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Периоперативные соображения для пациентов с множественной миеломой.

Множественная миелома — неизлечимый рак, характеризующийся распространением клональных плазменных клеток, в основном в костном мозге, но вызывающий широкомасштабные системные осложнения. Кроме того, этот рак обычно встречается у пожилых пациентов, которые часто являются слабыми и страдают от многочисленных коморбидов. Общемировая распространенность множественной миеломы неуклонно возрастает, а терапевтические достижения способствуют повышению уровня выживания. Существует несколько осложнений миеломы, о которых анестезиолог должен знать в связи с самим заболеванием, конкретными и подкрепляющими

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… optimise pain management perioperatively. 8 , 40 For spinal column involvement, patients can undergo low-dose radiation which provides marked pain relief with a relatively small incidence of side effects. 11 , 19 , 36 In appropriate cases, minimally invasive procedures such as vertebroplasty and kyphoplasty …

Analysis of Early Post-Radiation Surgical Management of Metastatic Spinal Tumors.

Background/Objectives: Radiotherapy is one of the various treatment options for patients with metastatic spinal tumors (MST). However, it is difficult to say that this is definitely an optimal treatment for MST, and there are several patients who need surgical treatment because pain or neurologic deficits occur even after radiotherapy. Therefore, this study aimed to analyze which patients received early operative treatment after radiotherapy. Methods: We included 81 patients who underwent decompression and fusion surgery after radiotherapy for MST. Patients who underwent surgery within 6 month

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… The exclusion criteria were as follows: (1) other surgery such as separation surgery, vertebroplasty, and kyphoplasty; (2) insufficient chart records of the patients’ treatment; (3) when the stereotactic radiosurgery was performed; (4) if the surgery was performed during radiotherapy; (5) patients with …

Bortezomib therapy in a real-world setting in patients with relapsed or refractory multiple myeloma.

Bortezomib is a proteasome inhibitor, approved for treating newly diagnosed and relapsed multiple myeloma (MM). This realworld, multicenter, observational, non-interventional study of bortezomib was designed to collect and analyze prospective data in Taiwanese patients with relapsed or refractory MM. The primary endpoints included clinical effectiveness outcomes (disease response, disease progression [PD], time-to-response, time-toprogression, response duration, and overall survival [OS]). Secondary endpoints were safety and healthcare resource utilization. Total 100 patients (median [range] a

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… red cell transfusions, loperamide, prophylactic antiemetic, antineoplastic therapy, antibiotics, and non-steroidal anti-inflammatory agents), anti-MM agents (including systemic corticosteroids, clarithromycin, and thalidomide), and treatments consonant with real-world practice (orthopedic surgery, kyphoplasty …

Comparative Effectiveness and Safety of Denosumab Versus Bisphosphonates in Elderly Patients with Cancer Bone Metastases: A Target Trial Emulation Study.

Objective: Bone-modifying agents (BMA) are central to the prevention of skeletal-related events (SREs) in patients with cancer bone metastases, yet evidence guiding agent selection in very old patients remains limited. This study aimed to compare the effectiveness and safety of Denosumab versus bisphosphonates in patients aged ≥75 years with solid tumour-related bone metastases using a target trial emulation framework. Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network to emulate a hypothetical randomised trial. Patients aged ≥75 years with solid

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… Outcomes The primary outcome was SRE, defined as a composite of (1) pathological fracture in neoplastic disease (ICD-10-CM: M84.5x); (2) spinal cord compression (ICD-10-CM: G95.2, G55); (3) radiation therapy to bone (CPT: 77401–77425, 77385–77386); (4) surgery to bone including vertebroplasty and kyphoplasty …

The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine.

BACKGROUND: Osteoarthritis (OA) in the lumbar spine can potentially lead to an overestimation of bone mineral density (BMD), and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial. Radiofrequency Echographic Multi Spectrometry (REMS) is being recognized as an innovative diagnostic tool for assessing bone status. The purpose of this study was to evaluate whether the use of REMS may enhance the identification of osteoporosis in patients with osteoarthritis. METHODS: A cohort of 500 patients (mean age: 63.9 ± 11.2 years) dia

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… These findings confirm REMS technology’s capability not only to address artifacts related to osteoarthritis but also those associated with spondylitis, vertebral fractures, and vertebroplasty or kyphoplasty operations. …

Belantamab mafodotin плюс венетоклакс в t()11;14)-положительное повторное или повторное несколько миелом – испытание BELI(E)VE

Множественная миелома (ММ) — широко неизлечимая злокачественная клетка B-клеток, которая в основном затрагивает пожилых людей. 10% от рака гематологов. Несмотря на достижения в области терапии, которые значительно увеличили средний показатель общего выживания (ОС), ММ по-прежнему является клинической проблемой с плохим прогнозом в отношении пациентов, отказывающихся от лечения в нескольких классах лекарственных препаратов. Существует острая потребность в новаторских и индивидуализированных методах лечения, в том числе для пациентов с транслокацией (см.11;14), подгруппу, характеризующуюся особо

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… Kyphoplasty is not considered a major surgery. 8. A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: a. Is not a woman of childbearing potential (WOCBP) b. … Kyphoplasty is not considered a major surgery. 8. A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: a. Is not a woman of childbearing potential (WOCBP) b. …

Practical management of disease-related manifestations and drug toxicities in patients with multiple myeloma.

Multiple myeloma (MM) is a very heterogeneous disease with multiple symptoms and clinical manifestations. MM affects mainly elderly patients and is difficult to manage in the presence of comorbidities, polypharmacy, frailty and adverse events of disease-targeted drugs. The rapid changes in MM treatment resulting from constant innovations in this area, together with the introduction of numerous new drugs with distinct mechanisms of action and toxicity profiles, have led to an increased complexity in the therapeutic decision-making and patient management processes. The prolonged exposure to nove

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… Vertebroplasty and kyphoplasty are alternatives to control pain associated with vertebral collapse. These techniques consist of the percutaneous injection of bone cement to stabilize the vertebral body, and should ideally be performed as soon as possible after vertebral collapse. … The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the international myeloma working group (IMWG). …

Oral Presentations

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Упорное использование опиоидов связано с более коротким выживанием миэломы.

Цель " Превышение " содержания опиоидов связана со значительным кризисом в области общественного здравоохранения, однако по-прежнему имеет решающее значение в качестве адъюнкт-процесса лечения во многих миеломах (ММ). Остаются вопросы о балансе между выгодами от продолжающегося использования опиоидов, особенно когда миэлома пациента находится в ремиссии. Этот ретроспективный обзор посвящен ассоциации хронического опиоида (COU) среди пациентов, преимущественно цветных. 174 В одном из городских медицинских центров были изучены пациенты, получившие аутологическую трансплантацию стволовы

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… non-steroidal analgesics, THC- or CBD-based systemic or topical products), non-pharmacological therapies (i.e., physical therapy, acupuncture [ 34 ], meditation [ 35 ], exercise), neurobehavioral treatments (i.e., cognitive behavioral therapy), and interventional treatments (i.e., epidural, local nerve blocks, kyphoplasty …

Evaluating the triglyceride glucose index as a predictive biomarker for osteoporosis in patients with type 2 diabetes.

OBJECTIVE: Osteoporosis is a common condition among individuals with type 2 diabetes; however, the relationship between insulin resistance, as measured by the Triglyceride Glucose Index (TyG), and osteoporosis has not been sufficiently explored. This study seeks to address this research gap by investigating the diagnostic value of TyG in identifying osteoporosis in patients with type 2 diabetes. METHODS: A retrospective analysis was performed on clinical data from 207 diabetic subjects (83 in the osteoporosis group, 124 in the non-osteoporosis group), using SPSS version 27.0 and MedCalc 23 fo

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… Analysis of re-fracture factors after percutaneous vertebral kyphoplasty for osteoporotic vertebral compression fractures . Chin J Bone Joint Surg . ( 2020 ) 13 : 987–90 . doi: 10.3969/j.issn.2095-9958.2020.12.04 21 Qiu HL . …

Vertebral body density role in determining vertebral osteoporotic fracture type and its progression.

Vertebral osteoporotic fractures (VOF) are among the most frequent fractures in the elderly, often leading to an impaired lifestyle and a high economic burden. Although a reduced bone mass density is considered one of the main risk factors for VOF, its role in determining the fracture type, using the AO spine-DGOU classification for osteoporotic thoracolumbar fractures, as well as its progression, is unknown. The current study aimed to: (1) reveal whether the bone density of the vertebral bodies of fractured and non-fractured vertebrae predicts the type of fracture, (2) examine whether bone de

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… Painful osteoporotic vertebral fracture: Pathogenesis, evaluation, and roles of vertebroplasty and kyphoplasty in its management . JBJS , 85 ( 10 ), 2010 – 2022 . 14563813 Schnake , K. J. , Blattert , T. …

Validity and reliability of the osteoporotic fracture treatment score (OF score) and outcomes across various treatments in osteoporosis vertebral compression fracture patients.

BACKGROUND: Osteoporotic vertebral compression fractures (OVF) are prevalent and substantially impact healthcare systems and patients' quality of life. The osteoporotic fracture treatment score (OF score), developed by the German Society of Orthopedics and Trauma (DGOU), guides surgical decisions, but its reliability and validity are underexplored. This study assessed the OF score's inter- and intraobserver reliability, validated its treatment recommendations, and investigated intermediate outcomes of different DGOU-recommended surgical strategies for OVF. METHODS: A retrospective cohort stud

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… (B) A kyphotic correction of 13 degrees Surgical treatment classification Surgical treatments for OVF were classified according to the DGOU treatment recommendations [ 12 ]: Stand-alone cement augmentation (CA) : This technique includes vertebroplasty or kyphoplasty without posterior instrumentation …

Exploring participant perceptions of a virtually supported home exercise program for people with multiple myeloma using a novel eHealth application: a qualitative study.

IntroductionSupervision, tailoring, and flexibility have been proposed as key program elements for delivering successful exercise programs for people with multiple myeloma (MM). However, no studies to date have evaluated the acceptability of an intervention employing these components. The aim of this study was to determine the acceptability of a virtually supported exercise program and eHealth application for people with MM.MethodsA qualitative description approach was used. One-on-one interviews were conducted with participants who completed the exercise program. Content analysis was used to

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… Table 1 Participant demographic and medical information 1 SCT stem cell transplantation; 2 includes vertebroplasty, kyphoplasty, or orthopedic surgeries related to myeloma Variable | Mean ± SD/median (range) Age (years) | 64.9 ± 6.7 BMI (kg/m 2 ) | 26.8 ± 5.2 Time since diagnosis (months) | 31 (9–134 …

Quality of life and its selected determinants in the group of patients with surgically treated spinal tumors.

INTRODUCTION: Spinal metastases are a common manifestation of advanced neoplastic disease. Destructive neoplastic lesions within the axial skeleton cause unrelieved pain and nervous system disorders involving spinal stenosis and other neural structures. The development of new systemic therapies, radiotherapy and minimally invasive spinal surgeries has increased patients' quality of life by minimising pain and neurological disorders due to vertebral neoplastic infiltration. The aim of the study was to assess the patients' quality of life before and after spine stabilisation surgery with spinal

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… The obtained results indicate that surgery within the axial skeleton (vertebroplasty, kyphoplasty) determines the improvement in respondents’ functionality and quality of life (p<0.001). …

Educational Case: Osteoporosis.

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… Manipulative reduction combined with concave side percutaneous kyphoplasty for treatment of kyphoscoliosis deformity caused by thoracolumbar osteoporotic vertebral compression fracture Spine J 19 9 2019 S182 10.1016/j.spinee.2019.05.476 27 Cruz E.S. Bharara A. Bharara N. …

Severe Disc degeneration is associated with lower caudal subendplate hounsfield unit values in degenerative lumbar spinal stenosis.

STUDY DESIGN: Retrospective radiological analysis OBJECTIVE: To analyze the distribution of computed tomography (CT)-based Hounsfield unit (HU) values of lumbar vertebrae and explore the correlation between HU values and the modified Pfirrmann grades in patients with degenerative lumbar spinal stenosis (DLSS). METHOD: A total of 82 DLSS patients were divided into two gender-based groups for this retrospective analysis. Demographic data, including age, gender, body mass index, medical history, smoking status, operative levels, bone turnover markers (BTMs), and bone metabolism indicators, of al

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… Analysis of intervertebral discs adjacent to thoracolumbar A3 fractures treated by percutaneous instrumentation and kyphoplasty. Orthop Traumatol Surg Res. 2020;106(6):1221–6. 10.1016/j.otsr.2020.05.006. 26. Su Q, Li Y, Feng X, Tan J, Ge H, Cheng B, Zhang Y. …

Бремя костных заболеваний не влияет на общее выживание вновь диагностированных пациентов с множественной миеломой - единый центр, ретроспективный анализ изображений 119 Пациенты.

Множественная миелома (ММ) часто вызывает миеломное заболевание костей (МБД), проявляющееся в остеолитических повреждениях и событиях, связанных с скелетами (СР), что существенно снижает качество жизни и повышает заболеваемость. Низкая доза для всего тела (WBLDT) стала стандартом для оценки участия костей в диагностике, однако ее прогнозируемое значение остается неясным. Цель этого исследования состояла в том, чтобы оценить нагрузку МБМР на вновь диагностированных пациентов ММ с использованием WBLDT и изучить связи между характеристиками изображений и результатами выживаемости.МЕТОДЫ: В этом р

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… Changes of inflammatory cytokines in vertebral compression fractures patients with percutaneous balloon kyphoplasty. Br. J. Neurosurg. 2024;38:231–235. doi: 10.1080/02688697.2020.1823941. 19. Silbermann R., Roodman G.D. Myeloma bone disease: Pathophysiology and management. J. …

Periacetabular metastases: Proposed extension of the Harrington classification.

OBJECTIVES: To describe the functional outcomes, complications, and reconstruction types in patients with periacetabular metastases and to propose an extension of the Harrington classification. METHODS: Twenty-eight patients (13 males, 15 females) with a mean age of 63.8 ± 15.5 years presented with periacetabular metastases from January 2010 to December 2021. The periacetabular metastases were graded according to Harrington's classification, with four additional categories introduced: A) joint involvement, B) Enneking zone 1 involvement, C) pathological acetabular fracture, and X) none of the

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… Some authors use augmentation balloons, similar to those used in kyphoplasty, to optimize cementation. 22 The modified Harrington technique has evolved, with the introduction of dual mobility systems, reinforcement rings, and other anti-protrusion systems reducing the rates of prosthetic dislocation …

Prognostic role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with bone metastases.

BackgroundSkeletal metastases are a common problem in patients with cancer, and surgical decision making depends on multiple factors including life expectancy. Identification of new prognostic factors can improve survival estimation and guide healthcare providers in surgical decision making. In this study, we aim to determine the prognostic value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in patients with bone metastasis.MethodsOne thousand and twelve patients from two tertiary referral centers between 2002 and 2014 met the inclusion criteria. Bivariate and multiv

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… patients undergoing revision procedures, (2) patients with metastatic involvement of the acetabulum or pelvis requiring reconstruction, (3) operative treatments other than endoprosthetic reconstruction, plate-screw fixation, intra-medullary nailing, and dynamic hip screw for long bone fractures, and (4) kyphoplasty …

Multiple Myeloma: Cast Nephropathy, VTE, and Neurologic Complications.

Multiple myeloma accounts for approximately 1% of neoplastic diseases and 13% of hematologic cancers. Complications often associated with MM include neurologic and hematologic issues, infections, renal insufficiency, and bone involvement. It is crucial for advanced practice professionals caring for myeloma patients to assess patients accurately, be keenly aware of possible associated complications, and be familiar with appropriate interventions to prevent further injury. This article will provide an overview of MM-related renal insufficiency, with a focus on cast nephropathy, venous thromboemb

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… Central venous catheters and surgeries such as vertebroplasty and kyphoplasty lead to vascular wall injury and damage (Rome et al., 2008). …