Quantitative ultrasound and bone densitometry to evaluate the risk of nonspine fractures: a prospective study.

The ability of quantitative ultrasound (QUS) to estimate the risk of osteoporotic fractures was evaluated in a prospective study over a mean time of 5.47 years in 254 postmenopausal women (mean age 58.06+/-7.

Trisomy 4 leading to duplication of a mutated KIT allele in acute myeloid leukemia with mast cell involvement.

A G-->T transversion at nucleotide 2467 of the c-KIT gene leading to Asp816-->Tyr (D816Y) substitution in the phosphotransferase domain has been previously identified in a patient with rapidly progressing AML-M2 and mast cell involvement; the patient's blasts had a 47,XY, +4,t(8;21)(q22;q22) karyotype. Herein we confirm the simultaneous presence of both major chromosomal changes by multicolor fluorescence in situ hybridization (FISH) on interphase CD34+ mononuclear cells. By setting up culture leukemic blasts, spontaneous differentiation of adherent cells with mast-cell like features was proved by histochemical and immunoenzymatic analyses.

Comparison of octreotide and hyoscine butylbromide in controlling gastrointestinal symptoms due to malignant inoperable bowel obstruction.

In advanced cancer patients with inoperable bowel obstruction, the administration of antisecretive and antiemetic drugs has proved to be effective in controlling gastrointestinal symptoms caused by bowel obstruction. However, controlled studies concerning the most effective antisecretive drug are lacking. The aim of this randomized controlled study was to determine whether octreotide or hyoscine butylbromide was the more effective antisecretive drug for use in states of inoperable bowel obstruction.

Discriminant capacity of quantitative ultrasound versus dual X-ray absorptiometry to determine cancellous bone loss in ovariectomized rats.

The capacity of dual x-ray absorptiometry and quantitative ultrasound to discriminate bone loss and to predict the mechanical and microarchitectural properties of cancellous bone in an animal model of osteopenia was evaluated. Thirty-five female Sprague-Dawley rats (10 months old) were randomized into three groups: baseline group, 10 rats killed at the beginning of the study; ovx group, 15 rats ovariectomized; and sham group, 10 rats sham operated. At the beginning and end of the study, all the animals underwent osteosonography to record the proximal tail (C3 vertebra) bone speed of sound.

Role of octreotide, scopolamine butylbromide, and hydration in symptom control of patients with inoperable bowel obstruction and nasogastric tubes: a prospective randomized trial.

Bowel obstruction may be an inoperable complication in patients with end-stage cancer. Scopolamine butylbromide (SB) and octreotide (OCT) have been successfully used with the aim of reducing gastrointestinal (GI) secretions to avoid placement of a nasogastric tube (NGT); however, there have been no comparative studies concerning the efficacy of these drugs. Furthermore, there is little information about the role played by parenteral hydration in symptom control of these patients.

Invariant cone-excitation ratios may predict transparency.

Cone-excitation ratios for pairs of surfaces are almost invariant under changes in illumination and offer a possible basis for color constancy [Proc. R. Soc.

Geometry of proximal femur in the prediction of hip fracture in osteoporotic women.

111 White post-menopausal women with hip fracture and 329 healthy controls were studied in order to determine whether proximal femur geometry predicts hip fracture and improves the discriminant ability of femoral neck bone mineral density (BMD) in elderly women. All subjects underwent dual X-ray photon absorptiometry (DXA) of the hip from which the femoral neck BMD, hip axis length, femoral neck width and femoral neck-shaft angle were measured. Fractured subjects had a lower femoral neck BMD, a longer hip axis length and a more valgus neck-shaft angle.

Calcitriol and alendronate combination treatment in menopausal women with low bone mass.

Serum calcitriol levels decrease with advancing age in relation to reduced dietary intake or poor intestinal absorption of vitamin D. These decreased levels affect the development of senile osteopenia, which can be effectively prevented by the administration of alendronate and calcium. To evaluate the effect of a combined treatment with alendronate and calcitriol on bone mineral density (BMD), we followed 152 osteopenic postmenopausal women, aged 55-75 years, for 9 months.

The mechanical properties of fluoride-treated bone in the ovariectomized rat.

The effect of fluoride therapy on the osteopenic bone of the ovariectomized rat was studied by comparing the densitometric and biomechanical data. Forty retired breeder female Sprague-Dawley rats aged 10 months were randomly divided into five groups. One group (Group A) was killed at the beginning of the study and was used as a baseline.

Management of dyspnea in advanced cancer patients.

Dyspnea is a frequent and devastating symptom among advanced cancer patients and is often difficult to control. However, there has been considerably less emphasis in the literature on the appropriate characterization and management of this symptom than of other cancer-related symptoms. The purpose of this paper is to review issues relating to the prevalence, causes, prognosis and treatment of dyspnea in patients with advanced cancer.

Loss of bone mass after total hip replacement: preliminary data.

In a total of 37 females with cemented total hip replacement for monolateral coxarthrosis, of which 13 with prosthetic stem loosening, and 11 with monolateral coxarthrosis that is not prosthetized, bone mineral density (BMD) is determined by dual ray photonic absorbimetry selecting regions of interest (ROI) on the cortex of the femurs 4 cm under the lesser trochanter and on the ischium bilaterally. In females that are not prosthetized there are differences in bone mass between the two femurs and the ischium on both sides. In prosthetized patients BMD of the femur and of the ischium on the side operated on is significantly less than on the contralateral one (Student's "t" test: p < 0.

Carcinoid somatostatinoma of the duodenum.

Carcinoid somatostatinoma is a rare neuroendocrine malignant tumour and the duodenal location is an atypical site of presentation of which only few cases have been reported in the literature. A case of duodenal carcinoid somatostatinoma metastatic to lymph nodes in a 66-year-old patient is presented with an update of the literature. No relevant signs or symptoms were associated to the retrogastric lymph-node mass, which deformed but did not infiltrate the stomach wall.

The role of bisphosphonates in the treatment of painful metastatic bone disease: a review of phase III trials.

Metastatic bone disease is a frequent cause of morbidity in advanced cancer patients with a subsequent high incidence of skeletal complications (fractures, hypercalcemia, spinal cord compression) and severe pain. The osteolytic process is mainly characterized by an osteoclastic activity of bone resorption and inflammatory activity provoked by various cytokines and prostaglandins. Bisphosphonates represent a new class of drugs with inhibitory activity on bone resorption and on inflammatory processes which revealed themselves to be efficacious in a series of clinical conditions such as tumour-induced hypercalcemia, Paget's disease, osteoporosis and metastatic bone disease.

Role of pamidronate disodium in the treatment of metastatic bone disease.

Aims And Background: Bone metastases are a common feature of advanced neoplastic disease and are considered to be among the most frequent causes of pain and complications in oncologic patients. The main objective of the treatment of such patients is to control their symptoms and improve their quality of life. Pamidronate disodium is a second-generation bisphosphonate capable of inhibiting bone resorption (particularly osteoclast activity) without affecting bone remineralization.

Switching from morphine to oral methadone in treating cancer pain: what is the equianalgesic dose ratio?

Purpose: To define the dose ratio between morphine and methadone in relation to the previous morphine dose and the number of days needed to achieve the same level of analgesia in a group of patients with advanced cancer with pain who switched from morphine to oral methadone.

Patients And Methods: A cross-sectional prospective study of 38 consecutive cancer patients who switched from morphine to oral methadone was performed. The intensity of pain before, during, and after the switching period was assessed through a four-point verbal Likert scale.

Side effects of morphine administration in cancer patients.

According to the World Health Organization (WHO) guidelines, oral morphine is the first choice drug for treating moderate to severe cancer-related pain. The fear of the side effects caused by this drug and the scarce information about prevention and management of these effects are the main reasons for the underuse of morphine. The aim of this paper is to provide a review of the literature on the side effects most frequently present both in the titration phase and during chronic administration of oral morphine and to describe the appropriate treatment.

Pharmacological treatment of cancer pain: alternative routes of opioid administration.

Cancer-related pain is present in 51% of patients at various stages of the disease, and the incidence increases up to 74% in advanced and terminal stages. The World Health Organization proposed and issued very simple guidelines for the pharmacologic treatment of cancer-related pain. According to the guidelines, opioid analgesics are the mainstay of analgesic therapy, and the first choice for drug administration is considered to be the oral route.