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Osteoporosis: HELP
Articles from Serbia
Based on 78 articles published since 2009
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These are the 78 published articles about Osteoporosis that originated from Serbia during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline EMAS position statement: Managing women with premature ovarian failure. 2010

Vujovic, Svetlana / Brincat, Marc / Erel, Tamer / Gambacciani, Marco / Lambrinoudaki, Irene / Moen, Mette H / Schenck-Gustafsson, Karin / Tremollieres, Florence / Rozenberg, Serge / Rees, Margaret / Anonymous3380665. ·Institute of Endocrinology, Clinical Center of Serbia, Belgrade School of Medicine, Dr Subotica 13, 11000 Beograd, Serbia.vujovics@EUnet.rs ·Maturitas · Pubmed #20605383.

ABSTRACT: INTRODUCTION: Premature ovarian failure (also known as premature menopause) is defined as menopause before the age of 40. It can be "natural" or "iatrogenic" such as after bilateral oophorectomy. It may be either primary or secondary. In the majority of cases of primary POF the cause is unknown. Chromosome abnormalities (especially X chromosome), follicle-stimulating hormone receptor gene polymorphisms, inhibin B mutations, enzyme deficiencies and autoimmune disease may be involved. Secondary POF is becoming more important as survival after treatment of malignancy through surgery, radiotherapy and chemotherapy continues to improve. AIM: To formulate a position statement on the management of premature ovarian failure. MATERIALS AND METHODS: Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS: Diagnosis should be confirmed with an elevated FSH greater than 40 IU/L and an estradiol level below 50 pmol/L in the absence of bilateral oophorectomy. Further assessment should include thyroid function tests, autoimmune screen for polyendocrinopathy, karyotype (less than 30 years of age) and bone mineral density. Untreated early ovarian failure increases the risk of osteoporosis, cardiovascular disease, dementia, cognitive decline and Parkinsonism. The mainstay of treatment is hormone therapy which needs to be continued until the average age of the natural menopause. With regard to fertility, while spontaneous ovulation may occur the best chance of achieving pregnancy is through donor oocyte in vitro fertilization. It is essential that women are provided with adequate information as they may find it a difficult diagnosis to accept. It is recommended that women with POF are seen in a specialist unit able to deal with their multiple needs.

2 Review Balancing benefits and risks in the era of biologics. 2019

Adami, Giovanni / Saag, Kenneth G / Chapurlat, Roland D / Guañabens, Nuria / Haugeberg, Glenn / Lems, Willem F / Matijevic, Radmila / Peel, Nicola / Poddubnyy, Denis / Geusens, Piet. ·Rheumatology Unit, University of Verona, Pz Scuro 10, 37135, Verona, Italy. · Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA. · INSERM UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon, France. · Rheumatology Department, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain. · Division of Rheumatology, Medicine Department, Southern Hospital Trust, Trondheim, Norway. · Amsterdam UMC, location VUmc, Amsterdam, the Netherlands. · University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia. · Metabolic Bone Centre, Northern General Hospital Sheffield, UK. · Department of Gastroenterology, Infectious Diseases, and Rheumatology, Charité - Universitätsmedizin Berlin, Berlin, Germany. · CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands. ·Ther Adv Musculoskelet Dis · Pubmed #31695755.

ABSTRACT: Biologics are substances synthetized from biological sources used in the prevention and treatment of several diseases. Rheumatologists have many years of experience with biologics for the treatment of immune-mediated diseases and osteoporosis. Randomized clinical trials and postmarketing studies have demonstrated that treatment with biologics can result, albeit infrequently, in serious adverse events. To date, several risk mitigation strategies have been identified and implemented. The objective of the present perspective review is to examine the risk mitigation strategies of biologic treatments, with special focus on anti-tumor necrosis factors and denosumab.

3 Review Metabolic Perspectives for Non-classical Congenital Adrenal Hyperplasia With Relation to the Classical Form of the Disease. 2019

Macut, Djuro / Zdravković, Vera / Bjekić-Macut, Jelica / Mastorakos, George / Pignatelli, Duarte. ·Clinic of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. · Division of Endocrinology, University Children's Hospital, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. · Department of Endocrinology, UMC Bežanijska kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. · Unit of Endocrine Diseases, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece. · Faculty of Medicine, Instituto de Patologia e Imunologia Molecular da Universidade do Porto/I3S Research Institute, Hospital S João, University of Porto, Porto, Portugal. ·Front Endocrinol (Lausanne) · Pubmed #31632355.

ABSTRACT: Non-classical congenital adrenal hyperplasia (NC-CAH) represents mild form of CAH with the prevalence of 0. 6 to 9% in women with androgen excess. Clinical and hormonal findings in females with NC-CAH are overlapping with other hyperandrogenic entities such as polycystic ovary syndrome hence causing difficulties in diagnostic approach. Metabolic consequences in subjects with NC-CAH are relatively unknown. We are lacking longitudinal follow of these patients regarding natural course of the disease or the therapeutic effects of the different drug regiments. Patients with NC-CAH similarly to those with classical form are characterized with deteriorated cardiovascular risk factors that are probably translated into cardiometabolic diseases and events. An increased preponderance of obesity and insulin resistance in patients with NC-CAH begin at young age could result in increased rates of metabolic sequelae and cardiovascular disease later during adulthood in both sexes. On the other hand, growth disorder was not proven in patients with NC-CAH in comparison to CAH patients of both gender characterized with reduced final adult height. Similarly, decreased bone mineral density and osteoporosis are not constant findings in patients with NC-CAH and could depend on the sex, and type or dose of corticosteroids applied. It could be concluded that NC-CAH represent a particular form of CAH that is characterized with specificities in clinical presentation, diagnosis, therapeutic approach and metabolic outcomes.

4 Review Homocysteine and Hyperhomocysteinaemia. 2019

Zaric, Bozidarka L / Obradovic, Milan / Bajic, Vladan / Haidara, Mohamed A / Jovanovic, Milos / Isenovic, Esma R. ·Institute of nuclear science Vinca, University of Belgrade, Laboratory of Radiobiology and Molecular Genetics, Belgrade, Serbia. · Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia. · Faculty of Biology, University of Belgrade, Institute of physiology and biochemistry, Belgrade, Serbia. ·Curr Med Chem · Pubmed #29532755.

ABSTRACT: Homocysteine (Hcy) is a thiol group containing the amino acid, which naturally occurs in all humans. Hcy is degraded in the body through two metabolic pathways, while a minor part is excreted through kidneys. The chemical reactions that are necessary for degradation of Hcy require the presence of folic acid, vitamins B6 and B12. Consequently, the level of the total Hcy in the serum is influenced by the presence or absence of these vitamins. An elevated level of the Hcy, hyperhomocysteinemia (HHcy) and homocystinuria is connected with occlusive artery disease, especially in the brain, the heart, and the kidney, in addition to venous thrombosis, chronic renal failure, megaloblastic anemia, osteoporosis, depression, Alzheimer's disease, pregnancy problems, and others. Elevated Hcy levels are connected with various pathologies both in adult and child population. Causes of HHcy include genetic mutations and enzyme deficiencies in 5, 10-methylenetetrahydrofolate reductase (MTHFR) methionine synthase (MS), and cystathionine β-synthase (CβS). HHcy can be caused by deficiencies in the folate, vitamin B12 and to a lesser extent, deficiency in B6 vitamin what influences methionine metabolism. Additionally, HHcy can be caused by the rich diet and renal impairment. This review presents literature data from recent research related to Hcy metabolism and the etiology of the Hcy blood level disorder. In addition, we also described various pathological mechanisms induced by hereditary disturbances or nutritional influences and their association with HHcy induced pathology in adults and children and treatment of these metabolic disorders.

5 Review Modulation of autophagy as new approach in mesenchymal stem cell-based therapy. 2018

Jakovljevic, Jelena / Harrell, C Randall / Fellabaum, Crissy / Arsenijevic, Aleksandar / Jovicic, Nemanja / Volarevic, Vladislav. ·University of Kragujevac Serbia, Faculty of Medical Sciences, Department of Microbiology and immunology, Center for Molecular Medicine and Stem Cell Research, 69 Svetozar Markovic Street, 34000, Kragujevac, Serbia. · Regenerative Processing Plant, LLC, 34176 US Highway 19 N Palm Harbor, Palm Harbor, Florida, United States. · University of Kragujevac Serbia, Faculty of Medical Sciences, Department of Microbiology and immunology, Center for Molecular Medicine and Stem Cell Research, 69 Svetozar Markovic Street, 34000, Kragujevac, Serbia. Electronic address: vladislav.volarevic@ana.unibe.ch. ·Biomed Pharmacother · Pubmed #29787987.

ABSTRACT: Due to their trophic and immunoregulatory characteristics mesenchymal stem cells (MSCs) have tremendous potential for use in a variety of clinical applications. Challenges in MSCs' clinical applications include low survival of transplanted cells and low grafting efficiency requiring use of a high number of MSCs to achieve therapeutic benefits. Accordingly, new approaches are urgently needed in order to overcome these limitations. Recent evidence indicates that modulation of autophagy in MSCs prior to their transplantation enhances survival and viability of engrafted MSCs and promotes their pro-angiogenic and immunomodulatory characteristics. Here, we review the current literature describing mechanisms by which modulation of autophagy strengthens pro-angiogenic and immunosuppressive characteristics of MSCs in animal models of multiple sclerosis, osteoporosis, diabetic limb ischemia, myocardial infarction, acute graft-versus-host disease, kidney and liver diseases. Obtained results suggest that modulation of autophagy in MSCs may represent a new therapeutic approach that could enhance efficacy of MSCs in the treatment of ischemic and autoimmune diseases.

6 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.

7 Review New therapeutic potentials of milk thistle (Silybum marianum). 2013

Milić, Natasa / Milosević, Natasa / Suvajdzić, Ljiljana / Zarkov, Marija / Abenavoli, Ludovico. ·Department of Pharmacy, Faculty ofMedicine, University of Novi Sad, Novi Sad, Serbia. · Department of Neurology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Department of Health Sciences, University Magna Graecia, Catanzaro, Italy. ·Nat Prod Commun · Pubmed #24555302.

ABSTRACT: Silymarin is a bioflavonoid complex extract derived from dry seeds of Milk thistle [(Silybum marianum(L.) Gaemrnt. (Fam. Asteraceae/Compositaceae)] whose hepatoprotective effect has clinically been proved. Low toxicity, favorable pharmacokinetics, powerful antioxidant, detoxifying, preventive, protective and regenerative effects and side effects similar to placebo make silymarin extremely attractive and safe for therapeutic use. The medicinal properties of silymarin and its main component silibinin have been studied in the treatment of Alzheimer's disease, Parkinson's disease, sepsis, burns, osteoporosis, diabetes, cholestasis and hypercholesterolemia. Owing to its apoptotic effect, without cytotoxic effects, silymarin possesses potential applications in the treatment of various cancers. Silymarin is being examined as a neuro-, nephro- and cardio-protective in the damage of different etiologies due to its strong antioxidant potentials. Furthermore, it has fetoprotective (against the influence of alcohol) and prolactin effects and is safe to be used during pregnancy and lactation. Finally, the cosmetics industry is examining the antioxidant and UV-protective effects of silymarin. Further clinical studies and scientific evidence that silymarin and silibinin are effective in the therapy of various pathologies are indispensable in order to confirm their different flavonolignan pharmacological effects.

8 Review Design and optimization of drugs used to treat copper deficiency. 2013

Cakic, Milorad / Mitic, Zarko / Nikolic, Goran / Savic, Ivan / Savic, Ivana M. ·University of Nis, Faculty of Technology, Department of Pharmaceutics , Bulevar oslobodjenja 124, 16000 Leskovac , Serbia +381 16 242859 ; +381 16 242859 ; vana.savic@yahoo.com. ·Expert Opin Drug Discov · Pubmed #23919882.

ABSTRACT: INTRODUCTION: Copper is an essential element in the human organism. Furthermore, copper deficiency is rare; however, the hematologic manifestations associated with copper deficiency, such as anemia, leukopenia, neutropenia, myeloneuropathy and osteoporosis, are well known. AREAS COVERED: The authors present an overview of the various commercially available drugs used in the treatment of copper deficiency. Furthermore, the authors offer a description of copper complexes, as potential pharmaceutically active compounds, that can be used in the design of new formulations with therapeutic potential. EXPERT OPINION: Progress in the synthesis of new metallo-organic complexes (such as the copper-pullulan complex) and the chelated form of copper have provided new avenues for drug design that combat copper deficiency. The copper-pullulan complex, as an active compound, has been designed in its solid dosage form, and its optimization in the treatment of copper deficiency has been furthered through advancements in experimental design methodology. The authors believe that the numerous ongoing studies, evaluating the synthesis of these complexes, should produce new additions to the copper deficiency therapeutic armamentarium in the future.

9 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.

10 Review Premature ovarian failure. 2012

Vujović, Svetlana / Ivović, Miomira / Tancić-Gajić, Milina / Marina, Ljiljana / Barać, Marija / Arizanović, Zorana / Nenezić, Ana / Ivanisević, Maja / Micić, Jelena / Sajić, Silvija / Micić, Dragan. ·School of Medicine, University of Belgrade, Belgrade, Serbia. vujovics@eunet.rs ·Srp Arh Celok Lek · Pubmed #23350261.

ABSTRACT: Premature ovarian failure (POF) is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions) or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc.The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone), karyotype (<30 years of age), ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

11 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.

12 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.

13 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.

14 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.

15 Article Thyroid Mediation of the Isoflavone Effects on Osteoporotic Bone: The Endocrine Interference With a Beneficial Outcome. 2019

Šošić-Jurjević, Branka / Ajdžanović, Vladimir / Filipović, Branko / Severs, Walter / Milošević, Verica. ·Department of Cytology, Institute for Biological Research "Siniša Stanković", University of Belgrade, Belgrade, Serbia. · College of Medicine, Pennsylvania State University, Hershey, PA, United States. ·Front Endocrinol (Lausanne) · Pubmed #31681166.

ABSTRACT: -- No abstract --

16 Article Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis. 2019

Lorentzon, Mattias / Branco, Jaime / Brandi, Maria Luisa / Bruyère, Olivier / Chapurlat, Roland / Cooper, Cyrus / Cortet, Bernard / Diez-Perez, Adolfo / Ferrari, Serge / Gasparik, Andrea / Herrmann, Markus / Jorgensen, Niklas Rye / Kanis, John / Kaufman, Jean-Marc / Laslop, Andrea / Locquet, Médéa / Matijevic, Radmila / McCloskey, Eugene / Minisola, Salvatore / Pikner, Richard / Reginster, Jean-Yves / Rizzoli, René / Szulc, Pawel / Vlaskovska, Mila / Cavalier, Etienne. ·Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden. · Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. · CEDOC, NOVA Medical School, Medical Sciencies Faculty, NOVA University of Lisbon, Lisbon, Portugal. · Rheumatology Department, Egas Moniz Hospital, CHLO, Lisbon, Portugal. · FirmoLab Fondazione F.I.R.M.O, University of Florence, Florence, Italy. · WHO Collaborating Centre for Public Heath Aspects of Musculoskeletal Health and Aging, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · INSERM, UMR 1033, Université de Lyon, Hôpital E Herriot, 69437, Lyon Cedex 03, France. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, UK. · NHS Foundation Trust, Southampton, UK. · NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. · Department of Rheumatology and EA 44090, CHU Lille and University of Lille, 59000, Lille, France. · Hospital del Mar Institue of Medical Investigation, Autonomous University of Barcelona and Biomedical Research Network on Frailty and Healthy Aging (CIBERFES), Madrid, Spain. · Service of Bone Diseases, Geneva University Hospital and Faculty of Medicine, 1211, Geneva 14, Switzerland. · Department of Public Health and Health Management, University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania. · Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. · Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. · Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. · Department of Endocrinology, Ghent University Hospital, 9000, Ghent, Belgium. · Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · Belgium WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Liège, Belgium. · University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia. · Clinical Center of Vojvodina, Clinic for Orthopedic Surgery, Novi Sad, Serbia. · Department of Oncology and Metabolism, Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK. · Department of Internal Medicine and Medical Disciplines, Rome University, Sapienza, Italy. · Department of Clinical Biochemistry and Bone Metabolism, Klatovska Hospital, Klatovy, Czech Republic. · Department of Clinical Biochemistry and Heamathology, Faculty of Medicine Pilsen, Charles University Prague, Pilsen, Czech Republic. · Faculty of Health Care Studies, University of West Bohemia, Pilsen, Czech Republic. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. · Department of Pharmacology, Medical Faculty, Medical University Sofia, 2, Zdrave Str, 1431, Sofia, Bulgaria. · University of Liège, CHU de Liège, Liège, Belgium. Etienne.cavalier@chu.ulg.ac.be. ·Adv Ther · Pubmed #31440982.

ABSTRACT: INTRODUCTION: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. METHODS: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). RESULTS: Serum bone formation marker PINP and resorption marker βCTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of βCTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and βCTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. CONCLUSION: In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy.

17 Article Radiofrequency echographic multi-spectrometry for the in-vivo assessment of bone strength: state of the art-outcomes of an expert consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). 2019

Diez-Perez, Adolfo / Brandi, Maria Luisa / Al-Daghri, Nasser / Branco, Jaime C / Bruyère, Olivier / Cavalli, Loredana / Cooper, Cyrus / Cortet, Bernard / Dawson-Hughes, Bess / Dimai, Hans Peter / Gonnelli, Stefano / Hadji, Peyman / Halbout, Philippe / Kaufman, Jean-Marc / Kurth, Andreas / Locquet, Medea / Maggi, Stefania / Matijevic, Radmila / Reginster, Jean-Yves / Rizzoli, René / Thierry, Thomas. ·Department of Internal Medicine, Hospital del Mar/IMIM and CIBERFES, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain. ADiez@parcdesalutmar.cat. · FirmoLab Fondazione F.I.R.M.O., Florence, Italy. · Department of Biological, Experimental and Clinical Science, University of Florence, Florence, Italy. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. · NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium. · MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. · Department of Rheumatology and EA 4490, University-Hospital of Lille, Lille, France. · Bone Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. · Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria. · Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy. · Frankfurter Hormon und Osteoporose Zentrum, Frankfurt, Germany. · International Osteoporosis Foundation, Nyon, Switzerland. · Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. · Department of Orthopaedic Surgery and Osteology, Klinikum Frankfurt, Frankfurt, Germany. · Mayor Teaching Hospital, Charite Medical School, Berlin, Germany. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · National Research Council, Aging Program, Institute of Neuroscience, Padua, Italy. · Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Clinical Center of Vojvodina, Clinic for Orthopedic Surgery, Novi Sad, Serbia. · Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · Department of Rheumatology, Hospital Nord, CHU St Etienne, St Etienne, France. · INSERM 1059, University of Lyon, St Etienne, France. ·Aging Clin Exp Res · Pubmed #31422565.

ABSTRACT: PURPOSE: The purpose of this paper was to review the available approaches for bone strength assessment, osteoporosis diagnosis and fracture risk prediction, and to provide insights into radiofrequency echographic multi spectrometry (REMS), a non-ionizing axial skeleton technique. METHODS: A working group convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review the current image-based methods for bone strength assessment and fracture risk estimation, and to discuss the clinical perspectives of REMS. RESULTS: Areal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is the consolidated indicator for osteoporosis diagnosis and fracture risk assessment. A more reliable fracture risk estimation would actually require an improved assessment of bone strength, integrating also bone quality information. Several different approaches have been proposed, including additional DXA-based parameters, quantitative computed tomography, and quantitative ultrasound. Although each of them showed a somewhat improved clinical performance, none satisfied all the requirements for a widespread routine employment, which was typically hindered by unclear clinical usefulness, radiation doses, limited accessibility, or inapplicability to spine and hip, therefore leaving several clinical needs still unmet. REMS is a clinically available technology for osteoporosis diagnosis and fracture risk assessment through the estimation of BMD on the axial skeleton reference sites. Its automatic processing of unfiltered ultrasound signals provides accurate BMD values in view of fracture risk assessment. CONCLUSIONS: New approaches for improved bone strength and fracture risk estimations are needed for a better management of osteoporotic patients. In this context, REMS represents a valuable approach for osteoporosis diagnosis and fracture risk prediction.

18 Article Bone mineral health is sensitively related to environmental cadmium exposure- experimental and human data. 2019

Buha, Aleksandra / Jugdaohsingh, Ravin / Matovic, Vesna / Bulat, Zorica / Antonijevic, Biljana / Kerns, Jemma G / Goodship, Allen / Hart, Alister / Powell, Jonathan J. ·Department of Toxicology, Akademik Danilo Soldatović", University of Belgrade-Faculty of Pharmacy, Vojvode Stepe 450, 11000, Belgrade, Serbia. Electronic address: aleksandra@pharmacy.bg.ac.rs. · Biomineral Research, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK. · Department of Toxicology, Akademik Danilo Soldatović", University of Belgrade-Faculty of Pharmacy, Vojvode Stepe 450, 11000, Belgrade, Serbia. · Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK. · Institute of Orthopaedics and Musculoskeletal Science UCL, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London, HA7 4LP, UK. ·Environ Res · Pubmed #31247431.

ABSTRACT: Exposure to cadmium (Cd) is recognised as one of the risk factors for osteoporosis, although critical exposure levels and exact mechanisms are still unknown. Here, we first confirmed that in male Wistar rats challenged orally with 6 different levels of Cd (0.3-10 mg/kg b.w.), over 28 days, there was a direct dose relationship to bone Cd concentration. Moreover, bone mineral content was significantly diminished by ∼15% (p < 0.0001) plateauing already at the lowest exposure level. For the other essential bone elements zinc (Zn) loss was most marked. Having established the sensitive metrics (measures of Cd exposure), we then applied them to 20 randomly selected human femoral head bone samples from 16 independent subjects. Bone Cd concentration was inversely proportional to trabecular bone mineral density and mineral (calcium) content and Zn content of bone, but not the donor's age. Our findings, through direct bone analyses, support the emerging epidemiological view that bone health, adjudged by mineral density, is extremely sensitive to even background levels of environmental Cd. Importantly, however, our data also suggest that Cd may play an even greater role in compromised bone health than prior indirect estimates of exposure could reveal. Environmental Cd may be a substantially determining factor in osteoporosis and large cohort studies with direct bone analyses are now merited.

19 Article Endorsement by Central European experts of the revised ESCEO algorithm for the management of knee osteoarthritis. 2019

Kucharz, Eugene J / Szántó, Sándor / Ivanova Goycheva, Mariana / Petronijević, Milan / Šimnovec, Ksenija / Domżalski, Marcin / Gallelli, Luca / Kamenov, Zdravko / Konstantynowicz, Jerzy / Radunović, Goran / Šteňo, Boris / Stoilov, Rumen / Stok, Rasto / Vrana, Radovan / Bruyère, Olivier / Cooper, Cyrus / Reginster, Jean-Yves. ·Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia, Katowice, Poland. · Department of Sports Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. · Rheumatology Clinic, Medical Faculty, University Hospital "St. Iv. Rilski", Medical University, Sofia, Bulgaria. · Clinic of Rheumatology, MMA Medical Faculty, University of Defence, Military Medical Academy, Belgrade, Serbia. · Department of Orthopedics, General Hospital Jesenice, Jesenice, Slovenia. · Orthopedic and Trauma Department Medical, Veteran's Memorial Hospital, University of Lodz, Lodz, Poland. · Clinical Pharmacology and Pharmacovigilance Operative Unit, Department of Health Sciences, MaterDomini Hospital Catanzaro, University of Magna Graecia Catanzaro, Catanzaro, Italy. · Department of Internal Medicine, Clinic of Endocrinology, Medical University Sofia, University Hospital "Alexandrovska", Sofia, Bulgaria. · Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland. · Institute of Rheumatology, University of Belgrade Medical School, Resavska 69, Belgrade, Serbia. · II. Department of Orthopaedic and Trauma Surgery, Faculty of Medicine in Bratislava, Comenius University, University Hospital Bratislava, Bratislava, Slovakia. · Ultramedica, Vošnjakova 1, Ljubljana, Slovenia. · Osteocentrum Mediekos Ltd., Orthopedics, Ortopedie Hradiště Ltd., Uherské Hradiště, Czech Republic. · Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liege, Belgium. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium. · MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. · National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liege, Belgium. jyreginster@uliege.be. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium. jyreginster@uliege.be. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. jyreginster@uliege.be. ·Rheumatol Int · Pubmed #31129712.

ABSTRACT: Osteoarthritis (OA) is characterized by deterioration of the joints and associated with considerable pain and disability. OA is a chronic disease that requires intervention with both non-pharmacological and pharmacological treatment modalities and, inevitably, disease progression may necessitate successive treatments throughout the course of the disease. There is increasing data on the shortfalls of current pharmacological treatment of OA, and safety concerns associated with analgesic therapy use in OA arising from increasing evidence of gastrointestinal, cardiovascular, hepatic and renal adverse events with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Consequently, symptomatic slow-acting drugs for OA (SYSADOAs) may now be considered as a first-line treatment for knee OA, with a particular emphasis placed on the outstanding benefit: risk ratio of pharmaceutical-grade glucosamine and chondroitin sulfate formulations. In this short communication we review recent publications concerned with the safety of paracetamol, NSAIDs and SYSADOAs. Greater understanding of the benefits and limitations of current medications will lead to better disease management in OA. Furthermore, adherence to guideline recommendations across Europe and internationally, such as those from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), will promote evidence-based medicine and patient-centric care, ultimately leading to greater physician and patient satisfaction.

20 Article Medication-Related Osteonecrosis of the Jaws: Two Center Retrospective Cohort Studies. 2019

Petrovic, Milan / Jelovac, Drago B / Antic, Svetlana / Antunovic, Marija / Lukic, Nikola / Sabani, Melvil / Mudrak, Joerg / Jezdic, Zoran / Pucar, Ana / Stefanovic, Aleksandar / Kuzmanovic, Cedomir / Nikolic, Danilo / Konstantinovic, Vitomir. ·Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Serbia. · Center for Radiological Diagnostics, School of Dental Medicine, University of Belgrade, Serbia. · Laboratory for Anthropology, School of Medicine, University of Belgrade, Serbia. · Faculty of Medicine, Clinical Centre of Montenegro, Podgorica, Montenegro. · Faculty of Medicine, University of Belgrade, Serbia. · Joerg Mudrak, Private Clinic, Rotenburg an der Fulda, Germany. · Clinic for Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Serbia. ·Biomed Res Int · Pubmed #31011580.

ABSTRACT: This retrospective cohort study aims to describe characteristics of patients with MRONJ, to identify factors associated with MRONJ development, and to examine variables associated with favourable outcome. Totally 32 patients were followed and observed: 21 females and 11 males, in the age range 35-84 in the period from 2009 to 2018. Clinical, radiological examination (Orthopantomograph and CBCT) and biopsy were performed in order to achieve diagnosis. Demographic and clinical variables were taken into consideration: sex, age, primary disease, medication type, mode of delivery, anatomic location, drug treatment duration, timing of tooth extraction, chemotherapy, presence of bone metastasis, aetiology of MRONJ, disease stage, and treatment modality. MRONJ developed under osteoporosis and malignant disease in 11 and 21 patients, respectively. MRONJ development was triggered by tooth extraction or trauma in 30 out of 32 cases, whereas the two patients developed MRONJ spontaneously. Stages I, II, and III were confirmed in 5 (16%), 18 (58%), and 9 (28%) patients, respectively. Mandible was affected in 23 (72%) patients. MRONJ was treated in our department by conservative and surgical modality. In this study we found that 65% of all patients were classified in the cured/improvement group and 35% in the stable/progression group. The female gender, osteoporosis as primary disease, oral regime intake, shorter period on BPs, earlier stage of disease, and specific anatomic localisation (frontal and premolar maxilla) were factors associated with better response to therapy and favourable clinical outcome. Comprehensive treatment protocol and further randomized studies are necessary for further improvements.

21 Article Subregional areal bone mineral density (aBMD) is a better predictor of heterogeneity in trabecular microstructure of vertebrae in young and aged women than subregional trabecular bone score (TBS). 2019

Vom Scheidt, Annika / Grisolia Seifert, Eric Flavio / Pokrant, Carolin / Püschel, Klaus / Amling, Michael / Busse, Björn / Milovanovic, Petar. ·Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany. · Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Germany. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: b.busse@uke.de. · Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Germany; Laboratory for Anthropology and Skeletal Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Serbia. ·Bone · Pubmed #30776500.

ABSTRACT: BACKGROUND: Currently, bone densitometry fails to identify nearly half of those elderly patients at immediate fracture risk. To improve clinical assessment of vertebral fracture risk, we aimed to determine how the DXA-based 2D parameter Trabecular Bone Score (TBS) relates to subregional variability in 3D trabecular microstructure in young and elderly women compared to aBMD. METHODS: T12 vertebrae from 29 women (11 young: 32 ± 6 years, 18 aged: 71 ± 5 years) were DXA-scanned ex vivo in anterior-posterior (AP) and lateral projection providing vertebral aBMD and TBS. Additionally, aBMD and TBS were measured for three horizontal (superior, mid-horizontal, inferior) and three vertical subregions (anterior, mid-vertical, posterior) and related to 3D microstructure indices, i.e. bone volume per tissue volume (BV/TV), trabecular number and thickness (Tb.N, Tb.Th), based on HRpQCT. RESULTS: Subregional high-resolution tomography showed significant differences in trabecular parameters for both age groups: In horizontal subregions, BV/TV was lowest superiorly, Tb.Th was highest mid-horizontally, and Tb.N was lowest mid-horizontally and highest inferiorly. Correspondingly, aBMD varied between horizontal subregions, with differences depending on projection direction. TBS varied only in lateral projections of the aged group, with lower values for the mid-horizontal subregion. In vertical subregions, BV/TV, Tb.N, and aBMD were highest posteriorly for both groups. TBS did not differ between vertical subregions. Regression analysis showed aBMD as a predictor explained more of the variance in subregional 3D microstructure compared to TBS. Stepwise multi-regression analysis revealed only three combinations of subregion, projection, and group where aBMD and TBS were both significant predictors. CONCLUSIONS: Subregional aBMD reflects variations in trabecular bone microstructure better than subregional TBS for trisected regions. Specifically, lateral aBMD identifies microstructural heterogeneities independent of age and may improve prediction of vertebral strength and susceptibility to specific fracture types.

22 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.

23 Article ADIPONECTIN AS A POTENTIAL BIOMARKER OF LOW BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN WITH METABOLIC SYNDROME. 2018

Stojanovic, S S / Arsenijevic, N A / Djukic, A / Djukic, S / Zivancevic Simonovic, S / Jovanovic, M / Pejnovic, N / Nikolic, V / Zivanovic, S / Stefanovic, M / Petrovic, D. ·"Niska Banja" Institute for Treatment and Rehabilitation, Nis, Serbia. · University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Nis, Serbia. · University of Nis, Faculty of Medicine, Nis, Serbia. ·Acta Endocrinol (Buchar) · Pubmed #31149258.

ABSTRACT: Context: Adiponectin is an abundant adipokine, which has antiinflammatory, anti-atherosclerotic and vasoprotective actions, and potential antiresorptive effects on bone metabolism. It seems to be directly involved in the improvement and control of energy homeostasis, protecting bone health and predicting osteoporotic fracture risk. Objective: To examine the relationship between adiponectin level and bone mineral density (BMD) in post-menopausal women with metabolic syndrome (MetS) and low BMD, and to estimate the prognostic significance of adiponectin in osteoporosis. Design: Clinical-laboratory cross-sectional study including 120 middle-aged and elder women (average 69.18±7.56 years). Subjects and Methods: The anthropometric parameters were measured for all examinees. Lumbar spine and hip BMD, as well as body fat percentage, were measured using a Hologic DEXA scanner. In all subjects serum adiponectin concentration was measured by ELISA method. Results: The level of adiponectin was significantly positively correlated with BMD-total, BMD of the lumbar spine and BMD of the femoral neck (r=0.618, r=0.521, r=0.567; p<0.01). Levels of adiponectin and BMD are significantly lower in post-menopausal women with MetS and osteoporosis compared to patients with osteopenia (856.87±453.43 Conclusions: Post-menopausal women with MetS have significantly lower adiponectin level and low BMD compared to healthy examinees. Adiponectin may be an early, significant and independent predictor of developing osteoporosis in women with MetS, especially in post-menopausal period.

24 Article Obtaining patient-specific point model of the human ilium bone in the case of incomplete volumetric data using the method of parametric regions. 2018

Trajanovic, Miroslav / Tufegdzic, Milica / Arsic, Stojanka. ·Department for Production, IT and Management, Faculty of Mechanical Engineering, University of Nis, Aleksandra Medvedeva 14, Nis, 18000, Serbia. · Department for Mechanical Engineering, The First Technical School, Cirila i Metodija 26, Krusevac, 37000, Serbia. milica.tufegdzic@prva-tehnicka.edu.rs. · Department of Anatomy, Faculty of Medicine Nis, University of Nis, Blvd. Dr Zorana Djindjica 81, Nis, 18000, Serbia. ·Australas Phys Eng Sci Med · Pubmed #30267324.

ABSTRACT: In this paper, we present the methodology for determining the point model of the ilium bone in cases when volumetric data of the whole bone are not available. An extreme traumatic bone damage, osteoporosis, destruction of bone tissue by malignant bone tumors or the existence of only 2D medical image (X-ray) can be the reason for the lack of complete volumetric data. Points on the bone surface were defined at the curves that run through 26 previously defined parameters, at the edges of anteroposterior (A-P) and lateral projections and at the parts of the surface between some parameters. Those parts of the surface, enclosed by parameters, represent ten parametric regions. The values of coordinates, which represent the input data in the statistical program, were measured in a uniquely defined coordinate system. After establishing the correlations between the values of coordinates, 8869 different linear and nonlinear regression models were obtained. The prediction values for point coordinates were calculated and exported to a CAD program. Results obtained were tested on a randomly chosen male right ilium bone, applying the methodology for creating the prediction model using the method of parametric regions, which allows creating a complete polygonal model, for each region separately or just for some parts of the region. Results obtained in the form of regression equations for the right ilium bone can be applied to the left ilium bone. The results of the research were verified using a comparative deviation and distance analysis between the initial and obtained polygonal models.

25 Article Comparative assessment of fracture risk among osteoporosis and osteopenia patients: a cross-sectional study. 2018

Tomasevic-Todorovic, Snezana / Vazic, Atina / Issaka, Abukari / Hanna, Fahad. ·Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. · Higher School, College of Professional Studies in Education of Teachers, Kikinda, Serbia. · Department of Climate and Agriculture, School of Science and Health, Western Sydney University, Sydney, NSW, Australia. · Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar. ·Open Access Rheumatol · Pubmed #29881314.

ABSTRACT: Background: Both osteoporosis and osteopenia remain worldwide public health concerns. They both lead to bone fractures, which can lead to disability and burden on those who are afflicted. Objectives: To assess and compare fracture risk between these two groups of patients. Patients and methods: Our cross-sectional study included 82 patients (46 with osteoporosis and 36 with osteopenia) with an average age of 63±9.33 years, who received treatment at the Clinic for Medical Rehabilitation, Clinical Center of Vojvodina in Novi Sad, Serbia. The assessment of the fracture risk was executed by applying the Fracture Assessment Risk (FRAX) index (an algorithm developed by the World Health Organization) based on clinical fracture risks or combination of clinical fracture risks and bone mineral density. Results: Patients with osteoporosis had significantly higher risk of major fracture compared to patients with osteopenia ( Conclusion: Osteoporosis patients had a high risk of major osteoporotic fracture, while there was no association between the intermediate level for major osteoporotic fracture and osteo-penia. For patients suffering from an increased fracture risk, especially those who had already been diagnosed with osteoporosis, preventive measures such as designing individual therapeutic programs should be adopted.

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