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https://www.readbyqxmd.com/read/28412987/back-pain-in-the-emergency-department-pathological-fracture-following-spinal-manipulation
#1
Christopher Skappak, Erik J Saude
Back pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks. An initial evaluation with thoracolumbar radiographs revealed no significant findings...
April 17, 2017: CJEM
https://www.readbyqxmd.com/read/28361850/prognostic-value-of-the-bone-turnover-markers-in-multiple-myeloma
#2
D Auzina, R Erts, S Lejniece
BACKGROUND: Multiple myeloma (MM) is characterized by osteolytic bone disease resulting from increased osteoclast activity and reduced osteoblast function. AIM: The aim of our research was to determine connection between bone turnover markers and presence of bone lesions, their degree of severity, to monitor MM bone disease and to assess effectiveness of anti-myeloma treatment. MATERIALS AND METHODS: Serum samples and clinical data from 123 patients with newly diagnosed MM were collected at Riga East Clinical University Hospital (Riga, Latvia) from June 2014 to June 2016...
March 2017: Experimental Oncology
https://www.readbyqxmd.com/read/28289933/reinforced-cementoplasty-using-dedicated-spindles-in-the-management-of-unstable-malignant-lesions-of-the-cervicotrochanteric-region
#3
Kévin Premat, Frédéric Clarençon, Raphael Bonaccorsi, Vincent Degos, Évelyne Cormier, Jacques Chiras
OBJECTIVES: In long bones, cementoplasty alone does not provide sufficient stability, which may cause secondary fractures. This study reviewed the safety and efficacy of reinforced cementoplasty (RC) (percutaneous internal fixation using dedicated spindles combined with cementoplasty) for unstable malignant lesions of the cervicotrochanteric region (CTR) of the proximal femur. METHODS: Eighteen consecutive patients (nine women [50%] and nine men [50%]; mean age 55...
March 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28243849/an-evidence-based-approach-to-myeloma-bone-disease
#4
REVIEW
Nicholas Bingham, Antonia Reale, Andrew Spencer
Multiple myeloma is an incurable clonal plasma cell malignancy characterised by osteolytic bone lesions and the presence of a monoclonal immunoglobulin. The bone disease caused by myeloma is a major cause of morbidity with the related complications of pathological fractures, hypercalcaemia and bone pain affecting both quality of life and patient survival. The osteolytic lesions arise due to an imbalance of osteoclast and osteoblast function, arising from complex interactions between myeloma cells, bone marrow stromal cells and the bone marrow microenvironment...
February 27, 2017: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/28243172/uncemented-arthroplasty-after-hip-metastatic-disease-and-multiple-myeloma
#5
André Mathias Baptista, Sergio Pinheiro de Souza Meirelles, Daniel César Seguel Rebolledo, Luiz Filipe Marques Correia, Olavo Pires de Camargo
OBJECTIVE: To describe a case series using a combination of narrative, graphical exploratory analysis and Bayesian Network modeling. METHODS: Case series with 34 patients undergoing uncemented and hybrid arthroplasty procedures secondary to hip pain or fracture secondary to metastatic disease or multiple myeloma. RESULTS: The most common tumors included gastrointestinal, multiple myeloma and breast cancer. Most devices were total arthroplasty (n = 16, 84...
July 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28240368/extensive-remineralization-of-large-pelvic-lytic-lesions-following-total-therapy-treatment-in-patients-with-multiple-myeloma
#6
Meera Mohan, Rohan S Samant, Donghoon Yoon, Amy F Buros, Antonio Branca, Corey O Montgomery, Richard Nicholas, Larry J Suva, Roy Morello, Sharmilan Thanendrarajan, Carolina Schinke, Shmuel Yaccoby, Frits van Rhee, Faith E Davies, Gareth J Morgan, Maurizio Zangari
Osteolytic bone lesions are a hallmark of multiple myeloma (MM) bone disease. Bone destruction is associated with severely imbalanced bone remodeling, secondary to increased osteoclastogenesis and significant osteoblast suppression. Lytic lesions of the pelvis are relatively common in MM patients and are known to contribute to the increased morbidity because of the high risk of fracture, which frequently demands extensive surgical intervention. After observing unexpected radiological improvement in serial large pelvic CT assessment in a patient treated in a total therapy protocol, the radiographic changes of pelvic osteolytic lesions by PET/CT scanning in patients who received Total Therapy 4 (TT4) treatment for myeloma were retrospectively analyzed...
February 27, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28188075/bisphosphonate-related-osteonecrosis-and-metastasis-within-the-same-site-of-the-jaw
#7
Alessandro Corsi, Claudio Ungari, Mara Riminucci, Alessandro Agrillo
Osteonecrosis of the jaw (ONJ) is a well known complication in patients treated with bisphosphonates (BPs) for skeletal metastasis and multiple myeloma (MM). Few oncologic patients under treatment with BPs and with ONJ and metastasis or MM at the same site of the jaw have been described. We report here on a 54-year old white female who was treated with intra-venous zoledronic acid for skeletal metastasis of breast cancer who developed ONJ. Because of a fracture at the site of ONJ, resection of the affected segment was performed...
January 18, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28174184/multiple-myeloma-presenting-with-bilateral-ankle-pain-microangiopathy-and-complicated-by-streptococcal-meningitis-and-pneumocystis-carinii-pneumonia
#8
Louise Dunphy, Neeraj Singh, Elizabeth Keating
Multiple myeloma is characterised by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. This clone of plasma cells proliferates in the bone marrow, resulting in extensive skeletal destruction with osteolytic lesions, osteopenia and pathological fractures. Additional disease-related complications include hypercalcaemia, renal insufficiency, anaemia and infection. We present the case of a 64-year-old woman presenting with rapid onset, painful distal symmetrical lower limb weakness and an acute kidney injury...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28119431/ezh2-or-hdac1-inhibition-reverses-multiple-myeloma-induced-epigenetic-suppression-of-osteoblast-differentiation
#9
Juraj Adamik, Shunqian Jin, Quanhong Sun, Peng Zhang, Kurt R Weiss, Judith L Anderson, Rebecca Silbermann, G David Roodman, Deborah L Galson
In multiple myeloma, osteolytic lesions rarely heal because of persistent suppressed osteoblast differentiation resulting in a high fracture risk. Herein, chromatin immunoprecipitation analyses reveal that multiple myeloma cells induce repressive epigenetic histone changes at the Runx2 locus that prevent osteoblast differentiation. The most pronounced multiple myeloma-induced changes were at the Runx2-P1 promoter, converting it from a poised bivalent state to a repressed state. Previously, it was observed that multiple myeloma induces the transcription repressor GFI1 in osteoblast precursors, which correlates with decreased Runx2 expression, thus prompting detailed characterization of the multiple myeloma and TNFα-dependent GFI1 response element within the Runx2-P1 promoter...
April 2017: Molecular Cancer Research: MCR
https://www.readbyqxmd.com/read/28079810/risk-of-vertebral-compression-fractures-in-multiple-myeloma-patients-a-finite-element-study
#10
D Anitha, Baum Thomas, Kirschke S Jan, Karupppasamy Subburaj
The purpose of this study was to develop and validate a finite element (FE) model to predict vertebral bone strength in vitro using multidetector computed tomography (MDCT) images in multiple myeloma (MM) patients, to serve as a complementing tool to assess fracture risk. In addition, it also aims to differentiate MM patients with and without vertebral compression fractures (VCFs) by performing FE analysis on vertebra segments (T1-L5) obtained from in vivo routine MDCT imaging scans. MDCT-based FE models were developed from the in vitro vertebrae samples and were then applied to the in vivo vertebrae segments of MM patients (n = 4) after validation...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28073880/healing-of-pathological-fracture-in-a-case-of-multiple-myeloma
#11
Raju Vaishya, Vipul Vijay, Amit Kumar Agarwal
No abstract text is available yet for this article.
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28030702/effect-of-longer-interval-vs-standard-dosing-of-zoledronic-acid-on-skeletal-events-in-patients-with-bone-metastases-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Andrew L Himelstein, Jared C Foster, James L Khatcheressian, John D Roberts, Drew K Seisler, Paul J Novotny, Rui Qin, Ronald S Go, Stephen S Grubbs, Tracey O'Connor, Mario R Velasco, Douglas Weckstein, Ann O'Mara, Charles L Loprinzi, Charles L Shapiro
Importance: Zoledronic acid, a third-generation aminobisphosphonate, reduces the incidence of skeletal-related events and pain in patients with bone metastases. The optimal dosing interval for zoledronic acid is uncertain. Objective: To determine whether zoledronic acid administered every 12 weeks is noninferior to zoledronic acid administered every 4 weeks. Design, Setting, Participants: Randomized, open-label clinical trial conducted at 269 academic and community sites in the United States...
January 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28008381/pathologic-fracture-and-healthcare-resource-utilisation-a-retrospective-study-in-eight-european-countries
#13
Jean-Jacques Body, Yves Pascal Acklin, Oliver Gunther, Guy Hechmati, João Pereira, Nikos Maniadakis, Evangelos Terpos, Jindrich Finek, Roger von Moos, Susan Talbot, Harm Sleeboom
BACKGROUND: Skeletal-related events (SREs; pathologic fracture [PF], spinal cord compression and radiation or surgery to bone) are common complications of bone metastases or bone lesions and can impose a considerable burden on patients and healthcare systems. In this study, the healthcare resource utilisation (HRU) associated with PFs in patients with bone metastases or lesions secondary to solid tumours or multiple myeloma was estimated in eight European countries. METHODS: Eligible patients were identified in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland...
November 2016: Journal of Bone Oncology
https://www.readbyqxmd.com/read/27956901/spontaneous-tumour-lysis-syndrome-in-a-multiple-myeloma
#14
Can Huzmeli, Eylem Eliacik, Mustafa Saglam, Baris Doner, Ferhan Candan
The tumor lysis syndrome (TLS) is a collection of metabolic abnormalities that occur in consequence of the release of intracellular contents following lysis of tumor cells. TLS occurs spontaneously or after chemotherapy. Spontaneous TLS is uncommon occurrence in multiple myeloma (MM). We define a case of a 70-year-old woman patient who was found to have MM with spontaneous TLS, following a compression fracture of the T-12 vertebrae. While serum uric acid and phosphorous levels were high, low calcium levels were identified...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27888274/percutaneous-sacroplasty-for-the-management-of-painful-pathologic-fracture-in-a-multiple-myeloma-patient-case-report-and-review-of-the-literature
#15
REVIEW
A A Dmytriw, K Talla, R Smith
Percutaneous kyphoplasty has a well-established role in the treatment of pathologic fractures in patients with multiple myeloma. Despite this, there is a scarcity of literature surrounding its use and efficacy in the sacrum. We present a case of successful symptom resolution in a patient with painful sacral fracture following sacroplasty, and review the existing literature. An 81-year-man with multiple myeloma presented to the hematology/oncology clinic with a history of excruciating pain while seated. The impact of this pain on his quality of life subjectively was rated to be particularly high...
February 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/27863287/bone-health-in-the-elderly-cancer-patient-a-siog-position-paper
#16
REVIEW
J J Body, E Terpos, B Tombal, P Hadji, A Arif, A Young, M Aapro, R Coleman
More than a third of cancers are diagnosed in people over the age of 75. Androgen deprivation for prostate cancer and aromatase inhibitors in breast cancer accelerate age-related bone loss and increase fracture rates. BMD should be checked by dual energy X-ray absorptiometry at baseline and, dependent on risk, every 12-24months. Sufficient calcium, vitamin D and exercise are part of primary fracture prevention. Resistance exercise in particular may improve functional activity and bone density. In men at increased fracture risk and women with postmenopausal early breast cancer, antiresorptive treatment is warranted to reduce fracture rate and to increase overall survival in breast cancer...
December 2016: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/27809247/assessing-heterogeneity-of-osteolytic-lesions-in-multiple-myeloma-by-%C3%A2-h-hr-mas-nmr-metabolomics
#17
Laurette Tavel, Francesca Fontana, Josè Manuel Garcia Manteiga, Silvia Mari, Elisabetta Mariani, Enrico Caneva, Roberto Sitia, Francesco Camnasio, Magda Marcatti, Simone Cenci, Giovanna Musco
Multiple myeloma (MM) is a malignancy of plasma cells characterized by multifocal osteolytic bone lesions. Macroscopic and genetic heterogeneity has been documented within MM lesions. Understanding the bases of such heterogeneity may unveil relevant features of MM pathobiology. To this aim, we deployed unbiased ¹H high-resolution magic-angle spinning (HR-MAS) nuclear magnetic resonance (NMR) metabolomics to analyze multiple biopsy specimens of osteolytic lesions from one case of pathological fracture caused by MM...
October 31, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27791828/spine-stereotactic-radiosurgery-for-the-treatment-of-multiple-myeloma
#18
Jacob A Miller, Ehsan H Balagamwala, Samuel T Chao, Todd Emch, John H Suh, Toufik Djemil, Lilyana Angelov
OBJECTIVE The objective of this study was to define symptomatic and radiographic outcomes following spine stereotactic radiosurgery (SRS) for the treatment of multiple myeloma. METHODS All patients with pathological diagnoses of myeloma undergoing spine SRS at a single institution were included. Patients with less than 1 month of follow-up were excluded. The primary outcome measure was the cumulative incidence of pain relief after spine SRS, while secondary outcomes included the cumulative incidences of radiographic failure and vertebral fracture...
March 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27783835/percutaneous-acetabuloplasty-for-metastatic-lesions-to-the-pelvis
#19
Ryan A Durfee, Scott A Sabo, G Douglas Letson, Odion Binitie, David Cheong
Metastatic lesions of the acetabulum can be painful and debilitating. First-line treatment is multimodal and consists of disease-specific chemotherapy, osteoclastic inhibitors, analgesics, and radiation therapy. When these therapies fail, surgical intervention usually is indicated and varies from regional defect stabilization to large periacetabular reconstructions that are demanding procedures with high rates of complications. Percutaneous cement augmentation (acetabuloplasty) of lesions in selected patients has been explored as a less invasive method of lesional control...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27758772/effect-of-systemic-therapies-on-outcomes-following-vertebroplasty-among-patients-with-multiple-myeloma
#20
R J McDonald, J S McDonald, D F Kallmes, V T Lehman, F E Diehn, J T Wald, K R Thielen, A Dispenzieri, P H Luetmer
BACKGROUND AND PURPOSE: The role of vertebroplasty in patients with myeloma remains relatively undefined. Accordingly, we sought to better define the efficacy of vertebroplasty for myeloma-associated fractures and determine the effect of procedure timing relative to the initiation of systemic therapy on outcomes and complication rates. MATERIALS AND METHODS: Clinical, laboratory, and medication data were retrieved for 172 patients with multiple myeloma treated with vertebroplasty since October 2000...
December 2016: AJNR. American Journal of Neuroradiology
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