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Osteoporosis: HELP
Articles from Tunisia
Based on 24 articles published since 2008
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These are the 24 published articles about Osteoporosis that originated from Tunisia during 2008-2019.
 
+ Citations + Abstracts
1 Review [Paget's disease of bone: Diagnostic and therapeutic updates]. 2018

Alaya, R / Alaya, Z / Nang, M / Bouajina, E. ·Service de rhumatologie, centre hospitalier Sud Francilien, 91100 Corbeil-Essonnes, France. · Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie. Electronic address: zeineb_a@hotmail.fr. · Service de rhumatologie, hôpital Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie. ·Rev Med Interne · Pubmed #28690091.

ABSTRACT: Paget's disease of bone is the second most common metabolic bone disease after osteoporosis. Its pathogenesis is not yet clearly understood. Geographic distribution and epidemiological variations suggest a role of genetic and environmental factors in its pathophysiology. The frequency of the Paget's disease of bone increases with age. Its discovery can be fortuitous. Prognosis mainly depends on the occurrence of complications involving bones and joints, neurological, cardiovascular or metabolic systems. Treatment of symptomatic forms currently relies on bisphosphonates that have transformed its prognosis.

2 Review The importance of physical activity in osteoporosis. From the molecular pathways to the clinical evidence. 2016

Castrogiovanni, Paola / Trovato, Francesca Maria / Szychlinska, Marta Anna / Nsir, Houda / Imbesi, Rosa / Musumeci, Giuseppe. ·Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy. · Department of Clinical and Experimental Medicine, Internal Medicine Division, School of Medicine, University of Catania, Catania, Italy. · Department of Molecular and Cellular Biology and Plant Physiology, Centre of Biotechnology of Borj Cedreya, University of Carthage, Tunisia. · Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy. g.musumeci@unict.it. ·Histol Histopathol · Pubmed #27311988.

ABSTRACT: Osteoporosis is a very common bone disorder characterized by low bone mass and signs of deterioration, responsible for bone fragility typical in this pathology. The risk factors for the onset of osteoporosis are many and different from each other. Some of them cannot be modified, such as age, hereditary diseases and endocrine diseases. Others are modifiable, so that prevention is an advisable tool to reduce the incidence of osteoporosis. Among preventive tools, physical activity is certainly a valid instrument of prevention, in fact physical activity contributes to a healthy energy balance and increases muscle mass and bone mass. In the present narrative review, we wanted to pay attention to the possible influence of physical activity on the pathophysiological molecular pathways of osteoporosis and to the use of different exercise training in treatment of osteoporosis. From the literature analyzed, in relation to the effects of physical activity on bone metabolism, it is shown that exercise acts on molecular pathways of bone remodeling involving all cellular types of bone tissue. In relation to clinical trials adopted in patients with osteoporosis, it is evident that a multi-component training, including aerobic activity and other types of training (resistance and/or strength exercises), is the best kind of exercise in improving bone mass and bone metabolism in older adults and especially osteopoenic and osteoporotic women. With regard to whole-body-vibration training, it seems to be a valid alternative to current methods due to its greater adaptability to patients. In conclusion, physical activity, whatever the adopted training, always has beneficial effects on patients suffering from osteoporosis, and not only on bone homeostasis but on the whole skeletal muscle system.

3 Review Moderate alcohol use and health: a consensus document. 2013

Poli, A / Marangoni, F / Avogaro, A / Barba, G / Bellentani, S / Bucci, M / Cambieri, R / Catapano, A L / Costanzo, S / Cricelli, C / de Gaetano, G / Di Castelnuovo, A / Faggiano, P / Fattirolli, F / Fontana, L / Forlani, G / Frattini, S / Giacco, R / La Vecchia, C / Lazzaretto, L / Loffredo, L / Lucchin, L / Marelli, G / Marrocco, W / Minisola, S / Musicco, M / Novo, S / Nozzoli, C / Pelucchi, C / Perri, L / Pieralli, F / Rizzoni, D / Sterzi, R / Vettor, R / Violi, F / Visioli, F. ·NFI (Nutrition Foundation of Italy), Viale Tunisia 38, 20124 Milan, Italy. poli@nutrition-foundation.it ·Nutr Metab Cardiovasc Dis · Pubmed #23642930.

ABSTRACT: AIMS: The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities. DATA SYNTHESIS: In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician. CONCLUSIONS: The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered.

4 Review [Bisphosphonates: indications in bone diseases other than osteoporosis]. 2011

Abdelmoula, Leila Cheikhrouhou / Ben M'barek, Rim / Ben Hadj Yahia, Chiraz / Tekaya, Raoudha / Testouri, Nadia / Chaabouni, Lilia / Zouari, Rafik. ·Universite Tunis, El Manar, Tunisie. ·Tunis Med · Pubmed #21681711.

ABSTRACT: AIM: Report of bisphosphonates indications for osseous diseases other than osteoporosis. METHODS: Narrative review of the literature. RESULTS: Bisphosphonates represent a new medication which is increasingly used. Besides osteoporosis, it is indicated as first choice in different bone diseases such as Paget's disease and the prevention of bone complications in tumoral osteolysis. Bisphosphonates' efficiency has been proven in other pathologies: the fibrous dysplasia and the osteogenesis imperfecta. More over, many studies are driven having for goal to show the efficiency of bisphosphonates in the algoneurodystrophy, non corticosteroid-treated osteoporosis in chronic inflammatory rheumatism and aseptic osteonecrosis. CONCLUSION: Bisphosphonates are a powerful inhibition of osseous resoption frestable indicated for osteoporosis. Their indications were retended to paget's disease, malignant hypercalcemia, and osseous complications of malignant osterlysis.

5 Article Proficiencies of Zingiber officinale against spine curve and vertebral damage induced by corticosteroid therapy associated with gonadal hormone deficiency in a rat model of osteoporosis. 2018

Zammel, Nourhène / Amri, Nahed / Chaabane, Rim / Rebai, Tarek / Badraoui, Riadh. ·Laboratory of Histo-Embryology and Cytogenetics, Medicine Faculty of Sfax University, 3029, Sfax, Tunisia. · Laboratory of Biochemistry, CHU Hédi Chaker of Sfax, 3029, Sfax, Tunisia. · Laboratory of Histo-Embryology and Cytogenetics, Medicine Faculty of Sfax University, 3029, Sfax, Tunisia; Laboratory of Histology - Cytology, Medicine Faculty of Tunis, University of Tunis El Manar, 1007, La Rabta-Tunis, Tunisia. Electronic address: riadh.badraoui@fmt.utm.tn. ·Biomed Pharmacother · Pubmed #29864927.

ABSTRACT: This study was assessed to examine whether Zingiber officinale (ZO) can prevent spine disorder and trabecular microarchitecture disruption in osteoporotic murin model. Three groups of male rats were selected: Controls (CTRL), combined model of osteoporosis (CMO), in which rats were orchidectomized and treated with cortisol, and CMO treated with ZO (CMO + ZO). One month after the surgical procedures, the rats were sacrificed. Lumbar curve of the spine has been evaluated using the kyphotic method. The spines were submitted to histological and histomorphometric analysis and mineral (calcium and phosphorus) metabolism assessment. Compared to CTRL, the mean kyphotic angle (KA) was significantly higher in CMO rats. The spinal deconditioning associated decreased bone trabecular volume and a disrupted microarchitecture. A disorder was observed in the serum and bone levels of calcium and phosphorus in the combined severe osteopenia model. An increase in the level of TRAcP associated with an increase in osteoclast number and activity has been reported. These disturbances were reduced following the use of ZO in the CMO + ZO group. Finally, ginger might be an alternative therapeutic candidate for the treatment of severe osteopenia induced vertebral damage and spine curve disruption.

6 Article Turning the backbone into an ankylosed concrete-like structure: Case report. 2018

Kaissi, Ali Al / Chehida, Farid Ben / Grill, Franz / Ganger, Rudolf / Kircher, Susanne Gerit. ·Ludwig Boltzmann Institute of Osteology, at the Hanusch Hospital of WGKK and, AUVA, Trauma Centre Meidling, First Medical Department, Hanusch Hospital. · Orthopaedic Hospital of Speising, Paediatric Department, Vienna, Austria. · Ibn Zohr Institute of Radiology and Imaging, Tunis, Tunisia. · Institute of Medical Chemistry, Medical University of Vienna, Vienna, Austria. ·Medicine (Baltimore) · Pubmed #29642148.

ABSTRACT: RATIONALE: Progressive restriction of the spinal bio-mechanics is not-uncommon deformity encountered in spine clinics. Congenital spinal fusion as seen in Klippel-Feil-anomaly, progressive non-infectious anterior vertebral fusion, and progressive spinal hyperostosis secondary to ossification of the anterior longitudinal spinal ligament are well delineated and recognized. PATIENT CONCERNS: A 24-year-old girl has history of osteoporosis since her early childhood, associated with multiple axial and appendicular fractures and scoliosis. Recently she presented with episodes of severe back pain, spinal rigidity/stiffness with total loss of spine biomechanics. DIAGNOSES: She was provisionally diagnosed as having osteogenesis imperfecta and was investigated for COL1A1/A2 mutations which have been proven to be negative. Autosomal recessive type of osteogenesis imperfecta was proposed as well, no mutations have been encountered. A homozygous for CTSA gene mutation, the gene associated with Galactosialidosis was identified via whole exome sequencing (Next-Generation Sequencing projects) has been identified. INTERVENTIONS: Early in her life she had a history of frequent fractures of the long bones since she was 4 years which was followed by vertebral fractures at the age of 12 years. She manifested lower serum 25OH-D levels and were associated with lower LS-aBMD Z-scores with higher urinary bone turnover indexes (urinary NTX/Cr). OUTCOMES: Lysosomal storage diseases (LSD) have a strong correlation with the development of osteoporosis. LSD causes skeletal abnormalities results from a lack of skeletal remodeling and ossification abnormalities owing to abnormal deposition of GAGs (impaired degradation of glycosaminoglycans ) in bone and cartilage. 3D reconstruction CT scan of the spine showed diffuse hyperostosis of almost the entire spine (begins at the level of T4- extending downwards to involve the whole thoraco-lumbar and upper part of the sacrum) with total diffuse fusion of the pedicles, the transverse and articular processes, the laminae and the spinous processes. LESSONS: This is the first clinical report of adult patient with a history of osteoporosis and fractures with the late diagnosis of Galactosialidosis. Osteogenesis imperfecta (autosomal dominant and recessive) were the first given diagnoses which proven negative. The pathophysiology of the spine ankylosis in our current patient and its correlation with LSD, antiresorptive medications, vitamin D3 and supplemental calcium is not fully understood. Therefore, further studies are needed to elucidate this sort of correlation.

7 Article How frequent is osteogenesis imperfecta in patients with idiopathic osteoporosis?: Case reports. 2017

Al Kaissi, Ali / Windpassinger, Christian / Chehida, Farid Ben / Ghachem, Maher Ben / Nassib, Nabil M / Kenis, Vladimir / Melchenko, Eugene / Morenko, Ekatrina / Ryabykh, Sergey / Hofstaetter, Jochen G / Grill, Franz / Ganger, Rudolf / Kircher, Susanne Gerit. ·aLudwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital bOrthopedic Hospital of Speising, Pediatric Department, Vienna, Austria cIbn Zohr Institute of Radiology and Imaging studies, Tunis, Tunisia dPediatric Orthopedic Surgery, Children's Hospital of Tunis, Tunis, Tunisia eDepartment of Foot and Ankle Surgery, Neuroorthopaedics and Systemic Disorders, Pediatric Orthopedic Institute n.a. H. Turner, Saint Petersburg, Russia fAxial Skeleton and Neurosurgery Department, Restorative Traumatology and Orthopaedics, Ilizarov Center, Kurgan, Russia gInstitute of Medical Chemistry, Center of Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria. ·Medicine (Baltimore) · Pubmed #28858097.

ABSTRACT: RATIONALE: The term idiopathic osteoporosis itself is quite a non-specific disease label, which fails to address the etiological understanding. Bone mineral density alone is not a reliable parameter to detect patients at high risk of fracture. The diversity of the clinical phenotypes of discolored teeth, blueness of the sclera, back and joint pain, cardiovascular disease, Diabetes type II, hearing problems and a long list of orthopedic problems are have to be considered. PATIENTS CONCERNS: Our study has been designed in accordance with the clinical and radiological phenotype of eleven index cases with the provisional diagnosis of OI, which was followed by genotypic confirmation. This was followed by the invitation of siblings, parents, grandparents and other relatives to participate in the interviews, and to discuss the impact of the diagnosis. Proper collaboration with these families facilitated the process to identify other subjects with a history of fractures and other deformities/disabilities which were seemingly correlated to heritable connective tissue disorder. In total, 63 patients (27 children and 36 parents/grandparents and relatives) were enrolled in the study. Two groups of children were not included in our study. We excluded children with incomplete documentation and children who manifested de novo mutation. The term idiopathic osteoporosis (IOP) has been given to these families in other Institutes and was considered as a definite diagnosis. IOP was solely based on T scores, BMD and certain laboratory tests. Surprisingly, no single adult patient underwent clinical and or radiological phenotypic characterization. DIAGNOSES: A constellation of significant disease associations with osteoporotic fracture risk have been encountered. The index cases showed mutations in COL1A1 (17q21.31.q22) and COL1A2 (7q22.1), the genes encoding collagen type I. The phenotype/genotype confirmation in 11 children was the key factor to boost our research and to re-consult each family. Comprehensive clinical and radiological phenotypic documentation has been applied to most of other family subjects who principally received the diagnosis of IOP. INTERVENTIONS: All adult patients had normal serum calcium and only three patients showed an average of low serum phosphate of 0.7-0.61 mmol/l. Serumcrosslaps in six parents was in the average of (2.9-3.8 nM) and PTH levels were normal in all patients (the average showed 8.73 pg/ml). OUTCOMES: Our efforts to minimize and constrain the usage of the term idiopathic osteoporosis and to understand the sequence of pathological events that occurred in these families were emphasized. These efforts evolved into a remarkable and unique constellation of clinical findings. Strikingly, fracture represented a portion in a series of skeletal and extra-skeletal deformities and abnormalities which are all correlated to connective tissue disorder. This was achieved mainly through comprehensive phenotype/genotype confirmation, followed by scrutinizing the records of each family, clinical examination of the adults and revising the archives of our Hospitals and other Institutes. LESSONS: The sequence of diverse pathological events recorded within each family would be almost incomprehensible without a proper etiological understanding of the natural history of each child/family deformity that led to their occurrences. We wish to stress that, our current study is just an attempt to cover only a tiny fraction of the tip of the iceberg and to profoundly explore one of the most under-estimated causes of idiopathic osteoporosis.

8 Article Corticosteroid treatment exacerbates bone osteopenia in mice with gonadal hormone deficiency-induced osteoporosis. 2017

Badraoui, Riadh / Amri, Nahed / Zammel, Nourhène / Chaabane, Rim / Rebai, Tarek. ·Laboratory of Histo-Embryology and Cytogenetics, Medicine Faculty, Sfax University, 3029 Sfax, Tunisia; Laboratory of Histology - Cytology, Medicine Faculty, University of Tunis El-Manar, 1007 La Rabta-, Tunis, Tunisia. Electronic address: badraouir@yahoo.fr. · Laboratory of Histo-Embryology and Cytogenetics, Medicine Faculty, Sfax University, 3029 Sfax, Tunisia. · Laboratory of Biochemistry, CHU Hédi Chaker of Sfax, 3029 Sfax, Tunisia. ·Eur J Pharm Sci · Pubmed #28473228.

ABSTRACT: Gonadic deficiency and corticotherapy are important risk factors in the pathogenesis of osteoporosis. This study was outlined to assess the effects of combined orchidectomy (ORX) and corticosteroid (cortisol; CS) administration on bone remodeling and metabolism. Twenty-week-old male Swiss mice were randomized into four groups: either sham operated (sham), ORX, CS injected (CS), or ORX and CS injected (ORX+CS). After 28days, mice were euthanized. Both ORX and CS resulted in reduced trabecular volume, and mineral apposition rate and increased osteoclast number and activity. TRAcP levels were increased in ORX and CS mice, but reached highest values in ORX+CS. Bone and serum mineral content (calcium and phosphorus) were disrupted in ORX and CS groups when compared to Sham, and were more affected in ORX+CS group. Urinary calcium measures were increased in ORX, CS, and ORX+CS during the time course of the study. Increases were more prominent in ORX+CS. The differences between groups were generally more accentuated at ORX+CS group. Biochemical data showed a parallel extent to the histologic and histomorphometric changes. This study provides a valid pre-clinical model for severe and rapid osteopenia by ORX associated corticotherapy in which bone loss was significantly higher than either ORX or CS alones.

9 Article -643C > T RANKL gene polymorphism is associated with osteoporosis in Tunisian postmenopausal women. 2017

Sassi, R / Sahli, H / Cheour, E / Sellami, S / El Gaaied, A Ben Ammar. ·a Genetics, Immunology and Human Pathologies Laboratory, Faculty of Mathematical, Physical and Natural Sciences of Tunis , Tunis EL Manar University , Tunis , Tunisia. · b Immuno-Rheumatology Laboratory , Rabta Hospital, Faculty of Medicine of Tunis, Tunis EL Manar University , Tunis , Tunisia. ·Climacteric · Pubmed #28453307.

ABSTRACT: OBJECTIVES: The dynamic nature of the skeleton is achieved by a remodeling process. Receptor activator of nuclear factor kappa B (RANK) ligand (RANKL) stimulates bone resorption by activating RANK signaling. Therefore it is considered as a candidate gene regulating susceptibility to osteoporosis. In the current study, we have investigated the association between the RANKL gene -693G > C and -643 C > T polymorphisms and bone mineral density (BMD) in a population of postmenopausal Tunisian women. METHODS: Polymorphic sites in RANKL gene (rs9533155 -693G > C and rs9533156 -643 C > T polymorphisms) were determined using PCR-RFLP analysis in 566 postmenopausal Tunisian women. All statistical analysis were examined by SPSS software. RESULTS: We have detected a significant difference in lumbar spine and hip BMD for -643C > T genotypes. For -693G > C genotypes, a significant difference was detected only in hip BMD. The distribution of -643C > T genotypes and alleles between three groups (osteoporotic, osteopenic and normal women) revealed a significant association of the TT genotype with development of osteoporosis (p = 0.01; odds ratio 2.15), although for the -693G > C polymorphism, no significant results were found. CONCLUSION: We have demonstrated the association of the -643C > T polymorphism with BMD variation and osteoporosis risk in postmenopausal Tunisian women.

10 Article [Perceptions of Tunisian women based on the health beliefs model and their practices related to osteoporosis]. 2016

Belgacem, Amina / Nouira, Amel / Soussi, Sonia. ·Centre Hospitalo-universitaire Sahloul, Sousse, Tunisie. · Département de Médecine Communautaire, Faculté de Médecine de Sousse, Tunisie. · Ecole Supérieure des Sciences et Techniques de la Santé de Tunis, Tunisie. ·Pan Afr Med J · Pubmed #27217868.

ABSTRACT: INTRODUCTION: The aim of this study is to describe beliefs and practices of women related to health and osteoporosis in order to develop effective and targeted interventions for the prevention of this disease in the Tunisian context. METHODS: A descriptive cross-sectional study was conducted among 100 Tunisian women, aged 45 and older, who consult the basic health center in the suburban area of Sousse region (Tunisia). The collection of information was carried out with "osteoporosis health belief scale "developed by Kim and his colleagues validated and translated into Arabic in Tunisia and the questionnaire of "daily calcium inputs calculation" was developed by Patrice Fardellone. The interpretation of the results was based on the "Health Belief Model". RESULTS: Perception participants considered above average for the vulnerability of osteoporosis (58%). The advantages severity of their benefits of calcium intake and health motivation could be considered moderate moderated. However, the practical exposure to disease risks is relatively frequent and essentially related to socio-economic and cultural factors. CONCLUSION: The promotion programs should aim at creating a supportive physical and social environment for the adoption of safer behaviors and especially education must be targeted.

11 Article Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors. 2016

Chihaoui, Melika / Yazidi, Meriem / Chaker, Fatma / Belouidhnine, Manel / Kanoun, Faouzi / Lamine, Faiza / Ftouhi, Bochra / Sahli, Hela / Slimane, Hedia. ·Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. Electronic address: melikachihaoui@yahoo.fr. · Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. · Department of Rheumatology, University Hospital La Rabta, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. ·J Clin Densitom · Pubmed #26993664.

ABSTRACT: Hypopituitarism is a known cause of bone mineral loss. This study aimed to evaluate the frequency of osteopenia and osteoporosis in patients with Sheehan's syndrome (SS) and to determine the risk factors. This is a retrospective study of 60 cases of SS that have had a bone mineral density (BMD) measurement. Clinical, biological, and therapeutic data were collected. The parameters of osteodensitometry at the femoral neck and the lumbar spine of 60 patients with SS were compared with those of 60 age-, height-, and weight-matched control women. The mean age at BMD measurement was 49.4 ± 9.9 yr (range: 25-76 yr). The mean duration of SS was 19.3 ± 8.5 yr (range: 3-41 yr). All patients had corticotropin deficiency and were treated with hydrocortisone at a mean daily dose of 26.3 ± 4.1 mg. Fifty-seven patients (95%) had thyrotropin deficiency and were treated with thyroxine at a mean daily dose of 124.3 ± 47.4 µg. Thirty-five of the 49 patients, aged less than 50 yr at diagnosis and having gonadotropin deficiency (71.4%), had estrogen-progesterone substitution. Osteopenia was present in 25 patients (41.7%) and osteoporosis in 21 (35.0%). The BMD was significantly lower in the group with SS than in the control group (p < 0.001). The odds ratio of osteopenia-osteoporosis was 3.1 (95% confidence interval: 1.4-6.8) at the femoral neck and 3.7 (95% confidence interval: 1.7-7.8) at the lumbar spine. The lumbar spine was more frequently affected by low bone mineral mass (p < 0.05). The duration of the disease and the daily dose of hydrocortisone were independently and inversely associated with BMD at the femoral neck. The daily dose of thyroxine was independently and inversely associated with BMD at the lumbar spine. Estrogen-progesterone replacement therapy was not associated with BMD. Low bone mineral mass was very common in patients with SS. The lumbar spine was more frequently affected. The duration of the disease and the doses of hydrocortisone and thyroxine were involved in bone mineral loss.

12 Article Accelerated bone ingrowth by local delivery of Zinc from bioactive glass: oxidative stress status, mechanical property, and microarchitectural characterization in an ovariectomized rat model. 2015

Samira, Jbahi / Saoudi, Monji / Abdelmajid, Kabir / Hassane, Oudadesse / Treq, Rebai / Hafed, Efeki / Abdelfatteh, Elfeki / Hassib, Keskes. ·Campus de Beaulieu, UMR CNRS 6226, University of Rennes, Rennes, France. · Animal Ecophysiology Laboratory, Department of Life Sciences, Sfax Faculty of Science, University of Sfax, Sfax, Tunisia. · Higher Institute of Applied Biology of Medenine, University of Gabes, Gabes, Tunisia; jbahisamira@yahoo.fr. · Histology, Orthopaedic and Traumatology Laboratory, Sfax Faculty of Medicine, University of Sfax, Sfax, Tunisia. ·Libyan J Med · Pubmed #26486308.

ABSTRACT: BACKGROUND: Synthetic bone graft substitutes such as bioactive glass (BG) material are developed in order to achieve successful bone regeneration. Zn plays an important role in the proper bone growth, development, and maintenance of healthy bones. AIMS: This study aims to evaluate in vivo the performance therapy of zinc-doped bioactive glass (BG-Zn) and its applications in biomedicine. METHODS: Female Wistar rats were ovariectomized. BG and BG-Zn were implanted in the femoral condyles of Wistar rats and compared to that of control group. Grafted bone tissues were carefully removed to evaluate the oxidative stress status, histomorphometric profile, mechanical property, and mineral bone distribution by using inductively coupled plasma optical emission spectrometry. RESULTS: A significant decrease of thiobarbituric acid-reactive substances was observed after BG-Zn implantation. Superoxide dismutase, catalase (CAT), and glutathione peroxidase (GPx) activities significantly increased in ovariectomized group implanted with Zinc-doped bioactive glass (OVX-BG-Zn) as compared to ovariectomized group implanted with bioactive glass (OVX-BG). An improved mechanical property was noticed in contact of OVX-BG-Zn (39±6 HV) when compared with that of OVX-BG group (26±9 HV). After 90 days of implantation, the histomorphometric analysis showed that trabecular thickness (Tb.Th) and trabecular number (Tb.N) were significantly increased with 28 and 24%, respectively, in treated rats of OVX-BG-Zn group as compared to those of OVX-BG groups. Trabecular separation (Tb.Sp) and trabecular bone pattern factor (TBPf) were significantly decreased in OVX-BG-Zn group with 29.5 and 54% when compared with those of OVX-BG rat groups. On the other hand, a rise in Ca and P ion concentrations in the implanted microenvironment was shown and lead to the formation/deposition of Ca-P phases. The ratio of pyridinoline [Pyr] to dihydroxylysinonorleucine [DHLNL] cross-links was normalized to the control level. CONCLUSION: Our findings suggested that BG-Zn might have promising potential applications for osteoporosis therapy.

13 Article Polymorphisms in VDR gene in Tunisian postmenopausal women are associated with osteopenia phenotype. 2015

Sassi, R / Sahli, H / Souissi, C / Sellami, S / Ben Ammar El Gaaied, A. ·Genetics, Immunology and Human Pathologies Laboratory, Faculty of Mathematical, Physical and Natural Sciences of Tunis, Tunis El Manar University , Tunisia. ·Climacteric · Pubmed #25603555.

ABSTRACT: OBJECTIVES: Osteopenia is characterized by intermediate values of bone mineral density (BMD) as compared to normal and osteoporotic subjects. BMD, a surrogate phenotype for osteoporosis, is influenced in part by genetic factors. Among the genes associated with BMD, the vitamin D receptor (VDR) was the first gene studied as a potential candidate associated with BMD in adult and postmenopausal bone loss. However, results are controversial. METHODS: To determine whether VDR polymorphisms ApaI and TaqI are associated with BMD, osteopenia, osteoporosis and low-impact fracture risk in North Africans, these genotypes were analyzed in 566 postmenopausal Tunisian women. RESULTS: In postmenopausal Tunisian women, the GT ApaI genotype seems to be protective against osteoporosis development (p = 0.02; odds ratio = 0.54). Moreover, the presence of the combined GT/TT genotype of ApaI and TaqI polymorphisms is more frequent in normal BMD women than in osteoporotic women (p = 0.00; odds ratio = 0.41). Interestingly, the GG ApaI genotype is associated with osteopenia development (p = 0.02; odds ratio = 1.86) and also the TT TaqI polymorphism (p = 0.02; odds ratio = 1.53). The GG ApaI genotype is associated with a three times risk of vertebral fracture. CONCLUSIONS: The ApaI polymorphism showed an association with osteopenia and low-impact vertebral fracture incidence but not with osteoporosis. The TaqI polymorphism is associated specifically with the osteopenia phenotype. The presence of the two polymorphisms increases the risk to develop osteopenia in postmenopausal Tunisian women. Osteopenia seems to be genetically determined. However, osteoporosis is the result of interaction between genetic and environmental factors.

14 Article Association of LRP5 genotypes with osteoporosis in Tunisian post-menopausal women. 2014

Sassi, Rim / Sahli, Hela / Souissi, Chiraz / El Mahmoudi, Hejer / Zouari, Bechir / Ben Ammar ElGaaied, Amel / Sellami, Slaheddine / Ferrari, Serge Livio. ·Osteoporosis and Arthritis laboratory, Rabta hospital, Faculty of Medicine of Tunis, Tunis EL Manar University, Tunis, Tunisia. sasrim2006@yahoo.com. ·BMC Musculoskelet Disord · Pubmed #24885293.

ABSTRACT: BACKGROUND: Osteoporosis is a highly heritable trait. Among the genes associated with bone mineral density (BMD), the low-density lipoprotein receptor-related protein 5 gene (LRP5) has been consistently identified in Caucasians. However LRP5 contribution to osteoporosis in populations of other ethnicities remains poorly known. METHODS: To determine whether LRP5 polymorphisms Ala1330Val and Val667Met are associated with BMD in North Africans, these genotypes were analyzed in 566 post-menopausal Tunisian women with mean age of 59.5 ± 7 .7 years, of which 59.1% have low bone mass (T-score<-1 at spine or hip). RESULTS: In post-menopausal Tunisian women, 1330Val was weakly associated with reduced BMD T-score at lumbar spine (p=0.047) but not femur neck. Moreover, the TT/TC genotypes tended to be more frequent in women with osteopenia and osteoporosis than in women with normal BMD (p=0.066). Adjusting for body size and other potential confounders, LRP5 genotypes were no longer significantly associated with aBMD at any site. CONCLUSIONS: The less common Val667Met polymorphism showed no association with osteoporosis. The Ala1330Val polymorphism is weakly associated with lower lumbar spine bone density and osteopenia/osteoporosis in postmenopausal Tunisian women. These observations expand our knowledge about the contribution of LRP5 genetic variation to osteoporosis risk in populations of diverse ethnic origin.

15 Article [The decrease in bone density in chronic inflammatory bowel disease: prevalence and risk factors]. 2013

Trabelsi, Aida Ben Slama / Abdellaoui, Faouzi / Ksiaa, Mehdi / Souguir, Ahlem / Zeglaoui, Hela / Ben Rejeb, Mohamed / Brahem, Ahlem / Ajmi, Salem / Jmaa, Ali. ·Service de Gastro-entérologie et Hépatologie Sahloul Sousse, Tunisia. ·Pan Afr Med J · Pubmed #24198872.

ABSTRACT: -- No abstract --

16 Article [Prevalence of bone loss in adult celiac disease and associated factors: a control case study]. 2012

Younes, Mohamed / Ben Youssef, Hedi / Safer, Leila / Fadoua, Hassine / Zrour, Saoussen / Bejia, Ismail / Touzi, Mongi / Najjar, Mohamed Fadhel / Saffar, Hammouda / Bergaoui, Naceur. ·EPS de Monastir, Monastir, Tunisie. ·Tunis Med · Pubmed #22407624.

ABSTRACT: BACKGROUND: Bone loss in celiac disease (CD) is important and is associated to increased risk of fractures. The determining factors of this Bone loss and the osteoporosis fracture during this disease remain still unknown. The bone remodeling parameters seem to play it an important role. AIM: Through a transverse study including 30 patients with adult CD and 30 witnesses, we estimated bone mineral density (BMD) profile of these patients and determined associated factors to the bone loss. METHODS: Patients and witnesses benefited from an BMD measure, serum calcium and phosphore, alkaline phosphatasis, parathormone and hydroxyvitamin D dosage, bone remodeling parameters containing the osteocalcin, Propeptide N-terminal of the type I procollagen, BTélopeptide C-terminal ( B-CTX) of the type I procollagen I (bloody and urine CrossLaps). The patients benefited from a malabsorption bilan, a radiological examination of spine and an evaluation of the adhesion to the regime without gluten with a histological control. RESULTS: Our population consists of 3 men (10 %) and 27 women (90 %) with an average age of 30.4 years (19-50 years). The average delay of the diagnosis of the MC is of 46.7 months. The alkaline phosphatases, the P1NP and the bloody crossLaps were more raised at the patient's with regard to the witnesses with respectively p=0.038, p=0.041 and p=0.021. The parathormone was also more raised at the patients but without significant difference 67.8 vs 53.8 ng / l. The DMO is low at 21 patients (70 %) versus 2 witnesses only (6.6 %), with an osteoporosis in 3 patients (10 %) and an osteopenia in 18 patients (60 %). Factors associated to the BMD decline are low body mass index, nulliparity, diagnostic delay > to 2 years, the malabsorption syndrome, exaggerated intraepithelial lymphocytosis at the time of the histological control, an increase of bone remodeling parameters notably the alkaline phosphatasis, osteocalcin and bloody CrossLaps. While the BMD is more raised at the patient's having followed gluten regimens during more than 5 years. The age, the sex, the symptomatic character or not of the disease, the parathormone, hydroyviamin D and fractures are not correlated to the BMD profile patients. CONCLUSION: The bone loss is more frequent during the adult CD than in the general population. His research has to become integrated into the coverage of this disease notably in the presence of risk factors. The absence of correlation between BMD loss and fractures underlines the importance of others factors in determining of bone fragility during this affection.

17 Article [Effect of inhaled corticosteroids on bone mineral density in asthmatic adults: a 20 cases study]. 2011

Ben Hamida, Kaouther Saadallaoui / Fajraoui Krichene, Nadia / Ben Ghars Amara, Khedija / Haouachi, Rim / Sahli, Hela / Sellami, Slaheddine / Charfi, Mohamed Ridha / Zouari, Bechir. ·Hopital La Rabta, Tunis, Tunisie. ·Tunis Med · Pubmed #21557179.

ABSTRACT: BACKGROUND: Inhaled corticosteroids are widely used in the treatment of asthma but their safety on bone density is controversial. AIM: To study in a population of adults with asthma receiving inhaled corticosteroids for long term, the effect of this therapy on bone mineral density. METHODS: Prospective study including 20 asthmatics, aged from 20 to 45 years, treated with inhaled corticosteroids for 12 months or more, with no risk factors for osteoporosis. We compared osteodensitometric parameters in our patients, bone mass and T-score at vertebral and femoral witness to a population matched by age and sex. RESULTS: The average age of our patients was 35.45 ± 5.43 years and the average BMI was 30.03 ± 5.77 kg/m2. The average daily dose of corticosteroid was 925 ± 133.27g of equivalent of beclometasone with an average take of 33.5 ± 21.3 months. The vertebral site bone mass average was 1216 ± 0106 g/cm2 in the studied group and 1201 ± 0099 g/cm2 in the control group without significant difference (p = 0380). At femur, the bone mass average was 1037 ± 0143 g/cm2 in the patient group and 1056 ± 0107 g/cm2 in the control group (p = 0380). We did not find a significant link between bone mineral density and cumulative dose or the duration of taking inhaled corticosteroids, BMI and tobacco. CONCLUSION: Our work confirms like other previous studies the safety of inhaled corticosteroids on bone mineral density.

18 Article C-telopeptides of type I collagen in postmenopausal women: an experience in a Tunisian clinical laboratory. 2010

Bouzid, Kahena / Bahlous, Afef / Kalaï, Eya / Fellah, Hayet / Sahli, Hela / Sellami, Slaheddine / Abdelmoula, Jaouida. ·Laboratory of Clinical Biochemistry, Charles Nicolle Hospital - Tunis. ·Tunis Med · Pubmed #20582880.

ABSTRACT: AIM: The purpose of study was to evaluate the interest of C-telopeptides of type I collagen (CTX) in the diagnosis of osteoporosis in postmenopausal women and to define its cut-off value. METHODS: A transverse descriptive study enrolled postmenopausal women: 139 osteoporotic (G1) and 39 non osteoporotic (G2). The 2 groups were defined by bone density measurement. The following markers were measured: serum alkaline phosphatase (ALP), bone alkaline phosphatase (bone ALP), serum C-terminal telopeptide of type I collagen (CTX). Statistical analyses were performed using SPSS 10.5. The corresponding estimation of sensitivity and specificity of CTX have been presented as 'receiver Operating Curve' (ROC). RESULTS: There was no difference in the measurement of ALP and bone ALP in the 2 groups but CTX was statistically higher in G1 compared to G2 (p <0.001). The percentage of osteoporotic women (G1) with CTX values > 0.500 ng/ml was higher than that of non osteoporotic women (G2). We have established a ROC curve to find the cut-off value of CTX that enables the distinction between osteoporotic women with high level of bone remodelling, and non osteoporotic women. The cut-off value of CTX 0.55 pg/ml was the best; it associated best sensitivity and specificity. CONCLUSION: The total increase and significance for CTX was greater in the group of osteoporotic women and appeared therefore to be a good bone turnover marker in the diagnosis of osteoporosis in comparison with ALP and bone ALP. The cut-off value of CTX 0.55 pg/ml may improve the sensitivity and specificity of prediction of future fractures.

19 Article Effects of risedronate on bone turnover markers in osteoporotic postmenopausal women: comparison of two protocols of treatment. 2009

Bahlous, Afef / Bouzid, Kahena / Sahli, Héla / Sallami, Slaheddine / Abdelmoula, Jaouidia. ·Department of Clinical Biochemistry, Charles Nicolle Hospital, Tunis. ·Tunis Med · Pubmed #20180356.

ABSTRACT: BACKGROUND: Bisphosphonates are powerful agents able to prevent bone loss. AIM: The objective of the study was to evaluate the efficacy and tolerability of risedronate once a week (35 mg) compared with risedronate 5 mg once daily in women with osteoporosis. METHODS: A randomized, double-blind, active-controlled study enrolled 102 postmenopausal women aged 66.5+/-7.5 years with osteoporotic fractures. All women received risedronate during 6 months. Group 1 (G1, n=51) received risedronate 5 mg once daily and group 2 (G2, n=51) received 35 mg once a week. Serum alkaline phosphatase (ALP), bone alkaline phosphatase (bone ALP), serum C-terminal telopeptide of type I collagen (CTX) were measured at baseline, 3 months and 6 months after treatment in the two groups. RESULTS: We noted no significant difference in markers between women of the 2 groups. After 3 months, bone ALP and CTX decreased (respectively -22.1% and -47.6%) in the 2 groups with no significant difference between them. After 6 months study, bone ALP and CTX decreased respectively by -46.5% and -62.9% with no statistically significant difference between study groups for bone markers. CONCLUSION: Our study found that treatment with once weekly risedronate 35 mg is able to decrease CTX and bone ALP compared with risedronate 5 mg once daily, in postmenopausal women with osteoporotic fractures. We didn't find adverse events with the 35 mg once-a-week dose group compared to the once-daily dose group. Based on these results, the effects of risedronate 35 mg once a week are similar in efficacy to daily dosing and may lead less adverse events than once-a-month dose. This therapeutic protocol may provide an alternative for patients who prefer once-a-week oral dosing.

20 Article Effects of risedronate on bone turnover markers in osteoporotic postmenopausal women: comparison of two protocols of treatment. 2009

Bahlous, Afef / Bouzid, Kahena / Sahli, Héla / Sallami, Slaheddine / Abdelmoula, Jaouda. ·Department of Clinical Biochemistry, Charles Nicolle Hospital, Tunis. ·Tunis Med · Pubmed #19927782.

ABSTRACT: AIM: Bisphosphonates are powerful agents able to prevent bone loss. The objective of the study was to evaluate the efficacy and tolerability of risedronate once a week (35 mg) compared with risedronate 5 mg once daily in women with osteoporosis. METHODS: A randomized, double-blind, active-controlled study enrolled 102 postmenopausal women aged 66.5 + 7.5 years with osteoporotic fractures. All women received risedronate during 6 months. Group 1 (G1, n=51) received risedronate 5 mg once daily and group 2 (G2, n=51) received 35 mg once a week. Serum alkaline phosphatase (ALP), bone alkaline phosphatase (bone ALP), serum C-terminal telopeptide of type I collagen (CTX) were measured at baseline, 3 months and 6 months after treatment in the two groups. RESULTS: We noted no significant difference in markers between women of the 2 groups. After 3 months, bone ALP and CTX decreased (respectively -22.1% and -47.6%) in the 2 groups with no significant difference between them. After 6 months study, bone ALP and CTX decreased respectively by -46.5% and -62.9% with no statistically significant difference between study groups for bone markers. CONCLUSION: Our study found that treatment with once weekly risedronate 35 mg is able to decrease CTX and bone ALP compared with risedronate 5 mg once daily, in postmenopausal women with osteoporotic fractures. We didn't find adverse events with the 35 mg once-a-week dose group compared to the once-daily dose group. Based on these results, the effects of risedronate 35 mg once a week are similar in efficacy to daily dosing and may lead less adverse events than once-a-month dose. This therapeutic protocol may provide an alternative for patients who prefer once-a-week oral dosing.

21 Article Hypovitaminosis D in Tunisian osteoporotic postmenopausal women and the relationship with bone fractures. 2009

Bahlous, Afef / Farjallah, Nessrine / Bouzid, Kahena / Klouz, Anis / Mohsni, Amira / Sahli, Hela / Lakhal, Mohamed / Sallami, Slaheddine / Abdelmoula, Jaouida. ·Department of Biochemistry, Charles Nicolle Hospital, Tunis. ·Tunis Med · Pubmed #19537011.

ABSTRACT: AIM: The purpose of this study is to evaluate the frequency of hypovitaminosis D in Tunisian osteoporotic women and to search an eventual association between vitamin D status and the fracture risk. METHODS: A transverse descriptive study enrolled 134 osteoporotic menopausal women aged 50 years or more. We measured calcium, phosphorus, albumin, alkaline phosphatase, creatinine and 25 hydroxyvitamin D [25 (OH) vit D]. Bone mineral density (BMD) was measured for all and osteoporotic women were defined for a T-score of -2,5 or less in the spine, hip or femoral neck. Two groups were defined: G1 with fracture and G2 without fracture. We used SPSS 10.5, chi-2 tests and a statistical significance level of p<0,05. RESULTS: Women in G1 (n= 102) were more aged than those in G2 (n= 32) and their menopause was more ancient. Hypovitaminosis D was found in 45,2% of all women, respectively in 50,98% of G1 and 25% of G2. The mean level of vitamin D was more important in G2 (27,5 + 15,1 vs 21,3 + 12,8 ng/ml; p=0,002). BMD in femoral and lumbar were statistically lower when fractures are present (p<0,001). CONCLUSION: Our study shows that women with hypovitaminosis D (vit D < 20 ng/ml) are prone to osteoporotic fractures. All fracture in community in menopausal women, should be assessed with BMD and screening for 25 (OH) vit D. Increasing life expectancy in our country suggests that this public health problem will grow in the years to come, pointing out the importance of better management of osteoporosis and hypovitaminosis D to prevent fractures.

22 Article [Spinal cord compression due to benign osteoporotic vertebral fracture]. 2009

Kochbati, Samir / Daoud, Lilia / Zouaoui, W / Ktari, Sonia / Boussema, Fatma / Daghfous, Mohamed H / Rokbani, Lilia. ·Service de médecine interne, Hôpital Habib Thameur, Tunis, Tunisie. ·Tunis Med · Pubmed #19522451.

ABSTRACT: BACKGROUND: A neurologic compromise associated with vertebral fractures is generally due to a malignancy causes. Therefore, an osteoporotic vertebral fracture can sometimes cause neurologic complications. AIM: Report a case of neurologic compromise associated with osteoporotic vertebral fractures. OBSERVATION: A-62-year-old man suffered from rheumatoid arthritis since 1985, presented a cervical pain associated with quadriparesia secondary to a C5 osteoporotic vertebral fractures. CONCLUSION: Osteonecrosis may be the cause of neurologic compromise associated with osteoporotic vertebral fractures.

23 Article Bone mineral density in healthy Tunisian women. 2009

Sahli, Hela / Testouri, Nedia / Chihaoui, Manel Ben / Salah, Afef Hadj / Cheour, Elhem / Meddeb, Nihel / Zouari, Bechir / Sellami, Slaheddine. ·Department of Rheumatology, La Rabta Hospital 1006 Bab Saadoun, Tunis, Tunisia. sahlisrairihela@yahoo.fr ·Maturitas · Pubmed #19398172.

ABSTRACT: Interpretation of densitometric results requires a comparison with reference bone mineral density (BMD) values of normal age and sex-matched persons. Thus the aim of this study was to determine these values for healthy Tunisian women, to estimate the prevalence of osteoporosis and to compare our findings with other populations. A cross-sectional study of 1378 Tunisian women aged between 20 and 96 years was carried out using DXA (GE-Lunar Prodigy). Subjects with suspected conditions affecting bone metabolism were excluded. Measurements were taken at the lumbar spine and femoral neck. These values were expressed at T-scores, with reference to the mean BMD values of the group aged 20-40 years. The peak bone mass, estimated in this age group was 1.174+0.127 g/cm(2) at the lumbar spine and 1.016+/-0.118 g/cm(2) at the femoral site. It was attained respectively within the age of 25 years and 36 years. For both sites, the expected decline in BMD was shown when the successive age groups [40-49 years] and [50-59 years] were compared. Bone loss was rapid during the first 5 years after menopause. Thereafter BMD declined slowly but continually. The prevalence of osteoporosis in the women over 50 years of age, taking account of peak bone mass observed in our cohort, was 23.3% at the spine and 17.3% at the femoral neck with a combined prevalence of 23.4%. These rates attained respectively 30.4%, 11.8% and 32.9% when we considered the Italian values, which demonstrate the variability of osteodensitometric depending to the reference population adopted.

24 Article [The interest of biochemical markers of bone turnover for monitoring treatment of postmenopausal osteoporosis]. 2008

Kalaï, Eya / Bahlous, Afef / Makdouli, Abdelaziz / Sahli, Hella / Klouz, Anis / Lakhal, Mohamed / Sellami, Slaheddine / Abdelmoula, Jouda. ·Service de biochimie clinique, Hôpital Charles Nicolle, Tunis, Tunisie. ·Tunis Med · Pubmed #18444527.

ABSTRACT: BACKGROUND: Postmenopausal osteoporosis is especially female pathology, whose incidence increases with age. AIM: The purposes of this study are to evaluate the level of bone turnover by the determination of markers of bone formation (PAL, BAP) and marker of bone resorption (CTX) in the osteoporotic women, to study the correlations between bone biochemical markers, clinical parameters and radiological measurements and to assess the interest of biochemical markers therapeutic monitoring after 6 months of antiresorptive treatment. METHODS: The authors report a prospective study of 134 osteoporotic women classified in two groups according to the presence of osteoporotic fracture. Patients of the first group G1 (n=102) with fractures, were treated by the bisphosphonates (risedronate), whereas the ones of the second group G2 (n=32) without fractures, were submited to calcic supplementation and vitamin D. RESULTS: The analyses showed that the femoral and lumbar BMD were statistically lower in the presence of osteoporotic fractures. However, the values of CTX were statistically higher in the patients of G1 group compared to those of the G2 group (0,708 +/- 0,332 ng/ml versus 0,514 +/- 0,225 ng/ml). The CTX were statistically correlated with the femoral and lumbar BMD (r = -0,21, p<0,05 and r= -0,348, p<0,001). The hypovitminosis were observed in 50,98% (52/102) of women with ostéoporotic fractures, whereas it was only 25% (8/32) in women without fractures. After 6 months of treatment by the bisphosphonates, the PAL, the BAP and the CTX have decreased with an average of, respectively, 19%, 46,5% and 62,9%. These variations were significantly more important in G1 group. CONCLUSION: The biochemical markers of bone turnover, in particular those of the resorption (CTX), can predict the postmenopausal woman's bone loss evaluated by BMD, the risk of fractures and the efficiency of the bone treatments.