Bisphosphonates in osteoporosis: Where do we stand in 2009?

Bisphosphonates were discovered 40 years ago and remain the market leader in the field of osteoporosis. Bisphosphonates are classified as inhibitors of bone resorption and they act by inhibiting the mevalonate pathway to inhibit protein prenylation with resultant inhibition of osteoclastic activity. There are three ethical bisphosphonates as well as generic alendronate that have been approved for the treatment of osteoporosis in South Africa. These drugs offer a wide range of variations in dose, frequency of administration and method of administration. The wide choice in method of administration may lead to improved individual compliance to treatment protocols. There is strong evidence to support antifracture efficacy at vertebral and hip sites in patients treated for up to three years but long-term data as well as prospective data in osteopenic patients are lacking. Gastrointestinal side-effects are common, but can often be avoided by taking medication in the prescribed fashion. The acute phase response to intravenous administration can be prevented by co-administration of oral paracetamol or ibuprofen. Bisphosphonates can cause bone pain. The Food and Drug Administration (FDA) has accepted evidence that bisphosphonates do not cause atrial fibrillation. Osteonecrosis of the jaw is a rare complication of oral bisphosphonates as used in osteoporosis but may be associated with high dose intravenous treatment in cancer patients. Atypical low energy femur shaft fractures have been associated with long-term usage of the bisphosphonates. A large national observational register-based study reported that these fractures share the same epidemiology and treatment response as classical hip fractures and are best classified as osteoporotic fractures. The cost-effectiveness and treatment options of the bisphosphonates will ensure that they remain significant players in years to come.

Performance of autumn lambing ewes and lambs on irrigated and dryland winter pastures

(South African J of Animal Science, 2000, 30, Supplement 1: 151-152

Current Status of Simulations

As the title suggests, the purpose of this chapter is to review the current status of numerical simulations of black hole accretion disks. This chapter focuses exclusively on global simulations of the accretion process within a few tens of gravitational radii of the black hole. Most of the simulations discussed are performed using general relativistic magnetohydrodynamic (MHD) schemes, although some mention is made of Newtonian radiation MHD simulations and smoothed particle hydrodynamics. The goal is to convey some of the exciting work that has been going on in the past few years and provide some speculation on future directions.Comment: 15 pages, 14 figures, to appear in the proceedings of the ISSI-Bern workshop on "The Physics of Accretion onto Black Holes" (8-12 October 2012

The SARAO MeerKAT 1.3 GHz Galactic Plane Survey

We present the SARAO MeerKAT Galactic Plane Survey (SMGPS), a 1.3 GHz continuum survey of almost half of the Galactic Plane (251○ ≤l ≤ 358○ and 2○ ≤l ≤ 61○ at |b| ≤ 1 5). SMGPS is the largest, most sensitive and highest angular resolution 1 GHz survey of the Plane yet carried out, with an angular resolution of 8″ and a broadband RMS sensitivity of ∼10–20 μJy beam−1. Here we describe the first publicly available data release from SMGPS which comprises data cubes of frequency-resolved images over 908–1656 MHz, power law fits to the images, and broadband zeroth moment integrated intensity images. A thorough assessment of the data quality and guidance for future usage of the data products are given. Finally, we discuss the tremendous potential of SMGPS by showcasing highlights of the Galactic and extragalactic science that it permits. These highlights include the discovery of a new population of non-thermal radio filaments; identification of new candidate supernova remnants, pulsar wind nebulae and planetary nebulae; improved radio/mid-IR classification of rare Luminous Blue Variables and discovery of associated extended radio nebulae; new radio stars identified by Bayesian cross-matching techniques; the realisation that many of the largest radio-quiet WISE H II region candidates are not true H II regions; and a large sample of previously undiscovered background H I galaxies in the Zone of Avoidance

The MeerKAT Galaxy Cluster Legacy Survey: I. Survey overview and highlights

Please abstract in the article.The South African Radio Astronomy Observatory (SARAO), the National Research Foundation (NRF), the National Radio Astronomy Observatory, US National Science Foundation, the South African Research Chairs Initiative of the DSI/NRF, the SARAO HCD programme, the South African Research Chairs Initiative of the Department of Science and Innovation.http://www.aanda.orghj2022Physic

Preventing osteoporosis in postmenopausal women: Treatment approaches for family practitioners

Osteoporosis is defined as a systemic skeletal disorder that reduces the strength of bone, resulting in an increased risk of fracture. Fractures occur, even if an individual is subjected to minimal trauma such as a fall from own body height. The most common osteoporotic fractures are fractures of the vertebrae, femur neck and distal forearm but other peripheral fractures also play an important role. Osteoporotic fractures are common and will affect at least a third of women over the age of 50 years.1 It not only leads to significant morbidity, but also increased mortality. Osteoporosis is an age-related disease. In view of expectations that life expectancy is on the rise, the scope of the problem and the burden of the disease will escalate in future. The incidence of osteoporotic fractures in South Africa has not been recorded and most of our calculations are derived from Europe and North America. A false Impression has been created that Black South Africans are not prone to osteoporosis. It is true that ethnic Blacks have a lesser tendency to fracture at equivalent bone mineral density (BMD) values than do Europeans. This should however not distract from the fact that many Blacks suffer from the avoidable consequences of osteoporotic fractures. The prevention of osteoporotic fractures is a national priority for all our people. It is therefore obvious that the modern family physician needs to have a basic knowledge of the disease condition and a strategy for the prevention of fractures.Revie

The WHI: The effect of hormone replacement therapy on fracture prevention

The Women's Health Initiative (WHI) randomized, controlled trial was the first study to prove that hormone replacement therapy (HRT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women, even those at low risk of fracture. The study authors concluded that the bone-friendly aspect of HRT was limited in clinical practice as possible adverse effects outweighed possible benefit. On the strength of these publications, regulatory authorities downgraded the use of HRT for the prevention of fracture to second-line therapy. This article examines the original and subsequent evidence presented by the WHI study and concludes that the restrictions placed on HRT as a bone-specific drug by regulatory bodies have not withstood the test of time and are not supported by the data of the WHI. © 2012 International Menopause Society

The relationshipb etweenp re- and post-weaningp erformanceo f lambs on Italian ryegrass

The relationship between pre- and post-weaning performance of lambs on Italian ryegrass was investigated by grazing tambsa t differents tockingr ates.A positivec orrelationw asf ound betweenb oth the pre-weanings tockingr ate (P = 0.008)a nd weaningm ass( P = 0.001)a ndt he posGweaninga veraged aily gain, wherep ost-weanings tocking rate was not siSnificantw hen relatedt o animal performanceT. he correlationb etweent he w€aningm assi n early August and the final mass of lambs in Novembeq after 83 days on ryegnss, was highly significant (p = 0.001). Lambs stocked at a low stocking rate (20 ewes with lambVha) prior to weaning gained 13.3 kg, while lambs in the high pre-weanings tockingr ate( 36 ewesw ith lambVha)g ained1 1.9k g duringt hep ost-weaningp eriod.T he smaller lambs,o riginatingf tom pasturesw ith heavys tockingr ates,c ouldn ot catchu p on ryegrassp asturesi,n termso fmass gain, to achievea cceptables laughterm assw ithin a reasonablpee dod of time. The optimum pre-weaning stocking rate for ewes and lamb vhao n ryegrassw ill dependn oi only on the weaningm assd esired,b ut alsoo n the marketins strategyo f the producerf or the lambsafter weaning.Die verwantskaptu ssenv oor-e n na-speenp restasiev anl ammersw, at Italiaansera aigraste env erskillendev eebeladings gewei het, is ondersoek'.n Positiewek orrelasieis gevindt ussenb eidev oorspeenv eebelading(P = 0.008) en speenmass(aP = 0.001)o p na-speeng emiddelded aagliksem assatoenamme,e t na-speenv eebeladingn ie betekenisvol verwanta and iereplestasinei e.D ie korrelasietu ssens peenmassvar oegi n Augustuse n die finale massav and ie lammersi n Novembern a 83 daeo p raaigrasis hoogsb etekenisvo(lP = 0.001).L ammersi n die yoorsDeenla e veebelading( 20 ooie met lammers/hah) et 13.3k g en die lammersin die hod voorspeenv eebelading(3 6 ooie met lammers/ ha)h et I1.9 kg in massag edurended ie na-speenp eriodet oegeneemD. ie kleinerl ammers,a fkomstigv an hod veebeladingsh,e t nie op die weidingi n termev anm assatoenamoep gevango m 'n aanvaarbarsel agmassbai nner edelike tyd te bereik nie. Die optimum voorspeenv eebeladingv ir ooie en lammers/hao p raaigrass al nie slegsb epaal word deurd ie speenmasswaa t bereikw il word nie,m aaro ok deurd ie bemarkilg strategiev and ie produsenmt et die lammers na speen,Keywords: ltalian ryegrass, lambs, pre- and post-weaning performance

Crystallization of synthetic haemozoin (β-haematin) nucleated at the surface of lipid particles

The mechanism of formation of haemozoin, a detoxification by-product of several blood-feeding organisms including malaria parasites, has been a subject of debate; however, recent studies suggest that neutral lipids may serve as a catalyst. In this study, a model system consisting of an emulsion of neutral lipid particles was employed to investigate the formation of β-haematin, the synthetic counterpart of haemozoin, at the lipid-water interface. A solution of monoglyceride, either monostearoylglycerol (MSG) or monopalmitoylglycerol (MPG), dissolved in acetone and methanol was introduced to an aqueous surface. Fluorescence, confocal and transmission electron microscopic (TEM) imaging and dynamic light scattering analysis of samples obtained from beneath the surface confirmed the presence of homogeneous lipid particles existing in two major populations: one in the low micrometre size range and the other in the hundred nanometre range. The introduction of haem (Fe(iii)PPIX) to this lipid particle system under biomimetic conditions (37 °C, pH 4.8) produced β-haematin with apparent first-order kinetics and an average half life of 0.5 min. TEM of monoglycerides (MSG or MPG) extruded through a 200 nm filter with haem produced β-haematin crystals aligned and parallel to the lipid-water interface. These TEM data, together with a model system replacing the lipid with an aqueous organic solvent interface using either methyl laurate or docosane demonstrated that the OH and CO groups are apparently necessary for efficient nucleation. This suggests that β-haematin crystallizes via epitaxial nucleation at the lipid-water interface through interaction of Fe(iii)PPIX with the polar head group. Once nucleated, the crystal grows parallel to the interface until growth is terminated by the curvature of the lipid particle. The hydrophobic nature of the mature crystal favours an interior transport resulting in crystals aligned parallel to the lipid-water interface and each other, strikingly similar to that seen in malaria parasites. © The Royal Society of Chemistry 2010.Articl