micro-arc oxidation (MAO) for the prevention of peri-implantitis. We systematically investigated the physicochemical properties, antibacterial activity, and biocompatibility of Ce-doped coatings in vitro and in vivo. The results demonstrated that the increase of Ce concentration in the coating could increase the proliferation, adhesion and osteogenic differentiation of BMSCs in vitro. Results from in vivo osteogenesis experiments demonstrated that the 2Ce-MAO coating exhibited superior efficacy in promoting implant repair in osteoporotic rats. Furthermore, the results of in vitro and in vivo antibacterial experiments indicated that the Ce-TiO2 coating exhibits excellent antibacterial and anti-inflammatory properties. These findings suggest that the Ce-TiO2 coating prepared via MAO may be a promising approach for preventing peri-implantitis and promoting osteogenesis in osteoporosis.

Study of bone density according to СT data before and in the remote period after unicondylar knee arthroplasty

Background. Unicondylar knee arthroplasty has become popular among orthopedists in recent years. The main complication of this technology is the instability of the tibial component of the endoprosthesis due to the development of local osteoporosis in the area of arthroplasty. Patients with decreased bone density are at high risk of developing instability of the tibial component of the endoprosthesis. Therefore, determining the levels of bone mineral density in patients with osteopenia before arthroplasty make it possible to calculate the risk of complications in the long term. Objective: to evaluate the bone mineral density according to the computed tomography (CT) of the tibial plateau resection zone for unicondylar arthroplasty in patients at risk. Materials and methods. The state of three cortical layer zones was assessed: anterior, middle, posterior and 4 zones of the plateau cut plane. The optical density of bone tissue was measured on CT images of the tibial plateau of the knee joint using the Hounsfield scale. Changes in bone structures in the area of placing tibial component of the endoprosthesis were studied in 2 groups of patients: group I — ten individuals who had undergone unicondylar knee arthroplasty 3–6 years ago and complained of negative phenomena in the prosthetic knee, group II — ten patients who had undergone unicondylar arthroplasty 1.2–2 years ago. These patients underwent CT densitometry at the follow-up examination. Results. Before arthroplasty, the maximum optical density of bone tissue was statistically the same. The density of the cortical layer was maximal in the anterior part of the bone (~ 720 HU), minimal — in the posterior part (580 HU). For the spongy bone zone, the maximum optical density was observed in the anterior part (~ 470 HU), and in the posterior part, it was lower. In 3–6 years, patients of group I showed a significant decrease in the optical density of the bone, both in its cortical layer and in the cancellous tissue. The greatest losses were detected in the medial zones of the cancellous bone. Patients had areas of cortical layer resorption, and in some individuals, its complete absence. At the same time, the absorption index of the cortical layer in the areas of destruction did not exceed 100 HU. The maximum optical density of the cortical layer in the zones also decreased. In patients of group II, 1.5–2 years after arthroplasty, there were no noticeable changes in the bone structures in the surgery area. Changes occurred in the medial zones of the cancellous bone of the tibial plateau. Patients with osteopenia reported changes in bone optical density already in the first years after arthroplasty, although they do not lead to instability of the tibial component of the endoprosthesis. Conclusions. Patients with decreased bone density (osteopenia) during joint arthroplasty are at risk of developing local osteoporosis in the area of bone resection. The first signs of resorption of the cancellous bone can be observed 1.5–2 years after arthroplasty. Timely treatment measures can slow down the further progression of osteoporosis.

Physiotherapy Intervention in Elderly Immobility Syndrome: Narrative Review

With aging, several physiological changes occur in the elderly, including a decrease in muscle mass, bone density, and balance, which increase the risk of falls. As the elderly population continues to grow, the role of the physiotherapist becomes indispensable in promoting the autonomy and independence of these individuals. This study presents a narrative review on the physiotherapist's role in preventing immobility syndrome in the elderly. Immobility syndrome primarily affects the musculoskeletal system, leading to functional limitations that impact posture transfer and bed-to-chair mobility, hindering daily activities, altering gait patterns, and reducing the activity of certain systems. The implementation of early rehabilitation protocols within the first 48 hours of intervention can be applied to improve mobilization and prevent the onset of immobility syndrome. As the elderly population expands, the proactive involvement of physiotherapists in preventing and managing immobility-related issues becomes crucial. This not only enhances the quality of life for older individuals but also reduces the burden on healthcare systems. Overall, physiotherapy plays a vital role in mitigating the negative effects of immobility in the elderly, promoting their well-being, and maintaining their functional independence.

The comparison of Mental Index based on dental status in women using panoramic radiographs

Background: Bones will experience a decrease in density due to an imbalance in the process of resorption and remodeling. Women are known to be at greater risk of bone density loss than men, due to aging and hormonal effects. Decreased bone density can also affect alveolar bone and attachment to teeth, leading to tooth loss and edentulous. Panoramic radiographs are one of the regular examinations at dental clinics. They observe changes in the thickness of the cortical bone of the mandible and detect abnormalities in bone density by measuring them using the Mental Index (MI).
 Objectives: This research is aimed to determine the differences in Mental Index (MI) between dentate and edentulous regions in women through panoramic radiographs. 
 Materials and Methods: This research is using comparative analytic observational study with a cross-sectional approach, with 160 women panoramic radiograph samples available at the Dentistry Radiology Installation, RSGM-P, Trisakti University FKG, divided between 80 samples of the dentate region and 80 samples of the edentulous region. Calculations using MI with i-Dixel software version 2.2.0.3. (Morita, Japan) results in millimeters. 
 Results: There is a significant difference of MI between dentate and edentulous region (p = 0.000). The mean of dentate MI (right region 3.7443 ± 0.47927 mm and left region 3.7373 ± 0.41075 mm) was greater than edentulous MI (right region 2.4725 ± 0.48391 mm and left region 2.4421 ± 0.43962 mm). 
 Conclusion: The loss of teeth in women may lead to any change in the Mental Index (MI) 
 Keywords: Bone Density; Dental Status; Mental Index; Panoramic Radiograph

Analysis of the use of transosseous osteosynthesis in the treatment of patients with diabetic osteoarthropathy complicated by chronic osteomyelitis

Relevance Diabetic neuroosteoarthropathy (DNOAP) complicated by chronic osteomyelitis (CO) is one of the most common complications (up to 7.5 %) in patients with diabetes mellitus. Treatment failure of such patients leads to amputation of the segment, and in some cases, to death. The use of the method of transosseous osteosynthesis is the only alternative method in the struggle for the limb salvage.Purpose Based on X-ray morphological criteria for assessing bone quality, to determine the optimal assembly of the external fixation device (EFF), which provides favorable conditions for restoring limb weight-bearing capacity in the treatment of patients with DNOAP complicated by infection.Materials and methods The analysis of radiographs and the clinical course of the reparative process in 49 patients (mean age 55.5 ± 9.4 years) with DNOAP complicated by chronic osteomyelitis was carried out. Two groups were distinguished based on the Ilizarov apparatus assembly: wire-based (WB) used in 25 patients; hybrid construct (HC) in 24 patients. The X-ray obtained in Jpeg format were analyzed using specialized Hi-scene software. The density of the bones of the foot was studied by MSCT.Results Comparison of the indicators of bone optical density in both study groups showed that there was an insignificant increase in the postoperative period Od of the calcaneus by 25 % after treatment in patients from the HC group, and in the WB group by 43 % in the distal tibia. At the same time, we noted a significant increase in the Od values of the tibia in the postoperative period in patients from the HC group and in the body of the calcaneus in patients from the WB group. MSCT showed that the density of the calcaneus before treatment in patients with DNOAP in the region of the calcaneal tubercle was 194.37 ± 49.05 HU, in the region of the body it was 205.47 ± 38.36 HU, in the region of the distal tibia 280.00 ± 40.30 HU. The analysis of the results of bone osteosynthesis of the affected segment showed that the rate of satisfactory outcomes after dismantling the device in patients from the HC group was significantly higher than in the WB group (56 %) and amounted to 75 %.Discussion As is known, pronounced osteoporosis of the bones of the lower leg and foot is often characteristic of patients with diabetes mellitus complicated by DNOAP and chronic osteomyelitis. A possible arsenal of treatment methods that allow solving the problems of stable arrest of the osteomyelitic process and restoring limb support in such patients is very limited. The optimal choice of the Ilizarov apparatus assembly type has an impact on the outcome of treatment of patients with this pathology.Conclusion Based on X-ray morphological criteria for assessing bone quality, our study showed a decrease in optical and densitometric bone density in patients with DNOAP complicated by chronic osteomyelitis compared to the norm. The use of wire-based assembly of the apparatus does not provide sufficient conditions for the solution of the set of the surgical tasks in this category of patients. The introduction of half-pins into the apparatus system provides the necessary fixation time with the possibility of functional load on the operated segment in patients in the postoperative period.

Factors Related to Reduced Bone Density in β-Thalassemia Major Patients: Mazandaran Thalassemia Registry

Introduction: OsteoPenia and osteoPorosis are known to be one of the main comPlications of β-thalassemia major (β-TM). The aim of this study was to determine the factors associated with decreased bone density of these Patients.
 Methods: Lumbar and femoral neck bone mineral density (BMD) in β-TM Patients characterized via Dual-energy X-ray absorPtiometry (DXA) to PinPoint the association of iron chelators, diabetes mellitus, serum ferritin above 3000 ng/mL, hemoglobin below 8 gr/dl, using hydroxyurea, liver siderosis and moderate to severe hePatic and cardiac siderosis with BMD. The information was collected from the thalassemia registry in 2019 and statistical analysis was Performed by STATA-13 software.
 Results: Out of 1959 ParticiPants with β-thalassemia major registered in the registry, 139 ones (7.09%) had bone mineral density (53 males and 86 females). The Prevalence of abnormal bone density in the lumbar and femoral neck was (52.48 to 47.66) 57.5 and (40.18 to 57.52) 48.85 Percent, resPectively. After adjusting for the effects of Possible interventions, the odds ratio of abnormal bone density in the Patients consuming hydroxyurea and deferasirox were 0.24 (0.03 to 1.73) and 0.25 (0.03 to 1.69), resPectively. The highest odds were 8.21 (0.18 to 360.22), and 6.72 (0.60 to 74.83) for moderate to severe cardiac and hePatic dePosition, resPectively.
 Conclusion: The Prevalence of osteoPenia and osteoPorosis is high among thalassemia major Patients. ConsumPtion of hydroxyurea and deferasirox is the most imPortant Protective factor and moderate to severe cardiac and hePatic siderosis are the most imPortant risk factors for abnormal bone density.

Osteoporosis prediction in lumbar spine X-ray images using the multi-scale weighted fusion contextual transformer network

Osteoporosis is a bone-related disease characterized by decreased bone density and mass, leading to brittle fractures. Osteoporosis assessment from radiographs using a deep learning algorithm has proven a low-cost alternative to the golden standard DXA. Due to the considerable noise and low contrast, automated diagnosis of osteoporosis in X-ray images still poses a significant challenge for traditional diagnostic methods. In this paper, an end-to-end transformer-style network was proposed, termed FCoTNet, to overcome the shortcoming of insufficient fusion of texture information and local features in the traditional CoTNet. To extract complementary geometric representations at each scale of the transformer module, we integrated parallel multi-scale feature extraction architectures in each unit layer of FCoTNet to utilize convolution to aggregate features from different receptive fields. Moreover, in order to extract small-scale texture features which were more critical to the diagnosis of osteoporosis in radiographs, larger fusion weights were assigned to the feature maps with small-size receptive fields. Afterward, the multi-scale global modeling was conducted by self-attention mechanism. The proposed model was first investigated on a private lumbar spine X-ray dataset with the 5-fold cross-validation strategy, obtaining an average accuracy of 78.29 ± 0.93 %, an average sensitivity of 69.72 ± 2.35 %, and an average specificity of 88.92 ± 0.67 % for the multi-classification of normal, osteopenia, and osteoporosis categories. We then conducted a controlled trial with five orthopedic clinicians to evaluate the clinical value of the model. The average clinician's accuracy improved from 61.50 ± 10.79 % unaided to 80.00 ± 5.92 % aided (18.50 % improvement), sensitivity improved from 64.38 ± 8.07 % unaided to 83.31 ± 5.43 % aided (18.93 % improvement), and specificity improved from 80.11 ± 4.72 % unaided to 89.94 ± 3.82 % aided (9.83 % improvement). Meanwhile, the prediction consistency among clinicians significantly improved with the assistance of FCoTNet. Furthermore, the proposed model showed good robustness on an external test dataset. These investigations indicate that the proposed deep learning model achieves state-of-the-art performance for osteoporosis prediction, which substantially improves osteoporosis screening and reduced osteoporosis fractures.

CHANGES IN THE DENSITY AND COMPOSITION OF BONE TISSUE AND ALVEOLAR BONE ATROPHY IN RATS WITH HYPOTHIREOSIS AND CORRECTION WITH A COMPLEX OF MINERALS AND VITAMINS

Problem. For diseases of the thyroid gland, it is advisable to use hormone replacement therapy. However, numerous consequences of an overdose of L‑thyroxine drugs are known. The use of a preventive complex based on minerals, vitamins and quercetin can be an alternative to replacement therapy for correcting the consequences of disorders of the musculoskeletal system in thyroid diseases. Goal. The purpose of the work is an experimental study of the osteoprotective effectiveness of a complex of vitamins and minerals in rats with hypothyroidism. Method. In the experiment, 36 rats were used, which were divided into three groups: 12 intact, 12 animals that were simulated with hypothyroidism, and 12 rats that, against the background of hypothyroidism, were administered a preventive complex daily. The experiment on modeling hypothyroidism and its prevention lasted 4 months. Mandibles, lumbar vertebrae and femurs of rats of both sexes were isolated. Morphometric parameters were studied in vertebrae and femurs: density, content of mineral and organic components of bone tissue. The degree of atrophy of the alveolar process was determined in the jaws of the animals. Main results. Modeling hypothyroidism in rats caused a significant decrease in femoral bone density in males by 2.2% and in females by 1.7%, had no effect on lumbar vertebral density, and significantly increased alveolar process atrophy in males by 22.2% and in females by 15. 8%. The decrease in the density of the femur bone was due to a decrease in the content of the mineral component of bone tissue by 4.5–7.2%. The use of a preventive complex containing vitamins, minerals and quercetin led to an increase in the density of femurs to the level of healthy animals, increased the density of the lumbar vertebrae by 2.2–3.1%, and reduced atrophy of the alveolar process of the jaws in females by 21.5% and in males by 31.4%. Deterioration of the quality of bone tissue in thyroid insufficiency, as well as the osteotropic effectiveness of the prophylactic complex in conditions of hypothyroidism, were more pronounced in males. Conclusions. The conducted studies showed the development of dystrophic processes in the jaws and femurs of rats against the background of a deficiency of thyroid hormones and the positive effect of a complex of vitamins and minerals, which effectively stopped the atrophy of the alveolar process of the jaws and the decrease in the density of the femurs, and also increased the density of the lumbar vertebrae of rats with hypothyroidism.

Bone-Targeted Delivery of Cell-Penetrating-RUNX2 Fusion Protein in Osteoporosis Model.

The onset of osteoporosis leads to a gradual decrease in bone density due to an imbalance between bone formation and resorption. To achieve optimal drug efficacy with minimal side effects, targeted drug delivery to the bone is necessary. Previous studies have utilized peptides that bind to hydroxyapatite, a mineral component of bone, for bone-targeted drug delivery. In this study, a hydroxyapatite binding (HAB) tag is fused to 30Kc19α-Runt-related transcription factor 2 (RUNX2) for bone-targeting. This recombinant protein can penetrate the nucleus of human mesenchymal stem cells (hMSCs) and act as a master transcription factor for osteogenesis. The HAB tag increases the binding affinity of 30Kc19α-RUNX2 to mineral deposition in mature osteoblasts and bone tissue, without affecting its osteogenic induction capability. In the osteoporosis mouse model, intravenous injection of HAB-30Kc19α-RUNX2 results in preferential accumulation in the femur and promotes bone formation while reducing toxicity in the spleen. These findings suggest that HAB-30Kc19α-RUNX2 may be a promising candidate for bone-targeted therapy in osteoporosis.

Retrieval of a displaced implant from the mandibular body: A clinical report

The posterior mandible is often regarded as a reliable area for achieving primary stability during implant placement. However, in rare instances, implant displacement can occur in this region because of a significant decrease in bone density. Typically, surgical procedures such as the lateral or crestal approach have been used to remove displaced implants, requiring extensive bone removal and postponing implant placement for between 3 and 6 months. This clinical report presents an uncommon occurrence of implant displacement in the posterior mandible and introduces a less invasive approach to recovering it. This technique utilized the long screw of an open-tray impression post and an abutment to retrieve the displaced implant while simultaneously performing implant placement at the same site.

Finger Millet (Ragi): A Nutritional Boon for Osteoporosis

Abstract:: Background: Osteoporosis is a progressive bone disease that is characterized by a decrease in bone density. A serious concern should be taken on osteoporosis. Because of the dormant properties of the disease, it is hard to recognize the symptoms until fracture occurs. In Ayurveda, this depletion of the bone tissue is called Asthikshaya. This is due to nutrient deficiency because of malnutrition and imbalance of Vata dosha1,2 . To prevent osteopenia and osteoporosis, calcium and vitamin D supplements are required. Diet-based calcium supplement would be more acceptable and easier to practice. Finger millet (ragi, Eleusine coracana) is a good source of calcium and phosphorus and easily digestible.3,4Ragi is a good source of natural calcium. It helps in strengthening bones and also helps to balance Vata. This reduces the risk of Osteoporosis. Aim of study: 1.to recognize the importance of millets and 2.to introduce the Ragi as a best source of calcium. Conclusion: To maintain healthy life it is essential to promote nutritious diet to encourage healthy ageing and prevent early onset of chronic diseases. Various studies have shown that consumption of nutraceutical foods may provide greater health benefits. Ragi (Eleusine coracana) having nutraceutical properties, is the oldest cereal grain in India having strongest power to strengthen the bone