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Diagnostic and prognostic value of cardiac imaging in amyloidosis.

Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years. Different types of amyloidosis can affect the heart. Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis. These entities have a poor prognosis, so accurate diagnostic techniques are imperative for determining an early therapeutic approach. Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to his

Use of bisphosphonates in prostate cancer: Current status.

Bisphosphonates are a relatively newer class of drugs which have been used for the prevention of skeletal related complications of age related osteoporosis or metastatic disease from carcinoma breast or multiple myeloma. Their role in the management of prostate cancer is still under evolution. We hereby review the ongoing and some published randomized trials to define the role of bisphosphonates in various stages of prostate cancer.

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… MECHANISM OF ACTION Bisphosphonates (previously called diphosphonates) are stable pyrophosphate analogs that have several actions including likely inhibition of osteoblast proliferation and differentiation, decreasing osteoclast differentiation and induction of apoptosis through caspase activation.[ …

Ischemic Colitis as a Complication of Medication Use: An Analysis of the Federal Adverse Event Reporting System.

BACKGROUND: More than one decade ago, rising cases of ischemic colitis (IC) prompted the Federal Drug Administration to revoke alosetron's approval as treatment of irritable bowel syndrome (IBS). The aim of this study was to identify medical therapies associated with development of IC. METHODS: The Federal Adverse Event Reporting System was queried for the time between January 2004 and September 2015. We identified reports listing IC as treatment complication and extracted suspected causative and concomitantly administered drugs, indications for their use and outcomes. RESULTS: After elimina

Combination of zoledronic Acid and targeted therapy is active but may induce osteonecrosis of the jaw in patients with metastatic renal cell carcinoma.

PURPOSE: To investigate the efficacy and safety of zoledronic acid (ZA) combined with targeted therapy (TT). MATERIALS AND METHODS: A retrospective study was performed in patients with metastatic renal cell carcinoma treated with ZA and TT. RESULTS: Twenty-one patients received ZA and TT to prevent skeletal-related events and no pretherapy oral and maxillofacial (OM) examination (cohort A). Six patients (29%) developed osteonecrosis of the jaw (ONJ), which was observed only in patients receiving sunitinib and ZA. Sixteen patients received TT and ZA for hypercalcemia and no pretherapy OM exam

Burning Issues/Hot Topics: The Charcot Foot.

Charcot neuro-osteoarthropathy remains one of the most serious complications of diabetic neuropathy, with the potential for rapid progression to deformity, ulceration and limb-threatening outcomes. The earliest signs and symptoms are often subtle and easily missed, yet early recognition provides a narrow window of opportunity to prevent irreversible structural change. Contemporary diagnostic pathways are underpinned by close clinical observation and correlation of bedside findings with detailed imaging analysis, enabling earlier identification of active disease before collapse occurs. This art

Therapy strategies for multiple myeloma: current status.

Multiple myeloma (MM) is characterized by infiltration of bone marrow with a clone of neoplastic plasma cells. Impaired hematopoiesis and reduced production of functional immunoglobulins, as well as the induction of pathognomonic osteolytic lesions primarily contribute to the morbidity of patients with MM. Conventional chemotherapy is the treatment of choice for older patients, whereas those under 60 years benefit significantly from high-dose therapy followed by stem-cell rescue. The use of tandem transplantation, developed to further escalate the conditioning dose, has achieved additional imp

Treatment of Medication-Related Osteonecrosis of the Jaw Without and With the Use of Advanced Platelet-Rich Fibrin: A Retrospective Clinical Study.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is drug-induced bone destruction that is exposed for a minimum of 6 to 8 weeks in patients who have not received head and neck radiotherapy and who have not been diagnosed with facial bone metastases. MRONJ treatment outcomes are unpredictable. Therefore, alternative treatment methods are being explored, such as blood-derived platelet-rich preparations enriched with growth factors, including advanced platelet-rich fibrin (A-PRF). The presence of growth factors may enhance healing and reduce post-procedure complications. There are

Fibula flap versus soft tissue flap with reconstruction plate for mandibular stage 3 medication-related osteonecrosis of the jaw: a retrospective cohort study.

BACKGROUND: With the increasing incidence of medication-related osteonecrosis of the jaw (MRONJ), the choice of reconstruction method for mandibular stage 3 MRONJ remains controversial. This study aimed to compare the outcomes of fibula flap (FF) and soft tissue flap with reconstruction plate (SR) in patients with mandibular stage 3 MRONJ. METHODS: This retrospective cohort study included patients diagnosed with mandibular stage 3 MRONJ who underwent reconstruction between September 2018 and May 2024. Patients were categorized into the FF and SR groups. Demographic and general characteristics,

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

Radiotheranostics - Precision Medicine in Nuclear Medicine and Molecular Imaging.

'See what you treat and treat what you see, at a molecular level', could be the motto of theranostics. The concept implies diagnosis (imaging) and treatment of cells (usually cancer) using the same molecule, thus guaranteeing a targeted cytotoxic approach of the imaged tumor cells while sparing healthy tissues. As the brilliant late Sam Gambhir would say, the imaging agent acts like a 'molecular spy' and reveals where the tumoral cells are located and the extent of disease burden (diagnosis). For treatment, the same 'molecular spy' docks to the same tumor cells, this time delivering cytotoxic

Evaluating natural history and treatment response in cardiac amyloidosis: the evolving role of multimodality imaging.

Cardiac amyloidosis, characterized by the accumulation of misfolded proteins in the heart, is a major cause of restrictive cardiomyopathy. It includes two main forms-transthyretin and immunoglobulin light chain amyloidosis-and carries a poor prognosis if left untreated. With emerging new therapies, the growing need to assess treatment response highlights imaging biomarkers as valuable and promising surrogate endpoints. This review discusses current evidence on changes in imaging markers following treatment, contrasting them with the natural progression of the disease. The focus is on magnetic

Status and Future Directions of Therapeutics and Prognosis of Cardiac Amyloidosis.

Accumulation of aberrant proteins in the heart causes cardiac amyloidosis, an uncommon and complicated illness. It can be classified into two main types: light chain (AL) and transthyretin (ATTR). The diagnosis of cardiac amyloidosis is challenging due to its non-specific clinical presentation and lack of definitive diagnostic tests. Diagnostic accuracy has increased with the advent of modern imaging methods, including cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. Depending on the severity of cardiac amyloidosis, a number of treatments may be attempted

Ra223 in Bone Metastases with Osteolytic Activity.

Radium 223 dichloride (Ra223) is the only targeted alpha therapy able to extend survival in patients with bone metastases from prostate cancer. Mechanism of action and data currently available focused mainly on osteoblastic metastases from prostate cancer. In our institution, a patient with breast cancer affected by osteolytic metastases was treated with off-label use of Ra223. The evaluation of the deposit areas of Ra223 showed a perfect overlap with the regions of osteolysis previously detected by scintigraphy, indicating a possible therapeutic effect. This case report is the first document

Can Neutrophil/Lymphocyte Ratio be a Predictor for Bone Metastases of Solid Tumors?

Cancer-associated inflammation has been receiving increased attention due to its role in cancer development. It is known that tumors can cause an inflammatory reaction and inflammatory cells play an important role in neoplastic growth. In this study, we aimed to investigate any relationship between bone metastases and the neutrophil-to-lymphocyte ratio (NLR). Patients who were referred for bone scintigraphy to investigate bone metastasis were enrolled in the study. Patients' hematological parameters were obtained from the hospital database retrospectively. Patients with a nonmetastatic bone sc

Zoledronic acid inhibits RANK expression and migration of osteoclast precursors during osteoclastogenesis.

Bisphosphonates have been known to directly inhibit bone resorption and promote apoptosis in mature osteoclasts. Although bisphosphonates have been recognized as the most effective drugs to treat osteoporosis and bone cancer metastasis, the exact effects and mechanism(s) of bisphosphonates on osteoclastogenesis are unclear. The aim of this study was to clarify whether nitrogen-containing bisphosphonates affect recruitment and differentiation in osteoclasts. We examined the effects of zoledronic acid on receptor activator of NF-κB (RANK) expression and cell migration during osteoclastogenesis i

Chemotherapy and zoledronate sensitize solid tumour cells to Vgamma9Vdelta2 T cell cytotoxicity.

Combinations of cellular immune-based therapies with chemotherapy and other antitumour agents may be of significant clinical benefit in the treatment of many forms of cancer. Gamma delta (gammadelta) T cells are of particular interest for use in such combined therapies due to their potent antitumour cytotoxicity and relative ease of generation in vitro. Here, we demonstrate high levels of cytotoxicity against solid tumour-derived cell lines with combination treatment utilizing Vgamma9Vdelta2 T cells, chemotherapeutic agents and the bisphosphonate, zoledronate. Pre-treatment with low concentrat

A rare case of oral multisystem Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by high proliferation of Langerhans dendritic cells. LCH is a solitary or multifocal disease that primarily involves bone tissue and often affects children and young men. A 29 years-old Caucasian man was referred to the Oral Surgery Unit of George Eastman Hospital - Umberto I teaching hospital, with third degree mobility of teeth belonging to second, third and fourth quadrant. Panoramic radiograph showed multiple radiolucent areas with well demarcated borders on the right and left site of the mandible and on the left site of

Zoledronic acid overcomes chemoresistance and immunosuppression of malignant mesothelioma.

UNLABELLED: Matrix metalloproteinases (MMPs) are the major proteolytic enzymes which assist in regulating the metastatic process by degrading the extracellular matrix proteins. In this study, we have investigated the anti-metastatic potential of major bioactive compounds in the medicinal plant Indigofera aspalathoides targeting matrix metalloproteinases (MMP2 & MMP9) and it's in silico pharmacokinetic profiles using computational studies. Indigofera aspalathoides (Sivanar vembu in Tamil) is a renowned medicinal herb in traditional Indian medicine which contains indigocarpan, mucronulatol, indi

Osteoporosis: now and the future.

Osteoporosis is a common disease characterised by a systemic impairment of bone mass and microarchitecture that results in fragility fractures. With an ageing population, the medical and socioeconomic effect of osteoporosis, particularly postmenopausal osteoporosis, will increase further. A detailed knowledge of bone biology with molecular insights into the communication between bone-forming osteoblasts and bone-resorbing osteoclasts and the orchestrating signalling network has led to the identification of novel therapeutic targets. Novel treatment strategies have been developed that aim to in