Chlamydia pneumoniae and osteoporosis-associated bone loss: a new risk factor?

UNLABELLED: We found an association between the presence of Chlamydia pneumoniae DNA both in osteoporotic bone tissue and peripheral blood mononuclear cells (PBMCs) and the increase in circulating resorptive cytokines. INTRODUCTION: Our study was designed to determine whether C. pneumoniae infection may be involved in osteoporosis-associated bone loss. METHODS: The study included 59 women undergoing hip joint replacement surgery for femoral neck fracture: 32 with osteoporosis and 27 with osteoarthritis. A total of 118 tissue specimens (59 bone tissues, 59 PBMCs) were examined for C. pneumoniae DNA by real-time polymerase chain reaction (PCR). Serum levels of soluble receptor activator of nuclear factor kappa B ligand (sRANKL), osteoprotegerin (OPG), interleukin (IL)-1ß, tumor necrosis factor-α, and IL-6 were also measured. RESULTS: C. pneumoniae DNA was detected in osteoporotic bone tissue whereas it was not found in non-osteoporotic bone tissue (p < 0.05). A significantly higher rate of C. pneumoniae DNA (p < 0.05) was found in PBMCs of osteoporotic patients than in those of osteoarthritis patients. Among osteoporotic patients, serum sRANKL, IL-1, and IL-6 concentrations as well as sRANKL/OPG ratio significantly differ between patients with bone tissue and PBMCs positive to C. pneumoniae and C. pneumoniae-negative patients. CONCLUSION: The association between the presence of C. pneumoniae DNA, both in bone tissue and PBMCs, and the increase in sRANKL/OPG ratio as well as in IL-1ß and IL-6 levels observed in osteoporotic patients suggests C. pneumoniae infection as a new risk factor for osteoporosis.

Effect of stem modulus in a total hip arthroplasty model.

The purpose of this study was to determine the biological effects of the elastic modulus of the femoral stem in canine hip arthroplasty. Cementless total hip arthroplasty was performed in 12 dogs, six had a low elastic modulus polyacetal resin stem and six had a high modulus stainless steel stem. The components were otherwise similar. At six and 12 months after operation, radiographic and histomorphometric analysis showed that those with steel implants had more cortical porosity than did the other group (p less than 0.01). We suggest that the elastic modulus of the implant is an important factor in controlling cortical bone resorption. A low modulus femoral prosthesis can significantly decrease bone resorption which might otherwise eventually lead to implant failure.

[Endosteal hyperostosis with recessive transmission (Van Buchem's disease). A case report]. / Iperostosi endostale a trasmissione recessiva (malattia di Van Buchem). Segnalazione di un caso.

A rare case of Van Buchem's disease is described. This disease is a hereditary sclerosis dysplasia of bone which particularly affects the skull and long bones, the characteristic features being the endosteal deposition of bone, particularly in the diaphyses.

[Prognostic significance of skeletal lesions in multiple myeloma]. / Il significato prognostico delle lesioni scheletriche nel mieloma multiplo.

Prognostic significance of the skeletal lesions in multiple myeloma. Fifty-two patients with multiple myeloma have been analysed and relations between bone X-ray changes and several clinical biohumoral parameters and survival have been found. Our studies show no correlation between the extent of skeletal lesions and the seriousness of anaemia, or between bone marrow infiltration and renal involvement. The results also show that patients with apparently normal bones may also have serious anaemia, wide bone marrow infiltration and serious renal lesions rapidly leading to a poor prognosis. Comparison of survival curves, according to the grade of bone X-ray changes at presentation, shows no significant difference: the grade of bone lesions at diagnosis does not seem to considerably influence survival.

[Clinical and radiological diagnosis considerations on 2 cases of achalasia]. / Considerazioni cliniche e di diagnostica radiologica su due casi di acalasia.

Two cases of achalasia of the lower third of the oesophagus are presented. Leucoplakia was encountered in one of the cases. The clinical, aetiopathogenic and x-ray diagnostic aspects of achalasia are described in relation to the possibility that it may be associated with neoplasia or pre-cancerous alterations. In both the above cases, early dysphagia was encountered.

[CT x-ray in recurrences of lumbar disk herniation. Usefulness of the examination with contrast enhancement]. / La TC nelle recidive di ernia discale lombare. Utilità dell'esame con contrast enhancement.

The CT is an important and valuable instrument in the study of the postoperative lumbar spine, in the patients which presented persistent clinical manifestation. In this report the technique with contrast enhancement is outlined, the criteria for its interpretations are presented, and its advantages and limitations are reviewed; pitfalls in technique interpretation are stressed. Two hundred and fifty patients are referred to the CT without and with i.v. contrast medium for this diagnostic request: scar or herniation at surgery level.

[Radiographic diagnostic problems in cancer of the gastric stump in subjects gastrectomized for ulcer over 10 years earlier]. / Problemi di diagnostica radiografica del cancro del moncone gastrico in soggetti gastroresecati per ulcera da più di dieci anni.

On the basis of some observed cases the histological, clinical and radiological aspects of carcinoma of the gastric stump are described in detail. The condition is comparatively rare, but once it occurs, recurrences are fairly frequent and given the high mortality rate it requires prompt diagnosis. Double contrast examination of the digestive tract is a useful additional technique for this purpose.