Comparative evaluation of xenobiotics in human and dietary milk: persistent organic pollutants and mycotoxins.

Publications produced over the past 20 years regarding the concentration of xenobiotics in human and dietary milk were evaluated, focusing primarily on persistent organic pollutants (e.g. polychlorinated biphenyls, flame retardants), pesticides (e.g organochlorine) and mycotoxins. In general, countries of low industrialization rate present low levels of dietary milk contamination with dioxins compared to those with high rate of industrialization. According to published data, the most common persistent organic pollutants detected in breast and dietary milk are dichlorodiphenyltrichloroethane compounds, hexachlorocyclohexane, and hexachlorobenzene. Even though the potential risks of persistent organic pollutants in human milk have been acknowledged, the beneficial effect of breastfeeding as the optimal food source for newborn babies should not be disregarded. Especially when sharing information with the general public, it should be made clear that the presence of dioxins and persistent organic pollutants in human milk is not an indication for avoiding breastfeeding. The implications of xenobiotics in human and dietary milk is a matter of growing importance and warrants future work given its important health effects.

Testicular abscesses due to Brucella melitensis.

Brucella may cause testicular masses, which may be confused with a testicular tumour. We present the case of a man with fever and oedema in the scrotum. Ultrasound and colour Doppler ultrasound with a 6 to 15 MHz high-frequency linear-array transducer was performed, revealing bilateral scrotal wall oedema, heterogeneous echo texture and slightly increased vascularization of the right testis, with hypoechoic lesions characterized by hypervascular margins and no flow within them. These findings were compatible with testicular abscesses. Three blood cultures grew Brucella melitensis, so the patient received treatment with doxycycline and rifampin for 8 weeks, which resulted in disappearance of the testicular abscesses.

Correlation of bone mineral density with the histological findings of renal osteodystrophy in patients on hemodialysis.

AIMS: To examine the distribution of bone mineral density (BMD) in different histological groups of renal osteodystrophy. PATIENTS: We prospectively studied 62 patients, 41 men and 21 women, aged 57+/-11.5 years, who had been on hemodialysis for 60+/-55 months. The women had been amenorrheic for 13+/-4 years and 7 patients (11%) had a positive fracture history. METHODS: A bone biopsy was taken after tetracycline labelling and BMD of the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry (DEXA); serum intact parathyroid hormone (iPTH), bone Gla protein (BGP), phosphorus, calcium and alkaline phosphatase (ALP) were also determined. RESULTS: Histologically, 40 patients showed secondary hyperparathyroidism (sHPT), 6 mixed bone disease, 14 adynamic bone disease (A) and 2 osteomalacia. BMD of the lumbar spine was decreased in 43 patients (69%) and in 9 (14.5%) it was lower than -2 Z score units. BMD of the femoral neck was low in 55 patients (89%) and in 22 (35.5%) it was lower than -2 Z scores. BMD was lower in patients with sHPT than in those with adynamic bone disease (p<0.05) in which it was close to normal. BMD in both these sites correlated inversely with the biochemical markers (serum iPTH, BGP and ALP) and the histomorphometric indices of bone turnover. CONCLUSIONS: Osteopenia is frequent in patients on hemodialysis, especially those with biochemical and histological findings of sHPT.

The type and time of menopause as decisive factors for bone mass changes.

BACKGROUND: Early menopause, whether it be natural or surgical, is one of the established risk factors for osteoporosis. Surgical menopause, however, differs from natural menopause owing to the abrupt cessation of estrogen secretion. This study attempts to investigate the influence of menopause type on bone mineral density (BMD) changes. METHODS: Four groups, each consisting of 30 women, were compared: early menopause (EMP), surgical menopause (SUMP) and two groups of natural menopause. The two groups share a similar number of years since menopause (YSM) but have a different chronological age (NMPO), or share a similar age but different YSM (NMPY) to the EMP and SUMP. BMD was measured by the DXA method at L2-L4 vertebrae and proximal femur. RESULTS: Mean vertebral BMD of EMP was lower than that of SUMP (P < 0.05) and of NMPY (P < 0.001) women. Femoral neck BMD did not differ between SUMP and EMP women but both exhibited significantly lower BMD than either natural menopause groups. BMD of SUMP and vertebral BMD of NMPY women was inversely correlated to chronological age and to number of YSM. Pertaining to T-score values according to the osteoporotic range, NMPO, EMP and SUMP women being homogeneous exhibited significantly lower values than NMPY in the vertebrae (F-ratio = 7.84, P < 0.001). Whereas, in the femoral neck and the trochanter major, EMP and SUMP categories presented significantly lower T-score values than the NMPO and NMPY (F = 3.61, P < 0.01 and 2.8, P < 0.05 respectively). CONCLUSION: Women with early menopause exhibit lower vertebral BMD than women of similar age after either surgical or natural menopause. In women of similar age, surgical menopause results in lower vertebral and femoral neck densities compared to natural menopause. Chronological age and the interval after menopause negatively affects bone density in women with similar age whether in surgical or natural menopause.

Bone mineral density of vertebrae, proximal femur and os calcis in normal Greek subjects as assessed by dual-energy X-ray absorptiometry: comparison with other populations.

Dual energy X-ray absorptiometry (DXA) is an established method for the detection of even small changes in bone mineral density (BMD). It thus allows the earliest possible diagnosis of osteopenia, with consequent prompt estimation of fracture risk. However, for proper evaluation of densitometry results it is essential that a comparison with reference BMD values of normal age- and sex-matched persons from the same population be performed. For this purpose we determined bone density of the L2-L4 vertebrae, the L3 vertebra in the lateral projection, the proximal femur and the os calcis in a cross-sectional study of 168 men and 244 women from the Greek population. The age range of the subjects was 20-80 years. Peak bone mass for both sexes was attained in the 30-35 year age group for the vertebrae and in the 25-30 year age group for the proximal femur and os calcis. Mean annual vertebral bone loss calculated on cross-sectional data ranged from 0.1% to 0.22% for women < 50 years and from 1.3% to 1.6% for those > 50 years, whereas in men the range was from 0.36% to 0.64% for the whole age spectrum. Regarding femoral neck, the values wer 0.3% (women < 50 years), 1.2-1.5% (> 50 years) and 0.6-0.8% for men. Total bone loss between ages 20 and 70 was 29.5% for the vertebrae and 32% for the femoral neck in women, whereas the values for men were 19.5% and 29% respectively. A positive correlation was observed between bone density, body weight and body height in both sexes. Body mass index correlated significantly with density only in postmenopausal women. Compared with North American, Finnish and German populations, Greek men presented with lower BMD values in the decades above 40 years. Greek women exhibited lower vertebral BMD values than those from the USA. Germany and Japan (50-60 age group), whereas they did not differ from those of Finnish women. However, femoral neck BMD in Greek women was higher than in Japanese women in all age groups.