Alendronate treatment results in similar levels of trabecular bone remodeling in the femoral neck and vertebra

Summary  We aimed to determine whether trabecular bone in sites that have different surface-based remodeling rates, the femoral neck and vertebra, are differently affected by alendronate treatment. Alendronate treatment resulted in similar levels of turnover in both sites, suggesting that a lower limit of bone turnover suppression with alendronate may exist. Introduction  Bone turnover suppression in sites that already have a low surface-based remodeling rate may lead to oversuppression that could have negative effects on the biomechanical properties of bone. The goal was to determine how alendronate suppresses bone turnover at sites with different surface-based remodeling rates. Methods  Dynamic histomorphometric parameters were assessed in trabecular bone of the femoral neck and lumbar vertebrae obtained from skeletally mature beagles treated with saline (1 ml/kg/day) or alendronate (ALN 0.2 or 1.0 mg/kg/day). The ALN0.2 and ALN1.0 doses approximate, on a milligram per kilogram basis, the clinical doses used for the treatment of postmenopausal osteoporosis and Paget’s disease, respectively. Results  Alendronate treatment resulted in similar absolute levels of bone turnover in the femoral neck and vertebrae, although the femoral neck had 33% lower pre-treatment surface-based remodeling rate than the vertebra (p < 0.05). Additionally, the high dose of alendronate (ALN 1.0) suppressed bone turnover to similar absolute levels as the low dose of alendronate (ALN 0.2) in both sites. Conclusions  Alendronate treatment may result in a lower limit of trabecular bone turnover suppression, suggesting that sites of low pre-treatment remodeling rate are not more susceptible to oversuppression than those of high pre-treatment remodeling rate.     

Effects of 1 to 3 years' treatment with alendronate on mechanical properties of the femoral shaft in a canine model: Implications for subtrochanteric femoral fracture risk

Bisphosphonate (BP) treatment used to prevent bone loss in postmenopausal osteoporosis has recently been implicated in an apparent increase in subtrochanteric femoral fractures. Previous work showed that BPs can reduce the energy to fracture of cancellous bone, but limited data exist on material‐level mechanical properties of compact bone from the long bones. This study examined intrinsic mechanical properties of the femoral diaphysis of a canine model treated for 1 or 3 years with alendronate at two different doses. Seventy‐two dogs were treated orally with 0.2 mg/kg/day alendronate or 1.0 mg/kg/day alendronate; a control group was administered saline. Prismatic beam specimens were tested in four‐point bending under displacement control, and the intrinsic mechanical properties were calculated. No significant differences were found among groups in any mechanical property at either 1 or 3 years of treatment. We conclude that the material properties of the femoral diaphysis are not degraded following 1 to 3 years treatment with alendronate, even at high doses. Longer periods of treatment have not been studied using clinical doses of alendronate, but such studies need to be carried out to confirm a lack of effect of alendronate on mechanical properties of cortical bone in the subtrochanteric region of the femur. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:1288–1292, 2009     

Albinism and developmental delay: the need to test for 15q11-q13 deletion

We report on a 17-month-old African girl with cutaneous and ophthalmologic features of oculocutaneous albinism type 2 as well as microcephaly, absent speech, and tremulous movements. Mutations of the P gene within the Angelman/Prader-Willi syndrome critical region at 15q11-q13 cause oculocutaneous albinism type 2. Comorbid oculocutaneous albinism and Angelman syndrome were suspected and confirmed by cytogenetics. Phenotypic features of Angelman syndrome or Prader-Willi syndrome in a patient with albinism should prompt further investigation.     

The United States Physician Workforce and International Medical Graduates: Trends and Characteristics

Background International medical graduates (IMGs) have been a valuable resource for the United States physician workforce, and their contribution to the United States workforce is likely to increase. Objective To describe the historical trends and compare the characteristics of IMGs to United States medical graduates (USMGs) in the United States. Design Longitudinal analysis of the American Medical Association Physicians’ Professional Data (AMA-PPD) database using the 1978–2004 files and a comparative analysis of the characteristics of a random sample of 1,000 IMGs and a random sample of 1,000 USMGs using the 2004 file. Measurements Historical trends and characteristics of IMGs in the United States. Results Over the last 26 years, the number of IMGs in the United States grew by 4,873 per year reaching a total of 215,576 in 2004, about 2.4 times its size in 1978. The proportion of IMGs increased 0.12% per year, from 22.2% in 1978 to 25.6% in 2004. In 2004, compared with USMGs, IMGs were older, less likely to be board certified [Odds ratio (OR), 0.68; 95% CI, 0.53 to 0.86], less likely to work in group practice (OR, 0.60; 95% CI, 0.37 to 0.98), more likely to have Internal Medicine as practice specialty (OR, 2.10; 95% CI, 1.62 to 2.71) and more likely to be residents (OR, 1.52; 95% CI, 1.07 to 2.16). Conclusions Over the last quarter century, the IMGs provided a significant and steady supply for the United States physician workforce that continues to grow. Policymakers should consider the consequences for both the United States and source countries.     

Efficiency of diode laser and ultrasonic-activated irrigation in retreatment of gutta percha and bioceramic sealer: An in vitro study

This study was to determine the effectiveness of diode laser (LI) and ultrasonic (UI)-activated irrigation with or without a surfactant as adjunct techniques during the retreatment of gutta-percha and tricalcium silicate-based sealer (BC) sealer. Forty-two single-rooted premolars were instrumented and filled with gutta-percha and BC sealer, then retreated using NiTi retreatment rotary files. Teeth were randomly divided into three equal groups: Control (manual irrigation), UI and LI groups. Each group was subdivided into 2.5% NaOCl irrigant and ChlorCid™️ Surf subgroups. The amount of material removed following UI and LI was significantly greater than that of manual irrigation (p < 0.0001). However, there was no significant difference between the surfactant subgroups, irrespective of irrigation technique (p = 1.00, p = 0.535, p = 0.805). The use of UI and LI adjuncts to NiTi rotary retreatment techniques showed significant improvement in gutta-percha with BC sealer removal. However, surfactants had no effect on the efficacy.     

Polymorphism of glutathione S-transferases as genetic risk factors for the development of complications in type 2 diabetes mellitus

Background

Diabetes is characterized by chronic hyperglycemia that produces dysregulation of cellular metabolism and result in excess free radical production and oxidative stress. Glutathione S-transferases (GSTs) are a family of multifunctional enzymes that work as antioxidants. Therefore, diminished expression of GSTs may result in a reduced body defense against oxidative stress, followed by development of diabetic complications.

Objectives

To investigate the possible association between GSTM1 and GSTT1 polymorphism and the occurrence of complications in type 2 DM and to study the other risk factors for complications in DM.

Methods

Twenty noncomplicated type 2 diabetic patients and 40 complicated type 2 diabetic patients were enrolled in the study. The GSTM1 and GSTT1 genotypes were identified by polymerase chain reaction of peripheral blood DNA samples. Analysis of data was done by using SPSS (SPSS, Chicago, Ill).

Results

The frequencies of null GSTM1 and GSTT1 genotypes were 55% (11/20) and 40% (8/20), respectively, in noncomplicated DM group. The frequencies of null GSTM1 and GSTT1 genotype in complicated DM group were 57.5% (23/40) and 60% (24/40), respectively. The null GSTT1 genotype was more prevalent in the group of complicated DM with odds ratio (odds ratio, 2.3; 95% confidence interval, 0.75-6.7) when compared with noncomplicated DM.

Conclusion

Our data provide evidence that diabetics with null GSTT1 genotypes are substantially at higher risk for developing complications.     

Female perpetration of violence in heterosexual intimate relationships: adolescence through adulthood

This article critically reviews 62 empirical studies that examine the prevalence of female-perpetrated intimate partner violence across three distinct populations (adolescents, college students, and adults). All studies were published between 1996 and 2006 and reported prevalence rates of physical, emotional, and/or sexual violence perpetrated by females in heterosexual intimate relationships. The highest rates were found for emotional violence, followed by physical and sexual violence. Prevalence rates varied widely within each population, most likely because of methodological and sampling differences across studies. Few longitudinal studies existed, limiting the extent to which we could identify developmental patterns associated with female-perpetrated intimate partner violence. Differences and similarities across populations are highlighted. Methodological difficulties of this area of inquiry as well as implications for practice, policy, and research are discussed.