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Определение концепций физической активности, которые имеют клиническое значение для пациентов и лиц, обеспечивающих уход: систематический обзор качественных исследований.

Физическая активность (ПА) необходима для общего здоровья. Неоптимальная ПА связана с снижением качества жизни (QOL) и преждевременной смертью. При проведении клинических исследований и разработке терапевтических методов определение тех аспектов ПО, которые имеют значение для пациентов и лиц, обеспечивающих уход, имеет важнейшее значение для разработки специальных мероприятий, выявления индивидуальных контекстуальных факторов и повышения степени удовлетворенности пациентов и их участия в обеспечении их собственного благополучия. По мере быстрого развития цифровых технологий здравоохранения (ДТ

Survival Rate after Palliative Surgery Alone for Symptomatic Spinal Metastases: A Prospective Cohort Study.

The effect of spine surgery for symptomatic spinal metastases (SSM) on patient prognosis remains unclear. This study aimed to reveal the prognosis of patients with SSM after spine surgery. One hundred twenty-two patients with SSM were enrolled in this prospective cohort study. The patients who received chemotherapy after enrollment were excluded. The decision of surgery depended on patient's willingness; the final cohort comprised 31 and 24 patients in the surgery and non-surgery groups, respectively. The patients were evaluated by their performance status (PS), activities of daily living (ADL

Использование WB-LDCT для проведения различия между доброкачественными и злокачественными повреждениями в аппендикулярном скелете пациентов с заболеваниями плазменных клеток.

Цель настоящего исследования состоит в том, чтобы провести различие между доброкачественными и злокачественными повреждениями в аппендикулярном скелете пациентов с заболеваниями плазменных клеток с использованием низкодозированной томографии (КТ) и различных клинических показателей. Клинические и радиологические данные о 234 пациентах с множественной миеломой (международный возраст: 59,5 ± 8,4; мужчины: 128), которые отвечали критериям охвата и посетили нашу больницу в период с декабря 2020 года по февраль 2023 года, были подвергнуты ретроспективной оценке. В общей сложности 234 повреждения (1

Beyond SINS: A Critical Review of Biomechanical, Microstructural, and Radiomic Biomarkers for Predicting Fracture Risk in Spinal Metastases

Background/Objectives: Although the Spinal Instability Neoplastic Score (SINS) is widely used to estimate spinal metastases fracture risk and guide decisions on stabilisation procedures, prior studies have demonstrated mixed results. Patients with the same score exhibit clinically heterogeneous outcomes, with some SINS criteria correlating less well with the estimated fracture risk than others. There are also barriers to implementation such as the time burden required for manual calculation and interobserver variability associated with qualitative morphological criteria. SINS also lacks sensit

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… Another limitation stems from the use of a modified VBQ score, which places the cancellous bone ROIs in the vertebrae immediately cephalad and caudad to the pathologic/treated segment. …

Risk factor analysis of pulmonary cement embolism during percutaneous vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures.

OBJECTIVE: The purpose of this research is to evaluate the risk factors and incidence of pulmonary cement embolism (PCE) during percutaneous vertebroplasty (PVP) or kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) based on postoperative computed tomography (CT). METHODS: A total of 2344 patients who underwent PVP or PKP due to OVCFs in our spine center were analyzed retrospectively. According to the detection of postoperative pulmonary CT, the patients were divided into two groups: pulmonary cement embolism group (PCE group) and non-pulmonary cement embolism group (N

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… The balloon inflation can not only restore the height of the vertebral body to a certain extent, but also compact the surrounding cancellous bone in the process of balloon expansion, form a cavity in the vertebral body, reduce the perfusion pressure of bone cement, seal the osseous defects, and make …

Sclerotic bone: a sign of bone reaction in patients with medication related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction associated with antiresorptive drugs such as bisphosphonates and denosumab. When dealing with advanced and/or multiple MRONJ lesions undergoing surgical therapy, the extent of surgery is often a topic of discussion. The aim of this study was to identify the differences in bone density in and around the MRONJ lesion before and after surgical treatment to evaluate the needed surgical extend of the modelling osteotomy. In this retrospective study 26 patients with MRONJ lesions that were surgically treated in our dep

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… Cancellous bone remodeling occurs in specialized compartments lined by cells expressing osteoblastic markers. J. Bone Miner. Res. 2001;16(9):1575–1582. doi: 10.1359/jbmr.2001.16.9.1575. 40. Azuma Y, Sato H, Oue Y, Okabe K, Ohta T, Tsuchimoto M, et al. …

Educational Case: Osteoporosis.

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… Woven bone appears within seven days in fracture repair. 7 However, woven bone has a haphazard arrangement of collagen type 1 fibers, hence the name woven. 3 Although this provides initial structural support, maximum strength is achieved through remodeling as lamellar compact or cancellous bone. 3 In …

Modeling osteoporosis to design and optimize pharmacological therapies comprising multiple drug types.

For the treatment of postmenopausal osteoporosis, several drug classes with different mechanisms of action are available. Since only a limited set of dosing regimens and drug combinations can be tested in clinical trials, it is currently unclear whether common medication strategies achieve optimal bone mineral density gains or are outperformed by alternative dosing schemes and combination therapies that have not been explored so far. Here, we develop a mathematical framework of drug interventions for postmenopausal osteoporosis that unifies fundamental mechanisms of bone remodeling and the mec

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… In cortical bone, the outer protective bone layer, BRUs migrate as a whole in ‘tunnels,’ whereas within the inner cancellous bone, BRUs propagate on the surfaces of the trabeculae, renewing the bone matrix in the process ( Eriksen, 2010 ). … bone structure Journal of Bone and Mineral Research 18 1932 1941 10.1359/jbmr.2003.18.11.1932 14606504 Jilka RL Weinstein RS Bellido T Roberson P Parfitt AM Manolagas SC 1999 Increased bone formation by prevention of osteoblast apoptosis with parathyroid hormone The Journal of Clinical Investigation …

The role of CD8+ T cells in the immunoregulation of osteoporosis.

INTRODUCTION: Osteoporosis weakens the skeleton by lowering bone mass and damaging bone microarchitecture. A growing body of evidence points to disruptions in osteoimmune homeostasis as a key driver of this disease. In particular, apoptosis of bone cells and immune cells appears to be a critical contributing mechanism. Within the bone marrow, CD8+ T cells display a surprising functional duality: whether they protect bone or promote its loss depends heavily on local signals. Under healthy conditions or after mechanical loading, activated CD8+ T cells help maintain bone mass. They do so mainly b

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… In a xenotransplantation model that used cancellous bone from α1,3-galactosyltransferase-knockout (GTKO) pigs to repair bone defects, a decrease in the ratio of CD4 + to CD8 + T cells was observed, along with suppressed levels of IFN-γ and IL-2. … Repair of bone defects in rhesus monkeys with α1,3-galactosyltransferase-knockout pig cancellous bone. Front Bioeng Biotechnol. (2022) 10:990769. doi: 10.3389/fbioe.2022.990769 20. Voss JO, Pivetta F, Elkilany A, Schmidt-Bleek K, Duda GN, Odaka K, et al. …

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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… The ROI encapsulated only cancellous bone, avoiding cortical edges, osseous abnormalities, and voids. Vertebral body density homogeneity (SD in HU) | The average standard deviation of the density measurement (see above) was provided by the IntelliSpace Portal, Philips. …

Bisphophonates related osteonecrosis of the jaw.

OBJECTIVE: With sporadic reporting of BPs related osteonecrosis of jaw and in absence of definitive guidelines regarding the management of such patients, the dentists and the oral and maxillofacial surgeons need to be updated about this issue. The objective of this article was to produce an updated bibliographic review of BPs related ONJ. This paper reviews the literature regarding the same for better understanding of the problem and its management. BACKGROUND: Bisphosphonates (BPs) are potent inhibitors of bone resorption and are widely used in the treatment of osteoporosis and other disease

Non-union after bisphosphonate-associated atypical femoral fractures: a review of the current literature.

BACKGROUND: This article explores the mechanism of action of atypical femoral fractures (AFF), specifically focussing on osteoporosis, management challenges, and the implications for clinical practice. Non-union of AFF can result in severe pain, deformity and restricted mobility-all of which will have a detrimental impact on the patients' quality of life. PURPOSE: This review consolidates the current literature regarding non-union after bisphosphonate-associated atypical femoral fractures, providing a revision tool for higher examinations. METHOD/FINDINGS: An extensive search strategy was co

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… This study’s histomorphometric analysis of cancellous bone suggested that reduced bone turnover could lead to delayed fracture healing, potentially resulting in non-union. …

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

Poroelastic Characterization of Human Vertebral Metastases to Inform a Transdisciplinary Assessment of Spinal Tumors.

Background and Objectives: Vertebral metastases often lead to pathological fractures and spinal cord compression, thus impacting patient quality of life. This study aimed to quantify the poroelastic mechanical properties of vertebral metastatic tissue explanted during spine surgery and correlate it with clinical data. Methods: Nine patients (61.7 ± 13.1 years) were prospectively recruited from April 2021 to February 2022, where 78% had a vertebral fracture. Demographic and metastases data, including primary origin, spinal level, lesion volume, and SINS score, were collected, and tissue specime

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… Bone volume fraction explains the variation in strength and stiffness of cancellous bone affected by metastatic cancer and osteoporosis. Calcif. Tissue Int. 2008;83:368–379. doi: 10.1007/s00223-008-9174-x. 20. Whyne C., Hu S., Workman K., Lotz J. …

Important learning points for setting up a dental-oncology service in Ireland.

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Molecular-Based Treatment Strategies for Osteoporosis: A Literature Review.

Osteoporosis is an unavoidable public health problem in an aging or aged society. Anti-resorptive agents (calcitonin, estrogen, and selective estrogen-receptor modulators, bisphosphonates, anti-receptor activator of nuclear factor κB ligand antibody along with calcium and vitamin D supplementations) and anabolic agents (parathyroid hormone and related peptide analogs, sclerostin inhibitors) have major roles in current treatment regimens and are used alone or in combination based on the pathological condition. Recent advancements in the molecular understanding of bone metabolism and in bioengin

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… Teriparatide significantly increased cancellous bone volume (teriparatide, 14%; placebo, –24%) and reduced bone marrow star volume (teriparatide, –16%; placebo, 112%) as indicated by 2D histomorphometric analysis [ 57 ]. … 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. 58. …

Quality of life and financial toxicity of hematopoietic stem cell transplant recipients in COVID-19.

Objectiveto evaluate and correlate the quality of life and financial toxicity of adult patients undergoing hematopoietic stem cell transplantation during the COVID-19 pandemic.Methodobservational, analytical study, carried out with 35 patients in a reference hospital for transplantation in Latin America. For data collection, the Functional Assessment Cancer Therapy Bone Marrow Transplantation and COmprehensive Score for Financial Toxicity questionnaires were used. Spearman and Mann-Whitney correlation tests were used for data analysis.Resultsgeneral quality of life during COVID-19 had a low sc

Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study.

BackgroundOsteoporosis with vertebral compression fractures is increasingly common in the elderly population. Cement augmentation is one of the effective surgical treatments for these patients. Currently, there are several different types of cement augmentation treatments. No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures; thus, we retrospectively compared vertebroplasty, balloon kyphoplasty, and kyphoplasty with SpineJack or an intravertebral expandable pillar.AimTo compare the postoperative safety and efficacy of each

Митохондриальная передача метаболических перепрограмм и лекарственная устойчивость в метастазе костей: механизмы и терапевтические стратегии.

Кость это one из наиболее распространенных участков удаленного метастаза в твердых опухолях, в частности рак груди, рак простаты и рак легких. Метатические повреждения костей часто свидетельствуют о стойком сопротивлении многосистемной терапии, включая химиотерапию, целевую терапию, эндокринную терапию и ингибиторы иммунных контрольно-пропускных пунктов (ИПК). Накопляющиеся данные свидетельствуют о том, что метаболическая перепрограммирование в пределах костной микроокружающей среды способствует этому сопротивлению, однако механизмы в верхнем течении по-прежнему недостаточно понятны. В качеств

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… Regarding spatial distribution, the transfer frequency in cancellous bone regions is substantially higher than in cortical bone regions. … Spatial transcriptomic analysis has indicated that this difference is associated with higher BMSC density and a denser TNT network in cancellous bone regions ( 104 ). …

IMPROVE-BMT: A Pilot Randomized Controlled Trial of Prehabilitation Exercise for Adult Hematopoietic Stem Cell Transplant Recipients.

Background: There is limited evidence on the effects of aerobic and resistance training exercise interventions to improve physical function and patient-reported outcomes prior to autologous and allogeneic hematopoietic stem cell transplant (HSCT). IMPROVE-BMT was a single-site, pilot randomized controlled trial investigating the feasibility, acceptability, and safety of a pragmatic resistance training exercise program prior to HSCT compared to usual HSCT care. Secondary aims included differences in physical function between the exercise group (EX) and usual care control group (UC). Methods: Ou