Association of Chronic Obstructive Pulmonary Disease and Smoking Status With Bone Density and Vertebral Fractures in Male Lung Cancer Screening Participants

We studied the vertebral fracture prevalence on low‐dose chest computed tomography (CT) in male lung cancer screening participants and the association of fractures and bone density with chronic obstructive pulmonary disease (COPD) and smoking. 1140 male current and former smokers with ≥16.5 packyears from the NELSON lung cancer screening trial were included. Age, body mass index, and smoking status were registered. CT scans and pulmonary function tests were obtained on the same day. On CT, vertebral fractures and bone density were measured. The cohort had a mean age of 62.5 years (standard deviation 5.2) old; 531 (46.6%) had quit smoking; and 437 (38.3%) had COPD. Of the group, 100 (8.8%) participants had a vertebral fracture. Fracture prevalence was higher in current compared to former smokers (11.3% versus 5.8%, p = 0.001), but similar in participants with COPD compared to those without (9.6% versus 8.3%, p = 0.430). The multivariable adjusted odds ratio for fracture presence was 1.79 (95% CI: 1.13–2.84) in current smokers and 1.08 (95% CI: 0.69–1.67) in COPD participants. Bone density was lower in current compared to former smokers (103.2HU versus 108.7HU, p = 0.006) and in participants with COPD compared to those without [100.7 Hounsfield Units (HU) versus 108.9HU, p < 0.001]. In multivariate analysis, smoking status and COPD status were independently associated with bone density, corrected for age and body mass index. In conclusion, our study shows that lung cancer screening participants have a substantial vertebral fracture burden. Fractures are more common in current smokers, who also have lower bone density. We could not confirm that COPD is independently associated with vertebral fractures. © 2014 American Society for Bone and Mineral Research.     

Preparation of a semisynthetic vaccine to Streptococcus pneumoniae type 3.

A semisynthetic vaccine to Streptococcus pneumoniae type 3 has been developed. The hexasaccharide [leads to 3)GlcpA beta(1 leads to 4)Glcp beta(1 leads to]3 was isolated from a partial acid hydrolysate of the capsular polysaccharide S3. It was coupled to stearylamine by reductamination with NaCNBH3 and then incorporated into liposomes. These haptenated liposomes were tested for immunogenicity in mice. They induced protection to a lethal dose (25 50% lethal doses) of S. pneumoniae type 3 and gave rise to immunoglobulin M antibodies. No cross-protection was observed against S. pneumoniae type 11.     

Nϵ-(carboxymethyd)lysine,a constituent of human urine

An unknown urinary amino acid, present in small amounts in many children with various diseases, has been isolated and identified as N^?-(carboxymethyl) lysine. The identity of this compound was confirmed by synthesis. Its chromatographical characteristics are described.The compound also occurred in the urine of prematurely born infants. Even in healthy adults trace amounts could be detected.In a few patients strikingly higher excretions were observed, up to 67 mg/g creatinine, as determined by cation-exchange column chromatography. No clear correlation with a distinct clinical picture could be established.Speculations are given about the origin of the compound.     

Identification of three genes coding for aminoglycoside-modifying enzymes by means of the polymerase chain reaction

A polymerase chain reaction (PCR) was devised for the simultaneous identification of three widespread aminoglycoside-acetylating enzymes (AACs), namely, AAC(3)-I, AAC(3)-II and AAC(3)-IV. Three sets of 20-mer DNA primers were constructed, based on the nucleotide sequences of the genes coding these enzymes. Each of the three gene regions contained a unique restriction site. This property was used to confirm the specificity of the reactions. Evolutionarily-well-conserved sequences of the 16S rRNA bacterial genes were used to construct two 20-mer primers, which served as positive controls for the amplification reactions. Tests of twenty reference strains, containing ten different aminoglycoside-modifying enzymes, confirmed the specificity and the sensitivity of the method. The PCR method confirmed the presence of the aacC2 gene in 63 clinical strains, in which susceptibility data and colony hybridization had previously suggested the presence of the gene.     

Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging

Current guidelines and literature on screening for coronary artery calcium for cardiac risk assessment are reviewed for both general and special populations. It is shown that for both general and special populations a zero score excludes most clinically relevant coronary artery disease. The importance of standardization of coronary artery calcium measurements by multidetector CT is discussed. This consensus article is being published concurrently in the Springer Journal International Journal of Cardiovascular Imaging.