Personalized Nutritional Strategies to Reduce Knee Osteoarthritis Severity and Ameliorate Sarcopenic Obesity Indices: A Practical Guide in an Orthopedic Setting

Knee osteoarthritis (KOA) is one of the most common joint diseases, especially in individuals with obesity. Another condition within this population, and which presents frequently, is sarcopenic obesity (SO), defined as an increase in body fat and a decrease in muscle mass and strength. The current paper aims to describe recent nutritional strategies which can generally improve KOA clinical severity and, at the same time, ameliorate SO indices. Searches were carried out in the PubMed and Science Direct databases and data were summarized using a narrative approach. Certain key findings have been revealed. Firstly, the screening and identification of SO in patients with KOA is important, and to this end, simple physical performance tests and anthropometric measures are available in the literature. Secondly, adherence to a Mediterranean diet and the achievement of significant body weight loss by means of low-calorie diets (LCDs) remain the cornerstone nutritional treatment in this population. Thirdly, supplementation with certain micronutrients such as vitamin D, essential and non-essential amino acids, as well as whey protein, also appear to be beneficial. In conclusion, in the current review, we presented a detailed flowchart of three different nutritional tracks that can be adopted to improve both KOA and SO based on joint disease clinical severity

Local recurrences after limb salvage procedures for osteosarcoma: correlation with margins and chemotherapy induced necrosis

none8noneMERCURI M; CALDORA P; RUGGIERI P; BIAGINI R; ANDREOLI I; DI LIDDO M; ZMERLY H; CAMPANACCI MMercuri, M; Caldora, P; Ruggieri, Pietro; Biagini, R; Andreoli, I; DI LIDDO, M; Zmerly, H; Campanacci, M

Prostatic adenocarcinoma with oncocytic features.

A case of prostatic adenocarcinoma displaying prominent oncocytic features in a 72-year-old man is presented. Histological examination both of prostatic biopsy and surgical specimen showed neoplastic cells with large eosinophilic cytoplasms that strongly immunostained with anti-mitochondrial antibody; electron microscopy analysis was also performed, documenting an increased mitochondrial count in tumour cells. Although not recognized as a distinct histologic subtype by the World Health Organization (WHO) classification, the occurrence of oncocytic features in prostatic adenocarcinoma has been sporadically noticed and was sometimes associated with a less favourable outcome. In contrast, staging procedures in our patient were negative, in spite of a high Gleason’s score, and he is alive and well at 24 months after surgery. So far, biological studies performed on oncocytic tumours from other body sites have failed to demonstrate a pathogenetic role for mitochondrial accumulation in tumorigenesis

Local Recurrence after Limb Salvage Procedures for Osteosarcoma: Correlation with Margins and Chemotherapy Induced Necrosis"

Local Recurrence after Limb Salvage Procedures for Osteosarcoma: Correlation with Margins and Chemotherapy Induced Necrosi

Adjuvant Chemotherapy for Adult Soft Tissue Sarcomas of the Extremities and Girdles: Results of the Italian Randomized Cooperative Trial

Purpose: Adjuvant chemotherapy for soft tissue sar- coma is controversial because previous trials reported conflicting results. The present study was designed with restricted selection criteria and high dose-intensities of the two most active chemotherapeutic agents. Patients and Methods: Patients between 18 and 65 years of age with grade 3 to 4 spindle-cell sarcomas (primary diameter > 5 cm or any size recurrent tumor) in extremities or girdles were eligible. Stratification was by primary versus recurrent tumors and by tumor diameter greater than or equal to 10 cm versus less than 10 cm. One hundred four patients were randomized, 51 to the control group and 53 to the treatment group (five cycles of 4'-epidoxorubicin 60 mg/m2 days 1 and 2 and ifosfamide 1.8 g/m2 days 1 through 5, with hydration, mesna, and granulocyte colony-stimulating factor). Results: After a median follow-up of 59 months, 60 patients had relapsed and 48 died (28 and 20 in the treatment arm and 32 and 28 in the control arm, respectively). The median disease-free survival (DFS) was 48 months in the treatment group and 16 months in the control group (P=.04); and the median overall survival (OS) was 75 months for treated and 46 months for untreated patients (P=.03). For OS, the absolute benefit deriving from chemotherapy was 13% at 2 years and increased to 19% at 4 years (P = .04). Conclusion: Intensified adjuvant chemotherapy had a positive impact on the DFS and OS of patients with high-risk extremity soft tissue sarcomas at a median follow-up of 59 months. Therefore, our data favor an intensified treatment in similar cases. Although cure is still difficult to achieve, a significant delay in death is worthwhile, also considering the short duration of treatment and the absence of toxic deaths