Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density

ABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density.

OBJECTIVE: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). METHODS: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. RESULTS: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. CONCLUSION: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

Silver nanoprisms as plasmonic enhancers applied in the photodynamic inactivation of Staphylococcus aureus isolated from bubaline mastitis.

Mastitis is a bacterial infection that affects all lactating mammals, and in dairy cattle, it leads to a reduction in their milk production and, in worse cases, it may lead to animal death. One viable therapeutic modality for overcoming bacterial resistance can be photodynamic inactivation (PDI), a therapeutic modality for bacterial infection treatment. One of the main factors that can lead to an efficient PDI process is the association of metallic nanoparticles in the close vicinity of photosensitizers, which has shown promising results due to localized surface plasmon resonance phenomena. In this work, methylene blue (MB) molecules were associated with Ag prismatic nanoplatelets (AgNPrs) to use as PDI photosensitizer against Staphylococcus aureus isolated from bubaline mastitis. The optical plasmonic activity of AgNPrs was tuned to the MB absorption region (600-700 nm) by inducing their growth into prismatic shapes by a seed-mediated procedure, using poly (sodium 4-styrene sulfonate) as the surfactant. A simulation on the plasmonic properties of the nanoprisms, applying particle size within the dimensions determined by TEM image analysis (d = 32 ± 6 nm), showed a 30 % increase of the incident field on the prismatic tips. Photodynamic results showed that the electrostatic AgNPr-MB conjugates promoted enhancement (ca. 15 %) of the reactive oxygen species production. Besides, PDI mediated by AgNPrs-MB led to the complete inactivation of the mastitis S. aureus strain after 6 min inactivation, in contrast to PDI mediated by MB, which reduced less than a 0.5 bacterial log. Thus, the results show this plasmonic enhanced photodynamic tool's potential to be applied in the inactivation of multi-resistant bacterial strains.

Analysis of dispersive and dissipative media with optical resonances.

In this paper we analyze the problem of light-matter interaction when absorptive resonances are imbedded in the material dispersion. We apply an improved approach to aluminum (Al) in the optical frequency range to investigate the impact of these resonances on the operating characteristics of Al-based nanoscale devices. Quantities such as group velocity, stored energy density, and energy velocity, normally obtained using a single resonance model [Wave Propagation and Group Velocity (Academic Press, 1960), Nat. Mater. 11, 208 (2012)], are now accurately calculated regardless of the medium adopted. We adapt the Loudon approach [Nat. Mater. 11, 208 (2012)] to media with several optical resonances and present the details of the extended model. We also show pertinent results for Al-based metal-dielectric-metal (MDM) waveguides, around spectral resonances. The model delineated here can be applied readily to any metal accurately characterized by Drude-Lorentz spectral resonance features.

Comunicação interventricular, doença metabólica e nutrição: relato de caso / Ventricular septal defect, metabolic disease and nutrition: a case report

A comunicação interventricular é uma cardiopatia congênita que pode ser corrigida através de procedimento cirúrgico; porém doenças metabólicas associadas, como as glicogenoses, podem mudar o prognóstico do paciente, sendo a nutrição um importante fator no tratamento desses pacientes. Relata-se um caso envolvendo a comunicação interventricular, doença metabólica e tratamento nutricional.

High-frequency response of subwavelength-structured metals in the petahertz domain.

Electromagnetic plane waves, incident on and reflecting from a dielectric-conductor interface, set up a standing wave in the dielectric with the B-field adjacent to the conductor. It is shown here how the harmonic time variation of this B-field induces an E-field and a conduction current J (c) within the skin depth of a real metal; and that at frequencies in the visible and near-infrared range, the imaginary term sigmai of the complex conductivity sigma = sigma(r) + isigma(i) dominates the optical response. Continuity conditions of the E-field through the surface together with the in-quadrature response of the conductivity determine the phase relation between the incident E-M field and J(c). If slits or grooves are milled into the metal surface, a displacement current in the dielectric gap and oscillating charge dipoles at the structure edges are established in quadrature phase with incident field. These dipoles radiate into the aperture and launch surface waves from the edges. They are the principle source of light transmission through the apertures.

Estimation of right ventricular mass by two-dimensional echocardiography.

BACKGROUND: This report describes two original echocardiographic approaches to measure right ventricular (RV) mass (RVM). METHODS: In the bullet formula (5/24 pi D1 D2 L), where D1 and D2 are short axes and L the log axis, the RVM is obtained by subtracting the cavity volume from the RV total volume and subsequently multiplying the difference by myocardium density. The second method uses 3 endocardium segments measured at: (1) short axis plane of the aortic valve and left atrium (b1); (2) short axis plane at the midpoint between the tricuspid valve annulus and the apex (b2); and (3) 4-chamber view (h). Those segment lengths are applying in the formula A = [(b1 + b2)/2] x h. The result is multiplied by the wall thickness and by myocardium density. RESULTS: Both formulas were primarily tested in 30 mongrel dogs and have shown good correlation with the true mass ( r = 0.869 with the segments formula and r = 0.819 with the bullet formula). The same method was used in 20 human patients before heart transplant with similar results ( r = 0.810 with the segments formula and r = 0.836 with the bullet formula). CONCLUSIONS: The RVM can be satisfactorily estimated by 2-dimensional echocardiography. The linear regression between the calculated mass (using the smoothest and thinner myocardium thickness) and the actual mass may provide the correction factor for the RVM calculation. Two echocardiographic methods were used to measure right ventricular mass. One of them used a bullet formula variant (5/24 pi D1 D2 L). The second method used 3 endocardium segments measured in 3 2-dimensional echocardiographic planes (short axis of aortic valve and left ventricle, and 4-chamber view), and applied in the formula A = [(b1 + b2)/2] x h. Both formulas have shown good correlation with the true mass in 30 mongrel dogs ( r = 0.869 with the segments formula and r = 0.819 with the bullet formula) and in 20 human patients before heart transplant ( r = 0.810 and r = 0.836, respectively).

Estimation of Right Ventricular Mass by Two-dimensional Echocardiography

Background: This report describes two original echocardiographic approaches to measure right ventricular (RV) mass (RVM).Methods: In the bullet formula (5/24 D1 D2 L), where D1 and D2 are short axes and L the log axis, the RVM is obtained by subtracting the cavity volume from the RV total volume and subsequently multiplying the difference by myocardium density. The second method uses 3 endocardium segments measured at: (1) short axis plane of the aortic valve and left atrium (b1); (2) short axis plane at the midpoint between the tricuspid valve annulus and the apex (b2); and (3) 4-chamber view (h). Thosesegment lengths are applying in the formula A [(b1 b2)/2] h. The result is multiplied by the wallthickness and by myocardium density. Results: Both formulas were primarily tested in 30 mongrel dogs and have shown good correlation with the true mass (r 0.869 with the segments formula and r 0.819 with the bullet formula). The same method was used in 20 human patients before heart transplant with similar results (r 0.810 with the segments formula and r 0.836 with the bulletformula).Conclusions: The RVM can be satisfactorily estimated by 2-dimensional echocardiography. The linear regression between the calculated mass (using the smoothest and thinner myocardium thickness) and the actual mass may provide the correction factor for the RVM calculation.Two echocardiographic methods were used to measure right ventricular mass. One of them used a bullet formula variant (5/24 D1 D2 L). The second method used 3 endocardium segments measured in 3 2-dimensional echocardiographic planes (short axis of aortic valve and left ventricle, and 4-chamber view), and applied in the formula A [(b1 b2)/2] h. Both formulas have shown good correlation with the true mass in 30 mongrel dogs (r 0.869 with the segments formula and r 0.819 with thebullet formula) and in 20 human patients before heart transplant (r 0.810 and r 0.836, respectively).