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Whole-body magnetic resonance imaging (WBMRI) versus whole-body computed tomography (WBCT) for myeloma imaging and staging.

Myeloma-associated bone disease (MBD) develops in about 80-90% of patients and severely affects their quality of life, as it accounts for the majority of mortality and morbidity. Imaging in multiple myeloma (MM) and MBD is of utmost importance in order to detect bone and bone marrow lesions as well as extraosseous soft-tissue masses and complications before the initiation of treatment. It is required for determination of the stage of disease and aids in the assessment of treatment response. Whole-body low-dose computed tomography (WBLDCT) is the key modality to establish the initial diagnosis

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… Whole-body low-dose computed tomography in multiple myeloma staging: superior diagnostic performance in the detection of bone lesions, vertebral compression fractures, rib fractures and extraskeletal findings compared to radiography with similar radiation exposure. …

New agents in the Treatment of Myeloma Bone Disease.

Patients with multiple myeloma develop a devastating bone disease driven by the uncoupling of bone remodelling, excess osteoclastic bone resorption and diminished osteoblastic bone formation. The bone phenotype is typified by focal osteolytic lesions leading to pathological fractures, hypercalcaemia and other catastrophic bone events such as spinal cord compression. This causes bone pain, impaired functional status, decreased quality of life and increased mortality. Early in the disease, malignant plasma cells occupy a niche environment that encompasses their interaction with other key cellula

The Role of Post-Operative Radiotherapy for Non-Spine Bone Metastases (NSBMs).

Non-spine bone metastases (NSBMs) can cause significant morbidity and deterioration in the quality of life of cancer patients. This paper reviews the role of post-operative radiotherapy (PORT) in the management of NSBMs and provides suggestions for clinical practice based on the best available evidence. We identified six retrospective studies and several reviews that examined PORT for NSBMs. These studies suggest that PORT reduces local recurrence rates and provides effective pain relief. Based on the literature, PORT was typically delivered as 20 Gy in 5 fractions or 30 Gy in 10 fractions wit

Percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracic and lumbar metastatic tumors.

BACKGROUND AND AIM: With the greatly prolonged survival of cancer patients, more and more patients develop bone metastasis, especially spinal metastasis. Therefore, it is very important to choose the best surgical plan for patients with spinal metastasis in different conditions. This paper aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of thoracic and lumbar metastatic tumors. METHODS: Forty patients with thoracic and lumbar metastatic tumors were treated with PPSF combined with PVP and fol

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Progress in osteoporosis and fracture prevention: focus on postmenopausal women.

In the past decade, we have witnessed a revolution in osteoporosis diagnosis and therapeutics. This includes enhanced understanding of basic bone biology, recognizing the severe consequences of fractures in terms of morbidity and short-term re-fracture and mortality risk and case finding based on clinical risks, bone mineral density, new imaging approaches, and contributors to secondary osteoporosis. Medical interventions that reduce fracture risk include sufficient calcium and vitamin D together with a wide spectrum of drug therapies (with antiresorptive, anabolic, or mixed effects). Emerging

Structural complexity of the craniofacial trabecular bone in multiple myeloma assessed by fractal analysis.

PurposeThis study aimed to evaluate the structural complexity of craniofacial trabecular bone in multiple myeloma by fractal analysis of panoramic and lateral skull radiography, and to compare the fractal dimension values of healthy patients (HPs), pre-treatment patients (PTPs), and patients during bisphosphonate treatment (DTPs).Materials and methodsPairs of digital panoramic and lateral skull radiographs of 84 PTPs and 72 DTPs were selected. After application of exclusion criteria, 43 panoramic and 84 lateral skull radiographs of PTPs, 56 panoramic and 72 lateral skull radiographs of DTPs, a

Hypophosphatemic Osteomalacia Associated with Adefovir-induced Fanconi Syndrome Initially Diagnosed as Diabetic Kidney Disease and Vitamin D Deficiency.

A 68-year-old man with type 2 diabetes mellitus and chronic hepatitis B infection was referred to the nephrology department before planned surgery for hepatocellular carcinoma. He had been receiving low-dose adefovir dipivoxil (ADV) for 11 years. Laboratory findings revealed impaired re-absorption in the proximal renal tubules. He had been diagnosed with diabetic kidney disease and osteomalacia due to vitamin D deficiency; thus, ADV was not discontinued until he was referred to us. In this case, concomitant diabetes mellitus and vitamin D deficiency might have prevented the early diagnosis of

The Missing Link: Integrating Interventional Pain Management in the Era of Multimodal Oncology.

Cancer-related pain (CrP) is one of the most frequent and debilitating issues that affect the quality of life of patients with cancer. Systemic analgesics, particularly opioids, have been the cornerstone of pain management. However, the following shortcomings of the mentioned therapies, such as side effects, tolerance, and inadequate relief in refractory cases, make implementing a more complete, multimodal treatment plan necessary. Interventional pain management (IPM) uses specific invasive procedures, with different degree of invasiveness, such as nerve blocks, neurolysis, neuromodulation, an

Osteitis Fibrosa Cystica: The Hideous Face of Hyperparathyroidism.

Osteitis fibrosa cystica (OFC), the skeletal scourge of advanced hyperparathyroidism, unveils itself as a relentless destroyer of bone architecture, leaving behind a landscape of fragility and deformity. In the shadow of chronic kidney disease, where mineral imbalances reign, this rare but devastating entity emerges as a silent tormentor. We present the case of a hemodialysis patient who fell victim to this sinister complication, manifesting with excruciating bone pain, pathological fractures, and radiographic and histological evidence of cystic osteolytic lesions. Biological assessments revea

Osteoporosis in Men: A Review of an Underestimated Bone Condition.

Osteoporosis is called the 'silent disease' because, although it does not give significant symptoms when it is not complicated, can cause fragility fractures, with serious consequences and death. Furthermore, the consequences of osteoporosis have been calculated to weigh heavily on the costs of health systems in all the countries. Osteoporosis is considered a female disease. Actually, the hormonal changes that occur after menopause certainly determine a significant increase in osteoporosis and the risk of fractures in women. However, while there is no doubt that women are more exposed to osteo

Health-related quality of life following bisphosphonate therapy in individuals with Paget's disease of bone - A study from a teaching hospital in Southern India.

BACKGROUND: Paget's disease of bone (PDB) is associated with considerable morbidity because of bony pains, fractures, and deformities. Remission, as assessed by reduction in alkaline phosphatase levels, does not necessarily correlate with improvement in quality of life (QoL). Health-related quality of life (HR-QoL) in affected individuals is not well-studied in India. This study attempts to describe the QoL in individuals with PDB. METHODS: In this prospective observational study spanning 6 years (Jan 2017-Dec 2022), we included 29 treatment-naïve patients diagnosed with PDB based on clinical

The Effect of Perioperative Radiation Therapy on Spinal Bone Fusion Following Spine Tumor Surgery.

INTRODUCTION: Perioperative irradiation is often combined with spine tumor surgery. Radiation is known to be detrimental to healing process of bone fusion. We tried to investigate bone fusion rate in spine tumor surgery cases with perioperative radiation therapy (RT) and to analyze significant factors affecting successful bone fusion. METHODS: Study cohort was 33 patients who underwent spinal tumor resection and bone graft surgery combined with perioperative RT. Their medical records and radiological data were analyzed retrospectively. The analyzed factors were surgical approach, location of

Preoperative elevation of serum C--reactive protein is predictive for prognosis in myeloma bone disease after surgery.

We investigated whether preoperative levels of serum C-reactive protein (CRP) and its correlation with tumour clinicopathological findings adds prognostic information beyond the time of diagnosis in patients with myeloma bone disease (MM) to facilitate the surgical decision-making process. Six hundred and fifty-eight myeloma patients were evaluated retrospectively for surgery. Clinicopathological variables of patients who underwent surgery (n=71) were compared between patients with preoperative CRP>or=6 mg l-1 and those with CRP<6 mg l-1. Univariate and multivariate analyses were performed to

Multiple myeloma presenting as an unhealed extraction socket: Report of a case with brief review of literature.

Multiple myeloma (MM) is a relatively rare malignant hematological disease, which is characterized by a monoclonal malignant proliferation of plasma cells that causes osteolytic lesions. Maxillofacial presentations in patients with MM are not uncommon, but because the symptoms are varied, it is very difficult to diagnose MM in this region especially in patients with initial oral involvement. Furthermore, maxillofacial manifestations as an initial sign or symptom are scarce. We report a case of a 40-year-old male patient who presented with an unhealed socket in lower left back tooth region for

Levofloxacin prophylaxis in patients with newly diagnosed myeloma (TEAMM): a multicentre, double-blind, placebo-controlled, randomised, phase 3 trial.

BackgroundMyeloma causes profound immunodeficiency and recurrent, serious infections. Around 5500 new cases of myeloma are diagnosed per year in the UK, and a quarter of patients will have a serious infection within 3 months of diagnosis. We aimed to assess whether patients newly diagnosed with myeloma benefit from antibiotic prophylaxis to prevent infection, and to investigate the effect on antibiotic-resistant organism carriage and health care-associated infections in patients with newly diagnosed myeloma.MethodsTEAMM was a prospective, multicentre, double-blind, placebo-controlled randomise

Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis.

STUDY DESIGN: Prospective cohort study. PURPOSE: To report the outcome of 50 patients with spinal metastases treated with minimally invasive stabilization (MISt) using fluoroscopic guided percutaneous pedicle screws with/without minimally invasive decompression. OVERVIEW OF LITERATURE: The advent of minimally invasive percutaneous pedicle screw stabilization system has revolutionized the treatment of spinal metastasis. METHODS: Between 2008 and 2013, 50 cases of spinal metastasis with pathological fracture(s) with/without neurology deficit were treated by MISt at our institution. The patien

Current role of radiation therapy for multiple myeloma.

BackgroundRadiation therapy (RT) is a treatment modality traditionally used in patients with multiple myeloma (MM), but little is known regarding the role and effectiveness of RT in the era of novel agents, i.e., immunomodulatory drugs and proteasome inhibitors.MethodsWe retrospectively reviewed data from 449 consecutive MM patients seen at our institute in 2010-2012 to assess indications for RT as well as its effectiveness. Pain response was scored similarly to RTOG 0631 and used the Numerical Rating Pain Scale.ResultsAmong 442 evaluable patients, 149 (34%) patients and 262 sites received RT.

Дилопия и экстремальная гиперамиласемия>100,000 U/L) Провозглашение агрессивного поведения ИгГ каппы миэломы: доклад о деле и обзор литературы.

RATALE: Хотя производство амилазы эпителиальными опухолями было хорошо задокументировано, его связь с множественной миеломой (ММ) является крайне редкой, о чем сообщалось лишь ограниченное число случаев. Кроме того, насколько нам известно, информация о бинокльной диплопии в качестве известной и первичной клинической функции у пациентов с MM и одновременно гиперамиласемией не получила широкого распространения. ОЗАБОЧЕННОСТЬ: В настоящем докладе содержится описание 75-year-old человек с иммуноглобулином G kappa MM, поражающим диплопию и экстремальную гиперамиласемию ()>100,000 U/L) с нормальным

Efficacy and safety of vertebral augmentation techniques in patients with osteoporotic vertebral compression fractures: A single center, retrospective, observational study.

BACKGROUND: Back pain secondary to osteoporotic vertebral compression fractures (OVCF) is a common global health problem that is frequently overlooked. For some patients, conservative management (CM) is inadequate to treat the pain associated with OVCF. This subset of patients are often candidates for interventional vertebral augmentation techniques (VAT). Multiple studies have shown significant pain reduction, height restoration, reduction in hospitalization time, morbidity and mortality in patients treated with VAT as compared with those patients treated with CM. This study examines if the p