Relationship between the mandibular cortical index and calcaneal bone mineral density in postmenopausal women.

BACKGROUND AND OBJECTIVE: In clinical practice, a comparative analysis of bone mineral density (BMD) is carried out by examining different skeletal bones. This is useful for screening of postmenopausal osteoporosis (OP). The objective of this study was to determine the relation between the mandibular cortical index (MCI) and calcaneal BMD among postmenopausal women. MATERIALS AND METHODS: The study sample included 129 randomly selected postmenopausal women aged 50-77 years. The participants were examined using panoramic radiography for the analysis of the cortical layer in the mandibular base for MCI determination and using DXL for the examination of calcaneal BMD. According to T scores, the subjects were divided into three groups (Groups 1, 2, and 3). The panoramic radiographic examination of the mandible was performed; the MCI was determined and distributed into groups (C1; C2; C3). The MCI validity in determining the calcaneus BMD status was analyzed. RESULTS: The differences in BMD were statistically significant between Groups C1 and C3 (P<0.01), Groups C2 and C3 (P=0.01), and between the calcaneal BMD groups (P<0.001). There was a statistically significant inverse correlation between the MCI and calcaneal BMD (r=-0.3; P<0.001). The changes characteristic of Group C2 were documented more frequently than those of other morphological groups. The analysis of the MCI validity in BMD status showed low sensitivity (69.4%) and specificity (53.9%). CONCLUSIONS: The relation between MCI and calcaneal BMD was determined. The diagnostic discrimination of the MCI was found to be not sufficient in screening the women with postmenopausal osteoporosis and its application in clinical practice might be limited.

Left ventricular function by speckle-tracking echocardiography in patients with low-T3 syndrome and acute myocardial infarction.

BACKGROUND AND OBJECTIVE: Low-T3 syndrome is common in patients with acute myocardial infarction (AMI). Recent experimental and clinical data have suggested a potential negative impact of low-T3 syndrome on myocardial function in patients with AMI. The aim of this study was to assess left ventricular (LV) myocardial function in patients with low-T3 syndrome and to investigate the association between hormonal profile and the severity of LV dysfunction using speckle-tracking echocardiography (STE). MATERIALS AND METHODS: In 130 patients with first-onset ST-segment elevation acute myocardial infarction (STEMI), conventional 2D and speckle-tracking echocardiography within 48-72h after the hospitalization was performed, and blood samples for TSH, fT4, fT3, and anti-TPO levels were obtained to investigate thyroid hormone production within 24h and on the fourth day after the onset of STEMI symptoms. RESULTS: The patients were divided into two groups according to their serum level of fT3: group 1 with fT3 concentration below 3.2pmol/L (n=34) and group 2 with normal fT3 (>3.2pmol/L) level (n=96). LV ejection fraction (EF) tended to be lower in the low fT3 group. The systolic longitudinal strain did not differ between the groups, but the late diastolic longitudinal strain rate was lower in group 1 (P=0.011). The systolic basal LV rotation positively correlated with the level of fT3 (r=0.4; P<0.001), while a negative correlation was detected between myocardial rotational parameters - systolic apical rotation (r=-0.2; P<0.05), torsion (r=-0.3; P<0.001), and diastolic apical rotation rate (r=-0.3; P<0.01) - and fT3 levels. CONCLUSIONS: The late diastolic longitudinal LV strain rate and LV rotation evaluated by speckle-tracking echocardiography were impaired in patients with low-T3 syndrome after AMI.

Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer: a consensus of Lithuanian medical oncologists, radiation oncologists, endocrinologists, and family medicine physicians.

The aim of this article is to inform about cancer treatment-induced bone loss, to identify patients at risk and those that can benefit from bone targeted treatment as well as highlight the importance of the multidisciplinary approach in the bone health in cancer care. Patients with breast cancer treated or intended to be treated with aromatase inhibitors belong to a high-risk group because their fracture risk increases up to 30% due to a significant decrease in bone mineral density within 6-12 months after the start of hormonal treatment. To evaluate bone status and predict risk for fractures, lateral thoracic and lumbar spine X-ray imaging, bone mineral density measurement by dual energy X-ray absorptiometry at the lumbar spine L1-L4 vertebrae and/or hip and fracture risk factors assessment are mandatory tests prior to hormonal treatment. Morbidity and mortality associated with bone loss can be prevented with appropriate screening, lifestyle interventions, and therapy. Algorithm for the management of bone health in breast cancer patients was established in Lithuania to screen patients with increased risk for bone loss and to provide adequate specific osteoporosis treatment.

Carcinoma of two parathyroid glands caused by a novel MEN1 gene mutation - a rare feature of the MEN 1 syndrome.

Multiple endocrine neoplasia type 1 (MEN 1) is a rare syndrome inherited in an autosomal dominant pattern, characterized by combinations of tumors of the parathyroid glands, pituitary gland, and pancreatic islet cells and more rare tumors of endocrine organs and nonendocrine tissues. Germline mutations in the MEN1 gene are responsible for the MEN 1 syndrome, leading to an inactive form of menin protein. Benign lesions of the parathyroid glands are characteristic in patients with the MEN 1 syndrome; however, patients can develop parathyroid carcinomas very rarely. This report presents a clinical case of the MEN 1 syndrome: a 39-year-old woman underwent surgery for carcinoma of two parathyroid glands as well as was treated for pituitary prolactinoma, which caused infertility, and malignant insulinoma; the patient had multiple subcutaneous lipomas as well. Genetic analysis revealed a novel germline mutation in the MEN1 gene - a nucleotide insertion at codon 43 in exon 2 (c.129insA), which caused the occurrence of the MEN1 syndrome. The clinical case of the MEN 1 syndrome presented here is relevant in gathering the data on etiopathogenesis of not only MEN 1 syndrome, but an extremely rare pathology - parathyroid carcinoma - as well.

The relationship between panoramic radiomorphometric indices of the mandible and calcaneus bone mineral density.

OBJECTIVE: The aim of the study was to determine the relationship between bone mineral density in the calcaneus measured using the dual x-ray and laser osteodensitometry technique and bone mineral density in the mandible calculated using the panoramic radiomorphometric indices obtained by applying linear measurements in panoramic radiograms of postmenopausal women. MATERIAL AND METHODS: The participants of this study were postmenopausal women (n=129) aged 50 and more. The subjects underwent panoramic radiography of the mandibles, followed by the calculation of the panoramic radiomorphometric indices indicating bone mineral density of the mandible. The dual x-ray and laser osteodensitometer DXL Calscan were used for the measurements of bone mineral density in the calcaneus. Statistical analysis was preformed to find the relationship between bone mineral density measurements in the two anatomically different bones. RESULTS: Following the diagnostic criteria for osteoporosis recommended by the World Health Organization (1994), the subjects were distributed according to the calcaneus bone mineral density T-score into the normal bone mineral density (group 1), osteopenia (group 2), and osteoporosis (group 3) groups. Mean bone mineral density in the calcaneus in the general studied population was 0.38+/-0.07; the mean value of bone mineral density of the calcaneus in the group 1 (n=34) was 0.47+/-0.04 (g/cm(2)), in the group 2 (n=65) was 0.37+/-0.03 (g/cm(2)), and in the group 2 (n=30) was 0.29+/-0.03 (g/cm(2)). Differences in bone mineral density between the groups were determined using the analysis of variance (ANOVA) F=285.31; df=2; P<0.001 (T1 vs. T2, P<0.001; T1 vs. T3, P<0.001; T2 vs. T3; P<0.001). A statistically significant correlation was found in the general group between the mental index and bone mineral density in the calcaneus (r=0.356, P<0.001), and between the panoramic mandibular index and bone mineral density in the calcaneus (r=0.397, P<0.001). CONCLUSION: Bone mineral density in the calcaneus and the mandible measured using dual energy x-ray and laser osteodensitometer DXL Calscan and by applying panoramic radiography reflect general changes in the mineralization of these bones, characteristic of the postmenopausal period.

[The results of thyroid ultrasound examination in randomly selected schoolchildren]. / Atsitiktinai atrinktu jaunesniuju klasiu moksleiviu skydliaukes ultragarsinio tyrimo duomenys.

UNLABELLED: Iodine deficiency is an actual problem of public health and mostly manifests as enlargement of the thyroid (goiter). OBJECTIVE: The aim of the study was to determine the prevalence of goiter using different evaluation criteria and to establish the relationship between changes in thyroid volume and dimensions of the body. MATERIAL AND METHODS: Thyroid palpation and ultrasound examination were performed in 310 (7-11-year-old) randomly selected schoolchildren from two Lithuanian nearby small towns (Birzai and Rokiskis) in the district with lowest urinary iodine excretion (5.4 and 4.5 microg/dl). The size of thyroid gland was determined by inspection and palpation using the World Health Organization criteria. All children were examined ultrasonographically; thyroid volume was assessed by two criteria: F. Delange (1997) and M. B. Zimmermann (2004). RESULTS: There were no differences in means and medians of age and all body parameters (height, weight, body surface area, body mass index) in boys and girls of the same age. Higher means and medians of the body surface area in all age groups were found in Birzai as compared to Rokiskis (p<0.05). Comparing body mass index of all investigated schoolchildren with upper limits (97th percentile) of body mass index of normal British children, no statistically significant difference in the prevalence of obesity between towns was observed (1.9% - in Rokiskis, 5.0% - in Birzai; p>0.05). Grouping the children according to age revealed a higher prevalence of goiter in Birzai as compared to Rokiskis (88% vs. 63%, respectively, according to M. B. Zimmermann and 25% vs. 10%, respectively, according to F. Delange; p<0.05). There was no significant difference in the prevalence of goiter between the towns when children were grouped by body surface area. In all groups by age and body surface area, the mean thyroid volume exceeded 97th percentile by M. B. Zimmerman and did not exceed by F. Delange. CONCLUSIONS: The prevalence of goiter, assessing the thyroid volume in 7-11-year-old children by the different criteria, is significantly different. We recommend using the criteria based on body surface area in order to evaluate the constitutional characteristics of individual child's development.

Psychological state, quality of life, and body composition in postmenopausal women with osteoporosis in Lithuania.

SUMMARY: The objective of this study was to determine body composition, physical activity, and psychological state in postmenopausal women with osteoporosis. Fat mass, lean mass, water mass, and basal metabolic rate are lower, self-reported physical activity and risk factors of fractures are higher, and cognitive functions were worse in osteoporotic patients than in controls. Significant correlations were found between physical activity and emotional state parameters. INTRODUCTION: This study aims to determine peculiarities of body composition, physical activity, risk factors predicting fractures, psychological state and quality of life, and possible relations between them in postmenopausal women with osteoporosis in Lithuania. METHODS: Thirty-one postmenopausal women with osteoporosis and 29 healthy age- and sex-matched controls were included in the study. Profile of Mood State and Hospital Anxiety and Depression Scale were used for the assessment of emotional state. Trail Making Test and Digit Symbol Test of Wechsler Adult Intelligence Scale were used to evaluate cognitive functioning. Quality of life was evaluated using the World Health Organization Brief Quality of Life Questionnaire. Risk of fractures was assessed by the Risk Factors Predicting Questionnaire. RESULTS: Fat mass (22.4 +/- 4.7 vs. 40.6 +/- 14.2 kg, p < 0.001), lean mass (37.3 +/- 6.0 vs. 48.1 +/- 7.6 kg, p < 0.001), water mass (31.6 +/- 2.9 vs. 38.3 +/- 5.3 kg, p < 0.001), and basal metabolic rate (1,253 +/- 132 vs. 1,456 +/- 126 kcal, p < 0.001) were lower in osteoporotic patients than in controls. Self-reported physical activity (2.35 +/- 0.6 vs. 1.69 +/- 0.5, p < 0.001) and risk factors of fractures (5.9 +/- 2.1 vs. 2.6 +/- 2.4, p < 0.001) were higher in women with osteoporosis than in healthy age- and sex-matched controls (2.35 +/- 0.6 vs. 69 +/- 0.5, p < 0.001). Trail making A and B scores were higher in patients than in age- and sex-matched controls (55.8 +/- 19.9 vs. 45.1 +/- 19.9, p = 0.07 and 118.2 +/- 34.6 vs. 92.8 +/- 48.7, p = 0.006). Some significant correlations were detected between physical activity and emotional state and quality of life parameters. CONCLUSION: In postmenopausal women with osteoporosis, fat body mass, lean body mass, water body mass, basal metabolic rate, and waist-to-hip ratio are lower, physical activity and risk of fractures are higher, and cognitive functions are worse than in age- and sex-matched controls. Some psychological peculiarities could be related to physical activity in women with osteoporosis.