Furthermore, susceptibility had a strong genetic component, which

Furthermore, susceptibility had a strong genetic component, which allowed selection of a An. stephensi strain (Nijmegen Sda500) that is highly susceptible to P. falciparum infection [8]. A strain of An. gambiae

(L35) was selected to be highly refractory to infection with Plasmodium cynomolgy (primate malaria). The L35 strain melanizes P. cynomolgy, as well as several other Plasmodium species see more such as P. berghei (murine malaria), Plasmodium gallinaceum (avian malaria), and other primate malaria parasites such as Plasmodium gonderi, Plasmodium inui, and Plasmodium knowlesi. Interestingly, P. falciparum strains from the New World are also melanized effectively, but not those of African origin, suggesting that there are genetic differences between P. falciparum strains that affect their ability to infect An. gambiae [9]. The African strains of P. falciparum tested appeared to be better adapted to their natural mosquito vector. However, great differences in the level of resistance to P. falciparum infection have been documented in families derived from individual An. gambiae females collected in the field [3, 10], and a small region of chromosome 2L is a major determinant of genetic

resistance to infection [3]. Drosophila INCB28060 chemical structure melanogaster can support the development of Plasmodium gallinaceum oocysts when cultured ookinetes are injected into the hemocele [11]. This observation opened the possibility of using a genetic approach to screen for Drosophila genes that affect Plasmodium P. gallinaceum infection[12]. Furthermore, silencing of orthologs (or family members) of five of these candidate genes in An. gambiae (G3 check details strain) demonstrated that four of them also affected P. berghei infection in the mosquito [12]. In this study we compare how silencing a set of genes identified in the Drosophila screen affects Plasmodium infection in different vector-parasite combinations. oxyclozanide We conclude that there is a broad range of compatibility between different Plasmodium strains and particular mosquito strains that is determined by the interaction between the parasite and the mosquito’s immune system. We define compatibility as the extent to which the immune

system of the mosquito is actively limiting Plasmodium infection. For example, the P. yoelii-An. stephensi and P. falciparum-An. gambiae strains used in this study are highly compatible vector-parasite combinations, as silencing several genes involved in oxidative response or immunity has no significant effect on infection. In contrast, silencing the same genes has a strong effect in less compatible vector-parasite combinations such as P. yoelii-An. gambiae or P. berghei-An. gambiae. Results and discussion Effect of GSTT1 and GSTT2 silencing on P. berghei infection The effect of silencing An. gambiae orthologs (or homologs) of genes originally identified in the Drosophila genetic screen on P. berghei infectivity is summarized in Table 1[12].

Cell Microbiol 2009, 11:121–137 PubMedCrossRef 29 Xicohtencatl-C

Cell Microbiol 2009, 11:121–137.PubMedCrossRef 29. Xicohtencatl-Cortes J, Chacon ES, Saldana Z, Freer E, Giron JA: Interaction of Escherichia coli O157:H7 with leafy green produce. J Food Protect 2009, 72:1531–1537. 30. Fagerquist CK, Garbus BR, Miller WG, Williams KE, Yee E, Bates AH, Boyle S, Harden LA, Cooley MB, Mandrell RE: Rapid identification of protein biomarkers of Escherichia coli O157:H7 by matrix-assisted laser desorption ionization-time-of-flight – time-of-flight mass spectrometry and top-down proteomics. Anal Chem 2010, 82:2717–2725.PubMedCrossRef

31. Gunther NW, Pang H, Nunez A, Uhlich GA: Comparative proteomics of E. coli O157:H7: Two-dimensional gel electrophoresis vs. two-dimensional liquid

chromatography separation. The Open Proteom J 2010, 3:26–34.CrossRef 32. Tremoulet F, Duche O, Namane A, Martinie B, selleck Labadie JA: Proteomic study of Escherichia coli O157:H7 NCTC 12900 Vactosertib solubility dmso cultivated in biofilm or in MAPK inhibitor planktonic growth mode. FEMS Microbiol Lett 2002, 215:7–14.PubMedCrossRef 33. Zheng S, Schneider KA, Barder TJ, Lubman DM: Two-dimensional liquid chromatography protein expression mapping for differential proteomic analysis of normal and O157:H7 Escherichia coli. Biotechniq 2003, 35:1202–1212. 34. Sperandio V, Torres AG, Jarvis B, Nataro JP, Kaper JB: Bacteria-host communication: The language of hormones. PNAS 2003, 100:8951–8956.PubMedCrossRef Competing interests

The authors declare no competing financial interests. Authors’ contributions ITK was the project leader and designed, coordinated, obtained funding, conducted experiments, analyzed Liothyronine Sodium data and drafted the manuscript. RWG conducted experiments and tabulated data. BK and DAS performed proteomic analysis. SBC assisted in design and participated in helpful discussions. MJ was the co-project leader, and designed, coordinated, analyzed results and performed bioinformatic analysis. All authors read and approved the final manuscript.”
“Background Probiotic bacteria are live microorganisms which are beneficial to the host organism, and can exert health benefits beyond those of inherent basic nutrition. A recent study indicates that the use of probiotics is rapidly advancing from the field of nutrition towards therapeutic applications [1]. Probiotics have proven useful in preventing and treating diarrhea. Crohn’s disease and ulcerative colitis patients exhibit loss of immune tolerance to enteric bacteria. Probiotics have modest but consistent prophylactic efficacy and can regulate innate and adaptive immunity to enhance innate defenses against microbes and maintainimmune homeostasis [2, 3]. Therefore, immune modulation and inhibition of excessive immune response and inflammation are proposed to be mechanisms of action of probiotics [4, 5].

Furthermore, the patient may present with fever, dehydration, abs

Furthermore, the patient may present with fever, dehydration, absence of bowel sound and leukocytosis. These clinical signs might easily be detected in a non-pregnant woman, but are common in pregnancy [16]. The delay in diagnosis of sigmoid volvulus may lead to bowel infarction and necrosis with hypovolemia, electrolyte disturbances, renal failure, metabolic acidosis, septic shock and multiple organ failure with a significant devastating Selleck VX-661 outcome for the mother and the fetus. Maternal mortality for sigmoid volvulus has been reported to be 5% if the bowel

is viable, but rises to over 50% if perforation has occurred [13]. Fetal mortality in sigmoid volvulus is approximately 30%. The fetal death could be caused by reduction in placental blood flow in hypovolemia, or by reduction of the abdominal and pelvic blood flow due to increased intraabdominal pressure as a Staurosporine mouse result of massive AZD1152 sigmoid dilatation [10]. Diagnosis of intestinal obstruction in

pregnancy is difficult, as the classical symptoms of abdominal distension, nausea and vomiting are common in uncomplicated pregnancies [13]. The diagnosis should be suspected when a pregnant woman presents with a clinical symptom of abdominal pain, distention and absolute constipation [5]. The leukocytosis can be a consistent sign but in the first phase of the disease can be normal or slightly elevated [15]. Furthermore, the white cell count is normally elevated in pregnancy [22]. The use of radiological tools can be useful to establish the diagnosis, but many clinicians are reluctant to use them for fear of fetal complications. Radiation exposure may lead to chromosomal abnormalities, neurologic enough mutations and increased risk of hematologic malignancies [26]. However, even with plain computed tomography (CT) scans of the abdomen, the radiation dose is still thought to be within the safe exposure limit (5–10 rads) [27]. Still, many authors believe it is best avoided because of

the radiation risks to the fetus. In contrast, abdominal and obstetric ultrasonography may eliminate the radiologic risk and provide information about the fetus [22]. The management of sigmoid volvulus in pregnancy requires a multidisciplinary approach with general surgeons, obstetricians, and neonatologists [16]. The patient should be treated with fluids, electrolyte balance correction, prophylactic antibiotics, and nasogastric decompression. Tocolytics should be administered if uterine irritability is observed, and steroids initiated to promote fetal lung maturity [22]. Obstetric intervention should strictly depend on the condition of the fetus. The integrity of the uterus has to be preserved in the case of a vital fetus [19]. In cases of fetal maturity, a vaginal labor can be induced if the condition of the mother and fetus is stable [19].

CH/CC 7: Does the study adequately report on the strength of effe

CH/CC 7: Does the study adequately report on the strength of effect (e.g. ways of calculating effect size, reporting of confidence intervals)? CH/CC 8: Does the study use multivariate analysis? CH/CC 9: Is the study sample size appropriate for the analysis used? CH/CC

10: Do the authors report on the limitations of their study? CH/CC 11: Does the study report a participation rate at baseline >70 %?CH/CC 12: Does the study report attrition rates and provide evidence of comparisons of responders and non-responders? CH 13: Does the study report an attrition rate <20 %? CH 14: Does the study have HDAC activity assay a follow up time period >6 months? CH 15: Does the study use the same population HSP990 datasheet for cases and controls? CC 16: Are the study controls adequately (e.g. no pain for >3 months) screened for symptoms compared to cases? CC Appendix 3 See Table 4. Table 4 Data extraction tables for included studies Author (years) Country Study population Design Main study focus LBP assessment Work support assessment Findings Results Andersen et al. (2007) Denmark General workers sample Prospective cohort with a 2 year follow up Psychosocial risk factors for musculoskeletal symptoms within workers Presence of pain in previous 12 months + absence from work Danish National institute of Occupational health Questionnaire—CWS

and SS Low SS not a risk for LBP CWS as a non-significant risk factor for LBP HR 1.1 (0.8–1.6) HR 1.1 (0.8–1.6) Clays et al. (2007) Belgium General workers sample Prospective cohort over 6 years The impact of psychosocial factors on LBP Nordic questionnaire >8 days in previous 12 months Karasek Demand Control model—GWS Low GWS increased risk of LBP in men No association between GWS and risk in women RR 1.2 (1.02–1.42) RR 1.00 Galeterone (0.8–1.24) Dionne et al. (2007) Canada Consulters for LBP who have been absent from work

for at least 1 day Prospective BL, 6 week, 12 week, 1 year and 2 year follow ups RTW for those with LBP RMDQ, pain levels, fear avoidance Work APGAR No significant role for GWS on RTW OR 4.76 (0.43, 52.13) Elfering et al. (2002) Switzerland Workers (unspecified) Prospective cohort over 5 years Social support at work and risk of LBP Nordic questionnaire, pain frequency and JQ-EZ-05 manufacturer intensity, RMDQ, McGill Questionnaire General questions on support in employment No significant association between low GWS and LBP N/S Feuerstein et al. (2001) USA Military personnel Case control Workplace psychosocial factors associated with sickness absence due to LBP Self report LBP symptoms, NIOSH survey. One episode of LBP in past 12 months resulting in an episode of sickness absence Work environment scale (inclusive of one question on GWS) Participants with low GWS were at higher odds of getting LBP OR 1.22 (1.05, 1.36) Fransen et al.

There is an urgent need for clinicians to be able to examine a se

There is an urgent need for clinicians to be able to examine a set of biomarkers such as eIF4E and downstream effector molecules in order to set a current standard for prognosis. Acknowledgements The authors gratefully GDC-0449 supplier acknowledge the help of Ms. Wanda Green and Dr. Jill Williams in the preparation of the TMAs. The authors also thank the other members of the Breast Cancer Focus Group for helpful discussions on the preparation of this manuscript: Dr. Fleurette Abreo,

Dr. Jun Chung, Dr. Shile Huang, Dr. Kevin Pruitt, Dr. Robert Rhoads, Dr. Amanda Sun, Dr. Songlin Zhang, and Dr. Qian-Jin Zhang. This research was supported by funding from the Feist-Weiller Cancer Center, Shreveport and the Louisiana Gene Therapy Research Consortium. References 1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ: Cancer statistics, 2007. CA Cancer J Clin 2007, 57: 43–66.CrossRefPubMed 2. De Benedetti A, Harris AL: eIF4E expression in tumors: its possible role in progression of malignancies. Int J Biochem Cell Biol 1999, 31: 59–72.CrossRefPubMed 3. Dillon RL, White DE, Muller WJ: The phosphatidyl inositol

3-kinase signaling network: implications for human breast cancer. Oncogene 2007, 26: 1338–1345.CrossRefPubMed 4. Santen IWP-2 chemical structure RJ, Song RX, McPherson R, Kumar R, Adam L, Jeng MH, Yue W: The role of mitogen-activated protein (MAP) kinase in breast cancer. J Steroid Biochem Mol Biol 2002, 80: 239–256.CrossRefPubMed 5. Wu JT, Kral JG: The NF-kappaB/IkappaB signaling system: a molecular target in breast cancer therapy. J Surg

Res 2005, 123: 158–169.CrossRefPubMed 6. Sonenberg N: Regulation of translation and cell growth by eIF-4E. Biochimie 1994, 76: 839–846.CrossRefPubMed 7. Richter JD, Sonenberg Phospholipase D1 N: Regulation of cap-dependent translation by eIF4E inhibitory proteins. Nature 2005, 433: 477–480.CrossRefPubMed 8. Shantz LM, Pegg AE: Overproduction of ornithine decarboxylase caused by relief of translational repression is associated with neoplastic transformation. Cancer Res 1994, 54: 2313–2316.PubMed 9. Kevil CG, De Benedetti A, Payne DK, Coe LL, Laroux FS, Alexander JS: Translational regulation of vascular permeability factor by eukaryotic initiation factor 4E: implications for tumor angiogenesis. Int J Cancer 1996, 65: 785–790.CrossRefPubMed 10. Zimmer SG, DeBenedetti A, Graff JR: Translational control of malignancy: the mRNA cap-binding protein, STA-9090 in vivo eIF-4E, as a central regulator of tumor formation, growth, invasion and metastasis. Anticancer Res 2000, 20: 1343–1351.PubMed 11. Rosenwald IB, Lazaris-Karatzas A, Sonenberg N, Schmidt EV: Elevated levels of cyclin D1 protein in response to increased expression of eukaryotic initiation factor 4E. Mol Cell Biol 1993, 13: 7358–7363.PubMed 12.

https

Figure 2 Verification of genomic deletions by PCR of genomic DNA. Amplimers using AdeGUp (NotI)F and AdeGDwn(SphI)R for DB (lane 1) and DBΔadeFGH (lane 3) DNA; amplimers using AdeG Etomoxir RTF and AdeG RTR for DB (lane 2) and DBΔadeFGH (lane 4) DNA; amplimers using AdeGUp (NotI)F and AdeGDwn(SphI)R for R2 (lane 5) and R2ΔadeFGH (lane 7) DNA; amplimers using AdeG RTF and AdeG RTR for R2 (lane 6) and R2ΔadeFGH (lane 8) DNA; amplimers using AdeJ(UP) PstI F and AdeJ(DWN) SphI R for R2 (lane 9), R2ΔadeIJK (lane 11), DB (lane 13) and DBΔadeIJK (lane 15); amplimers using AdeJ F and AdeK R for R2 (lane 10), R2ΔadeIJK (lane 12), DB (lane 14) and DBΔadeIJK (lane 16); DBΔadeFGHΔadeIJK DNA

amplified using AdeGUp (NotI)F and AdeGDwn(SphI)R (lane 17), AdeG RTF and AdeG RTR (lane 18); AdeJ(UP) PstI F and AdeJ(DWN) SphI R (lane 19) and AdeJ F and AdeK R (lane 20); R2ΔadeFGHΔadeIJK DNA amplified with AdeGUp (NotI)F and AdeGDwn(SphI)R Batimastat datasheet (lane 21), AdeG RTF and AdeG RTR (lane 22), AdeJ(UP) PstI F and AdeJ(DWN) SphI R (lane 23) and AdeJ F and AdeK

R (lane 24); M, 1 kb DNA ladder (GeneRuler™). Transcriptional analysis of the ΔadeFGH and ΔadeIJK deletion mutants RNA was EPZ015666 solubility dmso extracted from parental strains and pump mutants cultured during mid-logarithmic growth in the absence of antibiotics. Analysis of the transcripts of the three major RND pumps in A. baumannii showed that the expression pattern of adeB, adeG and adeJ genes in both DB and R2 was similar (Figure  Carnitine palmitoyltransferase II 3). In the absence of any antibiotics, adeIJK was the most highly expressed pump while the expression of adeFGH was the lowest. All three pumps were also about 4-fold more highly expressed in DB as compared to R2 (Figure  3). Figure 3 Relative expression of adeB , adeG and adeJ in DB and R2 during mid-log phase. RNA was extracted from mid-log phase bacteria (OD600 = 1.0) cultured in LB medium. The numbers of

adeB, adeG and adeJ transcripts were each normalized to 16S rRNA transcripts. Black bars, DB; Light grey bars, R2. To confirm that the gene deletions had abolished the expression of the efflux pumps, the levels of transcripts of each gene in the adeFGH and adeIJK operons were measured in the deletion mutants and compared with the corresponding transcript levels in the parental strains. Both the DBΔadeFGH and R2ΔadeFGH mutants showed significant reduction (to ≤10%) in the transcript levels for adeF, adeG and adeH when compared to the parental strains (Figure  4A). Although detectable, the level of adeL transcription in these mutants was also significantly reduced when compared to the adeL transcripts in the parental strains. This was because the genomic deletion had included the putative adeL promoter. Inactivation of adeG in both DBΔadeFGH and R2ΔadeFGH mutants was confirmed by the almost undetectable levels of adeG transcripts (Figure  4A). Figure 4 Comparison of adeL-adeFGH operon and adeIJK operon expression in DB and R2 deletion mutants and parental strains.

Water Res 2008, 42:2300–2308 PubMedCrossRef 5 Wilén B-M, Nielsen

Water Res 2008, 42:2300–2308.PubMedCrossRef 5. Wilén B-M, Nielsen JL, Keiding K, Nielsen PH: Influence of microbial activity selleck compound on the stability of activated sludge flocs. Colloids Surf B Biointerfaces 2000, 18:145–156.CrossRef 6. Wilén B-M, Jin B, Lant P: Relationship between flocculation of activated sludge and composition of extracellular polymeric substances. Water Sci Technol 2003, 47:95–103.PubMed 7. Wilén B-M, Jin B, Lant P: The influence of key chemical constituents in activated sludge on surface and flocculating properties. Water Res 2003, 37:2127–2139.PubMedCrossRef 8. Figuerola ELM, Erijman L: Bacterial taxa abundance pattern in an industrial wastewater

treatment system determined by the check details full rRNA cycle approach. Environ Microbiol 2007, 9:1780–1789.PubMedCrossRef 9. Juretschko S, Loy A, Lehner A, Wagner M: The Microbial RG-7388 research buy Community Composition of a Nitrifying-Denitrifying Activated Sludge from an Industrial Sewage Treatment Plant Analyzed by the Full-Cycle rRNA Approach. Syst Appl Microbiol 2002, 25:84–99.PubMedCrossRef 10. Hagman M, Nielsen JL, Nielsen PH, Jansen JL: Mixed carbon sources for nitrate reduction in activated sludge-identification of bacteria and process

activity studies. Water Res 2008, 42:1539–1546.PubMedCrossRef 11. Gray ND, Miskin IP, Kornilova O, Curtis TP, Head IM: Occurrence and activity of Archaea in aerated activated sludge wastewater treatment plants. Environ Microbiol 2002, 4:158–168.PubMedCrossRef 12. Sánchez O, Garrido L, Forn I, Massana R, Maldonado MI, Mas J: Molecular characterization of activated sludge from a seawater-processing wastewater

treatment plant. Microb Biotechnol 2011, 4:628–642.PubMedCrossRef Immune system 13. Park H-D, Wells GF, Bae H, Criddle CS, Francis CA: Occurrence of Ammonia-Oxidizing Archaea in Wastewater Treatment Plant Bioreactors. Appl Environ Microbiol 2006, 72:5643–5647.PubMedCrossRef 14. Wells GF, Park HD, Yeung CH, Eggleston B, Francis CA, Criddle CS: Ammonia-oxidizing communities in a highly aerated full-scale activated sludge bioreactor: betaproteobacterial dynamics and low relative abundance of Crenarchaea. Environ Microbiol 2009, 11:2310–2328.PubMedCrossRef 15. Zhang T, Jin T, Yan Q, Shao M, Wells G, Criddle C, Fang HHP: Occurrence of ammonia-oxidizing Archaea in activated sludges of a laboratory scale reactor and two wastewater treatment plants. J Appl Microbiol 2009, 107:970–977.PubMedCrossRef 16. Daims H, Lücker S, Mussman M, Brito I, Spieck E, Head IM, Le Paslier D, Wagner M: Ammonia-oxidizing Archaea and nitrite-oxidizing Nitrospira in wastewater treatment plants: New insights based on molecular tools and environmental genomics. In ASPD5 specialist conference: Microbial Population Dynamics in Biological Wastewater Treatment. Aalborg, Denmark: IWA; 2009:80–83. 17.

There are some potential limitations to our study that provide un

There are some potential limitations to our study that provide uncertainty in the overall results. First, there is no anti-fracture efficacy data of strontium ranelate in the male population. The MALEO Trial was a bridging study and therefore did not represent the gold standard demonstration of anti-fracture efficacy. In accordance with the European guidelines on clinical investigation of medicinal products, the MALEO trial was a controlled study versus placebo with BMD measure Selleck Baf-A1 as primary efficacy criteria. Similar efficacy data on lumbar spine

and femoral neck (FN) BMD between men with osteoporosis at high risk of fracture (MALEO trial [15]) and PMO women (pivotal SOTI, TROPOS trials [5, 7]), however, supports the assumption, in the base-case analysis, of the same relative risk reduction. In addition, the anti-fracture efficacy of strontium ranelate verified in PMO women whatever the baseline characteristics [56] and check details whatever the 10-year fracture probabilities [57] as well as the relationship between BMD increase and fracture risk reduction [44, 45] reinforce this assumption. Second, even using efficacy data from the entire population of the clinical trials, the cost-effectiveness of the drug in real-life settings could be altered. Many studies have reported that adherence with osteoporosis medications is poor and suboptimal [58], and this may impact on the cost-effectiveness of therapies

[21, 59]. A sensitivity analysis assuming adherence similar to bisphosphonate’s adherence for postmenopausal

women confirms the potential impact of poor adherence on cost-effectiveness. Further research, however, would be required to estimate the cost-effectiveness of strontium ranelate in male osteoporosis in real-life settings. This will imply the collection of adherence data with strontium ranelate in male patients as well as on the relationship between poor adherence and fracture risk in men. Additional analyses evaluating the cost-effectiveness of strontium ranelate according to absolute fracture risk Dichloromethane dehalogenase would also be valuable. It has been increasingly suggested that treatment should be based on absolute fracture risk rather than on BMD threshold [60]. Although anti-osteoporosis treatment are not yet reimbursed based on absolute fracture risk, the development of FRAX® tool, recently available in Belgium [24], would help to identify new high-risk Selleck WH-4-023 populations of men that could be treated cost-effectively by strontium ranelate. Third, although most of the data were collected from male populations, some of these were derived from studies that were composed mainly of postmenopausal women. So, the impact of fractures on quality of life has not been specifically investigated in populations of men and would require further investigation. The decrease in quality of life due to osteoporotic fractures in men, however, appears comparable to that caused by postmenopausal osteoporotic women [61, 62].

In 276 (33%) of these patients, we found one or more vertebral fr

In 276 (33%) of these patients, we found one or more vertebral fractures. In 156

of these patients (54% of those who had a radiograph), this fracture—81 of which were moderate or severe—was unknown to the patient, indicating that either the fracture had occurred after the previous X-ray examination or the X-ray results had not been communicated to the patient. In the 138 patients known to have a vertebral fracture based on previous X-rays, VFA confirmed this in 129 (93%). An extensive sub study focused on detailed Defactinib comparison of VFA with radiographs in a subgroup has been published Selleckchem MDV3100 elsewhere [10]. BMD and VFA results As expected, a relationship was found between the BMD and the prevalence of vertebral selleck chemicals fractures (Table 4). In the entire cohort 28% of the patients had a normal BMD. In this subgroup a vertebral fracture

was still found using VFA in 14% (97/678) that was unknown in 74%. Osteopenia was found in 45% of the cohort, and in 21% (229/1,100) of that subgroup a vertebral fracture was detected, that was unknown in 71%. Osteoporosis was diagnosed in 27% of the cohort. In 33% (215/646) of these patients, a vertebral fracture was found, that was unknown in 65%. Table 4 Bone mineral density classification and the prevalence of vertebral fractures (VF) BMD class N (% total) N with VF (% class) N with only mild VF (% VF) VF unknown (% BMD class) Normal 678 (28%) 97 (14%) 46 (47%) 74 Osteopenia 1,100 (45%) 229 (21%) 104 (45%) 71 Osteoporosis 646

(27%) 215 (33%) 69 (32%) 65 The frequency of patient with at least one severe fracture was 9% (12/135) in those with normal BMD, rose to 36% (48/135) in those with osteopenia Org 27569 and to 56% (75/135) in those with osteoporosis, indicating that not only the frequency but also the severity of the fractures increased with decreasing BMD. Impact of VFA In the first 1,000 patients we aimed to send a questionnaire to the requesting physicians to obtain their initial and obviously subjective opinion of the BMD and VFA findings. In 58 patients, VFA results were technically inadequate and therefore 942 questionnaires were sent out. Of these, 468 were received back (50% response rate). Results are reported in Table 5.

Afonso LC, Scott P: Immune responses associated with susceptibili

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