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Bisphosphonate-Related Osteonecrosis of the Jaw and Oral Microbiome: Clinical Risk Factors, Pathophysiology and Treatment Options.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a serious health condition, impacting the lives of many patients worldwide. The condition challenges clinical care due to its complex etiology and limited therapeutic options. A thorough understanding of the pathophysiological and patient-related factors that promote disease development is essential. Recently, the oral microbiome has been implicated as a potential driver and modulating factor of BRONJ by several studies. Modern genomic sequencing methods have provided a wealth of data on the microbial composition of BRONJ lesio

Management of skeletal metastases: An orthopaedic surgeon's guide.

Skeletal metastasis is a common cause of severe morbidity, reduction in quality of life (QOL) and often early mortality. Its prevalence is rising due to a higher rate of diagnosis, better systemic treatment, longer lives with the disease and higher disease burden rate. As people with cancer live longer and with rising sensitivity of body imaging and surveillance, the incidence of pathological fracture, metastatic epidural cord compression is rising and constitutes a challenge for the orthopedic surgeon to maintain their QOL. Metastatic disease is no longer a death sentence condemning patients

Retrospective assessment of tolerability and efficacy of zoledronate in the palliative treatment of cancer-bearing dogs.

Zoledronate is a bisphosphonate frequently used for the treatment of hypercalcaemia of malignancy and tumour-associated bone pain in dogs, however, there is a paucity of information regarding its use in veterinary medicine. The aim of this retrospective study was to report the tolerability of zoledronate in the palliative treatment of cancer-bearing dogs and secondarily to to assess the efficacy of zoledronate for the treatment of hypercalcaemia of malignancy. Thirty-seven dogs (22 with tumour-associated bone pain and 15 with hypercalcaemia of malignancy) that received 114 zoledronate infusion

Comprehensive analysis of mRNA-microRNA-lncRNA expression profiles in post-traumatic elbow heterotopic ossification using RNA sequencing and experimental validation.

BackgroundThis study aimed to profile the molecular signatures of post-traumatic elbow heterotopic ossification (HO) to identify key regulators and potential therapeutic targets.MethodsTotal RNA from post-traumatic elbow HO tissues (n=4) and normal bone tissues (n=6) was subjected to high-throughput sequencing to identify differentially expressed mRNAs (DEGs), microRNAs (DEMs), and lncRNAs (DELs). Bioinformatics analyses included Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, protein-protein interaction network construction, and transcription factor (TF)

Definition and management of very high fracture risk in women with postmenopausal osteoporosis: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Association of Bone Assessment and Metabolism (ABRASSO).

Several drugs are available for the treatment of osteoporosis in postmenopausal women. Over the last decades, most patients requiring pharmacological intervention were offered antiresorptive drugs as first-line therapy, while anabolic agents were considered a last resource for those with therapeutic failure. However, recent randomized trials in patients with severe osteoporosis have shown that anabolic agents reduce fractures to a greater extent than antiresorptive medications. Additionally, evidence indicates that increases in bone mineral density (BMD) are maximized when patients are treated

Federated Computing in Orthopaedic Surgery: A Paradigm Shift in Collaborative Multicenter Research.

➢ Multicenter studies remain rare in orthopaedics (9.9% of recent publications) due to regulatory complexity, restrictive data-sharing policies, and administrative delays, despite their proven value in generating robust, generalizable evidence. ➢ Federated computing (FC) brings analytic code to each institution's data and returns only encrypted, aggregated results. This preserves patient privacy, maintains institutional control, and streamlines compliance by reducing or eliminating the need for complex data-use agreements. ➢ Extensive applications in other medical fields show that FC can match

A new taxonomy was developed for overlap across 'overviews of systematic reviews': A meta-research study of research waste.

Multiple 'overviews of reviews' conducted on the same topic ("overlapping overviews") represent a waste of research resources and can confuse clinicians making decisions amongst competing treatments. We aimed to assess the frequency and characteristics of overlapping overviews. MEDLINE, Epistemonikos and Cochrane Database of Systematic Reviews were searched for overviews that: synthesized reviews of health interventions and conducted systematic searches. Overlap was defined as: duplication of PICO eligibility criteria, and not reported as an update nor a replication. We categorized overview to

Educational Case: Atypical presentation of primary hyperparathyroidism with brown tumor.

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СРП 2013

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Genetic Background of Medication-Related Osteonecrosis of the Jaw: Current Evidence and Future Perspectives.

Medication-related osteonecrosis of the jaw (MRONJ) is a rare side effect of antiresorptive drugs that significantly hinders the quality of life of affected patients. The disease develops in the presence of a combination of factors. Important pathogenetic factors include inflammation, inhibition of bone remodeling, or genetic predisposition. Since the first description of this rare side effect in 2003, a growing body of data has suggested a possible role for genetic factors in the disease. Several genes have been suggested to play an important role in the pathogenesis of MRONJ such as SIRT1, V

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… It can affect various areas such as the femoral head, humeral head, spine, or jaw (osteonecrosis of the jaw; ONJ). ONJ is mainly caused by various medications (MRONJ), radiation therapy, and trauma to the jaw [ 1 ]. …

Какие факторы связаны с неблагоприятным прогнозом у нескольких пациентов с миеломой после операции?

Для изучения прогнозов пациентов с множественной миеломой (ММ) после операции, анализа факторов риска, ведущих к неблагоприятным результатам послеоперационного лечения, и создания номограммы. МЕТОДЫ: Клинические данные 154 пациентов с MM, которые прошли операцию в нашем учреждении между 2007 и 2019 был ретроспективно проанализирован. Оценка и сопоставление уровней боли, качества жизни и функционального состояния пациентов до и после операции (Р) < 0.05) были признаны статистически значимыми. Кривая выживания Каплана-Мейера использовалась для оценки средней продолжительности выживаемости. Отриц

Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions.

Lymph nodes (LNs) are important hubs for metastatic cell arrest and growth, immune modulation, and secondary dissemination to distant sites through a series of mechanisms, and it has been proved that lymph node metastasis (LNM) is an essential prognostic indicator in many different types of cancer. Therefore, it is important for oncologists to understand the mechanisms of tumor cells to metastasize to LNs, as well as how LNM affects the prognosis and therapy of patients with cancer in order to provide patients with accurate disease assessment and effective treatment strategies. In recent years

Cardiac Involvement in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma.

Cardiac involvement of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is recognized extremely rarely. In addition, most CLL/SLL patients with heart infiltration are asymptomatic. In this review, we present the results of a literature search for English language articles concerning CLL/SLL or Richter transformation with symptomatic cardiac involvement. In total, 18 well-described cases with CLL/SLL and heart infiltration were identified. Only three patients were not diagnosed with CLL/SLL before the cardiac manifestation. In other patients, cardiac CLL/SLL was diagnosed betwe

Glucocorticoid-induced osteonecrosis in systemic lupus erythematosus patients.

Osteonecrosis (ON) is a complex and multifactorial complication of systemic lupus erythematosus (SLE). ON is a devastating condition that causes severe pain and compromises the quality of life. The prevalence of ON in SLE patients is variable, ranging from 1.7% to 52%. However, the pathophysiology and risk factors for ON in patients with SLE have not yet been fully determined. Several mechanisms for SLE patients' propensity to develop ON have been proposed. Glucocorticoid is a widely used therapeutic option for SLE patients and high-dose glucocorticoid therapy in SLE patients is strongly assoc

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… The natural progression of symptomatic humeral head osteonecrosis in adults with sickle cell disease . J Bone Joint Surg Am . 2012 ; 94 : 156 ‐ 162 . 22258003 10.2106/JBJS.J.00919 8 Moskal JT , Topping RE , Franklin LL . Hypercholesterolemia: an association with osteonecrosis of the femoral head . …

Gaucher disease, state of the art and perspectives.

Knowledge about Gaucher disease (GD), considered a model for rare diseases, has considerably increased since its discovery. The pathophysiology of this lysosomal disorder is better known, and specific therapies that can control many aspects of the disease have been developed, particularly for the most common form, Type 1 GD. Yet, in part because of the rarity of GD, but also because of a lack of awareness by physicians, diagnostic delay too often leads to a belated management of patients having accumulated comorbidities. Gaucher cells, the most visible consequence of glucocerebrosidase deficie

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… When located in femoral or humeral heads, they may justify prosthetic surgery [ 5 , 6 ]. Finally, bone involvement can be osteopenia or even osteoporosis, with a risk of long bone fracture related to cortical thinning or spontaneous vertebral compression. …

A review of spontaneous bone metastases in domestic and laboratory animals.

Bone metastases cause significant morbidity and ultimately death in some human cancer patients. Although experimental animal models of skeletal metastases have been invaluable for investigating the molecular mechanisms of cancer progression and growth in bones, few of these models recapitulate the heterogeneous nature of bone metastases observed in humans. Animals with naturally occurring cancers have been proposed as ideal and unique models for human cancer research. From this, understanding the incidence, histologic features, clinical presentation, and response to therapy of spontaneous bone

Abstracts

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… Cadaver lab was also used in the training of military doctors to insert intraosseous vascular accesses in non-routine sites such as the humeral head. In the light of this evidence, at the Fondazione Policlinico Universitario A. …

Biopsy Techniques for Musculoskeletal Tumors: Basic Principles and Specialized Techniques.

Biopsy is a pivotal component in the diagnostic process of bone and soft tissue tumors. The objective is to obtain adequate tissue without compromising local tumor dissemination and the patient's survival. This review explores contemporary principles and practices in musculoskeletal biopsies, emphasizing the critical role of diagnostic accuracy while also delving into the evolving landscape of liquid biopsies as a promising alternative in the field. A thorough literature search was done in PubMed and Google Scholar as well as in physical books in libraries to summarize the available biopsy tec

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… Figure 3 Fluoroscopy-guided trocar needle biopsy for a bone lesion of the humeral head. Histology showed a giant cell tumor of the bone. There is no significant difference in diagnostic accuracy between core-needle and open biopsy for bone tumors [ 5 , 6 , 11 , 17 ]. …

Understanding the Progression of Bone Metastases to Identify Novel Therapeutic Targets.

Bone is one of the most preferential target site for cancer metastases, particularly for prostate, breast, kidney, lung and thyroid primary tumours. Indeed, numerous chemical signals and growth factors produced by the bone microenvironment constitute factors promoting cancer cell invasion and aggression. After reviewing the different theories proposed to provide mechanism for metastatic progression, we report on the gene expression profile of bone-seeking cancer cells. We also discuss the cross-talk between the bone microenvironment and invading cells, which impacts on the tumour actions on su

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… Cementoplasty can be applied in numerous sites including spine, humeral head or intertrochanteric region. …

Long-Term Effects of Pediatric Acute Lymphoblastic Leukemia Chemotherapy: Can Recent Findings Inform Old Strategies?

During the last few decades, pediatric acute lymphoblastic leukemia (ALL) cure rates have improved significantly with rates exceeding 90%. Parallel to this remarkable improvement, there has been mounting interest in the long-term health of the survivors. Consequently, modified treatment protocols have been developed and resulted in the reduction of many adverse long-term consequences. Nevertheless, these are still substantial concerns that warrant further mitigation efforts. In the current review, pediatric-ALL survivors' late adverse events, including secondary malignant neoplasms (SMNs), car

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… Osteonecrosis in ALL usually affects the femoral head, humeral head, shoulder, knee, and ankle ( 62 ). Different groups inferred variable prevalence of long-term low BMD among ALL survivors, ranging between 20% and 50% ( 63 ). …