The Optical Coherence Tomography and Raman Spectroscopy for Sensing of the Bone Demineralization Process

The presented research was intended to seek new optical methods to investigate the demineralization process of bones. Optical examination of the bone condition could facilitate clinical trials and improve the safety of patients. The authors used a set of complementary methods: polarization-sensitive optical coherence tomography (PS-OCT) and Raman spectroscopy. Chicken bone samples were used in this research. To stimulate in laboratory conditions the process of demineralization and gradual removal of the hydroxyapatite, the test samples of bones were placed into 10% acetic acid. Measurements were carried out in two series. The first one took two weeks with data acquired every day. In the second series, the measurements were made during one day at an hourly interval (after 1, 2, 3, 5, 7, 10, and 24 h). The relation between the content of hydroxyapatite and images recorded using OCT was analyzed and discussed. Moreover, the polarization properties of the bones, including retardation angles of the bones, were evaluated. Raman measurement confirmed the disappearance of the hydroxyapatite and the speed of this process. This work presents the results of the preliminary study on the possibility of measuring changes in bone mineralization by means of the proposed methods and confirms their potential for practical use in the future.

Optimization of Xylose Reductase production from Citrobacter sp.

Xylitol is a poly-hydroxy straight-chain five-carbon alcohol that can replace sugar in daily uses without any side effects. Lowered risk of dental carries and bone demineralization further support its involvement in a healthy lifestyle. In addition, its role in the synthesis of various commercial products like glycol, ethanol, and resins etc. increases its market value and makes it one of the most valuable bio-products. Microbial fermentation is a cost-effective and eco-friendly method for xylitol production from agricultural residues as available xylose is reduced to xylitol by Xylose reductase (XR) using an equivalent amount of NADPH as a mediator for electron transfer. Previous literature emphasized the use of fungi and yeast for xylitol production rather than bacteria. In contrast to available reports, the potential of the bacterial isolate was evaluated for xylitol production. The effect of process parameters was observed on xylitol yield in terms of XR activity. Out of sixty-eight bacterial isolates obtained, XYLBV-05 was selected for XR production after screening and was identified as Citrobacter sp. based on morphological, microscopic, and biochemical characteristics. Parametric analysis increased the XR production by 4.12 folds (36.61 U/ml). Preliminary results also proved its efficiency in conversion of biomass hydrolysate to xylitol at lab scale but further efforts are needed for xylitol production using agro-industrial lignocellulosic biomass at a large scale which will not only aid in the generation of revenue as a result of value-added products but will also help in environment conservation.

The Optical Coherence Tomography and Raman Spectroscopy for Sensing of the Bone Demineralization Process

Aim of the presented research was to develop an optical sensing system to investigate the demineralization process of the bones. Optical measurement techniques are widely used and increasingly adapted in biological and biomedical applications due to their non-destructive nature and safety. Optical examination of the bone condition could facilitate clinical trials and improve the safety of patients. The authors used a set of complementary methods: polarization-sensitive optical coherence tomography (PS-OCT) and Raman spectroscopy. To stimulate the process of demineralization and gradual removal of the hydroxyapatite, the test samples of chicken bones were placed into 10% acetic acid. Measurements were carried out in two series. The first one took two weeks with data acquired every day. In the second series, the measurements were made during one day at an hourly interval (after 1, 2, 3, 5, 7, 10, and 24 hours). Raman spectroscopy was used to evaluate the disappearance of the hydroxyapatite. The relation between the content of hydroxyapatite and images recorded using OCT was analyzed and discussed. Moreover, the polarization properties of the bones have been evaluated. Based on OCT images, the retardation angles of the bones have been calculated. This work presents a preliminary study on the mechanism of bone demineralization and confirms the potential of the applied optical methods.

Severe Osteomalacia and Fractures Secondary to Vitamin D Deficiency

Background: Vitamin D deficiency is a common entity among the elderly. Low vitamin D levels can lead to poor bone mineralization, in addition to elevations in PTH levels with resultant increases in bone turnover. However, severe Vitamin D deficiency causing osteomalacia has become uncommon in the United States due to increased screening and treatment. Vitamin D supplementation is a mainstay of therapy for osteoporosis, yet its effect on bone density is generally thought to be modest. We present here an extreme case of vitamin D deficiency leading to severe secondary hyperparathyroidism and bone demineralization, with excellent response to supplementation. Clinical Case: Patient was a 73-year-old woman with hypertension who presented to the ER with acute on chronic back and lower extremity pain. She had these pains for about a year, but they had worsened over the last 4 days. She had been homebound for the past 1–2 years due to severe pain while ambulating, reported a five-inch loss of height and 50 pounds weight loss, and maintained a vegan diet. She had not had medical care in 15 years. Imaging studies demonstrated a displaced left femoral neck fracture, a nondisplaced right femoral neck fracture, multilevel thoracolumbar compression fractures, and a nondisplaced right scapular fracture. Blood tests revealed normal renal function, calcium 8.6mg/dL (nl 8.5–10.5), phosphorus 2.6mg/dL (nl 2.5–4.5), and alkaline phosphatase 2,821U/L (nl 45–164). Secondary osteoporosis workup was negative for hypercalciuria or multiple myeloma, but was notable for a PTH level of 2,190 pg/mL (nl 10–65) and 25-OH Vitamin D level of <5ng/mL (nl >30). C-telopeptide was measured at 3,346 pg/mL (nl <1000) and osteocalcin >300ng/mL (nl 8–32). DEXA scan showed T-scores of -4.2 at the lumbar spine and -6.8 at the distal forearm. She was started on high-dose vitamin D supplementation, with serum Vitamin D level rising to 42.1ng/mL after 6 months of treatment. This corresponded to a decrease in PTH to 141.1pg/mL and alkaline phosphatase to 375U/L. Repeat DEXA two years later showed 52.8% increase in bone mineral density at the lumbar spine, and 27.1% increase at the forearm. The patient’s body pains have significantly improved and she is now ambulatory again. Conclusions: Vitamin D deficiency is an uncommon cause of severe bone demineralization in the United States. However, in certain high-risk populations, it can present with debilitating osteomalacia and numerous pathologic fractures. Even in cases of osteoporosis with severe PTH elevation, Vitamin D deficiency must be ruled out as a potential secondary etiology, as it can be easily treated with potentially dramatic response.

EFFECTIVENESS OF KINESIOTHERAPEUTIC EXERCISES IN LOMBALGY SECONDARY TO BONE DEMINERALIZATION AND LUMBAR HYPOLORDOSIS: AN EXPERIENCE REPORT

Objective: To report the experience of the effects of kinesiotherapy exercises applied to a patient with low back pain associated with bone demineralization and lumbar hypolordosis. Methods: Physiotherapeutic monitoring of a 55-year-old female patient from Bahia is presented, presenting a condition compatible with low back pain, secondary to bone demineralization in the lumbosacral spine, dorsal and lumbar hypolordosis. In the assessment, the Owestry questionnaires (14 points), Visual Analogue Scale (grade 6), FABQ-Brazil subscale (43 points), absence of lateral shift, hip movement (internal rotation D = 27º, E = 31º) were applied , segmental mobility test of the thoracolumbar spine (hypermobile vertebrae = L1 to S1), Pronation Instability test (positive), symptoms longer than 16 days, aberrant movements with finger climbing, centralization of symptoms in the flexion and lateral inclination movements, and periphery to knee E. in extension. Thus, it was classified in the Mobilization / Manipulation and Stabilization groups, which was subjected to physical therapy intervention during 12 visits. Therapeutic approaches were based on segmental stabilization exercises associated with co-contraction of the abdominal and pelvic muscles, passive stretching, myofascial release with digit pressure and pelvic, sacroiliac and thoracic mobilization exercises. Results: After treatment, there were positive effects on low back pain and when performing movements, gaining flexibility, mobility and muscle strength, as well as feeling of well-being and improved sleep. Conclusion: It is inferred, therefore, that the conduct based on clinical reasoning is of paramount importance for the physiotherapeutic performance in the kinetic-functional problems arising from low back pain, which contributed to the improvement of the pathological condition and promotion of quality of life.

Inertial sensor and Timed Up and Go test in elderly women with bone demineralization: a reliability and agreement study

O estudo visa avaliar: 1) confiabilidade teste-reteste e medidas de erro das variáveis quantitativas do teste Timed Up and Go (TUG) coletadas com o sensor inercial wireless Wiva® Science (TUGsi) e, 2) a concordância do TUGsi e o método cronometrado (TUGc) e entre os dois métodos aplicados em idosas com osteoporose e osteopenia. Foram recrutadas 18 idosas com desmineralização óssea. O tempo (s) de duas execuções do TUG (T1 e T2) foi mensurado com cronômetro manual por um avaliador e com o sensor inercial acoplado ao corpo em nível da vértebra L5 com coleta remota. T1 e T2 foram executadas com intervalo de 1 min. As subtarefas do TUG também foram captadas pelo sensor inercial. A confiabilidade teste-reteste e erro das variáveis foram avaliados pelo coeficiente de correlação intraclasse (CCI), erro padrão de medida (EPM) e mínima mudança detectável (MMD). A concordância entre as médias do tempo total do TUGc e TUCsi e entre T1 e T2 mensuradas com o sensor e cronômetro foram avaliadas pelo método Bland-Altman. A consistência interna das subtarefas do TUGsi variaram entre substancial a quase completa. O EPM e a MMD para o TUGsi foram de 1,27s e 2,48s, respectivamente. A concordância entre medidas do sensor e cronômetro apresentaram baixo erro sistemático. O sensor inercial foi confiável na verificação do desempenho do TUG e pode ser um complemento para avaliação de risco de quedas e mobilidade funcional de idosas com desmineralização óssea. Porém, não representa melhoria na investigação exclusiva do tempo total do teste.

Unraveling the Links Underlying Arterial Stiffness, Bone Demineralization, and Muscle Loss

The effects of elevated arterial stiffness on cardiovascular outcomes are widely studied, whereas the relation to noncardiovascular outcomes relevant to older persons, such as the effect on bones and muscles, is less well established. Arterial stiffness, bone demineralization, and muscle loss are all age-related processes with common risk factors, however, whether these are just parallel age-related alterations or whether these processes share common pathways is not yet understood. In this review, we outline previous literature using different assessments of arterial stiffness in various populations across the world to produce a comprehensive overview. Although there are many studies showing an association between arterial stiffness and loss of bone and muscle, the majority are cross-sectional and there is limited longitudinal evidence to justify causal conclusions. We also give an in-depth review of hypotheses and possible mechanisms which may underlie these associations including hormone dysregulation, impaired glucose metabolism, and inflammation. This narrative review highlights the associations between vessels, bones, and muscles with aging, offering insights into possible shared pathways.

An Ion-exchange Bone Demineralization Method for Improved Time, Expense, and Tissue Preservation

Here, we describe an ethylenediaminetetraacetic acid (EDTA)-based bone demineralization procedure that uses cation-exchange resin and dialysis tubing. This method does not require solution changes or special equipment, is faster than EDTA alone, is cost-effective, and is environmentally friendly. Like other EDTA-based methods, this procedure yields superior tissue preservation than formic acid demineralization. Greater protein antigenicity using EDTA as opposed to formic acid has been described, but we also find significant improvements in carbohydrate-based histological staining. Histological staining using this method reveals cartilage layers that are not distinguishable with formic acid demineralization. Carbohydrate preservation is relevant to many applications of bone demineralization, including the assessment of osteoarthritis from bone biopsies and the use of demineralized bone powder for tissue culture and surgical implants. The improvements in time, expense, and tissue quality indicate this method is a practical and often superior alternative to formic acid demineralization: