Diffuse Cutaneous Mastocytosis: A Current Understanding of a Rare Disease.

Mastocytosis is a heterogeneous disease characterized by the expansion and accumulation of neoplastic mast cells in various tissues. Diffuse cutaneous mastocytosis (DCM) is a rare and most severe form of cutaneous mastocytosis, which typically occurs in childhood. There have been reports of a familial DCM with specific gene mutations, indicating both sporadic and hereditary factors involved in its pathogenesis. DCM is associated with severe MC mediator-related symptoms and an increased risk of anaphylaxis. The diagnosis is based on the appearance of skin lesions, which typically show generalized thickening, erythroderma, blistering dermographism, and a positive Darier's sign. Recognition, particularly in infants, is challenging due to DCMs resemblance to other bullous skin disorders. Therefore, in unclear cases, a skin biopsy is crucial. Treatment focuses on symptom management, mainly including antihistamines and mast cell stabilizers. In extremely severe cases, systemic steroids, tyrosine kinase inhibitors, phototherapy, or omalizumab may be considered. Patients should be equipped with an adrenaline autoinjector. Herein, we conducted a comprehensive review of literature data on DCM since 1962, which could help to better understand both the management and prognosis of DCM, which depends on the severity of skin lesions, intensity of mediator-related symptoms, presence of anaphylaxis, and treatment response.

Regional disparities of prostate cancer mortality in Ecuador: an examination of trends and correlates from 2004 to 2019.

BACKGROUND: Prostate cancer is the leading cause of cancer death in Ecuadorian men. However, there is a lack of information regarding the evolution of prostate cancer mortality rates in Ecuador and its regions in the last few decades. OBJECTIVE: The aim of this study was to report prostate cancer mortality rates in Ecuador and its geographical areas and observe the evolution of these rates between 2004 and 2019. METHODS: An observational ecological study was conducted, analysing data for prostate cancer deaths from 2004 to 2019 in Ecuador. Age standardized mortality rates (ASMR) were calculated per 100,000 men using the world standard population with the direct method proposed by SEGI. Joinpoint regression analysis was performed to examine mortality trends. We used a Cluster Map to explore relationships among regions between 2015 and 2019. RESULTS: Ecuador reported 13,419 deaths by prostate cancer between 2004 and 2019, with the Coastal region accounting for 49.8% of the total deaths. The mean age at death was 79 years (± 10 years), 91.7% were elderly (more than 65 years old) and had primary education (53%). Deaths by prostate cancer were more frequently reported among mestizos (81.4%). There were no significant variations in these percentages in Ecuador and its regions during the study period. Carchi province had the highest mortality rate in 2005 and 2019 (> 13 deaths per 100,000). Heterogeneity in the evolution of mortality rates was reported among the provinces of Ecuador. Azuay decreased in the first few years, and then increased from 2010 to 2019, whereas Guayas and Pichincha decreased throughout the whole period. CONCLUSION: Although prostate cancer mortality rates in Ecuador have remained stable over the past few decades, there are significant disparities among the different regions. These findings suggest the need for the development of national and provincial registration measures, integrated healthcare actions, and targeted interventions to reduce the burden of prostate cancer in the Ecuadorian population.

Iron inactivation by Sporobolomyces ruberrimus and its potential role in plant metal stress protection. An in vitro study.

The endophytic Basidiomycete Sporobolomyces ruberrimus protects its host Arabidopsis arenosa against metal toxicity. Plants inoculated with the fungus yielded more biomass and exhibited significantly fewer stress symptoms in medium mimicking mine dump conditions (medium supplemented with excess of Fe, Zn and Cd). Aside from fine-tuning plant metal homeostasis, the fungus was capable of precipitating Fe in the medium, most likely limiting host exposure to metal toxicity. The precipitated residue was identified by Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), X-Ray Diffraction (XRD) and electron microscopy (SEM/TEM) with energy dispersive X-Ray analysis (EDX/SAED) techniques. The performed analyses revealed that the fungus transforms iron into amorphous (oxy)hydroxides and phosphates and immobilizes them in the form of a precipitate changing Fe behaviour in the MSR medium. Moreover, the complexation of free Fe ions by fungi could be obtained by biomolecules such as lipids, proteins, or biosynthesized redox-active molecules.

Treatment of nail psoriasis with pulsed dye laser versus combined pulsed dye and Nd:YAG lasers-An intrapatient left-to-right study.

BACKGROUND AND OBJECTIVES: There are limited treatment options for nail psoriasis. It is important to find new therapies and improve existing ones. The aim of this study was to compare the effectiveness of pulsed dye laser (PDL) versus combined PDL and Nd:YAG lasers in patients with nail psoriasis. METHODS: Fourteen patients (with a total of 126 nails affected by nail psoriasis) were treated with PDL (6 J/cm2, 7 mm, 0.45 milliseconds) on both hands and additionally with Nd:YAG (10 J/cm2 , 6 mm, 15 milliseconds) on the right hand. Three treatment sessions were applied at 4-week intervals and patients were followed up for 6 months after the last session. Disease severity was assessed using the Nail Psoriasis Severity Index, both 8- and 32-point variant. Additionally, Dermatology Life Quality Index was assessed before and after treatment. RESULTS: Overall, there was a statistical difference in 8- and 32-point NAPSI score before and after treatment for both hands. However, there was no statistical difference between the score for the right and left hands based on both scale variants. Some aspects of patients' lives showed improvement due to the treatment. CONCLUSIONS: Both PDL in monotherapy and combined Nd:Yag+PDL lasers are safe and effective in treatment of nail psoriasis, although combined therapy shows no advantage over the use of a single laser.

JAK-STAT Inhibitors in Atopic Dermatitis from Pathogenesis to Clinical Trials Results.

A common disease worldwide is known as atopic dermatitis (AD), named also as atopic eczema, which is a chronic recurrent complex inflammatory skin disorder. It affects 2-10% of the adult population and up to 20% of the pediatric population. The clinical AD picture appears in typically localized eczema and dry skin, and is dominated by a persistent pruritus followed by sleep disturbances. AD strongly impacts on the quality of life of AD patients and their families as well as on social and economic aspects. The pathogenesis of the disease is complex and consists of multiple interactions between immunological disturbances, skin barrier defect, and microbial dysbiosis with environmental influences. The treatment of AD reflects the pathogenetic disorders, starting from basic emollient therapy, and goes to topical anti-inflammatory regimens followed by phototherapy, systemic immunosuppressive drugs, and new biologic immunomodulators. This paper will thus summarize the novel collection of biological treatment JAK-STAT inhibitors dedicated to AD.

Atopic dermatitis. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society, Polish Society of Allergology, Polish Pediatric Society and Polish Society of Family Medicine. Part II. Systemic treatment and new therapeutic methods.

The treatment goal in atopic dermatitis is eliminating clinical symptoms of the disease, preventing exacerbations and complications, as well as improving patients' quality of life. In cases of severe atopic dermatitis and lack of response it is recommended to introduce systemic therapy. Patients ofter require multi-specialist consultations, and occasionally hospitalization. It is not recommended to use acupuncture, acupressure, bioresonance, homeopathy, or Chinese herbs in the treatment of atopic dermatitis.

Atopic dermatitis. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society, Polish Society of Allergology, Polish Pediatric Society and Polish Society of Family Medicine. Part I. Prophylaxis, topical treatment and phototherapy.

Atopic dermatitis is a chronic and recurrent inflammatory dermatosis with concomitant intensive pruritus, and is diagnosed both in children and adults. Atopic dermatitis-patients are predisposed to have bacterial, viral and fungal skin infections; they also suffer from an increased risk of developing food allergies (especially, at an infantile age), allergic rhinitis, or bronchial asthma (a so-called atopic march). Currently, an increasing atopic dermatitis incidence constitutes a serious medical problem that regards not only dermatology and allergology, but also paediatrics, and family medicine. The basis for atopic dermatitis treatment and prophylaxis is restoration of epidermal barrier functions by means of tailored emollients. Atopic dermatitis therapies should effectively eliminate clinical symptoms of the disease, prevent exacerbations as well as complications, and improve patients' quality of life.

Eosinophilic cystitis treated with hydrodistention and complementary methods: Case report. / Cistitis eosinofílica tratada con hidrodistensión y métodos complementarios: comunicación de un caso.

OBJECTIVE: Even though there is no established standard therapy for Eosinophilic cystitis (EC), the series of cases guide us in the treatment of patients. We report our therapeutic experience with hydrodistention and complementary methods. In order to establish a standard treatment in patients with EC. METHODS: Retrospective review of the clinical history of a patient diagnosed with eosinophilic cystitis. RESULTS: A 66-year-old woman presented female urethral syndrome 1 year before and was initially treated as a chronic cystitis. After further investigations including cystoscopy and bladder biopsy, she was diagnosed with EC.Urothelial mucosa bleeding was evidenced and cauterization and hydrodistention were performed. After the surgical treatment, corticosteroids and antibiotics were initiated.The maintenance treatment was continued with Vitamin C, Maurita flexuosa and Peumus boldus. The patient's condition has been improving and she is still asymptomatic one year later. CONCLUSION: The efficacy of treatment with hydrodistention, corticosteroids and antibiotics showed positive results in short and long term in this patient. Vitamin C, Maurita flexuosa and Peumus boldus showed favorable results in EC maintenance treatment.

OBJETIVO: A pesar de que no existe una terapia estándar establecida para la cistitis eosinofílica (CE), la serie de casos nos guía en el tratamiento de los pacientes. Presentamos nuestra experiencia terapéutica con hidrodistensión y métodos complementarios. Con el fin de establecer un tratamiento estándar en pacientes con CE.MÉTODOS: Revisión retrospectiva de la historia clínica de un paciente con diagnóstico de cistitis eosinofílica. RESULTADOS: Una mujer de 66 años presentó síndrome uretral femenino hace un año y fue tratada inicialmente como una cistitis crónica. Después de más investigaciones incluyendo una cistoscopia y una biopsia de la vejiga, se le diagnosticó CE. Se evidenció sangrado de la mucosa urotelial y se realizaron cauterización e hidrodistensión. Después del tratamiento quirúrgico, se iniciaron corticosteroides y antibióticos. El tratamiento de mantenimiento se continuó con Vitamina C, Maurita flexuosa y Peumus boldus. La condición del paciente ha mejorado y sigue estando asintomática un año después.CONCLUSIÓN: La eficacia del tratamiento con hidrodistención, corticosteroides y antibióticos mostró resultados positivos a corto y largo plazo en este paciente. La vitamina C, Maurita flexuosa y Peumus boldus mostraron resultados favorables en el tratamiento de mantenimiento de CE.

Validity of Body Mass Index as a Measure of Adiposity in Infancy.

OBJECTIVES: To assess the validity of body mass index (BMI) and age- and sex-standardized BMI z-score (BMIZ) as surrogates for adiposity (body fat percentage [BF%], fat mass, and fat mass index [kg/m2]) at 3 time points in infancy (1, 4, and 7 months) and to assess the extent to which the change in BMIZ represents change in adiposity. STUDY DESIGN: We performed a secondary analysis of 447 full-term infants in a previous trial of maternal vitamin D supplementation during lactation. Study staff measured infant anthropometrics and assessed body composition with dual-energy x-ray absorptiometry at 1, 4, and 7 months of age. We calculated Spearman correlations (rs) among BMI, BMIZ, and adiposity at each time point, and between change in BMIZ and change in adiposity between time points. RESULTS: Infants (N = 447) were 52% male, 38% white, 31% black, and 29% Hispanic. The BMIZ was moderately correlated with BF% (rs = 0.43, 0.55, 0.48 at 1, 4, and 7 months of age, respectively). BMIZ correlated more strongly with fat mass and fat mass index, particularly at 4 and 7 months of age (fat mass rs = 0.72-0.76; fat mass index rs = 0.75-0.79). Changes in BMIZ were moderately correlated with adiposity changes from 1 to 4 months of age (rs = 0.44 with BF% change; rs = 0.53 with fat mass change), but only weakly correlated from 4 to 7 months of age (rs = 0.21 with BF% change; rs = 0.27 with fat mass change). CONCLUSIONS: BMIZ is moderately correlated with adiposity in infancy. Changes in BMIZ are a poor indicator of adiposity changes in later infancy. BMI and BMIZ are limited as surrogates for adiposity and especially adiposity changes in infancy. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00412074.

Impact of renin-angiotensin system inhibitors on clinical outcomes and ventricular remodelling after transcatheter aortic valve implantation: rationale and design of the RASTAVI randomised multicentre study.

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement. METHODS AND ANALYSIS: The RAS blockade after TAVI (RASTAVI) trial aims to detect if there is a benefit in clinical outcomes and ventricular remodelling with this therapeutic strategy following the TAVI procedure. The study has been designed as a randomised 1:1 open-label study that will be undertaken in 8 centres including 336 TAVI recipients. All patients will receive the standard treatment. The active treatment group will receive ramipril as well. Randomisation will be done before discharge, after signing informed consent. All patients will be followed up for 3 years. A cardiac magnetic resonance will be performed initially and at 1 year to assess ventricular remodelling, defined as ventricular dimensions, ejection fraction, ventricular mass and fibrosis. Recorded events will include cardiac death, admission due to heart failure and stroke. The RASTAVI Study will improve the management of patients after TAVI and may help to increase their quality of life, reduce readmissions and improve long-term survival in this scenario. ETHICS AND DISSEMINATION: All authors and local ethics committees have approved the study design. All patients will provide informed consent. Results will be published irrespective of whether the findings are positive or negative. TRIAL REGISTRATION NUMBER: NCT03201185.

Cutaneous mastocytosis treatment: strategies, limitations and perspectives.

Mastocytosis is a rare myeloproliferative disease, characterized by excessive proliferation and accumulation of mast cells in the tissues. In cutaneous mastocytosis (CM), mast cells infiltration is limited to the skin, whereas in systemic mastocytosis (SM) internal organs are involved. The first-line treatment in CM is antimediator therapy (mainly H1 and H2 antihistamines) and short-term topical corticosteroids. Phototherapy is the second-line therapy which may be considered when antihistamines do not produce the expected improvement. New therapeutic options include omalizumab and KIT-targeting agents. Although the disappearance of skin lesions has been reported as a result of cytoreductive therapies in SM, the use of potentially toxic drugs in CM is not recommended. In all adults with mastocytosis and in pediatric patients with severe CM, a persistently elevated serum tryptase level and anaphylaxis in medical history, equipping with epinephrine autoinjector for use in case of anaphylaxis is recommended.

Associations of infant feeding with trajectories of body composition and growth.

Background: The extent to which breastfeeding is protective against later-life obesity is controversial. Little is known about differences in infant body composition between breastfed and formula-fed infants, which may reflect future obesity risk.Objective: We aimed to assess associations of infant feeding with trajectories of growth and body composition from birth to 7 mo in healthy infants.Design: We studied 276 participants from a previous study of maternal vitamin D supplementation during lactation. Mothers used monthly feeding diaries to report the extent of breastfeeding. We measured infants' anthropometrics and used dual-energy X-ray absorptiometry to assess body composition at 1, 4, and 7 mo. We compared changes in infant size (z scores for weight, length, and body mass index [BMI (in kg/m2)]) and body composition (fat and lean mass, body fat percentage) between predominantly breastfed and formula-fed infants, adjusting in linear regression for sex, gestational age, race/ethnicity, maternal BMI, study site, and socioeconomic status.Results: In this study, 214 infants (78%) were predominantly breastfed (median duration: 7 mo) and 62 were exclusively formula fed. Formula-fed infants had lower birth-weight z scores than breastfed infants (-0.22 ± 0.86 and 0.16 ± 0.88, respectively; P < 0.01) but gained more in weight and BMI through 7 mo of age (weight z score difference: 0.37; 95% CI: 0.04, 0.71; BMI z score difference: 0.35; 95% CI: 0, 0.69), with no difference in linear growth (z score difference: 0.05; 95% CI: -0.24, 0.34). Formula-fed infants gained more lean mass (difference: 303 g; 95% CI: 137, 469 g) than breastfed infants, but not fat mass (difference: -42 g; 95% CI: -299, 215 g).Conclusions: Formula-fed infants gained weight more rapidly and out of proportion to linear growth than did predominantly breastfed infants. These differences were attributable to greater accretion of lean mass, rather than fat mass. Any later obesity risk associated with infant feeding does not appear to be explained by differential adiposity gains in infancy.

Oleanolic acid modulates the immune-inflammatory response in mice with experimental autoimmune myocarditis and protects from cardiac injury. Therapeutic implications for the human disease.

Myocarditis and dilated cardiomyopathy (DCM) are inflammatory diseases of the myocardium, for which appropriate treatment remains a major clinical challenge. Oleanolic acid (OA), a natural triterpene widely distributed in food and medicinal plants, possesses a large range of biological effects with beneficial properties for health and disease prevention. Several experimental approaches have shown its cardioprotective actions, and OA has recently been proven effective for treating Th1 cell-mediated inflammatory diseases; however, its effect on inflammatory heart disorders, including myocarditis, has not yet been addressed. Therefore, the present study was undertaken to determine the effectiveness of OA in prevention and treatment of experimental autoimmune myocarditis (EAM). The utility of OA was evaluated in vivo through their administration to cardiac α-myosin (MyHc-α614-629)-immunized BALB/c mice from day 0 or day 21 post-immunization to the end of the experiment, and in vitro through their addition to stimulated-cardiac cells. Prophylactic and therapeutic administration of OA dramatically decreased disease severity: the heart weight/body weight ratio as well as plasma levels of brain natriuretic peptide and myosin-specific autoantibodies production were significantly reduced in OA-treated EAM animals, compared with untreated ones. Histological heart analysis showed that OA-treatment diminished cell infiltration, fibrosis and dystrophic calcifications. OA also decreased proliferation of cardiac fibroblast in vitro and attenuated calcium and collagen deposition induced by relevant cytokines of active myocarditis. Furthermore, in OA-treated EAM mice the number of Treg cells and the production of IL-10 and IL-35 were markedly increased, while proinflammatory and profibrotic cytokines were significantly reduced. We demonstrate that OA ameliorates both developing and established EAM by promoting an antiinflammatory cytokine profile and by interfering with the generation of cardiac-specific autoantibodies, as well as through direct protective effects on cardiac cells. Therefore, we envision this natural product as novel helpful tool for intervention in inflammatory cardiomyopathies including myocarditis.

Effect of soy isoflavone supplementation on menopausal quality of life.

OBJECTIVE: The purpose of this study was to assess the effect of soy isoflavone supplementation on quality of life in postmenopausal women. METHODS: A multicenter, randomized, double-blind, placebo-controlled 24-month trial was conducted to assess the effect of 80 or 120 mg of daily aglycone hypocotyl soy isoflavone supplementation on quality of life in 403 postmenopausal women using a validated Menopause-Specific Quality of Life questionnaire. RESULTS: Menopause-Specific Quality of Life domain scores at 1 year and 2 years were similar to baseline. There were no differences in domain scores among treatment groups. CONCLUSIONS: Soy isoflavone supplementation offers no benefit to quality of life in postmenopausal women.

Outcomes of flap salvage with medicinal leech therapy.

Medicinal leech therapy (MLT) to salvage venous congestion in native skin and local flaps is commonly practiced. However, the role of MLT in compromised regional and free flaps remains unclear. Leeches were used in 39 patients to treat venous congestion in native skin (n = 5), local flaps (n = 6), regional flaps (n = 14), and free flaps (n = 14). There were no total losses in patients with compromised native skin or local flaps. One patient who had received a radial forearm free flap expired before flap outcome could be assessed, and was excluded from analysis. Of the remaining 27 regional and free flaps, 33.3% were salvaged, 33.3% were partially salvaged, and 33.3% were lost. Means of 38.3 ± 34.0, 101.0 ± 11.2, and 157.9 ± 224.4 leeches and 1.7 ± 3.6, 3.2 ± 4.4, and 5.6 ± 5.2 units of blood were required for the salvaged, partially salvaged, and lost groups, respectively. Twenty-two patients required blood transfusion (57.9%). No patients developed wound infection with Aeromonas hydrophilia. Two patients developed donor site hematomas, and four patients developed recipient site hematomas. MLT is efficacious in congested native skin and local flaps. Some regional and free flaps can be totally or partially salvaged. However, the morbidity of MLT must be weighed against the risks of flap loss.

Collagen I scaffolds cross-linked with beta-glycerol phosphate induce osteogenic differentiation of embryonic stem cells in vitro and regulate their tumorigenic potential in vivo.

Embryonic stem cells (ESCs) have the potential to differentiate into all tissues of the adult organism. This, along with the ability for unlimited self-renewal, positions these cells for regenerative medicine approaches based on tissue engineering strategies. With the objective of developing a treatment regime for skeletal injuries and diseases, this study presents a novel protocol that effectively induces ESC differentiation into osteogenic and chondrogenic lineages while concurrently eliminating observed tumorigenicity during the period of observation after transplantation in vivo. Exposure to a collagen I matrix polymerized with beta-glycerol phosphate (BGP) induced the osteogenic differentiation of the ESCs with an efficiency of >80% without purification and/or lineage-specific cell selection. Furthermore, when the collagen I matrix was supplemented with chondroitin sulfate, chondrogenesis was promoted instead of osteogenesis. Interestingly, without purification of the differentiated cells from the collagen I matrix, these constructs did not lead to the formation of teratomas or tumors when implanted subcutaneously in a severe combined immunodeficiency (SCID). Furthermore, if undifferentiated ESCs were mixed with collagen I and then injected immediately (i.e., without previous in vitro differentiation), again, no teratomas or tumors were observed, whereas undifferentiated ESCs without collagen scaffolds all produced teratomas in this bioassay system. These results suggest that collagen I scaffolds not only induce osteogenic differentiation of ESCs, but also prevent ESCs from producing unwanted tumors when injected in vivo.

Clinical outcomes of a 2-y soy isoflavone supplementation in menopausal women.

BACKGROUND: Soy isoflavones are naturally occurring phytochemicals with weak estrogenic cellular effects. Despite numerous clinical trials of short-term isoflavone supplementation, there is a paucity of data regarding longer-term outcomes and safety. OBJECTIVE: Our aim was to evaluate the clinical outcomes of soy hypocotyl isoflavone supplementation in healthy menopausal women as a secondary outcome of a trial on bone health. DESIGN: A multicenter, randomized, double-blind, placebo-controlled 24-mo trial was conducted to assess the effects of daily supplementation with 80 or 120 mg aglycone equivalent soy hypocotyl isoflavones plus calcium and vitamin D on the health of 403 postmenopausal women. At baseline and after 1 and 2 y, clinical blood chemistry values were measured and a well-woman examination was conducted, which included a mammogram and a Papanicolaou test. A cohort also underwent transvaginal ultrasound measurements to assess endometrial thickness and fibroids. RESULTS: The baseline characteristics of the groups were similar. After 2 y of daily isoflavone exposure, all clinical chemistry values remained within the normal range. The only variable that changed significantly was blood urea nitrogen, which increased significantly after 2 y (P = 0.048) but not after 1 y (P = 0.343) in the supplementation groups. Isoflavone supplementation did not affect blood lymphocyte or serum free thyroxine concentrations. No significant differences in endometrial thickness or fibroids were observed between the groups. Two serious adverse events were detected (one case of breast cancer and one case of estrogen receptor-negative endometrial cancer), which was less than the expected population rate for these cancers. CONCLUSION: Daily supplementation for 2 y with 80-120 mg soy hypocotyl isoflavones has minimal risk in healthy menopausal women. This trial was registered at clinicaltrials.gov as NCT00665860.

Biomimetic Ca-P coatings incorporating bisphosphonates produced on starch-based degradable biomaterials.

In this study, sodium clodronate, a well-known therapeutic agent from the family of bisphosphonates (BPs), is incorporated in a biomimetic calcium phosphate (CaP) coating, previously formed on the surface of a starch-based biomaterial by a sodium silicate methodology, as a strategy to develop a site-specific drug delivery system for bone tissue regeneration applications. The effects on the resulting CaP coatings were evaluated in terms of morphology, chemistry, and structure. The dissolution of Ca and P from the coating and the release profiles of sodium clodronate was also assessed. As a preliminary approach, this first study also aimed at evaluating the effects of this BP on the viability of a human osteoblastic cell line since there is still little information available on the interaction between BPs and this type of cells. Sodium clodronate was successfully incorporated, at different doses, in the structure of a biomimetic CaP layer previously formed by a sodium silicate process. This type of BPs had a stimulatory effect on osteoblastic activity, particularly at the specific concentration of 0.32 mg/mL. It is foreseen that these coatings can, for instances, be produced on the surface of degradable polymers and then used for regulating the equilibrium on osteoblastic/osteoclastic activity, leading to a controlled regenerative effect at the interface between the biomaterial and bone.

Soy isoflavone supplementation and bone mineral density in menopausal women: a 2-y multicenter clinical trial.

BACKGROUND: Isoflavones are naturally occurring plant estrogens that are abundant in soy. Although purported to protect against bone loss, the efficacy of soy isoflavone supplementation in the prevention of osteoporosis in postmenopausal women remains controversial. OBJECTIVE: Our aim was to test the effect of soy isoflavone supplementation on bone health. DESIGN: A multicenter, randomized, double-blind, placebo-controlled 24-mo trial was conducted to assess the effects of daily supplementation with 80 or 120 mg of soy hypocotyl aglycone isoflavones plus calcium and vitamin D on bone changes in 403 postmenopausal women. Study subjects were tested annually and changes in whole-body and regional bone mineral density (BMD), bone mineral content (BMC), and T scores were assessed. Changes in serum biochemical markers of bone metabolism were also assessed. RESULTS: After study site, soy intake, and pretreatment values were controlled for, subjects receiving a daily supplement with 120 mg soy isoflavones had a statistically significant smaller reduction in whole-body BMD than did the placebo group both at 1 y (P < 0.03) and at 2 y (P < 0.05) of treatment. Smaller decreases in whole-body BMD T score were observed among this group of women at 1 y (P < 0.03) but not at 2 y of treatment. When compared with the placebo, soy isoflavone supplementation had no effect on changes in regional BMD, BMC, T scores, or biochemical markers of bone metabolism. CONCLUSION: Daily supplementation with 120 mg soy hypocotyl isoflavones reduces whole-body bone loss but does not slow bone loss at common fracture sites in healthy postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00665860.

Body-composition assessment in infancy: air-displacement plethysmography compared with a reference 4-compartment model.

BACKGROUND: A better understanding of the associations of early infant nutrition and growth with adult health requires accurate assessment of body composition in infancy. OBJECTIVE: This study evaluated the performance of an infant-sized air-displacement plethysmograph (PEA POD Infant Body Composition System) for the measurement of body composition in infants. DESIGN: Healthy infants (n = 49; age: 1.7-23.0 wk; weight: 2.7-7.1 kg) were examined with the PEA POD system. Reference values for percentage body fat (%BF) were obtained from a 4-compartment (4-C) body-composition model, which was based on measurements of total body water, bone mineral content, and total body potassium. RESULTS: Mean (+/- SD) reproducibility of %BF values obtained with the PEA POD system was 0.4 +/- 1.3%. Mean %BF obtained with the PEA POD system (16.9 +/- 6.5%) did not differ significantly from that obtained with the 4-C model (16.3 +/- 7.2%), and the regression between %BF for the 4-C model and that for the PEA POD system (R2 = 0.73, SEE = 3.7%BF) did not deviate significantly from the line of identity (y = x). CONCLUSIONS: The PEA POD system provided a reliable, accurate, and immediate assessment of %BF in infants. Because of its ease of use, good precision, minimum safety concerns, and bedside accessibility, the PEA POD system is highly suitable for monitoring changes in body composition during infant growth in both the research and clinical settings.