Effect Of Calcitrol And Calcium Supplementation In The Prevention Of Glucocorticoid-Induced Osteoporosis Among Systemic Lupus Erythematosus Patiens

Prolonged glucocorticoid therapy can lead to loss of bone mineral density (BMD) and higher risk of fracture. Fortunately this can be prevented or reduced if preventive measures are started early. Calcitriol (1 ,25-dihydroxyvitamin D3) and calcium supplementation is a rational therapy for minimising bone loss but has not been widely used locally. Our primary objective was to study the effect of calcitriol and calcium carbonate supplementation in the prevention of glucocorticoid-induced osteoporosis in our local systemic lupus erythematosus (SLE) patients. Our secondary objectives were to identify factors, which influenced the rate of bone loss in our SLE patients and also to see the effect of calcitriol and calcium carbonate on glucocorticoid-induced bone loss in the subgroup of patients with normal or reduced baseline BMD Sixty-nine SLE patients who were on long term glucocorticoid therapy were randomly assigned to receive either oral calcitriol 0.25 ).lg BD or calcium carbonate 1.25 gm BD for one year. BMD was measured every six months for a year by the same dual X-ray absorptiometry (DXA). There were no significant differences between groups at entry with respect to demographics and risk factors for osteoporosis. Analysis was done to see the effect of supplementation on the BMD of the spine and femur. Further sub-analysis was made to see the effect of supplementation on BMD of patients with normal bone density or osteopenia at entry. Calcitriol was more effective than calcium in preventing bone loss from the spine. Mean percentage change at 6 month for calcitriol and calcium were 2.16% and -0.55 % (p=0.05) respectively. While mean of change of BMD at one year for calcitriol and calcium were 0.52% and -0.32% respectively. Calcitriol also prevent bone loss from the femur in the first 6 months of the study (mean percentage change of 0.63o/o) but to a lesser degree than that in the spine. Calcium was unable to provide any protection against bone loss in the spine or femur. Those patients with osteopenic at baseline benefited most from calcitriol and calcium supplementation. When given calcitriol, their mean percentage increase in BMD of the spine were 3.62% at 6 month and 1.68% at one year. Those on calcium also showed an increase in BMD of 0. 77% and 1.66% respectively. Patients with normal baseline bone density showed an improvement only at the spine at 6 month (percentage increase of 1.12%) when given calcitriol supplementation. Calcitriol supplementation was more effective in preventing glucocorticoid-induced bone loss than calcium supplementation. Calcitriol with calcium supplementation offered protection against glucocorticoid-induced bone loss if given to patients who were osteopenia

Manganese-Catalyzed Cross-Coupling of Thiols with Aryl Iodides

Here we report the manganesecatalyzedcoupling reaction of thiols witharyl iodides, giving the aryl thioethers ingood to excellent yields; the system showsgood functional group tolerance and enablesthe sterically demanding aryl iodides tocouple with thiols

Differential effects of calcium- and vitamin D-fortified milk with FOS-inulin compared to regular milk, on bone biomarkers in Chinese pre- and postmenopausal women

PURPOSE: To compare the effects of a high-calcium vitamin D-fortified milk with added FOS-inulin versus regular milk on serum parathyroid hormone, and bone turnover markers in premenopausal (Pre-M) and postmenopausal (PM) women over 12 weeks. METHODS: Premenopausal women (n = 136, mean age 41 (±5) years) and postmenopausal women [n = 121, mean age 59 (±4) years] were recruited, and each age group randomised into two groups to take two glasses per day of control = regular milk (500 mg calcium per day) or intervention (Int) = fortified milk (1000 mg calcium for pre-M women and 1200 mg calcium for PM women, 96 mg magnesium, 2.4 mg zinc, 15 µg vitamin D, 4 g FOS-inulin per day). At baseline, week 4 and week 12 serum minerals and bone biochemical markers were measured and bone density was measured at baseline. RESULTS: Mean 25-hydroxyvitamin D [25(OH) vitamin D3] levels among groups were between 49 and 65 nmol/L at baseline, and over the 12 weeks of supplementation, the fortified milk improved vitamin D status in both Int groups. CTx-1 and PINP reduced significantly in both Pre-M and PM groups over the 12 weeks, with the changes in CTx-1 being significantly different (P < 0.035) between PM control and PM Int groups at week 12. Parathyroid hormone levels were significantly reduced in all groups over time, except for control PM group where levels increased at 12 weeks. CONCLUSION: The overall pattern of responses indicates that while both regular milk and fortified milk reduce bone resorption in young and older women, fortified milk is measurably more effective

Melanogenesis Inhibitor(s) from Phyla nodiflora

Overexpression of tyrosinase can cause excessive production of melanin and lead to hyperpigmentation disorders, including melasma and freckles. Recently, agents obtained from plants are being used as alternative medicines to downregulate tyrosinase synthesis and decrease melanin production. Phyla nodiflora Greene (Verbenaceae) is used as a folk medicine in Taiwanese for treating and preventing inflammatory diseases such as hepatitis and dermatitis. However, the antimelanogenesis activity and molecular biological mechanism underlying the activity of the methanolic extract of P. nodiflora (PNM) have not been investigated to date. Our results showed that PNM treatment was not cytotoxic and significantly reduced the cellular melanin content and tyrosinase activity in a dose-dependent manner (P<0.05). Further, PNM exhibited a significant antimelanogenesis effect (P<0.05) by reducing the levels of phospho-cAMP response element-binding protein and microphthalmia-associated transcription factor (MITF), inhibiting the synthesis of tyrosinase, tyrosinase-related protein-1 (TRP-1), and TRP-2, and decreasing the cellular melanin content. Moreover, PNM significantly activated the phosphorylation of mitogen-activated protein kinases, including phospho-extracellular signal-regulated kinase, c-Jun N-terminal kinase, and phospho-p38, and inhibited the synthesis of MITF, thus decreasing melanogenesis. These properties suggest that PNM could be used as a clinical and cosmetic skin-whitening agent to cure and/or prevent hyperpigmentation

Physicochemical and sensory analysis of instant cereal beverage incorporated with corncob powder

The primary objectives of this study were to process corncob into corncob powder (CCP) and to apply CCP in the formulation of instant cereal beverage (ICB) in order to produce high fibre ICB, and to investigate the physicochemical and sensory properties of the corncob-based instant cereal beverage. Corncobs were sourced and washed thoroughly before drying and grinding into CCP. CCP was then imparted into ICB formulation in three different ratios (10, 20 and 30% w/w) to partially substitute corn flour in the formulation. All four ICB samples including the commercial counterpart were analysed for their physicochemical and sensory properties. The incorporation of CCP has affected the viscosity, colour and sensory attributes significantly of the produced ICB. Higher contents of CCP in the formulation was found to be responsible for less viscous and browner effect compared to the commercial ICB samples. Formulation of ICB incorporated with 30% w/w CCP had the highest mean scores (6.00, p<0.05) of overall acceptability among all the other formulations and it was comparable to the commercial ICB in the current market

Technology Anxiety and Implicit Learning Ability Affect Technology Leadership to Promote the use of Information Technology at Elementary Schools

Abstract“Oversold & underused” is a criticism by Cuban (2001) of the investment of information technology (IT) in the classroom. Recently, Taiwan's educational administration has provided considerable financial support to IT in elementary schools, but few reports have provided evidence of its successful use. The present study aims to identify the personal factors that affect principals’ beliefs about the promotion of IT in their schools. 331 data were collected and analyzed with AMOS 19.0. The results of this study indicated that greater technology anxiety was negatively associated with perceived ease of using (PEU) IT, whereas implicit learning ability was positively correlated with perceived usefulness of IT. Technology leadership increased significantly with PEU and perceived usefulness (PU), it is also associated with the intention to overcome difficulties in promoting information technology in schools. The implications of this study may contribute to the reduction of principals’ technology anxiety, increasing their implicit learning ability and therefore fostering the future implementation of IT in schools, changing the myth of technology as “oversold & underused”

Reliable and valid NEWS for Chinese seniors: measuring perceived neighborhood attributes related to walking

Background : The effects of the built environment on walking in seniors have not been studied in an Asian context. To examine these effects, valid and reliable measures are needed. The aim of this study was to develop and validate a questionnaire of perceived neighborhood characteristics related to walking appropriate for Chinese seniors (Neighborhood Environment Walkability Scale for Chinese Seniors, NEWS-CS). It was based on the Neighborhood Environment Walkability Scale - Abbreviated (NEWS-A), a validated measure of perceived built environment developed in the USA for adults. A secondary study aim was to establish the generalizability of the NEWS-A to an Asian high-density urban context and a different age group. Methods : A multidisciplinary panel of experts adapted the original NEWS-A to reflect the built environment of Hong Kong and needs of seniors. The translated instrument was pre-tested on a sample of 50 Chinese-speaking senior residents (65+ years). The final version of the NEWS-CS was interviewer-administered to 484 seniors residing in four selected Hong Kong districts varying in walkability and socio-economic status. Ninety-two participants completed the questionnaire on two separate occasions, 2-3 weeks apart. Test-rest reliability indices were estimated for each item and subscale of the NEWS-CS. Confirmatory factor analysis was used to develop the measurement model of the NEWS-CS and cross-validate that of the NEWS-A. Results : The final version of the NEWS-CS consisted of 14 subscales and four single items (76 items). Test-retest reliability was moderate to good (ICC &gt; 50 or % agreement &gt; 60) except for four items measuring distance to destinations. The originally-proposed measurement models of the NEWS-A and NEWS-CS required 2-3 theoretically-justifiable modifications to fit the data well. Conclusions : The NEWS-CS possesses sufficient levels of reliability and factorial validity to be used for measuring perceived neighborhood environment in Chinese seniors. Further work is needed to assess its construct validity and generalizability to other Asian locations. In general, the measurement model of the original NEWS-A was generalizable to this study context, supporting the feasibility of cross-country and age-group comparisons of the effect of the neighborhood environment on walking using the NEWS-A as a tool to measure the perceived built environment

Substance abuse in adolescence in Taiwan Focus on ketamine

Ketamine is an anesthetic and analgesic agent but has been identified to have abuse potential in recent years. Ketamine abuse is found to be rapidly increasing especially among adolescents and early adults for its relative low cost and lack of immediate severe side effects. Ketamine is a NMDA antagonist and has acute antidepressant effects from recent pharmacological research. The association between abuse potential and antidepressant effects is still uncertain. Though there are no obvious physical withdrawal symptoms of ketamine, strong cravings were noted from chronic ketamine abusers. On the other hand, ketamine can cause severe damage to the urinary system. “Ketamine-induced uropathy” was proposed in recent years, with presentation of severe lower tract urinary symptoms (LUTS; including frequency, urgency, dysuria and hematuria) and urinary system damage. Similar to patients with other substance abuse, ketamine abusers have higher incidence of co-morbid psychiatric diseases. Currently there is still lack of specific medical treatment for managing ketamine abuse, but psychosocial intervention plays an important role especially for adolescents. In this brief review, we hope to call more attention to this emerging problem