Curettage of benign bone tumors without grafts gives sufficient bone strength: A case-series of 78 patients

Background and purpose The defect that results after curettage of a bone tumor is usually filled in the same way. We report the outcome in patients with benign bone tumors that were treated with curettage but no filling

Treatment of bone tumours by radiofrequency thermal ablation

Radiofrequency thermal ablation (RFTA) is considered the treatment of choice for osteoid osteomas, in which it has long been safely used. Other benign conditions (chondroblastoma, osteoblastoma, giant cell tumour, etc.) can also be treated by this technique, which is less invasive than traditional surgical procedures. RFTA ablation is also an option for the palliation of localized, painful osteolytic metastatic and myeloma lesions. The reduction in pain improves the quality of life of patients with cancer, who often have multiple morbidities and a limited life expectancy. In some cases, these patients are treated with RFTA because conventional therapies (surgery, radiotherapy, chemotherapy, etc.) have been exhausted. In other cases, it is combined with conventional therapies or other percutaneous treatments, e.g., cementoplasty, offering faster pain relief and bone strengthening. A multidisciplinary approach to the management of these patients is recommended to select the optimal treatment, including orthopaedic surgeons, neurosurgeons, medical and radiation oncologists and interventional radiologists

Skeletal Plasmacytoma: Progression of disease and impact of local treatment; an analysis of SEER database

<p>Abstract</p> <p>Background</p> <p>Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease.</p> <p>Methods</p> <p>Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients). Patient demographics and clinical characteristics, treatment(s), cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors.</p> <p>Results</p> <p>The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively). Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%). Age > 60 years was the only factor that correlated with progression of disease (p = 0.027).</p> <p>Discussion</p> <p>Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.</p

Frequency of Laboratory Test Utilization in the Intensive Care Unit and Its Implications for Large-Scale Data Collection Efforts

Objective: Mapping local use names to standardized nomenclatures such as LOINC (Logical Observation Identifiers Names and Codes) is a time-consuming task when done retrospectively or during the configuration of new information systems. The author sought to identify a subset of intensive care unit (ICU) laboratory tests, which, because of their frequency of use, should be the focus of efforts to standardize test names in ICU information systems. Design: The author reviewed the ordering practices in medical, surgical, and pediatric ICUs within a large university teaching hospital to identify the subset of laboratory tests that represented the majority of tests performed in these settings. The author compared the results of his findings with the laboratory tests required to complete several of the most frequently used ICU acuity scoring systems. Results: It was found that between 104 and 202 tests and profiles represented 99% of all testing in the three ICUs. All the laboratory studies needed for six commonly used ICU scoring systems fell into the top 21 laboratory studies and profiles performed in each ICU. Conclusion: The author identified a small subset of the LOINC database that should be the focus of efforts to standardize test names in ICU information systems. Mapping this subset of laboratory tests and profiles to LOINC vocabulary will simplify the process of collecting data for large-scale databases such as ICU scoring systems and the configuration of new ICU information systems