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Summary: The only difference between fractured and non-fractured postmenopausal women with PHPT of same sex, age, and BMI was a significantly mean higher serum k-periostin level. K-periostin value was associated with fracture at any site (odds ratio 1.044, 95% CI 1.005–1.091, p = 0.03). Introduction: To assess serum k-periostin fragment levels in patients with primary hyperparathyroidism (PHPT), fractured and non-fractured matched for sex, age, and body mass index. Methods: Twenty-five Caucasian fractured postmenopausal women with PHPT (group Fx) and 25 PHPT non-fractured (group NFx) were enrolled. Each patient underwent DXA scan at lumbar, hip, and forearm, spine X-ray, and biochemical evaluation of calcium metabolism. For k-periostin analyses, we utilized a specific ELISA test that detects CatK-generated fragment levels in the bloodstream. Results: We found no difference in mean BMD and bone turnover marker values between Fx and NFx groups. Prevalence of osteoporosis was not significantly different in Fx vs NFx (72% vs 60%, p = 0.55). Among Fx, 16% reported multiple fractures, 28% morphometric vertebral fractures, 4% femoral fractures, 28% non-vertebral non-femoral fractures, and 8% wrist fractures. The only detectable difference between Fx and NFx group was a significantly mean higher k-periostin serum level (46.2 ± 21.4 vs 34.7 ± 13.5 ng/ml, p = 0.02). K-periostin was associated with fracture at any site (odds ratio 1.044, 95% CI 1.005–1.091, p = 0.03). No difference in mean k-periostin values was found between patients with vertebral fracture vs those with non-vertebral fracture, and between those with multiple fractures vs those with single fracture. Conclusion: Serum k-periostin is significantly associated with fracture in PHPT. If confirmed by further studies, k-periostin could be considered a new marker of bone fragility in PHPT, independently of BMD. [ABSTRACT FROM AUTHOR]

Summary: This paper reports our personal experience filling the gap regarding changes of bone mineral density after surgical treatment in patient suffering from tumor-induced osteomalacia. Introduction: No systematic data are available regarding long-term bone mineral density (BMD) changes after surgical cure of patients with tumor-induced osteomalacia. Methods: From October 2001 through April 2018, we studied 10 consecutive patients (mean age ± SD, 45.5 ± 13.8 years; 5 males and 5 females) with tumor-induced osteomalacia. We evaluated BMD when initially presented at our Center and after surgical removal of the tumor. Results: Basal BMD and corresponding Z-score values (mean values ± SD) measured by DXA were as follows: L1–L4 = 0.692 ± 0.15 g/cm2, Z-score = − 2.80 ± 1.60; femur neck 0.447 ± 0.10 g/cm2, Z-score = − 2.66 ± 0.93; total femur = 0.450 ± 0.08 g/cm2, Z-score = −3.04 ± 0.85). Furthermore, Trabecular Bone Score (TBS) was evaluated in three patients (basal values, 0.990 ± 0.32). Seven patients were intermittently followed after surgical excision of the tumor while supplemented with cholecalciferol and calcium salts; the remaining three were lost to follow-up. There was a striking increase of BMD values that peaked at 26.7 ± 6.50 months: L1–L4 = 1.289 ± 0.247 g/cm2, p < 0.001, Z-score + 1.75 ± 1.42; femur neck = 0.890 ± 0.235 g/cm2, p = 0.028, Z-score = + 0.50 ± 1.40; total femur = 0.834 ± 0.150 g/cm2, p = 0.005, Z-score = − 0.74 ± 1.14. In patients with the greatest bone involvement at lumbar site, there was a striking increase of an average 1.5% (p < 0.01) in respect to baseline Z-score value for each additional month of observation during the first 2–3 years post-surgery. An improvement of trabecular microarchitecture was also documented (TBS, 1.255 ± 0.16). Conclusion: This is the first case series documenting an impressive increase of BMD at both lumbar and femoral sites, together with an improvement of trabecular microarchitecture as documented by TBS. This is the consequence of huge mineralization of the large amount of osteoid tissue after resolution of the disease. [ABSTRACT FROM AUTHOR]

Summary: We aimed to determine patients' reasons for continuing alendronate therapy over 5 years by administering a questionnaire. Bone mineral density, fractures, drugs, Charlson comorbidity index, and lifestyle factors were also considered. Education and awareness of the disease appeared highly associated with good alendronate adherence while worsening health status with discontinuation. Introduction: Aim of this study was to investigate patients' reasons for adhering to long-term alendronate therapy (more than 5 years), as data is not available in the current literature regarding the reasons behind long-term adherence. Methods: We studied 204 long-term adherent alendronate users: 65 postmenopausal outpatients still adherent (group C, years on treatment = 8.70 ± 1.31) were compared to 139 age-matched patients who discontinued therapy (group S, years on treatment = 8.64 ± 1.43). We evaluated main biochemical parameters, BMD values, fractures, and Charlson comorbidity index (CCI). A questionnaire was administered to analyze the reasons for long-term adherence. Results: There were no significant differences between groups concerning baseline DXA values, number of fractures, and CCI. A higher education level was observed in group C (C 54% vs S 35% of patients, p = 0.001). At the time of interview, there was a significantly higher number of patients with a CCI of two in group S compared to the beginning of treatment (56% vs 43%, p = 0.04), together with a higher number of patients taking more than 3 drugs (22% vs 11%, p = 0.01) compared to basal evaluation. Forty-seven percent of patients reported new diseases during the treatment as the main reason for stopping alendronate. A multivariate, stepwise logistic regression analysis showed that awareness of the disease was highly associated with adherence (OR = 0.20; 95% CI 0.045–0.93, p = 0.04) followed by higher education (OR = 0.526, 95% CI 0.345–0.801, p = 0.003). Worsening of CCI was associated with discontinuation (OR = 2.75, 95% CI 1.033–7.324, p = 0.04). Conclusions: Education and disease awareness are associated with long-term alendronate adherence while competing health problems negatively impact adherence. [ABSTRACT FROM AUTHOR]

Summary: Rationale: Calcidiol can be employed to correct vitamin D deficiency. Main results: Calcidiol administered at daily and weekly regimens over a period of 3 months was able to successfully raise 25-hydroxyvitamin D levels without altering other markers related to bone and mineral metabolism. Significance: Calcidiol supplementation is effective and safe. Introduction: The correction of vitamin D status is necessary to maintain an optimal mineral and skeletal homeostasis. Despite cholecalciferol (vitamin D) is the most commonly used drug for vitamin D supplementation, the more hydrophilic compound calcidiol (25-hydroxyvitamin D) can be employed at daily, weekly, and monthly regimens to reach in the short term the target levels of serum 25-hydroxyvitamin D [25(OH)D]. In the administration of different doses of calcidiol pharmacokinetic study (ADDI-D study), the efficacy and safety of daily and weekly dosages of calcidiol were tested. Methods: A total of 87 Caucasian, community-dwelling, postmenopausal women, aged 55 years or older, with vitamin D inadequacy (serum 25(OH)D levels <30 ng/ml, with mean 25(OH)D below 20 ng/ml, namely 16.5 ± 7.5 ng/ml) were randomized to receive three different dosages of calcidiol: 20 μg/day, 40 μg/day, and 125 μg/week for 3 months. The attained level of serum 25(OH)D was selected as primary endpoint to assess efficacy, while other parameters of mineral metabolism, (serum calcium, parathyroid hormone, phosphate, FGF23, urinary calcium, and markers of bone turnover) were assessed as secondary endpoints to establish safety. Results: In all the three groups, serum 25(OH)D values significantly and promptly rose and plateaued above the 30 ng/ml threshold remaining within safety interval after 14 days of treatment, with similar efficacy for the similar daily and weekly dose regimens. The different dosages were also equally effective in controlling secondary hyperparathyroidism. No significant changes in calcium and phosphate metabolism and in bone turnover markers were observed for any of the treatments, confirming the safety of this compound. Conclusions: The results of this study demonstrate the short- and mid-term efficacy and safety on core parameters of mineral metabolism of different daily or weekly dosages of calcidiol when used to treat vitamin D inadequacy or deficiency in postmenopausal women. Further studies are needed to assess falls as primary outcome of calcidiol supplementation. [ABSTRACT FROM AUTHOR]

Objectives: To identify frequent MRI features of parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (PHPT) using a fast protocol with a 3 T magnet.Methods: Thirty-eight patients with PHPT underwent a 3 T-MR. All patients had positive US and Tc-99 sestamibi, for a total number of 46 PTAs. T2-weighted IDEAL-FSE and T1 IDEAL-sequences, before and after contrast, were performed. Five features of PTAs were recognised: hyperintensity, homogeneous or "marbled" appearance and elongated morphology on T2-sequences; cleavage plane from thyroid gland on T2-outphase; rapid enhancement in post-contrast T1. Image quality for T2-weighted IDEAL FSE and usefulness for IDEAL post-contrast T1-weighted and T2-outphase sequences were also graded.Results: PTAs were hyperintense in T2-sequences in 44/46 (95.7%), "marbled" in 30/46 (65.2%) and elongated in 38/46 (82.6%) patients. Cleavage plane was observed in 36/46 (78.3%), and rapid enhancement in 20/46 (43.5%) patients. T2-sequences showed both excellent fat suppression and image quality (average scores of 3.2 and 3.1). T2-outphase images demonstrated to be quite useful (score 2.8), whereas, post-contrast T1 images showed a lower degree of utility (score 2.4).Conclusions: A fast protocol with 3.0-T MRI, recognising most common features of PTAs, may be used as a second-line method in the preoperative detection of PTAs.Key Points: 3 T MRI protocol based on T2-weighted IDEAL FSE sequences was used. T2-hyperintensity and elongated morphology are common features of PTAs. 3 T MRI could be used in the preoperative detection of PTAs. [ABSTRACT FROM AUTHOR]

Strong motivation for developing new prosthetic hand devices is provided by the fact that low functionality and controllability—in addition to poor cosmetic appearance—are the most important reasons why amputees do not regularly use their prosthetic hands. This paper presents the design of the CyberHand, a cybernetic anthropomorphic hand intended to provide amputees with functional hand replacement. Its design was bio-inspired in terms of its modular architecture, its physical appearance, kinematics, sensorization, and actuation, and its multilevel control system. Its underactuated mechanisms allow separate control of each digit as well as thumb–finger opposition and, accordingly, can generate a multitude of grasps. Its sensory system was designed to provide proprioceptive information as well as to emulate fundamental functional properties of human tactile mechanoreceptors of specific importance for grasp-and-hold tasks. The CyberHand control system presumes just a few efferent and afferent channels and was divided in two main layers: a high-level control that interprets the user’s intention (grasp selection and required force level) and can provide pertinent sensory feedback and a low-level control responsible for actuating specific grasps and applying the desired total force by taking advantage of the intelligent mechanics. The grasps made available by the high-level controller include those fundamental for activities of daily living: cylindrical, spherical, tridigital (tripod), and lateral grasps. The modular and flexible design of the CyberHand makes it suitable for incremental development of sensorization, interfacing, and control strategies and, as such, it will be a useful tool not only for clinical research but also for addressing neuroscientific hypotheses regarding sensorimotor control. [ABSTRACT FROM AUTHOR]

Magnetic hematite (α-Fe2O3) and goethite (α-FeOOH) nanoparticles, formed in the abandoned Libiola Mine (Liguria, Italy) as a result of Acid Mine Drainage (AMD) processes that involved sulfide-bearing rocks and sulfide-rich waste material, were investigated through the study of their magnetic properties in combination with electron paramagnetic resonance (EPR) spectroscopy. Both techniques revealed that the behaviour of the nanominerals involved was predominantly superparamagnetic. In contrast, the bulk antiferromagnetic behaviour of both hematite and goethite was substantially reduced. The observed magnetic properties reflected a great variability in the particle dimensions and confirmed that both nanominerals were the transformation products of a metastable amorphous species. Moreover, two peculiar phenomena were hypothesised: the transformation to hematite may occur before the coarsening of the amorphous transient and hematite and goethite can interconvert without intermediate crystallisation of metastable precursors. Goethite, in fact, appears to be formed as an alteration product of hematite, after a drastic change of the physico-chemical boundary conditions. [ABSTRACT FROM AUTHOR]

A minero-chemical and spectroscopic characterisation has been performed on a natural bornite sample from the Natural History Museum of the University of Florence, through the use of EPMA, XRD, continuous-wave (cw) and pulsed EPR spectroscopy. The use of different EPR techniques allowed to fully investigate the distribution and valence states of Cu and Fe and to study the early oxidation products of bornite. The microanalytical and XRD characterisation proved bornite to be homogeneous and stoichiometric. Cw-EPR measurements confirmed the presence of Fe(III) as fundamental valence state in bornite; moreover, no evidence of Cu(II) as a bulk transient species, due to a charge transfer process, has been revealed. The broadening of the Fe(III) EPR spectrum is ascribed to a partial transfer of spin density from Fe(III) to the surrounding cationic sublattice. In contrast, the pulsed EPR experiments, registered at 4.2 K, revealed the presence of both Fe(III) and Cu(II). These species were supposed to be present at the early stage of the surface alteration. The data provided by the electron spin-echo decay and modulation suggest both the oxidised Cu(II) and Fe(III) species to belong to premature surface water adducts (evidenced by proton nuclear modulation), which may evolve to sulphate species. [ABSTRACT FROM AUTHOR]

Integrated X-ray powder diffraction, scanning electron microscopy, electron probe, and transmission electron microscopy studies have identified the rare contact assemblage calaverite-sylvanite-hessite in a sample of gold ore from the Golden Mile deposit, Kalgoorlie, Australia. The presence of coexisting calaverite-hessite at Kalgoorlie is a non-equilibrium assemblage whereby the stable hessite-bearing assemblage is hessite-sylvanite, which formed from the breakdown of the ?-phase or ?-phase below 120?°C, stützite+?-phase, or sylvanite+stützite+?-phase, as predicted byCabri(1965). [ABSTRACT FROM AUTHOR]

The aim of this study was to optimise the parameters affecting the Bremsstrahlung scintigraphy of patients injected with strontium-89 chloride. The parameters considered were: (1) instrumental detection efficiency, and (2) tissue attenuation factor for [sup 89]Sr calibrated sources, which permit quantitative evaluation of the activity in a given bone lesion. Some typical examples of in vivo [sup 89]Sr imaging are presented to illustrate the clinical utility of the imaging procedure developed by us, which is implemented in our department for all patients treated with [sup 89]Sr chloride. [ABSTRACT FROM AUTHOR]

Ga-chloro-6-mercaptopurine andGa-citrato-6-mercaptopurine complexes have been prepared and their distribution in Morris-hepatoma-3924 A-bearing rats studied. The tumour affinity of the gallium-67 compounds varies in the order:Ga-chloro-6-mercaptopurine >Ga-citrato-6-mercaptopurine >Ga-citrate >Ga-chloride. [ABSTRACT FROM AUTHOR]

Cases of reduced uptake of pertechnetate-99m ion in the thyroid gland due to the presence, in the injected solution, of aluminium species at concentrations higher than 4 μg/cm are reported. This inconvenience can be avoided either by injecting chromatographically pure pertechnetate-99m ion or by allowing the eluate of high aluminium content to stand for about 4 h. [ABSTRACT FROM AUTHOR]

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Recent studies have shown that direct nerve stimulation can be used to provide sensory feedback to hand amputees. The intensity of the elicited sensations can be modulated using the amplitude or frequency of the injected stimuli. However, a comprehensive comparison of the effects of these two encoding strategies on the amputees’ ability to control a prosthesis has not been performed. In this paper, we assessed the performance of two trans-radial amputees controlling a myoelectric hand prosthesis while receiving grip force sensory feedback encoded using either linear modulation of amplitude (LAM) or linear modulation of frequency (LFM) of direct nerve stimulation (namely, bidirectional prostheses). Both subjects achieved similar and significantly above-chance performance when they were asked to exploit LAM or LFM in different tasks. The feedbacks allowed them to discriminate, during manipulation through the robotic hand, objects of different compliances and shapes or different placements on the prosthesis. Similar high performances were obtained when they were asked to apply different levels of force in a random order on a dynamometer using LAM or LFM. In contrast, only the LAM strategy allowed the subjects to continuously modulate the grip pressure on the dynamometer. Furthermore, when long-lasting trains of stimulation were delivered, LFM strategy generated a very fast adaptation phenomenon in the subjects, which caused them to stop perceiving the restored sensations. Both encoding approaches were perceived as very different from the touch feelings of the healthy limb (natural). These results suggest that the choice of specific sensory feedback encodings can have an effect on user performance while grasping. In addition, our results invite the development of new approaches to provide more natural sensory feelings to the users, which could be addressed by a more biomimetic strategy in the future. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Skeletal and nonskeletal effects of vitamin D: Is vitamin D a tonic for bone and other tissues?" by I. R. Reid and M. J. Bolland in a 2014 issue.