1
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Mamede IN, Stable ALL, Fiore CE. Obtaining efficient collisional engines via velocity-dependent drivings. Phys Rev E 2022; 106:064125. [PMID: 36671179 DOI: 10.1103/physreve.106.064125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Brownian particles interacting sequentially with distinct temperatures and driving forces at each stroke have been tackled as a reliable alternative for the construction of engine setups. However, they can behave very inefficiently depending on the driving used for the work source and/or when temperatures of each stage are very different from each other. Inspired by some models for molecular motors and recent experimental studies, a coupling between driving and velocities is introduced and detail investigated from stochastic thermodynamics. Exact expressions for thermodynamic quantities and distinct maximization routes have been obtained. The search of an optimal coupling provides a substantial increase of engine performance (mainly efficiency), even for large ΔT. A simple and general argument for the optimal coupling can be estimated, irrespective of the driving and other model details.
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Affiliation(s)
- Iago N Mamede
- Universidade de São Paulo, Instituto de Física, Rua do Matão, 1371, 05508-090 São Paulo, SP, Brazil
| | - Angel L L Stable
- Universidade de São Paulo, Instituto de Física, Rua do Matão, 1371, 05508-090 São Paulo, SP, Brazil
| | - C E Fiore
- Universidade de São Paulo, Instituto de Física, Rua do Matão, 1371, 05508-090 São Paulo, SP, Brazil
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2
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Mamede IN, Harunari PE, Akasaki BAN, Proesmans K, Fiore CE. Obtaining efficient thermal engines from interacting Brownian particles under time-periodic drivings. Phys Rev E 2022; 105:024106. [PMID: 35291114 DOI: 10.1103/physreve.105.024106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
We introduce an alternative route for obtaining reliable cyclic engines, based on two interacting Brownian particles under time-periodic drivings which can be used as a work-to-work converter or a heat engine. Exact expressions for the thermodynamic fluxes, such as power and heat, are obtained using the framework of stochastic thermodynamic. We then use these exact expression to optimize the driving protocols with respect to output forces, their phase difference. For the work-to-work engine, they are solely expressed in terms of Onsager coefficients and their derivatives, whereas nonlinear effects start to play a role since the particles are at different temperatures. Our results suggest that stronger coupling generally leads to better performance, but careful design is needed to optimize the external forces.
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Affiliation(s)
- Iago N Mamede
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - Pedro E Harunari
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
- Complex Systems and Statistical Mechanics, Physics and Materials Science Research Unit, University of Luxembourg, L-1511 Luxembourg, Luxembourg
| | - Bruno A N Akasaki
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - Karel Proesmans
- Complex Systems and Statistical Mechanics, Physics and Materials Science Research Unit, University of Luxembourg, L-1511 Luxembourg, Luxembourg
- Hasselt University, B-3590 Diepenbeek, Belgium
- Niels Bohr Institute, University of Copenhagen, Blegdamsvej 17, Copenhagen, Denmark
| | - C E Fiore
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
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3
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Fiore CE, Harunari PE, Noa CEF, Landi GT. Current fluctuations in nonequilibrium discontinuous phase transitions. Phys Rev E 2021; 104:064123. [PMID: 35030860 DOI: 10.1103/physreve.104.064123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/29/2021] [Indexed: 11/07/2022]
Abstract
Discontinuous phase transitions out of equilibrium can be characterized by the behavior of macroscopic stochastic currents. But while much is known about the average current, the situation is much less understood for higher statistics. In this paper, we address the consequences of the diverging metastability lifetime-a hallmark of discontinuous transitions-in the fluctuations of arbitrary thermodynamic currents, including the entropy production. In particular, we center our discussion on the conditional statistics, given which phase the system is in. We highlight the interplay between integration window and metastability lifetime, which is not manifested in the average current, but strongly influences the fluctuations. We introduce conditional currents and find, among other predictions, their connection to average and scaled variance through a finite-time version of large deviation theory and a minimal model. Our results are then further verified in two paradigmatic models of discontinuous transitions: Schlögl's model of chemical reactions, and a 12-state Potts model subject to two baths at different temperatures.
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Affiliation(s)
- C E Fiore
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - Pedro E Harunari
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil.,Complex Systems and Statistical Mechanics, Physics and Materials Science Research Unit, University of Luxembourg, Luxembourg L-1511, G.D. Luxembourg
| | - C E Fernández Noa
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - Gabriel T Landi
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
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4
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Encinas JM, Fiore CE. Influence of distinct kinds of temporal disorder in discontinuous phase transitions. Phys Rev E 2021; 103:032124. [PMID: 33862793 DOI: 10.1103/physreve.103.032124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/16/2021] [Indexed: 11/07/2022]
Abstract
Based on mean-field theory (MFT) arguments, a general description for discontinuous phase transitions in the presence of temporal disorder is considered. Our analysis extends the recent findings [C. E. Fiore et al., Phys. Rev. E 98, 032129 (2018)2470-004510.1103/PhysRevE.98.032129] by considering discontinuous phase transitions beyond those with a single absorbing state. The theory is exemplified in one of the simplest (nonequilibrium) order-disorder (discontinuous) phase transitions with "up-down" Z_{2} symmetry: the inertial majority vote model for two kinds of temporal disorder. As for absorbing phase transitions, the temporal disorder does not suppress the occurrence of discontinuous phase transitions, but remarkable differences emerge when compared with the pure (disorderless) case. A comparison between the distinct kinds of temporal disorder is also performed beyond the MFT for random-regular complex topologies. Our work paves the way for the study of a generic discontinuous phase transition under the influence of an arbitrary kind of temporal disorder.
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Affiliation(s)
- Jesus M Encinas
- Instituto de Física, Universidade de São Paulo, Caixa Postal 66318 05315-970 São Paulo, São Paulo, Brazil
| | - C E Fiore
- Instituto de Física, Universidade de São Paulo, Caixa Postal 66318 05315-970 São Paulo, São Paulo, Brazil
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5
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Akasaki BAN, de Oliveira MJ, Fiore CE. Entropy production and heat transport in harmonic chains under time-dependent periodic drivings. Phys Rev E 2020; 101:012132. [PMID: 32069596 DOI: 10.1103/physreve.101.012132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Indexed: 11/07/2022]
Abstract
Using stochastic thermodynamics, the properties of interacting linear chains subject to periodic drivings are investigated. The systems are described by Fokker-Planck-Kramers equation and exact solutions are obtained as functions of the modulation frequency and strength constants. Analysis will be carried out for short and long chains. In the former case, explicit expressions are derived for a chain of two particles, in which the entropy production is written down as a bilinear function of thermodynamic forces and fluxes, whose associated Onsager coefficients are evaluated for distinct kinds of periodic drivings. The limit of long chains is analyzed by means of a protocol in which the intermediate temperatures are self-consistently chosen and the entropy production is decomposed as a sum of two individual contributions, one coming from real baths (placed at extremities of lattice) and other from self-consistent baths. Whenever the former dominates for short chains, the latter contribution prevails for long ones. The thermal reservoirs lead to a heat flux according to Fourier's law.
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Affiliation(s)
- Bruno A N Akasaki
- Universidade de São Paulo, Instituto de Física, Rua do Matão, 1371, 05508-090 São Paulo, SP, Brazil
| | - Mário J de Oliveira
- Universidade de São Paulo, Instituto de Física, Rua do Matão, 1371, 05508-090 São Paulo, SP, Brazil
| | - C E Fiore
- Universidade de São Paulo, Instituto de Física, Rua do Matão, 1371, 05508-090 São Paulo, SP, Brazil
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6
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Noa CEF, Harunari PE, de Oliveira MJ, Fiore CE. Entropy production as a tool for characterizing nonequilibrium phase transitions. Phys Rev E 2019; 100:012104. [PMID: 31499824 DOI: 10.1103/physreve.100.012104] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Indexed: 11/07/2022]
Abstract
Nonequilibrium phase transitions can be typified in a similar way to equilibrium systems, for instance, by the use of the order parameter. However, this characterization hides the irreversible character of the dynamics as well as its influence on the phase transition properties. Entropy production has been revealed to be an important concept for filling this gap since it vanishes identically for equilibrium systems and is positive for the nonequilibrium case. Based on distinct and general arguments, the characterization of phase transitions in terms of the entropy production is presented. Analysis for discontinuous and continuous phase transitions has been undertaken by taking regular and complex topologies within the framework of mean-field theory (MFT) and beyond the MFT. A general description of entropy production portraits for Z_{2} ("up-down") symmetry systems under the MFT is presented. Our main result is that a given phase transition, whether continuous or discontinuous has a specific entropy production hallmark. Our predictions are exemplified by an icon system, perhaps the simplest nonequilibrium model presenting an order-disorder phase transition and spontaneous symmetry breaking: the majority vote model. Our work paves the way to a systematic description and classification of nonequilibrium phase transitions through a key indicator of system irreversibility.
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Affiliation(s)
- C E Fernández Noa
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - Pedro E Harunari
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - M J de Oliveira
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
| | - C E Fiore
- Instituto de Física da Universidade de São Paulo, 05314-970 São Paulo, Brazil
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7
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Abstract
We study the effects of distinct types of quenched disorder in the contact process with a competitive dynamics on bipartite sublattices. In the model, the particle creation depends on its first and second neighbors and the extinction increases according to the local density. The clean (without disorder) model exhibits three phases: inactive (absorbing), active symmetric, and active asymmetric, where the latter exhibits distinct sublattice densities. These phases are separated by continuous transitions; the phase diagram is reentrant. By performing mean-field analysis and Monte Carlo simulations we show that symmetric disorder destroys the sublattice ordering and therefore the active asymmetric phase is not present. On the other hand, for asymmetric disorder (each sublattice presenting a distinct dilution rate) the phase transition occurs between the absorbing and the active asymmetric phases. The universality class of this transition is governed by the less-disordered sublattice. Finally, our results suggest that random-field disorder destroys the phase transition if it breaks the symmetry between two active states.
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Affiliation(s)
- M N Gonzaga
- Departamento de Física e Matemática, CAP, Universidade Federal de São João del Rei, Ouro Branco-MG, 36420-000 Brazil
| | - C E Fiore
- Instituto de Física, Universidade de São Paulo, São Paulo-SP, 05314-970, Brazil
| | - M M de Oliveira
- Departamento de Física e Matemática, CAP, Universidade Federal de São João del Rei, Ouro Branco-MG, 36420-000 Brazil
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8
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Nuti R, Brandi ML, Checchia G, Di Munno O, Dominguez L, Falaschi P, Fiore CE, Iolascon G, Maggi S, Michieli R, Migliaccio S, Minisola S, Rossini M, Sessa G, Tarantino U, Toselli A, Isaia GC. Guidelines for the management of osteoporosis and fragility fractures. Intern Emerg Med 2019; 14:85-102. [PMID: 29948835 PMCID: PMC6329834 DOI: 10.1007/s11739-018-1874-2] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/06/2018] [Indexed: 12/16/2022]
Abstract
The purpose of this document, a result of the harmonisation and revision of Guidelines published separately by the SIMFER, SIOMMMS/SIR, and SIOT associations, is to provide practical indications based on specific levels of evidence and various grades of recommendations, drawn from available literature, for the management of osteoporosis and for the diagnosis, prevention, and treatment of fragility fractures. These indications were discussed and formally approved by the delegates of the Italian Scientific Associations involved in the project (SIE, SIGG, SIMFER, SIMG, SIMI, SIOMMMS, SIR, and SIOT).
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Affiliation(s)
- Ranuccio Nuti
- SIMI, (Italian Society of Internal Medicine), Rome, Italy
| | | | - Giovanni Checchia
- SIMFER (Italian Society of Physical and Rehabilitation Medicine), Rome, Italy
| | | | - Ligia Dominguez
- SIOMMMS (Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases), Rome, Italy
| | - Paolo Falaschi
- SIGG (Italian Society of Gerontology and Geriatrics), Firenze, Italy
| | | | - Giovanni Iolascon
- SIMFER (Italian Society of Physical and Rehabilitation Medicine), Rome, Italy
| | - Stefania Maggi
- SIGG (Italian Society of Gerontology and Geriatrics), Firenze, Italy
| | - Raffaella Michieli
- SIMG (Italian Society of General Medicine and of Primary Care), Firenze, Italy
| | | | | | | | | | | | - Antonella Toselli
- SIMG (Italian Society of General Medicine and of Primary Care), Firenze, Italy
| | - Giovanni Carlo Isaia
- SIOMMMS (Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases), Rome, Italy
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9
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Affiliation(s)
- Angelo Petralito
- The Istituto di Patologia Medica I, University of Catania, Catania, Italy
| | | | - Carmelo Erio Fiore
- The Istituto di Patologia Medica I, University of Catania, Catania, Italy
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10
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Affiliation(s)
- A Petralito
- The Istituto di Patologia Medica 2a, dell’Università di Catania, Catania, Italy
| | - C E Fiore
- The Istituto di Patologia Medica 2a, dell’Università di Catania, Catania, Italy
| | - R A Mangiafico
- The Istituto di Patologia Medica 2a, dell’Università di Catania, Catania, Italy
| | - L S Malatino
- The Istituto di Patologia Medica 2a, dell’Università di Catania, Catania, Italy
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11
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Abstract
Explosive (i.e., discontinuous) transitions have aroused great interest by manifesting in distinct systems, such as synchronization in coupled oscillators, percolation regime, absorbing phase transitions, and more recently, the majority-vote model with inertia. In the latter, the model rules are slightly modified by the inclusion of a term depending on the local spin (an inertial term). In such a case, Chen et al. [Phys Rev. E 95, 042304 (2017)2470-004510.1103/PhysRevE.95.042304] have found that relevant inertia changes the nature of the phase transition in complex networks, from continuous to discontinuous. Here we give a further step by embedding inertia only in vertices with degree larger than a threshold value 〈k〉k^{*}, 〈k〉 being the mean system degree and k^{*} the fraction restriction. Our results, from mean-field analysis and extensive numerical simulations, reveal that an explosive transition is presented in both homogeneous and heterogeneous structures for small and intermediate k^{*}'s. Otherwise, a large restriction can sustain a discontinuous transition only in the heterogeneous case. This shares some similarities with recent results for the Kuramoto model [Phys. Rev. E 91, 022818 (2015)PLEEE81539-375510.1103/PhysRevE.91.022818]. Surprisingly, intermediate restriction and large inertia are responsible for the emergence of an extra phase, in which the system is partially synchronized and the classification of phase transition depends on the inertia and the lattice topology. In this case, the system exhibits two phase transitions.
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Affiliation(s)
- Pedro E Harunari
- Instituto de Física, Universidade de São Paulo, Caixa Postal 66318 05315-970 São Paulo, São Paulo, Brazil
| | - M M de Oliveira
- Departamento de Física e Matemática, CAP, Universidade Federal de São João del Rei, Ouro Branco-MG, 36420-000 Brazil
| | - C E Fiore
- Instituto de Física, Universidade de São Paulo, Caixa Postal 66318 05315-970 São Paulo, São Paulo, Brazil
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12
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Affiliation(s)
- Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, Italy.
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Carmelo Erio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, Italy
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13
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Gaudio A, Fiore V, Rapisarda R, Sidoti MH, Xourafa A, Catalano A, Tringali G, Zanoli L, Signorelli SS, Fiore CE. Sclerostin is a possible candidate marker of arterial stiffness: Results from a cohort study in Catania. Mol Med Rep 2017; 15:3420-3424. [PMID: 28339088 DOI: 10.3892/mmr.2017.6390] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/13/2017] [Indexed: 11/06/2022] Open
Abstract
Osteoporosis and cardiovascular disease are worldwide public health issues. Recent evidence indicates a possible role of the canonical Wnt/β-catenin signalling pathway as a common mediator between these two diseases. The aim of the present study was to investigate the relationship between serum concentrations of sclerostin and Dkk1, two extracellular inhibitors of Wnt/β-catenin signalling, with carotid intima-media thickness (CIMT) and with arterial stiffness, evaluated by measuring the pulse wave velocity (PWV) in an ambulatory population of adults. To this aim, 67 subjects were recruited in the 'Atherosclerosis and osteoporosis: identification of common pathogenetic factors' investigation. Serum sclerostin levels correlated positively with CIMT (r=0.314, p=0.03) and inversely with the augmentation index, a marker of arterial stiffness (r=-0.286, p<0.05), whereas Dkk1 did not. Moreover, in a multivariate linear regression model, sclerostin [β -0.1472; p=0.0023; standard error (SE)=0.04620] was an independent predictor of PWV in the study subjects. Our study shows that, following adjustment for confounders, sclerostin is an independent predictor of arterial stiffness in an ambulatory population, whereas Dkk1 is not.
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Affiliation(s)
- Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Valerio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Rosario Rapisarda
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Maria Helga Sidoti
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Anastasia Xourafa
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, I-98125 Messina, Italy
| | - Giovanni Tringali
- Medical and Environmental Research Institute (IRMA), I-95024 Acireale, Italy
| | - Luca Zanoli
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
| | | | - Carmelo Erio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, I-95123 Catania, Italy
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14
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Solano CMD, de Oliveira MM, Fiore CE. Comparing the influence of distinct kinds of temporal disorder in a low-dimensional absorbing transition model. Phys Rev E 2016; 94:042123. [PMID: 27841620 DOI: 10.1103/physreve.94.042123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Indexed: 11/07/2022]
Abstract
Recently it was stated that temporal disorder constitutes a relevant perturbation in absorbing phase transitions for all dimensions. However, its effect on systems other than the standard contact process (CP), its competition with other ingredients (e.g., particle diffusion), and other kinds of disorder (besides the standard types) are unknown. In order to shed some light on the above-mentioned points, we investigate a variant of the usual CP, namely, the triplet annihilation model, in which the competition between triplet annihilation and single particle diffusion leads to an unusual phase diagram behavior, with reentrant shape and endless activity for sufficiently large diffusion rates. Two kinds of time-dependent disorder have been considered. In the former, it is introduced in the creation-annihilation parameters (as commonly considered in recent studies), whereas in the latter, the diffusion rate D is allowed to be time dependent. In all cases, the disorder follows a uniform distribution with fixed mean and width σ. Two values of σ have been considered in order to exemplify the regime of "weaker" and "stronger" temporal disorder strengths. Our results show that in the former approach, the disorder suppresses the reentrant phase diagram with a critical behavior deviating from the directed percolation (DP) universality class in the regime of low diffusion rates, while they strongly suggest that the DP class is recovered for larger hopping rates. An opposite scenario is found in the latter disorder approach, with a substantial increase of reentrant shape and the maximum diffusion, in which the reentrant shape also displays a critical behavior consistent with the DP universality class (in similarity with the pure model). In order to compare with very recent claims, the results from taking a bimodal distribution and critical behavior in the limit of strong disorder are presented. Also, the results derived from the mean-field theory are performed, presenting partial agreement with numerical results. Lastly, a comparison with the diffusive disordered CP is undertaken.
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Affiliation(s)
- C M D Solano
- Instituto de Física, Universidade de São Paulo, São Paulo-SP 05314-970, Brazil
| | - M M de Oliveira
- Departamento de Física e Matemática, CAP, Universidade Federal de São João del Rei, Ouro Branco-MG 36420-000, Brazil
| | - C E Fiore
- Instituto de Física, Universidade de São Paulo, São Paulo-SP 05314-970, Brazil
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15
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de Oliveira MM, Fiore CE. Temporal disorder does not forbid discontinuous absorbing phase transitions in low-dimensional systems. Phys Rev E 2016; 94:052138. [PMID: 27967145 DOI: 10.1103/physreve.94.052138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Indexed: 06/06/2023]
Abstract
Recent papers have shown that spatial (quenched) disorder can suppress discontinuous absorbing phase transitions. Conversely, the scenario for temporal disorder is still unknown. To shed some light in this direction, we investigate its effect in three different two-dimensional models which are known to exhibit discontinuous absorbing phase transitions. The temporal disorder is introduced by allowing the control parameter to be time dependent p→p(t), either varying as a uniform distribution with mean p[over ¯] and variance σ or as a bimodal distribution, fluctuating between a value p and a value p_{l}≪p. In contrast to spatial disorder, our numerical results strongly suggest that such uncorrelated temporal disorder does not forbid the existence of a discontinuous absorbing phase transition. We find that all cases are characterized by behaviors similar to their pure (without disorder) counterparts, including bistability around the coexistence point and common finite-size scaling behavior with the inverse of the system volume, as recently proposed [M. M. de Oliveira et al., Phys. Rev. E 92, 062126 (2015)PLEEE81539-375510.1103/PhysRevE.92.062126]. We also observe that temporal disorder does not induce temporal Griffiths phases around discontinuous phase transitions, at least not for d=2.
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Affiliation(s)
- M M de Oliveira
- Departamento de Física e Matemática, CAP, Universidade Federal de São João del Rei, Ouro Branco, Minas Gerais, 36420-000, Brazil
| | - C E Fiore
- Instituto de Física, Universidade de São Paulo, São Paulo, São Paulo, 05314-970, Brazil
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16
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Abstract
Pregnancy-associated osteoporosis is a rare condition. The pathogenesis is probably multifactorial but has not yet been completely clarified. In this case report, a 38-year-old woman was referred to hospital after suffering an acute, non-traumatic back pain one month after delivering her first child. The radiological examination revealed four vertebral fractures. Bone mineral density was reduced, particularly at spine level. Biochemical tests were within normal range, except for increased urinary deoxypyridinoline and a slight reduction of the serum 25-OH vitamin D level. The patient was treated with neridronate, calcium and cholecalciferol. After one month, the patient was free of pain and DXA measurement after six months showed a marked recovery of bone mineral density at the spine and hip level.
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Affiliation(s)
- Agostino Gaudio
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Carmelo Erio Fiore
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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17
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Zhukouskaya VV, Eller-Vainicher C, Gaudio A, Privitera F, Cairoli E, Ulivieri FM, Palmieri S, Morelli V, Grancini V, Orsi E, Masserini B, Spada AM, Fiore CE, Chiodini I. The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients. Osteoporos Int 2016; 27:49-56. [PMID: 26138582 DOI: 10.1007/s00198-015-3212-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 06/12/2015] [Indexed: 11/28/2022]
Abstract
UNLABELLED The objective of the study was to evaluate the usefulness of trabecular bone score (TBS) and bone mineral density (BMD) for identifying vertebral fractures (VFx) in well-compensated type 2 diabetic (T2D) patients. TBS and femoral neck BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients. INTRODUCTION In T2D, the prevalence of VFx is increased, especially in poorly compensated and complicated diabetic patients. The possibility of predicting the fracture risk in T2D patients by measuring BMD and TBS, an indirect parameter of bone quality, is under debate. Therefore, the objective was to evaluate the usefulness of TBS and BMD for identifying VFx in well-compensated T2D patients. METHODS Ninety-nine T2D postmenopausal women in good metabolic control (glycosylated haemoglobin 6.8 ± 0.7 %) and 107 control subjects without T2D were evaluated. In all subjects, we evaluated the following: the BMD at the lumbar spine (LS) and the femoral neck (FN); the TBS by dual X-ray absorptiometry; and VFx by radiography. In T2D subjects, the presence of diabetic retinopathy, neuropathy, and nephropathy was evaluated. RESULTS T2D subjects had increased VFx prevalence (34.3 %) as compared to controls (18.7 %) (p = 0.01). T2D subjects presented higher BMD (LS -0.8 ± 1.44, FN -1.06 ± 1.08), as compared to controls (LS -1.39 ± 1.28, p = 0.002; FN -1.45 ± 0.91, p = 0.006, respectively). TBS was not different between diabetics and controls. In fractured T2D patients, LS-BMD, FN-BMD, and TBS were reduced (-1.2 ± 1.44; -1.44 ± 1.04; 1.072 ± 0.15) and the prevalence of retinopathy (15.4 %) was increased than in nonfractured T2D subjects (-0.59 ± 1.4, p = 0.035; -0.87 ± 1.05, p = 0.005; 1.159 ± 0.15, p = 0.006; 1.8 %, p = 0.04, respectively). The combination of TBS ≤1.130 and FN-BMD less than -1.0 had the best diagnostic accuracy for detecting T2D fractured patients (SP 73.8 %, SN 63.6 %, NPV 78.9 %, PPV 56.8 %). CONCLUSIONS TBS and FN-BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients.
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Affiliation(s)
- V V Zhukouskaya
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy.
| | - C Eller-Vainicher
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A Gaudio
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - F Privitera
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - E Cairoli
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - F M Ulivieri
- Units of Nuclear Medicine, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - S Palmieri
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - V Morelli
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - V Grancini
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - E Orsi
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - B Masserini
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A M Spada
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - C E Fiore
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - I Chiodini
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
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Zhukouskaya VV, Eller-Vainicher C, Gaudio A, Privitera F, Cairoli E, Ulivieri FM, Palmieri S, Morelli V, Grancini V, Orsi E, Masserini B, Spada AM, Fiore CE, Chiodini I. Erratum to: The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients. Osteoporos Int 2016; 27:421. [PMID: 26194494 DOI: 10.1007/s00198-015-3248-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- V V Zhukouskaya
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy.
| | - C Eller-Vainicher
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - A Gaudio
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - F Privitera
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - E Cairoli
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - F M Ulivieri
- Units of Nuclear Medicine, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - S Palmieri
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - V Morelli
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - V Grancini
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - E Orsi
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - B Masserini
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A M Spada
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
| | - C E Fiore
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - I Chiodini
- Units of Endocrinology and Metabolic Diseases, Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Francesco Sforza Street 35, 20122, Milan, Italy
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de Oliveira MM, da Luz MGE, Fiore CE. Generic finite size scaling for discontinuous nonequilibrium phase transitions into absorbing states. Phys Rev E Stat Nonlin Soft Matter Phys 2015; 92:062126. [PMID: 26764651 DOI: 10.1103/physreve.92.062126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Indexed: 06/05/2023]
Abstract
Based on quasistationary distribution ideas, a general finite size scaling theory is proposed for discontinuous nonequilibrium phase transitions into absorbing states. Analogously to the equilibrium case, we show that quantities such as response functions, cumulants, and equal area probability distributions all scale with the volume, thus allowing proper estimates for the thermodynamic limit. To illustrate these results, five very distinct lattice models displaying nonequilibrium transitions-to single and infinitely many absorbing states-are investigated. The innate difficulties in analyzing absorbing phase transitions are circumvented through quasistationary simulation methods. Our findings (allied to numerical studies in the literature) strongly point to a unifying discontinuous phase transition scaling behavior for equilibrium and this important class of nonequilibrium systems.
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Affiliation(s)
- M M de Oliveira
- Departamento de Física e Matemática, CAP, Universidade Federal de São João del Rei, Ouro Branco, MG 36420-000 Brazil
- Theoretical Physics Division, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - M G E da Luz
- Departamento de Física, Universidade Federal do Paraná, Curitiba, PR 81531-980, Brazil
| | - C E Fiore
- Instituto de Física, Universidade de São Paulo, Caixa Postal 66318, São Paulo, SP 05315-970, Brazil
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Gaudio A, Muratore F, Fiore V, Rapisarda R, Signorelli SS, Fiore CE. Decreased bone cortical density at the forearm in subjects with subclinical peripheral arterial disease. Osteoporos Int 2015; 26:1747-53. [PMID: 25672808 DOI: 10.1007/s00198-015-3057-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 01/28/2015] [Indexed: 12/14/2022]
Abstract
UNLABELLED The association between peripheral arterial disease (PAD) and low bone mass is controversial. In our study, peripheral quantitative computed tomography shows a reduction of cortical but not trabecular, bone mineral density (BMD) at the forearm, in patients with subclinical PAD. INTRODUCTION Some controversy exists regarding the association between peripheral arterial disease (PAD) and low bone mass. Previous studies have evaluated bone mineral density (BMD) in patients with subclinical PAD, with mixed results. Inconsistency of data may depend on the fact that most studies measured areal bone mineral density (aBMD) by Dual-energy-x ray absorptiometry (DXA). Because DXA cannot distinguish between cortical and trabecular compartments, we reasoned that a study aimed to establish whether these compartments were differentially affected by PAD status could give more information on the nature of this association. METHODS In this cross-sectional study, we used peripheral quantitative computed tomography (pQCT) to examine volumetric cortical and trabecular mineral density at the radius (vBMD) in a cohort of subjects with subclinical PAD as defined by ABI ≤0.90 and compared them with healthy subjects with no evidence of PAD. RESULTS Patients with subclinical PAD had significantly reduced cortical density (1101.0 ± 45.4 vs 1156.2 ± 51.3 mg/cm(3), p < 0.001) and cortical area (75.0 ± 20.9 vs 99.9 ± 18.2 mm(2), p < 0.001) than healthy subjects. Trabecular density (178.1 ± 47.9 vs 165.8 ± 29.6 mg/cm(3)) was not significantly different in the two groups. CONCLUSION Subclinical PAD induces a selective bone loss at the radius compartment, not identified by standard DXA, which seems to occur primarily at the cortical level.
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Affiliation(s)
- A Gaudio
- Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy
| | - F Muratore
- Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy
| | - V Fiore
- Department of Clinical and Experimental Medicine, Section of Vascular Medicine, Medical Angiology Unit, University of Catania, Garibaldi Hospital, Piazza S. Maria di Gesù 5, 95123, Catania, Italy
| | - R Rapisarda
- Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy
| | - S S Signorelli
- Department of Clinical and Experimental Medicine, Section of Vascular Medicine, Medical Angiology Unit, University of Catania, Garibaldi Hospital, Piazza S. Maria di Gesù 5, 95123, Catania, Italy
| | - C E Fiore
- Department of Clinical and Experimental Medicine, Section of Metabolic Bone Disease, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124, Catania, Italy.
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Zhukouskaya VV, Eller-Vainicher C, Gaudio A, Cairoli E, Ulivieri FM, Palmieri S, Morelli V, Orsi E, Masserini B, Barbieri AM, Polledri E, Fustinoni S, Spada A, Fiore CE, Chiodini I. In postmenopausal female subjects with type 2 diabetes mellitus, vertebral fractures are independently associated with cortisol secretion and sensitivity. J Clin Endocrinol Metab 2015; 100:1417-25. [PMID: 25590217 DOI: 10.1210/jc.2014-4177] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT In type 2 diabetes (T2D), the vertebral fracture (VFx) prevalence and cortisol secretion are increased. OBJECTIVE The objective of this study was to evaluate the role of glucocorticoid secretion and sensitivity in T2D-related osteoporosis. DESIGN AND SETTING This was a case-control study in an outpatient setting. PATIENTS The patients were ninety-nine well-compensated T2D postmenopausal women (age, 65.7 ± 7.3 y) and 107 controls (age, 64.5 ± 8.2 y). MAIN OUTCOME MEASURES We assessed osteocalcin, C-terminal telopeptide of type I collagen, ACTH, cortisol after the dexamethasone suppression test (F-1mgDST), BclI and N363S single-nucleotide polymorphisms (SNPs) of glucocorticoid receptor, lumbar spine and femoral neck bone mineral density by dual x-ray absorptiometry, and VFx by radiography. RESULTS Compared with controls, T2D subjects had increased VFx prevalence (20 vs 34.3%, respectively; P = .031), bone mineral density (Z-scores, lumbar spine, 0.16 ± 1.28 vs 0.78 ± 1.43, P = .001; femoral neck, -0.03 ± 0.87 vs 0.32 ± 0.98, P = .008, respectively), and F-1mgDST (1.06 ± 0.42 vs 1.21 ± 0.44 μg/dL, 29.2 ± 1.2 vs 33.3 ± 1.2 nmol/L, respectively; P = .01), and decreased osteocalcin (10.6 ± 6.4 vs 4.9 ± 3.2 ng/mL, 10.6 ± 6.4 vs 4.9 ± 3.2 μg/L, respectively; P < .0001) and C-terminal telopeptide of type I collagen (0.28 ± 0.12 vs 0.14 ± 0.08 ng/mL, 0.28 ± 0.12 vs 0.14 ± 0.08 mcg/L, respectively; P < .0001). Fractured controls or T2D patients had increased sensitizing N363S SNP prevalence (20 and 17.6%, respectively) compared to non-fractured subjects (3.4 and 3.1%, respectively; P = .02 for both comparisons), and similar BclI SNP prevalence. The VFx presence was associated with the sensitizing variant of N363S SNPs in controls (odds ratio [OR] = 10.6; 95% confidence interval [CI], 1.8-63.3; P = .01) and in T2D patients (OR = 12.5; 95% CI, 1.8-88.7; P = .01), and with the F-1mgDST levels (OR = 2.1; 95% CI, 1.1-4.1; P = .03) only in T2D patients. CONCLUSIONS In postmenopausal T2D women, VFx are associated with cortisol secretion and the sensitizing variant of N363S SNPs.
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MESH Headings
- Aged
- Aged, 80 and over
- Bone Density
- Case-Control Studies
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/metabolism
- Female
- Gene Frequency
- Humans
- Hydrocortisone/metabolism
- Lumbar Vertebrae/diagnostic imaging
- Metabolism, Inborn Errors/epidemiology
- Metabolism, Inborn Errors/genetics
- Metabolism, Inborn Errors/metabolism
- Middle Aged
- Osteoporosis, Postmenopausal/epidemiology
- Osteoporosis, Postmenopausal/genetics
- Osteoporosis, Postmenopausal/metabolism
- Polymorphism, Single Nucleotide
- Postmenopause/metabolism
- Prevalence
- Radiography
- Receptors, Glucocorticoid/deficiency
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
- Spinal Fractures/epidemiology
- Spinal Fractures/genetics
- Spinal Fractures/metabolism
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Affiliation(s)
- Volha V Zhukouskaya
- Units of Endocrinology and Metabolic Diseases (V.V.Z., C.E.V., E.C., S.P., V.M., E.O., B.M., A.M.B., A.S., I.C.), Nuclear Medicine (F.M.U.), and Epidemiology (E.P., S.F.), Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Department of Clinical Sciences and Community Health (V.V.Z., E.C., S.P., V.M., A.M.B., S.F., A.S.), University of Milan, 20122 Milan, Italy; and Department of Medical and Pediatric Sciences (A.G., C.E.F.), University of Catania, 95124 Catania, Italy
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Gaudio A, Privitera F, Pulvirenti I, Canzonieri E, Rapisarda R, Fiore CE. Relationships between osteoprotegerin, receptor activator of the nuclear factor kB ligand serum levels and carotid intima-media thickness in patients with type 2 diabetes mellitus. Panminerva Med 2014; 56:221-225. [PMID: 25056244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this paper was to investigate the association of circulating osteoprotegerin (OPG) and receptor activator of the nuclear factor kB ligand (RANKL) levels with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM). METHODS We performed a cross-sectional community-based study including 40 T2DM postmenopausal women and 40 healthy controls. CIMT was measured by B-mode ultrasound. Serum OPG and RANKL were measured by solid-phase enzyme-linked immunosorbent assay (ELISA). RESULTS Serum OPG levels were higher in T2DM than in controls (median 2.9 vs 2.0 pmol/liter; P<0.001), significantly associated with CIMT in T2DM (P<0.001). RANKL levels were lower in T2DM than in controls (median 0.45 vs 0.60 pmol/liter; P<0.0001), however no association was found with CIMT. Serum OPG levels were associated with cross-sectional measure of CIMT in T2DM. CONCLUSION The data would support the role of an increased OPG/RANKL ratio as a possible marker of progression of vascular dysfunction in diabetes.
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Affiliation(s)
- A Gaudio
- Department of Medical and Pediatric Sciences University of Catania, Catania, Italy -
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Gaudio A, Privitera F, Battaglia K, Torrisi V, Sidoti MH, Pulvirenti I, Canzonieri E, Tringali G, Fiore CE. Sclerostin levels associated with inhibition of the Wnt/β-catenin signaling and reduced bone turnover in type 2 diabetes mellitus. J Clin Endocrinol Metab 2012; 97:3744-50. [PMID: 22855334 DOI: 10.1210/jc.2012-1901] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
CONTEXT Patients with type 2 diabetes (T2DM) have low bone turnover, poor bone quality, and circulating levels of sclerostin significantly higher than non-T2DM controls. There are no data on the possible association of sclerostin with β-catenin, a key component of the Wnt/β-catenin canonical signaling. OBJECTIVES The aim of the study was to evaluate the circulating β-catenin levels in T2DM patients and to analyze their relationship with sclerostin and bone turnover markers. DESIGN This was a cross-sectional study. SETTING AND PATIENTS The study was conducted at a clinical research center. Forty T2DM postmenopausal women were studied and compared with 40 healthy controls. Bone status was assessed by dual-energy x-ray absorptiometry measurements (bone mineral density) and by measuring bone alkaline phosphatase and carboxy-terminal telopeptide of type 1 collagen. Sclerostin and β-catenin were evaluated by an immunoenzymetric assay. RESULTS Consistent with previous reports in T2DM subjects, we found sclerostin levels higher and bone turnover markers lower than controls. In our cohort of T2DM patients, β-catenin levels are significantly lower than in controls (median 1.22 pg/ml, 25th to 75th percentiles 0.50-2.80; and median 4.25 pg/ml, 25th to 75th percentiles 2.20-7.62, respectively; P=0.0002). β-Catenin correlated negatively with sclerostin (P<0.0001) and positively with bone alkaline phosphatase (P=0.0030) only in T2DM patients and negatively with age in both groups. Eight of the 40 T2DM patients had vertebral fractures. CONCLUSIONS These results show for the first time that T2DM patients have serum concentrations of β-catenin lower than controls. The negative association of β-catenin with sclerostin suggests a biological effect of increased sclerostin on the Wnt signaling, which appears impaired in T2DM.
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Affiliation(s)
- Agostino Gaudio
- Department of Internal Medicine, University of Catania, Clinica Medica OVE, Via Plebiscito 628, 95124 Catania, Italy
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Gaudio A, Pennisi P, Muratore F, Bertino G, Ardiri A, Pulvirenti I, Tringali G, Fiore CE. Reduction of volumetric bone mineral density in postmenopausal women with hepatitis C virus-correlated chronic liver disease: a peripheral quantitative computed tomography (pQCT) study. Eur J Intern Med 2012; 23:656-60. [PMID: 22892442 DOI: 10.1016/j.ejim.2012.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 04/23/2012] [Accepted: 05/13/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND The prevalence of osteoporosis in chronic liver disease (CLD) varies considerably among the studies, depending on patient selection and diagnostic criteria. We aimed to measure bone turnover markers and volumetric bone mineral density (BMD) in a group of postmenopausal women with CLD using both dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), in comparison with age-matched healthy subjects. METHODS Thirty-five postmenopausal patients with HCV-correlated CLD and 35 healthy postmenopausal women, as controls, underwent a DXA scan at lumbar and femoral level and a pQCT measurement of the nondominant forearm. Serum concentrations of biochemical markers relevant to bone turnover were also measured. RESULTS Patients showed no differences in DXA values either at lumbar or femoral level compared to controls. On the contrary, pQCT geometrical (cortical cross-sectional area) and volumetric (total and trabecular volumetric BMD) parameters were significantly reduced in the CLD women. Also the Strength-Strain Index (SSI), an estimate of diaphyseal bone resistance to bending and torsion, was significantly lower in patients than in controls. Patients with CLD presented an unbalanced bone turnover, with increased bone resorption markers. CONCLUSIONS The bone geometrical and volumetric parameters measured in our CLD postmenopausal women, by pQCT, show a reduced bone mineral quality and stiffness. Conversely, DXA-measurements seem unable to appreciate the bone alterations in these patients. This would encourage further studies to validate pQCT analysis as a diagnostic tool for a correct estimate of bone involvement in CLD.
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Affiliation(s)
- Agostino Gaudio
- Department of Internal Medicine, University of Catania, Via Plebiscito 628, 95124 Catania Italy
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Fiore CE, Gaudio A. When the FRAX(®) test is applied to controlled clinical trials. Clin Cases Miner Bone Metab 2012; 9:135-137. [PMID: 23289024 PMCID: PMC3535994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
FRAX(®) is a computer-based algorithm developed by the World Health Organization Collaborating Centre for Metabolic Bone Diseases in Sheffield (UK). This algorithm calculates fracture probability from easily obtained clinical risk factors in men and women: age, sex, body mass index and dichotomized variables comprising prior fragility fracture, parental history of hip fracture, current tobacco smoking, use of long-term oral glucocorticoid, rheumatoid arthritis, other causes of secondary osteoporosis and high alcohol consumption (femoral neck bone mineral density can be optionally input to enhance fracture risk prediction). The output of FRAX(®) is the 10-year probability of a major osteoporotic fracture (hip, clinical spine, humerus or wrist fracture) and the 10-year probability of hip fracture.Recently various Authors have re-evaluated the effectiveness of drugs approved for postmenopausal osteoporosis to test whether they are more effective in women with higher FRAX(®) probabilities.
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Affiliation(s)
- Carmelo Erio Fiore
- Address for correspondence: Carmelo Erio Fiore, MD, Clinica Medica, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania, Italy, Phone: +39 095 7435386 - Fax: +39 095 322200, E-mail:
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Fiore CE, da Luz MGE. General approach for studying first-order phase transitions at low temperatures. Phys Rev Lett 2011; 107:230601. [PMID: 22182076 DOI: 10.1103/physrevlett.107.230601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Indexed: 05/31/2023]
Abstract
By combining different ideas, a general and efficient protocol to deal with discontinuous phase transitions at low temperatures is proposed. For small T's, it is possible to derive a generic analytic expression for appropriate order parameters, whose coefficients are obtained from simple simulations. Once in such regimes simulations by standard algorithms are not reliable; an enhanced tempering method, the parallel tempering-accurate for small and intermediate system sizes with rather low computational cost-is used. Finally, from finite size analysis, one can obtain the thermodynamic limit. The procedure is illustrated for four distinct models, demonstrating its power, e.g., to locate coexistence lines and the phase density at the coexistence.
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Affiliation(s)
- C E Fiore
- Departamento de Física, Universidade Federal do Paraná, 81531-980, Curitiba-PR, Brazil.
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Diacinti D, Pisani D, Del Fiacco R, Francucci CM, Fiore CE, Frediani B, Barone A, Bartalena T, Cattaruzza MS, Guglielmi G, Diacinti D, Romagnoli E, Minisola S. Vertebral morphometry by X-ray absorptiometry: which reference data for vertebral heights? Bone 2011; 49:526-36. [PMID: 21672644 DOI: 10.1016/j.bone.2011.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 04/23/2011] [Accepted: 05/25/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The recent improvement in the resolution of dual-energy X-ray absorptiometry (DXA) images enables most vertebral levels to be seen adequately and thus DXA may be a worthwhile alternative to radiologic morphometry for the identification of vertebral fractures (VF). In this multicenter study, we have derived reference data for vertebral heights and their ratios in Italian women using morphometric X-ray absorptiometry (MXA). METHODS DXA scans were acquired in 1254 consecutive pre- and postmenopausal women, (mean age 63.7 ± 11.3, range 26-88 yrs), referred to six osteoporosis centers. MXA analysis of these images was performed by the same operator measuring vertebral heights and height ratios from L4 to T4. We calculated measures of central tendency and dispersion of vertebral heights and vertebral ratios using different approaches (mean and standard deviation as well as median and interquartile range of raw data, mean and standard deviation of trimmed data using an iterative algorithm, and mean and standard deviation of not fractured vertebrae). RESULTS Independently of the approach that we used, all the measures of central tendency were similar, while significant differences were found when compared with reference ranges in other populations. The vertebral heights of our sample at every vertebral level were significantly smaller than both Rea population and the Lunar reference values, even after normalization. Splitting data according to age groups, there was a decrease in the vertebral heights and ratios between the younger and older women. CONCLUSIONS This study demonstrates that reference data for MXA should be population specific and age matched.
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Granata A, Floccari F, Ferrantelli A, Rotolo U, Di Lullo L, Fiorini F, Logias F, Gallieni M, Fiore CE. Does systematic preliminar colour Doppler study reduce kidney biopsy complication incidence? Int J Nephrol 2011; 2011:419093. [PMID: 21804941 PMCID: PMC3143450 DOI: 10.4061/2011/419093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 06/06/2011] [Indexed: 01/20/2023] Open
Abstract
While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned.
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Affiliation(s)
- Antonio Granata
- Departments of Nephrology and Dialysis and Internal Medicine, V. Emanuele Hospital, Via F. Paradiso 78/a, 95024 Acireale, Italy
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Granata A, Andrulli S, Fiorini F, Basile A, Logias F, Figuera M, Sicurezza E, Gallieni M, Fiore CE. Diagnosis of acute pyelonephritis by contrast-enhanced ultrasonography in kidney transplant patients. Nephrol Dial Transplant 2010; 26:715-20. [PMID: 20659906 DOI: 10.1093/ndt/gfq417] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Diagnostic imaging of acute pyelonephritis (APN) in renal transplanted patients is an important clinical issue. While conventional ultrasonography (US) has a limited diagnostic role, contrast-enhanced computer tomography and magnetic resonance imaging (MRI) represent the gold standard diagnostic tests. However, nephrotoxicity of either iodinated or paramagnetic contrast medium limits their use, especially in patients with kidney disease. Contrast-enhanced US (CEUS) may detect poorly perfused parenchymal renal areas, a useful feature in the diagnosis of APN. The aim of this study was to evaluate the diagnostic value of CEUS in APN compared with MRI as the reference test. METHODS From a pool of 389 kidney transplant patients, we prospectively recruited 56 patients with clinical suspicion of APN of the transplanted kidney. They underwent both CEUS and MRI, performed in a blinded manner by two different operators. Sensitivity, specificity, accuracy, positive and negative predictive values, and K statistics were calculated. RESULTS Thirty-seven out of 56 patients (66.1%) resulted positive for APN with the reference test, gadolinium-enhanced MRI. Thirty-five out of these 37 patients showed positive results for APN with CEUS, and 19 patients showed negative results for APN with both MRI and CEUS: sensitivity 95% (CI 82-99), specificity 100% (CI 83-100), accuracy 96% (CI 88-99), positive predictive value 100% (CI 90-100), negative predictive value 90% (CI 71-97) and K statistics 0.92 (P<0.01). CONCLUSIONS Our results suggest, for the first time, the feasibility of CEUS, a low-cost and low-risk diagnostic procedure, in the diagnosis of APN in kidney transplant patients.
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Affiliation(s)
- Antonio Granata
- Department of Nephrology, AOU Policlinico-Vittorio Emanuele Catania, Italy.
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Granata A, Andrulli S, Fiorini F, Logias F, Figuera M, Mignani R, Basile A, Fiore CE. Persistent left superior vena cava: what the interventional nephrologist needs to know. J Vasc Access 2009; 10:207-11. [PMID: 19670176 DOI: 10.1177/112972980901000313] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Variations in the course of the blood vessels are often incidental findings during clinical examination. Persistent left superior vena cava (PLSVC) is an uncommon anomaly, estimated to be present in about 0.3-0.5% of healthy individuals and in about 3-10% of patients with congenital heart disease. It results from the failure of the left anterior cardinal vein to degenerate during embryological development. Serious complications such as shock, angina and cardiac arrest have been described during catheterization in adults with a PLSVC. Since it frequently goes undiagnosed because of lack of symptoms when not accompanied by other anomalies, variations of the superior vena cava should be considered, especially when central venous catheterization via the subclavian or internal jugular vein is difficult. The embryological development, diagnosis, and clinical implications of a PLSVC are therefore reviewed in this article.
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Affiliation(s)
- Antonio Granata
- Departments of Nephrology & Dialysis, Internal Medicine & Radiology, Vittorio Emanuele-Ferrarotto-S. Bambino Hospital, University of Catania, Catania,Italy.
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Granata A, Fiorini F, Andrulli S, Logias F, Gallieni M, Romano G, Sicurezza E, Fiore CE. Doppler ultrasound and renal artery stenosis: An overview. J Ultrasound 2009; 12:133-43. [PMID: 23397022 DOI: 10.1016/j.jus.2009.09.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Renovascular disease is a complex disorder, most commonly caused by fibromuscular dysplasia and atherosclerotic diseases. It can be found in one of three forms: asymptomatic renal artery stenosis (RAS), renovascular hypertension, and ischemic nephropathy. Particularly, the atherosclerotic form is a progressive disease that may lead to gradual and silent loss of renal function. Thus, early diagnosis of RAS is an important clinical objective since interventional therapy may improve or cure hypertension and preserve renal function. Screening for RAS is indicated in suspected renovascular hypertension or ischemic nephropathy, in order to identify patients in whom an endoluminal or surgical revascularization is advisable. Screening tests for RAS have improved considerably over the last decade. While captopril renography was widely used in the past, Doppler ultrasound (US) of the renal arteries (RAs), angio-CT, or magnetic resonance angiography (MRA) have replaced other modalities and they are now considered the screening tests of choice. An arteriogram is rarely needed for diagnostic purposes only. Color-Doppler US (CDUS) is a noninvasive, repeatable, relatively inexpensive diagnostic procedure which can accurately screen for renovascular diseases if performed by an expert. Moreover, the evaluation of the resistive index (RI) at Doppler US may be very useful in RAS affected patients for predicting the response to revascularization. However, when a discrepancy exists between clinical data and the results of Doppler US, additional tests are mandatory.
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Affiliation(s)
- A Granata
- Department of Nephrology, Dialysis and Internal Medicine, AOU Policlinico "Vittorio Emanuele", Catania, Italy
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Pennisi P, Clementi G, Prato A, Luca T, Martinez G, Mangiafico RA, Pulvirenti I, Muratore F, Fiore CE. L-arginine supplementation normalizes bone turnover and preserves bone mass in streptozotocin-induced diabetic rats. J Endocrinol Invest 2009; 32:546-51. [PMID: 19494718 DOI: 10.1007/bf03346505] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Osteopenia, an important complication of diabetes mellitus, is responsible of an increase in bone fracture and of a delay in fracture healing. The pathogenesis of this complication is unclear, however decreased availability and synthesis of nitric oxide (NO) may be regarded as a possible cause of disregulation of bone turnover. The aim of our study was to evaluate the effect of streptozotocin (STZ)-induced diabetes in the rat on bone mineral density (BMD) and bone turnover. We also examined whether supplementation of L-arginine (which acts as a NO substrate) could be beneficial for bone. After 6 weeks of STZ treatment, diabetic rats showed a significant decrease of BMD in the whole body, at the spine, at the pelvis, and at the femur. Bone turnover evaluation revealed a significant decrease in the serum levels of osteocalcin (a marker of bone formation), and an increase of the serum levels of the C-terminal telopeptide of type I collagen (RatLaps; a marker of bone resorption). L-arginine supplementation prevented the diabetes-induced reduction of BMD and osteocalcin, and the increase of RatLaps. These pharmacological actions of L-arginine produce a new suggestion that increase of NO synthesis and availability is potentially useful for effective prevention and treatment of osteopenia associated with diabetes.
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MESH Headings
- Alkaline Phosphatase/blood
- Animals
- Arginine/administration & dosage
- Bone Density/physiology
- Bone Diseases, Metabolic/blood
- Bone Diseases, Metabolic/metabolism
- Bone Diseases, Metabolic/pathology
- Bone Diseases, Metabolic/prevention & control
- Bone Remodeling/drug effects
- Calcium/blood
- Collagen Type I/blood
- Creatinine/blood
- Diabetes Mellitus, Experimental/blood
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/pathology
- Male
- Nitric Oxide Donors/administration & dosage
- Osteocalcin/blood
- Peptides/blood
- Rats
- Rats, Sprague-Dawley
- Statistics, Nonparametric
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Affiliation(s)
- P Pennisi
- Department of Internal Medicine, University of Catania, Catania, Italy
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Barato AC, Bonachela JA, Fiore CE, Hinrichsen H, Muñoz MA. Simplest nonequilibrium phase transition into an absorbing state. Phys Rev E Stat Nonlin Soft Matter Phys 2009; 79:041130. [PMID: 19518196 DOI: 10.1103/physreve.79.041130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Indexed: 05/27/2023]
Abstract
We study in further detail particle models displaying a boundary-induced absorbing state phase transition [Deloubrière and van Wijland Phys. Rev. E 65, 046104 (2002) and Barato and Hinrichsen, Phys. Rev. Lett. 100, 165701 (2008)]. These are one-dimensional systems consisting of a single site (the boundary) where creation and annihilation of particles occur, and a bulk where particles move diffusively. We study different versions of these models and confirm that, except for one exactly solvable bosonic variant exhibiting a discontinuous transition and trivial exponents, all the others display nontrivial behavior, with critical exponents differing from their mean-field values, representing a universality class. Finally, the relation of these systems with a (0+1)-dimensional non-Markovian process is discussed.
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Affiliation(s)
- A C Barato
- Universität Würzburg, Fakultät für Physik und Astronomie, 97074 Würzburg, Germany
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Adami S, Giannini S, Bianchi G, Sinigaglia L, Di Munno O, Fiore CE, Minisola S, Rossini M. Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos Int 2009; 20:239-44. [PMID: 18551242 DOI: 10.1007/s00198-008-0650-y] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 05/07/2008] [Indexed: 12/20/2022]
Abstract
UNLABELLED Treatment with anti-resorptive agents over 13 months was associated with for three to fivefold lower bone mineral density changes and 1.5-fold increased risk of incidence fracture in vitamin D insufficient as compared to vitamin D repleted postmenopausal osteoporotic women. INTRODUCTION Several drugs were registered for the treatment of osteoporosis on the basis of clinical trials in which vitamin D repletion was a pre-requisite inclusion criteria and vitamin D supplements were used as adjunctive therapy. However, in routine clinical practice these supplements are not consistently recommended. METHODS We studied 1515 women with postmenopausal osteoporosis under treatment with anti-resorbing agents (alendronate, risedronate, raloxifene) for 13.1 months with an adherence > 75%. The patients were classified as vitamin D deficient (N = 514) or vitamin D repleted (N = 1001) according to risk factors (N = 1062) or the level of 25(OH) vitamin D [25(OH)D] above or below 50 nmol/l (N = 453). RESULTS Vitamin D deficient and vitamin D repleted subjects differed significantly for annualized spine and hip bone mineral density (BMD) changes adjusted for all available confounding factors (type of treatment, age, global calcium intake, baseline BMD values). One hundred fifty one patients suffered from a new incident clinical fracture. The adjusted odds ratio for incident fractures in vitamin D deficient as compared to vitamin D repleted women was 1.77 (1.20 - 2.59, 95% CI; p = 0.004). CONCLUSIONS Optimal vitamin D repletion seems to be necessary to maximize the response to anti-resorbers in terms of both BMD changes and anti-fracture efficacy.
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Affiliation(s)
- S Adami
- Rheumatology Unit, Ospedale di Valeggio, Verona, Italy.
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Fiore CE, Pennisi P, Pulvirenti I, Francucci CM. Bisphosphonates and atherosclerosis. J Endocrinol Invest 2009; 32:38-43. [PMID: 19724165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
The relevance of association between osteoporosis and cardiovascular disease in clinical settings, and the evidence of a biological linkage between bone and vascular calcification, encourage the search of drugs that may act as dual-purpose therapies, concordantly enhancing bone density and reducing atherosclerosis. Bisphosphonates (BP) reduce bone resorption and fracture risk, and also seem to have the potential to reduce atherosclerotic process. This unexpected activity is the result of their interference with cholesterol synthesis, inflammatory progression, and oxidative stress. Although most animal studies show a clear anti-atherogenic activity of BP, data in humans are not consistent or conclusive, given the high affinity of BP for bone, which prevents them from accumulating in other tissues at the concentration required to exert a clear pharmacological effect.
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Affiliation(s)
- C E Fiore
- Department of Internal Medicine, University of Catania, Catania, Italy.
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Adami S, Gatti D, Viapiana O, Fiore CE, Nuti R, Luisetto G, Ponte M, Rossini M. Physical activity and bone turnover markers: a cross-sectional and a longitudinal study. Calcif Tissue Int 2008; 83:388-92. [PMID: 18949504 DOI: 10.1007/s00223-008-9184-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 09/22/2008] [Indexed: 10/21/2022]
Abstract
Strenuous physical activity in young individuals has an important effect on both bone mass and bone turnover but the effect of moderate physical activity in adults remains uncertain. In a large cohort (N = 530) of healthy premenopausal women, bone formation markers (osteocalcin and N-terminal propeptide of type 1 procollagen [P1NP]), but not serum C-telopeptide of type 1 collagen (sCTX), were found to be significantly associated with the level of physical activity, and this association remained significant after adjusting the data (ANCOVA) by age and body mass index. Mean spine and hip bone mineral density (BMD) values were positively associated with physical activity but this was statistically significant (P = 0.050) only for adjusted values of spine BMD. Twenty-four healthy sedentary premenopausal women, subscribing to participate in a community exercise program lasting a month, and 18 age-matched controls were included in the longitudinal study. Serum osteocalcin and P1NP, but not sCTX, rose significantly, by ca. 25%, only in the active group after a month of exercise. The changes in the two bone formation markers remained statistically significant for values adjusted for body weight, which fell significantly in the exercise group. In conclusion, both the cross-sectional and the longitudinal parts of our study demonstrate that even minor changes in physical activity are associated with a clear effect on bone formation markers.
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Affiliation(s)
- Silvano Adami
- Rheumatology Unit, Ospedale di Valeggio, University of Verona, 37067, Valeggio, Verona, Italy.
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Adami S, Gatti D, Bertoldo F, Sartori L, Di Munno O, Filipponi P, Marcocci C, Frediani B, Palummeri E, Fiore CE, Costi D, Rossini M. Intramuscular neridronate in postmenopausal women with low bone mineral density. Calcif Tissue Int 2008; 83:301-7. [PMID: 18946626 DOI: 10.1007/s00223-008-9179-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 09/11/2008] [Indexed: 10/21/2022]
Abstract
Compliance to osteoporosis treatment with oral bisphosphonates is very poor. Intermittent intravenous bisphosphonate is a useful alternative, but this route is not readily available. Neridronate, a nitrogen-containing bisphosphonate that can be given intramuscularly (IM), was tested in a phase 2 clinical trial in 188 postmenopausal osteoporotic women randomized to IM treatment with 25 mg neridronate every 2 weeks, neridronate 12.5 or 25 mg every 4 weeks, or placebo. All patients received calcium and vitamin D supplements. The patients were treated over 12 months with 2-year posttreatment follow-up. After 12-month treatment, all three doses were associated with significant bone mineral density (BMD) increases at both the total hip and spine. A significant dose-response relationship over the three doses was observed for the BMD changes at the total hip but not at the spine. Bone alkaline phosphatase decreased significantly by 40-55% in neridronate-treated patients, with an insignificant dose-response relationship. Serum type I collagen C-telopeptide decreased by 58-79%, with a significant dose-response relationship (P < 0.05). Two years after treatment discontinuation, BMD declined by 1-2% in each dose group, with values still significantly higher than baseline at both the spine and the total hip. Bone turnover markers progressively increased after treatment discontinuation, and on the second year of follow-up the values were significantly higher than pretreatment baseline. The results of this study indicate that IM neridronate might be of value for patients intolerant to oral bisphosphonates and unwilling or unable to undergo intravenous infusion of bisphosphonates.
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Affiliation(s)
- Silvano Adami
- Rheumatology Unit, Ospedale di Valeggio, University of Verona, 37067, Valeggio, Verona, Italy.
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Granata A, Basile A, Figuera M, Logias F, Sicurezza E, Fiore CE. Usefulness of color Doppler ultrasonography for prebiopsy evaluation of native kidneys. Am J Kidney Dis 2008; 52:384-5. [PMID: 18640492 DOI: 10.1053/j.ajkd.2008.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 05/21/2008] [Indexed: 11/11/2022]
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Mangiafico RA, Alagona C, Pennisi P, Parisi N, Mangiafico M, Purrello F, Fiore CE. Increased augmentation index and central aortic blood pressure in osteoporotic postmenopausal women. Osteoporos Int 2008; 19:49-56. [PMID: 17676381 DOI: 10.1007/s00198-007-0438-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Accepted: 07/13/2007] [Indexed: 10/23/2022]
Abstract
UNLABELLED Osteoporosis has been associated with cardiovascular disease. We found increased augmentation index, a measure of wave reflections and arterial stiffness, and central pressures in osteoporotic postmenopausal women. They also showed a higher estimated aortic pulse wave velocity, indicating a stiffer aorta. These changes may increase cardiovascular risk in postmenopausal osteoporosis. INTRODUCTION Evidence suggests a link between osteoporosis and cardiovascular disease. We investigated whether augmentation index (AIx), a measure of pulse wave reflections and arterial stiffness, is increased and related to the osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL) system in postmenopausal osteoporosis. METHODS AIx and central aortic haemodynamics were assessed using pulse wave analysis in 182 cardiovascular disease-free osteoporotic postmenopausal women and in 160 controls. Statistical analysis was performed by unpaired t test, Mann-Whitney test, Spearman's correlation coefficient, and multivariate linear regression analysis. RESULTS AIx (37.2 +/- 7.0 vs. 29.6 +/- 9.2 %, P < 0.0001) and central aortic systolic (117.5 +/- 12.1 vs. 111.4 +/- 12.2 mmHg, P < 0.0001) and pulse (40.5 +/- 10.3 vs. 36.4 +/- 8.1 mmHg, P = 0.0007) pressures were significantly higher in osteoporotic patients than in controls. The estimated aortic pulse wave velocity (PWV) was also significantly higher in the osteoporotic group. In multivariate analysis for osteoporotic patients, femoral neck and lumbar spine bone mineral density T scores were independent negative predictors of AIx (P < 0.0001). AIx was not correlated with serum levels of OPG and RANKL. CONCLUSIONS Osteoporotic postmenopausal women show increased AIx and central aortic pressures, and a higher estimated aortic PWV, indicating a stiffer aorta. Such alterations may increase cardiovascular risk in postmenopausal osteoporosis.
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Affiliation(s)
- R A Mangiafico
- Department of Internal Medicine, University of Catania, Catania, Italy.
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Mangiafico RA, Malaponte G, Pennisi P, Li Volti G, Trovato G, Mangiafico M, Bevelacqua Y, Mazza F, Fiore CE. Increased formation of 8-iso-prostaglandin F(2alpha) is associated with altered bone metabolism and lower bone mass in hypercholesterolaemic subjects. J Intern Med 2007; 261:587-96. [PMID: 17547714 DOI: 10.1111/j.1365-2796.2007.01784.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the relationship of 8-iso-prostaglandin (PG) F(2alpha) levels, a reliable marker of in vivo oxidative stress and lipid peroxidation, with bone mineral density (BMD), bone turnover markers, osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa B ligand (RANKL) in hypercholesterolaemia. DESIGN Cross-sectional study. SETTING University hospital centre. METHODS Serum 8-iso-PGF(2alpha) levels were measured in 173 hypercholesterolaemic subjects and in 152 age- and sex-matched normocholesterolaemic controls. Femoral neck and lumbar spine BMD, serum bone-specific alkaline phosphatase (BAP), osteocalcin (OC), OPG and RANKL levels, as well as urinary levels of C-terminal telopeptides of type I collagen (CTX-I), were also assessed. RESULTS Hypercholesterolaemic subjects showed higher (P < 0.0001) serum 8-iso-PGF(2alpha) levels than controls. They also had decreased (P < 0.0001) femoral neck and lumbar spine BMD, and lower (P < 0.0001) serum BAP and OC levels. No significant differences between hypercholesterolaemic and control subjects were found when comparing urinary CTX-I levels, or serum OPG and RANKL levels. In multivariate linear regression analysis, serum 8-iso-PGF(2alpha) was the only negative predictor for femoral neck BMD and serum BAP and OC levels in hypercholesterolaemic subjects. No significant correlation (all P > 0.25) was present between serum 8-iso-PGF(2alpha) levels and urinary CTX-I levels, or serum OPG and RANKL levels, in hypercholesterolaemic subjects. CONCLUSIONS We found an association between increased serum 8-iso-PGF(2alpha) levels and lower bone mass and reduced serum BAP and OC concentrations in hypercholesterolaemic subjects. These results would suggest a possible role for oxidative stress in the development of lower bone mass in hypercholesterolaemia.
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Affiliation(s)
- R A Mangiafico
- Department of Internal Medicine, University of Catania, Catania, Italy.
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Fiore CE, Pennisi P, Ferro G, Ximenes B, Privitelli L, Mangiafico RA, Santoro F, Parisi N, Lombardo T. Altered osteoprotegerin/RANKL ratio and low bone mineral density in celiac patients on long-term treatment with gluten-free diet. Horm Metab Res 2006; 38:417-22. [PMID: 16823725 DOI: 10.1055/s-2006-944548] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Skeletal demineralization and mineral metabolism derangement are well-recognized features of untreated celiac disease (CD). Although treatment with a gluten-free diet appears to prevent bone loss while correcting skeletal demineralization in childhood, there is evidence that bone mineral density does not return to normal in celiacs diagnosed in adulthood. Osteoprotegerin (OPG), a member of the tumor necrosis factor receptor family, and ligand of receptor activator of NFkB (RANKL) are involved in the process of bone turnover and have been implicated in the pathogenesis of osteoporosis and other metabolic bone diseases. We measured OPG, RANKL, bone mineral density (BMD), and biochemical markers of bone turnover in 32 adult female premenopausal celiac patients on a gluten-free diet, and thirty age-matched healthy women. We correlated the OPG/RANKL ratio with the severity of bone loss. Celiac patients had a mean BMD lower than controls in lumbar spine and in the femoral neck. Serum levels of bone alkaline phosphatase (BAP, marker of bone formation), and urinary excretion of telopeptides of type I collagen (a marker of bone resorption) were significantly higher than in controls. Serum OPG and RANKL levels were significantly higher in CD patients than in controls, while the OPG/RANKL ratio was significantly lower in CD patients than in controls and was positively correlated with BMD at the spine. The role of elevated OPG in CD patients is unclear, but it might represent a compensatory mechanism against other factors that promote bone damage. Further studies are required to assess a possible therapeutic potential of osteoprotegerin in optimally treated celiacs with persistent osteopenia.
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Affiliation(s)
- C E Fiore
- Department of Internal Medicine, University of Catania, Catania, Italy.
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Mangiafico RA, Russo E, Riccobene S, Pennisi P, Mangiafico M, D'Amico F, Fiore CE. Increased prevalence of peripheral arterial disease in osteoporotic postmenopausal women. J Bone Miner Metab 2006; 24:125-31. [PMID: 16502119 DOI: 10.1007/s00774-005-0658-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Accepted: 10/03/2005] [Indexed: 10/25/2022]
Abstract
The aim of this study was to investigate the prevalence and correlates of peripheral arterial disease (PAD) in a population of osteoporotic postmenopausal women. The presence of PAD was assessed by ankle brachial index (ABI) in 345 ambulatory osteoporotic postmenopausal women, and in 360 community-based, age- and race-matched postmenopausal women with normal bone mineral density (BMD) (control group). PAD was detected in 63/345 (18.2%) osteoporotic women and in 14/360 (3.8%) control subjects (P < 0.0001). The mean ABI values were significantly lower in the osteoporosis group than in the control group (0.98 +/- 0.09 vs. 1.04 +/- 0.06, P < 0.0001). No difference in cardiovascular risk factors was observed between osteoporotic patients and controls, or between osteoporotic patients with and without PAD. Osteoporotic patients with PAD had lower femoral neck BMD T scores than those without PAD (-4.2 +/- 0.7 vs. -2.3 +/- 0.7, P < 0.0001). Only 4 PAD patients (5.1%) had intermittent claudication. In multivariate logistic regression analysis, factors independently associated with PAD within osteoporotic patients were lower femoral neck BMD T score (odds ratio (OR) = 0.20, 95% confidence interval (CI), 0.05-0.70, P = 0.01) and systolic blood pressure (OR = 1.02, 95% CI, 1.00-1.03, P = 0.01). This study shows for the first time an increased prevalence of PAD among osteoporotic postmenopausal women, with a lower femoral neck BMD T score being a significant independent predictor. The findings suggest that vascular status evaluation should be done in osteoporotic postmenopausal women in order to identify candidate patients for preventive and therapeutic cardiovascular interventions.
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Affiliation(s)
- Roberto Antonio Mangiafico
- Department of Internal Medicine, University of Catania School of Medicine, Clinica Medica "L. Condorelli," Ospedale Vittorio Emanuele, Via Plebiscito 628 95124, Catania, Italy.
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Mangiafico RA, Sarnataro F, Mangiafico M, Fiore CE. Impaired cognitive performance in asymptomatic peripheral arterial disease: relation to C-reactive protein and D-dimer levels. Age Ageing 2006; 35:60-5. [PMID: 16364935 DOI: 10.1093/ageing/afi219] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND PURPOSE asymptomatic peripheral arterial disease (APAD), a highly prevalent condition in the general older population, is associated with an increased risk of cerebrovascular events because of co-existing clinical or subclinical cerebral atherosclerosis. The purpose of this study was to investigate whether cognitive function is impaired in stroke- and transient ischaemic attack-free patients with APAD, and whether inflammatory and haemostatic markers are associated independently with neuropsychological performance. METHODS cognitive performances of 164 well-functioning, community-dwelling patients with APAD were compared with those of 164 age-, gender- and education-matched healthy control subjects on six neuropsychological tests. Levels of C-reactive protein (CRP), D-dimer and fibrinogen were also analysed in all participants. RESULTS patients with APAD scored significantly worse (P < 0.0001) than control subjects on five cognitive tests assessing domains of verbal working memory, attention, perceptuomotor speed, mental flexibility, visuoconstructive skills and visual memory. Multiple linear regression analyses showed that CRP and D-dimer were significant, independent predictors of poorer performances on four and three cognitive tests, respectively, within patients with APAD. CONCLUSIONS patients with APAD show cognitive impairment in a range of psychometric tests, and CRP and D-dimer appear to be independent negative predictors of some cognitive performances. These findings suggest the need for screening for APAD among at-risk subjects in order to identify patients to be treated for prevention of functional decline and dementia. They also support the hypothesis that inflammation and hypercoagulability are implicated in the pathophysiology of cognitive dysfunction associated with APAD.
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Affiliation(s)
- Roberto Antonio Mangiafico
- Department of Internal Medicine, University of Catania School of Medicine, Clinica Medica L. Condorelli, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania, Italy.
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Fiore CE, Riccobene S, Mangiafico R, Santoro F, Pennisi P. Hepatitis C-associated osteosclerosis (HCAO): report of a new case with involvement of the OPG/RANKL system. Osteoporos Int 2005; 16:2180-4. [PMID: 15983730 DOI: 10.1007/s00198-005-1858-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Accepted: 01/15/2005] [Indexed: 11/26/2022]
Abstract
We report a new case of hepatitis C-associated osteosclerosis (HCAO). The clinical presentation of the patient was an acquired deep severe bone pain with increased serum bone alkaline phosphatase activity (up to 12 times the upper limit of normal), and generalized bone sclerosis, temporally related to the hepatitis C-virus (HCV) infection. We documented in this patient an increase of circulating osteoprotegerin (OPG), and a concentration of circulating receptor activator for nuclear factor-kB ligand (RANKL) below the lower limit of the reference range. The observed abnormalities of the OPG/RANKL system may contribute to the maintenance of the positive balance of bone remodeling that characterizes patients with HCAO.
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Affiliation(s)
- C E Fiore
- Department of Internal Medicine, University of Catania OVE, Via Plebiscito 628, 95124, Catania, Italy.
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Pennisi P, D'Alcamo MA, Leonetti C, Clementi A, Cutuli VM, Riccobene S, Parisi N, Fiore CE. Supplementation of L-arginine prevents glucocorticoid-induced reduction of bone growth and bone turnover abnormalities in a growing rat model. J Bone Miner Metab 2005; 23:134-9. [PMID: 15750691 DOI: 10.1007/s00774-004-0551-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Accepted: 08/12/2004] [Indexed: 10/25/2022]
Abstract
The present study was designed to evaluate the effects of glucocorticoid (GC) treatment on bone turnover and bone mineral density in the growing rat. Because of the recent evidence that nitric oxide (NO) can counteract prednisolone-induced bone loss in mature rats, we examined the effect on bone of the NO donor L: -arginine in young male rats, in which bone mass is increased by the same biological mechanism as in children and adolescents. Thirty-six 10-week-old Sprague-Dawley male rats were assigned to six groups of six animals each, and treated for 4 weeks with either vehicle (once a week subcutaneous injection of 100 microl of sesame oil); prednisolone sodium succinate, 5 mg/kg, 5 days per week by intramuscular injection (i.m.); L-arginine, 10 mg/kg intraperitoneally (i.p.) once a day; N(G)-nitro-L-arginine methylester (L-NAME), 50 mg/kg subcutaneously once a day; prednisolone sodium succinate 5 mg/kg, 5 days per week i.m. +L-arginine 10 mg/kg i.p. once a day; or prednisolone sodium succinate, 5 mg/kg, 5 days per week i.m. +L-NAME 50 mg/kg subcutaneously once a day. Serum calcium, alkaline phosphatase (ALP), osteocalcin, and the C-terminal telopeptides of type I collagen (RatLaps) were measured at baseline conditions and after 2 and 4 weeks. Prior to treatment, and after 2 and 4 weeks, the whole body, vertebral, pelvic, and femoral bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) scanning. Prednisolone and prednisolone+L-NAME treated rats had significantly lower ALP and osteocalcin levels than controls at 2 and 4 weeks, and significantly higher levels of Rat-Laps than controls at 4 weeks. Prednisolone, L-NAME, and prednisolone+L-NAME produced a significant inhibition of bone accumulation and bone growth at all sites measured. Supplementation with L-arginine appeared to prevent the inhibition of bone growth and increase in bone resorption induced by prednisolone. These data would suggest, for the first time, that supplementation with an NO donor could be considered as a treatment for steroid-induced osteoporosis in the developing skeleton.
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Affiliation(s)
- Pietra Pennisi
- Department of Internal Medicine OVE, Via Plebiscito 628, 95124, Catania, Italy
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Pennisi P, Signorelli SS, Riccobene S, Celotta G, Di Pino L, La Malfa T, Fiore CE. Low bone density and abnormal bone turnover in patients with atherosclerosis of peripheral vessels. Osteoporos Int 2004; 15:389-95. [PMID: 14661073 DOI: 10.1007/s00198-003-1550-9] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2003] [Accepted: 11/06/2003] [Indexed: 10/26/2022]
Abstract
Patients with vascular calcifications often have low bone mineral density (BMD), but it is still uncertain if osteoporosis and peripheral vascular disease (VD) are interrelated and linked by a common pathomechanism. Moreover, data on bone turnover in patients with advanced atherosclerosis are lacking. We measured BMD by dual-energy X-ray absorptiometry (DXA) and quantitative bone ultrasound (QUS), as well as the serum levels of osteocalcin (OC), bone-specific alkaline phosphatase (BAP), osteoprotegerin (OPG) and its ligand RANKL, and the urinary concentration of the C-terminal telopeptides of type I collagen (CrossLaps), in 36 patient (20 male and 16 female) with serious atherosclerotic involvement of the carotid and/or femoral artery to investigate the underlying mechanism of vascular and osseous disorders. Thirty age-matched and gender matched healthy individuals served as controls. After adjustment for age, BMD was significantly reduced at the lumbar spine in 23/36 (63%) patients (mean T score -1.71+/-1.42) and at the proximal femur in 34/36 (93%) patients (neck mean T score -2.5+/-0.88). Ten patients (27%) had abnormal QUS parameters. Gender and diabetes had no effect on the relationship between vascular calcification and bone density at any site measured. VD subjects had OC and BAP serum levels lower than controls (13.3+/-3.1 vs 27.7+/-3.3 ng/ml, P<0.01, and 8.4+/-2.3 vs 12.5+/-1.4 microg/l, P<0.01, respectively). Urinary CrossLaps excretion was not significantly different in patients with VD and in controls (257.9+/-138.9 vs 272.2+/-79.4 micro g/mmol Cr, respectively). Serum OPG and RANKL levels were similar in patients and in controls (3.5+/-1.07 vs 3.4+/-1.05 pmol/l, and 0.37+/-0.07 vs 0.36+/-0.06 pmol/l, respectively). We proved high occurrence of osteoporosis in VD, with evidence of age and gender independence. Negative bone remodelling balance would be a consequence of reduced bone formation, with no apparent increased activation of the OPG-RANKL system.
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Affiliation(s)
- P Pennisi
- Department of Internal Medicine, University of Catania OVE, Via Plebiscito 628, 95124, Catania, Italy
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Mangiafico RA, Zeviani M, Bartoloni G, Fiore CE. Accelerated cardiomyopathy in maternally inherited diabetes and deafness. Int J Clin Pharmacol Res 2004; 24:15-21. [PMID: 15575173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The clinical features and course of cardiac involvement in a patient with maternally inherited diabetes and deafness associated with the mitochondrial DNA 3243 mutation are reported. A 45-year-old woman with maternally transmitted diabetes mellitus and deafness presented with congestive heart failure. The patient showed a short P-R interval on electrocardiogram (ECG) and had developed progression from left ventricular hypertrophy to a hypokinetic cardiomyopathy pattern over the course of 10 months. Rapid cardiac change was accompanied by left ventricular remodeling, as shown by wall thinning on echocardiogram and decrease in QRS voltages on ECG. Coronary arteriography revealed no significant stenosis. In the endomyocardial biopsy specimens, light microscopy showed nonspecific cardiomyopathic changes. Genetic testing for mitochondrial DNA mutations in peripheral blood lymphocytes revealed an adenine (A)-to-guanine (G) substitution at nucleotide 3243 in the mitochondrial DNA encoding the transfer RNA for leucine (tRNA Leu (UUR)). The proportion of mutant mitochondrial DNA was 25%. Two of the patient's daughters, aged 13 and 21 years, who were symptom free, were found to carry the same point mutation. A short P-R interval on ECG in the younger of them was the sole manifestation of the mutation. Unfortunately, 6 months after diagnosis, the patient died suddenly at home. Accelerated cardiomyopathy can occur as a mitochondria-related complication in patients with maternally inherited diabetes and deafness associated with the 3243 mutation.
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Affiliation(s)
- R A Mangiafico
- Department of Internal Medicine, University of Catania School of Medicine, Catania, Italy.
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Fiore CE, Pennisi P, DiStefano A, Riccobene S, Caschetto S. Pregnancy-associated changes in bone density and bone turnover in the physiological state: prospective data on sixteen women. Horm Metab Res 2003; 35:313-8. [PMID: 12916002 DOI: 10.1055/s-2003-41308] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Areal bone mineral density (BMD, g/cm 2) was measured for the total body, lumbar spine and hip with dual-energy x-ray absorptiometry (DXA) before pregnancy and after delivery in sixteen women aged 21 - 35 years. Additional measurements included quantitative ultrasound indices (broadband ultrasound attenuation, BUA, at the calcaneus at baseline and at 16, 26, and 36 weeks of pregnancy, and postpartum) as well as biochemical markers of bone formation and resorption (measured before pregnancy and during pregnancy at 16, 22, 26, 30, 34, and 36 weeks of pregnancy and postpartum). The results of measurements were as follows: 1. Postpartum BMD showed a significant reduction in the total body (- 13.4 %), in the spine (- 9.2 %) and in the hip (-7.8 % at the femoral neck and - 9.2 % at the Ward's triangle) compared to pre-pregnancy values. 2. Biochemical markers of bone resorption increased by 26 weeks. 3. Bone ultrasound measurements that provide information on bone density before delivery did not change throughout pregnancy. A significant reduction of BUA (- 14.5 % compared to baseline) was observed postpartum only. These data would suggest that pregnancy-induced bone loss develops rapidly after the 36 week of pregnancy, possibly via enhanced bone resorption.
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Affiliation(s)
- C E Fiore
- Division of Internal Medicine and Therapy, Department of Internal Medicine, University Hospital Vittorio Emanuele, Via Plebiscito 628, 95124 Catania, Italy.
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Pennisi P, Pizzarelli G, Spina M, Riccobene S, Fiore CE. Quantitative ultrasound of bone and clodronate effects in thalassemia-induced osteoporosis. J Bone Miner Metab 2003; 21:402-8. [PMID: 14586797 DOI: 10.1007/s00774-003-0435-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2002] [Accepted: 04/01/2003] [Indexed: 10/26/2022]
Abstract
Osteoporosis in beta-thalassemia major has emerged as a topic of interest since optimized transfusion regimens have increased life expectancy and quality in these patients. Although the pathogenesis of thalassemic osteopathy is multifactorial, the evidence of an increased resorption phase suggests that the use of antiresorptive drugs such as bisphosphonates can be considered a valuable therapeutic strategy to reduce bone turnover and the risk of fragility fractures. We compared the effects of long-term cyclical clodronate therapy (300 mg intravenous infusion every 3 weeks for 2 years) and of an active placebo (calcium 1 vitamin D) on bone mass and bone turnover in 30 male patients with beta-thalassemia major. We also tested the possibility of using quantitative ultrasound (QUS) for assessing bone involvement in thalassemic osteopenia and in monitoring the response to antiresorptive therapy. Broadband ultrasound attenuation (BUA) was significantly reduced in patients with beta-thalassemia major as compared to healthy controls. In calcium and vitamin D-treated patients, a significant decline in spine, femoral, and total body areal bone density was observed. In the patients given intravenous clodronate we measured a substantial stability of bone mass, which was not significantly changed at the end of the study. The urinary excretion of deoxypyridinoline (a marker of bone resorption) showed a progressive significant decline throughout the study period in clodronate-treated patients. No significant change was observed in BUA values in both groups of patients. These results indicate that intermittent intravenous clodronate administration was not able to increase areal bone density in our thalassemic patients. Moreover, this is the first study to have assessed the usefulness of broadband ultrasound measurements in beta-thalassemia major.
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Affiliation(s)
- Pietra Pennisi
- Department of Internal Medicine University of Catania, Via Plebiscito 628, 95124 Catania, Italy
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