Mohamed A. Galal ; Mushira A. Dahaba, ; Basma M. Zaki
and Hanaa M. Elshenawy. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMALES HAVING CHRONIC PERIODONTITIS. Cairo Dental Journal (30)Number (1), 1:10January, 2014.
Bone health of postpartum women: Unexpected high prevalence of a health probl...Premier Publishers
- The study examined the effect of pregnancy on bone mineral density (BMD) and bone turnover markers in 80 postpartum women in Saudi Arabia.
- Biochemical tests found that 64 women (80%) had low BMD, with 16 (25%) having osteoporosis. Vitamin D levels were deficient in 35.37% of women.
- BMI was the only predictor of BMD based on multiple regression analysis. No significant differences were found in bone markers between immediate postpartum and 12-month follow up for 27 women.
- The study concluded osteoporosis/osteopenia is a significant health problem in this group of postpartum women and further studies are needed.
This document discusses sarcopenia and muscle loss in older adults. It provides definitions of sarcopenia from various international organizations and diagnostic criteria. It also reviews research on the role of nutrition, including protein and vitamin D supplementation, resistance training, and multimodal exercise programs in preventing and treating sarcopenia. References are provided for 38 studies and reviews on topics related to sarcopenia in older adults.
This study evaluated the effectiveness of Osteobios and Guna-Fem supplements for treating early postmenopausal osteoporosis compared to calcium and vitamin D supplements. 70 postmenopausal women with osteoporosis were divided into two groups. The group treated with Osteobios and Guna-Fem showed greater reductions in pain levels, improvements in quality of life, and decreases in bone resorption markers compared to the calcium/vitamin D group. The results suggest Osteobios and Guna-Fem may be effective alternative or additional therapies for treating osteoporosis and improving patients' quality of life.
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...Apollo Hospitals
Osteoarthritis (OA) has become a major public health problem not only because of increasing prevalence worldwide (about 21 million people affected in the United States) but also frequent association with cardiovascular diseases-the leading cause of death in the industrialized countries.
Open-label dosing study to evaluate the safety and effects of a dietary plant-derived polisaccharide supplement on the N-glysocylation status of serum glycoporteins in healthy subjects
In this study of 277 post-menopausal women, the researchers found:
1) Higher bone mineral density was associated with increased severity of disc space narrowing at both the lumbar spine and femoral sites.
2) There was no association found between bone mineral density and severity of osteophytes.
3) Biochemical markers of bone resorption (CTX levels) decreased with increased severity of disc space narrowing, but were not associated with osteophyte severity. This suggests disc space narrowing may have a protective effect against bone loss through decreased bone resorption.
This study examined the association between estrogen receptor alpha (ERα) gene haplotypes and radiographic osteoarthritis (OA) of the knee in 1,483 elderly men and women. Three haplotypes (px, PX, Px) were identified. Carriage of the PX haplotype was associated with an increased prevalence and severity of radiographic knee OA, with odds ratios of 1.3 for heterozygotes and 2.2 for homozygotes. Separate analyses showed the association was driven by osteophytosis. This study provides evidence that polymorphisms in the ERα gene are risk factors for radiographic knee OA in both men and women.
This study examined the relationship between hormone replacement therapy (HRT) use and osteoarthritis (OA) in women. The study analyzed radiographic data from 1003 women and found that current HRT users had a 3-fold lower risk of knee OA compared to never users. Current HRT use was also associated with a non-significant reduced risk of distal interphalangeal OA. No clear protective effect was seen for carpometacarpal OA. Past HRT use showed weaker or no protective effects. The results suggest HRT may have a protective effect against OA when used continuously but not after stopping use. Larger prospective studies are still needed to confirm these findings.
Bone health of postpartum women: Unexpected high prevalence of a health probl...Premier Publishers
- The study examined the effect of pregnancy on bone mineral density (BMD) and bone turnover markers in 80 postpartum women in Saudi Arabia.
- Biochemical tests found that 64 women (80%) had low BMD, with 16 (25%) having osteoporosis. Vitamin D levels were deficient in 35.37% of women.
- BMI was the only predictor of BMD based on multiple regression analysis. No significant differences were found in bone markers between immediate postpartum and 12-month follow up for 27 women.
- The study concluded osteoporosis/osteopenia is a significant health problem in this group of postpartum women and further studies are needed.
This document discusses sarcopenia and muscle loss in older adults. It provides definitions of sarcopenia from various international organizations and diagnostic criteria. It also reviews research on the role of nutrition, including protein and vitamin D supplementation, resistance training, and multimodal exercise programs in preventing and treating sarcopenia. References are provided for 38 studies and reviews on topics related to sarcopenia in older adults.
This study evaluated the effectiveness of Osteobios and Guna-Fem supplements for treating early postmenopausal osteoporosis compared to calcium and vitamin D supplements. 70 postmenopausal women with osteoporosis were divided into two groups. The group treated with Osteobios and Guna-Fem showed greater reductions in pain levels, improvements in quality of life, and decreases in bone resorption markers compared to the calcium/vitamin D group. The results suggest Osteobios and Guna-Fem may be effective alternative or additional therapies for treating osteoporosis and improving patients' quality of life.
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...Apollo Hospitals
Osteoarthritis (OA) has become a major public health problem not only because of increasing prevalence worldwide (about 21 million people affected in the United States) but also frequent association with cardiovascular diseases-the leading cause of death in the industrialized countries.
Open-label dosing study to evaluate the safety and effects of a dietary plant-derived polisaccharide supplement on the N-glysocylation status of serum glycoporteins in healthy subjects
In this study of 277 post-menopausal women, the researchers found:
1) Higher bone mineral density was associated with increased severity of disc space narrowing at both the lumbar spine and femoral sites.
2) There was no association found between bone mineral density and severity of osteophytes.
3) Biochemical markers of bone resorption (CTX levels) decreased with increased severity of disc space narrowing, but were not associated with osteophyte severity. This suggests disc space narrowing may have a protective effect against bone loss through decreased bone resorption.
This study examined the association between estrogen receptor alpha (ERα) gene haplotypes and radiographic osteoarthritis (OA) of the knee in 1,483 elderly men and women. Three haplotypes (px, PX, Px) were identified. Carriage of the PX haplotype was associated with an increased prevalence and severity of radiographic knee OA, with odds ratios of 1.3 for heterozygotes and 2.2 for homozygotes. Separate analyses showed the association was driven by osteophytosis. This study provides evidence that polymorphisms in the ERα gene are risk factors for radiographic knee OA in both men and women.
This study examined the relationship between hormone replacement therapy (HRT) use and osteoarthritis (OA) in women. The study analyzed radiographic data from 1003 women and found that current HRT users had a 3-fold lower risk of knee OA compared to never users. Current HRT use was also associated with a non-significant reduced risk of distal interphalangeal OA. No clear protective effect was seen for carpometacarpal OA. Past HRT use showed weaker or no protective effects. The results suggest HRT may have a protective effect against OA when used continuously but not after stopping use. Larger prospective studies are still needed to confirm these findings.
This study investigated factors associated with the onset of generalized osteoarthritis (OA) in older women through qualitative interviews. It found that hereditary factors were present in most participants. Participants also believed that depression, stress, diet, and low health status during vulnerable periods like World War II contributed to their OA. The findings generate hypotheses for future quantitative studies to test.
A study of serum Cadmium and lead in Iraqi postmenopausal women with osteopor...IOSR Journals
Postmenopausal status is an independent risk factor for osteoporosis. Several studies have reported that heavy metals, including lead, mercury, cadmium, and arsenic, have harmful effects on bone. The aim of this study was to evaluate the effect of heavy metals, including Cadmium and Lead on osteoporosis in postmenopausal Iraqi women. This prospective study included a total of 70 postmenopausal women divided as 40patients with osteoporosis compared to 30 apparently healthy women as controls during 2011. Serum levels of Cadmium and Lead were measured using atomic absorption while serum Calcium, Phosphorus and Alkaline phosphatase were measured by spectrophotometry.The results showed that there was no significant difference between patients and controls regarding age, Body Mass Index, Calcium, Phosphorous, and Alkaline phosphatase. Serum levels of Cadmium and Lead were higher in patients compared to controls, p < 0.001 and p< 0.01 respectively. It is concluded that increased serum levels of cadmium and lead maybe associated with higher risk of osteoporosis in postmenopausal women.
Endocrine issues swirl around the Bariatric patient: Diabetes, thyroid conditions, and more. What do clinicians need to be aware of when caring for these patients pre or post surgery? What are the unique endocrinologic issues which explain the mechanism of success with bariatric surgery? Learn here.
—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures. Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.
Sanni Ali's presentation from Osteoporosis 2016: Antidiabetic medication use and the risk of fracture amongst type 2 diabetic patients: a nested case-control study
Find out more at: https://nos.org.uk/conference
The document discusses diabetes mellitus and fracture risk. It notes that type 2 diabetes affects over 700,000 people in the Netherlands and is associated with higher bone mineral density but also more rapid bone loss over time. While type 2 diabetes is initially linked to higher bone density due to factors like higher body weight, studies have shown those with type 2 diabetes have a 1.7 times higher risk of hip fractures and 1.2 times higher risk of any fracture after adjusting for characteristics like age, body mass index and bone mineral density. The increased fracture risk in type 2 diabetes may be due to factors beyond bone mineral density, such as changes in bone microarchitecture, turnover and material properties from excess glucose.
Vicki Harber
LA GIOVANE ATLETA
Il ciclo mestruale, punto di riferimento per un sviluppo sano della giovane atleta
Nel processo di sviluppo delle giovani atlete è necessario che siano integrati il monitoraggio continuo del menarca e il controllo del loro stato mestruale. Promuovere lo sviluppo di una giovane atleta e supervisionarne l’allenamento è impegnativo e complesso. Se dispongono di una conoscenza maggiore della funzione mestruale le giovani atlete e le loro famiglie hanno strumenti migliori per rispondere alle esigenze dell’allenamento e delle gare. Lo stato mestruale rappresenta un indicatore globale della salute e del benessere che fornisce informazioni che riguardano l’energia, il rischio di lesioni scheletriche e muscolari, l’apporto alimentare, il profilo metabolico e ormonale, il recupero e altri elementi, importanti per la prestazione. Inoltre, con l’uso crescente dei contraccettivi orali da parte delle giovani atlete che non hanno raggiunto la loro maturità scheletrica, allenatori, allenatrici e genitori debbono essere informati dei risultati recenti che riguardano la salute delle ossa.
The document provides guidelines for non-clinical evaluation of osteoporosis drugs. It recommends conducting long-term bone quality studies in two animal species to evaluate effects on bone turnover, mass, density, structure, and strength. Studies should be designed to support clinical development and be submitted for FDA review. Bone quality cannot be directly assessed, but nonclinical studies provide indirect measures of strength determined by both bone mass and quality.
Alpharadin<sup>®</sup> (Xofigo<sup>®</sup>) in the treatment of skeletal meta...Michael
Xofigo is a new radiopharmaceutical for treating metastatic bone cancer from prostate cancer. It delivers targeted alpha radiation directly to bone metastases through a mechanism similar to calcium uptake in bone. Clinical trials found Xofigo improved overall survival, decreased markers of disease progression, and reduced pain compared to placebo with fewer side effects than chemotherapy. Xofigo's short-range alpha emissions allow it to specifically target tumor cells in bone while sparing surrounding healthy tissue.
This document discusses four cases of unusual osteoporosis: 1) A 73-year-old man with vertebral fractures caused by hyperthyroidism due to amiodarone use. 2) A 51-year-old cyclist with recurrent fractures possibly due to low bone mineral density from cycling. 3) A 68-year-old man with low testosterone and back pain diagnosed with hypogonadism-induced osteoporosis. 4) A 45-year-old runner with vertebral fractures found to have an adrenal carcinoma causing Cushing's syndrome.
Long-term bisphosphonate use can lead to rare adverse effects like osteonecrosis of the jaw and atypical femoral fractures. Guidelines recommend treatment reviews after 5 years of bisphosphonates to determine if a "drug holiday" is appropriate to reduce risks. New drugs like romosozumab may provide alternative post-bisphosphonate treatment options to further reduce fracture risk compared to another course of antiresorptives or teriparatide. Overall, the document discusses balancing long-term bisphosphonate benefits with risks of rare adverse effects and considering newer anabolic options.
This clinical study compared bone mineral density (BMD) and body proportions in women with complete androgen insensitivity syndrome (CAIS) and gonadal dysgenesis (GD). It found that women with CAIS were taller than women with GD(XX) but shorter than women with GD(XY). Women with GD(XY) had a greater lower to upper body ratio than women with CAIS, suggesting greater estrogen deficiency in puberty. Women with GD(XY) were over 5 times more likely to have low hip BMD compared to women with CAIS, indicating androgen plays an important role in bone mineralization in women with CAIS.
1. The study examined the relationship between total haemoglobin mass, performance-related genotypes, and VO2max in 4 untrained subjects.
2. Results showed no clear relationship between total haemoglobin mass and VO2max. The subject with the highest endurance genotype score had the lowest VO2max.
3. The subject with the highest sprint genotype score had the lowest endurance genotype score, despite having the highest VO2max, suggesting genotypes may predict sport-specific performance.
1) The document discusses monitoring treatment for osteoporosis using DXA scans, bone turnover markers, and definitions of treatment success.
2) DXA scans directly measure bone mineral density and should be compared using the same region of interest and positioning to accurately assess changes over time. Bone turnover markers provide a dynamic measure of bone status and can change more quickly than BMD in response to treatment.
3) Factors like adherence, underlying conditions, and drug holidays can impact monitoring and determine if lack of changes indicate treatment failure or other issues. Defining treatment success requires considering multiple factors beyond just fractures.
This document summarizes research on physical activity programs for promoting weight loss in obese adults with intellectual and developmental disabilities. It reviewed 8 studies that tested interventions combining nutrition education and exercise programs. The interventions showed some success in short-term weight loss but long-term effectiveness was unclear since most studies lacked follow-up data. Only 1 study directly tested for weight loss effects and found diminishing returns over 6 years. Overall, more research is still needed to identify interventions that can sustainably promote weight loss in this population.
Review paper osteoarthritis and its possible treatmentsvalrivera
1. Osteoarthritis is the most common type of arthritis and affects millions of people and dogs each year. There are some potential treatments but no single definitive treatment.
2. Studies have found that glucosamine/chondroitin sulfate supplements provided benefits for dogs with osteoarthritis, including improved mobility and reduced pain. Long term use of supplements showed better results than traditional NSAID treatments.
3. Research is also exploring inhibitors of enzymes like MMPs that degrade cartilage. Early studies found that COL-3 inhibitor helped reduce breakdown of ligaments in arthritic dog knees.
Celecoxib alleviates tamoxifen-instigated angiogenic effects by ROS-dependent...Enrique Moreno Gonzalez
Tamoxifen (TAM) is widely used in the chemotherapy of breast cancer and as a preventive agent against recurrence after surgery. However, extended TAM administration for breast cancer induces increased VEGF levels in patients, promoting new blood vessel formation and thereby limiting its efficacy. Celecoxib (CXB), a selective COX-2 inhibitor, suppresses VEGF gene expression by targeting the VEGF promoter responsible for its inhibitory effect. For this study, we had selected CXB as non-steroidal anti-inflammatory drug in combination with TAM for suppressing VEGF expression and simultaneously reducing doses of both the drugs.
Mechanisms of Glucose Homeostasis FinalDan Svedberg
1) Bariatric surgery, including Roux-en-Y gastric bypass, adjustable gastric banding, and vertical sleeve gastrectomy, robustly improves glucose homeostasis in patients with type 2 diabetes through multiple mechanisms.
2) Increased secretion of hormones GLP-1 and PYY following bariatric surgery are thought to mediate improvements in glucose homeostasis by promoting insulin secretion, reducing insulin resistance, and decreasing food intake.
3) While many hormones are involved, studies using GLP-1 receptor antagonists show that GLP-1 signaling plays an important role in the metabolic effects of bariatric surgery, though it is not strictly necessary. The mechanisms by which bariatric surgery increases GLP-1 secretion
Assesment of metabolic syndrome among teaching and nonqasim Muhammad
This document provides an introduction and outline for a study assessing metabolic syndrome among teaching and non-teaching staff at the University of Sargodha. The introduction defines metabolic syndrome and its components, risk factors, diagnosis criteria, relationship to cardiovascular disease and diabetes, and global prevalence rates. It also discusses foods that may cause or reduce metabolic syndrome. The objectives are to assess metabolic syndrome and correlate volunteers' nutrition with metabolic syndrome. The research methodology section outlines ethical approval, study site/population, cross-sectional design, standard operating procedures for assessments, selection of volunteers, dietary intake assessment using a food frequency questionnaire, and statistical analysis.
Avui ens ha vingut a veure la Cleta, una nena que viu al bosc. La Cleta ens ha explicat que viu al bosc amb la seva família i ens ha ensenyat com s'ho passen bé jugant amb els animals del bosc. Ens ha convidat a anar algun dia a jugar amb ells.
This study investigated factors associated with the onset of generalized osteoarthritis (OA) in older women through qualitative interviews. It found that hereditary factors were present in most participants. Participants also believed that depression, stress, diet, and low health status during vulnerable periods like World War II contributed to their OA. The findings generate hypotheses for future quantitative studies to test.
A study of serum Cadmium and lead in Iraqi postmenopausal women with osteopor...IOSR Journals
Postmenopausal status is an independent risk factor for osteoporosis. Several studies have reported that heavy metals, including lead, mercury, cadmium, and arsenic, have harmful effects on bone. The aim of this study was to evaluate the effect of heavy metals, including Cadmium and Lead on osteoporosis in postmenopausal Iraqi women. This prospective study included a total of 70 postmenopausal women divided as 40patients with osteoporosis compared to 30 apparently healthy women as controls during 2011. Serum levels of Cadmium and Lead were measured using atomic absorption while serum Calcium, Phosphorus and Alkaline phosphatase were measured by spectrophotometry.The results showed that there was no significant difference between patients and controls regarding age, Body Mass Index, Calcium, Phosphorous, and Alkaline phosphatase. Serum levels of Cadmium and Lead were higher in patients compared to controls, p < 0.001 and p< 0.01 respectively. It is concluded that increased serum levels of cadmium and lead maybe associated with higher risk of osteoporosis in postmenopausal women.
Endocrine issues swirl around the Bariatric patient: Diabetes, thyroid conditions, and more. What do clinicians need to be aware of when caring for these patients pre or post surgery? What are the unique endocrinologic issues which explain the mechanism of success with bariatric surgery? Learn here.
—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures. Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.
Sanni Ali's presentation from Osteoporosis 2016: Antidiabetic medication use and the risk of fracture amongst type 2 diabetic patients: a nested case-control study
Find out more at: https://nos.org.uk/conference
The document discusses diabetes mellitus and fracture risk. It notes that type 2 diabetes affects over 700,000 people in the Netherlands and is associated with higher bone mineral density but also more rapid bone loss over time. While type 2 diabetes is initially linked to higher bone density due to factors like higher body weight, studies have shown those with type 2 diabetes have a 1.7 times higher risk of hip fractures and 1.2 times higher risk of any fracture after adjusting for characteristics like age, body mass index and bone mineral density. The increased fracture risk in type 2 diabetes may be due to factors beyond bone mineral density, such as changes in bone microarchitecture, turnover and material properties from excess glucose.
Vicki Harber
LA GIOVANE ATLETA
Il ciclo mestruale, punto di riferimento per un sviluppo sano della giovane atleta
Nel processo di sviluppo delle giovani atlete è necessario che siano integrati il monitoraggio continuo del menarca e il controllo del loro stato mestruale. Promuovere lo sviluppo di una giovane atleta e supervisionarne l’allenamento è impegnativo e complesso. Se dispongono di una conoscenza maggiore della funzione mestruale le giovani atlete e le loro famiglie hanno strumenti migliori per rispondere alle esigenze dell’allenamento e delle gare. Lo stato mestruale rappresenta un indicatore globale della salute e del benessere che fornisce informazioni che riguardano l’energia, il rischio di lesioni scheletriche e muscolari, l’apporto alimentare, il profilo metabolico e ormonale, il recupero e altri elementi, importanti per la prestazione. Inoltre, con l’uso crescente dei contraccettivi orali da parte delle giovani atlete che non hanno raggiunto la loro maturità scheletrica, allenatori, allenatrici e genitori debbono essere informati dei risultati recenti che riguardano la salute delle ossa.
The document provides guidelines for non-clinical evaluation of osteoporosis drugs. It recommends conducting long-term bone quality studies in two animal species to evaluate effects on bone turnover, mass, density, structure, and strength. Studies should be designed to support clinical development and be submitted for FDA review. Bone quality cannot be directly assessed, but nonclinical studies provide indirect measures of strength determined by both bone mass and quality.
Alpharadin<sup>®</sup> (Xofigo<sup>®</sup>) in the treatment of skeletal meta...Michael
Xofigo is a new radiopharmaceutical for treating metastatic bone cancer from prostate cancer. It delivers targeted alpha radiation directly to bone metastases through a mechanism similar to calcium uptake in bone. Clinical trials found Xofigo improved overall survival, decreased markers of disease progression, and reduced pain compared to placebo with fewer side effects than chemotherapy. Xofigo's short-range alpha emissions allow it to specifically target tumor cells in bone while sparing surrounding healthy tissue.
This document discusses four cases of unusual osteoporosis: 1) A 73-year-old man with vertebral fractures caused by hyperthyroidism due to amiodarone use. 2) A 51-year-old cyclist with recurrent fractures possibly due to low bone mineral density from cycling. 3) A 68-year-old man with low testosterone and back pain diagnosed with hypogonadism-induced osteoporosis. 4) A 45-year-old runner with vertebral fractures found to have an adrenal carcinoma causing Cushing's syndrome.
Long-term bisphosphonate use can lead to rare adverse effects like osteonecrosis of the jaw and atypical femoral fractures. Guidelines recommend treatment reviews after 5 years of bisphosphonates to determine if a "drug holiday" is appropriate to reduce risks. New drugs like romosozumab may provide alternative post-bisphosphonate treatment options to further reduce fracture risk compared to another course of antiresorptives or teriparatide. Overall, the document discusses balancing long-term bisphosphonate benefits with risks of rare adverse effects and considering newer anabolic options.
This clinical study compared bone mineral density (BMD) and body proportions in women with complete androgen insensitivity syndrome (CAIS) and gonadal dysgenesis (GD). It found that women with CAIS were taller than women with GD(XX) but shorter than women with GD(XY). Women with GD(XY) had a greater lower to upper body ratio than women with CAIS, suggesting greater estrogen deficiency in puberty. Women with GD(XY) were over 5 times more likely to have low hip BMD compared to women with CAIS, indicating androgen plays an important role in bone mineralization in women with CAIS.
1. The study examined the relationship between total haemoglobin mass, performance-related genotypes, and VO2max in 4 untrained subjects.
2. Results showed no clear relationship between total haemoglobin mass and VO2max. The subject with the highest endurance genotype score had the lowest VO2max.
3. The subject with the highest sprint genotype score had the lowest endurance genotype score, despite having the highest VO2max, suggesting genotypes may predict sport-specific performance.
1) The document discusses monitoring treatment for osteoporosis using DXA scans, bone turnover markers, and definitions of treatment success.
2) DXA scans directly measure bone mineral density and should be compared using the same region of interest and positioning to accurately assess changes over time. Bone turnover markers provide a dynamic measure of bone status and can change more quickly than BMD in response to treatment.
3) Factors like adherence, underlying conditions, and drug holidays can impact monitoring and determine if lack of changes indicate treatment failure or other issues. Defining treatment success requires considering multiple factors beyond just fractures.
This document summarizes research on physical activity programs for promoting weight loss in obese adults with intellectual and developmental disabilities. It reviewed 8 studies that tested interventions combining nutrition education and exercise programs. The interventions showed some success in short-term weight loss but long-term effectiveness was unclear since most studies lacked follow-up data. Only 1 study directly tested for weight loss effects and found diminishing returns over 6 years. Overall, more research is still needed to identify interventions that can sustainably promote weight loss in this population.
Review paper osteoarthritis and its possible treatmentsvalrivera
1. Osteoarthritis is the most common type of arthritis and affects millions of people and dogs each year. There are some potential treatments but no single definitive treatment.
2. Studies have found that glucosamine/chondroitin sulfate supplements provided benefits for dogs with osteoarthritis, including improved mobility and reduced pain. Long term use of supplements showed better results than traditional NSAID treatments.
3. Research is also exploring inhibitors of enzymes like MMPs that degrade cartilage. Early studies found that COL-3 inhibitor helped reduce breakdown of ligaments in arthritic dog knees.
Celecoxib alleviates tamoxifen-instigated angiogenic effects by ROS-dependent...Enrique Moreno Gonzalez
Tamoxifen (TAM) is widely used in the chemotherapy of breast cancer and as a preventive agent against recurrence after surgery. However, extended TAM administration for breast cancer induces increased VEGF levels in patients, promoting new blood vessel formation and thereby limiting its efficacy. Celecoxib (CXB), a selective COX-2 inhibitor, suppresses VEGF gene expression by targeting the VEGF promoter responsible for its inhibitory effect. For this study, we had selected CXB as non-steroidal anti-inflammatory drug in combination with TAM for suppressing VEGF expression and simultaneously reducing doses of both the drugs.
Mechanisms of Glucose Homeostasis FinalDan Svedberg
1) Bariatric surgery, including Roux-en-Y gastric bypass, adjustable gastric banding, and vertical sleeve gastrectomy, robustly improves glucose homeostasis in patients with type 2 diabetes through multiple mechanisms.
2) Increased secretion of hormones GLP-1 and PYY following bariatric surgery are thought to mediate improvements in glucose homeostasis by promoting insulin secretion, reducing insulin resistance, and decreasing food intake.
3) While many hormones are involved, studies using GLP-1 receptor antagonists show that GLP-1 signaling plays an important role in the metabolic effects of bariatric surgery, though it is not strictly necessary. The mechanisms by which bariatric surgery increases GLP-1 secretion
Assesment of metabolic syndrome among teaching and nonqasim Muhammad
This document provides an introduction and outline for a study assessing metabolic syndrome among teaching and non-teaching staff at the University of Sargodha. The introduction defines metabolic syndrome and its components, risk factors, diagnosis criteria, relationship to cardiovascular disease and diabetes, and global prevalence rates. It also discusses foods that may cause or reduce metabolic syndrome. The objectives are to assess metabolic syndrome and correlate volunteers' nutrition with metabolic syndrome. The research methodology section outlines ethical approval, study site/population, cross-sectional design, standard operating procedures for assessments, selection of volunteers, dietary intake assessment using a food frequency questionnaire, and statistical analysis.
Avui ens ha vingut a veure la Cleta, una nena que viu al bosc. La Cleta ens ha explicat que viu al bosc amb la seva família i ens ha ensenyat com s'ho passen bé jugant amb els animals del bosc. Ens ha convidat a anar algun dia a jugar amb ells.
Dental research process: a trial to understand, and how to connect with the s...Mohamed A. Galal
A trial to understand Dental Research Process, that can help assistant researchers and research assistants in Dental fields to go into their profession more and more.
1- Skills
2- Ideas
3- Relations
4- Mentor
5- Funding
Dental research process: a trial to understand, and how to connect with the s...Mohamed A. Galal
A trial to understand Dental Research Process, that can help assistant researchers and research assistants in Dental fields to go into their profession more and more.
5- Funding & Scholarships classification. (A trial to change our view)
The document describes a study that introduced an expert system to help postgraduate dental students diagnose and treat common oral ulcers. Sixty students evaluated the system, which included information on various ulcer conditions. Results showed that students successfully diagnosed conditions 75% of the time on average. The expert system was determined to be helpful for diagnosing and treating the most common oral ulcers.
This document discusses hemifacial microsomia, a rare congenital disease characterized by underdevelopment of the hard and soft tissues on one side of the face. It describes the various classifications and presentations of the condition from mild asymmetry to more severe cases involving facial nerve paralysis and spine deformities. Diagnosis involves clinical examination, radiography, and CT imaging. Treatment is multidisciplinary and may include orthognathic surgery, distraction osteogenesis, and orthodontics to correct dental malocclusions and asymmetries caused by the condition.
Nuclear medicine in oral & dental medicine & surgery2Mohamed A. Galal
Nuclear medicine involves using small amounts of radioactive materials to diagnose and treat diseases. It provides information about physiology rather than just anatomy. Common nuclear medicine procedures involve injecting radioactive tracers and using a gamma camera to obtain images. While it can detect diseases earlier than other methods and assess organ function, nuclear medicine exposes patients to radiation and may have limited resolution compared to other imaging modalities. Appropriate safety precautions must also be taken with radioactive materials.
This document provides guidelines for conducting a standardized clinical examination for temporomandibular disorders (TMD) based on the Diagnostic Criteria for TMD (DC/TMD). The examination involves assessing pain location, jaw range of motion, joint sounds, and muscle tenderness. Sections provide both concise and fully operationalized procedures for clinical and research use. Calibration of examiners is emphasized to ensure reliability of findings. The examination is intended to identify clinical features for TMD diagnoses; additional testing may be needed for comprehensive assessment of orofacial pain.
SEO Make Micro-Moments and Wordpress Work For User Journey Mapping With Conte...Dawn Anderson MSc DigM
Identifying SEO micro-moments in an era when customer journeys are fragmented by the move to mobile is key. Understand the types of content which rank for different intent. Build the content using Wordpress platform and top plugins without a line of code. Tie it all together with strong SEO signals. Be fast, be safe, be relevant, be there in moments that matter for prospects and win.
Technical SEO Myths Facts And Theories On Crawl Budget And The Importance Of ...Dawn Anderson MSc DigM
There are a lot of myths, facts and theories on crawl budget and the term is bandied around a lot. This deck looks to address some of those myths and also looks at some additional theories around the concepts of 'crawl rank' and 'search engine embarrassment'.
SEO - Stop Eating Your Words - Avoid Cannibalisation Of Your SitesDawn Anderson MSc DigM
Many webmasters and SEOs are stealing from themselves in their potential to rank in Google Search because they end up ranking the wrong pages for search terms. They are competing with themselves in many cases. Google does not always know which page to rank from a site for a query due to many things. One of which is 'too similar' content or 'wrong version' indexation. There are a number of ways to identify this problem and formulate strategies to fix this using on page and your own site power and relevance with clues from within as to which page is most important for given queries.
This document appears to be the minutes from a Key Club meeting. It includes the Key Club pledge, announcements about upcoming fundraising walks and rallies, including Walk Now for Autism Speaks and Fall Rally North. It also mentions electing officers, collecting membership forms and dues, and engaging in spirit cheers. The document provides information to Key Club members about upcoming events and opportunities to get involved in service projects and activities.
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My presentation at TEDx NIT Trichy. We all know Indian education system is broken. What is the alternative? How can we build a scalable, inclusive system that fosters creativity?
This document discusses the importance of vitamin D and other micronutrients for orthopedic patients. It summarizes that vitamin D plays a key role in bone metabolism and calcium homeostasis. Vitamin D deficiency has been linked to impaired fracture healing and increased risk of falls. The document recommends maintaining vitamin D levels of 30-35 ng/mL or higher for optimal bone health in orthopedic patients. Other micronutrients discussed include calcium and the roles of various vitamins and minerals in bone health and orthopedic outcomes.
This study evaluated the effectiveness of Osteobios and Guna-Fem supplements for treating early postmenopausal osteoporosis compared to calcium and vitamin D supplements. 70 postmenopausal women with osteoporosis were divided into two groups. The group treated with Osteobios and Guna-Fem showed greater reductions in pain levels, improvements in quality of life, and decreases in bone resorption markers compared to the calcium/vitamin D group. The results suggest Osteobios and Guna-Fem may be effective treatments for reducing symptoms of early postmenopausal osteoporosis.
This trial aimed to evaluate the efficacy and safety of vitamin D supplementation on the residual moderate and deep pockets following nonsurgical periodontal therapy.
This document discusses osteoporosis and its treatment. It defines osteoporosis as a bone mineral density (BMD) at least 2.5 standard deviations below the young adult mean. It lists common risk factors for osteoporotic fractures such as female sex, smoking, family history, and low calcium/vitamin D intake. It discusses screening tools like FRAX score and recommendations for BMD testing and lifestyle changes. It provides guidelines for initiating drug therapy and lists common osteoporosis treatments like bisphosphonates, denosumab, calcium/vitamin D, and raloxifene.
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Researchers found several connections between diet, obesity, medications, and kidney stone risk or formation based on analyses of large patient databases:
1) Total daily caloric intake was independently associated with increased kidney stone risk in women, even after accounting for obesity. Limiting calories may reduce stone risk.
2) Meat-heavy diets were linked to higher stone risk, while diets high in fruits, fiber, magnesium, iron and potassium reduced risk. Vegetarian diets had lower risk than high-meat diets.
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3) Use of statin medications to treat high cholesterol was associated with lower stone risk, especially in women. However, high cholesterol itself was tied to higher stone risk.
4)
Hypoglycaemia and improved testicular parameters in Sesamum radiatum treated ...lukeman Joseph Ade shittu
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1) Dietary supplements like glucosamine, chondroitin sulfate, vitamins, omega-3 fatty acids, and herbal extracts are commonly used to treat osteoarthritis (OA) symptoms, but their efficacy is unclear due to a lack of conclusive evidence.
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This document summarizes key information about osteoporosis. It defines osteoporosis as a systemic skeletal disease characterized by low bone mass and deterioration of bone tissue, leading to fragile bones and increased risk of fractures. It discusses risk factors like age, estrogen levels, family history and lifestyle factors. It also covers the global incidence of osteoporosis, noting that 200 million women worldwide are affected. Future directions are identified like better understanding nutrient requirements in different populations and roles of nutrients beyond calcium and vitamin D in bone health.
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Nutritional Interventional trials in muscle and cachexia PhD research directi...PhD Assistance
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CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC FEMALES HAVING CHRONIC PERIODONTITIS
1. Cairo (40)
E-mail: hph_cdj@yahoo.com
.. INTRODUCTION
Osteopenia and Osteoporosis are systemic
skeletal disorders characterized by compromised
bone strength and mass, with a consequent increase
in bone fragility and susceptibility to fracture.
Osteopenia is associated with reduction in the
amount of bone in addition to the presence of
microarchitectural changes without the occurrence
of clinical fracture. Osteoporosis on the other hand is
associated with high incidence of clinical fracture.
Cairo Dental Journal (30)
Number (1), 1:10
January, 2014
CLINICAL EVALUATION OF THE EFFECT OF
OMEGA-3 FATTY ACIDS ON OSTEOPOROTIC
FEMALES HAVING CHRONIC PERIODONTITIS
Mohamed A. Galal (1)
; Mushira A. Dahaba, (2)
; Basma M. Zaki(3)
and Hanaa M. Elshenawy (3)
1. Researcher Assistant of Oral Radiology, Department of Oral Medicine & Surgery, National
Research Centre, Cairo, Egypt.
2. Professor & Head of Oral Radiology Department, Faculty of Oral & Dental Medicine, Cairo
University, Egypt.
3. Researcher of Oral Medicine and Periodontology, Department of Oral Medicine & Surgery,
National Research Centre, Cairo, Egypt.
e-mail: afgalal@yandex.com
.. ABSTRACT
T
he aim of the present study is to assess the effect of Omega-3 fatty acids, as an
adjunctive therapy in management of chronic periodontitis in postmenopausal
osteoporotic females. Twenty four postmenopausal females having osteopenia or
osteoporosis and chronic periodontitis were included in this study. These patients were divided
into two groups: The Omega-3 group (O3) which included 13 subjects. They were given 1gm
omega-3 daily, plus Rutin-C and vitamin C (50 mg Rutin + 100 mg vitamin-C) once daily. The
second group which is the control group (C): 11 subjects were given Rutin-C and vitamin C
once daily. These medications were given for 9 months. Scaling and root planing was done
to all patients before starting the medical treatment. Periodontal Indices measured at 6 and 9
months were: Plaque Index (PI), Papillary Bleeding Index (BPI), Pocket depth (PD) and Clinical
Attachment Loss (CAL). The results showed that all the periodontal indices improved in both
groups after 6 and 9 months intervals, some were significant favoring omega-3 group (PI after
9 months), some were significant favoring control group (PBI after 6 & 9 months, and pocket
depth after 9 months), meanwhile, others were non-significant for the two groups (CAL after 6
& 9 months, plaque index and pocket depth after 6 months). It can be concluded that the use of
Omega-3 is a beneficial nutritional supplementation in chronic periodontitis cases.
KEYWORDS: Omega-3 Fatty Acids, Rutin-C, Vitamin-C, Osteoporotic/osteopenic females,
Periodontal Indices.
2. Mohamed A. Galal, et al.(2) C.D.J. Vol. 30. No. (1)
It is characterized by reduction in bone mineral
density to below the minimum level required to
ensure sufficient mechanical support. There is
also deterioration of bone tissues due to imbalance
between bone resorption and formation, favoring
resorption (Koduganti et al., 2009 and Passos et
al., 2010).
Osteoporosis occurs mainly in postmenopausal
females; although younger women and men can
be also affected. It was estimated that one in four
women during menopause and one in three women
> 65 years of age are affected by osteoporosis
(Passos et al., 2010).
The evaluation of the relationship between
osteoporosis and periodontitis is complicated by
the fact that both diseases are multifactorial in the
etiology. Multiple systemic factors influence the
progression of osteoporosis, including age, race,
diet, gender, hormone therapy, smoking, genetic
factors, exercise, and body weight. Several of these
factors are also risk factors for periodontal disease
(Al Habashneh et al., 2010).
Several researches support the idea that
osteoporosis independently influences alveolar bone
height loss. Strategies for reducing osteoporosis
risk also may help retard alveolar bone loss, which
can be easily fulfilled by meeting dietary intake
recommendations (Kaye 2007; Koduganti et al.
2009 and Otomo-Corgel et al. 2012).
Omega-3 fatty acids (FA) are a subset of
polyunsaturated fatty acids found in marine sources
aseicosapentaenoicacid(EPA)anddocosahexaenoic
acid (DHA) and in some leafy vegetables, nuts,
and oils as α-linolenic acid (ALA) (DeFilippis &
Sperling 2006).
Porphyromonas gingivalis (Pg) infected rats
treated with omega-3 FA had significantly less
alveolar bone resorption. These results demonstrated
the effectiveness of omega-3 FA supplemented diet
in modulating alveolar bone resorption following
Pg infection, and supported that omega-3 FA may
be a useful adjunct in the treatment of periodontal
disease (Kesavalu et al. 2006).
Omega-3 fatty acids in another study also
slowed the orthodontic incisor separation even after
buccal movement of the maxillary first molars,
which indicates their effect over bone enforcement
(Bartzela et al. 2009).
Another nutritional supplements were also
beneficial to periodontal health and affects
bone density as well. Rutin and Vitamin C are
a common and low-priced combination. Rutin
(RT), a quercetin-3-rutinosid or vitamin-P, is
considered as one of flavonoid glycosides, which
is found in onions, apples, tea and red wine. Rutin
is well known to exhibit multiple pharmacological
activities including antibacterial, antitumor,
anti-inflammatory, anti-diarrheal, antiulcer, anti-
mutagenic, vasodilator and immunomodulator.
Furthermore, rutin showed an inhibitory effect
against membrane lipid peroxidation, as well as
antioxidant activities which suggest its protective
role in oxidative stress-mediated diseases. Vitamin
C is a water-soluble enzyme, abundantly present in
different plants and some animals. Ascorbic acid is
the most predominant form in the human body and is
involved in tissue growth and repair. Ascorbic acid
has a potent antioxidant activity and is well known
to protect tissues from oxidative injury through
efficiently quenching the damaging free radicals
produced by many biological processes (Al-Rejaie
et al. 2012). Periodontitis is associated with a low
concentration of vitamin C in plasma (Pussinen et
al. 2003).
The aim of the present study is to assess the
effect of omega-3 fatty acids in management of
osteoporotic females with chronic periodontitis.
.. SUBJECTS AND METHODS
The research was conducted on a selected group
of postmenopausal women (≥ 50 years of age) who
attended the outpatient clinic in the medical unit
of the National Research Center (NRC), Cairo,
3. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS (3)
Egypt for bone densitometry testing in the routine
yearly check up. Only women who experienced
natural menopause (no menstruation for at least one
year) were chosen and invited to participate in this
study. They received systemic bone mineral density
(BMD) assessment as an initial screening using dual
energy x-ray absorptiometry (DXA) of the femur
and spine (Norland XR46 version 3.9.6).
Systemic BMD was classified according to the
WHO criteria, where osteoporosis was defined
as BMD ≥ 2.5 SD (standard deviation) below the
optimal mean BMD of young healthy individuals of
the same race and gender. Postmenopausal females
with BMD T-score less than -2.5 SD, where T-score
is the expression of BMD values in terms of standard
deviations from the normal value of a female young
adult mean were considered osteoporotic and were
included in this study. Women with a history of a
systemic condition or medication intake that might
influence the BMD or periodontal disease severity
were excluded i.e., women with a history of diabetes
mellitus, thyroid diseases, chronic renal problems,
and connective tissue diseases. Postmenopausal
females on corticosteroids, chemotherapy, recent
peptic or esophageal disorders were also excluded.
Exclusion criteria also included postmenopausal
females treated with drugs that inhibit gastric acid
secretion for more than 2 weeks in the last 6 months;
chronic treatment with NSAIDs (non-steroidal
anti-inflammatory drugs), hormone replacement
therapy or any other drug known to alter bone
calcium metabolism were not included. Smoking
females were not allowed to participate in the
study. All patients were systemically reviewed. The
participants were chosen to be of the same socio-
economic level. The postmenopausal females who
accepted the participation in the study were then
referred to the dental clinic at the NRC medical
services unit after making prior appointments for
evaluation of their oral condition. All participants
received further information about the study protocol
and objectives at the dental clinic. Participants
diagnosed as having chronic periodontitis according
to the criteria of the American Academy of
Periodontology (2000) were chosen. Each patient
presented with probing depth (PD) ≥ 5 mm in at
least three teeth or clinical attachment level (CAL)
≥ 4 to 6 mm and vertical bone loss ≥ 3 mm with no
history of periodontal therapy or use of antibiotics
in the preceding 6 months was selected to be part
of the study. The study included forty non-smoking
females, 50-65 years old, who were at least one year
postmenopausal, osteopenic or osteoporotic and
have not undergone hysterectomy or ovariectomy.
All patients were also diagnosed as having chronic
periodontitis.
Twenty four postmenopausal osteoporotic
or osteopenic females with age ≥50 years were
included in the study. Subjects were age-matched
into 2 groups:
The Control Group (C); this group comprised
eleven patients who were given Rutin C (Rutin
100 mg + Vitamin C 50 mg) once daily, for nine
months.
The Omega-3 group (O); this group comprised
thirteen patients who underwent took fish-oil gelati-
nous capsules rich in omega-3 fatty acids for nine
months twice daily (A daily dose of 1000mg Ome-
ga-3 PUFA), in addition to Rutin-C ( Rutin 100 mg
+ Vitamin C 50 mg) once daily as a common medi-
cation between Control group and Omega-3 group.
For both groups detailed oral hygiene
instructions were given and full mouth scaling
and root planing (initial therapy) using ultrasonic
scalers and periodontal curettes under local
anesthesia completed before starting the dietary
supplementations. Scaling and root planing was
performed for each patient in two sessions, one
session for half and completed over one week.
Occlusal adjustment was done whenever indicated.
Periodontal Assessment
Periodontal assessment was carried out at
baseline before starting the initial therapy and
the dietary supplementations, at 6 and 9 months
intervals.
4. Mohamed A. Galal, et al.(4) C.D.J. Vol. 30. No. (1)
At the baseline evaluation, all clinical parameters
were measured and mechanical treatment including
removal of all supra and subgingival calcified
deposits to obtain a smooth, hard surface was done.
Scaling and root planing was carried out by one of
the investigators in two successive sessions. Patients
were taught and encouraged to maintain their dental
health and plaque control through brushing and
flossing. All assessment measurements were taken
by the same investigator. The condition of all teeth
was assessed and recorded. The mean was taken for
the following measurements:
Plaque index (PI) according to Silness & Loe
(1964) and gingival index (GI) according to Loe
and Sillness (1963). Whole mouth probing depth
and clinical attachment level and Pocket depth (PD)
was measured according to the standard procedure
described by Glavind and Loe, 1967 using a
periodontal probe with Williams’ calibrations at the
free gingival margin and recorded at six locations
(mesiobuccal, distobuccal, midbuccal, mesiolingual,
distolingual and midlingual) on each tooth parallel
to the long axis of the examined tooth. The total of
the mean probing depth at the six locations on each
tooth for each patient was calculated in millimeters.
The distance from the cemento-enamel junction
(CEJ) to the free gingival margin and the distance
from the free gingival margin to the bottom of the
pocket/sulcus were measured at the mesiobuccal and
mid-buccal surfaces using also a calibrated probe.
From these two measurements, individual subject
mean attachment level (the distance from the CEJ to
the bottom of the pocket or sulcus) was calculated
in millimeters. All the measurements were taken at
baseline, 6 and 9 months intervals.
Ethical Consent:
The study protocol was approved by Medical
Research Ethical Committee (MREC) at the
National Research Center. A written informed
consent was signed by all subjects participating in
the study.
Statistical Analysis:
Data were presented as mean and standard
deviation (SD) values. Improvements after 6
months and after 9 months were also calculated, and
presented as mean and (SD) values as well. T-test
were done to compare between the improvements
after6monthsofthetwogroups(GroupO)&(Group
C), and to compare between the improvements
after 9 months of the two groups. The significance
level was set at P ≤ 0.05. Statistical analysis was
performed with Microsoft Excel 2007 for Windows.
.. RESULTS
All Periodontal Indices improved in all groups
with different criteria. In Plaque Index Omega-3
Fig. (1): Sheet of Periodontal Chart used in the experiment.
5. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS (5)
improvement was less than Control improvement at
the two intervals, while in the latter indices; Gingival
Index, Pocket depth & Clinical Attachment
Loss CAL; Control improvement was less than
Omega-3 improvement at the two intervals. These
improvements were related by t-test at 6 months
and 9 months. For Plaque Index the p-values at
6 months and 9 months respectively = 0.09513 &
0.03121*, which is only a significant difference
between the two groups at 9 months interval. For
Gingival Index, the p-values at 6 months and 9
months respectively = 0.00605* & 0.00119*, which
is a significant difference between the two groups
at 6 months and at 9 months intervals, with a favor
to control group. For Pocket depth the p-values
at 6 months and 9 months respectively = 0.11065
& 0.0245*, which is only a significant difference
between the two groups at 9 months interval, with
a favor also to control group. Finally, for CAL,
the p-values at 6 months and 9 months respectively
= 0.27183 & 0.12036, which are non-significant
difference between the two groups at 6 months and
at 9 months intervals. (Significant at P ≤ 0.05). See
Table (1) & Fig (2).
Fig. (2): Improvement in Plaque Index, Gingival Index, Pocket Depth and CAL (means) in 2 groups with time at 6 months and 9
months
TABLE (1): Means and SDs of improvements of all the results after 6 months and after 9 months, and P- value
of T-Tests between the two groups:
Index Change
Control Group Omega-3 Group
P-value
Mean SD Mean SD
Plaque
Index
After 6 months 0.24 0.17 0.33 0.15 0.09513
After 9 months 0.30 0.19 0.46 0.19 0.03121*
Gingival Index
After 6 months 0.286 0.22 0.075 0.11 0.00605*
After 9 months 0.399 0.27 0.068 0.095 0.00119*
Pocket Depth
After 6 months 0.41 0.32 0.27 0.21 0.11065
After 9 months 0.51 0.27 0.31 0.2 0.0245*
CAL
After 6 months 0.43 0.34 0.34 0.39 0.27183
After 9 months 0.54 0.27 0.39 0.34 0.12036
CAL=Clinical Attachment Loss. *: Significant at P ≤ 0.05
6. Mohamed A. Galal, et al.(6) C.D.J. Vol. 30. No. (1)
.. DISCUSSION
Women are more susceptible to certain chron-
ic diseases as they age, which may be affect their
periodontal health (Hughes 2010). Osteoporosis is
three times more common in women than in men,
and bone loss occurs as levels decline, usually from
around the age of 50 years (WHO Scientific Group
2003). Consequently, the study sample in our study
included postmenopausal female subjects 50 years
and older, suffering from osteoporosis, or osteope-
nia and chronic periodontitis. In the present work,
twenty four subjects were included, and divided ran-
domly into two groups: Group O: taking omega-3
supplements twice daily (500 mg) as well as one
Rutin-C daily (Rutin 50mg + ascorbic acid (vitamin
C) 100 mg), while the control group: (group C) was
taking only a single dose of Rutin-C daily.
In the GISSI Prevenzione study 1999 (a large
intervention trial of secondary prevention after
myocardial infarction) researchers identified a
substantial reduction in all-cause and cardiovascular
mortality with 1 g per day of n-3 PUFA
supplementation. In our study, the same dose was
used to test its efficacy in improving alterations
in alveolar bone density due to osteoporosis and
chronic periodontitis. The same dose was previously
recommended by Saravanan et al. 2010.
Salari Sharif et al. 2010 and McMahon 2012
who evaluated the effect of Omega-3 FA on bone
biomarkers in osteoporotic postmenopausal women
ingesting 900 mg of Omega-3 FA per day for 6
months. Tartibian et al. 2011 examined the effects
of long-term aerobic exercise and Omega-3 (O3)
supplementation on serum inflammatory markers,
bone mineral density (BMD), and bone biomarkers
in postmenopausal women. Subjects taking O3
supplementations consumed 1000 mg/d for 24
weeks, similar to the dose applied in our work.
Several researchers suggested increase of
this dose especially in chronic periodontitis; as
Martinez et al. 2013 constructed their study by
selecting a test group composed of 10 patients with
generalized chronic periodontitis (mean age 44
± 6.4 years) treated with scaling and root planing
associated with 4 months of ω-3 supplementation
Eicosapentaenoic acid (EPA) + Docosahexaenoic
acid (DHA), 3 g/d. Rosenstein et al. 2003 made
a clinical trial on thirty adult human subjects with
periodontitis who were administered either fish oil
3000 mg daily; borage oil 3000 mg daily; fish oil
1500 and borage oil 1500 mg daily, or placebo. The
gingival index, the plaque index (PI), periodontal
probing depths and beta-glucuronidase levels in
gingival crevicular fluid were measured at baseline
and after 12 weeks of treatment.
Vanlint & Ried in 2012 studied BMD and bone
turnover at baseline and 12 months, of 40 osteopenic
patients, who were randomized to either algal oil
containing 400mg docosahexanoic acid (DHA)
daily or placebo.
In accordance with these doses and follow-
up periods, the participants in the current work
were given 1000 mg/d of omega-3 supplements
and were followed- up after 6 and 9 months from
administration period.
Rutin-C (Rutin 50 mg +Ascorbic acid 100
mg) was applied in our work. Rutin is a common
medication for decreasing capillaries fragility
and gingivitis in the dental field. Ascorbic acid is
Vitamin C with good properties on gingival tissues.
McAnulty et al. 2011 recommended its use in
a study which examined the effects of 1,000 mg
quercetin + 1,000 mg vitamin C, and 400 mg O3
fatty acids ; taken each day for 2 weeks before and
during 3 days of cycling at 57% Wmax
(Maximal
Power Output) for 3 hours on plasma antioxidant
capacity, oxygen-radical absorbance capacity
(ORAC), plasma oxidative stress, and plasma
quercetin and vitamin C levels.
Since periodontal probing is such an important
aspect of the periodontal examination, the
technique must be systematic and consistent.
Bleeding at the gingival margin or sulcus is often
7. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS (7)
the first indicator of gingivitis or periodontitis.
Bleeding, pocket depths, and radiographs are used
together to determine periodontal condition. These
measurements are significant for two different types
of periodontal disease and their future treatment.
Gingival recession is important to the periodontal
examination because it accurately indicates the total
amount of attachment loss.Attachment loss can vary
from tooth to tooth. Any tooth can have attachment
loss without having a pocket. All these indices are
established in the literature for diagnosing existing
disease, determine the prognosis of individual teeth,
and monitor disease progression that tends to be
episodic and specific to the tooth and site (ADAA
Council on Education 2011).
Hence, in our study we performed a
comprehensive clinical examination and measured
four parameters or indices of periodontitis which
are: plaque index (PI), gingival Index (GI), pocket
depth (PD) and clinical attachment loss (CAL) to
assure accuracy of collected data in proving the
outcome of the proposed medication.
Many experimental studies were done to detect
Omega-3 effect on periodontitis and alveolar bone
loss. Dietary supplementation with high dose
docosahexanoic acid tuna oil caused a marked
elevation of O-3 FA levels in oral soft tissues. This
diet reduced the amount of alveolar bone loss in a
murine experimental periodontitis model compared
to a control diet containing no Omega-3 FAs (by an
average of 54-72% less alveolar bone resorption in
response to the different bacterial infections was
detected) (Bendyk 2008).
Indahyani et al. 2008, tested the hypothesis that
fish oil alters lipopolysaccharide (LPS)-induced
hydroxyapatite loss in rat alveolar bone, and found
that the hydroxyapatite contents of alveolar bone
in rats treated with fish oil at the same day with or
before LPS injection were significantly higher than
those in rats injected with LPS alone, but still lower
than those in untreated animals.
Kesavalu et al. 2006 have done a study on rats.
Rats were fed fish oil (O3 FA) or corn oil diets
for 22 weeks and were infected with Pg. Rats on
the O3 FA diet exhibited elevated serum levels of
eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA), documenting diet-induced changes. Pg-
infected rats treated with O3 FAhad significantly less
alveolar bone resorption.These results demonstrated
the effectiveness of an O3 FA-supplemented diet in
modulating alveolar bone resorption following Pg
infection, and supported that O3 FA may be a useful
adjunct in the treatment of periodontal disease.
These experimental animal studies are in line
with our results that proved that partial improvement
occurred due to omega-3 FAin chronic periodontitis
patients.
Dietary human surveys were done to confirm
this relation. “To date, the treatment of periodontitis
has primarily involved mechanical cleaning
and local antibiotic application. Thus, a dietary
therapy, if effective, might be a less expensive and
safer method for the prevention and treatment of
periodontitis” (Naqvi et al. 2010 and Snider 2010).
Using data from the National Health and
Nutrition Examination Survey (NHANES),
investigators from Harvard Medical School and
Harvard School of Public Health, Boston, found that
dietary intake of docosahexaenoic acid (DHA) and
eicosapentaenoic acid (EPA) was associated with a
decreased prevalence of periodontitis (by 20%), but
linolenic acid (LNA) did not exhibit this association.
The cross-sectional study involved more than 9,000
adults between 1999 and 2004 (Naqvi et al. 2010
and Snider 2010).
Iwasaki et al. 2011 studied the longitudinal
relationship between two types of O3 dietary intake
in presence of periodontal disease in 235 Japanese
subjects for whom data were available for the years
2003–2006. O3 intake was assessed at baseline
with a brief-type self-administered diet history
8. Mohamed A. Galal, et al.(8) C.D.J. Vol. 30. No. (1)
questionnaire. Full-mouth periodontal status,
measured as the clinical attachment level (CAL),
was recorded at baseline and once a year for 3 years.
Still we need confirmation from human clinical
trials which are very little in the literature; up to our
knowledge.
On the other hand in a very recent study
by Martinez et al. 2013 who constructed the
methodology of their study that the test group was
composed of 10 patients with generalized chronic
periodontitis (mean age 44 ± 6.4 years) treated with
scaling and root planing associated with 4 months
of O3 supplementation eicosapetaenoic acid (EPA)
plus docosahexaenoic acid (DHA), 3 g/d. The
placebo group was composed of 11 patients (47.9
± 10.5 years) that received scaling and root planing
plus placebo. The periodontal examination included
probing depth, clinical attachment level, bleeding
on probing and plaque index. They presented that
the O3 dietary supplementation had no effect on
clinical outcome of treatment.
In our study only little clinical outcome was
significant regarding the effect of Omega-3 in
comparison to control group since PI improvement
was the only significant outcome reported after 9
months in Omega-3 medicated cases. Periodontal
indices improved in the current work in both groups
after 6 and 9 months, some were significant favoring
Omega-3 group (PI after 9 months), others were
significant favoring control group (GI after 6 & 9
months, PD after 9 months), and others were non-
significant for the two groups (CAL after 6 & 9
months, PI and PD after 6 months).
Also in contrary to our results, Rosenstein et al.
2003 performed a clinical trial on thirty adult human
subjects with periodontitis who were administered
either fish oil 3000 mg daily; borage oil 3000 mg
daily; fish oil 1500 and borage oil 1500 mg daily, or
placebo. The modified GI, the (PI), periodontal PD
and beta-glucuronidase levels in gingival crevicular
fluid were measured at baseline and after 12 weeks
of treatment. Improvement in gingival inflammation
was observed in subjects treated with borage oil,
with a trend apparent in subjects treated with fish oil
or a combination of both. There was no statistically
significant improvement in PI, although a trend was
apparent in those receiving borage oil. Improvement
in PD was seen in those subjects treated with either
fish oil alone or borage oil alone, but statistical
significance was only seen for the comparison of
borage oil and placebo.
Other studies combined Omega-3 with other
NSAIDs, for antagonism as the study done by
El-Sharkawy et al. 2010 who tried to test their
innovative strategy for periodontal treatment using
Omega-3 and low dose aspirin. Eighty healthy
subjects with advanced chronic periodontitis were
enrolled in Mansoura, Egypt, in a parallel-design,
double-masked clinical study. The control group
was treated with (SRP) and a placebo, whereas
the O3 group was treated with SRP followed by
dietary supplementation of fish oil (900 mg EPA +
DHA) and 81 mg aspirin daily. Statistical analysis
demonstrated a significant reduction in PD and a
significant attachment gain after 3 and 6 months in
the O3 group compared to baseline and the control
group. The results of this preliminary clinical study
suggested that dietary supplementation with O3 FAs
and 81 mg aspirin may provide a sustainable, low-
cost intervention to augment periodontal therapy.
Vardar et al. 2005 used another NSAID; i.e.
Celecoxib. The results of the that study indicated
that celecoxib and Omega-3 fatty acid, when
used individually, show a rather partial effect on
the control of the analyzed mediators, but when
combined they show a synergic effect and provide
significant reductions in the gingival tissue levels
of prostaglandin E2 (PGE2), prostaglandin F2α
(PGF2α), leukotriene
B4 (LTB4), and platelet activating factor
(PAF) in LPS-induced experimental periodontitis
9. CLINICAL EVALUATION OF THE EFFECT OF OMEGA-3 FATTY ACIDS (9)
(Experimental periodontitis was induced by
repeated injection of Escherichia coli endotoxin).
These findings may pioneer further clinical human
studies investigating the possible place of celecoxib
and Omega-3 fatty acid in periodontal treatment.
This is in line with our study results which
proved that Omega-3 supplemental medications
have a positive impact on treatment of chronic
periodontitis, but with a weak relation clinically (not
all indices improved significantly), and this relation
even with the high dose given in these studies (3gm
– 6 gm /day), suggest that Omega-3 when used
individually is not effective.
Many of these studies focused on cellular factors
more than clinical indices, which makes Omega-3 in
such ways preventive more than being therapeutic,
rendering it of low grade importance in periodontitis
if compared to antibiotics.
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