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We previously showed that it is possible to cross-calibrate peripheral bone densitometers using the European Spine Phantom (ESP). We have now performed a multinational study of cross-calibrated radius bone density based on normal subjects of both sexes in eight European centers. Six centers were equipped with machines made by Scanco or Stratec for determining distal radial trabecular bone density by quantitative computed tomography (QCT) and two were equipped with Lunar SP2 single photon absorptiometry (SPA) equipment for measuring midshaft cortical bone density. Subjects recruited ranged from 20 to over 80 years of age. Over one hundred and fifteen men were studied by QCT and a different cohort of 104 men were studied with SPA; the equivalent figures for women were 235 and 123. Reference ranges were derived for bone density against age for each of the four groups, and their applicability is discussed in relation to between-center differences in the results obtained. There were insignificant differences (P > 0.05 with Bonferroni correction) between centers in the values obtained by QCT in the different populations. However, there were considerably larger and highly statistically significant differences between midshaft cortical bone density values of about 10% of overall means between subjects from eastern Finland and central Belgium (P < 0.001), with higher Finnish values. Women had considerably lower radial trabecular bone density values than men at all ages, a result that differentiates the radius from the spine. This sex difference widened after menopause. These results have important implications for understanding the contribution of bone density to the differential risk of Colles' fracture in the two sexes and suggest that further work is needed to establish young normal reference ranges for radial bone density in Europe. [ABSTRACT FROM AUTHOR]

Background: Women with inflammatory bowel diseases (IBD) often receive biologicals during pregnancy to maintain disease remission. Data on outcome of vedolizumab-exposed pregnancies (VDZE) are sparse., Aims: To assess pregnancy and child outcomes of VDZE pregnancies and to compare these results to anti-TNF exposed (TNFE) or both immunomodulatory and biologic unexposed (CON IBD) pregnancies., Methods: A retrospective multicentre case-control observational study was performed., Results: VDZE group included 79 pregnancies in 73 IBD women. The TNFE and CON IBD group included 186 pregnancies (162 live births) in 164 IBD women and 184 pregnancies (163 live births) in 155 IBD women, respectively. At conception, cases more often had active disease ([VDZE: 36% vs TNFE: 17%, P = .002] and [VDZE: 36% vs CON IBD: 24%, P = .063]). No significant difference in miscarriage rates were found between groups (VDZE and TNFE: 16% vs 13%, P = .567; VDZE and CON IBD: 16% vs 10%, P = .216). In live-born infants, median gestational age and birthweight were similar between groups. Median Apgar score at birth was numerically equal. Prematurity was similar in the VDZE group compared to the control groups, even when correcting for disease activity during pregnancy. The frequency of congenital anomalies was comparable between groups as were the percentages of breastfed babies. During the first year of life, no malignancies were reported and infants' infection risk did not significantly differ between groups., Conclusion: No new safety signal was detected in VDZE pregnancies although larger, prospective studies are required for confirmation., (© 2019 John Wiley & Sons Ltd.)

Background: The Fibromyalgia Impact Questionnaire (FIQ) is the most used questionnaire worldwide to measure the health status of patients with fibromyalgia. The questionnaire has been subjected to several studies to analyze psychometric properties. However, norm scores and cultural differences have not been presented., Objectives: To obtain and present norm scores for the FIQ in patients with fibromyalgia in different cultures, namely Southern, Central, and Northern areas of Europe., Study Design: This observational study consisted of women with fibromyalgia from 4 countries (Spain, Belgium, the Netherlands, and Sweden) classified in 3 areas (Southern, Central, and Northern) in Europe., Setting: Women with fibromyalgia from Spain, Belgium, the Netherlands, and Sweden., Methods: The impact of fibromyalgia was assessed by the FIQ. A total of 1,478 women with fibromyalgia were asked to fill out the FIQ in the Spanish (n = 531), Dutch and Belgian (n = 629), or Swedish (n = 318) versions., Results: The norm scores and percentiles score of the FIQ are presented. Norm scores differed between European areas (Southern area = 64.8 ± 15.9; Central area = 60.9 ± 15.7; Northern area = 62.8 ± 16.7). Perceived physical impairment, overall well-being (all, P < 0.001), FIQ total (P < 0.01), and morning tiredness (P < 0.05) in women with fibromyalgia from the Central area of Europe reported lower impact than Southern and Northern areas. The Northern area of Europe showed the lowest score of job difficulty, anxiety, depression (all, P < 0.001), and pain (P < 0.01), whereas the Southern area of Europe showed the lowest score of work missed subscale (P < 0.001) with regard to the rest of the areas studied., Limitations: The selection of patients was conducted with just women because of the scarce prevalence of fibromyalgia among men. Moreover, sociodemographic status, socioeconomic status, and clinical characteristics were not measured. Similar research should be conducted with adequate representation of populations from other parts of the world., Conclusions: Pairwise comparisons showed significant differences mainly between the Southern area versus Northern and Central areas of Europe. The impact of fibromyalgia showed mainly higher scores in women with fibromyalgia from the Southern area of Europe., Key Words: Symptom, psychometric, norm scores, European comparison.

Prevalence of Mycoplasma species infections in chronic fatigue syndrome (CFS) has been extensively reported in the scientific literature. However, all previous reports highlighted the presence of Mycoplasmas in American patients. In this prospective study, the presence of Mycoplasma fermentans, M. penetrans, M. pneumoniae and M. hominis in the blood of 261 European CFS patients and 36 healthy volunteers was examined using forensic polymerase chain reaction. One hundred and seventy-nine (68.6%) patients were infected by at least one species of Mycoplasma, compared to two out of 36 (5.6%) in the control sample (P<0.001). Among Mycoplasma-infected patients, M. hominis was the most frequently observed infection (n=96; 36.8% of the overall sample), followed by M. pneumoniae and M. fermentans infections (equal frequencies; n=67; 25.7%). M. penetrans infections were not found. Multiple mycoplasmal infections were detected in 45 patients (17.2%). Compared to American CFS patients (M. pneumoniae>M. hominis>M. penetrans), a slightly different pattern of mycoplasmal infections was found in European CFS patients (M. hominis>M. pneumoniae, M. fermentansz.Gt;M. penetrans).

Hip geometry and bone mineral density (BMD) have been shown previously to relate, independently of each other, to risk of hip fracture. We used Lunar DPX "beta" versions of hip strength analysis (HSA) and hip axis length (HAL) software to analyze scans from ten representative age-stratified population samples in the European Prospective Osteoporosis Study (EPOS). All 1617 subjects were >50 years of age, and 1033 were women. The data were modeled with gender and center as categorical variables. The bone mineral density of the upper half of the femoral neck declined at a faster rate with age than that in the lower half. Femoral neck cross-sectional moment of inertia (CSMI), a measure of resistance to bending, showed no significant age reduction in either gender. However, height and weight effects on CSMI were significantly more beneficial in men than in women (0.002 < p < 0.012) and the weight effect appeared to be mediated by bone mineral content (BMC). Compressive stress (Cstress), defined as the stress in the femoral neck at its weakest cross section arising from a standardized fall, was higher in women. Although Cstress increased with body weight when BMC was held constant, in practice it fell through the association and statistical interaction of rising body weight with rising BMC. HAL, as expected, was strongly positively associated with male gender and also height (p < 0.0001). Hip strength-related indices were markedly center-dependent. Significant differences (p < 0.0001) were noted between the centers for all the variables investigated that related to hip geometry. Adjustment for femoral neck bone mineral content (totBMC) showed these center differences to account for >50% of center variation in hip strength, which remained highly significant (p < 0.0001). We conclude that there are substantial geographical differences in femoral neck geometry as well as in BMD. These geometric variations may contribute to the large variations in hip fracture risk across Europe. The effects of aging on hip strength need to be explored in longitudinal studies.