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Hye Yang S, Mittal N, Bell AL, Bell CE. Utilization of Romosozumab in Primary Care. J Pharm Technol 2024; 40:152-157. [PMID: 38784024 PMCID: PMC11110734 DOI: 10.1177/87551225231220221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Objective: The objective of the study is to highlight the role and safety of romosozumab in patients at high risk of fractures in primary care. Data Sources: A systemic database search of PubMed/MEDLINE, ClinicalTrials.gov, and Cochrane Library was conducted for articles with keywords romosozumab, osteoporosis, and safety between inception and July 2022. Study Selection and Data Extraction: Phase 3 trials in patients with osteoporosis were included. Data results from these trials were utilized for assessment. Data Synthesis: Romosozumab decreased vertebral fracture incidence by 73% at 12 months (P < 0.001) in osteoporotic postmenopausal women compared with placebo. In an active-controlled fracture study in postmenopausal women with osteoporosis at high risk of fracture, a 48% lower risk of new vertebral fracture was observed at 24 months in the romosozumab-alendronate group (P < 0.001) compared with alendronate group. In a study comparing romosozumab with teriparatide in postmenopausal women with osteoporosis at high risk of fracture, 2.6% of the mean percentage change from baseline in the total hip (TH) areal bone mineral density (BMD) was observed with romosozumab, while teriparatide led -0.6% of change (P < 0.0001). Romosozumab significantly increased the mean percentage change from baseline in the lumbar spine (LS) and total hip (TH) BMD than placebo in men with osteoporosis (LS, 12.1% vs 1.2%; TH, 2.5% vs -0.5%; P < 0.001). Serious cardiovascular events were observed in the romosozumab compared with alendronate (2.5% vs 1.9%; odds ratio [OR] = 1.31; 95% confidence interval [CI] = 0.85-2.00) in postmenopausal women, and placebo (4.9% vs 2.5%) in men with osteoporosis. Relevance to Patient Care and Clinical Practice: This review discusses the role of romosozumab in patients with high fracture risk and its safety in primary care. Conclusions: Primary care physicians should consider romosozumab for patients at high fracture risk who are intolerant or have not responded to other pharmacological treatment. Further studies are needed to clarify the safety of cardiovascular events.
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Affiliation(s)
- Soon Hye Yang
- Department of Clinical and Administrative Sciences, College of Pharmacy, Larkin University, Miami, FL, USA
| | - Neha Mittal
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Amanda L. Bell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Zannetti EB, Cittadini N, Iovino P, De Maria M, D'Angelo D, Pennini A, Vellone E, Tarantino U, Alvaro R. Factors That Influence Quality of Life in Postmenopausal Osteoporotic Women With Nonvertebral Fractures: The Guardian Angel Multicenter Longitudinal Study. Orthop Nurs 2024; 43:151-157. [PMID: 38861745 DOI: 10.1097/nor.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
The knowledge of variables associated with quality of life in women with nonvertebral fractures is poor. The aim of this study was to examine the independent associations between sociodemographic and clinical factors, self-care, and quality of life in this specific population. We undertook a 3-year multicenter longitudinal study on a cohort of Italian postmenopausal osteoporotic women with three follow-ups at 1, 3, and 6 months. Nurses asked women to complete questionnaires on quality of life and self-care. The sample (n = 532) had a mean age of 74.78 years. The results showed that women taking more than two medications per day (p = .026) and those with nine or more years of education (p = .036) were more likely to exhibit better quality of life levels (p < .001) than their counterparts. Both self-care and quality of life scores improved over time in all participants. This study shows positive independent associations between quality of life and polypharmacy, education, and self-care behaviors, which were improved by educational interventions to attain a better quality of life in our participants.
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Affiliation(s)
- Emanuela Basilici Zannetti
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Noemi Cittadini
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Paolo Iovino
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Maddalena De Maria
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Daniela D'Angelo
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Annalisa Pennini
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Ercole Vellone
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Umberto Tarantino
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
| | - Rosaria Alvaro
- Emanuela Basilici Zannetti, PhD, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-5330-9808)
- Noemi Cittadini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0001-8862-6857)
- Paolo Iovino, PhD, RN,Department of Health Sciences, University of Florence (https://orcid.org/0000-0001-5952-881X)
- Maddalena De Maria, RN, MSN, PhD, Associate Professor of Nursing Science, Department of Life Health Sciences and Health Professions, Campus University, Rome, Italy https://orcid.org/0000-0003-0507-0158
- Daniela D'Angelo, PhD, RN,Research Nurse. Azienda Sanitaria Locale Roma/6, Via Borgo Garibaldi,12 00041 Albano Laziale (https://orcid.org/0000-0001-9451-0885)
- Annalisa Pennini, PhD, RN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-3676-5956)
- Ercole Vellone, PhD, RN, FAAN, FESC,Associate Professor of Nursing, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy and Department of Nursing and Obstetrics, Wroclaw Medical University, Poland (https://orcid.org/0000-0003-4673-7473)
- Umberto Tarantino, PhD, MD,Department of Orthopaedics and Traumatology, Policlinic Tor Vergata Foundation, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0003-0330-2189)
- Rosaria Alvaro, MSN, FESC, FAAN,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy (https://orcid.org/0000-0002-4659-1569)
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Pereira MVA, Galvani RG, Gonçalves-Silva T, de Vasconcelo ZFM, Bonomo A. Tissue adaptation of CD4 T lymphocytes in homeostasis and cancer. Front Immunol 2024; 15:1379376. [PMID: 38690280 PMCID: PMC11058666 DOI: 10.3389/fimmu.2024.1379376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
The immune system is traditionally classified as a defense system that can discriminate between self and non-self or dangerous and non-dangerous situations, unleashing a tolerogenic reaction or immune response. These activities are mainly coordinated by the interaction between innate and adaptive cells that act together to eliminate harmful stimuli and keep tissue healthy. However, healthy tissue is not always the end point of an immune response. Much evidence has been accumulated over the years, showing that the immune system has complex, diversified, and integrated functions that converge to maintaining tissue homeostasis, even in the absence of aggression, interacting with the tissue cells and allowing the functional maintenance of that tissue. One of the main cells known for their function in helping the immune response through the production of cytokines is CD4+ T lymphocytes. The cytokines produced by the different subtypes act not only on immune cells but also on tissue cells. Considering that tissues have specific mediators in their architecture, it is plausible that the presence and frequency of CD4+ T lymphocytes of specific subtypes (Th1, Th2, Th17, and others) maintain tissue homeostasis. In situations where homeostasis is disrupted, such as infections, allergies, inflammatory processes, and cancer, local CD4+ T lymphocytes respond to this disruption and, as in the healthy tissue, towards the equilibrium of tissue dynamics. CD4+ T lymphocytes can be manipulated by tumor cells to promote tumor development and metastasis, making them a prognostic factor in various types of cancer. Therefore, understanding the function of tissue-specific CD4+ T lymphocytes is essential in developing new strategies for treating tissue-specific diseases, as occurs in cancer. In this context, this article reviews the evidence for this hypothesis regarding the phenotypes and functions of CD4+ T lymphocytes and compares their contribution to maintaining tissue homeostasis in different organs in a steady state and during tumor progression.
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Affiliation(s)
- Marina V. A. Pereira
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Laboratory of High Complexity, Fernandes Figueira National Institute for The Health of Mother, Child, and Adolescent, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rômulo G. Galvani
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Triciana Gonçalves-Silva
- National Center for Structural Biology and Bioimaging - CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Zilton Farias Meira de Vasconcelo
- Laboratory of High Complexity, Fernandes Figueira National Institute for The Health of Mother, Child, and Adolescent, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Adriana Bonomo
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Vignolles-Jeong J, Weber MD, Xu DS, Elder JB, Chakravarthy VB. Letter: Global Spinal Alignment Considerations in the Oncological Spine Population. Neurosurgery 2023; 93:e105-e106. [PMID: 37489901 DOI: 10.1227/neu.0000000000002615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/06/2023] [Indexed: 07/26/2023] Open
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So E, Juels C, Scott RT, Sietsema DL. A Comparison of Ankle Fractures Relative to Other Fragility Fractures: A Review and Analysis of the American Orthopaedic Association's Own the Bone Database. Foot Ankle Int 2023; 44:879-887. [PMID: 37300238 DOI: 10.1177/10711007231178536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Ankle fragility fractures (AFX) continue to increase in the elderly population. There is limited knowledge of AFX characteristics compared to nonankle fragility fractures (NAFX). The American Orthopaedic Association's Own the Bone (OTB) is a fragility fracture initiative. This robust data set was used to examine and compare characteristics of patients presenting with AFX to those with NAFX. METHODS The OTB database contained 72,617 fragility fractures between January 2009 and March of 2022 and were reviewed in our secondary cohort comparative analysis. After exclusions, AFX accounted for 3229 patients and 54,772 patients were in the NAFX cohort. Bivariate analysis and logistic regression compared the AFX and NAFX groups concerning demographics, bone health factors, medication use, and prior fragility fracture. RESULTS AFX patients were found to have a higher likelihood to be younger (67.6 years old), female (81.4%), non-Caucasian (11.7%) and have a higher BMI (30.6) compared to NAFX. Prior AFX predicted the risk of a future AFX. The probability of an AFX increased with increased age and BMI. CONCLUSION A prior AFX is independently predictive of subsequent AFX. Therefore, these fractures should be considered a sentinel event. These patients are more likely to have higher BMI, to be of female gender, non-Caucasian race, and are younger compared to patients with NAFX. LEVEL OF EVIDENCE Level III, retrospective cohort.
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Affiliation(s)
- Eric So
- Capital Foot and Ankle - Bryan Physician Network, Lincoln, NE, USA
| | | | | | - Debra L Sietsema
- The CORE Institute (retired), Phoenix, AZ, USA
- MORE Foundation (retired), Phoenix, AZ, USA
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6
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Demehri S, Baffour FI, Klein JG, Ghotbi E, Ibad HA, Moradi K, Taguchi K, Fritz J, Carrino JA, Guermazi A, Fishman EK, Zbijewski WB. Musculoskeletal CT Imaging: State-of-the-Art Advancements and Future Directions. Radiology 2023; 308:e230344. [PMID: 37606571 PMCID: PMC10477515 DOI: 10.1148/radiol.230344] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 08/23/2023]
Abstract
CT is one of the most widely used modalities for musculoskeletal imaging. Recent advancements in the field include the introduction of four-dimensional CT, which captures a CT image during motion; cone-beam CT, which uses flat-panel detectors to capture the lower extremities in weight-bearing mode; and dual-energy CT, which operates at two different x-ray potentials to improve the contrast resolution to facilitate the assessment of tissue material compositions such as tophaceous gout deposits and bone marrow edema. Most recently, photon-counting CT (PCCT) has been introduced. PCCT is a technique that uses photon-counting detectors to produce an image with higher spatial and contrast resolution than conventional multidetector CT systems. In addition, postprocessing techniques such as three-dimensional printing and cinematic rendering have used CT data to improve the generation of both physical and digital anatomic models. Last, advancements in the application of artificial intelligence to CT imaging have enabled the automatic evaluation of musculoskeletal pathologies. In this review, the authors discuss the current state of the above CT technologies, their respective advantages and disadvantages, and their projected future directions for various musculoskeletal applications.
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Affiliation(s)
- Shadpour Demehri
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Francis I. Baffour
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Joshua G. Klein
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Elena Ghotbi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Hamza Ahmed Ibad
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Kamyar Moradi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Katsuyuki Taguchi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Jan Fritz
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - John A. Carrino
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Ali Guermazi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Elliot K. Fishman
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Wojciech B. Zbijewski
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
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7
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Zhang Y, Wang L, Kang H, Lin CY, Fan Y. Unlocking the Therapeutic Potential of Irisin: Harnessing Its Function in Degenerative Disorders and Tissue Regeneration. Int J Mol Sci 2023; 24:ijms24076551. [PMID: 37047523 PMCID: PMC10095399 DOI: 10.3390/ijms24076551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Physical activity is well-established as an important protective factor against degenerative conditions and a promoter of tissue growth and renewal. The discovery of Fibronectin domain-containing protein 5 (FNDC5) as the precursor of Irisin in 2012 sparked significant interest in its potential as a diagnostic biomarker and a therapeutic agent for various diseases. Clinical studies have examined the correlation between plasma Irisin levels and pathological conditions using a range of assays, but the lack of reliable measurements for endogenous Irisin has led to uncertainty about its prognostic/diagnostic potential as an exercise surrogate. Animal and tissue-engineering models have shown the protective effects of Irisin treatment in reversing functional impairment and potentially permanent damage, but dosage ambiguities remain unresolved. This review provides a comprehensive examination of the clinical and basic studies of Irisin in the context of degenerative conditions and explores its potential as a therapeutic approach in the physiological processes involved in tissue repair/regeneration.
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Affiliation(s)
- Yuwei Zhang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Lizhen Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
- Correspondence:
| | - Hongyan Kang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| | - Chia-Ying Lin
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
- Department of Biomedical, Chemical & Environmental Engineering, University of Cincinnati, Cincinnati, OH 45267, USA
- Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH 45267, USA
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
- School of Engineering Medicine, Beihang University, Beijing 100083, China
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8
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Gerstl B, Signorelli C, Wakefield CE, Deans R, Vaishnav T, Johnston K, Neville K, Cohn RJ, Anazodo A. Sexual and reproductive complications and concerns of survivors of childhood, adolescent and adult cancer. J Cancer Surviv 2023:10.1007/s11764-023-01349-6. [PMID: 36991269 DOI: 10.1007/s11764-023-01349-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/10/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Cancer survivors may experience infertility and sexual dysfunction following cancer treatment. Survivors report significant gaps in oncofertility care and consider these issues important, yet they are rarely discussed. The aims of this study were to evaluate survivors' sexual and reproductive complications across age groups and to identify specific groups of survivors at risk for sexual and reproductive complications. METHOD We report data collected from survivors of cancers diagnosed in childhood, adolescence and adulthood following the development and piloting of a reproductive survivorship patient reported outcome measure (RS-PROM). RESULTS One hundred and fifty survivors participated in the study (mean age at cancer diagnosis was 23.2 years [SD, 10.3 years]). About 68% of participants expressed concerns about their sexual health and function. Survivors (50%) expressed at least one body image concern, with the female gender the most common risk factor for all subgroups. A total of 36% of participants reported at least one concern regarding their fertility, with more male than female survivors reporting fertility preservation prior to treatment. Females compared with male participants were more likely to feel less physically attractive after treatment (OR = 3.83, 95% CI = 1.84-7.95, p < 0.001). More females than males were also more likely to feel dissatisfied with the appearance of a scar(s) after treatment (OR = 2.36, 95% CI = 1.13-4.91, p = 0.02). CONCLUSION The RS-PROM identified multiple reproductive complications and concerns for cancer survivors in the survivorship period. IMPLICATIONS FOR CANCER SURVIVORS Utilising the RS-PROM in conjunction with a clinic appointment could help identify and address cancer patients' concerns and symptoms.
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Affiliation(s)
- Brigitte Gerstl
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Childrens Hospital, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Childrens Hospital, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
| | - Rebecca Deans
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
- Department of Gynaecology, The Royal Hospital for Women, Sydney, NSW, Australia
- Fertility Research Centre, The Royal Hospital for Women, Sydney, NSW, Australia
| | - Tejnei Vaishnav
- Fertility Research Centre, The Royal Hospital for Women, Sydney, NSW, Australia
| | - Karen Johnston
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
| | - Kristen Neville
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
- Department of Endocrinology, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Childrens Hospital, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia.
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia.
- Fertility Research Centre, The Royal Hospital for Women, Sydney, NSW, Australia.
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia.
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9
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Park SH, Yoon SR, Nam JY, Ahn JY, Jeong SJ, Ku NS, Choi JY, Yeom JS, Kim JH. Impact of tuberculosis on the incidence of osteoporosis and osteoporotic fractures: a nationwide population-based cohort study. Public Health 2023; 216:13-20. [PMID: 36758345 DOI: 10.1016/j.puhe.2022.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Despite the high prevalence of tuberculosis (TB) and the disease burden of osteoporosis and osteoporotic fractures, there is still a lack of well-designed, large-scale studies demonstrating associations among them. We aimed to investigate the effect of TB on the incidence of osteoporosis and osteoporotic fractures. STUDY DESIGN This was a nationwide population-based cohort study. METHODS This study was conducted using the National Health Insurance Service Database of South Korea. We included patients with newly diagnosed TB aged >40 years from January 2006 to December 2017. An uninfected control for each TB patient was randomly extracted by frequency matching for sex, age, income level, residence, and registration date at a 2:1 ratio. The primary outcome was the incidence of osteoporosis and osteoporotic fractures between the two groups, adjusted for sex, age, income level, residence, comorbidities, body mass index, blood pressure, laboratory tests, alcohol drinking, and smoking. The risk factors associated with osteoporosis or osteoporotic fractures were also investigated. RESULTS A total of 164,389 patients with TB and 328,778 matched controls were included (71.9% males). The mean duration of follow-up was 7.00 ± 3.49 years. The incidence of osteoporosis in patients with TB was 6.1 cases per 1000 person-years, which was significantly higher than that in matched controls (adjusted hazard ratio [aHR] 1.349, 95% confidence interval [CI] 1.302-1.398, P < 0.001). The incidence of osteoporotic fractures was also higher in patients with TB than in controls (aHR 1.392, 95% CI 1.357-1.428, P < 0.001). Among fractures, the risk of hip fracture was the highest (aHR 1.703, 95% CI 1.612-1.798, P < 0.001). CONCLUSIONS TB independently contributes to the incidence of osteoporosis and osteoporotic fractures, particularly hip fractures.
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Affiliation(s)
- S H Park
- Chaum Life Center, CHA University, Seoul 06062, South Korea; Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang 10444, South Korea
| | - S R Yoon
- Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang 10444, South Korea
| | - J Y Nam
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang 10444, South Korea
| | - J Y Ahn
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - S J Jeong
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - N S Ku
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - J Y Choi
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - J-S Yeom
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - J H Kim
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul 03722, South Korea.
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10
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Testosterone Therapy in Oncologic Patients. CURRENT SEXUAL HEALTH REPORTS 2023. [DOI: 10.1007/s11930-022-00351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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11
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Nicholson TA, Sagmeister M, Wijesinghe SN, Farah H, Hardy RS, Jones SW. Oligonucleotide Therapeutics for Age-Related Musculoskeletal Disorders: Successes and Challenges. Pharmaceutics 2023; 15:237. [PMID: 36678864 PMCID: PMC9866666 DOI: 10.3390/pharmaceutics15010237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/04/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
Age-related disorders of the musculoskeletal system including sarcopenia, osteoporosis and arthritis represent some of the most common chronic conditions worldwide, for which there remains a great clinical need to develop safer and more efficacious pharmacological treatments. Collectively, these conditions involve multiple tissues, including skeletal muscle, bone, articular cartilage and the synovium within the joint lining. In this review, we discuss the potential for oligonucleotide therapies to combat the unmet clinical need in musculoskeletal disorders by evaluating the successes of oligonucleotides to modify candidate pathological gene targets and cellular processes in relevant tissues and cells of the musculoskeletal system. Further, we discuss the challenges that remain for the clinical development of oligonucleotides therapies for musculoskeletal disorders and evaluate some of the current approaches to overcome these.
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Affiliation(s)
- Thomas A. Nicholson
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Michael Sagmeister
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Susanne N. Wijesinghe
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Hussein Farah
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Rowan S. Hardy
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Simon W. Jones
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
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12
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Sun L, Zhang Y, Chen G, Ji Y, Ma Q, Qiao X, Wu S, Zhou L, Bu J, Zhu X, Zhang X, Jiang X, Liu C, Li X, Liu Y, Yang Y, Liu C. Targeting SOST using a small-molecule compound retards breast cancer bone metastasis. Mol Cancer 2022; 21:228. [PMID: 36581888 PMCID: PMC9798707 DOI: 10.1186/s12943-022-01697-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/07/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Breast cancer metastasis to the bone can be exacerbated by osteoporosis, is associated with poor long-term survival, and has limited therapeutic options. Sclerostin (SOST) is an endogenous inhibitor of bone formation, and an attractive target for treatment of osteoporosis. However, it is unclear whether SOST can be used as a therapeutic target for bone metastases of breast cancer, and whether small molecule compounds that target SOST in breast cancer cells can inhibit breast cancer bone metastasis. METHODS SOST expression in 442 breast cancer tissues was characterized by immunohistochemistry and statistically analyzed for the association with breast cancer bone metastases. Bone metastatic breast cancer SCP2 cells were induced for SOST silencing or overexpression and their bone metastatic behaviors were tested in vitro and in vivo. To identify potential therapeutics, we screened inhibitors of the interaction of SOST with STAT3 from a small chemical molecule library and tested the inhibitory effects of one inhibitor on breast cancer growth and bone metastasis in vitro and in vivo. RESULTS We found that up-regulated SOST expression was associated with breast cancer bone metastases and worse survival of breast cancer patients. SOST silencing significantly reduced the bone metastatic capacity of SCP2 cells. SOST interacted with STAT3 to enhance the TGF-β/KRAS signaling, increasing both tumor growth and bone metastasis. Treatment with one lead candidate, S6, significantly inhibited the growth of breast-cancer organoids and bone metastasis in mice. CONCLUSIONS Our findings highlight a new class of potential therapeutics for treatment of bone metastasis in breast cancer.
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Affiliation(s)
- Lisha Sun
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yixiao Zhang
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China ,grid.412467.20000 0004 1806 3501Department of Urology Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guanglei Chen
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yaoting Ji
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qingtian Ma
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xinbo Qiao
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Sijin Wu
- grid.9227.e0000000119573309Dalian Institute of Chemical Physics, Chinese Academy of Science, Dalian, China
| | - Lin Zhou
- grid.412561.50000 0000 8645 4345Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, China
| | - Jiawen Bu
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xudong Zhu
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoying Zhang
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaofan Jiang
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chao Liu
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xinnan Li
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Liu
- grid.412561.50000 0000 8645 4345Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, China
| | - Yongliang Yang
- grid.30055.330000 0000 9247 7930School of Bioengineering, Dalian University of Technology, Dalian, China
| | - Caigang Liu
- grid.412467.20000 0004 1806 3501Department of Oncology, Innovative Cancer Drug Research and Engineering Center of Liaoning Province, Cancer Stem Cell and Translation Medicine Lab, Shengjing Hospital of China Medical University, Shenyang, China
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13
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Ye C, Leslie WD, Al-Azazi S, Yan L, Lix LM, Czaykowski P, Singh H. Fractures and long-term mortality in cancer patients: a population-based cohort study. Osteoporos Int 2022; 33:2629-2635. [PMID: 36036268 DOI: 10.1007/s00198-022-06542-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
Abstract
UNLABELLED We assessed post-fracture mortality in a population-based cohort of 122,045 individuals with cancers. Major fractures (hip, vertebrae, humerus, and forearm) were associated with early and long-term increased all-cause mortality. INTRODUCTION Currently, there are no population-based data among cancer patients on post-fracture mortality risk across a broad range of cancer diagnoses. Our objective was to estimate the association of fracture with mortality in cancer survivors. METHODS Using Manitoba Cancer Registry data from the province of Manitoba, Canada, we identified all women and men with cancer diagnosed between January 1, 1987, and March 31, 2014. We then linked cancer data to provincial healthcare administrative data and ascertained fractures after cancer diagnosis and mortality to March 31, 2015. Hazard ratios for all-cause mortality in those with versus without fracture were estimated from time-dependent Cox proportional hazards models adjusted for multiple covariates. RESULTS The study cohort consisted of 122,045 cancer patients (median age 68 years, IQR 58-77, 49.2% female). During the median follow-up of 5.8 years from cancer diagnosis, we ascertained 7120 (5.8%) major fractures. All fracture sites, except for the forearm, were associated with increased mortality risk, even after multivariable adjustment. Excess mortality risk associated with a major fracture was greatest in the first year after fracture (HR 2.42, 95% CI 2.30-2.54) and remained significant > 5 years after fracture (HR 1.60, 95% CI 1.50-1.70) and for fractures occurring > 10 years after cancer diagnosis (HR 1.93, 95% CI 1.79-2.07). CONCLUSION Fractures among cancer patients are associated with increased all-cause mortality. This excess risk is greatest in the first year and persists more than 5 years post-fracture; increased risk is also noted for fractures occurring up to and beyond 10 years after cancer diagnosis.
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Affiliation(s)
- Carrie Ye
- University of Alberta, Edmonton, Canada.
| | | | | | - Lin Yan
- University of Manitoba, Winnipeg, Canada
| | - Lisa M Lix
- University of Manitoba, Winnipeg, Canada
| | - Piotr Czaykowski
- University of Manitoba, Winnipeg, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
| | - Harminder Singh
- University of Manitoba, Winnipeg, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
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14
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Chin KY, Ng BN, Rostam MKI, Muhammad Fadzil NFD, Raman V, Mohamed Yunus F, Syed Hashim SA, Ekeuku SO. A Mini Review on Osteoporosis: From Biology to Pharmacological Management of Bone Loss. J Clin Med 2022; 11:6434. [PMID: 36362662 PMCID: PMC9657533 DOI: 10.3390/jcm11216434] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 07/25/2023] Open
Abstract
Osteoporosis refers to excessive bone loss as reflected by the deterioration of bone mass and microarchitecture, which compromises bone strength. It is a complex multifactorial endocrine disease. Its pathogenesis relies on the presence of several endogenous and exogenous risk factors, which skew the physiological bone remodelling to a more catabolic process that results in net bone loss. This review aims to provide an overview of osteoporosis from its biology, epidemiology and clinical aspects (detection and pharmacological management). The review will serve as an updated reference for readers to understand the basics of osteoporosis and take action to prevent and manage this disease.
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15
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Xu Z, Yu Z, Chen M, Zhang M, Chen R, Yu H, Lin Y, Wang D, Li S, Huang L, Li Y, Yuan J, Yin P. Mechanisms of estrogen deficiency-induced osteoporosis based on transcriptome and DNA methylation. Front Cell Dev Biol 2022; 10:1011725. [PMID: 36325359 PMCID: PMC9618684 DOI: 10.3389/fcell.2022.1011725] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/28/2022] [Indexed: 11/24/2022] Open
Abstract
Osteoporosis is a disease that impacts the elderly. Low estrogen is related to changes in DNA methylation and consequent alterations in gene expression, leading to a new direction in research related to the pathophysiology of osteoporosis. We constructed an Ovariectomized (OVX) mouse model in our study, and the mouse models had osteoporosis based on the phenotype and methylation levels in the mouse’s bone. Furthermore, the methylation level of the OVX mice was significantly changed compared to that of SHAM mice. Therefore, we performed genome-level analysis on the mouse model using transcriptome and Whole Genome Bisulfite Sequencing (WGBS) by combining the data of two omics and discovered that the changes in gene expression level caused by osteoporosis primarily focused on the decrease of bone and muscle development and the activation of the immune system. According to intersection analysis of methylation and transcriptome data, the differentially expressed genes and pathways are consistent with the differentially expressed methylation locations and regions. Further, the differentially expressed methylation sites were mainly concentrated in promoters, exons, and other critical functional regions of essential differentially expressed genes. This is also the primary cause of gene differential expression variations, indicating that estrogen deficiency might regulate gene expression by altering methylation modification, leading to osteoporosis. We demonstrated the clinical value of methylation modification research, and these findings would improve the current understanding of underlying molecular mechanisms of osteoporosis incidence and development and provide new ideas for early detection and treatment of osteoporosis.
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Affiliation(s)
- Ziying Xu
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Zihui Yu
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Ming Chen
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Mingming Zhang
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Ruijing Chen
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Haikuan Yu
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Yuan Lin
- The Department of Orthopedic Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Duanyang Wang
- The Department of Orthopedic Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shang Li
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
| | - Ling Huang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yi Li
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
- *Correspondence: Pengbin Yin, ; Yi Li, ; Jing Yuan,
| | - Jing Yuan
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Pengbin Yin, ; Yi Li, ; Jing Yuan,
| | - Pengbin Yin
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China
- *Correspondence: Pengbin Yin, ; Yi Li, ; Jing Yuan,
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16
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Jensen-Battaglia M, Lei L, Xu H, Loh KP, Wells M, Tylock R, Ramsdale E, Kleckner AS, Mustian KM, Dunne RF, Kehoe L, Bearden J, Burnette BL, Whitehead M, Mohile SG, Wildes TM. Communication About Fall Risk in Community Oncology Practice: The Role of Geriatric Assessment. JCO Oncol Pract 2022; 18:e1630-e1640. [PMID: 35984998 PMCID: PMC9835996 DOI: 10.1200/op.22.00173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/12/2022] [Accepted: 07/06/2022] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Falls are a modifiable source of morbidity for older adults with cancer, yet are underassessed in oncology practice. In this secondary analysis of a nationwide cluster-randomized controlled trial, we examined characteristics associated with patient-oncologist conversations about falls, and whether oncologist knowledge of geriatric assessment (GA) resulted in more conversations. METHODS Eligible patients (ClinicalTrials.gov identifier: NCT02107443) were age ≥ 70 years, had stage III/IV solid tumor or lymphoma, were being treated with noncurative treatment intent, and ≥ 1 GA domain impairment. Patients in both arms underwent GA. At practices randomly assigned to the intervention arm, oncologists were provided a GA summary with management recommendations. In both arms, patients had one clinical encounter audio-recorded, transcribed, and coded to categorize whether a conversation about falls occurred. Generalized linear mixed models adjusted for arm, practice site, and other important covariates were used to generate proportions and odds ratios (ORs) from the full sample. RESULTS Of 541 patients (intervention N = 293 and usual care N = 248, mean age: 77 years, standard deviation: 5.3), 528 had evaluable audio recordings. More patients had conversations about falls in the intervention versus usual care arm (61.3% v 10.3%, P < .001). Controlling for the intervention and practice site, history of falls (OR, 2.1; 95% CI, 1.3 to 3.6; P = .005) and impaired physical performance (OR, 4.7; 95% CI, 1.7 to 12.8; P = .002) were significantly associated with patient-oncologist conversations about falls. CONCLUSION GA intervention increased conversations about falls. History of falls and impaired physical performance were associated with patient-oncologist conversations about falls in community oncology practice.
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Affiliation(s)
- Marielle Jensen-Battaglia
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Huiwen Xu
- Department of Preventive Medicine and Population Health and Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX
| | - Kah Poh Loh
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Megan Wells
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Rachael Tylock
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Erika Ramsdale
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Amber S. Kleckner
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland Baltimore, Baltimore, MD
| | - Karen M. Mustian
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Richard F. Dunne
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | - Lee Kehoe
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
| | | | - Brian L. Burnette
- Cancer Research of Wisconsin and Northern Michigan (CROWN) NCORP, Green Bay, WI
| | - Mary Whitehead
- SCOREboard Advisory Group, University of Rochester Medical Center, Rochester, NY
| | - Supriya G. Mohile
- University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester, NY
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17
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Association between prior cancer diagnosis and osteoporosis: a matched case-control study. Arch Osteoporos 2022; 17:112. [PMID: 35960383 DOI: 10.1007/s11657-022-01152-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/26/2022] [Indexed: 02/03/2023]
Abstract
Epidemiological studies show an inconsistent association between cancer and osteoporosis. In this nationally representative population-based study, we found that a prior cancer diagnosis was not associated with osteoporosis. This finding may primarily apply to cancer survivors seen many years after their cancer diagnosis. BACKGROUND Epidemiological studies show an inconsistent association between cancer and osteoporosis. We examined the association between a prior cancer diagnosis and osteoporosis in population-based data. METHODS We performed an age- and sex-matched case-control study (1:2 matching ratio) using the National Health and Nutrition Examination Survey, 2011-2018. Cases were determined by self-reported prior diagnosis of cancer; all controls were free of cancer at the time of bone density measurement with dual-energy x-ray absorptiometry. We defined osteoporosis as a T-score ≤ - 2.5 at femoral neck, total hip, or lumbar spine. Unconditional multivariable logistic regression was used to test the association between a prior cancer diagnosis and osteoporosis. RESULTS We identified 246 prior cancer cases and 492 controls (mean age: 65.8 years) in females, and 243 prior cancer cases and 486 controls (mean age: 68.0 years) in males. The most common types of cancer in females and males were breast cancer and prostate cancer, respectively. Osteoporosis prevalences were comparable between cases and controls among females (19.1% in cases vs. 18.7% in controls; P = 0.894) and males (5.8% in cases vs. 6.8% in controls; P = 0.594). After adjusting for covariates, a prior cancer diagnosis was not associated with osteoporosis in females (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.54-1.29) or males (OR: 1.09; 95% CI: 0.51-2.30). Results were unaffected by cancer severity, cancer type, or time since cancer diagnosis. CONCLUSIONS A prior cancer diagnosis was not associated with osteoporosis in this nationally representative population.
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18
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Sattar S, Haase KR, Alibhai SM, Penz K, Szafron M, Harenberg S, Amir E, Kuster S, Pitters E, Campbell D, McNeely ML. Feasibility and efficacy of a remotely delivered fall prevention exercise program for community-dwelling older adults with cancer: Protocol for the STABLE trial. J Geriatr Oncol 2022; 13:1273-1280. [DOI: 10.1016/j.jgo.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
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Klinedinst TC, Terhorst L, Rodakowski J. Chronic condition clusters and associated disability over time. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2022; 12:26335565221093569. [PMID: 35586039 PMCID: PMC9106307 DOI: 10.1177/26335565221093569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives Recent evidence shows that more complex clusters of chronic conditions are associated with poorer health outcomes. Less clear is the extent to which these clusters are associated with different types of disability (activities of daily living (ADL) and functional mobility (FM)) over time; the aim of this study was to investigate this relationship. Methods This was a longitudinal analysis using the National Health and Aging Trends Study (NHATS) (n = 6179). Using latent class analysis (LCA), we determined the optimal clusters of chronic conditions, then assigned each person to a best-fit class. Next, we used mixed-effects models with repeated measures to examine the effects of group (best-fit class), time (years from baseline), and the group by time interaction on each of the outcomes in separate models over 4 years. Results We identified six chronic condition clusters: Minimal Disease, Cognitive/Affective, Multiple Morbidity, Osteoporosis, Vascular, and Cancer. Chronic condition cluster was related to ADL and FM outcomes, indicating that groups experienced differential disability over time. At time point 4, all chronic condition groups had worse FM than Minimal Disease. Discussion The clusters of conditions identified here are plausible when considered clinically and in the context of previous research. All groups with chronic conditions carry risk for disability in FM and ADL; increased screening for disability in primary care could identify early disability and prevent decline.
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Affiliation(s)
- Tara C Klinedinst
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Tulsa, OK, USA
- OU-TU School of Community Medicine, Tulsa, OK, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juleen Rodakowski
- Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
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20
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Owen-Woods C, Kusumbe A. Fundamentals of bone vasculature: Specialization, interactions and functions. Semin Cell Dev Biol 2022; 123:36-47. [PMID: 34281770 DOI: 10.1016/j.semcdb.2021.06.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 02/06/2023]
Abstract
Angiogenesis, hematopoiesis and osteogenesis are fundamental processes mediating complex and essential biological functions. In the bone marrow, endothelial cells (ECs) are a principal mediator of regulatory signals that govern hematopoietic and mesenchymal stem cells. EC and osteoblast interactions and niche functions of ECs are fundamental in maintaining bone health and coordinating repair and regeneration following injury. These cellular interactions are subject to dysregulation and deterioration under stress, aging, chronic disease states and malignancy. Thus, the prospect of manipulating the bone vasculature has tremendous potential to advance therapeutic interventions for the management of bone diseases. This review discusses the current state of vascular-skeletal tissue interactions focusing on osteoblast and hematopoietic stem cells interaction with ECs.
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Affiliation(s)
- Charlotte Owen-Woods
- Tissue and Tumor Microenvironments Group, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Anjali Kusumbe
- Tissue and Tumor Microenvironments Group, NDORMS, University of Oxford, Oxford OX3 7FY, UK.
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21
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Rodríguez-Gómez I, Gray SR, Ho FK, Petermann-Rocha F, Welsh P, Cleland J, Iliodromiti S, Ara I, Pell J, Sattar N, Ferguson LD, Celis-Morales C. Osteoporosis and Its Association With Cardiovascular Disease, Respiratory Disease, and Cancer: Findings From the UK Biobank Prospective Cohort Study. Mayo Clin Proc 2022; 97:110-121. [PMID: 34996542 DOI: 10.1016/j.mayocp.2021.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate sex-specific associations of osteoporosis with incidence of and mortality from cardiovascular disease (CVD), respiratory disease, and cancer as well as with all-cause mortality. METHODS In total, 305,072 participants (53% [161,383] women) of UK Biobank were included in this study (2007-2010). Self-reported diagnosis of osteoporosis at baseline was the exposure of interest. The outcomes were CVD, respiratory disease, chronic obstructive pulmonary disease (COPD), all cancer, and prostate and breast cancer incidence and mortality and all-cause mortality. Associations between osteoporosis and outcomes were investigated using Cox proportional hazards models. RESULTS In men, osteoporosis was associated with a higher incident risk of all respiratory diseases (hazard ratio [HR], 1.26; 95% CI, 1.06 to 1.50) including COPD (HR, 1.82; 95% CI, 1.38 to 2.40). Men with osteoporosis also had a higher mortality risk from all causes (HR, 1.71; 95% CI, 1.38 to 2.11), CVD (HR, 1.68; 95% CI, 1.19 to 2.37), respiratory disease (HR, 2.35; 95% CI, 1.70 to 3.24), and COPD (HR, 3.64; 95% CI, 2.24 to 5.91). These associations persisted after adjustment for age, body mass index, and comorbidities. Women with osteoporosis had a higher risk of incident CVD (HR, 1.24; 95% CI, 1.97 to 1.44), respiratory disease (HR, 1.23; 95% CI, 1.13 to 1.33), and COPD (HR, 1.29; 95% CI, 1.10 to 1.52). Women with osteoporosis also had a higher mortality risk from respiratory disease (HR, 1.31; 95% CI, 1.00 to 1.72) and breast cancer (HR, 1.60; 95% CI, 1.14 to 2.26). CONCLUSION Compared with women, men with osteoporosis had a higher risk of all-cause mortality, mortality from respiratory diseases including COPD, and cancer incidence. Osteoporosis was strongly associated with respiratory disease and COPD in both sexes, even after full adjustment for covariates, although men with osteoporosis experienced a higher risk of adverse outcomes.
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Affiliation(s)
- Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - John Cleland
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Stamatina Iliodromiti
- Centre for Women's Health, Institute of Population Health Sciences, Queen Mary University London, London, United Kingdom
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Jill Pell
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Naveed Sattar
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Lyn D Ferguson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom; Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago, Chile; Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
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22
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Feasibility of a Remotely Delivered Strength and Balance Training Program for Older Adults with Cancer. Curr Oncol 2021; 28:4408-4419. [PMID: 34898562 PMCID: PMC8628693 DOI: 10.3390/curroncol28060374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
Falls are a major issue among older adults with cancer and lead to interruptions in cancer treatment. Resistance and balance training can prevent falls in older adults, but minimal evidence is available regarding the older cancer population, who often have unique risk factors. We used a pre-post design to assess the feasibility of a remotely delivered exercise program that progressed in difficulty and its efficacy on lower body strength, balance, and falls in older adults with cancer who had prior in-person exercise experience. Twenty-six older adults with cancer completed the intervention. Attendance rate for the virtual component was 97.6% and for the independent component was 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). The median balance score at baseline and end-of-study was 4 (IQR = 0). The median chair-stand time decreased from 9.2 s (IQR = 3.13) to 7.7 s (IQR = 4.6). A statistically significant difference in lower body strength (r = 0.68, p = 0.001) was detected post-intervention. The findings from this study can inform the design of a larger randomized trial.
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23
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Soen S, Kaku M, Okubo N, Touzeni S, Saito K, Kobayashi M. Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan. J Bone Miner Metab 2021; 39:1019-1030. [PMID: 34125296 DOI: 10.1007/s00774-021-01236-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/05/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Glucocorticoid-induced osteoporosis (GIOP) is associated with a high fracture risk. Practice guidelines by the Japanese Society for Bone and Mineral Research in 2014 recommend bone densitometry and appropriate treatment to reduce this risk. The study objectives were to describe characteristics of GIOP patients in Japan and to evaluate their management in a subgroup of patients without comorbid cancer. MATERIALS AND METHODS This retrospective cohort study was performed using the Medical Data Vision (MDV) database from Japan. Adult patients initiating oral glucocorticoid treatment with a total GIOP risk score ≥ 3, based on the 2014 practice guideline, identified between 2009 and 2019 were eligible. A subgroup of patients without any cancer diagnosis was also identified. Data were extracted on demographics, concurrent medical conditions, use of bone densitometry, and osteoporosis treatment. RESULTS 25,569 patients were eligible, of whom 12,227 had a confirmed cancer diagnosis. Mean age was 68.5 years and 12,356 patients (48.3%) were women. Concurrent medical conditions of interest were documented in 14,887 patients, most frequently rheumatoid arthritis (n = 4185) and asthma (n = 3085). Yearly bone densitometry was performed in 6.5% (n = 865) of the cancer-free subgroup; 51.8% (n = 6905) were prescribed an osteoporosis treatment, most frequently bisphosphonates (n = 5132; 74.3%). Between 2011 and 2018, rates of densitometry were stable, whereas prescription rates increased from 40.0 to 51.8%. CONCLUSION In spite of publication of guidelines for GIOP management, there is an important treatment gap in their application in everyday practice. For this reason, public health measures to increase physician awareness of GIOP are needed.
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Affiliation(s)
- Satoshi Soen
- Soen Orthopaedics, Osteoporosis and Rheumatology Clinic, Kobe, Japan
| | - Miki Kaku
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.
| | - Naoki Okubo
- Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co. Ltd, Tokyo, Japan
| | - Salsabil Touzeni
- Health Economics and Outcomes Research, Creativ-Ceutical, Tunis, Tunisia
| | - Kengo Saito
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan
| | - Makiko Kobayashi
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan
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Pagnotti GM, Thompson WR, Guise TA, Rubin CT. Suppression of cancer-associated bone loss through dynamic mechanical loading. Bone 2021; 150:115998. [PMID: 33971314 PMCID: PMC10044486 DOI: 10.1016/j.bone.2021.115998] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 02/06/2023]
Abstract
Patients afflicted with or being treated for cancer constitute a distinct and alarming subpopulation who exhibit elevated fracture risk and heightened susceptibility to developing secondary osteoporosis. Cancer cells uncouple the regulatory processes central for the adequate regulation of musculoskeletal tissue. Systemically taxing treatments to target tumors or disrupt the molecular elements driving tumor growth place considerable strain on recovery efforts. Skeletal tissue is inherently sensitive to mechanical forces, therefore attention to exercise and mechanical loading as non-pharmacological means to preserve bone during treatment and in post-treatment rehabilitative efforts have been topics of recent focus. This review discusses the dysregulation that cancers and the ensuing metabolic dysfunction that confer adverse effects on musculoskeletal tissues. Additionally, we describe foundational mechanotransduction pathways and the mechanisms by which they influence both musculoskeletal and cancerous cells. Functional and biological implications of mechanical loading at the tissue and cellular levels will be discussed, highlighting the current understanding in the field. Herein, in vitro, translational, and clinical data are summarized to consider the positive impact of exercise and low magnitude mechanical loading on tumor-bearing skeletal tissue.
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Affiliation(s)
- G M Pagnotti
- University of Texas - MD Anderson Cancer Center, Department of Endocrine, Neoplasia and Hormonal Disorders, Houston, TX, USA.
| | - W R Thompson
- Indiana University, Department of Physical Therapy, Indianapolis, IN, USA
| | - T A Guise
- University of Texas - MD Anderson Cancer Center, Department of Endocrine, Neoplasia and Hormonal Disorders, Houston, TX, USA
| | - C T Rubin
- Stony Brook University, Department of Biomedical Engineering, Stony Brook, NY, USA
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25
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Rivera-Díaz C, Volkow-Fernández P, Villalobos JL, Cornejo-Juárez P. Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms. SAGE Open Med 2021; 9:20503121211037471. [PMID: 34394933 PMCID: PMC8358488 DOI: 10.1177/20503121211037471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/19/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction: Higher prevalence of osteopenia and osteoporosis in HIV positive patients compared to non-infected population has been recognized. However, cancer patients have a higher risk of bone loss and fractures that is multifactorial. The aim of the study was to describe the prevalence of osteopenia and osteoporosis in HIV positive women with history of treated cancer. Methods: Between January 2018 and December 2019, women aged >40 years, HIV+ with a history of cancer diagnosis, who attended the AIDS Cancer Clinic at Instituto Nacional de Cancerología, Mexico City, and who had a dual X-ray absorptiometry performed during the study period were included. Two control groups (CG)—HIV negative women with history of cancer (CG1) and non-HIV, non-cancer women (CG2)—were matched by age 1:1. Results: Forty-eight patients in each group were included; the mean age was 51.1 ± 8.1 years. Osteopenia was found in femoral neck in 54.2% (HIV+), 37.5% (CG1), and 27.1% (CG2), p = 0.02; in spine was 35.7%, 47.9%, and 31.2%, respectively, p = 0.442. Osteoporosis in femoral neck was documented in 12.5%, 2.1%, and 0% in HIV+, CG1, and CG2 (p = 0.03), and in the spine was 47.9%, 16.7%, and 14.6%, respectively (p = 0.002). Conclusion: HIV patients with a history of treated cancer have a much higher prevalence of osteoporosis when compared with same-aged HIV-uninfected women with and without cancer. It is necessary to monitor Bone Mineral Density periodically, and all patients should be encouraged to make lifestyle changes, such as avoid tobacco and alcohol, and to increase exercising.
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Affiliation(s)
- Cecilia Rivera-Díaz
- Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - P Volkow-Fernández
- Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - José Luis Villalobos
- Imaging Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - P Cornejo-Juárez
- Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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Non-bone metastatic cancers promote osteocyte-induced bone destruction. Cancer Lett 2021; 520:80-90. [PMID: 34233150 DOI: 10.1016/j.canlet.2021.06.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
The effects of bone metastatic cancer on the skeleton are well described, whereas less is known regarding the effects of non-metastatic bone cancer on bone. Here we investigated the effects of three non-bone metastatic cancer cachexia models, namely Colon-26 adenocarcinoma (C26), ES-2 ovarian cancer (ES-2), and Lewis lung carcinoma (LLC). Even though C26, ES-2 and LLC tumor growth resulted in comparable weight and muscle loss, the ES-2 and LLC hosts exhibited severe bone loss, whereas only modest bone loss was observed in the C26 bearers, correlating with increased TRAP+ osteoclasts in the femurs of ES-2 and LLC but not C26 hosts. Surprisingly, all three showed increased osteocyte lacunar area indicating osteocytic osteolysis and displayed dramatically increased osteocyte death, as well as empty lacunae. To test whether tumor-secreted factors were responsible for the observed effect, IDG-SW3 osteocyte cells were co-cultured with cancer cells in permeable trans-wells. Apoptosis was observed in the osteocyte cells exposed to all three cancer cell lines suggesting that all tumors were cytotoxic for osteocytes. In addition, the expression of the osteoclastic markers, Acp5, CtsK, Atp6v0d2 and Mmp13, was elevated in IDG-SW3 osteocytes exposed to tumor factors, supporting the in vivo observations of increased lacunar size due to osteocytic osteolysis. For the first time, we describe osteocytic bone destruction and extensive osteocyte cell death in non-bone metastatic cancer. These bone alterations, in conjunction with muscle wasting, may create a musculoskeletal system that is incapable of full recovery upon eradication of tumor. Co-treatment with bone preserving therapies should be considered.
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Choi HG, Suh YJ, Lee JW, Min CY, Yoo DM, Lee SW. Analyses of the association between breast cancer and osteoporosis/fracture history: a cross-sectional study using KoGES HEXA data. Arch Osteoporos 2021; 16:98. [PMID: 34148148 DOI: 10.1007/s11657-021-00947-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/29/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED We performed a nationwide, population-based cohort study to evaluate the risk of osteoporosis and osteoporotic fracture in patients with breast cancer using the data from Korean Genome and Epidemiology Study (KoGES) and concluded that Korean women with breast cancer had a higher risk of osteoporosis than healthy women, regardless of age. PURPOSE This study aimed to evaluate the association between breast cancer and the occurrence of osteoporosis and osteoporotic fracture using data from the Korean Genome and Epidemiology Study (KoGES). METHODS Using the national KoGES health examinee (HEXA) data consisting of data from urban resident participants ≥ 40 years old, we extracted data for patients with breast cancer (n = 1080) and for control participants (n = 106,993); we then analyzed the occurrence of osteoporosis and osteoporotic fracture at baseline from 2004 to 2013 and during follow-up from 2012 to 2016. A logistic regression model was used to analyze the odds ratios (ORs) and the 95% confidence intervals (CIs). Subgroup analysis was performed based on age (younger group aged ≤ 51 years old; older group aged ≥ 52 years old). RESULTS The ORs (95% CIs) for osteoporosis and osteoporotic fracture were 1.54 (95% CI = 1.28-1.84, P < 0.001) and 1.01 (95% CI = 0.82-1.23, P = 0.949), respectively, in the breast cancer group. In the subgroup analysis based on age, the ORs (95% CIs) for osteoporosis were 2.41 (95% CI = 1.70-3.43, P < 0.001) in the younger group and 1.33 (95% CI = 1.08-1.64, P = 0.007) in the older group of breast cancer patients. The ORs (95% CIs) for osteoporotic fracture were 1.15 (95% CI = 0.81-1.63, P = 0.441) in the younger group and 0.95 (95% CI = 0.74-1.21, P = 0.661) in the older group of breast cancer patients. CONCLUSION We concluded that Korean women with breast cancer had a higher risk of osteoporosis than healthy women, but the same finding was not observed for osteoporotic fracture, regardless of age.
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Affiliation(s)
- Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea.,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Yong Joon Suh
- Department of Breast and Endocrine Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Jung Woo Lee
- Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Chan Yang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Suk Woo Lee
- Department of Obstetrics and Gynecology, Hallym University College of Medicine, Anyang, Republic of Korea. .,Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 14068, Republic of Korea.
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Choi HG, Lee JW, Min CY, Yoo DM, Lee SW. Analyses of the association between cervical cancer and osteoporosis/osteoporotic fracture: a cross-sectional study using KoGES HEXA data. Int J Clin Oncol 2021; 26:1752-1758. [PMID: 34091796 DOI: 10.1007/s10147-021-01951-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study aimed to evaluate the association between cervical cancer and the occurrence of osteoporosis and osteoporotic fracture using data from the Korean Genome and Epidemiology Study (KoGES). METHODS In this national cohort study using KoGES health examination (HEXA) data, we extracted data for patients with cervical cancer (n = 493) and control participants (n = 77,571); we then analyzed the occurrence of osteoporosis and osteoporotic fracture at baseline from 2004 to 2013 and during follow-up from 2012 to 2016. A logistic regression model was used to analyze the odds ratios (ORs) and the 95% confidence intervals (CIs). RESULTS The ORs (95% CIs) for osteoporosis and osteoporotic fracture were 1.49 (95% CI 1.15-1.92, p = 0.03) and 1.06 (95% CI 0.82-1.38, p = 0.634), respectively, in the cervical cancer group. The ORs (95% CIs) for osteoporosis were 2.12 (95% CI 1.14-3.95, p = 0.018) in the ≤ 51-year-old group and 1.43 (95% CI 1.08-1.89, p = 0.011) in the ≥ 52-year-old group of cervical cancer patients. CONCLUSION We concluded that Korean women with cervical cancer had a higher risk of osteoporosis than healthy women, but the same finding was not observed for osteoporotic fracture.
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Affiliation(s)
- Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea.,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Jung Woo Lee
- Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chan Yang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Suk Woo Lee
- Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang, Gyeonggi, 14068, Republic of Korea.
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Combined radiomics-clinical model to predict malignancy of vertebral compression fractures on CT. Eur Radiol 2021; 31:6825-6834. [PMID: 33742227 DOI: 10.1007/s00330-021-07832-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/24/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To develop and validate a combined radiomics-clinical model to predict malignancy of vertebral compression fractures on CT. METHODS One hundred sixty-five patients with vertebral compression fractures were allocated to training (n = 110 [62 acute benign and 48 malignant fractures]) and validation (n = 55 [30 acute benign and 25 malignant fractures]) cohorts. Radiomics features (n = 144) were extracted from non-contrast-enhanced CT images. Radiomics score was constructed by applying least absolute shrinkage and selection operator regression to reproducible features. A combined radiomics-clinical model was constructed by integrating significant clinical parameters with radiomics score using multivariate logistic regression analysis. Model performance was quantified in terms of discrimination and calibration. The model was internally validated on the independent data set. RESULTS The combined radiomics-clinical model, composed of two significant clinical predictors (age and history of malignancy) and the radiomics score, showed good calibration (Hosmer-Lemeshow test, p > 0.05) and discrimination in both training (AUC, 0.970) and validation (AUC, 0.948) cohorts. Discrimination performance of the combined model was higher than that of either the radiomics score (AUC, 0.941 in training cohort and 0.852 in validation cohort) or the clinical predictor model (AUC, 0.924 in training cohort and 0.849 in validation cohort). The model stratified patients into groups with low and high risk of malignant fracture with an accuracy of 98.2% in the training cohort and 90.9% in the validation cohort. CONCLUSIONS The combined radiomics-clinical model integrating clinical parameters with radiomics score could predict malignancy in vertebral compression fractures on CT with high discriminatory ability. KEY POINTS • A combined radiomics-clinical model was constructed to predict malignancy of vertebral compression fractures on CT by combining clinical parameters and radiomics features. • The model showed good calibration and discrimination in both training and validation cohorts. • The model showed high accuracy in the stratification of patients into groups with low and high risk of malignant vertebral compression fractures.
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Lin Y, Villacanas MG, Zou H, Liu H, Carcedo IG, Wu Y, Sun B, Wu X, Prasadam I, Monteiro MJ, Li L, Xu ZP, Gu W. Calcium-bisphosphonate Nanoparticle Platform as a Prolonged Nanodrug and Bone-Targeted Delivery System for Bone Diseases and Cancers. ACS APPLIED BIO MATERIALS 2021; 4:2490-2501. [DOI: 10.1021/acsabm.0c01455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yanling Lin
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Maria G. Villacanas
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Hong Zou
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
- Department of Pathology/Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang 832002, China
| | - Hangrui Liu
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Ines G. Carcedo
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Yilun Wu
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Bing Sun
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Xiaoxin Wu
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Indira Prasadam
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Michael J. Monteiro
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Li Li
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Zhi Ping Xu
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Wenyi Gu
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
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Kay FU, Ho V, Dosunmu EB, Chhabra A, Brown K, Duan X, Öz OK. Quantitative CT Detects Undiagnosed Low Bone Mineral Density in Oncologic Patients Imaged With 18F-FDG PET/CT. Clin Nucl Med 2021; 46:8-15. [PMID: 33234926 PMCID: PMC8931857 DOI: 10.1097/rlu.0000000000003416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE We assessed the prevalence of low bone mineral density (BMD) in oncologic patients undergoing F-FDG PET/CT. PATIENTS AND METHODS This is a retrospective analysis of 100 patients who underwent F-FDG PET/CT at a single center from October 2015 till May 2016. Quantitative CT (QCT) was used to assess BMD at the lumbar spine (BMDQCT) and femoral necks (BMDCTXA). SUVmax was used to evaluate metabolic activity of the bone marrow. Risk of osteoporosis-related fractures was calculated with femoral neck BMDCTXA and the FRAX algorithm, which was compared against measurements of CT attenuation of the trabecular bone at L1 (L1HU). RESULTS Osteoporosis and osteopenia were respectively present in 16% and 46% of patients 50 years and older. Bone marrow SUVmax was correlated with BMD at the lumbar spine (ρ = 0.36, P < 0.001). Increased age and low marrow SUVmax were associated with low BMDQCT at the lumbar spine (both P < 0.001), whereas increased age, female sex, and low marrow SUVmax were associated with low BMDCTXA at the femoral necks (P < 0.001, P < 0.001, P = 0.01, respectively). L1HU had an area under the curve of 0.95 (95% confidence interval [CI], 0.90-0.99) for detecting increased risk for osteoporosis-related fracture, with best threshold of 125.8 HU (95% CI, 115.7-144.9) yielding sensitivity of 100% (95% CI, 0.92-1.00), specificity of 0.90 (95% CI, 0.76-0.97), and accuracy of 0.91 (95% CI, 0.79-0.97). CONCLUSIONS Low BMD is frequent in oncologic patients undergoing F-FDG PET/CT. Decreased F-FDG avidity of the bone marrow correlates with decreased BMD, validating the link between osteoporosis and bone marrow fat. L1HU could be a simple and accurate approach for detecting patients at risk for osteoporosis-related fractures using PET/CTdata.
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Affiliation(s)
- Fernando U Kay
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas
| | - Vinh Ho
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas
| | - Edmund B Dosunmu
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas
| | - Avneesh Chhabra
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas
| | | | - Xinhui Duan
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas
| | - Orhan K Öz
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas
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Association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. Arch Osteoporos 2021; 16:22. [PMID: 33527234 PMCID: PMC7850996 DOI: 10.1007/s11657-021-00887-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/06/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but further studies for dose response are required. PURPOSE Cadmium exposure can exert detrimental effects on bone health, particularly in post-menopausal women. However, previous studies have failed to report an association in Korean post-menopausal women. We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. METHODS In total, 5432 participants from the 4th and 5th Korean National Health and Nutrition Examination Survey (KNHANES) were randomly sampled for measurements of heavy metal concentrations in the blood, bone mass density (BMD), and nutrient intake. We analyzed data for 1031 post-menopausal women ≥50 years of age. Blood cadmium levels were categorized into quartiles, and a multinomial logistic regression model was used for analysis. RESULTS There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but the odds ratio (OR) at the 4th level was lower than that at the 3rd level (OR and 95% confidence interval (CI) for osteopenia: 2nd quartile: 1.24, 0.88-1.74; 3rd quartile: 3.22, 2.24-4.64; 4th quartile: 1.27, 0.87-1.85; P for trend <0.001; OR and 95% CI for osteoporosis: 2nd quartile: 1.54, 1.05-2.25; 3rd quartile: 3.63, 2.31-5.69; 4th quartile: 1.70, 1.03-2.81; P for trend <0.001). This trend was consistent in the sensitivity analysis. CONCLUSION Our findings suggest that there is an association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. However, further prospective studies are required to determine whether there is a dose-response relationship and address potential selection bias, especially in patients with femoral neck osteoporosis.
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Kumar N, Patel R, Tan JH, Song J, Pandita N, Hey DHW, Lau LL, Liu G, Thambiah J, Wong HK. Symptomatic Construct Failure after Metastatic Spine Tumor Surgery. Asian Spine J 2020; 15:481-490. [PMID: 33108849 PMCID: PMC8377214 DOI: 10.31616/asj.2020.0166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/04/2020] [Indexed: 12/23/2022] Open
Abstract
Study Design Retrospective cohort study. Purpose To evaluate the incidence and presentation of symptomatic failures (SFs) after metastatic spine tumor surgery (MSTS). To identify the associated risk factors. To categorize SFs based on the management in these patients. Overview of Literature Few studies have reported on the incidence (1.9%–16%) and risk factors of SF after MSTS. It is unclear whether all SFs, occurring in MSTS-patients, result in revision surgery. Methods We conducted a retrospective analysis on 288 patients (246 for final analysis) who underwent MSTS between 2005–2015. Data collected were demographics and peri/postoperative clinical and radiological features. Early and late radiological SF were defined as presentation before and after 3 months from index surgery, respectively. Univariate and multivariate models of competing risk regression analysis were designed to determine the risk factors for SF with death as a competing event. Results We observed 14 SFs (5.7%) in 246 patients; 10 (4.1%) underwent revision surgery. Median survival was 13.4 months. The mean age was 58.8 years (range, 21–87 years); 48.4% were women. The median time to failure was 5 months (range, 1–60 months). Patients with SF were categorized into three groups: (1) SF when the primary implant was revised (n=5, 35.7%); (2) peri-construct progression of disease requiring extension (n=5, 35.7%); and (3) SFs that did not warrant revision (n=4, 28.5%). Four patients (28.5%) presented with early failure. SF commonly occurred at the implant-bone interface (9/14) and all patients had a spinal instability neoplastic score (SINS) >7. Thirteen patients (92.8%) who developed failure had fixation spanning junctional regions. Multivariate competing risk regression showed that preoperative Eastern Cooperative Oncology Group score was a significant risk factor for implant failure (adjusted sub-hazard ratio, 7.0; 95% confidence interval, 1.63–30.07; p<0.0009). Conclusions The incidence of SF (5.7%) was low in patients undergoing MSTS although these patients did not undergo spinal fusion. Preoperative ambulators involved a 7 times higher risk of failure than non-ambulators. Preoperative SINS >7 and fixations spanning junctional regions were associated with SF. Majority of construct failures occurred at the implant-bone interface.
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Affiliation(s)
- Naresh Kumar
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Ravish Patel
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Jiong Hao Tan
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Joshua Song
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Naveen Pandita
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | | | - Leok Lim Lau
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Gabriel Liu
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Joseph Thambiah
- Department of Orthopaedic Surgery, National University Health System, Singapore
| | - Hee-Kit Wong
- Department of Orthopaedic Surgery, National University Health System, Singapore
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Sha S, Du W, Parkinson A, Glasgow N. Relative importance of clinical and sociodemographic factors in association with post-operative in-hospital deaths in colorectal cancer patients in New South Wales: An artificial neural network approach. J Eval Clin Pract 2020; 26:1389-1398. [PMID: 31733029 DOI: 10.1111/jep.13318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 11/27/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Co-morbidities in colorectal cancer patients complicate hospital care, and their relative importance to post-operative deaths is largely unknown. This study was conducted to examine a range of clinical and sociodemographic factors in relation to post-operative in-hospital deaths in colorectal cancer patients and identify whether these contributions would vary by severity of co-morbidities. METHODS In this multicentre retrospective cohort study, we used the complete census of New South Wales inpatient data to select colorectal cancer patients admitted to public hospitals for acute surgical care, who underwent procedures on the digestive system during the period of July 2001 to June 2014. The primary outcome was in-hospital death at the end of acute care. Multilayer perceptron and back-propagation artificial neural networks (ANNs) were used to quantify the relative importance of a wide range of clinical and sociodemographic factors in relation to post-operative deaths, stratified by severity of co-morbidities based on Charlson co-morbidity index. RESULTS Of 6288 colorectal cancer patients, approximately 58.3% (n = 3669) had moderate to severe co-morbidities. A total of 464 (7.4%) died in hospitals. The performance for ANN models was superior to logistic models. Co-morbid musculoskeletal and mental disorders, adverse events in health care, and socio-economic factors including rural residence and private insurance status contributed to post-operative deaths in hospitals. CONCLUSION Identification of relative importance of factors contributing to in-hospital deaths in colorectal cancer patients using ANN may help to enhance patient-centred strategies to meet complex needs during acute surgical care and prevent post-operative in-hospital deaths.
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Affiliation(s)
- Sha Sha
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Wei Du
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Anne Parkinson
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Nicholas Glasgow
- Research School of Population Health, Australian National University, Canberra, Australia
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Metformin Attenuates Osteoporosis in Diabetic Patients with Carcinoma in Situ: A Nationwide, Retrospective, Matched-Cohort Study in Taiwan. J Clin Med 2020; 9:jcm9092839. [PMID: 32887312 PMCID: PMC7565460 DOI: 10.3390/jcm9092839] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/24/2020] [Accepted: 08/30/2020] [Indexed: 02/07/2023] Open
Abstract
Patients with diabetes are at increased risk of cancer development and osteoporosis. Metformin is an effective agent for diabetes management. Epidemiological studies have identified an association between metformin use and cancer prevention. This article outlines the potential for metformin to attenuate the rate of osteoporosis in diabetic patients with carcinoma in situ (CIS). From the National Health Insurance Research Database of Taiwan, 7827 patients with diabetes with CIS who were receiving metformin therapy were selected, along with 23,481 patients as 1:3 sex-, age- and index year-matched controls, who were not receiving metformin therapy. A Cox proportional hazard analysis was used to compare the rate of osteoporosis during an average of 15-year follow-up. Of the subjects who were enrolled, 801 (2.56%) had osteoporosis, including 168 from the metformin group (2.15%) and 633 from the without metformin group (2.70%). The metformin group presented a lower rate of osteoporosis at the end of follow-up (p = 0.009). The Cox proportional hazard regression analysis revealed a lower rate of osteoporosis for the metformin group (adjusted hazard ratio of 0.820; 95% confidence interval = 0.691–0.972, p = 0.022). Diabetic patients with CIS under metformin therapy presented lower osteoporosis rate than those who were not receiving metformin therapy.
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Dong H, Zhou W, Wang P, Zuo E, Ying X, Chai S, Fei T, Jin L, Chen C, Ma G, Liu H. Comprehensive Analysis of the Genetic and Epigenetic Mechanisms of Osteoporosis and Bone Mineral Density. Front Cell Dev Biol 2020; 8:194. [PMID: 32269995 PMCID: PMC7109267 DOI: 10.3389/fcell.2020.00194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/09/2020] [Indexed: 01/11/2023] Open
Abstract
Osteoporosis is a skeletal disorder characterized by a systemic impairment of bone mineral density (BMD). Genome-wide association studies (GWAS) have identified hundreds of susceptibility loci for osteoporosis and BMD. However, the vast majority of susceptibility loci are located in non-coding regions of the genome and provide limited information about the genetic mechanisms of osteoporosis. Herein we performed a comprehensive functional analysis to investigate the genetic and epigenetic mechanisms of osteoporosis and BMD. BMD and osteoporosis are found to share many common susceptibility loci, and the corresponding susceptibility genes are significantly enriched in bone-related biological pathways. The regulatory element enrichment analysis indicated that BMD and osteoporosis susceptibility loci are significantly enriched in 5′UTR and DNase I hypersensitive sites (DHSs) of peripheral blood immune cells. By integrating GWAS and expression Quantitative Trait Locus (eQTL) data, we found that 15 protein-coding genes are regulated by the osteoporosis and BMD susceptibility loci. Our analysis provides new clues for a better understanding of the pathogenic mechanisms and offers potential therapeutic targets for osteoporosis.
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Affiliation(s)
- Hui Dong
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China.,Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wenyang Zhou
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Pingping Wang
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Enjun Zuo
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Xiaoxia Ying
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Songling Chai
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Tao Fei
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Laidi Jin
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Chen Chen
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Guowu Ma
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
| | - Huiying Liu
- Department of Oral Prosthodontics, School of Stomatology, Dalian Medical University, Dalian, China
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Kim H, Yoo S, Park SG. Young cancer survivors have lower bone mineral density compared with healthy controls: a nationwide population-based study in Korea. Sci Rep 2020; 10:654. [PMID: 31959794 PMCID: PMC6971234 DOI: 10.1038/s41598-020-57503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/02/2020] [Indexed: 11/17/2022] Open
Abstract
Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors. The aim of this study was to assess the risk of bone loss in Korean cancer survivors, and the relationship between body composition and bone mineral density (BMD). We hypothesized that cancer survivors would have lower BMD than healthy people, and increased muscle mass has a protective effect on BMD. We measured BMD and body composition in 259 cancer survivors (99 men and 160 women). Subjects were selected from the Korean National Health and Nutrition Survey conducted from 2008 to 2011. Body composition and BMD were measured by dual-energy X-ray absorptiometry. We examined the linear trend of lumbar BMD according to tertiles of lean mass (LM) and fat mass (FM) by linear regression, adjusting for age, alcohol consumption, smoking, exercise, 25-hydroxyvitamin D, height, protein intake, and menopausal status. Cancer survivors under 50 years of age had lower lumbar BMD compared with healthy controls (0.93 ± 0.04 g/cm2 vs. 1.02 ± 0.01 g/cm2, p = 0.032 in males; 0.95 ± 0.02 g/cm2 vs. 0.98 ± 0.01 g/cm2, p = 0.015 in females). Lumbar BMD significantly increased from the lowest to highest tertiles of LM in male (p for trend < 0.001) and marginally significantly increased in female survivors (p for trend = 0.060). In this study of Korean cancer survivors, young survivors were at higher risk of having low lumbar BMD. Higher LM had beneficial effects on BMD in cancer survivors. To prevent osteoporosis and fractures, efforts to increase lean body mass, including bone, are needed for young cancer survivors.
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Affiliation(s)
- Hyoeun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, (48108), Republic of Korea
| | - Sunmi Yoo
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, (48108), Republic of Korea.
| | - Seung Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, (48108), Republic of Korea
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Sankey EW, Park C, Howell EP, Pennington Z, Abd-El-Barr M, Karikari IO, Shaffrey CI, Gokaslan ZL, Sciubba D, Goodwin CR. Importance of Spinal Alignment in Primary and Metastatic Spine Tumors. World Neurosurg 2019; 132:118-128. [PMID: 31476476 DOI: 10.1016/j.wneu.2019.08.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/18/2019] [Accepted: 08/22/2019] [Indexed: 12/12/2022]
Abstract
Spinal alignment, particularly with respect to spinopelvic parameters, is highly correlated with morbidity and health-related quality-of-life outcomes. Although the importance of spinal alignment has been emphasized in the deformity literature, spinopelvic parameters have not been considered in the context of spine oncology. Because the aim of oncologic spine surgery is mostly palliative, consideration of spinopelvic parameters could improve postoperative outcomes in both the primary and metastatic tumor population by taking overall vertebral stability into account. This review highlights the relevance of focal and global spinal alignment, particularly related to spinopelvic parameters, in the treatment of spine tumors.
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Affiliation(s)
- Eric W Sankey
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA
| | - Christine Park
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA
| | - Elizabeth P Howell
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA
| | - Zach Pennington
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Muhammad Abd-El-Barr
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA
| | - Isaac O Karikari
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher I Shaffrey
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA
| | - Ziya L Gokaslan
- Department of Neurosurgery, Brown University, Providence, Rhode Island, USA
| | - Daniel Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - C Rory Goodwin
- Department of Neurosurgery, Spine Division, Duke University Medical Center, Durham, North Carolina, USA.
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Park H. Cytological Study on the Cause of the Osteoporotic Side Effects of Adefovir Dipivoxil. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2019. [DOI: 10.15324/kjcls.2019.51.3.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ho Park
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan, Korea
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Berent TE, Dorschner JM, Craig TA, Drake MT, Westendorf JJ, Kumar R. Lung tumor cells inhibit bone mineralization and osteoblast activity. Biochem Biophys Res Commun 2019; 519:566-571. [PMID: 31537378 DOI: 10.1016/j.bbrc.2019.09.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/11/2019] [Indexed: 11/26/2022]
Abstract
Patients with non-small cell lung cancer (NSLC) often develop skeletal complications and fractures. To understand mechanisms of bone loss, we developed a murine model of non-metastatic NSLC. Decreased bone mineral density, trabecular thickness and mineralization, without an increase in bone resorption, were observed in vivo in mice injected with Lewis lung adenocarcinoma (LLC1) cells in the absence of tumor cell metastases. A decrease in trabecular bone mineral density was observed in mice injected with cell-free LLC1 CM. Plasma osteoblast biomarkers and PTH-related peptide (PTHrP) were reduced, and parathyroid hormone (PTH), 1,25-dihydroxyvitamin D, calcium and phosphate concentrations were normal in tumor-bearing mice. LLC1 cell conditioned medium (CM) inhibited alkaline phosphatase activity, osteoblast mineralization, and expression of Alpl and Ocn/Bglap mRNA in MC3T3 osteoblast cultures, whereas non-CM or CM from NIH/3T3 fibroblasts did not induce similar changes. LLC1 CM reduced Wnt3a-stimulated Tcf/Lef reporter plasmid activity and Wnt5A, Tcf1 and Lef1 mRNA expression in MC3T3 cells. Although concentrations of the Wnt inhibitor, DKK2, were increased in LLC1 CM compared to non-CM, depletion of DKK2 from LLC1 CM did not completely restore Wnt3a activity in MC3T3 cultures, and recombinant DKK2 failed to inhibit osteoblast mineralization. The data indicate that in a model of lung adenocarcinoma without bone metastases, tumor cells elaborate a secreted factor(s) that reduces bone mass, bone formation and osteoblast Wnt signaling without increases in bone resorption or calcium-regulating hormone concentrations. The factor(s) mediating this inhibition of osteoblast mineralization require further characterization.
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Affiliation(s)
- Taylor E Berent
- Department of Medicine, Divisions of Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jessica M Dorschner
- Department of Medicine, Divisions of Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Theodore A Craig
- Department of Medicine, Divisions of Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Matthew T Drake
- Department of Medicine, Divisions of Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jennifer J Westendorf
- Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Rajiv Kumar
- Department of Medicine, Divisions of Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Nephrology and Hypertension and Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Endocrinology, Diabetes, Metabolism and Nutrition, Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Department of Biochemistry and Molecular Biology, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Chen HM, Chen FP, Yang KC, Yuan SS. Association of Bone Metastasis With Early-Stage Breast Cancer in Women With and Without Precancer Osteoporosis According to Osteoporosis Therapy Status. JAMA Netw Open 2019; 2:e190429. [PMID: 30848812 PMCID: PMC6484629 DOI: 10.1001/jamanetworkopen.2019.0429] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Deaths from cancer are attributed more to secondary than primary tumors, but the pathogenesis of organ-specific cancer metastasis has not been determined. OBJECTIVE To investigate whether precancer osteoporosis and osteoporosis therapy are associated with alteration of bone metastasis patterns. DESIGN, SETTING, AND PARTICIPANTS This nationwide retrospective cohort study was performed from January 1, 2002, to December 31, 2013, using 2 cohorts from the Taiwan National Health Insurance Research Database: a random sample of 1 million beneficiaries from the Longitudinal Health Insurance Database who were enrolled in 2005 (LHID2005) and a specific data set of all the patients with osteoporosis. Patients diagnosed with breast cancer and precancer osteoporosis from January 1, 2002, to December 31, 2011, were included in the study, and their records were examined through December 31, 2013. From LHID2005, we selected 9104 women with early-stage breast cancer, of whom 705 had precancer osteoporosis. We identified 29 183 patients from the cohort of patients with breast cancer and osteoporosis, 14 020 of whom had precancer osteoporosis. Data analysis was performed from December 31, 2016, to August 31, 2018. EXPOSURES Precancer osteoporosis and osteoporosis therapy. MAIN OUTCOMES AND MEASURES The risk of bone metastasis in patients with and without precancer osteoporosis and patients receiving and not receiving osteoporosis therapy as well as time to bone metastasis development. RESULTS Among 9104 patients with breast cancer from the Longitudinal Health Insurance Database (mean [SD] age, 46.7 [14.0] years), precancer osteoporosis was not associated with a difference in risk of bone metastasis (adjusted hazard ratio [aHR], 0.87; 95% CI, 0.58-1.30; P = .49). Among 14 020 patients with precancer osteoporosis from the other cohort (mean [SD] age, 58.9 [11.6] years), osteoporosis therapy had no association with the risk of bone metastasis (bisphosphonates: aHR, 1.47; 95% CI, 1.00-2.17; P = .05; nonbisphosphonate drugs: aHR, 1.00; 95% CI, 0.72-1.39; P > .99). Compared with those without precancer osteoporosis (median time to bone metastasis development, 2.87 years; interquartile range [IQR], 1.34-4.86 years), among those with precancer osteoporosis, the median time to develop bone metastasis was shorter in those who did not receive treatment (1.74 years; IQR, 0.58-3.60 years; P < .001), whereas this time was the same for those who received treatment (bisphosphonates: 2.34 years; IQR, 1.23-3.13 years; nonbisphosphonate drugs: 2.08 years; IQR, 0.92-4.95 years). CONCLUSIONS AND RELEVANCE Precancer osteoporosis was not associated with risk of bone metastasis, but untreated osteoporosis was associated with accelerated progression of bone metastasis when it occurred. Organ microenvironments interact with disseminated cancer mostly after the specific organ has been predetermined to be the designated location. Because recurrences and metastases are major obstacles to cancer treatments, determining which organs may be at risk for metastases may be crucial to treating the disease.
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Affiliation(s)
- Hsiu-Man Chen
- Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan
- Bioinformatics Program, Taiwan International Graduate Program, Institute of Information Science, Academia Sinica, Taipei, Taiwan
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Fang-Ping Chen
- Osteoporosis Prevention and Treatment Center, Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Kang-Chung Yang
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shin-Sheng Yuan
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
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Sattar S, Alibhai SM, Spoelstra SL, Puts MT. The assessment, management, and reporting of falls, and the impact of falls on cancer treatment in community-dwelling older patients receiving cancer treatment: Results from a mixed-methods study. J Geriatr Oncol 2019; 10:98-104. [DOI: 10.1016/j.jgo.2018.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/19/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
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Fairman CM, Kendall KL, Hart NH, Taaffe DR, Galvão DA, Newton RU. The potential therapeutic effects of creatine supplementation on body composition and muscle function in cancer. Crit Rev Oncol Hematol 2018; 133:46-57. [PMID: 30661658 DOI: 10.1016/j.critrevonc.2018.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 12/16/2022] Open
Abstract
Low muscle mass in individuals with cancer has a profound impact on quality of life and independence and is associated with greater treatment toxicity and poorer prognosis. Exercise interventions are regularly being investigated as a means to ameliorate treatment-related adverse effects, and nutritional/supplementation strategies to augment adaptations to exercise are highly valuable. Creatine (Cr) is a naturally-occurring substance in the human body that plays a critical role in energy provision during muscle contraction. Given the beneficial effects of Cr supplementation on lean body mass, strength, and physical function in a variety of clinical populations, there is therapeutic potential in individuals with cancer at heightened risk for muscle loss. Here, we provide an overview of Cr physiology, summarize the evidence on the use of Cr supplementation in various aging/clinical populations, explore mechanisms of action, and provide perspectives on the potential therapeutic role of Cr in the exercise oncology setting.
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Affiliation(s)
- C M Fairman
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
| | - K L Kendall
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - N H Hart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Western Australia, Australia
| | - D R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - D A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
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Choi CK, Kweon SS, Lee YH, Nam HS, Park KS, Ryu SY, Choi SW, Kim SA, Shin MH. Nonlinear association between bone mineral density and all-cause mortality: the Dong-gu study. Osteoporos Int 2018; 29:2011-2020. [PMID: 30014158 DOI: 10.1007/s00198-018-4386-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/04/2018] [Indexed: 11/28/2022]
Abstract
UNLABELLED There was a U-shaped association between hip BMD and all-cause mortality, with the lowest mortality in the 90th percentile in males. However, there was an inverse linear relationship in females. In contrast, the association between lumbar spine BMD and mortality was less evident in males, with no association in females. INTRODUCTION Bone mineral density (BMD) is reported inversely associated with mortality. Although some previous studies provided evidence for nonlinear associations, these were not adequately assessed in most previous works. METHODS We evaluated the nonlinear relationship between BMD and mortality in Asians. Our study involved 8629 participants in the Dong-gu study from 2007 to 2010. Cox proportional hazard regression was used to calculate hazard ratios (HRs) according to BMD categories after adjusting for potential confounders. During a follow-up of 6.7 ± 1.4 years, 712 participants died. RESULTS There was a U-shaped association between hip BMD and all-cause mortality, with the lowest mortality in the 90th percentile in males. However, there was an inverse linear relationship in females. In males, compared with the 75th to 95th percentile group, the < 2.5th percentile group had a 3.89 (95% CI 2.41-6.28)-fold higher risk and the 2.5th to 5th percentile group had a 2.51 (95% CI 1.25-5.04)-fold higher risk. The HR was 2.51 (95% CI 1.25, 5.04) in the > 97.5th percentile group. In females, compared with that in the 75th to 95th percentile group, the HR was 2.33 (95% CI 1.24, 4.39) in the < 2.5th percentile group. In contrast, the association between lumbar spine BMD and mortality was less evident in males, with no association in females. CONCLUSION In conclusion, this study shows that the association between BMD and mortality varies by gender and that high and low BMD are predictors of all-cause mortality in males.
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Affiliation(s)
- C K Choi
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea
| | - S -S Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea
| | - Y -H Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - H -S Nam
- Department of Preventive Medicine, Chungnam National University Medical School, Daejeon, Republic of Korea
| | - K -S Park
- Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Republic of Korea
| | - S -Y Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - S -W Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - S A Kim
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea
| | - M -H Shin
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea.
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Taxel P, Faircloth E, Idrees S, Van Poznak C. Cancer Treatment-Induced Bone Loss in Women With Breast Cancer and Men With Prostate Cancer. J Endocr Soc 2018; 2:574-588. [PMID: 29942922 PMCID: PMC6007245 DOI: 10.1210/js.2018-00052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/15/2018] [Indexed: 12/14/2022] Open
Abstract
Cancer and cancer therapies can have a negative impact on bone health. Because cancer is a common diagnosis, survivorship concerns for osteoporosis and fragility fractures are an important component of care. This review addresses management of bone health in nonmetastatic cancer survivorship with a focus on breast cancer and prostate cancer.
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Affiliation(s)
| | | | - Sana Idrees
- Saint Vincent's Hospital, Bridgeport, Connecticut
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Foster EJ, Barlas RS, Bettencourt-Silva JH, Clark AB, Metcalf AK, Bowles KM, Potter JF, Myint PK. Long-Term Factors Associated With Falls and Fractures Poststroke. Front Neurol 2018; 9:210. [PMID: 29666603 PMCID: PMC5891595 DOI: 10.3389/fneur.2018.00210] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/16/2018] [Indexed: 12/21/2022] Open
Abstract
Background Risk factors for poststroke falls and fractures remain poorly understood. This study aimed to evaluate which factors increased risk of these events after stroke. Methods Data from 7,267 hospitalized stroke patients were acquired from the Norfolk and Norwich University Hospital Stroke Register from 2003–2015. The impacts of multiple patient level and stroke characteristics and comorbidities on post-discharge falls and fractures were assessed. Univariate and multivariable models were constructed, adjusting for multiple confounders, using binary logistic regression for short-term analysis (up to 1-year post-discharge) and Cox-proportional hazard models for longer term analysis (1–3, 3–5, and 0–10 years follow-up). Results The mean age (SD) was 76.3 ± 12.1 years at baseline. 1,138 (15.7%) participants had an incident fall; and 666 (9.2%) an incident fracture during the 10-year follow-up (total person years = 64,447.99 for falls and 67,726.70 for fractures). Half of the sample population were females (50.6%) and the majority had an ischemic stroke (89.8%). After adjusting for confounders: age, sex, previous history of falls, and atrial fibrillation were associated with an increased risk of both falls and fractures during follow-up. Furthermore, chronic kidney disease and hyperlipidemia were associated with an increased risk of falls, while previous stroke/transient ischemic attack increased fracture risk. Total anterior circulation stroke and a prestroke modified Rankin Scale score of 3–5 were associated with decreased risk of both events, with hypertension and cancer decreasing risk of falls only. Conclusion We identified demographic, stroke-related, and comorbid factors associated with poststroke falls and fracture incidence. Further studies are required to examine and establish the relationship between reversible factors and further explore the role of preventative measures to prevent poststroke falls and fractures.
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Affiliation(s)
- Emma J Foster
- Ageing Clinical and Experimental Research (ACER) Team, School of Medicine, Medical Sciences & Nutrition, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Raphae S Barlas
- Ageing Clinical and Experimental Research (ACER) Team, School of Medicine, Medical Sciences & Nutrition, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Joao H Bettencourt-Silva
- Norfolk and Norwich University Hospital, Norwich, United Kingdom.,Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Allan B Clark
- Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Anthony K Metcalf
- Norfolk and Norwich University Hospital, Norwich, United Kingdom.,Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Kristian M Bowles
- Norfolk and Norwich University Hospital, Norwich, United Kingdom.,Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - John F Potter
- Norfolk and Norwich University Hospital, Norwich, United Kingdom.,Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Phyo K Myint
- Ageing Clinical and Experimental Research (ACER) Team, School of Medicine, Medical Sciences & Nutrition, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.,Norwich Cardiovascular Research Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
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Sheill G, Guinan EM, Peat N, Hussey J. Considerations for Exercise Prescription in Patients With Bone Metastases: A Comprehensive Narrative Review. PM R 2018; 10:843-864. [DOI: 10.1016/j.pmrj.2018.02.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/07/2018] [Accepted: 02/13/2018] [Indexed: 12/17/2022]
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Bone Talk: Activated Osteoblasts Promote Lung Cancer Growth. Trends Mol Med 2018; 24:237-239. [PMID: 29402707 DOI: 10.1016/j.molmed.2018.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/18/2018] [Indexed: 11/21/2022]
Abstract
Cancer cells can directly stimulate the generation and recruitment of tumor-supportive bone marrow-derived cells (BMDCs), including neutrophils, via secreted factors. A new study demonstrates that lung tumors also remotely activate bone-residing osteoblasts, which in turn promote neutrophil production. This is a multistep mechanism of establishing a supportive tumor microenvironment.
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Live Fluorescent Staining Platform for Drug-Screening and Mechanism-Analysis in Zebrafish for Bone Mineralization. Molecules 2017; 22:molecules22122068. [PMID: 29186901 PMCID: PMC6149919 DOI: 10.3390/molecules22122068] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/10/2017] [Accepted: 11/22/2017] [Indexed: 11/21/2022] Open
Abstract
Currently, drug screening relies on cell-based experiments or on animal models to confirm biological effects. The mammalian system is considered too time-consuming, expensive and complex to perform high-throughput drug screening. There is a gap between in vitro cell-based models and the in vivo mammalian models. The zebrafish is an ideal model that could link preclinical toxicity screening with the drug development pipeline. Taking advantage of a highly conservative genomic, rapid development, large number of offspring, low cost and easy manipulation, zebrafish has been considered an excellent animal model for disease-based drug screening. In this study, zebrafish embryos were incubated with small molecular compounds that potentially affected bone mineralization in microplates. Two compounds of alendronate and dorsomorphin were used as positive and negative controls, respectively. The level of osteogenic mineralization was measured and quantified by using ImageJ software with fluorescent calcein-staining images. Among twenty-four tested compounds from the kinase inhibitor library, we identified two compounds, pentamidine and BML-267, which showed increased embryonic mineralization; while six compounds, RWJ-60475, levamisole HCL, tetramisole HCL, fenvalerate, NSC-663284, and BML-267ester, were inhibitory to bone mineralization. In addition, real time quantitative PCR (RT-qPCR) was performed to evaluate the biological pathways involved in bone metabolism at the molecular level. We confirmed that alendronate enhanced the level of bone mineralization by inhibiting osteoclast-related genes. In summary, our research established a simple method to screen potential bone metabolic drugs and to perform mechanism analysis for bone mineralization in vivo.
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Acute myeloid leukemia transforms the bone marrow niche into a leukemia-permissive microenvironment through exosome secretion. Leukemia 2017; 32:575-587. [PMID: 28816238 PMCID: PMC5843902 DOI: 10.1038/leu.2017.259] [Citation(s) in RCA: 273] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 12/15/2022]
Abstract
Little is known about how leukemia cells alter the bone marrow (BM) niche to facilitate their own growth and evade chemotherapy. Here, we provide evidence that acute myeloid leukemia (AML) blasts remodel the BM niche into a leukemia growth-permissive and normal hematopoiesis-suppressive microenvironment through exosome secretion. Either engrafted AML cells or AML-derived exosomes increased mesenchymal stromal progenitors and blocked osteolineage development and bone formation in vivo. Preconditioning with AML-derived exosomes ‘primed’ the animals for accelerated AML growth. Conversely, disruption of exosome secretion in AML cells through targeting Rab27a, an important regulator involved in exosome release, significantly delayed leukemia development. In BM stromal cells, AML-derived exosomes induced the expression of DKK1, a suppressor of normal hematopoiesis and osteogenesis, thereby contributing to osteoblast loss. Conversely, treatment with a DKK1 inhibitor delayed AML progression and prolonged survival in AML-engrafted mice. In addition, AML-derived exosomes induced a broad downregulation of hematopoietic stem cell-supporting factors (for example, CXCL12, KITL and IGF1) in BM stromal cells and reduced their ability to support normal hematopoiesis. Altogether, this study uncovers novel features of AML pathogenesis and unveils how AML cells create a self-strengthening leukemic niche that promotes leukemic cell proliferation and survival, while suppressing normal hematopoiesis through exosome secretion.
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