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Challenges for cancer patients returning home during SARS-COV-19 pandemic after medical tourism - a consensus report by the emirates oncology task force.

BackgroundThe COVID-19 pandemic has caused a global health crisis. Numerous cancer patients from non-Western countries, including the United Arab Emirates (UAE), seek cancer care outside their home countries and many are sponsored by their governments for treatment. Many patients interrupted their cancer treatment abruptly and so returned to their home countries with unique challenges. In this review we will discuss practical challenges and recommendations for all cancer patients returning to their home countries from treatment abroad.MethodExperts from medical, surgical and other cancer subsp

Analyzing the factors associated with efficacy among teriparatide treatment in postmenopausal women with osteoporosis.

BACKGROUND: Teriparatide (TPTD) is a widely used anabolic agent for the treatment of osteoporosis. Several factors have been identified to be related to bone mineral density (BMD) increase in anti-osteoporosis treatment with other agents; however, there has been no systematic analysis to summarize the associated determinants of BMD reaction to daily teriparatide treatment. METHODS: In this retrospective study, we performed a comprehensive investigation involving not only clinical data but also several relevant lifestyle factors to be examined for their potential contribution to BMD response.

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… bone) [ 38 ], which was verified in our results. … Recombinant human parathyroid hormone (1–34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Mineral Res. 2003;18(11):1932–1941. doi: 10.1359/jbmr.2003.18.11.1932. 9. …

Exploring versatile applications of a vacuum-assisted bone harvester in orthopedic surgery.

BACKGROUND: Orthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To mitigate these side effects, vacuum-assisted tools have been developed to aid in tissue removal. These devices enable surgeons to suction tissue without discarding it, potentially improving outcomes in conditions such as osteomyelitis or tumor removal while enabling collection of the material for downstream applications. Despite limited research, vacuum-a

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… Since March 1st, 2021, the Avitus® Bone Harvester has been approved for indications including to debride and capture infected, necrotic or diseased cancellous bone. Orthopedic procedures were classified based on CPT code as oncology or debridement for infection cases. … Novel Vacuum-assisted method for harvesting autologous cancellous bone graft and bone marrow from the proximal tibial metaphysis. Foot Ankle Orthop. 2021;6(1):2473011420981901. 10.1177/2473011420981901 10. Greco VE, Hammarstedt JE, O’Connor S, Regal S. …

Preoperative Assessment of Medication-Related Osteonecrosis of the Jaw Using [18F]fluoride Positron Emission Tomography (PET)/CT and [18F]fluorodeoxyglucose PET/MRI in Correlation with Histomorphometry and Micro-CT-A Prospective Comparative Study.

OBJECTIVES: The purpose of this study was to investigate the imaging characteristics of medication-related osteonecrosis of the jaw (MRONJ) using [18F]fluoride positron emission tomography/computed tomography (PET/CT) and [18F]fluorodeoxyglucose (FDG) PET/magnetic resonance imaging (MRI) for preoperative assessment and to correlate them with microarchitectural and histomorphometric data with respect to clinical findings. METHODS: Twelve patients (five female; mean age 75 ± 7.6 yr) with symptomatic MRONJ underwent both scans on the same day, and imaging findings were used to plan surgical inte

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… Our observations suggest that MRONJ is more common in the mandible due to its denser cortical bone and lower cancellous bone content compared to the mostly cancellous and well-vascularized maxilla [ 31 ]. …

The role of allogeneic platelet-rich plasma in patients with diabetic foot ulcer: Current perspectives and future challenges.

The frequency of chronic cutaneous wounds are sharply increasing in aging populations. Patients with age-related diseases, such as diabetes, tumors, renal failure and stroke are prone to soft tissue and skin injury, compounded by slowed healing in aging. Imbalance of wound inflammation, loss of growth factor secretion, and impairment of tissue repair abilities are all possible reasons for failed healing. Therefore, it is vital to explore novel approaches to accelerate wound healing. Platelet-rich plasma (PRP) as a cell therapy has been widely applied for tissue repair and regeneration. PRP pro

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… bone transplantation and al-PRP. … Allogeneic platelet gel with autologous cancellous bone graft for the treatment of a large bone defect. Eur. Surg. Res. 39, 170–174. 10.1159/000100490 Sun Y., Ma L., Ji M., Wang Z. (2022). …

The Landscape of COVID-19 in Cancer Patients: Prevalence, Impacts, and Recommendations.

Cancer patients are susceptible groups to COVID-19, and risk-adjusted models show that most cancer patients have a 25-39% mortality risk if infected with COVID-19. The infection rate of SARS-CoV-2 in cancer patients in China was 0.79% (12 of 1524 patients; 95% CI, 0.31.2%). The case fatality rate of COVID-19 in the overall population ranges from 2.3 to 8.0%; among these, the case fatality rate for cancer patients is at 5.6%. In a retrospective cohort study of 28 COVID-19-infected cancer patients, a total of 15 (53.6%) patients had severe outcomes with a mortality rate of 28.6%. In a pooled ana

Dental implants in patients treated with antiresorptive medication - a systematic literature review.

OBJECTIVE: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed. METHODS: The PICO design was used: (Patients) For which subclientel of patients with anti

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… bone, prominence of the inferior alveolar nerve canal, thickened sclerotic lamina dura, periradicular radiolucencies, cortical disruption, and persisting alveolar sockets. … In addition, other radiologic changes in patients with bisphosphonates have been described, such as regional or diffuse osteosclerosis, confluence of cortical and cancellous bone, prominence of the canal of the inferior alveolar nerve, a prominent lamina dura, radiolucences around the apex and cortical …

Myeloma: Patient accounts of their pathways to diagnosis.

BackgroundPathways to myeloma diagnosis can be prolonged, and are often preceded by multiple GP consultations and emergency presentation. This is the first qualitative study to examine events leading to diagnosis by asking patients about their experiences during this time.MethodsSet within a UK population-based cohort, semi-structured interviews were conducted with 20 myeloma patients with varying characteristics and pathways, 12 of whom invited their relatives to take part. Interviews were audio-recorded and qualitative analysis undertaken.ResultsPre-diagnostic awareness of myeloma was minima

Проблемы с диагностикой и оказанием неотложной медицинской помощи в случае быстро прогрессирующего заболевания лёгких, вторичного и многократного заболевания миеломой.

Одновременное представление множественной миеломы (ММ) и межститиальной болезни легких (МЛ) остается исключительно редким, при этом ограниченная литература описывает оптимальные стратегии управления для этой двойной патологии. Мы сообщаем о сложном случае 62-year-old Мужчина с недавно поставленным диагнозом MM с цитогенетикой промежуточного риска (del13q, набирающий 1q), который одновременно представил быстро прогрессирующий ILD, демонстрирующий обычную интерститальную пневмонию (МСАГВ). Пациентка 6-month Клинический курс был отмечен участием многих организаций, периодическими инфекциями, тром

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… On further evaluation, bone marrow biopsy confirmed the diagnosis with findings of diffuse plasma cell involvement with both mature and immature forms (plasmablasts) in sheets, grade 0 reticulin fibrosis, and cortico-cancellous bone architecture. …

Over- and under-prophylaxis for chemotherapy-induced (febrile) neutropenia relative to evidence-based guidelines is associated with differences in outcomes: findings from the MONITOR-GCSF study.

PurposeIn the MONITOR-GCSF study of chemotherapy-induced (febrile) neutropenia with biosimilar filgrastim, 56.6% of patients were prophylacted according to amended EORTC guidelines, but 17.4% were prophylacted below and 26.0% above guideline recommendations.MethodsMONITOR-GCSF is a prospective, observational study of 1447 evaluable patients from 140 cancers centers in 12 European countries treated with myelosuppressive chemotherapy for up to 6 cycles receiving biosimilar GCSF prophylaxis. Patients were classified as under-, correctly-, or over-prophylacted with GCSF relative to guideline recom

Bone Phenotyping Approaches in Human, Mice and Zebrafish - Expert Overview of the EU Cost Action GEMSTONE ("GEnomics of MusculoSkeletal traits TranslatiOnal NEtwork").

A synoptic overview of scientific methods applied in bone and associated research fields across species has yet to be published. Experts from the EU Cost Action GEMSTONE ("GEnomics of MusculoSkeletal Traits translational Network") Working Group 2 present an overview of the routine techniques as well as clinical and research approaches employed to characterize bone phenotypes in humans and selected animal models (mice and zebrafish) of health and disease. The goal is consolidation of knowledge and a map for future research. This expert paper provides a comprehensive overview of state-of-the-art

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… TMD values of 450-600 mg HA/cm 3 have been reported in the vertebrae of adult zebrafish ( 13 ) which is noticeably less than the TMD values of 800-1000 mg HA/cm3 in the cortical bone of adult mice ( 166 ) or human cancellous bone ( 167 ). … In the study of mouse bone, both static and dynamic histomorphometry are widely used mostly on sections of the distal femoral metaphysis and, for cancellous bone, in the appendicular skeleton. …

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

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… When this is produced in a cancellous bone, it forms radially expanding tunnels through the center of the trabecula resulting in dissecting osteitis characteristic of primary hyperparathyroidism ( Fig. 2 ). 28 , 30 , 32 Following these changes, the fibrovascular stroma further proliferates to completely … bone. …

A modified method for reducing renal injury in zoledronic Acid treatment of hypercalcemia and adverse skeletal events.

AimsIn this paper, we have reported a previously undescribed risk factor of deterioration of renal function in zoledronic acid treatment of skeletal metastasis - high serum calcium level. Based on this consideration, a modified method of treatment of hypercalcemia (HCM) with zoledronic acid is suggested in this paper.Material and methodsBone scan findings of 1090 cancer patients were analyzed, of which 26 had intense renal parenchymal uptake as a result of HCM or bone metastases. Subsequently, a total of 56 bone metastases patients with zoledronic acid treatment were divided into three groups:

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… Bone origin of the serum complex of calcium, phosphate, fetuin, and matrix Gla protein: Biochemical evidence for the cancellous bone-remodeling compartment. J Bone Miner Res. 2002;17:1171–9. doi: 10.1359/jbmr.2002.17.7.1171. 2. Green J, Clézardin P. …

The Role of Inflammatory Cytokines, the RANKL/OPG Axis, and the Immunoskeletal Interface in Physiological Bone Turnover and Osteoporosis.

Although it has long been recognized that inflammation, a consequence of immune-driven processes, significantly impacts bone turnover, the degree of centralization of skeletal and immune functions has begun to be dissected only recently. It is now recognized that formation of osteoclasts, the bone resorbing cells of the body, is centered on the key osteoclastogenic cytokine, receptor activator of NF- κ B ligand (RANKL). Although numerous inflammatory cytokines are now recognized to promote osteoclast formation and skeletal degradation, with just a few exceptions, RANKL is now considered to be

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… Thereafter, this is replaced by a second slow phase of bone loss in which the rate of cancellous bone loss is reduced, but the rate of cortical bone loss is unchanged or increased. … bone [ 292 ]. …

EMD originates from hyaluronan-induced homophilic interactions of CD44 variant-expressing MM cells under shear stress.

Extramedullary disease (EMD) is known to be associated with chemoresistance and poor prognosis in multiple myeloma (MM); however, the mechanisms of its development are not fully understood. Elucidating the mechanism of EMD development and its therapeutic targeting would greatly contribute to further improvement of treatment outcome in patients with MM. Here, we show that bone marrow stroma cell-derived hyaluronan (HA) elicits homophilic interactions of MM cells by binding to surface CD44, especially long-stretch variants, under physiological shear stress and generates cell clusters that might

Bisphosphonate-related osteonecrosis of the jaw: a review of the literature.

Bisphosphonates (BPs) are a class of drugs used to treat osteoporosis and malignant bone metastasis. BPs show high binding capacity to the bone matrix, especially in sites of active bone metabolism. The American Society for Bone and Mineral Research defines BRONJ as "an area of exposed bone in the maxillofacial region that has not healed within 8 weeks after identification by a healthcare provider in a patient who is receiving or has been exposed to a bisphosphonate and has not had radiation therapy to the craniofacial region." Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can advers

Hybrid Fixation Technique for Femoral Stem Revision in B3 Periprosthetic Fractures: A Report of Two Cases.

Periprosthetic femoral fractures (PPFs) are challenging complications following total hip arthroplasty, especially in cases with compromised bone stock. We present 2 cases of Vancouver Type B3 PPF treated with a monoblock cementless long-stem prosthesis, using cement only for distal fixation. This technique provided initial stability, allowing early mobilization and eventual fracture healing with bony ingrowth. Radiographic follow-up demonstrated successful outcomes with no significant complications. Our results support the potential of this method for treating complex PPF cases, offering a so

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… The distal femur was reamed with sized tapered reamers until the cancellous bone at the proximal entry of the distal segment, visible under direct visualization, was adequately removed, leaving the cortical bone intact. …

An innovative technique for osteoporotic vertebral compression fractures - vertebral osteotome with side-opening cannula.

ObjectiveThis study is to assess an innovative technique - a vertebral osteotome (VO) combined with side-opening injection cannula for percutaneous vertebroplasty (PVP).MethodsA retrospective study by propensity score matching. From January 2016 to April 2016, 63 patients who were diagnosed with monosegmental osteoporotic vertebral compression fracture received the innovative technique. The epidemiologic data, surgical indexes, and recovery outcomes were collected in the follow-up period. Propensity score matching identified 63 pairs form historical controls by traditional unilateral PVP appro

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… An asymmetrical cement distribution around fractured area was more likely to induce recollapse of augmented vertebrae because they increased maximum von Mises stress in the cancellous bone and cortical bone significantly. 27 In the present study, we used the mean ratio of bright areas to the whole vertebra …

New Generation of Meso and Antiprogestins (SPRMs) into the Osteoporosis Approach.

Receptor activator of nuclear factor κB (RANK) and its ligand (RANKL) play key roles in bone metabolism and the immune system. The RANK/RANKL complex has also been shown to be critical in the formation of mammary epithelia cells. The female hormones estradiol and progesterone closely control the action of RANKL with RANK. Blood concentration of these sex hormones in the postmenopausal period leads to an increase in RANK/RANKL signaling and are a major cause of women's osteoporosis, characterized by altered bone mineralization. Knowledge of the biochemical relationships between hormones and RAN

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… Recombinant Human Parathyroid Hormone (1-34) [Teriparatide] Improves Both Cortical and Cancellous Bone Structure. J. Bone Miner. Res. 2003;18:1932–1941. doi: 10.1359/jbmr.2003.18.11.1932. 88. Neer R.M., Arnaud C.D., Zanchetta J.R., Prince R., Gaich G.A., Reginster J. … Treatment with human parathyroid hormone (1-34) for 18 months increases cancellous bone volume and improves trabecular architecture in ovariectomized cynomolgus monkeys (Macaca fascicularis) Bone. 2001;28:150–159. doi: 10.1016/S8756-3282(00)00430-0. 93. …

Novel Developments in the Treatment of Multiple Myeloma-Associated Bone Disease.

Osteolytic bone disease is present in about 80% of patients with multiple myeloma at the time of diagnosis. Managing bone disease in patients with multiple myeloma is a challenge and requires a multi-faceted treatment approach with medication, surgery, and radiation. The established treatments with intravenous or subcutaneous antiresorptives can cause debilitating adverse events for patients, mainly osteonecrosis of the jaw, which, traditionally, has been difficult to manage. Now, oral surgery is recommended and proven successful in 60-85% of patients. Patients with spinal involvement may bene

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… Cancellous bone remodeling occurs in specialized compartments lined by cells expressing osteoblastic markers J. Bone Miner. Res. 2001 16 1575 1582 10.1359/jbmr.2001.16.9.1575 11547826 86. Kristensen H.B. Andersen T.L. Marcussen N. Rolighed L. Delaisse J.-M. … Osteoblast recruitment routes in human cancellous bone remodeling Am. J. Pathol. 2014 184 778 789 10.1016/j.ajpath.2013.11.022 24412092 87. Silvestris F. Cafforio P. Tucci M. Grinello D. Dammacco F. Upregulation of osteoblast apoptosis by malignant plasma cells: A role in myeloma bone disease Br. …