J. Jensen

Mortality, cancer, and comorbidities associated with chronic pancreatitis: a Danish nationwide matched-cohort study.

BACKGROUND & AIMSnWe aimed to assess the risk of death, cancer, and comorbidities among patients with alcoholic and nonalcoholic chronic pancreatitis (CP).nnnMETHODSnWe performed a nationwide retrospective cohort study, collecting data from Danish registries from 1995 through 2010. We evaluated the prevalences and incidences of death, cancers, and comorbidities among subjects with CP (cases) compared with age- and sex-matched individuals (controls). In total, 11,972 cases (71,814 person-years) and 119,720 controls (917,436 person-years) were included in the analysis. Hazard ratios (HR) were estimated by Cox proportional hazards regression.nnnRESULTSnForty-six percent of the cases died during the follow-up period, compared with 13.0% of controls (mean age, 63.7 vs 72.1 y; P < .0001), corresponding to a HR of 5.0 for CP (95% confidence interval [CI], 4.8-5.2). Cancer was a frequent cause of death among cases (10.2%) and controls (3.3%). Cancer (particularly pancreatic cancer) was a frequent cause of death among cases; the HR was 6.9 (95% CI, 7.5-11.8). Alcoholic CP did not produce a higher risk for cancer or death than nonalcoholic CP. Cerebrovascular disease (HR, 1.3; 95% CI, 1.2-1.4), chronic pulmonary disease (HR, 1.9; 95% CI, 1.8-2.1), ulcer disease (HR, 3.6; 95% CI, 3.3-3.9), diabetes (HR, 5.2; 95% CI, 5.0-5.6), and chronic renal disease (HR, 1.7; 95% CI, 1.5-1.9) occurred more frequently among patients with CP, but myocardial infarction did not (HR, 0.9; 95% CI, 0.8-1.0).nnnCONCLUSIONSnBased on a Danish nationwide cohort study, individuals with CP are at higher risk for death from cancer (particularly pancreatic cancer) and have a higher incidence of comorbidities than people without CP.

Urokinase plasminogen activator receptor affects bone homeostasis by regulating osteoblast and osteoclast function.

The uPAR and its ligand uPA are expressed by both osteoblasts and osteoclasts. Their function in bone remodeling is unknown. We report that uPAR‐lacking mice display increased BMD, increased osteogenic potential of osteoblasts, decreased osteoclasts formation, and altered cytoskeletal reorganization in mature osteoclasts.

The Risk of Fractures Among Patients With Cirrhosis or Chronic Pancreatitis

BACKGROUND & AIMSnCirrhosis and chronic pancreatitis (CP) are accompanied by inflammation and malnutrition. Both conditions can have negative effects on bone metabolism and promote fractures. We evaluated the risk of fractures among patients with CP or cirrhosis and determined the effect of fat malabsorption on fracture risk among patients with CP.nnnMETHODSnWe performed a retrospective cohort study using the Danish National Patient Register to identify patients diagnosed with CP or cirrhosis. We analyzed data collected from January 1, 1995, to December 31, 2010, on 20,769 patients (35.5% women with cirrhosis and 11,972 patients (33.5% women) with CP. Each patient was compared with 10 age- and sex-matched controls. We also assessed the risk of fractures among patients with CP who received pancreatic enzyme substitution (PES) for fat malabsorption.nnnRESULTSnDuring the study period, bone fractures occurred in 3954 patients with cirrhosis and 2594 patients with CP. The adjusted hazard ratio (HR) for any fracture was 2.4 in patients with cirrhosis (95% confidence interval [CI], 2.2-2.5) and 1.7 in patients with CP (95% CI, 1.6-1.8). The relative risk of low-trauma fractures was highest among individuals younger than 50 years old. Alcohol as an etiology was associated with an increased risk of fracture compared with patients with nonalcoholic cirrhosis (HR, 2.4 vs 1.5; P < .0001) and CP (HR, 2.0 vs 1.5; P < .0001). Patients with CP receiving PES for fat malabsorption had a lower risk of fractures than other CP patients (HR, 0.8; 95% CI, 0.7-0.9). However, increasing the duration of treatment with PES was associated with an increased risk of fracture.nnnCONCLUSIONSnPatients, especially younger patients, with cirrhosis or CP have an increased risk of fractures of all types.

Neutron spectroscopic study of crystal-field excitations and the effect of the crystal field on dipolar magnetism in LiRF4 (R = Gd, Ho, Er, Tm, and Yb)

We present a systematic study of the crystal-field interactions in the LiRF4 (R = Gd, Ho, Er, Tm, and Yb) family of rare-earth magnets. Using detailed inelastic neutron scattering measurements, we have been able to quantify the transition energies and wave functions for each system. This allows us to quantitatively describe the high-temperature susceptibility measurements for the series of materials and make predictions based on a mean-field approach for the low-temperature thermal and quantum phase transitions. We show that coupling between crystal field and phonon states leads to line-shape broadening in LiTmF4 and level splitting in LiYbF4. Furthermore, using high-resolution neutron scattering from LiHoF4, we find anomalous broadening of crystal-field excitations which we attribute to magnetoelastic coupling.

Low energy spin wave excitations in amplitude modulated magnetic structure of PrNi2Si2

Inelastic neutron scattering (INS) experiments and random phase approximation calculations have been used to investigate the low energy spin wave excitations in PrNi2Si2. The modulated magnitude of the ordered magnetic moments of Pr3+ ions implies that the associate, longitudinally polarized magnetic excitations are more intense and dispersive than the usual transverse spin waves. Within the random phase approximation the results are in good overall agreement with the predictions made by the model determined previously from the paramagnetic excitations. The most unusual observation is the well defined amplitude mode detected close to the magnetic Bragg point existing simultaneously with the phason mode. At low energies, an extra mode is observed to hybridize with the magnetic phasons in the neighborhood of the magnetic Brillouin zone center. A magnetoelastic interaction between the magnetic excitations and the longitudinal phonons is able to explain part of the disturbances, but it is concluded that the extra mode must be of some other, unknown origin. (Less)