There is an increased interest and more studies highlight the fact that bone strength depends not only on bone tissue quantity, but also on its quality, which is characterized by the geometry and shape of bones, trabecular bone microarchitecture, mineral content, organic matrix and bone turnover. Fibrillar type I collagen is the major organic component of bone matrix, providing form and a stable template for mineralization. The biomedical importance of collagen as a biomaterial for medical and cosmetic purposes and the improvement of the molecular, cellular biology and analytical technologies, led to increasing interest in establishing the structure of this protein and in setting of the relationships between sequence, structure, and function. Bone collagen crosslinking chemistry and its molecular packing structure are considered to be distinct features. This unique post-translational modifications provide to the fibrillar collagen matrices properties such as tensile strength and viscoelasticity. Understanding the complex structure of bone type I collagen as well as the dynamic nature of bone tissues will help to manage new therapeutic approaches to bone diseases.

Endocrine disruptors (ED) are exogenous agents that interfere with the normal function of the endocrine system and they are considered environmental chemicals with estrogen-like and/or anti-androgenic activity with important impact on the reproductive axis. They act via nuclear receptors, non-nuclear steroid receptors, nonsteroidal receptors, orphan receptors, and different enzyme pathways involved in the biosynthesis and/or metabolism of steroids. The molecules identified as ED and sources of exposure are diverse and vary worldwide, including from natural chemicals found in human and animal food (the main source) up to synthetic chemicals, such as as solvents, plasticizers, pesticides, fungicides, pharmaceuticals etc. ED are incriminated in the occurrence of malignant tumors, birth defects, attention deficit disorders, cognitive impairment, brain development, deformations of the body (including limbs), disturbance of sexual development, menstrual irregularity, precocious puberty, feminizing or masculinizing effects, abortion, not least obesity and decreased fertility. The principles of action are still studied and controversial, therefore, it is difficult to determine the minimum level at which adverse effect occurs and further studies are required.

Introduction. Current studies support the implication of metabolic changes associated with type 2 diabetes in altering bone metabolism, structure and resistance. Objective. We conducted a cross-sectional study on postmenopausal women aimed to analyze the differences in metabolic and bone profile in patients with and without type 2 diabetes Methods. We analyzed the metabolic and bone profile in postmenopausal women with and without type 2 diabetes (T2DM). Clinical, metabolic, hormonal parameters, along with lumbar, hip and femoral bone mineral density (BMD) and trabecular bone score (TBS) were evaluated. Results. 56 women with T2DM(63.57±8.97 years) and 83 non-T2DM (60.21±8.77 years) were included. T2DM patients presented a higher value of body mass index (BMI) and BMD vs. control group (p = 0.001; p = 0.03-lumbar level, p = 0.07-femoral neck and p = 0.001-total hip). Also, BMI correlated positively with lumbar-BMD and glycated hemoglobin (HbA1c) (r = 0.348, p = 0.01; r = 0.269, p = 0.04), correlation maintained even after age and estimated glomerular filtration rate (eGFR) adjustment (r = 0.383, p = 0.005; r = 0.237, p = 0.08). Diabetic patients recorded lower levels of 25(OH)D(p = 0.05), bone markers (p ≤ 0.05) and TBS(p = 0.07). For the entire patient group we found a negative correlation between HbA1c level and bone markers: r = -0.358, p = 0.0005-osteocalcin, r = -0.40, p = 0.0005-P1NP, r = -0.258, p = 0.005-crosslaps. Conclusions. Our results indicate the presence of altered bone microarchitecture in T2DZ patients according to the TBS score, combined with lower levels of bone markers, with a statistically significant negative correlation between HbA1c level and bone markers.

Sugammadex (Bridion) represents a class named muscle relaxant encapsulator. It can be used to reverse the neuromuscular blockade induced by rocuronium or vecuronium in case of general anesthesia. Its molecular weight is 2.178 g/mol, with a structure consisting in a ring of eight negative charges. It has no receptor interaction in human body and it is eliminated via kidney, being contraindicated in end-stage kidney disease patients. Sugammadex has few side effects but there are same case reports about allergic reactions. Only three drugs can actually interact with sugammadex: toremifene, flucloxacillin and fusidic acid. It can be used in elderly and pediatric patients, in morbidly obese patients, patients with hepatic insufficiency or mild and moderate renal insufficiency or in muscular disease. Despite its beneficial use, the high price remains its main issue.