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Does Measurement of First-Order and Heterogeneity Parameters Improve Response Assessment of Bone Metastases in Breast Cancer Compared to SUVmax in [18F]fluoride and [18F]FDG PET?
Azad, GK, Cousin, F, Siddique, M, Taylor, B, Goh, V, Cook, GJR
Molecular imaging and biology. 2019;(4):781-789
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Abstract
PURPOSE To establish whether first-order statistical features from [18F]fluoride and 2-deoxy-2-[18F] fluoro-D-glucose ([18F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) demonstrate incremental value in skeletal metastasis response assessment compared with maximum standardised uptake value (SUVmax). PROCEDURES Sixteen patients starting endocrine treatment for de novo or progressive breast cancer bone metastases were prospectively recruited to undergo [18F]fluoride and [18F]FDG PET/CT scans before and 8 weeks after treatment. Percentage changes in SUV parameters, metabolic tumour volume (MTV), total lesion metabolism (TLM), standard deviation (SD), entropy, uniformity and absolute changes in kurtosis and skewness, from the same ≤ 5 index lesions, were measured. Clinical response to 24 weeks, assessed by two experienced oncologists blinded to PET/CT imaging findings, was used as a reference standard and associations were made between parameters and progression free and overall survival. RESULTS [18F]fluoride PET/CT: In four patients (20 lesions) with progressive disease (PD), TLM and kurtosis predicted PD better than SUVmax on a patient basis (4, 4 and 3 out of 4, respectively) and TLM, entropy, uniformity and skewness on a lesion basis (18, 16, 16, 18 and 15 out of 20, respectively). Kurtosis was independently associated with PFS (p = 0.033) and OS (p = 0.008) on Kaplan-Meier analysis. [18F]FDG PET No parameter provided incremental value over SUVmax in predicting PD or non-PD. TLM was significantly associated with OS (p = 0.041) and skewness with PFS (p = 0.005). Interlesional heterogeneity of response was seen in 11/16 and 8/16 patients on [18F]fluoride and [18F]FDG PET/CT, respectively. CONCLUSION With [18F]fluoride PET/CT, some first-order features, including those that take into account lesion volume but also some heterogeneity parameters, provide incremental value over SUVmax in predicting clinical response and survival in breast cancer patients with bone metastases treated with endocrine therapy. With [18F]FDG PET/CT, no first-order parameters were more accurate than SUVmax although TLM and skewness were associated with OS and PFS, respectively. Intra-patient heterogeneity of response occurs commonly between metastases with both tracers and most parameters.
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Does Fluoride Affect Serum Testosterone and Androgen Binding Protein with Age-Specificity? A Population-Based Cross-Sectional Study in Chinese Male Farmers.
Duan, L, Zhu, J, Wang, K, Zhou, G, Yang, Y, Cui, L, Huang, H, Cheng, X, Ba, Y
Biological trace element research. 2016;(2):294-299
Abstract
Many studies have demonstrated that exposure to excess fluoride was associated with a variety of diseases. Little is known about the variation of testosterone (T) levels caused by fluoride exposure. The aim of this study is to explore the association of fluoride exposure and age with serum T and androgen-binding protein (ABP) levels in male farmers. A cross-sectional study was conducted in a county of Henan Province, China, including high fluoride exposure from drinking water villages and control villages. Male farmers aged 18-55 years old who lived in these villages were recruited by cluster sampling and divided into a higher fluoride exposure group (HFG) and a lower fluoride exposure group (LFG) according to the level of urinary fluoride. Levels of T and ABP in serum were measured using chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA) respectively. Markedly lower T levels were observed in male farmers from the HFG than in those from the LFG (t = 2.496, P < 0.05). Furthermore, younger farmers, 18-29 and 30-39 years old, may be the most likely to have lower T levels when exposed to fluoride (P < 0.05). No significant differences were observed in serum ABP levels in all male farmers between the two groups with different fluoride exposure. These results supported that excess fluoride exposure decreased serum T levels of male farmers with age-specificity.
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A clinical trial to evaluate the effects of prophylactic fluoride agents on the superelastic properties of nickel-titanium wires.
Vo, J, Chudasama, DN, Rinchuse, DJ, Day, R
World journal of orthodontics. 2010;(2):135-41
Abstract
AIM: To study the effects of a prophylactic fluoride regimen on the mechanical properties of nickel-titanium (Ni-Ti) archwires under clinical conditions. METHOD The unloading properties of 100 Ni-Ti wires were tested using a three-point bending test at five deflections (0.5 mm, 1.0 mm, 2.0 mm. 3.0 mm, and 3.1 mm). Sixty-six 0.016 3 0.022-inch Ni-Ti wires were tested after being used intraorally for 6 weeks using two protocols. Thirty-three wires were evaluated after the use of fluoride-containing Crest toothpaste (sodium fluoride 0.243%, 0.15% w/v fluoride ion) and Equate fluoride rinse (sodium fluoride 0.05%, fluoride ion 0.0226%). Another 33 wires were examined after a nonfluoridated natural toothpaste (Tom's of Maine; calcium carbonate, xylitol, myrrh, propolis, sodium lauryl sulfate, carrageenan, spearmint and peppermint oils, glycerin, and water) was used. Another 34 Ni-Ti wires served as a control; they were tested as received. Statistical analyses were carried out with a linear-mixed model (analysis of variance [ANOVA]). RESULTS Force degradation occurred within both groups of intraorally used wires but not in the unused archwires. When compared to unexposed wires, those with fluoride exposure exhibited slightly higher force degradation at 3.1 and 3.0 mm deflection, but they displayed less force degradation at 0.5 and 1.0 mm deflection. CONCLUSIONS Topical fluoride regimens decreased the unloading property of Ni-Ti wires at higher deflections but increased it at lower deflections.
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Efficacy of etidronate and sequential monofluorophosphate in severe postmenopausal osteoporosis: a pilot study.
Ringe, JD, Dorst, A, Faber, H, Kipshoven, C, Rovati, LC, Setnikar, I
Rheumatology international. 2005;(4):296-300
Abstract
In a three-year pilot study on 52 women with severe postmenopausal osteoporosis, treatment with etidronate followed by calcium and vitamin D (ECaD) was compared to etidronate followed by monofluorophosphate, calcium and vitamin D (EFCaD). BMD in lumbar spine, total hip and femoral neck increased significantly more with EFCaD than with ECaD. Pain-mobility score decreased significantly more with EFCaD than with ECaD (p=0.006). New vertebral fractures occurred in three patients under EFCaD (12%) and in nine under ECaD (35%), (p=0.048). Three patients under EFCaD (12%) and 15 under ECaD (58%) did not respond to therapy (p of difference=0.001). Mild or moderate adverse reactions were reported by 25 patients, with no significant difference between the two groups. The pilot study suggests that etidronate, sequentially followed by monofluorophosphate, could be a safe, effective and relatively inexpensive therapy in severe postmenopausal osteoporosis.
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Effect of fluoride varnish on the in vitro bond strength of orthodontic brackets using a self-etching primer system.
Kimura, T, Dunn, WJ, Taloumis, LJ
American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 2004;(3):351-6
Abstract
To reduce the number of steps involved with bonding procedures, manufacturers have simplified adhesive systems by combining the hydrophilic primer and the adhesive, or by combining the etchant, the primer, and the adhesive into 1 bottle and application. The purpose of this study was to investigate the relationship between the shear bond strength of orthodontic brackets to enamel, with or without fluoride varnish, by using either conventional or self-etching primer systems. Forty-eight extracted teeth were divided into 4 groups of 12 teeth each: group 1, fluoride varnish, conventional adhesive; group 2, fluoride varnish, self-etching primer system; group 3, no fluoride varnish, conventional adhesive; and group 4, no fluoride varnish, self-etching primer system. The bonding procedure followed the manufacturers' recommendations for the materials. Precoated adhesive orthodontic brackets were light-cured to the facial surfaces of the teeth and stored in whole human saliva at 37 degrees C for 24 hours. The specimens were subjected to a shear force in a testing machine until failure. The adhesive remnant index was used to score the teeth. Data were analyzed with a 2-way analysis of variance to test for differences in shear bond strength with respect to fluoride varnish and type of adhesive system used. The results showed no difference in bond strength among any of the experimental groups. Similarly, chi-square analysis determined that adhesive remnant index scores were not statistically different. The application of fluoride varnish does not affect the bond strength of orthodontic brackets to enamel with conventional or self-etching primer systems.
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Assessment of the metabolic activity of bone grafts with (18)F-fluoride PET.
Brenner, W, Vernon, C, Conrad, EU, Eary, JF
European journal of nuclear medicine and molecular imaging. 2004;(9):1291-8
Abstract
PURPOSE The aims of this prospective study were to evaluate quantitative approaches to (18)F-fluoride positron emission tomography (PET) imaging in allogenic bone grafts of the limbs, and to assess the time course of graft healing after surgery. METHODS We performed a total of 52 dynamic (18)F-fluoride PET studies in 34 patients with cancellous and full bone grafts. Seven patients were imaged three times at 6, 12, and 24 months after surgery, and four patients were imaged twice. PET data were quantitatively analyzed using non-linear regression (NLR) analysis, Patlak analysis, and standardized uptake value (SUV). RESULTS Fluoride bone metabolism in cancellous grafts decreased by 25% from 6 to 12 months post surgery, and revealed a total decrease of 60-65% after 2 years for SUV, K(Pat), and K(NLR). Full bone grafts first showed an increase by 20% from 6 to 12 months and from then on decreased to 70% of the initial activity at the end of 2 years with either quantification method. In two patients with non-union of their full bone grafts, increases in SUV, K(Pat), K(NLR), and K(1) far above average and outside the normal time pattern were observed. Highly significant correlations were found between SUV, K(Pat), K(NLR), and K(1) for both grafts and normal limb bones. In patients imaged repeatedly, the percentage changes in fluoride graft metabolism were also significantly correlated between SUV, K(Pat), and K(NLR). CONCLUSION Quantitative (18)F-fluoride PET is a promising tool for assessment of fluoride metabolism and normal healing in bone grafts of the limbs.
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Effect of raloxifene combined with monofluorophosphate as compared with monofluorophosphate alone in postmenopausal women with low bone mass: a randomized, controlled trial.
Reginster, JY, Felsenberg, D, Pavo, I, Stepan, J, Payer, J, Resch, H, Glüer, CC, Mühlenbacher, D, Quail, D, Schmitt, H, et al
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2003;(9):741-9
Abstract
Raloxifene effectively reduces the incidence of vertebral fractures in patients with postmenopausal osteoporosis. Recent data suggest that low-dose monofluorophosphate (MFP) plus calcium reduces the vertebral fracture rate in postmenopausal women with moderate osteoporosis. The objective of this study was to evaluate the combination of raloxifene and MFP in the treatment of postmenopausal women with osteopenia, osteoporosis and severe osteoporosis. A total of 596 postmenopausal women with osteopenia, osteoporosis and severe osteoporosis (mean femoral neck T-score of -2.87 SD) were randomized to treatment with 60 mg/day raloxifene HCl and 20 mg/day fluoride ions (as MFP) or 20 mg/day fluoride and placebo for 18 months. All patients received calcium (1000 mg/day) and vitamin D (500 IU/day) supplements. Changes in bone mineral density (BMD), as primary endpoint, and the rate of osteoporotic fractures and biochemical markers, as secondary endpoints, were assessed. As compared with MFP, raloxifene plus MFP was associated with significantly greater mean increases in the BMD of the femoral neck (1.37% versus 0.33%; P=0.004), total hip (0.89% versus -0.42%; P<0.001) and lumbar spine (8.80% versus 5.47% P<0.001). In the raloxifene plus MFP group, 16 patients sustained 17 osteoporotic fractures, as compared with 22 patients sustaining 34 incident osteoporotic fractures in the MFP group ( P=0.313). One patient in the raloxifene plus MFP group sustained multiple osteoporotic fractures, as compared with eight patients in the MFP group ( P=0.020). MFP alone significantly increased the serum bone alkaline phosphatase (bone ALP) and the urinary C-terminal crosslinking telopeptide of type I collagene (U-CTX). The addition of raloxifene in the combination arm blunted the rise in bone ALP, which remained nevertheless significant, and abolished the increase in U-CTX. The combination of raloxifene with MFP was generally well tolerated. This study demonstrates that, in postmenopausal women with osteopenia, osteoporosis and severe osteoporosis, the combination therapy of raloxifene plus MFP favorably influences the BMD and the bone formation and resorption balance, and may reduce the risk of multiple osteoporotic fractures compared to MFP alone.
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Fluoride metabolism in smokers and non-smokers following enflurane anaesthesia.
Laisalmi, M, Soikkeli, A, Kokki, H, Markkanen, H, Yli-Hankala, A, Rosenberg, P, Lindgren, L
British journal of anaesthesia. 2003;(6):800-4
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Abstract
BACKGROUND Inorganic fluoride is released by the metabolism of enflurane and the increased serum fluoride concentrations may impair renal function. Tobacco smoke consists of numerous reactive compounds that can either induce or inhibit drug metabolism. Studies on the interaction of smoking with anaesthetic drug metabolism and possible toxicity are warranted. METHODS Sixteen non-smoking and 17 smoking (>10 cigarettes day(-1)) generally healthy women undergoing elective gynaecological surgery were given 1 MAC (minimum alveolar concentration)-hour standardized anaesthesia with enflurane in oxygen-air mixture. The serum inorganic fluoride and renal function markers beta(2)-microglobulin, tumour-associated trypsin inhibitor (TATI) and serum creatinine were measured for 48 h. RESULTS The greatest inorganic fluoride concentration was between 8.4 and 21.0 (mean 13.8 (SD 3.4)) micromol litre(-1) in the non-smokers and between 8.6 and 38.0 (18.7 (7.0)) micromol litre(-1) in the smokers; the mean difference was 4.9 micromol litre(-1) (95% confidence interval (CI) 1.0-8.8, P<0.05). Serum beta(2)-microglobulin, TATI and creatinine were not increased. Serum inorganic fluoride concentrations were significantly greater in the smokers compared with the non- smokers 1, 2, 3 and 6 h after 1 MAC-hour inhalation with enflurane (P<0.05). Inorganic fluoride concentrations were still increased 24 h after anaesthesia in both groups. Urine beta(2)-microglobulin and TATI creatinine ratio remained at low values during the whole 48-h period in both groups. CONCLUSIONS Regular smoking is associated with an increase in serum inorganic fluoride concentration after anaesthesia with enflurane, but there are no signs of renal damage.
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Daily use of dentifrice with and without xylitol and fluoride: effect on glucose retention in humans in vivo.
Iwata, C, Nakagaki, H, Morita, I, Sekiya, T, Goshima, M, Abe, T, Isogai, A, Hanaki, M, Kuwahara, M, Tatematsu, M, et al
Archives of oral biology. 2003;(5):389-95
Abstract
The effect of daily use of three different dentifrices on glucose retention after glucose mouth rinsing was tested in this study regarding xylitol and fluoride. Six experimental groups used three different dentifrices produced by two different companies: xylitol- and fluoride-containing dentifrice (XF), non-xylitol- and fluoride-containing dentifrice (F), and non-xylitol- and non-fluoride-containing dentifrice (NonX-NonF). Subjects were divided at random and rinsed their mouths for 15s with 20ml of 0.5M glucose solution. Glucose and lactate retention were determined by collecting samples of saliva from the approximal areas of the maxillary and mandibular anterior teeth and using the enzyme membrane test. Samples were collected 0, 1 and 2 months after the start of regular dentifrice use. There were significant differences in glucose retention in relation to the dentifrice used, month of sampling, site of sampling, and time since start of rinsing. Their contribution ratios were 2.0, 4.4, 11.7 and 7.4%, respectively (P<0.01). There were significant differences observed between the XF and NonX-NonF groups, with the XF group presenting lower glucose retention than the NonX-NonF group. The XF group presented lower glucose retention than the F group. The F group showed lower glucose retention than the NonX-NonF group. There were significant differences in lactate retention in relation to the month and site of sampling, and their contribution ratios were 3.3 and 2.8%, respectively (P<0.01). There were, however, no significant differences in glucose and lactate retention in relation to the dentifrice manufacturer. It was concluded that the XF dentifrice was the most effective, and the F dentifrice was more effective in reducing glucose retention than the NonX-NonF dentifrice.
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Osteoporosis in inflammatory bowel disease: effect of calcium and vitamin D with or without fluoride.
Abitbol, V, Mary, JY, Roux, C, Soulé, JC, Belaiche, J, Dupas, JL, Gendre, JP, Lerebours, E, Chaussade, S, ,
Alimentary pharmacology & therapeutics. 2002;(5):919-27
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Abstract
BACKGROUND Previous data have indicated low bone formation as a mechanism of osteoporosis in inflammatory bowel disease. Fluoride can stimulate bone formation. AIM: To assess the effect of fluoride supplementation on lumbar spine bone mineral density in osteoporotic patients with inflammatory bowel disease treated in parallel with calcium and vitamin D. METHODS In this prospective, randomized, double-blind, parallel and placebo-controlled study, 94 patients with inflammatory bowel disease (lumbar spine T score below - 2 standard deviations, normal serum 25OH vitamin D), with a median age of 35 years, were included. Bone mineral density was measured by dual-energy X-ray absorptiometry. Patients were randomized to receive daily either sodium monofluorophosphate (150 mg, n=45) or placebo (n=49) for 1 year, and all received calcium (1 g) and vitamin D (800 IU). The relative change in bone mineral density from 0 to 12 months was tested in each group (fluoride or placebo) and compared between the groups. RESULTS Lumbar spine bone mineral density increased significantly in both groups after 1 year: 4.8 +/- 5.6% (n=29) and 3.2 +/- 3.8% (n=31) in the calcium-vitamin D-fluoride and calcium-vitamin D-placebo groups, respectively (P < 0.001 for each group). There was no difference between the groups (P=0.403). Similar results were observed according to corticosteroid intake or disease activity. CONCLUSIONS Calcium and vitamin D seem to increase lumbar spine density in osteoporotic patients with inflammatory bowel disease; fluoride does not provide further benefit.