Role of bisphenol A as environmental factor in the promotion of non-alcoholic fatty liver disease: in vitro and clinical study.

BACKGROUND: Bisphenol A is an endocrine disrupting chemical associated with type 2 diabetes mellitus (T2DM), cardiovascular disease and liver enzyme abnormalities. AIM: To evaluate bisphenol A plasma and urine levels in non-alcoholic fatty liver disease (NAFLD) patients compared to healthy subjects. Furthermore, we evaluated, in human HepG2 cells, the effects of exposure to different concentrations of bisphenol A on both oxidative stress induction and cell proliferation. METHODS: We enrolled 60 patients with histological diagnosis of NAFLD with or without T2DM and sixty healthy subjects. In vitro, the proliferation of bisphenol A-exposed HepG2 cells at two different concentrations (0.025 and 0.05 µM) was evaluated, both at high (H-HepG2) and at low (L-HepG2) glucose concentrations for 48 h. Lipoperoxidation was assessed by thiobarbituric acid reactive substances (TBARS) assay. RESULTS: Bisphenol A levels were significantly higher in 60 NAFLD subjects, both in urine and in plasma (P < 0.0001) when compared to controls and, in this group, it appeared to be higher in 30 non-alcoholic steatohepatitis patients compared to 30 simple steatosis subjects (P < 0.05), independently from the presence of T2DM. After a bisphenol A-free diet for 1 month, NAFLD patients showed a significant reduction in bisphenol A circulating levels (P < 0.05), without a significant reduction in urine levels. H-HepG2 cells treated with bisphenol A (0.05 µM) increased proliferation compared to controls at 48 h (P < 0.0001). Bisphenol A increased TBARS levels at 48 h versus controls. CONCLUSIONS: Our study reveals a possible role of bisphenol A as an environmental factor involved in the promotion of NAFLD, particularly in T2DM patients.

Vitamin K in hand osteoarthritis: results from a randomised clinical trial.

OBJECTIVES: Vitamin K has bone and cartilage effects, and previously shown to be associated with radiographic osteoarthritis. We evaluated vitamin K's effect on hand osteoarthritis in a randomised controlled trial. METHODS: This was an ancillary study to a randomised controlled trial assessing the effects of phylloquinone supplementation (vitamin K arm) versus placebo on bone loss and vascular calcification among older adults regardless of their vitamin K status. At the final 3-year study visit, we assessed the effects of vitamin K versus placebo on hand x-ray features of osteoarthritis using logistic regression and intention to treat, and also restricted analysis to the subgroup that had insufficient vitamin K concentrations at baseline. RESULTS: This ancillary study had 378 participants (193 in vitamin K arm, 185 in placebo arm). There were no effects of randomisation to vitamin K for radiographic osteoarthritis outcomes. Those with insufficient vitamin K at baseline who attained sufficient concentrations at follow-up had trends towards 47% less joint space narrowing (p = 0.02). CONCLUSIONS: There was no overall effect of vitamin K on radiographic hand osteoarthritis. SUBJECTS: that were insufficient in vitamin K at baseline who attained sufficient concentrations at follow-up may have had a benefit in joint space narrowing. A clinical trial in those who are vitamin K insufficient may be warranted. TRIAL REGISTRATION NUMBER: NCT00183001.

The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To test the effects of a high intensity home-based progressive strength training program on the clinical signs and symptoms of osteoarthritis (OA) of the knee. METHODS: Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 month home based progressive strength training program or a nutrition education program (attention control). Thirty-eight patients completed the trial with an adherence of 84% to the intervention and 65% to the attention control. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index pain and physical function subscales. Secondary outcomes included clinical knee examination, muscle strength, physical performance measures, and questionnaires to measure quality of life variables. RESULTS: Patients in the strength training group who completed the trial had a 71% improvement in knee extension strength in the leg reported as most painful versus a 3% improvement in the control group (p < 0.01). In a modified intent to treat analysis, self-reported pain improved by 36% and physical function by 38% in the strength training group versus 11 and 21%, respectively, in the control group (p = 0.01 for between group comparison). In addition, those patients in the strength training group who completed the trial had a 43% mean reduction in pain (p = 0.01 vs controls), a 44% mean improvement in self-reported physical function (p < 0.01 vs controls), and improvements in physical performance, quality of life, and self-efficacy when compared to the control group. CONCLUSION: High intensity, home based strength training can produce substantial improvements in strength, pain, physical function and quality of life in patients with knee OA.

Assessing the effect of radiocollars on juvenile guanaco survival.

To evaluate the potential impact of our research activities on guanacos (Lama guanicoe), we tested for effects of radiocollaring on juvenile (≤1 year of age) survival in Torres del Paine National Park, Chile during 1992-1996. The survival of collared (40.1%) and uncollared (38.2%) juveniles was not significantly different (G=0.08; P=0.77). Our results suggest that radiocollaring does not adversely affect the survival of juvenile guanacos. Although we observed no effect of radiocollaring, we still underline the importance of testing for effects of radiocollars in other wildlife investigations when feasible.

Immobilization of guanacos by use of tiletamine/zolazepam.

Adult male guanacos were immobilized by use of tiletamine/zolazepam. The effective dosage (mean +/- SD) was 5.0 +/- 1.1 mg/kg of body weight. Mean time from injection to immobilization was 7.3 minutes. Usually, immobilization was of sufficient duration (mean, 61 minutes) to allow guanacos to be weighed, measured, and to have ear tags inserted and blood samples collected. Adverse effects included twitching and rigidity of muscles, salivation, chewing movements, retching, vocalization, and stumbling during the recovery phase. All guanacos recovered without apparent complications.

Solubilized xenon 133 lung scintigraphy.

Lung scanning using solubilized xenon 133 can provide important information concerning both pulmonary perfusion and ventilation. This technique proved valuable in establishing the diagnosis of congenital lobar emphysema in a 7-month-old baby.

Indium-111-labeled leukocyte scintigraphy: diagnosis of subperiosteal abscesses complicating osteomyelitis in a child.

Preoperative 111In-labeled leukocyte scintigraphy demonstrated extensive subperiosteal abscesses complicating acute bilateral tibial osteomyelitis in a child. Plain radiographs showed only marked soft-tissue swelling; three-phase bone scintigraphy depicted both "hot" and "cold" areas consistent with acute osteomyelitis.

Detection of bacterial endocarditis with indium-111 labeled leukocytes.

Bacterial endocarditis in a patient with dense mitral annular calcification secondary to renal failure and hyperparathyroidism was detected by indium-111 labeled leukocyte imaging. Although the gallium-67 image was negative, echocardiography subsequently confirmed the diagnosis.

Detection of a prosthetic aortic valvular abscess with indium-111-labeled leukocytes.

An unsuspected annular abscess at the base of a prosthetic aortic valve in a patient with endocarditis was identified by indium-111-labeled leukocyte scintigraphy alone. This highly sensitive and specific technique expediently demonstrated the surgically proven inflammatory focus.

Arthroscopic treatment of medial meniscal avulsion fractures.

The meniscal ossicle is an infrequent radiographic finding in humans. It has long been recognized in relation to trauma to the meniscus. Previous theories as to the etiology of these ossicles have been that they are vestigial or result from metaplastic change in an area of injury. We present four patients with meniscal ossicles associated with a longitudinal tear of the medial meniscus. The origin of the ossicle was an avulsion of the insertion of the posterior horn of the medial meniscus. Arthroscopic resection in these patients resolved their symptoms.

Gallium-67 breast uptake in a patient with hypothalamic granuloma (sarcoid).

An unusual case is presented of bilateral breast uptake of [67Ga]citrate in a patient with a hypothalamic granuloma in the absence of galactorrhea is presented. A possible mechanism for this incidental finding is elevated prolactin levels, as other causes of gallium breast uptake such as drug therapy, and intrinsic breast disease, were not present.

Imaging of pelvic rhabdomyosarcoma by bone scintigraphy.

Urinary tract distortion caused by pelvic rhabdomyosarcoma was imaged during 99mTc-oxidronate bone scintigraphy for suspected metastatic disease. This appearance correlated well with the anatomy defined on other imaging modalities. Bone scanning also proved valuable in detecting an otherwise occult osseous metastasis from this unusual tumor.

A case of biliary atresia and polysplenia. Evaluation by hepatobiliary scintigraphy.

A 5-week old jaundiced female underwent hepatobiliary scintigraphy using technetium-99m disofenin. Early images suggested right-sided cardiac activity. A nearly symmetric, bilobed liver with left-sided predominance was discovered. No biliary ducts, gallbladder, or small bowel activity were demonstrated up to 24 hours post-injection. Laparotomy confirmed situs inversus, polysplenia, and extrahepatic biliary atresia.

CT detection of necrotising enterocolitis.

Necrotising enterocolitis may occur as a complication of granulocytopenia of any aetiology. The clinical presentation may be non-specific and the diagnosis therefore depends heavily on radiographic findings, particularly changes seen by CT. In immune-compromised patients being investigated for possible abdominal sources of fever, CT may be particularly helpful in elucidating bowel sources of infection. Two cases of necrotising enterocolitis demonstrated by CT are presented. The two cases were in immune-compromised patients with malignant disorders who presented with fever. The CT findings of this disorder are presented.