L1-L4 Vertebrae Research Articles

LOW GRADE LUMBAR SPONDYLOLISTHESIS AT L4&L5 AND L5&S1 VERTEBRAE IN RURAL SOUTH INDIAN POPULATION

Objectives: In heavy workers incidence of low back ache is common. Low grade spondylolisthesis has more options of treatment than high grade spondylilosthesis. Therefore, this study was done to find out clinical profile of low-grade spondylolisthesis at L4-L5 and L5-S1 vertebrae in rural south Indian population. Co-relation between Modic change (MC) and grades of spondylolisthesis was also assessed. Material and Methods: Study was carried out for a period of 2 years in 40 patients with age 20-70 years with single-level L4/L5 and L5/S1 low grade spondylolisthesis (Meyerding’s grade I and II), with clinical and neurological examination, assessment of pain by Visual Analogue Score (VAS) and investigations like X ray, CT scan & MRI. Results: Out of 40 cases, 27.5% were males and female were 72.5%. The most affected age group was 40-60 years (65%). Lower back pain (LBP) was the most common symptom (100%). Straight leg raise test was positive in 81.25%. Sensory and motar deficit was seen in 45% of patients. L4-L5 level is affected in 60% of low grade spondylolisthesis cases. Incidence of Meyerding’s grade I & II were 67.5% & 32.5% respectively. In both grades females were more in distribution than males and L4-L5 vertebral level was involved significantly. Isthmic (IS) & Degenerative (DS) spondylolisthesis was 82.5% & 17.5% respectively and both incidences were more in females. In IS the level affected was L5-S1 and in DS L4-L5 level. Incidence of MC type1 is 15%, type 2 is 85% and in type3 incidence was not found in any cases. Females showed higher incidence in type1 (83.3%)&type 2 (70.6%) as compared to Males (16.6% & 29.4% respectively) but this difference was not significant(p value>0.05).Type2 Modic changes were found significantlyhigh in grade II spondylolisthesis 70%compared to 30% intype 1(p value=0.02). Summary: Incidence of low spondylolisthesis was more in females and at L4-L5. Modic changes were gender non-specific and grade specific.This study elucidates the clinical presentations of low-grade spondylolisthesis and specific changes associated with it and that will help in tracing factors responsible for it and assessing treatment outcome.

VITAMIN D3 IN TREATMENT OF OSTEOPENIC SYNDROME IN CHILDREN WITH GROWTH DISORDERS

Background. The efficacy of vitamin D3 agents for impaired growth of children of different cause was studied in the research. A positive effect on bone mineralization and calcium-phosphorus metabolism was evidenced. The treatment and prophylaxis charts using this drug for osteopenic syndrome are developed for children with hypothalamic-pituitary dwarfism, subdwarfism and dwarfism of constitutional genesis. Objective. The aim of the research is to study the effect of calcimine and vitamin D3 in cases of impaired bone mineral density in children aged 6-18 years old with growth retardation of the hypothalamic-pituitary genesis, subdwarfism and dwarfism of constitutional origin. Methods. The study involved 25 children, aged 6-18 years old with growth retardation: hypothalamic-pituitary (10 children), subdwarfism (5 children) and dwarfism of constitutional origin (10 children). The control group consisted of 20 children. The structural and functional state of bone tissue was studied using a two-photon X-ray densitometer “Lunar”. In the study of calcium-phosphorus homeostasis, the level of calcium and the level of phosphorus in the blood serum were determined. Serum alkaline phosphatase levels were also studied as a marker for bone formation. Results. In the examined children, there was a significant calcium deficiency at the level of the vertebrae L1–L4. The calcium content in L1 was 72.8%, L2 – 75.7%, L3 – 81.2%, L4 – 80.1%, which significantly differed from bone density in healthy children of a similar age and body weight. It was also revealed that in children diagnosed with growth retardation of the pituitary genesis, bone rarefaction was diagnosed in 100% of cases, while with subdwarfism and dwarfism of constitutional genesis these indicators were 43% and 24%, respectively. Conclusions. A differentiated choice of vitamin D3 treatment, depending on the degree of osteopenia in children, allows adjusting the calcium metabolism and preventing osteoporosis in children with stunted growth. Vitamin D3 in the complex treatment of osteoporosis in children with growth impairment of different genesis normalizes calcium-phosphorus homeostasis, which increases bone mineral density and, therefore, reduces osteoporotic changes by stopping leaching of calcium from bones.

Bone mass density in lean and overweight women with polycystic ovary syndrome

Introduction Polycystic ovary syndrome is a condition characterized by hormonal and metabolic disturbances that may affect bone health. The purpose of this study was to investigate the effect of polycystic ovary syndrome on bone mineral density and to examine which clinical characteristics of the syndrome could influence bone mineral density. Materials and methods We examined 183 premenopausal women: 158 women with polycystic ovary syndrome and 25 healthy age- and body mass index matched controls. Bone mineral density and body composition were investigated by whole-body dual energy X-ray absorption. Total and free testosterone, sex hormone binding globulin, luteinizing hormone, follicle stimulating hormone, estradiol, fasting insulin and glucose, parathyroid hormone, calcium and 25-OH-cholecalciferol were measured. The effect of polycystic ovary syndrome on bone mineral density was analyzed by statistical two-way analysis of variance tests and multiple linear regressions for investigating the connection between bone mineral density and selected clinical parameters. Results Women with polycystic ovary syndrome had significantly lower bone density in the lumbar vertebrae L1–L4 compared to healthy controls, independently of body mass index. We found that total lean body mass was the most important associating factor for bone mineral density and these were strongly correlated throughout all regression analyzes. We found no connection between lumbar bone density and androgen status, hyperinsulinemia, estradiol or calcium homeostasis. Conclusions Premenopausal women with polycystic ovary syndrome have lower bone mineral density in the lumbar vertebrae L1–L4 compared to healthy controls. Total lean body mass and polycystic ovary syndrome are significantly associated to this finding.

Prevalence and Predictors of Osteoporosis and Osteopenia in Postmenopausal Women of Punjab, India.

The prevalence and predictors of osteoporosis and osteopenia remain to be examined in the postmenopausal women of Punjab, India. The present cross-sectional study screened 1628 postmenopausal women during September 2019 to March 2020. Osteoporosis and osteopenia were confirmed on the basis of T-scores using dual energy X-ray absorptiometry (DXA) at the hip (femoral neck) and lumbar spine regions (L1–L4 vertebrae). The prevalence of osteoporosis and osteopenia was observed to be 30.50% and 44.20%, respectively, in postmenopausal women of Punjab. In univariable and multivariable regression analysis, variables independently influencing the risk of osteoporosis and osteopenia were: higher systolic blood pressure (95%CI: 1.22–3.11 & 1.08–2.49), triglyceride levels (95%CI: 1.21–3.10 & 1.42–2.51), poor sleep quality (95%CI: 1.91–2.47 & 1.76–3.47) and C-reactive protein levels (95%CI: 2.18–3.56 & 1.03–2.18). Years since menopause >10 years was observed to be an independent predictor for the risk of osteopenia but not for osteoporosis. Higher body mass index (>30 kg·m−2) was observed to be a significant protective factor against the risk of osteoporosis (95%CI: 0.26–0.68) and osteopenia (95%CI: 0.19–0.52). The higher prevalence rates of osteoporosis and osteopenia in postmenopausal women of Punjab are alarming, which solicits awareness and earlier testing of those women who are approaching menopause.

Lumbar Skin Lesion in a Term Infant.

Lumbar Skin Lesion in a Term Infant.

Stress-strain distribution in intact L4-L5 vertebrae under the influence of physiological movements: A finite element (FE) investigation

This study is aimed at finding the stress and strain distribution in functional spinal unit of L4-L5 occurring due to physiological body movements under five loading conditions, namely compression, flexion, extension, lateral bending and torsion. To this purpose, 3D finite element (FE) model has been generated using 4-noded unstructured tetrahedral elements considered both for bones and intervertebral disc, and 1D tension-only spring elements for ligaments. The analyses were performed for a compression load of 500 N and for other load cases, a moment of 10 N-m along with a preload of 500 N was applied. The model was validated against in-vitro experimental data obtained from literature and FE analysis data for a range of motion (RoM) corresponding to various loading conditions. The highest stress was predicted in the case of torsion though the angular deformation was highest in case of flexion.

The Interference of Gamma Rays With Bone Mineral Density Measurements in 177Lu-PSMA and DOTATATE Therapy

The main purpose was to describe the interference of gamma radiation emitted by 177Lu with simultaneous bone mineral density BMD measures for patients undergoing 177Lu-PSMA and 177Lu DOTATATE therapy. A cohort of 9 patients underwent 177Lu-PSMA therapy were randomly selected to speculate the activity in the abdominopelvic region. So that, SPECT/CT scan at 24 h was used with attenuation and scatter correction. The activities were derived from the delineated ROIs over the abdominopelvic zone showing a range of 34−274 MBq. Next, a water path was placed under spine phantom mimicking L1-L4 vertebrae and followed by consecutive DEXA scans made by Hologic 4500 W and GE-Lunar DPX-NT systems. Five scans were performed without/and with different Lu-177 activities 37, 185, 370 and 555 MBq under the same geometric conditions. The obtained BMD readings of L1-L4 by the Hologic device were 1.027, 1.024, 1.021, 1.013, and 1.006 g/cm2 with presence of 0, 37, 185, 370, and 555 MBq 177Lu activity, respectively. Whereas, in Lunar device, it was found as higher as 1.163, 1.121, 1.09, 1.072, and 1.043, respectively. There was no statistically significant difference between both devices (pvalue ≥ 0.05). The fluctuation ranges in the L1-L4 BMD readings at the presence of 37−555 MBq were 0.3%−2%, and 3.6%−10.3% for Hologic and Lunar systems, respectively. It was emphasized that gamma radiation emitted by 177Lu relatively influence DEXA scans and the yielded BMD measures. Postponing DEXA scans as early as 8 d after 177Lu-PMSA and 11 d after 177Lu-DOTATATE therapies is recommended to avoid the erroneous contribution of gamma radiation and provide precise bone assessment.

Blueberry Polyphenols do not Improve Bone Mineral Density or Mechanical Properties in Ovariectomized Rats.

Osteoporosis-related bone fragility fractures are a major public health concern. Given the potential for adverse side effects of pharmacological treatment, many have sought alternative treatments, including dietary changes. Based on recent evidence that polyphenol-rich foods, like blueberries, increase calcium absorption and bone mineral density (BMD), we hypothesized that blueberry polyphenols would improve bone biomechanical properties. To test this, 5-month-old ovariectomized Sprague-Dawley rats (n = 10/gp) were orally gavaged for 90days with either a purified extract of blueberry polyphenols (0-1000mg total polyphenols/kg bw/day) or lyophilized blueberries (50mg total polyphenols/kg bw/day). Upon completion of the dosing regimen, right femur, right tibia, and L1-L4 vertebrae were harvested and assessed for bone mineral density (BMD), with femurs being further analyzed for biomechanical properties via three-point bending. There were no differences in BMD at any of the sites analyzed. For bone mechanical properties, the only statistically significant difference was the high dose group having greater ultimate stress than the medium dose, although in the absence of differences in other measures of bone mechanical properties, we concluded that this result, while statistically significant, had little biological significance. Our results indicate that blueberry polyphenols had little impact on BMD or bone mechanical properties in an animal model of estrogen deficiency-induced bone loss.

Myelosuppression in patients treated with 177Lutetium-lilotomab satetraxetan can be predicted with absorbed dose to the red marrow as the only variable

Background The aim of this study was to investigate dosimetry data and clinical variables to predict hematological toxicity in non-Hodgkin lymphoma (NHL) patients treated with [177Lutetium]Lu-lilotomab satetraxetan. Material and methods A total of 17 patients treated with [177Lu]Lu-lilotomab satetraxetan in a first-in-human phase 1/2a study were included. Absorbed dose to the red marrow was explored using SPECT/CT-imaging of the lumbar vertebrae L2–L4 over multiple time points. Percentage reduction of thrombocytes and neutrophils at nadir compared to baseline (PBN) and time to nadir (TTN) were chosen as indicators of myelosuppression and included as dependent variables. Two models were applied in the analysis, a multivariate linear model and a sigmoidal description of toxicity as a function of absorbed dose. A total of 10 independent patient variables were investigated in the multivariate analysis. Results Absorbed dose to the red marrow ranged from 1 to 4 Gy. Absorbed dose to the red marrow was found to be the only significant variable for PBN for both thrombocytes and neutrophils. The sigmoid function gave similar results in terms of accuracy when compared to the linear model. Conclusion Myelosuppression in the form of thrombocytopenia and neutropenia in patients treated with [177Lu]Lu-lilotomab satetraxetan can be predicted from the SPECT/CT-derived absorbed dose estimate to the red marrow.

Laboratory control of the osteoresorptive effects of glucorcorticoids in patients with purpose colitis.

The aim of the work was to develop an informative method for laboratory monitoring of osteoresorbent action during systemic administration of glucocorticoids in patients with ulcerative colitis. The study included 54 patients with ulcerative colitis aged 18 to 44 years: 35 (64,8%) men and 19 (35,2%) women. In patients of the clinical group before and after the first, second, third courses of glucocorticosteroids, as well as during the formation of steroid dependence, the concentration of the osteoresorption marker cathepsin K was determined simultaneously in the blood serum and gingival fluid by enzyme immunoassay. The concentration of the osteomarker was compared with the parameters of the densitometric density of the lumbar vertebrae L1-L4 during X-ray examination. It was found that with the systemic use of glucocorticoids in patients with ulcerative colitis, the concentration of cathepsin K in the gingival fluid increased earlier than in the blood serum. It was found that with an increase in the concentration of cathepsin K in the gingival fluid of more than 2,6 pmol/l in conditions of systemic administration of glucocorticosteroids, the risk of osteoporosis increased with a diagnostic sensitivity of 81,8% and a specificity of 74,4% (p=0,0001).The diagnostic accuracy was 78,1%. With an increase in the concentration of cathepsin K in the gingival fluid above the differential separation level (2,6 pmol/l), the risk of developing osteoporosis increased 3,2 times (p= 0,0001). The study developed a methodological and informational algorithm has been developed for the non-invasive control of steroidal osteoporosis in patients with ulcerative colitis with systemic use of glucocorticoids by assessing the concentration of cathepsin K in the gingival fluid.

Computed tomography-based opportunistic osteoporosis assessment: a comparison of two software applications for lumbar vertebral volumetric bone mineral density measurements

We aimed to compare two volumetric bone mineral density (vBMD) analysis programs, regarding (I) agreement of vBMD values based on mono- and dual-energy computed tomography (MECT and DECT) scans and (II) suitability for analyzing DECT data obtained at different energies. We retrospectively analyzed two abdominal CT datasets: one performed in a MECT scan (vertebrae L1-L3) and one in a DECT scan (vertebrae L1-L4). Each dataset included different individuals [MECT 15 patients (45 vertebrae) and DECT 12 patients (48 vertebrae), respectively]. vBMD analysis was conducted using Philips IntelliSpace (IP) and Mindways qCT Pro (MW). Regarding the DECT scans, vBMD analysis was done at three different energies: 80, 150 and synthetic 120 kVp and for MECT scan at 120 kVp. For comparison of vBMD results between different software (aim 1) MECT 120 kVp and DECT synthetic 120 kVp data was used. For analyzing suitability of using different DECT energies for vBMD assessment (aim 2) all three DECT energies were used and results from each software was analyzed separately. vBMD assessed with MW and IP, respectively correlated significantly for both the MECT (r=0.876; P<0.001) and DECT (r=0.837; P<0.001) scans, but the vBMD values were lower in using IP for vBMD assessment (8% and 14% lower for MECT and DECT, respectively; P=0.001). Regarding the different DECT energies, using MW for vBMD assessment showed significant correlations in vBMD results between 120 kVp and the two other energies (r=0.988 and r=0.939) and no significant differences in absolute vBMD values (P>0.05). The IP analysis as well showed significant correlation between 120 kVp and the other energies (r=0.769 and r=0.713, respectively), but differences in absolute vBMD values between the energies (P≤0.001). We show that the correlations between the vBMD derived from the two investigated software solutions were generally good but that absolute vBMD value did differ and might impact the clinical diagnosis of osteoporosis. Though small, our study data indicate that vBMD might be assessed in energies other than 120 kVp when using MW but not when using IP.

The role of genetic and metabolic disorders in osteoporosis

Osteoporosis is a progressive multifactorial systemic disease of the skeletal system characterized by the damage of the microarchitectonics of the bone tissue, which leads to the occurrence of low-energy fractures and impairment of the quality of life of individuals. The risk factors for the development of osteoporosis include smoking, which inhibits calcium absorption in the intestine and not only contributes to the reduction of bone density but also acts as a predictor of bronchopulmonary pathology. The systemic inflammation that develops in patients with chronic obstructive pulmonary disease, associated with the production of interleukins (IL)-6, IL-1, IL-8, and tumor necrosis factor – α, stimulates osteoclast-mediated bone resorption and a low level of osteoprotegerin closes the circle. In clinical practice, the determination of markers of bone resorption is required. This is a tartrate-resistant acid phosphatase, the 5β fraction of which signals the end of the resorption process; these are hydroxypyridine crosslinks – pyridoline (PYD) and deoxypyridoline, that stabilize the bone collagen molecule. Genetic factors also play an important role in the development of osteoporosis. The presence of the GG genotype or the G allele of the 283 A&gt; G polymorphism (Bsml) of the VDR gene is a predictor of osteoporosis of the lumbar vertebrae L1-L4. The substitution of cytosine for thymine (C&gt; T) in exon 17 of the calcitonin gene (CALCR) at position 1340 leads to the substitution of the amino acid proline (CCG) for leucine (CTG) at position 463 of the receptor protein molecule and affects bone density. But the most phylogenetically ancient mechanism for regulating the development and maintenance of tissue homeostasis by controlling cell proliferation, differentiation, migration, and apoptosis is the Wnt signaling pathway (SP-Wnt). Alterations in Wnt signaling observed in cases of genetic mutations cause various diseases of the human skeleton. A systematic literature search was carried out using the Scopus, PubMed, Web of Science databases.

Effect on bone mineral density in surgical versus medical castration for metastatic prostate cancer.

This pilot study aimed to objectively assess the osteoporotic effect caused by androgen deprivation therapy (ADT) in patients with prostate cancer and compare this effect in surgical versus medical castration, specifically with luteinizing hormone-releasing hormone (LHRH) antagonists. The study included 60 patients with metastatic prostate adenocarcinoma treated with either bilateral orchidectomy (group I) or LHRH antagonist (Degarelix) injection (group II). The patients had a baseline bone mineral density (BMD) assessment before the start of ADT using dual energy X-ray absorptiometry (DEXA) scan and then follow-up assessment after 6 months. BMD was measured at the spine (lumbar vertebrae L2-L4), femur (total), and forearm (one-third radius). Group I included 33 patients and group II 27 patients. Both the groups showed significant reduction in BMD at the spine and femur after 6 months, whereas the forearm did not show a significant reduction. Spine BMD showed 5.9%±2.6% and 4.7%±2.6% reduction whereas the femur BMD showed 6%±7.4% and 6%±4.7% reduction in the orchiectomy and the Degarelix groups, respectively. There was no statistically significant difference between the groups at the 3 measured sites. Both surgical castration and LHRH antagonists were associated with significant accelerated osteoporotic effect at the spine and femur after 6 months without difference between both the methods. Assessment of osteoporotic risk together with preventive or management measures should be started early during ADT.

Serum Irisin Level Is Positively Associated with Bone Mineral Density in Patients on Maintenance Hemodialysis.

Background Irisin is a circulating hormone-like myokine that plays an important role in bone metabolism. We performed a cross-sectional study to investigate whether serum irisin levels correlated with bone mineral density (BMD) in patients on maintenance hemodialysis (MHD). Methods Blood samples were obtained from 80 patients on MHD, and serum irisin concentrations were determined using a commercially available enzyme-linked immunosorbent assay. BMD was measured by dual-energy X-ray absorptiometry of the L2–L4 vertebrae. Results In the study cohort, 10 (12.5%) and 19 (23.8%) patients had osteoporosis and osteopenia, respectively, and 51 (63.75%) patients had normal BMD. Lumbar T-score was negatively associated with body height (P=0.010), body weight (P=0.002), body mass index (BMI, P=0.010), and serum irisin (P < 0.001) and was positively associated with advanced age (P=0.031), female sex (P=0.001), alkaline phosphatase (ALP, P=0.010), urea reduction rate (P=0.018), and fractional clearance index for urea (P=0.020). Multivariable forward stepwise linear regression analysis revealed that high serum logarithmically transformed irisin (log-irisin, β = 0.450, adjusted R2 change = 0.258; P < 0.001), female sex (β = −0.353, adjusted R2 change = 0.134; P < 0.001), and serum ALP level (β = −0.176, adjusted R2 change = 0.022; P=0.049) were significantly and independently associated with lumbar BMD in patients on MHD. Conclusions In addition to female sex and serum ALP level, serum irisin level was positively associated with lumbar BMD in patients on MHD.

The role of trabecular bone score, inaddition to FRAX, for the measurementof fracture risk in patients withdegenerative lumbar spine stenosis

Objectives: To investigate the relevance of Concomitant Trabecular Bone Score (TBS) and Areal Bone Mineral Density (aBMD) assessments to estimate fracture risk in patients with Degenerative Lumbar Spine Stenosis (DLSS). Methods: A cross-sectional prospective study was performed. Dual energy X-ray absorptiometry scans of the lumbar spine and hip were acquired in 50 patients with DLSS. TBS and aBMD were calculated from the anteroposterior views of L1-L4 vertebrae. The World Health Organisation Fracture Risk Assessment Tool (FRAX) was utilised to estimate hip or Major Osteoporotic Fracture (MOF) risk. Results: L1-L4 TBS scores revealed degraded microarchitecture, (TBS ≤ 1.20), partially degraded microarchitecture (TBS >1.20 and <1.35) or normal appearances (TBS ≥ 1.35) in 9 (18%), 14 (28%) and 27 (54%) patients, respectively. L1-L4 aBMD assessment demonstrated osteoporosis (T-score ≤- 2.5), osteopenia (T-score between -1.1 and -2.4) or normal bone density in 15 (30%), 11 (22%) and 24 (48%) patients, respectively. There was no relationship seen between L1-L4 aBMD and TBS measurements (r = 0.046; p = 0.75). A negative relationship was observed between TBS and body mass index (r = -0.438; p = 0.001) andbetween L1-L4 aBMD and FRAX (r = -0.617; p < 0.001); the latter included MOF and risk of hip fracture (r = -0.497; p < 0.001).No relationship was observed between TBS and FRAX included MOF and risk of hip fracture (r = -0.118; p = 0.416 and r = -0.014; p = 0.926, respectively) Conclusion: In patients with DLSS, TBS is a reliable, strong and standalone indicator of fracture risk

Renal morphological description of brown brocket deer, Mazama gouazoubira, Fisher 1814 (Artiodactyla; cervidae)

The brown brocket deer (Mazama gouazoubira) is a deer that lives in South America, particularly in Brazil and nearby countries such as Uruguay and Argentina. This study aimed to describe the topography, morphology, wraps and renal arterial segments of brocket deer. Used two specimens of M. gouazoubira; through dissection, the skin was completely removed and later scored the arteries of animals with stained latex red later the animals were fixed in a formaldehyde solution 10%. Sequentially through a ventral access block was removed from the animal gut and kidneys disjoint this block. The right kidney located at the level of the vertebrae L1-L3 and the left kidney at the level of vertebrae L2-L4 were presented rounded with smooth convex faces without lobation, wrapped sequentially by a thin fibrous capsule, the renal fat and fascia capsule. Medial to each kidney, the adrenal glands were. Renal artery forked in the hilar region in the cranial and caudal artery sectoral and one of these sectoral arteries (cranial and caudal) originated five main segments directed to the ventral region and the dorsal region each kidney, these segments are again bifurcated arterial segments totaling 14. Microscopically the kidneys presented similar organization to that presented by the ruminants with cortical and medullary region with fused lobes. The kidneys brocket deer resemble the kidneys of other ruminants in general, and to carnivores. Thus, its morphology, topography and the renal arterial segments and anatomical and surgical territories of the species studied have been shown to be unique.

Associations between bone mineral density, trabecular bone score, and body mass index in postmenopausal females

ObjectivesBone mineral density (BMD), as a gold standard determinant of osteoporosis, assesses only one of many characteristics contributing to the bone. Trabecular bone score (TBS) is applied to evaluate the microarchitecture of trabecular bone. A high body mass index (BMI) has been reported to have a positive correlation with BMD. However, the relation between BMI and TBS has remained unclear. Therefore, the aim of this study is to shed light on the associations between BMI, T-score, and TBS in postmenopausal women without a diagnosed underlying disease. MethodsIn this cross-sectional study, 1054 postmenopausal women were randomly recruited from the Department of Radiology, Isfahan University of Medical Sciences. Demographic characteristics and medical history of all subjects were collected from documents. TBS measurements for L1-L4 vertebrae were retrospectively performed by the TBS iNsight software using the dual X-ray absorptiometry (DXA) from the same region of spine of the subjects. The analysis was done to detect the correlation between TBS and BMI. ResultsA statistically significant negative correlation was found between TBS and BMI in patients with osteoporosis and low bone mass. In patients with normal T-scores, BMI was not significantly correlated to TBS (P > 0.05). Furthermore, there was a significant positive association between T-score and BMI. ConclusionsAlthough a higher BMI had a protective effect against osteoporosis, higher BMI was associated with a lower TBS in patients with an abnormal T-score. However, BMI did not have a significant effect on TBS in patients with normal T-scores.

18F-FDG, 11C-Methionine, and 68Ga-Pentixafor PET/CT in Patients with Smoldering Multiple Myeloma: Imaging Pattern and Clinical Features.

This study aimed to explore the correlation between imaging patterns and clinical features in patients with smoldering multiple myeloma (SMM) who simultaneously underwent 18F-FDG, 11C-Methionine, and 68Ga-Pentixafor positron emission tomography/computed tomography (PET/CT). We retrieved and analyzed clinical characteristics and PET imaging data of 10 patients with SMM. We found a significant correlation between bone marrow (BM) plasma cell (PC) infiltration and mean standardized uptake values (SUVmean) of lumbar vertebrae L2-L4 on 11C-Methionine PET/CT scans (r = 0.676, p = 0.031) and 68Ga-Pentixafor PET/CT scans (r = 0.839, p = 0.002). However, there was no significant correlation between BM involvement and SUVmean of lumbar vertebrae L2-L4 on 18F-FDG PET/CT scans (r = 0.558, p = 0.093). Similarly, mean target-to-background ratios (TBRmean) of lumbar vertebrae L2-L4 also correlated with bone marrow plasma cell (BMPC) infiltration in 11C-Methionine PET/CT (r = 0.789, p = 0.007) and 68Ga-Pentixafor PET/CT (r = 0.724, p = 0.018) PET/CT. In contrast, we did not observe a significant correlation between BMPC infiltration rate and TBRmean in 18F-FDG PET/CT (r = 0.355, p = 0.313). Additionally, on 11C-Methionine PET/CT scans, we found a significant correlation between BMPC infiltration and TBRmax of lumbar vertebrae L2-L4 (r = 0.642, p = 0.045). In conclusion, 11C-Methionine and 68Ga-Pentixafor PET/CT demonstrate higher sensitivity than 18F-FDG PET/CT in detecting BM involvement in SMM.

Differences In Bone Mineral Density At The Femoral Neck And Lumbar Regions Across Female Soccer Players, Olympic Lifters And Power Lifters

Power lifting can improve total body bone mineral density (BMD), but improvements in the regions most susceptible to injury (femoral neck and lumbar vertebrae) have not been demonstrated. Soccer players, who engage in odd-impact loading, have greater BMD at the femoral neck than sedentary controls. Olympic lifting involves both high- and odd-impact loading at the femoral neck and lumbar regions, but comparisons in BMD across sport-specific athletes have not yet been made. PURPOSE: To examine differences in total BMD and BMD at the femoral neck and lumbar vertebrae between female power lifters (PL), Olympic lifters (OL), soccer players (SP) and recreationally active individuals (RA). METHODS: Thirty-seven females participated in this study: 10 PL, 8 OL, 8 SP, and 11 RA (mean age = 24.5 ± 7.9 years). Total BMD, BMD at lumbar vertebrae L1-L4, and BMD at the femoral neck of the dominant leg were measured along with body composition (total fat mass, lean mass, and percent body fat) with dual-energy x-ray absorptiometry. Body composition components were compared across groups with a one-way ANOVA. BMD measures were compared across groups with an ANCOVA with weight, height, and body mass index as covariates. Tukey’s tests were used for post-hoc analysis. Significance was accepted at P < 0.05. RESULTS: All three athletic groups had greater total BMD than RA (1.071 ± 0.066 g·cm-2). OL (1.306 ± 0.08 g·cm-2) had greater total BMD than PL (1.071 ± 0.07 g·cm-2), but it was not different than SP. At the femoral neck, OL (1.127 ± 0.09 g·cm-2) and SP (1.212 ± 0.10 g·cm-2) [but not PL (1.075 ± 0.16 g·cm-2)] had greater BMD than RA (0.971 ± 0.99 g·cm-2). BMD at the femoral neck was greater in SP than in PL, with no difference between OL and PL. At lumbar spine sites L2 - L4, there was no difference across the three athletic groups. OL and PL had a greater BMD than RA at L2-4, whereas SP had greater BMD than RA at only at L4. There was no difference across all groups at L1. CONCLUSION: Olympic lifting includes both high- and odd- impact movements in addition to high-force loading. Olympic lifters showed similar BMD at the femoral neck as soccer players and similar BMD in the lumbar spine as power lifters. Thus, Olympic lifting may have greater BMD effects in the two key regions that are susceptible to injury compared to sports that do not combine power and odd-impact training.

Dimensões e esqueletopia dos rins em duas populações de Cerdocyon thous (Linnaeus, 1766)

Cerdocyon thous is the South American canid with great geographic distribution. To the south of Ecuador, two isolated populations have been identified, living in different average temperatures and food availability. The objective was to measure the length, width, thickness and volume of the kidneys, length of renal vessels, and verify the renal skeletopy in two populations of C. thous. Kidneys and renal vessels were measured from 34 cadavers collected on highways in the Brazilian territory. From the Atlantic Forest biome (latitude 22º), 14 specimens (seven males and seven female) were analyzed, and from the Pampa biome (latitude 29º), 20 specimens (eight males and twelve female). On average, in the right antimere the kidneys measured 49.9 ´ 25.2 ´ 24.4 mm, had a volume of 16.5 cm3, the renal artery measured 21.3 mm and the renal vein 19.4 mm. In the left antimere, the kidneys measured 49.3 ´ 24.4 ´ 22.8 mm, with a&nbsp; volume of 14.6 cm3 and the artery and vein measured 21.0 mm and 28.4 mm, respectively. The right kidney was always cranial and predominantly positioned ventrally to vertebrae L1–L3, while the left one was positioned ventrally to vertebrae L2–L4. There was no difference in the comparison between sexes or antimeres. Most renal dimensions were significantly higher in the specimens from the Pampa biome, possibly due to the body size and type of diet. This result warns of interpreting diagnoses that depend on the evaluation of the normal renal dimensions in this species.