scholarly journals Fracture Risk Evaluation of Bone Metastases: A Burning Issue

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5711
Author(s):  
Cyrille B. Confavreux ◽  
Hélène Follet ◽  
David Mitton ◽  
Jean Baptiste Pialat ◽  
Philippe Clézardin
Keyword(s):  
Numerical Simulation ◽  
Bone Metastasis ◽  
Fracture Risk ◽  
Bone Metastases ◽  
Risk Evaluation ◽  
Weight Bearing ◽  
Real Life ◽  
Stage Iv ◽  
Spinal Instability ◽  
Qualitative Approaches

Major progress has been achieved to treat cancer patients and survival has improved considerably, even for stage-IV bone metastatic patients. Locomotive health has become a crucial issue for patient autonomy and quality of life. The centerpiece of the reflection lies in the fracture risk evaluation of bone metastasis to guide physician decision regarding physical activity, antiresorptive agent prescription, and local intervention by radiotherapy, surgery, and interventional radiology. A key mandatory step, since bone metastases may be asymptomatic and disseminated throughout the skeleton, is to identify the bone metastasis location by cartography, especially within weight-bearing bones. For every location, the fracture risk evaluation relies on qualitative approaches using imagery and scores such as Mirels and spinal instability neoplastic score (SINS). This approach, however, has important limitations and there is a need to develop new tools for bone metastatic and myeloma fracture risk evaluation. Personalized numerical simulation qCT-based imaging constitutes one of these emerging tools to assess bone tumoral strength and estimate the femoral and vertebral fracture risk. The next generation of numerical simulation and artificial intelligence will take into account multiple loadings to integrate movement and obtain conditions even closer to real-life, in order to guide patient rehabilitation and activity within a personalized-medicine approach.

Contributing Factors for Bone Metastasis in Uterine Cervical Cancer

2013 ◽  
Vol 23 (7) ◽  
pp. 1311-1317 ◽  
Author(s):  
Aera Yoon ◽  
Chel Hun Choi ◽  
Ha-Jeong Kim ◽  
Jin-Young Park ◽  
Yoo-Young Lee ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Medical Center ◽  
Stage Iv ◽  
Metastatic Lesion ◽  
Uterine Cervical Cancer ◽  
Contributing Factors ◽  
Stage Iv Disease ◽  
Multiple Bone Metastases

ObjectiveThe purpose of this study was to describe the clinical characteristics and to assess the contributing factors in patients developing bone metastasis in uterine cervical cancer.MethodsTwo thousand thirteen patients had a diagnosis of uterine cervical cancer at Samsung Medical Center between June 1994 and December 2011. During the study period, 105 patients with bone metastasis were identified, and their clinicopathologic data were investigated retrospectively.ResultsAmong 105 patients with bone metastasis, 14 patients were excluded and 91 patients were evaluable. The median bone metastasis–free survival was 27 months (range, 0–279 months).The time to bone metastasis was significantly shorter in patients with adenocarcinoma than in patients with squamous cell carcinoma (median duration, 12 vs 29 months;P= 0.016). In addition, it was shorter in patients with stage IIB to stage IV disease than in those with stage I to stage IIA disease (15 vs 22 months;P= 0.02). The median survival after bone metastasis was 10 months, longer in the patients who received radiotherapy (± chemotherapy) than in the patients who received chemotherapy alone as a salvage therapy (12 vs 7 months;P= 0.01). Initial stage, number of bone metastases, location of involved bone, and coexisting metastatic lesion were not associated with the overall survival of the patients.ConclusionsOur study demonstrates that adenocarcinoma, advanced stage (IIB-IV) and initial multiple bone metastases contribute to earlier bone metastasis. Once bone metastasis was recognized, the survival of these patients was poor and no factors were identified to predict survival of those patients.

scholarly journals Scrambler therapy for incident pain in bone metastases

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lauren E. Berninger ◽  
Thomas J. Smith
Keyword(s):  
Bone Metastasis ◽  
Bone Metastases ◽  
Scrambler Therapy ◽  
High Doses ◽  
Electrical Neuromodulation ◽  
Incident Pain

Abstract Incident pain, described as pain induced by bone metastasis and produced by movement, can be devastating. The high doses of opioids needed to control such pain may sedate the patient and cause additional complications. Treatment of incident pain with pharmaceuticals has rarely been studied; only eight patients have been reported in the literature who did not receive additional opioids. We present the case of a 69 year old man with shoulder destruction due to bone metastases who was able to use his arm for normal activities without pain after three sessions of scrambler therapy, a noninvasive form of electrical neuromodulation that requires further study.

Designing an Emergency Management Simulation Testbed to Investigate Incident Management Team Performance

2020 ◽  
Vol 64 (1) ◽  
pp. 1881-1885
Author(s):  
Changwon Son ◽  
Farzan Sasangohar ◽  
S. Camille Peres ◽  
Jukrin Moon
Keyword(s):  
Emergency Management ◽  
Team Performance ◽  
Real Life ◽  
Management Team ◽  
Future Research ◽  
Incident Management ◽  
Emergency Operations ◽  
Management Domain ◽  
Qualitative Approaches ◽  
Complex Phenomena

Investigating real-life disasters and crises has been challenging due to accompanying difficulties and risks posed by these complex phenomena. Previous research in the emergency management domain has largely relied on qualitative approaches to describe the event after it occurred. To facilitate investigations for more generalizable findings, this paper documents ongoing efforts to design an emergency management simulation testbed called Team Emergency Operations Simulation (TEOS) in which an incident management team (IMT) is situated. First, we describe the design process based on our previous work. Next, we present the overall description of TEOS including representative roles, tasks, and team environments. We also propose measures of team performance of the IMT and propose future research that can be realized through TEOS.

Devising global strategies for fracture-risk evaluation

2007 ◽  
Vol 74 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Patricia Dargent-Molina ◽  
Claude-Laurent Benhamou ◽  
Bernard Cortet ◽  
Bruno Sutter ◽  
Thierry Thomas
Keyword(s):  
Fracture Risk ◽  
Risk Evaluation ◽  
Global Strategies

Clinical Evaluation of the Spinal Instability Neoplastic Score in Patients Treated With Radiotherapy for Symptomatic Spinal Bone Metastases

Spine ◽  
2017 ◽  
Vol 42 (16) ◽  
pp. E956-E962 ◽  
Author(s):  
Laurens Bollen ◽  
Karlijn Groenen ◽  
Willem Pondaag ◽  
Carla S.P. van Rijswijk ◽  
Marta Fiocco ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Clinical Evaluation ◽  
Spinal Instability ◽  
Spinal Bone Metastases

Prediction of the Absence of Brittle Failure Risk for Ferritic Steel Piping Components in the Brittle-Ductile Region

2011 ◽  
Author(s):  
S. Marie ◽  
J. Schwab ◽  
S. Vidard
Keyword(s):  
Brittle Fracture ◽  
Fracture Risk ◽  
Brittle Failure ◽  
Risk Evaluation ◽  
Critical Stress ◽  
Ferritic Steel ◽  
Loading Condition ◽  
Maximum Principal Stress ◽  
Fracture Transition ◽  
Secondary Loop

This paper deals with the brittle fracture risk evaluation for a C-Mn piping component in the upper shelf of the brittle to ductile fracture transition temperature range, with the main objective to validate a predictive criteria, able to demonstrate the complete absence of brittle fracture risk. The criteria is based one a critical stress and the volume around the crack were the maximum principal stress exceed this critical stress. The model is calibrated on notched tensile specimens and CT specimens. A four-points bending pipe test has then been designed using this criterion to insure that no brittle fracture will occurs at a temperature that all CT specimens failed by cleavage. The material is a French secondary loop Tu42C ferritic steel and the pipe dimensions for the test are the same than the size of the principal secondary loop pipes. The results of the pipe test confirm the prediction with the model and the interpretation lead to define an equivalence between the loading conditions (based on the J parameter) of the pipe and the loading condition of a CT specimen.

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