Estimating the avoidable burden of certain modifiable risk factors in osteoporotic hip fracture using Generalized Impact Fraction (GIF) model in Iran

Backgrounds: The number of hip fractures, the most common complication of osteoporosis, has increased rapidly over the past decades. The goal of this study is to estimate the avoidable burden of certain modifiable risk factor of the condition using the Generalized Impact Fraction (GIF) model, which has been suggested and used by epidemiologists to overcome the drawbacks associated with the use of Attributable Fraction index. In addition to preventing a risk factor or the avoidable fraction of burden, this index can also calculate the change in the burden, when a risk factor is altered.Methods: International databases were searched through PubMed, CINAHLD, Embase using OVID and Google scholar. National resources were searched through IranDoc, IranMedex, SID and Journal sites. Other resources include abstract books and articles sent to the IOF congress. The following search strategy was used: (" Osteoporotic fracture" OR " Fragility Hip fracture" OR " Calcium" OR " vitamin D" OR " BMI" OR " lean body weight" OR " Physical activity" OR " exercise" OR " Smoke" ) AND (" prevalence" OR " incidence" OR " relative risk" ) and limited to " humans." Results: With regards to different scenarios already explained in modifying the studied risk factors, the greatest impact in reducing the prevalence of risk factors on osteoporotic hip fractures, was seen in low serum vitamin D levels, low physical activity and low intake of calcium and vitamin D, respectively. According to the fact that interventions for low serum vitamin D and low intake of calcium and vitamin D, are related to each other, it can be concluded that implementing interventions to change these two risk factors, in the easy, moderate and difficult scenarios, would result in approximately a 5%, 11% and 17% decrease in the burden of osteoporotic hip fractures, respectively. The addition of interventions addressing low physical activity in the easy, moderate and difficult scenarios, an 8%, 21% and 35% reduction in the burden of osteoporotic hip fractures would be reported, respectively.Conclusion: Improving serum vitamin D levels, recommending the consumption of calcium and vitamin D supplementations and advocating physical activity are the most effective interventions to reduce the risk of osteoporotic hip fractures. © 2013 Shahnazari et al; licensee BioMed Central Ltd

Directing mesenchymal stem cells to bone to augment bone formation and increase bone mass.

Aging reduces the number of mesenchymal stem cells (MSCs) that can differentiate into osteoblasts in the bone marrow, which leads to impairment of osteogenesis. However, if MSCs could be directed toward osteogenic differentiation, they could be a viable therapeutic option for bone regeneration. We have developed a method to direct MSCs to the bone surface by attaching a synthetic high-affinity and specific peptidomimetic ligand (LLP2A) against integrin α4β1 on the MSC surface to a bisphosphonate (alendronate, Ale) that has a high affinity for bone. LLP2A-Ale induced MSC migration and osteogenic differentiation in vitro. A single intravenous injection of LLP2A-Ale increased trabecular bone formation and bone mass in both xenotransplantation studies and in immunocompetent mice. Additionally, LLP2A-Ale prevented trabecular bone loss after peak bone acquisition was achieved or as a result of estrogen deficiency. These results provide proof of principle that LLP2A-Ale can direct MSCs to the bone to form new bone and increase bone strength

A panel of cultivate specific marker based on polymorphisms at microsatellite markers for Iranian cultivated Almonds (Prunus dulcis).

Molecular markers developed for Prunus also offer a powerful tool to study the evolution of the genome, and for understanding of genome structure and determinants of genetic diversity. Two hundred eighty almond genotypes/cultivars from different origins distributed throughout Iran besides some foreign cultivars and their hybrids with Iranian ones were collected. Microsatellite analysis was carried out using 9 pair flanking SSR sequences previously cloned and sequenced specifically in almond. The total number of detected alleles was 152 (9 to 20 alleles per locus with an average of 16.87). The mean PIC value of the polymorphic loci wasrelatively high (0.81) and the mean value for He was 0.83, so that we were able to distinguish 98% of the genotypes using 5 loci. Incluster analysis, the genotypes were divided into 2 major groups, foreign cultivars and Iranian almond genotypes. Principal coordinate analysis based on Shared Allele method indicated proper distribution of the studied markers through the genome. Some specific markers were recorded among the germ plasm which can be used efficiently in rapid and precise identification of the related genotypes and also in breeding programs through MAS. Genotypes were coded using our suggested coding method for genotype molecular identification

Ionizing Radiation Stimulates Expression of Pro-Osteoclastogenic Genes in Marrow and Skeletal Tissue

Exposure to ionizing radiation can cause rapid mineral loss and increase bone-resorbing osteoclasts within metabolically-active, cancellous-bone tissue leading to structural deficits. To better understand mechanisms involved in rapid, radiation-induced bone loss, we determined the influence of total-body irradiation on expression of select cytokines known both to stimulate osteoclastogenesis and contribute to inflammatory bone disease. Adult (16wk), male C57BL/6J mice were exposed to either 2Gy gamma rays (137Cs, 0.8Gy/min) or heavy ions (56Fe, 600MeV, 0.50-1.1Gy/min); this dose corresponds to either a single fraction of radiotherapy (typical total dose is 10Gy) or accumulates over long-duration, interplanetary missions. Serum, marrow, and mineralized tissue were harvested 4hrs-7d later. Gamma irradiation caused a prompt (2.6-fold within 4hrs) and persistent (peaking at 4.1-fold within 1d) rise in the expression of the obligate osteoclastogenic cytokine, receptor activator of nuclear factor kappaB-ligand (Rankl) within marrow cells over controls. Similarly, Rankl expression peaked in marrow cells within 3d of iron exposure (9.2-fold). Changes in Rankl expression induced by gamma irradiation preceded and overlapped with a rise in expression of other pro-osteoclastic cytokines in marrow (e.g., monocyte chemotactic protein-1 increased 11.9-fold, tumor necrosis factor-alpha increased 1.7- fold over controls). Marrow expression of the RANKL decoy receptor, osteoprotegerin (Opg), also rose after irradiation (11.3-fold). The ratio Rankl/Opg in marrow was increased 1.8-fold, a net pro-resorption balance. As expected, radiation increased a serum marker of resorption (tartrate resistant acid phosphatase) and led to cancellous bone loss (16% decrease in bone volume/total volume) through reduced trabecular struts. We conclude that total-body irradiation (gamma or heavy-ion) caused temporal, concerted regulation of gene expression within marrow and mineralized tissue for select cytokines which are responsible for osteoclastogenesis and elevated resorption; this is likely to account for rapid and progressive 52 deterioration of cancellous microarchitecture following exposure to ionizing radiation

Changes in cortical bone response to high-fat diet from adolescence to adulthood in mice

UnlabelledDiabetic obesity is associated with increased fracture risk in adults and adolescents. We find in both adolescent and adult mice dramatically inferior mechanical properties and structural quality of cortical bone, in agreement with the human fracture data, although some aspects of the response to obesity appear to differ by age.IntroductionThe association of obesity with bone is complex and varies with age. Diabetic obese adolescents and adult humans have increased fracture risk. Prior studies have shown reduced mechanical properties as a result of high-fat diet (HFD) but do not fully address size-independent mechanical properties or structural quality, which are important to understand material behavior.MethodsCortical bone from femurs and tibiae from two age groups of C57BL/6 mice fed either HFD or low-fat diet (LFD) were evaluated for structural and bone turnover changes (SEM and histomorphometry) and tested for bending strength, bending stiffness, and fracture toughness. Leptin, IGF-I, and non-enzymatic glycation measurements were also collected.ResultsIn both young and adult mice fed on HFD, femoral strength, stiffness, and toughness are all dramatically lower than controls. Inferior lamellar and osteocyte alignment also point to reduced structural quality in both age groups. Bone size was largely unaffected by HFD, although there was a shift from increasing bone size in obese adolescents to decreasing in adults. IGF-I levels were lower in young obese mice only.ConclusionsWhile the response to obesity of murine cortical bone mass, bone formation, and hormonal changes appear to differ by age, the bone mechanical properties for young and adult groups are similar. In agreement with human fracture trends, adult mice may be similarly susceptible to bone fracture to the young group, although cortical bone in the two age groups responds to diabetic obesity differently

A panel of cultivate specific marker based on polymorphisms at microsatellite markers for Iranian cultivated almonds (Prunus dulcis).

Abstract Molecular markers developed for Prunus also offer a powerful tool to study the evolution of the genome, and for understanding of genome structure and determinants of genetic diversity. Two hundred eighty almond genotypes/cultivars from different origins distributed throughout Iran besides some foreign cultivars and their hybrids with Iranian ones were collected. Microsatellite analysis was carried out using 9 pair flanking SSR sequences previously cloned and sequenced specifically in almond. The total number of detected alleles was 152 (9 to 20 alleles per locus with an average of 16.87). The mean PIC value of the polymorphic loci was relatively high (0.81) and the mean value for H e was 0.83, so that we were able to distinguish 98% of the genotypes using 5 loci. In cluster analysis, the genotypes were divided into 2 major groups, foreign cultivars and Iranian almond genotypes. Principal coordinate analysis based on Shared Allele method indicated proper distribution of the studied markers through the genome. Some specific markers were recorded among the germplasm which can be used efficiently in rapid and precise identification of the related genotypes and also in breeding programs through MAS. Genotypes were coded using our suggested coding method for genotype molecular identification

Dried plum diet protects from bone loss caused by ionizing radiation

Bone loss caused by ionizing radiation is a potential health concern for radiotherapy patients, radiation workers and astronauts. In animal studies, exposure to ionizing radiation increases oxidative damage in skeletal tissues, and results in an imbalance in bone remodeling initiated by increased bone-resorbing osteoclasts. Therefore, we evaluated various candidate interventions with antioxidant or anti-inflammatory activities (antioxidant cocktail, dihydrolipoic acid, ibuprofen, dried plum) both for their ability to blunt the expression of resorption-related genes in marrow cells after irradiation with either gamma rays (photons, 2 Gy) or simulated space radiation (protons and heavy ions, 1 Gy) and to prevent bone loss. Dried plum was most effective in reducing the expression of genes related to bone resorption (Nfe2l2, Rankl, Mcp1, Opg, TNF-α) and also preventing later cancellous bone decrements caused by irradiation with either photons or heavy ions. Thus, dietary supplementation with DP may prevent the skeletal effects of radiation exposures either in space or on Earth

Deleterious Effects of Simulated Spaceflight on Bone and Microvasculature in Adult Mice

Long-term spaceflight leads to extensive changes in the musculoskeletal system attributable, in part, to unloading during microgravity exposure. Additionally, irradiation at doses similar to that of a solar flare or a round-trip sojourn to Mars may cause significant depletion of stem/progenitor cell pools throughout the body as well as inflammation associated with prompt skeletal-tissue degradation. Previously, we demonstrated that irradiation leads to rapid bone loss, which can be mitigated in the short term by injection of a potent antioxidant (-lipoic acid). Furthermore, simulated weightlessness in adult mice adversely affects skeletal responses to low linear energy transfer (LET) radiation (137Cs). Here, we hypothesized that simulated weightlessness exacerbates the adverse effects of simulated space radiation (including both protons and 56Fe ions) by adversely affecting skeletal structure and functions as well as associated vasculature. Furthermore, we hypothesized that an antioxidant cocktail, which has been shown to be protective in other tissues, mitigates space radiation induced bone loss

Comparing the effect of two teaching methods about HIV/AIDS on the students' knowledge and attitude at Islamic Azad University of Lahijan in 2003

Background : Inappropriate nutrition has an important role in many pathological conditions , including such common diseases as diabetes, cancer and cardiovascular diseases. Despite the recognition that physicians are often called upon to provide counseling in nutritional aspects of diseases, nutrition does not hold the place it deserves in medical schools' curricula, especially in clinical and case-based teaching. Objectve: The aim of this study was to determine the knowledge, attitude and practice of interns in Kerman Medical University regarding the nutrition. Methods: Self-administered questionnaires, including 29 questions and in a cross-sectional study were completed by 105 interns. Results: The mean knowledge, attitude and practice scores were 6.93 ± 1.89 (out of 14), 15.50 ± 3.54 (out of 40) and 1.48 ± 1.58 (out of 7), respectively. There were no significant differences in knowledge and practice scores between males and females, but male interns had higher score in attitude (P<0.05). We detected a statistically significant positive correlation between knowledge and attitude (r=0.22 , P=0.023), so that the higher knowledge level, the higher attitude score. A significant negative relationship was observed between interns' attitudes and their practices (r=-0.33 ,P= 0.001). Despite good attitude concerning nutrition principles, their practice scores were undesirable. Conclusion : The results of this study indicate that there are serious defects in the knowledge of the interns concerning the principles of nutrition. Furthermore, their attitudes and practices about nutrition are undesirable. Considering the importance of proper nutrition for good health and treatment and prevention of disease, there is a need for improvement of nutritional knowledge in future doctors. This requires careful planning and curricula changes to include the principles and practice of nutrition. In other words, nutririon needs to be re-evaluated and properly integrated into the medical school's curriculum. Keywords: Education, lecture, poster, knowledge, attitude, HIV/AIDS