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Donoso Brown EV, Manspeaker S, Blaskowitz MG, Bratton K. Occupational therapy practitioners' experiences with interprofessional collaborative practice. J Interprof Care 2024; 38:525-533. [PMID: 38602113 DOI: 10.1080/13561820.2024.2303489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/04/2024] [Indexed: 04/12/2024]
Abstract
Although occupational therapists engage as part of interprofessional healthcare teams, explicit investigation into their experiences of interprofessional collaborative practice (IPCP) has not been explored. This study evaluated occupational therapists in the United States experiences of IPCP with additional inquiry into which healthcare professionals occupational therapy practitioners interact with and how they engage in collaboration, during IPCP. An exploratory cross-sectional study was conducted using an online survey; 142 occupational therapy practitioners responded. Quantitative data were analyzed using descriptive and bivariate analyses; open-ended responses underwent consensual qualitative analysis. Participants reported most often engaging in IPCP with physical therapists, speech-language pathologists, nurses, physicians, and case managers, although variations in the top five professions were evident between practice settings. In addition, 82% of the respondents reported either feeling prepared or very prepared for IPCP after completing their pre-licensed educational programs. Two qualitative themes have emerged to describe key education-oriented and practice-oriented interprofessional experiences. To further enhance engagement in and preparedness for IPCP, occupational therapy professionals, and students may benefit from interprofessional training that involves the professions most often encountered during clinical practice. This type of learning could foster an understanding of communication and teamwork, thus enhancing readiness to participate in the IPCP team upon transition to practice.
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Affiliation(s)
- Elena V Donoso Brown
- Department of Occupational Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, USA
| | - Sarah Manspeaker
- Department of Athletic Training, Rangos School of Health Sciences, Duquesne University, Pittsburgh, USA
| | - Meghan G Blaskowitz
- Department of Occupational Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, USA
| | - Kira Bratton
- Department of Occupational Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, USA
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Copley J, Martin R, Dix C, Forbes R, Hill A, Mandrusiak A, Penman A, Patterson F, Davies S, Jauncey-Cooke J, Mahendran N, Hooper K, Collins C. Fostering collaborative practice through interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students. J Interprof Care 2024; 38:534-543. [PMID: 38343271 DOI: 10.1080/13561820.2024.2303499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/04/2024] [Indexed: 04/12/2024]
Abstract
Literature regarding simulation for learning interprofessional collaborative practice (IPCP) indicates a need to include a range of health professions and to focus on students' development of team communication and conflict resolution skills in day-to-day healthcare delivery. This study evaluated the impact of interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students on interprofessional collaboration competencies, specifically collaborative communication and conflict resolution during day-to-day interactions, and their intention for IPCP during placement. A series of simulations featuring the potential for interprofessional conflict and involving explicit coaching on communication and conflict resolution were conducted. A single cohort pre-test post-test design included the Students' Perceptions of Interprofessional Clinical Education Revised (SPICE-R), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), and an open response survey question on future intended practice. A total of 237 students participated in the simulation experience. Overall scores and scores on all IPCP competencies in the ICASS (n = 193) and SPICE-R (n = 226) improved for all professions post-simulation. The mean score of the ICCAS increased for 98% of the respondents and similarly the mean score of the SPICE-R increased for 71% of the respondents. Open-ended responses indicated students' intentions to pursue self-leadership in IPCP. Students who participated in an interprofessional simulation reported perceived improvements in IPCP competencies and were encouraged to initiate IPCP when on placement in the practice setting.
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Affiliation(s)
- Jodie Copley
- Occupational Therapy, The University of Queensland, ST LUCIA, Australia
| | - Romany Martin
- Physiotherapy, The University of Tasmania, Launceston, Newnham, Australia
| | - Clare Dix
- Nutrition and Dietetics, The University of Queensland, ST LUCIA, Australia
| | - Roma Forbes
- Physiotherapy, The University of Queensland, ST LUCIA, Australia
| | - Anne Hill
- Speech Pathology, The University of Queensland, ST LUCIA, Australia
| | | | - Adriana Penman
- Speech Pathology, The University of Queensland, ST LUCIA, Australia
| | - Freyr Patterson
- Occupational Therapy, The University of Queensland, ST LUCIA, Australia
| | - Sarah Davies
- Casual Academic, The University of Queensland, ST LUCIA, Australia
| | | | | | - Kelly Hooper
- School of Nursing, Midwifery and Social Work, The University of Queensland, ST LUCIA, Australia
| | - Cheryl Collins
- Nutrition and Dietetics, The University of Queensland, ST LUCIA, Australia
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Sielaff S, Gerlach K, Brunk J, Sill V, Jahn W, Pelli AC. Equine skeletal scintigraphy: Comparing lesion detection ability of methylene diphosphonate and hydroxymethylene diphosphonate in the caudal cervical and proximal metacarpal/metatarsal regions. Vet Rec 2024; 194:e4069. [PMID: 38578296 DOI: 10.1002/vetr.4069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 03/03/2024] [Accepted: 03/09/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Data regarding the lesion detection ability of different radiotracers are lacking in equine bone scintigraphy. METHODS In this prospective study, hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) were compared in horses with increased radiopharmaceutical uptake either in the caudal cervical region (CS group) or in the proximal metacarpal/metatarsal region (PMR group). Region of interest analysis was used to determine normal bone-to-soft tissue ratios, lesion-to-normal bone ratios and lesion-to-soft tissue ratios. Qualitative scoring and total count rates were recorded for each image. RESULTS A total of 213 scintigrams were included. Within the PMR group, there were significantly higher lesion-to-normal bone ratios for MDP compared with HMDP (p = 0.02). In the CS group, normal bone-to-soft tissue ratios were significantly higher for HMDP (p = 0.01). The interobserver agreement with regard to the qualitative assessment of the scintigrams was poor. LIMITATION Paired studies, comparing the different radiotracers in the same patient, were not feasible. CONCLUSION This study revealed minor differences between the two radiotracers, although these have no practical implications. Both radiopharmaceuticals are well suited for detecting lesions at the investigated sites using equine bone scintigraphy.
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Affiliation(s)
| | - Kerstin Gerlach
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Jan Brunk
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Volker Sill
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Werner Jahn
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Anna C Pelli
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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Wu X, Yang Z, Song C, Bu M, Li W, Duan J, Yang GF, Zhang A. Hydroxamate-Containing Bisphosphonates as Fosmidomycin Analogues: Design, Synthesis, and Proherbicide Activity. J Agric Food Chem 2024; 72:7684-7693. [PMID: 38532701 DOI: 10.1021/acs.jafc.3c07872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Fosmidomycin (FOS) is a natural product inhibiting the DXR enzyme in the MEP pathway and has stimulated interest for finding more suitable FOS analogues. Herein, two series of FOS analogue hydroxamate-containing bisphosphonates as proherbicides were designed, with bisphosphonate replacing the phosphonic unit in FOS while retaining the hydroxamate (BPF series) or replacing it with retro-hydroxamate (BPRF series). The BPF series were synthesized through a three-step reaction sequence including Michael addition of vinylidenebisphosphonate, N-acylation, and deprotection, and the BPRF series were synthesized with a retro-Claisen condensation incorporated into the reaction sequence. Evaluation on model plants demonstrated several compounds having considerable herbicidal activities, and in particular, compound 8m exhibited multifold activity enhancement as compared to the control FOS. The proherbicide properties were comparatively validated. Furthermore, DXR enzyme assay, dimethylallyl pyrophosphate rescue, and molecular docking verified 8m to be a promising proherbicide candidate targeting the DXR enzyme. In addition, 8m also displayed good antimalarial activities.
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Affiliation(s)
- Xin Wu
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Zili Yang
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Chunlin Song
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Mengwei Bu
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Weiguo Li
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Jiang Duan
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Guang-Fu Yang
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Aidong Zhang
- National Key Laboratory of Green Pesticide, College of Chemistry, Central China Normal University, Wuhan 430079, China
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Costa de Sousa V, Nunes Sousa FR, Felipe Vasconcelos R, Angelino Barreto G, Martins CS, Romero Dias N, Costa S, Chaves Bernardino MJ, de Almeida Silva G, Linhares N, Gondim D, Marques M, Chaves H, Alves K, Leitão R, Brito GAC, Nobre Pinho Ribeiro ME, Goes P. Polysacharide of Agaricus blazei gel mitigates bone necrosis in model of the jaws related to bisphosphonate via Wnt signaling. Sci Rep 2024; 14:8215. [PMID: 38589479 PMCID: PMC11002000 DOI: 10.1038/s41598-024-58445-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/29/2024] [Indexed: 04/10/2024] Open
Abstract
To investigate de effect of PAb gel on the bone tissue of rats submitted to Bisphosphonate-related osteonecrosis of the jaws (BRONJ). Initially, 54 animals were submitted to BRONJ model by Zoledronic Acid (ZA) (0.1 mg/kg 3x/wk for 9 wk, ip), followed by the 1st upper left molar extraction at the 8th wk. After tooth removal, the animals were divided into 3 groups, ZA that received placebo gel or PAb gel that received 1% PAb gel, inside the dental alveolus. The control Group (CONTROL) received 0.1 mg/kg of 0.9% saline and then placebo gel. Three weeks after tooth extraction, the animals were euthanized, and maxillae were colleted for macroscopic, radiographic, histological and Raman spectomery assays. Additionally, GSK3b, beta-catenin, and Runx2 mRNA expressions were determined. Blood samples were collected for the analysis of Bone-specific alkaline phosphatase (BALP) levels. PAb gel improved mucosal healing, increased the number of viable osteocytes, while it reduced the number of empty lacunae, as well as the amount of bone sequestration. Furthermore, PAb gel positively influenced the number and functionality of osteoblasts by stimulating Wnt signaling, thereby inducing bone remodeling. Additionally, PAb gel contributed to improved bone quality, as evidenced by an increase in bone mineral content, a decrease in bone solubility, and an enhancement in the quality of collagen, particularly type I collagen. PAb gel mitigated bone necrosis by stimulating of bone remodeling through Wnt signaling and concurrently improved bone quality. PAb gel emerges as a promising pharmacological tool for aiding in BRONJ therapy or potentially preventing the development of BRONJ.
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Affiliation(s)
- Vanessa Costa de Sousa
- Post Graduation of Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | | | - Gisele Angelino Barreto
- Post Graduation of Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Conceição S Martins
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nilson Romero Dias
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Sislana Costa
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | | | - Nadine Linhares
- Post Graduation of Dentistry, School of Dentistry, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Delane Gondim
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Mirna Marques
- Faculty of Medical School, Federal University of Ceará, Sobral, CE, Brazil
| | - Helliada Chaves
- School of Dentistry, Federal University of Ceará, Sobral, CE, Brazil
| | - Karuza Alves
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Renata Leitão
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Gerly A C Brito
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Paula Goes
- Department of Pathology and Legal Medicine, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.
- Lab of Medical Immunology, Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil.
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6
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Pazianas M. Depletion of macrophages deteriorates BrONJ-like lesions in mice. Bone. 2023 Dec;177:116899. Bone 2024; 181:116988. [PMID: 38070719 DOI: 10.1016/j.bone.2023.116988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/06/2023] [Indexed: 03/05/2024]
Affiliation(s)
- Michael Pazianas
- Center for Translational Medicine and Pharmacology, Icahn Sinai School of Medicine at Mount Sinai, 1 Gustave L. Levy PI, New York, NY 10029, USA.
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7
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Mauceri R, Coppini M, Pérez-Sayáns M, Toro C, Vitagliano R, Colella G, Rodolico V, Campisi G. Challenges in the diagnosis of oral squamous cell carcinoma mimicking medication-related osteonecrosis of the jaws: a multi-hospital-based case series. Oral Oncol 2024; 151:106689. [PMID: 38503259 DOI: 10.1016/j.oraloncology.2024.106689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Rodolfo Mauceri
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy; Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, 90127 Palermo, Italy
| | - Martina Coppini
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy; Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15782 A Coruña, Spain; Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15782 A Coruña, Spain; Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Corrado Toro
- Maxillofacial Surgery Unit, Clinica del Mediterraneo of Ragusa, 97100 Ragusa, Italy
| | - Rita Vitagliano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Vito Rodolico
- Department ProMISE, University of Palermo, 90127 Palermo, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy; Unit of Oral Medicine and Dentistry for fragile patients, Department of Rehabilitation, fragility, and continuity of care, University Hospital Palermo, 90127, Palermo, Italy
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8
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Yfanti Z, Tetradis S, Nikitakis NG, Eleni Alexiou K, Makris N, Angelopoulos C, Tsiklakis K. Radiologic findings of osteonecrosis, osteoradionecrosis, osteomyelitis and jaw metastatic disease with cone beam CT. Eur J Radiol 2024; 173:111387. [PMID: 38428257 DOI: 10.1016/j.ejrad.2024.111387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Zafeiroula Yfanti
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Sotirios Tetradis
- Section of Oral Maxillofacial Radiology, UCLA School of Dentistry, Los Angeles, CA, USA.
| | - Nikolaos G Nikitakis
- Department of Oral Medicine and Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Konstantina Eleni Alexiou
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Nikolaos Makris
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Kostas Tsiklakis
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
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9
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Ishibashi H, Sasahara T, Katagiri O, Yamada T. Necrotizing Fasciitis with Medication-related Osteonecrosis of the Jaw. Intern Med 2024; 63:887-888. [PMID: 37532542 PMCID: PMC11009002 DOI: 10.2169/internalmedicine.2442-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
| | - Teppei Sasahara
- Division of Infectious Diseases, School of Medicine, Jichi Medical University, Japan
| | - Oh Katagiri
- Emergency Department, Aso Iizuka Hospital, Japan
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10
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Böttiger Y, Ekenstråle E. [Adverse drug reactions in the oral cavity]. Lakartidningen 2024; 121:23205. [PMID: 38470273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Adverse drug reactions commonly occur in the oral cavity, and although these reactions are seldom life threatening, they may severely affect quality of life, as well as the nutritional status of the patient. Hyposalivation is often caused by antidepressants, antihistamines, and diuretics, and the risk increases with polypharmacy. A dry mouth may in turn lead to oral candidosis, which may also be caused by treatment with antibiotics, immunosuppressants or corticosteroids. Other possible adverse drug reactions that may be seen in the oral cavity include gingival hyperplasia, ulcerations, allergic mucosal reactions, changes in sensibility or taste, as well as discoloration of saliva and/or the oral mucosa. Drug-induced osteonecrosis of the jaw from bisphosphonates is also mentioned in this context. The risk of many adverse drug reactions in the mouth can be decreased by good oral hygiene, in combination with regular revisions of the patient's drug treatment. However, there is a risk that physicians do not examine the oral cavity, while dentists may not have complete information about the patient's drug treatment. A close collaboration between medical and dental health care is the key to reducing adverse drug reactions in the mouth.
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Affiliation(s)
- Ylva Böttiger
- professor, överläkare, medicinsk redaktör, Läkartidningen, klinisk farmakologi, Universitetssjukhuset i Linköping; Linköpings universitet
| | - Emma Ekenstråle
- övertandläkare och specialist i orofacial medicin, Kliniken för Orofacial medicin, Mälarsjukhuset, Eskilstuna, Region Sörmland
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Hata H, Shimomura S, Imamachi K, Sato J, Asaka T, Hirata K, Funayama K, Mori Y, Matsuzaka M, Nambu T, Kitagawa Y. Stability of standardized uptake values for quantitative bone SPECT for jawbone lesions: a single-center cross-sectional study. BMC Oral Health 2024; 24:305. [PMID: 38443942 PMCID: PMC10913536 DOI: 10.1186/s12903-024-04067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The long time required for bone uptake of radiopharmaceutical material after injection for bone scintigraphy is a burden for patients with poor health. Thus, to assess whether the uptake time could be reduced for single-photon emission computed tomography (SPECT) of the jawbone, this study evaluated differences in maximum standardized uptake values (SUVmax) within patients using SPECT imaging at 2 and 3 hours after radiopharmaceutical injection. METHODS A total of 33 patients undergoing treatment or in post-treatment follow-up for medication-related osteonecrosis of the jaw, who visited our hospital between July 2020 and August 2021 and could receive SPECT twice on the same day, were enrolled in the study. Patients were injected with technetium-99 m hydroxymethylene diphosphonate (Tc-99 m HMDP) intravenously. The SUVmax for healthy parietal bones and jawbone lesions were calculated from the SPECT images using quantitative analysis software, and the SUVmax were compared between 2- and 3-hour uptake times. RESULTS After exclusion, 30 patients were included in the study. In the 2-hour and 3-hour images, the median SUVmax of the parietal bones were 1.90 and 1.81, respectively, and those of the jawbone lesions were 9.25 and 9.39, respectively. The limits of agreement (LOA) ranged from - 0.33 to 0.25 in the parietal bones, and the %LOA ranged from - 9.8 to 17.3% in the jawbone lesions, showing high equivalence between the two uptake durations. The SUVmax showed no clinical differences between the 2- and 3-hour uptake durations for Tc-99 m HMDP SPECT of the jawbone. CONCLUSIONS The results of this study justify a 2-3-hour uptake window when performing quantitative SPECT of the jawbone. Therefore, the minimum uptake time can potentially be reduced to only 2 hours.
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Affiliation(s)
- Hironobu Hata
- Department of Dentistry and Oral Surgery, NHO Hokkaido Cancer Center, Sapporo, Japan.
- Department of Dentistry and Oral Surgery, NHO Hokkaido Cancer Center, 3-54, Kikusui4-Jyo 2-Tyoume, Sapporo Shiroishi-Ku, Hokkaido, 003-0804, Japan.
| | | | - Kenji Imamachi
- Department of Dentistry and Oral Surgery, NHO Hokkaido Cancer Center, Sapporo, Japan
- Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Jun Sato
- Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Takuya Asaka
- Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Yoichi Mori
- Department of Radiology, NHO Hokkaido Cancer Center, Sapporo, Japan
| | - Masashi Matsuzaka
- Clinical Research Support Centre, Hirosaki University Hospital, Hirosaki, Japan
- Department of Medical Informatics, Hirosaki University Hospital, Hirosaki, Japan
| | - Toshikazu Nambu
- Department of Radiology, NHO Hokkaido Cancer Center, Sapporo, Japan
| | - Yoshimasa Kitagawa
- Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
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12
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Straub A, Stapf M, Brands RC, Kübler AC, Lâm TT, Vollmer A, Gubik S, Scherf-Clavel O, Hartmann S. Investigation of clindamycin concentrations in human plasma and jawbone tissue in patients with osteonecrosis of the jaw: A prospective trial. J Craniomaxillofac Surg 2024; 52:355-362. [PMID: 38368214 DOI: 10.1016/j.jcms.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/18/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
The aim of this study was to investigate the jawbone concentration of clindamycin (CLI) in patients with an osteonecrosis of the jaw (ONJ). Patients with medication-related ONJ (MRONJ) and osteoradionecrosis (ORN) with an antibiotic treatment with CLI were included. Plasma, vital and necrotic bone samples were collected. Plasma and jawbone samples were analyzed by liquid chromatography-tandem mass spectrometry. Patients with MRONJ exhibited a mean plasma CLI concentration of 9.6 μg/mL (SD ± 3.6 μg/mL) and mean concentrations of 2.3 μg/g CLI (SD ± 1.4 μg/g) and 2.1 μg/g CLI (SD ± 2.4 μg/g) in vital and necrotic bone samples, without statistical significance (p = 0.79). In patients with ORN, mean concentration in plasma was 12.0 μg/mL (SD ± 2.6 μg/mL), in vital bone 2.1 μg/g (SD ± 1.5 μg/g), and in necrotic bone 1.7 μg/g (SD ± 1.2 μg/g). Vital and necrotic bone concentrations did not differ significantly (p = 0.88). The results demonstrate that CLI concentrations are considerably lower than in plasma, but sufficient for most bacteria present in ONJ. Within the limitations of the study, it seems that CLI is a relevant alternative to other antibiotics in the treatment of ONJ because it reaches adequate concentrations in jawbone.
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Affiliation(s)
- Anton Straub
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - Maximilian Stapf
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Am Hubland, 97074, Würzburg, Germany
| | - Roman C Brands
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Alexander C Kübler
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Thiên-Trí Lâm
- Institute for Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str. 2/E1, 97080, Würzburg, Germany
| | - Andreas Vollmer
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Sebastian Gubik
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Oliver Scherf-Clavel
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Am Hubland, 97074, Würzburg, Germany; Aalen University, Faculty of Chemistry, Beethovenstraße 1, 73430, Aalen, Germany
| | - Stefan Hartmann
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
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Cui D, Ma Q, Xie S, Wang G, Li G, Chen G. Comparison of the effectiveness of two adjustable negative pressure ureteral access sheaths combined with flex ureteroscopy for ≤ 2 cm renal stones. Sci Rep 2024; 14:4745. [PMID: 38413652 PMCID: PMC10899199 DOI: 10.1038/s41598-024-55333-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
To compare the safety and effectiveness of the combination of intelligent intrarenal pressure control platforms (IPCP) and flexible ureteral access sheath (FUAS) combined with retrograde intrarenal surgery (RIRS) for the treatment of renal stones less than 2 cm. We retrospectively collected 383 patients with renal stones who underwent RIRS in our department from June 2022 to October 2023. Inclusion criteria: stone length or the sum of multiple stone lengths ≤ 2 cm. Finally, 99 cases were included and divided into an IPCP group (n = 40) and FUAS group (n = 59) based on surgical methods. The main endpoint was the stone-free rate (SFR) at third months after surgery, with no residual stones or stone fragments less than 2 mm defined as stone clearance. The secondary endpoints were surgical time and perioperative complications, including fever, sepsis, septic shock, and perirenal hematoma. There was no statistically significant difference in general information between the two groups, including age, gender, body mass index, comorbidities, stone side, stone location, stone length, urine bacterial culture, and hydronephrosis. The operation time for IPCP group and FUAS group was 56.83 ± 21.33 vs 55.47 ± 19.69 min (p = 0.747). The SFR of IPCP group and FUAS group on the first postoperative day was 75.00% vs 91.50% (p = 0.024). The SFR was 90.00% vs 94.90% in the third month (p = 0.349).In IPCP group, there were 11 cases with stones located in the lower renal calyces and 17 cases in FUAS group. The SFR of the two groups on the first day and third months after surgery were 45.50% vs 88.20% (p = 0.014) and 63.60% vs 94.10% (p = 0.040), respectively, with statistical differences. For kidney stones ≤ 2 cm, there was no difference in SFR and the incidence of infection-related complications between IPCP and FUAS combined with RIRS, both of which were superior to T-RIRS. For lower renal caliceal stones, FUAS has a higher SFR compared to IPCP.
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Affiliation(s)
- Deheng Cui
- Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China
| | - Qinghong Ma
- Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China
| | - Shengbiao Xie
- Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China
| | - Guangzhi Wang
- Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China
| | - Guanghai Li
- Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China.
| | - Guoqiang Chen
- Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China.
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周 颖, 赵 宁, 黄 竑, 李 庆, 郭 传, 郭 玉. [Application of double-layer soft tissue suture closure technique in the surgical treatment of patients with mandible medication-related osteonecrosis of the jaw of early and medium stages]. Beijing Da Xue Xue Bao Yi Xue Ban 2024; 56:51-56. [PMID: 38318896 PMCID: PMC10845194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To investigate the clinical application effect of double-layer soft tissue (DLST) suture closure technique in patients with mandible medication-related osteonecrosis of the jaw (MRONJ) of early and medium stages resulted in application of anti-bone-resorptive drugs. METHODS Early to medium stage mandible MRONJ patients who underwent surgical treatment in the fourth ward of Peking University School and Hospital of Stomatology from October 2021 to September 2022 were included. Clinical information of the patients were collected, including primary disease, concomitant disease, medication regimen (drug type, duration of medication), MRONJ stage, clinical symptoms, imaging manifestations, etc. During surgery, after using marginal mandibulae resection to remove the necrotic bone, the wound was closed using DLST closure technique. Regular post-operative follow-up was performed to evaluate the therapeutic effect and complications of the DLST technique, the pain score and functional status of the patiens were evaluated. RESULTS This study totally included 13 patients, 12 women and 1 man, aged (66.69±13.14) years. Seven patients had osteoporosis, 2 had lung cancer, 3 had breast cancer and 1 had prostate cancer among their primary diseases; 7 had no concomitant diseases, 2 had diabetes mellitus, 2 had cardiovascular disease and 1 had dry syndrome. Intravenous zoledronic acid were used in 9 patients, the average duration was (37.7±20.0) months, and other drugs, such as letrozole tablets were taken in 7 patients at the same time; Denosumab injection was used in 3 patients for an average of (10.3±11.9) months; Alendronate sodium tablets were taken in 5 patients for an average of (55.20±27.20) months, and prednisone acetate tablets or acarbose tablets were taken to varying degrees in 2 patients. The average post-operative follow-up was 11.9 months (9 to 17 months), and all the 13 patients were cured without complications, such as pus overflow and so forth. The pre-operative score of Karnofsky performance status (KPS) in the patients was 68.46±14.05, and the post-operative score was 82.31±15.36, and the difference was statistically significant (P < 0.05). The pre-operative score of visual analogue scale (VAS) in the patients was 5.77±0.73 and the post-operative score was 0.38±0.51, and the difference had statistical significance (P < 0.001). CONCLUSION The double-layer soft tissue suture closure technique can achieve good clinical results in patients with MRONJ of the mandible using anti-bone-resorptive drugs alone, and can provide clinical treatment ideas for MRONJ patients with more complicated drug use.
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Affiliation(s)
- 颖 周
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 宁 赵
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 竑远 黄
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 庆祥 李
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 传瑸 郭
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 玉兴 郭
- />北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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Pereira-Silva M, Hadad H, de Jesus LK, de Freitas Santana Oliveira ME, de Almeida JM, Nímia HH, Magro Filho O, Okamoto R, Macedo SB, Palmieri Junior CF, Souza FÁ. Ozone therapy effect in medication-related osteonecrosis of the jaw as prevention or treatment: microtomographic, confocal laser microscopy and histomorphometric analysis. Clin Oral Investig 2024; 28:151. [PMID: 38360985 DOI: 10.1007/s00784-024-05547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.
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Affiliation(s)
- Maísa Pereira-Silva
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil.
| | - Henrique Hadad
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Laís Kawamata de Jesus
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Maria Eduarda de Freitas Santana Oliveira
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Juliano Milanezi de Almeida
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Heloisa Helena Nímia
- Department of Dental Materials and Prothesis, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, Araçatuba, São Paulo, 16015050, Brazil
| | - Osvaldo Magro Filho
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Araçatuba Dental School, São Paulo State University (UNESP), Marechal Rondon Highway, Araçatuba, São Paulo, 16066840, Brazil
| | - Sérgio Bruzadelli Macedo
- Department of Dentistry, University of Brasília (UnB), Asa Norte, Brasília, Distrito Federal, 70297-400, Brazil
| | - Celso Fernando Palmieri Junior
- Department of Oral & Maxillofacial Surgery, Louisiana State University Health Sciences Center (LSU), Kings Highway, Shreveport, LA, 71103, USA
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil.
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del Real Á, Cruz R, Sañudo C, Pérez-Castrillón JL, Pérez-Núñez MI, Olmos JM, Hernández JL, García-Ibarbia C, Valero C, Riancho JA. High Frequencies of Genetic Variants in Patients with Atypical Femoral Fractures. Int J Mol Sci 2024; 25:2321. [PMID: 38396997 PMCID: PMC10889592 DOI: 10.3390/ijms25042321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
This study explores the genetic factors associated with atypical femoral fractures (AFF), rare fractures associated with prolonged anti-resorptive therapy. AFF are fragility fractures that typically appear in the subtrochanteric or diaphyseal regions of the femur. While some cases resemble fractures in rare genetic bone disorders, the exact cause remains unclear. This study investigates 457 genes related to skeletal homeostasis in 13 AFF patients by exome sequencing, comparing the results with osteoporotic patients (n = 27) and Iberian samples from the 1000 Genomes Project (n = 107). Only one AFF case carried a pathogenic variant in the gene set, specifically in the ALPL gene. The study then examined variant accumulation in the gene set, revealing significantly more variants in AFF patients than in osteoporotic patients without AFF (p = 3.7 × 10-5), particularly in ACAN, AKAP13, ARHGEF3, P4HB, PITX2, and SUCO genes, all of them related to osteogenesis. This suggests that variant accumulation in bone-related genes may contribute to AFF risk. The polygenic nature of AFF implies that a complex interplay of genetic factors determines the susceptibility to AFF, with ACAN, SUCO, AKAP13, ARHGEF3, PITX2, and P4HB as potential genetic risk factors. Larger studies are needed to confirm the utility of gene set analysis in identifying patients at high risk of AFF during anti-resorptive therapy.
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Affiliation(s)
- Álvaro del Real
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
| | - Raquel Cruz
- Grupo de Medicina Xenómica, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas, Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Carolina Sañudo
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
| | - José L. Pérez-Castrillón
- Internal Medicine Department, University Hospital Rio Hortega of Valladolid, 47012 Valladolid, Spain;
| | - María I. Pérez-Núñez
- Traumatology Department, University Hospital M. Valdecilla, 39008 Santander, Spain;
| | - Jose M. Olmos
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - José L. Hernández
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Carmen García-Ibarbia
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Carmen Valero
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Jose A. Riancho
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Faulkner RA, Yang Y, Tsien J, Qin T, DeBose-Boyd RA. Direct binding to sterols accelerates endoplasmic reticulum-associated degradation of HMG CoA reductase. Proc Natl Acad Sci U S A 2024; 121:e2318822121. [PMID: 38319967 PMCID: PMC10873557 DOI: 10.1073/pnas.2318822121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/09/2024] [Indexed: 02/08/2024] Open
Abstract
The maintenance of cholesterol homeostasis is crucial for normal function at both the cellular and organismal levels. Two integral membrane proteins, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) and Scap, are key targets of a complex feedback regulatory system that operates to ensure cholesterol homeostasis. HMGCR catalyzes the rate-limiting step in the transformation of the 2-carbon precursor acetate to 27-carbon cholesterol. Scap mediates proteolytic activation of sterol regulatory element-binding protein-2 (SREBP-2), a membrane-bound transcription factor that controls expression of genes involved in the synthesis and uptake of cholesterol. Sterol accumulation triggers binding of HMGCR to endoplasmic reticulum (ER)-localized Insig proteins, leading to the enzyme's ubiquitination and proteasome-mediated ER-associated degradation (ERAD). Sterols also induce binding of Insigs to Scap, which leads to sequestration of Scap and its bound SREBP-2 in the ER, thereby preventing proteolytic activation of SREBP-2 in the Golgi. The oxygenated cholesterol derivative 25-hydroxycholesterol (25HC) and the methylated cholesterol synthesis intermediate 24,25-dihydrolanosterol (DHL) differentially modulate HMGCR and Scap. While both sterols promote binding of HMGCR to Insigs for ubiquitination and subsequent ERAD, only 25HC inhibits the Scap-mediated proteolytic activation of SREBP-2. We showed previously that 1,1-bisphosphonate esters mimic DHL, accelerating ERAD of HMGCR while sparing SREBP-2 activation. Building on these results, our current studies reveal specific, Insig-independent photoaffinity labeling of HMGCR by photoactivatable derivatives of the 1,1-bisphosphonate ester SRP-3042 and 25HC. These findings disclose a direct sterol binding mechanism as the trigger that initiates the HMGCR ERAD pathway, providing valuable insights into the intricate mechanisms that govern cholesterol homeostasis.
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Affiliation(s)
- Rebecca A. Faulkner
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX75390-9046
| | - Yangyan Yang
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX75390-9046
| | - Jet Tsien
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX75390-9046
| | - Tian Qin
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX75390-9046
| | - Russell A. DeBose-Boyd
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX75390-9046
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Seebald LM, Haratipour P, Jacobs MR, Bernstein HM, Kashemirov BA, McKenna CE, Imperiali B. Uridine Bisphosphonates Differentiate Phosphoglycosyl Transferase Superfamilies. J Am Chem Soc 2024; 146:3220-3229. [PMID: 38271668 PMCID: PMC10922802 DOI: 10.1021/jacs.3c11402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Complex bacterial glycoconjugates drive interactions between pathogens, symbionts, and their human hosts. Glycoconjugate biosynthesis is initiated at the membrane interface by phosphoglycosyl transferases (PGTs), which catalyze the transfer of a phosphosugar from a soluble uridine diphosphosugar (UDP-sugar) substrate to a membrane-bound polyprenol-phosphate (Pren-P). The two distinct superfamilies of PGT enzymes (polytopic and monotopic) show striking differences in their structure and mechanism. We designed and synthesized a series of uridine bisphosphonates (UBPs), wherein the diphosphate of the UDP and UDP-sugar is replaced by a substituted methylene bisphosphonate (CXY-BPs; X/Y = F/F, Cl/Cl, (S)-H/F, (R)-H/F, H/H, CH3/CH3). UBPs and UBPs incorporating an N-acetylglucosamine (GlcNAc) substituent at the β-phosphonate were evaluated as inhibitors of a polytopic PGT (WecA from Thermotoga maritima) and a monotopic PGT (PglC from Campylobacter jejuni). Although CHF-BP most closely mimics diphosphate with respect to its acid/base properties, the less basic CF2-BP conjugate more strongly inhibited PglC, whereas the more basic CH2-BP analogue was the strongest inhibitor of WecA. These surprising differences indicate different modes of ligand binding for the different PGT superfamilies, implicating a modified P-O- interaction with the structural Mg2+. For the monoPGT enzyme, the two diastereomeric CHF-BP conjugates, which feature a chiral center at the Pα-CHF-Pβ carbon, also exhibited strikingly different binding affinities and the inclusion of GlcNAc with the native α-anomer configuration significantly improved binding affinity. UBP-sugars are thus revealed as informative new mechanistic probes of PGTs that may aid development of novel antibiotic agents for the exclusively prokaryotic monoPGT superfamily.
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Affiliation(s)
- Leah M. Seebald
- Department of Biology and Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Pouya Haratipour
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Michaela R. Jacobs
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Hannah M. Bernstein
- Department of Biology and Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Boris A. Kashemirov
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Charles E. McKenna
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Barbara Imperiali
- Department of Biology and Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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19
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Kim HY, Jung YS, Park W, Choi YJ, Kim JY. Can medication-related osteonecrosis of the jaw be attributed to specific microorganisms through oral microbiota analyses? A preliminary study. BMC Oral Health 2024; 24:160. [PMID: 38302952 PMCID: PMC10832156 DOI: 10.1186/s12903-024-03945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/27/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Medication-related osteonecrosis of the jaw (MRONJ) can cause significant pain and loss of aesthetics and function if not treated properly. However, diagnosis still relies on detailed intraoral examinations and imaging. Prognosis varies even among patients with similar stages or conditions of MRONJ, emphasizing the need for a deeper understanding of its complex mechanisms. Thus, this study aimed to identify the oral microbiota of patients with MRONJ. METHODS This single-center prospective cohort study included patients with confirmed MRONJ who visited the Department of Oral and Maxillofacial Surgery at Yonsei University Dental Hospital between 2021 and 2022. Oral swab samples were collected from the affected and unaffected sides of each patient. The composition and enumeration of the microbial communities were analyzed, and the diversity was compared to verify ecological changes in the groups using a next-generation sequencing-based 16S metagenomic analysis. A statistical analysis was performed using Wilcoxon signed-rank test with SPSS version 22, and values of P less than 0.05 were considered statistically significant. RESULTS The final study sample included 12 patients. The mean age was 82.67 ± 5.73 (range, 72-90) years. Changes in microbial composition were observed at different taxonomic levels (phylum, genus, and species). The identified microorganisms were commonly associated with periodontitis, gingival disease, and endodontic infection, suggesting a multifactorial etiology of MRONJ. CONCLUSIONS Although this study is based on a small number of cases, it shows that MRONJ is not caused by a specific microorganism but can rather be caused by a variety of factors. By addressing these findings in large-scale studies, the significance of oral microbiome in pathogenesis can be further elucidated and can facilitate the development of effective therapeutic interventions for patients with MRONJ.
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Affiliation(s)
- Heon-Young Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Centre, Seoul, Republic of Korea
| | - Young-Soo Jung
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Wonse Park
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
| | - Yoon Jeong Choi
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jun-Young Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
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20
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Ellacott M, Bilgehan Çevik H, Giannoudis PV. Is there genetic susceptibility for atypical femoral fractures? Injury 2024; 55:111312. [PMID: 38199157 DOI: 10.1016/j.injury.2024.111312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The mechanisms underlying AFF remain unclear, with hypotheses including bone turnover suppression and morphological variation. Recent studies have suggested a potential genetic susceptibility to AFF. A scoping review was conducted using PubMed to identify studies published since 2016. Twenty-one studies were identified, focusing on histological and genetic analysis of AFF patients and Bisphosphonates users. Biopsies and imaging modalities were used to assess histological and morphometric parameters, while genetic sequencing was performed to identify variants in target genes. Genetic studies identified variants in geranylgeranyl diphosphate synthase 1 (GGPS1) and CYP1A1 genes, which play roles in osteoclast function and drug metabolism, respectively. Functional analysis revealed reduced enzymatic activity in mutant variants of these genes, which could be further inhibited by BP use. Other genes, such as ATRAID, ALPL, and COL1A2, were also associated with AFF. Histomorphometric studies supported the hypothesis of bone turnover suppression in AFF, with alterations in tissue mechanical properties and microarchitecture observed, particularly in cortical bone. The findings suggest a potential genetic susceptibility to AFF, with variants in GGPS1 and CYP1A1 genes affecting osteoblast and osteoclast function. Bone turnover suppression and altered tissue properties contribute to the pathogenesis of AFF.
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Affiliation(s)
| | - Hüseyin Bilgehan Çevik
- Department of Orthopaedics and Traumatology, Ankara Etlik City Hospital, University of Health Sciences, Turkey
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds, LS2 9LU, UK; NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, LS2 9LU, UK.
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21
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Chakraborty S, Chatterjee S, Chakravarty R, Sarma HD, Nanabala R, Goswami D, Joy A, Pillai MRA. Synthesis, Quality Control, and Bench-to-Bed Translation of a New [ 68Ga]Ga-Labeled NOTA-Conjugated Bisphosphonate for Imaging Skeletal Metastases by Positron Emission Tomography. Cancer Biother Radiopharm 2024; 39:92-101. [PMID: 38335449 DOI: 10.1089/cbr.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
Background: Early detection of skeletal metastasis is of great interest to determine the prognosis of cancer. Positron emission tomography-computed tomography (PET-CT) imaging provides a better temporal and spectral resolution than single photon emission computed tomography-computed tomography (SPECT-CT) imaging, and hence is more suitable to detect small metastatic lesions. Although [18F]NaF has been approved by U.S. FDA for a similar purpose, requirement of a medical cyclotron for its regular formulation restricts its extensive utilization. Efforts have been made to find suitable alternative molecules that can be labeled with 68Ga and used in PET-CT imaging. Objective: The main objective of this study is to synthesize and evaluate a new [68Ga]Ga-labeled NOTA-conjugated geminal bisphosphonate for its potential use in early detection of skeletal metastases using PET-CT. Methods: The authors performed a multistep synthesis of a new NOTA-conjugated bisphosphonic acid using thiourea linker and radiolabeled the molecule with 68Ga. The radiolabeled formulation was evaluated for its in vitro stability, affinity for hydroxyapatite (HA) particles, preclinical biodistribution in animal models, and PET-CT imaging in patients. Results: The bifunctional chelator (NOTA)-conjugated bisphosphonate was synthesized with 97.8% purity and radiolabeled with 68Ga in high yield (>98%). The radiolabeled formulation was found to retain its stability in vitro to the extent of >95% up to 4 h in physiological saline and human serum. The formulation also showed high affinity for HA particles in vitro with Kd = 907 ± 14 mL/g. Preclinical biodistribution studies in normal Wistar rats demonstrated rapid and almost exclusive skeletal accumulation of the complex. PET-CT imaging in a patient confirmed its ability to detect small metastatic skeletal lesions. Conclusions: The newly synthesized [68Ga]Ga-labeled NOTA-conjugated bisphosphonate is a promising radiotracer for PET-CT imaging for skeletal metastases.
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Affiliation(s)
- Sudipta Chakraborty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sucheta Chatterjee
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Bio Organic Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - Rubel Chakravarty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Haldhar D Sarma
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | | | - Dibakar Goswami
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Bio Organic Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - Ajith Joy
- Molecular Group of Companies, Ernakulam, India
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22
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Ma Y, Xu S, Xu Z, Zhang Y, Lu C, Chen D, Wang Q. Renal safety of zoledronic acid in patients with osteoporosis: a retrospective study. Endocrine 2024; 83:459-465. [PMID: 37971631 DOI: 10.1007/s12020-023-03567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION This study aimed to investigate the renal safety of Zoledronic Acid (ZOL) in patients with osteoporosis (OP). METHODS A total of 1379 patients (baseline estimated glomerular filtration rate, eGFR ≥ 60 mL/min/1.73 m2) with primary OP who received ZOL from January 2008 to October 2020 at our hospital were retrospectively analyzed. Baseline and the changes in renal function within 1 year following infusions were collected, the incidence of renal impairment (eGFR < 60 mL/min/1.73 m2 or a > 25% reduction in the eGFR from baseline) was noted and the risk factors were analyzed. Furthermore, the changes in renal function between a 3-year consecutive infusion and a single infusion of ZOL were compared. RESULTS Renal impairment occurred in 8.05% of patients, who with a significantly higher age, Charlson Comorbidity Index (CCI), smoking history, combination of hypertension or diabetes mellitus and worse renal function indicators (all P < 0.05). Binary logistic regression analysis showed that higher CCI (≥5) or smoking history or the baseline eGFR <90 mL/min/1.73 m2 were the risk factors for renal impairment (all P < 0.05). Patients of 3-year continuous infusion group had a significantly greater drop in the eGFR levels than the single infusion group after 1 year of infusion(s) (P < 0.05). CONCLUSION Attention should be given to possible potential renal impairment following ZOL infusion in clinical practice for the management of OP, particularly in patients with higher CCI (≥5) or smoking history or the baseline eGFR <90 mL/min/1.73 m2. Continuous infusion of ZOL exerts a significant impact on renal function when compared to single infusion and intensive monitoring of renal function is necessary.
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Affiliation(s)
- Yanhua Ma
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China
| | - Shen Xu
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhongyue Xu
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Zhang
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China
| | - Chunyan Lu
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China
| | - Decai Chen
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China
| | - Qin Wang
- Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, China.
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23
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Caserta S, Stagno F, Gangemi S, Allegra A. Highlights on the Effects of Non-Coding RNAs in the Osteonecrosis of the Jaw. Int J Mol Sci 2024; 25:1598. [PMID: 38338876 PMCID: PMC10855359 DOI: 10.3390/ijms25031598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Osteonecrosis of the jaw is the progressive loss and destruction of bone affecting the maxilla or mandible in patients treated with antiresorptive and antiangiogenic agents without receiving prior radiation therapy. The pathogenesis involves the inflammatory pathway of receptor activator of nuclear factor NF-kB ligand and the macrophage colony-stimulating factor, essential for osteoclast precursors survival and proliferation and acting through its receptor c-Fms. Evidence has shown the role of non-coding RNAs in the pathogenesis of osteonecrosis of the jaw and this finding might be useful in diagnosis since these small RNAs could be considered as biomarkers of apoptotic activity in bone. Interestingly, it has been proved that miR-29 and miR-31-5p, acting on specific targets such as CALCR and RhoA, promote programmed-cell death and consequently the necrosis of bone tissue. Specific long non-coding RNAs, instead, have been detected both at reduced levels in patients with multiple myeloma and osteonecrosis, and associated with suppression of osteoblast differentiation, with consequences in the progression of mandible lesions. Among non-coding genic material, circular RNAs have the capability to modify the expression of specific mRNAs responsible for the inhibition of bisphosphonates activity on osteoclastogenesis.
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Affiliation(s)
- Santino Caserta
- Hematology Unit, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 98125 Messina, Italy; (S.C.); (A.A.)
| | - Fabio Stagno
- Hematology Unit, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 98125 Messina, Italy; (S.C.); (A.A.)
| | - Sebastiano Gangemi
- Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy;
| | - Alessandro Allegra
- Hematology Unit, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 98125 Messina, Italy; (S.C.); (A.A.)
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24
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Guo J, Balić P, Borodkin VS, Filippov DV, Codée JDC. Synthesis of Unsymmetrical Difluoromethylene Bisphosphonates. Org Lett 2024; 26:739-744. [PMID: 38215221 PMCID: PMC10825822 DOI: 10.1021/acs.orglett.3c04211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/14/2024]
Abstract
We demonstrate the use of the symmetrical diethyl(dimethyl)difluoromethylene bisphosphonate reagent for the synthesis of terminal and unsymmetrical difluoromethylene bisphosphonates, close analogues of biologically important molecules. The difference in reactivity of the methyl and ethyl groups in the symmetrical diethyl(dimthyl)difluoromethylene bisphosphonate is exploited in a stepwise demethylation-condensation sequence to functionalize either side of the reagent to allow the generation of a series of close bioisosteres of natural pyrophosphate molecules, including ADPr, CDP-glycerol and CDP-ribitol.
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Affiliation(s)
- Jianyun Guo
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, Netherlands
| | - Pascal Balić
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, Netherlands
| | - Vladimir S. Borodkin
- Division
of Molecular Cell and Developmental Biology, School of Life Sciences, University of Dundee, Dow Street, DD1 5EH Dundee, U.K.
| | - Dmitri V. Filippov
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, Netherlands
| | - Jeroen D. C. Codée
- Leiden
Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC Leiden, Netherlands
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25
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Choi Y, Kim J, Rhee Y, Park JH, Nam W, Park W. The assessment of halitosis with a new screening tool in medication-related osteonecrosis of the jaw. Clin Oral Investig 2024; 28:102. [PMID: 38233664 DOI: 10.1007/s00784-024-05506-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVES This study aimed to identify the levels of halitosis in patients with Medication-related osteonecrosis of the jaw (MRONJ) and osteoporosis and to suggest a new MRONJ screening method using halitosis measurement. MATERIALS AND METHODS From October 2019 to April 2023, participants aged 19 years or older without periodontal disease were selected. Seventy-five participants, 25 in each group, were divided into an MRONJ group, an osteoporosis group without MRONJ, and a control group without osteoporosis and not taking osteoporosis drugs or antibiotics. Each participant underwent halitosis assessment twice using an exhaled breath analyzer to measure halitosis twice by blowing a straw for 1 min. Measured concentrations of hydrogen, hydrogen sulfide, and methyl mercaptan were compared between groups. RESULTS Data from 22 patients in the MRONJ group, 25 in the osteoporosis group, and 25 in the control group were analyzed. The concentrations of hydrogen sulfide and methyl mercaptan were significantly higher in the MRONJ group than in the other groups, but the concentrations of hydrogen did not differ between the groups. When comparing the concentrations of hydrogen sulfide and methyl mercaptan in osteoporosis patients and solid cancer patients in the MRONJ group, there was a significant difference in hydrogen sulfide concentration, but there was no significant difference in methyl mercaptan. CONCLUSIONS Quantifying the level of halitosis can be used to screen for MRONJ in patients taking bisphosphonates, such as patients with osteoporosis, prostate cancer, and breast cancer. CLINICAL RELEVANCE MRONJ is accompanied by bad breath, and the concentrations of hydrogen sulfide and methyl mercaptan are associated with MRONJ.
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Affiliation(s)
- Yiseul Choi
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jaeyeon Kim
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Hoo Park
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Wonse Park
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
- Department of Advanced General Dentistry, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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26
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Seaton J, Jones A, Johnston C, Francis K. Physiotherapy private practitioners' opinions regarding interprofessional collaborative practice: A qualitative study. J Interprof Care 2024; 38:10-21. [PMID: 37288950 DOI: 10.1080/13561820.2023.2221687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
Physiotherapy private practitioners comprise a growing proportion of Australia's primary care workforce, yet their views and experiences of interprofessional collaborative practice (IPCP) are poorly documented. The aim of this study was to explore Australian physiotherapy private practitioners' opinions regarding IPCP. Twenty-eight semi-structured interviews were conducted with physiotherapists in 10 private practice sites in Queensland, Australia. Interviews were analyzed using reflexive thematic analysis. Data analysis produced five themes that characterized physiotherapists' perceptions of IPCP: (a) quality of care considerations; (b) not a one-size-fits-all approach; (c) the need for effective interprofessional communication; (d) fostering a positive work culture; and (e) fear of losing clientele. The findings from this study suggest that physiotherapy private practitioners value IPCP because it can deliver superior client outcomes, can strengthen interprofessional relationships, and has the potential to enhance the professional reputation of the organizations within which they work. Physiotherapists also claimed that IPCP can contribute to poor client outcomes when performed inappropriately, while some reported approaching interprofessional referrals with caution following instances of lost clientele. The mixed views toward IPCP in this study highlight the need to explore the facilitators and barriers to IPCP in the Australian physiotherapy private practice setting.
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Affiliation(s)
- Jack Seaton
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Anne Jones
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Catherine Johnston
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Karen Francis
- School of Nursing, Paramedicine and Healthcare Sciences, Wagga Wagga, New South Wales, Australia
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27
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O'Donnell A, Gonyea J, Wensley T, Nizza M. High-quality patient-centered palliative care: interprofessional team members' perceptions of social workers' roles and contribution. J Interprof Care 2024; 38:1-9. [PMID: 37525994 DOI: 10.1080/13561820.2023.2238783] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
A core tenet of interprofessional collaborative practice (IPCP) is that efficient and effective teams are critical for the delivery of high-quality, patient-centered care. Although palliative care has a history of excellent care, increasing demands and larger patient loads are challenging teams to adapt and strengthen team functioning in hospital settings. The purpose of this qualitative study was to better understand the IPCP contributions of advanced palliative social workers (PSWs) through the eyes of their colleagues. Twenty-four interprofessional palliative care (IPPC) team members from other professions (i.e. nurse practitioners, physicians, physician assistants) from 16 hospitals across the U.S. participated in 20-minute semi-structured interviews. The Patient-Centered Clinical Method (PCCM) was used as a conceptual model to aid in the interpretation of the data. This model illuminated the centrality of PSWs' role in building and sustaining a therapeutic alliance between the patient and the IPPC team, through assessing and promoting care that centers the patient's experience with illness, creating space to initiate, process and revisit difficult healthcare conversations and helping to modulate the pace and intensity of emotionally laden discussions. PSWs also support the therapeutic relationship with the IPPC team by providing continuity and connection across and during the hospital experience and supporting the well-being of the IPPC team. This study offers novel insights into how PSWs contribute to patient-centered IPPC and furthers the articulation of the role of PSWs in hospital settings.
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Affiliation(s)
| | - Judith Gonyea
- School of Social Work, Boston University, Boston, USA
| | | | - Megan Nizza
- School of Social Work, Boston University, Boston, USA
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28
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Hadighi P, Faezi ST, Mortazavi SMJ, Rokni M, Aghaghazvini L, Kasaeian A, Nejadhosseinian M, Haerian H, Fateh HR. Evaluation of core decompression outcome in systemic lupus erythematosus with hip osteonecrosis: a retrospective cohort study. Adv Rheumatol 2024; 64:4. [PMID: 38167574 DOI: 10.1186/s42358-023-00345-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. METHODS In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. RESULTS In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphosphonate use (P < 0.02). Of the 23 studied cases, the mean cumulative dose of prednisolone before and after core decompression surgery was 46.41 mg and 14.74 mg respectively. Besides, one case (2.6%) that had a high anti-phospholipid antibodies level during follow-up did not have any radiographic deterioration, and 9 cases (23.1%) had some degrees of radiographic deterioration. CONCLUSIONS The patients group that used bis-phosphonate, had a higher level of satisfaction with joint function after core decompression. Patients with high-level anti-phospholipid antibodies are related to a poor prognosis after core decompression.
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Affiliation(s)
- Pouya Hadighi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Mohammad Javad Mortazavi
- Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Rokni
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Immunology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Nejadhosseinian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Haerian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Fateh
- Department of Physical Medicine and Rehabilitation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Jung JH, Kim JS, Kim BC, Lee J, Lim HJ. Spontaneous Recovery of Pathological Fracture Caused by Medication-Related Osteonecrosis of the Jaw. J Craniofac Surg 2024; 35:e14-e16. [PMID: 37606539 DOI: 10.1097/scs.0000000000009645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/14/2023] [Indexed: 08/23/2023] Open
Abstract
Pathological fracture is one of the most serious complications in medication-related osteonecrosis of the jaw (MRONJ). This case is a report of an 87-year-old woman who had been diagnosed with pathological fracture due to MRONJ. The authors performed minimally invasive and conservative treatment, such as intraoral dressing, antibiotic therapy, and simple debridement, for patients with pathologic fractures due to MRONJ. After 1 year, the inflammatory symptoms disappeared and pathological fractures spontaneously recovered.
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Affiliation(s)
- Joon Hyeok Jung
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon
| | - Je Seong Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon
| | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon
| | - Jun Lee
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon
- Wonkwang Bone Regeneration Research Institute, Daejoen Dental Hospital, College of Dentistry, Wonkwang University, Daejeon, Republic of Korea
| | - Hun Jun Lim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University, Daejeon
- Wonkwang Dental Research Institute, Wonkwang Universtiy, Iksan, Republic of Korea
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30
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Martin H, Henderson A, Allen R, Childs AM, Dunne J, Horrocks I, Joseph S, Kraft JK, Ward K, Mushtaq T, Mason A, Kyriakou A, Wong SC. Reporting of paediatric osteoporotic vertebral fractures in Duchenne muscular dystrophy and potential impact on clinical management: the need for standardised and structured reporting. Pediatr Radiol 2024; 54:117-126. [PMID: 38072887 PMCID: PMC10776500 DOI: 10.1007/s00247-023-05805-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND In boys with Duchenne muscular dystrophy (DMD), initiation of bisphosphonate is recommended upon identification of moderate or severe vertebral fractures, even if asymptomatic. Clear radiological reporting is important for consistency of clinical interpretation and management. OBJECTIVES To audit radiology reports of spine imaging for vertebral fracture assessment in DMD, and assess potential impact on diagnosis and management. MATERIALS AND METHODS Lateral thoracolumbar spine imaging (71 lateral spine radiographs and 13 lateral dual energy absorptiometry spine image) in 84 boys with DMD performed across two centres. Anonymised radiology reports by paediatric radiologists were circulated to two neuromuscular clinicians and two endocrinologists. Clinicians determined if there was vertebral fracture, no vertebral fracture, or unclear interpretation. Endocrinologists also determined if bisphosphonate was indicated. A single observer (a clinician with expertise in vertebral fracture assessment) performed vertebral fracture assessment in 37 images and re-reported using a structured format. Structured reports were re-circulated to the four clinicians to re-evaluate the degree of concordance in clinical diagnosis of vertebral fracture and treatment decisions with bisphosphonate. RESULTS The term "fracture" was used in 25/84 (30%) radiology reports and only in 8/43 (19%) with description of vertebral body abnormalities. Fracture grading was included in 7/43 (16%) radiology reports. Diagnostic concordance by the clinicians was noted in 36/84 (43%). Unclear interpretation was noted in 22% to 51% based on radiology reports. No unclear interpretation was noted with structured reports. Complete diagnostic (37/37, 100%) and treatment (37/37, 100%) concordance was noted with the structured reports, whereas complete diagnostic and treatment concordance was noted in only 16/37 (43%) and 17/37 (46%) of the radiology reports, respectively. CONCLUSION Only a third of radiology reports of spine imaging in DMD explicitly used the terminology "fracture". Grading was only noted in a small percentage. Variability in diagnostic interpretation by clinicians may lead to differing management plans. As identification of vertebral fracture is a trigger for treatment, developing reporting guidelines for paediatric vertebral fracture assessment will improve care. A structured template should be introduced for radiological reporting of paediatric vertebral fracture assessment.
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Affiliation(s)
- H Martin
- Department of Paediatric Endocrinology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - A Henderson
- Department of Paediatric Neurology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - R Allen
- Department of Paediatric Radiology, Royal Hospital for Children, Glasgow, UK
| | - A M Childs
- Department of Paediatric Neurology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - J Dunne
- Department of Paediatric Neurology, Royal Hospital for Children, Glasgow, UK
| | - I Horrocks
- Department of Paediatric Neurology, Royal Hospital for Children, Glasgow, UK
| | - S Joseph
- Department of Paediatric Neurology, Royal Hospital for Children, Glasgow, UK
| | - J K Kraft
- Department of Paediatric Radiology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - K Ward
- Department of Paediatric Neurology, Royal Hospital for Children, Glasgow, UK
| | - T Mushtaq
- Department of Paediatric Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - A Mason
- Department of Paediatric Endocrinology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - A Kyriakou
- Department of Paediatric Endocrinology, Makarios Children's Hospital, Nicosia, Cyprus
| | - S C Wong
- Department of Paediatric Endocrinology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK.
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
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31
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Okita S, Saito T, Yamamoto N, Mochizuki Y, Nakahara R, Shimamura Y, Kunisada T, Nishida K, Ozaki T. Five cases of atypical ulnar fractures associated with long-term bisphosphonate use: An anatomical and mechanical analysis using a finite element model. J Orthop Sci 2024; 29:449-453. [PMID: 36396507 DOI: 10.1016/j.jos.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/17/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022]
Affiliation(s)
| | - Taichi Saito
- Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | | | | | - Ryuichi Nakahara
- Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasunori Shimamura
- Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiyuki Kunisada
- Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keiichiro Nishida
- Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshifumi Ozaki
- Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Trinh A, Milat F. Response to: Zoledronate Increases Bone Mineral Density in Nonambulant Children With Cerebral Palsy: A Randomized, Controlled Trial. J Clin Endocrinol Metab 2023; 109:e418-e419. [PMID: 37437090 DOI: 10.1210/clinem/dgad386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Indexed: 07/14/2023]
Affiliation(s)
- Anne Trinh
- Department of Endocrinology, Monash Health, Melbourne 3168, Australia
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Monash University, Melbourne 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne 3168, Australia
| | - Frances Milat
- Department of Endocrinology, Monash Health, Melbourne 3168, Australia
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Monash University, Melbourne 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne 3168, Australia
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Mori R, Handa T, Ohsumi A, Ikezoe K, Tanizawa K, Uozumi R, Tanabe N, Oguma T, Sakamoto R, Hamaji M, Nakajima D, Yutaka Y, Tanaka S, Yamada Y, Oshima Y, Sato S, Fukui M, Date H, Hirai T. Evaluation of Bone Mineral Density in Lung Transplant Recipients by Chest Computed Tomography. Respiration 2023; 103:1-9. [PMID: 38052185 PMCID: PMC10823555 DOI: 10.1159/000535269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION Lung transplantation (LT) recipients are at risk of bone mineral density (BMD) loss. Pre- and post-LT BMD loss has been reported in some cross-sectional studies; however, there are limited studies regarding the serial BMD change in LT recipients. The aim of this study was to investigate the serial BMD changes and the clinical characteristics associated with BMD decline. METHODS This was a single-center, retrospective observational study. BMD was serially measured in thoracic vertebral bodies (Th4, 7, 10) using computed tomography (CT) before and 3 and 12 months after LT. The frequency of osteoporosis and factors associated with pre-LT osteoporosis and post-LT BMD loss were evaluated. The frequency of post-LT compression fracture and its associated factors were also analyzed. RESULTS This study included 128 adult LT recipients. LT recipients had decreased BMD (151.8 ± 42.2 mg/mL) before LT compared with age-, sex-, and smoking index-matched controls (176.2 ± 35.7 mg/mL). The diagnosis of COPD was associated with pre-LT osteoporosis. LT recipients experience further BMD decline after transplantation, and the percentage of recipients classified as exhibiting osteoporosis increased from 20% at baseline to 43% at 12 months. Recipients who had been taking no or small doses of glucocorticoids before LT had rapid BMD loss after LT. Early bisphosphonate use (within 3 months) after LT attenuated BMD loss and decreased new-onset compression fracture. CONCLUSION LT recipients are at high risk for BMD loss and compression fracture after LT. Early bisphosphonate use may decrease BMD loss and compression fracture.
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Affiliation(s)
- Ryobu Mori
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiro Ohsumi
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Industrial Engineering and Economics, Tokyo Institute of Technology, Tokyo, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Tsuyoshi Oguma
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masatsugu Hamaji
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Daisuke Nakajima
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yojiro Yutaka
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satona Tanaka
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshito Yamada
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yohei Oshima
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motonari Fukui
- Respiratory Disease Center, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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35
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Arundel P, Borg SA. Early Life Management of Osteogenesis Imperfecta. Curr Osteoporos Rep 2023; 21:779-786. [PMID: 37752354 PMCID: PMC10724332 DOI: 10.1007/s11914-023-00823-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE OF REVIEW This review aims to provide a review of the multidisciplinary management of infants with osteogenesis imperfecta (OI) during the first year of life, focusing on those with severe disease. The authors draw on published literature and direct experience of working in a large paediatric centre specialising in the management of rare bone disease. RECENT FINDINGS Whilst understanding of the pathophysiology of OI has grown over the past decade, the evidence base for management of infants remains limited. There has been a greater recognition of certain subjects of concern including pain management, cervical spine deformity, and neurocognitive development. Both international consensus guidelines on rehabilitation and disease-specific growth charts have been welcomed by clinical teams. The early involvement of multidisciplinary specialist care is critical in ensuring optimal care for the infant with severe OI. A long-term perspective which focuses on the axial, craniofacial, and peripheral skeleton as well as on development more generally provides a framework which can guide the management of infants with severe OI.
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Affiliation(s)
- Paul Arundel
- Sheffield Children's NHS Foundation Trust, Sheffield, UK.
- Highly Specialised Service for Complex Childhood Osteogenesis Imperfecta, NHS England, London, UK.
| | - Stephanie A Borg
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
- Highly Specialised Service for Complex Childhood Osteogenesis Imperfecta, NHS England, London, UK
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36
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Hong N, Shin S, Lee S, Rhee Y. Romosozumab is associated with greater trabecular bone score improvement compared to denosumab in postmenopausal osteoporosis. Osteoporos Int 2023; 34:2059-2067. [PMID: 37596432 DOI: 10.1007/s00198-023-06889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/11/2023] [Indexed: 08/20/2023]
Abstract
In this study, romosozumab demonstrated significantly greater improvement in trabecular bone score compared to denosumab therapy in postmenopausal women previously treated with antiresorptive agents. Notably, in patients previously treated with anti-resorptive agents, treatment with romosozumab resulted in similar increases in trabecular bone score compared to that of drug-naïve patients. PURPOSE Romosozumab significantly increases bone mineral density (BMD) and rapidly reduces fracture risk. Whether romosozumab can improve the spinal trabecular bone score (TBS) as a bone quality indicator merits further investigation. METHODS Data for postmenopausal women starting romosozumab or denosumab treatment at Severance Hospital, Korea, were analyzed. Romosozumab and denosumab groups were 1:1 matched using propensity scores, considering relevant covariates. Good responders were defined as those with TBS improvement of 5.8% or greater. RESULTS Overall, 174 patients (romosozumab, n = 87; denosumab, n = 87) were analyzed. Matched groups did not differ in age (64 years), weight, height, previous fracture (38%), lumbar spine or femoral neck BMD (T-score, -3.4 and -2.6, respectively), or prior bisphosphonate or selective estrogen receptor modulator (SERM) exposure (50%). The romosozumab group exhibited a greater increase in lumbar spine BMD (15.2% vs. 6.9%, p < 0.001) and TBS (3.7% vs. 1.7%, p = 0.013) than the denosumab group. In patients transitioning from bisphosphonate or SERM, romosozumab users showed greater improvement in TBS compared to denosumab users (3.9% versus 0.8%, P = 0.006); the drug-naive group showed no significant difference (3.6% versus 2.7%, P = 0.472). The romosozumab group had a higher proportion of good responders than the denosumab group (33.3% vs. 18.4%, p = 0.024). Romosozumab therapy for 12 months resulted in 3.8-fold higher odds of a good response in TBS than denosumab after covariate adjustment (adjusted odds ratio 3.85, p = 0.002). CONCLUSION Romosozumab could improve bone mass and bone quality, measured by TBS, in postmenopausal osteoporosis, particularly as a subsequent regimen in patients previously taking anti-resorptive agents.
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Affiliation(s)
- Namki Hong
- Division of Endocrinology, Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Sungjae Shin
- Division of Endocrinology, Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, 10444, Korea
| | - Seunghyun Lee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea
| | - Yumie Rhee
- Division of Endocrinology, Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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37
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Ting M, Huynh BH, Woldu HG, Gamal I, Suzuki JB. Clinical Impact on Dental Implant Survival in Patients Taking Antiresorptive Medications: A Systematic Review and Meta-Analysis. J ORAL IMPLANTOL 2023; 49:599-615. [PMID: 37905745 DOI: 10.1563/aaid-joi-d-21-00160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Dental implants are a predictable option to replace missing teeth. Patients on antiresorptive medications used to treat disorders associated with bone resorption may need dental implants to replace missing teeth. The data on implant failure in patients on antiresorptive medication requiring dental implants, is conflicting and limited. This systematic review aims to investigate if antiresorptive medications have any clinical impact on dental implant survival. Electronic databases were searched until May 2020. The focus question (PICOS): Participants: humans, Interventions: implant placement surgery in patients on antiresorptive medication, Comparisons: patients on antiresorptive medication vs control (patients not on antiresorptive medication), Outcomes: implant survival, and Study design: clinical studies. The protocol of this systematic review was registered in PROSPERO (CRD42020209083). Fourteen nonrandomized studies were selected for data extraction and risk of bias assessment using the ROBINS-1 tool. Only studies with a control were included for the meta-analysis, 8 articles were included in the meta-analysis using implant-level data, and 5 articles were included in the meta-analysis using patient-level data. There was no statistical significance between the 2 groups at the patient level based on 265 patients. However, there was a statistically significant difference at the implant level based on 2697 implants. Therefore, antiresorptive medications, mainly bisphosphonates (BPs), may significantly contribute to implant failure. Antiresorptive medications, especially BPs may reduce implant survival and impair the osseointegration of dental implants. Failed implants in patients on BPs may not lead to osteonecrosis and may be replaced with success.
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Affiliation(s)
- Miriam Ting
- Department of Periodontics, University of Pennsylvania, Philadelphia, PA
- Think Dental Learning Institute, Paoli, PA
- General Dental Practice Residency, Einstein Medical Center, Philadelphia, PA
- Private Practice, Paoli, PA
| | - Benzon H Huynh
- Indian Health Service, U.S. Department of Health and Human Services
| | - Henok G Woldu
- The Center for Health Analytics for National and Global Equity (C.H.A.N.G.E.), Columbia, MO
- Biostatistician, Private Company, CA
| | - Ibrahim Gamal
- Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Jon B Suzuki
- University of Maryland School of Dentistry, Baltimore, MD
- University of Washington School of Dentistry, Seattle, WA
- Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL
- Temple University Schools of Medicine and Dentistry, Philadelphia, PA
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Albokhari D, Alharbi O, Blesson A, Jain M. The diagnostic odyssey of a patient with dihydropyrimidinase deficiency: a case report and review of the literature. Cold Spring Harb Mol Case Stud 2023; 9:a006319. [PMID: 38199782 PMCID: PMC10815279 DOI: 10.1101/mcs.a006319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024] Open
Abstract
Dihydropyrimidinase (DHP) deficiency is an autosomal recessive metabolic disorder caused by biallelic pathogenic variants of DPYS Patients with DHP deficiency exhibit a broad spectrum of phenotypes, ranging from severe neurological and gastrointestinal involvement to cases with no apparent symptoms. The biochemical diagnosis of DHP deficiency is based on the detection of a significant amount of dihydropyrimidines in urine, plasma, and cerebrospinal fluid samples. Molecular genetic testing, specifically the identification of biallelic pathogenic variants in DPYS, has proven instrumental in confirming the diagnosis and facilitating family studies. This case study documents the diagnostic journey of an 18-yr-old patient with DHP deficiency, highlighting features at the severe end of the clinical spectrum. Notably, our patient exhibited previously unreported skeletal features that positively responded to bisphosphonate treatment, contributing valuable insights to the clinical characterization of DHP deficiency. Additionally, a novel DPYS variant was identified and confirmed pathogenicity through metabolic testing, further expanding the variant spectrum of the gene. Our case emphasizes the importance of a comprehensive diagnostic approach using genetic sequencing and metabolic testing for accurate diagnosis.
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Affiliation(s)
- Daniah Albokhari
- Department of Pediatrics, Taibah University College of Medicine, Medina 42353, Saudi Arabia
- King Faisal Specialist Hospital and Research Center, Medina 42523, Saudi Arabia
| | - Ohood Alharbi
- Taibah University College of Medicine, Medina 42353, Saudi Arabia
| | - Alyssa Blesson
- Department of Bone/Osteogenesis Imperfecta, Kennedy Krieger Institute, Baltimore, Maryland 21205, USA
| | - Mahim Jain
- Department of Bone/Osteogenesis Imperfecta, Kennedy Krieger Institute, Baltimore, Maryland 21205, USA;
- Department of Genetic Medicine, Johns Hopkins Medical Institute, Baltimore, Maryland 21205, USA
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Milovanovic P, Busse B. Micropetrosis: Osteocyte Lacunar Mineralization in Aging and Disease. Curr Osteoporos Rep 2023; 21:750-757. [PMID: 37917286 DOI: 10.1007/s11914-023-00832-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE OF REVIEW As the importance of osteocytes for bone mineral homeostasis is increasingly recognized, there is growing interest in osteocyte cell death as a relevant indicator in various physiological and pathological conditions. Micropetrosis is an established term used to describe osteocyte lacunae that are filled with minerals following osteocyte death. While the early reports of micropetrosis were purely descriptive, there is now an increasing body of literature showing quantitative data on micropetrosis in various conditions such as aging, osteoporosis, immobilization, and diabetes, and in osteoporosis treatment (denosumab and bisphosphonates). This review summarizes quantitative findings on micropetrosis, with a particular emphasis on the recent advances in the field. RECENT FINDINGS There is growing evidence that micropetrosis is more common in older, osteoporotic, and immobilized individuals, as well as in individuals with type 1 or type 2 diabetes. Denosumab and bisphosphonates seem to affect lacunar mineralization differently, where specifically bisphosphonates have been shown to prolong osteocyte viability and reduce micropetrosis. Despite continuous proceedings in the field of osteocyte-lacunar-network characteristics, more studies are necessary to further clarify the mechanisms of lacunar mineralization, the inter-site variability of micropetrosis accumulation, the relevance of micropetrosis in various diseases and conditions, and whether micropetrosis could be an indicator of bone fragility or a target for treatment.
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Affiliation(s)
- Petar Milovanovic
- Center of Bone Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Interdisciplinary Competence Center for Interface Research (ICCIR), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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40
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Patel V, Carey B. Pembrolizumab related osteonecrosis of the jaw. Br J Oral Maxillofac Surg 2023; 61:704-706. [PMID: 37957097 DOI: 10.1016/j.bjoms.2023.08.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/29/2023] [Indexed: 11/15/2023]
Abstract
Medication related osteonecrosis of the jaw (MRONJ) is a serious complication with potential implications on patients' ongoing medical care. This case report describes a case of MRONJ from pembrolizumab; a novel immune checkpoint inhibitor drug.
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Affiliation(s)
- Vinod Patel
- Fl 23, Oral Surgery Dept, Guy's & St Thomas' Hospital, London SE1 9RT, United Kingdom.
| | - Barbara Carey
- Fl 2, Head & Neck Dept, Guy's & St Thomas' Hospital, London SE1 9RT, United Kingdom.
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Mo Q, Deng Z, Xiao Y, Liu C, Zhao M. Value of nuclide scintigraphy in the diagnosis and prognosis of cardiac amyloidosis. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:1739-1745. [PMID: 38432865 PMCID: PMC10929958 DOI: 10.11817/j.issn.1672-7347.2023.230176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Indexed: 03/05/2024]
Abstract
Amyloidosis is a local or systemic disease caused by the deposition of misfolded proteins outside the cell, with rapid progression, and dire prognosis. Common types of cardiac amyloidosis are monoclonal immunoglobulin light chain amyloidosis (AL-CA) and transthyretin cardiac amyloidosis (ATTR-CA). Nuclear medicine examinations can be accurate, rapid, and non-invasive to help diagnose diseases and can effectively predict the prognosis of patients with CA. Technetium (99Tcm)-labeled bisphosphonate imaging has been included in the consensus of experts and has become the first-line imaging method for the diagnosis of ATTR-CA. 123I-metaiodoenzylguanidine (MIBG) as a norepinephrine analogue can effectively assess cardiac sympathetic innervation in patients with CA. Aβ- amyloid imaging agents such as 11C-pittsburgh compound B and 18F-flubetaben are expected to be new techniques for diagnosing AL-CA and incorporating them into cardiac staging systems for AL-CA patients in the future. New imaging agents such as 18F-NaF has been widely used in the diagnosis, treatment response monitoring, and prognosis assessment of CA. Summarizing the research value of nuclide imaging in CA may provide new ideas for clinical realization of early detection of CA and accurate assessment of disease prognosis.
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Affiliation(s)
- Qu Mo
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha 410008.
| | - Zilong Deng
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha 410008
| | - Yi Xiao
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha 410008
| | - Caiguang Liu
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha 410008
| | - Min Zhao
- Department of Nuclear Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
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Yoo J, Cheon M. Dynamic blood flow imaging with 99mTc-hydroxymethylene diphosphonate as a therapeutic response marker in patients with Raynaud's phenomenon. Sci Rep 2023; 13:19751. [PMID: 37957209 PMCID: PMC10643549 DOI: 10.1038/s41598-023-47197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
We evaluated the predictive value of dynamic blood flow scintigraphy with 99mTc-HDP (hydroxymethylene diphosphonate) for therapeutic response in patients with Raynaud's phenomenon (RP). Eighty patients who underwent dynamic blood flow scintigraphy using the one-hand chilling method were enrolled. We analyzed the quantitative variables as the ratio of chilled fingers to ambient fingers (CAfinger), that of the chilled hand to ambient hand (CAhand), and that of chilled fingers to ambient palm (FPR) (CAFPR) at 15 and 30 s after 99mTc-HDP bolus injection. Total cumulative radioactivity counts for 180 s were obtained. We evaluated the clinical utility of these quantitative parameters with other clinical variables, including RP severity, therapeutic compliance, types of RP, and scintigraphic interpretation of findings in patients with RP. Fifty-two patients showed poor therapeutic response. There were significant differences between good- and poor-therapeutic responder groups in RP intensity (p = 0.003), CAfinger15s (p = 0.008), CAfinger30s (p = 0.002), CAfinger180s (p = 0.011), CAhand15s (p = 0.008), CAhand30s (p = 0.007), CAhand180s (p = 0.017), CAFPR30s (p = 0.004), and CAFPR180s (p = 0.002). After multivariate logistic regression analysis, only CAfinger30s (p = 0.002) had an independent predictive value of the therapeutic response. 99mTc-HDP dynamic blood flow scintigraphy could be helpful in predicting the therapeutic response in patients with RP.
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Affiliation(s)
- Jang Yoo
- Department of Nuclear Medicine, Veterans Health Service Medical Center, Seoul, South Korea.
| | - Miju Cheon
- Department of Nuclear Medicine, Veterans Health Service Medical Center, Seoul, South Korea
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Yilmaz B, Topkan E. Letter to the Editor regarding "Radiologic findings of osteonecrosis, osteoradionecrosis, osteomyelitis and jaw metastatic disease with cone beam CT". Eur J Radiol 2023; 168:111123. [PMID: 37806191 DOI: 10.1016/j.ejrad.2023.111123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Busra Yilmaz
- Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Bahcesehir University, Istanbul, Turkey.
| | - Erkan Topkan
- Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey.
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Mizuta K, Oshiro H, Katsuki R, Tsuha Y, Aoki Y, Tome Y, Nishida K. Denosumab administration for bone metastases from solid tumors: a retrospective cross-sectional study. BMC Cancer 2023; 23:999. [PMID: 37853409 PMCID: PMC10585877 DOI: 10.1186/s12885-023-11495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Little is known on how denosumab reduces skeletal-related events (SREs) by bone metastases from solid tumors. We sought to evaluate the effect of denosumab administration in patients with bone metastases from solid tumors. METHODS Data of patients treated with denosumab were collected from electronic medical charts (n = 496). Eligible participants in this study were adult patients (age ≥ 18 years) with metastatic bone lesions from solid tumors treated with denosumab. SREs, surgical interventions, the spinal instability neoplastic score (SINS) for spinal region, and Mirels' score for the appendicular region were evaluated. To assess whether denosumab could prevent SREs and associated surgery, the SINS and Mirels' score were compared between patients with and without SREs. RESULTS A total of 247 patients (median age, 65.5 years old; median follow-up period, 13 months) treated with denosumab for metastatic bone lesions from solid tumors were enrolled in this study. SREs occurred in 19 patients (7.7%). SREs occurred in 2 patients (0.8%) who took denosumab administration before SREs. Surgical interventions were undertaken in 14 patients (5.7%) (spinal and intradural lesions in five patients and appendicular lesions in nine patients). The mean SINS of patients without SREs compared to those with SREs were 7.5 points and 10.2 points, respectively. The mean Mirels' scores of non-SREs patients and those with SREs were 8.07 points and 10.7 points, respectively. Patients with SREs had significantly higher Mirels' score than non-SREs patients (p < 0.01). Patients with SREs had higher SINS than non-SREs patients (p = 0.09). CONCLUSIONS SREs occurred in patients with higher SINS or Mirels' scores. Two patients suffered from SREs though they took denosumab administration before SREs. Appropriate management of denosumab for patients with bone metastasis is significant. Surgical interventions may be needed for patients who with higher SINS or Mirel's scores.
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Affiliation(s)
- Kohei Mizuta
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan
| | - Hiromichi Oshiro
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan
| | - Ryo Katsuki
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan
| | - Yuichi Tsuha
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan
| | - Yusuke Aoki
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan.
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Okinawa, Japan
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Kuchira R, Momo K, Kiryu Y, Sasaki T. Medication adherence of bisphosphonate weekly or monthly regimens in patients with osteoporosis using a nationwide large claims database. Pharmazie 2023; 78:207-211. [PMID: 38037217 DOI: 10.1691/ph.2023.3596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Bisphosphonate (BPN) therapy, which mainly targets osteoporosis, evolves rapidly, leaving patients and physicians with a substantial collection of BPN regimen options. In this study, we aimed to clarify BPN medication adherence between weekly and monthly regimens using a nationwide claims database in Japan. We analyzed 5,016 patients with a screening period of 3 months and a 12 month observation period who started using BPN. We used propensity score matching with baseline patient background after dividing the patients into two groups: weekly and monthly BPN users. Medication adherence was calculated using proportion days cover (PDC). A PDC of > 80% was 55.9% and 52.5% in monthly and weekly formulas, respectively, during the 12 months after initiating BPN treatment. PDC-based BPN medication adherence was higher in monthly regimens than in weekly regimens (66.3±34.0 vs. 64.1±36.8%). No differences were found in the proportion of patients with > 80% medication adherence between the monthly and weekly regimens after stratifying patient background using propensity score matching. Our clinical findings highlight the importance of closely monitoring BPN medication adherence, particularly during the initial year of therapy. Notably, half of the patients with osteoporosis exhibited low medication adherence. Therefore, prioritizing monthly regimens over weekly regimens is crucial to promote BPN adherence and ensure optimal treatment outcomes.
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Affiliation(s)
- R Kuchira
- Department of Pharmacy, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - K Momo
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
| | - Y Kiryu
- Department of Pharmacy, M&B Collaboration Medical corporation Hokuetsu Hospital, Niigata, Japan
| | - T Sasaki
- Department of Appropriate Medication Therapy Management (MTM), School of Pharmacy, Showa University, Tokyo, Japan
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Myoken Y, Kawamoto T, Fujita Y, Toratani S, Tsubahara Y, Yanamoto S. Oral squamous cell carcinoma clinico-radiographically mimicking MRONJ. Oral Oncol 2023; 145:106498. [PMID: 37567146 DOI: 10.1016/j.oraloncology.2023.106498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 08/13/2023]
Affiliation(s)
- Yoshinari Myoken
- Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Hiroshima, Japan.
| | | | - Yoshinori Fujita
- Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Shigeaki Toratani
- Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yohei Tsubahara
- Department of Dentistry, Self Defense Forces Hospital Yokosuka, Yokosuka, Japan
| | - Souichi Yanamoto
- Department of Oral Oncology, Hiroshima University, Hiroshima, Japan
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Wang Y, Ji N, Zhang Y, Chu J, Pan C, Zhang P, Ma W, Zhang X, Xi JJ, Chen M, Zhang Y, Zhang L, Sun T. B7H3-targeting chimeric antigen receptor modification enhances antitumor effect of Vγ9Vδ2 T cells in glioblastoma. J Transl Med 2023; 21:672. [PMID: 37770968 PMCID: PMC10537973 DOI: 10.1186/s12967-023-04514-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Glioblastoma (GBM) is a highly aggressive primary brain tumor with a poor prognosis. This study investigates the therapeutic potential of human Vγ9Vδ2 T cells in GBM treatment. The sensitivity of different glioma specimens to Vγ9Vδ2 T cell-mediated cytotoxicity is assessed using a patient-derived tumor cell clusters (PTCs) model. METHODS The study evaluates the anti-tumor effect of Vγ9Vδ2 T cells in 26 glioma cases through the PTCs model. Protein expression of BTN2A1 and BTN3A1, along with gene expression related to lipid metabolism and glioma inflammatory response pathways, is analyzed in matched tumor tissue samples. Additionally, the study explores two strategies to re-sensitize tumors in the weak anti-tumor effect (WAT) group: utilizing a BTN3A1 agonistic antibody or employing bisphosphonates to inhibit farnesyl diphosphate synthase (FPPS). Furthermore, the study investigates the efficacy of genetically engineered Vγ9Vδ2 T cells expressing Car-B7H3 in targeting diverse GBM specimens. RESULTS The results demonstrate that Vγ9Vδ2 T cells display a stronger anti-tumor effect (SAT) in six glioma cases, while showing a weaker effect (WAT) in twenty cases. The SAT group exhibits elevated protein expression of BTN2A1 and BTN3A1, accompanied by differential gene expression related to lipid metabolism and glioma inflammatory response pathways. Importantly, the study reveals that the WAT group GBM can enhance Vγ9Vδ2 T cell-mediated killing sensitivity by incorporating either a BTN3A1 agonistic antibody or bisphosphonates. Both approaches support TCR-BTN mediated tumor recognition, which is distinct from the conventional MHC-peptide recognition by αβ T cells. Furthermore, the study explores an alternative strategy by genetically engineering Vγ9Vδ2 T cells with Car-B7H3, and both non-engineered and Car-B7H3 Vγ9Vδ2 T cells demonstrate promising efficacy in vivo, underscoring the versatile potential of Vγ9Vδ2 T cells for GBM treatment. CONCLUSIONS Vγ9Vδ2 T cells demonstrate a robust anti-tumor effect in some glioma cases, while weaker in others. Elevated BTN2A1 and BTN3A1 expression correlates with improved response. WAT group tumors can be sensitized using a BTN3A1 agonistic antibody or bisphosphonates. Genetically engineered Vγ9Vδ2 T cells, i.e., Car-B7H3, show promising efficacy. These results together highlight the versatility of Vγ9Vδ2 T cells for GBM treatment.
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Affiliation(s)
- Yi Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100191, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Nan Ji
- Beijing Advanced Innovation Center for Biomedical Engineering, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100191, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Yang Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Junsheng Chu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Changcun Pan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Peng Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Weiwei Ma
- Tsinghua-Peking Center for Life Sciences, State Key Laboratory of Membrane Biology, School of Pharmaceutical Sciences, Tsinghua University, Beijing, 100084, China
| | - Xueguang Zhang
- Jiangsu Institute of Clinical Immunology, First Affiliated Hospital, Jiangsu Provincial Key Laboratory of Stem Cell and Biomedical Materials, Soochow University, Soochow University, Suzhou, 215000, China
| | - Jianzhong Jeff Xi
- State Key Laboratory of Natural and Biomimetic Drugs, Institute of Molecular Medicine, Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Mingze Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Yonghui Zhang
- Tsinghua-Peking Center for Life Sciences, State Key Laboratory of Membrane Biology, School of Pharmaceutical Sciences, Tsinghua University, Beijing, 100084, China.
| | - Liwei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100191, China.
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
| | - Tao Sun
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
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Keeling GP, Baark F, Katsamenis OL, Xue J, Blower PJ, Bertazzo S, T M de Rosales R. 68Ga-bisphosphonates for the imaging of extraosseous calcification by positron emission tomography. Sci Rep 2023; 13:14611. [PMID: 37669973 PMCID: PMC10480432 DOI: 10.1038/s41598-023-41149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/22/2023] [Indexed: 09/07/2023] Open
Abstract
Radiolabelled bisphosphonates (BPs) and [18F]NaF (18F-fluoride) are the two types of radiotracers available to image calcium mineral (e.g. bone), yet only [18F]NaF has been widely explored for the non-invasive molecular imaging of extraosseous calcification (EC) using positron emission tomography (PET) imaging. These two radiotracers bind calcium mineral deposits via different mechanisms, with BPs chelating to calcium ions and thus being non-selective, and [18F]NaF being selective for hydroxyapatite (HAp) which is the main component of bone mineral. Considering that the composition of EC has been reported to include a diverse range of non-HAp calcium minerals, we hypothesised that BPs may be more sensitive for imaging EC due to their ability to bind to both HAp and non-HAp deposits. We report a comparison between the 68Ga-labelled BP tracer [68Ga]Ga-THP-Pam and [18F]NaF for PET imaging in a rat model of EC that develops macro- and microcalcifications in several organs. Macrocalcifications were identified using preclinical computed tomography (CT) and microcalcifications were identified using µCT-based 3D X-ray histology (XRH) on isolated organs ex vivo. The morphological and mineral analysis of individual calcified deposits was performed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). PET imaging and ex vivo analysis results demonstrated that while both radiotracers behave similarly for bone imaging, the BP-based radiotracer [68Ga]Ga-THP-Pam was able to detect EC more sensitively in several organs in which the mineral composition departs from that of HAp. Our results strongly suggest that BP-based PET radiotracers such as [68Ga]Ga-THP-Pam may have a particular advantage for the sensitive imaging and early detection of EC by being able to detect a wider array of relevant calcium minerals in vivo than [18F]NaF, and should be evaluated clinically for this purpose.
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Affiliation(s)
- George P Keeling
- Department of Imaging Chemistry & Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - Friedrich Baark
- Department of Imaging Chemistry & Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - Orestis L Katsamenis
- Faculty of Engineering and Physical Sciences, Highfield Campus, µ-VIS X-Ray Imaging Centre, University of Southampton, Southampton, SO17 1BJ, UK
| | - Jing Xue
- Department of Medical Physics & Biomedical Engineering, University College London, Malet Place Engineering Building, London, WC1E 6BT, UK
| | - Philip J Blower
- Department of Imaging Chemistry & Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, UK
| | - Sergio Bertazzo
- Department of Medical Physics & Biomedical Engineering, University College London, Malet Place Engineering Building, London, WC1E 6BT, UK
| | - Rafael T M de Rosales
- Department of Imaging Chemistry & Biology, School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, SE1 7EH, UK.
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Jung J, Ryu JI, Shim GJ, Kwon YD. Effect of agents affecting bone homeostasis on short- and long-term implant failure. Clin Oral Implants Res 2023; 34 Suppl 26:143-168. [PMID: 37750523 DOI: 10.1111/clr.14144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/09/2023] [Accepted: 07/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To review the current evidence on the relationship between agents that affect bone homeostasis and dental implant failures. MATERIALS AND METHODS Electronic searches for bisphosphonates, denosumab, methotrexate, corticosteroids, romosozumab, sunitinib, and bevacizumab were performed using PubMed, MEDLINE (OVID), EMBASE (OVID), Cochrane Central Register of Controlled Trials (Cochrane Library), Cochrane Oral Health Group Trials Register (Cochrane Library) and Web of Science (Thomson Reuters). Manual searches were also conducted to complement the digital searches for recent issues. RESULTS Previous publications suggested that bisphosphonates do not compromise the survival of dental implants. However, one study documented an increased risk of implant failure in patients who had received high-dose of intravenous bisphosphonate therapy after implant rehabilitation. There has been an issue of MRONJ around implants in patients who have successfully received implant therapy before and after antiresorptive therapy, leading to late implant failure. Despite evidence on the detrimental effects of denosumab, methotrexate and corticosteroids on bone metabolism, their role in implant survival is not conclusive. CONCLUSIONS At present, there is insufficient evidence to establish a potential connection between agents that affects bone homeostasis and implant failure. However, some studies have reported negative results for implant therapy. In addition, implant-related sequestration in patients who received anti-resorptive therapy, despite of successful osseointegration, is also noticeable. Although limited studies are available at present, clinicians should still carefully consider the potential hazards and take appropriate precautions to minimize the risks associated with the medications and implant therapy.
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Affiliation(s)
- Junho Jung
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul, Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, College of Dentistry, Kyung Hee University, Seoul, Korea
| | - Gyu-Jo Shim
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul, Korea
| | - Yong-Dae Kwon
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul, Korea
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Musulluoğlu F, Alan H, Yılmaz S. Investigation of the effect of oral and internal bisphosphonate use on bone density in the jaws in patients with osteoporosis in panoramic radiography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:284-293. [PMID: 37316421 DOI: 10.1016/j.oooo.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/02/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES This study aims to quantitatively evaluate the effects of bisphosphonate use duration and route of administration on mandibular cortical and trabecular bone in postmenopausal women. STUDY DESIGN Ninety postmenopausal women over the age of 50 were included in this study. Trabecular bone density was specified numerically by fractal dimension (FD) in the region of interest selected on the panoramic radiograph. The width of the mandibular cortical (MCW) bone under the mental foramen of the mandible was measured. Mann-Whitney U test was used for parameters that did not show a normal distribution. Spearman rho correlation test was used to determine the relationship between continuous measurement parameters. RESULTS It was observed that FD and MCW of dentate and edentate individuals using bisphosphonate were statistically significantly lower than those of healthy individuals (P < .05). There was no significant correlation was found between the duration of use of bisphosphonates and the fractal values obtained from the relevant regions of the mandible (P > .05). CONCLUSION Fractal dimension was found to be lower in oral bisphosphonate use than in intravenous bisphosphonate use. The width of the mandibular cortical bone values was found to be lower in individuals using bisphosphonate than in healthy individuals. Fractal dimension and MCW may benefit clinicians as quantitative parameters in panoramic radiography in the diagnosis of osteoporosis.
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Affiliation(s)
- Ferhat Musulluoğlu
- Department of Oral and Maxillofacial Surgery, Inonu University Faculty of Dentistry, Malatya, Turkey.
| | - Hilal Alan
- Department of Oral and Maxillofacial Surgery, Inonu University Faculty of Dentistry, Malatya, Turkey
| | - Serkan Yılmaz
- Department of Dentomaxillofacial Radiology, Ministry of Health, Mersin Oral and Dental Health Hospital, Mersin, Turkey
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