Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Osteoporosis: HELP
Articles from Serbia
Based on 35 articles published since 2008
||||

These are the 35 published articles about Osteoporosis that originated from Serbia during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Occurrence and risk indicators of medication-related osteonecrosis of the jaw after dental extraction: a systematic review and meta-analysis. 2015

Gaudin, Elise / Seidel, Laurence / Bacevic, Miljana / Rompen, Eric / Lambert, France. ·Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium. · Biostatistics, University Hospital of Liège, University of Liege, Liège, Belgium. · Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liege, Liège, Belgium. · Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia. ·J Clin Periodontol · Pubmed #26362756.

ABSTRACT: AIMS: The primary objective was to assess the occurrence rate of Medication-Related OsteoNecrosis of the Jaw (MRONJ) after dental extraction in patients treated with Antiresorptive Drugs (ARD) for OsteoPorosis (OP) or for oncological reasons. The secondary objective was to compare the extraction techniques regarding the occurrence of MRONJ. MATERIALS AND METHODS: A systematic search in PubMed/MEDLINE, EMBASE and LILACS databases was performed. Prospective studies considering human patients treated with ARD and providing information regarding the occurrence of MRONJ after dental extraction were selected. Meta-analysis for incidence of MRONJ at the patient level was performed. The effect of administration route and surgical technique on MRONJ was evaluated. RESULTS: The risk of MRONJ after dental extraction was significantly higher in patients treated with ARD for oncological reasons (3.2%) than in those treated with per os ARD for OP (0.15%) (p < 0.0001). Dental extraction performed with adjusted extraction protocols decreased significantly MRONJ development. Potential risk indicators such as concomitant medications and pre-existing osteomyelitis were identified. CONCLUSION: The risk of MRONJ after dental extraction in patients treated with ARD exists, especially in patients treated for oncologic reasons. This risk tends to decrease with adjusted extraction protocols.

2 Review The relationship among hypertension, antihypertensive medications, and osteoporosis: a narrative review. 2013

Ilić, Katarina / Obradović, Nevena / Vujasinović-Stupar, Nada. ·Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, PO Box 146, 11221, Belgrade, Republic of Serbia. katarina.v.ilic@gmail.com ·Calcif Tissue Int · Pubmed #23192372.

ABSTRACT: Osteoporosis and hypertension are two frequent diseases among the aging population that share a similar etiopathology and often coexist. Moreover, treatment of hypertension affects bone mineral density and, therefore, can worsen osteoporosis. This narrative review considers the influence of the main etiologic factors that contribute to the development of hypertension and osteoporosis and examines the effect of the most often used antihypertensives on bones. A computerized literature search of relevant English publications regarding the etiology of hypertension and osteoporosis as well as the impact of antihypertensives on osteoporosis from 1996 to 2011 was completed in October 2011. The latest update in the search was performed from May to June 2012. The most relevant nongenetic factors in the etiology of osteoporosis and hypertension are low calcium intake, vitamin D and vitamin K deficiency, high consumption of sodium salt, and the effects of different forms of nitric oxide. Thiazide diuretics are the only antihypertensives that have a positive influence on bone mineral density. For other antihypertensive drugs, the data are conflicting, indicating that they may have a potentially negative or positive influence on bone mineral density and fracture risk reduction. Some studies did not find a correlation between the use of antihypertensives and bone mineral density. Due to the frequent coexistence of hypertension and osteoporosis, when selecting long-term antihypertensive therapy the potential effects of antihypertensive drugs on development, worsening, or improvement of osteoporosis should also be considered.

3 Review Hormone replacement for osteoporosis in women with primary biliary cirrhosis. 2011

Rudic, Jelena S / Poropat, Goran / Krstic, Miodrag N / Bjelakovic, Goran / Gluud, Christian. ·Department of Hepatology, Clinic of Gastroenterology, Clinical Centre of Serbia, Koste Todorovica 2, Belgrade, Serbia, 11000. ·Cochrane Database Syst Rev · Pubmed #22161447.

ABSTRACT: BACKGROUND: Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women. On the other hand, hormone replacement increases the risk of various adverse events. We could not identify any meta-analyses or systematic reviews on hormone replacement in women with primary biliary cirrhosis. OBJECTIVES: To assess the beneficial and harmful effects of hormone replacement for osteoporosis in women with primary biliary cirrhosis. SEARCH METHODS: The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, LILACS, clinicaltrials.gov, the WHO International Clinical Trials Registry Platform, and full text searches were conducted until November 2011. Manufacturers and authors were contacted during the review conductance. SELECTION CRITERIA: All randomised clinical trials of hormone replacement in primary biliary cirrhosis administered by any route, or regimen, or dose compared with placebo or no intervention. DATA COLLECTION AND ANALYSIS: Two authors extracted data. RevMan Analysis was used for statistical analysis of dichotomous data with risk ratio (RR) or risk difference (RD) and of continuous data with mean difference (MD), all with 95% confidence intervals (CI). Methodological domains were used to assess risk of systematic errors (bias). Trial sequential analysis was used to control for random errors (play of chance). MAIN RESULTS: Two trials with 49 participants were included. One trial had low risk of bias. The other trial had high risk of bias. Hormone replacement had no effect on all-cause mortality (RD 0.00; 95% CI -0.11 to 0.11, I² = 0%) and fractures (RD -0.08; 95% CI -0.24 to 0.07, I² = 0%). Hormone replacement significantly increased adverse events and number of patients having hormone replacement withdrawn due to adverse events (RR 5.26; 95% CI 1.26 to 22.04, I² = 0%). Hormone replacement had no significant effect on lumbar spine bone mineral density (MD 1.25 g/cm² yearֿ¹; 95% CI -0.91 to 3.42, I² = 0%). On the other hand, a significant increase in proximal femur bone mineral density was observed in the control group (MD 2.24 g/cm² yearֿ¹; 95% CI 0.74 to 3.74, I² = 0%). Hormone replacement had no significant effect on liver-related mortality, liver transplantation, or liver-related morbidity. Hormone replacement had no significant effect on serum bilirubin concentration (MD 4.60 µmol/L; 95% CI -3.42 to 12.62, I² = 0%). AUTHORS' CONCLUSIONS: We did not find evidence to support the use of hormone replacement for women with primary biliary cirrhosis. It seems that hormone replacement is connected with a significant increase in the occurrence of adverse events.

4 Review Bisphosphonates for osteoporosis in primary biliary cirrhosis. 2011

Rudic, Jelena S / Giljaca, Vanja / Krstic, Miodrag N / Bjelakovic, Goran / Gluud, Christian. ·Department of Hepatology, Clinic of Gastroenterology, Clinical Centre of Serbia, Koste Todorovica 2, Belgrade, Serbia, 11000. ·Cochrane Database Syst Rev · Pubmed #22161446.

ABSTRACT: BACKGROUND: Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Patients with primary biliary cirrhosis often have osteoporosis - either postmenopausal or secondary to the liver disease. No systematic review or meta-analysis has assessed the effects of bisphosphonates for osteoporosis in patients with primary biliary cirrhosis. OBJECTIVES: To assess the beneficial and harmful effects of bisphosphonates for osteoporosis in primary biliary cirrhosis. SEARCH METHODS: The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, LILACS, clinicaltrials.gov, the WHO International Clinical Trials Registry Platform, and full text searches were conducted until November 2011. Manufacturers and authors were contacted for additional studies during the conductance of the review. SELECTION CRITERIA: All randomised clinical trials of bisphosphonates in primary biliary cirrhosis compared with placebo or no intervention, or another bisphosphonate, or any other drug. DATA COLLECTION AND ANALYSIS: Two authors extracted data. RevMan Analysis was used for statistical analysis of dichotomous data with risk ratio (RR) or risk difference (RD) and of continuous data with mean difference (MD) or standardised mean difference (SMD), all with 95% confidence intervals (CI). Methodological components were used to assess risk of systematic errors (bias). Trial sequential analysis was also used to control for random errors (play of chance). MAIN RESULTS: Six trials were included. Three trials with 106 participants, of which two trials with high risk of bias, did not demonstrate significant effects of bisphosphonates (etidronate or alendronate) versus placebo or no intervention regarding mortality (RD 0.00; 95% CI -0.12 to 0.12, I² = 0%), fractures (RR 0.87; 95% CI 0.29 to 2.66, I² = 0%), or adverse events (RR 1.00; 95% CI 0.49 to 2.04). Two trials with 62 participants with high risk of bias compared one bisphosphonate (etidronate or alendronate) versus another (alendronate or ibandronate) and found no significant difference regarding mortality (RD -0.03; 95% CI -0.14 to 0.07, I² = 0%), fractures (RR 0.95; 95% CI 0.18 to 5.06, I² = 0%), or adverse events (RR 1.00; 95% CI 0.49 to 2.04, I² = 0%). Bisphosphonates had no significant effect on liver-related mortality, liver transplantation, or liver-related morbidity compared with placebo or no intervention, or another bisphosphonate. Bisphosphonates had no significant effect on bone mineral density compared with placebo or no intervention, or another bisphosphonate. Bisphosphonates compared with placebo or no intervention seem to decrease the urinary amino telopeptides of collagen I (NTx) concentration (MD -16.93 nmol bone collagen equivalents/mmol creatinine; 95% CI -23.77 to -10.10; 2 trials with 88 patients; I² = 0%) and serum osteocalcin (SMD -0.81; 95% CI -1.22 to -0.39; 3 trials with 100 patients; I² = 34 %) concentration. The former result was supported by trial sequential analysis, but not the latter. Alendronate compared with another bisphosphonate (ibandronate) had no significant effect on serum osteocalcin concentration (MD -3.61 ng/ml, 95% CI -9.41 to 2.18; 2 trials with 47 patients; I² = 82%) in a random-effects meta-analysis, but it significantly decreased serum osteocalcin (MD -4.40 ng/ml, 95% CI -6.75 to -2.05; 2 trials with 47 patients; I² = 82%), the procollagen type I N-terminal propeptide (MD -8.79 ng/ml, 95% CI -15.96 to -1.63; 2 trials with 47 patients; I² = 38%), and NTx concentration (MD -14.07 nmol bone collagen equivalents/mmol creatinine, 95% CI -24.23 to -3.90; 2 trials with 46 patients; I²=0%) in a fixed-effect model. The latter two results were not supported by trial sequential analyses. There was no statistically significant difference in the number of patients having bisphosphonates withdrawn due to adverse events compared with placebo or no intervention (RD -0.04; 95% CI -0.21 to 0.12; 2 trials with 46 patients; I² = 0%), or another bisphosphonate (RR 0.56; 95% CI 0.14 to 2.17; 2 trials with 62 patients; I² = 0%). One trial with 32 participants and with high risk of bias compared etidronate versus sodium fluoride without finding significant difference regarding mortality, fractures, adverse events, or bone mineral density. Etidronate compared with sodium fluoride significantly decreased serum osteocalcin, urinary hydroxyproline, and parathyroid hormone concentration. AUTHORS' CONCLUSIONS: We did not find evidence to support or refute the use of bisphosphonates for patients with primary biliary cirrhosis. The data seem to indicate a possible positive intervention effect of bisphosphonates on decreasing urinary amino telopeptides of collagen I concentration compared with placebo or no intervention with no risk of random error. There is need for more randomised clinical trials assessing the effects of bisphosphonates for osteoporosis on patient-relevant outcomes in primary biliary cirrhosis.

5 Review Tibolone: the way to beat many a postmenopausal ailments. 2008

Lazovic, Gordana / Radivojevic, Ubavka / Marinkovic, Jelena. ·Institute of Gynecology and Obstetrics of the Clinical Centre of Serbia, 11000 Belgrade, Serbia and Montenegro. lazovicg@eunet.yu ·Expert Opin Pharmacother · Pubmed #18377345.

ABSTRACT: OBJECTIVE: The effects of tibolone on climacteric symptoms, osteoporosis, cardiovascular disease, breasts and the endometrium are summarised, and its role in clinical practice is reviewed in this article. BACKGROUND: Tibolone has tissue-specific effects on receptors and enzymes that influence the synthesis and metabolism of endogenous sexual steroid hormones. METHODS: This evaluation was based on the findings from several randomised studies, which addressed the basic and clinical research on tibolone. RESULTS/CONCLUSION: Clinical trials prove that tibolone is effective in the treatment of the menopausal symptoms and for the postponement and calming of symptoms accompanying age-related diseases. The findings of basic researchers that tibolone affects the metabolism of every cell, including malignant cells, opened a door to a whole new domain of research that has a promising future.

6 Clinical Trial Vitamin D supplementation in patients with alcoholic liver cirrhosis: a prospective study. 2018

Savić, Željka / Vračarić, Vladimir / Milić, Nataša / Nićiforović, Dijana / Damjanov, Dragomir / Pellicano, Rinaldo / Medić-Stojanoska, Milica / Abenavoli, Ludovico. ·Clinic of Gastroenterology and Hepatology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Clinic of Radiology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Unit of Gastroenterology, Molinette Hospital, Turin, Italy. · Clinic for Endocrinology, Diabetes, and Metabolic Diseases, Clinical Center of Vojvodina, University of Novi Sad, Novi Sad, Serbia. · Department of Health Sciences, Magna Græcia University, Catanzaro, Italy - l.abenavoli@unicz.it. ·Minerva Med · Pubmed #29963831.

ABSTRACT: BACKGROUND: The liver is involved in the metabolism of vitamin D. The prevalence of osteopenia in alcoholic liver disease (ALD) patients is 34-48%, and the prevalence of osteoporosis is 11-36%. Advanced liver disease is considered a risk factor for the development of osteoporosis. The aim of this study was to establish the relationship between vitamin D level and Child-Pugh score in patients with alcoholic liver cirrhosis (ALC), and to evaluate the effects of oral vitamin D supplementation. METHODS: Seventy male ALC patients in the absence of active alcohol intake were enrolled and their clinical and laboratory data were recorded. A supplementation of cholecalciferol 1000 IU/day was administered. The vitamin D status was analyzed during the study, in patients stratified by Child-Pugh score. RESULTS: The study was completed by fifty patients. At the enrollment, the mean level of vitamin D was 60.73±28.02, 50.53±39.52 and 26.71±12.81 nmol/L, respectively for Child-Pugh score class A, B and C. During vitamin D supplementation it was found in all the patients a significant increase of its levels during the first six months (P<0.05). However, in class C the improvement was consistent also after year (P<0.05). At the end of the study, two of seven patients initially in class C changed in class A, four from class C to B, and one remained in class C (P=0.012). Out of seventeen patients initially in class B, eleven changed to class A, and six remained in class B. CONCLUSIONS: In patients with ALC, higher level of vitamin D level is related with lower Child-Pugh score. The supplementation of 1000 IU/day of vitamin D in these patients was optimal for a period of at least six months. A decrease in the Child-Pugh score was also found, with a redistribution of the patients in different classes.

7 Clinical Trial Prospective clinical study of once monthly ibandronate in the treatment of osteoporosis and prevention of fractures in postmenopausal women: ORPHEUM Study. 2011

Bumbasirević, Marko / Lesić, Aleksandar / Denić-Marković, Ljiljana / Zivković, Kristina / Anonymous2660718. ·Clinic for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, Belgrade, Serbia. ·Srp Arh Celok Lek · Pubmed #22338477.

ABSTRACT: INTRODUCTION: Osteoporosis is a serious problem, since about 50% of women over the age of 50 suffer at least one osteoporotic fracture. OBJECTIVE: The aim of this study was to evaluate compliance as well as the efficiency and safety of ibandronate treatment over a 6-month period in reducing the risk of subsequent fracture in women with postmenopausal osteoporosis. METHODS: A multicenter, prospective, observational study was conducted during one year in thirteen medical centres in Serbia. In the first part of the study the participants received ibandronate tablets (150 mg) once a month for six months. In the second part, the patients were under clinical follow-up. RESULTS: The mean age of the 184 menopausal women included in the study was 66.2 +/- 9.4 years. In 40.2% of the subjects the disease had been clinically manifest during the five preceding years. The mean T-score value at the onset of our investigation was -3.1 +/- 0.84 in 160 (87%) patients who were diagnosed osteoporosis. Compression vertebral fractures alone were noted in 24% of the women, spontaneous nonvertebral fractures in 49.4% and both in 4.9%. A history of osteoporotic fractures was much more common in patients with three or four risk factors (p = 0.001). Out of 39 adverse events during therapy with once monthly bisphosphonates only 2 (3.3%) were classified as severe. During the treatment, spontaneous fractures occurred in 13 (7.1%) patients. CONCLUSION: Ibadronate treatment once a month for 6 months was shown to be very safe, tolerated well and without more serious side effects.

8 Article Capture the vertebral fracture: Risk factors as a prediction. 2019

Zvekic-Svorcan, Jelena / Aleksic, Jelena / Jankovic, Tanja / Filipovic, Karmela / Cvetkovic, Milan / Vuksanovic, Miljanka / Filipov, Predrag. ·University of Novi Sad, Faculty of Medicine Novi Sad, Serbia. · Special Hospital for Rheumatic Diseases Novi Sad, Serbia. · Railway Healthcare Center, Belgrade, Serbia. · University of Novi Sad, Faculty of Sport and Physical Education Novi Sad, Serbia. · University of Belgrade, Medical Faculty, University Clinical Center Zvezdara, Belgrade, Serbia. · Health Center "Novi Sad", Novi Sad, Serbia. ·J Back Musculoskelet Rehabil · Pubmed #30347589.

ABSTRACT: OBJECTIVE: Vertebral fractures are the most common osteoporotic fractures occurring due to low bone mineral density, as well as other risk factors. The aim of the paper is to investigate risk factors for vertebral osteoporotic fracture occurrence in postmenopausal women. METHODS: Retrospective analysis of data pertaining to 651 postmenopausal women obtained from the National Osteoporosis Registry of Serbia was conducted. Further analyses were performed on 217 osteoporotic women identified from those records, whereby those in the experimental group (n= 110) had a vertebral fracture, while those assigned to the control group (n= 107) did not. The two groups were comparable in terms of age (t= 0.450; p> 0.01). Risk factors that could serve as the best predictors of vertebral fracture occurrence were investigated. Multivariate logistic regression analysis was used for testing effect of several factors on vertebral fracture occurrence as the dependent variable. RESULTS: Patients that have never suffered a vertebral fracture had a significantly higher bone mineral density (t= 8.161; p< 0.01) in comparison to those with a verified vertebral fracture. Factors that significantly contributed to the risk of vertebral fracture were presence of kyphosis (OR 708.338; 95% CI 19.238-26.081.950), use of glucocorticoids (OR 87.618; 95% CI 9.175-836.707), and presence of comorbidities (OR 7.327; 95% CI 1.500-35.793). Moreover, a unit increase in body mass index (BMI) was found to lower the probability of vertebral fracture by a factor of 0.846. Women that entered menopause later have lower chance of suffering a vertebral fracture (OR = 0.539; 95% CI 0.400-0.726). CONCLUSION: Lower body mass index, presence of kyphosis, use of glucocorticoids, early menopause onset, and presence of comorbidities are the factors that contribute the most to vertebral osteoporotic fracture occurrence.

9 Article The impact of thyroid autoimmunity (TPOAb) on bone density and fracture risk in postmenopausal women. 2017

Polovina, Snezana P / Miljic, Dragana / Zivojinovic, Sladjana / Milic, Natasa / Micic, Dragan / Brkic, Vera Popovic. ·Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia. snezanapolovina@gmail.com. · Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia. · Faculty of Medicine, University of Belgrade, Belgrade, Serbia. · Institute for Rheumatology, Belgrade, Serbia. · Institute for Medical Statistic and Informatics, Medical Faculty, University of Belgrade, Belgrade, Serbia. ·Hormones (Athens) · Pubmed #28500828.

ABSTRACT: OBJECTIVE: Skeletal development, linear growth, cartilage biology and bone turnover are highly dependent on the activity of thyroid hormones. Thyroid dysfunction affects the skeleton, and autoimmune thyroid disease, manifesting as a chronic inflammatory condition, may be an important contributing factor to impaired bone quality in these patients. MATERIALS AND METHODS: Measurement of TSH, FT4, TPOAb and bone mineral density and FRAX score calculations were performed in 189 postmenopausal women (110 euthyroid women and 79 women diagnosed with subclinical hypothyroidism) divided into subgroups according to the presence of TPOAb. RESULTS: In multivariate logistic regression analysis only TPOAb were found to be significantly related to fracture, independently of TSH values (p=0.018; OR=7.800; 95% CI 1.424-42.721). Lower bone mineral density and FRAX score for hip and for major osteoporotic fractures were associated with the presence of TPOAb in euthyroid postmenopausal women in an unadjusted logistic regression model, as well as in a model adjusted for age, BMI and smoking. TSH was a better predictive factor for fractures in women with subclinical hypothyroidism (FRAX main p <0.001; 95% CI for SE 0.858-0.959 and FRAX hip p <0.001; 95% CI for SE 0.628-0.854). CONCLUSION: Autoimmune thyroid disease is associated with decreased bone mineral density at both spine and hip and risk of future fracture incidence in euthyroid postmenopausal women. Presence of TPOAb is a potential marker of higher fracture risk in these patients. However, in subclinical hypothyroidism, TSH is a better indicator of future fragility fractures than TPOAb.

10 Article Porotic paradox: distribution of cortical bone pore sizes at nano- and micro-levels in healthy vs. fragile human bone. 2017

Milovanovic, Petar / Vukovic, Zorica / Antonijevic, Djordje / Djonic, Danijela / Zivkovic, Vladimir / Nikolic, Slobodan / Djuric, Marija. ·Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, 4/2 Dr Subotica, Belgrade, 11000, Serbia. · Department of Catalysis and Chemical Engineering, Institute of Chemistry, Technology and Metallurgy, University of Belgrade, 12 Njegoseva, Belgrade, 11000, Serbia. · Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, 31a Deligradska, Belgrade, 11000, Serbia. · Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, 4/2 Dr Subotica, Belgrade, 11000, Serbia. marijadjuric5@gmail.com. ·J Mater Sci Mater Med · Pubmed #28357689.

ABSTRACT: Bone is a remarkable biological nanocomposite material showing peculiar hierarchical organization from smaller (nano, micro) to larger (macro) length scales. Increased material porosity is considered as the main feature of fragile bone at larger length-scales. However, there is a shortage of quantitative information on bone porosity at smaller length-scales, as well as on the distribution of pore sizes in healthy vs. fragile bone. Therefore, here we investigated how healthy and fragile bones differ in pore volume and pore size distribution patterns, considering a wide range of mostly neglected pore sizes from nano to micron-length scales (7.5 to 15000 nm). Cortical bone specimens from four young healthy women (age: 35 ± 6 years) and five women with bone fracture (age: 82 ± 5 years) were analyzed by mercury porosimetry. Our findings showed that, surprisingly, fragile bone demonstrated lower pore volume at the measured scales. Furtnermore, pore size distribution showed differential patterns between healthy and fragile bones, where healthy bone showed especially high proportion of pores between 200 and 15000 nm. Therefore, although fragile bones are known for increased porosity at macroscopic level and level of tens or hundreds of microns as firmly established in the literature, our study with a unique assessment range of nano-to micron-sized pores reveal that osteoporosis does not imply increased porosity at all length scales. Our thorough assessment of bone porosity reveals a specific distribution of porosities at smaller length-scales and contributes to proper understanding of bone structure which is important for designing new biomimetic bone substitute materials.

11 Article Bone mineral density at different sites and vertebral fractures in Serbian postmenopausal women. 2017

Ilic Stojanovic, O / Vuceljic, M / Lazovic, M / Gajic, M / Radosavljevic, N / Nikolic, D / Andjic, M / Spiroski, D / Vujovic, S. ·a Institute for Rehabilitation , Belgrade , Serbia. · b Faculty of Medicine , University of Belgrade , Belgrade , Serbia. · c Belmedic General Hospital , Biochemical Laboratory Department , Belgrade , Serbia. · d Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade , Belgrade , Serbia. · e Physical Medicine and Rehabilitation Department , University Children's Hospital , Belgrade , Serbia. · f Medical University Clinic for Endocrinology , Diabetes and Metabolic Diseases , Belgrade , Serbia. ·Climacteric · Pubmed #27860483.

ABSTRACT: OBJECTIVES: This randomized study aimed to evaluate the correlation between bone mineral densities (BMD) measured at different sites and the frequency of vertebral fractures in a group of Serbian postmenopausal women. METHOD: BMD was measured in 130 naïve postmenopausal women by dual X-ray absorptiometry (DXA) at the ultra-distal part of the forearms, at the hip and at the lumbar spine. At each of the measurement sites, the patients were categorized as osteoporotic, or osteopenic, or in the reference range. Vertebral fractures were examined using thoracic and lumbar spine radiography. RESULTS: A T-score at different skeletal sites showed discordance in the site-specific region. Vertebral fractures were found in 58.82% of patients with hip osteopenia, in 45% with forearm osteopenia and in 54.54% with lumbar spine osteoporosis. CONCLUSIONS: The study confirmed that the reduction of BMD depends on age and choice of measurement site. The best correlation was obtained in the women with osteopenia at all measurement sites. The discovery of vertebral fractures by lateral thoracic and lumbar spine radiography improves prompt treatment. Reference values of BMD do not exclude vertebral fractures. Of vertebral fractures, 72.5% were asymptomatic and thus spine radiographies are obligatory. Currently discussed is the position of DXA for measuring BMD as a method of detection for patients at risk of fracture.

12 Article The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women. 2017

Grgić, Olja / Kovačev-Zavišić, Branka / Veljović, Tanja / Novaković-Paro, Jovanka / Maravić, Tatjana / Bajkin, Branislav. ·Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Clinic of Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Vojvodina; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Department of Oral Surgery, Dental Clinic of Vojvodina, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 12, Novi Sad, 21000, Serbia. branislav.bajkin@mf.uns.ac.rs. ·Clin Oral Investig · Pubmed #26941051.

ABSTRACT: OBJECTIVES: The aim of this study was to assess the determinants of oral health including the number of decayed, missing, and filled teeth (DMFT) and periodontal indices in postmenopausal women with osteoporosis, osteoporosis treated with bisphosphonate therapy, and control group and to examine the correlation between dental panoramic indices (Mental Index-MI, Mandibular Cortical Index-MCI) and bone mineral density in these three groups of patients. MATERIALS AND METHODS: The presented non-interventional study involved 120 postmenopausal women: women with osteoporosis (O) (n = 45), women with osteoporosis treated with bisphosphonates (OBP) (n = 45), and control group (C) (n = 30). DMFT, plaque, gingival and papilla bleeding index, pocket depth, clinical attachment loss, and the presence of periodontitis were evaluated for each patient. MI and MCI of all participants were measured on a dental panoramic radiograph. RESULTS: Group OBP showed significantly higher gingival, bleeding index and deeper pocket depth than C and/or O group. No significant differences were found in MI (p = .303) or MCI (p = .06) in all the examined groups. Also, there were no significant differences between the three groups in the presence of periodontitis as well as in the DMFT index. CONCLUSION: BP therapy could have a negative influence on periodontal health. Further, MI and MCI are not precise diagnostic tools for diagnosing low BMD in postmenopausal women. CLINICAL RELEVANCE: BP therapy could have a negative influence on the determinants of oral health in postmenopausal women with osteoporosis.

13 Article Age- and Sex-Specific Bone Structure Patterns Portend Bone Fragility in Radii and Tibiae in Relation to Osteodensitometry: A High-Resolution Peripheral Quantitative Computed Tomography Study in 385 Individuals. 2015

Milovanovic, Petar / Adamu, Umaimatu / Simon, Maciej J K / Rolvien, Tim / Djuric, Marija / Amling, Michael / Busse, Björn. ·Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany. Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Serbia. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany. · Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Serbia. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany. b.busse@uke.uni-hamburg.de. ·J Gerontol A Biol Sci Med Sci · Pubmed #25934995.

ABSTRACT: BACKGROUND: Age- and sex-specific 3D bone structure patterns in human radii and tibiae were investigated with respect to individuals' osteodensitometric status to unravel associations with site-specific fracture occurrences and underlying loading patterns. METHODS: A sample of 385 patients (121 men and 264 women, age range: 23-91 years) were investigated. The patients were classified according to dual X-ray absorptiometry T-scores in three groups: control (n = 60), osteopenia (n = 160), and osteoporosis (n = 165). Bone architecture and geometry were assessed by high-resolution peripheral quantitative computed tomography of the cortical and trabecular compartments in distal radii and tibiae. RESULTS: We found site-dependent age- and sex-related trends regarding bone architecture and geometry. Females displayed more pronounced age-related changes than males. Specifically, female radii showed both cortical and trabecular structural deterioration with aging, whereas the tibiae demonstrated exclusively cortical deterioration. The mean cortical perimeter revealed a significant age-related increase for both sexes even after adjusting for body height and weight, which suggests that periosteal expansion can be observed in both the tibia and also in the radius. Osteopenia and osteoporosis cases did not reveal higher cortical perimeters in comparison to controls. CONCLUSIONS: The tomographic assessment of bone structure further clarifies the architectural basis for increased bone fragility at distal radii and tibiae with advanced age leading to fracture predilection in females. Our findings may represent a morphological link to epidemiological data on age-dependent fracture incidences. Our data support the presence of periosteal apposition at both skeletal sites despite different loading magnitudes, and challenges the view on periosteal expansion just as a compensatory mechanism to counterbalance bone loss.

14 Article Tamoxifen stimulates calcitonin-producing thyroid C-cells and prevents trabecular bone loss in a rat model of androgen deficiency. 2015

Filipović, Branko / Šošić-Jurjević, Branka / Ajdžanović, Vladimir / Živanović, Jasmina / Isenović, Esma / Popovska-Perčinić, Florina / Milošević, Verica. ·Institute for Biological Research ″Siniša Stanković″, University of Belgrade, Belgrade, Serbia. · Vinca Institute of Nuclear Science, Laboratory for Molecular Genetics and Radiobiology, University of Belgrade, Belgrade, Serbia. · Faculty of Veterinary Medicine, ″Ss Cyril and Methodius″ University of Skopje, Skopje, FYR of Macedonia. ·J Anat · Pubmed #25851663.

ABSTRACT: Thyroid C-cells produce calcitonin (CT), a hypocalcemic hormone, that acts as an inhibitor of bone resorption. In this study, we investigated the effects of tamoxifen (TAM) as a selective estrogen receptor modulator on thyroid C-cells, trabecular bone and biochemical markers of bone metabolism in an animal model of androgen deficiency, represented by middle-aged orchidectomized (Orx) rats. Fifteen-month-old male Wistar rats were divided into: Orx and sham-operated (SO) groups. Rats from one Orx group were injected subcutaneously with TAM citrate (Orx + TAM; 0.3 mg kg(-1) b.w.), while the rats from SO and a second Orx group received vehicle alone, once a day for 3 weeks. The peroxidase-antiperoxidase method was applied for localization of CT in C-cells. Thyroid C-cells were morphometrically and ultrastructurally analyzed. An ImageJ image-processing program was used to measure bone histomorphometric parameters. Blood serum samples were analyzed for CT, osteocalcin (OC), calcium (Ca2+ ) and phosphorus (P). Urinary Ca2+ concentrations were measured. TAM treatment significantly increased thyroid C-cell volume (Vc ) and serum CT when compared with vehicle-treated Orx rats. Analysis of trabecular microarchitecture of the tibia showed that administration of TAM significantly increased cancellous bone area, trabecular thickness and trabecular number, whereas trabecular separation was significantly decreased compared with vehicle-treated Orx rats. Serum OC and urinary Ca2+ concentrations were significantly lower in comparison with the control Orx group. These results indicate that in our rat model of androgen deficiency, TAM stimulated calcitonin-producing thyroid C-cells and increased trabecular bone mass.

15 Article Multi-level characterization of human femoral cortices and their underlying osteocyte network reveal trends in quality of young, aged, osteoporotic and antiresorptive-treated bone. 2015

Milovanovic, Petar / Zimmermann, Elizabeth A / Riedel, Christoph / vom Scheidt, Annika / Herzog, Lydia / Krause, Matthias / Djonic, Danijela / Djuric, Marija / Püschel, Klaus / Amling, Michael / Ritchie, Robert O / Busse, Björn. ·Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestrasse 59, 22529 Hamburg, Germany; Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Dr Subotica 4/2, 11000 Belgrade, Serbia. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestrasse 59, 22529 Hamburg, Germany. · Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Dr Subotica 4/2, 11000 Belgrade, Serbia. · Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany. · Department of Materials Science and Engineering, University of California, Berkeley, USA; Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley CA 94720, USA. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestrasse 59, 22529 Hamburg, Germany; Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley CA 94720, USA. Electronic address: b.busse@uke.uni-hamburg.de. ·Biomaterials · Pubmed #25662494.

ABSTRACT: Characterization of bone's hierarchical structure in aging, disease and treatment conditions is imperative to understand the architectural and compositional modifications to the material and its mechanical integrity. Here, cortical bone sections from 30 female proximal femurs - a frequent fracture site - were rigorously assessed to characterize the osteocyte lacunar network, osteon density and patterns of bone matrix mineralization by backscatter-electron imaging and Fourier-transform infrared spectroscopy in relation to mechanical properties obtained by reference-point indentation. We show that young, healthy bone revealed the highest resistance to mechanical loading (indentation) along with higher mineralization and preserved osteocyte-lacunar characteristics. In contrast, aging and osteoporosis significantly alter bone material properties, where impairment of the osteocyte-lacunar network was evident through accumulation of hypermineralized osteocyte lacunae with aging and even more in osteoporosis, highlighting increased osteocyte apoptosis and reduced mechanical competence. But antiresorptive treatment led to fewer mineralized lacunae and fewer but larger osteons signifying rejuvenated bone. In summary, multiple structural and compositional changes to the bone material were identified leading to decay or maintenance of bone quality in disease, health and treatment conditions. Clearly, antiresorptive treatment reflected favorable effects on the multifunctional osteocytic cells that are a prerequisite for bone's structural, metabolic and mechanosensory integrity.

16 Article Why do treatment failure and recurrences of benign paroxysmal positional vertigo occur? 2014

Babac, Snezana / Djeric, Dragoslava / Petrovic-Lazic, Mirjana / Arsovic, Nenad / Mikic, Aleksandar. ·*ENT Clinic, Clinical and Hospital Center "Zvezdara"; †Medical School University of Belgrade, Clinic for Otorhinolaryngology and Maxillofacial Surgery; and ‡University of Belgrade School of Medicine, Clinic for Cardiac Surgery, Clinical Center of Serbia, Belgrade, Republic of Serbia. ·Otol Neurotol · Pubmed #24853239.

ABSTRACT: OBJECTIVE: To investigate the potential risk factors associated to the treatment failure and recurrence of benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral center. PATIENTS: Four hundred patients with benign paroxysmal positional vertigo, 119 men and 281 women, aged 27 to 88 years. INTERVENTION: Patients were treated once a week, with only one, appropriate, depending on the affected canal, repositioning maneuver (modified Epley, Semont, barbecue/inverted Gufoni, Kim). The control Dix-Hallpike test and the roll test were performed on 7 days. MAIN OUTCOME MEASURES: The treatment outcome and recurrence were evaluated with regard to sex, age, duration of symptoms, etiologic factors, migraines, osteoporosis, vascular risk factors, endocrine diseases, localization of otoconia, and simultaneous involvement of multiple canals. RESULTS: The results indicate that treatment was negatively affected by patients' age, osteoporosis, and head trauma, without them causing recurrent symptoms. The highest number of uncured patients was observed in the 73- to 88-year-old age group (14.8%). The application of more than one maneuver was necessary in 27.5% of cases with primary BPPV and 88.9% with secondary BPPV. The highest treatment success was achieved in the group with BPPV of the posterior semicircular canal (F = 3.668, p = 0.026). The recurrence rate was 15.5%. CONCLUSION: Potential risk factors associated to the treatment failure were as follows: the age older than 50, secondary BPPV, head trauma, the occurrence of osteoporosis, and localization of otoconia in the anterior semicircular canal. The analyzed factors did not have impact on the recurrence.

17 Article Nano-structural, compositional and micro-architectural signs of cortical bone fragility at the superolateral femoral neck in elderly hip fracture patients vs. healthy aged controls. 2014

Milovanovic, Petar / Rakocevic, Zlatko / Djonic, Danijela / Zivkovic, Vladimir / Hahn, Michael / Nikolic, Slobodan / Amling, Michael / Busse, Bjoern / Djuric, Marija. ·Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia; Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany. Electronic address: drpmilovanovic@gmail.com. · Laboratory for Atomic Physics, Institute of Nuclear Sciences Vinca, University of Belgrade, 11001 Belgrade, Serbia. Electronic address: zlatkora@vinca.rs. · Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia. Electronic address: ddjonic@yahoo.com. · Institute of Forensic Medicine, School of Medicine, University of Belgrade, 31a Deligradska, 11000 Belgrade, Serbia. Electronic address: vladinmejl@yahoo.com. · Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany. Electronic address: hahn@uke.de. · Institute of Forensic Medicine, School of Medicine, University of Belgrade, 31a Deligradska, 11000 Belgrade, Serbia. Electronic address: bobanvladislav@yahoo.com. · Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany. Electronic address: amling@uke.de. · Department of Osteology & Biomechanics, University Medical Center Hamburg-Eppendorf, 59 Lottestr., D-22529 Hamburg, Germany. Electronic address: b.busse@uke.uni-hamburg.de. · Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, 4/2 Dr Subotica, 11000 Belgrade, Serbia. Electronic address: marijadjuric5@gmail.com. ·Exp Gerontol · Pubmed #24614625.

ABSTRACT: To unravel the origins of decreased bone strength in the superolateral femoral neck, we assessed bone structural features across multiple length scales at this cortical fracture initiating region in postmenopausal women with hip fracture and in aged-matched controls. Our combined methodological approach encompassed atomic force microscopy (AFM) characterization of cortical bone nano-structure, assessment of mineral content/distribution via quantitative backscattered electron imaging (qBEI), measurement of bone material properties by reference point indentation, as well as evaluation of cortical micro-architecture and osteocyte lacunar density. Our findings revealed a wide range of differences between the fracture group and the controls, suggesting a number of detrimental changes at various levels of cortical bone hierarchical organization that may render bone fragile. Namely, mineral crystals at external cortical bone surfaces of the fracture group were larger (65.22nm±41.21nm vs. 36.75nm±18.49nm, p<0.001), and a shift to a higher mineral content and more homogenous mineralization profile as revealed via qBEI were found in the bone matrix of the fracture group. Fracture cases showed nearly 35% higher cortical porosity and showed significantly reduced osteocyte lacunar density compared to controls (226±27 vs. 247±32#/mm(2), p=0.05). Along with increased crystal size, a shift towards higher mineralization and a tendency to increased cortical porosity and reduced osteocyte lacunar number delineate that cortical bone of the superolateral femoral neck bears distinct signs of fragility at various levels of its structural organization. These results contribute to the understanding of hierarchical bone structure changes in age-related fragility.

18 Article Bisphosphonate-osteoclasts: changes in osteoclast morphology and function induced by antiresorptive nitrogen-containing bisphosphonate treatment in osteoporosis patients. 2014

Jobke, Björn / Milovanovic, Petar / Amling, Michael / Busse, Björn. ·Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Laboratory for Anthropology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: b.busse@uke.uni-hamburg.de. ·Bone · Pubmed #24211427.

ABSTRACT: Osteoclasts are unique cells capable of bone resorption and therefore have become a major target in osteoporosis treatment strategies. Bisphosphonates suppress bone turnover via interference with the internal enzymatic cell system of osteoclasts leading to cytoskeletal disruption. This mechanism found its clinical relevance in reducing bone resorption, stabilizing bone mass and reducing fracture risk in osteoporosis patients. However, knowledge about specific in vivo changes in osteoclast cell morphology and function is still insufficient. We examined osteoclasts in 23 paired bone biopsies from osteoporosis patients (18 males, 5 females; age: 52.6±11.5yrs) under nitrogen-containing bisphosphonate administration with a mean treatment duration of three years. Formalin-fixed, undecalcified sections were assessed by qualitative and quantitative bone histomorphometry, where the osteoclast morphology, nuclei, distribution, location as well as resorption parameters were investigated to obtain information about cell function and viability. After three years of treatment, resorption parameters decreased significantly while the number of osteoclasts remained unchanged. Out of 23 patients, nine developed previously termed "giant-osteoclasts" with increased size, numerous nuclei (>10 nuclei/Oc) and oftentimes detachment from the bone surface. These cells frequently had pycnotic nuclei and other morphological signs suggestive of osteoclast apoptosis. Characteristic large-sized osteoclasts were uniquely found in patients treated with nitrogen-containing bisphosphonates, thus being clearly distinguishable from giant-osteoclasts in other bone disorders such as Paget disease, secondary hyperparathyroidism or osteopetrosis. The resorption indices of large-sized osteoclasts, specifically the eroded perimeter and erosion depth, revealed significantly reduced values but not an entirely inhibited resorption capability. Bisphosphonate-osteoclasts' viability and affinity to bone seem significantly disturbed while the apoptotic process may be prolonged for a yet unknown period of time in favor of maintaining a low bone turnover.

19 Article The effect of short-term low-energy ultraviolet B irradiation on bone mineral density and bone turnover markers in postmenopausal women with osteoporosis: a randomized single-blinded controlled clinical trial. 2013

Micić, Ivan / Jeon, In-Ho / Park, So-Hyun / Hwa, Seo-Sung / Chun, Jae-Myeung / Stojiljković, Predrag. ·Clinic for Orthopedic Surgery and Traumatology, Clinical Center, Nis, Serbia. · Department of Orthopedic Surgery, Asan Medical Center, School of Medicine, Ulsan University, Seoul, Korea. · Department of Physical Therapy, Daegu University, Daegu, Korea. · Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. ·Srp Arh Celok Lek · Pubmed #24364223.

ABSTRACT: INTRODUCTION: The importance of vitamin D on bone health and osteoporosis was studied by many researchers. The main role of the Vitamin D is to absorb calcium and phosphate and increase bone mineralization. Older people are at an increased risk of the inadequate vitamin D production in the skin because of lower sun exposure and reduced ability of the skin to synthesize vitamin D. OBJECTIVE: The aim of this clinical trial was to evaluate the efficacy and tolerability of short-term (2 weeks) low energy UVB irradiation in postmenopausal women with osteoporosis using bone mineral density and bone turnover markers. METHODS: A three-month, single-blinded, randomized, placebo-controlled clinical trial was conducted at the University hospital in Daegu, Republic of Korea. Fifty-two postmenopausal Korean women (older than 65 years) with osteoporosis were randomly allocated to have either low energy UVB or placebo for 30 minutes a day for two weeks of treatment during winter. Laboratory analysis and physical examination before and 4, 8 and 12 weeks after treatment were carried out and BMD was measured before and 8 and 12 weeks after treatment. The effects of time and treatment interaction between these two groups were evaluated by repeated-measure two-factor analysis, and subgroup analysis was performed to examine UVB effect on the vitamin D insufficient group [serum 25(OH)D3 concentration < 30 ng/mL]. RESULTS: In vitamin D insufficient group, the effect of UVB irradiation on vitamin D and bone ALP as well as additional benefit on bone formation was confirmed. The vitamin D insufficient group showed statistically significant increment in serum 25(OH)D3 compared with the normal group (p < 0.05). However, there was no significant difference between two groups in the other bone turnover markers, such as serum calcium, PTH-C, serum osteocalcin, serum CTX and BMD. CONCLUSION: Low-energy-short-term UVB radiation for postmenopausal women may be of use in vitamin D synthesis. There was a modest benefit in change of bone ALP especially in women with the insufficient vitamin D.

20 Article Effects of calcitonin and calcium medication in treatment of edentulous osteoporotic mandible. 2013

Postic, Srdjan D. ·Clinic of Dental Prosthetic, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia. srdjan.postic@stomf.bg.ac.rs ·Vojnosanit Pregl · Pubmed #23885524.

ABSTRACT: BACKGROUND/AIM: In addition to damage of the bones that support the remaining teeth, degradation of osteoporotic oral bones also lead to a consequent reduction of supporting tissues and the loss of dentures retention. The aim of this study was to assess the clinical and radiographic outcomes following injection of a calcitonin and calcium solution into the buccal aspects of edentulous mandibles. METHODS: The experimental group of 67 edentulous patients diagnosed with osteoporosis, and the control group of 19 nonosteoporotic edentulous patients were treated with the calcitonin and calcium once solution per month. Mandibular bone density was measured from panoramic radiographs, supplemented by T scores of skeletal density in the experimental group. RESULTS: After the therapy, measurements showed moderate increases in bone density, compensating for up to 4% of the total loss of minerals and solidity of denture-bearing areas of osteoporotic mandibles. Osteoporosis affected women earlier than men in this study. CONCLUSION: Application of a calcitonin and calcium solution is a suitable method of preprosthetic therapy for edentulous osteoporotic patients.

21 Article Collagen type I alpha 1 gene polymorphism in premature ovarian failure. 2013

Vujović, Svetlana / Kanazir, Selma / Ivović, Miomira / Tancić-Gajić, Milina / Perović, Milka / Baltić, Svetlana / Marina, Ljiljana / Barać, Marija / Ivanisević, Maja / Micić, Jelena / Micić, Dragan. ·School of Medicine, University of Belgrade, Belgrade, Serbia. vujovics@eunet.rs ·Srp Arh Celok Lek · Pubmed #23858805.

ABSTRACT: INTRODUCTION: Premature ovarian failure (POF) is characterized by amenorrhea, hypergonadotropism and hypoestrogenism in women bellow 40 years. Osteoporosis is one of the late complications of POF. OBJECTIVE: To correlate collagen type I alpha1 (COLIA1) gene polymorphism with bone mineral density (BMD) in women with POF. METHODS: We determined the COLIA1 genotypes SS, Ss, ss in 66 women with POF. Single nucleotide polymorphism (G toT substitution) within the Sp 1-binding site in the first intron of the COLIA1 gene was assessed by polymerase chain reaction (PCR) followed by single-stranded conformation polymorphism (SSCP) analysis. Bone mineral density (BMD) was measured at the lumbar spine region by dual X-ray absorptiometry. STATISTICS: Kruskal-Wallis ANOVA, Chi-square test, Spearman correlation test. RESULTS: The relative distribution of COLIA1 genotype alleles was SS - 54.4%, Ss - 41.0% and ss - 4.5%. No significant differences were found between genotype groups in body mass index, age, duration of amenorrhea or BMD. A significant positive correlation was observed between BMI and parity. CONCLUSION: The COLIA1 gene is just one of many genes influencing bone characteristics. It may act as a marker for differences in bone quantity and quality, bone fragility and accelerated bone loss in older women. However, in young women with POF, COLIA1 cannot identify those at higher risk for osteoporosis.

22 Article The effects of sex steroids on thyroid C cells and trabecular bone structure in the rat model of male osteoporosis. 2013

Filipović, Branko / Sošić-Jurjević, Branka / Ajdžanović, Vladimir / Pantelić, Jasmina / Nestorović, Nataša / Milošević, Verica / Sekulić, Milka. ·Institute for Biological Research, University of Belgrade, Belgrade, Serbia. brankof@ibiss.bg.ac.rs ·J Anat · Pubmed #23171170.

ABSTRACT: Androgen deficiency is one of the major factors leading to the development of osteoporosis in men. Since calcitonin (CT) is a potent antiresorptive agent, in the present study we investigated the effects of androgen deficiency and subsequent testosterone and estradiol treatment on CT-producing thyroid C cells, skeletal and hormonal changes in middle-aged orchidectomized (Orx) rats. Fifteen-month-old male Wistar rats were either Orx or sham-operated (SO). One group of Orx rats received 5 mg kg(-1) b.w. testosterone propionate (TP) subcutaneously, while another group was injected with 0.06 mg kg(-1) b.w. estradiol dipropionate (EDP) once a day for 3 weeks. A peroxidase-antiperoxidase method was applied for localization of CT in the C cells. The studies included ultrastructural microscopic observation of these cells. The metaphyseal region of the proximal tibia was measured histomorphometrically using an imagej public domain image processing program. TP or EDP treatment significantly increased C cell volume (Vc), volume densities (Vv) and serum CT concentration compared with the Orx animals. Administration of both TP and EDP significantly enhanced cancellous bone area (B.Ar), trabecular thickness (Tb.Th) and trabecular number (Tb.N) and reduced trabecular separation (Tb.Sp). Serum osteocalcin (OC) and urinary Ca concentrations were significantly lower after these treatments in comparison with Orx rats. These data suggest that testosterone and estradiol treatment in Orx middle-aged rats affect calcitonin-producing thyroid C cells, which may contribute to the bone protective effects of sex hormones in the rat model of male osteoporosis.

23 Article Nanoparticles of cobalt-substituted hydroxyapatite in regeneration of mandibular osteoporotic bones. 2013

Ignjatović, Nenad / Ajduković, Zorica / Savić, Vojin / Najman, Stevo / Mihailović, Dragan / Vasiljević, Perica / Stojanović, Zoran / Uskoković, Vuk / Uskoković, Dragan. ·Institute of Technical Sciences, Serbian Academy of Sciences and Arts, Belgrade, Serbia. ·J Mater Sci Mater Med · Pubmed #23090835.

ABSTRACT: Indications exist that paramagnetic calcium phosphates may be able to promote regeneration of bone faster than their regular, diamagnetic counterparts. In this study, analyzed was the influence of paramagnetic cobalt-substituted hydroxyapatite nanoparticles on osteoporotic alveolar bone regeneration in rats. Simultaneously, biocompatibility of the material was tested in vitro, on osteoblastic MC3T3-E1 and epithelial Caco-2 cells in culture. The material was shown to be biocompatible and nontoxic when added to epithelial monolayers in vitro, while it caused a substantial decrease in the cell viability as well as deformation of the cytoskeleton and cell morphology when incubated with the osteoblastic cells. In the course of 6 months after the implantation of the material containing different amounts of cobalt, ranging from 5 to 12 wt%, in the osteoporotic alveolar bone of the lower jaw, the following parameters were investigated: histopathological parameters, alkaline phosphatase and alveolar bone density. The best result in terms of osteoporotic bone tissue regeneration was observed for hydroxyapatite nanoparticles with the largest content of cobalt ions. The histological analysis showed a high level of reparatory ability of the nanoparticulate material implanted in the bone defect, paralleled by a corresponding increase in the alveolar bone density. The combined effect of growth factors from autologous plasma admixed to cobalt-substituted hydroxyapatite was furthermore shown to have a crucial effect on the augmented osteoporotic bone regeneration upon the implantation of the biomaterial investigated in this study.

24 Article Osteoporosis in patients with chronic obstructive pulmonary disease. 2012

Ciric, Zorica / Stankovic, Ivana / Pejcic, Tatjana / Ristic, Lidija / Rancic, Milan / Radovic, Milan. ·Clinic for Lung Diseases, Clinical Centre of Nis, Nis, Serbia. zorica_ciric@yahoo.com ·Med Arch · Pubmed #23409517.

ABSTRACT: THE AIM: The aim of this study was to determine relationship between bone mineral density and severity of COPD and body mass index (BMI). PATIENTS AND METHODS: in this study 85 COPD patients were recruited. Diagnosis and severity of COPD was made according to the GOLD guidelines. Height and weight were measured, and BMI was calculated. BMD (at the lumbar spine and at the femoral neck) were performed using Dual energy X-ray absorptiometry (DXA). BMD was expressed in g/cm2 and standardized T-score. RESULTS: The increase of COPD severity leads to the decrease of average values of BMD (femoral neck p = 0.005; lumbar spine p = 0.026), as well as T score (femoral neck p = 0.026; lumbar spine = 0.156). Also, the decrease of BMI leads to the decrease of average values of BMD (femoral neck p = 0.034; lumbar spine p = 0.269) and T score (femoral neck p = 0.001; lumbar spine p = 0.105), as well as to the increase of total osteoporosis (p = 0.009). CONCLUSION: patients with severe COPD and lowe BMI have lower BMD and T score and more frequently have osteoporosis.

25 Article Validation of the osteoporosis quality of life questionnaire QUALEFFO-41 for the Serbian population. 2012

Tadic, Ivana / Vujasinovic Stupar, Nada / Tasic, Ljiljana / Stevanovic, Dejan / Dimic, Aleksandar / Stamenkovic, Bojana / Stojanovic, Sonja / Milenkovic, Sasa. ·Department of Social Pharmacy and Pharmaceutical Legislation, University of Belgrade, Faculty of Pharmacy, Vojvode Stepe 450, 11000 Belgrade, Serbia. ivana.tadic@pharmacy.bg.ac.rs ·Health Qual Life Outcomes · Pubmed #22709379.

ABSTRACT: BACKGROUND: Vertebral fractures could lead to reduced physical, social and mental functioning, and loss of personal independence. Therefore, during the treatment of osteoporosis, it has become necessary to examine the changes in everyday functioning, well-being and health related quality of life (HRQOL). To that effect, this study aims to translate, culturally adapt, and validate the Serbian version of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) for patients with vertebral fractures. METHODS: Nine female patients with osteoporosis participated in the pre-validation study. A validation, case-control study included two groups of female patients: one that consisted of 50 female patients with osteoporosis, and with at least one vertebral fracture, and another one that consisted of 50 control patients with osteoporosis but without fractures. They completed the QUALEFFO-41 and the EuroQol group questionnaire with five dimensions (EQ-5D) twice within a month. The validation study examined internal consistency, concurrent validity, test-retest reliability, sensitivity and specificity. RESULTS: During the pre-validation study, three of the items in the QUALEFFO-41 were slightly changed. Afterwards, during the validation study, the statistically significant differences (adjusted for: age, duration of menopause, current employment and marital status) in the mean values of all domains and total scores between the groups were noted. For the case group, the internal consistency of the QUALEFFO-41 domains and of total questionnaire was above 0.70. The test-retest reliability was tested by the intraclass correlation coefficients (ICC) that were in range 0.87 - 0.96 for the case, and 0.15 - 0.83 for the control group. Correlations between the total scores of the QUALEFFO-41 and the EQ-5D health state value, for both groups were negative and statistically significant (r = -0.78, p<0.001 and r = -0.73, p<0.001, respectively). The QUALEFFO-41 had a better prediction of the value of HRQOL of cases compared to the generic questionnaire EQ-5D (the AUC difference was 0.099, p = 0.013). CONCLUSIONS: The Serbian QUALEFFO-41 version is reliable, valid, sensitive and predictive for examinations of HRQOL in patients with prevalent vertebral fractures and can be used in further studies.

Next