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Mining the FAERS database reveals new safety signals for 120 mg denosumab in oncology practice.

OBJECTIVE: To detect and quantify adverse drug event (ADE) signals linked to 120 mg denosumab in the real world. METHODS: We queried the US Food and Drug Administration Adverse Event Reporting System (FAERS) for reports on 120 mg denosumab, standardized, and categorized these events with Preferred Terms (PT) and System Organ Classes (SOC) from MedDRA version 27.1. Disproportionality analysis was performed using the reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN). RESULTS: We identified 10,963 ADE reports for 120 mg of denosumab. Among 10 963 reports, 41.

Cement venogram as a harbinger of methacrylate embolism after kyphoplasty: A case series.

Vertebral compression fractures remain an important cause of pain and debility. Intractable pain may be approached with vertebral kyphoplasty. We herein present a case of symptomatic pulmonary cement embolism following kyphoplasty. Discovery of a paravertebral cement venogram at the time of this procedure prompted a case series review of our institutional experience with kyphoplasty. We found that cement embolization, whether symptomatic or discovered incidentally, was universally associated with a cement venogram at the site of vertebroplasty. We propose that a cement venogram be viewed as a

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… There was no documented cement extravasation into the spinal canal or neural foramina; there were no clinically relevant hematomas or neurologic dysfunction. For 95 cases, we had imaging of the procedure site and some form of follow-up chest CT imaging. …

Emergency Care

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Analysis of Early Post-Radiation Surgical Management of Metastatic Spinal Tumors.

Background/Objectives: Radiotherapy is one of the various treatment options for patients with metastatic spinal tumors (MST). However, it is difficult to say that this is definitely an optimal treatment for MST, and there are several patients who need surgical treatment because pain or neurologic deficits occur even after radiotherapy. Therefore, this study aimed to analyze which patients received early operative treatment after radiotherapy. Methods: We included 81 patients who underwent decompression and fusion surgery after radiotherapy for MST. Patients who underwent surgery within 6 month

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… The spinal canal at the thoracic region is narrower than at other regions, and for this reason, the spinal cord is vulnerable to space-occupying lesions in this region [ 25 ]. …

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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… T2-weighted (T2w) SE sequences optimally visualize the spinal canal and enable the detection of bone and soft-tissue edema. … -sp. | 4–5 mm | Spinal canal, bone/soft-tissue edema | *, # 3) T1w gradient-echo or T1w TSE | Sagittal/axial | wh.-bd. | 5 mm or thin, isotropic | Fat fraction maps | *, # 4) DWI SE-EPI, ADC calc., 3D MIP recon. of highest b-value images | Axial | wh. …

A Rare Culprit or an Elusive Culprit in Disguise? Unraveling Wild-Type ATTR Cardiac Amyloidosis in Heart Failure With Reduced Ejection Fraction.

Cardiac amyloidosis (CA) is a rare disorder caused by the deposition of abnormal proteins called amyloid in the myocardium, leading to dysfunction. The 2 most common forms of amyloidosis are AL (light chain) and ATTR (transthyretin). Diagnosing amyloidosis is challenging, especially in its early stages, due to its nonspecific symptoms and overlap with other conditions. Recent studies suggest that the incidence of wild-type transthyretin amyloidosis is rising, likely due to improved diagnostic techniques and an aging population. We present the case of a 72-year-old male with lower extremity ede

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… Carpal tunnel syndrome, spinal canal stenosis, cardiomyopathy, renal insufficiency, enteropathy, and diffuse myopathy as an expression of systemic ATTR amyloidosis—diagnostics and therapy . …

Иммуномодулирующий потенциал токсоплазмы гонди лизата в C57BL/6 модели мыши аутоиммунного энцефаломиелита.

Множественный склероз (MS) — изнурительное аутоиммунное заболевание, характеризующееся хроническим воспалением и обезвоживанием в центральной нервной системе. Иммунотерапия является одним из важнейших элементов борьбы с симптомами и прогрессированием MS. Цель этого исследования состояла в том, чтобы оценить иммуномуляторное воздействие токсоплазмы гонди лизат антигенов (ТЛА) в модели мыши C57BL/6 экспериментального аутоиммунного энцефаломиелита (EAE). Восемнадцать мышей были произвольно отнесены к трем группам: здоровый контроль, мыши, вызванные EAE, и мыши, вызванные EAE, обработанные TLA. Еж

Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression-A New Integrative Flowchart for Patient Management.

Metastatic spine disease (MSD) and metastatic spinal cord compression (MSCC) are major causes of permanent neurological damage and long-term disability for cancer patients. The development of MSD is pathophysiologically framed by a cooperative interaction between general mechanisms of bone growth and specific mechanisms of spinal metastases (SM) expansion. SM most commonly affects the thoracic spine, even though multiple segments may be affected concomitantly. The great majority of SM are extradural, while intradural-extramedullary and intramedullary metastases are less frequently seen. The ma

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… Effect of Single-Fraction vs Multifraction Radiotherapy on Ambulatory Status Among Patients with Spinal Canal Compression From Metastatic Cancer: The SCORAD Randomized Clinical Trial. JAMA. 2019;322:2084–2094. doi: 10.1001/jama.2019.17913. 43. …

Giant sacral chondrosarcoma in an elderly male : a case report.

UnlabelledPrimary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. L

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… Computed tomography scan reported a large lobulated enhancing mass arising from the sacrum with gluteal muscle invasion, bony destruction and erosion into sacral spinal canal (Figure 2a) . …

Sinking Skin Flap Syndrome After Decompressive Hemicraniectomy in a Patient With Calvarial Multiple Myeloma Who Underwent a Lumbar Puncture: A Case Report.

Sinking skin flap syndrome (SSFS) or "syndrome of the trephined" is a rare complication that can occur after decompressive craniectomy. Disabling neurologic deficits, as well as the impairment of overall mental status with the development of a concave deformity and relaxation of the skin flap, are frequently observed. This usually develops several weeks to months after craniectomy. The pathophysiology of the syndrome includes cerebrospinal fluid (CSF) hypovolemia and the development of an atmospheric pressure gradient that can be worsened by CSF diversion, dehydration, and change in position s

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… MRI cervical, thoracic, and lumbar spine showed a mass in the T3 area measuring 2.6 cm x 1.6 cm x 1.1 cm extending from T2 to T6 causing moderate spinal canal stenosis with compression concerning for leptomeningeal spread (Figure 3 ). …

Current Advancements in the Diagnosis and Treatment of Metastatic Spinal Cord Compression and Its Postintervention Care: A Comprehensive Review.

Malignant spinal cord compression (MSCC) is a serious oncological emergency that can result in neurological impairment and significant pain. It is associated with high morbidity, mortality, and a decrease in quality of life. This review reviews the current literature concerning diagnosis, guidelines, timely intervention, and management options in oncology patients with MSCC. A literature search of PubMed using relevant keywords and MeSH terms yielded 604 articles. Of these, 31 studies met the predefined inclusion criteria and were selected for detailed data extraction and synthesis into a narr

Effect of Bone Metastasis Cancer Board on Spinal Surgery Outcomes: A Retrospective Study.

Background and Objectives: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we aimed to clarify the effect of a BMCB on spinal metastasis treatment. Materials and Methods: We reviewed consecutive cases of posterior decompression and/or instrumentation surgery for metastatic spinal tumors from 2008 to 2019. The BMCB involved a team of specialists in orthopedics, re

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… Generally, patients with tumor-induced spinal canal stenosis (Bilsky Cord Compression Score ≥1) underwent palliative decompression, those with instability (SINS of ≥7) underwent posterior fixation with instrumentation, and those with both conditions underwent laminectomy and instrumentation. …

A retrospective cohort analysis of alignment parameters for spinal tumor patients with instrumentation at the cervicothoracic junction.

BACKGROUND: Previous research on spinal alignment and postoperative outcomes after cervical and upper thoracic fixation has suggested that clinical and patient-reported outcomes are improved when certain anatomical parameters are maintained. These parameters include the cervical sagittal vertical axis (cSVA), C2 and T1 slopes, and cervical lordosis (CL). For patients with primary and metastatic tumors involving the subaxial cervical and/or upper thoracic spine, there is minimal guidance on how to apply these parameters. Surgeons must make critical decisions when designing the optimal construct

Разоблачение множественных миеломы: важность подозрения в совершении злодеяний при атипичной хронической болезни, имитирующей дегенеративные условия.

Для пациентов с атипичной хронической болью необходима повышенная клиническая бдительность в отношении множественной миеломы. Симптомы могут перекликаться с дегенеративными мускулоскелетными условиями, что часто приводит к неправильному диагностике. Это подчеркивает необходимость проведения тщательной оценки в тех случаях, когда симптомы отклоняются от традиционных методов лечения, с тем чтобы содействовать своевременному диагностированию и эффективному регулированию злоумышленничества.

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… The lumbar spine MRI (Figure 5 ) demonstrated multiple chronic compression fractures involving the lower thoracic and lumbar spine with 25%–50% height loss, without retropulsion of bone toward the spinal canal. Mild degenerative changes were also noted, most pronounced at L4‐5 and L5‐S1. …

Hospital Use, Morbidity, and Cancer Risk by Age Group in Neurofibromatosis Type 1: A Nationwide Retrospective Cohort Study.

Neurofibromatosis type 1 (NF1) affects multiple organs progressively, leading to a shortened life expectancy. This study aimed to identify the complications that are prominent in each age group by comparing 28,082 patients with NF1 and 84,246 matched controls. Benign and malignant neoplasms along with neurological complications were the primary contributors to hospital use across most age groups. Respiratory and circulatory disorders were a common cause of hospital use in children and older adults, respectively. Except for soft tissue and central nervous system-originated malignancies, which a

Bone cements for percutaneous vertebroplasty and balloon kyphoplasty: Current status and future developments.

Osteoporotic vertebral compression fractures (OVCFs) have gradually evolved into a serious health care problem globally. In order to reduce the morbidity of OVCF patients and improve their life quality, two minimally invasive surgery procedures, vertebroplasty (VP) and balloon kyphoplasty (BKP), have been developed. Both VP and BKP require the injection of bone cement into the vertebrae of patients to stabilize fractured vertebra. As such, bone cement as the filling material plays an essential role in the effectiveness of these treatments. In this review article, we summarize the bone cements

Complications After Percutaneous Pedicle Screw Fixation for the Treatment of Unstable Spinal Metastases.

BackgroundComplications after surgical stabilization for the treatment of unstable spinal metastases are common. Less invasive surgical (LIS) procedures are potentially associated with a lower risk of complications; however, little is known regarding the complications after LIS procedures for the treatment of spinal metastases. Our primary objective was to determine the characteristics and rate of complications after percutaneous pedicle screw fixation (PPSF) for the treatment of mechanically unstable spinal metastases. The secondary objective was to identify factors associated with the occurr

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… After the second surgery, the patient developed a superficial wound infection and experienced neurologic deterioration due to tumor growth into the spinal canal; neither preoperative nor postoperative radiotherapy was administered. …

The Therapeutic Potential of Secreted Factors from Dental Pulp Stem Cells for Various Diseases.

An alternative source of mesenchymal stem cells has recently been discovered: dental pulp stem cells (DPSCs), including deciduous teeth, which can thus comprise potential tools for regenerative medicine. DPSCs derive from the neural crest and are normally implicated in dentin homeostasis. The clinical application of mesenchymal stem cells (MSCs) involving DPSCs contains various limitations, such as high cost, low safety, and cell handling issues, as well as invasive sample collection procedures. Although MSCs implantation offers favorable outcomes on specific diseases, implanted MSCs cannot su

Minimally invasive interventional therapy for pain.

Pain interventional therapy, known as the most promising medical technology in the 21st century, refers to clinical treatment technology based on neuroanatomy, neuroimaging, and nerve block technology to treat pain diseases. Compared with traditional destructive surgery, interventional pain therapy is considered a better and more economical choice of treatment. In recent years, a variety of minimally invasive pain interventional therapy techniques, such as neuroregulation, spinal cord electrical stimulation, intervertebral disc ablation, and intrasheath drug infusion systems, have provided eff

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… Spinal cord stimulation Spinal cord stimulation (SCS) refers to the method of disease treatment by implanting electrodes into the spinal canal and stimulating the spinal cord with a switch pulse current at a specific value. …

A New Deep Learning Algorithm for Detecting Spinal Metastases on Computed Tomography Images.

Study designRetrospective diagnostic study.ObjectiveTo automatically detect osteolytic bone metastasis lesions in the thoracolumbar region using conventional computed tomography (CT) scans, we developed a new deep learning (DL)-based computer-aided detection model.Summary of background dataRadiographic detection of bone metastasis is often difficult, even for orthopedic surgeons and diagnostic radiologists, with a consequent risk for pathologic fracture or spinal cord injury. If we can improve detection rates, we will be able to prevent the deterioration of patients' quality of life at the end