Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0005940 (bone disease)
 7,459 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Few isolated specimens or series of temporal bone abnormalities from antiquity are reported from North America. Infections were in the past and are today the most common otologic problems. Differentiating infectious disease residua from other causes of osteopathology has proven difficult for some not conversant with disease pathophysiology. During clinical experience spanning five decades and research involving several thousand aboriginal skeletons, data relating to temporal bone disease were accumulated. As a didactic exercise, findings in 18 illustrative temporal bones encountered during research are presented and discussed briefly.
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PMID:Ancient temporal bone osteopathology. 240 62

Adult T cell leukaemia/lymphoma was first identified by Japanese investigators in the mid 1970s. Distinctive characteristics include hypercalcaemia, metabolic bone disease, opportunistic infections and evidence of multiorgan involvement. The malignant cell has the surface phenotype of a T helper lymphocyte but functions as a T suppressor cell, and in leukaemic patients this cell usually has a unique multilobed appearance, which may aid in recognizing the disease. The overwhelming majority of patients with ATLL originate from the south-west Japanese archipelago, as well as the Caribbean basin and south-east USA. The geographic localization of this disease is the result of the endemic distribution of the human retrovirus (HTLV-I) which has been established as the cause of ATLL. Infection with this virus may result in no disease (asymptomatic carriers) or ATLL. While ATLL usually pursues an acute or subacute (prototypic) course, patients are also seen with 'chronic' or 'smouldering' disease. Over time, these more indolent variations may progress to the prototypic form. When aggressive, ATLL must be treated with intense combinations of cytotoxic drugs similar to those used to treat the more common B cell lymphoproliferative disorders. Even though half of the patients treated achieve a remission, the duration is usually brief and the overall actuarial median survival is only 11 months. In addition to recurrent disease, these patients frequently succumb to opportunistic infections.
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PMID:Adult T cell leukaemia/lymphoma. 287 62

Patients with HCL are subject to a variety of medical problems. Many of these complications are caused by the cytopenias and splenomegaly produced by proliferating neoplastic cells. Infection is a common cause of morbidity in HCL, but it is not clear whether there is an inherent defect in the immune system. The incidence of infection is related to neutropenia and is increased by the administration of cytotoxic drugs and corticosteroids; such drugs should be used cautiously in these patients. Opportunistic or unusual pathogens occur frequently in HCL, but recovery from such infections is the rule if the diagnosis is made early. Marrow hypoplasia is not infrequently seen and may present diagnostic difficulties. Such patients may have a lower tumor burden and clinically milder anemia. Hemorrhagic complications are unusual in HCL, though many patients have platelet function abnormalities. Other medical problems occur with increased frequency in HCL, and failure to recognize them leads to increased morbidity in this disease. Autoimmune disease is seen in up to one fourth of patients. It takes the form of self-limited skin and joint disease, or a more progressive, systemic of patients. It takes the form of self-limited skin and joint disease, or a more progressive, systemic vasculitis. Both forms can usually be treated with splenectomy or corticosteroids, but alkylating agents can also be used successfully. Bone disease is usually localized and responds well to radiotherapy. Other problems such as amyloidosis, multiple myeloma, and paraproteinemia are uncommon in HCL.
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PMID:Clinical problems in hairy cell leukemia: diagnosis and management. 639 Jun 85

Since the introduction of 99mTc labeled polyphosphates bone scintigraphy has become a widely accepted method for the evaluation of non-neoplastic bone diseases in children. High quality images require the child's immobilisation and a correct positioning as well as an optimized technical equipment. Two or three phase scintigraphy is the routinely procedure but additional techniques like pinhole images or SPECT can be very helpful for special indications and localisations. Due to the age and sex dependent differences of bone metabolism in the developing skeleton the interpretation of the bone scan in children is more difficult than in adults and requires more experience. Infections, trauma and aseptic necrosis are the most important non-neoplastic diseases requiring bone scintigraphy. Bone scan has a high sensitivity in the early detection of pathological bone metabolism indicating bone disease; other investigations, which are describing morphological changes like X-ray are less sensitive especially at the beginning of the disease. Negative bone scan rools out significant bone disorders with a high certainty. Follow-up studies can give additional informations about the response to therapeutical regimes and about the prognosis. To improve the specificity of a bone scan a combined interpretation of scintigraphy and X-ray is recommended.
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PMID:Bone scintigraphy in non-neoplastic diseases in children. 969 66

End-organ damage is the factor that differentiates plasma cell dyscrasia requiring therapy (active multiple myeloma [MM]) from disease that does not require therapy (monoclonal gammopathy of undetermined significance and smoldering [asymptomatic] MM). Progressive skeletal destruction is the hallmark of MM and responsible for principle morbidity in the disease. The spine is the most afflicted skeletal organ, and vertebral fractures have significantly contributed to its poor prognosis. Early mortality in MM is usually attributed to the combined effects of active disease and comorbid factors. Infection and renal failure are the main direct causes of early mortality. Using bisphosphonates to manage skeletal events mainly by preventing or slowing the destructive process has become an important adjunctive treatment in MM. Advances in minimally invasive surgical techniques, such as percutaneous vertebroplasty and kyphoplasty, offer these patients less-invasive options for treating vertebral collapse and restoring function. The aggressive management of other complications of the disease through more effective and less toxic therapy that targets the primary disease, in addition to supportive care, is resulting in patients experiencing less morbidity and probably lower mortality. This article reviews recent advances in the understanding of bone disease in MM, the role of bisphosphonates in preventing skeletal events, and available data on percutaneous vertebroplasty and kyphoplasty, and discusses the management of infection and renal failure, which seem to be responsible for high initial mortality and thereby compromise the current advances in therapy.
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PMID:Multiple myeloma: most common end-organ damage and management. 1733 86

The term 'osteonecrosis of the jaw' is typically used to describe the exposure of bone within the oral cavity. These lesions are often painful and can result in pathological fracture and disfigurement in severe cases. Infection and dental extractions commonly precede presentation, although lesions can occur spontaneously. There are no clear effective management strategies; surgery often makes the situation worse. The aetiology is far from clear. Historically, it was mainly associated with exposure to 'white phosphorus' contained in safety matches. More recently, it has presented as a complication of head and neck radio-therapy. The vast majority of contemporary reports refer to high-dose intravenous bisphosphonates used in the oncological setting. However, oral bisphosphonates, for the common indication of postmenopausal osteoporosis, have also been implicated, although the number of cases is minuscule considering the number of worldwide prescriptions. Osteonecrosis of the jaw poses a significant problem in oncology, but whether this worry is transferable to metabolic bone disease only time will tell. Certainly, further research into its pathophysiology and management is merited. With regard to management of postmenopausal osteoporosis, practice should not necessarily be altered at this early stage; however, pre-treatment worries regarding dental health should perhaps instigate a precautionary dental review.
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PMID:Bisphosphonate-associated osteonecrosis of the jaw. 1754 Jan 33

In myeloma bone disease, bisphosphonates have been shown to delay the progression of osteolytic lesions and prevent fractures. In the case of painful vertebral fractures, vertebroplasty and kyphoplasty have become standard procedures to control symptoms and restore the original height of the vertebrae. Adequate pain control is of crucial importance for the quality of life of myeloma patients, as is maintaining adequate hemoglobin levels with the use of erythropoietic growth factors. Infections should be treated aggressively in myeloma patients, as these contribute significantly to morbidity and mortality. In patients with repeated infectious complications, prophylactic measures such as long-term application of antibiotic or antiviral medication or use of intravenous immunoglobulins is recommended. The concerted action of these supportive therapies can significantly improve the wellbeing of myeloma patients in phases of disease progression as well as during phases of remission. In progressive disease, certain measures such as adequate pain control and radiotherapy can ameliorate symptoms until the therapeutic effect of systemic anti-neoplastic therapy becomes evident.
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PMID:Supportive care in multiple myeloma. 1807 Jul 21