The use of ultrasound in the assessment of bone status

The assessment of skeletal status has wide clinical applications, especially in the management of osteoporosis. Osteoporosis, once thought of as an unpreventable and untreatable aging process, has revealed many of its secrets over the last decade, and the advent of successful drug therapy has changed our perception of the disease. Non-invasive techniques play a fundamental role in the diagnosis of osteoporosis and in the assessment of the efficacy of drug treatments. The primary technique used in osteoporosis is dual X-ray absorptiometry (DXA), that has been established as a reliable means of measuring bone density. Quantitative ultrasound (QUS), because of the relative portability of the equipment, ease of use, lack of ionizing radiation and low cost, has great potential for widespread use. Five devices for QUS assessment have recently been approved by the Food and Drug Administration and many more applications are in progress. QUS is a relatively new technology, at least in its application to bone fragility. Nevertheless, QUS has demonstrated that it is able to detect bone fragility as well as DXA. However, diagnosis of osteoporosis by QUS remains contentious, but the problems are due more to the limitations of the present T-scores rather than to the technique. A better option for QUS would be to report results in terms of remaining lifetime fracture risk, keeping in mind that a risk estimate needs not only the QUS or DXA measurement, but also the specific data, such as age, weight, gender, hormonal status and fracture history of the patien

Geochemistry of european bottled water

In Europe, ca. 1900 "mineral water" brands are officially registered and bottled for drinking. Bottled water is groundwater and is rapidly developing into the main supply of drinking water for the general population of large parts of Europe. This book is the first state of the art overview of the chemistry of groundwaters from 40 European countries from Portugal to Russia, measured on 1785 bottled water samples from 1247 wells representing 884 locations plus additional 500 tap water samples acquired in 2008 by the network of EuroGeoSurveys experts all across Europe. In contrast to previously available data sets, all chemical data were measured in a single laboratory, under strict quality control with high internal and external reproducibility, affording a single high quality, internally consistent dataset. More than 70 parameters were determined on every sample using state of the art analytical techniques with ultra low detection limits (ICPMS, ICPOES, IC) at a single hydrochemical lab facility. Because of the wide geographical distribution of the water sources, the bottled mineral, drinking and tap waters characterized herein may be used for obtaining a first estimate of "groundwater geochemistry" at the scale of the European Continent, a dataset previously unavailable in this completeness, quality and coverage. This new data set allows, for the first time, to present a comprehensive internally consistent, overview of the natural distribution and variation of the determined chemical elements and additional state parameters of groundwater at the European scale. Most elements show a very wide range \u2013 usually 3 to 4 but up to 7 orders of magnitude \u2013 of natural variation of their concentration. Data are interpreted in terms of their origin, considering hydrochemical parameters, such as the influence of soil, vegetation cover and mixing with deep waters, as well as other factors (bottling effects, leaching from bottles). Chapters are devoted to comparing the bottled water data with those of European tap water and previously published datasets and discussing the implications of water chemistry for health. The authors also provide an overview of the legal framework, that any bottled water sold in the European Union must comply with. It includes a comprehensive compilation of current drinking water action levels in European countries, limiting values of the European Drinking/Mineral/Natural Mineral Water directives (1998/83/EC, 2003/40/EC, 2009/54/EC) and legislation in effect in 26 individual European Countries, and for comparison those of the FAO and in effect in the US (EPA, maximum contaminant level)

Geochemistry of European Bottled Waters.

Vengono riportate le concentrazioni di elementi in traccia delle acque minerali dell'Europa acquistate nei punti di vendit