Evaluation of Bone Mineral Density in Patients with Chronic Low Back Pain

STUDY DESIGN: This was designed as a retrospective study. PURPOSE: We investigated the relationship between bone mineral density (BMD) and chronic lower back pain (LBP). OVERVIEW OF LITERATURE: In spite of a large number of epidemiological surveys on the prevalence of LBP and BMD measurements completed separately in the general population, the relationship between the two has not been well documented. METHODS: The study included 171 patients with chronic LBP who underwent the BMD study. The control group was selected from our database regarding BMD without LBP. RESULTS: A total of 678 subjects, aged 18 to 100 years (mean, 49.9+/-12.9 years) were included in the study, 25% (n=171) of the subjects had LBP. Compared to those patients without LBP, patients exhibiting LBP had statistically significant lower mean weight, hip and spine BMD and T-score. Lower BMD and T-scores were significant regardless of the age group, gender, menopausal status, and obesity classification. CONCLUSIONS: Chronic LBP has a negative correlation with hip and spine bone mineral density.

Relationship between leptin levels and suppressed CD4 counts in HIV patients

To examine the relationship between serum leptin levels and suppression of CD4 count in HIV-infected individuals with highly active antiretroviral therapy [HAART]. Thirty seropositive HIV male patients selected from the Infectious Disease Hospital were classified into two groups according to their immunological and virological response to HAART. The first group included 15 male patients with low viral load and low CD4 counts; the second included 15 male patients with low viral load and high CD4 counts. Morning serum leptin and tumor necrosis factor-alpha levels of HIV patients were measured and correlated with fasting serum insulin, Homeostasis Model Assessment for Insulin Resistance [HOMA-IR], HIV viral load and CD4 count. Serum leptin levels were significantly higher in patients with high CD4 counts than in patients with low CD4 counts [mean serum leptin level 47.3 vs. 10.9 ng/ml, respectively; p < 0.0001]. A positive correlation was observed between serum leptin levels and CD4 counts [r = 0.697; p < 0.0001]; positive correlations were also seen between leptin levels and fasting serum insulin and HOMA-IR [r = 0.633, p < 0.0001, and r = 0.537, p < 0.003, respectively]. Serum leptin level was higher in HIV patients with high CD4 count and correlated with fasting serum insulin and HOMA-IR, thereby indicating that HAART treatment could lead to decreased levels of leptin in HIV patients, which might lead to impaired immunological recovery

Asthma during pregnancy: an immunologic perspective

Asthma is one of the most common medical conditions to complicate pregnancy and represents a significant public health issue. Increased maternal complications and adverse fetal outcomes are associated with asthma during pregnancy. Since asthma can adversely affect the outcome of pregnancy, it is important for us to understand the mechanisms underlying asthma during pregnancy. In general, asthma is characterized by an up-regulated systemic production of T-helper 2 [Th2] cytokines. Pregnancy also brings about changes in maternal immune status making it polarized towards the Th2 phenotype. Based on these considerations, we hypothesize that pregnancy-induced immune alterations may modify allergic mechanisms of asthma and that systemic Th2 cytokine and chemokine polarization does occur among asthmatics to a greater extent during pregnancy. We suggest that this is associated with exacerbation of asthma during pregnancy. The pathophysiology of asthma during pregnancy and the interrelationship between these two conditions are reviewed here