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Otological Effects of Paget's Disease
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
PDB is often found incidentally on X-ray or laboratory tests performed for other reasons. It can be diagnosed through radiology, radionuclide bone scanning, and biochemical tests of bone resorption or formation. Plain X-ray findings in the early stages of the disease may be confined to osteolytic lesions in the involved bones. As the disease progresses, further radiographic changes occur, including increased bone density, abnormal architecture, cortical thickening, bowing and overgrowth. Microfractures may be seen in long bones. Laboratory testing should include renal function and liver function tests, calcium, albumin, alkaline phosphatase and 25-hydroxyvitamin D.
Advances in Periprosthetic Fractures of the Hip Joint
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
Ali-Asgar Najefi, Arthur Galea, Nicholas Garlick, M. Zahid Saeed
Patients with osteolysis at the greater trochanter are at greatest risk of developing intraoperative and postoperative PFF [4, 30]. Stress shielding (redistribution of load and remodelling of the femur) can occur in response to an altered mechanical environment following a hip replacement and is a predisposing factor for these fractures. Cemented stems are associated with less stress shielding than uncemented stems [31, 32]. The Swedish registry showed that 70% of fractures involved loose prostheses, with 23% known to be loose and 47% first identified as loose at the time of surgery [6, 33].
The blood
Published in Brian J Pollard, Gareth Kitchen, Handbook of Clinical Anaesthesia, 2017
Alastair Duncan, Santosh Patel
In general, this occurs only in those patients with extensive osteolysis. It is exacerbated by dehydration secondary to vomiting and the inability to retain salt and water due to renal involvement. It may also be precipitated by bed rest and infection. Hypercalcaemia can cause vomiting, constipation, anorexia, depression, confusion, drowsiness and even coma.
CT-defined body composition as a prognostic factor in multiple myeloma
Published in Hematology, 2023
Alexey Surov, Franz Benkert, Wolfram Pönisch, Hans-Jonas Meyer
Regarding patients with multiple myeloma (MM), body composition assessment might be of special interest, as these patients are of severe risk for anorexia, malnutrition, and muscle wasting [10–12]. Moreover, frailty and potential risk for fractures are of utter importance, as these patients can frequently develop pathological osteolysis [12]. The association between the risk of fractures and LSMM has been established in patients with osteoporosis with results [13,14]. Moreover, the prognostic effect of LSMM assessment was demonstrated in hematological diseases in a recent meta analysis [15]. However, the exact benefit in MM patients is still scarce and further research is needed in this disease. In MM patients this can also be of great importance as the patients undergo regular staging CT investigations to rule out or diagnose new osteolysis.
Cross-Linked Versus Conventional Polyethylene for Long-Term Clinical Outcomes After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis
Published in Journal of Investigative Surgery, 2021
Jiangyuan Shi, Weicong Zhu, Shaohua Liang, Hongling Li, Siming Li
Previous systematic reviews [9–11] have demonstrated a significant reduction in radiological wear of HXLPE as compared to CPE bearing surfaces, but owing to the inclusion of short-to mid-term trials, these studies were not adequately powered to detect differences in clinical outcomes. Recently, several long-term (>10 years) clinical trials [12–16] have compared HXLPE and CPE. Nevertheless, the clinical advantages of HXLPE remain controversial. For instance, Devane et al. [15] used a 10-year double-blinded randomized controlled trial (RCT) to demonstrate the superiority of HXLPE liner for the prevention of revision and osteolysis. In contrast, Broomfield et al. [16] showed that an HXLPE group had no advantage in terms of reducing the incidence of revision as compared to a CPE group in a 12-year comparative study. Moreover, Tsukamoto et al. [14] reported that the osteolysis incidence was not significantly different between the two groups in a 15-year retrospective cohort study.
CD38: targeted therapy in multiple myeloma and therapeutic potential for solid cancers
Published in Expert Opinion on Investigational Drugs, 2020
Ying Jiao, Ming Yi, Linping Xu, Qian Chu, Yongxiang Yan, Suxia Luo, Kongming Wu
Osteolysis is one of the most common lesions in the plasma cell malignancy, which is caused by the disrupted balance between bone formation and desorption [52]. As the major cause of morbidity and mortality for MM patients, lytic bone destruction leads to bone pain and impairs the quality of life ultimately [53]. Thus, it is urgent to explore a proper therapeutic regimen for multiple bone disease and osteolysis-related diseases. It has been found that monocytes and early osteoclast progenitors express CD38 molecule, while mature osteoclasts do not [54]. Furthermore, it has been proved that daratumumab bound to monocytes with CD38 expression and inhibited osteoclastogenesis in vitro, which indicated the possibility for anti-CD38 antibody to inhibit multiple myeloma-induced osteolysis [54].