Mortality, bone density and grip strength: lessons from the past and hope for the future?

Lay Summary: What does this mean for patients? Low grip strength is important in the diagnosis of sarcopenia (loss of muscle mass and strength with age) and low bone density is used to define osteoporosis. Both sarcopenia and osteoporosis are common conditions among older people and are related to increased risk of poor health. In this study we examined grip strength and bone density in relation to the risk of death using data from older UK men and women from the Hertfordshire Cohort Study (aged 59–73 years at the start of the study). Lower grip strength was related to an increased risk of death (any cause) and death due to cardiovascular causes. In contrast, the relationships between bone density and risk of death (any cause) and death due to cardiovascular causes were weak. Relationships between muscle strength and risk of death were much stronger than the relationships between bone density and risk of death. This may reflect better treatment of low bone density, compared with low muscle strength, in this group of older people. This suggests that advances in the treatment of low muscle strength are required

Acute appendicitis caused by endometriosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Endometriosis is a well-recognized gynecological condition in the reproductive age group. Surgical texts present the gynecological aspects of the disease in detail, but the published literature on unexpected manifestations, such as appendiceal disease, is inadequate. The presentation to general surgeons may be atypical and pose diagnostic difficulty. Thus, a definitive diagnosis is likely to be established only by the histological examination of a specimen.</p> <p>Case presentation</p> <p>We report a case of endometriosis of the appendix in a 25-year-old Caucasian woman who presented with symptoms of acute appendicitis and was treated by appendectomy, which resulted in a good outcome.</p> <p>Conclusions</p> <p>We discuss special aspects of acute appendicitis caused by endometriosis to elucidate the pathologic entity of this variant of acute appendicitis.</p

Greater pQCT calf muscle density is associated with lower fracture risk, independent of FRAX, falls and BMD: a meta-analysis in the osteoporotic fractures in men (MrOS) study

We investigated the predictive performance of peripheral quantitative computed tomography (pQCT) measures of both calf muscle density (an established surrogate for muscle adiposity, with higher values indicating lower muscle adiposity and higher muscle quality) and size (cross-sectional area [CSA]) for incident fracture. pQCT (Stratec XCT2000/3000) measurements at the tibia were undertaken in Osteoporotic Fractures in Men (MrOS) United States (US), Hong Kong (HK), and Swedish (SW) cohorts. Analyses were by cohort and synthesized by meta-analysis. The predictive value for incident fracture outcomes, illustrated here for hip fracture (HF), using an extension of Poisson regression adjusted for age and follow-up time, was expressed as hazard ratio (HR) per standard deviation (SD) increase in exposure (HR/SD). Further analyses adjusted for femoral neck (fn) bone mineral density (BMD) T-score, Fracture Risk Assessment Tool (FRAX) 10-year fracture probability (major osteoporotic fracture) and prior falls. We studied 991 (US), 1662 (HK), and 1521 (SW) men, mean ± SD age 77.0 ± 5.1, 73.9 ± 4.9, 80 ± 3.4 years, followed for a mean ± SD 7.8 ± 2.2, 8.1 ± 2.3, 5.3 ± 2.0 years, with 31, 47, and 78 incident HFs, respectively. Both greater muscle CSA and greater muscle density were associated with a lower risk of incident HF [HR/SD: 0.84; 95% confidence interval [CI], 0.72–1.0 and 0.78; 95% CI, 0.66–0.91, respectively]. The pattern of associations was not materially changed by adjustment for prior falls or FRAX probability. In contrast, after inclusion of fn BMD T-score, the association for muscle CSA was no longer apparent (1.04; 95% CI, 0.88–1.24), whereas that for muscle density was not materially changed (0.69; 95% CI, 0.59–0.82). Findings were similar for osteoporotic fractures. pQCT measures of greater calf muscle density and CSA were both associated with lower incidence of fractures in older men, but only muscle density remained an independent risk factor for fracture after accounting for fn BMD. These findings demonstrate a complex interplay between measures of bone, muscle size, and quality, in determining fracture risk. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research

Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort

Objectives:We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged-infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies.Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries.Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT(&gt; MIC) (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving beta-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of &gt;= 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025].Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections

Interaction between karst terrain and bauxites : evidence from Quaternary orebody distribution in Guangxi, SW China.

Research Article. Geology. 2017.Abstract available in PDF file

Pyrite-rich bauxites from the Parnassos-Ghiona zone, Greece

Bauxite samples from the transition zone between red and grey type bauxite of the Parnassos-Ghiona geotectonic zone were analyzed for major and trace elements, including rare elements, and phase chemistry, using SEM/EDS, with the aim of establishing particular characteristics for this bauxite type that are indicative of its environment at formation. The most abundant mineral phases are boehmite or diaspore, hematite/goethite or pyrite. Anatase, kaolinite, chamosite, zircon and rare earth minerals are present in lesser amounts. Pyrite in a variety of forms and size, is a major mineral in gray bauxites and has a significant Se content (average 0.3 wt% Se). Also, gray bauxites are characterized by a lower REE content relative to red ones. Results suggest multi-stage modification of the ore

Chemical and mineralogical characteristics of tourmaline in pegmatites from Vavdos, Chalkidiki peninsula, N Greece

Pegmatite veins crosscutting dunites and serpentinites of the ophiolitic complex of the Vavdos (Gioldaki and Loukoviti), northern Greece contain tourmalines with a wide variation in size and composition. Pegmatite veins mainly consist of quartz crystals, microcline, albite, perthitised-feldspars. The accessory minerals include mostly coarse to medium grained zoned tourmaline, and lesser amounts of sericite (only occasionally biotite). There are also trace amounts of some rare earth element minerals, such as morazite, xenotime and minerals of the bastnaesite group (epigenetic products of monazite). The pegmatite veins host also fine-grained tourmalile, which shows an orientation parallel to the schistosity of the rock. They are composed of quartz, low-T albite and K-feldspars. Hydroxy apatite, chlorite, Nb-bearing REE minerals (koragoite), garnet, zircon and talc are also present in lesser amounts

Micro-organisms as fossils and present-day development in Ni-laterites and bauxites of the Balkan peninsula

A common feature of the Palaiochori (Grevena) and Katjeli Ni-laterite deposits, located in northern Greece and Albania,respectively, is the lack of magnetite or ferrian chromite surrounding chromite grains. The investigation using SEM/EDS of these Ni-laterites and grey bauxites of Greece, characterised by the presence of abundant pyrite, revealed the presence of micro-organism fossils. There is a close association of various bacteria with the pyrite surface, resulting in the dissolution of the latter. The sulphide/microbe interactions developed on pyrite surface and surrounding pisolites, suggest that such bacteria, which are able to selectively leach iron from bauxites and nickel from low-grade Ni-laterites, may have important biotechnological implications

The role of microorganisms on the mineralogical and geochemical characteristics of the Parnassos-Ghiona bauxite deposits, Greece

The Parnassos-Ghiona bauxite deposits of Greece are hosted within carbonate rocks and have been formed during different geological ages. The most economically important deposits occur in the B3 bauxite horizon, which is developed over long distance as a continuous layer of 1-10 m in thickness, within Cretaceous limestones. Due to intense tectonics, a significant (approximately 30 vol.%) bauxite ores along and near their contact with faults show a brittle deformation and change in the color from red to black-gray, in a distance of tens of meter. Commonly gray to whitish bauxites are aluminum-enriched (&amp;gt; 65 wt.% Al2O3) and iron depleted. The most salient feature of bauxite ores of black-gray, grayish-brown or yellowish color along faults is the abundance of secondary pyrite of varying size (from less than 1 μm to a few hundreds μm) and form, which is closely associated with organic matter. Frambroidal pyrite and pyrite veins crosscutting sulfide-rich zones are occasionally present. Dismembered pyrrhotite and pentlandite crystals are only occasionally present. Pyrite is Co, Ni free, while Se varies from 0.7 to 0.9 wt.% Se. Pyrrhotite is Ni-bearing (up to 0.5 wt.% Ni) and pentlandite contains cobalt (average 1.5 wt.% Co). Textural relationships between Fe-sulfides/Fe-oxides, and the total organic carbon (TOC) content, ranging from 0.06 wt.% in red-color bauxite ores to 2.78 wt.% in gray-color ores, is consistent with a biological activity. Bacteria may play a significant role in the mineralogical and chemical composition of laterite ores, and in leaching and beneficiation of low-grade ores. Due to the behaviour of ferric iron as an electron acceptor for energy metabolism in a wide spectrum of bacteria the mobility of iron in the bauxite ores may be the result of an effective leaching by percolating pore waters, depending mostly on the pH-Eh conditions. © 2006 Elsevier B.V. All rights reserved