558 research outputs found
Clinical and biochemical response to neridronate treatment in a patient with osteoporosis-pseudoglioma syndrome (OPPG)
Osteoporosis-pseudoglioma syndrome (OPPG) is a rare autosomal recessive syndrome characterized by juvenile-onset osteoporosis and ocular abnormalities due to a low-density lipoprotein receptor-related protein 5 (LRP5) gene mutation. Treatment with bisphosphonates, particularly with pamidronate and risedronate, has been reported to be of some efficacy in this condition. We report on a patient with OPPG due to an LRP5 gene mutation, who showed an encouraging response after a 36-month period of neridronate therapy. We report a case of a patient treated with bisphosphonates. Bisphosphonates should be administered in OPPG patients as a first-line therapy during early childhood
Serum creatine kinase isoenzymes in children with osteogenesis imperfecta
This study evaluates serum creatine kinase isoenzyme
activity in children with osteogenesis imperfecta to determine
its usefulness as a biochemical marker during treatment
with bisphosphonate. The changes of creatine kinase
(CK) isoenzyme activity during and after discontinuation therapy
were observed. These results could be useful in addressing
over-treatment risk prevention.
Introduction The brain isoenzyme of creatine kinase (CKbb)
is highly expressed in mature osteoclasts during osteoclastogenesis,
thus plays an important role in bone resorption. We
previously identified high serum CKbb levels in 18 children
with osteogenesis imperfect (OI) type 1 treated for 1 year with
bisphosphonate (neridronate). In the present study, serum CK
isoenzymes were evaluated in the same children with continuous
versus discontinued neridronate treatment over a further
2-year follow-up period.
Methods This study included 18 children with OI type 1, 12
with continued (group A) and 6 with ceased (group B)
neridronate treatment. Auxological data, serum biochemical
markers of bone metabolism, bone mineral density z-score,
and serum total CK and isoenzyme activities were determined
in both groups.
Results Serum CKbb was progressively and significantly increased
in group A (p < 0.004) but rapidly decreased to undetectable
levels in group B. In both groups, the cardiac muscle
creatine kinase isoenzyme (CKmb) showed a marked decrease,
while serum C-terminal telopeptide (CTx) levels were
almost unchanged.
Conclusions This study provides evidence of the cumulative
effect of neridronate administration in increasing serum CKbb
levels and the reversible effect after its discontinuation. This
approach could be employed for verifying the usefulness of
serum CKbb as a biochemical marker in patients receiving
prolonged bisphosphonate treatment. Moreover, the decreased
serum CKmb levels suggest a systemic effect of these drugs
Laterality of Stance during Optic Flow Stimulation in Male and Female Young Adults
During self-motion, the spatial and temporal properties of the optic flow input directly influence the body sway. Men and women have anatomical and biomechanical differences that influence the postural control during visual stimulation. Given that recent findings suggest a peculiar role of each leg in the postural control of the two genders, we investigated whether the body sway during optic flow perturbances is lateralized and whether anteroposterior and mediolateral components of specific center of pressure (COP) parameters of the right and left legs differ, reexamining a previous experiment (Raffi et al. (2014)) performed with two, side-by-side, force plates. Experiments were performed on 24 right-handed and right-footed young subjects. We analyzed five measures related to the COP of each foot and global data: anteroposterior and mediolateral range of oscillation, anteroposterior and mediolateral COP velocity, and sway area. Results showed that men consistently had larger COP parameters than women. The values of the COP parameters were correlated between the two feet only in the mediolateral axis of women. These findings suggest that optic flow stimulation causes asymmetry in postural balance and different lateralization of postural controls in men and women
An Unusual Case of Adrenal Metastasis from Colorectal Cancer: Computed Tomography and Fluorine 18-Fluoro-Deoxy-Glucose Positron Emission Tomography-Computed Tomography Features and Literature Review
Incidentally discovered adrenal masses are a common diagnostic problem. While computed tomography (CT) and magnetic resonance (MR) imaging can adequately characterize most benign or malignant adrenal masses, in some cases the results are indeterminate. We report and discuss a case of an adrenal metastasis with misleading clinical and CT features, in which an abnormal metabolic uptake detected through fluorine 18-fluoro-deoxy-glucose positron emission tomography (18F-FDG PET)-CT raised the suspicion of adrenal metastasis relatively early compared with apparently normal results on repeated follow-up CT examinations
Pain management in childhood leukemia. Diagnosis and available analgesic treatments
Pain is one of the most common symptoms in children suffering from leukemia, who are often misdiagnosed with other childhood painful diseases such as juvenile idiopathic arthritis. Corticosteroid-induced osteonecrosis (ON) and vincristine-induced peripheral neuropathy (VIPN) are the most common painful manifestations. Additionally, ongoing pain may continue to impact quality of life in survivorship. This narrative review focuses on the pathophysiological mechanisms of pain in childhood leukemia and current available indications for analgesic treatments. Pain management in children is often inadequate because of difficulties in pain assessment, different indications across countries, and the lack of specific pediatric trials. Analgesic drugs are often prescribed off-label to children by extrapolating information from adult guidelines, with possible increased risk of adverse events. Optimal pain management should involve a multidisciplinary team to ensure assessment and interventions tailored to the individual patient
Can body mass index influence the fracture zone in the fifth metatarsal base? A retrospective review
Fifth metatarsal base fracture are common in routine orthopaedic practice [1–6]. Lawrence and Botte [7] pro- posed a classification based upon the position of the fracture line (zone 1: tuberosity, zone 2: meta-diaphyseal junction, zone 3: proximal diaphysis). Pathomechani- cally, injury patterns develop in different ways: in zone 1, a traction injury caused by peroneus brevis tendon and the lateral band of the plantar fascia determine an avul- sion fracture of the tuberosity, also called “pseudo-Jones’ “fracture; in zone 2, forced foot adduction and excessive plantar flexion determine a fracture in the metaphyseal- diaphyseal junction, also called Jones’ fracture [8, 9]; in zone 3, acute over-bearing onto the area or chronic overload determine a fracture in the proximal portion of the diaphysis, distal to the intermetatarsal joint [10, 11].
To the best of the Authors’ knowledge, no study has been published to date on the relationship between the value of Body Mass Index (BMI) and the prevalence of fractures in a specific portion of the fifth metatarsal base. The aim of this study was to define the impact of BMI on fifth metatarsal base fractures location according to Lawrence and Botte classification [7]
Gastric cancer: predictors of recurrence when lymph-node dissection is inadequate
<p>Abstract</p> <p>Background</p> <p>The TNM classification (sixth edition) requires at least 15 lymph nodes to be examined to allow an accurate staging. However, in our environment, only 20% of patients have the recommended minimum of 15 nodes removed.</p> <p>Purpose</p> <p>To evaluate clinicopathological predictors of recurrence in patients with gastric cancer undergoing radical resection with an inadequate number of lymph nodes examined.</p> <p>Methods</p> <p>101 patients were included in this retrospective cohort. We evaluated age, gender, tumoral location, Borrmann type, Lauren histotype, type of gastrectomy, grade, invasion depth of tumor, lymph node involvement, ratio between metastatic and total number of excised lymph nodes keeping 20% as the cutoff value (LNR) and adjuvant treatment. The association between these variables and recurrence was investigated by using univariate methods and multivariate logistic regression analysis.</p> <p>Results</p> <p>Median (range) age was 63 years (44-85). 63% males, 37% females. Median follow-up time for the whole patients population was 36 months (10-104). Median number of lymph nodes retrieved was 6 (0-14). Recurrence: 50 of 101 cases (49,6%); 41 hematogeneus dissemination, 9 locoregional recurrences. The following factors were found to be correlated with the recurrence risk: tumoral location, invasion depth of tumor, lymph node involvement and LNR. A multivariate analysis revealed that depth of invasion [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.03-7.58, P = 0.04] and LNR (OR 2.34, 95% CI 1.05-5.21, P = 0.03) were independent risk factors for recurrences of gastric cancer. Median time to recurrence: 16 months (2-50). 82% of recurrences occurred within the first two years after surgical treatment. The estimated cumulative risk of recurrence at five years: 61% in the whole patients population, with serosal invasion and LNR > and < 20% was 82% and 44%, without serosal invasion 73% and 39% respectively.</p> <p>Conclusion</p> <p>Invasion depth of tumor and LNR were independent predictors of recurrence in gastric cancer after potentially curative resection with an inadequate number of lymph nodes examined.</p
On-line recognition of supernova neutrino bursts in the LVD detector
In this paper we show the capabilities of the Large Volume Detector (INFN
Gran Sasso National Laboratory) to identify a neutrino burst associated to a
supernova explosion, in the absence of an "external trigger", e.g., an optical
observation. We describe how the detector trigger and event selection have been
optimized for this purpose, and we detail the algorithm used for the on-line
burst recognition. The on-line sensitivity of the detector is defined and
discussed in terms of supernova distance and electron anti-neutrino intensity
at the source.Comment: Accepted for pubblication on Astroparticle Physics. 13 pages, 10
figure
First CNGS events detected by LVD
The CERN Neutrino to Gran Sasso (CNGS) project aims to produce a high energy,
wide band beam at CERN and send it toward the INFN Gran Sasso
National Laboratory (LNGS), 732 km away. Its main goal is the observation of
the appearance, through neutrino flavour oscillation. The beam
started its operation in August 2006 for about 12 days: a total amount of
protons were delivered to the target. The LVD detector, installed
in hall A of the LNGS and mainly dedicated to the study of supernova neutrinos,
was fully operating during the whole CNGS running time. A total number of 569
events were detected in coincidence with the beam spill time. This is in good
agreement with the expected number of events from Montecarlo simulations.Comment: Accepted for publication by the European Physical Journal C ; 7
pages, 11 figure
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