Is there an association between inhaled corticosteroids and bone density in postmenopausal women?

BACKGROUND: During the last decades, there has been increased concern about the association between oral corticosteroid (OC) therapy and osteoporosis. OBJECTIVE: The question currently discussed is whether inhaled corticosteroids (ICs) in recommended doses have any clinically relevant effects on bone mineral density (BMD). METHODS: We compared BMD in postmenopausal women exposed to corticosteroids only in inhaled form (IC group, n = 106) with that in women not exposed to corticosteroids (unexposed group, n = 674). BMD was also studied in 49 women exposed to OCs, intra-articular injections, or both in addition to ICs (OC group). The women were recruited from a population-based prospective cohort study. METHODS: We used a dietary survey, bone density measurement of the forearm, and a health questionnaire including an interview about past and present medication use. RESULTS: Mean BMD did not significantly differ between the IC group (0.434 g/cm2) and the unexposed group (0.429 g/cm2). The mean duration and dose of ICs was 8.2 +/- 5.03 years and 853 microg daily. Within the IC group, BMD stratified for cumulative dose of IC, duration, or current dose greater than or less than 1000 microg did not differ. BMD in the OC group was lower than that in the IC group (0.408 vs 0.434 g/cm2). CONCLUSION: No difference in BMD was noted between the IC group and unexposed control subjects, nor was any dose-response relationship observed between IC therapy and BMD.     

Is there any relationship between RDW levels and atrial fibrillation in hypertensive patient?

Background

Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke.

Objective

We aimed to investigate the relation between RDW and AF in patients with hypertensive

Method

We retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex

Results

The mean age of the study population was 71,09± 8,50 (af group) and 70,97±8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13±1,58 and 14,05±1,15 p<001) . Logistic regression analysis showed that RDW and left atrial dimension were only independently risk factory associated with atrial fibrillation. (Rdw odds ratio:1,846 CI; 1,221–2,793 p<0,05). Roc curve analyses were applied to determine the cut-off point. Cut-off point was at 14,195 and Sensitive, specificity was %71,4, %56 respectively.

Conclusion

RDW levels were higher in hypertensive patients with atrial fibrillation. An increased RDW level in the patient with hypertension may alert physician on developing or presence of atrial fibrillation.     

Are menopausal symptoms associated with bone mineral density and changes in bone mineral density in premenopausal women?

Background: The relationship between menopausal symptoms and bone mineral density (BMD) was examined in 290 premenopausal women, ages 44–50 years, participating in a randomized clinical trial of a dietary and exercise intervention: The Women's Healthy Lifestyle Project. Methods: Information on hot flashes (presence, absence), menstrual cycles (irregular, regular) and menstrual flow per period (variable, same) over the past 6 months was collected at entry. Participants reporting at least one menopausal symptom were classified as symptomatic and compared to those having no symptoms. Bone mineral density (BMD) at the lumbar spine (L1–L4), total hip and whole-body were made at baseline and at 30 months using a dual-energy X-ray absorptiometer (Hologic QDR 2000 densitometer). Results: Baseline BMD at the spine, hip and whole-body were significantly reduced in women reporting menopausal symptoms compared to asymptomatic women, after adjustment for age, weight and intervention status (all p<0.05). Women with irregular menstrual cycles had greater annualized rates of bone loss at the spine and hip than asymptomatic women (spine, −0.77 (1.6)% per year vs. −0.19 (1.0)% per year, p=0.0043; hip, −0.37 (1.1)% per year vs. −0.04 (1.0)% per year, p=0.061), after adjustments for age, percent change in weight, intervention status, and baseline BMD. Similar findings were not found for whole-body BMD. Conclusions: These results suggest that menopausal symptoms are useful for the effective identification of premenopausal women at higher risk of low BMD and perhaps, of osteoporosis.     

Is there a relation between vitamin D,interleukin-17, and bone mineral density in patients with inflammatory bowel disease?

IntroductionIn inflammatory bowel diseases (IBD), osteopenia and osteoporosis constitute a significant medical problem. Cytokines, especially IL-17, play an important role in the pathogenesis of IBD and osteoporosis. Vitamin D is a regulator of bone metabolism, and helps maintain immune system homeostasis.Material and methodsThe research sample consisted of 208 persons: 83 patients (age 35 ±11.99 years) with Crohn’s disease (CD); 86 patients (age 39.58 ±14.74 years) with ulcerative colitis (UC); and 39 persons (age 30.74 ±8.63 years) in the control group (CG). Clinical data on bone mineral density of the lumbar spine (L2-L4), bone mineral density of the femoral neck (FN), and body mass index (BMI) were collected. 25OHD and IL-17 serum concentrations were also measured.ResultsBody mass index (kg/m²) results: in CD, 21.51 ±3.68; in UC, 23.31 ±4.38; and in CG, 24.57 ±3.45 (p < 0.01). Densitometry results for L2–L4 T-score SD: in CD –0.83 ±1.45; in UC –0.47 ±1.15; in CG 0.09 ±0.70. Densitometry results for FN T-score SD: in CD –0.62 ±1.26; in UC –0.29±1.17; in CG 0.41 ±1.03 25OHD (ng/ml) serum concentrations: in CD, 21.33±12.50; in UC, 22.04±9.56; in CG, 21.56±9.11 (ns). IL-17 (pg/ml) serum concentrations: in CD, 8.55±10.99; in UC, 11.67±12.97; in CG, 5.16±9.11 (ns).ConclusionsInflammatory bowel diseases patients and persons from the CG did not differ in vitamin D or IL-17 levels. Patients with a mild course of the disease had a higher vitamin D concentration and bone mineral density. In UC, higher vitamin D concentrations were associated with lower IL-17 concentrations. The IBD patients with a severe course of the disease had a lower body mass than those in the CG and the patients with a mild course of the disease.     

Is there an association between autoimmunity and endometriosis?

Endometriosis is a benign gynecologic disorder that affects 5-10% of women of reproductive age worldwide. It is characterized by the presence of ectopic endometrial cells and stroma in various locations outside the endometrium. In some of these women there are also a chronic local inflammatory process and presence of autoantibodies. It is not known whether this process is part of the etiology or is a secondary response to the ectopic cells. Furthermore, endometriosis shares similarities with several autoimmune diseases, which include elevated levels of cytokines, decreased apoptosis, and cell-mediated abnormalities. Our aim in this paper was to review the association between autoimmunity and endometriosis. For this purpose we conducted a thorough literature review in the MEDLINE/PubMed database using the keyword endometriosis crossed with: autoimmune disease, autoimmune diseases, autoimmunity, autoantibodies, immunity, immune-modulation, endometrial antibodies, etc.     

Is there a relationship between bone and critical illness?

Critical illness is a result of a series of severe diseases of complicated causes. Although accumulating therapeutic strategies have been carried out for the prevention and treatment of critical illness, mortality remains high. Inflammations, electrolyte disturbances, hyperglycemia, and depressed immune function are factors that may be responsible. Recent studies have suggested that the bone influences hematopoiesis, immunity, and metabolism. Published data and our own work have led us to hypothesize that the bone plays an important role in the pathogenesis and outcome of critical illness.     

Is there an association between hysterectomy and subsequent adiposity?

OBJECTIVES: To examine the associations between hysterectomy and subsequent adiposity and to investigate whether these associations vary by characteristics of hysterectomy and are independent of pre-hysterectomy adiposity and potential confounding factors. METHODS: Using information on women from the 1946 and 1958 British birth cohort studies (N = 1790 and 4552, respectively), collected prospectively across life, regression analyses were used to examine the associations between hysterectomy and subsequent body mass index (BMI) and waist circumference. RESULTS: In unadjusted analyses there was a difference of 1.18 kg/m(2) (95% CI: 0.64, 1.74) in mean BMI and of 2.72 cm (1.45, 3.99) in waist circumference at age 44-45 years between women who had undergone hysterectomy and those who had not in the 1958 cohort, and differences of 0.76 kg/m(2) (-0.05, 1.57) and 0.34 cm (-1.58, 2.26) at age 43 years and 0.81 kg/m(2) (0.14, 1.49) and 1.45 cm (-0.15, 3.05) at age 53 years in the 1946 cohort. These differences attenuated and were no longer significant after adjustment for pre-hysterectomy BMI and confounders. There was no strong evidence of variation in associations by oophorectomy status, timing, route of or reason for procedure. CONCLUSIONS: This study demonstrates that British women who had previously undergone hysterectomy had higher BMI and waist circumference in middle-age than others. These differences appear to be accounted for by the higher BMI in earlier adulthood and increased levels of risk factors associated with both adiposity and hysterectomy risk among women who had undergone hysterectomy. This suggests that women are unlikely to gain weight as a direct result of hysterectomy.     

Is there an association between septate uterus and endometriosis?

BACKGROUND: The question of whether Müllerian anomalies are significantly more often combined with endometriosis is a controversially discussed problem. Some publications described this association in patients with obstructive but not non-obstructive Müllerian anomalies or controls without Müllerian anomalies. The aim of this study was to evaluate the incidence of endometriosis in patients with a septate uterus as a non-obstructive form of Müllerian anomalies. METHODS: In a retrospective study, we evaluated 120 patients (29.4 +/- 4.7 years; mean +/- SD) with a septate uterus. The control group consisted of 486 consecutive infertile patients (30.8 +/- 6.3 years) with a normal hysteroscopy and laparoscopy. RESULTS: The incidence of dysmenorrhoea was comparable in both groups, but the incidence of endometriosis was significantly higher in patients with a septate uterus (25.8 versus 15.2%, P = 0.006). CONCLUSION: Our results suggest a higher incidence of endometriosis in patients with a septate uterus. If it can be confirmed by others, the initial finding of a septate uterus in infertile patients should be followed by a combined hysteroscopy and laparoscopy.     

Is there an association between astrological data and personality?

A test was made of the hypothesis that personality characteristics can be predicted on the basis of various features of the individual's astrological chart. Astrological charts were prepared for 196 college-age Ss who also were administered the MMPI and the Leary Interpersonal Check List. Ss were divided into those who had extreme scores on any of the 13 personality variables studied and those who did not. For each personality variable, comparisons were made on a large number of astrological dimensions between distributions of Ss with and without extreme test scores. Six hundred thirty-two such comparisons were made and evaluated with chi-square tests. In that the obtained number of statistically significant chi-squares was less than what would be expected on a chance basis, the hypothesis was rejected.     

Is there association between TLR9 polymorphism and SLE susceptibility?

After reading the article “Susceptibility to SLE in South Indian Tamils may be influenced by genetic selection pressure on TLR2 and TLR9 genes”, we have some doubt. As the differences existed in genetic risk factors, SLE symptoms, and disease severity between the childhood-onset and adult-onset SLE patients, the association analyses in study population including both childhood-onset and adult-onset SLE patients might be inappropriate. Besides, in order to explore whether TLR9 (−1237C/T) polymorphism impact SLE occurrence, we reviewed current studies and conducted a meta-analysis. The results of meta-analysis showed no significant correlation between TLR9 (−1237C/T) and SLE susceptibility in total population (allele model OR = 0.97, 95%CI (0.81–1.14)), or in Caucasians (allele model OR = 1.05, 95%CI (0.72–1.39)) and in Asians (allele model OR = 0.94, 95%CI (0.54–1.35)). Therefore, confirmative evidence reveals that TLR9 (−1237C/T) polymorphism does not correlate with SLE susceptibility.     

Is there an association between menopause status and sexual functioning?

OBJECTIVE: The purpose of this study was to address whether: (1) there is an association between menopause status and various aspects of sexual functioning, and (2) the relative contributions of menopause status and other variables to various aspects of sexual functioning. DESIGN: Analyses are based on 200 women from the Massachusetts Women's Health Study II, a population-based sample of women transitioning through the menopause who were not HRT users, who had not had a surgical menopause, and who had partners. The women were classified as pre-, peri-, or postmenopausal according to menstrual cycle characteristics. Estradiol, estrone, and follicle-stimulating hormone were also measured. Sexual functioning was measured in terms of satisfaction, desire, frequency of sexual intercourse, belief that interest declines with age, arousal compared with a younger age, difficulty reaching orgasm, and pain. Predictor variables included sociodemographics, health, vasomotor symptoms, psychological variables, partner variables, and lifestyle behaviors. RESULTS: Menopause status was significantly related to lower sexual desire, a belief that interest in sexual activity declines with age, and women's reports of decreased arousal compared with when in their 40s. Menopause status was unrelated to other aspects of sexual functioning in either unadjusted or multiple regression analyses. In analyses in which log estradiol (E2) was included in addition to menopause status, log E2 was only related to pain. In multiple regression analyses, other factors such as health, marital status (or new partner), mental health, and smoking had a greater impact on women's sexual functioning than menopause status. CONCLUSIONS: Menopause status, but not E2, is related to some, but not all, aspects of sexual functioning. This may be due to menopause per se or other factors associated with menopause and aging (e.g., increased sexual dysfunction among aging men). Menopause status has a smaller impact on sexual functioning than health or other factors.     

Is there an association between multiple myeloma and prostate cancer?

In a series of 700 consecutive patients with prostate cancer, four patients were noted to have a history of multiple myeloma. An association between prostate cancer and multiple myeloma had not been previously described. An exploratory investigation of the biological basis of these two malignancies was undertaken to determine a possible mechanism for this association. A review of the genetic, molecular and chemical basis of prostate cancer and multiple myeloma development and progression is presented. A model suggesting the possible impact of immunosuppression from multiple myeloma and chemokines released by circulating myeloma cells including IGF-1, IL6, SDF1 and VEGF on the progression of prostate cancer to detectable stages is presented.     

Is there any relationship between recurrent oral aphthous stomatitis and prediabetes?

Periodontal disease has been associated with glycaemia. Recurrent aphthous stomatitis (RAS) is one of the most common oral lesions and is characterized by painful recurrent oral ulcers. However, the exact cause and treatment of RAS is not yet well-known. Furthermore, there is still unknown the relationship between RAS and glycaemia. Prediabetes has shown to have role on worse metabolic profile. However, there is still no data on the relationship between prediabetes and clinical RAS. Therefore, the purpose of this hypothesis is to assess whether the prediabetes aggravate RAS.     

Is there any information on micro-structure in microwave tomography of bone tissue?

In this work, two-dimensional simulations of the microwave dielectric properties of models with ellipses and realistic models of trabecular bone tissue are performed. In these simulations, finite difference time domain methodology has been applied to simulate two-phase structures containing inclusions. The results presented here show that the micro-structure is an important factor in the effective dielectric properties of trabecular bone. We consider the feasibility of using the dielectric behaviour of bone tissue to be an indicator of bone health. The frequency used was 950 MHz. It was found that the dielectric properties can be used as an estimate of the degree of anisotropy of the micro-structure of the trabecular tissue. Conductivity appears to be the most sensitive parameter in this respect. Models with ellipse shaped-inclusions are also tested to study their application to modelling bone tissue. Models with ellipses that had an aspect ratio of a/b = 1.5 showed relatively good agreement when compared with realistic models of bone tissue. According to the results presented here, the anisotropy of trabecular bone must be accounted for when measuring its dielectric properties using microwave imaging.     

Is there an association between postural balance and pulmonary function in adults with asthma?

OBJECTIVE:

Asthma may cause systemic repercussions due to its severity and the effects of treatment. Our objective was to compare posture, balance, functional capacity, and quality of life (QOL) according to the severity of disease, as assessed by pulmonary function levels.

METHOD:

This cross-sectional study evaluated fifty individuals with asthma. We compared two groups of adult individuals who were divided according to the median of the forced expiratory volume in one second (FEV₁) as follows: group A  =  FEV₁>74% predicted; group B  =  FEV₁<74% predicted. All patients underwent the following tests: spirometry, whole-body plethysmography, diffusing capacity for carbon monoxide (DLco), respiratory muscle strength, posture assessment, stabilometry, six-minute walking distance (6MWD), and QOL.

RESULTS:

All pulmonary function variables exhibited statistically significant differences between the two groups, except for the DLco. The maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and 6MWD were lower in group B. The maximal mediolateral velocity and the mediolateral displacement were significantly different, while the postural changes and QOL were similar between the groups.

CONCLUSIONS:

In adult individuals with asthma, the pulmonary function is associated with balance control in the mediolateral direction but does not influence the postural changes or QOL.