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Abstract: Osteoporosis and sarcopenia are two aspects of the geriatric syndrome that frequently occur together and affect one another in a condition referred to as osteosarcopenia. Preventive and treatment options for osteosarcopenia exist but are mainly focused on the treatment of osteoporosis, as there is still no FDA-approved treatment for sarcopenia. Drugs for osteoporosis include antiresorptive and anabolic drugs and hormonal replacement therapies and are prescribed based on age, BMD and other patient characteristics, which, however, do not include the possible co-existence of sarcopenia. As several studies and clinical trials have shown that the pharmacological treatment of osteoporosis can also affect muscle tissue, in either a positive or negative manner, sarcopenia should be another factor affecting the choice of treatment, especially when facing equal treatment options for osteoporosis. The aim of this review was to summarize our current knowledge on the effects of FDA-approved drugs for the treatment of osteoporosis on muscle quality, mass and function. A better understanding of the effects that certain drugs have on muscle tissue might in the future help us to simultaneously at least partially also address the wasting of muscle tissue and avoid further pharmacologically induced decline.
Keywords: osteoporosis, sarcopenia, osteosarcopenia, pharmacological treatment
Published in DiRROS: 09.12.2025; Views: 91; Downloads: 38
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Abstract: Background: Children with rheumatic diseases are at risk for contracting severe influenza and COVID-19 and are thus targeted for these vaccination. Objectives: To assess the influenza (flu) vaccination rate in children with Juvenile Idiopathic Arthritis (JIA), investigate families’ attitudes towards the influenza vaccine, and the effect of the COVID-19 pandemic on flu vaccine uptake. Methods: This multi-centre, cross-sectional study was conducted across 9 countries. JIA caregivers completed an anonymous questionnaire about their children’s influenza vaccination, including the 2019–2020 and 2020–2021 seasons, including knowledge, and perceptions regarding influenza vaccination. Results: Based on responses from 655 JIA caregivers, 152 children (23.2%) received influenza vaccinations in the 2020–2021 season, representing a significant rise from 18.6% in the previous season (p < 0.01). The likelihood of vaccination was higher among employed/self-employed caregivers compared to unemployed (28.2% and 29.9% vs. 13.9%), and those with tertiary education versus elementary (28% vs. 9.7%), both p < 0.01. Concerns of children’s vulnerability to SARS-CoV-2 and severe COVID-19 disease due to JIA were prevalent (51.3% and 85.3% respectively), with 51.3% supporting COVID-19 vaccination. Caregivers who previously vaccinated their children for influenza showed a greater inclination towards SARS-CoV-2 vaccination (73.4% and 79.5%, p < 0.01). Conclusions: Families of children with JIA reported an increasing flu vaccine uptake and a high intention for COVID- 19 vaccine administration. Previous vaccination behavior was shown as a significant predictor of future behaviour. Strengthening health education may address fears and lead to better vaccine coverage against both influenza and SARS-CoV-2 in children with JIA and other inflammatory rheumatic diseases.
Keywords: influenza vaccine, juvenile idiopathic arthritis, JIA, COVID-19, vaccination, children
Published in DiRROS: 09.12.2025; Views: 82; Downloads: 66
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Abstract: Background: Data on the incidence of IgG4-related disease (IgG4-RD) are scarce. Our aim was to determine the incidence of IgG4-RD in a well-defined region. Methods: This retrospective study covered the Ljubljana region over the period from January 2012 to December 2024. A review of cases diagnosed with IgG4-RD was performed at several departments of the University Medical Centre Ljubljana—an integrated secondary/tertiary university teaching hospital (rheumatology, nephrology, angiology, gastroenterology, abdominal surgery, ENT surgery, ophthalmology). While IgG4-RD cases at the Department of Rheumatology were collected prospectively, potential cases at other departments were retrieved by searching electronic medical database for the keyword “IgG4”. In addition, the Institute of Pathology, Faculty of Medicine, University of Ljubljana, provided a list of patients with histological features consistent with IgG4-RD. Year-specific incidence rates and an average incidence rate over the 13-year period were determined. Clinical features of patients were analysed. Results: During the observation period, 58 cases of IgG4-RD were diagnosed. Of these, 35 patients were residents of the Ljubljana region, which had an average adult population of 541,600. The estimated average annual incidence rate of IgG4-RD was 5.0 per million (95% confidence interval: 3.5; 6.9), with year-specific incidence rates fluctuating between 1.8 and 9.3 per million adults. The cases were stratified into four phenotypic categories: pancreato-hepato-biliary (17%), retroperitoneal fibrosis-aortitis (43%), head and neck-limited (14%), and Mikulicz syndrome with systemic involvement (26%). Conclusions: The average annual incidence rate of IgG4-RD was 5 per million adults, with the retroperitoneal fibrosis-aortitis phenotype predominating in our cohort.
Keywords: IgG4-related disease, epidemiology, demographic, incidence rate
Published in DiRROS: 09.12.2025; Views: 97; Downloads: 42
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Abstract: Aim: This prospective pilot anatomical study aimed to develop an ultrasoundguided transversus abdominis plane (TAP) block technique that desensitises cranial and mid-abdominal wall in grower pigs. We hypothesised that a fourpoint TAP approach would be more efficient than a three-point TAP in staining relevant nerves of the cranial and mid-abdominal wall. Methods: In phase I, the ultrasound anatomy of the abdominal wall musculature was examined on three pig cadavers (two piglets and one fattening pig) and the ultrasound localization of the needle in the corresponding interfascial plane was practised. In phase II, a three-point TAP injection was performed in three freshly euthanized cadavers of grower pigs. A 1% methylene blue solution (0.3 mL/ kg per injection point) was injected between the transversus abdominis and internal oblique muscle. In phase III, methylene blue solution was injected at four points (0.2 mL/kg per injection point) in four anaesthetized grower pigs prior to euthanasia. Positive nerve staining was defined as continuous staining of at least 1 cm of the nerve length. Binary variables (positive/negative) were used for nerve staining assessment. Results: The four-point TAP technique with a lower injection volume stained more nerves than the three-point technique with a higher injection volume, i.e., 69% of the observed nerves from the eighth-last thoracic to the third lumbar nerve were stained with the four-point TAP technique. The nerves in the centre were stained with a higher success rate, while the eighth-last thoracic and the second lumbar nerve were stained with less success (1/8 and 3/8, respectively). The third lumbar nerve was not stained. Conclusion: The four-point TAP technique could be used as part of a multimodal analgesia approach for cranial and mid-abdominal surgery in pigs, but live animal studies are needed to evaluate the clinical applicability and efficacy of desensitisation.
Keywords: abdominal surgery, cadaveric anatomical study, pig, regional anaesthesia, transversus abdominis plane block, methylene blue
Published in DiRROS: 09.12.2025; Views: 102; Downloads: 43
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Abstract: Background/Objectives: People with type 1 diabetes have an unmet need for cardiovascular protection due to the lack of new recommended antidiabetic therapies with cardiovascular benefits. We examined whether the addition of an empagliflozin/metformin combination, and each drug alone, can complement insulin to improve glucometabolic parameters in overweight people with type 1 diabetes at high cardiovascular risk. Methods: This pilot, single-center double-blind randomized controlled trial included 40 people with type 1 diabetes. In addition to insulin, they received empagliflozin (25 mg daily), metformin (2000 mg daily), an empagliflozin/metformin combination, or a placebo. The intervention period was 12 weeks. Glycemic parameters, insulin requirements, and blood and urine samples were analyzed. Indices for liver fibrosis were calculated. Due to potential safety concerns, participants regularly measured blood ketone values. Results: The empagliflozin/metformin combination decreased HbA1c (−0.6%, p < 0.05) and weight (−6.1 kg, p < 0.05). Empagliflozin decreased the urinary albumin-to-creatinine ratio (−31.4 ± 4.9%, p = 0.002). The empagliflozin/metformin combination and empagliflozin decreased the estimated daily proteinuria (−34.6 ± 5.0%, p = 0.006 and −35.9 ± 6.2%, p = 0.03, respectively), the calculated FIB-4 (up to −17.8 ± 5.2%, p = 0.04 and −10.7 ± 3.7%, p = 0.02, respectively), and other liver fibrosis indices and uric acid values. No significant side effects occurred during the study. Conclusions: The empagliflozin/metformin combination improved glycemic control, reduced weight and insulin requirements, and produced several additional beneficial metabolic effects in overweight people with type 1 diabetes with increased cardiovascular risk.
Keywords: type 1 diabetes, empagliflozin/metformin combination, glycemic control
Published in DiRROS: 09.12.2025; Views: 82; Downloads: 40
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