Mechanical Competence Of Ovariectomy-induced Compromised Bone After Single Or Combined Treatment With High-frequency Loading And Bisphosphonates

Osteoporosis leads to increased bone fragility, thus effective approaches enhancing bone strength are needed. Hence, this study investigated the effect of single or combined application of high-frequency (HF) loading through whole body vibration (WBV) and alendronate (ALN) on the mechanical competence of ovariectomy-induced osteoporotic bone. Thirty-four female Wistar rats were ovariectomized (OVX) or sham-operated (shOVX) and divided into five groups: shOVX, OVX-shWBV, OVX-WBV, ALN-shWBV and ALN-WBV. (Sham) WBV loading was applied for 10 min/day (130 to 150 Hz at 0.3g) for 14 days and ALN at 2 mg/kg/dose was administered 3x/week. Finite element analysis based on micro-CT was employed to assess bone biomechanical properties, relative to bone micro-structural parameters. HF loading application to OVX resulted in an enlarged cortex, but it was not able to improve the biomechanical properties. ALN prevented trabecular bone deterioration and increased bone stiffness and bone strength of OVX bone. Finally, the combination of ALN with HF resulted in an increased cortical thickness in OVX rats when compared to single treatments. Compared to HF loading, ALN treatment is preferred for improving the compromised mechanical competence of OVX bone. In addition, the association of ALN with HF loading results in an additive effect on the cortical thickness.5Fund for Scientific Research of Flanders (FWO Vlaanderen)Brazilian Science Without Borders Program [246131/2012-8

Perfil dos produtores rurais do Rio Pardo de Minas: estudo de caso nas comunidades Monte Alegre, Vereda Funda e Água Boa (I e II).

Resumo - O estudo objetiva traçar o perfil técnico-econômico, social, ambiental e institucional dos produtores rurais de três comunidades do município de Rio Pardo de Minas (Vereda Funda; Água Boa I e II e Monte Alegre), sendo um esforço inicial na busca por compreender as necessidades, demandas e aspirações da agricultura familiar local. O levantamento é resultado de dados primários coletados por meio de visitas exploratórias e da aplicação de 92 questionários semiestruturados. Um resultado interessante foi perceber que os produtores rurais, embora com baixos níveis de produtividade, escolaridade e de capacitação técnica, têm consciência da necessidade da preservação ambiental, dos seus fatores críticos e dos gargalos estruturais que determinam o fraco nível de desenvolvimento econômico local. O estudo permitiu concluir que algumas soluções tecnológicas simples e intervenções públicas plausíveis poderiam gerar benefícios imediatos para as comunidades, tais como: melhorar os sistemas de produção e práticas de manejo; aumentar a qualidade da mão de obra por meio de capacitação e assistência técnica; direcionar mais crédito rural para investimento em cisternas, poços artesianos, sistemas de irrigação, insumos agropecuários (como máquinas e equipamentos, adubos e fertilizantes, defensivos agrícolas), dentre outros. Abstract - The study aims to trace the technical, economic, social, environmental and institutional profile of farmers in three communities of Rio Pardo de Minas (Vereda Funda, Água Boa I and II and Monte Alegre), being an initial effort in the search for understanding the needs, demands and aspirations of the local family farmers. The survey is the result of primary data collected through exploratory visits and application of 92 semi-structured questionnaires. An interesting result was to realize that farmers, albeit with low levels of productivity, education and technical training, are very aware of the environmental preservation´s need and the critical structural factors that determine the low level of local economic development. The study concluded that some simple technological solutions and plausible public interventions could bring immediate benefits to the three communities farmers, such as improving production systems and management practices; increase the quality of labor force through training and technical assistance; direct more rural credit for investment in water tanks, wells, irrigation systems, agricultural inputs (such as machinery and equipment, fertilizers, pesticides), among others

Perfil dos produtores rurais de Rio Pardo de Minas: estudo de caso nas comunidades Monte Alegre, Vereda Funda e Água Boa (I e II).

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Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

Purpose: Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods: An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results: A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion: The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary: This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice

ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

Abstract The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease