Discordance in diagnosis of osteoporosis using spine and hip bone densitometry

BACKGROUND: Diagnostic discordance for osteoporosis is the observation that the T-score of an individual patient varies from one key measurement site to another, falling into two different diagnostic categories identified by the World Health Organization (WHO) classification system. This study was conducted to evaluate the presence and risk factors for this phenomenon in a large sample of Iranian population. METHODS: Demographic data, anthropometric measurements, and risk factors for osteoporosis were derived from a database on 4229 patients referred to a community-based outpatient osteoporosis testing center from 2000 to 2003. Dual-energy X-ray absorptiometry (DXA) was performed on L1–L4 lumbar spine and total hip for all cases. Minor discordance was defined as present when the difference between two sites was no more than one WHO diagnostic class. Major discordance was present when one site is osteoporotic and the other is normal. Subjects with incomplete data were excluded. RESULTS: In 4188 participants (3848 female, mean age 53.4 ± 11.8 years), major discordance, minor discordance, and concordance of T-scores were seen in 2.7%, 38.9% and 58.3%, respectively. In multivariate logistic regression analysis, older age, menopause, obesity, and belated menopause were recognized as risk factors and hormone replacement therapy as a protective factor against T-score discordance. CONCLUSION: The high prevalence of T-score discordance may lead to problems in interpretation of the densitometry results for some patients. This phenomenon should be regarded as a real and prevalent finding and physicians should develop a particular strategy approaching to these patients

Correlations between Diffusion Tensor Imaging (DTI) and Magnetic Resonance Spectroscopy (1H MRS) in schizophrenic patients and normal controls

<p>Abstract</p> <p>Background</p> <p>Evidence suggests that white matter integrity may play an underlying pathophysiological role in schizophrenia. N-acetylaspartate (NAA), as measured by Magnetic Resonance Spectroscopy (MRS), is a neuronal marker and is decreased in white matter lesions and regions of axonal loss. It has also been found to be reduced in the prefrontal and temporal regions in patients with schizophrenia. Diffusion Tensor Imaging (DTI) allows one to measure the orientations of axonal tracts as well as the coherence of axonal bundles. DTI is thus sensitive to demyelination and other structural abnormalities. DTI has also shown abnormalities in these regions.</p> <p>Methods</p> <p>MRS and DTI were obtained on 42 healthy subjects and 40 subjects with schizophrenia. The data was analyzed using regions of interests in the Dorso-Lateral Prefrontal white matter, Medial Temporal white matter and Occipital white matter using both imaging modalities.</p> <p>Results</p> <p>NAA was significantly reduced in the patient population in the Medial Temporal regions. DTI anisotropy indices were also reduced in the same Medial Temporal regions. NAA and DTI-anisotropy indices were also correlated in the left medial temporal region.</p> <p>Conclusion</p> <p>Our results implicate defects in the medial temporal white matter in patients with schizophrenia. Moreover, MRS and DTI are complementary modalities for the study of white matter disruptions in patients with schizophrenia.</p

Investigating of Antifungal Activity of Polylactic Acid Film Containing Iron Nanoparticles in a Food System

Background and Aims: Food contamination by fungi threatens human health. Active packaging containing antifungal compounds is a novel method to increase the safety and preservation of food. The aim of this study was to produce and investigate the antifungal properties of poly-lactic acid active film containing iron nanoparticles in grape juice packaging. Materials and Methods: Poly-lactic acid nanocomposite films were prepared by casting method through adding different amounts of nanoparticles (0, 2 and 4%) to 4% (w/w) solution of poly-lactic acid in chloroform and antifungal effect of films were investigated in in vitro and grape juice packaging. For this purpose, circular disks (6 mm) of film were prepared and placed on Potato Dextrose Agar media culture inoculated whit Aspergillus niger, Penicillium notatum, Botrytis cinerea. The diameter of the zone of inhibition was reported based on millimeters after 5 days of incubation of the plates at 27 ° C. In order to investigate the antifungal effect of nanocomposite in packaging of grape juice, 5×104 cfu/ml of these molds were inoculated to pasteurized grape juice and then packed with termal sewing and after a 15-days period, the molds population was counted. Results: The distribution of nanoparticles in the polymer, was uniform at concentration of 2% and formed agglomerate at concentration of 4%. The results of the disc diffusion test showed that adding of nanoparticles to the film caused antifungal effect against the tested fungi and this property increased with increasing percentage of nanoparticles. Also, the results of the study on the antifungal effect in grape juice packaging in the 15-days period showed that the population of fungi had an inverse relationship with concentrations of iron nanoparticles in grape juice samples. A. niger showed the most and B. sinera showed the least resistance to this nanoparticle.  Conclusions: Significant compatibility between iron nanoparticles and poly lactic acid provides the possibility of producing poly-lactic acid nanocomposite as an alternative for synthetic polymers from petroleum derivatives. Iron nanoparticles produce anti-fungal effects through the leakage of lactase dehydrogenase from the cell wall, impairment in mitochondrial function, chromosomes compression, and production of free radicals of oxygen. Due to the antifungal effect of iron nanoparticles, its application in poly-lactic acid film decreases fungal growth and, as a result, increases the shelf-life of foods

Differences in the MRI Signature and ADC Values of Diffuse Midline Gliomas with H3 K27M Mutation Compared to Midline Glioblastomas

We conducted a two-center retrospective survey on standard MRI features including apparent diffusion coefficient mapping (ADC) of diffuse midline gliomas H3 K27M-mutant (DMG) compared to midline glioblastomas H3 K27M-wildtype (midGBM-H3wt). We identified 39 intracranial DMG and 18 midGBM-H3wt tumors. Samples were microscopically re-evaluated for microvascular proliferations and necrosis. Image analysis focused on location, peritumoral edema, degree of contrast enhancement and DWI features. Within DMG, MRI features between tumors with or without histomorphological GBM features were compared. DMG occurred in 15/39 samples from the thalamus (38%), in 23/39 samples from the brainstem (59%) and in 1/39 tumors involving primarily the cerebellum (2%). Edema was present in 3/39 DMG cases (8%) versus 78% in the control (midGBM-H3wt) group (p &lt; 0.001). Contrast enhancement at the tumor rim was detected in 17/39 DMG (44%) versus 67% in control (p = 0.155), and necrosis in 24/39 (62%) versus 89% in control (p = 0.060). Strong contrast enhancement was observed in 15/39 DMG (38%) versus 56% in control (p = 0.262). Apparent diffusion coefficient (ADC) histogram analysis showed significantly higher skewness and kurtosis values in the DMG group compared to the controls (p = 0.0016/p = 0.002). Minimum relative ADC (rADC) values, as well as the 10th and 25th rADC-percentiles, were lower in DMGs with GBM features within the DMG group (p &lt; 0.001/p = 0.012/p = 0.027). In conclusion, DMG cases exhibited markedly less edema than midGBM-H3wt, even if histomorphological malignancy was present. Histologically malignant DMGs and midGBM-H3wt more often displayed strong enhancement, as well as rim enhancement, than DMGs without histomorphological malignancy. DMGs showed higher skewness and kurtosis values on ADC-histogram analysis compared to midGBM-H3wt. Lower minimum rADC values in DMGs indicated malignant histomorphological features, likely representing a more complex tissue microstructure