Densitometric Parameters Research Articles

MO539: Use of FRAX® Scale to Estimate Bone Fracture Risk in Patients Undergoing Haemodialysis

Abstract BACKGROUND AND AIMS Decreased bone mineral density in patients undergoing haemodialysis (HD) is related to the development of fractures that lead to increased morbimortality. There is limited evidence on fracture risk factors that would allow to identify patients at risk to prompt early treatment. In this context, FRAX® (Fracture Risk Assessment scale, which is freely available online at https://www.sheffield.ac.uk/FRAX/tool.aspx?country=4) scale aids in the risk prediction (as a percentage over a 10-year span) of both major and hip osteoporotic fractures in specific populations, including patients with chronic kidney disease (CKD) [1]. However, the evidence of its utility in HD patients is scarce [2]. The aim of our study is to identify patients on HD with increased risk of fractures based on FRAX® scale, blood-test and densitometric parameters. Also, we aim to demonstrate a correlation between a higher risk of fractures as assessed by FRAX® scale and densitometry-established osteoporosis. METHOD This is a single-centre retrospective study including patients undergoing periodic intermittent haemodiafiltration. Data regarding clinical and blood-test parameters were collected. FRAX® scale was used to estimate the risk of hip and major fractures. Patients were divided accordingly into high and low fracture risk, with a threshold set at a 10-year 3% risk of hip fracture and 10% for other major fractures, according to definitions for the general population given by FRIDEX (Fracture RIsk factors and bone DEnsitometry type central dual X-ray) and FROCAT cohorts[3]. The relationship between clinical, blood-test parameters and the degree of osteopaenia and osteoporosis was evaluated. Osteopaenia was defined as a T-score between −1 and −2.5 in femoral neck densitometry. Osteoporosis was established as a T-score lower than −2.5. Qualitative parameters were analysed using Fisher's exact test, whilst Mann–Whitney U test was employed in the analysis of quantitative parameters. RESULTS A total of 54 patients (59.26% male) with a median age of 60 years [interquartile range (IQR), 50–72.25] were recruited. Six low intensity fractures were observed (11.1%), five of them occurred in high-risk-FRAX-scale-classified patients (P 0.095). The observed median FRAX score for our sample was 7.35% (IQR, 4.97–13.25) for major fractures and 1.70% (IQR, 0.78–6.13) for hip fractures. Patients with a higher risk of major fracture, according to FRAX® scale (>7.5%), were older (P < 0.001) and had been on renal replacement therapy (RRT) for a longer period of time (P 0.008). Furthermore, a significantly higher proportion of patients with prior kidney transplantation (0.012) and osteoporosis (0.002) was found in this group. No differences were observed in blood-test parameters, KtV and dialysate composition between low and high-risk patients. Densitometry was performed in 26 patients (48.14%). In this subset, osteopaenia was observed in 14 patients (53.84%) and osteoporosis in 11 (42.31%). Patients with osteoporosis had a higher FRAX score for major fracture (21%, IQR 11.50–26.50; P 0.001) and hip fracture (7.80%, IQR 5.75–14.50; P < 0.001). No correlation was found between prior kidney transplantation or exposure to steroids and densitometry-established osteoporosis. CONCLUSIONS Despite not being validated yet in Spain, our results demonstrate that FRAX® scale significantly correlates with the degree of osteoporosis in patients undergoing HD, representing an effective tool for the identification of patients at high risk of suffering fractures, prompting early prevention and management.

The Effect of Endurance and Endurance-Strength Training on Bone Health and Body Composition in Centrally Obese Women-A Randomised Pilot Trial.

There is no consensus exercise programme to reduce body weight and improve body composition simultaneously preventing bone loss or stimulating osteogenesis. This pilot study compared the effect of endurance and endurance-strength training on body composition and bone metabolism in centrally obese women. Recruited subjects were randomly assigned to three-month endurance (n = 22) or endurance-strength training (n = 22). Body composition, bone mineral density (BMD) and content (BMC) were assessed before and after the intervention and markers of bone formation and resorption were measured. Both training significantly decreased fat mass; however, endurance-strength training had a more favourable effect on lean mass for the gynoid area (p = 0.0211) and legs (p = 0.0381). Endurance training significantly decreased total body BMC and BMD (p = 0.0440 and p = 0.0300), whereas endurance-strength training only reduced BMD (p = 0.0063). Changes in densitometric parameters did not differ between the groups but endurance training increased osteocalcin levels (p = 0.04845), while endurance-strength training increased tartrate-resistant acid phosphatase 5b concentrations (p = 0.00145). In conclusion, both training programmes were effective in the reduction of fat mass simultaneously negatively affecting bone health. However, endurance-strength training seemed to be more effective in increasing lean mass. The study protocol was registered in the ClinicalTrials.gov database under the number NCT03444207, date of registration: 23 February 2018 (retrospective registration).

Bone phenotypes in multiple endocrine neoplasia type 1: survey on the MEN1 Florentine database.

Multiple endocrine neoplasia type 1 (MEN1) is a rare, inherited cancer syndrome characterized by the development of multiple endocrine and non-endocrine tumors. MEN1 patients show a reduction of bone mass and a higher prevalence of early onset osteoporosis, compared to healthy population of the same age, gender, and ethnicity. During the monitoring and follow-up of MEN1 patients, the attention of clinicians is primarily focused on the diagnosis and therapy of tumors, while the assessment of bone health and mineral metabolism is, in many cases, marginally considered. In this study, we retrospectively analyzed bone and mineral metabolism features in a series of MEN1 patients from the MEN1 Florentine database. Biochemical markers of bone and mineral metabolism and densitometric parameters of bone mass were retrieved from the database and were analyzed based on age ranges and genders of patients and presence/absence of the three main MEN1-related endocrine tumor types. Our evaluation confirmed that patients with a MEN1 diagnosis have a high prevalence of earlyonset osteopenia and osteoporosis, in association with levels of serum and urinary markers of bone turnover higher than the normal reference values, regardless of their different MEN1 tumors. Fifty percent of patients younger than 26 years manifested osteopenia and 8.3% had osteoporosis, in at least one of the measured bone sites. These data suggest the importance of including biochemical and instrumental monitoring of bone metabolism and bone mass in the routine medical evaluation and follow-up of MEN1 patients and MEN1 carriers as important clinical aspects in the management of the syndrome.

The Influence of Nesfatin-1 on Bone Metabolism Markers Concentration, Densitometric, Tomographic and Mechanical Parameters of Skeletal System of Rats in the Conditions of Established Osteopenia.

Simple SummaryNesfatin-1 is an adipokine with little known effect on the skeletal system. In this study, we examined the effect of 8-wk administration of nesfatin-1 on densitometric, tomographic, and mechanical parameters of bones, as well as the concentration of bone metabolism markers in rats with experimentally induced established osteopenia.Our study aimed to evaluate the impact of nesfatin-1 administration on bone metabolism and properties in established osteopenia in ovariectomized female rats. In total, 21 female Wistar rats were assigned to two groups: sham-operated (SHAM, n = 7) and ovariectomized (OVA, n = 14). After 12 weeks of osteopenia induction in the OVA females, the animals were given i.p. physiological saline (OVA, n = 7) or 2 µg/kg body weight of nesfatin-1(NES, n = 7) for the next 8 weeks. The SHAM animals received physiological saline at the same time. Final body weight, total bone mineral density and content of the skeleton were estimated. Then, isolated femora and tibias were subjected to densitometric, tomographic, and mechanical tests. Bone metabolism markers, i.e., osteocalcin, bone specific alkaline phosphatase (bALP), and crosslinked N-terminal telopeptide of type I collagen (NTx) were determined in serum using an ELISA kit. Ovariectomy led to negative changes in bone metabolism associated with increased resorption, thus diminishing the densitometric, tomographic, and mechanical parameters. In turn, the administration of nesfatin-1 led to an increase in the value of the majority of the tested parameters of bones. The lowest bALP concentration and the highest NTx concentration were found in the OVA females. The bALP concentration was significantly higher after nesfatin-1 administration in comparison to the OVA rats. In conclusion, the results indicate that nesfatin-1 treatment limits bone loss, preserves bone architecture, and increases bone strength in condition of established osteopenia.

МЕТОДИКА СОЗДАНИЯ КОНЕЧНО-ЭЛЕМЕНТНОЙ МОДЕЛИ ПРОКСИМАЛЬНОЙ ЧАСТИ ПЛЕЧЕВОЙ КОСТИ ПО ДАННЫМ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ

The article describes the process of creating an average three-dimensional computer geometric model based on computed tomography data of patients over the age of 60 with signs of osteoporosis. The technique of creating a finite element model of the proximal part of the average humerus on the basis of computed tomography data is described. An algorithm is presented that describes the sequence of necessary actions to create a finite element model of the proximal part of the average humerus. The main geometrical parameters of the proximal humerus are highlighted. The tabular form presents the geometric mean parameters of the proximal humerus for a man and a woman from the study sample of patients. Various known methods for analyzing the distribution of bone density are displayed, and a proprietary method for measuring the density of the proximal humerus is presented. In a tabular form, according to the Hounsfield unit scale, the average densitometric parameters for the selected sectors of the average female and male proximal humerus are presented. A method is presented for reconstructing a computerized three-dimensional geometric model of the proximal humerus on the basis of computed tomography data using the free software InVesalius. An example of the development of a finite element mesh of the proximal humerus with subsequent verification calculation in ANSYS is presented. The average statistical finite element model developed on the basis of computed tomography data, taking into account the uneven distribution of bone density, will be used in the future for the design and virtual testing of various options of the humerus fixator.

Application of spiral computed tomography for determination of the minimal bone density variability of the maxillary sinus walls in chronic odontogenic and rhinogenic sinusitis

Background. There are many questions regarding the peculiarities of the course of odontogenic maxillary sinusitis, the likelihood of complications and the correct dosage of load during dental implantation. Purpose – to identify changes in minimal bone density in chronic odontogenic maxillary sinusitis and to compare it with chronic rhinogenic catarrhal maxillary sinusitis and physiological state of maxillary sinus. Materials and Methods. Our study involved 10 patients with chronic odontogenic maxillary sinusitis, 10 patients with chronic maxillary non-polyposis sinusitis of rhinogenic etiology, combined with hyperplasia of the sinus mucosa up to 1 cm. The control group comprised 10 patients with physiological condition of maxillary sinuses. In all subjects minimal bone density of superior, medial and inferior walls of maxillary sinus was analyzed. Results. The study showed that the maximum in physiological conditions is the minimal density of the upper wall of the maxillary sinus, the minimum is the lower wall. The minimal density of the lower wall was shown to undergo a statistically significant reduction in chronic catarrhal maxillary sinusitis only by 2%, the upper by 5%, the medial by 4% compared with the intact sinus, but with the odontogenic nature of maxillary sinusitis, this figure was 31% in the lower wall, 27% in the medial region. Only the density of the upper wall of the maxillary sinus remained quite stable, it decreased relative to the physiological one only by 6%. Conclusions. Minimal physiological densitometric parameters of lower, medial and upper walls were calculated. The reduction of minimal density of bone tissue in the cases of rhinogenic chronic catarrhal maxillary sinusitis. In the cases of chronic odontogenic maxillary sinusitis, maximum significant decrease of minimal density of both lower and medial walls is determined.

Lipoic acid (LA) dose-dependently protects bone losses in the mandible of rats during the development of osteopenia by inhibiting oxidative stress and promoting bone formation

Our study was carried out to evaluate the effect of lipoic acid (LA) on the densitometric properties, structure and mechanical strength of the mandible of Wistar rats with developing osteopenia. The study used 42 sham-operated (SHO) and ovariectomized (OVX) rats. The OVX rats were randomly divided (n = 6) onto two controls treated subcutaneously with physiological saline (OVX-PhS) and 17β-estradiol (OVX-E2), respectively, and onto four experimental OVX groups that received LA in the doses of 12.5, 25, 50 and 100 mg/kg/day for 28 days. The results demonstrated that the lack of estrogen brought about osteopenic bone changes, especially in the trabecular compartment. In addition, while the usage of LA in the doses of 12.5 and 25 LA had no effect in OVX rats, the dose of 100 effectively inhibited osteopenic changes of the mandible. This dose maintained structural, densitometric and mechanical parameters at levels like that in the SHO and OVX-E2 groups by inhibiting the destructive influence of oxidative stress. Dose 50, however, was revealed to be the most effective. It not only inhibited atrophic changes and the influence of oxidative stress, but also stimulated the formation of mandibular bone tissue. Our results suggest that the administration of LA is effective in preventing atrophic changes in the mandibular bone tissue in conditions of ovarian hormone deficiency and suggest its potential in the therapy of osteoporosis.

Компьютерно-томографическая характеристика образований надпочечников

Целью исследования стало изучение компьютерно-томографической характеристики образований надпочечников. Обследовано 98 больных с образованиями надпочечников. Больным проводили клинико-биохимические, гормональные исследования, компьютерную томографию надпочечников. У пациентов с образованиями надпочечников до 1 см (n = 57) длина надпочечника составляла 3,0 ± ± 0,26/3,06 ± 0,22 см, что достоверно выше по сравнению с контролем; р < 0,01 и р < 0,001 соответственно слева и справа. Денситометрические показатели данных образований варьировали от 27,1 ± 1,59 до 34,86 ± 2,20 слева и от 25,30 ± 1,32 до 38,13 ± 3,06 справа и в среднем составили 39,10 ± 1,87 едHU. Пациенты с образованиями от 1 до 3 см (n = 17) достоверно отличались от здорового контроля, но не отличались от двух остальных групп. Плотностные показатели этих образований варьировали от 27,40 ± 3,14 до 40,80 ± 3,68 едHU и в среднем составили 34,10 ± 3,62 едHU. У больных с большими образованиями надпочечников (n = 24) они имели значительную плотность, достоверно повышенную как по сравнению с контролем, так и с двумя предыдущими группами. Образования исходили из патологически измененной, диффузно гиперплазированной ткани надпочечников, характеризующейся утолщением ножек, увеличением длины до 3,10 ± 0,38 см. Для кортикостером характерно относительное достоверное снижение плотности образований, плотности и размеров надпочечников по сравнению с пациентами, у которых уровень кортизола был в норме. У больных с альдостеромами размеры надпочечников были больше, их плотностная вариация также превалировала, особенно отличалась плотность самого образования. У больных с феохромоцитомой, за исключением достоверно значимых отклонений показателей длины, толщины и высоты надпочечников с обеих сторон в сторону их повышения, имело место трудноразличимое по плотности образование надпочечников.

Effect of 2-6 weeks of systemic steroids on bone mineral density in children.

Background The use of systemic steroids for 6+ weeks in children is associated with decreased bone mineral content (BMC) and density (BMD). However, the effects of a shorter duration of use on BMD are unknown.Purpose To determine the effect of the use of systemic steroids for 2–6 weeks on BMD and BMC in pediatric patients.Methods Twenty-five pediatric patients (21 with tuberculosis, 2 with systemic juvenile idiopathic arthritis, 1 with inflammatory bowel disease, 1 with autoimmune hemolytic anemia) who received systemic steroids for 2–6 weeks and 25 age- and sexmatched controls were enrolled. BMC, BMD, and z scores of the whole body (WB), lumbar spine (LS), nondominant distal radius (DR), and total body less the head (TBLH) were determined by dual-energy x-ray absorptiometry at baseline, the end of steroid therapy or 6 weeks (whichever was earlier; first follow-up), and at the end of 3 months from baseline (second follow-up) in patients and at baseline in controls. The values were adjusted for confounding variables. Continuous and categorical variables were compared using Student t test and the chi-square test or Fisher exact test, respectively. Pairwise comparisons employed Bonferroni correction.Results Statistically significant decreases in BMC, BMD, and all z scores were observed. BMC declined by 5.37%, 2.08%, 1.82%, and 2.27%, and 11.42%, 3.75%, 3.34%, and 4.17% for WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. Similarly, BMD declined by 2.01%, 2.31%, 2.18%, and 1.70% and 4.59%, 3.76%, 3.14%, and 3.50% for the WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. A significant negative correlation was found among bone densitometric parameters, duration, and cumulative dose.Conclusion The use of systemic steroids for 2–6 weeks in pediatric patients decreased the BMD and BMC of trabecular and cortical bones, an effect that persisted after discontinuation.

Intracranial Densitometry-Augmented Machine Learning Enhances the Prognostic Value of Brain CT in Pediatric Patients With Traumatic Brain Injury: A Retrospective Pilot Study.

Background: The inter- and intrarater variability of conventional computed tomography (CT) classification systems for evaluating the extent of ischemic-edematous insult following traumatic brain injury (TBI) may hinder the robustness of TBI prognostic models.Objective: This study aimed to employ fully automated quantitative densitometric CT parameters and a cutting-edge machine learning algorithm to construct a robust prognostic model for pediatric TBI.Methods: Fifty-eight pediatric patients with TBI who underwent brain CT were retrospectively analyzed. Intracranial densitometric information was derived from the supratentorial region as a distribution representing the proportion of Hounsfield units. Furthermore, a machine learning-based prognostic model based on gradient boosting (i.e., CatBoost) was constructed with leave-one-out cross-validation. At discharge, the outcome was assessed dichotomously with the Glasgow Outcome Scale (favorability: 1–3 vs. 4–5). In-hospital mortality, length of stay (>1 week), and need for surgery were further evaluated as alternative TBI outcome measures.Results: Densitometric parameters indicating reduced brain density due to subtle global ischemic changes were significantly different among the TBI outcome groups, except for need for surgery. The skewed intracranial densitometry of the unfavorable outcome became more distinguishable in the follow-up CT within 48 h. The prognostic model augmented by intracranial densitometric information achieved adequate AUCs for various outcome measures [favorability = 0.83 (95% CI: 0.72–0.94), in-hospital mortality = 0.91 (95% CI: 0.82–1.00), length of stay = 0.83 (95% CI: 0.72–0.94), and need for surgery = 0.71 (95% CI: 0.56–0.86)], and this model showed enhanced performance compared to the conventional CRASH-CT model.Conclusion: Densitometric parameters indicative of global ischemic changes during the acute phase of TBI are predictive of a worse outcome in pediatric patients. The robustness and predictive capacity of conventional TBI prognostic models might be significantly enhanced by incorporating densitometric parameters and machine learning techniques.

The Effect of Endurance and Endurance-Strength Training on Bone Mineral Density and Content in Abdominally Obese Postmenopausal Women: A Randomized Trial.

The optimal type of exercise that simultaneously decreases body weight and preserves bone health in people with obesity is unknown. This parallel randomized trial aimed to compare the effect of endurance and endurance-strength training on bone mineral density (BMD) and content (BMC) in abdominally obese postmenopausal women. A total of 101 women were recruited and randomly assigned to endurance or endurance-strength training groups. Participants trained for 60 min per day, three times per week for 12 weeks. The endurance exercises were performed at an intensity of 50–75% of the maximum heart rate, whereas the strength exercises were at 50–60% of the one-repetition maximum. Pre- and post-intervention BMD and BMC of the total body, lumbar spine, and femoral neck and physical capacity were measured. There were no differences among the densitometric parameters in the endurance group, but a significant increase in whole-body BMD in the endurance-strength group was found. Moreover, there was a significant difference between the groups in the changes in the lumbar spine BMC. Furthermore, both training programs significantly improved physical capacity with no differences between groups. Endurance training was more effective in maintaining BMC at the lumbar spine. However, both groups did not differ in effect on BMD. Further studies with a long-term follow-up should be considered to confirm these findings. The study was registered with the German Clinical Trials Register within the number DRKS00019832, and the date of registration was 26 February 2020 (retrospective registration).

A cross-sectional comparison of selected anthropometric, laboratory, and densitometric parameters in postmenopausal osteoporotic women with and without vertebral compression fractures.

Osteoporosis leads to an increased risk of vertebral compression fractures (VCFs). Most of them are spontaneous, which makes early diagnosis difficult. The aim of the study was to find parameters that distinguish osteoporotic women with and without vertebral compression fractures. A total of 437 women with postmenopausal osteoporosis were enrolled to the study. Based on the results of densitometric vertebral fracture assessment, patients were divided into 2 groups: with (n = 193) and without (n = 244) VCFs. Then selected anthropometric, laboratory, and densitometric parameters as well as questionnaire data were compared. The following distinguishing factors were found among patients with VCFs in comparison to patients without such fractures: older age- 73.93 years vs. 69.63 years [p(1) < 0.001, p(2) < 0.001], shorter height - 1.56 m vs. 1.58 m [p(4) < 0.001], lower value of glomerular filtration rate (GFR) according to Cockcroft-Gault formula - 58.22 mL/min. vs. 66.25 mL/min. [p(1) < 0.025, p(2) = 0.002], lower peripheral blood haemoglobin and serum albumin concentration (OR = 1.24, 95% CI: 1.02-1.51, p(5) = 0.03; OR = 2.29, 95% CI: 1.09-4.80, p(5) = 0.03, respectively), and higher 10-year risk of major osteoporotic fracture (FRAX MOF) -12.01% vs. 9.69% [p(1) < 0.01, p(2) < 0.001] and hip fracture (FRAX HIP) - 3.85% vs. 2.55% [p(1) < 0.01, p(2) < 0.001]. In addition, among patients with VCFs a greater severity of back pain was found in the 11-grade scale of pain intensity - 6.12 vs. 4.29 [p(1) < 0.001, p(2) < 0.001, p(3) < 0.001]. The bone mineral content (BMC) and bone mineral density (BMD) of the hip were lower in patients with VCFs - 25.25 vs. 26.2 g and 0.72 g/cm² vs. 0.75 g/cm², respectively [p(4) = 0.04 and p(4) < 0.001, respectively]. Patients with VCFs were characterised by greater back pain intensity, higher fracture risk according to the FRAX calculator, and lower values of the following: GFR according to Cockcroft-Gault formula, peripheral blood haemoglobin and serum albumin concentration, and BMD of the hip. Further studies are required to validate the FRAX calculator to assess not only the risk of future fractures but also unrecognised VCFs.

RESULTS OF X-RAY AND DENSITOMETRIC INVESTIGATION IN PATIENTS WITH DESTRUCTIVE FORMS OF APICAL PERIODONTITIS IN EARLY FOLLOW UP PERIOD

This article presents a comparative analysis of the effectiveness of various treatment approaches, including bone mixture “mp3, Osteobiol, and platelet-enriched plasma, in the therapy of destructive forms of apical periodontitis in the early follow-up. The aim of this work is to investigate the dynamic changes in radiological and densitometric parameters depending on the treatment methods for patients with destructive forms of apical periodontitis in the early follow up period. The study involved 185 patients with destructive forms of apical periodontitis, who were examined and receive the treatment. The subjects were divided into 4 groups. Measurements of the size of the lesion in the bone tissue (for lesions of round shape) were performed by the formula: S = πr2. The area of lesions of elliptical shape was measured by the formula S = π ab, where π = 3.14; r = the radius of the circle; a = the value of the major half-axis of the ellipse; b = the length of the small half-axis of the ellipse. After 3 months of the follow up, the patients of group IV, who received the composition of platelet-rich plasma and osteoplastic material mp3 OsteoBiol, demonstrated an increase in the number of the lesions of the periapical zone sized 1.6-10 mm2 in 1.7 times, while the number of the subjects with foci of bone destruction sized 11–20 mm2 and 21–30 mm2 lowered in 2.8 times and 2.0 times, respectively. In 3 months of the follow up period, the patients of group IV showed the values of Rtg scoring of bone tissues destruction in the apical area with a lesion area of 1.6-20 mm that averaged 2.13±0.10 scores and indicated a reduction of the periapical process by 1/3.&#x0D; The average Rtg score in the patients of group IV (0.92 ± 0.10 points) was significantly higher than in the individuals in groups I and II, p, p 1 &lt;0.01, and was equal to the findings obtained in the individuals of the group III, p2 &gt; 0.05. The relative indicator of bone tissue repair in this follow up was characterized by the minimum values in the individuals of groups I and II: 0.49 ± 0.05 and 0.57 ± 0.06, p &lt;0.05, respectively. In the groups III and IV, the value of the relative indicators of bone tissue repair were significantly higher and scored 4.82 ± 0.54, p, p1 &lt;0.01, and 6.94 ± 0.77, p, p1 &lt;0.01, p2 &lt; 0.05, respectively.&#x0D; At the same time, the average Rtg scoring in patients of group IV was significantly higher than in the participants of groups I and II, and was identical to the values in the subjects of group III. This study has demonstrated the successful outcomes of the treatment of dystrophic forms of apical periodontitis in the early follow up period when applying the composition based on platelet-rich plasma and osteoplastic material "mp3 OsteoBiol".

Morphological characteristics of Candida albicans, Candida krusei, Candida guilliermondii, and Candida glabrata biofilms, and response to farnesol.

Background and Aim:Different Candida species isolated in humans and animals have different types of parasite activity. The most pathogenic species is Candida albicans followed by Candida tropicalis. However, the effects of the morphology of Candida krusei, Candida guilliermondii, and Candida glabrata biofilms on the pathogenicity of these species have not been fully characterized. To the best of our knowledge, there is no literature on the effect of farnesol on rare Candida species. This study aimed to check the effect of different farnesol concentrations on the species C. krusei, C. guilliermondii, and C. glabrata compared with the strain C. albicans ATCC 10231, which has been widely studied, and is a strong producer of biofilms.Materials and Methods:We studied the morphological and densitometric parameters of biofilms produced by Candida species under the influence of the drug farnesol (Sigma-Aldrich, St. Louis, MO). We used a heart brain broth with the addition of 2% bovine blood serum in 96-well plates. To each well, we added 100 mL of C. albicans, C. krusei, C. guilliermondii, or C. glabrata culture, and 0.2-400 mM farnesol. The microliter plates were cultured with the lid closed at 37°C for 48 h. Then, the liquid was removed, and the wells were washed 3 times with 200 mL phosphate buffer solution (pH 7.3). Biofilm fixation was performed using 150 mL of 96% ethanol for 15 min. Then, the microliter plates were dried for 20 min at 37°C, a 0.5% solution of crystalline violet was added, and the plates were placed in an incubator at 37°C. After 5 min, the contents of the wells were removed, washed 3 times with 200 mL of phosphate buffer solution (pH 7.2), and dried. The dye was extracted by washing with 200 mL of 96% ethanol for 30 min. The results were obtained using a photometric analyzer of enzyme immunoassay reactions at an optical density (OD) wavelength of 450 nm.Results:All of Candida spp. strains tested were susceptible to farnesol at concentrations ranging from 0.8 to 400 mM for C. albicans, C. krusei, and C. guilliermondii, and 12.5 to 400 mM for C. glabrata.Conclusion:This study provides new insights into the use of farnesol against biofilms produced by Candida species, but further studies in vivo are necessary to evaluate the effectiveness of the reduction of OD. To the best of our knowledge, the antimicrobial activity of farnesol against C. krusei, C. guilliermondii, and C. glabrata has not been reported previously, although studies have confirmed the inhibitory effect of farnesol on the growth of different microorganisms.

Camelina Oil Supplementation Improves Bone Parameters in Ovariectomized Rats.

Simple SummarySupplementation of ovariectomized rats with Camelina sativa oil, which is rich in polyunsaturated fatty acids (PUFA), especially n-3 family fatty acids, can be an effective way to improve bone parameters. Administration of 5 g/kg body weight and 9 g/kg body weight of camelina oil to rats suppressed a decrease in densitometric, tomographic, and strength parameters of femurs and an increase in the serum level of the C-terminal telopeptide of type I collagen caused by estrogen deficiency. Furthermore, ovariectomized rats receiving camelina oil were characterized by a high level of osteocalcin.The aim of the present study was to determine the effect of administration of Camelina sativa oil (CO) as a source of polyunsaturated fatty acids (PUFA) on bone parameters in ovariectomized rats (OVX). Overall, 40 10-week-old healthy female Wistar rats were divided into 4 groups with 10 animals in each. Rats in the control group (SHO) were subjected to a sham operation, whereas experimental rats (OVX) were ovariectomized. After a 7-day recovery period, the SHO the rats received orally 1 mL of physiological saline for the next 6 weeks. The OVX rats received orally 1 mL of physiological saline (OVX-PhS), 5 g/kg BW (OVX-CO5), or 9 g/kg BW (OVX-CO9) of camelina oil. The use of camelina oil had a significant effect on body weight, lean mass, and fat mass. The camelina oil administration suppressed the decrease in the values of some densitometric, tomographic, and mechanical parameters of femur caused by estrogen deficiency. The CO treatment increased significantly the serum level of osteocalcin and decreased the serum level of C-terminal telopeptide of type I collagen in the OVX rats. In conclusion, camelina oil exerts a positive osteotropic effect by inhibiting ovariectomy-induced adverse changes in bones. Camelina oil supplementation can be used as an efficient method for improving bone health in a disturbed state. However, further research must be carried out on other animal species supplemented with the oil.

Factors Associated With Inadequate Response to Bisphosphonate Therapy in Patients With Osteoporosis in Real-Life Clinical Practice: a Single-Center Retrospective Analysis of 300 Patients

Introduction: Bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) is a useful tool to monitor response to osteoporosis treatment in clinical practice. Despite bisphosphonates therapy, some patients may exhibit bone loss during treatment for different reasons. These patients may have greater fracture risk than responders and may have unrecognized secondary causes that require further attention and treatment. Objectives: To identify factors associated with inadequate response (IR) to bisphosphonates therapy in patients with osteoporosis in real-life clinical practice. Methods: This is a single-center case-control study of patients with osteoporosis treated with bisphosphonates as recommended. Baseline and follow-up (12–24 months/apart) DXA scans were performed on same device (GE-Lunar Prodigy). IR was defined as loss of BMD greater than the least significant change (LSC) on the follow-up DXA. Clinical, biochemical and densitometric parameters of patients with IR were compared to responders using t-test or Mann-Whitney test (continuous), or chi-square test (categorical variables), as appropriated. We used logistic regression to assess the association magnitude between exposures and IR. Results: From 300 patients included from 2014 to 2018 (13% males, mean age 68 ±10 years), 198(66%) were treated with oral bisphosphonates and 102(34%) with zoledronic acid (ZA). IR was observed in 44(15%) patients. All parameters were similar at baseline, except for greater prevalence of oral bisphosphonates (82% vs 63%, p=0.016) and anticonvulsants use (18% vs 7%, p=0.015) in patients with IR compared to responders. Additionally, patients with IR exhibited a lower % change in CTX following therapy in comparison to responders (median -37% [IQR -68; -16%] vs -57% [-74; -32], p=0.029, respectively), and higher serum CTX levels after treatment (median 236pg/mL [IQR 162; 344] vs 165pg/mL [119; 254], p=0.004). The likelihood of IR was greater with oral bisphosphonates then with ZA (OR 2.61, IC95% 1.16–5.81, p=0.002), and with anticonvulsants use (OR 2.94. IC95% 1.19–7.25, p=0.019). The association with IR persisted for both variables (p≤0.01), when accounted simultaneously in the same model, along with age and gender. Conclusion: Inadequate bisphosphonate response was present in 15% of individuals, which was independently associated with anticonvulsant use and particularly among those on oral bisphosphonate therapy rather than ZA. This knowledge may help to clinically identify potential modifiable factors related to unresponsiveness and to optimize treatment accordingly.

Visualization of microbial biofilms in case of digestive disorders in lambs

The paper demonstrates morphometric and densitometric parameters of microbial biofilms recovered from lambs with digestive disorders. Changes of quantitative and species composition of the intestinal microbiocenoses in the lambs with digestive disorders were compared with the ones of the clinically healthy lambs. Light microscopy results demonstrated formation of three-dimensional biofilm structure in the form of dense grid consisting of gram-negative and gram-positive bacteria, yeast cells, hyphas and pseudohyphas surrounded with intracellular polymer matrix. Presence of blastospores aided to the increased number of cells attached to the substrate, and biofilm was formed, which consisted of rod and round cells attached to the microfungi cells. In the process of dispersion that occurred during the destruction of the intercellular matrix and bacterial and yeast cell detachment, branched structures separated from the microcolonies and colonized microorganism- free regions of the substrate. The intensity of biofilm formation by the microorganisms under study was evaluated by optic density measurement in 48 hours of cultivation. Fluorescence microscopy results demonstrated that the dynamics of changes of the viable microbial structures was specified by intermittent periods of increased or decreased biofilm formation intensity. Cells characterized by active growth and replication and forming alternating subpopulations were detected in the examined microbial cultures. When determining the viability of the microorganisms in the biofilms, the viable (green fluorescence) and non-viable (red fluorescence) cells were differentiated.

Evaluation of topographic, tomographic, topometric, densitometric, and aberrometric features of cornea with pentacam HR system in subclinical keratoconus.

To investigate topographic, tomographic, topometric, densitometric, and aberrometric parameters in subclinical keratoconus with the Pentacam HR imaging system. Data of 3128 patients were evaluated, finding in 108 patients clinical keratoconus in one eye and subclinical keratoconus in the other. Corneal topographic, tomographic, topometric, densitometric, and aberrometric values obtained using the Pentacam HR imaging system were compared between clinical keratoconus, subclinical keratoconus, and normal eyes. Comparing eyes with subclinical keratoconus and the control group, while flat K, horizontal coma, horizontal trefoil, and vertical trefoil values were similar (p > 0.05 for each), all other parameters were significantly different (p < 0.05 for each). Densitometry values of eyes with subclinical keratoconus were significantly higher in all layers of the 0-2mm annular area and in the anterior and central layers of the 2-6mm annular area compared to the control group (p < 0.05 for each). According to the receiver operating characteristic curve analysis, the densitometry region with the largest area under the curve was the anterior layer of the 0-2mm annular area. The sensitivity in this region was 79.4% and the specificity 73.2% in distinguishing eyes with subclinical keratoconus from normal eyes when 19.3 GSU was considered the threshold. Corneal densitometry values in the 0-2 and 2-6mm annular areas, especially in the anterior layers, are parameters that can be used to predict and distinguish subclinical keratoconus from normal eyes.

СПОСОБЫ ИНДИКАЦИИ НЕКУЛЬТИВИРУЕМЫХ ЖИЗНЕСПОСОБНЫХ МИКРООРГАНИЗМОВ ПРИ КОНТРОЛЕ КРИТИЧЕСКИХ ТОЧЕК ТЕХНОЛОГИИ ЖИВОТНОВОДСТВА, ПТИЦЕВОДСТВА И ПИЩЕВЫХ ПРОИЗВОДСТВ

The results of morphometric and densitometric parameters biofilms are presented, effective methods of detecting uncultivated viable microorganisms isolated from a representative sample of objects of veterinary and sanitary supervision are tested and selected. Optical, luminescent and scanning electron microscopy revealed the formation of a three-dimensional structure biofilms in the form a dense network consisting of gram-negative and gram-positive bacteria, yeast cells, hyphal and pseudohyphalic forms, surrounded by an intercellular polymer matrix. The presence hyphae of microscopic fungi causes an increase in the number of cells adhered to the substrate, microcolonies were formed from bacteria and yeast cells of microscopic fungi. The pathogenesis of the syndrome of overgrowth of microorganisms is provided by the presence of various dissociative variants, the dispersion of uncultivated bacterial cells, which gain advantages in the hyperagregation of the architectonics of heterogeneous biofilms. Multilayer membranes, vesicles, cells with a defective cell wall, spheroplasts, protoplasts, L-shapes, needle-like and giant structures, and revertant cells were identified. The dynamics of changes in the viable structures microorganisms was characterized by alternating periods of decrease and increase in the intensity of biofilm formation. When detecting the viability of microorganisms in the composition biofilms, viable and non-viable cells were differentiated – a green luminescence spectrum and a red luminescence spectrum, respectively. The dissociation of the population caused an increase in the concentration of R-dissociant cells with a higher growth rate, cell lysis was detected after 48–72 h of cultivation, a change in the ratio phenotypic forms was observed – the M-dissociant was predominant. The study of the heterogeneous structure of the population, without disturbing the natural architectonics of biofilms, revealed direct correlations (r = 0,89) between morphometric (≥90 % of the field of view) and densitometric parameters (OD). The efficiency of a nutrient medium containing pancreatic hydrolyzate, mannitol, L-asparagine and glycerol was established for the repair of the cell wall, the reversal of L-forms of microorganisms.

Effect of 6-12 Weeks of Systemic Glucocorticoids on Bone Mineral Density in Children

Introduction: Prolonged use of systemic steroids in children is associated with many side-effects including effect on Bone Mineral Density (BMD). Effect of more than three months of systemic steroids on BMD has been studied in children but not the effect of 6-12 weeks duration of steroid. Aim: To evaluate the effect of 6-12 weeks of systemic glucocorticoids on BMD in children. Materials and Methods: A longitudinal observational study was conducted at a Tertiary Care Hospital. Dual Energy X-ray Absorptiometry (DEXA) of Whole Body (WB), Lumbar Spine (LS) and Distal Radius (DR) were done at baseline, end of steroid therapy or third month whichever was earlier and end of six months, on 30 patients receiving systemic steroid (Nephrotic Syndrome (NS)-7, Systemic Onset Juvenile Idiopathic Arthritis (SOJIA)-12, Tubercular Meningitis-11). Age and sex adjusted values of Bone Mineral Content (BMC), BMD and Z scores were analysed. Bone densitometric parameters of Total Body Less the Head (TBLH) were derived from WB values. X-rays of whole spine (antero-posterior and lateral view) were done at baseline and follow-up. Equal number of age and sex matched healthy controls were subjected to biochemical and DEXA scans at baseline. Continuous and categorical variables were compared using Student’s t-test and Fisher-exact test, respectively. Pairwise comparison over period of time was done using Bonferroni correction. Results: Bone densitometric parameters of cases and controls were comparable at baseline. At follow-up statistically significant decrease in BMD was found at all three sites. A statistically significant negative correlation was found between cumulative dose of steroid and duration of steroid treatment with Z score of TBLH. No vertebral fractures were detected at baseline or follow-up. Conclusion: Use of systemic glucocorticoids for 6-12 weeks negatively affects bone mineralisation, not only during therapy but even three months after stopping it.