A study of the value of trabecular bone score in fracture risk assessment of postmenopausal women

Objective: Trabecular Bone Score (TBS) is an index of bone microarchitecture that provides additional skeletal information to areal Bone Mineral Density (aBMD). Recently TBS data has been used to optimize the Fracture Risk Assessment Tool (FRAX) predictive value. The aim of this study was to evaluate the clinical value of TBS on FRAX algorithm. Materials and Methods: Among total of 358 postmenopausal Iranian women (mean age 61.3 ± 9.5 years) tested for aBMD and TBS, 184 osteopenic women were identified. Thoracolumbar spine X-ray done in all participants revealed twenty-one vertebral fractures. For the osteopenic group, FRAX and TBS adjusted FRAX (FRAX-TBS) were calculated and compared. Results: Mean TBS of the patients was 1.31 (±0.11). A significant correlation was found between TBS and spine aBMD (r = 0.50, p < 0.001) and TBS and femoral neck aBMD (r = 0.37, p < 0.0001). A strong positive correlation was observed between aBMD adjusted FRAX and FRAX-TBS in predicting the risk of major osteoporotic fracture (r = 0.90, p < 0.0001), and hip fracture (r = 0.97, p < 0.0001). According to the area under the receiver operating characteristics curve, the predictive value of the three different models using aBMD, TBS, and combination of aBMD and TBS were similar (0.765, 0.776, and 0.781, respectively; p = 0.19). The proportion of the women needed treatment remained unchanged using FRAX or FRAX-TBS. Conclusion: This study showed no clinical benefit for TBS in postmenopausal women. Adding TBS data to aBMD or FRAX neither improved aBMD predictive value for vertebral fracture nor changed the decision on treatment based on FRAX. © 201

Diabetes management during the COVID-19 pandemic: An Iranian expert opinion statement

The coronavirus infection is an evolving pandemic with high morbidity and mortality, especially in people with comorbidities. The case fatality rate (CFR) is 9.2 in the presence of diabetes, while it is 1.4 in those without any comorbidity. Diabetes is a prevalent disease globally; hence, healthcare professionals are highly concerned about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic progression. Current evidence does not support higher incidence of coronavirus disease 2019 (COVID-19) in people with diabetes (PWD). However, people with diabetes are considered high risk for developing complications. Optimal metabolic control is a challenging concept, especially in the presence of an acute and severe respiratory viral infection. In this consensus, we considered the challenging issues in management of patients with diabetes during the COVID-19 pandemic. The consensus covers various aspects of outpatient as well as inpatient care based on the current evidence. © 2020 The Author(s)

Occurrence Of Aflatoxin M1 In Raw Milk Produced In Ardebil Of Iran

Contamination of milk and dairy products to aflatoxin M1 is a risk for human and it can be a public heath concern. The aim of this study was to evaluate the presence of aflatoxin M1 in raw milk samples produced in Ardebil City (Iran) by ELISA (Enzyme Linked Immuno Sorbent Assay) technique. 122 samples of raw milk were collected from milk collecting centers and dairy plants in the region and aflatoxin M1 contamination was detected in all of milk samples. The mean concentration of aflatoxin M1 was 40.01ng/L and 14.75 percent of the samples had higher levels than the maximum recommended limits by ISIRI, European Community and Codex Alimentarius. With a view of the fact that milk is used by all the age groups including infants and children in the city of Ardebil, it is necessary to apply an ideal recommended limit to minimize the health hazard from aflatoxin M1 contamination in milk. Application of Good Agricultural Practices and Good Veterinary Practices by agriculture and also the Hazard Analysis and Critical Control Points (HACCP) system as a draft code of practice for preharvest and postharvest control of dairy cow’s feed and in milk and dairy products processing is effective

MGMT hypermethylation and BCL-2 overexpression associated with superficial bladder cancer and recurrence

BACKGROUND: Urinary bladder carcinoma is one of the leading causes of death among men, and its high recurrence rates make it one of the most solid tumors to treat. The silencing of the tumor suppressor gene by hypermethylation of the CpG islands and overexpression of proto-oncogene proteins are the main mechanisms in cancers. Here, we investigate methylation status of O6-methylguanine-DNA-methyltransferase (MGMT), a tumor suppressor gene and expression level of BCL-2 a proto-oncogene protein that is frequently observed in bladder carcinoma and its recurrences. MATERIALS AND METHODS: We analyzed the methylation of MGMT in 80 tissue samples of patients suffering from bladder cancer and 80 urine samples of cancer-free individuals by MS-PCR. Additionally, BCL-2 protein expression level was analyzed on these 80 tissue samples by immunohistochemistry. RESULTS: 45 of patients had MGMT methylation, of which this hypermethylation does not have significant association with an increase in grade, but there was significant association in cases with recurrence tumors and metastasis tumors. Among patients with recurrence tumor, 92.5 patients showed MGMT hypermethylation; 66 of these showed BCL-2 overexpression. CONCLUSION: Our data indicate that MGMT hypermethylation and BCL-2 overexpression may have an intense role in superficial bladder cancer recurrences. © 2016 - IOS Press and the authors