Effect of ibandronate on spontaneous osteonecrosis of the knee: a randomized, double-blind, placebo-controlled trial

Summary: Based on this double-blind, placebo-controlled study, ibandronate has no beneficial effect on clinical and radiological outcome in patients with spontaneous osteonecrosis of the knee over and above anti-inflammatory medication. Introduction: Observational studies suggest beneficial effects of bisphosphonates in spontaneous osteonecrosis (ON) of the knee. We investigated whether ibandronate would improve clinical and radiological outcome in newly diagnosed ON. Methods: In this randomized, double-blind, placebo-controlled trial, 30 patients (mean age, 57.3 ± 10.7years) with ON of the knee were assigned to receive either ibandronate (cumulative dose, 13.5mg) or placebo intravenously (divided into five doses 12weeks). All subjects received additional treatment with oral diclofenac (70mg) and supplementation with calcium carbonate (500mg) and vitamin D (400IU) to be taken daily for 12weeks. Patients were followed for 48weeks. The primary outcome was the change in pain score after 12weeks. Secondary endpoints included changes in pain score, mobility, and radiological outcome (MRI) after 48weeks. Results: At baseline, both treatment groups (IBN, n = 14; placebo, n = 16) were comparable in relation to pain score and radiological grading (bone marrow edema, ON). After 12weeks, mean pain score was reduced in both ibandronate- (mean change, −2.98; 95% CI, −4.34 to −1.62) and placebo- (−3.59; 95% CI, −5.07 to −2.12) treated subjects (between-group comparison adjusted for age, sex, and osteonecrosis type, p = ns). Except for significant decrease in bone resorption marker (CTX) in ibandronate-treated subjects (p < 0.01), adjusted mean changes in all functional and radiological outcome measures were comparable between treatment groups after 24 and 48weeks. Conclusions: In patients with spontaneous osteonecrosis of the knee, bisphosphonate treatment (i.e., IV ibandronate) has no beneficial effect over and above anti-inflammatory medication

Resonance Strength Measurement at Astrophysical Energies: The 17O(p,α)14N Reaction Studied via THM

In recent years, the Trojan Horse Method (THM) has been used to investigate the low-energy cross sections of proton-induced reactions on 17 O nuclei, overcoming extrapolation procedures and enhancement effects due to electron screening. We will report on the indirect study of the 17 O(p, α ) 14 N reaction via the Trojan Horse Method by applying the approach developed for extracting the resonance strength of narrow resonance in the ultralow energy region. The mean value of the strengths obtained in the two measurements was calculated and compared with the direct data available in literature

Intra-operative MRI facilitates tumour resection during trans-sphenoidal surgery for pituitary adenomas

Background During trans-sphenoidal microsurgical resection of pituitary adenomas, the extent of resection may be difficult to assess, especially when extensive suprasellar and parasellar growth has occurred. In this prospective study, we investigated whether intra-operative magnetic resonance imaging (iMRI) can facilitate tumour resection. Methods Twenty patients with macroadenomas, (16 non-functioning, three growth-hormone secreting and one pharmaco-resistant prolactinoma) were selected for surgery in the iMRI. The mean tumour diameter was 27 mm (range 11–41). The mean parasellar grade, according to the Knosp classification, was 2.3. Pre-operative coronal and sagittal T1-weighted and T2-weighted images were obtained. The trans-sphenoidal tumour resection was performed at the edge of the tunnel of a Signa SP 0.5-Tesla MRI. The surgeon aimed at a radical tumour resection that was followed by a peri-operative MRI scan. When a residual tumour was visualised and deemed resectable, an extended resection was performed, followed by another MRI scan. This procedure was repeated until the imaging results were satisfactory. In all patients, we were able to obtain images to assess the extent of resection and to classify the resection as either total or subtotal. Results After primary resection, eight out of 20 cases were classified as total resections. A second resection was performed in 11 of 12 cases classified as subtotal resections, and in four of these, total resection was achieved. A third resection was performed in three of the remaining seven cases with subtotal resections, but we did not achieve total resection in any of these cases. Therefore, the use of iMRI increased the number of patients with total resection from 8/20 (40%) to 12/20 (60%). The only observed complication was a transient spinal fluid leakage. Conclusion Intra-operative MRI during trans-sphenoidal microsurgery is useful in selected patients for a safe and more complete resection. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited

Particle Size Effects on the Quality of Flour Tortillas Enriched with Whole Grain Waxy Barley

Wheat tortillas were enriched with whole barley flour (WBF) of different particle sizes including 237 µm (regular [RD. 131 µm (intermediate [IM]). and 68 µm (microground [MG], Topographical and fluorescent microstructure images of flours, doughs, and tortillas were examined, Flours and tortillas were analyzed for color, protein, ash, starch, moisture. and β-glucan content. Farinograph testing was conducted on the flour blends, Water activity and texture analyses of tortillas were conducted, A 9-point hedonic scale was used by 95 untrained panelists to evaluate tortilla appearance, color, flavor, texture, and overall acceptability, Two commercial products (CP) were included in some analyses, As WBF particle size decreased, color was lighter; protein, moisture content and mixing stability decreased; ash, starch content, water absorption and farinograph peak time increased: and β-glucan content was constant. WBF tortillas were darker than the control (C), while 1M and MG tortillas had lower peak forces than C, No flavor differences were reported among C, R, and MG tortillas but higher scores were given to both CP in all attributes tested, Tortillas made with the largest WBF particle size (R) were the most similar in protein content, texture and flavor when compared with C tortillas made with refined bread flour

К проблеме социальной эффективности инноваций в профессиональном образовании

Movile Cave, Romania, is an unusual underground ecosystem that has been sealed off from the outside world for several million years and is sustained by non-phototrophic carbon fixation. Methane and sulfur-oxidising bacteria are the main primary producers, supporting a complex food web that includes bacteria, fungi and cave-adapted invertebrates. A range of methylotrophic bacteria in Movile Cave grow on one-carbon compounds including methylated amines, which are produced via decomposition of organic-rich microbial mats. The role of methylated amines as a carbon and nitrogen source for bacteria in Movile Cave was investigated using a combination of cultivation studies and DNA stable isotope probing (DNA-SIP) using 13C-monomethylamine (MMA). Two newly developed primer sets targeting the gene for gamma-glutamylmethylamide synthetase (gmaS), the first enzyme of the recently-discovered indirect MMA-oxidation pathway, were applied in functional gene probing. SIP experiments revealed that the obligate methylotroph Methylotenera mobilis is one of the dominant MMA utilisers in the cave. DNA-SIP experiments also showed that a new facultative methylotroph isolated in this study, Catellibacterium sp. LW-1 is probably one of the most active MMA utilisers in Movile Cave. Methylated amines were also used as a nitrogen source by a wide range of non-methylotrophic bacteria in Movile Cave. PCR-based screening of bacterial isolates suggested that the indirect MMA-oxidation pathway involving GMA and N-methylglutamate is widespread among both methylotrophic and non-methylotrophic MMA utilisers from the cave

Effects and mechanisms of strength training in children

It has been demonstrated that strength training can be organized in children in a safe and effective way. However, there is limited data regarding its impact on muscle hypertrophy. This study investigated the effects of a high-intensity strength training (HIS) on knee extensor/flexor strength, countermovement (CMJ) jumping height, postural control, soft lean mass and muscle cross-sectional area (CSA) of the dominant leg in prepubertal children. Thirty-two children participated in this study and were assigned to an intervention (INT; N=17) or a control class ( N=15). The INT participated in 10 weeks of weight-machine based HIS integrated in physical education. Pre/post tests included the measurements of peak torque of the knee extensors/flexors at 60 and 180°/s, CMJ jumping height, postural sway, soft lean mass of the leg by bioelectrical impedance analysis, and CSA (m. quadriceps) by magnetic resonance imaging. HIS resulted in significant increases in knee extensor/flexor peak torque (60°/s and 180°/s). HIS did not produce significant changes in CMJ jumping height, postural sway, soft lean mass, and CSA. Although HIS was effective at increasing peak torque of the knee extensors/flexors in children, it was unable to affect muscle size. It appears that neural factors rather than muscle hypertrophy account for the observed strength gains in children