Long-term safety and efficacy of raloxifene in the prevention and treatment of postmenopausal osteoporosis: an update

The integrity of bone tissue and its remodeling that occurs throughout life requires a coordinated activity of osteoblasts and osteoclasts. The decreased estrogen circulating level during postmenopausal transition, with a prevalence of osteoclastic activity over osteoblastic activity, represents the main cause of bone loss and osteoporosis. Osteoporosis is a chronic disease requiring long-term therapy and it is important to evaluate the efficacy and safety of treatments over several years, as the fear of health risks is a common reason for discontinuing therapy. Raloxifene is a selective estrogen receptor modulator (SERM) leading to estrogen-agonist effects in some tissues and estrogen-antagonist effects in others. Raloxifene is effective to prevent and treat postmenopausal vertebral osteoporosis, with reduction of spine fractures and, in post-hoc analyses, non-spine fractures in high-risk subjects. Moreover, raloxifene reduces the risk of invasive breast cancer and improves the levels of serum lipoprotein but with an increased risk of venous thromboembolism and fatal stroke, without significant change in the incidence of coronary events. For these reasons the overall risk-benefit profile is favorable. Therefore, when considering the use of raloxifene in a postmenopausal woman, we should take into account the osteoporosis-related individual risk and weigh the potential benefits, skeletal and extra-skeletal, against the health risks

Serum osteoprotegerin correlates with age and bone mass in postmenopausal, but not in fertile age women

Osteoprotegerin (OPG) and receptor activator of nuclear factor kappaB ligand (RANKL) are bone turnover modulators expressed by osteoblasts. The aim of this study was to assess the relationship between the circulating OPG/RANKL system, age and bone mass, in fertile age and postmenopausal women

The Influence of Time and Cement Type on Push-Out Bond Strength of Fiber Posts to Root Dentin

The bond strength of fiber posts luted with resin cements was evaluated after two storage times in different regions of a post space. A total of 40 single-rooted human teeth were endodontically treated and prepared for cementation of fiber posts (White Post DC). In groups 1 and 3 (G1 and G3, respectively), posts were luted with RelyX ARC, whereas the posts in groups 2 and 4 (G2 and G4, respectively) were luted with RelyX Unicem. After one month of storage at 100% humidity, G1 and G2 were transversally sectioned in 1.7-mm slices of the cervical (C), middle (M), and apical (A) thirds of the post space and submitted to push-out testing at 1 mm/min. After nine months of storage, the roots of G3 and G4 underwent the same process. Mean values were analyzed using the Mann-Whitney and Kruskal-Wallis tests (alpha=0.05). The bond strengths in G2 (C=4.26 +/- 2.29; M=4.67 +/- 3.54; A=7.27 +/- 4.30) were statistically higher than in G1 (C=3.81 +/- 1.07; M=1.57 +/- 1.62; A=1.99 +/- 1.60) in the middle and apical thirds (p=0.001). Bond strengths in G4 (C=3.36 +/- 1.39; M=4.49 +/- 2.17; A=3.83 +/- 1.92) were higher than in G3 (C=2.13 +/- 0.47; M=0.94 +/- 1.05; A=0.95 +/- 1.02) in all evaluated regions (p=0.02, p<0.001, and p<0.001, respectively). When comparing the root regions for each group, G1 had higher values in the cervical third than the middle third (p=0.02). The self-adhesive resin cement showed better results than the conventional resin cement at both storage times. For both materials a similar performance among the three root regions was found. Storage time did not influence the shear bond strength.366643648FUNDECT [23/200.084/2007]FUNDECT [23/200.084/2007

A rare case of female pelvic mass: angioleiomyoma of the broad ligament

Angioleiomyoma is a benign mesenchymal neoplasm composed of smooth muscle cells and thick-walled vessels. It is usually found in the skin of the lower extremities. Angioleiomyoma is a very rare tumor among the ever-expanding repertoire of growth variants described in benign uterine leiomyoma. More rare is a solitary tumor of the broad ligament. Thus angioleiomyoma of the broad ligament is an extremely rare benign tumor of the female pelvis. In this report a 52-year-old woman with a one-year history of abdominal pain was admitted to our hospital. Gynaecological and ultrasonography exams showed a large mass with increased vascularization in the right adnexal region. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy. The site of the benign mass was the left broad ligament of the uterus. On pathologic examination of the specimen, the tumor was diagnosed as angioleiomyoma. We present a case of angioleiomyoma of the broad ligament because of its extreme rarity and the large size of the tumor

A therapeutic algorithm for early-stage endometrial cancer: Indications, patient selection, and feasibility

Endometrial cancer is the most widely spread gynaecologic neoplasm in industrial countries. Mode of spread includes direct extension, lymphatic and haematic diffusion. Lymphatic involvement, particularly, is a topic of wide debate due to the strong therapeutic implications associated with it. In this regard, anatomic-surgical staging is better in that it corresponds to real conditions whereas clinical-instrumental staging is still today incomplete