Summary: Bone Strain Index (BSI) is a new dual-energy x-ray absorptiometry (DXA)-based index. We retrospectively evaluated data from 153 postmenopausal women with a history of type 2 diabetes mellitus (T2DM). Lumbar spine and femoral Bone Strain Index (BSI) were sensitive to skeletal impairment in postmenopausal women suffering from T2DM. Purpose: Bone Strain Index (BSI) is a new dual-energy X-ray absorptiometry (DXA)-based measurement. We evaluated the performance of BSI in predicting the presence of fragility fractures in type 2 diabetes mellitus (T2DM) postmenopausal women. Methods: We retrospectively evaluated data from a case–control study of 153 postmenopausal women with a history of at least 5 years of T2DM (age from 40 to 90 years). For each subject, we assessed the personal or familiar history of previous fragility fractures and menopause age, and we collected data about bone mineral density (BMD), BSI, and Trabecular Bone Score (TBS) measurements. Statistical analysis was performed having as outcome the history of fragility fractures. Results: Out of a total of 153 subjects, n = 22 (14.4%) presented at least one major fragility fracture. A negative correlation was found between lumbar BSI and lumbar BMD (r = − 0.49, p < 0.001) and between total femur BSI and total femur BMD (r = − 0.49, p < 0.001). A negative correlation was found between femoral neck BSI and femoral neck BMD (r = − 0.22, p < 0.001). Most DXA-based variables were individually able to discriminate between fractured and non-fractured subjects (p < 0.05), and lumbar BSI was the index with the most relative difference between the two populations, followed by femoral BSI. Conclusion: Lumbar spine and femoral BSI are sensitive to skeletal impairment in postmenopausal women suffering from T2DM. The use of BSI in conjunction with BMD and TBS can improve fracture risk assessment.

Myocardial iron overload represents a major cause of cardiac morbidity in patients with thalassemia. Cardiovascular magnetic resonance (CMR) T2* is the current reference for noninvasive myocardial iron quantification; however, it may be limited in detecting early iron-related myocardial changes. Native T1 mapping emerged as a complementary technique that may overcome some of the T2* limitations. The aim of this review is to analyze the available evidence on the use of native T1 mapping in thalassemia patients and to evaluate its relationship with T2*. Literature search was performed in PubMed, Scopus, Embase, and Cochrane. Studies evaluating myocardial T1 mapping in thalassemia patients were included. Data extraction focused on study characteristics, technical aspects, T1 and T2* values, and associations between the two measures. Sixteen studies were included. Most investigations reported a good relationship between T1 and T2* values. The strength of this association was higher in iron-overloaded cohorts and weaker in patients with normal T2*. Several studies described a subset of patients with reduced T1 despite normal T2*. Considerable heterogeneity was observed across studies in acquisition protocols, region of interest strategies and native T1 reference values. In conclusion, T1 mapping shows a global, though heterogeneous, association with T2* in thalassemia patients and its systematic integration in acquisition protocols represents a valuable complementary tool to T2*. Native T1 mapping may improve detection of early myocardial iron-related changes and support individualized patient management. Prospective longitudinal studies incorporating clinical outcomes are required to define the prognostic value and clinical role of T1 mapping.

In the bronchoalveolar lavage (BAL) of IPF patients, eosinophilia greater than 10% is observed. Additionally, nitric oxide (NO) plays a crucial role in the aberrant angiogenesis process in fibrotic lungs. Our aim is to evaluate the role of blood eosinophil counts (BECs) and FeNO as potential biomarkers for IPF. A total of 38 IPF patients (mean age 75.5 ± 6.7 years) followed at the University of Ferrara was enrolled. We monitored BECs and FeNO at baseline (T0, time of diagnosis and initiation of antifibrotic therapy) and after 12 months (T12) of treatment. We found higher BECs in patients on Nintedanib treatment (0.54 ± 0.13 x10³/mcrl) compared to those on Pirfenidone (0.13 ± 0.10 x10³/mcrl) or not on treatment (0.02 ± 0.01 x10³/mcrl). We also measured exhaled nitric oxide (FeNO) after 12 months of antifibrotic therapy and observed a higher FeNO concentration in patients treated with Nintedanib (29.42 ± 2.99 ppb) compared to the group on Pirfenidone therapy (20.8 ± 20.5 ppb). We propose for the first time in the literature the role of eosinophils and FeNO as potential biomarkers of response to antifibrotic therapy (Nintedanib). This needs to be further demonstrated in a larger population of patients.

Conventional radiography is widely used for postmortem foetal imaging, but its role in diagnosing congenital anomalies is debated. This study aimed to assess the effectiveness of X-rays in detecting skeletal abnormalities and guiding genetic analysis and counselling. This is a retrospective analysis of all post-abortion diagnostic imaging studies conducted at a centre serving a population of over 300,000 inhabitants from 2008 to 2023. The data were analysed using descriptive statistics. X-rays of 81 aborted foetuses (total of 308 projections; mean: 3.8 projections/examination; SD: 1.79) were included. We detected 137 skeletal anomalies. In seven cases (12.7%), skeletal anomalies identified through radiology were missed by prenatal sonography. The autopsy confirmed radiological data in all cases except for two radiological false positives. Additionally, radiology failed to identify a case of syndactyly, which was revealed by anatomopathology. X-ray is crucial for accurately classifying skeletal abnormalities, determining the causes of spontaneous abortion, and guiding the request for genetic counselling. Formal training for both technicians and radiologists, as well as multidisciplinary teamwork, is necessary to perform X-ray examinations on aborted foetuses and interpret the results effectively.