The aim of this study was to assess the efficiency of a self-administered questionnaire to identify subjects with postmenopausal osteoporosis in the setting of first line medical care. A sample of 300 postmenopausal women completed the questionnaire based on 18 items. Bone mineral density at the lumbar spine (BMD-L), total hip (BMD-H), and femoral neck (BMD-N) was used as objective criterion for evaluation. The mean risk score was 8.2 +/- 3.21. BMD was correlated with total risk score: r = -0.32 for BMD-L, -0.36 for BMD-N, and -0.43 for BMD-H. Cutoff points for the risk score (equal likelihood points) according to a T-score threshold of -2.5 were 8.6 for BMD-L and BMD-N and 9.3 for BMD-H; specificity and sensitivity was 62% and 62%, respectively, for BMD-L, 65% and 62% for BMD-N, and 75% and 63% for BMD-H. Stepwise multiple regression analysis of the questionnaire items in relation to BMD showed higher correlation coefficients for models including individual items rather than the overall risk score. Items concerning low weight, older age, and wrist fracture after 50 years of age were always selected as significant determinants of BMD (R = 0.43-0.55). Hormonal replacement therapy was also an important determinant. Lifestyle-related items did not contribute significantly. In conclusion, the diagnostic performance of the 18-item self-administered questionnaire was poorer than a shortened questionnaire omitting lifestyle factors. The clinical utility of a questionnaire should ultimately be evaluated in the specific optic of a chosen global strategy for prevention of osteoporotic fractures.
Recovered COVID19 patients often display cardiac dysfunction, even after a relatively mild infection. Here, we present the first histological description of cardiac SARS-CoV-2 infection. Within the heart, the ACE2 receptor is mostly expressed by pericytes. Using a COVID19 hamster model, we demonstrate SARS-CoV-2 is replicating in pericytes, and reduced pericyte density is present after infection. In healthy animals, pericytes recover; however, when metabolic comorbidities are present, they fail to recover. These latter animals present with cardiac fibrosis, cardiomyocyte hypertrophy, and early signs of diastolic dysfunction, resembling HFpEF. Biopsies from recovered COVID19 patients showed similar results, with pericyte loss being present.
The three-dimensional structure and density of living bone are closely related to its mscha~cal response, and are needed for an accurate estimation of its changes. However, d/agnostic techniques such as conventional QCT and DXA are inadequate for bic~echanical analysis due to
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