The clinical significance of sarcopenia and osteoporosis has increased with the increase in the population of older people. Sarcopenia is defined by decreased muscle mass and impaired muscle function, which is related to osteoporosis independently and dependently. Numerous lines of clinical evidence suggest that lean body mass is positively related to bone mass, which leads to reduced fracture risk. Genetic, endocrine and mechanical factors affect both muscle and bone simultaneously. Vitamin D, the growth hormone/insulin-like growth factor I axis and testosterone are physiologically and pathologically important as endocrine factors. These findings suggest the presence of interactions between muscle and bone, which might be very important for understanding the physiology and pathophysiology of sarcopenia and osteoporosis. Muscle/bone relationships include two factors: local control of muscle to bone and systemic humoral interactions between muscle and bone. As a putative local inducer of muscle ossification, we found Tmem119, a parathyroid hormone-responsive osteoblast differentiation factor. Moreover, osteoglycin might be one of the muscle-derived humoral bone anabolic factors. This issue may be important for the development of novel drugs and biomarkers for osteoporosis and sarcopenia. Further research will be necessary to clarify the details of the linkage of muscle and bone.
Axis, Cervical Vertebra ; Biomarkers ; Bone and Bones ; Fibrinogen ; Muscles* ; Osteoblasts ; Osteoporosis ; Physiology ; Sarcopenia ; Testosterone ; Vitamin D

Objective: This study aimed to confirm whether the methods for assessing the reported causal relationship between dietary supplement intake and adverse events are reliable in the clinical setting.
Design: The relationships between supplement intake and adverse events were assessed using two algorithms proposed in our previous report, and causal relationships were evaluated.
Methods: Twelve raters with a high probability of handling adverse event information examined 200 records of dialogues with supplement users.  Each rater independently assessed the causal relationship using the two algorithms.  The relationships between supplement intake and adverse events were assessed for all 200 cases.  Variability in the evaluation among raters was analyzed for each occupation and the whole group of raters.  The distributions of evaluation were analyzed, and inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC) and Fleiss’ kappa coefficient.
Results: All events of 200 cases seemed to be slight and within the range of variation in daily life.  Almost all cases were classified into two categories as “Possible” and “Lack of Information” by each rater.  The ICC values for all raters, pharmacists, dieticians, and health care workers were 0.644, 0.573, 0.678, and 0.694, respectively, and the kappa coefficients using the two algorithms were 0.466, 0.426, 0.468, and 0.519 and 0.481, 0.478, 0.465, and 0.517, respectively.  There were moderate levels of agreement based on the kappa coefficients and ICC values.
Conclusion: The two algorithms proposed in our previous report may be reliable in the clinical setting.  Their reliability could be enhanced by establishing a unified method of accumulation and recording adverse events for supplement intake, which should be evaluated by more raters using more cases of adverse events.

BACKGROUND: Streptococcus pneumoniae causes pneumonia, sepsis, and meningitis. This study aimed to investigate the clinical characteristics of mucoid and non-mucoid isolates of S. pneumoniae, and to explore the relationship between the isolate phenotypes and their antibiotic susceptibility. METHODS: Clinical isolates from 3,453 non-repetitive S. pneumoniae (189 mucoid and 3,264 non-mucoid) infections obtained between January 2008 and December 2012 from outpatients at the Kimitsu-Central Hospital were evaluated. RESULTS: Compared to the non-mucoid isolates, the mucoid phenotypes were more susceptible to certain antibiotics such as erythromycin, clarithromycin, and tetracycline as opposed to clindamycin, chloramphenicol, and rifampicin. The mucoid phenotype was isolated more frequently from schoolchildren, adults, and elderly adults in a variety of clinical sites, including otorrhea, genitalia, pus, and eye discharge than the non-mucoid phenotype. This suggested that mucoid isolates are more likely to be involved than non-mucoid isolates in various local infections. Systemic infection, which indicates invasiveness, was not associated with the mucoid or non-mucoid phenotype. CONCLUSIONS: The results of this study suggest that mucoid isolates tend to have higher susceptibility than non-mucoid isolates to antibiotics. To the best of our knowledge, mucoid and non-mucoid S. pneumoniae isolates considerably differ in terms of clinical isolation site and age-specific prevalence.
Adult ; Aged ; Anti-Bacterial Agents ; Chloramphenicol ; Clarithromycin ; Clindamycin ; Erythromycin ; Genitalia ; Humans ; Meningitis ; Outpatients* ; Phenotype ; Pneumonia ; Prevalence ; Rifampin ; Sepsis ; Streptococcus pneumoniae* ; Suppuration ; Tetracycline