Research into CSB is hindered by the lack of a generally accepted definition and reliable and valid assessment tools. Despite these limitations, evidence indicates that CSB is relatively common in ...the general adult population, causes substantial personal distress, and is a source of significant psychosocial disability. CSB appears to begin early in life, to have a male preponderance, and to run a chronic or episodic course. It is also commonly associated with psychiatric comorbidity, typically mood, anxiety, substance use, and personality disorders. Further research is needed to better our understanding of the disorder and improve our ability to develop specific interventions.
Patients with diabetes mellitus are at an increased risk of bone fractures. Several groups of effective antidiabetic drugs are available, which are very often given in combination. The effects of ...these medications on bone metabolism and fracture risk must not be neglected. Commonly used antidiabetic drugs might have a positive, neutral or negative impact on skeletal health. Increased risk of fracture has been identified with use of thiazolidinediones, most definitively in women. Also treatment with sulfonylureas can have adverse effects on bone. One consequence of these findings has been greater attention to fracture outcomes in trails of new diabetes medication (incretins and SGLT-2 inhibitors). The effect of insulin on bone is discussed and the risk of fractures in patients using insulin seems to be unrelated to insulin as itself. The aim of the review is to summarize effects of antidiabetic treatment on bone - bone mineral density, fractures and bone turnover markers. The authors also try to recommend a strategy how to treat patients with diabetes mellitus regarding the risk of osteoporotic fractures. In this review the problem of how to treat osteoporosis in patient with diabetes is also discussed.
Abstract Background Pediatric forearm fractures are a common presentation in emergency departments in Papua New Guinea. Often these children undergo “blind” closed reduction with reduction adequacy ...assessed by standard radiographs. This study aims to demonstrate the safety and efficacy of ultrasound (US) in guiding closed reduction of pediatric forearm fractures in a resource-limited setting. Methods We recruited consecutive children with closed forearm fractures requiring reduction. A US scanner was used to visualize and aid fracture reductions. The outcome measures were the rate of successful reductions (ie, adequate alignment without the need for a second procedure or further surgical intervention), length of stay in hospital, and adverse events during each procedure and at follow-up after 6 weeks. Results Of 47 children recruited, there were 44 (94%) successful reductions, whereas 3 (6%) required repeated reduction. The mean (SD) length of stay in hospital of the successful cases was 8.77 (3.66) hours. Two patients had tight plaster casts during early follow-up which were immediately addressed. Of the 44 successful cases, only 38 were retrieved for the final review. No further adverse events were observed in the latter. Conclusions This small-scale study has demonstrated the safe and efficacious use of US-guided close reduction of pediatric forearm fractures in a low-resource setting. Using US, real-time visualization of reduction efforts can reassure the clinician in decision making, thus reducing the rate of repeated reductions and allowing shorter hospital stay.
Osteoporosis is an increasingly widespread disease, as well as diabetes mellitus. It is now accepted that osteoporotic fractures are a serious co-morbidity and complication of diabetes. Despite of ...good bone mineral density in Type 2 Diabetes (T2DM) patients is the fracture risk elevated. It is due to reduced bone quality. To determine the effect of glycemic compensation on bone density and trabecular bone score (TBS) in T2DM. We analyzed a cohort of 105 postmenopausal women with T2DM. For all patients, central bone density (spinal and lumbar spine) was tested by DXA methodology, glycemic control parameters were assessed, and anthropometric parameters were measured. Bone quality was analyzed using TBS software. The results were statistically processed. Good glycemic compensation with glycated hemoglobin (A1c) value <7.0 % DCCT did not lead to BMD changes in patients with T2DM. However, patients with HbA1c <7 % DCCT had significantly better TBS (1.254±0.148 vs. 1.166±0.094, p=0.01). There was a negative correlation between TBS and glycated hemoglobin (r= -0,112, p<0.05) with glycemic fasting (r= -0.117, p<0.05). The optimal effect on TBS is achieved when all three markers of glycemic compensation (glycated hemoglobin, fasting plasma glucose and postprandial glycemia) are in optimal range. By using ROC curves glycated hemoglobin has the most significant effect on TBS. Optimal glycemic compensation, evaluated by glycated hemoglobin, does not lead to changes in BMD but has a beneficial effect on TBS in T2DM. Good glycemic control is required also for reduction of the risk of osteoporosis and osteoporotic fractures.
The effects of heavy doping with Cr and doping-induced precipitation on the magnetism of CdTe crystals, grown from the vapor phase, were investigated by means of different analytical electron ...microscopy techniques and magnetic measurements. It was revealed that upon post-grown cooling of the crystals, monoclinic Cr(Cd)
3
Te
4
precipitates with 3.7 at% of Cd nucleate and then form nano-thick single crystalline platelets on the {111} planes of the zinc-blende type Cd(Cr)Te matrix with the orientation relation of
100
Cr(Cd)
3
Te
4
/
/
111
Cd(Cr)Te
and
011
Cr(Cd)
3
Te
4
/
/
01
1
¯
Cd(Cr)Te
. The ferromagnetism of the CdTe:Cr crystals was confirmed in the range from liquid nitrogen temperature to above room temperatures by magnetization measurements using a vibrating sample magnetometer. Off-axis electron holography experiment proved that the ferromagnetism is mostly governed by Cr(Cd)
3
Te
4
particles both at liquid nitrogen temperature and at room temperature. It also revealed the anisotropy of the precipitates’ magnetic properties. The obtained results indicate the precipitation of magnetic dopants as an effective tool to induce high-temperature ferromagnetism into CdTe bulk crystals, which is of tight relevance for their potential spintronic application.
Graphical Abstract
The metabolic performance of the gut microbiota contributes to the onset of type 2 diabetes. However, targeted dietary interventions are limited by the highly variable inter-individual response. We ...hypothesized (1) that the composition of the complex gut microbiome and metabolome (MIME) differ across metabolic spectra (lean-obese-diabetes); (2) that specific MIME patterns could explain the differential responses to dietary inulin; and (3) that the response can be predicted based on baseline MIME signature and clinical characteristics.
Forty-nine patients with newly diagnosed pre/diabetes (DM), 66 metabolically healthy overweight/obese (OB), and 32 healthy lean (LH) volunteers were compared in a cross-sectional case-control study integrating clinical variables, dietary intake, gut microbiome, and fecal/serum metabolomes (16 S rRNA sequencing, metabolomics profiling). Subsequently, 27 DM were recruited for a predictive study: 3 months of dietary inulin (10 g/day) intervention.
MIME composition was different between groups. While the DM and LH groups represented opposite poles of the abundance spectrum, OB was closer to DM. Inulin supplementation was associated with an overall improvement in glycemic indices, though the response was very variable, with a shift in microbiome composition toward a more favorable profile and increased serum butyric and propionic acid concentrations. The improved glycemic outcomes of inulin treatment were dependent on better baseline glycemic status and variables related to the gut microbiota, including the abundance of certain bacterial taxa (i.e., Blautia, Eubacterium halii group, Lachnoclostridium, Ruminiclostridium, Dialister, or Phascolarctobacterium), serum concentrations of branched-chain amino acid derivatives and asparagine, and fecal concentrations of indole and several other volatile organic compounds.
We demonstrated that obesity is a stronger determinant of different MIME patterns than impaired glucose metabolism. The large inter-individual variability in the metabolic effects of dietary inulin was explained by differences in baseline glycemic status and MIME signatures. These could be further validated to personalize nutritional interventions in patients with newly diagnosed diabetes.
This article is focused on endocrine-mediated osteoporosis caused by growth hormone (GH) disorders; adult GH deficiency and acromegaly. GH and insulin like growth factor-1 (IGF-1) stimulate linear ...bone growth through complex hormonal interactions and activates epiphyseal prechondrocytes. GH, via receptor activator of nuclear factor-kappaB (RANK), its ligand (RANK-L), and the osteoprotegerin system, stimulates production of osteoprotegerin and its accumulation in bone matrix. Malfunction of this mechanism, could lead to specific bone impairment. However, the primary problem of bone disease in GH secretion disorders is the primary prevention of osteoporotic fractures, so it is important to determine bone quality that better reflects the patient's actual predisposition to fracture. A method estimating bone quality from lumbar spine dual X-ray absorptiometry (DXA) scans is trabecular bone score (TBS). TBS in addition to bone mineral density (BMD) is a promising predictor of the osteoporotic fracture risk in women with postmenopausal osteopenia. In acromegaly TBS better defines risk of fracture because BMD is normal or even increased. TBS helps to monitor the effect of growth hormone therapy. Despite these findings, TBS should not be used alone, but a comprehensive consideration of all fracture risk factors, BMD and bone turnover markers is necessary.
Polycrystalline (Cd,Cr)Te ingots with 2.5, 5, and 25 at.% of nominal chromium content were prepared by alloying the mixture of elemental Cd, Te, and Cr₂Te₃ salt. The alloys were studied by means of ...scanning electron microscopy, X-ray diffraction, and energy dispersive X-ray spectroscopy methods in order to determine their crystallinity and phase composition. It was found that the ingots of the lowest doped material are composed of continuous CdTe:Cr host matrix with embedded Cr-related second-phase particles. With the exception of zinc-blende type Cd₁₋ₓ Cr ₓ Te, the grains of Cr–Te intermetallic compounds with μm-sized particles of pure Cr are solidified from the higher-doped melt. The mechanism of their formation was examined on the basis of the phase diagram for the Cr–Te system. Chromium solubility limit in the cadmium telluride lattice was estimated to be about 1.5 at.%.
Highly doped CdTe:Cr single crystals were grown by the modified physical vapour transport method from pre-synthesized charge with 2.5 and 5at% of chromium in the initial feed. Complex investigations ...of their structure and composition were performed by means of scanning electron microscopy, X-ray diffraction, energy dispersive X-ray spectroscopy and secondary ion mass-spectroscopy techniques. It was revealed that the grown crystals contain Cr–Te-related particles arised in consequence of phase separation due to exceeding of chromium solubility limit in cadmium telluride. Besides, in the crystal grown from the nominally higher doped ingot there appear Te inclusions and void originated from the presence of Te-rich solutions on the growth interface. Formation mechanism of the observed structural imperfections during growth process was addressed. Concentration of Cr atoms, incorporated into the host matrix of vapour grown CdTe crystals, was found to be about 0.1at%.
•Highly doped CdTe:Cr single crystals were grown by the modified PVT method.•Structure and composition of CdTe:Cr crystals were studied by SEM, XRD, EDX and SIMS.•Cr–Te-related particles, Te inclusions and voids were revealed in CdTe:Cr single crystals.•Formation mechanism of the structural imperfections was addressed.•The solubility of Cr in vapour grown CdTe single crystals was found to be about 0.1at%.
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