OSTEOPOROSIS FROM YESTERDAY TO TODAY ­ A NARRATIVE REVIEW

Despite different lifestyles, humankind has suffered from osteoporosis for thousands of years. A literature review concerning the history of osteoporosis in the following databases: Index Medicus, Medline, PubMed, and PMC Citations was done. In the final analysis, 18 review articles and 31 original papers were included. The works were published during the period 1705-2020. Although there is evidence of the existence of osteoporosis for many centuries, it was first described as a disease at the beginning of the 18th century. It was first perceived as an unavoidable course of aging with no possibility to cure. This approach changed only in the 20th century thanks to sudden diagnostic and therapeutic progress. This paper presents the milestones and most important researchers in osteoporosis history. Rapid progress in diagnostic and therapeutic possibilities sheds new light on osteoporosis' nature. A comprehensive outlook on its history may help find answers for the still unsolved problems of this disease.

Clinical Conformity Between Heel Ultrasound and Densitometry in Postmenopausal Women: A Systematic Review.

OBJECTIVES: To assess the conformity between heel ultrasound and densitometry, and the clinical application of densitometry T-score "gold standard" in quantitative ultrasound as a method of osteoporosis diagnosis in postmenopausal women. METHODS: The study is a systematic review of studies published in the last 17 years in PubMed, NLM Gateway, Medline, Embase, and Cochrane Library. Calcaneal quantitative ultrasound sensitivity and specificity were analyzed with regard to densitometry measurements in postmenopausal women. In addition, we summarized the values of ultrasound T-scores, for which their accuracy in osteoporosis diagnosis is the highest. RESULTS: The inclusion criteria met 15 research studies conducted on postmenopausal women. In 11 of them, the authors concluded that clinical conformity between heel ultrasound and densitometry is good. The recommended quantitative ultrasound T-score for osteoporosis diagnosis ranged between -1 and -3.65. CONCLUSIONS: Heel ultrasound should be considered to be as accurate as densitometry in diagnosing osteoporosis. Nevertheless, it needs to have separate T-score ranges determined, because those used in densitometry are not adequate.

Steatosis influences hepatocytes proliferative potential in chronic hepatitis C patients.

The study evaluates the influence of steatosis on hepatocytes proliferative potential, reflected by proliferating cell nuclear antigen (PCNA) expression in chronic hepatitis C (CHC) patients both in steatotic and non-steatotic areas of lobules. The liver histology was evaluated according to Kleiner's score. Nonalcoholic steatohepatitis (NASH) was also defined as the presence of lobular inflammation, hepatocyte ballooning and steatosis. Expression of PCNA was significantly in patients with definite NASH compared to those with simple steatosis, but not to those with borderline NASH. Advanced steatosis negatively influenced PCNA expression. NASH not only affects PCNA expression in staetotic, but also in non-steatotic lobule areas. Expression of PCNA could be an independent indicator of changes in hepatocyte metabolism in CHC patients. High NAS values and low PCNA expression may be a negative prognostic factor in predicting the further course of the disease.

Quality of life in patients with prostate cancer treated with radical image-guided radiotherapy.

AIM OF THE STUDY: The evaluation of quality of life during image-guided radiotherapy (IGRT) in patients with prostate cancer. MATERIALS AND METHODS: The study consisted of 180 prostate cancer patients treated with radical radiotherapy (IGRT). The patients were irradiated using conformal or dynamic techniques with 2 Gy fractionation doses to a total dose of 76 Gy. Patients in the high-risk group (41%) were also irradiated to the pelvic lymph nodes. Quality of life was assessed with EORTC questionnaires: general QLQ-C30 and prostate-specific module QLQ-PR25, which were filled in by patients before and upon completion of radiotherapy. A change of ≥ 10 points in a linearised scale (0-100) was considered clinically significant. RESULTS: Global quality of life decreased slightly during radiotherapy (from 61 to 57 points), but from the clinical point of view, likewise most of the other quality of life parameters remained stable. In the general module (QLQ-C30) only diarrhoea changed in a clinically relevant way, i.e. by 10 points (from 10 to 20 points), which was mainly observed in patients with elective pelvic irradiation (increase of 18 points, from 10 to 28 points). In the prostate-specific module (QLQ-PR25) only urinary symptoms changed significantly, i.e. by 13 points (from 24 to 37 points). CONCLUSIONS: The quality of life in patients with prostate cancer does not change in a clinically significant way during radiotherapy, which corroborates good treatment tolerance. Increased urinary symptoms and, in the case of pelvic irradiation, also increased diarrhoea have a negative impact on symptom-related quality of life.