1,721,053 research outputs found
Bone metabolism in primary hypercalciuria
Full text linkPrimary Hypercalciuria (PH) is very frequently accompanied by some degrees of bone demineralization. The most frequent clin- ical condition in which this association has been studied is cal- cium nephrolithiasis. In these patients bone density has been reported to be very frequently low and increased susceptibility to fragility fractures has been described. One of the most im- portant aspects is the very poor definition of this bone disease from aic point of view. At present, the mostcommon findings seem to range from those of a low bone turnover condition to an osteomalacic trait. Many factors are in- volved in the complex relationships between bone loss and PH. Since bone loss has been mainly reported in patients with fast- ing hypercalciuria, a primary alteration in bone metabolism has
been proposed as a cause of both hypercalciuria and bone
demineralization. This hypothesis has been strengthened by
the observation that some bone resorbing-cytokines, such as
IL-1, IL-6, and TNF- are elevated in hypercalciuric patients. The effect of an excessive response to the acid load induced by di- etary protein intake seems an additional factor explaining a primitive alteration of bone. The intestine plays a major role in the clinical course of bone disease in PH. Patients with absorp-tive hypercalciuria less frequently show bone disease and a re-
duction in dietary calcium greatly increases the probability of bone loss in PH subjects. It has recently been reported that greater bone loss is associated with a larger increase in intesti- nal calcium absorption in PH patients. Considering the absence of PTH alterations, it has been proposed that this is not a com- pensatory phenomenon, but probably the marker of disturbed
cell calcium transport, involving both intestinal and bone tis- sue. While renal hypercalciuria is rather uncommon, the kidney still seems to play a role in the pathogenesis of bone loss of PH patients, possibly via the effect of mild to moderate urinary phosphate loss, with secondary hypophosphatemia. In conclu- sion, bone loss is very common among PH patients. Even if most of the factors involved in this process have been identi- fied, many aspects of this intriguing clinical condition remain to be elucidate
Osteoporosis associated with idiopathic hypercalciuria: A peculiar form of metabolic bone disease.
No full text
Clodronate in a case of femoral head stress fracture in a male with idiopathic osteoporosis: complete recovery with a 6-year follow-up
No full textA male patient 54-year-old, sport practice (tennis and keep-fit exercise) suddenly suffered from disabling pain in the right hip with a severe functional limitation, in absence of any trauma. MRI showed an evident bone marrow edema of the whole femoral right head and neck, that leaded to the diagnosis of CRPS-1. He was therefore treated with a 30-day course of hyperbaric room without results. After rheumatological visit a further radiological opinion changed the diagnosis to incomplete fracture of femoral head with diffuse bone marrow edema. Therefore, he was treated with intravenous clodronate (CLO) at the dose of 300 mg in 250 cc of saline solution for 10 days, added to cholecalciferol, with complete recovery within 4 weeks. Maintenance treatment was performed with weekly intramuscular CLO for 6 months. At this time male idiopathic osteoporosis (spine T-score -3.1) was diagnosed and treated with alendronate. After 6-year follow-up, no pain nor functional limitation was present, and spine T-score decreased to -1.9
Climate change, air pollution, and increase of respiratory allergies: just a coincidence or something more?
Full text linkIt is well known that the prevalence of respiratory allergies has increased over time. At the same time, climate change has become part of our everyday life. The resulting question is whether this 'allergic epidemic' is linked to this aspect. It is assumed that the causes of the increase of respiratory allergies are mainly related to environmental factors and lifestyle: first, the improvement of social and health conditions and related hygiene hypothesis; secondly, lifestyle change and anthropogenic activities, which have caused an alteration in the balance normally existing between soil, water, and atmosphere, giving rise to the phenomena of climate change. In fact, it has been demonstrated that they can influence beginning, duration, and intensity of the pollen season, as well as the allergenicity of pollen. The consequence is both an increase in frequency and intensity of allergic symptomatology in subjects previously affected by allergy, and a promotion of the sensitization of the airways to allergens present in the atmosphere in predisposed subjects. Several intervention strategies aiming to mitigate climate change and reduce anthropogenic emissions and, consequently, respiratory allergies are possible and can be implemented on an individual and social level. It follows that the allergist cannot solve the problem of the progressive increase of respiratory allergies on his own. Anyway, his role can have both clinical and educational purposes with a special commitment to reduce health impact due to environmental risk factors. KEYWORDS: respiratory allergies; allergenic potential of pollen; climate change; pollution
Prevalenza di bassa massa ossea e fratture da fragilità pre e post trapianto di fegato.
No full textVERONA, 21-23 OTTOBR
IgE-mediated fish allergy in children: is omega-3 supplementation useful?
No full textThe management of fish allergy relies on the elimination of all fish from the diet. Nevertheless, an exclusion diet can be problematic from a paediatric nutritional perspective. The issue of a substitute diet for children suffering from fish allergy seems to be not adequately addressed and the consequences of a fish exclusion diet in paediatric age are not known. Fish has an important nutritional value, it is rich in vitamins of group B, D and A, selenium, calcium and phosphorus, iron, zinc, magnesium, iodine and omega-3. While vitamins and iodine are normally present in the diet, omega-3 is present in few other foods, such as vegetable seed oils and nuts. Hence, the scientific research indicates a generic advice regarding a possible omega-3 supplementation in children with fish allergy. Given the knowledge about omega-3 supplementation having a potential good risk-benefit ratio and the absence of serious adverse events related to the omega-3 supplementation, this type of supplementation may seem advisable in children affected by fish allergy
Osteogenesis Imperfecta: A Heterogeneous Heritable Disease
No full textBone is a dynamic organ, able to replace old or disrupted tissue through a remodelling process. It contains a relatively small number of cells (osteoblasts, osteocytes, osteoclasts and Mesenchymal Stem Cells (MSCs)) entrenched in a matrix. Perturbation or disruption of the complex molecular pathways controlling MSC proliferation and osteogenic commitment may be determined by mutations affecting key genes in bone development. Osteogenesis Imperfecta (OI) also known as brittle bone disease is a genetic pathology in which bones do not form properly and therefore are fragile and break easily. OI is a heterogeneous congenital heritable disease that mainly affects connective tissues. Nowadays we number 18 types of OI, characterized by various modes of inheritance: autosomal dominant, recessive and X-linked
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