Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m². Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05–1.83) and 1.46 (CI: 1.20–1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis.

Where population coverage is limited, the exclusive use of Cancer Registries might limit ascertainment of incident cancer cases. We explored the potentials of Nationwide hospital discharge records (NHDRs) to capture incident breast cancer cases in Italy.

Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presented by age groups (absolute number of cases from 20 to ≥80 years old) and per Region (rates per 100,000 inhabitants) for each year. Results: The overall number of new hospitalizations due to malignant Melanoma increased by 16.8% from 2001 (n = 4846) to 2008 (n = 5823), with the rate per 100,000 inhabitants passing from 10.5 to almost 12.0 at a national level. The majority of new diagnoses of malignant Melanoma was observed in two age groups: 61–70 years old (from 979 in 2001 up to 2109 in 2008, corresponding to 15.1 and 18.1 new cases per 100,000 inhabitants, respectively) and 71–80 years old (from 954 in 2001 up to 1141 in 2008, corresponding to 19.5 and 21.8 new cases per 100,000 inhabitants, respectively). The number of hospitalizations due to Melanoma increased in all age groups with the only exception of the youngest patients aged 20–30 years old. The highest increases over the 8-year period were observed in people aged ≥81 years old (+34%), 61–70 years old (+20%) and surprisingly in the age group 31–40 years old (+17%). Southern Regions showed lower hospitalization rates compared to Northern Italy and Region Lazio. The highest increases between 2001 and 2008 were observed in Trentino/Alto Adige, Friuli Venezia Giulia, Valla d’Aosta and Veneto Region. Conclusions: Hospitalizations due to malignant Melanoma in Italy seem to be influenced by environmental or population-related factors showing a decreasing incidence rate from the Northern to Southern Regions.

Objective(s): We aimed to determine the impact of microgravity-induced osteoporosis on the future of space programs. Material and methods: We performed a metanalysis of the available literature, finding out different studies about i) muscle atrophy due to the absence of workload, which can consequently induce bone loss; ii) the effect of long term inactivity on bone mass; iii) the effect of calcium and vitamin D supplementation in women and men in order to prevent bone loss; iv) the effect of bisphosphonates in preventing bone resorption due to long term inactivity (animal models); v) studies concerning osteoporosis carried out during space missions. Results: Unloading of weight bearing bones as induced by microgravity or immobilization has significant impacts on the calcium and bone metabolism and is the most likely cause for space osteoporosis. During a 4.5–6 month stay in space most of the astronauts develop a reduction in bone mineral density in spine, femoral neck, trochanter, and pelvis of 1–1.6% measured by dual energy X-ray absorption (DEXA). Dependent on the mission length and the individual turnover rates of the astronauts it can even reach individual losses of up to 14% in the femoral neck. Calcaneal mineral density is lost at a 5% rate of its mass each month. Attempts to prevent disuse osteoporosis with both mechanical and biochemical means, including exercise, skeletal compression, increased hydrostatic pressure to the lower body, supplemental calcium and/or phosphorus, calcitonin, or etidronate were not successful. In Gemini, Apollo, and Skylab astronauts it was shown a negative calcium balance due primarily to hypercalciuria. Altered bone cell activity would probably result in irreversible bone loss with the premature development of senile osteoporosis many years after space flight. Conclusion(s): Microgravity-induced osteoporosis represents a challenge for the future of space programs and therefore needs to be furhter investigated.

Objectives: We aimed to analyze bone mineralization in postmenopausal women of Southern Apulia and to evaluate the effect of obesity-related phenotypes as BMI ≥30 kg/m², diabetes, hypertension and cardiovascular diseases. Methods: The PROF project is a population-based study on 3.356 subjects (40–99 years) analyzed by phalangeal quantitative ultrasound (QUS) to evaluate bone mineral status. A total of 2.756 postmenopausal women were involved and examined by phalangeal QUS based on the transmission of ultrasound through the proximal phalanges (digits II–V). We collected personal, anthropometric and clinical data for each subjects analyzed. The primary outcome of phalangeal QUS was AD- SoS (Amplitude dependent Speed of Sound) T score. Logistic regression analysis was used to evaluated odds ratios (95% CI) of osteoporosis in subjects with obesity, diabetes, cardiovascular disease and hypertension. Results were adjusted by age, physical activity and use of drugs causing osteoporosis. According to the WHO criteria, osteoporosis status was defined as T- Score ≤3.2 S.D. the average value registered in young healthy women. Results: Mean age of postmenopausal women was 64±9.5 years and mean BMI was 28.7±3.5. Pearson correlation analysis revealed a negative association between T score and BMI (P<0.001). Significant odds ratio of osteoporosis status adjusted for age, physical activity and use of drugs causing osteoporosis were observed in women affected by diabetes and obesity, being OR (95% CI) respectively 1.39 (1.05–1.83) and 1.46 (1.20–1.78). Conclusions: Diabetes and obesity in postmenopausal women with the characteristics of the examined population increase the risk of osteoporosis independently from the effect of the age, physical activity and drugs causing osteoporosis.

Background: Osteoporosis is a leading cause of morbidity in patients affected by β-thalassaemia major (TM) and intermediate thalassaemia (TI). Appropriate supportive care and identification of long-term sequels of therapy are important in thalassaemic patients. As low bone mineral quality (BMQ) in patients can be considered a marker of possible degeneration to osteopenia and osteoporosis in adulthood, we evaluated bone features in a young population followed at ‘A. Perrino’ Hospital in Brindisi. Methods: Fifty-five thalassaemic patients (29 males, 26 females; aged 18–45 years) were analyzed during 2012 and compared vs a matched control population (55 healthy adults: 24 males, 31 females; aged 18–46 years). Seven patients were affected by TI while the rest was affected by TM. BMQ was assessed by quantitative ultrasound (QUS) technique at the phalanx level. The main values of phalangeal QUS are the amplitude-dependent speed of sound (AD-SoS, m/s) and the bone transmission time (BTT, μs). Results: QUS values were significantly lower in cases than in controls (AD-SoS: 2119.4±53.9 and BTT: 1.75±0.3 in controls; AD-SoS 2031±75.2 and BTT: 1.43±0.3 in cases). AD-SoS was negatively associated with BMI (r=−0.36, P=0.0067 in controls; r=−0.37, P=0.0054 in cases), while BTT was correlated with gender in both cases (P<0.01) and controls (P<0.0001), showing lower values in females. Conclusion: Our results suggest that bone quality in thalassaemic young patients is influenced by many factors that were not present in control subjects, such as iron chelation therapy, delayed sexual maturation, GH deficiency, parathyroid dysfunction, hypothyroidism, and liver diseases.