Teriparatide (TPT) is the active 1-34 amino acid sequence with osteoanabolic use for severe osteoporosis. Our aim is to analyze the biochemical and clinical profile of patients treated with TPT based on Romanian protocol. The inclusion and exclusion criteria are based on specific country protocol for TPT 20 �g/day, for 2 years, once in life time based on self administration. This is a transversal study including data of a tertiary centre of endocrinology on patients who signed the informed consent. This is a real life study, of observational type (the intervention meaning the TPT recommendation was done by individual decision of each clinician). Normal total and ionic calcium is associated with low 25-hydroxyvitamin D levels and a mean lumbar T-score of -3.1�0.7SD. 50% of patients treated with TPT have digestive conditions, less than 10% are first time users, a high severity profile is based on a median of 4 years regarding prior anti-osteoporotic medication and of 3 previous fragility fractures.
Heart failure (HF) and renal dysfunction are frequent associated in the same patient. The purpose of our study was to assess the prevalence of renal dysfunction and the clinical status in admitted patients for decompensated HF. Material and Methods. 397 patients succesively hospitalized for decompensated HF, NYHA III or IV functional class, with left ventricular ejection fraction (LVEF) � 45% were included in the study. Renal dysfunction was defined by glomerular filtration rate (GFR) [ 60 mL/min/1.73 m 2. The mean GFR in patients with HF was 63.89 � 21.5 mL/min/1.73 m2 .The prevalence of renal dysfunction was 49.6%. Patients with GFR [ 60 mL/min/1.73m2, compared with those with preserved renal function were significantly more frequent older (75.37 � 6.84 vs. 71.33 � 8.08 years; p [0.001), females (53,8% vs. 43.5%; p = 0.04), had a significantly higher prevalence of diabetes mellitus (50.2% vs. 28.5%; p [0.001), atrial fibrillation (53.8% vs 46.2%, p = 0.04) and anemia (47.7% vs. 29.5% ; p [0.001). Also, patients with renal dysfunction had more severe HF than those without renal dysfunction (NYHA class IV: 65% vs 45%, p [0.001, clinical congestion: 78.2% vs 68%, p = 0.02, LVEF [35%: 47.21% vs � 35%, p [0.001). Renal dysfunction can be considered an additional marker of severe cardiac dysfunction along with NYHA IV class and low LVEF. The presence of both renal dysfunction and anemia could represent prognostic markers in HF patients with reduced LVEF.
Turner syndrome represents a condition that associates diverse pathology with somatic, metabolic (diabetes), cardio-vascular, digestive, respiratory and bone involvement along with chromosomal abnormalities. In our study we have analyzed the bone pathology that occurs in Turner syndrome and the response in the therapy with ibandronat. The decrease in value of the bone turn-over biomarkers and the decrease of the T score after the administration of ibandronate p.o. in a monthly dosage demonstrates the efficiency of this bisphosphonate in the treatment of the osteoporosis secondary to sexual hormone deficiency in Turner syndrome.
5-hydroxytryptamine (5-HT) dually influences skeleton status through positive, indirect central effect and negative, direct, gut-associated impact. Circulating form is usually tested via venous blood sample. A limited number of clinical studies are published on this specific topic. We introduce a cross-sectional study on menopausal women with normal (N=29) and low bone mineral density (N=32) based on lumbar Dual-Energy X-Ray Absorptiometry (DXA) to whom serum serotonin was assessed and found no correlation with bone loss. This aspect confirms conflicting published data regarding the relationship between circulating levels and fracture risk assessment.
Turner syndrome (TS) is characterized by partial or complete loss of a sexual chromosome, resulting in an incomplete development of the body, gonadic failure, cardiac and renal abnormalities, oro-dental changes, etc. In our study, we proposed to perform a histological and immunohistochemical (IHC) study of the periodontium changes in patients with TS. The biological material under study was represented by fragments of gingival mucosa harvested from 18 patients with TS who presented advanced periodontal lesions and required dental extractions. The fragments of gingival mucosa were processed by the classical histological technique of paraffin inclusion, subsequently the obtained sections being stained by the Hematoxylin-Eosin (HE) and examined under the optical microscope. For the IHC study, there were performed serial sections incubated with anti-cluster of differentiation (CD) 3, anti-CD20 and anti-CD68 antibodies for highlighting immune cells, as well as with anti-matrix metalloproteinase (MMP) 2 and anti-MMP8 antibodies for highlighting MMPs (MMP2 and MMP8) involved in the periodontal tissue lesions. In the present study, during the histological examination, there were observed morphological changes, both in the epithelium and in the gingival mucosa chorion. Epithelial changes consisted in the onset of acanthosis processes, in the thickening of the epithelium due to the increase of the spinous layer, as well as in the parakeratosis phenomenon. In the chorion, there was observed the presence of inflammatory infiltrates in various stages, presence of fibrosis (extended in some cases) and the presence of an important vascularization in some cases, with a high number of immunocompetent cells involved in the inborn immune response, but also in the adaptive one, as well as a more or less intense immunoexpression of MMP2 and MMP8. Our study suggests that TS may contribute to the development of some inflammatory processes in the marginal periodontium.
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