Bone deposition,bone resorption,and osteosarcoma

Bone deposition and bone resorption are ongoing dynamic processes, constituting bone remodeling. Some bone tumors, such as osteosarcoma (OS), stimulate focal bone deposition. OS is the most common primary bone tumor in children and young adults. A complex network of genes regulates bone remodeling and alterations in its expression levels can influence the genesis and progression of bone diseases, including OS. We hypothesized that the expression profiles of bone remodeling regulator genes would be correlated with OS biology and clinical features. We used real‐time PCR to evaluate the mRNA levels of the tartrate‐resistant acid phosphatase (ACP5), colony stimulating factor‐1 (CSF1R), bone morphogenetic protein 7 (BMP7), collagen, type XI, alpha 2 (COL11A2), and protein tyrosine phosphatases zeta 1 (PTPRZ1) genes, in 30 OS tumor samples and correlated with clinical and histological data. All genes analyzed, except CSF1R, were differentially expressed when compared with normal bone expression profiles. In our results, OS patients with high levels of COL11A2 mRNA showed worse overall (p = 0.041) and event free survival (p = 0.037). Also, a trend for better overall survival was observed in patients with samples showing higher expression of BMP7 (p = 0.067). COL11A2 overexpression and BMP7 underexpression could collaborate to OS tumor growth, through its central role in bone remodeling process. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:1142–1148, 2010     

International field testing of the reliability and validity of the EORTC QLQ-BM22 module to assess health-related quality of life in patients with bone metastases

BACKGROUND:

The objective of this international field study was to test the reliability, validity, and responsiveness of the European Organization for Research and Treatment of Cancer (EORTC) QLQ‐BM22 module to assess health‐related quality of life (HRQOL) in patients with bone metastases.

METHODS:

Patients undergoing a variety of bone metastases‐specific treatments were accrued. The QLQ‐BM22 was administered with the QLQ‐C30 at baseline and at 1 follow‐up time point internationally. A debriefing questionnaire was administered to determine patient acceptability and understanding.

RESULTS:

Large‐scale field testing of the QLQ‐BM22 in addition to the QLQ‐C30 took place in 7 countries: Brazil, Canada, Cyprus, Egypt, France, India, and Taiwan. A total of 400 patients participated. Multitrait scaling analyses confirmed 4 scales in the 22‐item module. The scales were able to discriminate between clinically distinct patient groups, such as between those with a poor and those with a better performance status. The QLQ‐BM22 was well received in all 7 countries, and the majority of patients did not recommend any significant changes from the module in its current form.

CONCLUSIONS:

The final QLQ‐BM22 module contains 22 items and 4 scales assessing Painful Sites, Painful Characteristics, Functional Interference, and Psychosocial Aspects. Results confirmed the validity, reliability, cross‐cultural applicability, and sensitivity of the 22‐item EORTC QLQ‐BM22. It is therefore recommended that the QLQ‐BM22 be used in addition to the QLQ‐C30 in clinical trials to assess HRQOL in patients with bone metastases. Cancer 2012;. © 2011 American Cancer Society.     

Injection of resorbable materials

Resorbable filling materials are currently the safest products available. The side effects with this type of material are few compared to the number of patients treated. We can therefore suggest materials that have maximum safety to our patients, particularly in cosmetic indications.     

The co‐occurrence of anaemia and stunting in young children

Anaemia and stunting are prevalent nutritional problems among children of low‐income countries that have profound effects on development, morbidity, and mortality. Many use a single conceptual framework to identify the basic determinants of these and other forms of malnutrition. One would expect that problems with matching underlying determinants should co‐occur in affected individuals to a greater degree than by chance. In 2 populations of children—ages 6–18 months in Bihar, India, (n = 5,664) and 6–36 months in Lambayeque, Peru (n = 688)—we measured the frequency of the co‐occurrence of anaemia and stunting. We compared this value with the value expected by chance, the product of the prevalence of anaemia and stunting, using a chi‐square test. We also built logistic regression models for each condition. The frequency of co‐occurrence in the Indian population was 21.5%, and in the Peruvian population, it was 30.4%, which are similar to frequencies expected by chance, 21.3% (p = .97) and 31.5% (p = .85). In Peru, anaemia was associated with age and consumption of treated water. Stunting was associated with age, sex, dietary diversity, hand washing, language spoken, and wealth. In India, anaemia was associated with age, sex, caste, dietary diversity, and household hunger. Stunting was associated with age, sex, caste, wealth, and maternal illiteracy. Despite some basic shared factors, anaemia and stunting are more independent than commonly assumed. Interventions that target children based on 1 condition may miss children with the other form of malnutrition.     

Mesorectal Invasion Depth in Rectal Carcinoma Is Associated With Low Survival

Background

Most cases of rectal cancer (RC) in our institution are in pathologic stage T3. They are a heterogeneous group but have been classified in a single-stage category. We performed the present study to validate the prognostic significance of the mesorectal extension depth (MED) in T3 RC measured in millimeters beyond the muscularis propria plane.

Early childhood diarrhea and cardiometabolic risk factors in adulthood: the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study

BackgroundNutritional deficits in early life have been associated with a higher prevalence of the metabolic syndrome (MetS) in adulthood. Early childhood diarrhea contributes to undernutrition and may potentially increase the risk for adult noncommunicable diseases. Our objective was to examine associations between early childhood diarrhea burden and later development of MetS.MethodsWe studied individuals who participated in the Institute of Nutrition of Central America and Panama Nutritional Supplementation Longitudinal Study (1969–1977) and were followed up in 2002–2004. We used logistic regression to determine associations of diarrhea burden at ages 0 to 6, 6 to 12, and 12 to 24 months with odds of MetS and elevations in its components as adults.ResultsAmong 389 adults age 25 to 42 years at follow-up, the prevalence of MetS was 29%. Adjusting for several confounders including adult body mass index (BMI), each absolute 1% increase in diarrhea burden at age 0 to 6 months (but not at other time periods) was associated with increased odds of MetS (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01–1.06). This was attributable primarily to associations with elevated blood pressure (OR, 1.03; 95% CI, 1.00–1.06) and waist circumference (OR, 1.03; 95% CI, 1.00–1.06).ConclusionsChildhood diarrhea burden at 0 to 6 months is associated with MetS in adulthood after controlling for childhood growth parameters and adult BMI.     

Lipoabdominoplasty without undermining

Background: The classic abdominoplasty still provides the best aesthetic results, despite many advances in abdominoplasty techniques. However, this procedure is associated with a relatively high incidence of complications. Objective: A new technique is described that combines lipoplasty with traditional abdominoplasty without undermining of the abdominal flap. Methods: Lipoplasty proceeds from the region above the umbilicus to the flanks and the region below the umbilicus. The skin below the umbilical scar is resected as in classical abdominoplasty, but a thinner fatty layer with its connective tissue, lymphatic vessels, and blood vessels is preserved. Complementary lipoplasty is performed if necessary to remove excess fat. Results: The procedure results in an improved body shape, better accommodation of the abdominal flap, and a more youthful appearance of the abdomen with less scarring and no incidence of “dog ears” or major complications. Conclusions: Lipoabdominoplasty without undermining enhances aesthetic results with fewer complications than traditional abdominal aesthetic surgery. Aesthetic Surg J 2001;21:518-526.)