Percepção de estudantes universitários acerca das ações regulatórias dos nutrientes no sistema imune / University students perception about nutrient regulatory actions in the immune system / Percepción de los estudiantes universitarios sobre las acciones reguladoras de los nutrientes en el sistema inmunitario

O sistema imunológico é formado por um conjunto de células que protege o organismo contra patógenos e outros agentes estranhos. A imunidade pode atuar de maneira correta e eficaz, entretanto é necessário o consumo adequado de alimentos que têm como função fortalecer e regular o sistema imunológico. Dessa forma, questiona-se: qual o conhecimento dos estudantes universitários de uma faculdade em Sete Lagoas/MG acerca dos alimentos, fontes de vitaminas A, C, D, zinco, glutamina e ômega-3, como nutrientes reguladores na manutenção do sistema imune? Trata-se de um estudo de natureza descritiva e exploratória, por meio de uma pesquisa de campo, realizada com 50 acadêmicos matriculados em uma faculdade localizada em Sete Lagoas/MG. Dos entrevistados, a maioria reconheceu os grupos de alimentos que possuíam os nutrientes estudados: vitamina A (76%), vitamina C e D (70%), zinco (52%), glutamina e ômega-3 (76%). Os resultados evidenciaram que a maioria dos estudantes universitários (84%) apresentou conhecimento acerca da relação entre os nutrientes e suas ações regulatórias no sistema imune. Conclui-se que é importante a pesquisa de temáticas como esta, no sentido de informar e conscientizar os indivíduos sobre os benefícios da ingestão de vitaminas e minerais e sua relação com a manutenção do sistema imune, a fim de influenciar em melhores escolhas alimentares.

The immune system is made up of a set of cells that protect the body against pathogens and other foreign agents. Immunity can act correctly and effectively, however, adequate consumption of foods that have the function of strengthening and regulating the immune system is necessary. Thus, the question is: what is the knowledge of academics from a college in Minas Gerais about food, sources of vitamins A, C, D, zinc, glutamine and omega-3 as regulatory nutrients in the maintenance of the immune system? This is a descriptive and exploratory study, through field research, carried out with 50 academics enrolled in a college located in a municipality of Minas Gerais. Of the respondents, most recognized the food groups that had the nutrients studied: vitamin A (76%), vitamin C and D (70%), zinc (52%), glutamine and omega-3 (76%). The results showed that most academics (84%) had accurate knowledge of the relationship between nutrients and their regulatory actions in the immune system. It is concluded that it is important to research topics such as these, in order to inform and make individuals aware of the benefits of the intake of vitamins and minerals and their relationship with the maintenance of the immune system, in order to influence better food choices.

El sistema inmunológico está formado por un conjunto de células que protegen al organismo contra patógenos y otros agentes extraños. La inmunidad puede actuar de forma correcta y efectiva, sin embargo, es necesario consumir alimentos adecuados cuya función sea fortalecer y regular el sistema inmunológico. Por lo tanto, surge la pregunta: ¿qué conocimiento tienen los estudiantes universitarios de una facultad de Sete Lagoas/MG sobre alimentos, fuentes de vitaminas A, C, D, zinc, glutamina y omega-3, como nutrientes reguladores en el mantenimiento del sistema inmunológico? Se trata de un estudio descriptivo y exploratorio, a través de investigación de campo, realizado con 50 académicos matriculados en una facultad ubicada en Sete Lagoas/MG. De los entrevistados, la mayoría reconoció los grupos de alimentos que contenían los nutrientes estudiados: vitamina A (76%), vitamina C y D (70%), zinc (52%), glutamina y omega-3 (76%). Los resultados mostraron que la mayoría de los estudiantes universitarios (84%) tenía conocimiento sobre la relación entre los nutrientes y sus acciones reguladoras sobre el sistema inmunológico. Se concluye que es importante investigar temas como este, con el fin de informar y concientizar a los individuos sobre los beneficios de la ingesta de vitaminas y minerales y su relación con el mantenimiento del sistema inmunológico, para incidir en mejores elecciones alimentarias.

Bone aluminum accumulation in the current era / Acúmulo de alumínio no tecido ósseo na era atual

In the last few years, evidence from the Brazilian Registry of Bone Biopsy (REBRABO) has pointed out a high incidence of aluminum (Al) accumulation in the bones of patients with CKD under dialysis. This surprising finding does not appear to be merely a passive metal accumulation, as prospective data from REBRABO suggest that the presence of Al in bone may be independently associated with major adverse cardiovascular events. This information contrasts with the perception of epidemiologic control of this condition around the world. In this opinion paper, we discussed why the diagnosis of Al accumulation in bone is not reported in other parts of the world. We also discuss a range of possibilities to understand why bone Al accumulation still occurs, not as a classical syndrome with systemic signs of intoxication, as occurred it has in the past.

Nos últimos anos, evidências do Registro Brasileiro de Biópsia óssea (REBRABO) apontaram uma alta incidência de intoxicação por alumínio (Al) no tecido ósseo de pacientes com DRC em diálise. Essa surpreendente informação parece representar não apenas um acúmulo passivo deste metal, visto que dados prospectivos do REBRABO sugerem que a presença de Al no tecido ósseo pode estar independentemente relacionada a eventos cardiovasculares adversos maiores. Essas informações contrastam com a percepção mundial do controle epidemiológico dessa condição. Neste artigo de opinião, discutimos por que o diagnóstico de acúmulo ósseo de Al não é relatado em outras partes do mundo, e também discutimos uma gama de possibilidades para entender por que nós acreditamos que o acúmulo de Al no tecido ósseo ainda ocorre, não como se apresentava no passado, ou seja, como uma síndrome com sinais e sintomas sistêmicos de intoxicação.

Analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as inflammatory biomarkers in chronic kidney disease: impact of parathyroidectomy / Análise das relações neutrófilo/linfócito e plaqueta/linfócito como marcadores inflamatórios na doença renal crônica: impacto da paratireoidectomia

Abstract Introduction: Secondary hyperparathyroidism (SHPT) is one of the causes for inflammation in CKD. We assessed the impact of parathyroidectomy (PTX) on neutrophil-to-lymphocyte (N/L) and platelet-to-lymphocyte (P/L) ratios in SHPT patients. Methods: A total of 118 patients [hemodialysis (HD, n = 81), and transplant recipients (TX, n = 37)] undergoing PTX between 2015 and 2021 were analyzed. Results: There was a significant reduction in calcium and PTH levels in both groups, in addition to an increase in vitamin D. In the HD group, PTX did not alter N/L and P/L ratios. In the TX group, there was a reduction in N/L and P/L ratios followed by a significant increase in total lymphocyte count. Conclusion: N/L and P/L ratios are not reliable biomarkers of inflammation in SHPT patients undergoing PTX. Uremia, which induces a state of chronic inflammation in dialysis patients, and the use of immunosuppression in kidney transplant recipients are some of the confounding factors that prevent the use of this tool in clinical practice.

Resumo Introdução: O hiperparatireoidismo secundário (HPTS) é uma das causas de inflamação na DRC. Avaliamos o impacto da paratireoidectomia (PTX) nas relações neutrófilo/linfócito (N/L) e plaqueta/linfócito (P/L) em pacientes com HPTS. Métodos: Foram analisados 118 pacientes [hemodiálise (HD, n = 81) e transplantados (TX, n = 37)] submetidos à PTX entre 2015 e 2021. Resultados: Houve redução significativa de cálcio e PTH nos dois grupos, além de elevação de vitamina D. No grupo HD, a PTX não mudou as relações N/L e P/L. Já no grupo TX, houve redução nas relações N/L e P/L acompanhadas de elevação significativa do número de linfócitos totais. Conclusão: As relações N/L e P/L não são marcadores fidedignos de inflamação em pacientes com HPTS submetidos à PTX. A uremia, que induz um estado de inflamação crônica em pacientes dialíticos, e o uso de imunossupressão em pacientes transplantados renais são alguns dos fatores de confusão que impedem o uso dessa ferramenta na prática clínica.

Single-Slice Hounsfield Unit (HU) Value of the Chinese Proximal Humerus on Routine Chest CT: A Study on Opportunistically Screening for Low Bone Density / Valor de Unidad Hounsfield (HU) de Corte Único del Húmero Proximal Chino en una Tomografía Computarizada de Tórax de Rutina: Un Estudio sobre la Detección Oportunista de Baja Densidad Ósea

SUMMARY: A Study on Relationship between Single-Slice Hounsfield Unit(HU) value of the Chinese proximal humerus and Bone Mineral Density(BMD) Using Routine Chest CT and Dual-energy X-ray Absorptiometry(DEXA) was performed. Data were collected from 240 individuals who underwent DEXA and routine chest CT scans (including full images of the proximal humerus) on the same day at 967 Hospitals between January 2019 and December 2021. The method of measuring single-slice HU values of the proximal humerus on routine chest CT scans exhibited high reliability and repeatability (intraclass correlation coefficient > 0.961, P < 0.001). A strong positive correlation was observed between single-slice HU values of the proximal humerus and DEXA results, with the 20-mm HU value demonstrating the highest correlation. Across different BMI groups, the Area Under Curve (AUC) for the 20-mm HU value was consistently the largest (AUC=0.701- 0.813, P< 0.05). Therefore, the 20-mm HU value can be considered a reliable reference for the opportunistic screening of low BMD, with reference values of -4HU for underweight individuals, -13HU for normal weight individuals, -7HU for overweight individuals, and -16HU for obese individuals. Values below these thresholds indicate a risk of low BMD. This study enriches the Chinese BMD data and offers a swift and effective approach for opportunistically screening low BMD.

Se realizó un estudio sobre la relación entre el valor de la Unidad Hounsfield (HU) de corte único del húmero proximal chino y la densidad mineral ósea (DMO) mediante TC de tórax de rutina y absorciometría de rayos X de energía dual (DEXA). Se recopilaron datos de 240 personas que se sometieron a DEXA y tomografías computarizadas de rutina de tórax (incluidas imágenes completas del húmero proximal) el mismo día en 967 hospitales entre enero de 2019 y diciembre de 2021. El método para medir los valores de HU de un solo corte del húmero proximal en las tomografías computarizadas de tórax mostraron alta confiabilidad y repetibilidad (coeficiente de correlación intraclase > 0,961, P < 0,001). Se observó una fuerte correlación positiva entre los valores de HU de un solo corte del húmero proximal y los resultados de DEXA, demostrando el valor de HU de 20 mm la correlación más alta. En diferentes grupos de IMC, el área bajo la curva (AUC) para el valor HU de 20 mm fue consistentemente el más grande (AUC = 0,701-0,813, P <0,05). Por lo tanto, el valor de HU de 20 mm puede considerarse una referencia fiable para el cribado oportunista de DMO baja, con valores de referencia de -4 HU para personas con bajo peso, -13 HU para personas con peso normal, -7 HU para personas con sobrepeso y -16 HU para personas obesas. Los valores por debajo de estos umbrales indican un riesgo de DMO baja. Este estudio es un aporte para los datos chinos sobre la DMO y ofrece un enfoque rápido y eficaz para detectar de forma oportunista la DMO baja.

Incorporación de Tecnología Tridimensional mediante Tomografía Microcomputarizada en el Estudio de la Anatomía de Salmónidos: Una Evaluación de Utilidad / Integration of Three-Dimensional Technology through Microcomputed Tomography in the Study of Salmonid Anatomy: A Utility Evaluation

Los salmónidos, durante su desarrollo, pueden experimentar ocasionalmente deformaciones esqueléticas. Para su diagnóstico se emplean diversas metodologías, entre las que se incluyen radiografías, técnicas histológicas, diafanización con tinciones de alizarina y azul de alcián, así como el uso del microscopio electrónico de barrido (SEM), cada una con sus inherentes ventajas y desventajas. Este estudio tuvo como finalidad evaluar y comparar la eficacia de la tomografía microcomputarizada (Micro-CT) para el análisis anatómico, reconstruyendo tridimensionalmente las imágenes y contrastándolas con los resultados obtenidos mediante la técnica de diafanización. Se analizaron las aletas caudales de cinco ejemplares de salmón Oncorhynchus kisutch: dos sujetos a diafanización y tres procesados para análisis mediante Micro-CT utilizando el equipo BRUKER SkyScan 1272. La técnica de Micro-CT demostró superioridad en la resolución de las estructuras óseas, facilitando una exploración detallada de las variaciones morfológicas y la distribución de la densidad mineral. Este enfoque permitió identificar anomalías en la morfología y crecimiento de las últimas vértebras y lepidotriquias dorsales, así como una densidad incrementada en lepidotriquias dorsales malformadas. La mayor resolución proporcionada por la Micro-CT no solo potencia nuestra comprensión de la ontogenia piscícola y su adaptación a ambientes diversos, sino que además inaugura perspectivas innovadoras para el estudio de la evolución de las estrategias locomotoras y las respuestas adaptativas frente a cambios ambientales a través del tiempo.

SUMMARY: During their development, some species of salmonids may occasionally experience skeletal deformations. Several methodologies are currently being used for the diagnosis of such malformations, among which X-rays, histological techniques, diaphanization coupled either with Alizarin Red or Alcian Blue stains, as well as Scanning Electron Microscopy (SEM) can be mentioned. Each one of those methods presents inherent advantages and disadvantages. The purpose of this study was twofold: Firstly, to evaluate and compare the effectiveness of microcomputed tomography (Micro-CT) technology for anatomical analysis, three-dimensionally reconstructing the obtained images; and secondly, to contrast those images with the results obtained through the diaphanization technique. The caudal fins of five specimens of the Oncorhynchus kisutch salmon were analyzed: Two specimens were subjected to diaphanization and three were processed for Micro-CT analysis, using the BRUKER SkyScan 1272 equipment. The Micro-CT technology demonstrated superiority in the resolution of bone structures, facilitating a detailed exploration of morphological variations, as well as the distribution of mineral density. This experimental approach allowed us to identify anomalies in the morphology and growth of the last vertebrae and dorsal lepidotrichiae, as well as an increased mineral density in the malformed dorsal lepidotrichiae. The higher resolution provided by Micro-CT not only enhances our understanding of the fish ontogeny and its adaptation to diverse environments, but also opens innovative perspectives for the study of the evolution of locomotor strategies and adaptive responses to environmental changes.

Effects of a benzalkonium chloride surfactant-sodium hypochlorite combination on microhardness and mineral content of dentin / Efectos de una combinación de tensioactivo de cloruro de benzalconio e hipoclorito de sodio en la microdureza y el contenido mineral de la dentina

Abstract This study aimed to investigate the impact of the combination of Benzalkonium chloride (BAC) and sodium hypochloride (NaOCl) and its application after ethylenediaminetetraacetic acid (EDTA) in root canal irrigation procedures on the microhardness and mineral content of dentin. Distal roots of mandibular third molars were embedded in auto-polymerizing acrylic resin, sectioned coronally to apically resulting in fifty-four root sections. Thirty sections underwent microhardness evaluation, and twenty-four sections were randomly chosen for mineral analysis. The microhardness assessment comprised three groups: Group 1 (2.5% NaOCl), Group 2 (2.5% NaOCl with 0.084% BAC), and Group 3 (2.5% NaOCl with 0.084 BAC post-17% EDTA). Initial and post-irrigation microhardness values were measured for each group. For mineral analysis, samples were categorized into four groups: distilled water, 2.5% NaOCl, 2.5% NaOCl with 0.084% BAC, and 17% EDTA+2.5% NaOCl with 0.084% BAC. X-ray photoelectron spectroscopy immediately measured magnesium, phosphorus, and calcium mineral contents on dentin surfaces post-irrigation. Results indicated a significant reduction in root dentin microhardness for all solutions (p<0.05). However, no statistically significant difference in the percentage of reduction was observed among the groups (p>0.05). XPS analysis revealed no significant disparity in dentin surface mineral content among the groups (p>0.05). In conclusion, the addition of Benzalkonium chloride to sodium hypochloride, either alone or after EDTA, did not induce a significant alteration in dentin microhardness or mineral content. These findings contribute to a nuanced understanding of dental irrigation protocols and their effects on dentin properties during endodontic procedures.

Resumen Este estudio tuvo como objetivo investigar el impacto de la combinación de cloruro de benzalconio (BAC) e hipocloruro de sodio (NaOCl) y su aplicación después del ácido etilendiaminotetraacético (EDTA) en procedimientos de irrigación del conducto radicular sobre la microdureza y el contenido mineral de la dentina. Las raíces distales de los terceros molares mandibulares se incluyeron en resina acrílica autopolimerizable y se seccionaron de coronal a apical, lo que dió como resultado cincuenta y cuatro secciones de raíz. Treinta secciones se sometieron a una evaluación de microdureza y veinticuatro secciones fueron elegidas al azar para el análisis mineral. La evaluación de la microdureza comprendió tres grupos: Grupo 1 (2,5% NaOCl), Grupo 2 (2,5% NaOCl con 0,084% BAC) y Grupo 3 (2,5% NaOCl con 0,084 BAC post-17% EDTA). Para cada grupo se midieron los valores de microdureza inicial y post- irrigación. Para el análisis mineral, las muestras se clasificaron en cuatro grupos: agua destilada, 2,5% NaOCl, 2,5% NaOCl con 0,084% BAC y 17% EDTA+2,5% NaOCl con 0,084% BAC. La espectroscopía fotoelectrónica de rayos X midió inmediatamente el contenido de minerales de magnesio, fósforo y calcio en las superficies de la dentina después de la irrigación. Los resultados indicaron una reducción significativa en la microdureza de la dentina radicular para todas las soluciones (p<0,05). Sin embargo, no se observó diferencia estadísticamente significativa en el porcentaje de reducción entre los grupos (p>0,05). El análisis XPS no reveló ninguna disparidad significativa en el contenido mineral de la superficie de la dentina entre los grupos (p>0,05). En conclusión, la adición de cloruro de benzalconio al hipocloruro de sodio, solo o después de EDTA, no indujo una alteración significativa en la microdureza o el contenido mineral de la dentina. Estos hallazgos contribuyen a una comprensión matizada de los protocolos de irrigación dental y sus efectos sobre las propiedades de la dentina durante los procedimientos de endodoncia.

Renal osteodystrophy and clinical outcomes: a prospective cohort study / Osteodistrofia renal e desfechos clínicos: um estudo de coorte prospectivo

Abstract Introduction: Renal osteodystrophy (ROD) refers to a group of bone morphological patterns that derive from distinct pathophysiological mechanisms. Whether the ROD subtypes influence long-term outcomes is unknown. Our objective was to explore the relationship between ROD and clinical outcomes. Methods: This study is a subanalysis of the Brazilian Registry of Bone Biopsies (REBRABO). Samples from individual patients were classified as having osteitis fibrosa (OF), mixed uremic osteodystrophy (MUO), adynamic bone disease (ABD), osteomalacia (OM), normal/minor alterations, and according to turnover/mineralization/volume (TMV) system. Patients were followed for 3.4 yrs. Clinical outcomes were: bone fractures, hospitalization, major adverse cardiovascular events (MACE), and death. Results: We enrolled 275 participants, of which 248 (90%) were on dialysis. At follow-up, 28 bone fractures, 97 hospitalizations, 44 MACE, and 70 deaths were recorded. ROD subtypes were not related to outcomes. Conclusion: The incidence of clinical outcomes did not differ between the types of ROD.

Resumo Introdução: Osteodistrofia renal (OR) refere-se a um grupo de padrões morfológicos ósseos que decorrem de mecanismos fisiopatológicos distintos. É desconhecido se os subtipos de OR influenciam desfechos em longo prazo. Nosso objetivo foi explorar as relações entre OR e desfechos. Métodos: Este estudo é uma subanálise do Registro Brasileiro de Biópsias Ósseas (REBRABO). As amostras de cada paciente foram classificadas em osteíte fibrosa (OF), osteodistrofia urêmica mista (MUO), doença óssea adinâmica (ABD), osteomalácia (OM), alterações normais/menores, e pelo sistema Remodelação / Mineralização / Volume (RMV). Os pacientes foram acompanhados por 3,4 anos. Os eventos clínicos foram: fraturas ósseas, hospitalizações, eventos cardiovasculares adversos maiores (MACE), e óbito. Resultados: Analisamos 275 indivíduos, 248 (90%) deles estavam em diálise. No acompanhamento, 28 fraturas ósseas, 97 hospitalizações, 44 MACE e 70 óbitos foram registrados. Os subtipos de OR não foram relacionados aos desfechos clínicos. Conclusão: A incidência de desfechos clínicos não diferiu entre os tipos de OR.

Actividad física, maduración biológica y salud ósea en función de la condición socioeconómica en escolares colombianos / Physical Activity, Biological Maturation and Bone Health as a Function of the Socio-Economic Status in Colombian Schools / Atividade física, maturação biológica e saúde óssea como função do status socioeconômico em escolas colombianas

Resumen Introducción: diversos estudios describen los diferentes beneficios de la práctica de actividad física en niños y adolescentes; su déficit en estos grupos etarios, provoca un aumento concomitante de alteraciones cardiovasculares y metabólicas. Objetivo: analizar los patrones de actividad física, la maduración biológica y el contenido mineral óseo en escolares colombianos entre 8 y 16 años de edad en función del estrato socioeconómico al que pertenecen. Materiales y métodos: estudio de enfoque cuantitativo, descriptivo, transversal con alcance correlacional el cual incluyó una muestra representativa para escolares colombianos entre 8-16 años de edad a los cuales se les valoró el nivel de actividad física a través del PAQ-C, igualmente, se evaluaron diferentes medidas antropométricas y de manera indirecta se determinó la velocidad pico de crecimiento (VPC) y la densidad mineral ósea (DMO). Resultados: se evaluaron un total de 2147 escolares de los cuales el 56,7 % pertenecían a instituciones educativas del sistema público, se encontraron asociaciones estadísticamente significativas entre el sexo y el estrato socioeconómico con el nivel de actividad física (p<0,005) y las demás variables de estudio. Conclusión: se puede concluir que la actividad física, la maduración biológica y la salud ósea guardan estrecha relación con la condición socioeconómica en escolares colombianos lo que permite establecer diagnósticos tempranos y toma de decisiones frente a programas y estrategias educativas y de salud pública.

Abstract Introduction: Several studies describe the different benefits of physical activity in children and adolescents. Indeed, when a deficit of physical activity is evident in these age groups, there is a concomitant increase in metabolic and metabolic disorders. Objective: to analyze the patterns of physical activity, biological maturation and bone mineral content in Colombian schoolchildren between 8 and 16 years of age according to the socioeconomic status to which they belong. Materials and methods: A quantitative, descriptive, cross-sectional study with a correlational scope, which included a representative sample of Colombian schoolchildren between 8 and 16 years of age, who were assessed for their level of physical activity through the PAQ-C, also, different anthropometric measurements are evaluated and indirectly the peak growth velocity (PSV) and bone mineral density (BMD) are prolonged. Results: a total of 2147 schoolchildren were evaluated, of which 56.7% belonged to educational institutions of the public system, statistically significant associations were found between sex and socioeconomic status with the level of physical activity and the other study variables. Conclusion: It can be concluded that physical activity, biological maturation and bone health are closely related to socioeconomic status in Colombian schoolchildren, which allows early diagnoses and decision-making regarding educational and public health programs and strategies.

Resumo Introdução: Vários estudos descrevem os diferentes benefícios da prática de atividade física em crianças e adolescentes. De fato, quando um déficit de atividade física é evidenciado nessas faixas etárias, ocorre um aumento concomitante de distúrbios cardiovasculares e metabólicos. Objetivo: analisar os padrões de atividade física, maturação biológica e conteúdo mineral ósseo em escolares colombianos entre 8 e 16 anos de idade de acordo com o status socioeconômico ao qual pertencem. Materiais e métodos: Um estudo quantitativo, descritivo, transversal com escopo correlacional, que incluiu uma amostra representativa de escolares colombianos entre 8 e 16 anos de idade, que foram avaliados quanto ao seu nível de atividade física por meio do PAQ-C, além disso, diferentes medidas antropométricas são avaliadas e, indiretamente, a velocidade máxima de crescimento (PSV) e a densidade mineral óssea (DMO) são prolongadas. Resultados: Um total de 2147 escolares foram avaliados, dos quais 56,7% pertenciam a instituições educacionais do sistema público, foram encontradas associações estatisticamente significativas entre sexo e status socioeconômico com o nível de atividade física e as outras variáveis do estudo. Conclusão: Pode-se concluir que a atividade física, a maturação biológica e a saúde óssea estão intimamente relacionadas ao status socioeconômico em escolares colombianos, o que permite diagnósticos precoces e tomada de decisões em relação a programas e estratégias educacionais e de saúde pública.

Apicificação, apicogênese e revascularização, conceitos e conduta clínica: uma revisão de literatura / Apexification, apexogenesis and revascularization, concepts and clinical management: a literature review

O tratamento endodôntico de dentes com rizogênese incompleta requer uma atenção especial, uma vez que o tratamento convencional é inviável e devemos evitar a perda dos dentes permanentes. Na maioria das vezes, as causas que interrompem a formação radicular são os traumatismos dentários e as cáries extensas, que podem atingir a polpa coronária, podendo levar, inclusive, à necrose pulpar. Atualmente, esses casos têm sido tratados por meio da apicificação, apicogênese e da revascularização pulpar, com uso de medicações a base de hidróxido de cálcio, antibiótico e MTA (Agregado trióxido mineral). Nessas técnicas, a intenção é induzir o desenvolvimento radicular completo ou o fechamento apical por tecido duro calcificado. O objetivo deste trabalho foi realizar uma breve revisão de literatura, utilizando artigos científicos disponíveis nas plataformas Café (UFF), Scielo e PubMed, a fim de descrevermos os conceitos de apicificação, apicogênese e revascularização, expondo as suas indicações e condutas clínicas ideais para a realização destes tratamentos. Pode-se concluir que são procedimentos clínicos simples e de conhecimento extremamente importantes para qualquer cirurgião-dentista, uma vez que são tratamentos emergenciais bastante comuns no dia a dia. Além disso, sabe-se da necessidade de manter um dente permanente sadio na boca, que pode evitar grandes problemas no futuro.

Endodontic treatment on teeths with incomplete rhizogenesis requires special attention, since conventional treatment is infeasible and we must avoid the loss of permanent teeth. Most often, the causes that interrupt root formation are dental trauma and extensive caries, which can reach the coronary pulp and may even lead to pulpal necrosis. Currently, these cases have been treated through apexification, apexogenesis and pulpal revascularization, with the use of calcium hydroxide, antibiotic and MTA (Aggregate mineral trioxide) base medications. In these techniques, the intent is to induce complete root development or apical closure by calcified hard tissue. The objective of this work was to carry out a review of literature, using scientific articles available on the Café platform (UFF), Scielo and PubMed, in order to describe the concepts of apexification, apexogenesis and revascularization, exposing their indications and ideal clinical procedures for the realization of these treatments. It can be concluded that they are simple clinical procedures and of knowledge extremely important for any dentist, since they are emergency treatments that are quite common day by day. In addition, it is known that one needs to maintain a permanent healthy tooth in the mouth, which can avoid major problems in the future.

Phosphocalcic Profile of Chronic Kidney Disease at Libreville

Introduction: As kidney function declines towards the more severe stages of chronic kidney disease (CKD), the interactions between kidney, intestine and bone become increasingly unstable. CKD with mineral and bone disorders and secondary hyperparathyroidism would be developing. The aim of this study was to determine the phosphocalcic profile of CKD patients in Libreville.Materials and Methods: This was a cross sectional study with 89 CKD patients recruited. A blood sample was taken to measure PTH, vitamin D, FGF-23 by ELISA method; calcium, magnesium, fasting blood glucose, phosphate and creatinine by spectrophotometer.Results: Mean phosphorus levels were 1.3 � 0.5 mmol/L and hormone levels 81.8 � 26.2 pg/mL and 27.5 � 5.0 ng/mL for PTH and vitamin D respectively. Significant hyperphosphatemia was found among 43 (48.3%; p=0.0135) patients. There were 59 (66.3%) subjects with hypovitaminosis D p=0.0000. Less than 50% of patients had normal blood glucose levels (p=0.0034). PTH was 99.4 � 16.4 pg/mL in dialysis patients and 61.7 � 20.3 pg/mL in non-dialysis patients, with a p=0.0000. Vitamin D levels were significantly higher in patients without calcium supplementation (29.5 � 5.0 ng/mL) than in those with supplementation (25.1 � 4.0 ng/mL, p= 0.0000).Conclusion: Phosphate levels remained high in our study population. Vitamin D deficiency was found in the majority of our patients. It would be advisable to readjust the management of these patients in order to minimize the effects of hyperphosphatemia and improve life quality.

Study on Body Composition of Patients with Diabetes Mellitus by Dual-Energy X-Ray Absorptiometry: A Morphological Study / Estudio sobre la Composición Corporal de Pacientes con Diabetes Mellitus Mediante Absorciometría de Rayos X de Energía Dual: Un Estudio Morfológico

SUMMARY: Diabetes is a form of endocrine disease. Dual-energy X-ray Absorptiometry (DXA) provides a detailed view of the body composition to find out what makes people with diabetes different from those with other diseases. We scanned 371 patients with DXA to analyze their body composition parameters. Three hundreds and seventy one patients (178 women/193 men), who with different diseases, with a mean±SD Body Mass Index (BMI) of 25.32±8.3 kg/m2 were included. The body composition of 371 patients was assessed. Bone Mineral Density (BMD), Fat Weight, Lean Weight, waist-to-hip ratio, Lean Mass Index (LMI), Fat Mass Index (FMI), the relationship between Fat percentage and BMI were analyzed. The 371 patients included 156 diabetics and 215 non-diabetics. Non-diabetic patients also included 5 obesity patients, 9 patients with fatty liver, 39 patients with hypertension, 22 patients with hyperlipidemia, 18 patients with cardiovascular disease, 11 patients with chest and lung disease, 4 patients with chronic disease, 14 patients with brain disease and 93 patients with other diseases. Among 156 diabetic patients, 129 had VAT > 100 cm2 and 27 had VAT ≤100 cm2. The lean weight (LW) of male diabetic patients was significantly higher than that of female diabetic patients. The fat weight (FW) of female patients with diabetes was significantly higher than that of male patients. The waist-hip ratio (WHR) was 1.37 ± 0.25 in male diabetic patients and 1.18 ± 0.21 in female diabetic patients. Among the 215 non-diabetic patients, the obese and fatty liver patients, which the weight (WT) (obesity: 83.87 ± 8.34 kg fat liver: 85.64±28.60 kg), FW (obesity: 28.56 ± 4.18 kg fat liver: 28.61 ± 10.79 kg), LW (obesity: 52.62 ± 9.64 kg fat liver: 54.29±17.58 kg), BMI (obesity: 28.76 ± 1.88 kg/m2 fat liver: 29.10 ± 5.95 kg/m2), was much higher than other patients. Diabetes patients had less fat mass than non- diabetic patients; the difference was around 2 kg. BMI is also a modest number. BMD doesn't differ all that much. Non-diabetic patients with fatty liver obesity and cardiovascular disease had higher fat mass and BMI than patients with other illnesses. Body composition can provide precise information on the makeup of different body areas, but further in-depth exams are required to ascertain the body's endocrine profile.

La diabetes es una enfermedad endocrina. La absorciometría de rayos X de energía dual (DXA) proporciona una vista detallada de la composición corporal para descubrir qué diferencia a las personas con diabetes de aquellas con otras enfermedades. Escaneamos a 371 pacientes con DXA para analizar sus parámetros de composición corporal. Se incluyeron 371 pacientes (178 mujeres/193 hombres), con diferentes enfermedades, con un Índice de Masa Corporal (IMC) medio ± DE de 25,32 ± 8,3 kg/m2. Se evaluó la composición corporal de 371 pacientes. Se analizaron la densidad mineral ósea (DMO), el peso graso, el peso magro, la relación cintura-cadera, el índice de masa magra (LMI), el índice de masa grasa (FMI), y la relación entre el porcentaje de grasa y el IMC. De los 371 pacientes 156 eran diabéticos y 215 no diabéticos. Los pacientes no diabéticos también incluyeron 5 con obesidad, 9 con hígado graso, 39 con hipertensión, 22 con hiperlipidemia, 18 con enfermedad cardiovascular, 11 con enfermedad torácica y pulmonar, 4 con enfermedad crónica, 14 con enfermedad cerebral y 93 pacientes con otras enfermedades. Entre los 156 pacientes diabéticos, 129 tenían un IVA > 100 cm2 y 27 tenían un IVA ≤100 cm2. El peso magro (PV) de los hombres diabéticos fue significativamente mayor que el de las mujeres diabéticas. El peso graso (FW) de las mujeres diabéticas fue significativamente mayor que el de los hombres diabéticos. El índice cintura-cadera (ICC) fue de 1,37 ± 0,25 en hombres diabéticos y de 1,18 ± 0,21 en mujeres diabéticas. Entre los 215 pacientes no diabéticos, los pacientes obesos y con hígado graso, cuyo peso (WT) (obesidad: 83,87 ± 8,34 kg hígado graso: 85,64 ± 28,60 kg), FW (obesidad: 28,56 ± 4,18 kg hígado graso: 28,61 ± 10,79 kg), PV (obesidad: 52,62 ± 9,64 kg, hígado graso: 54,29 ± 17,58 kg), IMC (obesidad: 28,76 ± 1,88 kg/m2, hígado graso: 29,10 ± 5,95 kg/m2), fue mucho mayor que otros pacientes. Los pacientes diabéticos tenían menos masa grasa que los pacientes no diabéticos; la diferencia fue de alrededor de 2 kg. La DMO no difiere mucho. Los pacientes no diabéticos con obesidad debido al hígado graso y enfermedades cardiovasculares tenían mayor masa grasa e IMC que los pacientes con otras enfermedades. La composición corporal puede proporcionar información precisa sobre la composición de diferentes áreas del cuerpo, pero se requieren exámenes más profundos para determinar el perfil endocrino del cuerpo.

Whitening toothpastes effect on enamel surface morphology, chemical profile and color: An In Vitro study / Efecto de las pastas dentales blanqueadoras sobre la morfología, el perfil químico y el color de la superficie del esmalte: un estudio In Vitro

Abstract To assess the effect of different whitening toothpastes on enamel surface morphology, chemical profile and their whitening efficiency. Sixty teeth were divided into 5 groups (12 teeth/group); Gp I: brushed with no toothpaste. Gp II: brushed with Pearl-based toothpaste. Gp III: brushed with Charcoal- based toothpaste. Gp IV: brushed with Alumina-based toothpaste. Gp V: brushed with salt and lemon- based toothpaste. Each tooth was brushed with a bean sized toothpaste wetted with distilled water twice daily by using standard electronic toothbrush for four weeks. Enamel surface morphology, chemical profile and color of each tooth were investigated. Chemical profile results and color measurements were analyzed statistically. Gp I revealed normal enamel surface morphology and chemical profile. Gp II and Gp III demonstrated surface morphology close to Gp I with insignificant reduction in mineral content. Gp IV showed obvious shallowing of perikymata ridges, exposure of fish-scale appearance, with pits and depressions, alongside to the significant reduction in mineral content. Gp V presented the most enamel surface alteration with widening of prism sheath and depressions all over the surface, besides the highest significant reduction in mineral content. Gp V, followed by Gp IV, demonstrated the highest color and whiteness changes, followed by Gp III, then Gp II, while the lowest value was in Gp I. Salt & lemon-based toothpaste, followed by Alumina-based, exerted the most considerable changes in the morphology and chemical profile of the enamel surface, beside to the higher whitening effects on teeth than the others.

Resumen El objetivo del presente estudio fue evaluar el efecto de diferentes pastas dentales blanqueadoras sobre la morfología y el perfil químico de la superficie del esmalte y su eficacia blanqueadora. Sesenta dientes se dividieron en 5 grupos (12 dientes/grupo); Grupo I: cepillado sin pasta de dientes. Grupo II: cepillado con pasta de dientes a base de perlas. Grupo III: cepillado con pasta de dientes a base de carbón. Grupo IV: cepillado con pasta de dientes a base de Alúmina. Grupo V: cepillado con sal y pasta de dientes a base de limón. Cada diente se cepilló con una pasta de dientes del tamaño de un frijol humedecida con agua destilada dos veces al día utilizando un cepillo de dientes electrónico estándar durante cuatro semanas. Se investigaron la morfología de la superficie del esmalte, el perfil químico y el color de cada diente. Los resultados del perfil químico y las mediciones de color se analizaron estadísticamente. El Grupo I reveló una morfología de la superficie del esmalte y un perfil químico normales. Los Grupos II y III demostraron una morfología de superficie cercana a la del Grupo I con una reducción insignificante en el contenido mineral. El grupo IV mostró una evidente reducción de las crestas perikymatas, exposición de apariencia de escamas de pez, con hoyos y depresiones, junto con una reducción significativa en el contenido mineral. El grupo V presentó la mayor alteración de la superficie del esmalte con ensanchamiento de la vaina del prisma y depresiones en toda la superficie, además de una significativa reducción en el contenido mineral. El grupo V, seguido del grupo IV, demostró los mayores cambios de color y blancura, seguido del grupo III, luego el grupo II, mientras que el valor más bajo se presentó en el grupo I. Las pastas dentales a base de sal y limón, seguidas de las de alúmina, ejercieron los cambios más considerables en la morfología y el perfil químico de la superficie del esmalte, además de tener mayores efectos blanqueadores sobre los dientes que las demás.

Assessment of atherosclerosis and endothelial dysfunction risk factors in patients with primary glomerulonephritis / Avaliação dos fatores de risco de aterosclerose e disfunção endotelial em pacientes com glomerulopatias primárias

Abstract Introduction: Glomerulonephritis are the third cause of chronic kidney disease (CKD) requiring dialysis in Brazil. Mineral and bone disorder (MBD) is one of the complications of CKD and is already present in the early stages. Assessment of carotid intima-media thickness (CIMT) and flow-mediated vasodilatation (FMV) are non-invasive ways of assessing cardiovascular risk. Hypothesis: Patients with primary glomerulonephritis (PG) have high prevalence of atherosclerosis and endothelial dysfunction, not fully explained by traditional risk factors, but probably influenced by the early onset of MBD. Objective: To evaluate the main markers of atherosclerosis in patients with PG. Method: Clinical, observational, cross-sectional and controlled study. Patients with PG were included and those under 18 years of age, pregnants, those with less than three months of follow-up and those with secondary glomerulonephritis were excluded. Those who, at the time of exams collection, had proteinuria higher than 6 grams/24 hours and using prednisone at doses higher than 0.2 mg/kg/day were also excluded. Results: 95 patients were included, 88 collected the exams, 1 was excluded and 23 did not undergo the ultrasound scan. Patients with PG had a higher mean CIMT compared to controls (0.66 versus 0.60), p = 0.003. After multivariate analysis, age and values for systolic blood pressure (SBP), FMV and GFR (p = 0.02); and FMV and serum uric acid (p = 0.048) remained statistically relevant. Discussion and conclusion: The higher cardiovascular risk in patients with PG was not explained by early MBD. Randomized and multicentric clinical studies are necessary to better assess this hypothesis.

Resumo Introdução: Glomerulopatias são a terceira causa de doença renal crônica (DRC) com necessidade de diálise no Brasil. Distúrbio mineral e ósseo (DMO) é uma das complicações da DRC e está presente já nos estágios iniciais. A avaliação da espessura médio-intimal de carótidas (EMIC) e da vasodilatação fluxo-mediada (VFM) são maneiras não invasivas de avaliação do risco cardiovascular. Hipótese: Pacientes com glomerulopatias primárias (GP) apresentam alta prevalência de aterosclerose e disfunção endotelial, não explicada totalmente pelos fatores de risco tradicionais, mas provavelmente influenciada pela instalação precoce do DMO. Objetivo: Avaliar os principais marcadores de aterosclerose em pacientes com GP. Método: Estudo clínico, observacional, transversal e controlado. Foram incluídos portadores de GP e excluídos menores de 18 anos, gestantes, menos de três meses de seguimento e os com glomerulopatia secundária. Também foram excluídos aqueles que, no momento da coleta, apresentavam proteinúria maior que 6 gramas/24 horas e uso de prednisona em doses superiores a 0,2 mg/kg/dia. Resultados: 95 pacientes foram incluídos, 88 colheram os exames, 1 foi excluído e 23 não realizaram a ultrassonografia. Os pacientes com GP apresentaram maior EMIC média em relação ao controle (0,66 versus 0,60), p = 0,003. Após análise multivariada, mantiveram relevância estatística a idade e os valores de pressão arterial sistólica (PAS), VFM e TFG (p = 0,02) e VFM e ácido úrico sérico (p = 0,048). Discussão e conclusão: Pacientes com GP apresentaram maior risco cardiovascular, entretanto esse risco não foi explicitado pelo DMO precoce. Estudos clínicos randomizados e multicêntricos são necessários para melhor determinação dessa hipótese.

Influence factors of bone mineral density and its correlation with insulin resistance in obese children in Qianjiang area / 公共卫生与预防医学

Objective To explore the influencing factors of bone mineral density (BMD) in obese children in Qianjiang area and analyze the correlation between BMD and insulin resistance. Methods The data on pediatric cases from the outpatient department of Jianghan Oilfield General Hospital in Qianjiang from January 2018 to December 2022 were collected. A total of 183 obese children who met the inclusion and exclusion criteria were included in the study and selected in the observation group. A total of 352 children undergoing physical examination during the same period were selected as the control group. Results The body mass, waist circumference, waist to hip ratio, and BMI of obese children were significantly higher than those of the control group (P<0.001). Biochemical indexes including FBG, FINS, Home-IR, ALP, and LDL-C in obese children were significantly higher than those in the control group (P<0.05), while bone mineral density, Ca, P, sOC and HDL-C were significantly lower than those in the control group (P<0.001). The bone mineral density of obese children was significantly correlated with their exercise intensity, sunshine exposure duration, sitting time, intake of milk and dairy products, intake of sweets, supplementation of trace elements, BMI, Home-IR, and sex (all P<0.05). BMI, Home-IR, sex, exercise intensity, and sunshine exposure length were independent risk factors affecting bone mineral density of obese children (all P<0.05). Bone mineral density was negatively correlated with BMI and Home-IR (P=0.028 and0.017, respectively), and positive correlation with exercise intensity and sunlight exposure (P=0.033). Conclusion BMD of obese children in Qianjiang area is affected by gender, body mass index, diet, vitamin intake, and physical activity, and is negatively correlated with insulin resistance. Home-IR can be used as a reference for screening BMD of obese children.

Clinical risk factors for chronic complications in patients with type 2 diabetes and their correlation with bone mineral density and 1,25-dihydroxyvitamin D3 / 公共卫生与预防医学

Objective To analyze the clinical risk factors for chronic complications in patients with type 2 diabetes and their correlation with bone mineral density and 1,25-dihydroxyvitamin D3. Methods A total of 163 patients with type 2 diabetes mellitus were selected as research subjects and were divided into complication group and non-complication group according to the presence or absence of chronic complications. The independent related factors for chronic complications in patients with type 2 diabetes mellitus were analyzed. Spearman rank correlation analysis was used to evaluate the correlation between bone mineral density, 1,25-dihydroxyvitamin D3 and chronic complications. Results Among the 326 patients with type 2 diabetes mellitus, 202 developed chronic complications (61.96%), including 71 cases of cardiovascular disease, 59 cases of neuropathy, 33 cases of renal lesion, and 28 cases of retinopathy. There were statistically significant differences in the duration of diabetes mellitus, fasting blood glucose, systolic blood pressure, glycosylated hemoglobin, triglyceride, low density lipoprotein cholesterol, serum creatinine, bone mineral density, and 1,25-dihydroxyvitamin D3 between the complication group and the non-complication group (P<0.05). Logistic multivariate regression analysis showed that the duration of diabetes mellitus, systolic blood pressure, glycosylated hemoglobin, ow density lipoprotein cholesterol, serum creatinine, bone mineral density, and 1,25-dihydroxyvitamin D3 were all independent related factors for the occurrence of chronic complications in patients with type 2 diabetes mellitus (P<0.05). Spearman correlation analysis showed that bone mineral density and 1,25-dihydroxyvitamin D3 were negatively correlated with chronic complications (P<0.05). Conclusion Bone mineral density and 1,25-dihydroxyvitamin D3 in patients with type 2 diabetes mellitus are closely related to chronic complications.

Effects of microRNA-103a-3p on osteoporosis through tumor protein 53-regulated inhibitor of apoptosis 1/P53 / 解剖学报

Objective To investigate the efeects of microRNA(miR)-103a-3p regulates tumor protein 53-regulated inhibitor of apoptosis 1(TRIAP1)on osteoblast differentiation and bone mass in ovariectomized mice.Methods MC3T3-E1 cells were divided into normal group,miR-103a-3p-NC group,miR-103a-3p mimic group,miR-103a-3p mimic+TRIAP1-NC group,miR-103a-3p mimic+TRIAP1 mimic group.mRNA expression of miR-103a-3p,TRIAP1,P53 were detected by Real-time PCR;Cell proliferation and apoptosis were detected by MTT test and flow cytometry;cytoskeleton and mineralization of cells were detected by F-actin immunofluorescence staining and alizarin staining;alkaline phosphatase(ALP)activity was detected by ELISA.24 female mice were divided into sham group,osteoporosis(OP)group,miR-103a-3p antagonist-NC group,miR-103a-3p antagonist group(six in each group),extract bilateral ovaries to establish an OP model,sham group mice only isolated fat around ovarian tissue.mRNA expression of miR-103a-3p,TRIAP1,P53,ALP,osteocalcin(OCN),osteopontin(OPN)of bone tissue were detected;microCT detect bone mineral density(BMD),bone mineral content(BMC);haematoxylin eosin staining was used to observe pathological changes of bone tissue.Results After miR-103a-3p mimic was transfected into cells,the miR-103a-3p and P53 expression increased,TRIAP1 expression decreased,cell proliferation decreased,apoptosis increased,F-actin expression decreased,the number of calcium nodules decreased,and ALP enzyme activity decreased(P<0.01);however,after TRIAP1 mimic was additionally transfected into cells,the above result caused by miR-103a-3p mimics were significantly reversed(P<0.01).In OP group,the miR-103a-3p and P53 expression in bone tissue increased,the TRIAP1,ALP,OCN and OPN expression decreased,BMD and BMC were decreased,and bone tissue construct was damaged(P<0.05);in miR-103a-3p antagonist group,the miR-103a-3p and P53 expression in bone tissue decreased,TRIAP1,ALP,OCN,OPN expression increased,BMD and BMC increased,and bone tissue construct was improved(P<0.05).Conclusion MiRNA-103a-3p mediate TRIAP1/P53 to inhibit proliferation and mineralization of osteoblast,while miR-103a-3p antagonistic treatment reduce bone loss in OP mice.

Correlation between Bone Density at Different Hip Positions with Muscle Parameters and Physical Performance in Middle-aged and Elderly People in Kunming Area / 昆明医科大学学报

Objective To investigate the correlation between bone mineral density(BMD)at different hip positions with muscle parameters and physical performance in middle-aged and elderly people in Kunming area.Methods 531 middle-aged and elderly volunteers were recruited from the Radiology Department of the First People's Hospital of Yunnan Province from May 2021 to April 2022.All study subjects completed the five-times-sit-to-stand test(FTSST)and hip quantitative CT(QCT)examinations.Volunteers'total hip(TH),femoral neck(FN),and intertrochanteric(IT)BMD were measured by using QCT PRO workstation and using OsiriX software to measure the area and density of their gluteus maximus muscle,gluteus medius,and minimus muscle and midthigh muscle.Divide male and female volunteers into positive and negative groups respectively based on FTSST time≥12 seconds or<12 seconds,and analyze the differences in hip BMD between the groups;Also divide male and female volunteers into three groups(50～59 years old,60～69 years old,70 years old and above)at the age of 10,and analyze the correlation between hip BMD and muscle parameters in different age and gender stratification.Control for age and BMI,and then perform partial correlation analysis on the above indicators.Results The BMD of the hip in the female FTSST positive group was lower than that in the negative group(P<0.001),while there was no statistically significant difference between the male groups(P>0.05).After adjusting for age and BMI,among males,FN BMD was positively correlated with gluteus medius and minimus muscle density in the age groups of 50～59 and 60～69(P<0.05),while TH BMD,FN BMD,and IT BMD were strongly positively correlated with gluteus medius and minimus muscle density in the age group over 70(P<0.05).For females,the correlation between hip BMD and muscle density in the age groups of 50～59 and 60～69 was weak,while BMD in all parts of the hip was not correlated with muscle density in the age group over 70(P>0.05).There was a negative correlation between TH BMD,FN BMD,and gluteus medius and minimus muscle area in the age group of 50～59 years old for males(P<0.05),while there was a significant negative correlation between TH BMD,IT BMD,and gluteus maximus area in the age group of 70 years old and above for females(P<0.05).Conclusion The BMD of various parts of the hip in the female FTSST positive group is lower than that in the negative group.The density of the gluteus medius and minimus muscle can to some extent serve as a predictive indicator of femoral neck bone strength in middle-aged and elderly men in Kunming area.

Effectiveness research of opportunistic screening for osteoporosis based on chest CT and deep convolutional neural network / 实用放射学杂志

Objective To analyze the feasibility and efficacy of a deep convolutional neural network(DCNN)model based on chest CT images to evaluate bone mineral density(BMD).Methods A total of 1 048 health check subjects'2 096 central level images of lumbar 1 and 2 vertebral bodies were used for experiments and analysis in this retrospective study.According to the results of quanti-tative computed tomography(QCT)BMD measurement,the subjects were divided into three categories:normal,osteopenia,osteopo-rosis(OP).Herein,a DCNN segmentation model was constructed based on chest CT images[training set(n=1 096),tuning set(n=200),and test set(n=800)],the segmentation performance was evaluated using the Dice similarity coefficient(DSC)to com-pare the consistency with the manually sketched region of vertebral body.Then,the DCNN classification models 1(fusion feature construction of lumbar 1 and 2 vertebral bodies)and model 2(image feature construction of lumbar 1 alone)was developed based on the training set(n=530).Model performance was compared in a test set(n=418)by the receiver operating characteristic(ROC)curve analysis.Results When the number of images in the training set(n=300)was adopted,the DSC value was 0.950 in the test set.The results showed that the sensitivity,specificity and area under the curve(AUC)of model 1 and model 2 in diagno-sing osteopenia and OP were 0.716,0.960,0.952;0.941,0.948,0.980;0.638,0.954,0.940;0.843,0.959,0.978,respectively.The AUC value of normal model 1 was higher than that of model 2(0.990 vs 0.983,P=0.033),while there was no significant difference in AUC values between osteopenia and OP(P=0.210,0.546).Conclusion A DCNN may have the potential to evaluate bone mass based on chest CT images,which is expected to become an effective tool for OP screening.

Application of quantitative CT-based imaging histology in the diagnosis of osteoporosis / 实用放射学杂志

Objective To investigate the application value of quantitative computed tomography(QCT)-based imaging histology in the diagnosis of clinical osteoporosis.Methods A total of 182 patients who underwent QCT scans of the chest or abdomen were ana-lyzed retrospectively,and the patients were divided into osteoporosis group(56 cases)and non-osteoporosis group(126 cases)accord-ing to the bone mineral density(BMD)values measured by QCT.The cases were randomly divided into training set(110 cases)and validation set(72 cases)at a ratio of 6︰4.The L1-L2 vertebrae were outlined with the region of interest(ROI)and the image features were extracted using ITK-SNAP 3.6.0 and A.K.software.(1)Radiomics score(Rad-score)model was established using maximum relevance minimum redundancy(mRMR)and least absolute shrinkage and selection operator(LASSO)algorithm.(2)The L1 and L2 vertebrae BMD value and T-value from the dual energy X-ray absorptiometry(DXA)examination of the patient were obtained to build the model separately for analysis and for comparison with the Rad-score model.(3)The discriminative ability,clinical applica-tion performance and calibration ability of Rad-score in the training and validation sets were evaluated using receiver operating charac-teristic(ROC)curves,decision curve analysis(DCA)and calibration curves.(4)Data on sensitivity,specificity,accuracy and area under the curve(AUC)were used to compare the predictive ability of DXA and Rad-score.DeLong test was used for comparison of differences between Rad-score and DXA models.Results Four optimal ima-ging histology features were finally selected to create Rad-score model,which confirmed the significant correlation between Rad-score and QCT for the diagnosis of osteoporosis.The calibration curve showed that Rad-score model had a good fit in both the training set and the validation set.The results of the DeLong test showed that the AUC of Rad-score model were greater than those of DXA model.Conclusion The QCT-based imaging histology model has high sen-sitivity,specificity and accuracy,with outstanding advantages and good performance for osteoporosis diagnosis,and is superior to the DXA model.

Meta-analysis of efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures / 中国组织工程研究

OBJECTIVE:To compare the efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures through a Meta-analysis. METHODS:By searching PubMed,Cochrane Library,EMbase,CNKI,WanFang and VIP databases,18 randomized controlled studies on terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures were included according to inclusion and exclusion criteria.Endnote X9 software was used to manage the literature and Revman 5.3 software was used to perform a Meta-analysis on the extracted data.The incidences of vertebral fracture,non-vertebral fracture and adverse reaction in postmenopausal osteoporosis patients treated with terlipatide and bisphosphate were analyzed. RESULTS:A total of 18 randomized controlled studies were included,of which 10 were of medium and high quality and 8 were of low quality.Meta-analysis results showed that the fracture incidence in the teriparatide group[risk ratio(RR)=0.56,95%confidence interval(CI):0.48-0.66,P＜0.000 01]was lower than that in the bisphosphonate group,and teriparatide was superior to alendronate in preventing fractures in postmenopausal women with osteoporosis(RR=0.50,95%CI:0.35-0.69,P＜0.000 1)and other bisphosphonates(RR=0.58,95%CI:0.49-0.70,P＜0.000 01).During the follow-up over 18 months,teriparatide was superior to bisphosphonates in preventing fractures in postmenopausal women with osteoporosis(RR=0.56,95%CI:0.48-0.69,P＜0.000 01).In addition,we found that teriparatide was superior to bisphosphonates in preventing vertebral fractures(RR=0.48,95%CI:0.37-0.62,P＜0.000 01)and non-vertebral fractures(RR=0.63,95%CI:0.51-0.78,P＜0.000 1)in postmenopausal women with osteoporosis.Teriparatide was superior to bisphosphonates in increasing lumbar bone density[odds ratio=4.16,95%CI:2.96-5.36,P＜0.000 1)and femoral neck bone density(odds ratio=1.02,95%CI:0.04-2.01,P=0.04).There was no significant difference in adverse reactions between teriparatide and bisphosphonates(RR=0.95,95%CI:0.85,1.06,P=0.37). CONCLUSION:Teriparatide is superior to bisphosphonates in preventing vertebral and non-vertebral fractures in postmenopausal women with osteoporosis,but the safety and adverse drug reactions of teriparatide and bisphosphonates are basically similar.Teriparatide is superior to bisphosphonate in preventing fracture and improving lumbar and femoral neck bone density regardless of short-term(＜18 months)or long-term(≥18 months)use.